先辨痧症治其标，后审内伤治其本（土七）。
一老妇争产相殴，发热嗽痰，胸中胀闷，诊知内伤兼痧，刺痧筋二十余针，服石二方，
稍松，用土七方治其内伤，服后下黑粪，瘀消症平，后用木六方，并前虚症亦除。
痧恶饮热，有反喜热汤者，症益莫识慢痧所以渐成痨瘵也。毒入气分伤肺，喘嗽吐痰，
发热
轻
毒
患
一人痧胀不服药，惟放痧三次，胃脘间成一块，咳嗽吐痰，发热不食，日渐 瘦，右关
芤而紧，余俱数。此内有瘀血，必吐出方解，用桃仁、苏木、泽兰、白蒺、香附、乌药酒煎
服。吐出紫黑血碗许，更用活血引下之剂，加童便，酒服愈。
痧毒冲心则昏迷，痧毒冲肺则气喘痰壅，甚则鼻衄，痧毒入肝则胸胁疼痛，不能转侧，
甚而血涌吐出。痧毒流于大肠则大便血，流于膀胱则小便血，治宜先清痧毒，顺其所出之路
，则气自顺而血自宁（土八，革一）。
一人放痧，不服药，变筋骨疼痛，十日后吐血甚多，疼痛不愈，诊其脉芤，此痧退尚存
瘀血，用匏四方。
一幼儿痧痛，大便红，令放痧，用土八方。
一女痧痛溺血甚多，放痧不愈，用革一方加银花、连翘、牛膝、益母而痊。
一人痧胀鼻衄，是痧气由衄而泄，用金六方。
痧粒不过红点而已，至有浑身成片斑烂，发热头晕者，金五方主之。
犯痧小便不通
毒结膀胱，溺水不利，小腹胀痛难忍，用土四方。
一八岁小儿发热，眼窜不语，或以惊风治，以伤寒治，一无效。予用涤痧散、灯心汤调
，灌下便作呻吟，已经十日大小便闭，小腹胀急，手不可按，用润下丸五分，小便去数升，
再用一钱，大去宿粪，遂愈。
一位老妇人因争夺家产发生争执打斗，出现发热、咳嗽咳痰、胸中胀闷的症状。诊察得知是内伤兼夹痧症，针刺放痧筋二十多针，服用石二方后症状稍缓解，接着用土七方治疗内伤，服药后排出黑色粪便，瘀血消除，病症平息，之后再用木六方，之前的虚损症状也一并除去了。
痧症患者通常厌恶热饮，但也有反而喜欢热汤的，这种病情更难识别，导致慢痧逐渐演变成痨瘵（慢性消耗性疾病）。毒邪侵入气分损伤肺脏，出现气喘、咳嗽、吐痰、发热的症状。
有一位患者患痧胀不服药，只进行了三次放痧，胃脘部形成一块硬块，咳嗽吐痰，发热且不进食，日渐消瘦。右关脉芤而紧，其余脉象数。这是内有瘀血，必须吐出才能解除，使用桃仁、苏木、泽兰、白蒺藜、香附、乌药，用酒煎服。吐出约一碗紫黑色的血，再用活血引下之剂，加入童便，用酒送服而痊愈。
痧毒冲犯心脏则昏迷，痧毒冲犯肺脏则气喘痰壅，甚至鼻出血；痧毒侵入肝脏则胸胁疼痛，不能转身侧卧，甚至血液涌出呕吐出来；痧毒流注于大肠则大便带血，流注于膀胱则小便带血。治疗应当先清除痧毒，顺应其排出的途径，那么气机自然顺畅，血液自然安宁（参考土八方、革一方）。
有一位患者放痧后不服药，变为筋骨疼痛，十天后吐血很多，疼痛不愈，诊察其脉象芤，这是痧退后尚存瘀血，使用匏四方。
一名女子患痧痛，溺血（尿血）很多，放痧后未愈，使用革一方加金银花、连翘、牛膝、益母草而痊愈。
痧疹不过只是红点而已，如果有浑身成片斑烂，伴有发热头晕的，由金五方主治。
患痧症导致小便不通，毒邪结聚膀胱，溺水不利（此处疑为原文笔误，结合语境应为小便不利），小腹胀痛难忍，使用土四方。
一名八岁小儿发热，眼球上窜、不语，有人按惊风治疗，有人按伤寒治疗，都无效。我用涤痧散、灯心汤调匀，灌下后患儿开始呻吟，已经十日大小便闭塞，小腹胀急，手不可按压，使用润下丸五分，小便排出数升，再用一钱，排出宿粪，于是痊愈。
First, differentiate the Sha disease (Sha disease, a condition characterized by skin eruptions and systemic toxicity often associated with heat-toxin) to treat its branch (manifestations); subsequently, examine the internal injury to treat its root (etiology). (Formula Tu Qi).
An elderly woman engaged in a dispute over property inheritance, resulting in physical altercation. She presented with fever, cough with sputum, and chest distension and oppression. The diagnosis revealed an internal injury complicated by Sha disease. Twenty-plus needles were applied for bloodletting at the Sha veins (superficial dilated veins used for bloodletting in Sha disease treatment). After administering Shi Er Fang (Stone Two Formula), symptoms slightly relieved. Subsequently, Tu Qi Fang was used to treat the internal injury. Upon ingestion, black stool was passed, indicating the elimination of blood stasis and resolution of the condition. Later, Mu Liu Fang was administered, resolving previous deficiency syndromes as well.
Patients with Sha disease typically dislike hot drinks; however, some may prefer hot soup. This presentation makes the condition difficult to recognize, leading to slow Sha disease gradually evolving into Lao Zhai (consumptive disease/tuberculosis). When toxin enters the Qi level and damages the Lung, it causes wheezing, cough, expectoration, and fever.
A patient suffering from Sha distension refused medication and underwent bloodletting three times only. A hard mass formed in the epigastrium, accompanied by cough, expectoration, fever, anorexia, and progressive emaciation. The pulse at the right Guan position was hollow (Kou) and tight, while other positions showed rapid (Shu) pulses. This indicated internal blood stasis, which must be expelled via vomiting to resolve. An decoction of Tao Ren (Persicae Semen), Su Mu (Lignum Sappan), Ze Lan (Herba Lycopi), Bai Ji Li (Tribuli Fructus), Xiang Fu (Cyperi Rhizoma), and Wu Yao (Linderae Radix) was prepared with wine. Approximately one bowl of dark purple-black blood was vomited. Thereafter, a formula promoting blood circulation and guiding downward was administered, added with Tong Bian (Urine of a healthy child), and taken with wine, resulting in recovery.
When Sha toxin rushes to the Heart, it causes coma; when rushing to the Lung, it causes wheezing and phlegm obstruction, potentially leading to epistaxis; when entering the Liver, it causes hypochondriac pain and inability to turn or lie on the side, potentially leading to hematemesis; when flowing into the Large Intestine, it causes hematochezia; when flowing into the Bladder, it causes hematuria. Treatment should first clear the Sha toxin, following the pathway of its exit, so that Qi will naturally flow smoothly and Blood will calm down (Refer to Tu Ba Fang, Ge Yi Fang).
A patient underwent bloodletting but took no medicine, developing bone and joint pain. Ten days later, severe hemoptysis occurred, and pain persisted. The pulse was hollow (Kou), indicating residual blood stasis after the dissipation of Sha. Pao Si Fang was prescribed.
A toddler suffered from Sha pain and red stools. Bloodletting was performed, and Tu Ba Fang was administered.
A female patient suffered from severe Sha pain and hematuria. After bloodletting failed to cure her, Ge Yi Fang was used with additions of Yin Hua (Flos Lonicerae), Lian Qiao (Fructus Forsythiae), Niu Xi (Achyranthis Bidentatae Radix), and Yi Mu Cao (Herba Leonuri) for recovery.
A patient with Sha distension experienced epistaxis. This indicates that Sha Qi is venting through the nose. Jin Liu Fang was prescribed.
Sha macules are merely red spots. However, if widespread ulcerative patches appear on the body accompanied by fever and dizziness, Jin Wu Fang is the primary prescription.
If Sha disease causes urinary retention due to toxin accumulation in the Bladder, leading to difficulty in urination and unbearable lower abdominal distension and pain, Tu Si Fang is used.
An eight-year-old boy presented with fever, upward deviation of the eyes, and muteness. Treatments for Wind Stroke (Jing Feng) and Cold Damage (Shang Han) were ineffective. I administered Di Sha San (Sha-Cleansing Powder) mixed with Deng Xin Tang (Junci Medulla Decoction) and forced it down. The patient began groaning. Having been constipated for ten days with lower abdominal distension and tenderness unyielding to touch, Run Xia Wan (Moistening-Down Pill) was given in a dose of 5 fen. Several sheng of urine were passed. A subsequent dose of 1 qian resulted in the passage of accumulated feces, leading to recovery.