痧症危急，莫善于先放其痧。乃今更有放痧而血不流者，虽痧筋隐隐，无可如何，故放痧之人往往遇此便为凶。若
余则不然，是其放痧虽血不流，而亦有可救者，即至昏迷不醒，势在临危，若审其无食积、血、痰阻滞于中，用宝花散
冷服，或阴阳水，或泥浆水、或晚蚕沙水、或细辛水、或白沙糖梅水，择一方而用之，俟其稍醒，然后扶起，再行别法
疗治。至如有因血瘀而放之不出，用童便、桃仁、红花之类，以救之。有因饭后便犯痧症，多用盐汤或矾汤冷冻饮料，以吐
去新食。食久痧胀，用卜子、山楂、麦芽之类以消之。有积痧阻，用槟榔、大黄之类以驱之，阿魏丸之类以治之。或痰
血凝结，昏迷欲死，不省人事，用菜油二两，麝香一钱，调下立苏，此为良法。如是先去食积、血痰之阻滞者，则痧筋
自然复现，痧气自然散行，而后，可刮即刮，可放即放，当药即药。盖缘痧症初发，未攻坏脏腑故耳。乃知初起放痧不
出凶症，未始不可以挽回也。医者甚毋以其放痧不出，昏迷如死，见为凶极而弃之欤。
痧症愈则即愈，不愈须防其有内溃之忧，故治痧之法，刮之、放之宜愈，不愈即当用药以治之。至若杂症之兼乎痧
也，亦宜刮、宜放，而急宜用药以治其痧为要策。此治痧者，不可一日无治法，亦不可一日无治药也。乃今有不用药而
惟恃乎放痧，竟有其放痧数次不愈者，或乃曰彼无昏迷不醒之重症，可无害于事也。不知放痧数次不愈，则必日甚一日，
内有伏毒，盘居脏腑，虽不见有昏迷不醒之事，而痧毒之攻击于脏腑间者，甚可危也。且放痧何以数次不愈乎？盖惟人
有食积、血痰阻滞其毒，故痧虽放而不尽。设有能消除其食积、血痰，则痧毒无阻，尚乌有不愈者耶？惟其不用药而惟
恃乎放痧，故痧毒不尽，势必攻坏脏腑。医者慎毋以放痧数次不愈为轻症，而忽视之欤。
痧症病情危急，没有比先进行放痧疗法更好的方法了。然而现在更有这样的情况：进行了放痧操作但血液不流出，虽然皮下可见隐隐约约的痧筋（皮下显露的紫色或暗红色脉络），却无可奈何，因此从事放痧的人往往遇到这种情况就认为是不祥之兆（预后不良）。但我则不然，即使放痧时血液不流出，也有可以救治的方法。即便患者已经昏迷不醒，形势危在旦夕，如果诊察确认其中焦没有食积、瘀血、痰浊阻滞，可使用宝花散冷服，或者饮用阴阳水（生熟水混合）、泥浆水、晚蚕沙水（晚蚕沙浸泡的水）、细辛水、白沙糖梅水，选择其中一方服用，等待患者稍微苏醒后，再将其扶起，随后采用其他方法治疗。至于那些因为血瘀导致放不出血的，使用童便（健康儿童的尿液）、桃仁、红花等药物来救治。有因饭后立即患上痧症的，多用盐汤或矾汤冷冻后饮用，以催吐去除新摄入的食物。若是食物停滞日久导致的痧胀，使用萝卜子（莱菔子）、山楂、麦芽等药物来消食导滞。若有积滞型痧毒阻塞，使用槟榔、大黄等药物来驱除，或用阿魏丸等方剂来治疗。如果是痰血凝结，导致昏迷欲死、不省人事的情况，使用菜油二两、麝香一钱调匀后服用，患者立刻苏醒，这是良法。像这样先去除了食积、血痰的阻滞，那么痧筋自然会重新显现，痧气自然会消散运行，之后，该刮痧的就刮痧，该放痧的就放痧，该用药的就用药。这是因为痧症初发，尚未攻伐损坏脏腑的缘故。由此可知，初起时放痧不出血虽属凶险之症，但未始不可以挽回。医者千万不要因为放痧不出血、患者昏迷如死，就认为是极凶之症而放弃治疗。
痧症痊愈了就彻底好了，若未痊愈须防备其发生内溃的危险，所以治疗痧症的方法，刮痧、放痧应当能治愈；若不能治愈，就应当用药来治疗。至于杂病兼夹痧症的，也适宜刮痧、放痧，但紧急情况下宜用药治疗痧症作为主要策略。这是治疗痧症的原则，不可一日无治法，也不可一日无治药。然而现在有人不用药，只依赖放痧，竟然有放痧数次仍不愈的情况，有人就说：“那人没有昏迷不醒的重症，对事情无害。”殊不知放痧数次不愈，病情必定一天比一天加重，体内有伏留的毒邪，盘踞在脏腑之中，虽然不见昏迷不醒的症状，但痧毒攻击脏腑之间，是非常危险的。况且为什么放痧数次仍不愈呢？大概是因为人体内有食积、血痰阻滞了毒邪，所以痧毒虽然被放出但不能排尽。假使能够消除食积、血痰，那么痧毒就没有阻碍，哪有不能痊愈的道理呢？正因为不用药而只依赖放痧，所以痧毒不能完全清除，势必会攻伐损坏脏腑。医者务必不要因为放痧数次不愈就认为是轻症而忽视它。
In critical cases of Sha disease (Sha syndrome, a condition characterized by acute abdominal pain, vomiting, diarrhea, and cyanosis often associated with environmental toxins or heatstroke), there is no better method than performing bloodletting (releasing Sha) first. However, currently there are cases where blood does not flow after bloodletting; although the Sha veins (subcutaneous purple or dark red vascular networks visible under the skin) are faintly visible, one feels helpless. Consequently, practitioners often regard this situation as ominous (indicating a poor prognosis). I, however, am different. Even if blood does not flow during bloodletting, there are methods to save the patient. Even if the patient is in a coma and the situation is critical, provided that examination confirms no obstruction by food stagnation, blood stasis, or phlegm turbidity in the middle jiao (middle burner), one can administer Baohua San (Precious Flower Powder) cold, or drink Yin-Yang water (a mixture of boiled and unboiled water), mud water, water soaked with Bombyx Batryticatus (Late Silkworm Sand), Xixin water (Asarum root water), or Bai Shatang Mei water (white rock sugar plum water). Choose one of these prescriptions and use it. Wait for the patient to regain slight consciousness, then help them sit up, and subsequently treat with other methods. For cases caused by blood stasis preventing blood flow, use Tongbian (child's urine), Taoren (Peach Seed), Honghua (Safflower), etc., to rescue the patient. In cases where Sha disease occurs immediately after eating, drink salted broth or alum broth chilled to induce vomiting and expel the newly ingested food. For Sha distension caused by long-standing food retention, use Radish seed (Lai Fuzi), Hawthorn fruit (Shanzha), and Malt (Maiya) to digest and guide out stagnation. For blockage caused by accumulated Sha toxin, use Betel nut (Binglang) and Rhubarb (Dahuang) to drive it out, or treat with Awei Wan (Asafetida Pill). In cases of phlegm and blood coagulation leading to coma, near-death state, and loss of consciousness, administer 2 liang of Rapeseed oil mixed with 1 qian of Musk (Shexiang); the patient will revive immediately. This is an excellent method. By first removing the obstructions of food stagnation, blood stasis, and phlegm, the Sha veins will naturally reappear, and the Sha qi (pathogenic energy) will naturally dissipate and circulate. Afterward, scraping can be performed where appropriate, bloodletting where necessary, and medication where indicated. This is because at the initial stage of Sha disease, the internal organs have not yet been damaged by the pathogen. Thus, it is known that even though initial failure to bleed during bloodletting indicates a critical condition, it is not beyond redemption. Physicians must not abandon treatment simply because blood does not flow upon bloodletting and the patient appears comatose and lifeless.
If Sha disease resolves, it is fully cured; if not, one must guard against the danger of internal ulceration/collapse. Therefore, the methods for treating Sha disease include scraping and bloodletting, which should lead to recovery; if they fail, medication should be employed. For miscellaneous diseases complicated by Sha, scraping and bloodletting are also suitable, but the urgent priority is to use medication to treat the Sha component. These are the principles of treating Sha: one cannot go a day without therapeutic methods, nor a day without therapeutic medicines. However, nowadays some people do not use medicine and rely solely on bloodletting, resulting in cases where bloodletting several times fails to cure the condition. Some argue, "Since the patient does not have severe symptoms like coma, it poses no harm." Little do they know that if bloodletting fails after several attempts, the condition will inevitably worsen day by day. There is latent toxin within, entrenched in the internal organs. Although coma may not be present, the attack of Sha toxin on the internal organs is extremely dangerous. Moreover, why does bloodletting fail to cure after several attempts? It is likely due to obstructions by food stagnation, blood stasis, and phlegm hindering the expulsion of the toxin. Thus, although Sha is released, it is not completely eliminated. If one could eliminate the food stagnation, blood stasis, and phlegm, the Sha toxin would face no obstruction, and how could it fail to heal? Precisely because medicine is not used and reliance is placed solely on bloodletting, the Sha toxin is not fully cleared, inevitably leading to damage of the internal organs. Physicians must not consider repeated failed bloodletting as a mild condition and ignore it.