脉不明不可乱用药，症不明不可轻用药。手法不明即药亦不能速效，故手法为治痧要着
一曰 。痧在肌表未发出者，以灯照之，隐隐肤间，且慢 ，若既发出，状如蚊咬，粒
如麸。疏则累累，密则连片，更有发过一层复发两、三层者。 法看头额及胸前两边，
或
腹
一曰刮。痧在肤里发不出者，则用刮。若背脊颈骨上下及胸前胁肋两肩臂弯，用铜钱或
碗口蘸香油刮之。若在头额项后两肘臂膝腕，用棉纱线或苎麻绳蘸油戛见红紫血点起方止。
大小腹软肉内痧，用食盐以手擦之，痧既刮出，痛楚亦轻矣。
一曰刺。古言东南卑湿利用砭，以针刺放毒血，即砭道也。痧重者经铁器难解，放痧当
用瓷锋作针，为妥善得法。
头顶心百会穴（只挑破略见微血，以泄毒瓦斯，不用针入）、印堂（头痛甚者用之，针锋
微
大头
（乳头
两手 下
或谓针
中名委中
上下前后，
直刺委中，
恐令筋吊
痧筋现者毒入血分，宜放。乍隐乍现者毒入气分，及现而放。微见者乃毒阻气分，治宜
通其肠胃，痧筋自现。至伏而不现者，必从脉症辨之，血则散，食则消，痰积则驱，结既解
而筋复现，然后刺放可也？
痧筋或现数处或一处，必刺去恶血，令痧毒尽泄。或误饮热汤，痧筋反隐而不现，略现
亦刮放不出，急饮冷水解之，后可刮放，痧为食积所阻，刮放不出者，当先消食积而再刮放
。热极血凝，瘀阻胸腹，刮放不尽者，当先散瘀血而再刮放。痧发兼遇恼怒，伤肝作胀，刮
放难尽者，又当先用破气药再刮放，如此，痧毒皆可渐消矣。
脉象不明，不可胡乱用药；症状不清，不可轻易用药。手法不明，即使用药也不能迅速见效，因此手法是治疗痧症的关键措施。
第一种方法是“放”。痧毒在肌表尚未发出的时候，用灯照看，皮肤间隐约可见，此时暂不要进行放血操作。如果痧毒已经发出，形状像蚊子叮咬，颗粒像麦麸一样。稀疏的则一颗颗相连，密集的则连成一片，更有发过一层后又复发两三层的情况。放血法主要观察头额部及胸前两侧，或者腹部。
第二种方法是“刮”。痧毒在皮肤里面发不出来的，就用刮痧法。如果在背脊、颈骨上下以及胸前、胁肋、两肩、臂弯处，可用铜钱或碗口蘸香油进行刮拭。如果在头额、项后、两肘、臂、膝、腕处，可用棉纱线或苎麻绳蘸油戛（刮擦），直到出现红紫色的血点为止。大小腹部的软肉内若有痧毒，可用食盐用手擦拭，痧毒刮出后，疼痛也会减轻。
第三种方法是“刺”。古语说东南地区地势低洼潮湿，适宜使用砭石，即用针刺破放出毒血，这就是砭道。痧症严重的，经过铁器难以解除，放痧时应当用瓷器的锋刃作针，这样才妥善得法。
头顶心的百会穴（只挑破略见微血，以泄解毒气，不用针深入）、印堂穴（头痛严重时使用，针锋微……大头……乳头……两手……下……或谓针……中名委中……上下前后，直刺委中，恐令筋吊……）。
痧筋显现的，说明毒邪已入血分，宜于放血。忽隐忽现的，说明毒邪已入气分，待其显现时再放。微微显现的，乃是毒邪阻滞气分，治疗宜通利肠胃，痧筋自然会出现。至于潜伏而不显现的，必须从脉象和症状来辨别：若是血瘀则散血，食积则消食，痰积则驱痰，结滞解开而筋络复现，然后才可以刺放。
痧筋或在数处显现，或在一处显现，必须刺去恶血，使痧毒完全排泄。如果误饮热汤，痧筋反而隐藏不现，略微显现也刮放不出来，应紧急饮用冷水以解之，之后才可刮放。若痧症为食积所阻，刮放不出来的，应当先消除食积然后再刮放。若热极导致血凝，瘀血阻滞胸腹，刮放不尽的，应当先消散瘀血然后再刮放。若痧症发作兼遇恼怒，损伤肝脏导致胀满，刮放难尽的，又应当先用破气药，然后再刮放，如此，痧毒都可以逐渐消除了。
If the pulse is unclear, one must not administer medication recklessly; if the symptoms are indistinct, one must not prescribe drugs lightly. If the manual techniques are unknown, even medication cannot yield rapid results; therefore, manual techniques are the crucial approach for treating Sha (heatstroke/toxin syndrome).
The first method is "Bleeding" (Fang). When Sha toxin is on the body surface but has not yet erupted, it can be faintly seen under the skin when illuminated by a lamp. At this stage, bleeding should be delayed. Once the Sha has erupted, it resembles mosquito bites, with granules like bran. When sparse, they appear as distinct clusters; when dense, they merge into patches. In some cases, after one layer erupts, two or three more layers may follow. The bleeding technique primarily observes the forehead and both sides of the chest, or the abdomen.
The second method is "Scraping" (Gua). When Sha toxin is trapped beneath the skin and cannot erupt, scraping is used. For areas such as the spine, neck, upper and lower back, chest, ribs, shoulders, arm bends, use a copper coin or the rim of a bowl dipped in sesame oil to scrape. For the forehead, back of the neck, elbows, arms, knees, and wrists, use cotton yarn or ramie rope dipped in oil to scrape until red-purple blood spots appear. For Sha in the soft flesh of the large and small abdomen, rub with salt using the hand. Once the Sha is scraped out, the pain will also alleviate.
The third method is "Puncturing" (Ci). Ancient texts state that in the low-lying and damp regions of the southeast, Bian stones were utilized. This involves using needles to puncture and release toxic blood, which constitutes the Bian method. For severe Sha cases where iron tools are ineffective, porcelain shards should be used as needles for puncturing, as this is the most appropriate and effective method.
[Text fragment regarding specific acupoints]: Baihui (GV20) at the vertex of the head (only prick the skin slightly to reveal trace blood to vent toxic vapors, do not insert the needle deeply); Yintang (EX-HN3) between the eyebrows (used for severe headache, with slight needle insertion)... [Fragmented text regarding Weizhong (BL40) behind the knee].
When Sha veins (distended superficial veins) appear, it indicates the toxin has entered the Blood level, and bleeding is indicated. When they appear intermittently, the toxin has entered the Qi level; bleed only when they manifest. When they are faintly visible, the toxin is obstructing the Qi level; treatment should focus on promoting bowel movement and urination, after which the Sha veins will naturally appear. For those that are latent and do not appear, differentiation based on pulse and symptoms is necessary: if due to blood stasis, resolve the stasis; if due to food retention, digest the food; if due to phlegm accumulation, expel the phlegm. Once the obstruction is resolved and the veins reappear, puncturing and bleeding can then be performed.
Whether Sha veins appear in multiple locations or a single location, malignant blood must be removed to ensure complete discharge of Sha toxin. If hot soup is mistakenly consumed, the Sha veins may retract and become invisible; even if slightly visible, they cannot be scraped or bled out. Immediately drink cold water to resolve this, after which scraping and bleeding can proceed. If Sha is obstructed by food retention and cannot be scraped/bled, food retention must be eliminated first before proceeding. If extreme heat causes blood coagulation and stasis obstructs the chest and abdomen, making scraping/bleeding incomplete, blood stasis must be dispersed first before continuing. If Sha eruption is accompanied by anger, damaging the Liver and causing distension, making scraping/bleeding difficult to complete, Qi-moving and breaking herbs should be administered first, followed by scraping and bleeding. In this manner, Sha toxins can be gradually eliminated.