痧犯太阳则头痛发热。犯少阳则耳旁肿胀，寒热往来，犯阳明则面目如火，但热不寒。
犯太阴则腹痛。犯厥阴则小腹或胸胁痛。犯少阴则腰痛。以上皆身凉。犯肺则咳嗽痰喘微热
，甚则鼻衄。犯心则心痛或心胀，头额冷汗如珠，而身或热或凉。犯膀胱则小便溺血、甚则
身热。犯大肠则痢下脓血，重则呕吐身热。犯肝则沉重不能转侧，晡热内热，甚则吐血。犯
三焦则热毒内攻，上则口渴，下则更结。
凡痧气壅阻发而为热，若误为外感传经热症而发汗温饮，虽慢痧迟缓，亦必变出头汗、
发狂、谵语种种重症。不知外感之脉浮数而紧，热症之脉洪数有力，痧症之脉终有不同，或
有可疑，须看痧筋有无辨之。
痧症身凉而内热者宜攻其里，表实者宜透其肌，用药随时活变，故不主方。
痧感肌表，人不自知。则入半表半里，故胸中作闷，或作呕吐而腹痛生焉。此可粹刮而
愈。不愈用金四、金五方。
痧毒入里，故欲吐不吐，欲泻不泻，冲心则心胸大痛，攻腹则盘肠吊痛，可放痧而愈。
不愈，用丝三、石六方。
痧毒中深，逆攻心膂，立时发晕，气血不流，放亦无紫血，即有亦不多。惟当审脉辨症
，的系风寒暑湿，气血食积痰饮，施治令苏，气血流动，然后扶起放痧。如不醒，择用丝五
、匏一、土五方。如此重症，立时连进汤丸，方能有救。
痧阻于气分宜刮，壅于血分宜放。痛而绞动者，阻于食积之气分也。痛而不移者，壅于
血分而有瘀也。发于头面上部，毒瓦斯上壅也。缠于手足下部，毒瓦斯下注也。上吐下泻，痧气
冲激也。烦闷气胀，痧气壅塞也。恶寒发热，痧气遏于肌表也！胸膈偏痛，毒血滞于经络也
。为肿为胀，食积血瘀结于肠胃也。吐血便血，痧气泛溢而忧溃败也。咳嗽喘急，痧壅气分
而生痰逆也。立时闷绝者，毒血攻心也。手足软而不能运者，毒血注下也。腰胁俱痛者，偏
痛半身者，身重不能转侧者，皆毒壅瘀也。变成肿毒溃烂者，毒血凝滞攻坏肌表也。
Sha toxin invading the Taiyang channel causes headache and fever.
Invading the Shaoyang channel causes swelling beside the ears, alternating chills and fever (Han Re Wang Lai).
Invading the Yangming channel causes the face and eyes to be red like fire, with fever but no aversion to cold.
Invading the Taiyin channel causes abdominal pain.
Invading the Jueyin channel causes pain in the lower abdomen or hypochondrium.
Invading the Shaoyin channel causes lower back pain.
In all the above cases, the body temperature is typically cool.
Invading the Lung causes cough, wheezing with phlegm, and slight fever; in severe cases, epistaxis occurs.
Invading the Heart causes heart pain or chest fullness, cold sweat on the forehead and head dripping like pearls, while the body may be either hot or cool.
Invading the Bladder causes hematuria; in severe cases, the body becomes hot.
Invading the Large Intestine causes dysentery with pus and blood; in severe cases, vomiting and fever occur.
Invading the Liver causes heaviness of the body making turning difficult, afternoon and internal heat; in severe cases, hematemesis occurs.
Invading the Sanjiao causes internal attack by heat toxicity: upward leads to thirst, downward leads to constipation.
Whenever Sha Qi (Sha pathogenic factor) stagnates and obstructs, causing fever, if mistakenly treated as an exogenous transmission heat syndrome and administered diaphoresis or warm drinks, even slow Sha (Man Sha) will inevitably transform into severe conditions such as sweating on the head only, mania, and delirium.
One must know that the pulse of exogenous diseases is floating, rapid, and tight; the pulse of heat syndromes is surging, rapid, and forceful; whereas the pulse of Sha syndromes is fundamentally different. If there is doubt, one must examine the presence of Sha Jin (visible purple-black subcutaneous veins) to distinguish them.
For Sha syndromes presenting with a cool body but internal heat, it is appropriate to purge the interior; for exterior excess (Biao Shi), it is appropriate to vent the muscle layer. Medication should be adapted flexibly according to the situation; therefore, there is no fixed main formula.
When Sha toxin affects the muscle surface, the person is unaware of it. It then enters the half-exterior half-interior region, causing chest stuffiness, possibly accompanied by vomiting and abdominal pain. This can be cured by Gua Sha (scraping therapy). If not cured, use Formula Jin Si or Jin Wu.
When Sha toxin enters the interior, the patient desires to vomit but cannot, desires to defecate but cannot. If it attacks the heart, there is severe chest and heart pain; if it attacks the abdomen, there is colicky intestinal pain. This can be cured by Fang Sha (pricking to bleed). If not cured, use Formula Si San or Shi Liu.
When Sha toxin penetrates deeply and counterattacks the heart and diaphragm, dizziness occurs immediately, and Qi and Blood stagnate. Even after Fang Sha, no purple blood flows out, or very little does. At this point, one must carefully examine the pulse and differentiate symptoms. Confirming it is due to Wind-Cold, Summerheat-Dampness, or stagnation of Qi, Blood, Food, Phlegm, or Fluids, treatment should be applied to restore consciousness. Once Qi and Blood flow freely, then perform Fang Sha. If the patient remains unconscious, select Formula Si Wu, Bao Yi, or Tu Wu. For such severe cases, administering decoctions or pills continuously at once is necessary for rescue.
Sha obstruction in the Qi level is suitable for scraping; stagnation in the Blood level is suitable for pricking/bleeding. Pain that is cramping and moving indicates obstruction in the Qi level due to food stagnation. Pain that is fixed and unmoving indicates stagnation in the Blood level with blood stasis. Manifestations on the head and upper body indicate upward congestion of toxic vapors. Manifestations winding around the hands and feet indicate downward pouring of toxic vapors. Upper vomiting and lower diarrhea indicate agitation by Sha Qi. Irritability, stifling sensation, and distension indicate blockage by Sha Qi. Aversion to cold and fever indicate Sha Qi being constrained at the muscle surface. Unilateral chest and diaphragm pain indicates toxic blood stagnating in the collaterals. Swelling and distension indicate food stagnation and blood stasis knotting in the intestines and stomach. Hematemesis and hematochezia indicate Sha Qi overflowing leading to溃败 (collapse/decay). Cough and急促 wheezing indicate Sha blocking the Qi level generating rebellious phlegm. Sudden stifling and coma indicate toxic blood attacking the heart. Flaccidity and inability to move the limbs indicate toxic blood pouring downward. Pain in both waist and hypochondrium, unilateral pain, or body heaviness preventing turning all indicate toxic congestion and blood stasis. Transformation into swollen toxins and ulceration indicates toxic blood stagnation attacking and damaging the muscle surface.