论
《内经》曰∶大怒则形气绝而血菀于上。又曰∶怒则气逆，甚则吐血。又曰∶阳明厥逆，喘咳身热，善惊衄呕血。
又曰湿淫汗出为鼽衄。又曰∶脾移热于肝，则为惊衄。胞移热于膀胱，则癃而溺血。又曰∶结阴者，便血一升，再结二
升，三结三升。又曰∶卧则血归肝，肝受血而能视（一云目得血而能视，此云肝者，盖目为肝之外候），足受血而能步，
掌受血而能握，指受血而能摄。又曰∶心出血，肝纳血。肺出气，肾纳气。夫人身之气血者，情性之所根据附，并行不悖，
循环无端。经曰∶一息不运则机缄穷，一毫不续则穹壤判。若夫暴喜伤心，则气缓而心不出血，故肝无所受。或暴怒伤
肝，则气逆而肝不纳血，故其血无所归。又若房劳过度，以致阴火沸腾，血从火起，故错经而妄行也。是以从肺而上溢
于鼻者，曰衄血。从胃而上溢于口者，曰呕血。夫所谓络血唾血者，出于肾也。咳血嗽血者，出于肺也。有痰带血丝出
者，或从肾或从肺来也。其血出于小便者，曰溺血，曰血淋。出于大便者，曰肠风痔血。粪前来者曰近血，粪后来者曰
远血，流结于肠胃之间而成积者曰血瘕血蔑。大抵血从下流者为顺，易治；血从上溢者为逆，难治。丹溪曰∶口鼻出血；
皆是阳盛阴虚，有升无降，血随气上，越出上窍，法当补阴抑阳，气降则血归经。又曰∶诸见血为热证。正经所谓知其
要者，一言而终，不知其要者，流散无穷，此之谓也。
脉法
《内经》曰∶脉来如悬钩，为衄血常脉。脉至而搏，血衄身热者死。肠 下脓血，脉悬绝则死，滑大则生，血温身
热者死。
《脉经》曰∶脉得诸涩濡弱，为亡血，脉来轻轻在肌肉，尺中自浮，目睛晕黄，衄血未止；晕黄去，目睛慧了，知
衄当止。太阳脉大而浮，必衄吐血。
病患面无血色，无寒热，脉沉弦者，衄也。
脉浮弱，手按之绝者，下血；烦咳者，必吐血。
脉极虚芤迟，为清谷、亡血、失精。
脉芤为失血，涩为少血。
脉弦而紧，胁痛，肝脏伤，主有瘀血。
吐血唾血，脉滑小弱者生，实大者死。
唾血，脉坚强者死，滑濡者生。
方法
丹溪曰∶口鼻出血，皆是阳盛阴虚，有升无降，血随气上，越出上窍，法当补阴抑阳，气降则血归经。
按∶此语虽见前论，盖一章之大旨，故重录以示学人。
衄血，凉血行血为主，犀角地黄汤入郁金。
一方 用荆芥穗研服，或用萝卜上半段杵汁服，又以汁滴入鼻窍中，或灸大椎及哑门穴二、三壮，俱可止之。
《本草衍义》以萱草叶洗净，研汁一盏，入生姜汁三分之一，细细呷之，治大热衄血。
吐血是火载血上，错经妄行，脉必大而芤（大则发热，芤则热失血。）
大法，四物汤加炒栀子、童便、姜汁、竹沥。
─方 用韭汁（一方，凡血逆行，或吐血，或唾血，或见血腥气，用韭汁服之最妙）、童便、姜汁磨入郁金饮之，其
血自清。如无郁金，以山茶花代之。一方，用郁金末，以姜汁、童便和好酒调服。
吐血，大全良方四生丸甚妙（亦治衄血）。
又方 童便调香附末服之。
又方 童便二分，酒一分，擂侧柏叶，温饮之。
吐血亦有因怒而得者，经曰∶怒则气逆，甚则呕血。
一方 治吐血不止，用干姜炮为末，童便调服。
山栀子，最能清胃脘之血。
有先吐血、后有痰者，是阴虚火盛，四物汤为主，加痰火药。若先吐痰而后血多者，是积热，降痰火为急。
有暴吐紫血成块者，是热伤血结于中，吐出为好，用四物汤加清热等药调之。
唾血（鲜血随唾而出）出于肾，亦有瘀血内积，肺气壅遏，不能下降，用天门冬、麦门冬、知母、贝母、桔梗、黄
柏、熟地黄、远志，或加干姜。
咳血（嗽出痰内有血）痰盛心热，多是血虚，用青黛、栝蒌仁、诃子、贝母、海石、山栀子为末，姜汁蜜丸噙化，
嗽盛者加杏仁，后以八物汤加减调理（痰盛者宜更加痰药）。
咯血，用姜汁、童便、青黛入血药中用，如四物汤、地黄膏、牛膝膏之类（有咯血痰带血丝出者同治，但宜加痰药）。
舌上无故出血如线，用槐花炒为末掺之。一方，用蒲黄炒焦为末敷之，极妙。
大便下血，有热有虚，热用四物汤加炒山栀子、升麻、秦艽、阿胶，虚用四物汤加干姜（炮）、升麻。
便血，用白芷、五倍子为丸服效。
便血，有风邪下陷者，盖风伤肝，肝生血故也，宜升提之，四物汤加防风、荆芥、升麻、柴胡、秦艽、槐花、条芩、
地榆、枳壳，煎服。
有湿伤血者，宜行湿清热，苍术、白术、黄连、黄柏、当归，川芎、芍药、地榆、槐花，水煎服之。
因积热下血，用苍术、陈皮各一两半，连翘五钱，黄连、黄芩、黄柏各七钱半，炒为末，生地黄膏丸服。
肠风下血，独在胃与大肠出，用黄芩、秦艽、槐角、青黛、升麻。
一方 用大黄、煨桃仁（去尖另研）各三钱，当归、槟榔、皂角仁、黄柏、荆芥穗、枳壳各五钱， 皮（炙黄）、黄
连（炒）、秦艽、槐角子各一两。上为末，面糊为丸，如梧桐子大，每服五十丸，白汤送下。如鲜血下甚者，棕榈灰、莲
房灰各五钱。
凡经血逆行，或血腥，或吐血、唾血，用韭汁服，自清。
（以上丹溪方法凡二十七条）
人参饮子（东垣） 治衄血。
麦门冬 当归身 白芍药 甘草（各一钱） 人参 黄 （各一钱五分） 五味子（九枚）
上细切，作一服，水一盏半，煎至一盏，温服。
痰涎杂血出于脾，葛根、黄 、芍药、黄连、川归、沉香末、甘草，水煎服。（丹溪）
三黄补血汤（东垣） 治吐血。
黄 川归 柴胡（各一钱） 熟地黄 川芎（各一钱五分） 芍药 生地黄（各二钱） 牡丹皮 升麻（各五分）
上细切，作一服，水二盏，煎至一盏，温服。
一方 治痰嗽吐血。
红花 杏仁（去皮尖，另研） 紫菀茸 鹿茸（酥炙） 枇杷叶（拭去毛，姜汁涂炙黄） 木通（各一两） 大黄
（五钱）
上为细末，蜜丸龙眼大，噙化。
黄 散（东垣） 治咳血成劳。
黄 麦门冬 熟地黄 桔梗 白芍药（各一钱） 甘草（五分）
上细切，作一服，水一盏半，煎至一盏，去渣温服。
一方 治痰带血咳出。
白术（一钱五分） 川归 芍药 牡丹皮（各一钱） 桃仁（五分，研） 栀子（七分半，炒黑色） 生甘草（三
分） 麦门冬（五分）
上细切，水一盏半，煎至一盏，去渣温服。
鸡苏散（济生） 治劳伤肺经，咳嗽有血。
鸡苏（即薄荷） 黄 （各五分） 生地黄 阿胶珠 贝母 白茅根（各一钱） 桔梗 麦门冬 蒲黄（炒黑色） 甘
草（各五分） 细切，水煎服。
薏苡仁散（东垣） 治肺损嗽血。
薏苡仁（不拘多少）
上一味，研细末，以 猪肺一个煮熟，蘸药食之。
又方（丹溪） 用猪心一个，竹刀 开，入沉香末一钱重，大半夏七个，入在心中，纸包数重，外以童子小便
沃湿， 火煨熟，取去半夏吃之，嗽血、吐血皆效。
一方（丹溪） 治溺血，山栀子饮。
栀子（不拘多少，炒黑色）
上为细末，水煎，连渣服。
一方（丹溪） 用小蓟根、琥珀二味为末，水煎服之。盖二物能治下焦热结血淋。
又方（丹溪） 治溺血神效。
生地黄（四钱二分） 小蓟根 滑石 通草（炒） 蒲黄（炒） 淡竹叶 藕节 当归（酒浸） 山栀子（炒黑色）
甘草（炙，各七分）
上细切，作一服，水二盏，煎至一盏，去渣温服。
治溺血因血虚者，用四物汤加牛膝膏服。（丹溪）
一方 治溺血。用五苓散合四物汤煎服效。（丹溪）
凡用血药，不可单行单止，又不可纯用寒凉药，必加辛温升药，如加凉药用酒煮、酒炒之类，乃寒因热用之法也。
（丹溪）
（局方）一方 治小儿尿血。用甘草、升麻煎汤，调益元散。
犀角地黄汤（局方） 治衄血及吐红。
犀角（镑） 赤芍药 牡丹皮 生地黄（各一钱）
上细切，作一服，水煎，食后服。
四生丸（局方） 治吐血、衄血，阳乘于阴，血热妄行。
生荷叶 生艾叶 生地黄 生侧柏叶
上各等分细研，为丸如弹子大，每服一丸，水煎或盐汤化下。
圣饼子（丹溪） 治咯血。
青黛（一钱） 杏仁（四十个，以黄蜡煎炒黄色）
上研杏仁细，入青黛捏作饼子，用时以柿饼一个破开，以药饼置于柿中合定，湿纸包，炮煨，连柿饼研细，米饮调
下。
地榆汤（东垣） 治结阴便血不止，渐而极多。
地榆（四钱） 生甘草（一钱五分） 炙甘草（一钱） 缩砂（七枚，另研）
上细切，作一服，水一盏半，煎至一盏，温服。
结阴丹（东垣） 治结阴肠风脏毒下血等证。
枳壳（炒） 葳灵仙 黄 陈皮 樗根皮 何首乌 荆芥穗（各等分）
上细末，酒糊为丸，如梧桐子大，每服五、七十丸，清米饮入醋少许送下。
椿皮散 治血痢及肠风下血，神验。
樗根白皮（二两） 槐角仁（四两） 枯白矾（二两） 炙甘草（一两）
上为细末，每服三钱，清米饮调下。
乌梅丸 治大便下血如神。
僵蚕（一两，炒） 乌梅肉（一两五钱）
上为细末，醋糊为丸，醋汤下三、五十丸，空心服。
槐花散（本事） 治肠风脏毒下血。
槐花（炒） 侧柏叶（杵） 荆芥穗 枳壳（麸炒黄色）
上各等分为末，每服二钱，空心米饮调下。
加减四物汤（东垣） 治肠风下血。
侧柏叶 生地黄 当归 川芎（各八分） 枳壳（麸炒） 荆芥穗 槐花（炒） 甘草（炙，各四分） 地榆 条
黄芩 防风（各六分） 乌梅（大者，一个）
上细切，作一服，加生姜三片，煎至一盏，去渣空心温服。
当归和血散（东垣） 治肠 湿毒下血。
槐花（炒） 青皮（各六分） 当归身 升麻（各一钱） 川芎（四分） 荆芥穗 熟地黄 白术（各六分）
上为细末，每服三钱，米饮调下。
枳壳散 东垣曰∶血清而色鲜者肠风，血浊而黯者为脏毒，粪前来者为近血，粪后来者为远血，此药并皆治之。
枳壳（十两，麸炒黄色） 甘草（三钱，炙）
上为细末，每服一钱，空心米饮调，送下酒煮黄连丸。
酒煮黄连丸（东垣）
黄连（去须，十二两） 好酒（五升）
上将黄连细切，以银石器盛酒，煮黄连待酒干尽为度，焙干为末，面糊为丸，如梧桐子大，每服三十丸，空心服。
秘方枳壳汤（局方） 治大便肠风下血。
枳壳（一两，麸炒黄色） 黄连（二两，以槐花四两同炒，去槐花不用）
上二味，量水煎浓汁，食前温服。
槐角丸（局方） 治五种肠风下血，痔漏脱肛，并皆治之。
槐角（二两，炒） 地榆 黄芩 当归 防风 枳壳（麸炒，各一两）
上为细末，酒面糊为丸，如梧桐子大，每服五十丸，空心清米饮送下。
升阳去热和血汤（东垣） 治肠 下血，另作一派，其唧唧然出者，有力而远，四散如筛，肠腹中作痛，热毒
所作也。
陈皮（二分） 熟地黄 当归身 苍术 秦艽 肉桂（各三分） 生地黄 牡丹皮 生甘草（各五分） 升麻（七
分） 炙甘草 黄 （各一钱） 白芍药（一钱五分）
上细切，作一服，水二盏，煎至一盏，食前稍热服。
升阳补胃汤（证治及详，见《兰室秘藏》泻痢门。）
生地黄散 治郁热衄血、咯血、吐血等证。
枸杞子 柴胡 黄连 地骨皮 天门冬 白芍药 甘草 黄芩 黄 生地黄 熟地黄（各五分）
上细切，作一服，水一盏半，煎至一盏，温服。
玉屑膏 治热血。
黄 人参
上二味，各等分为末，用萝卜大者，切片浓一指许四、五片，蜜淹少时，蘸蜜炙干，尽蜜二两为度，勿令焦，点
药未吃，不拘时，仍用盐汤送下。
龙骨散 治衄血不止。凡九窍出血，皆可止之。
龙骨（不拘多少）
上一味细研，次入臭中即止。
麝香散 治鼻衄不止。
白矾（枯） 龙骨（各五钱） 麝香（一分半）
上各另研和匀，每用时，先以冷水洗鼻孔净，然后用药吹入孔内，或以湿纸捻蘸入亦妙。
经验方 治泻血。
百药煎（一两，以五钱烧灰存性）
上共研细，饭丸如梧桐子大，每服三、四十丸。或以米汤调下末子二、三钱亦可。
又方 治前证。
用干柿饼烧灰存性，清米饮调下二、三钱，立止。
桃仁承气汤 治男子妇人血结胸，手不可近，及中焦蓄血，妄言见鬼，昏迷如狂，及久病胃脘疼痛，蓄血等证。
抵当汤 治下部蓄血，脐下结痛满硬等证。（二方并见伤寒门）
[丹溪活套]云∶凡诸见血证，皆是阳盛阴虚，君相二火亢甚，煎迫其血而出诸窍也，悉宜四物汤加知母、黄柏补
阴降火之剂为主治。如衄血、咳血或痰带血丝出者，皆从肺中来也，本方加酒洗蒲黄、黄芩、茅花等药，以泻肺火。
如呕血、吐血，此从胃中来也，本方加石膏、知母等药，以泻胃火。唾血、咯血及潮热咳血，此血从肾中来也，本方用
Treatise
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: Great anger causes the form and qi to sever, with blood stagnating in the upper body. It also states: Anger causes qi to rebel; in severe cases, hematemesis (vomiting blood) occurs. It further states: Rebellious qi of the Yangming channel leads to panting, coughing, fever, fright, epistaxis (nosebleed), and hematemesis.
It also states: Excessive dampness causing sweating leads to rhinorrhea and epistaxis. It states: Heat transferred from the Spleen to the Liver results in fright and epistaxis. Heat transferred from the Bladder leads to strangury (difficulty urinating) and hematuria (blood in urine). It states: In Jie Yin syndrome (yin binding), there is one sheng of melena upon first occurrence, two shengs upon recurrence, and three shengs upon third recurrence. It states: When lying down, blood returns to the Liver; when the Liver receives blood, vision is possible (another version says the eyes receive blood to see; mentioning the Liver here implies the eyes are the external manifestation of the Liver); when the feet receive blood, walking is possible; when the palms receive blood, grasping is possible; when the fingers receive blood, holding is possible. It states: The Heart expels blood, and the Liver stores it. The Lungs exhale qi, and the Kidneys grasp it. Qi and blood in the human body are the foundation of temperament and nature, running parallel without contradiction, circulating endlessly. The classics say: If movement ceases for even a breath, the mechanism of life is exhausted; if continuity is broken by even a hair's breadth, the distinction between heaven and earth (life and death) becomes apparent. If excessive joy injures the Heart, qi becomes slack, and the Heart fails to expel blood properly, leaving the Liver without anything to receive. Or if excessive anger injures the Liver, qi rebels, and the Liver fails to store blood, leaving the blood without a place to return. Furthermore, excessive sexual activity causes ministerial fire to boil, and blood rises with the fire, leading to irregular menstruation and reckless flow. Therefore, blood overflowing from the Lungs into the nose is called epistaxis. Blood overflowing from the Stomach into the mouth is called hematemesis.所谓 "luo xue" (collateral bleeding) and "tuo xue" (spitting blood) originate from the Kidneys. "Ke xue" (coughing blood) originates from the Lungs. Blood mixed with phlegm and coming out as streaks may come from either the Kidneys or the Lungs. Blood discharged via urination is called "niao xue" (hematuria) or "xue lin" (blood strangury). Blood discharged via defecation is called "chang feng" (intestinal wind) or "zhi xue" (hemorrhoidal bleeding). Blood appearing before stool is called "jin xue" (proximal blood); blood appearing after stool is called "yuan xue" (distal blood). Blood accumulating between the intestines and stomach forming masses is called "xue jia" (blood mass) or "xue mie". Generally, blood flowing downward is considered favorable and easy to treat; blood overflowing upward is considered unfavorable and difficult to treat. Zhu Danxi said: Bleeding from the mouth and nose is due to excess yang and deficiency yin, with rising but no descending, causing blood to follow rebellious qi and escape through the upper orifices. The treatment method should be to tonify yin and suppress yang; when qi descends, blood returns to its vessels. He also said: All manifestations of bleeding are heat syndromes. The classics say: Those who know the essence can conclude with one word; those who do not know the essence will scatter infinitely. This is what is meant.
Pulse Diagnosis
The *Huangdi Neijing* states: A pulse that feels like a hanging hook indicates epistaxis as a common pulse pattern. A pulse that comes with a beating sensation, accompanied by epistaxis and fever, indicates a fatal prognosis. Purulent bloody stools with a suspended-extreme pulse indicate death; a slippery-large pulse indicates survival; warm blood with fever indicates death.
The *Mai Jing* (Pulse Classic) states: Pulses presenting as various types of choppy, soggy, or weak pulses indicate loss of blood. A pulse felt lightly in the muscle layer, with the chi position floating naturally, and yellow halos around the eyes, indicates ongoing epistaxis; when the yellow halos disappear and the eyes become clear, it is known that epistaxis will cease. A Taiyang pulse that is large and floating必然 leads to epistaxis or hematemesis.
A patient with a pale face lacking color, without chills or fever, and with a deep-chord-like pulse, is experiencing epistaxis.
A floating-weak pulse, which feels interrupted upon pressure, indicates lower body bleeding; irritability and coughing indicate inevitable hematemesis.
An extremely deficient, knotted, and slow pulse indicates diarrhea with undigested food, loss of blood, or seminal emission.
A knotted pulse indicates loss of blood; a choppy pulse indicates scant blood.
A chord-like and tight pulse with hypochondriac pain indicates liver injury and primarily involves blood stasis.
For hematemesis and spitting blood, a slippery-small-weak pulse indicates survival; a solid-large pulse indicates death.
For spitting blood, a firm pulse indicates death; a slippery-soggy pulse indicates survival.
Methods
Zhu Danxi said: Bleeding from the mouth and nose is due to excess yang and deficiency yin, with rising but no descending, causing blood to follow rebellious qi and escape through the upper orifices. The treatment method should be to tonify yin and suppress yang; when qi descends, blood returns to its vessels.
Note: Although this statement appeared in the previous discussion, it serves as the main theme of this chapter, so it is recorded again to instruct learners.
For epistaxis, the primary approach is cooling blood and promoting blood circulation, using Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) with Yu Jin (Curcuma aromatica Rhizome).
One formula: Use Jing Jie Sui (Schizonepeta Spike) ground into powder for oral administration, or use juice pressed from the upper half of a radish for drinking, and drip the juice into the nasal cavity. Alternatively, moxa on Da Zhui (GV14) and Ya Men (GV15) acupoints for two or three moxa cones can stop the bleeding.
Ben Cao Yan Yi (Extension of Materia Medica) records: Wash Xuann Cao Ye (Daylily Leaf), press one cup of juice, add one-third cup of Sheng Jiang Zhi (Fresh Ginger Juice), and sip slowly to treat severe heat-induced epistaxis.
Hematemesis is fire carrying blood upward, causing erratic flow; the pulse must be large and knotted (large indicates fever, knotted indicates heat and blood loss).
The general method is Si Wu Tang (Four Substances Decoction) added with Chao Zhi Zi (Stir-fried Gardenia Fruit), Tong Bian (Child's Urine), Jiang Zhi (Ginger Juice), and Zhu Li (Bamboo Sap).
One formula: Use Jiu Zhi (Leek Juice) (Another note says: For any reverse flow of blood, whether hematemesis, spitting blood, or smelling a metallic scent, taking leek juice is best), Tong Bian (Child's Urine), Jiang Zhi (Ginger Juice), and Yu Jin (Curcuma aromatica Rhizome) ground together for drinking; the blood will naturally clear. If Yu Jin is unavailable, Shan Cha Hua (Camellia Flower) can substitute. Another formula: Use Yu Jin powder, mixed with Jiang Zhi (Ginger Juice), Tong Bian (Child's Urine), and good wine for oral administration.
For hematemesis, Si Sheng Wan (Four Raw Pills) from Da Quan Liang Fang is very effective (also treats epistaxis).
Another formula: Take Xiang Fu powder (Cyperus Rotundus Rhizome) mixed with Tong Bian (Child's Urine).
Another formula: Mix two parts Tong Bian (Child's Urine) with one part wine, grind Ce Bai Ye (Biota Tops) until warm, then drink.
Hematemesis can also result from anger; the classics state: Anger causes qi to rebel, leading to hematemesis in severe cases.
One formula: To treat persistent hematemesis, use Gan Jiang (Dried Ginger) roasted into powder, taken with Tong Bian (Child's Urine).
Shan Zhi Zi (Gardenia Fruit) is best at clearing heat from the stomach region.
If hematemesis is followed by phlegm, it indicates yin deficiency with hyperactive fire; use Si Wu Tang (Four Substances Decoction) as the base, adding herbs for phlegm-fire. If profuse phlegm precedes heavy bleeding, it indicates accumulated heat; resolving phlegm-fire is urgent.
If sudden expulsion of purple blood clots occurs, it indicates heat injuring blood and coagulating in the middle jiao; expulsion is beneficial. Use Si Wu Tang (Four Substances Decoction) added with heat-clearing herbs for regulation.
Spitting blood (fresh blood mixed with saliva) originates from the Kidneys. It may also involve internal blood stasis and lung qi obstruction preventing descent. Use Tian Dong (Asparagus Root), Mai Dong (Ophiopogon Tuber), Zhi Mu (Anemarrhena Rhizome), Bei Mu (Fritillaria Bulb), Jie Geng (Platycodon Root), Huang Bo (Phellodendron Bark), Shu Di Huang (Prepared Rehmannia Root), Yuan Zhi (Polygala Root), or add Gan Jiang (Dried Ginger).
Coughing blood (blood in sputum) with abundant phlegm and heart heat is mostly due to blood deficiency. Use Qing Dai (Indigo Naturalis), Gua Lou Ren (Trichosanthes Seed), He Zi (Chebulic Myrobalan), Bei Mu (Fritillaria Bulb), Hai Shi (Floating Stone), and Shan Zhi Zi (Gardenia Fruit) ground into powder, formed into pills with ginger juice and honey for sucking. Add Xing Ren (Apricot Seed) for severe coughing. Later, regulate with Ba Wu Tang (Eight Substances Decoction) modified (add more phlegm-resolving herbs if phlegm is abundant).
For hacking blood, use Jiang Zhi (Ginger Juice), Tong Bian (Child's Urine), and Qing Dai (Indigo Naturalis) added to blood-invigorating medicines, such as Si Wu Tang (Four Substances Decoction), Di Huang Gao (Rehmannia Paste), or Niu Xi Gao (Achyranthes Paste) (Cases with hacking blood and blood-streaked sputum are treated similarly, but add phlegm-resolving herbs).
For spontaneous linear bleeding from the tongue, use Chai Hua (Sophora Flower) roasted into powder applied locally. One formula: Use Pu Huang (Typha Pollen) roasted until charred, ground into powder for application, which is excellent.
Lower gastrointestinal bleeding presents as heat or deficiency syndromes. For heat, use Si Wu Tang (Four Substances Decoction) added with Chao Shan Zhi Zi (Stir-fried Gardenia), Sheng Ma (Cimicifuga Rhizome), Qin Jiao (Gentiana Macrophylla Root), and E Jiao (Donkey-hide Gelatin). For deficiency, use Si Wu Tang (Four Substances Decoction) added with Gan Jiang (Dried Ginger, roasted) and Sheng Ma (Cimicifuga Rhizome).
For melena, use Bai Zhi (Angelica Dahurica Root) and Wu Bei Zi (Gallnut) made into pills for effective treatment.
For melena caused by wind pathogen sinking, since wind injures the Liver and the Liver generates blood, lifting therapy is appropriate. Use Si Wu Tang (Four Substances Decoction) added with Fang Feng (Saposhnikovia Root), Jing Jie (Schizonepeta), Sheng Ma (Cimicifuga Rhizome), Chai Hu (Bupleurum Root), Qin Jiao (Gentiana Macrophylla Root), Huai Hua (Sophora Flower), Tiao Huang Qin (Scutellaria Root), Di Yu (Sanguisorba Root), and Zhi Ke (Aurantii Fructus), decocted and taken orally.
For blood injured by dampness, promote dampness resolution and heat clearance. Use Cang Zhu (Atractylodes Rhizome), Bai Zhu (Atractylodes Macrocephala Rhizome), Huang Lian (Coptis Rhizome), Huang Bo (Phellodendron Bark), Dang Gui (Angelica Sinensis Root), Chuan Xiong (Ligusticum Rhizome), Shao Yao (Peony Root), Di Yu (Sanguisorba Root), and Huai Hua (Sophora Flower), decocted in water.
For lower bleeding due to accumulated heat, use Cang Zhu (Atractylodes Rhizome) and Chen Pi (Citrus Reticulata Peel) each 1.5 liang, Lian Qiao (Forsythia Fruit) 5 qian, Huang Lian (Coptis Rhizome), Huang Qin (Scutellaria Root), and Huang Bo (Phellodendron Bark) each 7.5 qian. Stir-fry into powder, make pills with Sheng Di Huang paste (Raw Rehmannia Root).
Intestinal wind bleeding discharges only from the Stomach and Large Intestine. Use Huang Qin (Scutellaria Root), Qin Jiao (Gentiana Macrophylla Root), Huai Jiao (Sophora Fruit), Qing Dai (Indigo Naturalis), and Sheng Ma (Cimicifuga Rhizome).
One formula: Use Da Huang (Rhubarb Rhizome) and Wei Tao Ren (Simmered Peach Kernel, de-husked and ground separately) each 3 qian, Dang Gui (Angelica Sinensis Root), Bing Lang (Areca Seed), Zao Jiao Ren (Gleditsia Spine Kernel), Huang Bo (Phellodendron Bark), Jing Jie Sui (Schizonepeta Spike), and Zhi Ke (Aurantii Fructus) each 5 qian, Rou Pi (Cinnamon Bark, roasted yellow), Huang Lian (Coptis Rhizome, stir-fried), Qin Jiao (Gentiana Macrophylla Root), and Huai Jiao Zi (Sophora Fruit) each 1 liang. Grind all into fine powder, make pills with flour paste size of Sophora seeds. Take 50 pills per dose with warm water. If fresh blood discharge is severe, add Zong Lu Hui (Date Palm Fiber Ash) and Lian Fang Hui (Lotus Pod Ash) each 5 qian.
For any reverse flow of menstrual blood, metallic smell, hematemesis, or spitting blood, take Leek Juice; the blood will naturally clear.
(Above are twenty-seven methods from Danxi.)
Ren Shen Yin Zi (Li Dongyuan) Treats Epistaxis.
Mai Dong (Ophiopogon Tuber), Dang Gui Shen (Angelica Sinensis Root Tip), Bai Shao Yao (White Peony Root), Gan Cao (Licorice Root) (each 1 qian); Ren Shen (Ginseng Root), Huang Qi (Astragalus Root) (each 1.5 qian); Wu Wei Zi (Schisandra Berry) (9 berries).
Cut finely, prepare as one dose. Add 1.5 cups of water, decoct to 1 cup. Take warm.
Phlegm-saliva mixed with blood originating from the Spleen: Ge Gen (Kudzu Root), Huang Qi (Astragalus Root), Shao Yao (Peony Root), Huang Lian (Coptis Rhizome), Chuan Gui (Angelica Sinensis Root), Chen Xiang Mu (Aquilaria Wood Powder), Gan Cao (Licorice Root). Decoct in water and take. (Zhu Danxi)
San Huang Bu Xue Tang (Three-Yellow Blood-Tonifying Decoction) (Li Dongyuan) Treats Hematemesis.
Huang Qi (Astragalus Root), Chuan Gui (Angelica Sinensis Root), Chai Hu (Bupleurum Root) (each 1 qian); Shu Di Huang (Prepared Rehmannia Root), Chuan Xiong (Ligusticum Rhizome) (each 1.5 qian); Shao Yao (Peony Root), Sheng Di Huang (Raw Rehmannia Root) (each 2 qian); Mu Dan Pi (Moutan Cortex), Sheng Ma (Cimicifuga Rhizome) (each 0.5 qian).
Cut finely, prepare as one dose. Add 2 cups of water, decoct to 1 cup. Take warm.
One formula: Treats Phlegm-Cough with Hematemesis.
Hong Hua (Safflower), Xing Ren (Apricot Kernel, de-husked and de-seeded, ground separately), Zi Wan (Aster Root), Lu Rong (Deer Antler, prepared with butter), Pi Pa Ye (Loquat Leaf, brushed clean of hairs, coated with ginger juice and roasted), Mu Tong (Akebia Stem) (each 1 liang); Da Huang (Rhubarb Rhizome) (5 qian).
Grind into fine powder, make pills with honey size of longan. Suck slowly.
Huang Qi San (Astragalus Powder) (Li Dongyuan) Treats Coughing Blood progressing to Consumption.
Huang Qi (Astragalus Root), Mai Dong (Ophiopogon Tuber), Shu Di Huang (Prepared Rehmannia Root), Jie Geng (Platycodon Root), Bai Shao Yao (White Peony Root) (each 1 qian); Gan Cao (Licorice Root) (0.5 qian).
Cut finely, prepare as one dose. Add 1.5 cups of water, decoct to 1 cup. Strain and take warm.
One formula: Treats Coughing up Blood-Streaked Phlegm.
Bai Zhu (Atractylodes Macrocephala Rhizome) (1.5 qian), Chuan Gui (Angelica Sinensis Root), Shao Yao (Peony Root), Mu Dan Pi (Moutan Cortex) (each 1 qian); Tao Ren (Peach Kernel) (0.5 qian, ground); Zhi Zi (Gardenia Fruit) (0.75 qian, stir-fried black); Sheng Gan Cao (Raw Licorice Root) (0.3 qian); Mai Dong (Ophiopogon Tuber) (0.5 qian).
Cut finely, add 1.5 cups of water, decoct to 1 cup. Strain and take warm.
Ji Su San (Elsholtzia Powder) (Ji Sheng Fang) Treats Lung Meridian Injury from Overwork, Coughing with Blood.
Ji Su (Elsholtzia, i.e., Bo He/Mint), Huang Qi (Astragalus Root) (each 0.5 qian); Sheng Di Huang (Raw Rehmannia Root), E Jiao Zhu (Fried Donkey-hide Gelatin), Bei Mu (Fritillaria Bulb), Bai Mao Gen (Imperata Rhizome) (each 1 qian); Jie Geng (Platycodon Root), Mai Dong (Ophiopogon Tuber), Pu Huang (Typha Pollen, stir-fried black), Gan Cao (Licorice Root) (each 0.5 qian).
Cut finely, decoct in water and take.
Yi Yi Ren San (Coix Seed Powder) (Li Dongyuan) Treats Lung Damage with Coughing Blood.
Yi Yi Ren (Coix Seed) (any amount).
Grind this single herb into fine powder. Cook one pig lung thoroughly, dip in powder, and eat.
Another Formula (Zhu Danxi): Use one pig heart, cut open with a bamboo knife. Insert 1 qian of Chen Xiang Mu (Aquilaria Wood Powder) and seven Ban Xia (Pinellia Tuber). Place inside the heart, wrap tightly in paper, soak externally with child's urine, and roast over charcoal until cooked. Remove Ban Xia and consume. Effective for coughing blood and hematemesis.
One Formula (Zhu Danxi): Treats Hematuria, Shan Zhi Zi Yin (Gardenia Drink).
Zhi Zi (Gardenia Fruit) (any amount, stir-fried black).
Grind into fine powder. Decoct in water, take including the dregs.
One Formula (Zhu Danxi): Use Xiao Ji Gen (Small Thistle Root) and Hu Po (Amber) ground into powder, decocted in water and taken. These two herbs treat lower jiao heat accumulation causing blood strangury.
Another Formula (Zhu Danxi): Highly effective for Hematuria.
Sheng Di Huang (Raw Rehmannia Root) (4.2 qian), Xiao Ji Gen (Small Thistle Root), Hua Shi (Talcum), Tong Cao (Akebia Stem, stir-fried), Pu Huang (Typha Pollen, stir-fried), Dan Zhu Ye (Lophatherum Leaf), Ou Jie (Lotus Node), Dang Gui (Angelica Sinensis Root, soaked in wine), Shan Zhi Zi (Gardenia Fruit, stir-fried black), Gan Cao (Licorice Root, roasted) (each 0.7 qian).
Cut finely, prepare as one dose. Add 2 cups of water, decoct to 1 cup. Strain and take warm.
For hematuria due to blood deficiency, use Si Wu Tang (Four Substances Decoction) added with Niu Xi Gao (Achyranthes Paste). (Zhu Danxi)
One Formula: Treats Hematuria. Combining Wu Ling San (Five-Ingredient Powder with Poria) with Si Wu Tang (Four Substances Decoction) decocted and taken is effective. (Zhu Danxi)
When using blood-invigorating herbs, do not use them singly or solely for stopping bleeding. Do not use purely cold-natured herbs; must add acrid-warm lifting herbs. For example, when using cold herbs, process them with wine boiling or wine frying. This is the method of "cold used with heat." (Zhu Danxi)
(Ju Fang) One Formula: Treats Pediatric Hematuria. Decoct Gan Cao (Licorice Root) and Sheng Ma (Cimicifuga Rhizome) in water, mix with Yi Yuan San (Benefit Primordial Powder).
Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) (Ju Fang) Treats Epistaxis and Hematemesis.
Xi Jiao (Rhinoceros Horn, sliced), Chi Shao Yao (Red Peony Root), Mu Dan Pi (Moutan Cortex), Sheng Di Huang (Raw Rehmannia Root) (each 1 qian).
Cut finely, prepare as one dose. Decoct in water. Take after meals.
Si Sheng Wan (Four Raw Pills) (Ju Fang) Treats Hematemesis and Epistaxis due to Yang invading Yin, causing reckless blood flow from heat.
Sheng He Ye (Raw Lotus Leaf), Sheng Ai Ye (Raw Mugwort Leaf), Sheng Di Huang (Raw Rehmannia Root), Sheng Ce Bai Ye (Raw Biota Tops).
Mix equal parts, grind finely, make pills size of marbles. Take one pill per dose, decoct in water or dissolve in salt water.
Sheng Bing Zi (Holy Cake) (Zhu Danxi) Treats Hacking Blood.
Qing Dai (Indigo Naturalis) (1 qian), Xing Ren (Apricot Kernel) (40 pieces, fried in yellow wax until yellow).
Grind Xing Ren finely, mix with Qing Dai, shape into cakes. When using, split one persimmon cake, place the medicine cake inside, close it, wrap in wet paper, roast/steam. Grind together with the persimmon cake finely, mix with rice drink, and take.
Di Yu Tang (Sanguisorba Decoction) (Li Dongyuan) Treats Persistent Jie Yin Melena, gradually becoming excessive.
Di Yu (Sanguisorba Root) (4 qian), Sheng Gan Cao (Raw Licorice Root) (1.5 qian), Zhi Gan Cao (Roasted Licorice Root) (1 qian), Suo Sha (Amomum Fruit, 7 pods, ground separately).
Cut finely, prepare as one dose. Add 1.5 cups of water, decoct to 1 cup. Take warm.
Jie Yin Dan (Jie Yin Pill) (Li Dongyuan) Treats Jie Yin, Chang Feng (Intestinal Wind), Zang Du (Visceral Toxin) lower bleeding syndromes.
Zhi Ke (Aurantii Fructus, stir-fried), Wei Ling Xian (Clematis Root), Huang Qi (Astragalus Root), Chen Pi (Citrus Reticulata Peel), Chu Gen Pi (Toona Bark), He Shou Wu (Polygonum Multiflorum Root), Jing Jie Sui (Schizonepeta Spike) (equal parts).
Grind into fine powder, make pills with wine paste size of Sophora seeds. Take 50-70 pills per dose, swallow with clear rice drink plus a little vinegar.
Chun Pi San (Toona Bark Powder) Treats Bloody Dysentery and Intestinal Wind Lower Bleeding. Highly effective.
Chu Gen Bai Pi (Toona White Bark) (2 liang), Huai Jiao Ren (Sophora Fruit Kernel) (4 liang), Ku Bai Fan (Calcined Alum) (2 liang), Zhi Gan Cao (Roasted Licorice Root) (1 liang).
Grind into fine powder. Take 3 qian per dose, mix with clear rice drink.
Wu Mei Wan (Mume Pill) Treats Lower GI Bleeding. Miraculous.
Jiang Can (Silkworm, stir-fried) (1 liang), Wu Mei Rou (Mume Flesh) (1.5 liang).
Grind into fine powder, make pills with vinegar paste. Take 30-50 pills with vinegar water, on an empty stomach.
Huai Hua San (Sophora Flower Powder) (Ben Shi Fang) Treats Intestinal Wind and Visceral Toxin Lower Bleeding.
Huai Hua (Sophora Flower, stir-fried), Ce Bai Ye (Biota Tops, pounded), Jing Jie Sui (Schizonepeta Spike), Zhi Ke (Aurantii Fructus, bran-roasted yellow) (equal parts).
Grind into powder. Take 2 qian per dose, mix with rice drink on an empty stomach.
Jia Jian Si Wu Tang (Modified Four Substances Decoction) (Li Dongyuan) Treats Intestinal Wind Lower Bleeding.
Ce Bai Ye (Biota Tops), Sheng Di Huang (Raw Rehmannia Root), Dang Gui (Angelica Sinensis Root), Chuan Xiong (Ligusticum Rhizome) (each 0.8 fen); Zhi Ke (Aurantii Fructus, bran-roasted), Jing Jie Sui (Schizonepeta Spike), Huai Hua (Sophora Flower, stir-fried), Gan Cao (Licorice Root, roasted) (each 0.4 fen); Di Yu (Sanguisorba Root), Tiao Huang Qin (Scutellaria Root), Fang Feng (Saposhnikovia Root) (each 0.6 fen); Wu Mei (Mume, large, one piece).
Cut finely, prepare as one dose. Add 3 slices of Sheng Jiang (Fresh Ginger). Decoct to 1 cup. Strain and take warm on an empty stomach.
Dang Gui He Xue San (Angelica Blood-Harmonizing Powder) (Li Dongyuan) Treats Intestinal Damp-Toxin Lower Bleeding.
Huai Hua (Sophora Flower, stir-fried), Qing Pi (Citrus Unripe Peel) (each 0.6 fen); Dang Gui Shen (Angelica Sinensis Root Tip), Sheng Ma (Cimicifuga Rhizome) (each 1 qian); Chuan Xiong (Ligusticum Rhizome) (0.4 fen); Jing Jie Sui (Schizonepeta Spike), Shu Di Huang (Prepared Rehmannia Root), Bai Zhu (Atractylodes Macrocephala Rhizome) (each 0.6 fen).
Grind into fine powder. Take 3 qian per dose, mix with rice drink.
Zhi Ke San (Aurantii Fructus Powder) Li Dongyuan stated: Clear, bright blood indicates Intestinal Wind; turbid, dark blood indicates Visceral Toxin; blood before stool is Proximal Blood; blood after stool is Distal Blood. This formula treats all of them.
Zhi Ke (Aurantii Fructus, 10 liang, bran-roasted yellow), Gan Cao (Licorice Root, 3 qian, roasted).
Grind into fine powder. Take 1 qian per dose, mix with rice drink on an empty stomach, followed by Jiu Zhu Huang Lian Wan (Wine-Boiled Coptis Pill).
Jiu Zhu Huang Lian Wan (Wine-Boiled Coptis Pill) (Li Dongyuan)
Huang Lian (Coptis Rhizome, de-tender, 12 liang), Hao Jiu (Good Wine, 5 sheng).
Cut Huang Lian finely. Place in silver or earthenware vessel with wine. Boil Huang Lian in wine until wine is completely dry. Dry, grind into powder, make pills with flour paste size of Sophora seeds. Take 30 pills per dose, on an empty stomach.
Mi Fang Zhi Ke Tang (Secret Recipe Aurantii Fructus Decoction) (Ju Fang) Treats Lower GI Intestinal Wind Bleeding.
Zhi Ke (Aurantii Fructus, 1 liang, bran-roasted yellow), Huang Lian (Coptis Rhizome, 2 liang, stir-fried with 4 liang Huai Hua (Sophora Flower), discard Huai Hua).
Decoct these two ingredients in appropriate water to make a thick liquid. Take warm before meals.
Huai Jiao Wan (Sophora Fruit Pill) (Ju Fang) Treats Five Types of Intestinal Wind Lower Bleeding, Hemorrhoids, Fistula, Rectal Prolapse. All are treated.
Huai Jiao (Sophora Fruit, 2 liang, stir-fried), Di Yu (Sanguisorba Root), Huang Qin (Scutellaria Root), Dang Gui (Angelica Sinensis Root), Fang Feng (Saposhnikovia Root), Zhi Ke (Aurantii Fructus, bran-roasted) (each 1 liang).
Grind into fine powder, make pills with wine-flour paste size of Sophora seeds. Take 50 pills per dose, swallow with clear rice drink on an empty stomach.
Sheng Yang Qu Re He Xue Tang (Ascending Yang, Dispersing Heat, Harmonizing Blood Decoction) (Li Dongyuan) Treats Lower GI Bleeding where blood spurts forcefully and far, scattering like a sieve, accompanied by abdominal pain, caused by heat toxin.
Chen Pi (Citrus Reticulata Peel) (0.2 fen); Shu Di Huang (Prepared Rehmannia Root), Dang Gui Shen (Angelica Sinensis Root Tip), Cang Zhu (Atractylodes Rhizome), Qin Jiao (Gentiana Macrophylla Root), Rou Gui (Cinnamon Bark) (each 0.3 fen); Sheng Di Huang (Raw Rehmannia Root), Mu Dan Pi (Moutan Cortex), Sheng Gan Cao (Raw Licorice Root) (each 0.5 fen); Sheng Ma (Cimicifuga Rhizome) (0.7 fen); Zhi Gan Cao (Roasted Licorice Root), Huang Qi (Astragalus Root) (each 1 qian); Bai Shao Yao (White Peony Root) (1.5 qian).
Cut finely, prepare as one dose. Add 2 cups of water, decoct to 1 cup. Take slightly warm before meals.
Sheng Yang Bu Wei Tang (Ascending Yang, Tonifying Stomach Decoction) (See detailed syndrome treatment in Lan Shi Mi Cang, Diarrhea/Dysentery Section.)
Sheng Di Huang San (Raw Rehmannia Powder) Treats Depressed Heat Epistaxis, Hacking Blood, Hematemesis.
Gou Qi Zi (Goji Berry), Chai Hu (Bupleurum Root), Huang Lian (Coptis Rhizome), Di Gu Pi (Lycium Bark), Tian Dong (Asparagus Root), Bai Shao Yao (White Peony Root), Gan Cao (Licorice Root), Huang Qin (Scutellaria Root), Huang Qi (Astragalus Root), Sheng Di Huang (Raw Rehmannia Root), Shu Di Huang (Prepared Rehmannia Root) (each 0.5 qian).
Cut finely, prepare as one dose. Add 1.5 cups of water, decoct to 1 cup. Take warm.
Yu Xie Gao (Jade Paste) Treats Hot Blood.
Huang Qi (Astragalus Root), Ren Shen (Ginseng Root).
Grind both into equal parts powder. Take large radish, slice about one finger thick, 4-5 slices. Soak in honey briefly, dip in honey, roast until dry. Repeat until 2 liang of honey is consumed, ensuring not to burn. Apply/eat the medicine anytime, still take with salt water.
Long Gu San (Dragon Bone Powder) Treats Persistent Epistaxis. Stops bleeding from all nine orifices.
Long Gu (Dragon Bone Fossil) (any amount).
Grind this single herb finely. Next, apply to the affected area (note: text says "enter foulness," likely implying local application or insufflation) to stop bleeding.
She Xiang San (Musk Powder) Treats Persistent Epistaxis.
Bai Fan (Alum, calcined), Long Gu (Dragon Bone Fossil) (each 5 qian), She Xiang (Musk) (0.15 qian).
Grind each separately and mix evenly. When using, first wash nasal cavity clean with cold water, then insufflate medicine into the nostrils, or insert with a wet paper wick, which is also excellent.
Experience Formula: Treats Hematochezia.
Bai Yao Jian (Medicated Leaven) (1 liang, burn 0.5 liang to ash retaining character).
Grind all finely, make pills with rice paste size of Sophora seeds. Take 30-40 pills per dose. Alternatively, mix 2-3 qian of powder with rice water and take.
Another Formula: Treats the above condition.
Burn dried persimmon cake to ash retaining character. Mix 2-3 qian with clear rice drink. Stops immediately.
Tao Ren Cheng Qi Tang (Peach Kernel Draining Fury Decoction) Treats Blood Binding in Chest in men and women, tenderness to touch, Middle Jiao Blood Accumulation, delirium seeing ghosts, coma resembling madness, chronic epigastric pain, Blood Accumulation syndromes.
Di Dang Tang (Break Through Decoction) Treats Lower Body Blood Accumulation, pain and fullness below navel. (Both formulas appear in Shang Han Men/Treatise on Cold Damage section.)
[Danxi Huo Tao] states: All bleeding syndromes are due to excess yang and deficiency yin, with Ministerial Fire hyperactivity scorching and forcing blood out through the orifices. All should be primarily treated with Si Wu Tang (Four Substances Decoction) added with Zhi Mu (Anemarrhena Rhizome) and Huang Bo (Phellodendron Bark) to tonify yin and descend fire. For epistaxis, coughing blood, or blood-streaked sputum originating from the Lungs, add Jiu Xi Pu Huang (Wine-Washed Typha Pollen), Huang Qin (Scutellaria Root), Mao Hua (Magnolia Flower) etc. to drain Lung fire. For hematemesis and vomiting blood originating from the Stomach, add Shi Gao (Gypsum) and Zhi Mu (Anemarrhena Rhizome) etc. to drain Stomach fire. For spitting blood, hacking blood, and tidal fever coughing blood originating from the Kidneys, use the base formula with...