痧症轻者，脉固如常，重者，脉必变异。若医家但识其脉，不识痧筋，势必据脉用药，而脉已多变，则实病变虚，
虚病变实，诚不可恃。曷若取脉症不合者，认痧筋有无，有则据痧用药，无则据脉用药，乃无差误。故余谓医家当识痧
筋。
──在头顶心百会穴。
──在印堂。
──在两太阳穴。
──在喉中两傍。
──在舌下两傍。
──在双乳。
──在两手十指头。
──在两臂弯。
──在两足十趾头。
──在两腿弯。
凡痧有青筋紫筋，或现于数处，或现于一处，必须用针刺之，先去其毒血，然后据痧用药。治其脾、肝、肾及肠、
胃经络痧，万不失一。
尝见人犯痧症，延一放痧者放之，以为放痧之法，止于此矣。不知放痧之人，固有善于彼者，不善于此，亦有善于
此者，不善于彼。使病家延一放痧之人，略知一二，未识其全，则血肉之痧，有放而未尽者矣。苟医者不识痧筋，见
其痧之已放，而孟浪用药，药不能治及于血肉之分；或痧症复发，痧毒肆攻，而轻者变重。病家不明其故，归咎于医，
医者之名，由兹而损，岂反不为放痧之人所误乎。故医家识痧，必须令其放尽。
痧毒所发，得善放者放之，未有不可尽，而亦有不尽者，何也？盖痧者，热毒也。或误饮热汤，则青筋、紫筋，反
隐而不现。即略现青筋、紫筋而放之，其毒血亦不流；并刮痧亦不出，热汤为之害也。此当急饮冷水以解之，然后可再
放而血流；再刮而痧出。或又有痧毒方发，而为食物积滞所阻，食积与痧毒凝结于中，即放之不尽，刮之不出者，食物
积滞为之害也。此当先消食积，而再放刮。或又有痧毒瘀滞，热极血凝，而瘀血不流，阻于胸腹，故放之、刮之，有不
尽者，此当先散瘀血而后放刮。或又痧毒方发，而兼遇恼怒气逆，怒气伤肝，则愈作胀，故痧气益盛，而放刮俱难尽，
此又当先用破气之药以顺之，而再放刮。如此则痧毒皆可渐消也。
痧症轻的，脉象本来和平常一样；重的，脉象必然发生变异。如果医生只认识脉象，不认识痧筋，势必依据脉象来用药，而脉象已经多变，就会导致实证变成虚证，虚证变成实证，这确实不可依靠。不如取那些脉象与症状不相符合的情况，辨别痧筋有无，有则依据痧症用药，无则依据脉象用药，这样就没有差错。所以我称医生应当认识痧筋。
──在头顶心的百会穴处。
──在印堂处。
──在两太阳穴处。
──在喉咙两侧。
──在舌下两侧。
──在双乳处。
──在两手十指头处。
──在两臂弯处。
──在两足十趾头处。
──在两腿弯处。
凡是痧症有青筋紫筋显现，或者出现在几处，或者出现在一处，必须用针刺破它，先去除毒血，然后依据痧症用药。治疗脾、肝、肾以及肠、胃经络的痧症，万无一失。
曾经见到有人患痧症，请一个放痧的人来放痧，以为放痧的方法仅仅到此为止了。不知道放痧的人，有的擅长这里不擅长那里，也有擅长这里不擅长那里的。如果病人家属请一个放痧的人，稍微懂一点皮毛，却不识全貌，那么血肉中的痧，就有放不尽的时候。假如医生不认识痧筋，看到痧已经放了，就鲁莽地用药，药物不能治及到血肉的部位；或者痧症复发，痧毒肆意攻冲，轻症变成重症。病人家属不明白其中的缘故，归咎于医生，医生的名声，由此受损，这岂不是反而被放痧的人所误导吗？所以医生认识痧症，必须令其放尽。
痧毒发作，遇到善于放痧的人来放，没有不能放尽的，但也有放不尽的，为什么呢？大概痧是热毒。如果误饮热汤，青筋、紫筋反而隐藏不显现。即使略微显现青筋、紫筋而进行放痧，其毒血也不流出；并且刮痧也刮不出痧，这是热汤造成的危害。这应当急饮冷水来解除它，然后可以再放痧而血流出来；再刮痧而痧出。或者又有痧毒刚刚发作，而被食物积滞所阻碍，食积与痧毒凝结在中间，即使放痧也放不尽，刮痧也刮不出，这是食物积滞造成的危害。这应当先消除食积，然后再放痧刮痧。或者又有痧毒瘀滞，热极导致血凝，而瘀血不流动，阻塞在胸腹，所以放痧、刮痧，有放不尽刮不出的情况，这应当先散瘀血而后放痧刮痧。或者又痧毒刚刚发作，而兼遇恼怒导致气逆，怒气伤肝，则胀满更甚，所以痧气更加旺盛，而放痧刮痧都难以放尽刮尽，这又应当先用破气的药物来顺气，然后再放痧刮痧。像这样，痧毒都可以逐渐消除。
For mild cases of Sha (Sha disease, a condition characterized by heat-toxin accumulation manifesting as subcutaneous vascular changes), the pulse remains normal; for severe cases, the pulse inevitably undergoes alteration. If physicians only recognize the pulse but fail to identify Sha veins (subcutaneous distended and discolored veins indicative of Sha toxin), they will inevitably prescribe medication based solely on the pulse. Since the pulse has already changed significantly, this may lead to misinterpreting excess patterns as deficiency patterns, or deficiency patterns as excess patterns, which is indeed unreliable. It is better to examine cases where the pulse and symptoms are inconsistent, determine the presence or absence of Sha veins, and if present, prescribe treatment according to Sha pathology; if absent, prescribe according to the pulse. This approach ensures no errors. Therefore, I assert that physicians must learn to identify Sha veins.
── Located at Baihui (GV20, Hundred Convergences), situated at the vertex of the head.
── Located at Yintang (Ex-HN3, Hall of Impression), between the eyebrows.
── Located at both Taiyang (EX-HN5, Temporal) acupoints.
── Located on both sides of the throat.
── Located on both sides under the tongue.
── Located on both breasts.
── Located at the tips of the ten fingers of both hands.
── Located in both antecubital fossae (inner elbow creases).
── Located at the tips of the ten toes of both feet.
── Located in both popliteal fossae (back of the knee creases).
Whenever Sha presents with cyanotic (blue-green) or purplish veins appearing either in multiple locations or a single location, one must puncture them with needles to first drain the toxic blood, and then administer medication tailored to Sha pathology. Treating Sha affecting the meridians of the Spleen, Liver, Kidney, Intestines, and Stomach yields infallible results.
I have observed patients suffering from Sha who employ a practitioner specialized in "Sha release" (phlebotomy/puncturing to release Sha toxin), believing that this method constitutes the entirety of Sha treatment. However, practitioners skilled in Sha release vary: some excel in certain areas but not others, and vice versa. If a patient’s family hires a Sha release practitioner who knows only rudimentary techniques without mastering the full scope, the Sha toxins residing in flesh and blood may not be fully released. If a physician fails to recognize Sha veins and, seeing that Sha has been released, rashly prescribes medication, the drugs may fail to reach the level of flesh and blood. Alternatively, if Sha recurs and the Sha toxin attacks unchecked, mild cases may deteriorate into severe ones. Unaware of the root cause, families may blame the physician, damaging the physician’s reputation. Would this not be a detriment caused by relying solely on the Sha release practitioner? Thus, when physicians diagnose Sha, they must ensure it is completely released.
When Sha toxin erupts, even with skilled release, there are instances where it cannot be fully eliminated, and others where it is incomplete. Why? Sha is essentially heat-toxin. If hot soup is mistakenly ingested, the cyanotic and purplish veins may retract and become invisible. Even if these veins appear slightly and are punctured, the toxic blood may not flow; scraping may also fail to bring out Sha. This hindrance is caused by the hot soup. In such cases, one should urgently drink cold water to counteract the heat, after which Sha release can proceed to allow blood flow, and scraping can successfully extract Sha. Alternatively, if Sha toxin is just emerging but is obstructed by food stagnation, causing food accumulation and Sha toxin to coagulate internally, release and scraping may prove ineffective due to the obstruction of food stagnation. Here, one must first resolve the food stagnation before proceeding with Sha release and scraping. Or, if Sha toxin causes stasis and extreme heat leads to blood coagulation, blocking the chest and abdomen, resulting in incomplete release and scraping, one must first dissipate the blood stasis before proceeding. Or again, if Sha toxin is emerging concurrently with emotional anger causing Qi rebellion, anger injuring the Liver, leading to increased distension and exacerbating Sha Qi, making release and scraping difficult to complete, one must first use herbs that break up Qi stagnation to regulate Qi flow, before proceeding with Sha release and scraping. By following these methods, Sha toxin can be gradually resolved.