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Slow Sha (Sha syndrome with slow onset) has a protracted course, the pathogen enters the Blood aspect, has not yet attacked the Heart, but remains stagnant in the meridians. It manifests as pain or numbness on either the left or right side of the body, eventually leading to hemiplegia. When blue-purple "Sha veins" are visible under the skin, they should be pricked to bleed, and herbal formulas used to dissipate toxins, invigorate blood, and resolve stasis (using Tu Liu Fang).

A patient experienced morning chills and evening fevers, with shortness of breath persisting for half a year. Medication was ineffective. Subsequently, pain in the right half of the body developed, preventing free flexion and extension, accompanied by phlegm-cough and reduced appetite, evolving into a deficiency-consumption weakness. However, the pulse did not match the symptoms. Examination revealed Sha veins; after pricking more than twenty needles, two doses of Tu Liu Fang were administered. The pain and phlegm expectoration were completely relieved. Later, Liu Wei Wan (Six-Ingredient Pill with Rehmannia) was taken in the morning, and Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) in the evening, resolving the alternating chills and fever.

The patient previously suffered from Gu Zhang (Abdominal Distension Syndrome resembling drum), but suddenly contracted Sha syndrome, exacerbating the abdominal distension. Sha syndrome requires early treatment.

A patient presented with protruding umbilicus and cyanotic subcutaneous veins, with the epigastric region flattening out, indicating Blood Gu Zhang. The fingertips were black, confirming concurrent Sha syndrome. More than twenty needles were pricked, releasing blood from the legs and arms, providing slight relief. After taking Si San Fang, the cyanotic veins below the umbilicus gradually receded. Subsequently, drugs for treating Gu Zhang were used to guide out noxious fluids, and Zhi Gu Xiang Yuan Wan (Efficacious Drum-Regulating Citron Pill) was taken daily. Over two months, the Gu Zhang symptoms completely resolved.

Slow Sha lingering for a long time stagnates in the skin, muscles, intestines, and stomach. If not treated early, it will transform into true Gu Zhang.

A patient suffered from acute anger-induced abdominal fullness and bloating, with protruding cyanotic veins below the umbilicus and a flattened epigastric region. This is Slow Sha transforming into Gu Zhang. More than twenty needles were pricked, releasing toxic blood. The color of the umbilical veins lightened, and the abdomen felt relaxed. Shi Er Fang was administered, and the abdominal distension gradually subsided.

Previously suffering from Phlegm-Fire cough disease, the patient suddenly experienced severe asthma-like wheezing (sawing sound), or profuse oily sweat on the head, and indescribable irritability and oppression. Although this is a critical Phlegm-Fire condition, if concurrently infected with seasonal epidemic turbid pathogens causing sudden severity, one must examine the pulse and symptoms. First, clear the Sha toxin, then treat the Phlegm, and gradually tonify Qi and Blood.

An elderly woman, chronically weak due to Phlegm-Fire, suddenly developed phlegm obstruction and severe sawing-like asthma. Her six pulses were irregular, resembling the pecking of a sparrow. This indicates concurrent Sha syndrome, with room for recovery. Evil blood was pricked out. Formulas to dissipate Sha, digest food, resolve phlegm, and regulate Qi were used, along with Tu Wu Fang. Symptoms gradually stabilized. She later recovered after massive tonification of Qi and Blood.

Patients with prior Consumption-Weakness may experience occasional hemoptysis or mild dry cough, bright red malar flush and lips, or unremitting bone-steaming fever. Once infected with seasonal epidemic turbid pathogens, they inevitably develop concurrent Sha syndrome, manifesting as phlegm-asthma, throat obstruction sensation, or abdominal distension and irritability. These symptoms feel heavier than usual deficiencies. Treatment should primarily focus on resolving Sha; only after Sha is fully cleared should the underlying Consumption-Weakness be treated.

A patient with Consumption-Weakness and hemoptysis presented with a surging, forceful pulse. Physicians considered this pulse contraindicated for this condition. Observing the violent and stagnant nature of the illness, I noted cyanotic veins in the popliteal fossa. Sha release was performed first. The pulse became harmonious and symptoms calmed. Subsequently, herbs to dissipate Sha, digest food, and remove accumulation were used. Diet gradually improved. Later, Liu Wei Wan and Shi Quan Tang (Ten Complete Decoction) were administered, curing the Consumption-Weakness. This is because previous pathogens were expelled via the Sha mechanism, allowing tonification to be effective.

A female patient with hemoptysis and dry cough had experienced cool days and hot nights for a long time. Due to anger, she suddenly developed afternoon fever, abdominal distension and oppression, phlegm-asthma, and coma. The Left Guan pulse was slightly slack, while other pulses were irregular upon palpation. Anger typically causes a forceful Left Guan pulse; Consumption-Weakness usually presents with wiry and rapid pulses. Internal blood stasis would typically show a knotted pulse at Cun and Guan. Since the pulse does not match the symptoms, concurrent Sha syndrome is evident. Sha veins were pricked, and Shi Er Fang was doubled and drunk as a clear tea. Consciousness cleared, and asthma ceased, though the Consumption-Weakness remained unresolved.