痧气冲于心胸，故心烦或嗜睡，此等之痧，俱属慢痧之类，轻而且浅，人多误以心烦嗜睡治之，日甚一日，倘日服
热酒热汤热物，虽非骤然紧急，势必日渐凶险，故并录之以示戒。
治验∶
一王培元适会于其弟宋臣书室，云及心烦之甚，已非一日，将服他药。余诊之，脉症不合，止而不服，阅腿弯痧筋
刺而放之，不药而痊。此等痧甚多，姑记一以为例。
一余弟骧武，每心烦嗜睡，自识其痧，便欲刮放，不药而痊。此由中气虚，故易感痧患，虽轻之至，不足具述，然
亦痧之一症也。姑录之以广其说。
先有痰火咳嗽之疾，忽尔喘急痰涎喉声如锯，或头汗如油，喘而不休，心胸烦闷，莫可名状。虽云痰火危笃，往往
有之，然亦有兼感时气或秽气所触，骤然势盛者，凡治必宜细细察脉按症，先清其痧，次治其痰，然后渐补气血，则标
本兼得其理矣。
治验∶
一汪子建母，七旬有余，素犯痰火老弱之症，忽痰涎壅盛，喘急不休，喉声如锯。延余诊视，六脉不匀，有如雀啄，
虽老弱痰火之脉，尝有歇指，亦不足怪，然视其骤然作变，病必有异。余曰∶“此兼痧症，尚可治也”。阅其左腿弯下，
有青筋二条，刺之紫黑血流如注，先用散痧消食豁痰顺气之剂，并进牛黄抱龙丸，病势渐安，后惟补其气血，乃痊。
一盛君和母，五十岁，痰火多年，忽面赤头汗，遍身俱肿，喘急烦闷倍常。延余诊视，余思老年痰火，固所宜然，
何面赤头汗，遍身俱肿之骤也。及按其脉，又与症相合，不可据以为痧。然恐痧之为祸不小，若竟以老弱痰火治之，终
觉疑而不安，细视其十指，有细红丝筋，历历可验，则其痧之为老弱变症也，明矣。先治其痧，刺指头二十余针，去其
毒血，次用稍冷汤服宝花散，面赤头汗身肿俱除，喘急亦渐和缓。唯是老弱痰火为终身之疾。
Sha Qi (Sha Pathogen) rushes upward to the heart and chest, causing mental restlessness or excessive sleepiness. Such sha conditions all belong to the category of Slow Sha (Chronic Sha), which is mild and superficial. People often mistakenly treat them as ordinary mental restlessness or sleepiness, leading to a worsening condition day by day. If one consumes hot wine, hot soups, or hot foods daily, although it may not cause sudden emergency, it will inevitably lead to increasingly dangerous conditions. Therefore, this situation is recorded here as a warning.
Clinical Cases:
Mr. Wang Peiyuan met me in the study of his younger brother, Song Chen. He mentioned that he had been suffering from severe mental restlessness for several days and was about to take other medicines. Upon examination, I found that his pulse and symptoms were inconsistent. I advised him to stop taking medicine. Then, I examined the Sha veins (superficial veins showing sha pathogen) behind his knees and performed needle pricking with bloodletting. He recovered without further medication. There are many such cases of sha; I record this one as an example.
My younger brother, Xiang Wu, frequently experienced mental restlessness and sleepiness. Recognizing it as sha himself, he performed scraping (Gua Sha) and bloodletting, recovering without medication. This was due to deficiency of Middle Qi (Spleen/Stomach energy), making him susceptible to sha pathogens. Although the condition was extremely mild and hardly worth detailing, it is indeed a manifestation of sha. I record it here to broaden the discussion.
A patient previously suffering from Phlegm-Fire Cough suddenly developed rapid panting, profuse phlegm saliva, and a sawing sound in the throat, or oily sweat on the head, continuous panting, and indescribable mental restlessness in the chest. Although such critical Phlegm-Fire conditions do occur, they are sometimes accompanied by contraction of seasonal pathogens or foul qi, causing a sudden exacerbation. In treating such cases, one must carefully examine the pulse and symptoms, first clearing the sha, then treating the phlegm, and subsequently tonifying Qi and Blood gradually. This approach addresses both the branch and root causes rationally.
Clinical Cases:
The mother of Wang Zijian, over seventy years old, had a history of Phlegm-Fire and frailty. Suddenly, she presented with profuse phlegm saliva, continuous rapid panting, and a sawing sound in the throat. I was invited to examine her. Her six pulses were irregular, resembling Sparrow Pecking Pulse (a sign of impending death or severe organ failure). While occasional pauses in the pulse can be seen in elderly patients with Phlegm-Fire and are not surprising, the sudden onset indicated an abnormality. I said, "This is a sha condition combined with other factors, and it is still treatable." I observed two blue veins below the left popliteal fossa. After pricking them, dark purple blood flowed out like a stream. I first administered a formula to dissipate sha, resolve food stagnation, transform phlegm, and regulate Qi, along with Niuhuang Baolong Wan (Calculus Bovis Dragon-Embracing Pill). The condition gradually stabilized, and subsequent treatment focused on tonifying Qi and Blood, leading to recovery.
The mother of Mr. Sheng Junhe, fifty years old, had suffered from Phlegm-Fire for many years. Suddenly, she developed facial flushing, sweating on the head, generalized edema, and panting and restlessness worse than usual. I was invited to examine her. I thought that facial flushing and sweating could be expected in elderly patients with Phlegm-Fire, but the sudden onset of generalized edema was unusual. Upon palpating her pulse, it seemed consistent with the symptoms, so I could not definitively diagnose sha based on this alone. However, fearing that if it were sha, the harm could be significant, and feeling uneasy about treating it solely as Phlegm-Fire in a frail patient, I carefully examined her ten fingers. I found distinct fine red thread-like veins, clearly indicating that this was a variation of sha in a frail constitution. I first treated the sha by pricking the fingertips more than twenty times to drain toxic blood. Then, I administered Baohua San (Precious Flower Powder) with slightly cool water. The facial flushing, head sweating, and edema disappeared, and the panting gradually eased. However, Phlegm-Fire associated with frailty remained a lifelong condition.