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In cases of Sha syndrome (Sha disease) where there is no food stagnation or blood stasis, but the Sha Qi (Sha pathogenic factor) is abundant and obstructive, the decoction should be taken cold. In cases where Sha Qi is obstructed due to food stagnation without blood stasis, the decoction should be taken slightly cold. In cases where Sha toxicity is severe accompanied by blood stasis, the decoction should be taken slightly warm. When Sha pathogens enter the Qi level (functional level) with toxic obstruction, scraping therapy (Gua Sha) is appropriate. When Sha pathogens enter the Blood level (material level) with toxic obstruction, bloodletting therapy is appropriate. If Sha pain is accompanied by cramping and writhing sensations, it indicates Sha toxin obstructing the Qi level associated with food stagnation. If Sha pain is fixed and unchanging in location, it indicates Sha toxin obstructing the Blood level with stasis. If Sha rashes appear on the upper parts such as the head and face, it indicates Sha toxic vapors obstructing upwards. If Sha rashes spread to the lower parts such as hands and feet, it indicates Sha toxic blood pouring downwards. If Sha syndrome presents with vomiting and diarrhea, it is caused by Sha Qi surging up and down. If Sha syndrome presents with irritability, oppression, and abdominal distension, it is caused by Sha Qi obstructing the heart and diaphragm region. If Sha syndrome presents with aversion to cold and fever, it is caused by Sha Qi being suppressed at the muscle and surface level. If Sha syndrome presents with unilateral chest and diaphragm pain, it is caused by toxic blood stagnating in the meridians. If Sha syndrome presents with accumulation and stagnation in the intestines and stomach, it is caused by food stagnation and blood stasis leading to swelling and distension. If Sha syndrome presents with hematemesis (vomiting blood) or hematochezia (blood in stool), it is caused by Sha blood overflowing and tissue destruction. If Sha syndrome presents with cough and急促 breathing (asthma/shortness of breath), it is caused by Sha toxin obstructing the Qi level generating phlegm and rebellious Qi. If Sha syndrome leads to sudden death from suffocation/oppression, it is caused by Sha toxic blood attacking the Heart. If Sha syndrome presents with flaccidity and inability to move the limbs, it is caused by Sha entering the Blood level and toxin pouring into the lower parts. If Sha syndrome presents with pain in both the waist and hypochondrium, it is caused by Sha obstructing the Blood level with stasis. If Sha syndrome presents with unilateral pain on half of the body, it is caused by toxin pouring into half the body with blood stasis. If Sha syndrome presents with heaviness of the body and inability to turn over, it is caused by Sha toxic blood being obstructed and stagnant, unable to circulate. If Sha syndrome transforms into swollen sores and ulcers, it is caused by toxic blood coagulating and stagnating, damaging the muscle and surface.

If Sha syndrome does not occur simultaneously with miscellaneous diseases (Za Bing), then there is no issue. However, if it occurs concurrently with miscellaneous diseases, and the physician can only treat the Sha syndrome but not the miscellaneous diseases, this is dangerous. If the miscellaneous disease is harmful, does this not lead the patient to death? The error lies not in the Sha syndrome, but in the miscellaneous disease. There are physicians who can treat a hundred diseases but cannot treat Sha; I certainly consider them liable for medical errors. Now, consider a patient suffering from both a miscellaneous disease and Sha. A physician specializing in Sha treatment, who cannot treat miscellaneous diseases, commits an even greater error. Can their liability for harming patients be excused? Take, for example, a patient with Lao Ruo (consumptive weakness), a condition of fundamental deficiency, complicated by acute and dangerous Sha syndrome. If one consults a Sha specialist, they may claim, "I am skilled in treating Sha." Initially, using harsh purgative or draining drugs to treat extreme Sha distension might seem acceptable under the principle that "when there is disease, the disease bears the brunt," implying that even strong purgatives would not harm the fundamental constitution. However, once five to six parts of the Sha have subsided and three to four remain, while still focusing on Sha, one must also protect the fundamental constitution. The correct approach is to use mild purgatives that do not damage the foundation. Overuse of purgatives will damage the foundation, causing further harm to a deficient condition. Moreover, when eight or nine parts of Sha have dispersed and only one or two remain, medication should primarily protect the foundation, addressing Sha only slightly. Once Sha is completely resolved, leaving only fundamental deficiency, tonification and supplementation should be prioritized. Only then can one claim to treat the disease correctly without error. If one fails to understand conditions of fundamental deficiency beforehand, leading to inappropriate medication and lack of methodical dosing, how can one avoid the blame for medical error? From this single instance, one can extrapolate to all diseases. Therefore, I assert that to treat Sha effectively, one must first understand a hundred diseases.