痧毒肆行，盘转肠胃，虽不痛不疼，苦楚万状，命在须臾，此紧痧之症也。
治验∶
一张方曦内人，十一月间，胸腹中气不舒畅，惟是盘旋绞绞于胸腹肠胃中，叫喊几死，将及半日。时晚延余，诊其
脉洪大无伦，令其仆妇，放指头痧二十余针。用救苦丹、沉香丸清茶稍冷冻饮料之，未愈。付防风胜金汤加桃仁、红花，治
之而痊。
一汪履公弟，三月，饭后骤然叫喊，腹中绞绞，述闷无极，六脉俱伏。放腿弯痧六针，紫黑毒血出如涌泉，未愈。
用盐汤冷冻饮料二大碗吐去新食，付清气化痰饮，稍冷服而愈。
一盛玉铉，炎月旁晚，胸腹述闷，苦不可言。自谓死期在即，举客惊骇。延余，右三部脉伏，左三部脉洪大无伦。
放指头痧三十余针，未愈。用矾汤冷冻饮料二碗，吐去新食，付蒲黄饮减姜黄加卜子，微冷服而痊。
自汗阳亏，盗汗阴弱，闻声而惊震，遇响而惶 者，虚极之候。若因痧有是症者，固表固本在所大忌，务宜辨之。
治验∶
一陈肃达内人，本质素虚，几遇病非人参不效。四月间，心胸烦闷，汗流不绝，闻声惊恐。初病延余，脉未显，难
辨。余闻素虚，虽不敢用参，付平剂，不应。延他医付药加参补之，疾益甚。复拉余，按脉不见沉微反见浮洪紧大。余
曰∶“痧也。”三子叔杨为母放痧毕。余用宝花散，沉香阿魏丸微冷茶饮之，渐安。肃达恐虚实未明，停药二日，后用归
身、山药、茯苓、麦冬、沙参、丹皮四剂而愈。
一潘中黄，心胸烦闷，睡即盗汗不已，先将腿弯痧筋放之，即发晕，不愈。越六日，延余，按其脉，不与症合。余
曰∶“痧毒幸放，故无大害。其发晕者，适遇痧气冲心，是以得晕，非放痧之害也。”复为放指上痧三十余针，未愈。用
宝花散微冷冻饮料之，用独活红花汤加卜子，调黑糖治之而痊。
一祝公庵次子，发热头疼，自汗如油，痰喘如锯，时觉昏沉。有以牛黄抱龙丸、生姜汤治之。更重延余诊之，脉上
盛而虚。放乳边痧三针，腿弯上下痧六针，未愈。付桃仁红花汤加牛膝、石斛、细茶微温饮之，三剂而安。
一石敬村女，口渴盗汗，腹胀如臌，有治之，不应。余按脉，弦细无力。放指头痧二十余针。用苏木散合宝花散、
砂仁汤，微温饮之，付蒲黄饮加角刺、卜子温饮四剂、又用清凉至宝饮，二剂而痊。
Sha poison (Sha toxin) spreads rampant, coiling within the intestines and stomach. Although there is no pain, the suffering is extreme, and life hangs in the balance; this is the syndrome of Tight Sha (Jin Sha).
Case Records:
The wife of Zhang Fangxi, in November, experienced qi stagnation in the chest and abdomen, feeling as if qi was twisting and churning within the chest, abdomen, intestines, and stomach. She cried out until near death for nearly half a day. I was consulted in the evening. Her pulse was excessively surging and large (Hong Da). I instructed her maid to perform sha-bleeding (releasing sha blood) on over twenty finger tips. She was given Jiuku Dan (Rescue Suffering Pill) and Chenxiang Wan (Agarwood Pill) with slightly chilled tea to drink, but did not recover. Subsequently, Fangfeng Shengjin Tang (Windproof Decoction to Win Metal), added with Taoren (Peach Seed) and Honghua (Safflower), was prescribed, leading to recovery.
The younger brother of Wang Luigong, in March, suddenly cried out after eating, with abdominal twisting pain and unbearable stifling sensation. All six pulses were deep-hidden (Fu). Six needle-sha-bleedings were performed on the popliteal fossae (back of the knee). Purple-black toxic blood flowed out like a spring, but he did not recover. Two large bowls of salt water, chilled, were drunk to induce vomiting of the new food. Qingqi Huatan Yin (Clear Qi and Transform Phlegm Drink) was then prescribed and taken slightly cold, resulting in recovery.
Sheng Yuxuan, in midsummer evening, suffered from chest and abdominal stifling sensation, indescribably painful. He believed his death was imminent, causing panic among guests. I was consulted. The three positions on the right wrist showed hidden (Fu) pulses, while the three positions on the left wrist showed excessively surging and large (Hong Da) pulses. Over thirty needle-sha-bleedings were performed on the finger tips, but he did not recover. Two bowls of Fan Tang (Alum Decoction), chilled, were drunk to induce vomiting of new food. Puhuang Yin (Pollen Drink) with reduced Jianghuang (Turmeric) and added Boluobozi (Radish Seed) was prescribed and taken slightly cold, leading to recovery.
Spontaneous sweating indicates Yang deficiency; night sweating indicates Yin weakness. Being startled by sounds and alarmed by noises are signs of extreme deficiency. If these symptoms arise due to Sha, consolidating the exterior and tonifying the root are strictly contraindicated; careful differentiation is essential.
Case Records:
The wife of Chen Sudai has always had a deficient constitution, rarely recovering without Ginseng (Renshen). In April, she experienced chest and heart vexation and stuffiness, continuous sweating, and fearfulness upon hearing sounds. When initially consulted, the pulse was not apparent, making differentiation difficult. Knowing her chronic deficiency, I dared not use Ginseng and prescribed a mild formula, which failed. Another physician prescribed medicine with added Ginseng for tonification, worsening the condition. Upon re-examination, the pulse was not sinking and faint, but rather floating, surging, tight, and large. I stated, "This is Sha." Her three sons performed sha-bleeding for their mother. I prescribed Baohua San (Precious Flower Powder) and Chenxiang Awai Wan (Agarwood and Asafetida Pill) taken with slightly chilled tea, leading to gradual peace. Sudai feared that the excess-deficiency status was unclear and stopped medication for two days. Later, four doses of Guishen (Angelica Sinensis Root), Shanyao (Chinese Yam), Fuling (Poria), Maidong (Ophiopogon Tuber), Shashen (Glehnia Root), and Danpi (Moutan Cortex) led to recovery.
Pan Zhonghuang suffered from chest and heart vexation and stuffiness, with incessant night sweating during sleep. Sha-veins in the popliteal fossae were released first, causing immediate dizziness, but he did not recover. Six days later, I was consulted. His pulse did not match the symptoms. I said, "Fortunately, the Sha toxin was released, so there is no major harm. The dizziness occurred because Sha qi happened to rush to the heart, causing syncope; it was not a harm caused by sha-bleeding." I performed over thirty needle-sha-bleedings on the fingers, but he did not recover. Baohua San (Precious Flower Powder) was taken with slightly chilled liquid. Duhuo Honghua Tang (Angelica Pubescens and Safflower Decoction) added with Boluobozi (Radish Seed) and mixed with brown sugar was prescribed, leading to recovery.
The second son of Zhu Gong'an suffered from fever, headache, spontaneous sweating like oil, phlegm-wheezing sounding like sawing, and occasional lethargy. He was treated with Niuhuang Baolong Wan (Cattle Gallstone Holding Dragon Pill) and Ginger Soup. The condition worsened, and I was consulted. The pulse was excess at the upper position and deficiency at the lower position. Three needle-sha-bleedings were performed on the breast margin, and six on the upper and lower popliteal areas, but he did not recover. Taoren Honghua Tang (Peach Seed and Safflower Decoction) added with Niuxi (Achyranthes Root), Shihu (Dendrobium Stem), and Xiacha (Fine Tea) was prescribed and taken slightly warm. After three doses, he stabilized.
The daughter of Shi Jingcun suffered from thirst, night sweating, and abdominal distension like drum-tightness. Previous treatments failed. Her pulse was wiry, fine, and powerless. Twenty-plus needle-sha-bleedings were performed on the finger tips. Sumu San (Sappan Wood Powder) combined with Baohua San (Precious Flower Powder) and Sharen Tang (Amomum Fruit Decoction) was taken slightly warm. Puhuang Yin (Pollen Drink) added with Jiaoci (Hawthorn Thorn) and Boluobozi (Radish Seed) was taken warm for four doses. Finally, Qingliang Zhibao Yin (Cooling Precious Treasure Drink) was taken for two doses, leading to recovery.