痧者，天地间之厉气也。入于气分，则毒中于气而作肿作胀。入于血分，则毒中于血而为蓄、为瘀。凡遇食积、痰
火、气血即因之阻滞，结聚而不散，此痧之所以可畏也。故人之壮实者，有痧胀之症，饮热酒、热汤而变者固然；即人
之虚弱者，有痧胀之症，饮热酒、热汤而变者，亦无不然。至如人有杂病，兼犯痧症，是为杂病变端，而亦畏夫热酒、
热汤，人不知觉、遂遭其祸，则是痧之发，又何论人之虚实乎。夫惟人之实者犯之，固即以有余治之，而虚者犯之，亦
当以有余治之。盖其有余者，非有余于本原，乃有余于痧毒也。论者以为人之实者，固可以有余治之，而人之虚者，以
有余治之，则益虚其虚矣，而不知非然也。夫人有痧毒，如家之遇贼寇也，人有虚实，如家之有浓薄也，假若贼寇操戈
已入于室内矣，而乃以家之资财之薄也，其贼寇可不驱而出之乎！吾见家有贼寇，必先驱之为是。人有痧毒，亦无不先
驱之为是也。故痧发不论虚实，驱毒在所当先，温补必于收后，此痧之所以有实而无虚也。
方书所载，怪病之谓痰，此古人之格言也。是以中风、痰厥、昏迷不醒及流痰、肿痛，具责之痰。然有治痰而痰得
其治者，十中一二，有治痰而痰不为所治者，十有八九。是非痰之不可治也，盖因其症之凶危，医者胶于方书之语，咸
谓其痰之使然。而中风、痰厥、昏迷之类，遂有不可名言者矣。若余于中风，痰厥、昏迷之类，尝有治痰而得其效矣。
讵敢曰一一非痰，然其间因痧而有是症者，虽云今之时气使然，何乃十有八九余切其脉而不洪滑，即有可疑。或症有口
渴身热，脉变而为沉迟；或症有不渴身凉，脉变而紧数；此皆脉症不合。须识其痧，一取青紫筋色而辨之，自有确见。
若医者惟执为痰以治之，便成大害。然则古人所谓怪病之谓痰，痰诚有其病之怪，而余则有见夫怪病之谓痧、而痧之为
怪，更有甚于痰也。则是痧之为害，莫有大于此者，岂可付之不论不议耶。
痧，是天地间的一种烈性邪气。侵入气分，则毒邪中于气而引发肿胀；侵入血分，则毒邪中于血而形成蓄积、瘀滞。凡是遇到食积、痰火、气血阻滞的情况，都会因此结聚不散，这就是痧症令人畏惧的原因。所以，身体壮实的人，患有痧胀（痧毒引起的肿胀）症状，饮用热酒、热汤后病情变化固然常见；即使是身体虚弱的人，患有痧胀症状，饮用热酒、热汤后病情变化，也没有不是这样的。至于有人患有其他杂病，又兼感痧症，这属于杂病的变证，同样畏惧热酒、热汤，人们不知晓其中道理，于是遭受祸害，这说明痧症的发作，哪里还论及人的体质虚实呢？只有身体壮实的人感染它，固然可以用攻邪有余的方法治疗；身体虚弱的人感染它，也应当用攻邪有余的方法治疗。因为所谓的“有余”，并非指人体本源有余，而是指痧毒有余。评论者认为，身体壮实的人，当然可以用攻邪有余的方法治疗；而身体虚弱的人，如果用攻邪有余的方法治疗，就会使虚者更虚，却不知道情况并非如此。人有了痧毒，就像家里遇到了盗贼；人有虚实之分，就像家里的财力有厚薄之别。假如盗贼拿着兵器已经闯入室内了，难道因为家里财力薄弱，就可以不将盗贼驱逐出去吗！我看见家里有盗贼，必定先将其驱逐才是正确的做法。人有了痧毒，也必定先将其驱逐才是正确的做法。所以，痧症发作不论体质虚实，驱除毒邪都是首要任务，温补疗法必须在收功之后使用，这就是痧症之所以表现为实证而没有虚证的原因。
医书中所记载的，“怪病多由痰引起”，这是古人的格言。因此，中风、痰厥（因痰浊上蒙清窍导致的昏厥）、昏迷不醒以及流痰、肿痛等症状，都归咎于痰。然而，治疗痰症而取得效果的，十人中只有一二人；治疗痰症而未见效的，十人中有八九人。这并不是痰症不可治，而是因为病症凶险危急，医生拘泥于医书的言辞，都认为这是痰造成的。于是中风、痰厥、昏迷等病症，就有了无法用言语说明的情况了。至于我对于中风、痰厥、昏迷这类病症，曾经有过通过治痰而取得疗效的案例。岂敢断言这些病症完全不是痰引起的，但其中因痧症而出现这些症状的，虽然说是当下的时气所致，为何我切脉时十之八九脉象不洪滑，这就值得怀疑了。或者症状表现为口渴身热，脉象却变为沉迟；或者症状表现为不渴身凉，脉象却变为紧数；这些都是脉象与症状不相符合。必须识别出这是痧症，通过观察并刺破青紫色的筋络来辨别，自然会有确切的见解。如果医生只执着于按痰症治疗，就会造成巨大的危害。既然这样，古人所说的“怪病多由痰引起”，痰确实有其病症怪异的一面，但我认为怪病是由痧引起的，而痧的怪异程度，甚至超过痰。那么，痧症的危害，没有比这更大的了，怎么可以不予讨论和议论呢。
Sha (Toxic Heat Pathogen) is a fierce pathogenic factor in the heaven and earth. When it enters the Qi Level (the functional level of the body), the toxin affects the Qi, causing swelling and distension. When it enters the Blood Level (the material level of the body), the toxin affects the Blood, leading to accumulation and stasis. Whenever there is food stagnation, phlegm-fire, or obstruction of Qi and Blood, these factors become bound together and do not disperse; this is why Sha is so feared. Therefore, for robust individuals suffering from Sha Distension (distension caused by Sha toxin), changes after drinking hot wine or hot soup are indeed common; even for weak individuals suffering from Sha Distension, changes after drinking hot wine or hot soup are equally inevitable. As for those who have miscellaneous diseases and concurrently contract Sha syndrome, this constitutes a variation of the miscellaneous disease. They too fear hot wine and hot soup. Because people are unaware of this mechanism, they suffer disaster. This shows that the onset of Sha does not depend on whether the person is excess or deficient. For robust individuals contracting Sha, one should certainly treat with methods addressing excess; for weak individuals contracting Sha, one should also treat with methods addressing excess. The "excess" referred to here is not an excess in the person's original constitution, but an excess of Sha toxin. Critics argue that while robust individuals can be treated with excess-addressing methods, treating weak individuals with such methods would further deplete their deficiency, failing to realize that this is not the case. A person having Sha toxin is like a home encountering bandits; a person being excess or deficient is like a home having abundant or scarce resources. If bandits armed with weapons have already entered the room, can one refrain from driving them out simply because the family's resources are scarce? I see that when a home has bandits, it is correct to drive them out first. Similarly, when a person has Sha toxin, it is correct to drive it out first. Thus, regardless of whether the Sha onset occurs in an excess or deficient constitution, expelling the toxin must be the priority; warming and tonifying therapies must only be used after the toxin is expelled. This is why Sha manifests as excess and has no deficiency aspect.
Medical texts state that "strange diseases are attributed to Phlegm," which is an ancient maxim. Therefore, conditions such as Stroke (Zhong Feng), Phlegm Syncope (Tan Jue - syncope due to phlegm clouding the clear orifices), coma, wandering abscesses (Liu Tan), and swelling/pain are all blamed on Phlegm. However, among those treated for Phlegm, only one or two out of ten achieve cure, while eight or nine out of ten do not respond. This does not mean Phlegm diseases are incurable; rather, it is because the symptoms are critical and dangerous, and physicians stick rigidly to textual doctrines, attributing everything to Phlegm. Consequently, conditions like Stroke, Phlegm Syncope, and Coma become difficult to explain verbally. Regarding my own experience with Stroke, Phlegm Syncope, and Coma, I have indeed achieved efficacy through treating Phlegm. I dare not claim that none of these cases were due to Phlegm. However, among those cases where symptoms arose due to Sha, although we attribute it to the prevailing seasonal climate, why is it that upon palpating the pulse in eight or nine out of ten cases, it was not surging and slippery? This raises suspicion. Or, if symptoms include thirst and fever, yet the pulse becomes deep and slow; or if symptoms include no thirst and coolness, yet the pulse becomes tight and rapid—these are instances where pulse and symptoms do not match. One must recognize Sha and distinguish it by observing and pricking blue-purple veins, which will yield clear insight. If physicians insist on treating solely as Phlegm, it leads to great harm. Thus, while the ancient saying "strange diseases are attributed to Phlegm" holds true regarding the strangeness of Phlegm diseases, I observe that strange diseases are often due to Sha, and the strangeness of Sha exceeds that of Phlegm. Therefore, no harm surpasses that of Sha; how can it be left unexamined and undiscussed?