山内水间有沙虱，其蛊甚细，不可见。人入水浴及汲水澡浴，此虫着身，及阴雨日行草
间亦着人，便钻入皮里。其诊法，初得时，皮上正赤，如小豆黍粟，以手摩赤上，痛如刺。
过三日之后，令百节强，疼痛，寒热，赤上发疮。此虫渐入至骨，则杀人。
人在山涧洗浴竟，巾拭KT KT 如芒毛针刺，熟看见处，以竹簪挑拂去之。已深
者，用针挑取虫子，正如疥虫，着爪上，映光方见行动也。挑不得，灸上三七壮，则虫死病
除。若止两三处，不能为害，多处不可尽挑灸。挑灸其上而犹觉昏昏，是其已大深，便应须
根据土俗作方术拂出之，并作诸药汤浴，皆得一二升，出都尽乃止。
此七日内宜瘥，不尔则续有飞蛊来，人攻啖心脏便死。飞蛊白色，如韭叶大，长四五寸
，初着腹胁，肿痛如刺，即破鸡 之，尽出食鸡，或得三四数过，与取尽乃止，兼取麝
香、犀角护其内，作此治可瘥。勿谓小小，不速治，则杀人。
彼土呼此病为呼 。（吴音沙作 。读如鸟长尾 音也。）言此虫能招呼沙虱入人体内，人行有得沙虱，还至即以
火自灸
燎令遍，则此虫自堕地也。
自三吴已东及南，诸山郡山县，有山谷溪源处，有水毒病，春秋辄得。一名中水，一名
中溪，一名中洒（苏骇反），一名水中病，亦名溪温。今人中溪，以其病与射工诊候相似，通呼溪病。
其实有异，有疮是射工，无疮是溪病。
初得恶寒，头微痛，目匡疼，心内烦懊，四肢振 ，腰背骨节皆强，两膝疼，或吸
吸热，但欲睡，旦醒暮剧，手足指逆冷至肘膝。二三日则复生虫，食下部，肛内有疮，
不痒不痛，令人不觉，视之乃知。不即治，六七日下部便脓溃，虫上食五脏，热盛烦毒，注
下不禁，八九日死。一云十余日死。
水毒有阴阳，觉之急视下部。若有疮正赤如截肉者，为阳毒，最急；若疮如鳢鱼齿者，
为阴毒，犹小缓。皆杀人，不过二十日。又云，水毒有雌雄，脉洪大而数者为阳，是雄溪，
易治，宜先发汗及浴。脉沉细迟者为阴，是雌溪，难治。
欲知审是中水者，手足指冷即是，若不冷非也。其冷或一寸，或至腕，或至肘膝。冷至
二寸为微，至肘膝为剧。又云∶作数斗汤，以蒜四五升捣碎投汤内，消息视之，莫令大热，
绞去滓，适寒温，以自浴，若身体发赤斑文者是也。又云∶若有发疮处，但如黑点，绕边赤
，状似鸡眼。在高处难治，下处易治。余诊同，无复异，但觉寒热头痛，腰背急强，手脚冷
，欠KT 欲眠，朝瘥暮剧，便判是溪病，不假蒜汤及视下部疮也。
此证者，至困时亦不皆洞利及齿间血出，惟热势猛者，则心腹烦乱，不食而狂语，或有
下血物如烂肝，十余日至二十日则死。不测，虫食五脏，肛伤，以不治。
又云∶溪病不歇，仍飞蛊来人，或皮肤腹胁间突起，如烧痛，如刺，登破生鸡
上，辄得白虫，状似蛆，长四五六七寸，或三四六八枚无定。此即应是所云虫啖食五脏及下
部之事。又云∶中溪及射工法急救，令七日内瘥，不尔则有飞蛊来入人身内，攻啖五脏便死
。彼土辟却之法，略与射工相似。
在山林和水边有沙虱，这种虫子非常细小，肉眼看不见。人们下水洗澡或打水沐浴时，这种虫会附着在身上；在阴雨天走在草丛间也会沾上它，随后便钻入皮肤内。诊断方法是：刚染病时，皮肤上出现正红色的斑点，像小豆、黍米或粟粒大小，用手摩擦红色部位，感觉疼痛如针刺。过了三天之后，全身关节僵硬疼痛，伴有寒热症状，红色部位长出疮疡。这种虫逐渐深入至骨骼，就会致人死亡。
人在山涧洗浴完毕后，用毛巾擦拭身体时，感到“窸窣”作响，如同芒毛针刺一般，仔细查看患处，用竹签挑拨去除虫子。如果虫子已经钻得较深，用针挑取虫子，就像疥虫一样，放在指甲上对着光才能看见它在活动。如果挑不出来，就在患处艾灸三七壮（21壮），虫子死去，病也就好了。如果只有两三处感染，不会造成大害；但如果多处感染，就不能全部挑灸。如果在挑灸后仍然感到昏沉，说明虫子已经钻得很深，应当依据当地风俗采用方术将其驱除，并配合各种药汤洗浴，每次用量一二升，直到虫子完全排出为止。
此病七日内应当痊愈，否则会有飞蛊飞来，攻击并啃食心脏，导致死亡。飞蛊呈白色，大小如韭菜叶，长四五寸，最初附着在腹部和胁部，肿痛如针刺，此时立即剖开鸡皮覆盖其上，让虫子全部爬到鸡身上，然后吃掉鸡肉，或者重复三四次，直到虫子取尽才停止。同时服用麝香、犀角以保护内脏，这样治疗可以痊愈。不要认为这是小病而不迅速治疗，否则会致死。
当地人称这种病为“呼 。”（吴地发音，“沙”读作“ ”，读音同鸟的长尾“ ”）。意思是这种虫子能召唤沙虱进入人体，人一旦沾染了沙虱，回到住处就用火遍身熏灸，这种虫子就会自动掉落地上。
自三吴以东及南方各山郡山县，在有山谷溪源的地方，有水毒病，春秋季节容易发作。又名中水、中溪、中洒（苏骇反）、水中病，也称溪温。现在人们遇到中溪的情况，因为它的病症与射工相似，通称为溪病。其实二者不同，有疮的是射工，无疮的是溪病。
初发病时恶寒，头部微痛，眼眶疼，心中烦闷懊恼，四肢震颤，腰背骨节皆僵硬，两膝疼痛，或有灼热感，只想睡觉，早晨清醒傍晚加重，手足指尖冷至肘膝。二三天后又生出虫子，啃食下部器官，肛内有疮，不痒不痛，让人察觉不到，视之才知道。如果不立即治疗，六七天后面部下部就会化脓溃烂，虫子向上啃食五脏，热盛烦毒，腹泻不止，八九日死亡。另一种说法是十余日死亡。
水毒分阴阳，发觉后应立即检查下部。如果有疮，颜色正红如截断的肉，属于阳毒，最为紧急；如果疮色像鳢鱼牙齿，属于阴毒，稍微缓和些。两者都会致死，不超过二十天。又说，水毒有雌雄之分，脉象洪大而数的是阳，是雄溪，容易治疗，适宜先发汗及洗浴。脉象沉细迟的是阴，是雌溪，难治。
想要确切知道是否是中水，看手足指尖是否发冷即可，如果不冷就不是。寒冷程度或一寸，或至手腕，或至肘膝。冷至二寸为轻微，至肘膝为严重。又说：煮几斗热水，将四五升蒜捣碎投入汤中，观察水温，不要太烫，滤去渣滓，温度适宜后自行洗浴，如果身体出现赤色斑纹的就是中了水毒。又说：如果有发疮的地方，只是像黑点，周围发红，形状似鸡眼。位置在高处的难治，低处的易治。我的诊断与此相同，没有差异，只要觉得寒热头痛，腰背拘急僵硬，手脚冷，打哈欠想睡，早晨好转傍晚加重，就可以判断是溪病，不需要用蒜汤洗浴或检查下部疮口。
此证发展到极度困顿时，也不一定是洞泄和齿间出血，只有热势猛烈者，才会心腹烦乱，不吃东西而胡言乱语，有的排出像烂肝一样的血块，十余日至二十日死亡。无法预测，因虫子啃食五脏，肛门受伤，由于未及时治疗而死。
又说：溪病不愈，仍有飞蛊进入人体，或在皮肤、腹部胁部突起，如烧灼痛，如针刺，剖开鸡皮覆盖其上，往往能得到白虫，形状像蛆，长四五六七寸，数量不定，有三四个到三四十个不等。这应该就是所说的虫子啃食五脏及下部的情况。又说：中溪及射工的急救方法，令七日内痊愈，否则会有飞蛊进入人身内，攻啖五脏致死。当地躲避的方法，大致与射工相似。
In the mountains and by the water, there are *Shashi* (sand lice), which are extremely fine and invisible to the naked eye. When people enter the water to bathe or draw water for washing, these insects attach to the body; walking through grass on rainy days also causes them to adhere to humans, drilling into the skin. The diagnostic method is as follows: at the onset, a red spot appears on the skin, the size of a small bean, millet, or grain of sorghum. Rubbing the red area with fingers causes pain like needle pricks. After three days, stiffness and pain occur in all joints, accompanied by aversion to cold and fever, and sores develop on the red spots. As the insect gradually penetrates to the bone, it becomes fatal.
After bathing in mountain streams, when wiping the body with a towel, one may hear a rustling sound and feel prickles like bristles. Carefully inspecting the affected area allows one to pick out the insect with a bamboo pin. If the insect has penetrated deeply, use a needle to extract it; like *Jiechong* (scabies mites), it can only be seen moving when held against the light on the fingernail. If it cannot be picked out, apply moxibustion (Moxibustion) for twenty-one moxa cones (3 × 7) on the lesion; the insect will die, and the disease will be cured. If there are only two or three lesions, they are not harmful; but if there are many, they cannot all be treated by picking and moxibustion. If dizziness persists after treatment, the insect has penetrated deeply. One should follow local customs to expel it using specific methods and bathe in various medicinal decoctions, consuming one or two sheng per session, until the insect is completely expelled.
The condition should resolve within seven days; otherwise, flying gu (flying parasites) will come, attack, and devour the heart, leading to death. These flying gu are white, the size of a leek leaf, and four to five cun long. Initially attaching to the abdomen and flanks, they cause swelling and pain like needle pricks. Immediately break open a chicken and cover the wound; the insects will crawl onto the chicken. Eat the chicken meat, repeating this three or four times until all insects are removed. Simultaneously administer Musk (Moschus) and Rhinoceros Horn (Rhinocerotis Cornu) to protect the internal organs. This treatment can cure the disease. Do not consider it a minor illness and delay treatment, as it can be fatal.
Locals call this disease "Hu Sha" (Wu dialect pronunciation). It means this insect can summon sand lice into the human body. Once infected, returning home, one should fumigate the entire body with fire, causing the insect to fall off automatically.
From Sanwu eastward and southward, in mountainous counties and towns with valleys and streams, there is a disease called *Shuidu* (water toxicity), occurring frequently in spring and autumn. Also known as *Zhongshui*, *Zhongxi*, *Zhongsai*, *Shuizhongbing*, or *Xiwen*. Currently, cases of *Zhongxi* are generally called *Xibing* because their symptoms resemble those of *Shegong* (archer bug). However, they differ: *Shegong* presents with sores, while *Xibing* does not.
Initial symptoms include aversion to cold, slight headache, orbital pain, inner restlessness and vexation, trembling of the four limbs, stiffness of the waist, back, and joints, knee pain, burning heat sensation, lethargy, worsening in the evening compared to morning, and coldness of the finger tips extending to the elbows and knees. After two or three days, new insects emerge, devouring the lower orifices. Sores appear inside the anus, without itching or pain, going unnoticed until visual inspection reveals them. If not treated immediately, pus and ulceration occur in the lower region after six or seven days. The insects ascend to devour the five zang organs, causing intense heat, vexation, and toxic sensations, with uncontrollable diarrhea. Death occurs in eight or nine days, or according to another account, ten to twelve days.
*Shuidu* is classified into Yin and Yang. Upon detection, examine the lower region immediately. If the sore is bright red like cut meat, it is *Yangdu* (Yang toxicity), which is most urgent. If the sore resembles the teeth of an snake (*Li*), it is *Yindu* (Yin toxicity), which is slightly less acute. Both are fatal within twenty days. Another view states that *Shuidu* has male and female types. A pulse that is large, rapid, and forceful indicates *Yang* (male *Xi*), which is easier to treat and suitable for inducing sweating and bathing. A pulse that is deep, fine, and slow indicates *Yin* (female *Xi*), which is difficult to treat.
To confirm *Zhongshui*, check if the finger tips are cold. Coldness extending one cun, to the wrist, or to the elbows and knees indicates severity. Coldness up to two cun is mild; reaching the elbows and knees is severe. Another method involves boiling several dou of water, adding four or five sheng of crushed garlic, monitoring the temperature to ensure it is not too hot, straining the residue, and bathing in the warm solution. Appearance of red spots on the body confirms the diagnosis. Another sign is a black dot-like sore surrounded by redness, resembling a chicken eye. Lesions in high places are harder to treat; those in low places are easier. My diagnosis aligns with this: if one feels chills, fever, headache, stiffness of the waist and back, cold hands and feet, yawning, sleepiness, and symptom fluctuation (better in morning, worse in evening), it can be judged as *Xibing* without needing garlic baths or examining lower sores.
In critical stages, this condition does not always present with profuse diarrhea or bleeding from the gums. Only when the heat pathogen is fierce do patients experience mental confusion, refusal to eat, and delirious speech. Some pass blood clots resembling rotten liver. Death occurs between ten and twenty days. The outcome is unpredictable; death results from insects devouring the five zang organs and damaging the anus due to lack of timely treatment.
It is also said that if *Xibing* does not subside, flying gu continue to enter the body, causing protrusions in the skin, abdomen, or flanks, with burning and stabbing pain. Covering the area with broken chicken skin attracts white insects resembling maggots, four to seven cun long, in varying numbers (three to thirty-eight). This corresponds to the description of insects devouring the five zang organs and lower regions. Emergency treatment for *Zhongxi* and *Shegong* aims for recovery within seven days; otherwise, flying gu enter the body, devour the five zang organs, and cause death. Local preventive methods are similar to those for *Shegong*.