痧毒攻胃，故蛔死入于大肠，与宿粪相结，腹中大痛，是为蛔结。
治验∶
一朱子佩女，痧发痛极，头汗如雨。延余诊之，脉芤而洪实，放痧不出，刮痧不起。用细辛大黄丸微冷服，又用荆
芥银花汤稍冷服。又三日，痧筋乃现，放之。服药如前，腹痛不止，至十九日，日用药加大黄，大便下死蛔三条，结
粪亦下，痛尤不止，又现痧筋，放之，服前药，乃愈。
痧毒中于脏腑之气闭塞不通，上攻三阳颠顶，故痛入脑髓，发晕沉重，不省人事，名真头痛。朝发夕死，夕发旦死，
急刺破巅顶，出毒血以泄其气，药惟破其毒瓦斯，清其脏腑为主。痧毒中于脏腑之血，壅瘀不流，上冲三阳头面肌肉，故
肌肉肿胀，目闭耳塞，心胸烦闷。急刺破巅顶及诸青筋，出毒血。药宜清其血分，破其壅阻为要。
治验∶
一张显如，头痛发晕沉重，六脉俱伏，刺巅顶一针，余痧筋俱刺，少苏。复诊其脉，沉实而上鱼际，用清气化痰饮，
冷服而安。
一汪路真内室，头面红肿，发热头痛，心胸迷闷。诊脉，芤而疾。刺左腿弯三针，血流如注。冷服红花膏子半杯，
用蒲黄饮三剂而痊。
痧毒冲心，属之于气，则时痛时止，痰涎壅盛，昏迷烦闷，此其候也，治宜刺手臂，服顺气之剂为主。痧毒攻心，
属之于血，则大痛不已，昏沉不醒，此其候也。治宜刺腿弯，服活血之剂为主。迟则难救。
治验∶
一郑延旦次子，心中暴痛，口吐痰涎，迷闷不能出声。延余，两寸沉而伏，关尺洪而紧，刺痧筋二十针，用乌药顺
气汤，冷冻饮料四剂而安。
一严瑞宇三女，饭时心中暴痛，昏沉不醒。日暮延余，六脉已绝，辞之，次日而殂。
Sha toxin attacks the stomach, causing roundworms to die and enter the large intestine, where they bind with retained feces, resulting in severe abdominal pain; this is termed "Roundworm Obstruction" (Hui Jie).
Clinical Case:
A daughter of Zhu Ziping suffered from an outbreak of Sha disease with extreme pain and profuse sweating on the head. Upon my examination, her pulse was Kou (hollow) yet Hong (surging) and solid. Bloodletting failed to expel the pathogen, and Gua Sha (scraping therapy) yielded no results. I prescribed Xixin Dahuang Wan (Asarum and Rhubarb Pill) to be taken slightly cold, followed by Jingjie Yinhua Tang (Schizonepeta and Honeysuckle Decoction) also taken slightly cold. Three days later, Sha Jin (visible subcutaneous veins) appeared, and bloodletting was performed. Medication continued as before, but abdominal pain persisted. By the nineteenth day, the dosage of Dahuang (Rhubarb Root and Rhizome) was increased daily. Three dead roundworms and bound feces were passed in the stool, yet the pain remained unrelieved. Sha Jin appeared again, and bloodletting was repeated. After taking the previous medication, she recovered.
When Sha toxin invades the Qi of the Zang-Fu organs, it causes obstruction and blockage, attacking upward to the vertex (Dian Ding), which belongs to the Three Yang meridians. Consequently, pain penetrates into the brain marrow, accompanied by dizziness, heaviness, and loss of consciousness; this is named "True Headache" (Zhen Tou Tong). If onset occurs in the morning, death follows by evening; if in the evening, death follows by morning. Emergency treatment requires puncturing the vertex to release toxic blood and vent the pathogenic Qi. Pharmacological treatment should focus on breaking down toxic vapors and clearing the Zang-Fu organs. When Sha toxin invades the Blood of the Zang-Fu organs, it causes stagnation and瘀 (stasis), preventing flow, and rushes upward to the muscles of the head and face along the Three Yang meridians. This results in muscle swelling, closed eyes, blocked ears, and chest oppression. Emergency treatment involves puncturing the vertex and various blue veins (Qing Jin) to release toxic blood. Pharmacological treatment should prioritize clearing the Blood level and breaking down stagnation.
Clinical Case:
Zhang Xianru presented with headache, dizziness, and a sense of heaviness; all six pulses were Fu (deep and hidden). One needle was inserted at the vertex, and all visible Sha Jin were pricked. The patient showed slight improvement. On follow-up, the pulse was Chen (deep) and Shi (solid), reaching up to the Yu Ji area. Qingqi Huatan Yin (Clear Qi and Transform Phlegm Drink) was administered cold, bringing stability.
The wife of Wang Luzhen exhibited redness and swelling of the head and face, fever, headache, and mental confusion/chest oppression. Her pulse was Kou and Ji (rapid). Three needles were inserted at the popliteal fossa of the left leg, resulting in profuse bleeding. Half a cup of Honghua Gaozi (Safflower Paste) was taken cold, followed by three doses of Puhuang Yin (Cattail Pollen Drink), leading to recovery.
When Sha toxin rushes to the Heart and affects the Qi level, symptoms include intermittent pain, abundant phlegm-saliva, coma, and irritability. Treatment should primarily involve needling the arms and administering Qi-regulating formulas. When Sha toxin attacks the Heart and affects the Blood level, symptoms include unremitting severe pain, stupor, and unconsciousness. Treatment should primarily involve needling the popliteal fossa and administering Blood-invigorating formulas. Delayed treatment makes rescue difficult.
Clinical Case:
The second son of Zheng Yandan experienced sudden severe epigastric/cardiac pain, vomiting of phlegm-saliva, and inability to speak due to confusion. Examination revealed that the Cun positions of both wrists were Chen and Fu, while the Guan and Chi positions were Hong and Jin. Twenty needles were inserted into Sha Jin. Wuyao Shunqi Tang (Lindera Regulating Qi Decoction) was administered as a chilled drink for four doses, resulting in stabilization.
The third daughter of Yan Ruiyu experienced sudden severe cardiac pain during meals, followed by stupor and unconsciousness. She was consulted in the evening, but all six pulses had vanished. I declined treatment, and she passed away the following day.