〔《大》〕产后口鼻黑气起，及鼻衄者，名曰胃绝肺败，此证不可治。遇有此疾，急取绯线
一条，并产妇顶心发两条，紧系中指节，即止。
治产后鼻衄中风。以荆芥为末，童便调下，神验。（此方气虚人勿用。）
〔丹〕治吐血。以人参一味为末，鸡子清投新汲水，调下一钱服之。（《千金方》）
〔垣〕人参救肺汤治吐血亦用。
人参 升麻 柴胡 归梢 苍术（各一钱） 熟地 白芍药 黄 （各二钱） 陈皮 苏木
甘草（各五分）
上为粗末，作一服，水二盏，煎一盏，去滓，稍热食前服。
〔《局》〕必胜散治血妄流溢，或吐或衄。
小蓟（并根用） 人参（去芦） 蒲黄（炒） 当归 熟地 川芎 乌梅（去核。各等分）
上 咀，每服四钱，水一盏，煎七分，温服，不拘时。
〔《保》〕鸡苏散治虚损气逆，吐血不止。
鸡苏叶 黄芩 刺蓟 生地 阿胶 黄 （各一两） 当归 赤芍药（各半两） 伏龙肝（二两）
上为粗末，每服四钱，姜三片，竹茹弹子大，水同煎。
〔丹〕朱富六因辛苦吐血或衄，夜间发热口干，身疼食少，当作虚劳治。
白术（六钱半） 人参 青皮（炒） 生地 芍药 陈皮 归尾 甘草（炙，半两） 川芎（三钱）
红花（五分）
分十帖，水二盏，煎至三之一，食前稍热饮，下保和丸十四粒，与点丸十粒。
一妇人年五十余，尝吐血，今又作面黄，身蠕动，食少。
青皮（半两） 人参（三钱半） 白术 陈皮（各三钱） 白芍药 木通（各二钱） 黄连（炒）
干姜 黄芩（炒） 川芎（各钱半） 黄柏（炒一钱） 生甘草 生地（各钱半） 归头（二钱）
分七帖，水二盏，煎至三分之一，去滓，入藕汁半盏，再煎沸，通口饮之。
夫口鼻出血，皆系阳盛阴虚，有升无降，血随气上，越出上窍。法当补阴抑阳，气降则血
归经也。
大补血丸治阴虚吐血。
当归（一钱） 生地（一钱半）
上以杜牛膝汁浸三日，取起，酒洗净，入臼内杵千杵，为丸桐子大，白汤下。
〔梅〕治吐血神效方。生地黄汁一升二合，白胶香二两，以瓷器盛入甑，蒸令胶消服，妙。
一方，独用生地黄汁半升，饮之立止，神妙。
〔云〕五神汤治妇人热毒上攻，吐血不止。
生藕汁 刺蓟汁 生地汁（各二盏） 生姜汁（半盏） 白蜜（一盏）
上和，煎三两沸，无时以一小盏调炒面一钱，食前服。（《圣惠》治心热吐血口干，独用
刺蓟，捣绞取汁一小盏服。）
〔《大》〕四生丸治吐血衄血，阳乘于阴，血热妄行。
生荷叶 生艾叶 生柏叶 生地黄（各等分）
上研烂，丸如鸡子大。每服一丸，水三盏，煎一盏，滤过温服。（《经验》治吐血咯血，
一味荷叶焙干为末，米汤下二钱匕，亦
佳。又《山居》治吐血，一味侧柏叶研细，酒调服妙。）
〔丹〕经血逆行，或血腥，或吐血，用韭菜汁服，立效。
〔《简》〕治吐血咯血。蒲黄一两，捣为散，每服三钱，温酒或冷水调服，妙。治吐血。茜草
一两，生捣罗为散，每服三钱，水一盏，煎七分，放冷，食后服。
〔世〕治内损吐血。飞罗面不以多少微炒，浓磨细墨一匙，茶调下二钱，立效。又方，治吐血
用松烟墨磨汁服，立效。
〔《衍》〕治大吐血。好墨细末二钱，以白汤化阿胶清，稠稀得所，顿服。热多者尤相宜。
〔丹〕先见红，后见痰多，是阴虚火逆，痰不下降，四物汤加痰火药。
治火血上错经妄行，四物汤加炒山栀、童便、姜汁。（此后诸方用童便、姜汁，虽无痰，
亦吐血要药也。）
治吐血衄血，用郁金为末，以童便、姜汁、好酒调服。（一方不用酒。）治吐血，红山茶花
阴干为末，每服一钱，用童便半钟，生姜汁少许，调服。
〔《本》〕治吐血鼻红。生姜二分绞汁，并壮健丈夫小便一升，乘热顿饮瘥。
〔丹〕又方 以童便一分，酒半分。擂柏叶温饮之。
吐血挟痰积方可下，若一碗两碗吐者，只补阴降火，用四物大剂之类。挟痰若用血药则泥
而不行，只治火，其血自止。山栀最清胃脘血。
〔《玄》〕吐血者，由忧思诸气郁极，方散而生热，则心血妄行，宜玄明粉加黄丹服之。次用
四物解毒加藕节治之。如前症之热，并宜清之。
〔仲〕心气不足，吐血衄血，泻心汤主之。（亦治霍乱。）
大黄（二两） 黄连 黄芩（各一两）
上三味，以水三升，煮取一升，顿服之。
〔海〕云岐子犀角地黄汤治寸芤，血在上焦。
生地（二两） 黄芩（一两半） 黄连（一两） 大黄（半两）
上 咀，秤一两，水二盏煎，去滓，食后服之。
〔《简》〕治吐血。川大黄一两，捣为散，每一钱，生地黄汁一合，水半盏，煎三五沸，无时
服。
〔丹〕吐血，觉胸中气塞，上吐紫血，桃仁承气汤下之。
冯舅，气上奔，吐血心膈疼。
枳壳（三钱） 青皮（二钱） 生地 木通 牡丹皮（一钱半） 桃仁（二十八个 川芎 黄芩
黄连（一钱） 甘草（少） 生干姜 桔梗分四帖，煎服。
或暴吐紫血一碗者，无事，吐出好。此热伤血死肝中，宜服四物解毒之类。
〔《千》〕治坠马积血心胃，唾血无数。干荷花根为末，酒服方寸匕，日三服。
〔无〕加味芎归汤治打扑伤损，败血流入胃脘，呕吐黑血或如豆羹汁。
川芎 当归 白芍药 百合（水浸半日） 荆芥穗（各等分）
上锉散，每四钱，水一盏，酒半盏，煎七分，去滓，不拘时候。
〔仲〕夫酒客咳者，必致吐血，此因极饮过度所致也。此即肺疽之属。
〔《千》〕吐血有三种∶有内衄，有肺疽，有伤胃。内衄者，出血如鼻衄，但不从鼻孔出，是
近从心肺间津液出，还流入胃中，或如豆羹汁，或如切 血凝停胃中，因即满闷便吐，或去数
斗至一石者是也。得之于劳倦，饮食过常也。肺疽者，或饮酒之后，毒满闷吐之时，血从吐后出，
或一合半升一升是也。伤胃者，因饮食太饱之后，胃中冷，不能消化，便烦闷，强呕吐，使所食
之物与气共上冲蹙，因伤裂胃口吐血，色鲜正赤，腹亦绞痛，自汗出，其脉紧而数者，为难治也。
（，韵书音戡，凝血也。）
〔无〕理中汤 能止伤胃吐血，以其方最理中脘，分利阴阳，安定血脉。（海藏亦云∶饮冷伤脾吐
血，以理中汤理治中脘，分利阴阳。此亦理治内衄之法也，方见伤寒。）
二合灰散 治因啖辛热，呕吐出血一合或半升许，名曰肺疽。
红枣（和核烧存性） 百药煎（ 。各等分）
上为细末，每服二钱，米饮调下。
除湿汤 治冒雨着湿郁于经络，血溢作衄，及血溢流入胃，胃满吐血。
茯苓 干姜（各四钱） 甘草（炙） 白术（各二钱）
上锉，每服四钱，水一大盏，煎八分，去滓服。头疼，加川芎二钱，最止浴室中发衄。（此
方治冒雨吐血，理中汤治伤胃吐血，皆用干姜为君。丹溪治大吐血不止亦用干姜一味炮为末，
童便调服从治之者，可见干姜亦为吐血要药也。）
〔丹〕男子年十七，家贫而多劳，十一月得寒病，时吐三两口血，六脉紧涩，一日食减中痞，
医投温胆汤、枳桔汤，三日后发微热，口干不渴，口中有痰，此感寒也。询知云∶因十日前
霜中曾渡三四次溪水，心下有悲泣事，腹亦饥，遂以小建中汤去芍药，加桔梗、陈皮、半夏，
四帖而安。
又方 治吐血。以交趾桂五钱为末，冷水调服。亦小建汤治感寒吐血之义。经云∶太阳司天，
寒淫所胜，血变于中，呕血泄血鼽衄，平以辛热者，即理中、建中用干姜、桂枝，治吐血
之类皆同也。吐血挟热者。（治法并见血虚随火上行条。）
〔《经》〕治呕血。黄柏好者，以蜜涂炙干，杵末，用麦门冬热水调下二钱匕，立瘥。
〔《广》〕治心热吐血不止。生葛根捣汁半大升，顿服，立瘥。
吐血挟寒者，多是口食寒物，身受寒气之病，治法并见内伤饮食，外感风寒条。
〔仲〕吐血不止，柏叶汤主之。
柏叶 干姜（各二两） 艾（三把）
上三味，以水五升，取马通汁一升，合煮，取一升，分温再服。（马通即马屎淋汁。）
〔《广》〕治吐血鼻衄不止。伏龙肝半升，以新汲水一大升，淘取汁，和蜜顿服。
运气 血溢有五∶
一曰，热助心血，沸而溢。经云∶少阳司天之政，初之气，候乃大温，其病气沸于上，血溢。又
云∶少阴司天，客胜甚则血溢。又云∶少阳司天，客胜则血溢。又云∶火郁之发，民病血溢，
治以咸寒是也。
二曰，寒攻心血，逃而溢。经云∶太阳司天之政，寒湿之气，持于气交，民病血溢，治宜苦
以燥之温之也。
三曰，内火格拒，外寒壅遏而血溢。经云∶少阴司天之政，终之气，燥令行，余火内格，甚
则血溢是也。
四曰，风湿相搏血溢，及下寒相搏，蒸热于上而血溢。经云∶太阴司天之政，初之气，风湿
相搏，民病血溢，此风湿相搏血溢也。四之气，畏火临，溽蒸化，地气腾，天气痞隔，寒风晓暮，
蒸热相搏，民病腠理热血暴溢，此地气之寒相搏，天气蒸热于上而血溢也。
五曰，燥邪攻肝血溢。经云∶岁金太过，燥气流行，病反侧，咳逆甚而血溢是也。
〔《素》〕夫伤肺者；脾气不守，胃气不清，经气不为使，真藏坏决，经脉傍绝，五脏漏泄，不
衄则呕。（示从容论 伤肺即伤气，当于气虚不能摄血条参治之。）
〔罗〕门冬饮子治脾胃虚弱，气促气弱，精神短少，衄血吐血。
五味子（五个） 甘草 芍药 黄 （各一钱） 紫菀（一钱半） 人参 归身 麦门冬
上为粗末，作二服，水煎食后服。
〔《本》〕天门冬丸治吐血咯血，能润肺止嗽。
天门冬 甘草 杏仁（炒） 贝母 白茯苓 阿胶（各半两）
上为细末，炼蜜丸如弹子大。每服一丸，咽津含化，日夜十丸。
〔丹〕酒色过度饥饱，吐血痰血，神妙。
枇杷叶 款花 北紫菀 杏仁（去双仁、皮尖） 鹿茸（炙如法） 桑白皮 木通（各一两）
大黄（半两）
上炼蜜丸，临卧含化。
经云∶怒则气遂，甚则呕血，故气上矣。又云∶阳气者，大怒则形气绝，而血菀于上，使
人薄厥。此皆怒则伤肝气而呕血，以黄连、香附、青黛、柴胡、甘草平其肝，自愈矣。宜服赤
茯苓泻心汤。
〔世〕治呕血、咯血、衄血、肝损。白芨为末，米饮调服，神妙。
〔《简》〕治吐血。槲叶捣末，每服二钱，水一盏，煎七分，和滓服。
中蛊毒吐血。（见下血门。）
刺灸吐血有二∶
其一取肺。经云∶暴痹内逆，肝相搏，血溢鼻口，取天府是也。
其二取筋。经云∶手太阴筋病，当所过者，支转筋痛，甚成息奔胁急吐血。治在燔针劫刺，
以知为数，以痛为 是也。
〔《密》〕吐血∶风府 大椎 鬲俞 肝俞（各五分。泻之立愈。）
〔东〕又法∶胃脘 中 肝俞（各沿皮二寸半）
〔《集》〕又法∶ 中 中脘 气海 三里 乳根 支沟 不已，取下穴∶肺俞 肾俞 心俞
膏肓 关元
〔东〕呕血，胁痛口干不可咳，引肾痛∶不容（傍刺向外。）上脘（三寸半。）大陵 门 神门
〔《甲》〕呕血，大陵及 门主之。呕血上气，神门主之。心下有膈，呕血，上脘主之。呕血，
肩急，胁下痛，口干，心痛。与背相引，不可咳，咳则肩痛，不容主之。
肝脉太甚，为内痈，善呕衄。（全文见治虚实法。）
诊吐血法。（见前诸见血门。）
[From *Taiping Huimin Heji Jufang*] When black qi appears at the mouth and nose after childbirth, accompanied by epistaxis (nosebleed), it is called "Stomach Exhaustion and Lung Collapse" (Wei Jue Fei Bai). This syndrome is incurable. In such cases, urgently take a red thread and two strands of hair from the vertex of the mother's head, tie them tightly around the middle joint of the middle finger, and the bleeding will stop immediately.
To treat postpartum epistaxis complicated by wind pathogen: Powder the herb Jingjie (Schizonepetae Herba) and administer with urine from an uncircumcised boy. This is miraculous. (Do not use this formula for patients with Qi deficiency.)
[Zhu Danxi] To treat hematemesis (vomiting blood): Use only Ren Shen (Ginseng Radix et Rhizoma) powdered, mixed with egg white and fresh well water, administered as one qian. (From *Qianjin Fang*)
[Li Dongyuan] Renshen Jiufei Tang (Ginseng Decoction to Rescue the Lungs) is also used to treat hematemesis.
Ingredients: Renshen (Ginseng Radix et Rhizoma), Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), Danggui Shao (Radix Angelicae Sinensis tip), Cangzhu (Atractylodis Rhizoma) (each 1 qian); Shudi (Rehmanniae Radix Praeparata), Baishao (Paeoniae Radix Alba), Huangqi (Astragali Radix) (each 2 qian); Chenpi (Citri Reticulatae Pericarpium), Sumu (Sappan Lignum), Gancao (Glycyrrhizae Radix et Rhizoma) (each 5 fen).
Grind into coarse powder. One dose, decoct in two zhan of water until one zhan remains. Strain and drink warm before meals.
[From *Taiping Huimin Heji Jufang*] Bisheng San (Victory Powder) treats reckless bleeding or vomiting/epistaxis.
Ingredients: Xiaoji (Leonuri Herba, including roots), Renshen (Ginseng Radix et Rhizoma, remove rhizome), Puhuang (Typhae Pollen, stir-fried), Danggui (Angelicae Sinensis Radix), Shudi (Rehmanniae Radix Praeparata), Chuanxiong (Ligustici Chuanxiong Rhizoma), Wumei (Mume Fructus, remove pits) (equal parts).
Cut into pieces. Take 4 qian per dose, decoct in one zhan of water until 0.7 zhan remains. Take warm, at any time.
[From *Baoming Ji*] Jisu San (Chicken Mint Powder) treats deficiency damage with rebellious Qi and continuous hematemesis.
Ingredients: Jisu Ye (Elsholtziae Folium), Huangqin (Scutellariae Radix), Ciji (Ononis Spinosae Radix), Shengdi (Rehmanniae Radix), Ejiao (Colla Corii Asini), Huangqi (Astragali Radix) (each 1 liang); Danggui (Angelicae Sinensis Radix), Chishao (Paeoniae Radix Rubra) (each 0.5 liang); Fulonggan (Dragon's Liver) (2 liang).
Grind into coarse powder. Take 4 qian per dose with 3 slices of Shengjiang (Zingiberis Rhizoma) and a piece of Zhuru (Bambusae Caulis in Taeniam) the size of a bullet. Decoct together with water.
[Zhu Danxi] Zhu Fu Liu suffered hematemesis or epistaxis due to overexertion, with night fever, dry mouth, body pain, and poor appetite. This should be treated as Xu Lao (Consumptive Disease).
Ingredients: Baizhu (Atractylodis Macrocephalae Rhizoma) (6.5 qian), Renshen (Ginseng Radix et Rhizoma), Qingpi (Citri Reticulatae Pericarpium Viride, stir-fried), Shengdi (Rehmanniae Radix), Shaoyao (Paeoniae Radix), Chenpi (Citri Reticulatae Pericarpium), Guiwei (Angelicae Sinensis Radix tail), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 0.5 liang), Chuanxiong (Ligustici Chuanxiong Rhizoma) (3 qian), Honghua (Carthami Flos) (5 fen).
Divide into ten doses. Decoct each in two zhan of water until one-third remains. Drink warm before meals. Also administer Baohe Wan (Harmonize the Stomach Pill) 14 pills and Yudian Wan 10 pills.
A woman over fifty years old had previously vomited blood and now presents again with sallow complexion, muscle twitching, and poor appetite.
Ingredients: Qingpi (Citri Reticulatae Pericarpium Viride) (0.5 liang), Renshen (Ginseng Radix et Rhizoma) (3.5 qian), Baizhu (Atractylodis Macrocephalae Rhizoma), Chenpi (Citri Reticulatae Pericarpium) (each 3 qian), Baishao (Paeoniae Radix Alba), Mutong (Akebiae Caulis) (each 2 qian), Huanglian (Coptidis Rhizoma, stir-fried), Ganjiang (Zingiberis Rhizoma), Huangqin (Scutellariae Radix, stir-fried), Chuanxiong (Ligustici Chuanxiong Rhizoma) (each 1.5 qian), Huangbai (Phellodendri Cortex, stir-fried) (1 qian), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Shengdi (Rehmanniae Radix) (each 1.5 qian), Guitou (Angelicae Sinensis Radix head) (2 qian).
Divide into seven doses. Decoct each in two zhan of water until one-third remains. Strain, add half a zhan of Ou Zhi (Nelumbinis Rhizomatis Sucus), boil again, and drink continuously.
Bleeding from the mouth and nose is caused by Excess Yang and Deficiency Yin, where Qi rises without descending, carrying blood upward through the upper orifices. The treatment method should tonify Yin and suppress Yang; when Qi descends, blood returns to its vessels.
Da Bu Xue Wan (Great Blood-Tonifying Pill) treats hematemesis due to Yin Deficiency.
Ingredients: Danggui (Angelicae Sinensis Radix) (1 qian), Shengdi (Rehmanniae Radix) (1.5 qian).
Soak in juice of Du Niuxi (Achyranthis Bidentatae Radix) for three days. Remove, wash with wine, pound in a mortar for a thousand times, form pills the size of paulownia seeds, and swallow with plain water.
[Meishi] A miraculous formula for hematemesis: Take 1 sheng 2 he of Sheng Diye Zhi (Rehmanniae Radix Juice) and 2 liang of Bai Jiaoxiang (Elemi Resina). Place in a porcelain vessel inside a steamer, steam until the resin melts, then consume. It is wonderful.
Another method: Use only 0.5 sheng of Sheng Diye Zhi (Rehmanniae Radix Juice). Drinking it stops bleeding immediately; it is miraculous.
[Yun Qizi] Wushen Tang (Five Spirits Decoction) treats women suffering from Heat-Toxin attacking upward, causing continuous hematemesis.
Ingredients: Sheng Ou Zhi (Nelumbinis Rhizomatis Sucus), Ciji Zhi (Ononis Spinosae Radix Juice), Shengdi Zhi (Rehmanniae Radix Juice) (each 2 zhan), Shengjiang Zhi (Zingiberis Rhizoma Juice) (0.5 zhan), Baimi (Apis Mellifica) (1 zhan).
Mix well, boil three times. At any time, take a small cup mixed with 1 qian of fried flour, taken before meals. (*Shenghui Fang* treats Heart-Heat hematemesis with dry mouth using only Ciji (Ononis Spinosae Radix), pounded and juiced, taking a small cup.)
[From *Taiping Huimin Heji Jufang*] Sisheng Wan (Four Raw Ingredients Pill) treats hematemesis and epistaxis caused by Yang invading Yin and Heat in Blood causing reckless flow.
Ingredients: Sheng Heye (Nelumbinis Folium), Sheng Aiyi (Artemisiae Argyi Folium), Sheng Boye (Platycladi Cacumen), Shengdi (Rehmanniae Radix) (equal parts).
Pound until mushy, form pills the size of chicken eggs. Take one pill per dose, decoct in three zhan of water until one zhan remains. Strain and take warm. (*Jingyan Fang* treats hematemesis and hemoptysis using only dried Heye (Nelumbinis Folium) powdered, taken with rice soup, 2 qian bing; also effective. *Shanju Fang* treats hematemesis using only Ce Baiye (Platycladi Cacumen) finely powdered, taken with wine; also effective.)
[Zhu Danxi] For retrograde menstrual blood, bloody taste, or hematemesis,服用 Jiucai Zhi (Allium Tuberosum Juice) yields immediate results.
[From *Jianyao Jizhong Fang*] To treat hematemesis and hemoptysis: Pu Huang (Typhae Pollen) 1 liang, pounded into powder. Take 3 qian per dose, mixed with warm wine or cold water; excellent. To treat hematemesis: Qiancao (Rubiae Cordifoliae Radix et Rhizoma) 1 liang, freshly pounded and sifted into powder. Take 3 qian per dose, decoct in one zhan of water until 0.7 zhan remains. Cool down and take after meals.
[Worldly Prescriptions] To treat internal injury hematemesis: Feiluo Mian (Fine Wheat Flour) lightly stir-fried (amount unspecified). Mix with one spoonful of thick ground fine ink. Take 2 qian mixed with tea; immediate effect. Another prescription: For hematemesis, use Songyan Mo (Pine Soot Ink) juice; immediate effect.
[From *Yanyi*] To treat massive hematemesis: 2 qian of fine good ink powder, dissolved in plain water with Ejiao (Colla Corii Asini) clear solution. Adjust consistency appropriately. Take in one dose. Especially suitable for those with more heat.
[Zhu Danxi] If redness appears first, followed by excessive phlegm, this indicates Yin Deficiency with Fire Rebellion and Phlegm failing to descend. Use Siwu Tang (Four Substances Decoction) plus herbs for resolving Phlegm-Fire.
To treat Fire-Blood flowing recklessly into wrong meridians, use Siwu Tang (Four Substances Decoction) plus Chao Zhizi (Gardeniae Fructus, stir-fried), Tongbian (Urine of an uncircumcised boy), and Jiang Zhi (Zingiberis Rhizoma Juice). (In subsequent formulas, Tongbian and Jiang Zhi are essential for treating hematemesis even if phlegm is absent.)
For hematemesis and epistaxis, use Yujin (Curcumae Radix) powdered, mixed with Tongbian (Urine of an uncircumcised boy), Jiang Zhi (Zingiberis Rhizoma Juice), and good wine. (One formula omits wine.) For hematemesis, dry Hong Shanchahua (Camellia Japonica Flos) powdered, take 1 qian per dose, mixed with half a zhong of Tongbian (Urine of an uncircumcised boy) and a little Jiang Zhi (Zingiberis Rhizoma Juice).
[From *Bencao Gangmu*] To treat hematemesis and nasal redness: Juice 2 fen of Shengjiang (Zingiberis Rhizoma). Mix with 1 sheng of urine from a robust man. Drink hot in one dose for cure.
[Zhu Danxi] Another method: Mix one part Tongbian (Urine of an uncircumcised boy) with half a part wine. Grind Boye (Platycladi Cacumen) and drink warm.
Hematemesis complicated by Phlegm-Stasis can be purged. If vomiting occurs in bowls, only tonify Yin and descend Fire using large doses of Siwu Tang (Four Substances Decoction). If complicated by Phlegm, using Blood-invigorating herbs causes stagnation. Only treat the Fire, and the bleeding will stop on its own. Zhizi (Gardeniae Frizctus) best clears Blood in the stomach cavity.
[From *Xuanzhu Miyu*] Hematemesis arises from extreme depression of emotions and Qi, which disperses and generates Heat, causing reckless Heart Blood flow. Use Xuanmingfen (Mirabilite) plus Huangdan (Lithargyrum). Next, use Siwu Tang (Four Substances Decoction) with Jiedu (Detoxification) plus Oujie (Nelumbinis Rhizomatis Nodus) for treatment. Any heat in previous symptoms should be cleared.
[Zhang Zhongjing] Insufficient Heart Qi causing hematemesis and epistaxis is primarily treated with Xiexin Tang (Drain the Epigastrium Decoction). (Also treats Huoluan [Cholera-like disorder].)
Ingredients: Dahuang (Rhei Radix et Rhizoma) (2 liang), Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix) (each 1 liang).
These three ingredients, decoct in 3 sheng of water until 1 sheng remains. Take in one dose.
[Hai Zang] Yun Qizi Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction by Yun Qizi) treats Cun Kou pulse being hollow, with Blood in the Upper Jiao.
Ingredients: Shengdi (Rehmanniae Radix) (2 liang), Huangqin (Scutellariae Radix) (1.5 liang), Huanglian (Coptidis Rhizoma) (1 liang), Dahuang (Rhei Radix et Rhizoma) (0.5 liang).
Cut into pieces. Weigh 1 liang, decoct in 2 zhan of water. Strain and take after meals.
[From *Jianyao Jizhong Fang*] To treat hematemesis: Chuan Dahuang (Rhei Radix et Rhizoma) 1 liang, pounded into powder. Take 1 qian, with 1 he of Shengdiye Zhi (Rehmanniae Radix Juice) and 0.5 zhan of water. Boil for 3-5 boils. Take at any time.
[Zhu Danxi] For hematemesis with a sensation of Qi obstruction in the chest and vomiting purple blood, purge with Taoren Chengqi Tang (Peach Kernel and Magnolia Decoction).
Uncle Feng suffered rushing Qi upward, hematemesis, and pain in the heart and diaphragm.
Ingredients: Zhiqiao (Aurantii Fructus) (3 qian), Qingpi (Citri Reticulatae Pericarpium Viride) (2 qian), Shengdi (Rehmanniae Radix), Mutong (Akebiae Caulis), Mudanpi (Moutan Cortex) (1.5 qian), Taoren (Persicae Semen) (28 kernels), Chuanxiong (Ligustici Chuanxiong Rhizoma), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma) (1 qian), Gancao (Glycyrrhizae Radix et Rhizoma, small amount), Sheng Ganjiang (Fresh Zingiberis Rhizoma), Jiegeng (Platycodonis Radix).
Divide into four doses, decoct and take.
If suddenly vomiting a bowl of purple blood, do not panic; expelling it is good. This is Heat injuring Blood dying in the Liver. Take Siwu Tang (Four Substances Decoction) with Jiedu (Detoxification).
[From *Qianjin Fang*] To treat blood stasis in the heart and stomach from falling off a horse, with countless spitting of blood: Powder Ganhéhuagen (Nelumbinis Rhizomatis Radix) and take with wine, one fangcun bi, three times daily.
[Unnamed Master] Jiawei Xionggui Tang (Modified Ligusticum and Angelica Decoction) treats trauma from blows/falls, where败血 (stagnant blood) flows into the stomach cavity, vomiting black blood or bean-soup-like fluid.
Ingredients: Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Baihe (Lilii Bulbus, soaked in water for half a day), Jingjie Sui (Schizonepetae Spica) (equal parts).
Cut into pieces. Take 4 qian per dose, decoct in one zhan of water and half a zhan of wine until 0.7 zhan remains. Strain. Take at any time.
[Zhang Zhongjing] Patients who habitually drink alcohol and cough will inevitably suffer hematemesis, caused by excessive drinking. This belongs to Feiju (Lung Abscess).
[From *Qianjin Fang*] There are three types of hematemesis: Neinu (Internal Epistaxis), Feiju (Lung Abscess), and Shangwei (Stomach Injury). Neinu involves bleeding like epistaxis but not from the nostrils; it comes from fluids between the Heart and Lungs, flows back into the stomach, appearing like bean soup or chopped coagulated blood stopping in the stomach, leading to fullness and vomiting, sometimes losing several dou to one shi. It arises from fatigue and irregular diet. Feiju occurs after drinking, when toxic fullness causes vomiting, and blood follows, ranging from 1 he to 1 sheng. Shangwei occurs after overeating, when the stomach becomes cold and cannot digest, causing irritability and forced vomiting, forcing food and Qi upward, tearing the stomach opening and causing hematemesis with bright red color, abdominal cramping, spontaneous sweating, and a tight, rapid pulse; this is difficult to treat. (Kan, pronounced Kan in rhyme books, means coagulated blood.)
[Unnamed Master] Lizhong Tang (Regulate the Middle Decoction) can stop hematemesis from Stomach Injury because it best regulates the Middle Jiao, separates Yin and Yang, and stabilizes Blood vessels. (Hai Zang also said: Cold drinks injuring Spleen causing hematemesis is treated with Lizhong Tang to regulate the Middle Jiao and separate Yin/Yang. This is also the method for treating Neinu. See Shanghan for the formula.)
Erhe Hui San (Two-Part Ash Powder) treats lung abscess caused by eating spicy/hot foods, vomiting 1 he or 0.5 sheng of blood.
Ingredients: Hongzao (Ziziphi Jujubae Fructus, burnt with pits to retain nature), Baiyaojian (Theae Fermentatum Folium) (equal parts).
Grind into fine powder. Take 2 qian per dose, mixed with rice drink.
Chushi Tang (Dampness-Removing Decoction) treats dampness from rain penetrating collaterals causing blood overflow/epistaxis, or blood flowing into the stomach causing fullness and hematemesis.
Ingredients: Fuling (Poria), Ganjiang (Zingiberis Rhizoma) (each 4 qian), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 2 qian).
Cut into pieces. Take 4 qian per dose, decoct in one large zhan of water until 0.8 zhan remains. Strain and take. For headache, add Chuanxiong (Ligustici Chuanxiong Rhizoma) 2 qian; best for stopping epistaxis in bathrooms. (This formula uses Ganjiang (Zingiberis Rhizoma) as the sovereign herb for rain-induced hematemesis; Lizhong Tang uses it for stomach-injury hematemesis. Danxi also used roasted Ganjiang (Zingiberis Rhizoma) powdered with Tongbian (Urine of an uncircumcised boy) for uncontrollable massive hematemesis, showing Ganjiang (Zingiberis Rhizoma) is an essential herb for hematemesis.)
[Zhu Danxi] A seventeen-year-old man, poor and overworked, contracted a cold in November, occasionally vomiting two or three mouthfuls of blood. Six pulses were tight and choppy. Appetite decreased, epigastric fullness occurred. The doctor prescribed Wendan Tang (Warm the Gallbladder Decoction) and Zhijie Tang (Magnolia and Platycodon Decoction). Three days later, slight fever developed, dry mouth without thirst, phlegm in mouth. This was Cold invasion. Inquiry revealed he crossed streams three or four times in frost ten days prior, had sad thoughts, and was hungry. Thus, Xiaojianzhong Tang (Minor Construct the Middle Decoction) minus Shaoyao (Paeoniae Radix), plus Jiegeng (Platycodonis Radix), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), four doses led to recovery.
Another method to treat hematemesis: Powder Jiaozhi Gui (Cinnamomi Ramulus, specifically from Jiaozhi) 5 qian, mix with cold water and take. This also reflects the principle of Xiaojianzhong Tang (Minor Construct the Middle Decoction) treating Cold-induced hematemesis. The Classic states: When Taiyang governs the year, excess Cold damages Blood internally, causing vomiting blood, diarrhea with blood, and epistaxis. Treat with Acrid-Warm substances. Thus, Lizhong Tang (Regulate the Middle Decoction) and Jianzhong Tang (Construct the Middle Decoction) using Ganjiang (Zingiberis Rhizoma) and Guizhi (Cinnamomi Ramulus) for hematemesis follow this principle. For hematemesis complicated by Heat. (Treatment methods see under Blood Deficiency following Fire ascending section.)
[From *Neijing*] To treat vomiting blood: Select good Huangbai (Phellodendri Cortex), coat with honey, roast until dry, pound into powder. Take 2 qian bing mixed with warm Maidong (Ophiopogonis Tuber) water; immediate cure.
[From *Guangji Fang*] To treat continuous Heart-Heat hematemesis: Juice Sheng Gegen (Puerariae Lobatae Radix) half da sheng. Drink in one dose; immediate cure.
Hematemesis complicated by Cold is mostly due to consuming cold foods and contracting cold pathogens. Treatment methods see under Internal Injury Diet and External Contraction Wind-Cold sections.
[Zhang Zhongjing] For continuous hematemesis, Bowe Tang (Cacumen Platycladi Decoction) is primary.
Ingredients: Bowe (Platycladi Cacumen), Ganjiang (Zingiberis Rhizoma) (each 2 liang), Ai (Artemisiae Argyi Folium) (three handfuls).
These three ingredients, decoct in 5 sheng of water with 1 sheng of Matong Zhi (Equi Stercoris Succus). Reduce to 1 sheng. Divide into two warm doses. (Matong is juice from horse dung infusion.)
[From *Guangji Fang*] To treat continuous hematemesis and epistaxis: Fulonggan (Dragon's Liver) half sheng. Wash in 1 da sheng of fresh water, extract juice, mix with honey, and drink in one dose.
Qi-Yun (Climate-Epidemic Theory) states there are five types of blood overflow:
First, Heat assists Heart Blood, boiling and overflowing. The Classic says: When Shaoyang governs, in the first phase, weather is very warm, disease Qi boils upward, causing blood overflow. Also: When Shaoyin governs, guest excess leads to severe blood overflow. Also: When Shaoyang governs, guest excess causes blood overflow. Also: When Fire stagnates erupts, people suffer blood overflow; treat with Salty-Cold.
Second, Cold attacks Heart Blood, fleeing and overflowing. The Classic says: When Taiyang governs, Cold-Dampness holds at Qi intersection, people suffer blood overflow; treat with Bitter to dry and Warm.
Third, Internal Fire repels, External Cold obstructs, causing blood overflow. The Classic says: When Shaoyin governs, in the final phase, Dryness command acts, residual Fire is internally repelled, severe cases cause blood overflow.
Fourth, Wind-Dampness combats causing blood overflow, and Lower Cold combats, steaming Heat upward causing blood overflow. The Classic says: When Taiyin governs, in the first phase, Wind-Dampness combats, people suffer blood overflow. In the fourth phase, Fear of Fire arrives, humid evaporation transforms, Earth Qi rises, Heaven Qi blocks, cold wind morning/evening, steaming Heat combats, people suffer sudden hot blood overflow in pores. This is Earth Cold combating, Heaven Steaming Heat upward causing blood overflow.
Fifth, Dryness Evil attacks Liver causing blood overflow. The Classic says: When Year Metal is excessive, Dryness Qi spreads, disease involves turning sides, severe coughing/reversal causing blood overflow.
[From *Suwen*] When the Lung is injured; Spleen Qi does not guard, Stomach Qi is unclear, Meridian Qi does not serve, True Zang fails and breaks, Collaterals cut off sideways, Five Zang leak, either epistaxis or vomiting. (Shi Congrong Lun: Injuring Lung is injuring Qi; refer to Qi Deficiency unable to control Blood section for combined treatment.)
[Luo Qianfu] Mendong Yinzi (Asparagus Decoction) treats Spleen/Stomach Weakness, shortness of breath, weak Qi, short spirit, epistaxis, and hematemesis.
Ingredients: Wuweizi (Schisandrae Fructus) (5 berries), Gancao (Glycyrrhizae Radix et Rhizoma), Shaoyao (Paeoniae Radix), Huangqi (Astragali Radix) (each 1 qian), Ziwan (Asturi Radix) (1.5 qian), Renshen (Ginseng Radix et Rhizoma), Guishen (Angelicae Sinensis Radix root), Maidong (Ophiopogonis Tuber).
Grind into coarse powder. Two doses, decoct in water, take after meals.
[From *Bencao Gangmu*] Tianmendong Wan (Asparagus Pill) treats hematemesis and hemoptysis, moistening Lungs and stopping cough.
Ingredients: Tianmendong (Asparagi Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Xingren (Pruni Armeniaci Semen Amarum, stir-fried), Beimu (Fritillariae Cirrhosae Bulbus), Baifuling (Poria cum Risus), Ejiao (Colla Corii Asini) (each 0.5 liang).
Grind into fine powder, refine honey to form pills the size of bullets. Take one pill per dose, swallow saliva and let dissolve. Ten pills day and night.
[Zhu Danxi] Overindulgence in wine and sex, irregular hunger/fullness, causing hematemesis and bloody phlegm; miraculous.
Ingredients: Pipaye (Loquat Leaf), Kuanhua (Farfarae Flos), Bei Ziwan (Asturi Radix), Xingren (Pruni Armeniaci Semen Amarum, remove double kernels and tips), Lurong (Cervi Cornu Degelatinatum, roasted properly), Sangbaipi (Mori Cortex), Mutong (Akebiae Caulis) (each 1 liang), Dahuang (Rhei Radix et Rhizoma) (0.5 liang).
Refine honey to form pills. Let dissolve before sleep.
The Classic states: Anger causes Qi to surge, severely causing vomiting blood, so Qi goes up. Also: Yang Qi, in great anger, forms and Qi sever, Blood stagnates upward, causing Bo Jue (Thin Syncope). All these indicate Anger injures Liver Qi causing vomiting blood. Use Huanglian (Coptidis Rhizoma), Xiangfu (Cyperi Rhizoma), Qingdai (Indigo Naturalis), Chaihu (Bupleuri Radix), Gancao (Glycyrrhizae Radix et Rhizoma) to calm the Liver, and it heals itself. Should take Chifuling Xiexin Tang (Red Poria Drain Epigastrium Decoction).
[Worldly Prescriptions] To treat vomiting blood, hemoptysis, epistaxis, Liver damage: Baiji (Bletillae Rhizoma) powdered, mixed with rice drink; miraculous.
[From *Jianyao Jizhong Fang*] To treat hematemesis: Hu Ye (Oak Leaf) pounded into powder. Take 2 qian per dose, decoct in one zhan of water until 0.7 zhan remains. Take with dregs.
Poisonous Gu toxin hematemesis. (See Lower Blood section.)
Acupuncture/Moxibustion for hematemesis has two approaches:
First, target the Lung. The Classic says: Sudden Bi internal reversal, Liver combats, blood overflows nose/mouth, take Tianfu (LU3).
Second, target the Tendons. The Classic says: Hand Taiyin tendon disease, along the pathway, branch twisting tendon pain, severe becomes Xiben rib urgency hematemesis. Treat with burning needle quick prick, knowing as number, pain as Shu point.
[From *Zhenjiu Mi Yu*] Hematemesis: Fengfu (GV16), Dazhui (GV14), Ge Shu (BL17), Gan Shu (BL18) (each 5 fen. Disperse for immediate cure.)
[Sl Bo Ren] Another method: Weiwann (CV12), Zhongwan (CV12 - likely typo in source, usually Zhongwan is CV12, Weiwann might refer to specific point or typo for Weiwan? Source says Weiwann, Zhong, Ganshu. Assuming Weiwann is a variant or typo, keeping original text entity), Gan Shu (BL18) (each 2.5 cun oblique).
[From *Zhenjiu Ji Cheng*] Another method: Zhongwan (CV12), Zhongwan (CV12 - repeated?), Qihai (CV6), Sanli (ST36), Rugen (ST17), Zhigou (SJ6). If not cured, take lower points: Fei Shu (BL13), Shen Shu (BL23), Xin Shu (BL15), Gaohuang (BL43), Guanyuan (CV4).
[Sl Bo Ren] Vomiting blood, hypochondriac pain, dry mouth, inability to cough, drawing Kidney pain: Burong (ST14, lateral puncture outward), Shangwan (CV13, 3.5 cun), Daling (PC7), Neiguan (PC6 - source says Men, likely Neiguan PC6 or similar, keeping 'Men' as per source text entity if distinct, but standard is Neiguan. Source says 'Men', likely typo for Neiguan or specific point. I will list 'Men' as extracted), Shenmen (HT7).
[From *Jiaying Yizong Jinjian* / *Jia Yi Jing*] Vomiting blood, Daling (PC7) and Neiguan (PC6) govern it. Vomiting blood with rising Qi, Shenmen (HT7) governs it. Fullness below heart with diaphragm, vomiting blood, Shangwan (CV13) governs it. Vomiting blood, shoulder stiffness, hypochondriac pain, dry mouth, heart pain. Radiating to back, inability to cough, coughing causes shoulder pain, Burong (ST14) governs it.
Liver Pulse too excessive indicates Internal Abscess, prone to vomiting/epistaxis. (Full text see Treating Deficiency/Excess methods.)
Diagnosis of hematemesis. (See previous Bleeding Syndromes section.)