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Those who experience vomiting and diarrhea first, followed by severe cramping pain in the heart and abdomen, mostly suffer from Sha (Sha disease) triggered by foul qi. Those who experience severe cramping pain in the heart and abdomen first, followed by vomiting and diarrhea, mostly suffer from Sha triggered by summer-heat qi. Dizziness and stifling sensation in the chest and heart, with sticky and coagulated phlegm-saliva, mostly stem from internal injury by latent heat. Generalized swelling and pain of the whole body, inability to move the four limbs, stiff tongue and inability to speak, mostly arise when cold-damp water qi passes through, stagnating and transforming into fire-toxin.

Sha is a pestilential qi. When it enters the Qi level, it causes swelling and distension; when it enters the Blood level, it forms accumulation and stasis. If encountering food retention or phlegm-fire, it obstructs Qi flow and stagnates blood. It is most taboo to consume hot soup or hot wine. Regardless of whether the patient's constitution is deficient or excess, it should always be treated as an excess condition. There is absolutely no method of tonification. Medications must be harsh and reducing; the pathogen will naturally withstand the medicinal force. Stop medication once the disease is addressed (Zhong Bing).

Differentiation by Meridians, Chapter 3

Pain and distending pain in the lower back, back, and vertex, radiating to Fengfu (DU16), unbearable due to severity, indicates Sha of the Foot-Taiyang Bladder Meridian. Redness and swelling of both eyes, dry lips, dry nose, and cramping abdominal pain indicate Sha of the Foot-Yangming Stomach Meridian. Swelling of the hypochondrium, pain radiating to both ears, indicates Sha of the Foot-Shaoyang Gallbladder Meridian. Abdominal distension with board-like hardness, inability to flex or extend, weakness in the four limbs, and incessant diarrhea indicate Sha of the Foot-Taiyin Spleen Meridian. Hanging pain in the chest and heart, heavy body difficult to move, swelling and distension, indicate Sha of the Foot-Jueyin Liver Meridian. Pain radiating to the waist and kidneys (including external genitals), hard distension in the lower abdomen, indicates Sha of the Foot-Shaoyin Kidney Meridian. Cough with hoarse voice, rebellious Qi causing choking, indicates Sha of the Hand-Taiyin Lung Meridian. Numbness and pain in half of the body, inability to flex or extend the left foot, indicates Sha of the Hand-Taiyang Small Intestine Meridian. Distending pain in half of the body, inability to flex or extend the trunk, inability to flex or extend the right foot, indicates Sha of the Hand-Yangming Large Intestine Meridian. Severe illness with lethargy/coma, or delirium and loss of consciousness, indicates Sha of the Hand-Shaoyin Heart Meridian. Alternating between wakefulness and sleep, or speaking alone in one or two sentences, indicates Sha of the Hand-Jueyin Pericardium Meridian. Heat and distension in the chest and abdomen, removing clothes and blankets, extreme dryness, indicates Sha of the Hand-Shaoyang Sanjiao Meridian.

Note: The symptoms presented by diseases of the twelve meridians should be treated according to the specific manifestations. Channel-directing herbs are indispensable. The pathways of the hand and foot meridians are listed below for reference: The Hand-Shaoyin Heart Meridian originates at the ulnar end of the little finger. The Hand-Taiyang Small Intestine Meridian originates at the radial end of the little finger and ascends along the lateral side. The Hand-Shaoyang Sanjiao Meridian originates at the tip of the ring finger. The Hand-Jueyin Pericardium Meridian, also known as the Hand-Zhujin, emerges from the tip of the middle finger. The Hand-Yangming Large Intestine Meridian originates at the tip of the index finger. The Hand-Taiyin Lung Meridian emerges from the tip of the thumb. The Foot-Jueyin Liver Meridian originates above the hair on the big toe. The Foot-Taiyin Spleen Meridian originates at the tip of the big toe. The Foot-Yangming Stomach Meridian originates between the outer sides of the second toe. Another branch enters the tip of the big toe, and another branch enters the outer side of the middle toe. The Foot-Shaoyang Gallbladder Meridian originates between the fourth toes. The Foot-Taiyang Bladder Meridian originates at the lateral end of the little toe. The Foot-Shaoyin Kidney Meridian originates below the little toe. Reading this facilitates acupuncture treatment.

For Bladder and Small Intestine: Platycodon Root (Jiegeng), Notopterygium Rhizome (Qianghuo), and a few Pinellia Tuber (Banxia) [Note: Text says "Baixu" likely referring to specific preparation or typo for Banxia/Baizhi context, but literal translation used]. For Stomach and Large Intestine: Kudzu Root (Gegen), Magnolia Bark (Houpo), and Angelica Dahurica (Baizhi) in small amounts. For Spleen: Peony Root (Shaoyao). For Kidney: Salt and Wine together.

[Table 1]
[Table 2]

For Gallbladder, Liver, Sanjiao, and Pericardium: Bupleurum Root (Chaihu), Moutan Cortex (Danpi), and Qingdai. Use Chuanxiong Rhizome (Chuanxiong) sparingly, heed this warning again. For Lung: Scallion Stem (Congbai), Platycodon Root (Jiegeng), Angelica Dahurica (Baizhi). For Heart: Only Acrid/Warm herbs.

Qianghuo, Chuanxiong, and Baizhi should be used in precious small amounts. Shengma (Cimicifugae Rhizoma) is contraindicated for Stomach, Intestines, Spleen, and Lung. For Kidney, strictly avoid adding Cinnamon Twig (Guizhi).