疟有一日一发，有间日一发，有三日一发，邪气所凑，感受各有浅深。若三日一发者，所感独深，但痧毒乘之，阴
受其祸，即有不测，焉能识之。迩于全书所记外，见有痧类三疟者，故续编之以彰其害焉。
治验∶
一陆淑韩祖，年近七旬，八月患疟，间二日一发，寒热甚重，心胸烦闷，将及半月。诊之，左脉微涩。余曰∶“不意
斯疾亦有痧焉。”刺腿弯痧三针，流血紫黑。用宝花散、沉香丸，清茶微冷冻饮料之，付防风散痧汤加连翘、柴胡、橘红、胆
星微冷服二剂，六日乃痊。
一怀惟贞，患三疟半年，忽烦闷沉重，坐卧不安，六脉俱伏。余曰∶“此三疟兼痧者也。”刺腿弯痧二针，流紫黑毒
血。用宝花散，清茶微冷冻饮料之，遂松。后不服药，渐痊。
咽喉诸疾，亦有兼痧之症。与若云咽喉从古无兼痧论，试思古人治咽喉十八症，有刺少商穴法，此何异乎？夫少商
穴属太阴肺经在手指爪角内侧，刺之出血，以泻其毒，治唯一经尚有其效。若乃兼痧凡经络所伤，或上或下，随经刺放，
以拔痧毒，乃反莫救于咽喉乎。余窃谓咽喉兼痧，痧毒内发，病必难愈。若按脉看筋，能先治痧，令痧毒一去，然后内
服药饵，外用吹敷可也。
治验∶
一余长孙，犯喉疳，脉虚而微数，阅腿弯痧筋，放三针，流紫黑毒血。吹冰硼散，用清凉至宝饮减细辛加射干、连
翘、枳壳、牛膝、贝母微温饮之而愈，
一陆思湖，犯喉癣危急，医治不应。余诊之，脉弦而紧，右寸脉伏。阅有痧筋，刺十余针，紫黑毒血，流如涌泉。
吹冰硼散，用清凉至宝饮减细辛加山豆根、连翘、菊叶饮之而痊。
一缪瑞吾子，犯喉痹疼痛，脉两寸俱伏。余曰∶“症与脉异，殆必有痧。若止治喉痹恐难即愈。”不信，辞之。他医
调治，痛益甚。复延余，放指头痧三十余针。口噙冰梅，治其痰涎。用清凉至宝饮减细辛加射干、连翘微冷冻饮料之，即愈。
一潘象黄邻人，犯咽喉肿大，看有痧筋。云此宜刺放，然后医治则愈。尝对余谈及，余虽不临症治之，然即此一人，
知天下犯咽喉肿大，必有同也。故并记之。
疟疾有一种是一天发作一次，有一种是隔天发作一次，还有一种是三天发作一次，这是由于邪气聚集所致，感受的深浅各不相同。如果是三天发作一次的疟疾，说明感受的病邪特别深重，但如果此时又夹杂了痧毒，阴分受到祸害，就会出现不可预测的危险情况，这怎么能被识别出来呢？除了全书中已记载的内容外，我见到有类似三日疟的痧症，因此续编此篇以彰显其危害。
治疗验案：
有一位陆淑韩的祖父，年纪接近七十岁，八月患疟疾，每隔两天发作一次，寒热症状非常严重，心胸烦闷，持续将近半个月。诊脉时，左脉微涩。我说：“没想到这种病也有痧症。”在腿弯处刺痧三针，流出紫黑色的血。使用宝花散、沉香丸，用清茶稍微冷冻后饮用，再服用防风散痧汤加连翘、柴胡、橘红、胆星，稍微冷却后服用两剂，六天后痊愈。
有一位怀惟贞，患三日疟半年，忽然感到烦闷沉重，坐卧不安，六脉都伏隐不见。我说：“这是三日疟兼夹痧症。”在腿弯处刺痧二针，流出紫黑色的毒血。使用宝花散，用清茶稍微冷冻后饮用，症状随即缓解。后来没有再服药，逐渐痊愈。
咽喉的各种疾病，也有兼夹痧症的情况。有人说咽喉从古以来没有兼夹痧症的论述，试思考古人治疗咽喉十八种病症，有用刺少商穴的方法，这与刺痧有什么不同呢？少商穴属于手太阴肺经，位于手指指甲角内侧，刺之出血以泻除毒邪，即使只针对这一条经络治疗都有疗效。如果是兼夹痧症，凡是经络受损，无论在上在下，随经络针刺放血，以拔出痧毒，难道反而对咽喉病症无法救治吗？我私下认为咽喉兼夹痧症，是痧毒在内发作，病情必然难以治愈。如果通过诊脉和观察筋络，能先治疗痧症，待痧毒去除之后，然后再内服药物，外用吹敷疗法即可。
治疗验案：
我的长孙，患喉疳，脉象虚而微数，查看腿弯处的痧筋，放血三针，流出紫黑色的毒血。吹入冰硼散，使用清凉至宝饮减去细辛，加入射干、连翘、枳壳、牛膝、贝母，稍微温热后饮用而痊愈。
陆思湖，患喉癣危急，其他医生治疗无效。我诊察他，脉象弦而紧，右寸脉伏隐。查看发现有痧筋，刺十余针，流出紫黑色的毒血，如泉水涌出。吹入冰硼散，使用清凉至宝饮减去细辛，加入山豆根、连翘、菊叶饮用而痊愈。
缪瑞吾的儿子，患喉痹疼痛，两手寸脉都伏隐。我说：“症状与脉象不符，大概一定有痧症。如果只治疗喉痹恐怕难以立即痊愈。”他不相信，告辞离去。其他医生调理治疗，疼痛更加剧烈。再次请我去，在手指头放痧三十多针。口中含着冰梅，治疗其痰涎。使用清凉至宝饮减去细辛，加入射干、连翘，稍微冷冻后饮用，随即痊愈。
潘象黄的邻居，患咽喉肿大，看到有痧筋。他说这应该先刺放痧毒，然后治疗才能痊愈。他曾对我谈及此事，我虽然未亲自临症治疗，但仅凭这一人，可知天下患有咽喉肿大的病人，必定有相同的情况。因此一并记录下来。
Malaria may occur once a day, every other day, or once every three days. This is due to the gathering of pathogenic factors, with varying depths of infection. In cases of malaria occurring once every three days, the pathogenic factor is deeply rooted. If this is compounded by Sha toxin (Sha disease: a condition caused by external pathogens leading to blood stasis and toxicity), the Yin aspect suffers disaster, leading to unpredictable dangers, which are difficult to identify. Beyond what is recorded in the main text, I have observed Sha conditions resembling three-day malaria; thus, I continue this compilation to highlight its harm.
Clinical Cases:
1. Grandfather of Lu Shuhan, nearly seventy years old, contracted malaria in August, occurring every other day. The chills and fever were severe, accompanied by chest and heart irritability, lasting nearly half a month. Pulse diagnosis revealed a slightly choppy left pulse. I said, "Unexpectedly, this disease also involves Sha." Three needles were used to puncture Sha points at the popliteal fossa, releasing purple-black blood. Baohua San (Precious Flower Powder) and Chenxiang Wan (Agarwood Pill) were administered, taken cold with clear tea. Fangfeng San Sha Tang (Saposhnikovia Decoction for Dispelling Sha) was modified with Chaihu (Bupleuri Radix), Lianqiao (Forsythiae Fructus), Juhong (Citri Reticulatae Pericarpium Rubrum), and Dansheng (Arisaematis Cum Bile), taken cool. After two doses, recovery occurred within six days.
2. Huai Weizhen suffered from three-day malaria for half a year. Suddenly, he experienced severe irritability and heaviness, unable to sit or lie comfortably. All six pulses were hidden (Fu pulse). I said, "This is three-day malaria complicated by Sha." Two needles were used to puncture Sha points at the popliteal fossa, releasing purple-black toxic blood. Baohua San was administered, taken cold with clear tea, resulting in immediate relief. He took no further medication and gradually recovered.
Various throat diseases also present with complications involving Sha. Some claim that ancient texts contain no discussion of throat diseases complicated by Sha. Consider that ancient treatments for eighteen types of throat disorders included the method of puncturing Shaoshang (LU-11). How is this different? Shaoshang belongs to the Lung Meridian of Hand-Taiyin, located on the radial side of the thumb nail angle. Puncturing it to release blood drains toxicity; even treating solely this meridian yields efficacy. If Sha is involved, damaging meridians anywhere in the body, puncturing and bleeding along the affected meridians extracts Sha toxin. Why would this fail to treat throat conditions? I believe that when Sha complicates throat diseases, internal Sha toxin eruption makes the condition difficult to cure. By examining the pulse and observing tendons, if Sha is treated first to eliminate Sha toxin, followed by internal herbal medicine and external insufflation applications, recovery is possible.
Clinical Cases:
1. My eldest grandson suffered from Hougan (Throat Ulcer/Gangrene). The pulse was deficient and slightly rapid. Observing Sha tendons in the popliteal fossa, three needles released purple-black toxic blood. Bingpeng San (Ice and Borax Powder) was insufflated into the throat. Qingliang Zhibao Yin (Cooling Precious Treasure Drink) was modified by removing Xixin (Asari Radix et Rhizoma) and adding Shexuan (Belamcandae Rhizoma), Lianqiao, Zhike (Aurantii Fructus Immaturus), Niuxi (Achyranthis Bidentatae Radix), and Beimu (Fritillariae Thunbergii Bulbus), taken warm. He recovered.
2. Lu Sihu suffered from critical Houxuan (Throat Lichen/Atrophy). Other physicians' treatments failed. My diagnosis showed a wiry and tight pulse, with the right Cun position hidden. Sha tendons were observed. Over ten needles released purple-black toxic blood flowing like a spring. Bingpeng San was insufflated. Qingliang Zhibao Yin was modified by removing Xixin and adding Shandougen (Sophorae Tonkinensis Radix), Lianqiao, and Juye (Chrysanthemi Indici Folium). He recovered.
3. Son of Miao Ruiwu suffered from Houbi (Throat Bi/Sore Throat) with pain. Both Cun positions were hidden. I said, "The symptoms and pulse differ; there must be Sha. Treating only Houbi may not lead to quick recovery." He did not believe me and left. Other physicians' treatments worsened the pain. Upon my return, over thirty needles were used to release Sha from the fingertips. Bingmei (Ice Plum) was held in the mouth to manage phlegm and saliva. Qingliang Zhibao Yin was modified by removing Xixin and adding Shexuan and Lianqiao, taken cold. He recovered immediately.
4. Neighbor of Pan Xianghuang suffered from Yanhou Zhongda (Throat Swelling). Sha tendons were visible. He stated that puncturing Sha first, then treating medically, leads to recovery. He discussed this with me. Although I did not treat him personally, based on this single case, I infer that patients worldwide suffering from throat swelling likely share similar characteristics. Thus, I record this together.