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If diseases occur in the mouth and tongue, and are coincidentally triggered by pathogenic influences causing Sha (a condition characterized by skin eruptions or subcutaneous hemorrhages due to external pathogens), although the Sha symptoms may manifest later, treatment must not be delayed. Even if the mouth and tongue symptoms are severe, Sha Zhang (Sha distension) is comparatively more urgent; one must absolutely not treat the mouth and tongue first and delay the treatment of Sha Zhang.

Case Record 1:
An elderly man named Zhen Shuo developed Chong She (double tongue/swelling under the tongue), suffering from unbearable pain. A physician treated him using methods for Shaoyin Junhuo (Ministerial Fire of Shaoyin), but without effect. Upon palpating his pulse, I found the Cun position on the left side was Chen Wei (deep and faint), and the Guan position on the right was Wu Li (weak). Based on the pulse, tonification seemed appropriate; based on the symptoms, cooling seemed appropriate. I examined the Sha Jin (visible subcutaneous veins indicating Sha) and performed bloodletting at the popliteal fossa (back of the knee) with over ten needles, extracting dark purple-black toxic blood. He requested a prescription. I said, "The medications you previously took were all cooling in nature; you should add a small amount of Huanglian (Coptidis Rhizoma). The medicaments blown into your mouth/nose were likely sialogogues; you should add more Bingpian (Borneol). This will bring efficacy to the disease. However, do not take the medication with warm water; slightly cool temperature is sufficient." He recovered in three days.

Case Record 2:
Nie Mingong suffered from Kou Gan (oral ulceration/gangrene) leading to rotting lesions; blowing medicinal powder aggravated the condition, and bloodletting did not cure it. He sought my treatment. His right pulse was Wei Huan (faint and slow), and his left pulse was Chen Fu (deep and hidden). I prescribed Qingliang Zhibao Yin (Cooling Precious Treasure Decoction), removing Xixin (Asari Radix et Rhizoma) and adding Shigao (Gypsum Fibrosum), Niuxi (Achyranthis Bidentatae Radix), Wuyao (Linderae Radix), Zhike (Aurantii Fructus Immaturus), and Qingpi (Citri Reticulatae Pericarpium Viride). It was administered slightly chilled. Externally, I prescribed Bingpeng San (Borneol and Borax Powder) added with Danfan (Alum) and Ercha (Myrobalan) to be blown into the oral cavity.

True Feng (madness/leprosy-like conditions) exists, as does pseudo-Feng. If one fails to distinguish the reality and indiscriminately attacks with herbs like Huashe (Naja atra/Snake), errors will occur. I have observed that Sha Zhang has many variations, some resembling Feng; thus, I have formally named this type Lei Feng Sha (Pseudo-Feng Sha).

Case Record 3:
Fan Si suffered from coughing and rapid breathing, with bright red coloration on both malar eminences and lips/mouth. A physician treated him for deficiency syndromes, but without effect. I treated him for Sha, and he recovered. Half a year later, circular, elevated red patches suddenly appeared on his face. Surgeons diagnosed this as Da Feng (severe leprosy/madness). I palpated his pulse, finding it faint and slow, and identified it as Sha. Examining the Sha Jin, I performed bloodletting below the popliteal fossa with three needles, releasing dark purple-black toxic blood, and performed bloodletting on the fingertips with over twenty needles. I prescribed Chenxiang Yujin San (Agarwood and Curcuma Powder), administered with clear tea chilled. Additionally, I prescribed Rusheng San (Miraculous Sage Powder) added with Honghua (Carthami Flos) and Qingpi, mixed with black sugar soup, and administered slightly chilled. He recovered.

Internal heat accumulation and stagnation in the intestines and stomach, obstructing Qi flow, results in Huangqi Bing (Yellow Qi Disease). Often, this is complicated by Sha. If Sha is not treated first, Huangqi Bing cannot ultimately be cured.

Case Record 4:
The younger sister-in-law of Xiawu contracted Huangqi Bing. Her complexion was sallow, her abdomen distended like a drum, and her legs and feet were edematous. Her six pulses were Wei Se (faint and choppy). I instructed a servant to perform bloodletting on her with over thirty needles, extracting dark purple-black toxic blood. I prescribed Chenxiang Yujin San, and Qingliang Zhibao Yin added with Qingpi, Wuyao, Binglang (Arecae Semen), Shanzha (Crataegi Fructus), Buluozi (Raphani Semen), and Niuxi. These were taken slightly cold. The abdominal distension began to loosen. Subsequently, only the specific medicine for Huangqi Bing was used, taken slightly chilled for four doses, resulting in recovery.

Case Record 5:
Kuai Xiangnian contracted Huangqi Bing. He had fever, thirst, cracked lips, sallow complexion, abdominal distension, edema in hands and feet, and diarrhea immediately after eating. Upon palpating his pulse, the rhythm was irregular (Xu Ji Bu Chang). Observing the Sha Jin above and below the popliteal fossa, I punctured with over ten needles, releasing flowing toxic blood. I prescribedawei Wan (Elsholtzia Pill) and Sharen Tang (Amomum Decoction), administered slightly chilled. The Qi distension subsequently decreased. I then treated him with the specific medicine for Huangqi Bing for six doses, resulting in recovery.

Case Record 6:
Dong Linqiao suffered from abdominal distension like a drum, slight edema in both feet, inability to eat, and a dry, sallow complexion. Various medicines had no effect. He sought my treatment. His pulse was not Hong Shu (surging and rapid), but rather Chen Chi (deep and slow). I punctured his fingers and arms with over thirty needles, after which his chest and abdomen felt comfortable. I immediately prescribed the medicine for Huangqi Bing, administered slightly chilled. He recovered in four doses.