麻黄人参芍药汤(东垣) 治吐血外感寒邪,内虚蕴热。
桂枝(五分,补表虚) 麻黄(去外寒) 黄 (实表益卫) 炙甘草(补脾) 白芍(安太阴)
人参(益元气而实表) 麦冬(补肺气,各三分) 五味子(五粒安肺气) 当归(五分,和血养血)
水煎,热服。按此方以解表为止血,是东垣之巧思幸中,非有定识也。观其每味自注药
性,俱悖圣经,便知其陋。
甘草干姜汤(《金匮》)
炙甘草(四钱) 干姜(二钱,炮)
水二杯,煎八分服。
柏叶汤(《金匮》) 治吐血不止。
柏叶(生用,三钱,无生者用干者二钱) 干姜(一钱) 艾叶(生用,二钱,如无生者,用干者一钱)
水四杯,取马通二杯,煎一杯服。如无马通,以童便二杯,煎八分服。
黄土汤(《金匮》) 治先便后血为远血。亦治衄血、吐血、血不止。
灶心黄土(八钱,原方四钱) 生地 黄芩 甘草 阿胶 白术 附子(炮,各一钱五分)
水三杯,煎八分服。
赤小豆散(《金匮》) 治先血后便为近血。
赤小豆(浸令出芽晒干,一两) 当归(四钱)
共研末。每服三钱,浆水下。即洗米水,三日后有酸味是也。按凡止血标药可随宜作引
,血余灰可用一二两同煎,诸血皆验。栀子、茜草、干侧柏治上血,槐花、生地黄、乌梅、
续断治血崩。凡下血及血痢,口渴,后重,脉洪有力者为火盛。可用苦参子去壳,仁勿破,
外以龙眼肉包之,空腹以仓米汤送下九粒,一日二三服,渐加至十四粒,二日效。
Mahuang Renshen Shaoyao Decoction (by Li Dongyuan) is used to treat hematemesis caused by external cold pathogen invasion and internal deficiency with accumulated heat.
Guizhi (Cinnamon Twig, 5 fen, to tonify exterior deficiency), Mahuang (Ephedra Herb, to dispel external cold), Huangqi (Astragalus Root, to solidify the exterior and benefit Wei Qi), Zhi Gancao (Prepared Licorice Root, to tonify Spleen), Baishao (White Peony Root, to soothe the Taiyin channel), Renshen (Ginseng Root, to benefit Yuan Qi and solidify the exterior), Maidong (Ophiopogon Tuber, to tonify Lung Qi, each 3 fen), Wuweizi (Schisandra Fruit, 5 grains, to calm Lung Qi), Danggui (Angelica Sinensis Root, 5 fen, to harmonize and nourish Blood).
Decoct in water and take hot. Note: This formula uses the method of releasing the exterior to stop bleeding. This is a clever idea of Li Dongyuan that happened to be effective, but it does not reflect profound medical insight. Observing that he annotated the properties of each herb himself, all of which contradict the classic texts, reveals his limited knowledge.
Gancao Ganjiang Tang (from *Jin Gui Yao Lue*)
Zhi Gancao (Prepared Licorice Root, 4 qian), Ganjiang (Dried Ginger, 2 qian, processed).
Decoct in two cups of water until reduced to eight-tenths, then administer.
Baiye Tang (from *Jin Gui Yao Lue*) is used to treat persistent hematemesis.
Baiye (Calamansi Leaf, raw, 3 qian; if unavailable, use dried Baiye, 2 qian), Ganjiang (Dried Ginger, 1 qian), Aye (Mugwort Leaf, raw, 2 qian; if unavailable, use dried Aye, 1 qian).
Decoct in four cups of water with Matong (Horse Dung Juice, 2 cups) until reduced to one cup, then administer. If Matong is unavailable, use Tongbian (Child's Urine, 2 cups), decoct until reduced to eight-tenths, then administer.
Huangtu Tang (from *Jin Gui Yao Lue*) is used to treat "distant blood" (hematochezia where blood appears after stool). It also treats epistaxis, hematemesis, and uncontrollable bleeding.
Zaoxin Huangtu (Caulined Earth, 8 qian; original formula uses 4 qian), Sheng Dihuang (Rehmannia Root, raw), Huangqin (Scutellaria Root), Gancao (Licorice Root), Ejiao (Donkey-Hide Gelatin), Baizhu (Atractylodes Rhizome), Fuzi (Aconite Lateral Root, processed, each 1.5 qian).
Decoct in three cups of water until reduced to eight-tenths, then administer.
Chixiaodou San (from *Jin Gui Yao Lue*) is used to treat "near blood" (bleeding before stool).
Chixiaodou (Adzuki Bean, soaked until sprouted and sun-dried, 1 liang), Danggui (Angelica Sinensis Root, 4 qian).
Grind together into powder. Take 3 qian per dose, administered with Jiangshui (Sour Rice Water). Jiangshui refers to rice washing water left for three days until it develops a sour taste. Note: Any hemostatic symptomatic treatment can be used as an guiding agent according to circumstances. Xueyu Hui (Hair Charcoal) can be decocted together in amounts of 1-2 liang and is effective for various types of bleeding. Zhizi (Gardenia Fruit), Qiancao (Rubia Root), and Gansibai (Dried Calamansi Leaf) treat upper bleeding; Huaihua (Sophora Flower), Sheng Dihuang (Raw Rehmannia Root), Wumei (Mume Fruit), and Xuduan (Dipsacus Root) treat metrorrhagia. For lower bleeding and bloody dysentery, accompanied by thirst, tenesmus, and a surging and forceful pulse, this indicates excessive fire. One may use Kushenzi (Sophora Seed), remove the shell without breaking the kernel, wrap it in Longyanrou (Longan Aril), and take nine grains on an empty stomach with Cangmi Tang (Rice Decoction), two to three times a day, gradually increasing to fourteen grains. Effect should be seen within two days.