腿弯上下，有细筋，深青色，或紫色，或深红色者，（肌肤白嫩者，方有紫红色。）即是痧筋，刺之方有紫黑毒血。
其腿上大筋不可刺，刺亦无毒血，反令人心烦。腿两边硬筋上筋，不可刺，刺之恐令人筋吊。若臂弯筋色，亦如此辨之。
其余非亲见不明白，故不具载。至如头顶心一针，惟取挑破，略见微血，以泄痧毒之气而已，不可直刺。其指尖刺之太
近指甲，虽无大害，当知令人头眩。若一应刺法不过针锋微微入肉，不必深入。
背脊、颈骨上下及胸前胁肋、两背肩臂痧，用铜钱蘸香油刮之，或用刮舌 子脚蘸香油刮之。头额、腿上痧，用
绵纱线或麻线蘸香油刮之。大小腹软肉内痧，用食盐以手擦之。
尝览古人遗言∶东南卑湿之地，利用砭，所谓针刺出毒者，即用砭之道也。但放痧之人，具用铁针，轻者一针即愈，
重者数次不愈，盖因痧毒入深，一经铁气，恐不能解。余惟以银针刺之，则银性最良，入肉无毒，以之治至深之痧毒，
不尤愈于铁针乎？此余所以刺痧筋者，独有取乎银针也。
凡伤寒杂症，所犯止有一症，用药不贵乎多。痧症凶暴非常，变幻百出。如犯在气分，有兼痰兼血；在血分，有兼
食兼积，或又有兼外感内壅，往往皆然，不可执一。故用药治之，宜尽虑到，不然，一有不及，其祸不测，此所以不厌
乎多也。
Above and below the popliteal fossa (back of the knee), there are fine tendons that appear dark cyan, purple, or deep red; (in individuals with fair and tender skin, they may appear purple-red.) These are Sha tendons (tendons affected by Sha toxin); upon pricking them, dark purple-black toxic blood will flow out.
The large tendons on the thigh must not be pricked; doing so yields no toxic blood and instead causes mental restlessness. The superficial tendons on the hard tendons on both sides of the thigh must not be pricked, as this may cause tendon spasms or retraction. If the tendons in the cubital fossa (elbow crease) exhibit similar colors, they should be identified using the same criteria.
Other cases that are not clearly understood without personal observation are not recorded here. Regarding the Baihui point (GV20, located at the vertex of the head), one should only pierce the skin slightly to allow a trace of blood to emerge, thereby venting the Qi of Sha toxin; direct deep insertion is prohibited. Pricking the fingertips too close to the nail bed, while not causing major harm, should be known to induce dizziness. In all pricking methods, the needle tip should merely enter the flesh slightly; deep insertion is unnecessary.
For Sha affecting the spine, neck bones, chest, hypochondrium, and the shoulders and arms on both back sides, scrape the area with a copper coin dipped in sesame oil, or use the handle of a tongue scraper dipped in sesame oil for scraping. For Sha on the forehead and legs, use cotton yarn or hemp yarn dipped in sesame oil for scraping. For Sha within the soft flesh of the abdomen and lower abdomen, rub the area with hands dipped in salt.
I have read the ancient advice: In the low-lying and damp regions of the southeast, Bian stone therapy (stone acupuncture) is advantageous. This refers to the method of "pricking to expel toxins" using Bian stones. However, those who perform Sha release often use iron needles; mild cases heal after one prick, but severe cases do not heal after multiple attempts. This is likely because the Sha toxin has penetrated deeply, and exposure to iron Qi may fail to resolve it. I exclusively use silver needles for pricking, as silver possesses the best properties, is non-toxic when entering the flesh, and is superior to iron needles for treating deeply seated Sha toxins. This is why I specifically choose silver needles for pricking Sha tendons.
In cases of Cold Damage (Shanghan) and miscellaneous diseases, the pathogenic factor usually involves only one aspect, so medication does not need to be numerous. However, Sha disease is fierce and violent, with myriad variations. If the pathogen affects the Qi level, it may be complicated by phlegm or blood stasis; if it affects the Blood level, it may be complicated by food retention or accumulation. Furthermore, external contraction combined with internal obstruction often occurs simultaneously. One cannot adhere to a single approach. Therefore, when prescribing medication, one must consider all possibilities comprehensively; otherwise, any oversight may lead to unpredictable disasters. This is precisely why the use of medications should not disdain being numerous.