脉芤而浮者，肺痧也。脉芤而散者，心痧也。脉弦长而动者，肝痧也。脉芤大而滑实者，脾痧也。脉沉细而动止不
匀者，肾痧也。大肠之痧，类于肺而长。小肠之痧，类于心而细。胆之痧，类于肝而数。胃之痧，类于脾而紧。膀胱之
痧，类于肾而浮虚。三焦命门之痧，脉必怪异。
伤食之痧，脉多战动。伤血之痧，脉多芤滑。伤暑之痧，脉多洪滑而疾数。伤风之痧，脉多沉微。秽触之痧，脉多
变异不常。伤气之痧，脉多沉伏，或形如雀啄。伤寒湿之痧，脉多沉细。
痧症之脉，与诸症之脉不同。如伤寒伤风，自有伤寒伤风之脉。若伤寒伤风，一兼痧症，其脉必变，病必凶暴是也。
凡遇杂症有痧皆然。
治验∶
一用成屠兄夫人，忽然昏迷沉重，痰涎壅盛，已三日矣。延余往视，诊脉，洪大无伦，身不发热，口不干燥，惟不
省人事。余曰∶“脉症不合，此痧胀也”。刮痧稍醒，用沉香郁金散、荆芥汤加山棱、蓬术、枳实、紫朴、砂仁微冷冻饮料之，
三剂而愈。
一忱云溪年老一子，七岁，发热五日，状类伤寒，昏迷沉重，服伤寒药，病势亦甚，将在临危。其婿吴彩云延余往
视，诊其脉，形如雀啄，怪脉已现，不可复救，但细按左关，指下或时厥厥动摇，此暗痧而入不觉也。幸其年幼，可抱
而起，视其腿弯，有紫筋三条，刺之，血流如注，不愈，用阿魏丸、大黄丸、清茶微冷冻饮料之，又用荆芥汤加山楂、卜子、
槟榔、细辛，微冷冻饮料之。连服二头服，方知人事，次日脉复如常，痧气退尽，但身热未痊，乃用伤寒阳明胃经药，三剂
而愈。余治痧不及具述，各举一二为例，以见痧症不可忽也。
余之痧脉要诀，至矣尽矣，痧症之脉，莫有外于此矣。议者以为余之秘夫脉，而不尽言其脉之所以然者，正在此也。
嗟嗟，人之议余也，以余之论痧脉而脉有未明也。抑思余之刊刻是书也，将以晓天下之人，使天下咸识夫痧症之祸也，
岂有所秘而不言者乎？即如伤寒自有伤寒之脉，非虚语也。夫冬月正伤寒，头痛恶寒，身热无汗，脉必紧盛，故见夫人
迎紧盛之脉。若余月虽有头痛恶寒，身热无汗，总名伤寒，脉未有其人迎紧盛者，此冬月所以有正伤寒之脉也。假若冬
月有正伤寒之症，不见有正伤寒紧盛之脉，或变而为沉迟，或变而为微细，是脉症之不合也多矣。而又取青筋、紫筋之
色以辨之，则痧症之发可验而知也。且如伤寒有两手无脉曰双伏，一手无脉曰单伏，必有正汗也。此以汗之将来一时脉
伏言之，非云时时脉伏而有汗也。若所犯伤寒症已如是，而脉之伏也日日如是，则是脉与脉伏正汗之说不合，独不可以
验其痧症之因乎？又如伤寒传经热症，有云气口紧盛，伤食之验，若人症犯胸中饱闷，宜乎气口脉紧盛矣，及按其气口
之脉，不见紧盛，反若空虚，是脉症之不合，更可以验其痧之发矣。若更取青紫筋色而辨其的确以治其痧，尚何疑乎？
即此类推，余症可以尽知。
脉象芤而浮的，是肺痧。脉象芤而散的，是心痧。脉象弦长且动的，是肝痧。脉象芤大而滑实的，是脾痧。脉象沉细且动止不匀的，是肾痧。大肠的痧症，脉象类似肺但更长。小肠的痧症，脉象类似心但更细。胆的痧症，脉象类似肝但更数（快）。胃的痧症，脉象类似脾但更紧。膀胱的痧症，脉象类似肾但更浮虚。三焦和命门的痧症，脉象必定怪异。
伤食引起的痧症，脉象多表现为战动（跳动不稳）。伤血引起的痧症，脉象多表现为芤滑。伤暑引起的痧症，脉象多表现为洪滑而疾数（快）。伤风引起的痧症，脉象多表现为沉微。秽浊之气触犯的痧症，脉象多变异无常。伤气引起的痧症，脉象多表现为沉伏，或者形状如雀啄。伤寒湿引起的痧症，脉象多表现为沉细。
痧症的脉象，与其他病症的脉象不同。例如伤寒、伤风，自有其特定的脉象。如果伤寒或伤风兼夹痧症，其脉象必然发生变化，病情必定凶险暴烈。凡是遇到杂症兼有痧症的情况都是如此。
治疗验案：
有一位成屠兄长的夫人，突然昏迷沉重，痰涎壅盛，已经三天了。请我去诊治，诊脉发现脉象洪大无比，身体不发热，口不干燥，只是不省人事。我说：“脉象与症状不符，这是痧胀。”刮痧后患者稍醒，使用沉香郁金散、荆芥汤加莪术、蓬术、枳实、紫朴（厚朴）、砂仁，微冷冻后服用，三剂痊愈。
另一位是忱云溪家年老的一子，七岁，发热五天，症状类似伤寒，昏迷沉重，服用伤寒药后病势更重，即将危殆。他的女婿吴彩云请我去诊治，诊其脉象，形状如雀啄，怪脉已现，看似不可救治，但仔细按压左关部，指下有时感到厥厥动摇，这是暗痧侵入而未被察觉。幸好他年幼，可以抱起查看，见其腿弯处有三条紫筋，刺之，血流如注，仍未愈，使用阿魏丸、大黄丸、清茶微冷冻后服用，又用荆芥汤加山楂、萝卜子、槟榔、细辛，微冷冻后服用。连服两剂头煎药后，才恢复意识，次日脉象恢复正常，痧气退尽，但身体余热未清，于是使用治疗伤寒阳明胃经的药物，三剂痊愈。我治疗痧症的情况无法全部叙述，各举一二为例，以显示痧症不可忽视。
我的痧脉要诀，已经详尽无遗，痧症的脉象没有超出这个范围的。议论的人认为我秘而不宣脉象，而没有完全说出脉象之所以然的原因，正是基于此。唉，人们议论我，是因为认为我对痧脉的论述中脉理尚不明确。但想想我刊刻这本书的目的，是为了让天下人知晓，使天下人都认识痧症的危害，难道有什么秘密而不说的吗？就像伤寒自有伤寒的脉象，这不是空话。在冬季正值伤寒时，头痛恶寒，身热无汗，脉象必定紧盛，所以见到寸口脉紧盛（注：原文“迎”通“寸”，指寸口脉）。如果在其他月份虽有头痛恶寒、身热无汗，总称为伤寒，脉象却没有寸口紧盛的，这就是冬季才有正伤寒脉象的原因。假如冬季有正伤寒的症状，却不见正伤寒紧盛的脉象，或者变为沉迟，或者变为微细，这是脉症不合的情况很多。此时再取青筋、紫筋的颜色来辨别，那么痧症的发生就可以验证而知晓了。况且如伤寒有两手无脉叫做双伏，一手无脉叫做单伏，必定会有正汗（正常出汗）出现。这是说汗出之前暂时脉伏，不是说时时脉伏而有汗。如果所患伤寒症状已经如此，而脉象伏匿日日如此，那么这就与脉伏正汗的说法不合，难道不可以借此验证是痧症的原因吗？又如伤寒传经热症，有人说气口脉紧盛是伤食的验证，如果人症状犯胸中饱闷，按理气口脉应该紧盛，但按察气口脉，不见紧盛，反而空虚，这是脉症不合，更可以验证痧症的发生。如果再取青紫筋色来确切辨别并治疗痧症，还有什么可疑虑的呢？由此类推，其他病症都可以完全知晓。
Pulse being *kōu* (hollow) and floating indicates Lung Sha (Sha disease of the Lung). Pulse being *kōu* (hollow) and scattered indicates Heart Sha. Pulse being wiry, long, and moving indicates Liver Sha. Pulse being *kōu* (hollow), large, slippery, and solid indicates Spleen Sha. Pulse being deep, fine, and irregular in rhythm indicates Kidney Sha. Sha of the Large Intestine resembles that of the Lung but is longer. Sha of the Small Intestine resembles that of the Heart but is finer. Sha of the Gallbladder resembles that of the Liver but is rapid. Sha of the Stomach resembles that of the Spleen but is tight. Sha of the Bladder resembles that of the Kidney but is floating and deficient. Sha of the Sanjiao (Triple Burner) and Mingmen (Gate of Life) will have bizarre pulses.
Sha caused by food injury often presents with a trembling or unstable pulse. Sha caused by blood injury often presents with a *kōu* (hollow) and slippery pulse. Sha caused by summerheat often presents with a surging, slippery, and rapid pulse. Sha caused by wind often presents with a deep and faint pulse. Sha caused by foul contact often presents with variable and irregular pulses. Sha caused by Qi injury often presents with a deep and hidden pulse, or one resembling the pecking of a sparrow. Sha caused by cold-dampness often presents with a deep and fine pulse.
The pulse of Sha disease differs from that of other diseases. For instance, Shanghan (Cold Damage) and Shangfeng (Wind Injury) have their own specific pulses. If Shanghan or Shangfeng is complicated by Sha disease, the pulse must change, and the condition becomes fierce and violent. This applies to all miscellaneous diseases complicated by Sha.
Case Record 1: The wife of my friend Cheng Tu suddenly fell into a heavy coma with abundant phlegm and saliva for three days. I was summoned to examine her. Her pulse was excessively surging and large; she had no fever, no dry mouth, but was unconscious. I said, "The pulse and symptoms do not match; this is Sha distension." After scraping therapy, she regained slight consciousness. She was administered Chenxiang Yujin San (Agarwood and Turmeric Powder) combined with Jingjie Decoction (Schizonepeta Decoction) plus Ezhu (Curcuma Zedoaria Rhizome), Pengzhu (Curcuma Phaeocaulis Rhizome), Zhishi (Immature Bitter Orange), Zipu (Magnolia Officinalis Bark), and Sharen (Amomum Fruit), served slightly chilled. She recovered after three doses.
Case Record 2: An elderly man named Chen Yunxi had a seven-year-old son who had been feverish for five days, presenting similarly to Shanghan, with heavy coma. After taking medicines for Shanghan, his condition worsened to the brink of death. His son-in-law, Wu Caiyun, summoned me. Upon palpation, the pulse resembled the pecking of a sparrow, indicating a strange pulse that seemed incurable. However, upon careful palpation of the Left Guan position, there was a momentary throbbing sensation under the fingers, indicating hidden Sha that had gone unnoticed. Fortunately, due to his young age, he could be lifted and examined; three purple veins were found behind his knees. These were pricked, and blood flowed profusely. As he did not recover immediately, Awei Wan (Asafoetida Pill) and Dahuang Wan (Rhubarb Pill) were administered with clear tea, slightly chilled. Additionally, Jingjie Decoction plus Shanzha (Hawthorn Fruit), Boluozi (Radish Seed), Binglang (Areca Nut), and Xixin (Asarum Root) were administered, slightly chilled. After two doses of the first decoction, he regained consciousness. The next day, his pulse returned to normal, and Sha qi completely subsided, though residual heat remained. Therefore, medicines targeting the Yangming Stomach Channel for Shanghan were used, and he recovered after three doses. I cannot detail all my cases of treating Sha; I present these two as examples to show that Sha disease must not be neglected.
My essential principles of Sha pulses are exhaustive; there is no Sha pulse outside of these descriptions. Critics argue that I keep the pulse secret and do not fully explain the rationale behind it, which is precisely why they say so. Alas, people criticize me, claiming my discussion on Sha pulses lacks clarity regarding the pulse itself. But consider that I published this book to enlighten the world and make everyone aware of the dangers of Sha disease. Do I have any secrets? Just as Shanghan has its own specific pulse, this is not empty talk. In winter, when one truly contracts Shanghan, with headache, aversion to cold, fever, and absence of sweat, the pulse must be tight and vigorous, hence the presence of a tight and vigorous Cun Kou (Cun position of the radial artery) pulse. In other months, even if one has headache, aversion to cold, fever, and absence of sweat, collectively termed Shanghan, the Cun Kou pulse is rarely tight and vigorous; this is why only in winter does one see the true Shanghan pulse. If in winter, one has the symptoms of true Shanghan but lacks the tight and vigorous pulse, or if the pulse changes to deep-slow or faint-thin, this discrepancy between pulse and symptoms is common. At such times, observing the color of green or purple veins allows one to verify the occurrence of Sha disease. Furthermore, in Shanghan, having no pulse in both hands is called Double Fu (Hidden), and in one hand is Single Fu (Hidden); this is always accompanied by proper sweating. This refers to the temporary hiding of the pulse before sweating occurs, not constant pulse hiding with sweating. If the Shanghan symptoms persist daily while the pulse remains hidden, this contradicts the theory of pulse hiding preceding proper sweating, allowing one to verify that the cause is indeed Sha disease. Similarly, in transmitted heat syndromes of Shanghan, a tight and vigorous Qi Kou (Guan position of the radial artery) pulse is considered evidence of food injury. If a patient suffers from chest fullness and oppression, one would expect a tight and vigorous Qi Kou pulse. However, if palpation reveals an empty pulse rather than a tight one, this mismatch between pulse and symptoms further verifies the onset of Sha disease. By additionally observing green and purple veins for confirmation and treating the Sha accordingly, what doubt could remain? By analogy, other diseases can be fully understood.