先有膨胀而痧气乘之，臌胀益甚，在臌胀不可先医，在痧气自宜早治。
治验∶
一江云甫肚腹胀急如臌，脐突筋青，心口将平。余诊之，知为血臌之症，其指头黑色，此臌症之所无也。视指上有
青筋，兼痧无疑，刺二十余针，又刺臂弯腿弯青筋五针，俱去其毒血，略松，用蒺藜散微温饮之，脐下青筋渐退，后用
臌症之药，导去恶水，日服治臌香圆丸二月余，臌症尽平，永不复发。
痧者，毒也。慢痧之毒，迁延时日，留滞肌肤、肠胃、血肉之中，若不早治，即成真臌。
治验∶
一严天玉次子，气急作胀，胸腹饱闷，脐下有青筋突起，心口将平，此慢痧成臌也。刺腿弯青筋六针，出紫黑毒血
甚多，又刺指头出毒血二十四针，脐上青筋即淡色，腹内觉松。用宝花散微冷服，腹胀渐消，其后不复用药施治，但恐
其根未除，日后复发，姑志之以例其余。
心主血，痧毒入于血分，故易攻心，此痧症所以发昏也。若痧之慢者，冲激迟缓，未逆于心，留滞经络，或在于右，
或在于左，为半身疼痛，或麻痹不仁，如此半身不遂，总因痧毒之遗害也。治之者，见有痧筋，急宜刺破，然后用药以
散其毒，活血以消其瘀，则痧根既拔，其症渐痊。若不知治，绵延日久，痧毒益深，势不可遏，当又有变症难愈矣。
治验∶
一章道庵屡患吐血，发热不凉，左半身疼痛不已，行步艰难。延余诊视，初不觉其为痧也，细思脉症不合之处，检
其痧筋刺之，用桃仁、泽兰、独活、乌药煎二剂微温服，吐血疼痛俱愈，永不复发。
一盛成年朝凉夜热，气急半年，服药不应，反加右半身
疼痛，不能俯仰，咳嗽吐痰，饮食减少，成劳弱不足之症。棹舟迎余，脉不见弦数，而微细，时有歇指，脉症不合，阅
其痧筋刺二十余针，用姜黄、旋复花、丹参、橘红、赤芍、玄胡索、泽兰、山楂、角刺、穿山甲二剂，微温服，疼痛吐
痰俱除。后朝用六味地黄丸，夕用补中益气汤。朝凉夜热俱愈。
Initially, abdominal distension occurred, followed by an invasion of Sha Qi (Sha pathogenic factor), causing the Gu Zhang (Tympanites) to worsen. For Gu Zhang, immediate treatment is not advisable; however, for Sha Qi, early treatment is appropriate.
Case Record:
Jiang Yunfu suffered from severe abdominal distension resembling Gu Zhang, with a protruding umbilicus and exposed subcutaneous veins, and his epigastrium was flattened. Upon diagnosis, I determined this was Blood Gu Zhang (Gu Zhang caused by blood stasis). The blackening of his fingertips was a symptom absent in ordinary Gu Zhang. Observing greenish veins on the fingers, I confirmed the presence of Sha. I performed acupuncture on more than twenty points and five points on the veins at the antecubital and popliteal fossae, draining toxic blood. His condition slightly improved. He then took Jili San (Tribulus Powder) warm, after which the veins below the umbilicus gradually receded. Subsequently, he was treated with formulas for Gu Zhang to guide out noxious fluids, taking Zhi Gu Xiangyuan Wan (Gu Zhang-Resolving Fragrant Pill) daily for over two months. The Gu Zhang symptoms completely resolved and never recurred.
Sha refers to toxic pathogens. The toxins of chronic Sha linger over time, stagnating in the skin, muscles, intestines, stomach, flesh, and blood. If not treated early, it will develop into true Gu Zhang.
Case Record:
The second son of Yan Tianyu experienced shortness of breath and distension, chest and abdominal fullness, protruding veins below the umbilicus, and a flattened epigastrium. This indicated that chronic Sha had transformed into Gu Zhang. I punctured six points on the veins at the popliteal fossa, releasing a large amount of dark purple-black toxic blood, and punctured the fingertips twenty-four times to release toxic blood. The veins above the umbilicus lightened in color, and the abdomen felt relaxed. He took Baohua San (Treasure Flower Powder) cool. The abdominal distension gradually subsided. No further medication was administered thereafter, but fearing the root cause remained and recurrence might occur, I recorded this case as an example for similar situations.
The Heart governs blood. When Sha toxins enter the blood level, they easily attack the Heart, which is why Sha syndromes can cause coma or mental confusion. In cases of chronic Sha, the impact is slow and has not yet reversed into the Heart, but remains stagnant in the meridians, either on the right or left side, manifesting as hemibody pain or numbness and insensitivity. Such hemiplegia is entirely due to the lingering harm of Sha toxins. Treatment requires identifying Sha veins and urgently puncturing them, followed by using herbs to dissipate toxins and invigorate blood to resolve stasis. Once the root of Sha is eradicated, symptoms will gradually recover. If untreated, the duration extends, Sha toxins deepen, and the momentum becomes unstoppable, leading to difficult-to-cure complicated syndromes.
Case Record:
Zhang Dao'an repeatedly suffered from hematemesis, persistent fever, unceasing pain in the left hemibody, and difficulty walking. Upon consultation, I initially did not recognize it as a Sha syndrome. After carefully analyzing discrepancies between the pulse and symptoms, I identified Sha veins and punctured them. He took two doses of a decoction containing Tao Ren (Peach Kernel), Ze Lan (Lycopus Herb), Du Huo (Angelica Pubescens Root), and Wu Yao (Lindera Fruit), taken warm. Both hematemesis and pain were cured, with no recurrence.
Sheng Chengnian experienced morning chills and night fevers, and shortness of breath for half a year. Medication was ineffective, and right-sided hemibody pain worsened, preventing flexion and extension. He coughed up phlegm, had reduced appetite, and developed a deficiency syndrome resembling consumptive disease. He rowed a boat to invite me. His pulse was neither wiry nor rapid, but faint and fine, with occasional intermissions, indicating a mismatch between pulse and symptoms. Identifying Sha veins, I punctured more than twenty points. He took two doses of a decoction containing Jiang Huang (Turmeric Rhizome), Xuan Fu Hua (Inula Flower), Dan Shen (Salvia Miltiorrhiza Root), Ju Hong (Aged Tangerine Peel), Chi Shao (Red Peony Root), Yuan Hu Suo (Corydalis Rhizome), Ze Lan, Shan Zha (Hawthorn Fruit), Jiao Ci (Gleditsia Spine), and Chuan Shan Jia (Pangolin Scales), taken warm. Pain and phlegm were eliminated. Later, he took Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) in the morning and Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi) in the evening. The morning chills and night fevers completely resolved.