伤寒食未化，下之太早，反引寒邪入胃，变而为热，热邪固结所食，不能消化，乃成结胸。若痧胀新食，固宜以吐
为先，至所食既久，骤然痧胀，虽所食消化未尽，下之无害。盖痧胀非有寒邪入胃，变成热结之患。但因痧毒在肠胃，
则肠胃中肌肉作肿作胀，盘肠绞痛，遍及脏腑，故外宜用刮放以泄毒于表，内可即下以攻毒于里，则肿胀自当之以潜消，
而食积亦因之以通利，原无结胸之可忧也。然痧胀固非伤寒热结者比，但下之，必须内兼食积，又宜以渐而进，中病即
止。
痧退后，竟治杂症，固所宜然。但痧后余毒，或尚存些须，按脉而脉已不显，辨症而症已若清，此时用药，若即认
为惟是杂症已尔，仅以治杂症之药治之，设使稍有相犯，吾恐斯人尚不得保其命也。盖痧后尤痘后，痘后之症，固不可
舍痘余毒而单治杂症，痧后之症，又岂可舍痧余毒而单治杂症乎？此治痧后杂症，又不可不深虑，而于杂症剂中，更兼
解毒活血乃能收全功也。
凡人有病则宜治，将死则宜救，乃有犯痧不信夫痧者，是其智之所短，即其数之所尽也。故人有犯乎慢痧，尤可缠
绵时月而病日深，若犯乎紧痧，未有不立时凶危而入于死。如此不信，真数尽之人也。即告之以痧症之祸，而彼仍茫然
不觉，虽有热心，无益于事。故不信之误，人自当知。尝见一士不信痧，忽然犯紧痧暗症，咽喉疼痛，喘急如锯，发热
沉重，胸中饱闷，吹药、服药喉中益痛，痛连耳际，或时在左，或时移右，痰胀昏迷，亡危之极，殆难尽述。幸而审明
痧症，急为放痧，涌出毒血甚多，刮痧遍体俱有，服药至晚而安，痰胀亦消，喉痛亦止。缘不守痧禁，饮温酒热茶，立
时复发而终，此真痧毒之为害也。呜呼惜哉！更见同时三女，一犯此症，刮痧而愈；一犯此症，放痧而愈；一犯此症，
认为喉鹅，治之而死。信者如此，不信者如彼，痧其可忽也耶！
伤寒病期间，如果食物尚未消化就过早使用泻下法，反而会将寒邪引入胃中，转化为热证。热邪与未消化的食物牢固结合，导致无法消化，从而形成结胸证。如果是痧胀病伴随新近摄入的食物，确实应当以催吐为首选方法；但如果进食时间已久，突然发生痧胀，即使食物尚未完全消化，使用泻下法也是无害的。这是因为痧胀并非像伤寒那样有寒邪入胃变成热结的祸患。只是因为痧毒存在于肠胃之中，导致肠胃肌肉肿胀、腹部绞痛，疼痛波及脏腑。因此，外部适宜采用刮痧和放血疗法以从体表泄出毒素，内部可以立即使用泻下法以攻逐体内的毒素，这样肿胀自然会逐渐消退，食积也会随之通畅化解，原本不必担忧会出现结胸证。然而，痧胀毕竟不同于伤寒的热结证，使用泻下法时，必须确认体内兼有食积，并且应该循序渐进，一旦病情好转就要立即停止。
痧症退去后，治疗其他杂症，这本是适宜的。但是，痧症后的余毒可能还残留少许，此时按脉象诊察已不明显，辨别症状也似乎已经清晰。在这种情况下用药，如果仅仅认为这只是普通的杂症，只用治疗杂症的药物来处理，倘若稍有触犯禁忌，我担心此人恐怕连性命都难以保全。因为痧症之后的情况甚至比痘疹之后更为复杂，痘疹后的病症，固然不能抛开痘疹余毒而单独治疗杂症，那么痧症后的病症，又岂能抛开痧毒余邪而单独治疗杂症呢？所以在治疗痧症后的杂症时，不可不深思熟虑，在针对杂症的方剂中，更应兼顾解毒和活血，才能取得圆满的效果。
大凡人生病了就应当治疗，濒临死亡时就应当抢救。但有些人犯了痧症却不相信这是痧症，这是他们智慧上的短处，也就是他们气数将尽的表现。所以，人如果感染了慢性的痧症，往往可以缠绵数月，病情日益加深；如果感染了急性的紧痧，没有不是立刻出现凶险危重状况而死亡的。像这样不相信痧症，真是气数已尽的人啊。即使向他们告知痧症的祸害，他们仍然茫然不觉，虽然你有热心帮助，也对事情无济于事。因此，这种因不信而产生的错误，人们自己应当知晓。我曾经见过一位读书人不相信痧症，忽然感染了隐性的紧痧，咽喉疼痛，气喘急促如同拉锯，发热且身体沉重，胸中饱闷不适，吹药和服药后喉咙更加疼痛，疼痛牵连到耳际，有时在左边，有时转移到右边，痰多肿胀并昏迷，危险到了极点，几乎难以详尽描述。幸好经过仔细审察确诊为痧症，紧急进行放痧治疗，涌出了大量的毒血，全身刮痧，服药至晚上才安定下来，痰肿也消除了，喉痛也停止了。但因为不遵守痧症的禁忌，饮用了温酒和热茶，立刻复发并最终死亡，这真是痧毒造成的危害啊。唉，真令人惋惜！又见到同时有三个女子，一个犯了这个病症，通过刮痧治愈；一个犯了这个病症，通过放痧治愈；还有一个犯了这个病症，被误认为是喉鹅（一种咽喉疾病），治疗后死亡。相信的人是这样，不相信的人是那样，痧症怎么可以忽视呢！
During a Shanghan (Cold Damage) disease, if purgation is administered too early before food has been digested, it may inadvertently draw cold pathogens into the stomach, transforming into heat. The heat pathogen firmly binds with the undigested food, preventing digestion, thereby forming Jie Xiong (Chest Binding). If Sha Zhang (Sha Distension) occurs alongside recently ingested food, emesis should indeed be the primary treatment. However, if the food was ingested some time ago and Sha Zhang suddenly appears, even if the food is not fully digested, purgation is harmless. This is because Sha Zhang does not suffer from the complication of cold pathogens entering the stomach and turning into heat binding as seen in Shanghan. Rather, Sha toxins reside in the intestines and stomach, causing swelling and distension of the intestinal and gastric muscles, accompanied by severe abdominal colic that spreads to the viscera. Therefore, externally, Gua Sha (scraping therapy) and bloodletting are suitable to vent toxins from the surface, while internally, purgation can be used immediately to attack toxins within. Consequently, the swelling will gradually subside, and food stagnation will also be cleared, eliminating the worry of developing Jie Xiong. Nevertheless, Sha Zhang is certainly not comparable to the heat binding of Shanghan; when using purgation, one must ensure there is concurrent food stagnation, proceed gradually, and stop once the disease is addressed.
After the Sha rash subsides, treating miscellaneous diseases is appropriate. However, residual Sha toxins may still linger slightly. At this stage, the pulse may no longer be distinct, and symptoms may appear resolved. When prescribing medication at this time, if one assumes it is merely a miscellaneous disease and treats it solely with remedies for miscellaneous conditions, any slight contraindication might endanger the patient's life. The condition after Sha illness is particularly critical; just as one cannot ignore residual toxins from smallpox (Dou) to treat miscellaneous diseases alone, how can one ignore residual Sha toxins after Sha illness? Thus, when treating miscellaneous diseases post-Sha, deep consideration is required. One must incorporate detoxification and blood-invigorating methods into the formula for miscellaneous diseases to achieve complete success.
Generally, when people are ill, they should be treated; when near death, they should be rescued. However, those who contract Sha but refuse to believe it suffers from a lack of wisdom and exhausted destiny. If one contracts slow Sha, the illness may linger for months and deepen daily; if one contracts tight Sha (Jin Sha), death often follows immediately with critical danger. Such disbelief indicates a person whose fate is sealed. Even if informed of the dangers of Sha, they remain oblivious, rendering well-intentioned advice useless. Therefore, individuals must recognize the error caused by disbelief. I once witnessed a scholar who disbelieved in Sha suddenly contracting hidden tight Sha. He suffered from sore throat, wheezing like a saw, fever, heavy body, chest fullness, and worsening pain upon applying medicated powder or taking medicine, with pain radiating to the ears, alternating sides, accompanied by phlegm, swelling, and coma, reaching extreme peril. Fortunately, after careful diagnosis confirming Sha, emergency bloodletting released abundant toxic blood, whole-body scraping was performed, and evening medication brought relief, resolving phlegm, swelling, and throat pain. However, due to violating Sha dietary taboos by drinking warm wine and hot tea, the condition relapsed instantly, leading to his death. This truly demonstrates the harm of Sha toxins. Alas, what a pity! I also observed three women simultaneously: one recovered via scraping, one via bloodletting, and one died after being misdiagnosed with Hou E (Goose Throat/Epiglottitis) and treated accordingly. Those who believe fare thus, those who do not fare otherwise. How can Sha be neglected!