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In critical cases of Sha disease (Sha syndrome, a condition characterized by acute abdominal pain, vomiting, diarrhea, and cyanosis often associated with environmental toxins or heatstroke), there is no better method than performing bloodletting (releasing Sha) first. However, currently there are cases where blood does not flow after bloodletting; although the Sha veins (subcutaneous purple or dark red vascular networks visible under the skin) are faintly visible, one feels helpless. Consequently, practitioners often regard this situation as ominous (indicating a poor prognosis). I, however, am different. Even if blood does not flow during bloodletting, there are methods to save the patient. Even if the patient is in a coma and the situation is critical, provided that examination confirms no obstruction by food stagnation, blood stasis, or phlegm turbidity in the middle jiao (middle burner), one can administer Baohua San (Precious Flower Powder) cold, or drink Yin-Yang water (a mixture of boiled and unboiled water), mud water, water soaked with Bombyx Batryticatus (Late Silkworm Sand), Xixin water (Asarum root water), or Bai Shatang Mei water (white rock sugar plum water). Choose one of these prescriptions and use it. Wait for the patient to regain slight consciousness, then help them sit up, and subsequently treat with other methods. For cases caused by blood stasis preventing blood flow, use Tongbian (child's urine), Taoren (Peach Seed), Honghua (Safflower), etc., to rescue the patient. In cases where Sha disease occurs immediately after eating, drink salted broth or alum broth chilled to induce vomiting and expel the newly ingested food. For Sha distension caused by long-standing food retention, use Radish seed (Lai Fuzi), Hawthorn fruit (Shanzha), and Malt (Maiya) to digest and guide out stagnation. For blockage caused by accumulated Sha toxin, use Betel nut (Binglang) and Rhubarb (Dahuang) to drive it out, or treat with Awei Wan (Asafetida Pill). In cases of phlegm and blood coagulation leading to coma, near-death state, and loss of consciousness, administer 2 liang of Rapeseed oil mixed with 1 qian of Musk (Shexiang); the patient will revive immediately. This is an excellent method. By first removing the obstructions of food stagnation, blood stasis, and phlegm, the Sha veins will naturally reappear, and the Sha qi (pathogenic energy) will naturally dissipate and circulate. Afterward, scraping can be performed where appropriate, bloodletting where necessary, and medication where indicated. This is because at the initial stage of Sha disease, the internal organs have not yet been damaged by the pathogen. Thus, it is known that even though initial failure to bleed during bloodletting indicates a critical condition, it is not beyond redemption. Physicians must not abandon treatment simply because blood does not flow upon bloodletting and the patient appears comatose and lifeless.

If Sha disease resolves, it is fully cured; if not, one must guard against the danger of internal ulceration/collapse. Therefore, the methods for treating Sha disease include scraping and bloodletting, which should lead to recovery; if they fail, medication should be employed. For miscellaneous diseases complicated by Sha, scraping and bloodletting are also suitable, but the urgent priority is to use medication to treat the Sha component. These are the principles of treating Sha: one cannot go a day without therapeutic methods, nor a day without therapeutic medicines. However, nowadays some people do not use medicine and rely solely on bloodletting, resulting in cases where bloodletting several times fails to cure the condition. Some argue, "Since the patient does not have severe symptoms like coma, it poses no harm." Little do they know that if bloodletting fails after several attempts, the condition will inevitably worsen day by day. There is latent toxin within, entrenched in the internal organs. Although coma may not be present, the attack of Sha toxin on the internal organs is extremely dangerous. Moreover, why does bloodletting fail to cure after several attempts? It is likely due to obstructions by food stagnation, blood stasis, and phlegm hindering the expulsion of the toxin. Thus, although Sha is released, it is not completely eliminated. If one could eliminate the food stagnation, blood stasis, and phlegm, the Sha toxin would face no obstruction, and how could it fail to heal? Precisely because medicine is not used and reliance is placed solely on bloodletting, the Sha toxin is not fully cleared, inevitably leading to damage of the internal organs. Physicians must not consider repeated failed bloodletting as a mild condition and ignore it.