凡病用药得宜未有不效，而痧症竟有得宜不效者，何也？夫痧者，热毒也。热毒用药宜凉不宜温，宜消不宜补，汤
剂入口，必须带冷，冷则直入肠胃，而肌肤血肉之间，虽有良剂，安能得至乎？此治痧者，莫先于刮之放之也。如刮之
放之，而肌肤血肉之毒已除，然后将肠、胃、脾、肝、肾、三阴之毒，用药以驱之，药固未有不效者也。然亦有刮之放
之而药有不效者，是非药不效也。盖其时虽放，而放之或有未尽；虽刮，而刮之或有未到，则是肌肤血肉之毒犹在，故
即用药，而药有不效耳。若刮已到，放已尽，而痧症犹在，则是痧毒惟在肠、胃、脾、肝、肾、三阴经络，非药将何以
治之乎。
痧症危极，昏迷不醒，即扶之不起，呼之不应，虽欲刮放而不可刮放，乃更有用药以救之，而能必其效者，何也？
盖痧症用药，必须带冷，冷虽未能即周于肌肤血肉之间，而昏迷不醒，乃痧之热毒冲于心膈，故心不能自主而昏迷。若
药带冷入口，即从心膈间顺流而下，则热毒之气在心膈间者，随药而消，故昏者复明，迷者复醒。即有不醒者，乃食积、
血、痰所阻，若能攻而下之，未有不醒者矣。此余治痧，所以又用药而必得其效也。
痧气壅遏，未有不阻塞于中，故作痛、作胀，用荆芥、防风之类，从表而散；用青皮、陈皮之类，从中而消；用枳
实、大黄之类，从大便而下；用木通、泽泻之类，从小便而行；用山楂、卜子之类，所以治其食之阻；用金银花、红花
之类，所以治其血之壅；用槟榔、蓬术之类，所以治其积之滞也。
凡是疾病用药得当，没有不生效的，但痧症（一种由热毒引起的急性病证）却有时用药得当也不见效，为什么呢？所谓痧，就是热毒。治疗热毒的药物性质应当清凉而不宜温热，应当消散而不宜补益。汤药入口时，必须带有凉意，因为凉性药物能直接进入肠胃；如果药是热的，虽然使用了良方，也无法到达肌肤和血肉之间。因此，治疗痧症，没有比刮痧、放血更优先的方法了。
如果经过刮痧和放血后，肌肤血肉之间的毒素已经清除，然后再用药物驱除肠、胃、脾、肝、肾以及三阴经中的毒素，那么药物就没有不生效的。然而，也有即使进行了刮痧和放血，药物仍然不见效的情况，这并不是药物本身无效。而是因为当时虽然进行了刮放操作，但可能刮得不够彻底，或者放血没有放尽，导致肌肤血肉间的毒素仍然存在，所以即使用药，药物也难以见效。如果刮痧确实到位，放血确实彻底，而痧症的症状依然存在，这说明痧毒仅仅存在于肠、胃、脾、肝、肾以及三阴经络之中，除了用药之外，还有什么其他方法可以治疗呢？
当痧症危重至极，患者昏迷不醒，甚至扶不起来，叫也没有反应，此时想进行刮痧或放血都已经无法操作，这时更有使用药物来急救且能保证见效的方法，为什么呢？这是因为治疗痧症用药必须带凉意。凉药虽然不能立即遍达肌肤血肉之间，但昏迷不醒是因为痧的热毒冲撞于心膈部位，导致心神不能自主而昏迷。如果药液带着凉意入口，就会从心膈间顺流而下，那么盘踞在心膈间的热毒之气就会随着药力而消散，所以昏睡的人恢复清醒，迷乱的人恢复知觉。即使有仍然不醒的，那是由于食积、瘀血、痰浊阻滞所致，如果能通过攻下法将其排出，没有不醒来的。这就是我治疗痧症时，又通过用药而必得其效的原因。
痧气壅滞遏阻，没有不在中焦阻塞的，所以会导致疼痛、胀满。使用荆芥、防风等药物，从体表发散邪气；使用青皮、陈皮等药物，从中焦消导积滞；使用枳实、大黄等药物，从大便向下通泄；使用木通、泽泻等药物，从小便引导湿热下行；使用山楂、莱菔子等药物，以治疗饮食停滞的阻碍；使用金银花、红花等药物，以治疗血液壅滞；使用槟榔、莪术等药物，以治疗积滞不通。
In general, when medication is appropriate for any disease, it is invariably effective. However, in cases of Sha syndrome (an acute condition caused by heat-toxin), even with appropriate medication, there are instances where it fails to take effect. Why is this? Sha refers to heat-toxin. Medications for treating heat-toxin should be cooling rather than warming, and should promote dispersion rather than tonification. When the decoction enters the mouth, it must be cool; a cooling nature allows it to enter the intestines and stomach directly. If it is not cool, although excellent prescriptions are used, how can they reach the skin, muscles, and flesh? Therefore, in treating Sha, nothing takes precedence over scraping (Gua Sha) and bloodletting.
If, after scraping and bloodletting, the toxins in the skin, muscles, and flesh have been eliminated, one then uses medication to drive out the toxins from the intestines, stomach, spleen, liver, kidneys, and the three Yin meridians. In such cases, the medication will certainly be effective. However, there are also situations where, despite scraping and bloodletting, the medication remains ineffective. This is not because the medication itself is ineffective. It is that at the time, although scraping and bloodletting were performed, they may not have been thorough enough, or the scraping may not have reached all areas, meaning the toxins in the skin, muscles, and flesh still remain. Thus, even if medication is administered, it may fail to work. If scraping has indeed reached the necessary extent and bloodletting has been completed thoroughly, yet the symptoms of Sha persist, it indicates that the Sha toxin resides solely within the meridians of the intestines, stomach, spleen, liver, kidneys, and the three Yin channels. Apart from medication, what other method could treat this?
When Sha syndrome becomes critically severe, causing coma and unconsciousness, where the patient cannot be supported upright nor responds to calls, making scraping or bloodletting impossible, there is another method using medication for rescue that guarantees efficacy. Why? Because medication for Sha must be cool. Although cool medicine may not immediately circulate through the skin, muscles, and flesh, coma and unconsciousness occur because the heat-toxin of Sha rushes to the heart and diaphragm area, causing the heart spirit to lose control, resulting in coma. If the medicine enters the mouth while cool, it flows down smoothly from the heart and diaphragm area. Consequently, the heat-toxin qi residing in the heart and diaphragm dissipates along with the medicinal action, so the comatose regain consciousness, and the confused become alert. Even if some do not wake up, it is due to obstruction by food retention, blood stasis, or phlegm. If these can be purged downward via purgation methods, recovery of consciousness is inevitable. This is why, in my treatment of Sha, I achieve guaranteed efficacy by employing medication.
Sha qi stagnation and obstruction invariably block the middle jiao, leading to pain and distension. Use Jingjie (Schizonepetae Herba) and Fangfeng (Saposhnikoviae Radix) to disperse from the exterior; use Qingpi (Aurantii Fructus Immaturus) and Chenpi (Aurantii Pericarpium) to resolve from the middle jiao; use Zhishi (Aurantii Fructus) and Dahuang (Rhei Radix et Rhizoma) to purge downward through the large intestine; use Mutong (Akebiae Caulis) and Zexie (Alismatis Rhizoma) to guide downward through urination; use Shanzha (Crataegi Fructus) and Boluozhi (Radish Seed) to treat obstruction caused by food retention; use Jinyinhua (Lonicerae Japonicae Flos) and Honghua (Carthami Flos) to treat blood stasis; use Binglang (Arecae Semen) and Ezhu (Curcumae Rhizoma) to treat accumulation and stagnation.