朱（左） 任重受伤，营血瘀滞，蓄而暴决，呕血盈盆，大便紫黑，由此面黄力乏，腹中结块。脉涩两关独弦。
蓄者虽去，新者复瘀，势必复为呕下。临时汗脱，不可不虑。
于术 乌药 当归炭 五灵脂（酒炒） 炒赤芍 蓬术 楂炭 桃仁 奎党参 焦麦芽 延胡 制香附
蓄血呕血，急饮韭汁童便，若时有冷汗及大便血下无度者，死症也。（正蒙志）
左 呕吐紫瘀，中州之痞满转舒，其为血蓄阳，明以通为顺，略见一斑。但神情困顿，由血虚而气阴并
伤，治宜补气养阴，以图恢复。六腑以通为用，阳明为多气多血之乡，补则滞，滞则涩不能流，安保气血
之不复蓄乎。夫气血精神，藉资五谷，惟裕生化之源，斯不言补而补已在其中矣。
金石斛 甜杏仁 赤白芍 半夏曲 茜根炭 川牛膝
云茯苓 橘白 生熟谷芽 白蒺藜 盐水炒竹茹 泽泻
邵（左） 呕出紫瘀，气撑脘痞较退。深恐根蒂未除，而致复聚。
生锦纹（一钱五分酒炙后下） 延胡 竹茹 炒赤芍 茯苓 韭汁（半杯） 当归炭 瓦楞子 白蒺藜
二诊 逆上之血，已从下行，然脘腹仍觉不舒，脐下作满。蓄血未清。还恐变胀。
炒当归（一钱五分） 瓦楞子（五钱） 丹参炭（三钱） 川桂木（五分） 郁金（一钱） 炒赤芍（一钱
五分） 元明粉（一钱冲） 参三七（一钱） 生锦纹（一钱酒炙后入） 桃仁（一钱五分） 延胡索（一钱五分）
三诊 便解色黄，瘀血已楚。再和中而运旋脾胃，以裕其生化之源。
当归炭 炒赤芍 野于术 茯苓 参三七 磨郁金 丹皮炭 牛膝炭 枳实 白蒺藜
左 脘痛之后，面目带黄，此营滞也。
当归炭 桃仁 旋复花 黑山栀 泽泻 猩绛
泽兰叶 白蒺藜 炒牛膝 川郁金 延胡
左 少腹偏右作痛，曾经泻下紫瘀，当时痛减，今复渐甚。良由气中血滞。当为宣通。
楂炭 金铃子 制香附 延胡 赤芍 乌药 当归炭 沉香（三分） 大黄（四分） 木香（二分
）琥珀（四分以上四味研末药汁调服）
Zhu (Left-side case): Due to bearing heavy loads, physical injury occurred, causing stagnation of Ying blood (nutritive blood). The accumulated blood suddenly ruptured, resulting in vomiting a basin-full of blood and dark purple-black stools. Consequently, the complexion is sallow with fatigue, and masses are palpable in the abdomen. The pulse is choppy (Se), particularly wiry (Xian) at both Guan positions.
Although the existing stasis has been expelled, new blood will again become stagnant, inevitably leading to recurrent hematemesis or melena. One must consider the potential crisis of sweating profusely as if escaping (Han Tuo) temporarily.
Prescription: Atractylodis Rhizoma (Yuzhu), Linderae Radix (Wuyao), Carbonized Angelicae Sinensis Radix (Danggui Tan), Trogopterori Faeces (Wulingzhi, stir-fried with wine), Stir-fried Paeoniae Radix Rubra (Chishao), Curcumae Zedoaria Rhizoma (Pengzhu), Carbonized Crataegi Fructus (Zhaca Tan), Persicam Semen (Taoren), Codonopsis Radix (Kuidangshen), Scoriated Hordei Fructus (Jiaomaiya), Corydalis Rhizoma (Yanhu), Prepared Cyperi Rhizoma (Zhi Xiangfu).
For hematemesis caused by blood stasis, drinking fresh juice of Allium tuberosum (Leek juice) and urine of a healthy child (Tongbian) is urgently recommended. If cold sweat appears intermittently and bloody stools flow without restraint, it indicates a fatal condition. (Recorded in *Zhengmeng Zhi*)
Left (Another Left-side case): Vomiting purple stasis; the fullness and distension in the middle jiao (Spleen/Stomach) have somewhat relieved. This illustrates the principle that "blood stasis in Yang regions should be treated by promoting circulation," offering a glimpse into the matter. However, the patient's spirit is lethargic due to blood deficiency injuring both Qi and Yin. Treatment should tonify Qi and nourish Yin to facilitate recovery. The Six Fu organs function through free flow; the Yangming channel is the region abundant in Qi and Blood. Tonification may cause stagnation; stagnation leads to sluggish flow, making it impossible to ensure that Qi and Blood do not accumulate again. Spirit and vitality rely on the essence of grains; only by enriching the source of transformation and transportation can tonification occur implicitly without explicit mention.
Prescription: Dendrobii Caulis (Shihu), Sweet Almond Seed (Xingren), Red and White Paeoniae Radices (Chibai Shao), Fermented Pinelliae Rhizoma (Banxia Qu), Rubiae Radix et Rhizoma Carbonized (Qiangent Tan), Achyranthis Bidentatae Radix (Chuan Niuxi); Poria (Fuling), Tangerine Albedo (Ju Bai), Raw and Scoriated Setariae Fructus & Sorghi Fructus Germinatus (Shengshu Guya), Tribuli Fructus (Bijili), Bamboo Shavings stir-fried with salt water (Zhuru), Alismatis Rhizoma (Zexie).
Shao (Left-side case): After vomiting purple stasis, the sensation of Qi distending and epigastric fullness has decreased. There is deep concern that the root cause remains, potentially leading to re-aggregation of stasis.
Prescription: Rheum Palmatum Radix et Rhizoma (Sheng Jinwen, 1.5 qian, stir-fried with wine, added later), Corydalis Rhizoma (Yanhu), Bamboo Shavings (Zhuru), Stir-fried Paeoniae Radix Rubra (Chishao), Poria (Fuling), Leek Juice (0.5 cup), Carbonized Angelicae Sinensis Radix (Danggui Tan), Arcae Concha (Walengzi), Tribuli Fructus (Bijili).
Second Visit: The regurgitated blood has now moved downward via defecation. However, the epigastrium and abdomen still feel uncomfortable, with fullness below the umbilicus. Blood stasis is not yet cleared. There is fear of transformation into abdominal distension (Zhang).
Prescription: Stir-fried Angelicae Sinensis Radix (1.5 qian), Arcae Concha (5 qian), Carbonized Salviae Miltiorrhizae Radix (Danshen Tan), Cinnamomi Ramulus (Chuan Guimu), Curcumae Radix (Yujin), Stir-fried Paeoniae Radix Rubra (1.5 qian), Natrii Sulfas (Yuanming Fen, taken with decoction), Notoginseng Radix (Shen Sanqi, 1 qian), Rheum Palmatum Radix et Rhizoma (1 qian, stir-fried with wine, added later), Persicam Semen (1.5 qian), Corydalis Rhizoma (1.5 qian).
Third Visit: Stools are passed with yellow color; stasis is largely cleared. Next, harmonize the middle and regulate the Spleen and Stomach to enrich the source of transformation and transportation.
Prescription: Carbonized Angelicae Sinensis Radix, Stir-fried Paeoniae Radix Rubra, Wild Atractylodis Rhizoma, Poria, Notoginseng Radix, Crushed Curcumae Radix, Carbonized Moutan Cortex, Carbonized Achyranthis Bidentatae Radix, Immature Bitter Orange (Zhishi), Tribuli Fructus (Bijili).
Left (Another Left-side case): Following epigastric pain, the face and eyes show yellowness, indicating stagnation of Ying blood (nutritive blood).
Prescription: Carbonized Angelicae Sinensis Radix, Persicam Semen, Inulae Flos (Xuanfuhua), Gardeniae Fructus Charred (Heishanzhi), Alismatis Rhizoma (Zexie), Sangxuehong (Cochineal/Dyed Silk - *Note: Often used for cooling blood/stopping bleeding*); Ze Lan Ye (Euphorbiae Humifusae Herba), Tribuli Fructus (Bijili), Stir-fried Achyranthis Bidentatae Radix, Curcumae Radix (Chuan Yujin), Corydalis Rhizoma (Yanhu).
Left (Another Left-side case): Pain in the lower abdomen on the right side. Previously, purging expelled purple stasis, and pain decreased at that time. Now, it has gradually worsened. This is likely due to blood stagnation within Qi. It should be dispersed and unblocked.
Prescription: Carbonized Crataegi Fructus (Zhaca), Meliae Semen (Jinlingzi), Prepared Cyperi Rhizoma (Zhi Xiangfu), Corydalis Rhizoma (Yanhu), Paeoniae Radix Rubra (Chishao), Linderae Radix (Wuyao), Carbonized Angelicae Sinensis Radix (Danggui Tan), Aquilariae Lignum Resinatum (Chenxiang, 3 fen), Rheum Palmatum Radix et Rhizoma (Dahuang, 4 fen), Aucklandiae Radix (Muxiang, 2 fen); Succinum (Hupo, >4 fen). *Instruction: Grind the above four ingredients into powder and take with the medicinal decoction.*