Library

Wen Xie (Warm pathogenic factors occur in all four seasons; if they cause epistaxis, the method of acrid-cool clearing and moistening should be used.)
Xingren (Apricot Seed), Dan Qin (Light Scutellaria Root), Shan Zhi (Gardenia Fruit), Yu Jin (Curcuma Aromatica Rhizome), Yuan Shen (Scrophularia Root), Lian Qiao (Forsythia Fruit)

Feng Wen (Wind-Warmth [Spring seasonal disease])
Yuan Shen (Scrophularia Root), Chi Shao (Red Peony Root), Lian Qiao (Forsythia Fruit), Sang Ye (Mulberry Leaf), Dan Pi (Moutan Cortex), Ju Pi (Tangerine Peel), Mao Hua (Reed Flower)

Jiu Re Shang Wei (Alcohol-Heat Damaging the Stomach)
Sheng Bian Dou (Raw Lablab Bean), Mai Dong (Ophiopogon Tuber), Bei Sha Shen (Glehnia Root), Jing Mi (Rice Grain)

Shi Re Wei Huo Shang Zheng Chu Nu (Damp-Heat and Stomach-Fire Steaming Up Causing Epistaxis)
Yu Nu Jian (Jade Woman Decoction), containing Shu Di (Prepared Rehmannia Root), Zhi Mu (Anemarrhena Rhizome), Sheng Shi Gao (Raw Gypsum Fibrosum), Mai Dong (Ophiopogon Tuber), Niu Xi (Achyranthes Root)

Dan Huo Shang Sheng Xin Ying Re Jian Nu (Gallbladder Fire Rising with Heart-Nutrient Heat Complicating Epistaxis)
Xi Jiao (Rhinoceros Horn - *Note: Substitute with Water Buffalo Horn in modern practice*), Sheng Di (Raw Rehmannia Root), Dan Shen (Salvia Miltiorrhiza Root), Zhi Mu (Anemarrhena Rhizome), Niu Xi (Achyranthes Root), Ce Bai Ye (Biota Tops), Yuan Shen (Scrophularia Root), Lian Qiao (Forsythia Fruit), Shan Zhi (Gardenia Fruit), Dan Pi (Moutan Cortex), He Ye (Lotus Leaf)

Yin Xu Yang Mao Zhi Nu (Yin Deficiency with Yang Flaring Up Causing Epistaxis)
Sheng Di (Raw Rehmannia Root), Gui Ban (Tortoise Shell), E Jiao (Donkey-Hide Gelatin), Mai Dong (Ophiopogon Tuber), Sheng Bai Shao (Raw White Peony Root), Chuan Bai (Phellodendron Bark), Niu Xi (Achyranthes Root), Tian Dong (Asparagus Tuber), Fu Ling (Poria), Chuan Shi Hu (Dendrobium Stem), Ren Shen (Ginseng Root), Shan Yao (Dioscorea Rhizome), Shu Di (Prepared Rehmannia Root), Dan Pi (Moutan Cortex), Ze Xie (Alisma Rhizome), Shi Jue Ming (Haliotidis Shell), Lian Zi (Lotus Seed), Qian Shi (Euryale Seed), Yuan Shen (Scrophularia Root), Shan Yu (Cornus Fruit), Bu Gu Zhi (Psoralea Fruit), Dan Cai (Edible Mussel)

Bian Xue (Blood in Stool) is not outside the two meanings of Wind invading the intestines and stomach, and Damp-Heat damaging the Spleen. The *Neijing* states this is injury to the Yin Collaterals; Yin Collaterals refer to the collaterals subordinate to the lower parts of the Zang-Fu organs.
Niao Xue (Hematuria) arises from Bladder郁热 (Stagnant Heat); use Wu Ling San (Five-Ingredient Powder with Poria) combined with Lian Zi Tang (Lotus Seed Decoction). Zhi Mu (Anemarrhena Rhizome), Bai (Phellodendron Bark), and Shan Zhi (Gardenia Fruit) can all be added. If there is no pain, it is a deficiency pattern, and Qi-tonifying therapy is beneficial (if there is no pain in the urethra, Bu Zhong Yi Qi Tang [Tonify the Middle and Augment the Qi Decoction] can be used). Xia Xue (Lower Bleeding) in the Large Intestine is mostly due to Damp-Heat. Chang Feng (Intestinal Wind) and Zang Du (Visceral Toxin) must be distinguished by clear and turbid qualities. Blood before stool is Jin Xue (Near Blood), heat in the Lower Jiao; blood after stool is Yuan Xue (Far Blood), heat in the Upper Jiao. Si Wu Tang (Four Substance Decoction) plus Jing Jie (Schizonepeta Spike), Huai Hua (Sophora Flower), and Yu Pi (Ulmus Bark) are all excellent. Zong Hui (Cinnabar Ash/Tree Fern Ash), Chen Pi (Aged Tangerine Peel), Qiao Ke (Magnolia Bud/Bark - *Note: Context implies Magnolia or similar bark*, here interpreted as part of the formula components like Zhi Ke), Fu Ling (Poria), and Gan Cao (Licorice Root) assist. For fever, Chai Hu (Bupleurum Root) combined with Gui Ban (Tortoise Shell) is effective; for Blood deficiency, Shu Di (Prepared Rehmannia Root) and Xue Yu Tan (Charred Human Hair) are commonly used. For stasis masses, Tao Ren (Peach Kernel), Hong Hua (Safflower), Dan Shen (Salvia Root), Wei Lian (Upper Part of Coptis Rhizome), and Bie Jia (Trionyx Carapace) are used; Yan Hu Suo (Corydalis Rhizome) and Chi Shao (Red Peony Root) are added to the previous formula.

Shi Re (Damp-Heat Pattern)
Jing Jie Tan (Charred Schizonepeta Spike), Chuan Lian (Coptis Rhizome), Wu Mei (Mume Fruit), Guang Pi (Tangerine Peel), Mao Zhu (Atractylodes Rhizome), Di Yu (Sanguisorba Root), Gan Ju Tan (Charred Chrysanthemum Flower), Huang Qin (Scutellaria Root), Bai Shao (White Peony Root), Chuan Po (Magnolia Bark), Huai Mi (Sophora Flower Bud), Yu Zhu (Atractylodes Macrocephala Rhizome), Fu Ling (Poria), Sang Ye (Mulberry Leaf), Ze Xie (Alisma Rhizome), Dan Pi (Moutan Cortex)

Yang Xu Han Shi (Yang Deficiency with Cold-Damp Pattern)
Mao Zhu (Atractylodes Rhizome), Guang Pi (Tangerine Peel), Zhi Cao (Honey-fried Licorice Root), Chai Hu (Bupleurum Root), Ren Shen (Ginseng Root), Fu Zi (Aconite Lateral Root), Chuan Po (Magnolia Bark), Pao Jiang (Roasted Ginger), Sheng Ma (Cimicifuga Rhizome), Di Yu (Sanguisorba Root), Fu Ling (Poria), Fang Feng Gen (Saposhnikovia Root), Bai Shao (White Peony Root), He Ye (Lotus Leaf), Jian Shen Qu (Medicated Leaven), Ge Gen (Kudzu Root)

Da Chang Xue Re (Large Intestine Blood-Heat Pattern)
Sheng Di (Raw Rehmannia Root), Di Yu Tan (Charred Sanguisorba Root), Huang Bo (Phellodendron Bark), Liao Dou Pi (Lablab Bean Skin), Shi Bing (Persimmon Cake), Shan Zhi (Gardenia Fruit), Dan Shen (Salvia Root), Chao Chu Pi (Stir-fried Principal Tree Bark), Huai Hua (Sophora Flower), Chao Huang Qin (Stir-fried Scutellaria Root), Dan Pi (Moutan Cortex), Yuan Shen (Scrophularia Root), Wu Jia Pi (Acanthopanax Bark), Dang Gui (Angelica Sinensis Root), Chao Yin Hua (Stir-fried Honeysuckle Flower), Bai Shao (White Peony Root)

Pi Wei Yang Xu (Spleen-Stomach Yang Deficiency [Bleeding like a gush])
Si Jun Zi Tang (Four Gentlemen Decoction) plus Mu Gua (Chaenomeles Fruit), Pao Jiang (Roasted Ginger), Yu Liang Shi Zhi Wan (Halloysitum and Lithargyrum Pill)

Yin Shang Chang Wei (Yin Injury of Intestines and Stomach)
Sheng Di (Raw Rehmannia Root), Dan Pi (Moutan Cortex), Zhu Xin (Bamboo Heart), Fu Ling (Poria), Bu Yin Wan (Nourish Yin Pill), Yuan Shen (Scrophularia Root), Lian Qiao (Forsythia Fruit), Tian Dong (Asparagus Tuber), Niu Xi (Achyranthes Root), Hu Qian Wan (Tiger Crouching Pill)

Yin Xu Xue Se (Yin Deficiency with Blood Stagnation [Anal prolapse and pulling pain, anus feels like burning, Yang is unharmonious, still due to loss of nourishment by Yin Essence])
Sheng Di Tan (Charred Raw Rehmannia Root), Huo Ma Ren (Hemp Seed), Gui Xu (Angelica Sinensis Tail), Dong Kui Zi (Malva Seed), Liao Dou Pi (Lablab Bean Skin), Zha Tan (Charred Hawthorn Fruit)

Pi Shen Xu (Spleen-Kidney Deficiency Pattern)
Liu Wei Wan (Six-Ingredient Pill) plus Qian Shi (Euryale Seed), Wu Wei Zi (Schisandra Fruit), Lian Rou (Lotus Seed Meat), Gui Pi Wan (Restore the Spleen Pill)

Shen Yang Xu (Kidney Yang Deficiency Pattern)
Ren Shen (Ginseng Root), Cong Rong (Cistanche Stem), Bu Gu Zhi (Psoralea Fruit), Bai Ren (Baiji Seed), Jiu Zi (Leek Seed), Lu Rong (Deer Antler Velvet), Lu Jiao (Deer Antler), Ba Ji Tian (Morinda Root), Yuan Zhi Rou (Polygala Flesh), Fu Ling (Poria), Shu Di (Prepared Rehmannia Root), Tu Si Zi (Dodder Seed), Gui Shen (Angelica Sinensis Body)

Shen Yin Xu (Kidney Yin Deficiency Pattern)
Shu Di (Prepared Rehmannia Root), Gui Ban Xin (Tortoise Shell Heart), Gui Shen (Angelica Sinensis Body), Zhi Mu (Anemarrhena Rhizome), Shan Yao (Dioscorea Rhizome), Shan Yu (Cornus Fruit), Liao Dou Pi (Lablab Bean Skin), Bai Shao (White Peony Root), Fu Shen (Poria with Hostwood), Di Yu (Sanguisorba Root), Dan Pi (Moutan Cortex), Wu Wei Zi (Schisandra Fruit), Wu Mei (Mume Fruit), Hua Long Gu (Calcined Fossilized Bones)

Lao Li Luo Shang (Injury of Collaterals due to Overexertion [Stasis must accumulate in the collaterals; once collaterals and intestines/stomach are involved, bleeding occurs downward—this is a fixed principle])
Ren Shen (Ginseng Root), Shan Dang Gui (Shaanxi Angelica Sinensis Root), Fu Ling (Poria), Zhi Cao (Honey-fried Licorice Root), Da Bai Shao (Large White Peony Root), Rou Gui (Cinnamon Bark)

Xue Yu Zai Luo (Blood Stasis in the Collaterals)
Gui Xu (Angelica Sinensis Tail), Xuan Fu Hua (Inula Flower), Bai Zi Ren (Biota Seed), Tao Ren (Peach Kernel), Xin Jiang (New Crimson Silk/Dyed Fabric), Qing Cong Guan (Green Onion Tube)

Yang Ming Bu He (Yangming Failure to Close)
Ren Shen (Ginseng Root), Chuan Chuan Bai (Stir-fried Phellodendron Bark), Shan Yu Rou (Cornus Flesh), Chi Shi Zhi (Red Halloysite), Wu Mei (Mume Fruit), Yu Yu Liang (Halloysitum), Wu Wei Zi (Schisandra Fruit), Bai Jing Mi (White Rice Grain), Qing Xin Lian Zi Yin (Clear the Heart Lotus Seed Decoction)
*(Qing Xin Lian Zi Yin Composition: Ren Shen [Ginseng Root], Chai Hu [Bupleurum Root], Huang Qin [Scutellaria Root], Di Gu Pi [Lycium Bark], Che Qian Zi [Plantago Seed], Huang Qi [Astragalus Root], Fu Ling [Poria], Gan Cao [Licorice Root], Shi Lian Zi [Stone Lotus Seed], Mai Men Dong [Ophiopogon Tuber])*

He Shu Tian said: Regarding Bian Xue (Blood in Stool), ancient texts distinguish between Chang Feng (Intestinal Wind), Zang Du (Visceral Toxin), and Mai Zhi (Vascular Hemorrhoids), but essentially all stem from injury to the Yin Collaterals. By distinguishing whether the blood appears early or late in defecation, one can determine the nature of the affected Zang-Fu organs, thereby preventing the loss of Qi's controlling function and blood having no place to return, which would result in continuous bleeding like a leaking vessel. When the Lung system causes dryness, astringency requires moistening and descending methods, such as Sang Ma Wan (Mulberry and Hemp Seed Pill) and herbs like Tian Dong (Asparagus Tuber), Di Huang (Rehmannia Root), Yin Hua (Honeysuckle Flower), and Shi Bing (Persimmon Cake). When the Heart system involves fire burning, boiling blood requires clearing and transforming methods, such as Zhu Ye Di Huang Tang (Bamboo Leaf and Rehmannia Decoction) and Bu Xin Dan (Tonify the Heart Pill). Spleen disease inevitably involves dampness and slipperiness, requiring drying and ascending methods, such as Mao Zhu Li Zhong Tang (Atractylodes and Central Warming Decoction) and Dong Yuan Yi Qi Tang (Dong Yuan's Qi-Augmenting Decoction). Liver disease involves Wind and Yang; pain and urgency require softening and purging methods, such as Zhu Che Wan (Stopping Cartilage Pill) and sweet-sour mild agents. Kidney disease presents with emaciation and lumbar soreness, requiring filling and tonifying methods, such as Hu Qian Wan (Tiger Crouching Pill) and Li Yin Jian (Regulate Yin Decoction). As for the Gallbladder meridian acting as the pivot, rebellion causes Wood-Fire to stir the Nutrient level, requiring clearing and nourishing herbs like Sang Ye (Mulberry Leaf), Shan Zhi (Gardenia Fruit), and Dan Pi (Moutan Cortex). The Large Intestine is a dry organ, often involving warmth and heat; Wind invasion requires acrid-cool and bitter-dry methods. The Stomach is the sea of water and grain, abundant in Qi and Blood, encompassing both Zang and Fu diseases; it requires harmonizing and tonifying, addressing both heat and cold, which is hard to exhaustively describe. The Spleen and Stomach are soft organs, tolerating rigid medicines; the Heart and Liver are rigid organs, tolerating soft medicines. Luo Qianfu treated Bian Xue using Ping Wei San (Peace the Stomach Powder) as the main formula, adding Gui (Cinnamon Twig), Fu (Aconite), and Gan Jiang (Dried Ginger), with heavy doses of Chao Di Yu (Charred Sanguisorba Root) to secure lower dampness, achieving remarkable effects. To warm and tonify the奇经 (Extraordinary Vessels) and Kidney, use Ban Long Wan (Spotted Dragon Pill). To soothe and tonify the Middle Earth, use Zhi Zhu Wan (Magnolia and Immature Citrus Pill). To guard and tonify the Heart and Spleen, use Gui Pi Wan (Restore the Spleen Pill). For Spleen Dampness and Kidney Dryness, use Hei Di Huang Wan (Black Earth Rehmannia Pill). For major tonification of Essence and Qi, use Tian Zhen Wan (Heavenly True Pill). To ascend and descend the Spleen and Stomach, use Ping Wei San (Peace the Stomach Powder). To block and secure the Yangming, use Yu Yu Liang Chi Shi Zhi Wan (Halloysite and Red Halloysite Pill). To restore previous decoction therapies, use Wu Ren Tang (Five Seeds Decoction). To skillfully manage post-illness Yuan Xu (Primordial Deficiency), use Yang Ying Tang (Nourish the Camp Decoction).