陈皮、青皮，陈行痧气，青伐肝气，痧气壅阻郁结不行者，非此不利。枳壳、枳实，破
痧气，驱毒瓦斯，除胀气，下食气，积滞壅塞者，非此不开。枳壳性缓，枳实性速，各有所宜
。荆芥，透肌解表，散痧毒。痧筋隐隐不发者，非此不现。防风，透肌发表，为臣使之功，
寒热往来，痧毒壅滞郁遏不发者，非此不清。柴胡，和解表里，专治少阳胆经寒热往来。前
胡，疏风消痰治嗽，表热者宜用。干葛，散阳明胃经之邪，兼能解渴。紫朴，宽中治呕，消
痰下气。薄荷，辛凉利窍，消肿解毒，消气清喉。紫苏，疏风顺气，身热当用。独活，发散
治热，其性至颈而还，力不能过发，且可活血解痧毒是最要之味。细辛，透窍散痧之妙药，
勿以其味辛而疑之。
（汾）按∶细辛极散真气，过服即能杀人。壮实而痧重者多止钱许，老稚单弱者酌减少
用
桔梗，入肺经，其性上而复下，故能引枳壳破胸中至高之气。香附，行血中之气，恐香
燥须便制，行血酒炒，敛血醋炒。延胡索，活血行气，理血气凝滞作痛；五灵脂，善消宿血
，血块凝滞不散，非此不破。郁金，能入心经散郁消瘀，痧毒攻心者，非此不能奏功（时以
价高用姜黄代之，终不妙）。木香，行滞气，燥湿气，驱寒气，开郁气，痧后腹痛不解，此
要药也。砂仁，顺气开郁，散痧消食，始终可用。乌药，善行周身之气，凡痧所阻滞者，
得此无处不到。秦艽，活血驱风，消痧毒筋骨疼痛，壮实不清者，非此不解。连翘，消痧毒
，解诸经火邪，清热而不滞，治痧要药。栀子，凉心去火，发斑并痧根红者可用。贝母，川
贝专治热痰，土贝兼破瘀血。白芥子，胁下之痰，非此不达。天冬、麦冬，润肺消痰，一治
其本，一治其标（去心）。杏仁，泻肺润肠胃，利气消痰涎（去皮尖）。桑皮、兜铃，治嗽泻
肺
（汾）按∶兜铃清热降气，但肺虚挟寒者大忌。曾闻之世医者云∶凡治嗽禁用诃子、兜
铃
用
赤芍，血热发斑者可用。陈香圆，破结气可用。丹参，亦活血之剂；山楂、卜子、麦芽
、神曲，痧为食壅，善消而不暴。红花、茜草、银花，活血解痧毒。桃仁，破瘀活血，瘀为
血阻，非此不流。痧为血滞，非此不顺。苏木，取恶血新瘀者莫及。荆三棱、蓬莪术，食积
心痛、痧毒阻滞痞闷者宜用。牛膝，活血，引痧气下行。香薷，通上彻下，利水气，治暑伤
之要药（说详金三方）。牛蒡子，解痧毒，清喉，痧中要药。刘寄奴，散瘀血，解痧毒，下
气
产
至
药
破
胃
明
汤
山甲
痢下血
清热
天仙子
评∶荆芥细辛防风∶痧症寒热，不由外感，其毒从鼻吸而入，搏击肌表。荆芥、细辛，
善能透窍，使由窍入者亦由窍泄。防风臣使为佐，不比麻黄、羌活，专计发表，反有升发火
毒之虑也。
陈皮、青皮，陈皮能行散痧气，青皮能疏伐肝气。对于痧气壅塞阻滞、郁结不通的情况，非用这两味药不能通利。枳壳、枳实，能破散痧气，驱除毒瓦斯，消除胀气，下行食积之气。对于积滞壅塞的情况，非用这两味药不能开通。枳壳药性缓和，枳实药性迅猛，各有所适宜之处。荆芥，能透达肌表解表，散发痧毒。对于痧筋隐隐约约不能透发出来的情况，非用此药不能显现。防风，能透达肌表发表，起到臣使的作用。对于寒热往来、痧毒壅滞郁遏不能透发的情况，非用此药不能清解。柴胡，能和解表里，专门治疗少阳胆经的寒热往来。前胡，能疏风消痰治疗咳嗽，表热者适宜使用。干葛（葛根），能发散阳明胃经的邪气，兼能解除口渴。紫朴（厚朴），能宽中焦治疗呕吐，消痰下气。薄荷，辛凉通利孔窍，消肿解毒，消气清喉。紫苏，能疏风顺气，身体发热时应当使用。独活，能发散治疗热证，其药力仅到达颈部便返回，力量不能过度发散，且可以活血解痧毒，这是最重要的药物之一。细辛，是透达孔窍散发痧毒的妙药，不要因为它的味道辛辣而怀疑它。
（汾）按语：细辛极其耗散真气，过量服用即能致人死亡。体质壮实且痧症重者，多止用一钱左右；年老体弱或年幼单弱者酌情减少用量。
桔梗，入肺经，其药性上行又下行，所以能引导枳壳破除胸中至高之处的邪气。香附，能行血中之气，恐怕其香燥之性，所以需要炮制：行血用酒炒，敛血用醋炒。延胡索，能活血行气，调理因血气凝滞引起的疼痛；五灵脂，善于消除宿血，对于血块凝滞不散的情况，非用此药不能攻破。郁金，能入心经散郁消瘀，对于痧毒攻心的情况，非用此药不能奏效（当时因为价格高，常用姜黄代替，但终究不如郁金好）。木香，能行滞气，燥湿气，驱寒气，开郁气，痧症后腹痛不缓解，这是要药。砂仁，能顺气开郁，散痧消食，从头到尾都可以使用。乌药，善于运行周身之气，凡是痧症所阻滞的地方，得到此药无处不到。秦艽，能活血驱风，消除痧毒引起的筋骨疼痛，体质壮实且病邪不清者，非用此药不能解除。连翘，能消除痧毒，解诸经火邪，清热而不留滞，是治疗痧症的要药。栀子，能凉心去火，出现发斑以及痧根发红者可以使用。贝母，川贝专治热痰，土贝兼能破瘀血。白芥子，胁下的痰饮，非用此药不能到达。天冬、麦冬，润肺消痰，一个治本，一个治标（需去心）。杏仁，能泻肺润肠胃，利气消痰涎（需去皮尖）。桑白皮、马兜铃，治疗咳嗽泻肺。
（汾）按语：马兜铃清热降气，但是肺虚挟寒者大忌。曾听世间的医生说：凡治疗咳嗽禁用诃子、马兜铃。
赤芍，血热发斑者可以使用。陈香圆，破结气可以使用。丹参，也是活血的药剂；山楂、莱菔子、麦芽、神曲，对于因食物壅塞导致的痧症，善于消导而不猛烈。红花、茜草、金银花，能活血解痧毒。桃仁，能破瘀活血，瘀血被血液阻滞，非用此药不能流通。痧症因血滞引起，非用此药不能顺畅。苏木，取除恶血和新瘀者没有能比得上的。荆三棱、蓬莪术，对于食积心痛、痧毒阻滞痞闷的情况适宜使用。牛膝，能活血，引导痧气下行。香薷，能通上彻下，利水气，是治疗暑伤的要药（详细说明见金三方）。牛蒡子，能解痧毒，清喉，是痧症中的要药。刘寄奴，能散瘀血，解痧毒，下气。
评：荆芥、细辛、防风：痧症的寒热，不是由外感引起，其毒气从鼻吸入，搏击肌表。荆芥、细辛，善于透达孔窍，使从孔窍进入的毒气也从孔窍泄出。防风作为臣佐使药，不同于麻黄、羌活专门讲究发表，反而有升发火毒的顾虑。
Chenpi (Citri Reticulatae Pericarpium) and Qingpi (Citri Reticulatae Pericarpium Viride), Chenpi circulates Sha Qi (pathogenic factors associated with "Sha" syndrome), while Qingpi attacks Liver Qi. For cases where Sha Qi is congested, obstructed, and stagnated without moving, these two herbs are indispensable for promoting flow. Zhike (Aurantii Fructus) and Zhishi (Aurantii Fructus Immaturus), break Sha Qi, drive out toxic vapors, eliminate distension, and direct food Qi downward. For conditions of accumulation and congestion, these two are essential for opening the blockage. Zhike has a mild nature, whereas Zhishi acts rapidly; each has its specific indications. Jingjie (Schizonepetae Herba), penetrates the muscle layer to release the exterior and dissipates Sha toxins. For cases where Sha vessels are faintly visible but fail to erupt, this herb is necessary for manifestation. Fangfeng (Saposhnikoviae Radix), penetrates the muscle layer to release the exterior, serving as an assistant or envoy herb. For alternating chills and fever, and Sha toxins that are congested, stagnant, and suppressed from erupting, this herb is required for clearing. Chaihu (Bupleuri Radix), harmonizes the exterior and interior, specifically treating alternating chills and fever in the Shaoyang Gallbladder channel. Qianhu (Peucedani Radix), disperses wind, eliminates phlegm, and treats coughs; suitable for exterior heat. Gegen (Puerariae Lobatae Radix), disperses pathogenic factors in the Yangming Stomach channel and also relieves thirst. Zhipu (Magnoliae Officinalis Cortex), expands the middle jiao to treat vomiting, eliminates phlegm, and directs Qi downward. Bohe (Menthae Haplocalycis Herba), pungent and cool, benefits orifices, reduces swelling, resolves toxicity, clears Qi, and soothes the throat. Zisu (Perillae Folium), disperses wind and regulates Qi; should be used when there is body heat. Duhuo (Angelicae Pubescentis Radix), disperses and treats heat; its action reaches only to the neck and does not extend further, preventing excessive dispersion, and it can invigorate blood and resolve Sha toxins, making it one of the most important herbs. Xixin (Asari Radix et Rhizoma), is a miraculous herb for penetrating orifices and dispersing Sha toxins; do not doubt it due to its pungent taste.
(Fen) Commentary: Xixin is extremely dispersing and can deplete True Qi; overdose can be fatal. For robust individuals with severe Sha syndrome, the dose should generally not exceed one qian (approx. 3-5g); for the elderly, children, or those who are weak, the dosage should be reduced accordingly.
Jiegeng (Platycodonis Radix), enters the Lung channel; its nature moves upward and then downward, thus it can guide Zhike to break Qi stagnation in the highest part of the chest. Xiangfu (Cyperi Rhizoma), moves Qi within the blood. Because of its aromatic dryness, it requires processing: wine-fried to move blood, vinegar-fried to astringe blood. Yanhusuo (Corydalis Rhizoma), invigorates blood and moves Qi, regulating pain caused by blood and Qi stagnation; Wulingzhi (Trogopterori Faeces), excels at eliminating old blood; for blood clots that are stagnant and do not disperse, this herb is necessary to break them. Yujin (Curcumae Longae Radix), enters the Heart channel to dissipate depression and resolve stasis; for Sha toxins attacking the Heart, this herb is essential for efficacy (currently, due to high cost, Jianghuang [Curcumae Longae Rhizoma] is often used as a substitute, but it is ultimately inferior). Muxiang (Aucklandiae Radix), moves stagnant Qi, dries dampness, drives out cold, and opens depression; for post-Sha abdominal pain that persists, this is a key herb. Sharen (Amomi Fructus), smooths Qi, opens depression, disperses Sha, and aids digestion; it can be used throughout the course of treatment. Wuyao (Linderae Radix), excellently moves Qi throughout the body; wherever Sha syndrome causes obstruction, this herb reaches all places. Qinjiao (Gentianae Macrophyllae Radix), invigorates blood, dispels wind, and eliminates Sha toxin-induced bone and joint pain; for robust individuals with unresolved pathogens, this herb is necessary for relief. Lianqiao (Forsythiae Fructus), eliminates Sha toxins, clears fire pathogens in all channels, clears heat without causing stagnation, and is a key herb for treating Sha syndrome. Zhizi (Gardeniae Fructus), cools the Heart and removes fire; usable for macules eruption and red Sha roots. Beimu (Fritillariae Bulbus), Chuanbeimu specifically treats hot phlegm, Tubei also breaks blood stasis. Baijiexi (Sinapis Semen), reaches phlegm under the hypochondrium; this herb is necessary for its effect. Tandong (Asparagi Radix) and Maidong (Ophiopogonis Radix), moisten the Lung and eliminate phlegm; one treats the root, the other the branch (remove the heart). Xingren (Armeniacae Semen Amarum), drains the Lung, moistens the intestines and stomach, promotes Qi movement, and eliminates phlegm saliva (remove skin and tips). Sangbaipi (Mori Cortex) and Dudiling (Aristolochiae Manshuriensis Radix), treat coughs and drain the Lung.
(Fen) Commentary: Dudiling clears heat and descends Qi, but is strictly contraindicated for deficiency of the Lung with cold. I have heard physicians say: When treating coughs, Hezi (Terminalia Chebulae Fructus) and Dudiling are forbidden.
Chishao (Paeoniae Radix Rubra), usable for blood heat causing macules. Chenxiangyuan, usable for breaking knotted Qi. Danshen (Salviae Miltiorrhizae Radix), is also a blood-invigorating agent; ShanZha (Crataegi Fructus), Laofuzi (Raphani Semen), Maiya (Hordei Fructus Germinatus), Shenqu (Massa Medicata Fermentata), for Sha caused by food congestion, excel at digestion without being violent. Honghua (Carthami Flos), Qiancao (Rubiae Cordifoliae Radix), and Yinhua (Lonicerae Japonicae Flos), invigorate blood and resolve Sha toxins. Taoren (Persicae Semen), breaks stasis and invigorates blood; for blood stasis blocking flow, this herb is necessary for circulation. For Sha caused by blood stagnation, this herb ensures smoothness. Sumu (Sappan Lignum), no other herb matches it for removing foul blood and fresh stasis. Sanleng (Sparganii Rhizoma) and Ezhu (Curcumae Rhizoma), suitable for food accumulation causing heart pain and Sha toxin obstruction leading to fullness and oppression. Niuxi (Achyranthis Bidentatae Radix), invigorates blood and guides Sha Qi downward. Xiangru (Elsholtziae Herba), connects the upper and lower, promotes urination, and is a key herb for summerheat injury (details in Jin San Fang). Niubangzi (Arctii Fructus), resolves Sha toxins, clears the throat, and is a key herb in Sha syndrome. Liujinu (Artemisiae Annuae Herba), disperses blood stasis, resolves Sha toxins, and directs Qi downward.
Chan Zhi Yao Po Wei Ming Tang Shan Jia Li Xia Xue Qing Re Tian Xian Zi
Commentary: Jingjie, Xixin, Fangfeng: The chills and fever in Sha syndrome are not caused by external contraction; the toxin enters via the nose and battles the muscle layer. Jingjie and Xixin excellently penetrate orifices, allowing toxins that entered via orifices to exit through them. Fangfeng serves as an assistant/envoy, unlike Mahuang (Ephedrae Herba) and Qianghuo (Notopterygii Rhizoma et Radix) which focus solely on releasing the exterior, thereby avoiding the risk of raising fire toxins.