郁金 价贵时有换之以姜黄者，其二味温凉之性虽有不同，然以之治痧，下气消瘀，姜黄末为无效。若欲入心
经，散郁消瘀，则痧毒攻心者，非郁金不能立奏其功，姜黄有所不及，故方中所载郁金切勿以姜黄代之。
穿山甲 土炒用。凡痧毒瘀血壅塞阻而不通，得此透入经络，引诸药所不能到者，即到所犯经络血分之所。识
者其留意焉。
黑丑 通上彻下，痧毒胀满，必须用此于丸散中，救人立功。凡破气之味俱莫能及，但耗散真气，恐人有宜有
不宜，故方中不载。
大黄 治食积阻痧毒。余为丸以备急用，其功莫大。若痧胀之极，必须急服此以攻之，恐病有宜有不宜。故方
中虽载，不及细加，惟审病症缓急轻重而行之。（丑黄等分，粥丸三分稍冷汤下。）
凡治吐症，用半夏、藿香。独痧症作吐，半夏性燥，须防益助火邪，断不可用，若藿香惟取其正气，以治秽浊。然
亦必痧毒无阻，乃可俟冷冻饮料之。倘或痧气有害于中，骤用此以止吐，反有闭门逐盗之忧。如肠胃有食积血瘀，留滞痧毒，
用藿香香燥止吐，适长其毒，是宜知忌。（下通痧毒，其吐自止。）
痧症寒热不由外感，往往毒从鼻吸而入，搏激肌表。羌活、麻黄俱在所禁，若用荆芥、细辛善能透窍。盖恶毒之气，
由窍而入，故用之，以治痧胀亦由窍而泄。若防风乃臣使之味，仅取为透窍之佐，不比麻黄、羌活专攻发表，反有升宣
火毒之虑也。至如独活发散治热，其性至颈而还，力不能过发，且可活血解痧毒，是痧症最要之味欤。
郁金：价格昂贵时，有时会用姜黄来替代。虽然这两味药的温凉属性有所不同，但用于治疗痧症时，在降气消瘀方面，姜黄粉末并非无效。但如果想要进入心经，以疏散郁结、消除瘀血，那么对于痧毒攻心的情况，非郁金不能立即见效，姜黄则有所不及，所以方剂中记载的郁金千万不要用姜黄代替。
穿山甲：需用土炒后使用。凡是痧毒与瘀血壅塞阻滞不通的情况，依靠穿山甲可以透入经络，引导其他药物到达它们无法抵达的病邪所在的经络血分部位。懂行的人应当留意这一点。
黑丑（牵牛子）：能通利上下，治疗痧毒引起的胀满，必须在丸药或散剂中使用此药，才能救人并建立功效。凡是破气的药物都没有它能达到的效果，但它会耗散真气，恐怕有人适合有人不适合，所以在方剂中没有收录。
大黄：用于治疗食积阻滞导致的痧毒。我将其制成丸药以备紧急使用，其功效非常大。如果痧胀极其严重，必须急服此药以攻逐病邪，但恐怕病症有适宜和不适宜之分。因此方剂中虽然记载了它，但没有详细添加用法，只应根据病症的缓急轻重来决定是否施行。（黑丑与大黄等量，用米粥制成丸药，每服三分，稍冷后用汤水送下。）
凡是治疗呕吐症状，通常使用半夏和藿香。唯独痧症引起的呕吐，半夏性燥，必须防止它进一步助长火邪，绝对不可使用；若用藿香，只是取其正气来治疗秽浊之气。然而这也必须是在痧毒没有阻碍的情况下，才可以等待服用冷冻饮料（指寒凉之品）。倘若痧气伤害了中焦，骤然使用这些药物来止吐，反而会有“闭门逐盗”（将病邪关在体内）的担忧。如果肠胃中有食积和血瘀，留滞了痧毒，使用藿香的香燥之性来止吐，恰好会助长毒势，这是应该知道的禁忌。（若能通泄痧毒，呕吐自然停止。）
痧症的寒热不是由外感引起的，往往是毒气从鼻吸入，搏激肌表。羌活、麻黄都在禁忌之列，如果使用荆芥、细辛，善于透达孔窍。因为恶毒之气是由孔窍而入的，所以使用它们，使痧胀之毒也由孔窍而泄出。至于防风，属于臣使之药，仅取它作为透窍的辅助，不像麻黄、羌活那样专门攻发表证，反而有升宣火毒的顾虑。至于独活，发散以治热，其药力只能到达颈部便返回，力量不足以过度发散，且可以活血解除痧毒，这大概是痧症中最重要的一味药吧。
Jinyin (Curcuma aromatica): When the price is high, it is sometimes replaced by Jianghuang (Curcuma longa). Although their properties of warmth and coolness differ, in treating Sha syndrome (Sha disease), Jianghuang powder is not ineffective for descending Qi and resolving stasis. However, if the intention is to enter the Heart meridian to dissipate stagnation and resolve blood stasis, for cases where Sha toxin attacks the Heart, only Jinyin can achieve immediate results, whereas Jianghuang falls short. Therefore, Jinyin recorded in prescriptions must never be substituted with Jianghuang.
Shanjiujia (Pangolin Scales): Use after stir-frying with soil. In all cases where Sha toxin and blood stasis are congested and obstructed, preventing free flow, Shanjiujia penetrates into the collaterals, guiding other medicines to reach the blood level of the affected meridians where they could not otherwise arrive. Those who understand this should pay attention.
Heiqiu (Semen Kochiae): It unblocks both upper and lower aspects. For Sha toxin causing distension and fullness, this herb must be used in pills or powders to save lives and achieve efficacy. No other qi-breaking herbs can match its effect, but it consumes and scatters true Qi; thus, it may be suitable for some and unsuitable for others, which is why it is not included in the main prescriptions.
Dahuang (Rhei Radix et Rhizoma): Treats Sha toxin caused by food accumulation and obstruction. I prepare it as pills for emergency use, and its merit is immense. If Sha distension is extreme, urgent administration of this herb to attack the pathogen is necessary, yet one must consider that the condition may be suitable or unsuitable for such treatment. Therefore, although recorded in the formulas, detailed instructions are omitted; one should act according to the urgency and severity of the symptoms. (Equal parts of Heiqiu and Dahuang, made into pills with rice gruel; take 3 fen per dose, slightly cooled, washed down with decoction.)
Generally, for treating vomiting, Banxia (Pinelliae Rhizoma) and Huoxiang (Agastaches Herba) are used. However, specifically for vomiting caused by Sha syndrome, Banxia is drying and hot; one must guard against it exacerbating fire pathogens, so it must absolutely not be used. If Huoxiang is used, it is solely to utilize its righteous Qi to treat turbid and foul pathogens. Nevertheless, this is only permissible when Sha toxin does not cause obstruction, allowing for the consumption of cold beverages. If Sha Qi harms the middle jiao, suddenly using these agents to stop vomiting risks "closing the door to drive out the thief" (trapping the pathogen inside). If there is food accumulation and blood stasis in the intestines and stomach, retaining Sha toxin, using the aromatic and drying nature of Huoxiang to stop vomiting would inadvertently nourish the toxin. This is a contraindication that must be known. (If Sha toxin is successfully purged, vomiting will cease spontaneously.)
The chills and fever in Sha syndrome do not arise from external contraction but often result from toxins entering through the nose and agitating the muscle surface. Qianghuo (Notopterygii Rhizoma et Radix) and Mahuang (Ephedrae Herba) are strictly prohibited. If Jingjie (Schizonepetae Spica) and Xixin (Asari Radix et Rhizoma) are used, they effectively penetrate the orifices. Since evil toxic Qi enters through the orifices, these herbs are employed to allow Sha distension toxins to exit via the orifices. Fangfeng (Saposhnikoviae Radix), being a ministerial agent, is taken only as an assistant for penetrating orifices; unlike Mahuang and Qianghuo which specifically attack the exterior to induce sweating, Fangfeng carries the risk of ascending and disseminating fire toxins. As for Duhuo (Angelicae Pubescentis Radix), its dispersing action treats heat, but its force returns at the neck and cannot over-disperse; furthermore, it can invigorate blood and resolve Sha toxin. Thus, it is likely the most crucial herb for Sha syndrome.