治因吐衄不止，致阴分亏损，不能潜阳而作热，不能纳气而作喘。甚或冲气因虚上干，为呃逆、为眩晕。
心血因虚甚不能内荣，为怔忡、为惊悸不寐。或咳逆、或自汗诸虚证蜂起之候。
生山药（一两） 清半夏（三钱） 净萸肉（五钱） 生赭石（六钱，轧细） 牛蒡子（二钱，炒捣）
生杭芍（四钱） 甘草（钱半）
治吐血过多，气分虚甚，喘促咳逆，血脱而气亦将脱。其脉上盛下虚，上焦兼烦热者。
生山药（一两） 野台参（五钱） 生赭石（八钱，轧细） 知母（六钱） 大生地（六钱） 生杭芍（四钱）
牛蒡子（四钱，炒捣） 三七（二钱，细轧药汁送服）
一叟，年六十四，素有劳疾，因劳嗽太甚，呕血数碗。其脉摇摇无根，或一动一止，或两三动一止。此气
血虚极，将脱之候也。诊脉时见其所嗽吐者，痰血相杂。询其从前呕吐之时心中发热。为制此汤，一剂而血止，
又服数剂脉亦调勺。
附录∶
直隶青县张××来函∶
河间裘××，年二十八岁。患咳嗽吐血，且咯吐甚多，气分太虚，喘息迫促，上焦烦热，其脉大而无力，右
部尤甚，盖血脱而气亦将脱也。急用保元寒降汤，加青竹茹、麦门冬各三钱。一剂血止。至第二剂，将台参五
钱易为西洋参一钱，服之而愈。方病相投，效如影响，洵不误也。
Treatment for continuous hematemesis or epistaxis leading to deficiency of the Yin aspect, resulting in the inability to anchor Yang causing heat, and the inability to grasp Qi causing panting. In severe cases, the Chong vessel Qi may rise upward due to deficiency, manifesting as hiccups or dizziness.
Heart Blood, severely deficient, fails to nourish internally, leading to palpitations (Zhenchong), fright palpitations, and insomnia. Or cough with rebellious Qi, spontaneous sweating, and various other deficiency syndromes arising simultaneously.
Raw Dioscoreae Rhizoma (Shanyao) (30g) Clear-processed Pinelliae Tuber (Banxia) (9g) Cleaned Corni Fructus (Yurou) (15g) Raw Ostrich Shell (Zheshi) (18g, finely crushed) Arctii Fructus (Niubangzi) (6g, stir-fried and crushed)
Raw Paeoniae Radix Alba (Baishao) (12g) Licorice Root (Gancao) (4.5g)
Treatment for excessive hematemesis causing severe deficiency of the Qi aspect, panting with cough and rebellious Qi, where blood loss is so great that Qi is also on the verge of collapse. The pulse is excess at the upper position and deficient at the lower position, accompanied by irritability and heat in the Upper Jiao.
Raw Dioscoreae Rhizoma (Shanyao) (30g) Wild Taishen (Taishen) (15g) Raw Ostrich Shell (Zheshi) (24g, finely crushed) Anemarrhenae Rhizoma (Zhimu) (18g) Large Raw Rehmanniae Radix (Dihuang) (18g) Raw Paeoniae Radix Alba (Baishao) (12g)
Arctii Fructus (Niubangzi) (12g, stir-fried and crushed) Notoginseng Radix et Rhizoma (Sanqi) (6g, finely crushed, taken with decoction juice)
An elderly man, sixty-four years old, had a chronic consumptive disease. Due to severe labor-induced cough, he vomited several bowls of blood. His pulse was unstable and rootless; sometimes it beat once then stopped, or two or three times then stopped. This indicates extreme deficiency of Qi and Blood, on the verge of collapse. During pulse diagnosis, it was observed that his sputum contained mixed phlegm and blood. Upon inquiry, he reported feeling heat in the heart during previous vomiting episodes. This formula was prescribed. After one dose, bleeding stopped. After taking a few more doses, the pulse became harmonious.
Appendix:
Letter from Zhang XX of Qing County, Zhili:
Qiu XX of Hejian, twenty-eight years old, suffered from cough and hemoptysis, with significant expectoration. His Qi aspect was extremely deficient, with urgent and rapid panting, and irritability and heat in the Upper Jiao. His pulse was large but forceless, especially in the right position, indicating that blood loss was causing Qi to be on the verge of collapse. Baoyuan Hanjian Decoction was urgently administered, with added Green Bamboo Shavings (Qingzhuru) and Ophiopogonis Radix (Maidong), each 9g. Bleeding stopped after one dose. For the second dose, Taishen (15g) was replaced with American Ginseng (Xiyangshen) (3g). He recovered after taking it. The prescription matched the condition perfectly, and the effect was immediate, proving accurate.