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Although Sha disease (Sha syndrome) begins abruptly, it does not necessarily present with heaviness of the body. If caused by obstruction from ingested heat-toxin, the entire body becomes heavy and painful, making turning over impossible. After bloodletting (Fangsha), it is urgent to eliminate stasis and detoxify; if left untreated for a long time, it becomes difficult to cure, and if bloodletting is ineffective, death ensues (referencing *Pao San, Juan Si*).

One person suffered slight abdominal pain in the twelfth lunar month, vomiting sour fluid. After drinking ginger decoction, the pain intensified, accompanied by distension, heaviness, and inability to turn over. The right pulse was hidden (Fu). Following bloodletting, Formula Pao 3 was used, reducing the Sha symptoms. A second bloodletting followed by administration of Formula Pao 4 led to recovery.

When Sha toxin rushes to the heart and chest, it causes mental restlessness or lethargy. These are all cases of slow-onset Sha. If mistakenly treated as simple mental restlessness or lethargy, the condition worsens day by day. Ingestion of hot substances will inevitably lead to increasing danger, eventually becoming an incurable disease. The treatment method: primarily rely on pricking to bleed; recovery can occur without medication.

A emaciated individual habitually suffered from Sha attacks, occurring several times a month. Upon attack, the face turned dark blue like indigo, and the entire body's green veins swelled up like chopsticks. Pain attacked from the lower abdomen up to the chest and hypochondrium, causing extreme fatigue and inability to bear upright posture. Previously treated as deficiency consumption with warming and tonifying methods, the exhaustion became more severe. Needling Quchi (LI11) and Weizhong (BL40) released dark blood like a stream, providing slight relief. Then, Di Sha Wan (Detoxifying Sha Pill) was advanced with hot wine, yielding immediate effect. Subsequent continuous intake of several doses completely eradicated the root cause.

Summer-heat and epidemic toxins attacking the interior result in phlegm-wheezing and blood stasis, leading to stupor and unconsciousness. If the primordial Qi is substantial and internal organs resist evil, the pathogen scatters into the muscles, manifesting as swelling and distension. Mistakenly drinking hot soup causes great harm. This is concealed Sha, which should be distinguished by identifying anomalies in the pulse.

A young woman had swelling in both hands and feet, spreading towards the abdomen. All six pulses were wiry, thin, deep, and slow, indicating a complication of slow-onset Sha. Due to refusal to undergo bloodletting, the swelling worsened after several days. Reluctantly undergoing bloodletting at over twenty sites released purple-black blood. Shi Shi Er Fang (Shi's Second Formula) was used, combined with herbs to dissipate Sha, detoxify, resolve stasis, and regulate Qi. Because the Sha condition had lingered for a long time, it took over ten prescriptions before the swelling subsided.

A maid suffered from chronic sores for a long time, with an abdomen distended like drum-tympany and swollen hands and feet. The left pulse was slightly rapid, while the right pulse exhibited intermittent skipping. If swelling were caused by internal invasion of sore-toxin, the pulse would necessarily be surging, rapid, and forceful. Since the pulse and symptoms did not match, this was harm caused by slow-onset Sha. Indeed, there were green veins in the popliteal fossa. Five needles were inserted, but she did not recover. Another ten-plus needles were inserted into the fingertips. Shi Shi Er Fang (Shi's Second Formula) combined with Formula Pao 4 were administered. After five doses, she returned to normal.