论曰伤寒病在表，当汗不汗，邪无所出，热结在里，皆成瘀血，然太阳病不解，热结膀
胱，其人如狂者，少腹硬满，小便自利，下血乃愈，又阳明病其人喜忘者，木有瘀血，大便
虽硬反易，其色必黑，凡病患腹不满，其人自言满者，亦为瘀血在里，皆宜下之，使瘀血得
下即愈，诊其脉沉结者，瘀血之病也。
治伤寒阳明证，其人喜忘者，必有蓄血，所以然者，本有瘀血，故令喜忘，大便虽硬反
易，其色必黑，宜抵当汤方
水蛭（三十枚熬） 虻虫（三十枚去翅足炒） 桃仁（二十一枚去皮尖麸炒） 大黄（一
两酒洗锉炒）
上四味，锉如麻豆大，以水五盏，煮取三盏，去滓温服一盏，不下更服。
治伤寒太阳病不解，热结膀胱，其人如狂，血自下者愈，其外不解者，尚未可攻，当先
解其外，外已解，但少腹急结者，乃可攻之，宜桃仁承气汤方
桃仁（汤去皮尖双仁十二枚） 大黄（锉一两） 桂（去粗皮半两） 甘草（炙半两） 芒
硝（半两）
上五味，先锉四味如麻豆大，以水三盏，煎取一盏半，去滓下芒硝，再煎数沸，分温三
服，以微利为度，未利移时再服。
治伤寒八九日至十二日，病不解，发热如狂，少腹满闷，其脉沉结，内有瘀血，桃仁丸
方桃仁（汤浸去皮尖双仁微炒研细） 水蛭（粳米同炒微焦用） 虻虫（各一分去翅足
炒） 大黄（生锉一两）
上四味，除桃仁，捣罗为细末，入桃仁同研匀，炼蜜为丸，如梧桐子大，每服二十丸，
煎桃仁汤下，如人行五七里，瘀血下为效，未下再服。
治伤寒太阳病，随经入里，瘀热内积，蓄血喜忘如狂，大黄芍药汤方
大黄（锉炒半两） 芍药 牡丹皮 犀角（镑屑各一两） 生干地黄（一两半）
上五味，锉如麻豆大，每服五钱匕，用水二盏，煎取一盏，去滓温服。
治伤寒数日不得汗，内有蓄血，芍药汤方
芍药 牡丹皮（各一两） 生干地黄（一两半） 犀角（镑屑一两）
上四味，粗捣筛，每服三钱匕，用水一盏半，煎至八分，去滓食后温服。
治伤寒及温病，应发汗而不发，内有蓄血，及鼻衄吐血不尽，内余瘀血，面黄大便黑，
芍药地黄汤方
芍药（三分） 牡丹皮（二两） 犀角（镑屑一两） 地黄（二两）
上三味，锉如麻豆大，每服三钱匕，用水一盏，煎至七分，去滓下生地黄汁三合，搅令
匀，食后温服，如狂者，加黄芩一两，去黑心用
治伤寒内有瘀血，大便不利，小腹急痛，大黄汤方
大黄（锉炒一两） 桃仁（汤浸去皮尖双仁麸炒黄研半两） 水蛭（米炒黄一分） 木
通（半两锉）
上四味，除桃仁外，粗捣筛，入桃仁同研令匀，每服二钱匕，以水一盏，煎至七分，去
滓温服，不计时候。
Commentary states: When pathogenic factors of Shanghan (Cold Damage) are in the exterior, sweating should be induced. If sweating is not performed, the pathogen has no outlet, heat becomes constrained within, and all result in blood stasis. However, if Taiyang disease (disease of the Bladder channel) is unresolved, heat constrains in the Bladder, the patient appears manic-like, with hardness and fullness in the lower abdomen, yet urination is normal; only after bleeding does the condition resolve. Furthermore, in Yangming disease (disease of the Stomach and Large Intestine channels), if the patient suffers from forgetfulness, it is due to blood stasis; although the stool is hard, it is surprisingly easy to pass, and its color must be black. In any case where a patient's abdomen is not distended but they complain of fullness, this also indicates blood stasis within; all such cases are suitable for purgation therapy, and the condition resolves once the blood stasis is expelled. If the pulse is deep and knotted, it indicates a disease of blood stasis.
To treat Yangming syndrome of Shanghan where the patient suffers from forgetfulness, there must be accumulated blood. The reason is that blood stasis already existed, causing forgetfulness. Although the stool is hard, it is easy to pass, and its color is black. Diding Tang (Diding Decoction) is indicated.
Shuizhi (Hirudo, thirty pieces, roasted) Mengchong (Ophryognathia, thirty pieces, wings and legs removed, roasted) Taoren (Prunus persica seed, twenty-one pieces, skin and tip removed, bran-roasted) Dahuang (Rhei Radix et Rhizoma, one liang, wine-washed, cut, and roasted)
The above four herbs are cut into sizes similar to hemp seeds and beans. Boil in five sheng of water until three sheng remain, strain, and take one sheng warm. If the blood stasis is not expelled, administer again.
To treat unresolved Taiyang disease of Shanghan where heat constrains in the Bladder, causing manic-like behavior: if blood discharges spontaneously, the patient recovers. If the exterior syndrome is still unresolved, internal attack is not yet permissible; first resolve the exterior. Once the exterior is resolved, if only urgency and binding pain in the lower abdomen remain, then attack internally. Tao Ren Cheng Qi Tang (Tao Ren Decoction for Directing Downward) is indicated.
Taoren (Prunus persica seed, twelve double-kernel pieces, soaked in water, skin and tip removed) Dahuang (Rhei Radix et Rhizoma, cut, one liang) Gui (Cinnamomi Ramulus, bark removed, half liang) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, half liang) Mangxiao (Natrii Sulfas, half liang)
The above five herbs: first cut the first four into sizes similar to hemp seeds and beans. Boil in three sheng of water until one and a half sheng remain, strain, add Mangxiao, boil briefly, divide into three warm doses. Take until slight loose stools occur. If no loosening occurs, wait a while and take again.
To treat Shanghan persisting from eight to twelve days without resolution, presenting with fever and manic-like behavior, lower abdominal fullness, and a deep, knotted pulse indicating internal blood stasis, Tao Ren Wan (Tao Ren Pill) is indicated.
Taoren (Prunus persica seed, soaked in water, skin and tip removed, double-kernel, lightly roasted and finely ground) Shuizhi (Hirudo, stir-fried with rice grains until slightly scorched) Mengchong (Ophryognathia, each one fen, wings and legs removed, roasted) Dahuang (Rhei Radix et Rhizoma, raw, cut, one liang)
The above four herbs: excluding Taoren, pound and sieve the others into fine powder. Mix with Taoren and grind evenly. Form pills using refined honey, sized like sophora seeds. Take twenty pills per dose, washed down with decocted Tao Ren soup. After walking approximately five to seven li, if blood stasis is expelled, it is effective. If not, take again.
To treat Shanghan where pathogens enter the interior via the channels, accumulating heat and blood stasis, causing forgetfulness and manic-like behavior, Da Huang Shao Yao Tang (Da Huang and Peony Decoction) is indicated.
Dahuang (Rhei Radix et Rhizoma, cut, fried, half liang) Shaoyao (Paeoniae Radix) Mudanpi (Moutan Cortex) Xijiao (Rhinocerotis Cornu, shaved into flakes, each one liang) Shenggan Dihuang (Rehmanniae Radix Preparata, one and a half liang)
The above five herbs are cut into sizes similar to hemp seeds and beans. Take five qianbi per dose, boil in two sheng of water until one sheng remains, strain, and take warm.
To treat Shanghan persisting for several days without sweating, with internal accumulated blood, Shao Yao Tang (Peony Decoction) is indicated.
Shaoyao (Paeoniae Radix) Mudanpi (Moutan Cortex, each one liang) Shenggan Dihuang (Rehmanniae Radix Preparata, one and a half liang) Xijiao (Rhinocerotis Cornu, shaved into flakes, one liang)
The above four herbs are coarsely crushed and sifted. Take three qianbi per dose, boil in one and a half sheng of water until eight-tenths remain, strain, and take warm after meals.
To treat Shanghan and Wenbing (Warm Diseases) where sweating should have been induced but was not, resulting in internal accumulated blood, or where epistaxis and hematemesis were incomplete leaving residual internal blood stasis, manifesting as yellowish complexion and black stool, Shao Yao Di Huang Tang (Peony and Rehmannia Decoction) is indicated.
Shaoyao (Paeoniae Radix, three fen) Mudanpi (Moutan Cortex, two liang) Xijiao (Rhinocerotis Cornu, shaved into flakes, one liang) Dihuang (Rehmanniae Radix, two liang)
The above three herbs are cut into sizes similar to hemp seeds and beans. Take three qianbi per dose, boil in one sheng of water until seven-tenths remain, strain, add three he of fresh Dihuang juice, mix well, and take warm after meals. If manic-like symptoms occur, add Huangqin (Scutellariae Radix, one liang), removing the dark heart.
To treat Shanghan with internal blood stasis, difficult defecation, and urgent lower abdominal pain, Da Huang Tang (Da Huang Decoction) is indicated.
Dahuang (Rhei Radix et Rhizoma, cut, fried, one liang) Taoren (Prunus persica seed, soaked in water, skin and tip removed, double-kernel, bran-roasted yellow, ground, half liang) Shuizhi (Hirudo, stir-fried with rice until yellow, one fen) Mutong (Akebiae Caulis, half liang, cut)
The above four herbs: excluding Taoren, coarsely crush and sift the others. Add Taoren and grind evenly. Take two qianbi per dose, boil in one sheng of water until seven-tenths remain, strain, and take warm at any time.