疟有一日一发，有间日一发，有三日一发，邪气所凑，感受各有浅深。若三日一发者，所感独深，但痧毒乘之，阴
受其祸，即有不测，焉能识之。迩于全书所记外，见有痧类三疟者，故续编之以彰其害焉。
治验∶
一陆淑韩祖，年近七旬，八月患疟，间二日一发，寒热甚重，心胸烦闷，将及半月。诊之，左脉微涩。余曰∶“不意
斯疾亦有痧焉。”刺腿弯痧三针，流血紫黑。用宝花散、沉香丸，清茶微冷冻饮料之，付防风散痧汤加连翘、柴胡、橘红、胆
星微冷服二剂，六日乃痊。
一怀惟贞，患三疟半年，忽烦闷沉重，坐卧不安，六脉俱伏。余曰∶“此三疟兼痧者也。”刺腿弯痧二针，流紫黑毒
血。用宝花散，清茶微冷冻饮料之，遂松。后不服药，渐痊。
咽喉诸疾，亦有兼痧之症。与若云咽喉从古无兼痧论，试思古人治咽喉十八症，有刺少商穴法，此何异乎？夫少商
穴属太阴肺经在手指爪角内侧，刺之出血，以泻其毒，治唯一经尚有其效。若乃兼痧凡经络所伤，或上或下，随经刺放，
以拔痧毒，乃反莫救于咽喉乎。余窃谓咽喉兼痧，痧毒内发，病必难愈。若按脉看筋，能先治痧，令痧毒一去，然后内
服药饵，外用吹敷可也。
治验∶
一余长孙，犯喉疳，脉虚而微数，阅腿弯痧筋，放三针，流紫黑毒血。吹冰硼散，用清凉至宝饮减细辛加射干、连
翘、枳壳、牛膝、贝母微温饮之而愈，
一陆思湖，犯喉癣危急，医治不应。余诊之，脉弦而紧，右寸脉伏。阅有痧筋，刺十余针，紫黑毒血，流如涌泉。
吹冰硼散，用清凉至宝饮减细辛加山豆根、连翘、菊叶饮之而痊。
一缪瑞吾子，犯喉痹疼痛，脉两寸俱伏。余曰∶“症与脉异，殆必有痧。若止治喉痹恐难即愈。”不信，辞之。他医
调治，痛益甚。复延余，放指头痧三十余针。口噙冰梅，治其痰涎。用清凉至宝饮减细辛加射干、连翘微冷冻饮料之，即愈。
一潘象黄邻人，犯咽喉肿大，看有痧筋。云此宜刺放，然后医治则愈。尝对余谈及，余虽不临症治之，然即此一人，
知天下犯咽喉肿大，必有同也。故并记之。
Malaria may occur once a day, every other day, or once every three days. This is due to the gathering of pathogenic factors, with varying depths of infection. In cases of malaria occurring once every three days, the pathogenic factor is deeply rooted. If this is compounded by Sha toxin (Sha disease: a condition caused by external pathogens leading to blood stasis and toxicity), the Yin aspect suffers disaster, leading to unpredictable dangers, which are difficult to identify. Beyond what is recorded in the main text, I have observed Sha conditions resembling three-day malaria; thus, I continue this compilation to highlight its harm.
Clinical Cases:
1. Grandfather of Lu Shuhan, nearly seventy years old, contracted malaria in August, occurring every other day. The chills and fever were severe, accompanied by chest and heart irritability, lasting nearly half a month. Pulse diagnosis revealed a slightly choppy left pulse. I said, "Unexpectedly, this disease also involves Sha." Three needles were used to puncture Sha points at the popliteal fossa, releasing purple-black blood. Baohua San (Precious Flower Powder) and Chenxiang Wan (Agarwood Pill) were administered, taken cold with clear tea. Fangfeng San Sha Tang (Saposhnikovia Decoction for Dispelling Sha) was modified with Chaihu (Bupleuri Radix), Lianqiao (Forsythiae Fructus), Juhong (Citri Reticulatae Pericarpium Rubrum), and Dansheng (Arisaematis Cum Bile), taken cool. After two doses, recovery occurred within six days.
2. Huai Weizhen suffered from three-day malaria for half a year. Suddenly, he experienced severe irritability and heaviness, unable to sit or lie comfortably. All six pulses were hidden (Fu pulse). I said, "This is three-day malaria complicated by Sha." Two needles were used to puncture Sha points at the popliteal fossa, releasing purple-black toxic blood. Baohua San was administered, taken cold with clear tea, resulting in immediate relief. He took no further medication and gradually recovered.
Various throat diseases also present with complications involving Sha. Some claim that ancient texts contain no discussion of throat diseases complicated by Sha. Consider that ancient treatments for eighteen types of throat disorders included the method of puncturing Shaoshang (LU-11). How is this different? Shaoshang belongs to the Lung Meridian of Hand-Taiyin, located on the radial side of the thumb nail angle. Puncturing it to release blood drains toxicity; even treating solely this meridian yields efficacy. If Sha is involved, damaging meridians anywhere in the body, puncturing and bleeding along the affected meridians extracts Sha toxin. Why would this fail to treat throat conditions? I believe that when Sha complicates throat diseases, internal Sha toxin eruption makes the condition difficult to cure. By examining the pulse and observing tendons, if Sha is treated first to eliminate Sha toxin, followed by internal herbal medicine and external insufflation applications, recovery is possible.
Clinical Cases:
1. My eldest grandson suffered from Hougan (Throat Ulcer/Gangrene). The pulse was deficient and slightly rapid. Observing Sha tendons in the popliteal fossa, three needles released purple-black toxic blood. Bingpeng San (Ice and Borax Powder) was insufflated into the throat. Qingliang Zhibao Yin (Cooling Precious Treasure Drink) was modified by removing Xixin (Asari Radix et Rhizoma) and adding Shexuan (Belamcandae Rhizoma), Lianqiao, Zhike (Aurantii Fructus Immaturus), Niuxi (Achyranthis Bidentatae Radix), and Beimu (Fritillariae Thunbergii Bulbus), taken warm. He recovered.
2. Lu Sihu suffered from critical Houxuan (Throat Lichen/Atrophy). Other physicians' treatments failed. My diagnosis showed a wiry and tight pulse, with the right Cun position hidden. Sha tendons were observed. Over ten needles released purple-black toxic blood flowing like a spring. Bingpeng San was insufflated. Qingliang Zhibao Yin was modified by removing Xixin and adding Shandougen (Sophorae Tonkinensis Radix), Lianqiao, and Juye (Chrysanthemi Indici Folium). He recovered.
3. Son of Miao Ruiwu suffered from Houbi (Throat Bi/Sore Throat) with pain. Both Cun positions were hidden. I said, "The symptoms and pulse differ; there must be Sha. Treating only Houbi may not lead to quick recovery." He did not believe me and left. Other physicians' treatments worsened the pain. Upon my return, over thirty needles were used to release Sha from the fingertips. Bingmei (Ice Plum) was held in the mouth to manage phlegm and saliva. Qingliang Zhibao Yin was modified by removing Xixin and adding Shexuan and Lianqiao, taken cold. He recovered immediately.
4. Neighbor of Pan Xianghuang suffered from Yanhou Zhongda (Throat Swelling). Sha tendons were visible. He stated that puncturing Sha first, then treating medically, leads to recovery. He discussed this with me. Although I did not treat him personally, based on this single case, I infer that patients worldwide suffering from throat swelling likely share similar characteristics. Thus, I record this together.