治肝郁多怒，胃郁气逆，致吐血、衄血及吐衄之证屡服他药
不效者，无论因凉因热，服之皆有捷效。
川大黄（一钱细末） 油肉桂（一钱细末） 生赭石（六钱细末）
上药三味，将大黄、肉桂末和匀，用赭石末煎汤送下。
一妇人，年近三旬，咳嗽痰中带血，剧时更大口吐血，常觉心中发热。其脉一分钟九十至，按之不实。
投以滋阴宁嗽降火之药数剂无效。因思此证，若用药专止其嗽，嗽愈其吐血亦当愈。遂用川贝九钱，煎取清汤
四茶盅，调入生山药细末一两，煮作稀粥。俾于一日连进二剂，其嗽顿止（此方可为治虚嗽良方），吐血证亦
遂愈。数日后，觉血气上潮，肺复作痒而嗽，因此又复吐血。自言夜间睡时，常作生气恼怒之梦，怒极或梦中
哭泣，醒后必然吐血。据所云云，其肝气必然郁遏，遂改用舒肝（连翘薄荷不可多用）泻肝（龙胆楝子）之品，
而以养肝（柏子仁生阿胶）镇肝（生龙骨生牡蛎）之药辅之，数剂病稍轻减。而犹间作恼怒之梦，梦后仍复吐
血。欲辞不治，病家又信服难却。再四踌躇，恍悟平肝之药，以桂为最要，肝属木，木得桂则枯也（以桂作钉
钉树，其树立枯），而单用之则失于热。降胃止血之药，以大黄为最要（观《金匮》治吐衄有泻心汤重用大黄
可知），胃气不上逆，血即不逆行也，而单用之又失于寒。若二药并用，则寒热相济，性归和平，降胃平肝，
兼顾无遗。况俗传方，原有用此二药为散，治吐血者，用于此证当有捷效。而再以重坠之药辅之，则力专下行，
其效当更捷也。遂用大黄、肉桂细末各一钱和匀，更用生赭石细末煎汤送下，吐血顿愈，恼怒之梦，亦从此不
作。后又遇吐血者数人，投以此方，皆随手奏效。至其人身体壮实而暴得吐血者，又少变通其方∶大黄、肉桂
细末各用钱半，将生赭石细末六钱与之和匀，分三次服，白开水送下，约点半钟服一次。
Treats conditions of hematemesis (vomiting blood) and epistaxis (nosebleed), as well as recurrent bleeding syndromes that have failed to respond to other medications, caused by Liver Qi stagnation leading to irritability and excessive anger, and Stomach Qi stagnation causing rebellious upward flow. Regardless of whether the etiology is cold or heat, this formula yields rapid efficacy.
Rhizoma Rhei Preparatum (Cinnabar Rhubarb, one qian, finely powdered)
Cortex Cinnamomi Oleosum (Oily Cinnamon Bark, one qian, finely powdered)
Fossilia Os Draconis Cruda (Raw Hematite, six qian, finely powdered)
The above three herbs: Mix the powders of Rhizoma Rhei Preparatum and Cortex Cinnamomi evenly. Decoct Fossilia Os Draconis Cruda in water to make a decoction, and use it to swallow the mixed powder.
A woman, nearly thirty years old, suffered from cough with blood-streaked sputum; during severe episodes, she vomited large amounts of blood and often felt heat in her heart/chest. Her pulse beat ninety times per minute, and felt empty upon heavy pressure.
Prescriptions aimed at nourishing Yin, calming cough, and descending fire were administered for several doses without effect. Reflecting on this case, I reasoned that if medication specifically stopped the cough, the hematemesis would likely cease as well. Thus, I used Radix Baeckea (Chuanbei) nine qian, decocted to obtain four tea-cupfuls of clear liquid, into which was stirred one liang of fine powder of Raw Rhizoma Dioscoreae (Shanyao), and boiled into a thin porridge. The patient was instructed to consume two doses within one day. The cough ceased immediately (this formula serves as an excellent prescription for treating deficiency-type cough), and the hematemesis also resolved. Several days later, she felt blood and Qi surging upward, her lungs became itchy again triggering a cough, and consequently, she bled again. She stated that during sleep at night, she frequently dreamed of anger and irritation; in extreme anger or while crying in dreams, she would inevitably vomit blood upon waking. Based on her description, her Liver Qi must have been stagnant and obstructed. Therefore, I switched to using herbs that soothe the Liver (Qiaoyin, Bohe should not be used in excess) and purge the Liver (Longdan, Lianzi), assisted by herbs that nourish the Liver (Baiziren, Raw Ejiao) and anchor the Liver (Raw Longgu, Raw Muli). After several doses, the condition slightly improved. However, she still occasionally had angry dreams, and bled again after waking from them. I wished to discontinue treatment, but the family’s trust made refusal difficult. After much deliberation, I suddenly realized that among herbs that calm the Liver, Cinnamon Bark is most essential; the Liver belongs to Wood, and Wood withers when encountering Cinnamon (as illustrated by driving nails made of Cinnamon into trees, causing them to wither). However, using Cinnamon alone results in excessive heat. Among herbs that descend Stomach Qi and stop bleeding, Rhizoma Rhei Preparatum is most essential (as seen in Xixin Tang in *Jin Gui Yao Lue*, which heavily uses Rhizoma Rhei for treating hematemesis and epistaxis); if Stomach Qi does not rebel upward, blood will not flow in reverse. Yet, using Rhizoma Rhei Preparatum alone results in excessive cold. If these two are used together, their cold and hot properties balance each other, achieving a neutral nature, thereby descending Stomach Qi and calming the Liver simultaneously without omission. Moreover, folk prescriptions originally existed using these two herbs as a powder to treat hematemesis; applying this to such cases should yield rapid effects. By adding heavy, sinking herbs to assist, the force becomes focused downward, and the efficacy should be even more rapid. Consequently, I used one qian each of finely powdered Rhizoma Rhei Preparatum and Cortex Cinnamomi, mixed evenly, and used a decoction of finely powdered Raw Fossilia Os Draconis Cruda to administer it. The hematemesis ceased instantly, and the angry dreams never occurred again. Later, I encountered several other patients with hematemesis who received this formula, all responding promptly. For those who were physically robust and suffered sudden hematemesis, I modified the formula slightly: one and a half qian each of finely powdered Rhizoma Rhei Preparatum and Cortex Cinnamomi, mixed evenly with six qian of finely powdered Raw Fossilia Os Draconis Cruda, divided into three doses, taken with plain boiled water, approximately every half hour.