伤寒下血，若太阳病外已解，但少腹急结者，桃仁承气汤也。（方论见蓄血。）
若阳明胃实谵语者，宜刺期门穴。（论见谵语。）
太阳病，以火熏汗不得汗，其人必躁而清血。（论见躁。）淋家不可发汗，发汗则便血。太阳病下之，其
脉浮滑者，必下血。（论见大法。）
少阴病，但欲寐，一身手足尽热者，必便血也。伤寒热少厥微，不欲食，烦躁数日，小便利，色白，若欲
食者愈，若呕而胸胁烦满者，必便血也。
咽痛吐血，若面赤斑斑如锦纹者，为阳毒，宜升麻鳖甲汤。（方论见阳毒。）
若下后利不止，手足厥逆，下部脉不至者，麻黄升麻汤。（方论见下利。）
脉浮热甚，反灸之，必咽燥唾血。（论见大法。）服桂枝汤吐者，必吐脓血。（论见吐。）
身黄如狂，屎黑喜忘者，为蓄血。太阳病，表证在而发热恶寒，脉反沉结，而身黄发狂，少腹硬
满者，若小便不利，为无血也，小便自利，血证谛也，宜以抵当汤主之。
（论见发热）。
抵当汤
水蛭（十个，熬去子，杵） 虻虫（十枚，去翅足熬） 大黄（一两，汤浸，去皮） 桃仁（七枚，
去皮，捶碎）
上 咀，作一服，水一盏，煎七分，去渣温服。
伤寒有热，少腹满，应小便不利，今反利者，为有血也，当下之，不用余药，宜抵当丸。
水蛭（五枚，炙） 虻虫（五枚，去翅足，炒） 桃仁（六枚） 大黄（三钱）
上为末，炼蜜和作一丸，以水一盏，煎至七分，顿服， 时当下血。不下再服。
太阳病不解，热结膀胱，其人似狂，若血自下者，病愈。其外未解者，尚未可攻，当先解外。外解，
但小腹急结者，宜攻之，桃仁承气汤。（王海藏方有姜七片，桂、硝各三钱。）
桃仁（十二枚，去皮尖，双仁者不用） 大黄（一两） 甘草（炙） 桂枝 芒硝（各半两）
上 咀，每服一两，水二盏，煎至一盏，去渣，入硝化开，食后服。
阳明症，胃家实，喜忘，大便黑色，虽硬反易者，有蓄血，宜抵当汤。（论见胃实。）
〔海〕初便褐色者重，再便深褐色者愈重，三便黑色者为尤重。色变者，以其火燥也，如羊血在日色中，
须臾变褐色，久则渐变而为黑色，即此意也，当详察之。
〔许〕血在上则喜忘，在下则发狂。
病患无表里症，发热七八日，虽脉浮数者，可下之。假令已下，脉不解，胃热则消谷善饥，至六七
日不大便者，有瘀血，宜抵当汤。若脉数不解，血下不止，必协热而便脓血也。
〔成〕当不大便六七日之际，无喜忘如狂之症，又无少腹硬满之候，何以知其有蓄血？盖以其脉浮数故也。
浮则热客于气，数则热客于血，下后浮数俱去，则病已，若下后数去而浮仍在，则荣血中热去而卫气中
热在，为邪气独留心下，善饥，邪热不杀谷，潮热反渴也。若下后浮去而数不解，则卫气中热去而荣血中热
在，血热合并，迫血下行，胃虚协热，消谷善饥。血至下焦，若下不止，则血得以泄，必脓血也。若不
大便六七日，则血不得出泄，必蓄在下焦为瘀血，故须以抵当汤下之。
病者胸满痞痿，舌青口燥，但漱水不欲下咽，无寒热，脉微大来迟，腹不满，其人言我满，为有瘀血。
（海云∶漱水不咽，胸满，心下手不可近者，桃仁承气汤主之。）
病者如热状，烦满，口干燥而渴，其脉反无热，此为阴伏，是瘀血也，当下之。
Blood discharge in cold damage: If the exterior syndrome of Taiyang disease has been resolved, but there is only urgency and binding in the lower abdomen, Tao Ren Cheng Qi Tang (Peach Kernel Decoction to Order the Qi) should be used. (Discussion on formulas can be found under "Accumulated Blood".)
If there is excess heat in the Yangming stomach accompanied by delirious speech, puncturing Qimen (LR14) acupoint is appropriate. (Discussion can be found under "Delirium".)
In Taiyang disease, if fire steaming is used for sweating but no sweat occurs, the patient will inevitably become restless and experience hematochezia. (Discussion can be found under "Restlessness".) Patients with Lin syndrome (dysuria) must not undergo sweating therapy; if sweating is induced, it will lead to hematochezia. In Taiyang disease, if purgation is mistakenly applied and the pulse is floating and slippery, blood discharge will inevitably occur. (Discussion can be found under "General Principles".)
In Shaoyin disease, if the patient desires sleep, and the whole body and hands and feet are hot, hematochezia will inevitably occur. In cold damage, if heat is slight and extremity cold is mild, appetite is lost, restlessness persists for several days, urination is free and urine color is clear/white, desire for food indicates recovery; however, if vomiting occurs with irritability and fullness in the chest and hypochondrium, hematochezia will inevitably occur.
Throat pain with hematemesis: If the face is red with mottled patterns like brocade, this is Yang Du (Yang Toxin), and Sheng Ma Bie Jia Tang (Cimicifuga and Turtle Shell Decoction) is appropriate. (Discussion on formulas can be found under "Yang Toxin".)
If diarrhea persists after purgation, with cold reversal of the hands and feet and absent pulses at the lower position, Ma Huang Sheng Ma Tang (Ephedra and Cimicifuga Decoction) should be used. (Discussion on formulas can be found under "Diarrhea".)
If the pulse is floating and heat is severe, moxibustion is contraindicated; applying it will inevitably cause dry throat and spitting of blood. (Discussion can be found under "General Principles".) If vomiting occurs after taking Gui Zhi Tang (Cinnamon Twig Decoction), pus and blood will inevitably be vomited. (Discussion can be found under "Vomiting".)
Jaundice resembling madness, black stool, and forgetfulness indicate Accumulated Blood (Xu Xue). In Taiyang disease, if exterior symptoms persist with fever and aversion to cold, yet the pulse is sinking and knotted, accompanied by jaundice, madness, and hardness/fullness in the lower abdomen: if urination is difficult, there is no blood stasis; if urination is spontaneous, the diagnosis of blood stasis is confirmed, and Di Dang Tang (Resist the Pill Decoction) is appropriate. (Discussion can be found under "Fever").
Di Dang Tang (Resist the Pill Decoction)
Shui Zhi (Leech, ten pieces, roasted, seeds removed, pounded) Meng Chong (Dragonfly larva, ten pieces, wings and legs removed, roasted) Da Huang (Rhubarb Root and Rhizome, one liang, soaked in boiling water, skin removed) Tao Ren (Peach Seed, seven kernels, skin removed, crushed)
Chop the above ingredients into one dose, add one cup of water, decoct to seven-tenths, remove dregs, and take warm.
In cold damage with heat and lower abdominal fullness, urination should normally be difficult; if it is now free, it indicates blood stasis. It should be purged without other medicines; Di Dang Wan (Resist the Pill) is appropriate.
Shui Zhi (Leech, five pieces, dried over fire) Meng Chong (Dragonfly larva, five pieces, wings and legs removed, stir-fried) Tao Ren (Peach Seed, six kernels) Da Huang (Rhubarb Root and Rhizome, three qian)
Grind the above into powder, mix with refined honey to form one pill. Add one cup of water, decoct to seven-tenths, and take in one dose. Blood stasis should be discharged at this time. If not discharged, administer again.
If Taiyang disease is unresolved and heat binds in the Bladder, the patient appears manic. If blood discharges spontaneously, the disease resolves. If the exterior is not yet resolved, attacking the interior is premature; resolve the exterior first. Once the exterior is resolved, if only urgency and binding in the lower abdomen remain, attack with Tao Ren Cheng Qi Tang (Peach Kernel Decoction to Order the Qi). (Wang Haizang's formula adds seven slices of fresh ginger, Gui Zhi [Cinnamon Twig] and Mang Xiao [Mirabilite], each three qian.)
Tao Ren (Peach Seed, twelve kernels, skin and tips removed, double-kernel ones excluded) Da Huang (Rhubarb Root and Rhizome, one liang) Gan Cao (Licorice Root, roasted) Gui Zhi (Cinnamon Twig) Mang Xiao (Mirabilite, half liang each)
Chop the above ingredients. For each dose, use two cups of water, decoct to one cup, remove dregs, dissolve Mang Xiao, and take after meals.
In Yangming syndrome, with excess in the Stomach organ, forgetfulness, black stool that is hard yet easy to pass, this indicates Accumulated Blood (Xu Xue), and Di Dang Tang (Resist the Pill Decoction) is appropriate. (Discussion can be found under "Stomach Excess".)
[Ha] The first passage being brown is severe; the second being dark brown is more severe; the third being black is most severe. The color change is due to fire and dryness, similar to sheep blood turning brown in sunlight, then gradually blackening over time. This principle should be carefully observed.
[Xu] Blood in the upper jiao causes forgetfulness; blood in the lower jiao causes madness.
When a patient has neither exterior nor interior symptoms but has had fever for seven or eight days, even if the pulse is floating and rapid, purgation may be used. If purgation has already been performed and the pulse remains unresolved, gastric heat leads to efficient digestion and frequent hunger. If there is no bowel movement for six or seven days, blood stasis exists, and Di Dang Tang (Resist the Pill Decoction) is appropriate. If the rapid pulse persists and bleeding continues, it will inevitably result in pus and blood mixed with heat.
[Cheng Wujing] During the period of no bowel movement for six or seven days, without symptoms of forgetfulness or mania, and without lower abdominal hardness/fullness, how do we know there is accumulated blood? It is because of the floating and rapid pulse. Floating indicates heat lodged in Wei Qi (Defensive Qi); rapid indicates heat lodged in Ying Qi (Nutritive Qi). After purgation, if both floating and rapid pulses disappear, the disease is cured. If the rapid pulse disappears but the floating pulse remains, heat in Ying Qi is gone but heat in Wei Qi remains; pathogenic qi lingers in the epigastrium, causing frequent hunger, inability to digest food properly due to pathogenic heat, tidal fever, and paradoxical thirst. If the floating pulse disappears but the rapid pulse persists, heat in Wei Qi is gone but heat in Ying Qi remains. Blood heat combines, forcing blood downward. With deficient Stomach heat, efficient digestion and frequent hunger occur. When blood reaches the Lower Jiao, if downward bleeding does not stop, blood is expelled, resulting in pus and blood. If there is no bowel movement for six or seven days, blood cannot be expelled, accumulating in the Lower Jiao as blood stasis; thus, Di Dang Tang (Resist the Pill Decoction) is required to purge it.
When a patient presents with chest fullness and痞 (plugged sensation), blue tongue, dry mouth, desiring to rinse water in the mouth but not swallow, without chills or fever, with a pulse that is slightly large and slow in return, and claims abdominal fullness despite no visible distension, this indicates blood stasis.
[Hai Yun]: Rinsing water without swallowing, chest fullness, and tenderness/pain in the epigastrium unapproachable to touch are treated with Tao Ren Cheng Qi Tang (Peach Kernel Decoction to Order the Qi).
When a patient appears to have heat, irritability, dry mouth, and thirst, yet the pulse shows no signs of heat, this is Yin Fu (hidden Yin heat), indicating blood stasis, which should be purged.