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If a person's diet and daily routine lose their regularity, all can cause blood stasis to stagnate and fail to circulate. Epistaxis (nosebleed) indicates blood accumulation in the Upper Jiao (Upper Burner), treated with Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction). Tenderness and inability to press upon the area below the heart indicate blood accumulation in the Middle Jiao (Middle Burner), treated with Taohe Chengqi Tang (Peach Pit and Magnolia Bark Decoction). Swelling of the umbilical and abdominal region with black stool indicates blood accumulation in the Lower Jiao (Lower Burner); Didang Tang Pill (Vanguard Decoction Pill), Xiayuxue Tang (Drain Stasis Blood Decoction), and Daididang Tang (Substitute Vanguard Decoction) may be selected according to severity. Blood accumulation in the three Jiaos manifests primarily in the left pulse because the Liver governs the storage of blood. Falling from heights, being struck by heavy objects, or suffering arrow and blade wounds causing stagnant blood in the chest and abdomen can be treated by decocting Dahuang (Rhubarb Root and Rhizome) with Tongbian (Child's Urine) and wine, purging the stasis according to severity; or using Xiangke San (Aromatic Shell Powder) added with Tongbian. For dull pain in the waist and hypochondrium, Fuyuan Tongqi San (Revitalize Origin Qi-Regulating Powder) is used without Qian Niu (Pharbitis Seed), adding Zhike (Bitter Orange Fruit), Chaihu (Bupleurum Root), and Mudanpi (Tree Peony Bark). If evil blood remains in the abdomen and hypochondrium causing unbearable pain, Fuyuan Huoxue Tang (Revitalize Origin Invigorate Blood Decoction) is indicated. If accompanied by blood stasis presenting as delirious states resembling possession, Danggui Huoxue Tang (Angelica Invigorating Blood Decoction) is used. After excessive drinking and intercourse, exhausting the Liver, if blood accumulates at the stomach opening, Jiuzhi (Leek Juice) and Tongbian are used to deliver Yueju Wan (Yueju Pill); if ineffective, Pingwei San (Calm the Stomach Powder) without Cangzhu (Atractylodes Rhizome) is combined with Taoren (Peach Seed) and Danpi (Moutan Cortex). For deficient persons, Lizhong Tang (Regulate the Middle Decoction) is combined with Yueju Wan. If in the lower abdomen, Daididang Wan (Substitute Vanguard Pill) is used with Shufu Zi (Prepared Aconite Lateral Root) 3 fen; for deficient persons, Renshen (Ginseng Root) about 1 qian must be added to assist the medicinal force. If there is body chills and fever, jaundice, and a wiry, fine, and hidden pulse, and various tonifying and purgative medicines fail, the Qianjin Fang uses Dahuang, Mangxiao (Mirabilite), Guiwei (Angelica Sinensis Tail), Taoren, Renshen, and Guixin (Cinnamon Twig) made into powder, taken with wine, two fangcun chi (measurements), relying on the power of Ginseng and Cinnamon to attack. For those who consume rich foods and are obese, often generating phlegm-damp-heat, if blood accumulates at the stomach opening, possibly with fullness in the hypochondrium or knotting pain in the lower abdomen, use Junxue Wan (Unblock Blood Pill) in the morning to cultivate Stomach Qi, and Bentong Didang Wan (Modified Vanguard Pill) in the evening to specifically dissipate accumulated blood, achieving the subtlety of using harsh drugs gently. Even in deficient persons with blood stasis, the pulse may be hollow (Kou), but one section will likely show a wiry quality; thus, tonification should be combined with blood removal, using Taohe Chengqi Tang plus 5 qian of Renshen, divided into three doses for slow purgation, which can save two out of ten cases. Furthermore, for persons with weak Middle Qi having dead blood in the epigastrium who always hiccup after drinking ginger soup, use Renshen and Yunzhu (Cloud Atractylodes Rhizome) each 2 liang powdered, mixed with 1 liang of Taoren stir-fried with Ganqi (Dry Resin of Lac Insect), removing the resin, grinding finely, and forming honey pills the size of quail eggs. Chew one pill slowly morning and evening, taken with strong wine.

Shiwan stated: Passing black stool like lacquer in blood accumulation is extremely critical. However, if after purgation the spirit and qi calm slightly and the pulse shows no abnormal changes, it is treatable. If after purgation the spirit becomes confused and the pulse shows collapse, accompanied by cold extremities and hiccups, it is mostly incurable. For example, acupuncturist Qi Wenyu, after food stagnation and cold damage, passed black stool like lacquer, was restless and agitated, with a wiry, firm, and rapid pulse, indicating incomplete elimination of stasis filth. He was given Danggui (Angelica Sinensis Root), Danpi, Fuling (Poria), Guizhi (Cinnamon Twig), Niuxi (Achyranthes Root), and Lingli (Pangolin Scales), and after passing another sheng (unit of volume) of black blood, he recovered. Yan Wenshi Taishan (surname forgotten), due to chronic fatigue and fever, also passed black stool like lacquer after seven or eight days. Two days later, his consciousness calmed slightly, and the pulse became soft and weak, indicating the stasis had been exhausted. He was given Dushen Tang (Single Ginseng Decoction) and Tongbian, and recovered through regulation and tonification. Ophthalmologist Zou Taifu, injured the Liver by anger, suffered vomiting and inability to eat, and after five or six days passed blood like lacquer. The pulse was wiry, small, and rapid, weakening upon pressure, indicating the stasis had gone but Liver Qi was not yet pacified. It was cured by dispersing with Chenxiang Jiangqi San (Aquilaria Descend Qi Powder). Official Jiang Runong, exhausted Qi and injured the Liver, passed bright, lacquer-like dark blood continuously for three or four days, with coma and occasional mild hiccups. The pulse was wiry, large, and hollow, indicating exhaustion of righteous Qi, with the pulse appearing large and empty due to stirring by deficient Yang. Even if Cang Gong or Bian Que were reborn, what good would it do?

Li Shicai treated Zhang Mingzhi, who had hematemesis for two years, sallow complexion, tidal fever and cough, slight pain in the diaphragm, and a rapid, deep, and forceful pulse. The pain was unpressable and worse at night, indicating firm blood accumulation requiring strong purgation. However, due to chronic illness, harsh purgation was avoided initially. He used Yujin (Curcuma Longa Rhizome), Jiangzhen (Lignum Dalbergiae Odoriferae), Danggui, Shengdi (Rehmannia Root), Shanji (Pangolin Scales), Pengzhu (Curcuma Zedoaria Rhizome), and Renshen. After passing lacquer-like black blood several times, the pain decreased. Pain recurred after a month, indicating the disease was severe and the medicine too light. Thus, Dahuang, Ganqi, Pengzhu, Yujin, Shanji, Rougui (Cinnamon Bark), Guiwei, Taoren, and Mengchong (Blister Beetle) were made into pills. Daily, a dose of Ginseng decoction was taken, followed by one qian of pills in the afternoon. After ten days, the blood accumulation was largely purged, and stability was achieved after several treatments.

Lu Buanyuan treated the nephew of Laixi'an Lianxian, a robust man who had suffered cold damage for twenty-eight days, was unconscious, unable to speak, flailing his limbs, with a drum-like hot abdomen, red eyes, coarse breathing, dry teeth, and black tongue. He had taken Ren Shen, Fuzi (Prepared Aconite Root), Shigao (Gypsum Fibrosum), digestive aids, Dahuang, Huangqin (Scutellaria Root), and Huanglian (Coptis Rhizome) without success, and famous physicians had declared him hopeless. Upon examination, the pulse was turbid and beating forcefully against the fingers. One dose of Dahuang 1 liang assisted by blood-invigorating herbs caused the passage of one or two dou (units of volume) of foul-smelling black blood, leading to slight recovery. Clarity was achieved after four doses. Treating disease with medicine is like drinking wine; for someone with the capacity of the vast sea, giving only drops makes the throat and lips drier. Moreover, for a large physique with deep pathogenic factors, how can efficacy be achieved without increasing the dosage tenfold?