Library

Wu Qiu treated a young man with hematemesis (vomiting blood), where the bleeding was gushing like a spring. Various medicines were ineffective, and the patient was emaciated and critically ill. Wu took the blood vomited by the patient, placed it in a clay vessel, waited for it to coagulate, then put it into a pot and stir-fried it until black. It was placed on paper on the ground to eliminate fire toxicity, finely ground into powder, and taken at a dose of 0.5 fen each time, administered with Ophiopogonis Decoction (Maimendong Tang). After two or three doses, the bleeding stopped. This is likely the method of "using blood to guide blood back" (Xue Dao Xue Gui). I observe that: recently, people have passed down a prescription for treating sudden severe hematemesis, which involves dipping silk cotton into the vomited blood, baking it over fire to preserve its properties, grinding it into powder, and taking it orally; this is very effective. Now, seeing Wu's case, we know that this method can be used not only in the initial stage.

Medical texts vary on whether to use bitter-cold herbs for treating hematemesis; some advocate it, while others prohibit it. Gu Xiaolan's medical record reveals the key principle. The record states: A woman surnamed Xu suffered from profuse hematemesis that lasted for several days without stopping. Her eyes were closed, and she was unconscious. Her face was red, limbs were weak, breathing was coarse, and she could not lie flat. Her condition was as precarious as stacked eggs. The pulse was deep on the left and surging on the right, but upon heavy pressure, there was still a root. This indicated that stagnant heat had long steamed the Lung and Stomach, compounded by external summer-heat forcing its way in, damaging the Yang collaterals, causing the Blood Sea to fail to contain blood, leading to imminent danger. Since all medicines were bitter-cold, administering them caused immediate vomiting. Therefore, borrowing the intent of Ba Zhi Yin (Eight Juices Drink), hoping that sweet-cold herbs could enter the stomach to clear the upper jiao, after the bleeding stopped, other treatments would be considered. One cup of sugarcane juice, one cup of lotus root juice, one cup of reed rhizome juice, two spoonfuls of white loquat fruit juice, half a cup of white radish juice, one cup of pear juice, and one cup of watermelon juice were mixed raw. Three spoonfuls of fresh lotus leaf juice were added. The seven juices were blended evenly, heated in a double boiler, and mixed with melon juice. It was slowly administered continuously through the mouth. After ingestion, she slept at night, the bleeding stopped, and her spirit cleared. However, she remained fatigued and reluctant to speak, with a faint breath. Although the pulse had slightly normalized, the right pulse became more floating, large, and powerless. This indicated excessive blood loss, posing a risk of deficiency collapse. The Classic says: "In cases of blood depletion, tonify Qi." We should follow this rule. Use 0.7 qian of Ginseng Radix et Rhizoma (Renshen) mixed with Aquae Lapidum Calcariorum (Qiushi Shui); 0.7 qian of Scutellariae Radix (Huangqin) roasted black with Scutellaria decoction; 1 qian of Angelicae Sinensis Radix (Danggui Shen) stir-fried black; 1.5 qian of Dioscoreae Hypoglaucae Rhizoma (Huai Shanyao); 3 qian of Poria (Fuling); 1.5 qian of Ophiopogonis Radix (Da Maidong) with heart removed; seven steamed Schisandrae Fructus (Bei Wuwei Zi). Mix with sugarcane juice, pear juice, and lotus root juice. After taking the medicine, appetite improved, spirit strengthened, and she recovered. A disciple asked: In the syndrome of blood rushing upward, cold syndromes are usually treated with bitter-cold herbs to subdue them. Why did sweet-cold herbs work here? I replied: Danxi said, "Deficiency fire should be tonified." This woman had been a widow for many years, accumulating worry and thought, causing long-term damage to the Heart and Spleen. Compounded by external summer-heat steaming, stomach blood overflowed massively. Bitter-cold herbs caused vomiting upon contact with the mouth, indicating deficiency fire. Hence, sweet-cold herbs stopped the bleeding. If it were excess heat reversing upward, Zhongjing once used Rhubarb (Dahuang). Or in cases of blood depletion benefiting Qi, Dongyuan originally had the Single Ginseng Decoction (Dushen Tang) method. One cannot adhere rigidly to one approach. From this case, we see that for hematemesis due to excess fire, bitter-cold herbs are indeed appropriate. However, except for excess fire, bitter-cold herbs are generally unsuitable. Nowadays, most hematemesis cases involve deficiency, yet doctors often immediately prescribe bitter-cold herbs. No wonder few recover. There are other instructive cases prohibiting bitter-cold herbs for hematemesis.

Wu Fuxian treated a girl surnamed He suffering from hematemesis and coughing, with reduced appetite and loose stools. All six pulses were excess, especially on the left side. The doctor prescribed Si Wu Tang (Four Substances Decoction) plus Scutellariae Radix (Huangqin) and Anemarrhenae Rhizoma (Zhimu). Wu said: Danggui and Chuanxiong are acrid and dispersing, which is inappropriate for hematemesis; Huangqin and Zhimu are bitter-cold and damage the Spleen, which is strictly prohibited. Instead, he prescribed Coicis Semen (Yiyiren), Polygonati Odorati Rhizoma (Yuzhu), Paeoniae Radix Alba (Baishao), Lycii Fructus (Gouqi), Ophiopogonis Radix (Maidong), Glehniae Radix (Shashen), Dipsaci Radix (Chuanduan), Nelumbinis Plumula (Jianlian), and Lilii Bulbus (Baihe). After twenty doses, the pulse slowed slightly; after fifty doses, she recovered. This formula is excellent for treating hematemesis and coughing due to Yin deficiency, but efficacy is only seen after dozens of doses. Is this not proof that the Kingly Way (Wangdao) methods do not yield quick results?

Furthermore, Cheng Shi's *Yi Gou* records the treatment of Li's son who suffered from hematemesis, panting, coughing, edema, and weakness in the legs preventing walking. The pulse was floating, choppy, and rapid. This was attributed to sexual exhaustion. Treatment used Poria (Fuling), Paeoniae Radix Alba (Baishao), Coicis Semen (Yiyiren), Chaenomelis Fructus (Mu Gua), Moutan Cortex (Danpi), Euryales Semen (Qianshi), Achyranthis Bidentatae Radix (Niuxi), Fritillariae Bulbus (Beimu), Lilii Bulbus (Baihe), and Glycyrrhizae Radix et Rhizoma (Gancao). After ten-plus doses, panting stabilized, floating pulse receded, and bleeding stopped. Aconitum (Baizhu) was added to the previous formula, and after twenty-plus doses, he recovered. For this disease, if cooled to stop bleeding, floating panting would worsen; if warmed to stop panting, hematemesis would intensify, leading inevitably to death. Only by employing clever methods within bland prescriptions could life be saved. Those treating hematemesis who understand this will not be misled by drugs.

Medical texts often mention the miraculous effect of infant urine (Tongbian) for treating hematemesis. However, one must select urine from healthy infants who have not consumed fishy or turbid substances. Those with means can purchase it, but how can poor families obtain it? There is a prescription: Salviae Miltiorrhizae Radix (Danshen) steamed in a rice cooker, soaked in water to make tea, drunk daily; this is very effective.