血随气布（四字精细）要循经，失（其常）度奔腾若迅霆，寒（冬寒）则麻黄（汤加减，盖以麻黄能散
血，行于经络、肌腠、皮毛，环转流行不息，是不致上溢、下溢之患矣。李东垣麻黄人参芍
药汤暗合此意，张隐庵用紫苏梗，时贤用荆芥亦同）温（春温）桂去，秋宜泻白（散）夏膏灵（竹叶石膏
汤或白虎汤皆以石膏为主，）四生（丸）妙在鲜荷艾，六味（汤）功归泽泻苓，解到理中（汤）黄土汤外，
道行脉络竹皮青。
任（脉）冲（脉）血海督（脉）司权，专取奇经得秘传，续断三钱同侧柏，鹿茸一具断红丸（侧柏叶炒
香，续断酒炒各三钱，各鹿茸一具酥炙，醋煮阿胶为丸，每服四、五十丸，乌梅汤、人参汤任
下。鹿茸有血，任冲之血最盛，从督而布护也。此为下血久不止症，深一层以用药。
血虽阴类运阳和（《内经》及汉唐诸家秘旨，）运籍黄 （黄 质轻而行速，取其善运）用倍多
，少佐当归阴得主（阴以阳为主，得主有常，则所行不妄，）笑他门外怪云何（甲子岁，余治某下
血症，议用此方，门外汉以黄 作胀阻之，另服止血套药，愈后变症百出。
喘促者，气上冲而不得倚息也。与痰饮，咳嗽，哮症参观。有内外虚实四证；外证为风
寒，以小青龙汤加杏仁主之。内证为水饮，以小半夏汤加茯苓八钱主之。实证非气闭不开即
肺胀不约，气闭因支饮壅满，呼吸不能自如，以葶苈大枣泻肺汤主之；肺胀其人喘，目如脱
状，脉浮大者，以越婢加半夏汤主之。虚证非脾虚不能转运即肾虚不能吸纳，脾虚以六君子
汤加干姜、细辛、五味子主之；肾虚宜真武汤，黑锡丹主之；亦有气短为微饮，宜从小便主
之。出气短者，宜苓桂甘术汤；入气短者，宜肾气丸。此证不尽属于热，缘《内经》有“诸
逆上冲，皆属于火”句，故属于热证。
Blood follows the distribution of Qi (these four characters are precise and subtle), and must follow the meridians; if it loses its normal regulation, it surges like a swift thunderbolt.
In winter, when affected by cold, Ma Huang Tang (Ephedra Decoction) should be used with modifications, because Ephedrae Herba (Mahuang, 麻黄) can disperse blood stasis, allowing it to circulate endlessly through the meridians, muscle interstices, and skin/hair follicles, thereby preventing the disaster of blood overflowing upwards or downwards. Li Dongyuan's Ma Huang Ren Shen Shao Yao Tang (Ephedra, Ginseng, and Peony Decoction) implicitly conforms to this idea; Zhang Yin'an uses Perillae Caulis (Zi Su Geng, 紫苏梗), and contemporary experts use Schizonepetae Herba (Jing Jie, 荆芥), for the same reason.
In spring, when affected by warmth, Cinnamon Twig (Gui Zhi, 桂枝) should be removed; in autumn, Xie Bai San (Drain White Powder) is suitable; in summer, pastes/decoctions are effective, such as Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) or Bai Hu Tang (White Tiger Decoction), both of which take Gypsum (Shi Gao, 石膏) as the main ingredient.
Si Sheng Wan (Four Generations Pill) is ingenious in its use of fresh Lotus Leaf (He Ye, 荷叶) and Mugwort Leaf (Ai Ye, 艾叶); Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) derives its merit from Alisma Rhizoma (Ze Xie, 泽泻) and Poria (Fu Ling, 茯苓).
Beyond understanding Li Zhong Tang (Regulate the Middle Decoction) and Huang Tu Tang (Yellow Earth Decoction), one can master the principles of regulating collaterals and clearing heat using formulas like Zhu Pi Da Wan (Bamboo Peel Great Pill).
The Ren Mai (Conception Vessel), Chong Mai (Penetrating Vessel), and Du Mai (Governor Vessel) jointly govern the Blood Sea; specifically targeting the Extraordinary Vessels yields secret transmission techniques.
Dipsaci Radix (Xu Duan, 续断) three qian combined with Platycladi Cacumen (Ce Bai Ye, 侧柏叶), along with one Antler of Sika Deer (Lu Rong, 鹿茸), constitutes Duan Hong Wan (Stop Red Pill) [Preparation: Platycladi Cacumen stir-fried until fragrant, Dipsaci Radix wine-fried, each three qian; Antler of Sika Deer roasted in butter, then boiled in vinegar with Donkey-hide Gelatin (E Jiao, 阿胶) to form pills; take 40–50 pills per dose, washed down with Mume Decoction or Ginseng Decoction at will. The antler contains blood; the blood of the Ren and Chong vessels is most abundant, distributed and protected via the Du vessel. This is a deeper-level medication strategy for chronic bleeding that does not stop].
Although blood belongs to Yin, it requires the harmony of Yang for transport (this is the secret intent of Neijing and various schools from the Han and Tang dynasties). Transport relies mainly on Astragali Radix (Huang Qi, 黄芪) [Astragali Radix is light in quality and fast in action, taken for its ability to promote movement]; the dosage should be doubled. A small amount of Angelicae Sinensis Radix (Dang Gui, 当归) is added so that Yin finds its Master (Yin is governed by Yang; having a master and maintaining regularity ensures blood does not flow recklessly). How can one laugh at those outsiders who claim otherwise? (In the year Jiazi, I treated a patient with lower bleeding syndrome and proposed this formula. An outsider obstructed it, claiming Astragali Radix would cause distension, and advised taking standard hemostatic drugs instead. After recovery, myriad complications arose.)
Chuan Cu (Panting/Dyspnea) refers to Qi rushing upward without the ability to lean on breathing for support. It should be studied in conjunction with Phlegm-Fluids (Tan Yin, 痰饮), Cough (Ke Sou, 咳嗽), and Asthma (Xiao Zheng, 哮证).
There are four syndromes: External, Internal, Deficiency, and Excess.
The External syndrome is caused by Wind-Cold, primarily treated with Xiao Qing Long Tang (Minor Green Dragon Decoction) plus Apricot Kernel (Xing Ren, 杏仁).
The Internal syndrome is caused by Fluid retention, primarily treated with Xiao Ban Xia Tang (Minor Pinellia Decoction) plus Poria (Fu Ling, 茯苓) eight qian.
The Excess syndrome involves either Qi closure not opening or Lung distension lacking restraint. Qi closure is due to Branch-Fluids (Zhi Yin, 支饮) being congested and full, making breathing difficult; it is primarily treated with Ting Li Da Zao Xie Fei Tang (Descurainia Seed and Jujube Decoction to Drain the Lungs). Lung distension presents with panting, eyes protruding as if falling out, and a floating, large pulse; it is primarily treated with Yue Bi Jia Ban Xia Tang (Yuebi Plus Pinellia Decoction).
The Deficiency syndrome involves either Spleen deficiency failing to transport or Kidney deficiency failing to grasp Qi. Spleen deficiency is primarily treated with Liu Jun Zi Tang (Six Gentlemen Decoction) plus Dried Ginger (Gan Jiang, 干姜), Asarum Root (Xi Xin, 细辛), and Schisandra Fruit (Wu Wei Zi, 五味子). Kidney deficiency is primarily treated with Zhen Wu Tang (True Warrior Decoction) or Hei Xi Dan (Black Pellet Pill). There are also cases where shortness of breath is due to slight fluid retention, best treated by promoting urination.
Shortness of breath upon exhalation is treated with Ling Gui Gan Zhu Tang (Poria, Cinnamon Twig, Licorice, and Atractylodes Macrocephala Decoction); shortness of breath upon inhalation is treated with Shen Qi Wan (Kidney Qi Pill).
This condition does not entirely belong to Heat syndromes; because Neijing states "All rebellious upward rushing belongs to Fire," it is often mistakenly categorized as a Heat syndrome.