病有翻胃兼痧，有痧变翻胃；有噎膈兼痧，有痧变噎膈，其痧似慢，日渐凶暴，宜细辨之。
治验∶
一包世球年六旬余，患翻胃症，食即心痛呕吐不止。余按其脉，六部洪紧有力。乃阅痧筋，放手臂腿上痧二十余针。
付以乌药顺气汤及降香桃花散，俱微温服，四日而痊。
一蔡爱山，胸中饱闷，欲食不食，食即胃脘不宁，苦楚万状。余诊之，后三部脉微涩。放腿弯痧二十余针，略松。
日服苏木散，微温酒下二钱，六日而愈。
筋骨疼痛，多延蔓终身。治此者，或风或湿，或气阻血凝，或流痰流火，如此而已。然有效有不效，或为痧暗相缠，
令人莫识，此痧甚慢，不可不知也。
治验∶
一董季连，筋骨疼痛，卧床二年，诸药不应。余诊之，右脉微弦，左脉沉细，阅痧筋放之，血流紫黑。用圆红散，
微温汤饮之，付蒲黄饮加五灵脂、角刺温服六剂而痊。
一郝文仔，筋骨疼痛，步履艰难，吐痰气急，左脉微芤，右脉弦紧。放腿弯痧紫黑血三针。用必胜汤加角刺，微温
饮之，渐愈。
世俗传鬼箭之说，有针挑、火 、油发、艾桃揩诸法。不敢服药，疑真有鬼祸，非也。识者辨之谓，鬼箭是风，神
箭是寒，床箭是湿。痛而转动者，气与痰也；痛而难转动者，血也，各有方治。然中亦有杂痧者，先治痧毒，后除余症，
亦箭亦须知也。
治验∶
一曹叔恒，遍身走注疼痛，不能展动，或曰∶“此鬼箭也。”以油发、艾叶揩之，以灯心蘸菜油点火 之，不应。适
见余，自述其病诊之，脉左虚右实，放痧三针，流紫黑血。用桃仁红花汤加穿山甲、天虫、香附微温服，渐痊。
一钟洪武内室，腰背疼痛，卧床不起。有以为鬼箭之病，从痛处挑筋十余针，不愈。延余，脉徐疾不常。曰∶“瘀也。”
令其婢刮而且放，刺腿弯痧二十余针，流紫黑毒血。用红花汤加穿山甲、泽兰、刘寄奴四剂微温服乃痊。
疾病中有翻胃兼夹痧证，也有痧证转化为翻胃；有噎膈兼夹痧证，也有痧证转化为噎膈。这类痧证看似缓慢，但病情日渐凶险暴烈，应当仔细辨别。
治疗验案：
一位包世球，年龄六十多岁，患翻胃病，进食后即心痛、呕吐不止。我诊察他的脉象，六部脉洪大、紧束且有力。于是查看他身上的痧筋，在手臂和腿部放痧二十多针。
给予乌药顺气汤及降香桃花散，均微温服用，四天后痊愈。
一位蔡爱山，胸中饱闷，想吃却吃不下，进食后胃脘部不安宁，痛苦万分。我诊察他的脉象，尺部脉微弱而涩滞。在腿弯处放痧二十多针，症状稍缓解。
每日服用苏木散，用微温酒送服二钱，六天后痊愈。
筋骨疼痛，大多蔓延终身难以治愈。治疗此类病症，或因风邪，或因湿邪，或因气阻血凝，或因流痰流火，大致如此。然而有的有效，有的无效，有时是因为被痧毒暗中缠扰，让人无法识别，这种痧证发展非常缓慢，不可不知晓。
治疗验案：
一位董季连，筋骨疼痛，卧床两年，各种药物均无效果。我诊察他的脉象，右脉微弦，左脉沉细，查看痧筋并放痧，流出紫黑色的血液。使用圆红散，用微温的汤水送服，又给予蒲黄饮加入五灵脂、角刺（皂角刺），微温服用六剂后痊愈。
一位郝文仔，筋骨疼痛，行走艰难，吐痰且气急，左脉微芤（中空如葱管），右脉弦紧。在腿弯处放痧，流出紫黑色血液三针。使用必胜汤加入角刺，微温饮用，逐渐痊愈。
世俗流传关于“鬼箭”的说法，有针挑、火灸、油发、艾桃擦拭等方法。不敢服药，怀疑真有鬼祸作祟，这是不对的。懂行的人辨别说，“鬼箭”是风邪，“神箭”是寒邪，“床箭”是湿邪。疼痛且能转动的，是气与痰所致；疼痛且难以转动的，是血瘀所致，各有相应的方治。然而其中也有夹杂痧毒的情况，应先治疗痧毒，再去除其余症状，这也是需要知道的。
治疗验案：
一位曹叔恒，全身游走性疼痛，不能伸展活动，有人说：“这是鬼箭。”用油发、艾叶擦拭，用灯心草蘸菜油点火灼烧，没有效果。恰好见到我，自述病情，我诊察其脉象，左脉虚，右脉实，放痧三针，流出紫黑色血液。使用桃仁红花汤加入穿山甲、天虫（僵蚕）、香附，微温服用，逐渐痊愈。
一位钟洪武的内室（妻子），腰背疼痛，卧床不起。有人认为是鬼箭病，从痛处挑筋十余针，未愈。延请我诊治，脉象徐疾无常。我说：“这是瘀血。”让她的婢女刮痧并放痧，刺腿弯处放痧二十多针，流出紫黑色毒血。使用红花汤加入穿山甲、泽兰、刘寄奴，微温服用四剂后痊愈。
Diseases may present with Fanwei (regurgitation/vomiting) complicated by Sha (toxic heat/epidemic pathogen), or Sha transforming into Fanwei; similarly, there is Yige (dysphagia/chest obstruction) complicated by Sha, or Sha transforming into Yige. Such Sha conditions may appear slow in onset but become increasingly fierce and violent day by day; they require careful differentiation.
Case Records:
Bao Shiqiu, over sixty years old, suffered from Fanwei (regurgitation/vomiting). Upon eating, he experienced immediate heart pain and incessant vomiting. I palpated his pulse, finding it surging (Hong), tight (Jin), and forceful in all six positions. I then examined the Sha veins (superficial veins indicating Sha toxicity) and performed Sha bloodletting on his arms and legs with more than twenty needles.
I prescribed Wuyao Shunqi Decoction (Aucklandia Decoction to Smooth Qi) and Jiangxiang Taohua Powder (Aquilaria and Peach Blossom Powder), both administered warm. He recovered in four days.
Cai Aishan complained of fullness and oppression in the chest, desiring to eat but unable to do so. After eating, his epigastrium felt unsettled, causing extreme suffering. I diagnosed his pulse as faint and choppy (Se) in the rear three positions (cun, guan, chi on the left wrist, typically referring to the deeper or specific positional pulses depending on context, here likely implying kidney/liver deficiency or stagnation). I performed Sha bloodletting on the popliteal fossa (leg bend) with more than twenty needles, which provided slight relief.
He took Sumu Powder (Sappan Wood Powder) daily, taken with two qian using slightly warm wine, and recovered in six days.
Bone and joint pain often persists for a lifetime. Treatments for this condition address wind, dampness, qi stagnation with blood coagulation, or wandering phlegm and fire. However, treatments vary in efficacy. Sometimes the condition is secretly entangled by Sha toxicity, making it unrecognizable. This type of Sha progresses very slowly and must be recognized.
Case Records:
Dong Jilian suffered from bone and joint pain, remaining bedridden for two years without response to various medications. I diagnosed his pulse as slightly wiry (Xian) on the right and deep and fine (Chen Xi) on the left. Examining the Sha veins, I performed bloodletting, yielding purple-black blood. I prescribed Yuanhong Powder (Round Red Powder), administered with slightly warm decoction. Additionally, I prescribed Puhuang Yin (Polygonum Infusum Drink) added with Wulingzhi (Trogopterus Dung) and Jiaoci (Gleditsia Sinensis Spine), taken warm for six doses, resulting in recovery.
Hao Wenzi suffered from bone and joint pain, difficulty walking, expectoration of phlegm, and shortness of breath. His left pulse was slightly hollow (Kou), and his right pulse was wiry and tight. I performed Sha bloodletting on the popliteal fossa, extracting three needles' worth of purple-black blood. I prescribed Bisheng Tang (Victory Guaranteed Decoction) added with Jiaoci, taken warm, leading to gradual recovery.
Secular traditions speak of "Guijian" (Ghost Arrow), employing methods such as needle picking, moxibustion, oil application, and rubbing with mugwort and peach branches. Patients dare not take medicine, suspecting actual ghostly harm, which is incorrect. Experts differentiate that "Guijian" refers to Wind, "Shenjian" (Divine Arrow) refers to Cold, and "Chuangjian" (Bed Arrow) refers to Dampness. Pain that allows movement indicates Qi and Phlegm; pain that restricts movement indicates Blood stasis. Each has its specific treatment. However, some cases involve mixed Sha toxicity. One must first treat the Sha toxin, then eliminate residual symptoms. This principle regarding arrows must also be understood.
Case Records:
Cao Shuheng suffered from migrating pain throughout the body, unable to extend or move. Some said, "This is Guijian." They used oil application and mugwort rubbing, and ignited lamp wicks dipped in vegetable oil for burning, but to no avail. When he saw me, he described his illness. I diagnosed his pulse as deficient (Xu) on the left and excess (Shi) on the right. I performed Sha bloodletting with three needles, extracting purple-black blood. I prescribed Taoren Honghua Tang (Peach Kernel and Safflower Decoction) added with Chuanshanjia (Pangolin Scale), Tianchong (Bombyx Batryticatus), and Xiangfu (Cyperus Rhizome), taken warm, leading to gradual recovery.
The wife of Zhong Hongwu suffered from lower back and back pain, remaining bedridden. Someone suspected Guijian disease and picked tendons at the painful sites with more than ten needles, without success. I was consulted and found her pulse irregular in speed. I stated, "This is Blood stasis." I instructed her maid to perform Gua Sha (scraping) and Sha bloodletting, puncturing the popliteal fossa with more than twenty needles, extracting purple-black toxic blood. She was prescribed Honghua Tang (Safflower Decoction) added with Chuanshanjia, Zelan (Lycopus Herb), and Liujinu (Ajania Chinensis Herb), taken warm for four doses, resulting in recovery.