《诗》疏谓江南有射工，一名短弧，含沙射人。《病源》卷二十四分其种类为射工、沙
虱、
溪毒三者。其中人状，皆如伤寒，有恶寒、体热、四肢拘急、头痛、骨 屈伸、张口欠KT 等
候。《本草纲目》四十二溪毒、射工毒、沙虱毒三者相近，俱似伤寒，故有挑沙、刮沙之法
。其腹痛闷乱，须臾杀人者，谓之搅肠沙。据引诸说，则痧本作沙，即指射工所含者言也。
其沙着人肉，则或挑或刮以出之，证治相符，的有明征。后人踵用其法，不能灼知是否为射
工病，但见恶寒发热，状如伤寒者即用之，于是治痧之法，遂混入治暑中。所以误者，以射
工毒亦盛行于夏故尔！夏月人气自虚，倘非沙毒而用刮挑，则邪气被却不得出，有因而增病
者矣，诊者审之！至沙加 旁作痧，而近医遂云感触痧秽，乃天地间另一种气。此所谓不得
其说，从而为之辞也。
胞宫血气之生，源有灵机，故有化机，不可有一物入留其中，有之则血气随物而裹，即
令经
闭腹大，谓之胎也。第其入留之物，有内外之别。由内入留者，本气所结，故无所成；由外
入留者，他气所感，故有所成。二者皆于经行初净得之，有所成者，必如其所感。当经行后
，感男子之精，即成为人；感虫蛇异物之精，即成为虫蛇异物。至其生时，皆有可验。此自
外入留者二也。其自内入留者四∶一为气。多怒之妇，当其经行胞净，气乘虚入，则血与气
结，令人经闭腹大，方书谓之气胎，治之下其气而消；一为液。多痰之妇，当其经行胞净，
痰乘虚入，则血与痰结，令人经闭腹大，方书谓之痰胎，治之下其痰而消；一为水。《灵枢
》谓之石瘕，与气、液二胎同法，治之下其水而消；一为血。当经行时，或因举重，或因犯
房，致经事不卒，血瘀胞宫，亦令人经闭腹大，绝似真胎，治之下其血而消。以上四者，系
妇人本气所结，法与感异，而与积聚同。细考《病源》八瘕及魏之 《续案》，自知其故。
《病源》又有鬼胎，云是精魅入藏所致。然鬼交多在梦寐，非真有施泄，焉得似胎？若精物
意在吸取人精，令人瘵死，亦非有所施泄，焉得似胎？以今俗称痰胎为鬼胎推之，疑《病源
》所云鬼者，亦对人言之耳！但须分别此五者，方能各尽其法，如概予以统同之号，即概施
以安镇之药，多不效也。嗟乎！医学不明，难免闺门不白之冤，仁者可不究诸！
《诗经》的疏注中提到，江南地区有一种叫“射工”的动物，又名“短弧”，它会含着沙粒射击人。《诸病源候论》卷二十四将这类疾病分为射工、沙虱、溪毒三种。其中人的症状，都像伤寒一样，有恶寒、身体发热、四肢拘急、头痛、骨骼屈伸不利、张口呵欠等表现。《本草纲目》第四十二卷指出，溪毒、射工毒、沙虱毒这三种病症相近，都类似伤寒，因此有挑沙、刮沙的治疗方法。其中腹痛烦闷，短时间内致人死亡的，称为“搅肠沙”。综合引用各种说法，可知“痧”字原本写作“沙”，即指射工所含的沙粒而言。这种沙附着在人的皮肤上，就需要通过挑或刮的方法将其取出，这与证治相符，是有明确证据的。后人沿用了这种方法，但不能确切知道是否为射工病，只要见到恶寒发热、状如伤寒的情况就使用此法，于是治疗痧症的方法，便混入了治疗暑病的范畴中。所以造成误治的原因，是因为射工毒也盛行于夏季！夏季人体阳气自然虚弱，如果不是沙毒而用刮挑之法，则邪气被遏制而不能排出，有的因此加重病情了，诊治者应当审慎！至于在“沙”字旁加“疒”旁写成“痧”，近代的医生便说是感触了“痧秽”，认为是天地间另一种气。这就是所谓找不到正确的解释，从而牵强附会地加以解释。
胞宫（子宫）血气的生成，源于具有灵性的生机，因此具有化生的机能，不可让任何异物留存其中，如果有异物留存，血气就会包裹住该异物，即使导致经闭腹大，也称为“胎”。只是这个留存的东西，有内部和外部的区别。由内部产生的留存，是本脏之气郁结而成，所以不能形成真正的胎儿；由外部侵入的留存，是受外界异气感应所致，所以能形成某种形态。这两种情况都是在月经刚刚干净时发生的。能够形成形态的，必然像所感应的对象。在月经结束后，感应到男子的精液，就成为人；感应到虫蛇异物的精气，就成为虫蛇异物。到了出生时，都有可以验证的地方。这是从外部侵入留存的两种情况。从内部滞留形成的有四种：一是气。易怒的妇女，在月经刚净时，气乘虚而入，则血与气结聚，使人经闭腹大，医书称之为“气胎”，治疗时降其气而消散；二是液。多痰的妇女，在月经刚净时，痰乘虚而入，则血与痰结聚，使人经闭腹大，医书称之为“痰胎”，治疗时下其痰而消散；三是水。《灵枢》称之为“石瘕”，与气、液两种胎治疗方法相同，治疗时利其水而消散；四是血。在行经期间，或因举重，或因房事，导致经血未排尽，瘀血滞留胞宫，也使人经闭腹大，极像真胎，治疗时下其瘀血而消散。以上四种，都是妇人本脏之气郁结而成，治法与感受外邪不同，而与积聚类同。仔细考证《诸病源候论》中的八瘕以及魏之琇的《续案》，自然明白其中的缘故。《诸病源候论》中还有“鬼胎”，说是精魅进入脏腑所致。然而鬼交多在梦寐中进行，并非真有精液的施泄，怎么能像怀孕？如果是精物意在吸取人的精气，使人患痨病而死，也没有精液的施泄，怎么能像怀孕？以现在俗称的“痰胎”为“鬼胎来推测，怀疑《诸病源候论》所说的“鬼”，也是相对于人来说的罢了！但是必须区分这五种情况，才能各自采用恰当的方法，如果一概给予统一的名称，就一概施用安镇的药物，大多无效啊。唉！医学如果不明，难免会有闺门不白之冤，仁爱的人怎能不深入研究呢！
The commentary on the *Classic of Poetry* mentions that in the Jiangnan region, there is a creature called "Shegong" (Arrow Bug), also known as "Duanhu" (Short Bow), which shoots people while holding sand. Volume 24 of *Zhubing Yuanhou Lun* (Treatise on the Pathogenesis and Symptoms of All Diseases) classifies these into three types: Shegong, Shashi (Sand Louse), and Xidu (Stream Poison). The symptoms upon infection resemble Taiyang disease (a syndrome caused by pathogenic factors affecting the Taiyang channel), presenting with aversion to cold, fever, stiffness and spasm of the four limbs, headache, difficulty in flexing and extending the bones, and yawning. Volume 42 of *Bencao Gangmu* (Compendium of Materia Medica) states that Xidu, Shegong poison, and Shashi poison are similar, all resembling Taiyang disease; therefore, methods such as picking out sand and scraping sand are used. Among them, those causing abdominal pain and restlessness, leading to death within a short time, are called "Jiaochangsha" (Intestine-Churning Sha). Based on these citations, it can be inferred that "Sha" was originally written as "Sha" (sand), referring to the sand held by the Shegong. When this sand adheres to human flesh, it must be removed by picking or scraping, which aligns with the treatment principles and provides clear evidence. Later generations followed this method but could not definitively determine if it was a Shegong disease; they simply applied it whenever aversion to cold and fever resembling Taiyang disease were observed. Consequently, the methods for treating Sha became mixed with those for treating Summerheat. The reason for this error lies in the fact that Shegong poison also prevails in summer! In summer, human Qi is naturally deficient; if scraping and picking are used when there is no sand poison, the pathogenic factor will be suppressed without being expelled, potentially exacerbating the illness. Practitioners must exercise caution! As for adding the disease radical (Bing) to "Sha" to form "Sha" (illness/sand-poison), modern physicians claim it results from contracting "Sha Hui" (filthy Sha), considering it another type of Qi in heaven and earth. This is what is meant by failing to find the correct explanation and thus resorting to forced reasoning.
The generation of Blood and Qi in the Baogong (Uterus) stems from a spiritual vitality, possessing transformative mechanisms. No foreign object should remain inside; if one does, the Blood and Qi will envelop it. Even if this leads to amenorrhea and abdominal distension, it is termed "Tai" (Fetus/Pregnancy). However, the retained object differs in origin: internal or external. Retention originating internally is formed by the condensation of the body's own Qi, thus failing to develop into a true fetus. Retention originating externally is induced by external pathogenic Qi, thus taking shape. Both occur when menstruation has just ceased. Those that take shape will resemble the inducing agent. After menstruation, if one is influenced by male essence, a human is formed; if influenced by the essence of insects, snakes, or other foreign objects, such creatures are formed. Their birth presents verifiable signs. These constitute the two cases of external retention. There are four cases of internal retention: First is Qi. For women prone to anger, when Qi enters due to deficiency after menstruation ceases, Blood and Qi knot together, causing amenorrhea and abdominal distension. Medical texts call this "Qi Tai" (Qi Fetus); treatment involves descending Qi and resolving the knot. Second is Fluid (Ye). For women prone to phlegm, when Phlegm enters due to deficiency after menstruation ceases, Blood and Phlegm knot together, causing amenorrhea and abdominal distension. Medical texts call this "Tan Tai" (Phlegm Fetus); treatment involves draining Phlegm and resolving the knot. Third is Water. *Ling Shu* (Spiritual Pivot) calls this "Shi Jia" (Stone Mass); it shares the same treatment method as Qi and Fluid fetuses, involving draining Water and resolving the mass. Fourth is Blood. During menstruation, due to heavy lifting or sexual intercourse, menstrual flow may not complete, causing Blood stasis to remain in the Baogong. This also causes amenorrhea and abdominal distension, closely mimicking a true pregnancy. Treatment involves draining Blood stasis and resolving the mass. The above four are formed by the condensation of the woman's own Qi; their treatment differs from external contraction and is similar to Accumulation and Collection (Ji Ju). Careful study of the "Eight Jia" in *Zhubing Yuanhou Lun* and Wei Zhixiu's *Xu An* will reveal the truth. *Zhubing Yuanhou Lun* also mentions "Ghost Tai," attributed to spirits entering the viscera. However, ghost intercourse usually occurs in dreams without actual emission of essence; how can it resemble pregnancy? If a spirit intends to absorb human essence, causing consumption disease (Zhai), there is also no emission of essence; how can it resemble pregnancy? Inferring from the common modern usage of calling "Tan Tai" (Phlegm Fetus) "Ghost Tai," it is suspected that the "Ghost" mentioned in *Zhubing Yuanhou Lun* refers to something relative to humans! One must distinguish between these five types to apply appropriate treatments. If given a unified label and treated uniformly with sedative/calming medicines, most will prove ineffective. Alas! Without clear medical knowledge, unjust accusations against women in the inner quarters are inevitable. How can benevolent practitioners fail to investigate this deeply!