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Shengshengzi said: Hemoptysis (coughing up blood) is mostly caused by fire pathogen stagnating in the Lung. The treatment should focus on clearing Lung heat, descending rebellious fire, opening stagnation, and resolving phlegm; once the cough stops, the bleeding will also cease. One must not solely use hemostatic herbs, as this may cause Qi stagnation and phlegm obstruction, preventing the resolution of stagnation. If the cough does not stop, how can the bleeding stop? If the patient has afternoon fever and a fine, rapid pulse, this indicates deficiency of True Yin. In such cases, one should clear the Upper Jiao and tonify the Lower Jiao.

Shengshengzi said: I had a niece who was ten years old. Because her teeth were loose during the shedding of deciduous teeth, she pulled them out using *Boehmeria nivea* (Ramie) fibers, causing continuous bleeding. We collected the blood in small earthenware basins, accumulating eleven basins over one day and night. We applied powdered medicine to the wound site, but shortly after, the blood was vomited from the mouth again. However, the patient did not appear fatigued, which is a rare occurrence. This demonstrates that the volume of blood in the human body is immeasurable. Upon palpation, her pulses were all surging, large, and forceful. We administered two qian of *Rhei Radix et Rhizoma* (Rhubarb Root and Rhizome), processed three times, mixed with a decoction of *Aurantii Fructus Immaturus* (Bitter Orange Fruit) and a small amount of fresh urine from a healthy male child (Tongbian). By midnight that night, she passed several pieces of black stool, and the bleeding stopped immediately without recurrence. Later, I encountered a man whose gums bled enough to fill a basin each time, occurring once a month for over ten months despite various treatments. Each episode was accompanied by mental cloudiness. Knowing he enjoyed drinking alcohol, I prescribed the previous formula. He recovered after a single dose.

Another elderly woman suffered from the same condition, recurring every five to seven days, with daily blood loss exceeding one sheng. She also improved with the previous formula, passing black stools. Thus, it is known that this disease is often caused by excessive heat in the Yangming channel. The Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) are both attached to the Yangming channel. The Yangming channel is rich in Qi and Blood. Therefore, the bleeding surges like a tide. In acute conditions, treat the branch (symptoms); thus, employing the method of "removing firewood from under the cauldron" (clearing lower excess heat to stop upper bleeding) resulted in immediate recovery. It must be understood that if bleeding is due to Kidney deficiency, the blood will drip out slowly, and the teeth may ache faintly; it will never be so sudden and severe. Differentiating between excess and deficiency is crucial.

Some claim that tremors accompanied by locking of the jaw and shivering are not Zhenzhen (tremor/twitching). "Jin Gu Li" refers to grinding teeth and shivering, which appears cold but is actually heat. Zhenzhen, however, involves Wood Qi (Liver Wind). It manifests only as trembling of the hands, elbows, knees, and feet, without external signs of cold or shivering.

Shengshengzi said: Zhenzhen refers to a disease where the patient's hands and feet shake, resembling the act of shaking off dust. The sinews and vessels cannot restrain the limbs, making them unable to maintain stillness; this is a manifestation of Wind. The *Neijing* states: "All wind diseases involving shaking and dizziness belong to Liver Wood." Wood governs Wind; Wind belongs to Yang Qi, and Yang Qi is active. When Wood Qi is excessive, it overacts on Spleen Earth. The Spleen governs the four limbs, which are the extremities of all Yang channels. The movement is caused by the stirring of Wood Qi, which is what the classics refer to as "Wind invading the extremities causes disease." There are cases where only the head moves while the limbs remain still. This is because the head is the summit of all Yang channels; when Wood Qi rushes upward, only the head moves. If the Qi disperses to the four extremities, the hands and feet move while the head remains still. These are all cases of excessive Wood Qi combined with Fire transformation. Wood fears Metal. Metal is the offspring of Earth. If Earth is controlled by Wood, it has no spare capacity to generate Metal. The *Suwen* says: "The Liver is one Yang, the Heart is two Yang, and the Kidney is an isolated Zang organ. One Water cannot overcome two Fires." Consequently, Wood carries Fire and lacks fear (of Metal), instead insulting what it cannot conquer (Metal), attacking without restraint. This is what the *Nanjing* refers to as "Wood overflowing and overcoming Metal." This disease is rare in young adults, appearing after middle age, and is especially common in the elderly. Since the elderly suffer from insufficient Yin and Blood, and little Water cannot extinguish flourishing Fire, it is extremely difficult to treat. Previous masters rarely discussed it. Only Zhang Dairen treated an old man named Ma from Xinzhai, diagnosing it as a combination of Wood-Fire and Phlegm, achieving success. Those encountering this syndrome should refer to these principles and apply profound thought in their diagnosis and treatment.