痧毒之气上凌肺金，故气逆发呛而咳嗽，痰涎上涌，或呕哕恶心，或面目浮肿，或心胸烦闷，此痧毒入于气分，
痧筋往往不现，治以刮痧为主。间有入于血分者，必有痧筋，然后刺之。临症用药，宜理痧毒为主，若以伤风咳嗽治之
则
误矣。
治验∶
一俞仲嘉长女，五月发热咳嗽，呕吐痰涎，胸中胀闷，面目浮肿。延他医服伤风痰嗽之药四剂，心中益胀闷，遂止
不药，将及一月。余偶过，求余诊之，右寸脉虚，知其为痧之变症也。刮痧讫，用防风散痧汤加贝母、薄荷、童便微冷
饮之，即痊。
一王惟诚咳嗽，发呛不绝声，面目俱肿，呕痰不已，更吐鲜血。延余治之，六脉弦紧且数，此痧毒之气，搏激于筋
脉间，故见脉乃尔。刺指头，出毒血三针，令多为刮痧。用宝花散加童便微冷服，又用圆红散微温服而痊。
痛而不吐泻者，名干霍乱。毒入血分，宜放痧。新食宜吐，久食宜消食，下结宜攻。痛而吐泻者，毒入气分，宜刮
痧。不愈，视有痧筋则放，宜调其阴阳之气为主。须知肠胃食积，宜驱不宜止，止则益痛。若吐泻而后痛者，此因泻粪
秽气所触，治宜略用藿香正气冷冻饮料。然必须除食积血滞，或消或攻或活血。山药、茯苓不可乱施；燥湿之剂，俱在所
禁；温暖之药，未可乱投。
治验∶
一沈篆玉九月间，干霍乱，腹中盘肠大痛，放痧三十余针，又王君先为之刮痧，不愈。余用宝花散加大黄丸，清茶
稍冷冻饮料之而痊。
一彭君明晚间腹中大痛，吐泻数十次，痛益甚。延余诊之，左脉芤而滑，右脉弦细而涩，此宿食已从吐泻而尽，乃
毒入血分，血瘀作痛也。放痧，不愈。用独活红花汤，圆红散微温饮之，吐泻腹痛少愈。次日，服前药吐泻腹痛俱已。
一童敬桥内室，吐泻腹痛，自刮痧，服阴阳水痛益甚。余用三香丸微冷冻饮料之而安。
The pathogenic qi of Sha (sand poisoning) attacks the Metal of the Lung, causing rebellious Qi leading to choking coughs and coughing, with phlegm and saliva surging upward, or dry heaving, hiccups, and nausea, or edema of the face and eyes, or vexation and oppression in the chest and heart. This indicates that Sha toxin has entered the Qi level; at this time, Sha veins often do not appear, and treatment should primarily focus on *Guasha* (scraping therapy). In rare cases where it enters the Blood level, there must be visible Sha veins, after which pricking bloodletting is performed. When prescribing medication for clinical presentation, one should prioritize regulating Sha toxin; treating it as a common cold-induced cough would be an error.
Case Record 1:
The eldest daughter of Yu Zhongjia suffered from fever, coughing, vomiting of phlegm and saliva, chest distension and oppression, and facial edema in May. After consulting other physicians and taking four doses of medicine for wind-cold phlegm cough, her chest oppression worsened, so she stopped taking medicine for nearly a month. I happened to pass by and was requested to diagnose her. The pulse at the right Cun position was deficient, indicating this was a variant manifestation of Sha syndrome. After performing *Guasha*, I prescribed Fangfeng San Sha Tang (Wind-Dispersing Sha-Scattering Decoction) added with Fumu (Fritillariae Bulbus) and Bohe (Menthae Haplocalycis Herba), administered slightly cooled with Tongbian (Child's Urine), resulting in immediate recovery.
Wang Weicheng suffered from continuous choking coughs, edema of the face and eyes, incessant vomiting of phlegm, and even hemoptysis. Upon my diagnosis, the pulses in all six positions were wiry, tight, and rapid. This indicated that Sha toxin qi was agitated within the meridians and vessels, hence such a pulse presentation. Pricking the fingertips released toxic blood via three needle punctures, and extensive *Guasha* was performed. Baohua San (Precious Flower Powder) was taken slightly cooled with Tongbian (Child's Urine), followed by Yuanhong San (Round Red Powder) taken slightly warm, leading to recovery.
Pain without vomiting or diarrhea is named Gan Huoluan (Dry Cholera). If toxin enters the Blood level, bloodletting (*Fangsha*) is indicated. For recent food stagnation, emesis is appropriate; for long-standing food stagnation, digestion-promoting methods are used; for lower jiao accumulation, purgation is applied. Pain accompanied by vomiting and diarrhea indicates toxin entering the Qi level, making *Guasha* appropriate. If unresolved, observe for Sha veins and perform bloodletting; treatment should primarily focus on harmonizing Yin and Yang Qi. It must be understood that gastrointestinal food stagnation should be expelled, not arrested; arresting it will exacerbate pain. If pain occurs after vomiting and diarrhea, it is due to contact with foul exhalations from fecal discharge; treatment may slightly employ Huoxiang Zhengqi Lengdongyin (Agastache-Patchouli Corrective Beverage, served chilled). However, one must eliminate food stagnation and blood stasis through digestion, purgation, or blood-invigorating methods. Shanyao (Dioscoreae Rhizoma) and Fuling (Poria) should not be used indiscriminately; drying-dampness formulas are strictly contraindicated; warming medicines should not be administered recklessly.
Case Record 2:
Shen Zhuanyu suffered from Dry Cholera in September, experiencing severe abdominal pain coiling around the intestines. After thirty-plus needles of bloodletting and prior *Guasha* by Dr. Wang, he remained unwell. I prescribed Baohua San (Precious Flower Powder) combined with Dahuang Wan (Rhubarb Pill), administered slightly chilled with clear tea water, resulting in recovery.
Mr. Peng Ming suffered from severe abdominal pain at night, with dozens of episodes of vomiting and diarrhea, intensifying the pain. Upon diagnosis, the left pulse was hollow and slippery, while the right pulse was wiry, fine, and choppy. This indicated that old food stagnation had been exhausted through vomiting and diarrhea, and the pain was now caused by toxin entering the Blood level and blood stasis. Bloodletting was performed but failed to resolve the issue. Duohuo Honghua Tang (Angelicae Pubescentis and Safflower Decoction) and Yuanhong San (Round Red Powder) taken slightly warm reduced the vomiting, diarrhea, and abdominal pain. By the next day, after taking the previous medicine, all symptoms resolved.
The wife of Tong Jingqiao suffered from vomiting, diarrhea, and abdominal pain. After self-*Guasha* and consuming Yin-Yang Water, her pain intensified. I prescribed Sanxiang Wan (Three Fragrances Pill) administered slightly chilled, bringing relief.