泻久则肉瘦，或健脾或燥湿，或消积或渗水，或补命门火，或平肝木气，治泻之药，不过如是。若慢痧之变，久泻
肉瘦，病原不同，但宜治痧，则泻自止矣。
治验∶
一姚公 潘婢，久泻不已，不思米食，日渐 瘦，大肉渐脱，脉反有力。放痧二十余针，紫黑毒血成流。付宝花散、
阿魏丸，俱稍冷冻饮料之即愈。
一莫电云，久泻不已，骨瘦如柴，唇红口渴，粥食不进，胸中饱闷，脉反微伏。放腿弯痧四针，毒血紫黑流出如花。
用沉香丸，清茶稍冷冻饮料之，付棱术汤加银花，泽兰治之而愈。
一巢茂公次子，久泻肉削，咳嗽不已，夜卧盗汗，目白微红。余诊之，脉寸伏关弦。放腿弯上下痧三针，复刮痧毕。
付清凉至宝饮加山楂、卜子、银花微冷冻饮料之而痊。
妇人幽隐疾，多有兼痧，最难识认，惟在诊脉之人，指下明白，乃无差误尔。
治验∶
一妇人患血淋三月矣，头面腿足俱肿，六脉洪实紧盛。余意血淋热症也。洪实紧盛，热脉也。何乃头面腿足骤俱肿，
殆其痧乎。令其家人，放腿弯痧二十余针。多用清凉解毒之剂，治之而痊。
一妇人患血崩，其家人曰∶痧也。引他妇阅之，果有痧筋，放之。用养血和中之剂，治之而愈。
香港脚有因乎痧者，此慢痧缠绵腿足，或半年一年，或五年十年。其疾仅在腿足，上身气血流通。脉往往不现，但两
尺脉微数有力而已。几遇杂病，切忌升提以防痧。若不知治，痧毒肆行，腿足红肿，痧筋一散，无从可放，所以四肢痧
难治。
治验∶
一老年人苦足底燥烈，以为气血衰微所致，不用药治之。阅有痧筋，放四针，毒瓦斯散行，腿足遂肿。次日放痧四十
余针，其肿渐平。三日又放痧四十余针，足底渐滋润。惟是日当放痧，不服药而愈。
一王姓者，患香港脚，腿足俱肿，看有痧筋， 痛不治，缘世人犯此者多，故记之。
腹泻日久则肌肉消瘦，治疗腹泻的药物，大致不外乎健脾、燥湿、消积、渗利水湿、补益命门之火、平抑肝木之气这几类。如果是慢痧引起的变证，虽然表现为久泻肉瘦，但病因不同，只要针对痧毒进行治疗，腹泻自然就会停止。
医案记录：
有一位姚姓人家的潘家婢女，长期腹泻不止，不想吃米食，身体日渐消瘦，大块肌肉逐渐脱失，脉象反而有力。对其放痧二十多针，流出紫黑色的毒血如水流淌。给予宝花散和阿魏丸，嘱咐用稍冷冻的饮料送服，随即痊愈。
有一位莫电云，长期腹泻不止，骨瘦如柴，嘴唇红赤口渴，粥饭无法进食，胸中饱闷，脉象反而微伏。对其腿弯处放痧四针，流出如花般美丽的紫黑色毒血。使用沉香丸，配合清茶稍冷冻后饮用，并开具棱术汤加金银花、泽兰进行治疗而痊愈。
巢茂公的次子，久泻导致肌肉削瘦，咳嗽不止，夜间睡觉盗汗，眼白部分微微发红。我诊察他的脉象，寸口脉伏，关部脉弦。对其腿弯上下部位放痧三针，随后又进行了刮痧。给予清凉至宝饮加山楂、莱菔子、金银花，嘱咐用微冷冻的饮料送服而康复。
妇女幽隐部位的疾病，大多兼夹痧毒，最难识别辨认，关键在于诊脉医生的手指下感觉要明白清晰，才不会出差错。
医案记录：
有一位妇人患血淋症三个月了，头面及腿足全部肿胀，六脉洪大、实、紧、盛。我推测这是血淋的热证。洪实紧盛的脉象属于热脉。为何头面腿足突然全部肿胀？这大概是痧毒所致。让她的家人对其腿弯处放痧二十多针。多用清凉解毒的药物，治疗而痊愈。
另一位妇人患血崩症，她的家人说是痧毒。引来其他妇人查看，果然有痧筋，于是进行放痧。使用养血和中的药物，治疗而痊愈。
香港脚（足部疾患）有因痧毒引起的，这是慢痧缠绵于腿足之间，有的半年一年，有的五年十年。病症仅在腿足，上身气血流通正常。脉象往往不显现异常，只有两尺脉微数且有力而已。遇到杂病时，切忌使用升提之法，以防引发或加重痧毒。如果不知道正确治疗方法，痧毒肆意横行，导致腿足红肿，一旦痧筋消散，就无法再放痧，所以四肢部的痧毒难以治疗。
医案记录：
一位老年人苦于足底干燥灼热，认为是气血衰微所致，没有用药治疗。后来发现有痧筋，放四针，毒气散发运行，腿足随即肿胀。第二天放痧四十多针，肿胀逐渐平息。第三天又放痧四十多针，足底逐渐变得滋润。只是那天应当放痧，不服药而痊愈。
Prolonged diarrhea leads to emaciation. The medications for treating diarrhea generally include only strengthening the spleen, drying dampness, resolving accumulation, promoting diuresis to leach out water, tonifying the fire of the Gate of Vitality (Mingmen), and pacifying the Qi of the Liver Wood. If this is a variation caused by slow Sha (a toxic pathogenic factor in traditional Chinese medicine), although it manifests as prolonged diarrhea and emaciation, the etiology differs. By treating the Sha directly, the diarrhea will cease spontaneously.
Clinical Cases:
1. A maid named Pan from the Yao household suffered from persistent diarrhea without relief. She had no appetite for rice, her body became increasingly thin, and large muscles gradually wasted away, yet her pulse was surprisingly forceful. Over twenty needle pricks were performed for Sha release, resulting in the flow of dark purple-black toxic blood. Baohua San (Precious Flower Powder) and Awei Wan (Asafoetida Pill) were prescribed, to be taken with slightly chilled beverages, leading to recovery.
2. Mo Dianyun suffered from persistent diarrhea, becoming as thin as firewood, with red lips, thirst, inability to consume porridge, chest fullness and oppression, and a pulse that was surprisingly faint and deep. Four needle pricks were performed on the popliteal fossa (back of the knee), releasing floral-like dark purple-black toxic blood. Chenxiang Wan (Agarwood Pill) was used, taken with clear tea slightly chilled, along with Lingzhu Tang (Rhizoma Atractylodis Decoction) added with Yin Hua (Jin Yin Hua/Honeysuckle Flower) and Ze Lan, resulting in recovery.
3. The second son of Chao Maogong suffered from muscle wasting due to prolonged diarrhea, incessant coughing, night sweats during sleep, and slight redness in the whites of his eyes. Upon examination, the Cun (inch) position pulse was hidden/faint, and the Guan (bar) position pulse was wiry. Three needle pricks were performed above and below the popliteal fossa for Sha release, followed by Gua Sha (scraping therapy). Qingliang Zhibao Yin (Cooling Precious Treasure Drink) added with Shan Zha (Hawthorn Fruit), Bo Zi (Lai Fu Zi/Radish Seed), and Yin Hua (Honeysuckle Flower) was prescribed, to be taken with slightly chilled beverages, leading to recovery.
Women's hidden ailments often involve concurrent Sha toxicity, making them difficult to identify. It relies entirely on the diagnostician's tactile clarity under the fingers to avoid errors.
Clinical Cases:
1. A woman suffered from hematuria (blood dysuria) for three months. Her head, face, legs, and feet were all swollen, and her six pulses were surging, solid, tight, and vigorous. I suspected this was a heat syndrome of hematuria. Surging, solid, tight, and vigorous pulses indicate heat. Why did her head, face, legs, and feet suddenly swell? This must be due to Sha. Her family was instructed to perform over twenty needle pricks on the popliteal fossa for Sha release. Numerous cooling and detoxifying agents were used, leading to recovery.
2. Another woman suffered from metrorrhagia (uterine bleeding). Her family stated it was Sha. Other women were invited to inspect, confirming the presence of Sha veins (distended superficial veins). These were released. Blood-nourishing and middle-joint harmonizing agents were used, leading to recovery.
Hong Kong Foot (podagra/foot disease) can be caused by Sha. This involves slow Sha lingering in the legs and feet for half a year to a year, or even five to ten years. The pathology is confined to the legs and feet, while Qi and Blood circulation in the upper body remains unobstructed. The pulse often shows no abnormalities, except for the two Chi (cubit) positions being slightly rapid and forceful. When encountering miscellaneous diseases, one must strictly avoid lifting and ascending methods to prevent aggravating Sha. If the correct treatment is unknown, Sha toxin spreads unchecked, causing swelling and redness in the legs and feet. Once the Sha veins dissipate, there is no way to release the Sha, which is why Sha in the four limbs is difficult to treat.
Clinical Cases:
1. An elderly man suffered from dryness and burning sensation on the soles of his feet, attributing it to deficiency of Qi and Blood, and thus took no medication. Later, Sha veins were observed. Four needle pricks were performed; as the toxic qi dispersed and circulated, his legs and feet swelled. The next day, over forty needle pricks were performed, and the swelling gradually subsided. On the third day, another forty needle pricks were performed, and the soles gradually became moist. He recovered on that day simply by having Sha released, without taking medicine.
2. A patient surnamed Wang suffered from Hong Kong Foot, with swelling in both legs and feet. Sha veins were visible. The pain was not treated because many people suffer from this condition in the world, so it is recorded here.