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Li Dongyuan stated: In cases of nasal epistaxis (nosebleed) in patients with Shanghan (Cold Damage), Zhang Zhongjing advised against using diaphoresis (sweating method) because the pulse is thready. If the pulse is floating and tight, Mahuang Tang (Ephedra Decoction) may be used; if the pulse is floating and slow, Guizhi Tang (Cinnamon Twig Decoction) may be used. However, if the pulse has already become thready, neither of these two formulas should be used. Instead, Huangqin Shaoyao Tang (Scutellaria and Peony Decoction) is appropriate for treatment.

In miscellaneous diseases, bleeding symptoms are generally attributed to heat. For instance, nasal epistaxis originating from the Lung meridian should be treated with substances such as Xijiao (Rhinoceros Horn, now substituted with Water Buffalo Horn), Shengma (Cimicifugae Rhizoma), Zhizi (Gardeniae Fructus), Huangqin (Scutellariae Radix), Shaoyao (Paeoniae Radix), Shengdihuang (Rehmanniae Radix), Zican (Boraginis Herba), Danshen (Salviae Miltiorrhizae Radix et Rhizoma), and Ejiao (Asini Corii Colla). Hemoptysis or spitting of blood originating from the Kidney meridian should be treated with Tianmendong (Asparagi Radix), Mendong (Ophiopogonis Radix), Beimu (Fritillariae Bulbus), Zhimu (Anemarrhenae Rhizoma), Jiegeng (Platycodonis Radix), Baibu (Stemonae Radix), Huangbai (Phellodendri Cortex), Yuanzhi (Polygalae Radix), and Shudihuang (Rehmanniae Radix Preparata). Blood mixed with phlegm originating from the Spleen meridian should be treated with Gegen (Puerariae Lobatae Radix), Huanglian (Coptidis Rhizoma), Shaoyao (Paeoniae Radix), Danggui (Angelicae Sinensis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), and Chenxiang (Aquilariae Lignum Resinatum). Vomiting blood originating from the Stomach meridian: for excess patterns, Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) is indicated; for deficiency patterns, Xiaojianzhong Tang (Minor Construct the Middle Decoction) with added Huanglian is indicated.

Blood disorders manifesting with upward flow, whether through spitting or vomiting, constitute a "rebellious" (ni) pattern. If the condition transforms into downward flow presenting as foul dysentery-like stool, it constitutes a "smooth" (shun) pattern. Upward flow of blood is rebellious and difficult to treat; downward flow is smooth and easier to treat. Therefore, Zhang Zhongjing stated: In cases of Blood Accumulation (Xueyu), if blood is passed via the bowels, the condition will likely resolve spontaneously, which aligns with this principle. If a person without prior illness suddenly develops diarrhea, it indicates disease progression. Now, if a patient with an upward-flowing blood disorder subsequently develops downward flow with foul dysentery-like stool, it indicates that the pathogenic factor is departing; thus, this is auspicious.

The Classic states: In all cases of bleeding, if the body is hot and the pulse is large, the prognosis is poor due to excessive Fire pathogen. If the body is cool and the pulse is quiet, the prognosis is good due to the recovery of Healthy Qi (Zhengqi). Therefore, the Pulse Canon states: In cases of nasal epistaxis or hematemesis, a deep and fine pulse is favorable; if the pulse suddenly becomes floating and large, it portends danger. This is what is meant.

Various disorders related to menstrual blood in women are detailed in the Section on Women's Diseases.

Baidu San (Decoction for Overcoming Toxicity) treats continuous lower gastrointestinal bleeding caused by Wind-Heat invading the Large Intestine meridian. If caused by alcohol toxicity, add Huanglian. (Formula details see Section on Cough.) Commentary: This formula derives from the Shaoyang pattern examples and acts as a herb addressing both exterior and interior.

Huaihua San (Sophora Flower Powder) from *Ben Shi Fang* treats lower gastrointestinal bleeding due to Changfeng (Intestinal Wind) and Zangdu (Visceral Toxin).
Ingredients: Huaihua (Sophorae Flos, stir-fried), Baimao Gen / Ce Bai Ye (Biota Top Leaf, pounded), Jingjie Sui (Schizonepeta Spike), Zhike (Aurantii Fructus Immaturus) in equal parts.
Preparation and Administration: Grind into powder. Take 2 qian per dose, administered on an empty stomach with rice water.

Jieyin Dan (Binding Yin Pill) from *Ba Cui Fang* treats lower gastrointestinal bleeding due to Changfeng and Zangdu.
Ingredients: Zhike (Aurantii Fructus Immaturus, stir-fried), Weilingxian (Syneilesis Herba), Huangqin (Scutellariae Radix), Chenpi (Citri Reticulatae Pericarpium), Chun Gen Pi (Toosendan Cortex), Heshouwu (Polygoni Multiflori Radix), Jingjie Sui (Schizonepeta Spike) in equal parts.
Preparation and Administration: Grind into powder, bind with wine paste to form pills the size of paulownia seeds. Take 50–70 pills per dose with rice water, adding a small amount of vinegar.
Commentary: These two formulas primarily target the Hand Taiyin Lung meridian and Hand Yangming Large Intestine meridian.

Jiasheng Jiawei Siwu Tang (Modified Four Substances Decoction from *Jisheng Fang*) treats persistent lower gastrointestinal bleeding due to Changfeng.
Ingredients: Ce Bai Ye (Biota Top Leaf), Shengdihuang (Rehmanniae Radix), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma) each 1 liang; Zhike (Aurantii Fructus Immaturus), Jingjie Sui (Schizonepeta Spike), Huaihua (Sophorae Flos, stir-fried), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) each 0.5 liang.
Preparation and Administration: Coarsely crush. Take 4 qian per dose, decoct with Wumei (Mume Fructus) and fresh ginger.
Commentary: This formula primarily targets the Foot Jueyin Liver meridian and Foot Taiyin Spleen meridian. Generally, this medication tonifies blood and cools blood. The attribution of "Wind" here is viewed as a manifestation of deficiency, not because Wind pathogen resides in the intestines.

Li Dongyuan's Huangqi Shaoyao Tang (Astragalus and Peony Decoction) treats chronic nasal epistaxis accompanied by sallow complexion, dry eyes with excessive discharge, and hand numbness.
Ingredients: Huangqi (Astragali Radix) 3 liang, Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) 2 liang, Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Lobatae Radix), Shaoyao (Paeoniae Radix) each 1 liang, Qianghuo (Notopterygii Rhizoma et Radix) 0.5 liang.
Preparation and Administration: Coarsely crush. Take 3 qian per dose, decoct in water and take warm.
Commentary: This formula primarily targets the Hand and Foot Taiyin Lung/Spleen meridians and Hand and Foot Yangming Stomach/Large Intestine meridians. However, prolonged blood deficiency leads to deficiency in the Yang aspect. Thus, insufficient blood causes numbness, and Yin deficiency with Fire hyperactivity leads to various complications; this is indeed not caused by Wind. This formula derives from the principle of raising Yang and nourishing Yin.