默默不语，语亦无声，形如哑子，此乃痧气壅盛，热痰上升，阻逆气管，故咽喉闭塞而然。治宜先放其痧，审其肺
肾脾三经之脉为要，然后推详余经之脉，则知病之所本矣。
治验∶
一吴子瑞一女，十一月间，忽然痧胀，心中烦闷，昏沉不语。子瑞善放痧，稍醒，语更终日无声。余诊之，左关有
力，右脉沉伏，伤气之痧也。此女日为后母所詈，故有此变，用陈香丸一丸煎汤微冷冻饮料之，稍有声焉，未愈。次日，左
脉弦长而动，余曰∶“怒气伤肝，痧气犹阻于肝经之故”。刺腿弯紫筋三针，血流如注，又刺顶心、臂指二十余针，乃用
三香散、陈皮浓朴汤加延胡索、香附微温饮之，乃痊。
心胸胀极，痧毒内攻，故头顶向上，形如角弓反张，是脏腑已坏，死症也，不可以治。
痰涎壅盛，气急发喘，喉声如锯，痛若喉鹅。但喉鹅之症，喉内肿胀，若痧、则有如喉鹅之痛，而无喉鹅之肿胀。
又形若急喉风，但喉风之症，痛而不移，若痧，则痛无一定，且痧有痧筋；喉鹅无痧筋，此可辨也。
治验∶
一施三先痰气壅盛，吹吊痰药，益凶暴痛极。余诊之，脉多怪异，此三焦命门之痧也。阅臂指筋刺十一针，腿弯有
青筋，刺三针，出紫黑毒血甚多，不愈。用沉香郁金散、救苦丹清茶冷冻饮料之，外吹冰硼散，又用荆芥银花汤微冷冻饮料之，
三剂而痊。
一周龙生，喉痛之极，痰涎壅盛。延余，余曰∶“痧也”。不信，饮热汤，至夕而殂。
默默不语，说话也没有声音，身体像哑巴一样，这是因为痧气壅盛，热痰上升，阻滞逆乱气管，所以咽喉闭塞而造成的。治疗应当先放痧，审查肺、肾、脾三经的脉象为关键，然后推究详查其他经络的脉象，就能知道疾病的根本所在了。
治验：
有一位吴子瑞的女儿，在十一月间，忽然发生痧胀，心中烦闷，昏沉不语。吴子瑞擅长放痧，患者稍微清醒后，整天说话依然没有声音。我诊察她的脉象，左关脉有力，右脉沉伏，这是伤气的痧症。这个女子每天被继母责骂，所以出现这种变故。我用陈香丸一丸煎汤，微冷冻后让她饮用，她稍微能发出声音了，但病未痊愈。第二天，左脉变得弦长且跳动明显，我说：“怒气伤肝，是痧气仍然阻滞在肝经的缘故。”针刺腿弯处的紫筋三针，血流如注，又针刺头顶心、手臂手指二十多针，然后用三香散、陈皮浓朴汤加延胡索、香附，微温服用，于是痊愈。
心胸极度胀满，痧毒内攻，所以头顶向上仰，身体像角弓反张一样，这是脏腑已经败坏，属于死症，无法治疗。
痰涎壅盛，气急发喘，喉咙里发出像拉锯一样的声音，疼痛如同喉鹅（喉部肿痛如鹅）。但是喉鹅的症状，喉内部肿胀；如果是痧症，则有像喉鹅一样的疼痛，但没有喉鹅那样的肿胀。又像急喉风，但是喉风的症状，疼痛位置固定不移；如果是痧症，则疼痛没有定处，而且痧症有痧筋；喉鹅没有痧筋，这一点可以辨别。
治验：
有一位施三先，痰气壅盛，吹入吊痰药后，病情更加凶险暴烈，疼痛至极。我诊察他的脉象，多有怪异，这是三焦命门的痧症。阅读并观察手臂手指的筋络，针刺十一针，腿弯处有青筋，针刺三针，流出很多紫黑色的毒血，病未愈。用沉香郁金散、救苦丹配清茶冷冻后饮用，外部吹入冰硼散，又用荆芥银花汤微冷冻后饮用，三剂药后痊愈。
有一位周龙生，喉咙痛到极点，痰涎壅盛。请我去诊治，我说：“是痧症。”他不相信，喝了热汤，到了傍晚就死亡了。
Mute and silent, speaking without sound, the body resembling that of a mute person; this is due to the excessive accumulation of Sha Qi (pathogenic factor associated with "sha" disease), where hot phlegm ascends, obstructing and reversing the flow in the respiratory tract, thus causing blockage of the throat. Treatment should first involve Sha bloodletting (releasing Sha pathogen by pricking vessels). It is crucial to examine the pulses of the Lung, Kidney, and Spleen meridians, and then carefully investigate the pulses of other meridians to determine the root of the disease.
Case Record:
The daughter of Wu Zirui suddenly developed Sha distension in November, experiencing mental restlessness, lethargy, and muteness. Mr. Wu was skilled in Sha bloodletting; after slight recovery of consciousness, she remained voiceless throughout the day. Upon examination, the pulse at the Left Guan position was forceful, while the Right pulse was deep and hidden, indicating Sha injury to Qi. This girl had been scolded daily by her stepmother, leading to this condition. I prescribed one pill of Chenxiang Wan (Agarwood Pill) decocted in water, cooled slightly, and administered orally. She regained some ability to make sounds, but was not cured. The next day, the Left pulse became wiry, long, and active. I stated, "Anger injures the Liver; it is because Sha Qi remains obstructed in the Liver meridian." I pricked three needles into the purple veins behind the knees, resulting in profuse bleeding. I also pricked over twenty points on the vertex and fingers. Then, I administered Sanxiang San (Three Fragrances Powder) combined with Chenpi Nongpo Tang (Tangerine Peel and Magnolia Bark Decoction) plus Yanhusuo (Corydalis Rhizome) and Xiangfu (Cyperus Rhizome), served warm. She recovered.
Extreme distension in the chest and heart, with Sha toxin attacking internally, causes the head to tilt backward, resembling opisthotonos (body arched like a bowstring). This indicates destruction of the Zang-Fu organs, representing a fatal syndrome that cannot be treated.
Excessive accumulation of saliva and phlegm, rapid breathing and wheezing, roaring sounds in the throat like sawing, and pain resembling Hou'e (throat goose/swollen throat). However, in Hou'e syndrome, there is swelling inside the throat; whereas in Sha syndrome, there is pain similar to Hou'e but without such swelling. It may resemble Ji Houfeng (acute wind-stroke of the throat), but in Houfeng, the pain is fixed in location; in Sha syndrome, the pain is migratory/unfixed, and Sha syndrome presents with Sha veins (visible subcutaneous veins); Hou'e does not have Sha veins. This distinction allows for differentiation.
Case Record:
Shi Sanxian suffered from excessive phlegm-Qi stagnation. After using medicated powder blown into the throat to induce vomiting of phlegm, his condition became more violent and painful. Upon examination, his pulses were highly irregular, indicating Sha disease of the Sanjiao (Triple Burner) and Mingmen (Gate of Life). I observed the veins on the arms and fingers and applied eleven needle pricks. There were greenish veins behind the knees, which were pricked three times, releasing a large amount of dark purple toxic blood. The condition did not improve immediately. I administered Chenxiang Yujin San (Agarwood and Turmeric Powder) and Jiuku Dan (Pain-Relieving Pill) with clear tea, cooled. Externally, Bingpeng San (Borneol and Borax Powder) was blown into the throat. He also drank Jingjie Yinhua Tang (Schizonepeta and Forsythia Decoction), cooled slightly. After three doses, he recovered.
Zhou Longsheng suffered from extreme throat pain and excessive saliva/phlegm. When summoned, I diagnosed him with Sha disease. He did not believe me and drank hot water. By evening, he died.