先有痰喘气急而痧胀因之，先治其痧，后治其痰气。无令痧为本病之助，先有痧胀而痰喘气急因之，但治其痧而痰
喘气急自愈。若痧有寒热不清，痰喘气急者，兼和解。痧有有热无寒，痰喘气急者，兼清热。痧有食结不化，痰喘气急
者，兼消食顺气。痧有大便不通、小便不利，痰喘气急者，急攻其里。痧有痢下脓血，或赤或白，痰喘气急者，急攻其
积。痧有瘀血凝滞，小便利、大便黑，痰喘气急者，急消其瘀。痧有呕吐紫黑血，或鲜血，痰喘气急者，当虑痧毒攻坏
脏腑，不痛者，可治，痛而不已者，难治，服药不应者，死。
治验∶
一祖南轩四月，发热头痛，胀闷昏迷，痰喘气急。延余，六脉无根。余曰∶“脉法，六脉无根者，死。若为痧胀而然，
则有救”。其家善放痧，因阅痧筋放之，不愈。余用沉香郁金散，圆红散，稍冷服，又用化毒丹一服，昏迷即醒，胀闷痰
喘气急俱平。更用防风散痧汤加青皮、连翘、山楂、卜子、熟大黄一钱服之。发热头痛俱已，六脉如旧。
一费道元内室，痰喘气急，胀闷不已。延余，左三部脉浮紧而数，右三部脉如无。余曰∶“痧胀暗发也”。其兄善放
痧，刺乳下，出紫黑毒血二针如注，六脉复旧。余用和脾宣化饮二服，稍冷冻饮料之，痰喘气急胀闷俱痊。
一钱公肃子二月晚间，痰喘气急，发热身重，腹中绞痛。延余，脉沉微，刮痧放痧不愈。用藿香汤稍冷服之，又用
棱
术汤加大黄五分，微温服之，诸病俱痊。
先出现痰喘气急，随后因之引发痧胀的，应先治疗痧胀，后治疗痰气。不要让痧成为本病的帮凶；若先有痧胀，随后因之引发痰喘气急的，只需治疗痧胀，痰喘气急便会自愈。
如果痧证伴有寒热不清、痰喘气急的，兼用和解法。
如果痧证有热无寒、痰喘气急的，兼用清热法。
如果痧证有食积不化、痰喘气急的，兼用消食顺气法。
如果痧证有大便不通、小便不利、痰喘气急的，急攻其里实。
如果痧证有痢疾下脓血，或赤或白、痰喘气急的，急攻其积滞。
如果痧证有瘀血凝滞、小便利、大便黑、痰喘气急的，急消其瘀血。
如果痧证有呕吐紫黑血或鲜血、痰喘气急的，应当顾虑痧毒攻坏脏腑。若不疼痛者，可治；疼痛不止者，难治；服药无效者，死。
治验：
一、祖南轩，四月间，发热头痛，胀闷昏迷，痰喘气急。请我诊治，六脉无根。我说：“脉法上，六脉无根者主死。若是因痧胀所致，则有救。”其家人擅长放痧（一种刺破皮肤放出恶血以治病的方法），于是查看痧筋进行放痧，但未愈。我用沉香郁金散、圆红散，稍冷服下，又服用化毒丹一次，昏迷即醒，胀闷痰喘气急全部平息。再用防风散痧汤加青皮、连翘、山楂、卜子、熟大黄一钱服用。发热头痛均已消除，六脉恢复如常。
二、费道元的内室（妻子），痰喘气急，胀闷不已。请我诊治，左三部脉浮紧而数，右三部脉若无。我说：“这是痧胀暗发。”其兄长擅长放痧，刺乳下部位，流出紫黑毒血两针如注，六脉恢复如常。我用和脾宣化饮服用两次，稍冷冻后饮用，痰喘气急胀闷全部痊愈。
三、钱公肃的儿子，二月晚间，痰喘气急，发热身重，腹中绞痛。请我诊治，脉沉微，刮痧放痧未愈。用藿香汤稍冷服下，又用棱术汤加大黄五分，微温服下，诸病全部痊愈。
If phlegm and wheezing with rapid breathing occur first, followed by Sha Zhang (Sha Distension), treat the Sha first, then treat the phlegm and Qi. Do not allow Sha to assist the primary disease; if Sha Zhang occurs first, followed by phlegm and wheezing with rapid breathing, only treat the Sha, and the phlegm and wheezing with rapid breathing will heal spontaneously.
If Sha presents with unclear cold and heat accompanied by phlegm and wheezing with rapid breathing, concurrently use Harmonizing methods (He Jie).
If Sha presents with heat but no cold accompanied by pheng and wheezing with rapid breathing, concurrently use Clearing Heat methods (Qing Re).
If Sha presents with food stagnation not transforming accompanied by phlegm and wheezing with rapid breathing, concurrently use Digesting Food and Smoothing Qi methods (Xiao Shi Shun Qi).
If Sha presents with constipation and difficult urination accompanied by phlegm and wheezing with rapid breathing, urgently attack the interior excess (Gong Li).
If Sha presents with dysentery discharging pus and blood, either red or white, accompanied by phlegm and wheezing with rapid breathing, urgently attack the accumulation (Gong Ji).
If Sha presents with stagnant blood coagulation, free urination, black stool, accompanied by phlegm and wheezing with rapid breathing, urgently eliminate the blood stasis (Xiao Yu).
If Sha presents with vomiting purple-black blood or fresh blood, accompanied by phlegm and wheezing with rapid breathing, one must consider that Sha toxin is attacking and damaging the Zang-Fu organs. If there is no pain, it is treatable; if pain persists, it is difficult to treat; if medication is ineffective, death ensues.
Case Records:
1. Zu Nanxuan, in April, suffered from fever and headache, distension and fullness with coma, and phlegm and wheezing with rapid breathing. Upon consultation, the six pulses were rootless. I said, "In pulse diagnosis, rootless six pulses indicate death. However, if this is due to Sha Zhang, there is hope for recovery." His family was skilled in Fang Sha (releasing Sha by pricking skin to bleed), so they examined the Sha veins and performed bleeding, but without improvement. I prescribed Chenxiang Yujin San (Agarwood and Curcuma Powder) and Yuanhong San, taken slightly cool, followed by a dose of Huadu Dan (Detoxification Pill). The coma immediately cleared, and distension, fullness, phlegm, wheezing, and rapid breathing all subsided. Subsequently, I prescribed Fangfeng San Sha Tang (Saposhnikovia Powder to Dispel Sha) added with Qingpi (Green Tangerine Peel), Lianqiao (Forsythia Fruit), Shanzha (Hawthorn Fruit), Buzi (Radish Seed), and Shu Dahuang (Prepared Rhubarb Root) 1 qian, taken orally. The fever and headache were resolved, and the six pulses returned to normal.
2. The wife of Fei Daoyuan suffered from phlegm and wheezing with rapid breathing and persistent distension and fullness. Upon consultation, the three positions on the left wrist were floating, tight, and rapid, while the three positions on the right wrist seemed absent. I said, "This is latent Sha Zhang." Her brother was skilled in Fang Sha, pricked below the breast, releasing two needles' worth of purple-black toxic blood like a gush, and the six pulses returned to normal. I prescribed Heshi Xuanhua Yin (Spleen-Harmonizing and Transformation-Dispersing Decoction) twice, taken slightly chilled after cooling. Phlegm, wheezing, rapid breathing, and distension all healed.
3. The son of Qian Gongsu, in February evening, suffered from phlegm and wheezing with rapid breathing, fever with heavy body, and colicky abdominal pain. Upon consultation, the pulse was deep and faint. Gua Sha (scraping therapy) and Fang Sha did not yield improvement. I prescribed Huoxiang Tang (Patchouli Decoction), taken slightly cool, followed by Lengzhu Tang (Rhizoma Acori and Rhizoma Curcumae Decoction) added with Dahuang (Rhubarb Root) 5 fen, taken slightly warm. All ailments were cured.