夏伤于暑，秋必疟痢。痢初必先泄泻，肠胃空虚，则易感秽气，即成痧痛。或炎热疫疠
，因积而发，亦致痧痛。夫痢不兼痧，积去便轻，若一兼犯，必绞痛异常，止治痢无效，或
变如猪肝色，如屋漏水、或惟血水，或变噤口不食，呕哕凶危，或休息久痢，绵延岁月，惟
先治痧兼治积，则痧消而积易去，积去而痧可清矣。
一人发热痢血水，日百余次，肛门窘迫，腹痛异常，呕哕不食，六脉迟数不常，或时歇
止，此痧痢也。刮放后，痛减半，用石一方、砂仁汤下，煎用竹六方，去赤白滞甚多，诸症
悉愈。
一人发热胀闷沉重，痢下紫血，医但治痢，甚危笃。见六脉洪大不匀，令刮痧，用匏三
方入童便饮，次以苏木、红花、五灵脂、茜草、乌药、香附、当归导瘀乃安。
痧有寒热往来，类乎疟疾，或昏沉、或狂乱、或痰喘、或烦闷叫喊，或呕哕吐痰，睡卧
不安，或大小便结，舌黑生芒，如此重极，脉必有变，不与疟同，宜细辨。
一人日晡寒热，昏沉胀闷，大便不通，舌焦苔浓，左脉浮大而虚，右沉细而涩，不似疟
脉，视乳下有青筋，刺出毒血，用散痧消毒活血药，诸症退。又用润下丸二钱，大便通，惟
寒热未退，用小柴胡汤而痊。
疟忽兼犯乎痧，疟必因痧而变，苟慢以为疟而忽视之，必至伤人，是非先治其痧，即轻
痧亦必有遗患（土一）。
一少男患疟凶暴，验筋放痧，稍松，用石二、金八方两服，扶而起，次日伤食患益甚，
更放痧，用散痧消食顺气解毒药，三服稍安。后又伤食发热，用楂、卜、青、陈、紫朴、白
芥四服，大便不通加大黄、枳实，便通热减，但病久虚晕心跳，用枣仁、茯神、参、 、熟
地之类，调补一月，痊。
一妇疟八日，忽壮热不已，昏沉不醒，左脉不匀，右虚涩，非疟脉也。刺臂青筋，流紫
黑血，不愈。服金五方加藿、朴、槟、卜并土一方，稍醒，次日又刺指头，服金五方加军、
枳，热退后用丝二方运动其气，痊。
夏季感受暑邪，秋季必然发生疟疾和痢疾。痢疾初起时必定先有泄泻，导致肠胃空虚，此时容易感染秽浊之气，从而形成痧症引起的疼痛。或者是由于炎热季节的疫疠之气，因体内积滞而发作，也会导致痧痛。如果痢疾不兼夹痧症，积滞去除后病情就会减轻；一旦兼夹了痧邪，必定会出现异常的剧烈绞痛，单纯治疗痢疾无效，或者大便颜色变为像猪肝一样的颜色，像屋漏水的样子，或者只有血水，或者转变为噤口痢（不能进食），出现呕吐呃逆等凶险危重的症状，或者是迁延日久的休息痢，绵延多年。只有先治疗痧症并兼治积滞，那么痧邪消除后积滞就容易去除，积滞去除了痧邪也可以清除了。
有一人发热并下痢血水，每天一百多次，肛门窘迫紧迫，腹痛异常剧烈，呕吐呃逆不能进食，六脉迟数无常，有时间歇停止，这是痧痢。经过刮痧放血治疗后，疼痛减半，使用石一方、砂仁汤送服，煎煮竹六方，排出了大量的赤白脓血积滞，各种症状全部痊愈。
有一人发热、腹胀闷重，下痢紫血，医生只治疗痢疾，病情非常危重。诊察发现六脉洪大且不均匀，令其刮痧，用匏三方加入童便饮用，接着用苏木、红花、五灵脂、茜草、乌药、香附、当归来引导瘀血排出，这才安定下来。
痧症有寒热往来的表现，类似于疟疾，或者神志昏沉、或者狂乱、或者痰喘、或者烦闷叫喊，或者呕吐呃逆吐痰，睡卧不安，或者大小便闭塞不通，舌苔黑而生芒刺，如此严重的情况，脉象必定有变化，与疟疾不同，应当仔细辨别。
有一人傍晚时分寒热往来，神志昏沉腹胀闷，大便不通，舌焦苔厚腻，左脉浮大而虚，右脉沉细而涩，不像疟疾的脉象，查看乳下有青筋，针刺放出毒血，使用散痧消毒活血的药物，各种症状消退。又服用润下丸二钱，大便通畅，只有寒热未退，用小柴胡汤而痊愈。
疟疾忽然兼夹痧邪，疟疾必定因为痧邪而发生变证，如果慢待将其当作普通疟疾而忽视它，必定会伤害人体，这不是先治疗痧邪，即使是轻微的痧症也必定留下后患。
一个少年患疟疾凶险暴烈，验看筋络进行放痧，稍微缓解，服用石二方、金八方两剂，扶起身体，第二天因伤食病情更加严重，再次放痧，使用散痧消食顺气解毒的药物，三剂后稍微安宁。后来又因伤食发热，使用山楂、萝卜、青皮、陈皮、紫朴、白芥子四剂，大便不通加大黄、枳实，大便通畅后热势减退，但因为病久体虚出现头晕心跳，使用酸枣仁、茯神、人参、[缺失字]、熟地黄之类的药物，调补一个月，痊愈。
一位妇女患疟疾八天，忽然高热不退，神志昏沉不醒，左脉不均匀，右脉虚涩，不是疟疾的脉象。针刺手臂青筋，流出紫黑色血液，病未愈。服用金五方加藿香、厚朴、槟榔、萝卜以及土一方，稍微清醒，第二天又针刺手指头，服用金五方加军（大黄）、枳实，热退后用丝二方运行其气，痊愈。
Summer damage by heat, autumn must have malaria and dysentery. Dysentery initially must first present with diarrhea; when the intestines and stomach are empty, it is easy to be infected with turbid qi, which immediately forms sha pain (pain caused by sha syndrome). Or due to epidemic pestilence in hot weather, developing because of accumulation, also causing sha pain. If dysentery does not combine with sha, after the accumulation is removed, the stool becomes lighter; if once combined with sha, there must be abnormal severe colic. Treating only dysentery is ineffective, or it may change to a color like pig liver, like dripping roof water, or only bloody water, or change to jinkou li (dysentery with inability to eat), vomiting and hiccups being fierce and dangerous, or chronic intermittent dysentery lasting for years. Only by first treating sha and simultaneously treating accumulation can sha be eliminated so that accumulation is easily removed, and once accumulation is removed, sha can be cleared.
One person had fever and dysentery with bloody water, over a hundred times a day, anus feeling urgent and oppressive, abdominal pain extremely severe, vomiting and hiccups preventing eating, six pulses slow and rapid irregularly, sometimes pausing intermittently; this is sha dysentery. After scraping and bleeding, pain reduced by half. Using Shi Yi Fang (Formula One of Stone) administered with Amomum fruit decoction, decocting Zhu Liu Fang (Formula Six of Bamboo), removing much red and white stagnation, all symptoms completely healed.
One person had fever, distension, oppression, and heaviness, passing purple blood in stool. The physician only treated dysentery, condition becoming very critical. Observing six pulses surging and large but uneven, ordered scraping. Using Pao San Fang (Formula Three of Gourd) taken with child's urine, then using Spatholobus stem, Carthamus flower, Trogopterus dung, Rubia root, Lindera root, Cyperus rhizome, Angelica sinensis to guide out stasis, thus stabilized.
Sha has alternating chills and fever, resembling malaria, or coma, or mania, or phlegm wheezing, or irritability and shouting, or vomiting and spitting phlegm, restless sleep, or constipation of both bowels and bladder, black tongue with prickles. Such extreme severity implies pulse changes different from malaria; careful differentiation is required.
One person had evening chills and fever, coma, distension and oppression, no bowel movement, scorched tongue with thick coating, left pulse floating, large and deficient, right pulse deep, fine and choppy, unlike malaria pulse. Viewing bluish veins under the breast, pricked to release toxic blood, used herbs to dissipate sha, detoxify, and invigorate blood, all symptoms receded. Then used Run Xia Wan (Moistening Down Pill) 2 qian, bowel movement unblocked, only chills and fever remained unreduced, used Xiao Chai Hu Tang (Minor Bupleurum Decoction) for recovery.
Malaria suddenly combining with sha, malaria must change due to sha. If neglected as mere malaria, it will surely harm people. It is not [so] unless sha is treated first; even mild sha must leave sequelae.
A young male suffered violent malaria. Checking tendons and performing sha bleeding provided slight relief. Used Shi Er Fang (Formula Two of Stone) and Jin Ba Fang (Formula Eight of Gold) two doses, supported him to sit up. Next day, food stagnation made illness worse. Performed sha bleeding again, used herbs to dissipate sha, digest food, smooth qi, and detoxify. Three doses brought slight peace. Later, food stagnation caused fever. Used Hawthorn seed, Radish, Green tangerine peel, Aged tangerine peel, Purple Magnolia bud, White mustard seed four doses. No bowel movement added Rhubarb and Immature bitter orange. Bowel movement unblocked, heat reduced. But long illness caused deficiency, dizziness, and palpitations. Used Sour jujube seed, Poria cocos, Ginseng, [missing character], Prepared Rehmannia root etc., tonifying and regulating for one month, recovered.
A woman suffered malaria for eight days, suddenly high fever unceasing, coma unconscious. Left pulse uneven, right pulse deficient and choppy, not malaria pulse. Pricked arm bluish veins, flowed purple-black blood, not cured. Took Jin Wu Fang (Formula Five of Gold) plus Agastache, Magnolia bark, Areca nut, Radish and Tu Yi Fang (Formula One of Earth), slightly awake. Next day pricked fingertips, took Jin Wu Fang plus Jun (Rhubarb), Immature bitter orange. Heat retreated, then used Si Er Fang (Formula Two of Silk) to move qi, recovered.