痧疹之发，必欲尽透。故治麻疹，须要见于肌表者多，多则毒瓦斯俱泄，然后肠胃不留余毒。治痧，在肌表者，用刮；
在血肉者，用放。亦犹治麻疹，须尽透肌表之谓也。
痘疮为秽气所触，实时作变，痧胀也∶麻疹为秽气所触，实时反隐，亦痧胀也；若暑气时行不正之气，感为痧者，
讵无相类者欤。
治验∶
一陈姓婢十四岁，四月，壮热烦闷，腹痛身重，斑痧遍体，脉微而细，触秽之症也。阅腿弯痧筋，放七针，手指放
十余针，俱紫黑毒血，烦闷稍松，用宝花散、阿魏丸清茶微冷冻饮料之，又付活血顺气之剂，腹痛遂止，斑痧渐散，身体轻
快，痘即起发。视其形色，已四朝矣。后皆如期灌胀收靥而愈。可见痘中触秽因痧而隐者，比比也。
犯伤寒者，有外感三阳之寒，有直中三阴之寒，兼痧者，非可俱兼也。痧者，热毒也，热毒入里，内作肿胀；热毒
发外，肌肤肿胀，或升头面，或散四肢，此等恶疾，俱由热毒之气所攻也。若直中三阴之真寒症，无有兼痧者，盖三阴
既已直中，则热气与寒气所拒，无由而入也。至于外感三阳，或先受痧而感寒，或先受寒而感痧，或痧毒骤发，热极而
生寒战，甚至于手足厥冷，则俱有之。若先有痧而感寒者，知其慢痧，方可暂散寒邪而后治痧；先有寒而感痧者，痧症
为重，当先治痧而后治寒。至如痧毒骤发热极而生寒战，手足厥冷者，紧痧也。若一误服用发散、升提、温饮之药，须
防时刻凶危，急用凉水饮之，稍解胸腹中热胀之气，然后或刮或放，用药治之。
痧疹的发作，必须力求完全透发。因此治疗麻疹，需要使皮疹在肌肤表面显现得充分，显现得越多，毒气就越能全部宣泄，这样肠胃中就不会残留余毒。治疗痧症，对于在肌肤表层的，采用刮痧法；对于在血肉深层的，采用刺络放血法。这也如同治疗麻疹，必须让邪气尽透于肌表的道理一样。
痘疮如果受到秽浊之气的触碰，会立刻发生变证，这属于痧胀范畴；麻疹如果受到秽浊之气的触碰，会立刻隐没不透，这也属于痧胀范畴；如果是感受暑气或时行不正之气而引发的痧症，难道没有与上述情况相似的吗？
治疗验案：
有一位陈姓婢女，十四岁，四月间发病，表现为高热、烦躁闷乱、腹痛、身体沉重，全身布满斑痧，脉象微细，这是触犯了秽浊之气的症状。检查发现其腿弯处有痧筋，于是刺破放出七针血，手指处刺破放出十余针血，流出的都是紫黑色的毒血。随后患者烦闷感稍缓解，给予宝花散和阿魏丸，用清茶稍微冷却后喂服，又配合使用活血顺气的药剂，腹痛随即停止，斑痧逐渐消散，身体变得轻快，痘疹随即发出。观察其形色，病程已经四天了。后来都按照预期过程，经历灌浆、膨胀、收靥的阶段而痊愈。由此可见，痘疹中因触犯秽气且兼夹痧症而隐没的情况，比比皆是。
患伤寒的人，有的是外感三阳经的寒邪，有的是寒邪直中三阴经，但并非所有情况都能兼夹痧症。痧症本质上是热毒，热毒入里，会在体内引起肿胀；热毒发于体表，会引起肌肤肿胀，或者上攻头面，或者散布四肢，这些恶疾，都是由热毒之气攻冲所致。如果是寒邪直中三阴经的真寒证，就没有兼夹痧症的，因为三阴经既然已经被寒邪直中，热气与寒气相互排斥，热毒便无法侵入。至于外感三阳经的情况，有的先感受痧邪再感受寒邪，有的先感受寒邪再感受痧邪，有的则是痧毒突然发作，热极而生寒战，甚至出现手足厥冷，这些情况都存在。如果是先有痧症再感受寒邪的，知道这是慢痧，才可以暂时发散寒邪，然后再治疗痧症；如果是先有寒邪再感受痧邪的，说明痧症为重，应当先治疗痧症，然后再治疗寒邪。至于像痧毒突然发作、热极生寒战、手足厥冷的，属于紧痧。如果误用了发散、升提、温热的药物，必须防备随时出现凶险危重的情况，应立即用凉水饮用，以稍微缓解胸腹中的热胀之气，然后或刮痧或放血，再用药物治疗。
The eruption of sha-rash (Sha-rash, a disease characterized by rash and swelling caused by toxic heat) must strive for complete penetration. Therefore, in treating measles (Measles, an acute infectious disease), it is necessary to ensure that the rash manifests sufficiently on the skin surface; the more it manifests, the more completely the toxic qi (Toxic Qi, pathogenic factors with strong virulence) can be excreted, so that no residual toxin remains in the intestines and stomach. In treating sha syndrome (Sha Syndrome, a category of diseases caused by exposure to foul or toxic air, characterized by sudden onset, abdominal distension, and pain), for those located on the skin surface, scraping (Scraping, a therapeutic method using a smooth-edged instrument to scrape the skin) is used; for those located in the flesh and blood, pricking and bleeding (Pricking and Bleeding, a technique involving puncturing superficial veins to release blood) is used. This is also consistent with the principle of treating measles, which requires the pathogen to be fully vented through the skin surface.
If variola (Smallpox) is touched by foul qi (Foul Qi, noxious environmental pathogens), it immediately undergoes pathological changes, which falls under the category of sha syndrome; if measles is touched by foul qi, it immediately becomes obscured and fails to erupt, which also falls under sha syndrome; if sha is contracted due to summerheat qi or irregular seasonal pathogens, are there not similarities?
Clinical Case:
A fourteen-year-old maid surnamed Chen fell ill in April. She presented with high fever, irritability and chest oppression, abdominal pain, and heavy limbs, with macular sha covering her body. Her pulse was faint and fine, indicating symptoms caused by contact with foul qi. Examination revealed visible sha vessels (Sha Vessels, dilated superficial veins indicating sha toxin) behind her knees, from which seven needles were drawn to release blood. More than ten needles were drawn from her fingers, releasing dark purple-black toxic blood. Subsequently, her irritability and oppression slightly relieved. She was administered Baohua San (Treasure Flower Powder) and Awei Wan (Asafoetida Pill), given cool boiled water mixed with clear tea, followed by formulas to invigorate blood and regulate qi. The abdominal pain ceased, the macular sha gradually dispersed, and her body felt light and agile. The smallpox then erupted. Observing its color and shape, four days had passed since onset. Later, she recovered according to the expected stages of filling, swelling, and scabbing. This demonstrates that cases where smallpox becomes obscured due to foul contact and concurrent sha are common.
Patients suffering from cold damage (Cold Damage, diseases caused by cold pathogenic factors) may have exterior cold affecting the Three Yang meridians or direct invasion of cold into the Three Yin meridians, but not all conditions involve concurrent sha. Sha is essentially heat toxin (Heat Toxin). When heat toxin enters the interior, it causes internal swelling; when it manifests externally, it causes skin and muscle swelling, ascending to the head and face or dispersing to the four limbs. These severe diseases are all caused by the attack of heat toxin qi. If it is a true cold syndrome caused by direct invasion of cold into the Three Yin meridians, there is no concurrent sha, because once the Three Yin meridians are invaded by cold, the heat qi and cold qi repel each other, leaving no pathway for entry. Regarding exterior cold affecting the Three Yang meridians, some patients first contract sha and then cold, some first contract cold and then sha, and some experience sudden eruption of sha toxin, where extreme heat generates chills, even leading to cold extremities. All these scenarios exist. If one first has sha and then contracts cold, knowing it is slow sha (Slow Sha, a milder form of sha), one may temporarily disperse the cold pathogen before treating sha. If one first has cold and then contracts sha, indicating sha is the primary pathology, one should treat sha first, then treat cold. As for cases where sha toxin suddenly erupts, extreme heat generates chills, and extremities become cold, this is tight sha (Tight Sha, a severe, acute form of sha). If one mistakenly uses dispersing, ascending, or warming medications, one must guard against immediate critical danger. Immediately administer cool water to slightly relieve the heat and distension in the chest and abdomen, then proceed with scraping or pricking/bleeding, followed by medicinal treatment.