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A gentleman born in this world, unwilling to be a person of no use to the world, must strive to become an indispensable person. Therefore, if a gentleman cannot serve as an excellent prime minister (Liangxiang), he will become an excellent physician (Liangyi). Generally speaking, an excellent prime minister saves the world, while an excellent physician saves lives; their actions align with their inner compassion for others' suffering, and their principles are similar.

I have devoted myself to studying diseases such as Shanghan (Cold Damage), Douzhen (Smallpox/Chickenpox), Jingfeng (Pediatric Convulsions), Nue (Malaria), Li (Dysentery), and conditions before and after childbirth, which I shall not elaborate on here. However, regarding the disease known as "Sha" (Sand/Plague toxin), mild cases may allow for delay, but acute cases hang by a thread. For patients' families, sincere pleas for help are essential; for physicians, urgent assistance is required. This differs from other ailments that can be managed slowly over time.

Recently, epidemic qi has circulated widely. During the Chou-Yin years (approx. 1702-1703 AD), Sha outbreaks occurred in both rural and urban areas. Manifestations include Ansha (Hidden Sha), Mensha (Stifling Sha), Shatong (Sha Pain), Luogongsha, Jinkousha, Pu'eshasha, Gonggongsha, Panchangsha, or concurrent Sha with Shanghan, Malaria, Dysentery, or postpartum conditions. Entire households may suffer, spreading among neighbors, causing deep sorrow. I have encountered many such critical cases requiring emergency rescue.

The general treatment methods involve three approaches: If Sha is in the skin and muscles, scraping (Gua Sha) cures it; if Sha is in the flesh and blood, bloodletting (Fang Sha) cures it. These two represent superficial Sha, which remains manageable even if severe. However, deep and severe Sha obstructs the intestines and stomach, blocks meridians, and directly attacks the Heart (Shao Yin Zong Zhu). Such patients are either critically ill or dying within days. They cannot be supported or roused. At this extreme stage, scraping or bloodletting becomes difficult. Alas, seeing patients near death is heartbreaking. When Sha reaches this point, only medicine can revive them. Thus, beyond scraping and bloodletting, medicinal treatment is necessary. Combining all three methods ensures survival.

Some practitioners only know scraping and bloodletting. If these fail, they declare the case fatal and abandon the patient. This is common. Physicians, however, bear the responsibility to save lives and act as gentlemen. Some claim medical texts do not record "Sha," suggesting it is untreatable by medicine. Yet, ancient texts mention "Jiaochangsha" (Intestinal Twisting Sha), "Gan Huoluan" (Dry Cholera), "Qingjin" (Blue Veins), "Baihuzheng" (White Tiger Syndrome), and "Zhong'e" (Sudden Evil Strike). These are early records of Sha, though brief and lacking specialized study. No text explicitly states that Sha should not be treated with medicine.

Furthermore, Sha can manifest as "True Headache" (Zhen Tou Tong), fatal within hours, recorded under headache categories; or "True Heart Pain" (Zhen Xintong), also rapidly fatal, recorded under heart pain examples. Though often considered incurable, recognizing Sha as the cause allows for potential recovery.

Sha may present as facial swelling resembling Datouwen (Big Head Plague); throat obstruction resembling Ji Houfeng (Acute Throat Wind); dizziness and coma resembling Zhongfeng (Stroke) or Zhongshu (Heat Stroke); or aphasia and lethargy resembling lost soul/spirit. In these critical states, without timely scraping/bloodletting, medicine is the only hope.

Sha symptoms mimic many diseases: headache and chills resemble Shanghan; cough and irritability resemble Shangfeng (Wind Cold); malaria may coexist with or transform into Sha; dysentery may trigger Sha. Sha presents in myriad ways: epistaxis, hematemesis, hematochezia; massive swelling, toxicity, flowing fire, flowing phlegm; pre/post-natal complications; Qi, Food, Blood, or Fire stagnation triggering Sha; limb swelling/pain; abdominal masses resembling Pi (Glomus) or Jiexiong (Chest Binding); vomiting/passing roundworms; chest, hypochondriac, abdominal, lower back, or generalized pain. In men, it may resemble Xuxue (Blood Stasis) but requires different blood-level treatment; in women, it may resemble Daojing (Retrograde Menstruation) but requires different Qi-level treatment.

Sha is diverse and complex. The key lies in distinguishing true vs. false pulses and accurately identifying symptoms before prescribing. Treat Sha in skin/muscles with scraping; in flesh/blood with bloodletting; in intestines, meridians, and Liver/Kidney/Spleen Yin channels with herbs. If Sha spreads extensively regardless of exterior/interior levels, combine all three methods. My goal is to save the critically ill and revive the dying. My treatments have proven effective. I publish this collection to enlighten future generations, fulfilling my duty to humanity and ensuring I am not useless to the world.