堂侄女××，适邻村王氏，年三十岁。于乙酉仲春，得吐血证。
病因 因家务自理，劳心过度，且禀赋素弱，当此春阳发动之时，遂病吐血。
证候 先则咳嗽痰中带血，继则大口吐血，其吐时觉心中有热上冲，一日夜吐两三次，
剧时可吐半碗。两日之后，觉精神气力皆不能支持，遂急迎愚延医。自言心中摇摇似将上脱，两
颧发红，面上发热，其脉左部浮而动，右部浮而濡，两尺无根，数逾五至。
诊断 此肝肾虚极，阴分阳分不相维系，而有危在顷刻之势。遂急为出方取药以防虚脱。
处方 生怀山药（一两） 生怀地黄（一两） 熟怀地黄（一两） 净萸肉（一两） 生赭石（一两轧细）
急火煎药取汤两盅，分两次温服下。
效果 将药甫煎成未服，又吐血一次，吐后忽停息闭目 然罔觉。诊其脉跳动仍旧，知能
苏醒，约四分钟呼吸始续，两次将药服下，其血从此不吐。俾即原方再服一剂，至第三剂即原方加
潞党参三钱、天冬四钱，连服数剂，身形亦渐撤消。继用生怀山药为细面，每用八钱煮作茶汤，少
调以白糖，送服生
赭石细末五分，作点心用之以善其后。
天津王××，年二十四岁，得咳嗽吐血证。
病因 禀赋素弱，略有外感，即发咳嗽，偶因咳嗽未愈，继又劳心过度，心中发热，遂至吐血。
证候 先时咳嗽犹轻，失血之后则嗽益加剧。初则痰中带血，继则大口吐血，心中发热，气息微
喘，胁下作疼，大便干燥。其脉关前浮弦，两尺重按不实，左右皆然，数逾五至。
诊断 此证乃肺金伤损，肝木横恣，又兼胃气不降，肾气不摄也。为其肺金受伤，是以咳嗽痰中
带血；为胃气不降，是以血随气升，致胃中血管破裂而大口吐血；至胁下作疼，乃肝木横
恣之明证；其脉上盛下虚，气息微喘，又肾气不摄之明征也。治之者，宜平肝、降胃、润肺、
补肾，以培养调剂其脏腑，则病自愈矣。
处方 生怀山药（一两） 生赭石（六钱轧细） 生怀地黄（一两） 生杭芍（五钱）
天冬（五钱） 大甘枸杞（五钱） 川贝母（四钱） 生麦芽（三钱）
牛蒡子（三钱捣碎） 射干（二钱） 广三七（三钱细末） 粉甘草（二钱细末）
药共十二味，将前十味煎汤一大盅，送服三七、甘草末各一半，至煎渣再服，仍送服其余一半。
效果 服药一剂，吐血即愈，诸病亦轻减。后即原方随时为之加
减，连服三十余剂，其嗽始除根，身体亦渐壮健。
Cousin's daughter ××, married to the Wang family in a neighboring village, aged thirty. In the mid-spring of the Yiyi year (乙酉), she contracted hematemesis (vomiting blood).
Etiology Due to managing household affairs independently and excessive mental exertion, combined with a constitution that was inherently weak, during this time when spring yang qi is activating, she fell ill with hematemesis.
Symptoms Initially, coughing with blood-streaked sputum, followed by large-mouthed vomiting of blood. During vomiting, she felt heat rushing up from the heart. She vomited two or three times within a day and night; at its worst, half a bowl could be vomited. After two days, feeling that her spirit and strength could no longer support her, she urgently invited me to treat her. She described her heart as trembling as if about to collapse, redness on both malar bones, and heat on the face. Her pulse was floating and restless on the left side, floating and soft on the right side, rootless in both chi positions, with a rate exceeding five beats per cun (approx. 50-60 bpm depending on context, but literally "exceeds five zhi").
Diagnosis This indicates extreme deficiency of the Liver and Kidney, where Yin and Yang cannot maintain mutual connection, presenting a critical situation imminent in an instant. I immediately prescribed a formula to prevent collapse.
Prescription Raw Huai Dioscorea Rhizome (Sheng Huai Shanyao) [Dioscoreae Hypoglaucae Rhizoma] (1 liang), Raw Huai Rehmannia Root (Sheng Huai Dihuang) [Rehmanniae Radix] (1 liang), Cooked Huai Rehmannia Root (Shu Huai Dihuang) [Rehmanniae Radix Preparata] (1 liang), Clean Cornus Fruit (Jing Yurou) [Corni Fructus] (1 liang), Raw Ocher Stone (Sheng Zheshi) [Haematitum] (1 liang, finely crushed).
Decoct rapidly to obtain two bowls of decoction, taken warm in two doses.
Outcome Before the medicine was even finished decocting and consumed, she vomited blood once more. After vomiting, she suddenly ceased breathing and closed her eyes, yet remained unconscious. Palpating her pulse, the beating continued, indicating she would regain consciousness. After approximately four minutes, respiration resumed. After taking the medicine in two doses, the bleeding stopped completely. She was instructed to take one additional dose of the original formula. By the third dose, Luodangshen [Codonopsis Radix] (3 qian) and Tiandong [Asparagi Radix] (4 qian) were added to the original formula. After several doses, her emaciation gradually improved. Subsequently, Raw Huai Dioscorea Rhizome was ground into fine powder. Each time, 8 qian were boiled as a tea-like beverage, slightly sweetened with white sugar, and taken with 5 fen of fine Raw Ocher Stone powder as a snack for convalescence.
Wang ×× from Tianjin, aged twenty-four, suffered from coughing and hematemesis.
Etiology With an inherently weak constitution, a slight external contraction triggered coughing. Due to the unresolved cough and subsequent excessive mental exertion, causing heat in the heart, he eventually developed hematemesis.
Symptoms Initially, the cough was mild, but intensified after blood loss. At first, there was blood in the sputum, followed by large-mouthed vomiting of blood, heat in the heart, slight panting, pain in the hypochondrium, and dry stools. The pulse at the guan position was floating and wiry; both chi positions were empty upon heavy pressure, similarly on both sides, with a rate exceeding five beats per cun.
Diagnosis This condition involves damage to Lung Metal, rampant Liver Wood, accompanied by failing descent of Stomach Qi and failure of Kidney Qi to secure. Because Lung Metal is injured, there is coughing with blood-streaked sputum; because Stomach Qi fails to descend, blood rises with Qi, rupturing vessels in the Stomach leading to large-mouthed hematemesis; pain in the hypochondrium is clear evidence of rampant Liver Wood; an upper-excess and lower-deficient pulse with slight panting are clear signs of Kidney Qi failing to secure. Treatment should involve calming the Liver, descending Stomach Qi, moistening the Lungs, and tonifying the Kidneys to nourish and regulate the Zang-Fu organs, so the disease will heal itself.
Prescription Raw Huai Dioscorea Rhizome (Sheng Huai Shanyao) [Dioscoreae Hypoglaucae Rhizoma] (1 liang), Raw Ocher Stone (Sheng Zheshi) [Haematitum] (6 qian, finely crushed), Raw Huai Rehmannia Root (Sheng Huai Dihuang) [Rehmanniae Radix] (1 liang), Raw Hang Peony Root (Sheng Hang Shao) [Paeoniae Radix Alba] (5 qian), Tiandong [Asparagi Radix] (5 qian), Large Sweet Goji Berry (Da Gan Gouqi) [Lycii Fructus] (5 qian), Chuan Bei Mu [Fritillariae Cirrhosae Bulbus] (4 qian), Raw Malt (Sheng Maiya) [Hordei Fructus Germinatus] (3 qian), Niu Bang Zi [Arctii Fructus] (3 qian, crushed), Shegan [Belamcandae Rhizoma] (2 qian), Guang Sanqi [Notoginseng Radix et Rhizoma] (3 qian, fine powder), Fen Gancao [Glycyrrhizae Radix et Rhizoma Preparata] (2 qian, fine powder).
Twelve ingredients in total. Decoct the first ten ingredients to obtain one large bowl of decoction. Take half of the Sanqi and Gancao powders with it. When decocting the dregs for the second dose, take the remaining half of the powders.
Outcome After one dose, hematemesis ceased, and other symptoms alleviated. Thereafter, modifications were made to the original formula as needed. After taking over thirty doses, the cough was eradicated, and the body gradually became robust.