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Pulse being *kōu* (hollow) and floating indicates Lung Sha (Sha disease of the Lung). Pulse being *kōu* (hollow) and scattered indicates Heart Sha. Pulse being wiry, long, and moving indicates Liver Sha. Pulse being *kōu* (hollow), large, slippery, and solid indicates Spleen Sha. Pulse being deep, fine, and irregular in rhythm indicates Kidney Sha. Sha of the Large Intestine resembles that of the Lung but is longer. Sha of the Small Intestine resembles that of the Heart but is finer. Sha of the Gallbladder resembles that of the Liver but is rapid. Sha of the Stomach resembles that of the Spleen but is tight. Sha of the Bladder resembles that of the Kidney but is floating and deficient. Sha of the Sanjiao (Triple Burner) and Mingmen (Gate of Life) will have bizarre pulses.

Sha caused by food injury often presents with a trembling or unstable pulse. Sha caused by blood injury often presents with a *kōu* (hollow) and slippery pulse. Sha caused by summerheat often presents with a surging, slippery, and rapid pulse. Sha caused by wind often presents with a deep and faint pulse. Sha caused by foul contact often presents with variable and irregular pulses. Sha caused by Qi injury often presents with a deep and hidden pulse, or one resembling the pecking of a sparrow. Sha caused by cold-dampness often presents with a deep and fine pulse.

The pulse of Sha disease differs from that of other diseases. For instance, Shanghan (Cold Damage) and Shangfeng (Wind Injury) have their own specific pulses. If Shanghan or Shangfeng is complicated by Sha disease, the pulse must change, and the condition becomes fierce and violent. This applies to all miscellaneous diseases complicated by Sha.

Case Record 1: The wife of my friend Cheng Tu suddenly fell into a heavy coma with abundant phlegm and saliva for three days. I was summoned to examine her. Her pulse was excessively surging and large; she had no fever, no dry mouth, but was unconscious. I said, "The pulse and symptoms do not match; this is Sha distension." After scraping therapy, she regained slight consciousness. She was administered Chenxiang Yujin San (Agarwood and Turmeric Powder) combined with Jingjie Decoction (Schizonepeta Decoction) plus Ezhu (Curcuma Zedoaria Rhizome), Pengzhu (Curcuma Phaeocaulis Rhizome), Zhishi (Immature Bitter Orange), Zipu (Magnolia Officinalis Bark), and Sharen (Amomum Fruit), served slightly chilled. She recovered after three doses.

Case Record 2: An elderly man named Chen Yunxi had a seven-year-old son who had been feverish for five days, presenting similarly to Shanghan, with heavy coma. After taking medicines for Shanghan, his condition worsened to the brink of death. His son-in-law, Wu Caiyun, summoned me. Upon palpation, the pulse resembled the pecking of a sparrow, indicating a strange pulse that seemed incurable. However, upon careful palpation of the Left Guan position, there was a momentary throbbing sensation under the fingers, indicating hidden Sha that had gone unnoticed. Fortunately, due to his young age, he could be lifted and examined; three purple veins were found behind his knees. These were pricked, and blood flowed profusely. As he did not recover immediately, Awei Wan (Asafoetida Pill) and Dahuang Wan (Rhubarb Pill) were administered with clear tea, slightly chilled. Additionally, Jingjie Decoction plus Shanzha (Hawthorn Fruit), Boluozi (Radish Seed), Binglang (Areca Nut), and Xixin (Asarum Root) were administered, slightly chilled. After two doses of the first decoction, he regained consciousness. The next day, his pulse returned to normal, and Sha qi completely subsided, though residual heat remained. Therefore, medicines targeting the Yangming Stomach Channel for Shanghan were used, and he recovered after three doses. I cannot detail all my cases of treating Sha; I present these two as examples to show that Sha disease must not be neglected.

My essential principles of Sha pulses are exhaustive; there is no Sha pulse outside of these descriptions. Critics argue that I keep the pulse secret and do not fully explain the rationale behind it, which is precisely why they say so. Alas, people criticize me, claiming my discussion on Sha pulses lacks clarity regarding the pulse itself. But consider that I published this book to enlighten the world and make everyone aware of the dangers of Sha disease. Do I have any secrets? Just as Shanghan has its own specific pulse, this is not empty talk. In winter, when one truly contracts Shanghan, with headache, aversion to cold, fever, and absence of sweat, the pulse must be tight and vigorous, hence the presence of a tight and vigorous Cun Kou (Cun position of the radial artery) pulse. In other months, even if one has headache, aversion to cold, fever, and absence of sweat, collectively termed Shanghan, the Cun Kou pulse is rarely tight and vigorous; this is why only in winter does one see the true Shanghan pulse. If in winter, one has the symptoms of true Shanghan but lacks the tight and vigorous pulse, or if the pulse changes to deep-slow or faint-thin, this discrepancy between pulse and symptoms is common. At such times, observing the color of green or purple veins allows one to verify the occurrence of Sha disease. Furthermore, in Shanghan, having no pulse in both hands is called Double Fu (Hidden), and in one hand is Single Fu (Hidden); this is always accompanied by proper sweating. This refers to the temporary hiding of the pulse before sweating occurs, not constant pulse hiding with sweating. If the Shanghan symptoms persist daily while the pulse remains hidden, this contradicts the theory of pulse hiding preceding proper sweating, allowing one to verify that the cause is indeed Sha disease. Similarly, in transmitted heat syndromes of Shanghan, a tight and vigorous Qi Kou (Guan position of the radial artery) pulse is considered evidence of food injury. If a patient suffers from chest fullness and oppression, one would expect a tight and vigorous Qi Kou pulse. However, if palpation reveals an empty pulse rather than a tight one, this mismatch between pulse and symptoms further verifies the onset of Sha disease. By additionally observing green and purple veins for confirmation and treating the Sha accordingly, what doubt could remain? By analogy, other diseases can be fully understood.