痧从时气所感，因而咳嗽，肺经受伤，不可以伤风治之，盖伤风以疏风为主，若痧则纯乎疏风，非其所宜，当刮痧
为先，宜清喉顺气凉肺散痧为主。若专重疏风，纵非紧痧急症，亦必咳嗽日甚，缠绵不已，劳嗽等症，由此而成，慎之
慎之。
治验∶
一徐茂公伤风咳嗽，日晡微寒发热。余诊之，右寸脉浮而芤，余脉虚而无力，时气所感，肺经之痧也。其弟为之放
痧、刮痧，稍可。不服药，至十余日，咳嗽不止。余用射干兜苓汤加前胡、山豆，稍冷冻饮料之，渐愈。
痘本先天，因时而发，必由外感。至若痧者，亦时疫之气所感作胀作痛。而胎元之毒，因之俱发，凡痘未见点之前
痧胀，必心胸烦闷，痰涎壅塞，甚至昏迷沉重，不省人事，此其候也。其小儿滑疾之脉，类于痧症厥厥动摇之脉。虽若
疑似难明，然痧有痧筋可辨，宜先刺出毒血，而后用药清理之，则痧自退，痘自起矣。若痘点既形，触秽痘隐者，诸痘
科自悉，不赘。
治验∶
一夏子亮幼子，五月发热，痰喘气急四肢战动，两目无神，不省人事，口热如炉，面有隐隐红紫细点。延余看痘，
阅其腿弯有紫筋两条。余曰∶“两目无神，四肢战动，痘之候也。隐隐微点，痘之形也。口热如炉，红紫之色，热之盛
也。但是，痰喘气急，有腿弯紫筋两条，必痘因痧胀而发。治宜先放其痧，后发其痘，则痘自起”。用针刺出毒血，随
用荆芥、连翘、防风、红花、青皮、桔梗、枳壳、山楂，卜子一剂，俟稍冷冻饮料之，其痘即发，至十二朝乃痊。
痧症因感受时行疫气所致，进而引发咳嗽，导致肺经受损。此证不可按普通伤风来治疗，因为伤风的治疗以疏风为主；若对痧症单纯使用疏风法，则并不适宜。应当以刮痧为首要手段，治疗宜以清利咽喉、顺降气机、凉润肺脏、消散痧毒为主。如果专门注重疏风解表，即使不是紧急严重的痧症，也必然导致咳嗽日益加重，缠绵难愈，从而演变为劳嗽等慢性病症，务必谨慎对待。
验案：
有一位名叫徐茂公的患者，患伤风咳嗽，每日傍晚时分出现轻微恶寒发热。我诊察其脉象，右寸脉浮而中空（芤脉），其余脉象虚弱无力，判断为感受时行疫气，属于肺经的痧症。他的弟弟为他进行了放痧和刮痧治疗，症状稍有好转。但他不服用药物，直到十多天后，咳嗽仍不止息。我使用射干兜苓汤，加入前胡、山豆根，让患者稍冷却后饮用，病情逐渐痊愈。
痘疹本源于先天胎毒，随季节气候发作，必定由外感诱发。至于痧症，也是感受时行疫气之气，导致身体胀满疼痛。而胎元中的毒邪，因此一并发作。凡是痘疹尚未出点之前的痧胀，必然表现为心胸烦闷，痰涎壅盛阻塞，甚至昏迷沉重，不省人事，这是其典型征候。小儿滑数疾速的脉象，类似于痧症中厥逆动摇的脉象。虽然两者疑似难辨，但痧症有“痧筋”可以辨别，应当先刺破放出毒血，然后再用药清理，这样痧毒自退，痘疹自然发出。如果痘点已经形成，却因接触秽浊之气导致痘疹隐伏不出，这是各类痘科医生都知晓的道理，此处不再赘述。
验案：
夏子亮的小儿子，五月间发热，伴有痰喘、气急、四肢颤抖，两目无神，不省人事，口中热气如火炉般灼热，面部有隐隐的红紫色细密斑点。请我去看痘疹，查看他腿弯处有两条紫筋。我说：“两目无神、四肢颤抖，是痘疹的征候；隐隐微现的斑点，是痘疹的形态；口中热气如火、呈现红紫色，说明热势炽盛。但是，因为有痰喘气急以及腿弯处的两条紫筋，必然是痘疹因痧胀而引发。治疗应当先放痧，再透发痘疹，这样痘疹自然能发出。”我用针刺破皮肤放出毒血，随即使用荆芥、连翘、防风、红花、青皮、桔梗、枳壳、山楂、莱菔子各一剂，让患者稍冷却后饮用，痘疹随即发出，到第十二天痊愈。
Sha disease (Sha syndrome, a type of acute toxic heat condition) arises from contracting seasonal epidemic pathogens, leading to cough and injury to the Lung meridian. This condition should not be treated as common wind-cold invasion (Shangfeng). While treatment for wind-cold focuses on dispersing wind, purely dispersing wind is inappropriate for Sha disease. The primary intervention should be *Guasha* (scraping therapy), with treatment principles centered on clearing the throat, smoothing Qi flow, cooling the Lungs, and dissipating Sha toxins. If one focuses solely on dispersing wind, even if it is not an urgent or severe case of Sha, the cough will inevitably worsen daily and become chronic, potentially evolving into consumptive cough (Laosou). One must exercise extreme caution.
Clinical Case 1:
Mr. Xu Maogong suffered from wind-cold-induced cough. In the late afternoon, he experienced mild chills and fever. Upon pulse diagnosis, his right Cun position was floating and hollow (Kou pulse), while other pulses were weak and forceless. I diagnosed this as Sha disease affecting the Lung meridian due to seasonal epidemic pathogens. His brother performed *Fangsha* (pricking to bleed) and *Guasha*, which provided slight relief. However, he refused herbal medicine. After more than ten days, the cough persisted. I prescribed Shegan Doulings Tang modified with Qianhu (Pei Sanqi Rhizome) and Shandougen (Millettia Speciosa Root), administered cool after slight refrigeration. His condition gradually improved.
Smallpox originates from congenital fetal toxicity and erupts according to seasonal timing, invariably triggered by external pathogenic invasion. Similarly, Sha disease results from contracting seasonal epidemic qi, causing distension and pain. The fetal toxin is thereby activated and erupts simultaneously. Prior to the appearance of smallpox spots, Sha distension manifests as mental restlessness and chest oppression, phlegm-saliva obstruction, and in severe cases, coma, heaviness, and loss of consciousness. These are the characteristic signs. The rapid and slippery pulse seen in children resembles the jerking and unstable pulse associated with Sha-related syncope. Although differentiation may be difficult, Sha disease can be identified by visible Sha veins (subcutaneous dark purple veins). It is advisable to first prick these veins to release toxic blood, followed by herbal medication to clear the pathogen. Consequently, the Sha toxins will recede, and the smallpox will naturally emerge. If smallpox spots have already formed but remain hidden due to contact with foul/impure substances, this falls within the expertise of smallpox specialists, so further elaboration is omitted here.
Clinical Case 2:
The young son of Xia Ziliang developed fever in May, accompanied by phlegm-wheezing,急促 breathing (asthma/dyspnea), trembling limbs, spiritless eyes, loss of consciousness, oral heat resembling a furnace, and faint red-purple fine spots on the face. He was consulted for smallpox examination. Inspection revealed two purple veins in the popliteal fossa (back of the knee). I stated: "Spiritless eyes and limb tremors indicate smallpox; faint spots indicate the morphology of smallpox; intense oral heat and red-purple coloration indicate excessive heat. However, given the phlegm-wheezing and the two purple veins in the popliteal fossa, it is certain that the smallpox eruption is triggered by Sha distension. Treatment should prioritize releasing Sha via pricking, followed by promoting smallpox eruption, allowing the rash to emerge naturally." I used needles to prick the skin and release toxic blood, then administered a decoction containing Jingjie (Schizonepetae Herba), Lqiaoqiao (Forsythiae Fructus), Fangfeng (Saposhnikoviae Radix), Honghua (Carthami Flos), Qingpi (Aurantii Fructus Immaturus), Jiegeng (Platycodonis Radix), Zhike (Aurantii Fructus), Shanzha (Crataegi Fructus), and Lubizi (Raphani Semen). Administered cool after slight refrigeration, the smallpox erupted immediately, and the patient recovered by the twelfth day.