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Sha disease (Sha syndrome) presents in both acute and chronic forms, yet most people fail to recognize them. Fortunately, in recent times, some practitioners in the southern regions have employed scarification (Bianci), acquiring a rudimentary understanding of Sha disease; however, they are unable to elucidate each symptom in detail, which is deeply regrettable. Consequently, there are claims that "Sha disease should be treated with scarification, and immediate treatment saves lives," while others assert that "Sha disease must not be scarified, as doing so leads to frequent recurrences." Once such statements circulate, they cause significant harm to patients. Nevertheless, these views can be distinguished. Generally, when Sha disease first occurs, pathogenic factors overwhelm the healthy Qi (Vital Energy); even robust individuals are susceptible. Recurrent Sha disease arises from deficiency of healthy Qi, making one easily susceptible to pathogens. Thus, some individuals suffer from recurrent Sha, experiencing attacks every ten days or half a month, or once every one or two months, often enduring Sha pain. Without scraping (Gua Sha) or bloodletting, relief is impossible, giving rise to the notion that "Sha disease should not be scarified, for it causes frequent recurrence." They fail to realize that the susceptibility and recurrence of Sha are inevitably due to inherent weakness of Stomach Qi (Stomach's functional activity). I have previously used the "Jue Sha Fang" (Absolute Sha Decoction) to tonify Stomach Qi, after which Sha naturally ceases. Furthermore, by using Ren Shen (Radix Ginseng) and other strongly tonifying herbs to consolidate the body, Sha has invariably been eradicated. However, this treatment is only permissible on days when Sha symptoms have completely resolved and no trace of Sha toxin remains, thereby eliminating the root cause. Otherwise, if any Sha Qi (Sha pathogenic factor) remains, such medications must absolutely not be taken, as their sweet, pungent, warm, and hot strongly tonifying properties might instead exacerbate the pathogenic toxins.

In miscellaneous diseases (Za Zheng), severe conditions may allow time to pass, but coma caused by Sha disease admits no delay. Why? Coma resulting from miscellaneous diseases is merely due to the surging of Phlegm (Tan), Qi (Energy), or Blood (Xue), or fainting due to extreme deficiency; thus, time can be spared. In contrast, coma from Sha disease is solely due to Sha Qi rushing to the Heart, which is still resolvable. However, if attacked by Sha toxins, the toxic blood will surge, inevitably damaging the Zang-Fu organs (Viscera), leaving no room for delay. Therefore, patients suffering from Sha distension and coma must be guarded against sudden death. The toxic blood, along with Food Retention (Shi Ji), Phlegm, and Qi stagnation, must accumulate between the heart, abdomen, chest, and diaphragm, causing the meridians to cease circulation and Qi and Blood to stop moving. Although one wishes to perform bloodletting, blood does not flow; although one wishes to scrape, Sha signs do not appear. This is why emergency medication is required for treatment. The therapeutic method involves addressing the specific obstruction: if obstructed by food, resolve the food retention; if by accumulation, resolve the accumulation; if by phlegm, blood, or Qi stagnation, dissipate these obstructions; if triggered by Summerheat-Heat (Shu Re), latent heat (Fu Re), or turbid Qi (Hui Qi), dissipate these pathogens. Once the chest and diaphragm relax, consciousness returns. Subsequently, inspect the purple and cyan veins for scarification, and apply either scraping or medication according to the manifestation of the symptoms to execute the art of saving lives.