有一种小腹胀满。小便自利。（或有漱水不欲咽者。然必以小便为验。） 其人如狂。为蓄血
。一名热入血室。男女俱有此血室。在男子则下血谵语。在女子则经水适来适断。其血必结。（
如结胸状）其病必日轻夜重。小柴胡汤加归尾调之。男子谵语。其血自下者结。（结当作吉。颇
有下后即死者。但血来必骤而多。）结而如狂发黄者。桃仁承气汤。邪犯心胃者。犀角地黄汤。
（谦按。结当作吉四字。恐欠妥协。又云颇有下后即死者。症之凶危已极。何吉之有哉。况
内经云男子便血如注者谓之结。阴一结一升。再结二升。三结三升之旨。其结不当作吉解。又显
然可据矣。）
桃仁承气汤
桃仁（泡去皮尖） 桂枝 白芍（酒炒） 大黄（红花酒制） 芒硝
上加生姜三片。或加柴胡青皮枳实炙甘草。
犀角地黄汤
治主脉浮。客脉芤。浮芤相合。血积胸中。热之甚。血在上焦。此方主之。
犀角（使） 大黄（君） 生地（臣） 黄芩（佐） 黄连（佐）
又方
犀角（使） 生地（君） 白芍（臣） 丹皮（佐）
上方如无犀角。以升麻代之。热多者加黄芩。脉大来迟腹不满。自言满者。无热也。不用黄
芩。升麻与犀角。性味主治不同。以升麻代之者。以其能引入阳明也。但蓄血症不得以升麻代之
耳。此方并治疮疹火盛。
There is a condition characterized by fullness and distension in the lower abdomen, with urination being free and unobstructed. (There may be a desire to rinse the mouth without swallowing, but patency of urination must be taken as the diagnostic criterion.) The patient exhibits manic behavior, which indicates Blood Stasis (Blood Accumulation). This pattern is also known as Heat Entering the Blood Chamber (Xue Shi). Both men and women possess the "Blood Chamber." In men, it manifests as bleeding from below and delirious speech; in women, it occurs when menstruation has just started or suddenly stopped, causing the blood to coagulate. (The presentation resembles Chest Binding/Jie Xiong syndrome.) The disease severity is typically lighter during the day and heavier at night. It is treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Dang Gui Wei (Tail of Angelica Sinensis) to regulate it. If a man presents with delirium and the blood discharges spontaneously, this is considered auspicious [Note: The original text suggests 'Jie' should be read as 'Ji' (auspicious), but the commentator argues against this, noting that death often follows discharge, indicating extreme danger, not auspiciousness. Furthermore, the *Nei Jing* refers to profuse rectal bleeding as 'Jie' (binding/knotting), implying accumulation rather than relief]. If there is coagulation accompanied by mania and jaundice, Tao Ren Cheng Qi Tang (Peach Kernel Drain the Extremities Decoction) is used. If the pathogenic factor invades the Heart and Stomach, Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) is indicated.
Tao Ren Cheng Qi Tang (Peach Kernel Drain the Extremities Decoction)
Ingredients: Tao Ren (Peach Kernel, soaked, skin and tips removed), Guizhi (Cinnamon Twig), Baishao (White Peony Root, stir-fried with wine), Dahuang (Rhubarb Root and Rhizome, processed with Hong Hua wine), Mangxiao (Mirabilite).
Preparation: Add three slices of Sheng Jiang (Fresh Ginger) to the above herbs. Alternatively, Chai Hu (Bupleurum Root), Qing Pi (Aurantii Fructus Pericarpium), Zhi Shi (Immature Bitter Orange), and Zhi Gan Cao (Honey-fried Licorice Root) may be added.
Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction)
Indications: The principal pulse is Floating (Fu), and the guest pulse is Hollow (Kou). The combination of Floating and Hollow pulses indicates blood accumulation in the chest with severe heat. When the blood pathology is located in the Upper Jiao (Upper Burner), this decoction is the primary treatment.
Ingredients: Xi Jiao (Rhinoceros Horn, Minister herb), Dahuang (Rhubarb Root and Rhizome, Sovereign herb), Sheng Di (Rehmannia Root, Deputy herb), Huang Qin (Scutellaria Root, Assistant herb), Huang Lian (Coptis Rhizome, Assistant herb).
Another Formula
Ingredients: Xi Jiao (Rhinoceros Horn, Minister herb), Sheng Di (Rehmannia Root, Sovereign herb), Baishao (White Peony Root, Deputy herb), Dan Pi (Moutan Bark, Assistant herb).
Note: If Xi Jiao is unavailable in the above formula, Sheng Ma (Cimicifugae Rhizoma) may be used as a substitute. If heat is predominant, add Huang Qin. If the pulse is large but slow, the abdomen is not distended, yet the patient complains of fullness, this indicates an absence of excess heat; therefore, Huang Qin should not be used. Sheng Ma and Xi Jiao differ significantly in nature, flavor, and therapeutic action. Sheng Ma is used as a substitute because it guides the medicine into the Yangming channel. However, for Blood Stasis patterns, Sheng Ma cannot replace Xi Jiao. This formula also treats sores and rashes caused by excessive fire-toxin.