（附∶金疮内损瘀血方）
（吐血 呕血 咳血）
医经所载，失血有三种∶一曰血衄，二曰肺疽，三曰伤胃是也。盖心主血，肝藏血，肺
主气，血为营，气为卫，相随上下升降，无有休息者也。六气不伤，七情不郁，营卫调平，
则无壅决之虞。节宣失宜，必致壅闭，遂不得循经流注，失其常度，故有妄行之患焉。夫血
之妄行也，未有不因热之所发。盖血得热则淖溢，血气俱热，血随气上，乃吐衄也。大抵脉
芤为失血，沉细者易治，浮大者难治。又有感冒，汗后不解，郁结经络，随气涌泄，而成衄
血。思虑伤心，心伤则吐衄，肺伤亦令人唾血。又有折伤吐血。治疗之法，当以证别之。乃
可施治。
又论∶夫吐血、呕血、咳血三者皆谓之失血。盖肺主于气，心主于血，肝藏于血、血之
与气，营周一身，相随上下，无有休息者焉。倘乖调摄，营卫差经，血随气逆，遂有妄行之
患。所致之由，因大虚损，或饮酒过度，或强食过饱，或饮啖辛热，或忧思恚怒，动扰三经
而然。诸失血之脉，沉细者易治，脉数浮大者难治，且咳血一证，不嗽者易治，兼嗽者为难
愈，为肺伤故也。医经云∶便血犹可止，咳血不易医。喉不停物，毫发必咳，血渗入喉，愈
渗愈咳，愈咳愈渗。饮溲溺者，十无一死，服寒凉者，百无一生。以此观之，寒凉之剂，不
宜过进也。诸方备列，参而用之，庶得万全耳。
(Attachment: Formula for Internal Injury and Blood Stasis due to Golden Wounds)
(Hematemesis, Hemorrhage from Vomiting, Hemoptysis)
Medical classics record that there are three types of blood loss: one is epistaxis (Xuenü), two is lung abscess (Feiju), and three is stomach injury. Generally, the Heart governs blood, the Liver stores blood, the Lung governs Qi. Blood belongs to Ying (Nutritive Qi), and Qi belongs to Wei (Defensive Qi); they follow each other up and down, ascending and descending, without rest. If the Six Evils do not injure the body, and the Seven Emotions do not cause stagnation, and Ying and Wei are harmonious and balanced, then there is no danger of congestion and rupture. If regulation and discharge are improper, it will inevitably lead to obstruction, causing the blood to fail to flow according to the meridians and lose its normal rhythm, thus resulting in the hazard of reckless flowing. As for the reckless flowing of blood, it invariably arises from heat. Generally, when blood encounters heat, it becomes fluid and overflows; when both blood and Qi are hot, blood follows Qi upward, resulting in hematemesis and epistaxis. Broadly speaking, a Koubloodless pulse indicates blood loss; a deep and fine pulse is easy to treat, while a floating and large pulse is difficult to treat. There is also nasal bleeding caused by cold damage where sweating fails to resolve the condition, with pathogens stagnating in the meridians and surging out with Qi. Excessive thinking injures the Heart; heart injury leads to hematemesis or epistaxis, and lung injury causes spitting of blood. There is also hematemesis due to trauma. The method of treatment should distinguish based on syndromes before applying therapy.
Furthermore, it is discussed that hematemesis, hemorrhage from vomiting, and hemoptysis are all referred to as blood loss. Generally, the Lung governs Qi, the Heart governs blood, and the Liver stores blood. Blood and Qi circulate throughout the body, following each other up and down without rest. If care and regulation are neglected, and the pathways of Ying and Wei deviate, blood follows Qi in rebellion, leading to the hazard of reckless flowing. The causes include severe deficiency and exhaustion, excessive drinking, forced overeating, consumption of spicy and hot foods, or worry, thought, anger, and resentment, which disturb the three meridians. Regarding the pulses of various blood losses, deep and fine pulses are easy to treat, while rapid, floating, and large pulses are difficult to treat. Moreover, regarding hemoptysis, cases without coughing are easy to treat, while those accompanied by coughing are difficult to cure because the Lung is injured. Medical classics state: "Rectal bleeding can still be stopped, but hemoptysis is not easy to treat." If nothing remains in the throat, even a hair will induce coughing; when blood seeps into the throat, the more it seeps, the more one coughs, and the more one coughs, the more it seeps. Those who drink urine rarely die (ten out of ten survive), whereas those taking cold-natured medicines rarely survive (one out of a hundred). From this perspective, cold-natured preparations should not be administered excessively. Various formulas are listed in detail; refer to them and use them appropriately to achieve optimal results.