痧毒冲心则昏迷；痧毒冲肺则气喘痰壅，甚则鼻衄；痧毒入肝则胸胁疼痛，不能转动，甚则血涌由吐而出；痧毒流
于大肠，则大便血；流于膀胱，则小便血。治宜先清其痧毒之气，顺其所出之路，则气自顺而血自宁矣。若不知治，紧
则变在顷刻，迟则变成劳弱，或时时便血溺血难愈。
治验∶
一孙盛元痧胀，放痧不服药，变筋骨疼痛。十日后，吐血甚多，疼痛不愈。延余，诊其脉芤，此痧气已退，尚存瘀
血，用桃仁、红花活血之剂，四服而痊。
一潘国安痧胀鼻衄，是痧气由衄而泄，用清凉至宝饮而痊。
一周瑞亭子六岁，痧痛大便红。延余，令放痧，服散痧消瘀活血之剂而痊。
一何君叔女痧痛，溺血甚多。延余，令放痧，不愈。用荆芥薄荷汤加益母、金银花、牛膝、连翘治之而痊。
痧毒入胃，胃必热胀。热胀之极，蛔不能存，因而上涌，乘吐而出，或蛔结腹痛，不大便；或蛔入大肠，由大便而
出，与伤寒吐蛔，伏阴在内者不同，治宜清其痧胀为主。
治验∶
一蒋公尚次女，发热心痛，口多痰涎，吐蛔二条。延余，右关沉细而疾，余脉洪数，刮痧，刺腿弯一针，微有紫黑
血点，服连翘薄荷饮三剂，痧退。服小柴胡汤，身凉而愈。
一沈存原痧胀，吐不止。延余，脉洪而紧，刮痧讫，用药加熟大黄一钱，微冷冻饮料之，吐止胀消。后二日复痧胀，吐
蛔一条，脉复洪紧，更用熟大黄一钱，微冷冻饮料之，痧退而安。
一汤仲文，腹胀大痛。延余诊之，脉散乱无根，此蛔结也，痧实始之。放痧后，用散痧去毒之剂，加大黄二钱微冷
饮之，大便下死蛔二条并宿粪而愈。
Sha poison rushing to the heart leads to coma; sha poison rushing to the lungs causes asthma and phlegm obstruction, and in severe cases, epistaxis (nosebleed); sha poison entering the liver results in chest and hypochondriac pain, inability to turn the body, and in severe cases, blood surging out through vomiting; sha poison flowing into the large intestine causes hematochezia (blood in stool); flowing into the bladder causes hematuria (blood in urine). Treatment should first clear the qi of sha poison, following the path of its exit, so that qi will naturally flow smoothly and blood will calm. If this treatment is not known, urgent changes can occur in an instant, while delay may lead to consumptive weakness or persistent hematochezia and hematuria that are difficult to cure.
Clinical Cases:
1. Sun Shengyuan suffered from Sha Distension (Sha Zhang). After bloodletting (Fang Sha), he did not take medicine, which transformed into bone and tendon pain. Ten days later, he vomited a large amount of blood, and the pain persisted. I was consulted. His pulse was Kou (hollow like a scallion stalk), indicating that the sha qi had subsided but stasis remained. I used a formula with Tao Ren (Persicae Semen) and Hong Hua (Carthami Flos) to invigorate blood. After four doses, he recovered.
2. Pan Guo'an suffered from Sha Distension with epistaxis. This indicated that sha qi was venting through the nose. He recovered after taking Qing Liang Zhi Bao Yin (Cooling Precious Treasure Drink).
3. The six-year-old son of Zhou Ruiting suffered from sha pain with red stool. I was consulted. I instructed him to undergo bloodletting and take a formula to dissipate sha, eliminate stasis, and invigorate blood. He recovered.
4. The daughter of Mr. He Junshu suffered from sha pain with significant hematuria. I was consulted. I instructed her to undergo bloodletting, but she did not improve. I treated her with Jing Jie Bo He Tang (Schizonepeta and Mint Decoction) added with Yi Mu Cao (Leonuri Herba), Jin Yin Hua (Lonicerae Japonicae Flos), Niu Xi (Achyranthis Bidentatae Radix), and Lian Qiao (Forsythiae Fructus). She recovered.
When sha poison enters the stomach, the stomach must become hot and distended. When heat and distension reach their extreme, roundworms (Ascaris) cannot survive, thus they surge upward and are expelled through vomiting. Alternatively, roundworms may cluster causing abdominal pain and constipation; or they may enter the large intestine and be expelled through stool. This differs from vomiting roundworms in Cold Damage (Shang Han) due to latent yin within. Treatment should primarily focus on clearing sha distension.
Clinical Cases:
1. The second daughter of Jiang Gongshang suffered from fever, heart pain, and excessive salivary phlegm, vomiting two roundworms. I was consulted. Her right Guan pulse was deep, fine, and rapid, while other pulses were surging and rapid. I performed scraping (Sha Fa) and pricked one needle at the popliteal fossa (Leg Bend), releasing slightly purple-black blood points. She took Lian Qiao Bo He Yin (Forsythia and Mint Drink) for three doses, and the sha subsided. She then took Xiao Chai Hu Tang (Minor Bupleurum Decoction), became cool, and recovered.
2. Shen Cunyuan suffered from Sha Distension with incessant vomiting. I was consulted. His pulse was surging and tight. After scraping, I added cooked Da Huang (Rhei Radix et Rhizoma) to the prescription. It was taken cold. Vomiting stopped, and distension resolved. Two days later, sha distension recurred, and she vomited one roundworm. Her pulse returned to being surging and tight. I again used cooked Da Huang (Rhei Radix et Rhizoma), taken cold. The sha subsided, and she stabilized.
3. Tang Zhongwen suffered from severe abdominal distension and pain. I was consulted. His pulse was scattered and rootless, indicating roundworm clustering, initiated by sha excess. After bloodletting, I used a formula to dissipate sha and remove toxin, adding Da Huang (Rhei Radix et Rhizoma). It was taken cold. He passed two dead roundworms and old feces in his stool and recovered.