王 脉弦如刃，吐血后左胁微痛，喉中如有物阻。治在肝络，使血不瘀，则吐可止，止
后当与补阴。
新绛纱（三钱） 归须（二钱） 元胡索（二钱） 旋复花（三钱） 炒桃仁（三钱） 降香末（
三钱） 丹皮（三钱） 苏子霜（二钱） 郁金（二钱）
又 如刃之脉，已渐平减，但虚数如故。
新绛纱（三钱） 制香附（钱半） 焦白芍（三钱） 旋复花（三钱） 丹皮（五钱，炒） 细生
地（三钱） 降香末（三钱） 归须（二钱） 广郁金（二钱）
又 肝为刚藏，劲气初平，未便腻补，取松灵之解肝络者宜之。
辽沙参（三钱） 细生地（三钱） 丹皮（五钱，炒） 桑叶（钱半） 焦白芍（六钱） 整石斛
（三钱） 白蒺藜（三钱） 麦冬（五钱，连心） 生甘草（一钱） 广郁金（二钱） 归须（钱半）
又 昨日仍有瘀血吐出，今尚未可呆补。
沙参（三钱） 细生地（三钱） 沙苑蒺藜（二钱） 桑叶（钱半） 丹皮（五钱） 茶菊花（二
钱） 麦冬（五钱，连心） 焦白芍（三钱） 钗石斛（五钱） 当归（钱半） 生甘草（一钱） 羚角片（
二钱）
外另服新绛三钱。
普女 二十三岁 大凡吐血，左脉坚搏，治在下焦血分，右脉坚搏，治在上焦气分。又
有心
血、肝血、大肠血、小肠血、胃血、冲脉血，各种不同，岂一概见血，投凉所可治哉，无怪
乎室女童男，劳瘵干血甚数，体浓色白，少腹痛，小便短赤，咳吐瘀紫，继见鲜红血，喉中
咸，此冲脉袭受寒邪，致经不得行，倒送而吐耳。大忌柔润寒凉，议温镇冲脉，行至阴之瘀
浊，使经得行而血症愈矣。苦辛通法。
小茴香（二钱） 两头尖（二钱） 桃仁（三钱） 降香末（三钱） 韭白汁（三茶匙） 紫石英
（三钱） 归须（二钱） 川楝子（三钱） 琥珀（三分，研细冲）
罗 三十二岁 右脉浮洪，咳痰吐血，唇绛，治在上焦气分。
桑叶（二钱） 生苡仁（五钱） 杏仁（三钱） 茯苓块（五钱） 沙参（三钱） 连翘（八分）
生扁豆（五钱）
三帖。
初三日 血后咳不止，进食不香，右脉不浮而仍洪，兼与养阳明之阴。
桑叶（钱半） 茯苓块（三钱） 百合（二钱） 生扁豆（三钱） 生苡仁（三钱） 玉竹（二钱）
麦冬（二钱，连心） 沙参（三钱） 甜杏仁（二钱）
初五日 诸证俱退，惟进食不旺，右脉大垂尺泽，先与甘寒养胃阴。
大麦冬（六钱，连心） 桑叶（一钱） 生扁豆（三钱） 玉竹（三钱，炒） 甜杏仁（三钱）
细生地（三钱） 秋梨汁（一酒杯，冲） 沙参（三钱）
初九日 甘润养阴。
麦冬（六钱，连心） 桑叶（一钱） 生扁豆（三钱） 甜杏仁（二钱） 大生地（三钱） 玉竹
（二钱，炒） 沙参（三钱） 柏子霜（二钱） 火麻仁（二钱） 白芍（三钱） 冰糖（三钱）
四帖。
伊芳 二十四岁 癸酉七月二十五日 六脉弦数，两关独浮，左更甚，右胁痛，胸中痞塞
，肝郁吐血，先理肝络。
新绛纱（三钱） 广郁金（二钱） 旋复花（二钱） 归须（二钱） 降香末（二钱） 丹皮（三
钱，炒） 苏子霜（三钱）
三帖。
乙丑三月十七日
细生地（五钱） 丹皮（五钱） 白芍（四钱） 甘草（钱半） 阿胶（二钱） 麻仁（三钱） 沙
参（二钱） 天冬（三钱） 麦冬（四钱） 真云连（一钱，炒黑） 黄柏炭（三钱） 三七（一钱）
水八碗，煮取三杯，分三次服。
二十三日 左脉仍弦细数锋钢如刃，吐血，左手脉坚搏，治在下焦血分。
细生地（五钱） 丹皮（五钱） 白芍（四钱） 甘草（钱半） 霍石斛（五钱） 阿胶（二钱）
麻仁
（三钱） 沙参（三钱） 天冬（三钱） 麦冬（四钱，连心） 元参（三钱） 茯苓块（三钱） 黄苓
炭（二钱）
煮四杯，分四次服。
二十六日 脉数减，弦刚甚。
大生地（五钱） 炒白芍（四钱） 炙甘草（钱半） 丹皮（五钱） 阿胶（二钱） 麻仁（二钱）
洋参（三钱） 麦冬（四钱） 茯苓块（三钱） 生牡蛎（三钱）
章 丙寅二月初九日 劳伤吐血，脉双弦，《金匮》谓大则为虚，弦则为减，虚弦相搏
，其名曰革，男子失精亡血诸不足，小建中汤主之。
白芍（六钱） 桂枝（四钱） 炙甘草（三钱） 大枣（二枚） 生姜（四钱） 胶饴（一两，去
渣后入上火二三沸）
水五碗，煮取两碗，渣再煮一碗，分三次服，病轻者日一帖，重则日再作服。
章 丙寅二月二十四日 右脉空大，左脉弦，血后咳吐浊痰腥臭，真液不守，阴火上冲
克金，非纯补纯清之症，然而惫矣。
沙参（二钱） 麦冬（三钱，连心） 生扁豆（三钱） 枇杷叶（钱半） 霜桑叶（三钱） 生阿
胶（
三钱） 甜杏仁（二钱，蜜炙，研去尖皮） 白花百合（二钱） 五味子（钱半，研） 天门冬（三
钱）
藿石斛五钱，煎汤代水，浓煎两杯，分二次服。
二十八日 脉少敛，痰咳亦减，切戒用心。
沙参（三钱） 麦冬（三钱，连心） 天门冬（三钱） 百合（三钱） 生阿胶（三钱） 生牡蛎
（三钱） 桑叶（二钱） 生白扁豆（三钱） 生西洋参（钱半） 五味子（三钱）
水五碗，煮取两碗，渣再煮一杯，分三次服，日二帖。
脉大敛戢，古所谓脉小则病退是也，颇有起色，若得舌苔化去，则更妙矣。
沙参（三钱） 桑叶（三钱） 白扁豆（三钱） 麦冬（三钱，连心） 洋参（钱半） 天门冬（
三钱） 五味子（三钱） 芦根汁（五杯，鲜冲） 梨汁（一小杯，冲） 生苡仁（五钱）
四帖。
胡 三十一岁 乙酉四月二十八日 劳伤吐血，汗多足麻，六脉弦细不数，小建中汤主
之。
白芍（六钱） 桂枝（四钱） 炙甘草（三钱） 生姜（五钱） 大枣（三枚，去核） 胶饴（一
两，去渣后入上火二三沸）
五月初六日 汗减，足麻愈，食少加，再服。
十五日 前药已服十四帖，诸症皆愈，惟咳嗽未止，于前原方加云苓、半夏。
沈 二十四岁 乙酉五月初十日 六脉弦数，劳伤吐血，建中汤主之。
白芍（六钱，炒） 生姜汁（三匙，冲） 桂枝（三钱） 大枣（二枚，去核） 炙甘草（三钱）
胶饴（一两）
十二日 加麦冬（五钱） 丹皮（三钱）
煮三杯，分三次服。四帖。
十四日 肝郁胁痛，病名肝着，治在肝经之络，经药弗愈也。
新绛纱（三钱） 归横须（二钱） 吴萸（一钱） 旋复花（三钱） 广郁金（二钱） 青皮（三
钱） 苏子霜（三钱） 广皮炭（二钱） 降香末（三钱） 半夏（三钱）
煮三杯，分三次服。
十五日 六脉弦劲，前用建中，现脉已和，左手仍劲，胸前咳甚则痛，间有一二日紫色
之血，按∶肝脉络胸，是肝络中尚有瘀滞，且与宣络。
新绛纱（二钱） 归须（二钱） 广皮炭（二钱） 旋复花（三钱） 丹皮炭（三钱） 桃仁泥（
三钱） 苏子霜（三钱） 郁金（二钱） 降香末（三钱） 姜半夏（五钱）
四帖。
二十一日 六脉弦数，以清气在头之故，受微风，右寸独浮大而衄血，暂与清清道之风
热。
白茅根（五钱） 甜杏仁（三钱） 黑山栀（一钱，炒） 桑叶（三钱） 侧柏叶（三钱，炒）
茶菊花（三钱） 鲜芦根（三钱）
吴 七十岁 周身痒不可当，脉洪，狂吐血，与大黄黄连泻心汤，以后永不发。
史 五十岁 酒客大吐狂血盛盆，六脉洪数，面赤，三阳实火为病，与大黄黄连泻心汤
，一帖而止，二帖脉平，后七日又复发，血如故，又二帖。
吴 二十五岁 每日饱食就床，脾阳致困，因失其统血之职，此为伤食吐血，脉弦，与
灶中黄土，每日一斤，分二次煎服，将尽半月而愈，戒其夜食，永远不发。
寿 二十岁 乙酉十一月十二日 怒伤吐血，两胁俱痛，六脉弦紧，误补难愈。凡怒伤
肝郁，必有瘀血，故症现胁痛，一以活肝络为主，俟瘀血去净，而后可以补虚。
新绛纱（三钱） 桃仁（三钱） 丹皮炭（三钱） 归须（三钱） 降香末（三钱） 苏子霜（二
钱） 旋复花（三钱） 广郁金（二钱）
煮三杯，分三次服。四帖。
二十二日 复诊脉之弦紧虽减，而未和缓，胁痛虽大减，而未净除，与原方去桃仁，加
细生地（五钱）。
四帖。
十二月初五日 六脉弦细而紧，《金匮》谓脉双弦者寒也，弦则为减，男子失精亡血，
小建中汤主之。怒伤吐血愈后，以小建中复阳生阴。
焦白芍（六钱） 生姜（三钱） 桂枝（三钱） 大枣（二枚） 炙甘草（三钱） 胶饴（一两，
后化入）
初九日 加丹皮（三钱） 麦冬（三钱）
服八帖。
十八日 诸症全愈，胃口大开，虚未全复，于原方加麦冬二钱，使分布津液于十二经脏
，则虚从饮食中复矣。
金 三十日 肝郁胁痛吐血，病名肝着，且有妊娠，一以宣肝络为要，与新绛旋复花汤
法，切戒恼怒介属。
新绛纱（三钱） 旋复花（三钱包） 丹皮（五钱） 降香末（三钱） 归须（三钱） 桃仁（二
钱） 香附（三钱） 广郁金（二钱） 苏子霜（二钱）
以胁痛止为度。
Patient Wang. The pulse is wiry and hard like a blade. After hematemesis, there is slight pain in the left hypochondrium and a sensation of obstruction in the throat. Treatment focuses on unblocking the liver collaterals; if blood does not stagnate, hematemesis will cease. After cessation, yin-nourishing tonification should be administered.
Xinjiang Sha (New Crimson Gauze, 3 qian) Guixu (Radix Angelicae Sinensis Cauda, 2 qian) Yuanhusuo (Rhizoma Corydalis, 2 qian) Xuanfuhua (Flos Inulae, 3 qian) Chao Taoren (Semen Persicae, fried, 3 qian) Jiangxiang Mo (Lignum Dalbergiae Odoriferae Powder, 3 qian) Danpi (Cortex Moutan, 3 qian) Suzi Shuang (Fructus Perillae Paste, 2 qian) Yujin (Radix Curcumae Longae, 2 qian).
Second visit. The wiry pulse like a blade has gradually softened, but the deficiency-thready rapid pulse remains.
Xinjiang Sha (New Crimson Gauze, 3 qian) Zhi Xiangfu (Rhizoma Cyperi Prepared, 1.5 qian) Jiao Baishao (Radix Paeoniae Alba, charred, 3 qian) Xuanfuhua (Flos Inulae, 3 qian) Danpi (Cortex Moutan, 5 qian, fried) Xi Shengdi (Radix Rehmanniae Preparata, 3 qian) Jiangxiang Mo (Lignum Dalbergiae Odoriferae Powder, 3 qian) Guixu (Radix Angelicae Sinensis Cauda, 2 qian) Guang Yujin (Radix Curcumae Longae, 2 qian).
Third visit. The Liver is a rigid organ. As the vigorous qi has just calmed, greasy tonics are inappropriate. It is suitable to select light and agile herbs to resolve the liver collaterals.
Liao Shashen (Radix Glehniae, 3 qian) Xi Shengdi (Radix Rehmanniae Preparata, 3 qian) Danpi (Cortex Moutan, 5 qian, fried) Sangye (Folium Mori, 1.5 qian) Jiao Baishao (Radix Paeoniae Alba, charred, 6 qian) Zheng Shihu (Herba Dendrobii, whole, 3 qian) Bai Jili (Semen Tribuli, 3 qian) Maidong (Radix Ophiopogonis, 5 qian, with heart) Sheng Gancao (Radix Glycyrrhizae Preparata, 1 qian) Guang Yujin (Radix Curcumae Longae, 2 qian) Guixu (Radix Angelicae Sinensis Cauda, 1.5 qian).
Fourth visit. Stasis blood was expectorated yesterday; currently, rigid tonification is not yet appropriate.
Shashen (Radix Glehniae, 3 qian) Xi Shengdi (Radix Rehmanniae Preparata, 3 qian) Shayuan Jili (Semen Astragali Complanati, 2 qian) Sangye (Folium Mori, 1.5 qian) Danpi (Cortex Moutan, 5 qian) Chajujuhua (Flos Chrysanthemi Indici, 2 qian) Maidong (Radix Ophiopogonis, 5 qian, with heart) Jiao Baishao (Radix Paeoniae Alba, charred, 3 qian) Chai Shihu (Herba Dendrobii Nobile, 5 qian) Danggui (Radix Angelicae Sinensis, 1.5 qian) Sheng Gancao (Radix Glycyrrhizae Preparata, 1 qian) Lingjiao Pian (Cornu Saigae Tataricae Slice, 2 qian).
Separately take Xinjiang Sha (New Crimson Gauze, 3 qian).
Miss Pu, aged 23. Generally, for hematemesis, if the left pulse is firm and pounding, the disease lies in the lower jiao blood level; if the right pulse is firm and pounding, the disease lies in the upper jiao qi level. There are also differences among Heart blood, Liver blood, Large Intestine blood, Small Intestine blood, Stomach blood, and Chong Mai blood. How can one simply administer cooling agents upon seeing blood? No wonder cases of consumptive dry-blood syndrome in unmarried women and boys are numerous: they have a fat body, white complexion, lower abdominal pain, short dark urine, coughing up purple-black stasis blood, followed by fresh red blood, and a salty taste in the throat. This is due to cold pathogen invading the Chong Mai, causing menstrual blood to fail to flow normally and regurgitate upwards as hematemesis. Greasy, moistening, and cold-cooling substances are strictly contraindicated. The proposed treatment is to warm and anchor the Chong Mai, resolving stasis and turbidity in the yin levels, allowing menstrual blood to flow normally, thus curing the blood disorder. Employ the Bitter-Acrid Unblocking Method.
Xiaohuixiang (Fructus Foeniculi, 2 qian) Liangtoujian (Rhizoma Smilacis Glabrae et Rhizoma Smilacis Chinae, 2 qian) Taoren (Semen Persicae, 3 qian) Jiangxiang Mo (Lignum Dalbergiae Odoriferae Powder, 3 qian) Jiubai Zhi (Juice of Allium Tuberosum White Part, 3 tea spoons) Zi Shiyin (Hematitum, 3 qian) Guixu (Radix Angelicae Sinensis Cauda, 2 qian) Chuanlianzi (Fructus Toosendan, 3 qian) Hupo (Electrum, 0.3 qian, finely ground and taken with decoction).
Patient Luo, aged 32. The right pulse is floating and surging. There is cough with sputum containing blood and crimson lips. The disease lies in the upper jiao qi level.
Sangye (Folium Mori, 2 qian) Sheng Yiren (Semen Coicis, 5 qian) Xingren (Semen Armeniacae Amarum, 3 qian) Fuling Kuai (Poria, 5 qian) Shashen (Radix Glehniae, 3 qian) Lianqiao (Fructus Forsythiae, 0.8 fen) Sheng Bian Dou (Semen Phaseoli Radiati, 5 qian).
Three doses.
March 3rd. After hematemesis, cough persists, appetite is poor. The right pulse is no longer floating but remains surging. Concurrently nourish the yin of the Yangming (Stomach).
Sangye (Folium Mori, 1.5 qian) Fuling Kuai (Poria, 3 qian) Baihe (Bulbus Lilii, 2 qian) Sheng Bian Dou (Semen Phaseoli Radiati, 3 qian) Sheng Yiren (Semen Coicis, 3 qian) Yuzhu (Rhizoma Polygonati Odorati, 2 qian) Maidong (Radix Ophiopogonis, 2 qian, with heart) Shashen (Radix Glehniae, 3 qian) Tian Xingren (Semen Armeniacae Amarum Sweet, 2 qian).
May 5th. All symptoms have receded, only appetite is weak. The right pulse at the Cun position is large and sinking. First, administer sweet-cold herbs to nourish Stomach yin.
Da Maidong (Radix Ophiopogonis, 6 qian, with heart) Sangye (Folium Mori, 1 qian) Sheng Bian Dou (Semen Phaseoli Radiati, 3 qian) Yuzhu (Rhizoma Polygonati Odorati, 3 qian, fried) Tian Xingren (Semen Armeniacae Amarum Sweet, 3 qian) Xi Shengdi (Radix Rehmanniae Preparata, 3 qian) Qiuli Zhi (Juice of Autumn Pear, one wine cup, mixed in) Shashen (Radix Glehniae, 3 qian).
September 9th. Sweet-moistening to nourish yin.
Maidong (Radix Ophiopogonis, 6 qian, with heart) Sangye (Folium Mori, 1 qian) Sheng Bian Dou (Semen Phaseoli Radiati, 3 qian) Tian Xingren (Semen Armeniacae Amarum Sweet, 2 qian) Da Shengdi (Radix Rehmanniae Preparata, large dose, 3 qian) Yuzhu (Rhizoma Polygonati Odorati, 2 qian, fried) Shashen (Radix Glehniae, 3 qian) Baizi Shuang (Semen Platycladi Paste, 2 qian) Huomaren (Semen Cannabis, 2 qian) Baishao (Radix Paeoniae Alba, 3 qian) Bingtang (Saccharum, 3 qian).
Four doses.
Yi Fang, aged 24. July 25, Guiyou Year. All six pulses are wiry and rapid. The Guan positions alone are floating, more so on the left. Right hypochondriac pain, chest stuffiness. Hematemesis due to Liver depression. First regulate the Liver collaterals.
Xinjiang Sha (New Crimson Gauze, 3 qian) Guang Yujin (Radix Curcumae Longae, 2 qian) Xuanfuhua (Flos Inulae, 2 qian) Guixu (Radix Angelicae Sinensis Cauda, 2 qian) Jiangxiang Mo (Lignum Dalbergiae Odoriferae Powder, 2 qian) Danpi (Cortex Moutan, 3 qian, fried) Suzi Shuang (Fructus Perillae Paste, 3 qian).
Three doses.
March 17, Yichou Year.
Xi Shengdi (Radix Rehmanniae Preparata, 5 qian) Danpi (Cortex Moutan, 5 qian) Baishao (Radix Paeoniae Alba, 4 qian) Gancao (Radix Glycyrrhizae Preparata, 1.5 qian) Ejiao (Colla Corii Asini, 2 qian) Maren (Semen Cannabis, 3 qian) Shashen (Radix Glehniae, 2 qian) Tiandong (Radix Asparagi, 3 qian) Maidong (Radix Ophiopogonis, 4 qian) Zhen Yunlian (Radix Coptidis, 1 qian, charred black) Huangbai Tan (Cortex Phellodendri Charred, 3 qian) Sanqi (Radix Notoginseng, 1 qian).
Eight bowls of water, boil to obtain three cups, divide into three doses.
March 23rd. The left pulse remains wiry, thready, rapid, and sharp like a blade. Hematemesis. The left hand pulse is firm and pounding; the disease lies in the lower jiao blood level.
Xi Shengdi (Radix Rehmanniae Preparata, 5 qian) Danpi (Cortex Moutan, 5 qian) Baishao (Radix Paeoniae Alba, 4 qian) Gancao (Radix Glycyrrhizae Preparata, 1.5 qian) Huo Shihu (Herba Dendrobii Humilis, 5 qian) Ejiao (Colla Corii Asini, 2 qian) Maren (Semen Cannabis, 3 qian) Shashen (Radix Glehniae, 3 qian) Tiandong (Radix Asparagi, 3 qian) Maidong (Radix Ophiopogonis, 4 qian, with heart) Yuanshen (Radix Scrophulariae, 3 qian) Fuling Kuai (Poria, 3 qian) Huangqin Tan (Radix Scutellariae Charred, 2 qian).
Boil four cups, divide into four doses.
March 26th. The rapidity of the pulse decreases, but the wiry rigidity is severe.
Da Shengdi (Radix Rehmanniae Preparata, 5 qian) Chao Baishao (Radix Paeoniae Alba, fried, 4 qian) Zhi Gancao (Radix Glycyrrhizae Preparata, honey-fried, 1.5 qian) Danpi (Cortex Moutan, 5 qian) Ejiao (Colla Corii Asini, 2 qian) Maren (Semen Cannabis, 2 qian) Yangshen (Radix Panacis Quinquefolii, 3 qian) Maidong (Radix Ophiopogonis, 4 qian) Fuling Kuai (Poria, 3 qian) Sheng Muli (Concha Ostreae, 3 qian).
Patient Zhang. February 9, Bingyin Year. Hematemesis due to labor injury. The pulse is double-wiry. *Jinkui Yaolue* states: "Large indicates deficiency, wiry indicates reduction." When deficiency and wiry interact, it is named Ge Pulse (Leather Pulse). For men with loss of essence, loss of blood, and various deficiencies, Xiao Jianzhong Tang is the primary formula.
Baishao (Radix Paeoniae Alba, 6 qian) Guizhi (Ramulus Cinnamomi, 4 qian) Zhi Gancao (Radix Glycyrrhizae Preparata, honey-fried, 3 qian) Dazao (Fructus Jujubae, 2 pieces) Shengjiang (Rhizoma Zingiberis Recens, 4 qian) Jiaoyi (Malt Sugar, 1 liang, added after removing dregs, boiled for 2-3 boils).
Five bowls of water, boil to obtain two bowls. Boil dregs again to obtain one bowl. Divide into three doses. For mild cases, one dose daily; for severe cases, twice daily.
Patient Zhang. February 24, Bingyin Year. The right pulse is empty and large, the left pulse is wiry. After bleeding, cough produces turbid, foul-smelling sputum. True fluids are not retained; Yin fire rushes upward to attack Metal (Lung). This is not a case suitable for pure tonification or pure clearing, yet the patient is exhausted.
Shashen (Radix Glehniae, 2 qian) Maidong (Radix Ophiopogonis, 3 qian, with heart) Sheng Bian Dou (Semen Phaseoli Radiati, 3 qian) Pipaye (Folium Eriobotryae, 1.5 qian) Shuang Sangye (Folium Mori, 3 qian) Sheng Ejiao (Colla Corii Asini, 3 qian) Tian Xingren (Semen Armeniacae Amarum Sweet, 2 qian, honey-fried, ground, tips and skins removed) Baihua Baihe (Bulbus Lilii, 2 qian) Wuweizi (Fructus Schisandrae, 1.5 qian, ground) Tiandong (Radix Asparagi, 3 qian).
Huo Shihu (Herba Dendrobii Humilis, 5 qian), decoct as water substitute. Concentrate decoction to two cups, divide into two doses.
February 28th. The pulse has slightly converged, cough with sputum has also decreased. Strictly avoid mental exertion.
Shashen (Radix Glehniae, 3 qian) Maidong (Radix Ophiopogonis, 3 qian, with heart) Tiandong (Radix Asparagi, 3 qian) Baihe (Bulbus Lilii, 3 qian) Sheng Ejiao (Colla Corii Asini, 3 qian) Sheng Muli (Concha Ostreae, 3 qian) Sangye (Folium Mori, 2 qian) Sheng Bai Bian Dou (Semen Phaseoli Radiati, 3 qian) Sheng Xiyangshen (Radix Panacis Quinquefolii, 1.5 qian) Wuweizi (Fructus Schisandrae, 3 qian).
Five bowls of water, boil to obtain two bowls. Boil dregs again to obtain one bowl. Divide into three doses. Two doses daily.
The pulse has significantly converged, which is what ancients called "small pulse indicates disease retreat." There is considerable improvement. If the tongue coating disappears, it would be even better.
Shashen (Radix Glehniae, 3 qian) Sangye (Folium Mori, 3 qian) Bai Bian Dou (Semen Phaseoli Radiati, 3 qian) Maidong (Radix Ophiopogonis, 3 qian, with heart) Yangshen (Radix Panacis Quinquefolii, 1.5 qian) Tiandong (Radix Asparagi, 3 qian) Wuweizi (Fructus Schisandrae, 3 qian) Lugenzhi (Semen Arundinis Juice, five cups, fresh juice mixed in) Lizhi (Juice of Pear, one small cup, mixed in) Sheng Yiren (Semen Coicis, 5 qian).
Four doses.
Patient Hu, aged 31. April 28, Yiyu Year. Hematemesis due to labor injury, excessive sweating, numbness in feet. The six pulses are wiry and thready, not rapid. Xiao Jianzhong Tang is the primary formula.
Baishao (Radix Paeoniae Alba, 6 qian) Guizhi (Ramulus Cinnamomi, 4 qian) Zhi Gancao (Radix Glycyrrhizae Preparata, honey-fried, 3 qian) Shengjiang (Rhizoma Zingiberis Recens, 5 qian) Dazao (Fructus Jujubae, 3 pieces, pitted) Jiaoyi (Malt Sugar, 1 liang, added after removing dregs, boiled for 2-3 boils).
June 6th. Sweating reduced, foot numbness cured, food intake increased. Continue taking.
June 15th. Previous medicine taken for fourteen doses; all symptoms resolved except cough. Add Yunling (Poria) and Banxia (Rhizoma Pinelliae) to the original formula.
Patient Shen, aged 24. May 10, Yiyu Year. Six pulses wiry and rapid. Hematemesis due to labor injury. Jianzhong Tang is the primary formula.
Baishao (Radix Paeoniae Alba, 6 qian, fried) Shengjiang Zhi (Juice of Rhizoma Zingiberis Recens, 3 spoons, mixed in) Guizhi (Ramulus Cinnamomi, 3 qian) Dazao (Fructus Jujubae, 2 pieces, pitted) Zhi Gancao (Radix Glycyrrhizae Preparata, honey-fried, 3 qian) Jiaoyi (Malt Sugar, 1 liang).
June 12th. Add Maidong (Radix Ophiopogonis, 5 qian) Danpi (Cortex Moutan, 3 qian).
Boil three cups, divide into three doses. Four doses.
June 14th. Liver depression causing hypochondriac pain, disease name Gan Zhuo (Liver Fixation). Treatment targets the collaterals of the Liver meridian. Previous medicines failed to cure.
Xinjiang Sha (New Crimson Gauze, 3 qian) Guihengxu (Radix Angelicae Sinensis Transverse Roots, 2 qian) Wuyu (Fructus Evodiae, 1 qian) Xuanfuhua (Flos Inulae, 3 qian) Guang Yujin (Radix Curcumae Longae, 2 qian) Qingpi (Pericarpium Citri Reticulatae Viride, 3 qian) Suzi Shuang (Fructus Perillae Paste, 3 qian) Guangpi Tan (Pericarpium Citri Reticulatae Charred, 2 qian) Jiangxiang Mo (Lignum Dalbergiae Odoriferae Powder, 3 qian) Banxia (Rhizoma Pinelliae, 3 qian).
Boil three cups, divide into three doses.
June 15th. Six pulses wiry and strong. Previously used Jianzhong Tang; now the pulse is harmonized, but the left hand pulse remains strong. Severe pain in the chest upon coughing. Occasionally purple blood is expectorated. Note: The Liver collateral connects to the chest. This indicates stasis remains in the Liver collaterals. Further promote collateral circulation.
Xinjiang Sha (New Crimson Gauze, 2 qian) Guixu (Radix Angelicae Sinensis Cauda, 2 qian) Guangpi Tan (Pericarpium Citri Reticulatae Charred, 2 qian) Xuanfuhua (Flos Inulae, 3 qian) Danpi Tan (Cortex Moutan Charred, 3 qian) Taoren Ni (Semen Persicae Paste, 3 qian) Suzi Shuang (Fructus Perillae Paste, 3 qian) Yujin (Radix Curcumae Longae, 2 qian) Jiangxiang Mo (Lignum Dalbergiae Odoriferae Powder, 3 qian) Jiang Banxia (Rhizoma Pinelliae Prepared with Ginger, 5 qian).
Four doses.
June 21st. Six pulses wiry and rapid. Due to clear qi being in the head, affected by slight wind, the right Cun pulse alone is floating, large, and epistaxis occurs. Temporarily administer herbs to clear wind-heat from the respiratory tract.
Baimaogen (Radix Imperatae, 5 qian) Tian Xingren (Semen Armeniacae Amarum Sweet, 3 qian) Hei Shanzhi (Fructus Gardeniae, 1 qian, fried) Sangye (Folium Mori, 3 qian) Cebaiye (Folium Platycladi, 3 qian, fried) Chajujuhua (Flos Chrysanthemi Indici, 3 qian) Xian Lugen (Rhizoma Arundinis, 3 qian).
Patient Wu, aged 70. Whole body itching unbearable. Pulse surging. Wild hematemesis. Administer Dahuang Huanglian Xiexin Tang. It will never recur afterwards.
Patient Shi, aged 50. Alcoholic with massive wild hematemesis filling a basin. Six pulses surging and rapid. Red face. Disease caused by excess fire of the Three Yangs. Administer Dahuang Huanglian Xiexin Tang. Bleeding stopped after one dose, pulse normalized after two doses. Seven days later, it relapsed with same volume of blood. Took two more doses.
Patient Wu, aged 25. Goes to bed immediately after full meals. Spleen Yang becomes trapped, losing its function of controlling blood. This is hematemesis due to food injury. Pulse is wiry. Administer Zaot Zhong Huangtu (Earth from the middle of a stove). One jin daily, divided into two decoctions. Cured in nearly half a month. Advised to avoid night eating; it will never recur.
Patient Shou, aged 20. November 12, Yiyu Year. Hematemesis due to anger injuring the Liver. Both hypochondria painful. Six pulses wiry and tight. Mistaken tonification will not cure. Whenever anger injures the Liver causing depression, there must be blood stasis. Hence symptoms present as hypochondriac pain. Treatment primarily focuses on activating Liver collaterals. Only after stasis is completely removed can deficiency be tonified.
Xinjiang Sha (New Crimson Gauze, 3 qian) Taoren (Semen Persicae, 3 qian) Danpi Tan (Cortex Moutan Charred, 3 qian) Guixu (Radix Angelicae Sinensis Cauda, 3 qian) Jiangxiang Mo (Lignum Dalbergiae Odoriferae Powder, 3 qian) Suzi Shuang (Fructus Perillae Paste, 2 qian) Xuanfuhua (Flos Inulae, 3 qian) Guang Yujin (Radix Curcumae Longae, 2 qian).
Boil three cups, divide into three doses. Four doses.
November 22nd. Second consultation. The wiry-tightness of the pulse has decreased but is not yet harmonious. Hypochondriac pain has greatly decreased but not disappeared. Remove Taoren (Semen Persicae) from the original formula, add Xi Shengdi (Radix Rehmanniae Preparata, 5 qian).
Four doses.
December 5th. Six pulses wiry, thready, and tight. *Jinkui Yaolue* states: "Double wiry pulse indicates cold," "Wiry indicates reduction." For men with loss of essence and blood, Xiao Jianzhong Tang is the primary formula. After recovery from hematemesis due to anger injuring the Liver, use Xiao Jianzhong Tang to restore Yang and generate Yin.
Jiao Baishao (Radix Paeoniae Alba, charred, 6 qian) Shengjiang (Rhizoma Zingiberis Recens, 3 qian) Guizhi (Ramulus Cinnamomi, 3 qian) Dazao (Fructus Jujubae, 2 pieces) Zhi Gancao (Radix Glycyrrhizae Preparata, honey-fried, 3 qian) Jiaoyi (Malt Sugar, 1 liang, dissolved later).
December 9th. Add Danpi (Cortex Moutan, 3 qian) Maidong (Radix Ophiopogonis, 3 qian).
Take eight doses.
December 18th. All symptoms completely resolved, appetite open. Deficiency not fully recovered. Add Maidong (Radix Ophiopogonis, 2 qian) to the original formula to distribute fluids to the twelve meridians and zang-fu organs. Then deficiency will recover through diet.
Patient Jin. Thirty years old. Liver depression causing hypochondriac pain and hematemesis, disease name Gan Zhuo (Liver Fixation), and pregnant. Treatment priority is promoting Liver collateral circulation, using the method of Xinjiang Xuanfuhua Tang. Strictly avoid anger and shellfish/creatures.
Xinjiang Sha (New Crimson Gauze, 3 qian) Xuanfuhua (Flos Inulae, 3 qian wrapped) Danpi (Cortex Moutan, 5 qian) Jiangxiang Mo (Lignum Dalbergiae Odoriferae Powder, 3 qian) Guixu (Radix Angelicae Sinensis Cauda, 3 qian) Taoren (Semen Persicae, 2 qian) Xiangfu (Rhizoma Cyperi, 3 qian) Guang Yujin (Radix Curcumae Longae, 2 qian) Suzi Shuang (Fructus Perillae Paste, 2 qian).
Continue until hypochondriac pain stops.