衄血、火升、痰盛、身热，多退血虚，四物汤加减用。戴云∶咳血者，嗽出，
痰内有血者是；呕血者，呕全血者是；咯血者，毋咳出皆是血疙瘩；衄血者，鼻中出血
也；溺血，小便出血也；下血者，大便出血也。惟有各名色分六，俱是热证，但有虚实新
旧之不同。或妄言为寒者，误也。
入方
青黛 栝蒌仁 诃子 海粉 山栀
上为末，以蜜同姜汁丸。噙化。咳甚者，加杏仁去皮尖，后以八物汤加减调理。
附方
黄 散 治咳血成劳。
甘草（四钱） 黄 麦门冬 熟地黄 桔梗 白芍（各半两）
上 咀。每服半两，水煎服。
茯苓补心汤 治心气虚耗，不能藏血，以致面色痿黄，五心烦热，咳嗽唾血。
茯苓 半夏 前胡 紫苏 人参 枳壳（炒） 桔梗 甘草 葛根（各半分） 当归（二两） 川
芎（七钱半）陈皮 白芍（各二两） 熟地黄
上 咀。水姜枣煎。
呕血，火载血上，错经妄行。脉大发热，喉中痛者，是气虚，用参、 、蜜炙
黄
火载血上，错经妄行，用四物汤加炒山栀、童便、姜汁服。
又方∶山茶花、童便、姜汁，酒服。又郁金末，治吐血，入姜汁、童便良。又方∶用韭
汁、童便二
童
，血溢鼻口，但怒气致血证者则暴甚，故经曰∶“抑怒以全阴”者是也，否则五志之火动甚
载血上，错经妄行也。用柴胡、黄连、黄芩、黄 、地骨、生熟地黄、白芍，以水煎服。
虚者以保命生地黄散，再加天门冬、枸杞、甘草等分，水煎服。
附方
治呕血
黄柏（蜜炙）
上捣为末。煎麦门冬汤调二钱匕，立瘥。
《圣惠方》治呕血。
侧柏叶
上为末。不计时，以粥饮调下二钱匕。
《保命》生地黄散
生地黄 熟地黄 枸杞 地骨皮 天门冬 黄 白芍 甘草 黄芩
上 咀。水煎，食前。
Epistaxis (nosebleed), rising fire, excessive phlegm, and body heat are mostly due to deficiency of blood after loss. Siwu Tang (Four Substances Decoction) should be used with modifications. Dai Yun said: Hemoptysis (coughing up blood) is when blood is coughed out; if there is blood in the sputum, it is hemoptysis; Hematemesis (vomiting blood) is when whole blood is vomited; Spitting blood (spitting without coughing) refers to spitting out blood clots; Epistaxis is bleeding from the nose; Hematuria is bleeding from urination; Lower gastrointestinal bleeding is bleeding from defecation. Although named as six different types, they all belong to heat syndromes, but differ in terms of deficiency/excess and newness/chronicity. Those who rashly claim it is a cold syndrome are mistaken.
Prescription
Qingdai (Indigo Naturalis), Gualou Ren (Trichosanthis Semen), Hezi (Chebulae Fructus), Haifen (Tintinnabulum Pulvis), Shanzhi (Gardeniae Fructus).
Grind the above into powder. Form pills with honey and ginger juice. Hold in the mouth to dissolve. For severe cough, add Xingren (Prunus Armeniacae Semen) peeled and cored. Afterwards, regulate with Babu Tang (Eight Substances Decoction) with modifications.
Supplementary Prescription
Huang San (Astragalus Powder) treats hemoptysis progressing to consumption.
Gancao (Glycyrrhizae Radix et Rhizoma) (4 qian), Huangqi (Astragali Radix), Maimendong (Ophiopogonis Radix), Shudihuang (Rehmanniae Radix Preparata), Jiegeng (Platycodonis Radix), Baishao (Paeoniae Radix Alba) (each 0.5 liang).
Cut into pieces. Take 0.5 liang per dose, decoct in water and drink.
Fuling Buxin Tang (Poria Decoction for Tonifying the Heart) treats deficiency and exhaustion of heart qi, inability to store blood, leading to sallow complexion, five-palm heat, coughing and spitting blood.
Fuling (Poria), Banxia (Pinelliae Rhizoma), Qianhu (Peucedani Radix), Zisu (Perillae Folium), Renshen (Ginseng Radix), Zhike (Aurantii Fructus Immaturus, stir-fried), Jiegeng (Platycodonis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Gegen (Puerariae Radix) (each 0.5 fen), Danggui (Angelicae Sinensis Radix) (2 liang), Chuanxiong (Ligustici Chuanxiong Rhizoma) (7.5 qian), Chenpi (Citri Reticulatae Pericarpium), Baishao (Paeoniae Radix Alba) (each 2 liang), Shudihuang (Rehmanniae Radix Preparata).
Cut into pieces. Decoct with water, fresh ginger, and jujube.
Hematemesis occurs when fire carries blood upward, causing blood to flow recklessly along incorrect pathways. If the pulse is large with fever and throat pain, it indicates qi deficiency; use Renshen (Ginseng Radix), Huangqi (Astragali Radix), and honey-fried Huangqi (Astragali Radix).
When fire carries blood upward, causing blood to flow recklessly along incorrect pathways, use Siwu Tang (Four Substances Decoction) added with stir-fried Shanzhi (Gardeniae Fructus), Tongbian (Uterine Urine of Child), and Jiangzhi (Zingiberis Rhizoma Juice).
Another prescription: Shanchahua (Camelliae Japonicae Flos), Tongbian (Uterine Urine of Child), Jiangzhi (Zingiberis Rhizoma Juice), taken with wine. Also, Yujin (Curcumae Radix) powder treats hematemesis; adding Jiangzhi (Zingiberis Rhizoma Juice) and Tongbian (Uterine Urine of Child) is effective. Another prescription: Use 2 he of Jiuzhi (Allii Tuberosi Juice) and Tongbian (Uterine Urine of Child). When blood overflows from the nose and mouth, if caused by anger, the condition becomes acute and severe. Thus, the classic states: "Restrain anger to preserve yin." Otherwise, the fire of the five emotions moves vigorously, carrying blood upward and causing blood to flow recklessly along incorrect pathways. Use Chaihu (Bupleuri Radix), Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Huangqi (Astragali Radix), Digupi (Lycii Cortex), Shengdihuang (Rehmanniae Radix), Shudihuang (Rehmanniae Radix Preparata), and Baishao (Paeoniae Radix Alba). Decoct in water and drink.
For deficiency patterns, use Baoming Shengdihuang San (Life-Preserving Rehmannia Powder) plus Tianmendong (Asparagi Radix), Gouqi (Lycii Fructus), and Gancao (Glycyrrhizae Radix et Rhizoma) in equal parts. Decoct in water and drink.
Supplementary Prescription
Treating Hematemesis
Huangbai (Phellodendri Cortex), honey-fried.
Grind into powder. Mix with 2 qianbi using Maidong Tang (Ophiopogon Decoction); cure will follow immediately.
Shenghui Fang (Formulas of the Holy Grace Pavilion) treats hematemesis.
Cebaiye (Platycladi Cacumen).
Grind into powder. Take 2 qianbi mixed with rice gruel at any time.
Baoming Shengdihuang San (Life-Preserving Rehmannia Powder)
Shengdihuang (Rehmanniae Radix), Shudihuang (Rehmanniae Radix Preparata), Gouqi (Lycii Fructus), Digupi (Lycii Cortex), Tianmendong (Asparagi Radix), Huangqi (Astragali Radix), Baishao (Paeoniae Radix Alba), Gancao (Glycyrrhizae Radix et Rhizoma), Huangqin (Scutellariae Radix).
Cut into pieces. Decoct in water; take before meals.