痧中禁忌，余虑不知痧，误犯之。尤虑知痧，罔识所忌。譬若昏夜迷途，高低莫辨，从步于岩谷间，鲜不颠仆者
矣。盖痧受病，与杂症不同；见端与杂症相类。病家不信，以杂症治之，勿顾痧中禁忌，势必日甚一日，病入膏肓。
即有进言刮放，一试焉无及矣。则受迷于痧胀之始者，此其一。亦有始即知痧，稍用刮放，便谓业既治痧当用别药。幸
而不犯痧禁，或可收功。若痧气未绝，一犯所忌，愈服愈危，身命难保，乃曰非因痧胀之故。则受迷于痧胀之终者，此
其一。更有患痧不识，用别药不效，因而仅用刮放，不佐以治痧之剂，或仅投一二剂，复投别症之药，致痧患复发，
茫然不觉，乃曰治痧无效，不足信也。不知治痧用药，稍或不合，势必痧毒内攻而毙。则始终受迷于痧胀之害者，又
其一。更不特如是己也。或痧症有时汗出如油，误服酸敛固表之味；或痧症有时寒热无汗，误服升提温散之方；或痧症
有时足冷过膝，误服附子、吴茱、姜、桂之品；或痧症有时上吐下泻，误服香燥涩滞之类；或痧症有时恶寒畏冷，误服
姜椒辛辣之物；更有痧症变为脉虚，误用温补之药；痧症变为脉旺，误用冰寒之药。或痧症变为怪脉，虽不皆生然，
误认必死，弃而不救。而且痧症尝似气虚，误用参 苓术以补气，尝似血虚，误用熟地、何首乌以补血。而且痧多死
症，凶险非常，不复细审病源，以为别症将毙。而且痧症略松，食物太早，因而痧物相裹，结于心胸，难以解散。
而且痧症未绝，痧毒尚仔，骤饮热汤、热酒，遂致痧症复发，凶危莫遏，每有变在顷刻，悔之无及。此等受迷，皆余所
目击而心伤者也。若乃有见痧讳言痧，犯痧恶言痧，虽死于痧，勿知为痧之害者，其天下之所限乎，余固不得而强之。
即有摈刮痧、放痧、治痧之方法者，余亦不得而强之也。尝观医林多士，业擅岐黄，深通
古籍者，动辄援引《内经》，谆谆不已，竟不知黄帝始制九针
之法以疗民病，多刺少药。即如《内经》有云∶诸疟而脉不见，刺十指间出血，血去必已先视身之赤如小豆者，尽取之。
又云∶先其发时，如食顷而刺之，一刺则衰，二刺则知，三刺则已。不已，刺舌下两脉出血。不已，刺 中（即委中）。
盛经出血，又刺项以下挟脊者，必已。如先头痛及重者，先刺头上及两额、两眉间，出血。先项背痛者，先刺之。先腰
脊痛者，先刺 中出血。先手臂痛者，先刺手少阴、阳明十指间。先足胫酸痛者，先刺足阳明十指间出血。又如腰痛引
项脊尻背如重状，刺其 中太阳正经出血，刺解脉在膝筋肉分间， 外廉之横脉，出血，血变而止。解脉令人腰痛如引
带，如折腰状，善恐。刺解脉在 中结络如黍米，刺之血射以黑，见赤血而已。经载煌煌，垂训万古，正后人之所当祖
习者也。故痧多变，余不能尽述。凡在尔所不信者，试于清夜思之。苟遇斯疾，偶尔心迷，当刺不刺，当药不药，或误
入，或误己，彼此不异，谅有同心。慎之！慎之！
痧症中的禁忌，我担心的是人们不了解痧症而误犯这些禁忌。更令人担忧的是，即使知道是痧症，却不清楚具体的禁忌事项。这就像在昏暗的夜晚迷失了道路，高低地形分辨不清，在岩谷之间行走，很少有不跌倒的。
因为痧症致病，与一般杂病不同；但其初期表现与杂病相似。病人家属如果不相信这是痧症，按照杂病来治疗，不顾及痧症的禁忌，病情势必一天天加重，最终病入膏肓。此时即使有人建议采用刮痧或放痧疗法，尝试也来不及了。这就是在痧症开始时受到迷惑的情况之一。
也有的人一开始就知道是痧症，稍微用了刮痧或放痧后，就认为既然已经治过痧症，就应该用其他药物。幸好没有触犯痧症禁忌，或许还能取得疗效。但如果痧气未除，一旦触犯禁忌，服药越多越危险，性命难保，反而说这不是痧症造成的。这就是在痧症结束时受到迷惑的情况之一。
更有甚者，患痧症却不认识，使用其他药物无效，因此仅用刮痧或放痧，不配合治疗痧症的药物，或者只投一两剂药，又改用治疗其他病症的药物，导致痧症复发，茫然不觉，反而说治痧无效，不值得相信。却不知道治疗痧症用药，如果稍有不当，势必导致痧毒内攻而死亡。这就是始终受到痧症危害迷惑的情况之一。
不仅如此，还有以下情况：有的痧症有时出汗如油，误服酸敛固表的药物；有的痧症有时寒热无汗，误服升提温散的方法；有的痧症有时脚冷超过膝盖，误服附子、吴茱萸、生姜、肉桂等药物；有的痧症有时上吐下泻，误服香燥涩滞的药物；有的痧症有时恶寒畏冷，误服姜椒辛辣的食物；更有痧症变为脉虚，误用温补的药物；痧症变为脉旺，误用冰寒的药物。有的痧症变为怪脉，虽然不一定致死，但误认为是必死之症，放弃不救。而且痧症常看似气虚，误用人参、茯苓、白术来补气；常看似血虚，误用熟地黄、何首乌来补血。而且痧症多为死症，凶险非常，不再仔细审查病源，以为是其他病症将死。而且痧症症状稍缓解，进食过早，因而痧毒与食物相裹结于心胸，难以解散。而且痧症未除，痧毒尚存，突然饮用热汤、热酒，致使痧症复发，凶危无法遏制，往往顷刻间发生变化，后悔莫及。这些受迷惑的情况，都是我亲眼目睹并内心悲伤的。至于那些见到痧症讳言痧症，厌恶痧症而谈论痧症，即使死于痧症，也不知道是痧症危害的人，大概是天下命运所限吧，我固然不能强行改变他们。即使有排斥刮痧、放痧、治痧方法的人，我也不能强行要求他们。
我曾观察医林中的许多人士，擅长岐黄之术，深通古籍者，动辄引用《黄帝内经》，谆谆教诲不已，竟然不知道黄帝最初制定九针之法以治疗百姓疾病，多是针刺少用药。正如《黄帝内经》所说：“诸疟而脉不见，刺十指间出血，血去必已。先视身之赤如小豆者，尽取之。”又说：“先其发时，如食顷而刺之，一刺则衰，二刺则知，三刺则已。不已，刺舌下两脉出血。不已，刺委中（即腘窝处的膀胱经穴位）。盛经出血，又刺项以下挟脊者，必已。如先头痛及重者，先刺头上及两额、两眉间，出血。先项背痛者，先刺之。先腰脊痛者，先刺委中出血。先手臂痛者，先刺手少阴、阳明十指间。先足胫酸痛者，先刺足阳明十指间出血。”又如“腰痛引项脊尻背如重状，刺其委中太阳正经出血，刺解脉在膝筋肉分间，外廉之横脉，出血，血变而止。解脉令人腰痛如引带，如折腰状，善恐。刺解脉在委中结络如黍米，刺之血射以黑，见赤血而已。”经文记载辉煌，垂训万古，正是后人应当效法学习的。所以痧症变化多端，我不能全部叙述。凡是不相信我所说的，请在清夜深思。假如遇到这种疾病，偶尔心中迷惑，该针刺而不针刺，该用药而不用药，或者误入歧途，或者害了自己，彼此无异，想必有同感。谨慎啊！谨慎啊！
Contraindications in Sha (Sha Syndrome) are a concern of mine; I fear people do not know about Sha and inadvertently violate them. Even more concerning is that even if one knows it is Sha, one fails to recognize the specific contraindications. This is like being lost on a dark night, unable to distinguish high from low terrain; walking among cliffs and valleys, few escape falling.
The pathogenesis of Sha differs from miscellaneous diseases (Zazheng), yet its initial manifestations resemble those of miscellaneous diseases. If patients or their families do not believe it is Sha and treat it as a miscellaneous disease, ignoring Sha's contraindications, the condition will inevitably worsen day by day until it becomes incurable (entering the Gao Huang). At this point, even if someone suggests scraping (Guasha) or bloodletting (Fangsha), it will be too late. This constitutes one type of confusion at the onset of Sha syndrome.
Others may know it is Sha from the beginning. After slight scraping or bloodletting, they assume that since Sha has been treated, other medications should be used. Fortunately, if no Sha contraindication is violated, recovery might be achieved. However, if Sha Qi is not eliminated and a contraindication is violated, further medication increases danger, making life hard to preserve, yet they claim it was not due to Sha. This constitutes one type of confusion at the end stage of Sha syndrome.
Furthermore, some suffer from Sha but fail to recognize it. When other medications prove ineffective, they resort only to scraping or bloodletting without accompanying Sha-specific formulas, or use only one or two doses before switching to treatments for other conditions. This causes Sha to recur, leaving them bewildered. They then claim Sha treatment is ineffective and unreliable. They fail to realize that any mismatch in Sha treatment medication can lead to internal attack by Sha toxin and death. This constitutes another type of confusion regarding the harm of Sha throughout its course.
Moreover, there are specific errors:
1. In cases where Sha presents with sweating like oil, sour and astringent medicines that consolidate the exterior are mistakenly administered.
2. In cases with chills, fever, and anhidrosis, ascending and warming-dispersing prescriptions are mistakenly used.
3. In cases where coldness extends up the legs past the knees, Aconite (Fuzi), Evodia (Wuzhuyu), Ginger (Shengjiang), and Cinnamon Twig (Rougui) are mistakenly given.
4. In cases with vomiting and diarrhea, aromatic, drying, and astringent substances are mistakenly used.
5. In cases with aversion to cold, pungent and spicy foods like ginger and pepper are mistakenly consumed.
6. When the pulse becomes deficient (Xu), warming and tonifying drugs are mistakenly applied.
7. When the pulse becomes vigorous (Wang), icy-cold drugs are mistakenly used.
8. When strange pulses appear, although not always fatal, they are misinterpreted as certain death, leading to abandonment of treatment.
9. Sha often resembles Qi deficiency, leading to mistaken use of Ginseng (Renshen), Poria (Fuling), and Atractylodes (Baizhu) to tonify Qi.
10. Sha often resembles Blood deficiency, leading to mistaken use of Prepared Rehmannia (Shudihuang) and Polygonum multiflorum (Heshouwu) to tonify Blood.
11. Because Sha involves many critical cases with extreme peril, practitioners fail to carefully examine the disease source, assuming the patient will die from other conditions.
12. When Sha symptoms slightly relax, food is introduced too early, causing Sha toxins to bind with food in the chest and heart, making resolution difficult.
13. While Sha persists and toxins remain, sudden consumption of hot soup or hot wine causes recurrence of Sha, with perilous consequences that cannot be contained, often changing in an instant, leaving regret too late.
These instances of confusion are all witnessed by me with a sorrowful heart. As for those who hide the fact of Sha when seen, speak against Sha when disgusted by it, and die from Sha without realizing it is Sha's harm—this may be limited by destiny in the world, and I cannot force change upon them. Similarly, I cannot force those who reject methods of scraping, bloodletting, and treating Sha.
I have observed many scholars in the medical field proficient in Qihuang (Traditional Chinese Medicine) and deeply versed in ancient texts, who constantly cite the *Neijing* (Inner Canon of the Yellow Emperor). Yet they seem unaware that the Yellow Emperor originally established the Nine Needles method to treat the people's diseases, emphasizing acupuncture over herbal medicine. For instance, the *Neijing* states: "In malaria cases where the pulse is not visible, prick the ten fingers to bleed; bleeding ensures cure. First observe any red spots like small beans on the body and treat all of them." It also says: "Prick before the onset, after about the time it takes to eat a meal. One prick reduces severity, two pricks bring improvement, three pricks result in cure. If not cured, prick the two vessels under the tongue to bleed. If still not cured, prick Weizhong (BL-40). Bleed from full meridians, and prick below the neck along the spine; this will surely cure. If headache and heaviness occur first, prick the head, temples, and between the eyebrows to bleed. If neck and back pain occur first, prick there first. If lower back and spine pain occur first, prick Weizhong to bleed. If arm pain occurs first, prick the ten fingers of Hand Shaoyin and Hand Yangming. If lower leg soreness and pain occur first, prick the ten fingers of Foot Yangming to bleed." Furthermore: "For lower back pain radiating to the neck, spine, buttocks, and back feeling heavy, prick the Taiyang main meridian at Weizhong to bleed. Prick Jie Mai at the muscle-bone junction behind the knee, and the transverse vessel on the lateral side; bleed until the blood color changes. Jie Mai causes lower back pain like pulling a belt or breaking the waist, accompanied by fear. Prick Jie Mai at Weizhong where collaterals knot like millet seeds; black shooting blood indicates the need to stop when red blood appears." The scriptures are magnificent, instructing for eternity, serving as models for posterity. Thus, Sha varies greatly, and I cannot describe all variations. Those who do not believe me, please reflect quietly at night. If you encounter such illness and momentarily lose your way, failing to prick when you should, or failing to medicate when you should, whether harming others or yourself, the outcome is similar. I trust we share this understanding. Be cautious! Be cautious!