（吐 衄 咳 咯 唾 便 溺血等）
经曰∶心出血，肝纳血。又曰∶卧则血归肝，目受血而能视，足受血而能步，掌受血而能握
，指受血而能摄。所以动言视听，无非血养。又曰∶怒则气逆，甚则呕血。夫吐血者，多因大怒
伤肝，忧愁思虑伤心；酒色过度，阳盛阴虚，水不制火；或浓味醇酒，以动胃火，感受之由不同
，无出于火载血上，错经妄行。凡荣卫太虚，腑脏易损，血脉空竭。因而恚怒惊忿，暴气逆溢，
不循经络，血脉流散，是证作矣。诸失血多属于君相二火、诸经之热，煎逼其血而出诸窍也。色
赤紫为热极。凡血上行者为逆，复而下行变痢为顺。药兼降气，则血归经。脉多芤涩，沉细者顺
，洪大者逆。身凉脉静者易治，身热脉盛者难治。
主方 犀角（磨汁或镑） 牡丹皮 赤芍（各钱半） 生地黄（二钱） 黄连（一钱五分）
上水一盏，童便一钟，煎服。
如血不止加茅根汁，磨京墨汁各半钟和服。吐血出于胃加天门冬、黑山栀、阿胶、焦荆芥、
蒲黄；浓味动胃火加石膏、枳壳。衄血鼻出，咳血，痰中血丝皆肺火，加黄芩、连翘、玄参。唾血
咯血皆出于肾，加黄柏、知母、熟地、黑山栀。凡血紫黑成块，胸中气塞加大黄、桃仁。大便血
，脏气伤，风邪入，下血，面黄时热加防风、枳壳、柴胡、升麻、槐角、地榆。小便血，小肠与
心为表里，心热则尿血，
兼有膀胱火，山栀、滑石、瞿麦、木通。诸见血，药中可用藕节汁、扁柏叶、山茶花、大小蓟；
甚不止，暂用广西三七、真花蕊石、发灰、白芨，可以为末，调服三钱。止后多用郁金、山茶、
桃仁，以清瘀血，心无后患。有吐多神昏不省者，乃阴气暴绝，孤阳欲飞越而去，不能独存，急
用人参一两，煎浓汁半钟灌下，气复则苏。如血止火降，胸宽气和，止是虚弱无力，参、 、白
术、归身之类补之。
地黄饮子 治吐血、衄血、下血、溺血等证，皆属于热。
生地 熟地 枸杞子 地骨皮 黄芩 天门冬 芍药 黄 甘草（等分）
上咀，每服七钱，水二钟，煎八分，去渣，食远服。如脉微身凉恶风者，加桂二分。
必胜散 治男、妇错经妄行流溢，或咳或衄血，并治。
小蓟 人参（肺热减去） 蒲黄（炒黑） 熟地黄（酒洗） 当归 乌梅 川芎（各一钱）
上咀，作一服，水二钟，煎一钟，不拘时服。
麦门冬汤 治思虑伤心，吐血衄血。
麦冬 天门冬 远志 当归 白芍药 生地黄 人参 黄 牡丹皮 阿胶 藕节 炙草（
各一钱）
上作一服，每服水二钟，姜一片，煎一钟，不拘时服。
刺蓟散 治衄血诸血，经日不止。
刺蓟 苦参 黄连 栀子仁 生地黄 侧柏叶 大黄（炒。各一两）
上咀，每服五钱，水二钟，入竹茹五分，煎八分，温服。
槐榆丸 治大便下血，诸痔及脱肛。
槐角子 地榆 枳壳 黄芩（条） 防风 当归（头，等分）
上为末，水法丸桐子大，每服二钱，空心白汤送下。
四生丸 治吐衄血，阳乘于阴，血热妄行等证。
生艾叶 生薄荷叶 侧柏叶 生地黄（等分）
上俱捣烂，丸如鸡子大，每用一丸煎，去渣服。
十灰散 治痨证，诸失血，嗽血，先服此。
大蓟 小蓟 荷叶 侧柏叶 茅根 茜根 山栀 大黄 牡丹皮 棕榈皮
各烧灰，纸包盖，地下过宿，等分发，研匀。先以藕节汁或萝卜汁，磨京墨调末五钱，服。
甚有去升斗不能止者，花蕊石、发灰、三七、白芨、研末暂服。神昏服独参汤。
简便方 治吐血。
藕节 荷叶顶（各七个） 水煎，入蜜一匙服。
又 鲜地黄汁（一升） 姜汁（半合） 和服。或生地酒煎服，或生蜜汤服。
又 百合捣汁饮，煮食亦可。又熟猪肝蘸白芨末食；或单白芨。
又 生藕、生地黄、大蓟各捣汁三合，入蜜一匙服。
又 萝卜捣汁和童便（或盐少许，或酒同服。）
舌上无故出血∶槐花末敷。
止吐衄血∶白芨末，凉水调盐花贴鼻 中。或贴印堂及鼻，纸封，频以凉水润之；或湿纸搭
颈项或顶心，频以凉水润之。茅根（煎）、京墨（磨）、藕、萱草、马鞭草、车前草（并捣汁）、
百草霜（或锅煤）、栀子（炒研）、黄葵子、炒黄糯米、发灰 并可研末，凉水调下皆效（随用一
味。）
止衄血∶槐花（末）、莲房（烧灰）、发（烧灰）、鸬 粪（烧灰）、栀子（烧灰），皆可吹入鼻。萝卜（汁）、车前
（汁）、葱（汁，皆可滴入鼻内。石榴花瓣、墙头苔藓，皆可塞入鼻。
咯血疙瘩∶杏仁（研细），青黛作饼，以柿合湿纸裹煨，慢嚼，米汤下。
大便下血∶乌梅 五倍子（炒焦） 白芷（研末，等分） 米糊丸桐子大。每服百丸，白汤送
下。
又 臭椿根皮为末，醋糊丸汤下。或僵蚕末、乌梅肉蒸、捣，丸服。或苦楝子炒黄为末，蜜
和丸服。
又 茄科（烧灰，三钱），米汤下，或木槿煎服。或山楂末，或五倍子末，皆可汤服。
小便出血∶蒲黄（炒） 破故纸（炒） 陈锻石（炒）等分，研末，汤服。
又 辰砂五苓散，灯心汤下。或柿饼（烧灰），米汤调下。或车前子水煎服。或车前草捣汁服。
又 蒲黄（炒），研末服。后四物汤加木通、车前子煎，调玄明粉服，全止。
小便血条∶当归、白芷为末（二钱），淡豆豉煎汤下。或黄连、黄柏末（二钱），车前子煎汤调下。
又 五倍子末，乌梅捣丸服。或郁金为末，葱汤调下；或扁柏叶为末，酒调下。
(Conditions such as hematemesis, epistaxis, hemoptysis from coughing, spitting blood, and hematochezia or hematuria)
The classics state: The Heart generates blood, and the Liver stores blood. It is also said: When lying down, blood returns to the Liver; when the eyes receive blood nourishment, they can see; when the feet receive blood nourishment, they can walk; when the palms receive blood nourishment, they can grasp; when the fingers receive blood nourishment, they can hold objects. Therefore, all movements, speech, vision, and hearing rely on the nourishment of blood. It is further stated: Anger causes Qi to rebel, and in severe cases, it leads to vomiting blood. Generally, hematemesis is often caused by severe anger injuring the Liver, or worry and overthinking injuring the Heart; excessive indulgence in alcohol and sexual activity leading to excess Yang and deficiency of Yin, where Water fails to control Fire; or consuming rich flavors and strong wine, stirring up Stomach Fire. Although the etiological factors differ, all ultimately归结 to Fire carrying blood upward, causing blood to flow recklessly and deviate from its normal course. Whenever Ying (Nutritive) and Wei (Defensive) Qi are extremely deficient, Zang-Fu organs become easily damaged, and blood vessels are depleted. If at this time, due to anger or fright, violent Qi rebels and overflows, failing to follow the meridians, causing blood vessels to scatter, this condition arises. Most hemorrhagic conditions belong to the hyperactivity of Ministerial Fire (Mingmen Fire) and Sovereign Fire (Heart Fire), as well as heat in various meridians, which boil and force blood out through the orifices. Blood that is red and purple indicates extreme heat. Generally, blood flowing upward is considered a "Rebellious" (Ni) pattern, whereas if it transforms into downward flow becoming dysentery, it is considered a "Smooth" (Shun) pattern. Medications should incorporate methods to direct Qi downward, so that blood may return to its vessels. The pulse is often Kou (Hollow) or Se (Choppy); a deep and fine pulse is favorable, while a flooding and large pulse is unfavorable. A cool body with a calm pulse indicates an easy-to-treat case, whereas a hot body with a vigorous pulse indicates a difficult-to-treat case.
Main Formula: Xi Jiao (Rhinoceros Horn, ground for juice or sliced), Mu Dan Pi (Moutan Cortex), Chi Shao (Red Peony Root) (each 1.5 qian), Sheng Di Huang (Fresh Rehmannia Root) (2 qian), Huang Lian (Coptis Rhizome) (1.5 qian).
Take one cup of water and one bell of Tong Bian (Child's Urine), decoct and take orally.
If bleeding does not stop, add Mao Gen Juice (Sedge Rhizome Juice) and Jing Mo Zhi (Beijing Ink Juice), half a bell each, mixed and taken.
For hematemesis originating from the Stomach, add Tian Men Dong (Asparagus Tuber), Hei Shan Zhi (Black Gardenia Fruit), E Jiao (Donkey-hide Gelatin), Jiao Jing Jie (Charred Schizonepeta), Pu Huang (Typha Pollen). For Stomach Fire stirred by rich flavors, add Shi Gao (Gypsum) and Zhi Ke (Aurantium Fructus).
For epistaxis, hemoptysis, and blood-streaked sputum, all attributed to Lung Fire, add Huang Qin (Scutellaria Root), Lian Qiao (Forsythia Fruit), Xuan Shen (Scrophularia Root).
For spitting blood and globules of blood from the throat, all originating from the Kidney, add Huang Bo (Phellodendron Bark), Zhi Mu (Anemarrhena Rhizome), Shu Di Huang (Prepared Rehmannia Root), Hei Shan Zhi (Black Gardenia Fruit).
For blood that is purple-black and clotted, with chest qi stagnation, add Da Huang (Rhubarb Root) and Tao Ren (Peach Seed).
For hematochezia caused by injury to Zang Qi and invasion of Wind Pathogen, presenting with yellowish complexion and intermittent fever, add Fang Feng (Saposhnikovia Root), Zhi Ke (Aurantium Fructus), Chai Hu (Bupleurum Root), Sheng Ma (Cimicifuga Rhizome), Huai Jiao (Sophora Fruit), Di Yu (Sanguisorba Root).
For hematuria, since the Small Intestine and Heart are exterior-interior paired, Heart Heat causes urinary blood, combined with Bladder Fire, use Shan Zhi (Gardenia Fruit), Hua Shi (Talcum), Qu Mai (Dianthus Herb), Mu Tong (Akebia Stem).
For any visible bleeding, Lotus Node Juice (Ou Jie Zhi), Ce Bai Ye (Biota Tops), Shan Cha Hua (Camellia Flower), Da Ji (Great Thistle) and Xiao Ji (Small Thistle) can be added to the prescription. If bleeding is severe and uncontrolled, temporarily use San Qi (Notoginseng Root), Zhen Hua Rui Shi (Flower Mineral Stone), Fa Hui (Hair Ash), and Bai Ji (Bletilla Rhizome), grind into powder, mix and take 3 qian. After bleeding stops, frequently use Yu Jin (Curcuma Radix), Shan Cha (Camellia), and Tao Ren (Peach Seed) to clear blood stasis, ensuring no aftereffects for the Heart. In cases of massive hematemesis leading to unconsciousness, this indicates sudden collapse of Yin Qi and floating away of isolated Yang, which cannot survive alone. Urgently use Ren Shen (Ginseng Root) 1 liang, decoct into a thick half-bell of juice, and administer via gavage. Upon restoration of Qi, consciousness will return. If bleeding stops, fire descends, chest feels open, and Qi is peaceful, but only weakness and lack of strength remain, tonify with Ren Shen (Ginseng Root), [Text missing, likely Fu Ling or similar], Bai Zhu (Atractylodes Macrocephala Rhizome), Dang Gui Shen (Angelica Sinensis Root Body), etc.
Di Huang Yin Zi (Rehmannia Decoction): Treats hematemesis, epistaxis, hematochezia, hematuria, etc., all belonging to Heat patterns.
Ingredients: Sheng Di Huang (Fresh Rehmannia Root), Shu Di Huang (Prepared Rehmannia Root), Gou Qi Zi (Lycium Fruit), Di Gu Pi (Lycium Bark), Huang Qin (Scutellaria Root), Tian Men Dong (Asparagus Tuber), Shao Yao (Peony Root), Huang Qi (Astragalus Root), Gan Cao (Licorice Root) (equal parts).
Grind into coarse powder. Take 7 qian per dose, with two cups of water, decoct to eight parts, remove dregs, and take long after meals. If pulse is faint, body is cool, and aversion to wind exists, add Gui Zhi (Cinnamon Twig) 2 fen.
Bi Sheng San (Invincible Powder): Treats irregular menstrual flow and overflow in men and women, or coughing/epistaxis with blood.
Ingredients: Xiao Ji (Small Thistle), Ren Shen (Ginseng Root) (reduce/remove if Lung Heat), Pu Huang (Typha Pollen) (stir-fried black), Shu Di Huang (Prepared Rehmannia Root) (wine-washed), Dang Gui (Angelica Sinensis), Wu Mei (Mume Fruit), Chuan Xiong (Ligusticum Rhizome) (each 1 qian).
Grind into coarse powder, make one dose. With two cups of water, decoct to one cup, take at any time.
Mai Men Dong Tang (Ophiopogon Decoction): Treats hematemesis and epistaxis caused by overthinking injuring the Heart.
Ingredients: Mai Dong (Ophiopogon Tuber), Tian Men Dong (Asparagus Tuber), Yuan Zhi (Polygala Root), Dang Gui (Angelica Sinensis), Bai Shao Yao (White Peony Root), Sheng Di Huang (Fresh Rehmannia Root), Ren Shen (Ginseng Root), Huang Qi (Astragalus Root), Mu Dan Pi (Moutan Cortex), E Jiao (Donkey-hide Gelatin), Ou Jie (Lotus Node), Zhi Gan Cao (Honey-fried Licorice Root) (each 1 qian).
Make one dose. With two cups of water and one slice of ginger, decoct to one cup, take at any time.
Ci Ji San (Thorn Thistle Powder): Treats epistaxis and various hemorrhages persisting for days.
Ingredients: Ci Ji (Thorn Thistle), Ku Shen (Sophora Root), Huang Lian (Coptis Rhizome), Zhi Zi Ren (Gardenia Seed), Sheng Di Huang (Fresh Rehmannia Root), Ce Bai Ye (Biota Tops), Da Huang (Rhubarb Root) (stir-fried, each 1 liang).
Grind into coarse powder. Take 5 qian per dose, with two cups of water, add Zhu Ru (Bamboo Shavings) 5 fen, decoct to eight parts, take warm.
Huai Yu Wan (Sophora and Sanguisorba Pill): Treats hematochezia, various hemorrhoids, and rectal prolapse.
Ingredients: Huai Jiao Zi (Sophora Fruit), Di Yu (Sanguisorba Root), Zhi Ke (Aurantium Fructus), Huang Qin (Scutellaria Root) (strip form), Fang Feng (Saposhnikovia Root), Dang Gui Tou (Angelica Sinensis Root Head) (equal parts).
Grind into fine powder, make pills with water resembling tung tree seeds. Take 2 qian per dose, fasting, with plain boiled water.
Si Sheng Wan (Four Raw Herbs Pill): Treats hematemesis, epistaxis, Yang invading Yin, reckless blood flow due to blood heat, etc.
Ingredients: Sheng Ai Ye (Raw Mugwort Leaf), Sheng Bo He Ye (Raw Mint Leaf), Ce Bai Ye (Biota Tops), Sheng Di Huang (Fresh Rehmannia Root) (equal parts).
All ingredients are mashed thoroughly, made into pills the size of chicken eggs. Use one pill per dose, decoct, remove dregs, and take.
Shi Hui San (Ten Ashes Powder): Treats consumption syndromes, various hemorrhages, hemoptysis. Take this first.
Ingredients: Da Ji (Great Thistle), Xiao Ji (Small Thistle), He Ye (Lotus Leaf), Ce Bai Ye (Biota Tops), Mao Gen (Sedge Rhizome), Qian Gen (Rubia Root), Shan Zhi (Gardenia Fruit), Da Huang (Rhubarb Root), Mu Dan Pi (Moutan Cortex), Zong Lu Pi (Date Palm Stem Bark).
Burn each herb to ash, cover with paper, bury underground overnight. Divide equally, grind uniformly. First, mix 5 qian of powder with Ou Jie Zhi (Lotus Node Juice) or Luo Bo Zhi (Radish Juice) and Jing Mo (Beijing Ink). Take.
In cases of massive loss (even a dou or sheng) that cannot be stopped, temporarily use Hua Rui Shi (Flower Mineral Stone), Fa Hui (Hair Ash), San Qi (Notoginseng Root), Bai Ji (Bletilla Rhizome), ground into powder. For unconsciousness, use Du Shen Tang (Single Ginseng Decoction).
Jian Bian Fang (Simple and Convenient Formula): Treats hematemesis.
Formula 1: Ou Jie (Lotus Node), He Ye Ding (Lotus Leaf Tip) (seven of each), decoct in water, add one spoonful of honey, take.
Formula 2: Xian Di Huang Zhi (Fresh Rehmannia Juice) (one sheng), Jiang Zhi (Ginger Juice) (half he), mix and take. Alternatively, decoct Sheng Di Huang in wine, or take with raw honey water.
Formula 3: Mash Bai He (Lily Bulb) for juice to drink, or cook and eat. Alternatively, eat cooked pork liver dipped in Bai Ji powder, or use Bai Ji alone.
Formula 4: Sheng Ou (Raw Lotus Root), Sheng Di Huang (Fresh Rehmannia Root), Da Ji (Great Thistle) each mashed for 3 he of juice, add one spoonful of honey, take.
Formula 5: Mash Luo Bo (Radish) for juice, mix with Tong Bian (Child's Urine) (or add a little salt, or take with wine).
Spontaneous bleeding from the tongue: Apply Huai Hua powder.
Stop hematemesis and epistaxis: Bai Ji powder, mix with cold water and salt flowers, apply to nostrils. Or apply to Yintang and nose, seal with paper, frequently moisten with cold water. Or place wet paper on neck or crown, frequently moisten with cold water. Mao Gen (decocted), Jing Mo (ground), Ou (Lotus), Xuan Cao (Daylily), Ma Bian Cao (Verbena), Che Qian Cao (Plantain), Bai Cao Shuang (Soot), Zhi Zi (Gardenia, stir-fried and ground), Huang Kui Zi (Abutilon Seed), Chao Huang Nu Mi (Stir-fried Yellow Glutinous Rice), Fa Hui (Hair Ash) can all be ground into powder, mixed with cold water and taken (choose one according to need).
Stop epistaxis: Huai Hua (powder), Lian Fang (Lotus Pod, burned to ash), Fa (Hair, burned to ash), Lu Chan Fen (Cormorant Feces, burned to ash), Zhi Zi (Gardenia, burned to ash) can all be blown into the nose. Luo Bo (juice), Che Qian (juice), Cong (Onion, juice) can all be dripped into the nose. Shi Liu Hua Ban (Pomegranate Petals), Qiang Tou Tai Xian (Wall Moss) can all be stuffed into the nose.
Globules of blood from coughing: Yan Xing (Almond, finely ground), Qing Dai (Indigo Naturalis) made into a cake, wrapped in persimmon and wet paper, baked/simmered, chewed slowly, swallowed with rice soup.
Hematochezia: Wu Mei (Mume Fruit), Wu Bei Zi (Gallnut) (stir-fried until charred), Bai Zhi (Angelica Dahurica Root) (ground, equal parts), make pills with rice paste the size of tung seeds. Take 100 pills per dose, with plain boiled water.
Alternative: Chou Chun Gen Pi (Toona Root Bark) ground into powder, made into pills with vinegar paste, taken with water. Or Jiang Can (Silkworm) powder, steamed and mashed Wu Mei flesh, made into pills. Or Ku Lian Zi (Chinaberry Seed) stir-fried until yellow, ground into powder, made into pills with honey.
Alternative: Qia Ke (Eggplant Family part, burned to ash, 3 qian), taken with rice soup, or Mu Jin (Hibiscus) decocted and taken. Or Shan Zha (Hawthorn) powder, or Wu Bei Zi powder, all taken with water.
Hematuria: Pu Huang (Typha Pollen) (stir-fried), Po Gu Zhi (Cibotium Rhizome) (stir-fried), Chen Duan Shi (Old Burnt Lime) (stir-fried) in equal parts, grind into powder, take with water.
Alternative: Chen Sha Wu Ling San (Cinnabar Five-Ingredient Powder with Poria), taken with Deng Xin Cao (Juncus Decoction). Or Shi Bing (Persimmon Cake, burned to ash), mixed with rice water. Or Che Qian Zi (Plantain Seed) decocted in water. Or Che Qian Cao (Plantain Herb) mashed for juice.
Alternative: Pu Huang (Typha Pollen) (stir-fried), ground into powder and taken. Afterwards, Si Wu Tang (Four Substances Decoction) plus Mu Tong (Akebia Stem) and Che Qian Zi (Plantain Seed) decocted, mixed with Xuan Ming Fen (Mirabilite), taken to completely stop bleeding.
Xiao Bian Xue Tiao (Regimen for Hematuria): Dang Gui (Angelica Sinensis), Bai Zhi (Angelica Dahurica) ground into powder (2 qian), taken with Dan Dou Chi (Fermented Soybean) decoction. Or Huang Lian (Coptis Rhizome), Huang Bo (Phellodendron Bark) ground into powder (2 qian), taken with Che Qian Zi (Plantain Seed) decoction.
Alternative: Wu Bei Zi (Gallnut) powder, Wu Mei (Mume Fruit) mashed into pills. Or Yu Jin (Curcuma Radix) powder, taken with Cong Tang (Green Onion Decoction); or Bian Bai Ye (Biota Tops) powder, taken with wine.