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Jinyin (Curcuma aromatica): When the price is high, it is sometimes replaced by Jianghuang (Curcuma longa). Although their properties of warmth and coolness differ, in treating Sha syndrome (Sha disease), Jianghuang powder is not ineffective for descending Qi and resolving stasis. However, if the intention is to enter the Heart meridian to dissipate stagnation and resolve blood stasis, for cases where Sha toxin attacks the Heart, only Jinyin can achieve immediate results, whereas Jianghuang falls short. Therefore, Jinyin recorded in prescriptions must never be substituted with Jianghuang.

Shanjiujia (Pangolin Scales): Use after stir-frying with soil. In all cases where Sha toxin and blood stasis are congested and obstructed, preventing free flow, Shanjiujia penetrates into the collaterals, guiding other medicines to reach the blood level of the affected meridians where they could not otherwise arrive. Those who understand this should pay attention.

Heiqiu (Semen Kochiae): It unblocks both upper and lower aspects. For Sha toxin causing distension and fullness, this herb must be used in pills or powders to save lives and achieve efficacy. No other qi-breaking herbs can match its effect, but it consumes and scatters true Qi; thus, it may be suitable for some and unsuitable for others, which is why it is not included in the main prescriptions.

Dahuang (Rhei Radix et Rhizoma): Treats Sha toxin caused by food accumulation and obstruction. I prepare it as pills for emergency use, and its merit is immense. If Sha distension is extreme, urgent administration of this herb to attack the pathogen is necessary, yet one must consider that the condition may be suitable or unsuitable for such treatment. Therefore, although recorded in the formulas, detailed instructions are omitted; one should act according to the urgency and severity of the symptoms. (Equal parts of Heiqiu and Dahuang, made into pills with rice gruel; take 3 fen per dose, slightly cooled, washed down with decoction.)

Generally, for treating vomiting, Banxia (Pinelliae Rhizoma) and Huoxiang (Agastaches Herba) are used. However, specifically for vomiting caused by Sha syndrome, Banxia is drying and hot; one must guard against it exacerbating fire pathogens, so it must absolutely not be used. If Huoxiang is used, it is solely to utilize its righteous Qi to treat turbid and foul pathogens. Nevertheless, this is only permissible when Sha toxin does not cause obstruction, allowing for the consumption of cold beverages. If Sha Qi harms the middle jiao, suddenly using these agents to stop vomiting risks "closing the door to drive out the thief" (trapping the pathogen inside). If there is food accumulation and blood stasis in the intestines and stomach, retaining Sha toxin, using the aromatic and drying nature of Huoxiang to stop vomiting would inadvertently nourish the toxin. This is a contraindication that must be known. (If Sha toxin is successfully purged, vomiting will cease spontaneously.)

The chills and fever in Sha syndrome do not arise from external contraction but often result from toxins entering through the nose and agitating the muscle surface. Qianghuo (Notopterygii Rhizoma et Radix) and Mahuang (Ephedrae Herba) are strictly prohibited. If Jingjie (Schizonepetae Spica) and Xixin (Asari Radix et Rhizoma) are used, they effectively penetrate the orifices. Since evil toxic Qi enters through the orifices, these herbs are employed to allow Sha distension toxins to exit via the orifices. Fangfeng (Saposhnikoviae Radix), being a ministerial agent, is taken only as an assistant for penetrating orifices; unlike Mahuang and Qianghuo which specifically attack the exterior to induce sweating, Fangfeng carries the risk of ascending and disseminating fire toxins. As for Duhuo (Angelicae Pubescentis Radix), its dispersing action treats heat, but its force returns at the neck and cannot over-disperse; furthermore, it can invigorate blood and resolve Sha toxin. Thus, it is likely the most crucial herb for Sha syndrome.