痧症类伤寒，不独类伤寒传经热症。观诸痧变脉侯，更有不似阳而似阴者。几令人反疑为直中三阴真寒症，痧毒入
深也。稍用热药热饮，便不可救疗。
治验∶
一章晋卿，发热沉重，口渴，两颧红赤，唇燥舌苔，两手震动，举家惊惶。脉沉微无力，时有用干姜、肉桂治之；
有用附子治之，此则认脉为阴，而作伤寒三阴真寒症治之也，服之危笃。延余四子端英诊之，知其脉症不合，看腿弯痧
筋放四针，流紫黑毒血。付石膏、黄连、黄芩兼活血顺气之药，稍热饮之一剂而松，再剂而安。
一杨馥音，发热呕吐泻泄，手足蜷挛，怕闻响声，头汗如雨。有指为虚极而然，用大剂人参补之，反加昏闷。余按
其脉，沉细无力。视其面，有戴阳之色。迨询所饮见热而拒，遇冷则喜。余思，此必内有痧症热毒，故脉症若斯。扶看
腿弯痧筋二条，放之、流紫黑毒血如注。用桃仁红花汤加角刺、牛膝微温服四剂，用清凉至宝饮加黄芩，温饮二剂而痊。
一何心祝，身不发热，咳嗽吐泻，蜷卧沉重，手足俱冷，昏迷不醒，喉中痰声不绝。医者四人咸云床褥不谨，内中
阴寒，用人参、黄 、附子、干姜等药服之，病日增。余按脉，徐疾不常，时有歇指。探其气口，热如炉。看其舌，有
黄黑苔芒刺。余曰∶“此非直中阴经真寒症也。”其族兄争之不已。余曰∶“焉有阴症，而舌胎芒刺，口热如炉者乎？况服
参姜附已有明征，若必欲以阴治，请辞。”其家人固求，余先用阴阳水二碗饮之，遂觉稍醒，其弟二人竭力扶起，放腿
弯痧六针。付以射干兜苓汤去甘菊加乌药、玄明粉、槟榔、卜子二剂，稍冷冻饮料之。后减玄明粉加童便，六服而痊。
痧症与伤寒相似，不仅表现为类似伤寒传经的热证。观察各种痧症变化的脉象和症状，更有不像阳证而像阴证的。这几乎让人怀疑是寒邪直中三阴经的真寒假热证，其实是痧毒深入体内所致。如果稍微使用热药或热饮，就无法救治了。
治疗案例：
一章晋卿，发热且身体沉重，口渴，两颧红赤，嘴唇干燥舌苔厚，双手震颤，全家惊慌失措。脉象沉微无力，当时有人用干姜、肉桂治疗；也有人用附子治疗，这是将脉象误认为阴证，当作伤寒三阴经真寒证来治疗，服药后病情危重。后来请我的四儿子章端英诊治，他判断脉症不符，查看腿弯处的痧筋，针刺放血四针，流出紫黑色的毒血。给予石膏、黄连、黄芩以及活血顺气的药物，稍加温热服用一剂后症状缓解，再服一剂后病情安定。
杨馥音，发热呕吐腹泻，手足蜷缩拘挛，害怕听到响声，头部出汗如雨。有人指出这是极度虚弱所致，使用大剂量人参补益，反而加重了昏闷感。我按压其脉象，沉细无力。观察其面色，有戴阳（虚阳上浮）之色。等到询问得知，他喝热的东西就抗拒，遇冷的东西则喜欢。我思考，这必定是内有痧症热毒，所以脉象和症状才如此。扶起患者查看腿弯处两条痧筋，针刺放血，流出如注的紫黑色毒血。使用桃仁红花汤加皂角刺、牛膝，微温服用四剂；再用清凉至宝饮加黄芩，温服二剂后痊愈。
何心祝，身体不发热，咳嗽呕吐腹泻，蜷卧身体沉重，手足俱冷，昏迷不醒，喉中痰声不断。四位医生都说是床铺褥子不慎受寒，体内阴寒，使用人参、黄芪、附子、干姜等药物治疗，病情日益加重。我按脉，脉率徐疾不定，时有间歇。探查其气口脉，热得像火炉一样。看他的舌头，有黄黑苔且生芒刺。我说：“这不是寒邪直中阴经的真寒证。”他的族兄争辩不休。我说：“哪有阴证，却出现舌苔芒刺、口鼻热气如炉的情况呢？况且服用参姜附子后已有明显证据表明不对，如果一定要用治阴证的方法，请允许我辞职。”家人坚决请求治疗，我先让他喝两碗阴阳水，他随即觉得稍微清醒，他的两个弟弟竭力将他扶起，针刺腿弯处痧筋六针。给予射干兜苓汤去掉甘菊，加入乌药、玄明粉、槟榔、莱菔子，服用两剂，稍冷冻后饮用。后来减少玄明粉用量，加入童便，服用六剂后痊愈。
Sha disease resembles Taiyang disease (Exterior Syndrome of the Bladder Channel), not only manifesting as heat syndromes similar to the transmission stages of Taiyang disease. Observing the various pulse and symptom changes in Sha disease, there are cases that appear more like Yin syndromes than Yang syndromes. This almost leads one to suspect it is a True Cold syndrome caused by cold pathogens directly invading the Three Yin channels, but it is actually due to deep penetration of Sha toxin. If even slightly hot medicines or hot drinks are used, the condition becomes incurable.
Clinical Cases:
Zhang Jinqing presented with fever and heavy body sensation, thirst, redness on both malar areas, dry lips and thick tongue coating, and tremors in both hands, causing panic among his family. The pulse was deep, faint, and forceless. At that time, some physicians treated him with Ganjiang (Dried Ginger) and Rougui (Cinnamon Bark); others used Fuzi (Prepared Aconite Root). This approach misidentified the pulse as indicating a Yin syndrome and treated it as a True Cold syndrome of the Three Yin channels in Taiyang disease. After taking these medicines, his condition became critical. He then consulted my fourth son, Duan Ying, who determined that the pulse and symptoms were inconsistent. Upon examining the Sha veins in the popliteal fossa, four needles were applied for bloodletting, releasing dark purple-black toxic blood. He was prescribed Shigao (Gypsum Fibrosum), Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), along with herbs to invigorate blood and regulate Qi. Taken slightly warm, one dose alleviated the symptoms, and a second dose stabilized the condition.
Yang Fuyin suffered from fever, vomiting, and diarrhea, curled limbs and tendons, aversion to loud noises, and profuse sweating on the head. Some pointed out this was due to extreme deficiency and prescribed large doses of Renshen (Ginseng Radix et Rhizoma) for tonification, which instead worsened his drowsiness and oppression. I palpated his pulse, finding it deep, thin, and forceless. His facial complexion showed Daiyang (Floating Yang) signs. Upon inquiry, he rejected hot drinks but preferred cold ones. I reasoned that this must be internal Sha heat-toxin, explaining such pulse and symptom presentation. Two Sha veins in the popliteal fossa were identified; after needle insertion and bloodletting, dark purple-black toxic blood flowed profusely. Tao Ren Honghua Tang (Peach Kernel and Safflower Decoction) was administered with Jiaoci (Gleditsiae Spina) and Niuxi (Achyranthis Bidentatae Radix), taken slightly warm for four doses. Subsequently, Qingliang Zhibao Yin (Cooling Precious Drink) with added Huangqin (Scutellariae Radix) was taken warm for two doses, resulting in recovery.
He Xin Zhu had no fever, but experienced cough, vomiting, and diarrhea, lying curled with a heavy body, cold hands and feet, unconsciousness, and continuous phlegm rattle in the throat. Four physicians attributed the condition to improper bedding causing internal Yin cold, prescribing Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Fuzi (Prepared Aconite Root), and Ganjiang (Dried Ginger). The illness worsened daily. I palpated the pulse, finding it irregular in speed with intermittent pauses. Palpating the Qikou (Radial Artery at the wrist), it felt hot like a furnace. His tongue displayed yellow-black coating with prickles. I stated, "This is not a True Cold syndrome from direct invasion of the Yin channels." His clan brother argued vehemently. I replied, "How can a Yin syndrome present with tongue prickles and oral/nasal heat like a furnace? Moreover, the adverse reaction to Ginseng, Ginger, and Aconite serves as clear evidence. If you insist on treating it as a Yin syndrome, please excuse me." The family insisted on treatment. I first had him drink two bowls of Yinyang Shui (Yin-Yang Water), after which he regained slight consciousness. His two brothers helped sit him up, and six needles were inserted into the Sha veins in the popliteal fossae. Shegan Douleng Tang (Belamcanda and Scutellaria Decoction) was prescribed, excluding Ganju (Chrysanthemi Flos), and adding Wuyao (Linderae Radix), Xuanmingfen (Natrii Sulfas), Binglang (Arecae Semen), and Bobo (Raphani Fructus). Two doses were taken slightly chilled. Later, the dosage of Xuanmingfen was reduced, and Tongbian (Child's Urine) was added. Six doses resulted in full recovery.