或谓余曰∶“古书所载，屋漏雀啄诸怪脉现者死，脉代者死，为五脏有绝也。见一部无脉，二三部无脉，焉得有生理
乎”。及览玉衡痧脉，止有六部无脉者死。即诸怪脉，必曰放痧服药不应者死。与古书所载不同，何欤？曰∶“古人论此
等脉为死脉者，其常也∶余论此等脉尚当救之者，因乎痧之变也。”凡痧胀之脉都有类诸死脉者，余惟见此疾，实怜之，
冀万有一可救者，因痧之变，不执常脉而轻弃之也。
治验∶
一陈见雅内室，怀娠发热，赤痢腹痛不止，服他药不效。余诊之，脉四动一止，代脉也。阅有痧筋，放二十余针，
用宝花散微冷服之，付以桑寄生、益母草、连翘、苏梗、红花、金银花、山楂、卜子、当归、枳壳、青皮、黄芩微冷冻饮料，
四剂而愈。
一张舜瞻侧室，腹疼、嗽痰、呕吐。延余，脉如弹石，知其患痧痛极，脉亦变也。令其婢放痧三十余针，用宝花散、
救苦丹、砂仁汤稍冷冻饮料之，付以独活红花汤加山楂、神曲、卜子、青皮、微冷冻饮料二剂而愈。
一傅纯宇，发热昏沉，脉如解索，先用阴阳水，捣芋艿汁饮之，放指臂痧三十余针，稍觉清爽，用细辛大黄丸清茶
稍冷冻饮料之，付以荆芥银花汤加青皮，微温服二剂而痊。
一邬云公，头面红肿，目闭喉痛，六脉无根，知其痧气阻塞脉路也。刺腿足痧四十余针，流紫黑血甚多，又刺手臂
痧二十余针，未愈。用清凉至宝饮减细辛，加山豆根、射干、牛膝、石斛、桑皮、枳壳稍冷冻饮料，三剂而痊。
一金子近次子祖翼，九月间，适因劳动，饮食不时，忽壮热头痛。自以紫苏汤熏头而大汗，胸中胀闷，他医用药下
之，反口吐白沫，时有议以为痧，乃更延医诊视，见舌苔灰色，以伤寒药治之。子近恐犯痧气，先以半小钟试服，少顷，
即谵语，片时而止。热仍不解，愈觉沉重，脉有八至。遂连易三医，皆云伤寒，三次服药，皆昏沉谵语如前。第五日，
眼如火赤，唇若涂朱，鼻如烟煤，舌苔黑燥，枯干而短，声音不清，足冷至腹，阴囊卵缩，肉脱神昏，医者皆辞不治，
已备后事。至七日，乃始放痧，因病势危笃，止放二针，唇眼舌声诸死症顿愈，阴囊二卵渐舒，脉竟平复，始现腹痛，
乃知口渴。因惑人言痧症不可服药，止饮童便，服紫金锭而痛止，后又随痛随服，继进饮食。大便干结，至十八日，用
蜜导法，遂变下痢，日夜五六十次。凡六日，始服痧症药一剂即安睡，痢乃止。后延他医，调理补之不数日，睡时即发
遍身水晶 ，觉时即隐，医家莫解其故。子近因刮穿颈额间 流出皆汗也。即盗汗不止，他医咸谓∶久病虚脱 大
用补剂敛汗，不惟无益，更加自汗且完谷不化，小便短赤频数变为砂淋，医又皆束手谢事。爰复放痧，用八正散二剂服
之，痧气始转，身即壮热约有二更时，身凉汗止。惟日食生茨菇五六日，砂淋亦止而全愈。祖翼之病，变幻迟久，总因
止放二针，不服痧症药以除根之故也。究以治痧而得全脉而八至，死症虽多，其可弃耶。
一金子近长子权可，八月间，发 通身如麻疹状。延他医视之，则日∶“ 疹”。复延幼科诊之，亦云∶“痧疹”。服
药十日不退，脉仅二至，医家因疑其少年鉴丧，故而虚脱，欲用补剂。子近恐亦痧气不敢服，命权可起而视之，则遍身
痧点，皆活动流注两腿皮肉红紫，因放腿弯痧一针，而皮肉白。又放腿弯痧数针，而皮肉皆白，惟小腿红紫未退。卧即
复流动遍散于身，仍作稀稀 点。缘脉尤二至，用川乌、草乌为一小丸服之，脉复如常，大汗出而全愈。
有人对我说：“古书中记载，出现屋漏脉、雀啄脉等怪脉的会死亡，出现代脉的会死亡，这是因为五脏之气断绝。如果一部无脉，或者二三部无脉，怎么会有生机呢？”等到我研读《玉衡》中关于痧症的脉象，发现只有六部皆无脉的才会死亡。即使是那些怪脉，也必定是指出放痧和服药后无效的才会死亡。这与古书的记载不同，为什么呢？我说：“古人将这些脉象论述为死脉，这是常理；我论述这些脉象仍然应当救治，是因为痧症的变化所致。”凡是痧胀病的脉象都有类似各种死脉的情况，我只是看到了这种疾病，实在怜悯它，希望万分之一有可救的机会，因为痧症变化多端，不固执于常规的脉象而轻易放弃患者。
治疗验案：
一位陈见雅的夫人，怀孕发热，赤痢腹痛不止，服用其他药物无效。我诊察她的脉象，每四次跳动有一次停顿，这是代脉。观察到有痧筋，放出二十多针血，用宝花散微冷服用，并开具桑寄生、益母草、连翘、苏梗、红花、金银花、山楂、萝卜子、当归、枳壳、青皮、黄芩，微冷冻后饮用，四剂后痊愈。
一张舜瞻的侧室，腹痛、咳嗽痰多、呕吐。请我去诊治，脉象像弹石一样坚硬，知道她患的是极痛的痧症，脉象也因此改变。让她的婢女放痧三十多针，用宝花散、救苦丹、砂仁汤稍冷冻后饮用，并开具独活红花汤加山楂、神曲、萝卜子、青皮，微冷冻后饮用，两剂后痊愈。
一位傅纯宇，发热昏沉，脉象像解索一样杂乱，先用阴阳水，捣芋艿汁饮用，放指臂痧三十多针，稍微觉得清爽，用细辛大黄丸配清茶稍冷冻后饮用，并开具荆芥银花汤加青皮，微温服用两剂后痊愈。
一位邬云公，头面红肿，眼睛闭合喉咙痛，六脉无根，知道是痧气阻塞了脉路。刺腿足痧四十多针，流出很多紫黑色的血，又刺手臂痧二十多针，病未愈。用清凉至宝饮减去细辛，加入山豆根、射干、牛膝、石斛、桑白皮、枳壳，稍冷冻后饮用，三剂后痊愈。
金子近的次子祖翼，九月间，恰好因为劳累，饮食不规律，突然高热头痛。自己用紫苏汤熏头导致大汗淋漓，胸中胀闷，其他医生用药攻下，反而口吐白沫，当时有人议论认为是痧症，于是再请医生诊视，看到舌苔灰色，以伤寒药治疗。金子近担心触犯痧气，先试服半小钟，片刻后，出现胡言乱语，一会儿停止。热仍未退，越发觉得沉重，脉象达到八至（一息八至以上）。于是连续更换三位医生，都说是伤寒，三次服药，都出现昏沉胡言乱语如前所述。第五天，眼睛红如火，嘴唇像涂了朱砂，鼻子像烟煤黑，舌苔黑燥，干枯短缩，声音不清，脚冷至腹部，阴囊收缩，肌肉脱陷神志昏迷，医生们都推辞不治，已经准备好后事。到了第七天，才开始放痧，因为病情危重，只放了二针，唇眼舌声等各种死症顿时痊愈，阴囊两个睾丸逐渐舒展，脉象竟然平复，这才显现出腹痛，才知道口渴。因为听信别人说痧症不可服药，只喝童便，服用紫金锭疼痛停止，之后又随痛随服，接着进食。大便干结，到第十八天，用蜜导法通便，于是变成下痢，日夜五六十次。经过六天，才服用一剂痧症药就安稳入睡，痢疾才停止。后来请其他医生调理补益，没过几天，睡觉时就发作遍身水晶痧（一种痧症表现），醒来时即隐没，医生们不明白其中的缘故。金子近因为刮破颈额间皮肤，流出的都是汗液。于是盗汗不止，其他医生都说久病虚脱，大量使用补剂收敛汗液，不仅无益，反而加重自汗且完谷不化（消化不良），小便短赤频数变为砂淋（尿路结石或感染），医生们又都束手无策辞职离去。于是再次放痧，用八正散二剂服用，痧气才转化，身体随即壮热约有两个时辰，身体凉汗止。只是每天生吃茨菇五六天，砂淋也停止而完全痊愈。祖翼的病，变幻迟缓长久，总因只放二针，不服用痧症药以除根的缘故。终究是因为治疗痧症而得到全脉且脉象八至，虽然死症很多，难道可以放弃吗？
金子近长子权可，八月间，发疹通身如麻疹状。请其他医生看，则说：“疹”。再请儿科医生诊视，也说：“痧疹”。服药十天不退，脉仅二至（一息两至以下），医生因此怀疑他少年丧妻悲伤过度，故而虚脱，想用补剂。金子近担心也是痧气不敢服用，命令权可起身查看，则遍身痧点，都在活动流注两腿皮肉红紫，于是放腿弯痧一针，皮肉变白。又放腿弯痧几针，皮肉都变白，只有小腿红紫未退。躺下后又流动遍散于全身，仍作稀稀疏疏的点。因为脉象仅二至，用川乌、草乌做成一个小丸服用，脉象恢复如常，大汗出而痊愈。
Someone said to me, "Ancient texts record that the appearance of strange pulses such as 'House Leaking' (Wulu) and 'Sparrow Pecking' (Quezhao) indicates death; the appearance of a 'Intermittent Pulse' (Daimai) indicates death, due to the exhaustion of the Qi of the Five Zang organs. If there is no pulse in one position, or in two or three positions, how can there be any hope for life?" Upon studying the pulse patterns of Sha disease (Sha Syndrome) in *Yuheng*, I found that only when all six positions lack a pulse is it fatal. Even with those strange pulses, it is specified that death occurs only if bloodletting (Fangsha) and medication fail to respond. This differs from ancient texts. Why? I replied, "When ancients discussed these pulses as fatal, they were referring to the general rule; my discussion that these pulses should still be treated is due to the variability of Sha disease." The pulses of Sha distension often resemble various fatal pulses. I merely see this illness and feel great pity, hoping for even a one-in-ten-thousand chance of salvation. Because Sha disease varies, I do not adhere rigidly to standard pulse diagnoses to lightly abandon patients.
Clinical Cases:
1. The wife of Chen Jianya was pregnant, suffering from fever, bloody dysentery, and incessant abdominal pain. Other medications were ineffective. My diagnosis revealed her pulse had four beats followed by one pause, which is an Intermittent Pulse (Daimai). Observing Sha veins (Sha Jin), I performed bloodletting at over twenty points. She took Baohua San (Precious Flower Powder) cooled slightly. I prescribed Sangjisheng (Taxilli Herba), Yimucao (Leonuri Fructus), Lianqiao (Forsythiae Fructus), Sugeng (Perillae Caulis), Honghua (Carthami Flos), Jinyinhua (Lonicerae Japonicae Flos), Shanzha (Crataegi Fructus), Bozi (Raphani Semen), Danggui (Angelicae Sinensis Radix), Zhike (Aurantii Fructus), Qingpi (Aurantii Fructus Immaturus), and Huangqin (Scutellariae Radix), taken cold after slight freezing. After four doses, she recovered.
2. A concubine of Zhang Shunzhan suffered from abdominal pain, coughing with phlegm, and vomiting. Upon examination, her pulse felt like striking stones, indicating extreme pain from Sha disease and altered pulse characteristics. I instructed her maid to perform bloodletting at over thirty points on the Sha vessels. She was given Baohua San (Precious Flower Powder), Jiuku Dan (Pain-Relieving Pill), and Amomi Decoction, served slightly cold. I prescribed Duhuo Honghua Tang (Angelicae Pubescentis and Carthami Decoction) added with Shanzha (Crataegi Fructus), Shenqu (Massae Fermentatae Medicinalis), Bozi (Raphani Semen), and Qingpi (Aurantii Fructus Immaturus), served slightly cold. After two doses, she recovered.
3. Fu Chunyu suffered from fever and lethargy, with a pulse resembling untying a knot (Jiesuo). Initially, he drank juice made from mashed taro root mixed with Yin-Yang Water. Bloodletting was performed at over thirty points on the fingers and arms, bringing slight relief. He then took Xixin Dahuang Wan (Asari and Rheum Pills) with clear tea, served slightly cold. I prescribed Jingjie Yinhua Tang (Schizonepeta and Lonicera Decoction) added with Qingpi (Aurantii Fructus Immaturus), taken warm. After two doses, he recovered.
4. Wu Yungong presented with redness and swelling of the head and face, closed eyes, and sore throat. His six pulses lacked root, indicating Sha Qi blocking the pulse pathways. I punctured Sha vessels on the legs and feet over forty times, draining much dark purple-black blood. I then punctured Sha vessels on the arms over twenty times, but the condition did not improve. I prescribed Qingliang Zhibao Yin (Clearing Heat and Treasuring Treasure Drink) with Xixin (Asari Radix) removed, and added Shandougen (Millettiae Speciosae Radix), Shegan (Belamcandae Rhizoma), Niuxi (Achyranthis Bidentatae Radix), Shihu (Dendrobii Caulis), Sangbai pi (Mori Cortex), and Zhike (Aurantii Fructus), served slightly cold. After three doses, he recovered.
5. Zu Yi, the second son of Jin Zijin, in September, due to labor and irregular diet, suddenly developed high fever and headache. He used Perilla Soup to fumigate his head, causing profuse sweating, leading to chest fullness and oppression. Other physicians used purgatives, causing him to vomit white foam. Some suggested it was Sha disease, so another physician examined him. Seeing gray tongue coating, they treated it as Cold Damage (Shanghan). Jin Zijin feared triggering Sha Qi and tested half a small cup first. Shortly after, he experienced delirium, which ceased after a moment. The fever persisted, and he felt increasingly heavy. His pulse reached eight beats per respiration (Ba Zhi). Three physicians consecutively diagnosed Cold Damage (Shanghan). After three doses of medicine, he remained lethargic and delirious. On the fifth day, his eyes were red as fire, lips red as cinnabar, nose black as soot, tongue coating black and dry, short and shriveled, voice unclear, feet cold up to the abdomen, scrotum retracted, muscles wasted, and spirit confused. Physicians refused treatment, and funeral preparations began. On the seventh day, bloodletting was finally performed. Due to the critical condition, only two needles were used. The fatal signs regarding lips, eyes, tongue, and voice instantly resolved. The scrotum and testes gradually relaxed. The pulse normalized. Abdominal pain appeared, and thirst was noted. Confused by advice that Sha disease cannot be treated with herbs, he only drank child's urine and took Zijin Ding (Purple Gold Tablet), stopping the pain. He continued taking it with pain episodes and resumed eating. Stool became dry and hard. On the eighteenth day, honey suppositories were used, leading to diarrhea, occurring 50-60 times daily. After six days, one dose of Sha disease medication allowed him to sleep peacefully, and the diarrhea stopped. Later, other doctors attempted tonification. Within days, during sleep, he developed widespread Crystal Sha (a type of Sha manifestation); upon waking, it vanished. Doctors were puzzled. Jin Zijin noticed that scraping the neck and forehead released sweat. Night sweats ensued. Other doctors attributed this to deficiency collapse from chronic illness and used strong tonics to stop sweating. This worsened spontaneous sweating and caused undigested food in stool. Urine became scant, red, and frequent, turning into Sand Lin (Gravel Strangury). Doctors again gave up. I performed bloodletting again and prescribed Bazheng San (Eight-Normal Powder) for two doses. The Sha Qi transformed. He developed high fever for about two double-hours (four hours), then cooled down and sweating stopped. He ate raw Colocasia esculenta (Taro) for five to six days. The Sand Lin stopped, and he fully recovered. Zu Yi's illness was prolonged and变幻 (variable). It was entirely due to only two needles being used and no Sha-specific medication being taken to remove the root cause. Ultimately, treating Sha disease restored the full pulse and addressed the rapid pulse (Ba Zhi). Although many fatal signs were present, could we have abandoned him?
6. Quan Ke, the eldest son of Jin Zijin, in August, developed a rash all over the body resembling measles. Other physicians diagnosed it as "Rash" (Zhen). Pediatricians also diagnosed it as "Sha Rash" (Sha Zhen). After ten days of medication without improvement, his pulse slowed to two beats per respiration (Er Zhi). Doctors suspected grief-induced deficiency collapse from his recent widowhood and proposed tonification. Jin Zijin feared it was Sha Qi and forbade the medicine. Upon inspection, the body was covered with active Sha spots flowing into the skin and flesh of both legs, which were red and purple. I punctured one point at the popliteal fossa (leg bend), and the skin turned white. Several more punctures at the leg bends turned the skin white, except for the lower legs which remained red and purple. When lying down, the rash flowed and scattered over the body, appearing as sparse dots. Since the pulse was only two beats, I administered a small pill made of Chuanwu (Aconiti Radix Preparata) and Caowu (Aconiti Kusnezoffii Radix). The pulse returned to normal, profuse sweating occurred, and he recovered.