陈载庵云∶《痧症全书》中涤痧丸，失载其方，余访得之，即是龚云林《万病回春》所
载白
虎丸，用千年锻石，刮去杂色泥土为末，水飞过，丸如桐子大，每服五十丸，再视病轻重加
减，烧酒送下。此药顺气散血，化痰消滞，治青筋。（北方谓之青筋，南方谓之痧。）初觉头
疼恶心，或腹痛，或腰疼，或遍身作痛，不思饮食，即进一服，当时血散而愈。若用砭刺之
法，耗损其血，不若此方之神妙。（《松峰说疫》亦采此方，谓霍乱痧胀皆治之，惟青筋多
生冷寒湿所致，宜用烧酒，至热症或用冷水冷茶送，随症变通可耳。）又治心腹痛，及妇人
崩漏带下，或久患赤白痢，并一切打扑内伤，血不能散，服之皆大效。载庵言以此药施人治
痧症，获效果捷。千年锻石不可得，用古墓中锻石可也
长洲龙柏青霏《脉药联珠》谓痧胀之症，多属奇经，盖奇经为十二经之支流也，五脏之
清气
不升，六腑之浊气不降，譬犹五湖四渎，浸溢泛滥，尽入江河，而清浊已混，更水甚土崩，
泥沙扰混，流荡不清，井俞壅塞，故其病有痧胀之名。痧胀者，犹沙涨也。痧胀总由十二经
清浊不分，流溢入于奇经，而奇经脉现，则为痧症也。邪气滞于经络，与脏腑无涉，不当徒
以药味攻脏腑，宜先用提刮之法及刺法，使经络既通，然后用药，始堪应手。其论痧症属奇
经，未经人道，理实确而可信也。
咸丰六年，夏秋之交，杭州人患吊脚痧，吐泻腹痛，足筋拘急，不即救，一二时即死，
传有
外治神方甚验，好善之家，制药施送，救人不少，干霍乱症亦可治。七年八月，运司河下刘
某患绞肠痧，势甚危险，其邻某知柴垛桥边夏家有此药，急往乞取，治之立愈。余目击其效
，真神药也。兹录其方，并载药价，有力预备济人，功德无量。麝香、（五钱，钱十八千九
百），母丁香 （一两，钱一百四十）、 桂心（去皮（一两二钱，钱二千二百），生香附、（一两，钱十），倭硫黄、（三两
五
钱，钱二千五百，又
合药工分二百十小痧药瓶五百三个，钱六百五十）。共药七两五钱，每一瓶贮药一分五厘，
每用一瓶，病重者用二瓶，上药研极细末，分贮小瓶，黄蜡封口，用时先将暖脐膏药烘透，
倒药末在中间，即向病者脐上贴住，一时即愈。（此方救病甚速，然药性猛烈，断不可服，
孕妇忌贴。）
绞肠痧即干霍乱，《温病条辨》谓由寒湿，其驱浊阴以救中焦之真阳，方用附子、干姜
等热
药。《伤寒论汇言》谓此症得之夏秋间，设或见腹痛脉沉，误作阴寒治疗，一进热物汤茶
酒药等，即刻闷乱而死。二说截然相反，余谓此症寒热皆有之，医者切宜审慎用药。其治之
之法，有不论寒热皆可用者，外治则取委中穴，（腿湾处。）多用热水急拍，红筋高起，刺之
出血即愈，内治则用马粪，（年久弥佳。）瓦上焙干末，滚水冲服（一方加黄土入淡黄酒煎服
。）二三钱，不知，再作服。二法皆载《温病条辨》，实良方也。（马粪并治霍乱吐泻，余曾
疗治多人。）
陈载庵说：《痧症全书》中记载的涤痧丸，缺失了方剂内容，我寻访得知，它其实就是龚云林在《万病回春》中记载的白虎丸。该方使用千年锻石（经长期煅烧的石块），刮去杂色泥土后研成粉末，用水飞法处理，制成如梧桐子大小的药丸。每次服用五十丸，再根据病情轻重增减剂量，用烧酒送服。此药能顺气散血、化痰消滞，治疗青筋（北方称为青筋，南方称为痧）。初觉头疼恶心，或腹痛，或腰痛，或全身疼痛，不思饮食时，立即服用一次，当时即可血散而愈。如果用砭刺的方法，会耗损血液，不如这个方子神妙。（《松峰说疫》也收录了这个方子，说霍乱和痧胀都能治疗，只是青筋多由生冷寒湿引起，适宜用烧酒送服；如果是热症，或者用冷水、冷茶送服，随症状变化灵活变通即可。）又治疗心腹痛，以及妇人崩漏带下，或久患赤白痢疾，以及一切跌打内伤导致血不能消散的情况，服用都有显著疗效。载庵说用此药施治痧症，获得效果迅速。千年锻石难以得到，可以使用古墓中的锻石代替。
长洲龙柏青霏在《脉药联珠》中说，痧胀之症，多属于奇经八脉，因为奇经是十二正经的支流。五脏的清气不升，六腑的浊气不降，就像五湖四渎泛滥，全部流入江河，导致清浊混杂，进而水土崩塌，泥沙搅混，流荡不清，井穴俞穴壅塞，所以这种病有痧胀之名。痧胀，就像沙涨一样。痧胀总归是由于十二经清浊不分，流溢进入奇经，而奇经脉显现，就成为痧症。邪气阻滞于经络，与脏腑无关，不应当仅仅用药物攻伐脏腑，适宜先用提刮法和刺法，使经络通畅之后，然后再用药，才能应手取效。他论述痧症属于奇经，这是前人未曾涉及的，道理确实确切可信。
咸丰六年，夏秋之交，杭州人患吊脚痧，出现呕吐腹泻、腹痛、足部筋脉拘挛紧急的症状，如果不及时救治，一两个时辰就会死亡。流传着一种外治神方非常灵验，乐善好施的人家制药施送，救人不计其数，干霍乱症也可以治疗。七年八月，运司河下的刘某患绞肠痧，病情非常危险，他的邻居某知道柴垛桥边夏家有此药，急忙前往乞求取来，治疗后立刻痊愈。我亲眼目睹了其疗效，真是神药啊。现在记录这个方子，并列出药价，有能力者预备济人，功德无量。麝香（五钱，价格十八千九百文）、母丁香（一两，价格一百四十文）、桂心（去皮，一两二钱，价格二千二百文）、生香附（一两，价格十文）、倭硫黄（三两五钱，价格二千五百文，另加药工费二百一十文，小痧药瓶五百三个，价格六百五十文）。共药七两五钱，每一瓶贮药一分五厘，每次用一瓶，病重者用两瓶。将上述药物研成极细粉末，分装在小瓶中，用黄蜡封口。使用时先将暖脐膏药烘透，将药末倒在中间，即贴在病人肚脐上，一个时辰即可痊愈。（此方救病非常迅速，但药性猛烈，绝对不可内服，孕妇忌贴。）
绞肠痧即干霍乱，《温病条辨》认为由寒湿引起，驱除浊阴以挽救中焦的真阳，方剂使用附子、干姜等热药。《伤寒论汇言》认为此症得之于夏秋之间，如果见到腹痛脉沉，误作阴寒治疗，一旦进服热物、汤茶酒药等，即刻闷乱而死。两种说法截然相反，我认为此症寒热皆有，医者切宜审慎用药。其治疗方法，有不论寒热皆可用的方法。外治则取委中穴（腿弯处），多用热水急拍，红筋高起，刺之出血即愈。内治则用马粪（年久的更好），在瓦上焙干研末，滚水冲服（一方加黄土入淡黄酒煎服），二三钱，无效，再服。这两种方法都记载在《温病条辨》，确实是良方。（马粪也治疗霍乱吐泻，我曾治疗多人。）
Chen Zai'an stated: The "Disha Wan" (Purifying Sha Pill) recorded in the *Shazheng Quanshu* (Complete Book of Sha Disease) lacks its prescription. I investigated and found that it is actually the "Baihu Wan" (White Tiger Pill) recorded by Gong Yunlin in the *Wanbing Huichun* (Ten Thousand Diseases Returning to Spring). It uses thousand-year-old Duan Shi (calcined stone), scraping off impure colored mud, grinding it into powder, processing it via water flotation method, and forming pills the size of a Chinese quince seed. Each dose consists of fifty pills, with adjustments made according to the severity of the illness, taken down with distilled liquor. This medicine promotes qi circulation, dissipates blood stasis, resolves phlegm, and eliminates stagnation, treating Qingjin (Green Veins; known as Qingjin in the North and Sha in the South). When one initially feels headache, nausea, abdominal pain, lower back pain, or generalized body pain, and has no appetite, taking one dose immediately will dissipate blood stasis and cure the condition at once. If the Bianci (scarification) method is used, it depletes blood, which is not as miraculous as this prescription. (*Songfeng Shuoyi* also adopts this prescription, stating it treats both Huoluan (Cholera-like syndrome) and Shazhang (Sha distension); however, Qingjin is mostly caused by cold, raw food, and dampness, so using distilled liquor is appropriate. For heat syndromes, one may use cold water or cold tea for administration, adapting flexibly to symptoms.) It also treats heart and abdominal pain, as well as metrorrhagia and leukorrhea in women, chronic red-and-white dysentery, and all types of traumatic internal injuries where blood cannot dissipate; taking it yields significant effects. Zai'an stated that using this medicine to treat Sha diseases achieved rapid results. Since thousand-year-old Duan Shi is unobtainable, Duan Shi from ancient tombs can be used instead.
Longzhou Longbai Qingfei, in *Maiyao Lianzhu* (Linked Pearls of Pulse and Medicine), stated that Shazhang syndromes mostly belong to the Eight Extraordinary Vessels, as these vessels are tributaries of the Twelve Regular Meridians. When the clear qi of the Five Zang Organs does not ascend and the turbid qi of the Six Fu Organs does not descend, it is like the five lakes and four great rivers overflowing and flooding, entering the rivers and streams, mixing clear and turbid substances. Furthermore, if water levels rise excessively and soil collapses, sand and mud are stirred up, causing turbulent flow and blockage of Jing-Well and Shu points. Thus, the disease bears the name Shazhang. Shazhang is akin to a sand surge. Shazhang generally arises because the clear and turbid aspects of the Twelve Regular Meridians are indistinguishable, flowing into the Eight Extraordinary Vessels, causing their meridians to manifest, thus becoming Sha syndromes. Pathogenic factors stagnate in the meridians without involving the Zang-Fu organs. One should not merely attack the Zang-Fu organs with medicinal flavors but should first employ lifting, scraping methods, and needling techniques to unblock the meridians before administering medication, which will then yield immediate results. His theory that Sha syndromes belong to the Eight Extraordinary Vessels, a topic previously unexplored, is indeed accurate and credible.
In the sixth year of Xianfeng, during the transition between summer and autumn, people in Hangzhou suffered from Diaojiao Sha (Hanging Foot Sha), presenting with vomiting, diarrhea, abdominal pain, and acute spasm of the leg tendons. Without timely rescue, death would occur within one or two hours. An external treatment divine prescription circulated, proving very effective. Benevolent families prepared and distributed the medicine, saving countless lives; it could also treat Gan Huoluan (Dry Cholera). In August of the seventh year, a certain Mr. Liu from the Transport Commissioner's River Office suffered from Jiaochang Sha (Intestine-Twisting Sha), with a critical condition. His neighbor knew that the Xia family near Chaiduo Bridge possessed this medicine and urgently went to request it. After treatment, he recovered immediately. I witnessed its efficacy with my own eyes; it is truly a divine medicine. Herein I record the prescription along with drug prices, so that those with means may prepare it to help others, accumulating boundless merit. Moschus (5 qian, price 18,900 wen), Mother Clove Bud (1 liang, price 140 wen), Guixin (Cinnamon Bark, peeled, 1 liang 2 qian, price 2,200 wen), Sheng Xiangfu (Raw Cyperi Rhizoma, 1 liang, price 10 wen), Wo Liuhuang (Imported Sulfur, 3 liang 5 qian, price 2,500 wen, plus processing fee 210 wen, 503 small Sha medicine bottles, price 650 wen). Total weight seven liang 5 qian. Each bottle stores 1 fen 5 li of medicine. Use one bottle per dose; for severe cases, use two bottles. Grind the above medicines into extremely fine powder, store separately in small bottles, and seal with yellow beeswax. When using, first thoroughly warm the Nuanqi Gaoyao (Navel-Warming Plaster), place the powder in the center, and apply it directly to the patient's umbilicus. Recovery occurs within one shichen (two hours). (This prescription acts very quickly to save lives, but its nature is fierce; it must absolutely not be ingested internally, and pregnant women are forbidden to apply it.)
Jiaochang Sha is synonymous with Gan Huoluan (Dry Cholera). *Wenbing Tiaobian* (Systematic Differentiation of Warm Diseases) attributes it to cold-dampness, prescribing hot medicines such as Fuzi (Aconiti Lateralis Radix Praeparata) and Ganjiang (Zingiberis Rhizoma) to expel turbid yin and rescue the true yang of the Middle Jiao. *Shanghan Lun Huiyan* states that this syndrome occurs in summer and autumn; if abdominal pain and deep pulse are seen and mistakenly treated as Yin-cold, immediately ingesting hot foods, soups, teas, or wines will cause sudden suffocation and death. These two theories are diametrically opposed. I believe this syndrome presents with both cold and heat patterns; physicians must exercise extreme caution in medication. There are treatments applicable regardless of cold or heat. Externally, one may select Weizhong BL-40 (located at the popliteal crease), repeatedly slap vigorously with hot water until red veins protrude, then puncture to bleed for cure. Internally, one may use horse dung (older is better), bake it dry on tiles, grind into powder, and take with boiling water (another formula adds Huangtu (Yellow Earth) decocted in light yellow wine), 2-3 qian. If ineffective, administer again. Both methods are recorded in *Wenbing Tiaobian* and are indeed excellent prescriptions. (Horse dung also treats Huoluan with vomiting and diarrhea; I have treated many patients with it.)