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At the initial stage, there is falling, lockjaw (trismus), unconsciousness, chest pain with the body arching forward, nasal flaring, and tinnitus. It is urgent to release a large amount of toxic blood, using Jinqi Wan (Golden Seven Pill), Shiyi Wan (Stone One Pill), and Zhuwuwu (Bamboo Five).

There is acute pain in the lower abdomen, retraction of the kidneys (testes), dark complexion, stagnant qi, and cold sweating. This is named Tuoyang syndrome (Yang Collapse), resembling Sha disease. Use three stalks of scallion white with roots, mash them, add four bowls of wine, boil down to two bowls, and divide into three doses. Additionally, apply hot fried salt to moxibustion point Qihai (CV6) below the navel until warmth is felt.

Abdominal distension extends to the back or waist and hips, feeling like stabbing pain from thorns. Use mud from the bottom of a liquor jar, grind it fine and sieve it, mix with liquor to form a ball, and roll/rub it over the painful area. Fine white hairs will immediately adhere to the ball.

Abdominal distension and whole-body stiff pain. For these two symptoms, use a small needle to pierce the skin on the chest or lower back to pick out tendon fibers; this will heal spontaneously. Only examine the painful areas; if fine hairs are gathered, that is the sign. Medicinally, use Disha Wan (Sha-Cleansing Pill) and Puji Xiaodu Yin (Universal Benefit Detoxification Decoction).
One person was stooped and unable to walk forward, claiming to have been struck by a ghost's arrow. Yaoqiao examined the painful area, threaded red and green silk through a small needle, passed it through the skin for about two or three fen, then pulled it off abruptly. There was no bleeding or visible hairy protrusion from the puncture. After picking three or four needles, his walking speed returned to normal.

If Sha toxin does not attack internally, it ulcerates externally, causing swelling and toxicity. Besides this, there are cases manifesting as purple hemorrhage, which is also an atypical symptom (Zhu Liu).
A foster daughter had swelling in her hands, feet, and lower half of the body, with abdominal distension. Purple hemorrhagic spots appeared on both legs and feet, densely distributed like longan flesh. Everyone said it was leprosy, and medication worsened the condition. When Sha veins were observed in the popliteal fossae, five needles were used for bloodletting, plus more than ten on the fingers, completely removing the toxic blood. The pulse was harmonious. Two doses of the Zhu Liu Formula were administered, leading to scabbing and recovery.

One person suffered from severe leprosy, with loss of eyebrows and hair, disfigurement, and contracture of limbs. An elderly man performed bloodletting for Sha three times, stating: "This is Sha-Feng disease." He transmitted a formula saying: "Take it daily, and you will gradually recover" (The formula is attached after Zhu Liu).

Abdominal distension, fullness, loss of appetite, severe pain in both hypochondria, and expectoration of bloody sputum resembling watermelon pulp juice. Use Xunlu Xiang (Frankincense/Lingling Fragrance) as the chief herb, assisted by Jinu (Rhizoma Polygonati) and Qiancao (Radix Rubiae) etc., to treat it; recovery follows immediately (Xunlu Xiang refers to Lingling Xiang produced in Danyang).
Xiangwen heard that the capital once suffered from a seasonal epidemic where anyone vomiting pale red saliva died within a few days. A spirit medium transmitted a prescription, known only to be mixed with pig bile to make tablets, each tablet capable of saving three people. Coincidentally, a physician used pig bile as a guiding drug, and the patient recovered instantly. It was used repeatedly with success. This case is similar to the current one, recorded here.