Library

The eruption of sha-rash (Sha-rash, a disease characterized by rash and swelling caused by toxic heat) must strive for complete penetration. Therefore, in treating measles (Measles, an acute infectious disease), it is necessary to ensure that the rash manifests sufficiently on the skin surface; the more it manifests, the more completely the toxic qi (Toxic Qi, pathogenic factors with strong virulence) can be excreted, so that no residual toxin remains in the intestines and stomach. In treating sha syndrome (Sha Syndrome, a category of diseases caused by exposure to foul or toxic air, characterized by sudden onset, abdominal distension, and pain), for those located on the skin surface, scraping (Scraping, a therapeutic method using a smooth-edged instrument to scrape the skin) is used; for those located in the flesh and blood, pricking and bleeding (Pricking and Bleeding, a technique involving puncturing superficial veins to release blood) is used. This is also consistent with the principle of treating measles, which requires the pathogen to be fully vented through the skin surface.

If variola (Smallpox) is touched by foul qi (Foul Qi, noxious environmental pathogens), it immediately undergoes pathological changes, which falls under the category of sha syndrome; if measles is touched by foul qi, it immediately becomes obscured and fails to erupt, which also falls under sha syndrome; if sha is contracted due to summerheat qi or irregular seasonal pathogens, are there not similarities?

Clinical Case:
A fourteen-year-old maid surnamed Chen fell ill in April. She presented with high fever, irritability and chest oppression, abdominal pain, and heavy limbs, with macular sha covering her body. Her pulse was faint and fine, indicating symptoms caused by contact with foul qi. Examination revealed visible sha vessels (Sha Vessels, dilated superficial veins indicating sha toxin) behind her knees, from which seven needles were drawn to release blood. More than ten needles were drawn from her fingers, releasing dark purple-black toxic blood. Subsequently, her irritability and oppression slightly relieved. She was administered Baohua San (Treasure Flower Powder) and Awei Wan (Asafoetida Pill), given cool boiled water mixed with clear tea, followed by formulas to invigorate blood and regulate qi. The abdominal pain ceased, the macular sha gradually dispersed, and her body felt light and agile. The smallpox then erupted. Observing its color and shape, four days had passed since onset. Later, she recovered according to the expected stages of filling, swelling, and scabbing. This demonstrates that cases where smallpox becomes obscured due to foul contact and concurrent sha are common.

Patients suffering from cold damage (Cold Damage, diseases caused by cold pathogenic factors) may have exterior cold affecting the Three Yang meridians or direct invasion of cold into the Three Yin meridians, but not all conditions involve concurrent sha. Sha is essentially heat toxin (Heat Toxin). When heat toxin enters the interior, it causes internal swelling; when it manifests externally, it causes skin and muscle swelling, ascending to the head and face or dispersing to the four limbs. These severe diseases are all caused by the attack of heat toxin qi. If it is a true cold syndrome caused by direct invasion of cold into the Three Yin meridians, there is no concurrent sha, because once the Three Yin meridians are invaded by cold, the heat qi and cold qi repel each other, leaving no pathway for entry. Regarding exterior cold affecting the Three Yang meridians, some patients first contract sha and then cold, some first contract cold and then sha, and some experience sudden eruption of sha toxin, where extreme heat generates chills, even leading to cold extremities. All these scenarios exist. If one first has sha and then contracts cold, knowing it is slow sha (Slow Sha, a milder form of sha), one may temporarily disperse the cold pathogen before treating sha. If one first has cold and then contracts sha, indicating sha is the primary pathology, one should treat sha first, then treat cold. As for cases where sha toxin suddenly erupts, extreme heat generates chills, and extremities become cold, this is tight sha (Tight Sha, a severe, acute form of sha). If one mistakenly uses dispersing, ascending, or warming medications, one must guard against immediate critical danger. Immediately administer cool water to slightly relieve the heat and distension in the chest and abdomen, then proceed with scraping or pricking/bleeding, followed by medicinal treatment.