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In the mountains and by the water, there are *Shashi* (sand lice), which are extremely fine and invisible to the naked eye. When people enter the water to bathe or draw water for washing, these insects attach to the body; walking through grass on rainy days also causes them to adhere to humans, drilling into the skin. The diagnostic method is as follows: at the onset, a red spot appears on the skin, the size of a small bean, millet, or grain of sorghum. Rubbing the red area with fingers causes pain like needle pricks. After three days, stiffness and pain occur in all joints, accompanied by aversion to cold and fever, and sores develop on the red spots. As the insect gradually penetrates to the bone, it becomes fatal.

After bathing in mountain streams, when wiping the body with a towel, one may hear a rustling sound and feel prickles like bristles. Carefully inspecting the affected area allows one to pick out the insect with a bamboo pin. If the insect has penetrated deeply, use a needle to extract it; like *Jiechong* (scabies mites), it can only be seen moving when held against the light on the fingernail. If it cannot be picked out, apply moxibustion (Moxibustion) for twenty-one moxa cones (3 × 7) on the lesion; the insect will die, and the disease will be cured. If there are only two or three lesions, they are not harmful; but if there are many, they cannot all be treated by picking and moxibustion. If dizziness persists after treatment, the insect has penetrated deeply. One should follow local customs to expel it using specific methods and bathe in various medicinal decoctions, consuming one or two sheng per session, until the insect is completely expelled.

The condition should resolve within seven days; otherwise, flying gu (flying parasites) will come, attack, and devour the heart, leading to death. These flying gu are white, the size of a leek leaf, and four to five cun long. Initially attaching to the abdomen and flanks, they cause swelling and pain like needle pricks. Immediately break open a chicken and cover the wound; the insects will crawl onto the chicken. Eat the chicken meat, repeating this three or four times until all insects are removed. Simultaneously administer Musk (Moschus) and Rhinoceros Horn (Rhinocerotis Cornu) to protect the internal organs. This treatment can cure the disease. Do not consider it a minor illness and delay treatment, as it can be fatal.

Locals call this disease "Hu Sha" (Wu dialect pronunciation). It means this insect can summon sand lice into the human body. Once infected, returning home, one should fumigate the entire body with fire, causing the insect to fall off automatically.

From Sanwu eastward and southward, in mountainous counties and towns with valleys and streams, there is a disease called *Shuidu* (water toxicity), occurring frequently in spring and autumn. Also known as *Zhongshui*, *Zhongxi*, *Zhongsai*, *Shuizhongbing*, or *Xiwen*. Currently, cases of *Zhongxi* are generally called *Xibing* because their symptoms resemble those of *Shegong* (archer bug). However, they differ: *Shegong* presents with sores, while *Xibing* does not.

Initial symptoms include aversion to cold, slight headache, orbital pain, inner restlessness and vexation, trembling of the four limbs, stiffness of the waist, back, and joints, knee pain, burning heat sensation, lethargy, worsening in the evening compared to morning, and coldness of the finger tips extending to the elbows and knees. After two or three days, new insects emerge, devouring the lower orifices. Sores appear inside the anus, without itching or pain, going unnoticed until visual inspection reveals them. If not treated immediately, pus and ulceration occur in the lower region after six or seven days. The insects ascend to devour the five zang organs, causing intense heat, vexation, and toxic sensations, with uncontrollable diarrhea. Death occurs in eight or nine days, or according to another account, ten to twelve days.

*Shuidu* is classified into Yin and Yang. Upon detection, examine the lower region immediately. If the sore is bright red like cut meat, it is *Yangdu* (Yang toxicity), which is most urgent. If the sore resembles the teeth of an snake (*Li*), it is *Yindu* (Yin toxicity), which is slightly less acute. Both are fatal within twenty days. Another view states that *Shuidu* has male and female types. A pulse that is large, rapid, and forceful indicates *Yang* (male *Xi*), which is easier to treat and suitable for inducing sweating and bathing. A pulse that is deep, fine, and slow indicates *Yin* (female *Xi*), which is difficult to treat.

To confirm *Zhongshui*, check if the finger tips are cold. Coldness extending one cun, to the wrist, or to the elbows and knees indicates severity. Coldness up to two cun is mild; reaching the elbows and knees is severe. Another method involves boiling several dou of water, adding four or five sheng of crushed garlic, monitoring the temperature to ensure it is not too hot, straining the residue, and bathing in the warm solution. Appearance of red spots on the body confirms the diagnosis. Another sign is a black dot-like sore surrounded by redness, resembling a chicken eye. Lesions in high places are harder to treat; those in low places are easier. My diagnosis aligns with this: if one feels chills, fever, headache, stiffness of the waist and back, cold hands and feet, yawning, sleepiness, and symptom fluctuation (better in morning, worse in evening), it can be judged as *Xibing* without needing garlic baths or examining lower sores.

In critical stages, this condition does not always present with profuse diarrhea or bleeding from the gums. Only when the heat pathogen is fierce do patients experience mental confusion, refusal to eat, and delirious speech. Some pass blood clots resembling rotten liver. Death occurs between ten and twenty days. The outcome is unpredictable; death results from insects devouring the five zang organs and damaging the anus due to lack of timely treatment.

It is also said that if *Xibing* does not subside, flying gu continue to enter the body, causing protrusions in the skin, abdomen, or flanks, with burning and stabbing pain. Covering the area with broken chicken skin attracts white insects resembling maggots, four to seven cun long, in varying numbers (three to thirty-eight). This corresponds to the description of insects devouring the five zang organs and lower regions. Emergency treatment for *Zhongxi* and *Shegong* aims for recovery within seven days; otherwise, flying gu enter the body, devour the five zang organs, and cause death. Local preventive methods are similar to those for *Shegong*.