失血家。胃气清和。津液自生。火自降。痰自顺。而病亦自愈矣。若伤饮食。则中宫壅滞。气与火不得顺利。上
冲于肺。则为咳嗽。外蒸肌肉则发热。内郁于心则为烦。由是血不得宁。因之复发。名为食复。宜甲己化土
汤。加枳壳浓朴炒栀子麦芽为主。咳者加紫菀麦冬五味子杏仁。发热者加石膏知母。心烦者加黄连当
归。腹痛者加酒大黄。已动血者。加桃仁苏木。或用逍遥散。照上加减法。亦调和胃气善方。小柴胡汤亦可。
仲景治食复。言有宿食者。皆主芍药大黄。义取二物力能推荡。盖宿食不去。不独阻新食之进。且伤气壅
邪。转生诸疾。故主大黄以速去之。以免伤其正气。胜查麴之功千万。医者须知此理。临证庶有胆识。
夫失血之人。所以易于停食者。多是胃中有热。贪多饮食。既食之后。脾津枯少。不能糜烂消化。是以易于
停食。宜四君子汤加黄精山药玉竹天花粉麦芽白芍生地黄枸杞子当归麦冬山楂莱菔汁煎服。此等
治法。但读东垣脾胃论者。断不能知。
（怒复）
静则气平而生阴。动则气躁而生阳。烦热喘咳。随之而作。失血病。因劳动而复发者。十之五六。亟宜调息
瞑目。以收敛浮动之气。使阴生阳秘。而血乃不复动矣。人参固本汤。加蒲黄苏木治之。烦热甚者。宜用地
骨皮散。加炒栀子蒲黄。喘咳甚者。宜人参清肺汤治之。或三才汤。加五味子云茯苓沉香甘草。清燥救肺
汤亦治之。血复止后。多饮独参汤。熟睡以息之。
怒复者。怒气伤肝。相火暴发。而血因奋兴。当归芦荟丸以泻之。龙胆泻肝汤以清之。丹栀逍遥散以和之。
小柴胡汤。加牡蛎青皮以抑之。血潮不止者。泻心汤。加当归白芍沉香香附子降真香以止之。十灰散。用
香附子槟榔童便醋调服以止之。去血过多。则阴愈伤。阳愈亢。怒气愈不能平。宜当归人参沉香香附子
生地黄五味子。以大补之。少与之食。以消息之。
总之。失血之人。戒劳更能戒怒。医学考辨。有戒怒诗云。病家误。戒忿怒。忿怒无非些小故。血随气上不循
经。犹如轻车就熟路。吾临血证多矣。每有十剂之功。败于一怒。病家自误。医士徒劳。堪发一叹。
For patients with a history of blood loss, if the Stomach Qi is clear and harmonious, body fluids (Jin Ye) will naturally generate, deficient fire will naturally descend, and phlegm-dampness will naturally flow smoothly, leading to spontaneous recovery from illness. If dietary indiscretion injures the Spleen and Stomach, it causes stagnation in the Middle Jiao (Spleen and Stomach), preventing Qi and Fire from flowing smoothly. Rising upward to invade the Lung, it causes coughing; steaming outwardly into the muscles, it causes fever; internally stagnating in the Heart, it causes mental restlessness (Fan). Consequently, Blood fails to remain tranquil, leading to recurrence, which is termed "Food Relapse" (Shi Fu). The appropriate prescription is Jiaji Huatu Decoction (Earth Transforming Decoction based on Heavenly Stems Jia and Ji), using Zhiqiao (Bitter Orange Fruit), Houpo (Magnolia Bark), Chao Zhizi (Fried Gardenia Fruit), and Maiya (Barley Sprout) as principal herbs. For those with cough, add Ziwan (Aster Root), Maidong (Ophiopogon Tuber), Wuweizi (Schisandra Berry), and Xingren (Apricot Seed); for fever, add Shigao (Gypsum Fibrosum) and Zhimu (Anemarrhena Rhizome); for mental restlessness, add Huanglian (Coptis Rhizome) and Danggui (Angelica Sinensis); for abdominal pain, add Jiudahuang (Wine-processed Rhubarb Rhizome); for active bleeding, add Taoren (Peach Seed) and Sumu (Calamus Wood or related herb). Alternatively, Xiaoyao San (Free and Easy Wanderer Powder) may be used with modifications according to the above principles, which is also an excellent formula for harmonizing Stomach Qi. Xiao Chaihu Tang (Minor Bupleurum Decoction) can also be employed. Zhang Zhongjing, in treating food relapse, stated that cases with retained food should primarily use Shaoyao (Peony Root) and Dahuang (Rhubarb Rhizome). The rationale lies in the ability of these two herbs to push away and purge stagnation. Because retained food remains, it not only obstructs the intake of new food but also injures Zheng Qi (Upright Qi) and congestes pathogenic factors, giving rise to various diseases. Therefore, Dahuang is advocated to rapidly eliminate retained food, thereby avoiding injury to Zheng Qi. Its efficacy surpasses that of studying fermentative agents by thousands of times. Physicians must understand this principle to possess courage and insight in clinical practice.
Those who have suffered blood loss are prone to food retention mostly because there is heat in the Stomach, leading to gluttony. After eating, due to dryness and scarcity of Spleen Jin Ye (body fluids), the food cannot be properly decomposed and digested, making food retention easy. The appropriate treatment is Sizijunzi Tang (Four Gentlemen Decoction), added with Huangjing (Polygonatum Rhizome), Shanyao (Dioscorea Rhizome), Yuzhu (Polygonatum Odoratum Rhizome), Tianhuafen (Trichosanthes Root), Maiya (Barley Sprout), Baishao (White Peony Root), Sheng Dihuang (Rehmannia Root), Gouqizi (Goji Berry), Danggui (Angelica Sinensis), Maidong (Ophiopogon Tuber), Shanzha (Hawthorn Fruit), and Laifuzhi (Radish Juice), decocted and taken orally. Such therapeutic methods would certainly not be known by those who have only read Li Dongyuan's Treatise on the Spleen and Stomach (Piwei Lun).
(Nervous Anger Relapse)
Stillness calms Qi and generates Yin; movement agitates Qi and generates Yang. Mental restlessness, fever, wheezing, and coughing arise accordingly. In blood-loss diseases, recurrences caused by labor account for five to six out of ten. It is urgent to regulate breathing and close the eyes to converge floating Qi, allowing Yin to generate and Yang to secure, so that Blood ceases to move recklessly. Ren Shen Gu Ben Tang (Ginseng Decoction to Consolidate the Root), added with Puhuang (Tylpha Pollen) and Sumu, is used for treatment. For severe mental restlessness and fever, Digupi San (Lycium Bark Powder) added with Chao Zhizi (Fried Gardenia Fruit) and Puhuang (Tylpha Pollen) is appropriate. For severe wheezing and coughing, Ren Shen Qing Fei Tang (Ginseng Decoction to Clear the Lungs) is appropriate. Alternatively, Santang Tang (Three Capabilities Decoction) added with Wuweizi (Schisandra Berry), Yun Fuling (Poria Cocos with Pine Wood), Chenxiang (Agarwood), and Gancao (Licorice Root) may be used. Qingzao Jiufei Tang (Clear Dryness and Rescue the Lungs Decoction) is also effective. After bleeding stops, drinking Du Shen Tang (Single Ginseng Decoction) in large quantities and sleeping soundly helps to rest the body.
The term "Nervous Anger Relapse" refers to anger injuring the Liver, causing Ministerial Fire (Xiang Huo) to erupt violently, causing Blood to surge and act recklessly. Danggui Luhui Wan (Angelica and Ailanthus Pill) is used to purge fire; Longdan Xiegan Tang (Gentian Decoction to Drain the Liver) is used to clear heat; Danpi Xiaoyao San (Moutan and Bupleurum Free and Easy Wanderer Powder) is used to harmonize. Xiao Chaihu Tang (Minor Bupleurum Decoction) added with Muli (Oyster Shell) and Qingpi (Green Tangerina Peel) is used to suppress it. For unceasing blood surging, Xiexin Tang (Drain the Heart Decoction) added with Danggui (Angelica Sinensis), Baishao (White Peony Root), Chenxiang (Agarwood), Xiangfuzi (Cyperus Rhizome), and Jiangzhenxiang (Liquidambar Resin) is used to stop bleeding. Shihui San (Ten Ashes Powder), mixed with Xiangfuzi (Cyperus Rhizome), Binglang (Areca Seed), Tongbian (Child Urine), and Cu (Vinegar), is used to stop bleeding. If excessive blood loss occurs, Yin is further injured, Yang becomes hyperactive, and anger becomes even harder to calm. It is appropriate to use Danggui (Angelica Sinensis), Renshen (Ginseng Root), Chenxiang (Agarwood), Xiangfuzi (Cyperus Rhizome), Sheng Dihuang (Rehmannia Root), and Wuweizi (Schisandra Berry) for major tonification. Food should be given in small amounts to slowly nourish and regulate.
In summary, patients with blood loss must avoid labor and, more importantly, avoid anger. Medical examinations include a poem warning against anger: "The patient errs, beware of indignation. Indignation arises from trivial matters. Blood follows Qi upward, failing to follow its vessels, like a light cart taking a familiar road." I have treated many blood disorders, often seeing the efficacy of ten doses ruined by a single fit of anger. The patient harms themselves through their own actions, rendering the physician's efforts futile. This is truly worthy of a sigh.