痧症不忌食物，痧毒裹食，结成痧块于胁而痛。其痧块变症甚多，故为难治。且治痧惟在初发，若不识，或饮热汤，
毒血凝结，即慢痧不至胀急伤人，亦成胁痛，瘀之日久，势必难散。
治验∶
一朱子佩夫人，身热吐痰胁痛，饮圆汤，益喘呕不已。延余，左脉洪数，右脉似伏。余曰∶“痧也”。子佩刺其腿弯
痧筋二针，不愈，服童便，喘呕稍减。余用阿魏丸、大黄丸白汤微冷下，身热，吐痰俱已。又用必胜汤微冷下，三服而
痊。
一王养初，子佩母舅也。吐痰胁痛，误吃圆肉，放痧数次日久不愈。延余诊之，余辞不治，以痧毒裹圆，结成痧块，
不可解耳。况日久攻坏脏腑，虽药无益，后易数医，变喉旁发肿而殁。
夏伤于暑，秋必疟痢。痢疾初发，必先泄泻，肠胃泄泻，必致空虚。内虚则易感触秽恶之气，即成痧痛。或天气炎
热，时行疫疠感动肠胃，因积而发，亦致痧痛。夫痢不兼痧，积去之后，便可得痊。即甚凶极，药无不效。若一兼痧，
势必绞痛异常，止治其痢，用药无效。或变痢如猪肝色；或变痢如屋漏水；或变痢惟血红水；或变噤口不食，呕哕凶危；
或变休息久痢，岁月绵延，常苦痢患。余惟先治其痧兼治其积，则痧消而积易去，积去而痧可清。凡遇痢疾，如此治之，
无不奏功，诚为良法。
治验∶
一曾奉先，七月间发热，下痢血水。日百余次，肛门急迫，腹痛异常，呕哕不食。延余治之，六脉迟数不常，或时
歇指，此痧痢也。刮痧放痧讫，痛乃减半。用沉香阿魏丸，砂仁汤稍冷冻饮料之，用当归、山楂、红花、枳实、赤芍、泽兰、
青皮、卜子、槟榔各一钱，熟大黄五分，加童便一钟稍冷冻饮料二服，痢下赤白甚多，诸症俱愈。
一余弟骧武下赤白痢，日数十余次，腹中大痛，大便窘迫。余诊之，六脉微细，放痧二十针，又刮痧，不愈。用宝
花散、沉香阿魏丸，稍冷汤饮之，腹痛渐宁。用当归、山楂、陈皮、槟榔、红花、乌药各一钱，熟大黄八分加童便饮之，
赤白俱下，痛亦渐安，后用当归一两，山楂二钱，服之，赤白痢全愈。
一奚仲嘉内室，腹中绞痛，喘急气逆。余诊，六脉无根，此痧胀也。放痧，不愈。用沉香阿魏丸，砂仁煎汤，稍冷
饮之，痛遂止。次日，小腹痛，频下痢赤白，用当归、金银花、青皮、陈皮、乌药、山楂、卜子，加童便稍冷冻饮料之，渐
稀，用当归一两服四剂而愈。
一吴瑞云发热，胀闷沉重。放痧后，痢下紫血。他医以痧气已清，但治其痢，势在危笃，举家惊惶。延余，六脉洪
大不匀，此痧气未清，痧毒尚盛也。令刮痧讫，用当归枳壳汤，入童便冷冻饮料之，次以苏木、红花、五灵脂，茜草、乌药、
香附、当归、赤芍以导其瘀乃安。后发余毒于肛门边，出脓而愈。
Sha disease does not strictly forbid food consumption; however, sha toxin may envelop the food, forming sha masses in the hypochondrium and causing pain. There are many variations of these sha masses, making them difficult to treat. Moreover, treating sha disease is crucial during its initial onset. If unrecognized or if hot soup is consumed, toxic blood will coagulate. Even if it does not develop into slow sha (a chronic form of sha disease) causing distension and urgency that harms the body, it will still result in hypochondriac pain. If stasis persists for a long time, it will inevitably be difficult to dissipate.
Case Records:
Mrs. Zhu Zippei presented with fever, expectoration, and hypochondriac pain. After drinking a decoction containing *Litchi Chinensis* seed (Yuanrou), her wheezing and vomiting worsened. Upon consultation, her left pulse was surging and rapid, while the right pulse seemed hidden. I diagnosed it as "sha disease." Mr. Zippei pricked two points on the sha vessels (superficial veins) in her popliteal fossa, but there was no improvement. She then consumed child's urine (Tongbian), which slightly alleviated her wheezing and vomiting. I administered Awei Wan (Asafoetida Pill) and Dahuang Wan (Rhubarb Pill), taken orally with warm water cooled slightly to induce purgation. Her fever and expectoration ceased. Subsequently, I prescribed Bisheng Tang (Victory Decoction), also taken cold. After three doses, she recovered completely.
Wang Yangchu, maternal uncle of Mrs. Zhu Zippei, suffered from expectoration and hypochondriac pain. He mistakenly consumed *Litchi Chinensis* seed (Yuanrou). Despite multiple sessions of bloodletting (Fangsha) over a long period, he did not recover. When consulted, I declined treatment because the sha toxin had enveloped the lychee seed, forming an indestructible sha mass. Furthermore, after a long duration, the toxins had damaged the zang-fu organs; medication would be ineffective. Later, several other physicians treated him, but he eventually developed swelling beside his throat and died.
Summer heat contracted in summer leads to malaria or dysentery in autumn. At the onset of dysentery, diarrhea usually occurs first. Diarrhea empties the intestines and stomach. Internal deficiency makes one susceptible to foul and evil qi, resulting in sha pain. Alternatively, extreme heat or epidemic pathogens may disturb the intestines and stomach, triggering symptoms due to accumulation, also causing sha pain. If dysentery is not complicated by sha, once the accumulation is cleared, recovery follows. Even in severe cases, medication is effective. However, if complicated by sha, excruciating colic ensues. Treating only the dysentery yields no effect. The stool may change color like pig liver, resemble leaking roof water, consist only of bloody water, or progress to closed-mouth dysentery (Jinkou Li) where eating is impossible, accompanied by violent vomiting and retching, posing a critical danger. It may also become chronic intermittent dysentery (Xiuxi Li), lingering for years. My method is to first treat the sha while simultaneously addressing the accumulation. Once sha dissipates, accumulation is easily removed; once accumulation is gone, sha can be cleared. Applying this method to all cases of dysentery ensures success; it is indeed an excellent approach.
Case Records:
Zeng Fengxian experienced fever and bloody watery dysentery in July, defecating over a hundred times daily with urgent anal tenesmus, severe abdominal pain, and vomiting preventing food intake. His six pulses were irregularly slow and rapid, sometimes skipping beats. This was diagnosed as sha-dysentery. After scraping (Guasha) and bloodletting (Fangsha), pain reduced by half. Chenxiang Awei Wan (Agarwood and Asafoetida Pill) was given, drunk slightly chilled in Amomum villosum (Sharen) decoction. Then, a prescription of Danggui (Angelica Sinensis), Shanzha (Crataegus), Honghua (Carthamus), Zhishi (Immature Bitter Orange), Chishao (Red Peony Root), Zelan (Lycopus), Qingpi (Green Tangerine Peel), Boluoz (Radish Seed), and Binglang (Areca Nut), each 1 qian, plus Shu Dahuang (Prepared Rhubarb) 0.5 qian, mixed with Tongbian (Child's Urine) and drunk slightly chilled. After two doses, large amounts of red and white discharge passed, and all symptoms resolved.
My brother, Yu Xiangwu, suffered from red and white dysentery, defecating dozens of times daily with severe abdominal pain and tenesmus. His six pulses were faint and thin. After twenty needles of bloodletting and scraping, there was no improvement. Baohua San (Precious Flower Powder) and Chenxiang Awei Wan were administered, drunk in slightly cool liquid, gradually calming the abdominal pain. Then, Danggui, Shanzha, Chenpi (Aged Tangerine Peel), Binglang, Honghua, and Wuyao (Lindera), each 1 qian, plus Shu Dahuang 0.8 qian, mixed with Tongbian, was given. Both red and white discharges passed, and pain subsided. Finally, Danggui 1 liang and Shanzha 2 qian were taken, leading to complete recovery.
The wife of Xi Zhongjia suffered from severe colic, wheezing, and rebellious qi. Her six pulses were rootless, indicating sha-distension. Bloodletting provided no relief. Chenxiang Awei Wan was given, drunk in slightly cool Amomum villosum decoction, stopping the pain. The next day, lower abdominal pain occurred with frequent red and white dysentery. A formula of Danggui, Jinyinhua (Honeysuckle), Qingpi, Chenpi, Wuyao, Shanzha, and Boluoz, mixed with Tongbian and drunk slightly chilled, thinned the discharge. Finally, Danggui 1 liang taken over four doses cured the condition.
Wu Ruiyun presented with fever, distension, fullness, and heaviness. After bloodletting, purple blood appeared in the stool. Other physicians believed sha qi had cleared and treated only the dysentery, leading to a critical condition that alarmed the family. Upon my consultation, his six pulses were surging, large, and uneven, indicating uncleared sha qi and abundant sha toxin. After scraping, Danggui Zhike Tang (Angelica and Aurantium Decoction) mixed with Tongbian and drunk chilled was administered. Subsequently, Sumu (Sappan Wood), Honghua, Wulingzhi (Trogopterus Dung), Qiancao (Rubia Cordifolia), Wuyao, Xiangfu (Cyperus), Danggui, and Chishao were used to guide out stasis, bringing peace. Later, residual toxicity manifested as pus near the anus, and he recovered after drainage.