百部根（二两） 升麻（半两） 桂心 五味子 甘草（炙） 紫菀 干姜（各一两）
上七味，蜜丸，桐子大。每服三十丸，日三次，知为度。忌生葱、海藻、菘菜。
〔《外》〕疗肺偏损胸中虚，肺偏痛、唾血气咳，款冬散。
款冬花 当归（各六分） 桂心 芎 五味子 附子（炮。各七分） 细辛 贝母（各四分）
干姜 生地（各八分） 白术 甘草（炙） 杏仁（去皮尖。各五分） 紫菀（三分）
上共为末，清酒服方寸匕，日二服。忌生葱、生菜、桃、李、雀肉、海藻、菘菜、猪肉、
芜荑。
按∶唾血咳血，属寒者少。今此二方，用姜附热剂，盖为肾足少阴脉是动病咳唾血者设也。
用者审之。
〔《脉》〕肺伤者，其人劳倦则咳唾血，其脉细紧浮数，皆吐血，此为躁扰嗔怒得之，脉伤
气壅所致。
经云∶肺脉不及，则令人喘，呼吸少气而咳，上气见血下者，此病皆肺虚，咳唾血之症，治
法并见气虚条。
治虚劳久嗽咯血。用五倍子焙为细末，每服一钱，用温茶一大口许调匀，食后米饮半盏调服。
〔《玄》〕肺经呕咳诸血，及痰中有血，初用生萝卜汁半盏，入盐少许，服之立效，如无生萝
卜，用萝卜子一钱，苏叶一钱，同煎服。次用鸡苏散加阿胶治之。（《本草》云∶萝卜大下气，
气下则血亦下也。）
〔《经》〕治咳嗽甚者，或有吐血。鲜桑白皮一斤，米泔浸三宿，净刮上黄皮锉细，入糯米四
两焙干，一处捣为末，每服一二钱，米饮调下。此方神效。
〔《本》〕治久嗽咯血，成肺痿，及吐白涎，胸膈满闷不食，扁豆散。
扁豆 生姜（各半两） 枇杷叶（去毛） 半夏 人参 白术（各一分） 白茅根（三分）
上锉，水三升，煎一升，去渣，下槟榔末一钱，和匀，分四服，不拘时候。
〔《千》〕治上气咳嗽喘息，喉中有物，唾血方。
生姜汁 杏仁（各二升） 糖 蜜（各一升） 猪膏（二合）
上五味，先以猪膏煎杏仁色黄出之，以纸拭令净。捣如膏。又和姜汁、蜜糖等合煎，令可丸。
每服如杏仁一枚，日夜六七服，渐次增加。
上后二方生姜多，肺虚及汗多亡阳与血下便者，忌用。
〔《素》〕少阴所谓咳唾则有血者，阳脉伤也。（脉解篇）
运气 咳唾血有二∶
一曰热伤肺。经云∶少阴司天，热淫所胜，民病唾血。又云∶少阳司天，火淫所胜，病咳唾
血。治以咸寒是也。
二曰湿伤肾。经云∶太阴司天，湿淫所胜，咳唾则有血，治以苦热是也。
〔丹〕治咯血。用白芨一两，藕节半两，为细末，每一钱，汤调服，神效。或云芨下咽至血窍，
则窍为芨末填而血止也。
〔《山》〕咯血。新棉灰半钱，酒调下。
针灸唾嗽血毒，取足少阴一经。经云∶肾足少阴之脉是动，则病咳唾有血。视盛虚热寒陷下
取之也。
〔东〕吐血内损∶地五会（三分，灸五壮） 鱼际（五分泻） 尺泽（一寸补）
〔《甲》〕唾血时寒热，泻鱼际，补尺泽。唾血振寒，嗌干，太渊主之。内伤唾血不足，
外无膏泽，地五会
灸。胸胁胀满，咳逆上气呼吸及唾浊沫脓血，库房主之。
〔《外》〕治上气唾脓血，灸两乳下黑肉际，各一十壮。
〔仲〕寸口脉数，其人咳，口中反有浊唾涎沫者何？师曰∶此为肺痿之病。若口中辟辟燥，咳
即胸中隐隐痛，脉反滑数，此为肺痈。咳唾脓血，脉数虚为肺痿，数实，为肺痈。
上肺痿唾脓血治法，散见本门诸方。若肺痿，但唾涎沫无脓血者，见咳嗽门。
肺脉微急，为肺寒热，怠惰咳唾血，引腰背胸，若鼻 肉不通。（经云∶急者多寒。
全文见治虚实法。）
〔《素》〕肺脉搏坚而长，当病吐血。（王注云∶肺虚极则咯逆故唾血。脉要精微篇）
〔《脉》〕唾血，脉紧强者死，滑者生。
手少阴筋病内急，心承伏梁，下为肘网。其成伏梁唾脓血者，死不治。（全文见筋 伏梁心之积，在脐上。）
心脉微缓，为伏梁在心，唾血。（全文见虚实法。）
〔罗〕肺痿辨 华严寺何上座，年未四十。四月间，因澡浴大汗出，还寺剃头伤风寒，头疼，
四肢困倦，就市中撮取通圣散服之，又发汗。头疼少减，再日复作，又以前药发之，汗数次，
四肢添劳重，喘促自汗恶风，咳而有血，懒于言语，饮食减少。求医治之，与药又多以生姜为引。
至六月间，精神愈困，饮食减少，形体羸瘦，或咳或唾，经血极多，请予治之，具说前由。诊
其脉浮数七八至，按之无力。予曰∶不救矣。或曰∶何为不救？予曰∶血之与汗，异名同类。夺
汗者无血，夺血者无汗。《金匮要略》云∶肺痿之病，从何得之？师曰∶或从汗出，或被快药下
利，重亡津液，故得之。今肺气已虚，又以辛药泻之，重虚其肺，不死何待。藏气法时论云∶
肺欲收，急食酸以收之，以酸补之，以辛泻之，盖不知《内经》之旨。仲景云∶医术浅狭，懵
然不知病源，为治乃误，发汗吐下之相反，其祸至速。世人但务彼翕习之荣，而莫见此倾危
之习，惟明者居然能护其本，近取诸身，夫何远之有焉。其僧不数日果亡。
Radix Stemonae (2 liang) Rhizoma Cimicifugae (0.5 liang) Cortex Cinnamomi Radix Schisandrae Fructus Glycyrrhizae Preparata (Honey-fried) Flos Asteris Radium Gingeris (each 1 liang)
The above seven ingredients are processed into honey pills, sized like Sophora japonica seeds. Take 30 pills per dose, three times daily, until efficacy is observed. Avoid raw green onion, Sargassum, and Chinese cabbage.
[From *Waitai Miyao*] For treating Lung deficiency causing chest emptiness, unilateral Lung pain, hemoptysis with sputum, and cough with Qi rebellion, use the Kuantong Powder.
Flos Tussilaginis Radix Angelicae Sinensis (each 6 fen) Cortex Cinnamomi Radix Ligustici Chuanxiong Radix Schisandrae Radix Aconiti Lateralis Preparata (Pao, each 7 fen) Radix Asari Rhizoma et Radix Belleririci (each 4 fen) Radium Gingeris Radix Rehmanniae Recens (each 8 fen) Rhizoma Atractylodis Macrocephalae Fructus Glycyrrhizae Preparata (Honey-fried) Semen Pruni Armeniacae (de-skinned and de-seeded, each 5 fen) Flos Asteris (3 fen)
All ingredients are ground into powder. Take one fangcun bi (a square-inch measure) with clear wine, twice daily. Avoid raw green onion, raw vegetables, peach, plum, sparrow meat, Sargassum, Chinese cabbage, pork, and Elsholtzia.
Note: Hemoptysis or coughing up blood is rarely due to Cold. These two formulas use hot agents like Ziang (Dried Ginger) and Fuzi (Prepared Aconite Root), likely designed for conditions where the Foot-Shaoyin Kidney Meridian is affected, causing coughing and spitting of blood. Users should exercise caution.
[From *Maijing*] When the Lung is injured, fatigue induces coughing and spitting of blood. The pulse may be fine, tight, floating, or rapid; all indicate hematemesis/hemoptysis caused by agitation and anger, leading to vessel injury and Qi stagnation.
The Classics state: If the Lung pulse is deficient, it causes asthma, shortness of breath, cough, upward rushing Qi, and lower bleeding. These diseases belong to Lung deficiency and symptoms of coughing/spitting blood; treatment methods are detailed in the Qi Deficiency section.
For treating chronic cough and hemoptysis due to deficiency exhaustion: Roast Galla Chinensis until dry, grind into fine powder. Take 1 qian per dose, mixed with a large mouthful of warm tea, taken after meals with half a cup of rice water.
[From *Bencao Yanyi*] For vomiting and coughing with various bleeds from the Lung meridian, and blood in phlegm: Initially, take half a cup of fresh radish juice with a little salt for immediate effect. If fresh radish is unavailable, decoct 1 qian Raphani Semen and Perilla Folium together. Subsequently, treat with Jisu San plus Colla Corii Asini. (*Bencao* states: Radish strongly directs Qi downward; as Qi descends, Blood also descends.)
[From *Jingyi*] For severe cough or hematemesis: Take 1 jin of fresh Cortex Mori, soak in rice washing water for three nights, wash clean, scrape off yellow skin, and chop finely. Mix with 4 liang of glutinous rice, roast dry, and grind together into powder. Take 1-2 qian per dose with rice water. This formula is miraculous.
[From *Bencao Gangmu*] For chronic cough with hemoptysis progressing to Feiwei (Lung萎/Flaccidity), spitting white saliva, chest fullness, and anorexia, use Bidou San.
Semen Phaseoli Radiati Radix Zingiberis Recens (each 0.5 liang) Folium Eriobotryae (de-hairy) Rhizoma Pinelliae Radix Ginseng Rhizoma Atractylodis Macrocephalae (each 1 fen) Radix Imperatae (3 fen)
Chop herbs, decoct in 3 sheng of water until 1 sheng remains, strain, add 1 qian of Arecae Semen powder, mix well, and divide into four doses. Take at any time.
[From *Qianjin Fang*] For upper Qi cough, asthma, sensation of foreign body in throat, and hemoptysis:
Radix Zingiberis Recens Juice Semen Pruni Armeniacae (each 2 sheng) Sugar Mel (each 1 sheng) Medulla Suillae (2 he)
The above five ingredients: First, fry Semen Pruni Armeniacae in Medulla Suillae until yellow, remove, wipe clean with paper, and pound into paste. Mix with Radix Zingiberis Recens Juice, Mel, and Sugar, and decoct until pillable. Take a dose the size of one Semen Pruni Armeniacae, 6-7 times day and night, gradually increasing.
The latter two formulas contain much Ziang (Fresh Ginger); they are contraindicated for Lung deficiency, excessive sweating with Yang collapse, and those with rectal bleeding.
[From *Suwen*] What Shaoyin means by "coughing and spitting blood" is injury to the Yang pulses. (See *Maiejie Pian*)
In Yunqi (Five Movements and Six Qi) theory, hemoptysis has two types:
First, Heat injuring the Lung. The Classics state: When Shaoyin governs the year, excess Heat causes people to spit blood. Also: When Shaoyang governs, excess Fire causes cough and hemoptysis. Treat with salty-cold substances.
Second, Dampness injuring the Kidney. The Classics state: When Taiyin governs, excess Dampness causes cough and spitting blood. Treat with bitter-hot substances.
[From Zhu Danxi] For hemoptysis: Use 1 liang of Rhizoma Bletillae and 0.5 liang of Node Lotus Rhizome, grind to fine powder. Take 1 qian mixed with water. Miraculous effect. Some say Bletia powder fills the blood vessels upon swallowing, stopping the bleed.
[From *Shanju Bencao*] For hemoptysis: Take 0.5 qian of ash from new cotton, mixed with wine.
Acupuncture for toxic hemoptysis/cough selects the Foot-Shaoyin channel. The Classics state: Disturbance of the Foot-Shaoyin Kidney Meridian causes cough and spitting blood. Select points based on excess/deficiency, heat/cold, and sinking.
[Wang Zhizhong] For internal damage from hematemesis: Diwuhui (ST41? Note: Text says Diwuhui, usually BL60 or ST41 context dependent, here likely referring to a specific point in this context, often associated with foot/kidney in older texts or typo for another point, but sticking to text: Diwuhui) - Puncture 3 fen, Moxa 5 zhuang. Yuji (LU10) - Puncture 5 fen, reduce method. Chize (LU5) - Puncture 1 cun, tonify method.
[From *Jiayi Jing*] For hemoptysis with chills and fever, reduce Yuji (LU10), tonify Chize (LU5). For hemoptysis with tremors/chills and dry throat, Taiyuan (LU9) is primary. For internal injury hemoptysis with insufficiency and lack of luster, moxa Diwuhui. For chest/flank distension, cough with rebellious Qi, rapid breathing, and spitting turbid foam/pus/blood, Kukufang (ST22) is primary.
[From *Waitai Miyao*] For upper Qi spitting pus and blood, moxa the junction of black flesh below both nipples, 10 zhuang each.
[Zhang Zhongjing] If Cun Kou pulse is rapid, and the person coughs, yet has turbid saliva/phlegm in the mouth, what is this? Master says: This is Feiwei (Lung Flaccidity). If the mouth is dry, coughing causes hidden chest pain, and the pulse is slippery and rapid, this is Fei Yong (Lung Abscess). Coughing and spitting pus/blood with a rapid but empty pulse indicates Feiwei; rapid and solid pulse indicates Fei Yong.
Treatment methods for Feiwei with pus/blood are scattered in this category's formulas. For Feiwei with only saliva/phlegm and no pus/blood, see the Cough category.
If the Lung pulse is slightly urgent, it indicates Lung cold/heat, lethargy, hemoptysis, pulling pain in waist/back/chest, or nasal polyp obstruction. (Classics: Urgent pulses often indicate Cold. See full text in Treating Excess/Deficiency methods.)
[From *Suwen*] If the Lung pulse is firm and long, one should expect hematemesis. (Wang Bing notes: Extreme Lung deficiency leads to rebellious Qi, hence hemoptysis. See *Maiyao Jingwei Lun*)
[From *Maijing*] For hemoptysis, a tight and strong pulse indicates death; a slippery pulse indicates survival.
Hand-Shaoyin tendon disease with internal tension, Heart Fu Liang accumulation, extending down to form elbow nets. If it develops into Fu Liang with spitting pus/blood, it is incurable/deadly. (Full text in Tendon Bi, Fu Liang, Heart Accumulation, located above navel.)
If the Heart pulse is slightly slow, it indicates Fu Liang in the Heart and hemoptysis. (Full text in Treating Excess/Deficiency methods.)
[Luo Tianyi] Differentiation of Feiwei: He, Abbot of Huayan Temple, under 40 years old. In April, after bathing and profuse sweating, he shaved his head at the temple and caught wind-cold. Symptoms: headache, limb fatigue. He bought Tongsheng San from the market and took it, inducing further sweating. Headache reduced slightly, but recurred next day. Repeated sweating with the same medicine led to heavier limbs, asthma, spontaneous sweating, aversion to wind, cough with blood, reluctance to speak, and decreased appetite. Doctors treated him with ginger as a guide. By June, spirit was more exhausted, appetite lower, body emaciated, intermittent cough/sputum, extremely heavy menstruation. I diagnosed: Pulse floating and rapid, 7-8 beats per breath, weak on pressure. I said: Incurable. Someone asked why. I said: Blood and sweat are different names for the same substance. Depriving sweat deprives blood; depriving blood deprives sweat. *Jingui Yaolue* asks: How is Feiwei acquired? Master says: From sweating or purgatives causing severe fluid loss. Now Lung Qi is already deficient, and pungent drugs were used to disperse, further damaging the Lung. How can he not die? *Zangqi Fazhi Lun* states: Lung desires consolidation; use sour to consolidate, sour to tonify, pungent to disperse. They ignored the *Neijing*. Zhongjing said: Shallow medical knowledge leads to ignorance of disease origin, causing treatment errors. Opposing methods like sweating, vomiting, purging bring rapid disaster. People seek superficial glory, ignoring danger. Only the wise protect the root. Taking examples from oneself, what is far? The monk died days later.