先有膨胀而痧气乘之，臌胀益甚，在臌胀不可先医，在痧气自宜早治。
治验∶
一江云甫肚腹胀急如臌，脐突筋青，心口将平。余诊之，知为血臌之症，其指头黑色，此臌症之所无也。视指上有
青筋，兼痧无疑，刺二十余针，又刺臂弯腿弯青筋五针，俱去其毒血，略松，用蒺藜散微温饮之，脐下青筋渐退，后用
臌症之药，导去恶水，日服治臌香圆丸二月余，臌症尽平，永不复发。
痧者，毒也。慢痧之毒，迁延时日，留滞肌肤、肠胃、血肉之中，若不早治，即成真臌。
治验∶
一严天玉次子，气急作胀，胸腹饱闷，脐下有青筋突起，心口将平，此慢痧成臌也。刺腿弯青筋六针，出紫黑毒血
甚多，又刺指头出毒血二十四针，脐上青筋即淡色，腹内觉松。用宝花散微冷服，腹胀渐消，其后不复用药施治，但恐
其根未除，日后复发，姑志之以例其余。
心主血，痧毒入于血分，故易攻心，此痧症所以发昏也。若痧之慢者，冲激迟缓，未逆于心，留滞经络，或在于右，
或在于左，为半身疼痛，或麻痹不仁，如此半身不遂，总因痧毒之遗害也。治之者，见有痧筋，急宜刺破，然后用药以
散其毒，活血以消其瘀，则痧根既拔，其症渐痊。若不知治，绵延日久，痧毒益深，势不可遏，当又有变症难愈矣。
治验∶
一章道庵屡患吐血，发热不凉，左半身疼痛不已，行步艰难。延余诊视，初不觉其为痧也，细思脉症不合之处，检
其痧筋刺之，用桃仁、泽兰、独活、乌药煎二剂微温服，吐血疼痛俱愈，永不复发。
一盛成年朝凉夜热，气急半年，服药不应，反加右半身
疼痛，不能俯仰，咳嗽吐痰，饮食减少，成劳弱不足之症。棹舟迎余，脉不见弦数，而微细，时有歇指，脉症不合，阅
其痧筋刺二十余针，用姜黄、旋复花、丹参、橘红、赤芍、玄胡索、泽兰、山楂、角刺、穿山甲二剂，微温服，疼痛吐
痰俱除。后朝用六味地黄丸，夕用补中益气汤。朝凉夜热俱愈。
先出现腹部胀大，随后痧气侵袭，导致臌胀症状更加严重。对于臌胀病，不宜立即治疗；但对于痧气，则应当尽早治疗。
治验案例：
有一位名叫江云甫的患者，肚腹胀满紧急如同臌胀，脐部突起，青筋暴露，心口窝平坦几乎消失。我诊察后，判断这是血臌的病症，其手指头呈现黑色，这是普通臌胀病所没有的症状。观察手指上有青筋显露，兼有痧气无疑，于是针刺二十多针，又刺破手臂弯和腿弯处的青筋五针，都排出了毒血，症状略微缓解。随后用蒺藜散微温服下，脐下的青筋逐渐消退。之后再用治疗臌胀的药物，引导排出恶水，每日服用治臌香圆丸两个多月，臌胀症状完全平息，从此不再复发。
痧，就是毒邪。慢痧的毒邪，迁延时日，滞留于肌肤、肠胃、血肉之中，如果不尽早治疗，就会变成真正的臌胀。
治验案例：
严天玉的次子，呼吸急促且身体发胀，胸腹饱闷，脐下有青筋突起，心口窝平坦几乎消失，这是慢痧演变为臌胀。针刺腿弯处青筋六针，流出大量紫黑色的毒血，又针刺手指头排出毒血二十四针，脐上的青筋颜色变淡，腹部感觉轻松。用宝花散微冷服下，腹胀逐渐消除。此后不再用药施治，但担心病根未除，日后可能复发，姑且记录此案以作为其他类似情况的范例。
心主血脉，痧毒侵入血分，所以容易攻心，这就是痧症会导致神志昏乱的原因。如果是慢痧，冲击较为迟缓，尚未逆乱于心，而是留滞于经络，或在右侧，或在左侧，表现为半身疼痛，或麻木不仁，像这种半身不遂，总归是因为痧毒遗留的危害所致。治疗时，见到有痧筋，应当急宜刺破，然后用药来消散毒邪，活血以消除瘀血，这样痧根既已拔除，症状便会逐渐痊愈。如果不知道这样治疗，拖延日久，痧毒加深，势头不可遏制，当时又会出现难以治愈的变症。
治验案例：
章道庵多次患吐血，发热不退，左半身疼痛不止，行走困难。请我诊治，起初并未察觉是痧症，仔细思考脉象与症状不符之处，检查发现其有痧筋并予以刺破，使用桃仁、泽兰、独活、乌药煎煮两剂，微温服下，吐血和疼痛全部痊愈，从此不再复发。
另一位患者盛成年，早晨凉晚上热，呼吸急促半年，服药无效，反而加重右半身疼痛，不能俯仰，咳嗽吐痰，饮食减少，形成了劳弱不足的病症。他划船来接我，脉象不见弦数，而是微细，时有间歇，脉象与症状不符，查看其有痧筋，针刺二十多针，使用姜黄、旋复花、丹参、橘红、赤芍、玄胡索、泽兰、山楂、角刺、穿山甲煎煮两剂，微温服下，疼痛和吐痰全部消除。后来早上服用六味地黄丸，晚上服用补中益气汤，早晨凉晚上热的症状全部痊愈。
Initially, abdominal distension occurred, followed by an invasion of Sha Qi (Sha pathogenic factor), causing the Gu Zhang (Tympanites) to worsen. For Gu Zhang, immediate treatment is not advisable; however, for Sha Qi, early treatment is appropriate.
Case Record:
Jiang Yunfu suffered from severe abdominal distension resembling Gu Zhang, with a protruding umbilicus and exposed subcutaneous veins, and his epigastrium was flattened. Upon diagnosis, I determined this was Blood Gu Zhang (Gu Zhang caused by blood stasis). The blackening of his fingertips was a symptom absent in ordinary Gu Zhang. Observing greenish veins on the fingers, I confirmed the presence of Sha. I performed acupuncture on more than twenty points and five points on the veins at the antecubital and popliteal fossae, draining toxic blood. His condition slightly improved. He then took Jili San (Tribulus Powder) warm, after which the veins below the umbilicus gradually receded. Subsequently, he was treated with formulas for Gu Zhang to guide out noxious fluids, taking Zhi Gu Xiangyuan Wan (Gu Zhang-Resolving Fragrant Pill) daily for over two months. The Gu Zhang symptoms completely resolved and never recurred.
Sha refers to toxic pathogens. The toxins of chronic Sha linger over time, stagnating in the skin, muscles, intestines, stomach, flesh, and blood. If not treated early, it will develop into true Gu Zhang.
Case Record:
The second son of Yan Tianyu experienced shortness of breath and distension, chest and abdominal fullness, protruding veins below the umbilicus, and a flattened epigastrium. This indicated that chronic Sha had transformed into Gu Zhang. I punctured six points on the veins at the popliteal fossa, releasing a large amount of dark purple-black toxic blood, and punctured the fingertips twenty-four times to release toxic blood. The veins above the umbilicus lightened in color, and the abdomen felt relaxed. He took Baohua San (Treasure Flower Powder) cool. The abdominal distension gradually subsided. No further medication was administered thereafter, but fearing the root cause remained and recurrence might occur, I recorded this case as an example for similar situations.
The Heart governs blood. When Sha toxins enter the blood level, they easily attack the Heart, which is why Sha syndromes can cause coma or mental confusion. In cases of chronic Sha, the impact is slow and has not yet reversed into the Heart, but remains stagnant in the meridians, either on the right or left side, manifesting as hemibody pain or numbness and insensitivity. Such hemiplegia is entirely due to the lingering harm of Sha toxins. Treatment requires identifying Sha veins and urgently puncturing them, followed by using herbs to dissipate toxins and invigorate blood to resolve stasis. Once the root of Sha is eradicated, symptoms will gradually recover. If untreated, the duration extends, Sha toxins deepen, and the momentum becomes unstoppable, leading to difficult-to-cure complicated syndromes.
Case Record:
Zhang Dao'an repeatedly suffered from hematemesis, persistent fever, unceasing pain in the left hemibody, and difficulty walking. Upon consultation, I initially did not recognize it as a Sha syndrome. After carefully analyzing discrepancies between the pulse and symptoms, I identified Sha veins and punctured them. He took two doses of a decoction containing Tao Ren (Peach Kernel), Ze Lan (Lycopus Herb), Du Huo (Angelica Pubescens Root), and Wu Yao (Lindera Fruit), taken warm. Both hematemesis and pain were cured, with no recurrence.
Sheng Chengnian experienced morning chills and night fevers, and shortness of breath for half a year. Medication was ineffective, and right-sided hemibody pain worsened, preventing flexion and extension. He coughed up phlegm, had reduced appetite, and developed a deficiency syndrome resembling consumptive disease. He rowed a boat to invite me. His pulse was neither wiry nor rapid, but faint and fine, with occasional intermissions, indicating a mismatch between pulse and symptoms. Identifying Sha veins, I punctured more than twenty points. He took two doses of a decoction containing Jiang Huang (Turmeric Rhizome), Xuan Fu Hua (Inula Flower), Dan Shen (Salvia Miltiorrhiza Root), Ju Hong (Aged Tangerine Peel), Chi Shao (Red Peony Root), Yuan Hu Suo (Corydalis Rhizome), Ze Lan, Shan Zha (Hawthorn Fruit), Jiao Ci (Gleditsia Spine), and Chuan Shan Jia (Pangolin Scales), taken warm. Pain and phlegm were eliminated. Later, he took Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) in the morning and Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi) in the evening. The morning chills and night fevers completely resolved.