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Yanning Sheng, in *Zhi Yan*, stated: The ancients said that various bleeding syndromes are not cold syndromes; rather, they are caused by heat forcing the blood to act recklessly. However, these cases often involve accompanying pathogenic factors. Some are accompanied by wind (Wind), some by dampness (Dampness), and some by qi stagnation. Others may be triggered by drugs or mineral pills, with heat as the root cause. Treatment for the upper, middle, and lower jiao (Triple Burner) varies appropriately. For the upper jiao, Gardenia (Gardeniae Fructus), Scutellaria (Scutellariae Radix), Coptis (Coptidis Rhizoma), Peony (Paeoniae Radix), Rhinoceros Horn (Rhinocerotis Cornu - *note: modern substitute usually used*), and Cattail Pollen (Typhonii Rhizoma) are used, supplemented by Moutan Bark (Moutan Cortex) and Rehmannia Root (Rehmanniae Radix). The ancients said: If one is exposed to wind and cold, it is because yang fire burns the evil, fanned by wind, causing blood to move recklessly. In such cases, Cinnamon Twig (Cinnamomi Ramulus) is added to "subdue wood" (calm liver wind). If dampness is involved, Atractylodes (Atractylodis Rhizoma), Sanguisorba (Sanguisorbae Radix), and White Peony (Paeoniae Radix Alba) are used, supplemented by "fire agents" (warming agents). Bleeding from the large intestine is due to fire-evil of the Hand-Yangming Large Intestine channel being affected by wind and dampness. It is treated with fire agents and wind agents, as wind can overcome dampness, using herbs like Coptis, Scutellaria, Peony, Phellodendron (Phellodendri Cortex), Schizonepeta (Schizonepetae Spica), Saposhnikovia (Saposhnikoviae Radix), and Notopterygium (Notopterygii Rhizoma et Radix), along with Crown Flower (Celosiae Cristatae Flos), which reflects the principle of "describing categories" (analogy).

For symptoms of blood overflow, leakage, and other reckless conditions due to accumulation, I initially tended to use formulas containing Peach Kernel (Persicae Semen) and Rhubarb (Rhei Radix et Rhizoma) to promote blood circulation and break up stasis, thereby curbing their aggressive nature. (In cases of sudden hematemesis in the early stage, strong purgatives should be urgently administered to curb the aggressive nature. If the disease has persisted for a long time and righteous qi is already deficient, the method should be regulation. Zhang Zhongjing said: Those who have lost blood or are constitutionally deficient should not be purged.) Later, differentiation and treatment were applied. Although results were often achieved, the underlying principles remained unclear. Later, in Siming, I met an old friend, Su Yifangju, who said: There is a skilled doctor in our hometown whose name I have forgotten. Whenever he treats blood loss and reckless bleeding, he first uses strong purgatives. When asked how the body can withstand purging after blood loss, he replied: Since the blood is acting recklessly and has lost its proper course, if the accumulated stasis is not removed, this reckless behavior will become the norm, and how can the blood be cleansed? Moreover, what is removed goes away, and what is generated arises anew; where is the deficiency? Hearing this, I was startled and said: This is a profound statement. My past doubts are now resolved.

He further said: Regarding women and blood, when menstrual blood accumulates, it becomes the fetus; the accumulated remains accumulated, and the new arises anew. During childbirth, it becomes lochia; what is expelled goes away, and what is generated arises anew. When it transforms into milk, there is no leakage from below as menstruation. Blood loss is a common reckless reversal in blood disorders; for postpartum and nursing women, the processes of expelling and generating are the same. Patients with blood loss need purgatives to break blood stasis, applied at the initial stage of accumulation and recklessness. Conversely, those who have lost blood and are deficient should not be purged, which is a warning for the period after blood loss.

He also said: Blood movement caused by fright belongs to the Heart. Blood movement caused by anger belongs to the Liver. Blood movement caused by worry belongs to the Lung. Blood movement caused by overthinking belongs to the Spleen. Blood movement caused by fatigue belongs to the Kidney.

He also said: Hematemesis occurs when the Foot-Yangming Stomach channel ascends along its pathway,渗溢 (seeping and overflowing) into the stomach cavity. Hematuria occurs when the Foot-Taiyang Bladder channel enters the bladder along its pathway. He also said: Bleeding before and after defecation: bleeding before defecation is due to the Hand-Yangming Large Intestine channel descending along its pathway, seeping into the large intestine and passing through the rectum to exit. Bleeding after defecation is due to the Foot-Yangming Stomach channel entering the stomach (injury to yin collaterals causing internal blood overflow), overflowing and exiting downward. This is what the ancients called "proximal blood" and "distal blood."

He also said: Hemoptysis is the most severe illness and difficult to treat because the Hand-Taiyin Lung channel has abundant qi but little blood. Furthermore, the Lung represents metal and is a clear and descending organ. Now constrained by fire, it forces blood upward, causing hemoptysis, which is a severe deviation. Upper qi disturbance with blood appearance, and lower pathology heard as sound, refers to wheezing, hemoptysis, and coughing with phlegm.

He also said: Falling from heights, startling falls, and blows leading to stagnant evil blood are all discussed under Wind Stroke (Zhong Feng) and ultimately return to the Jueyin (Liver/Pericardium). This is the theory of Haicang (Zhang Yuansu). Generally, Jueyin has much blood and transforms into wind-wood, hence this classification. Organic lesions should be diagnosed from the blood aspect, while non-organic lesions should be treated according to routine methods. Xia Zhongyong suffered palpitations and heart unrest after falling into the sea due to fright; this was a non-organic lesion, treated as a wind case, and he recovered.

He also said: Saliva mixed with blood (sputumting blood) is blamed on the frying and pressing force of yang fire in the lower jiao. (Saliva blood belongs to kidney deficiency with flaming fire.) The Kidney governs saliva and corresponds to the Foot-Shaoyin Kidney channel, which has little blood and abundant qi, making the syndrome difficult to treat.

There are also conditions called "Intestinal Wind" (Chang Feng) and "Visceral Toxin" (Zang Du). Intestinal Wind is caused by accumulated heat in the Foot-Yangming Stomach channel, which turns into wind over time, stirring the blood. Visceral Toxin is caused by accumulated heat in the Foot-Taiyin Spleen channel, which generates dampness over time, flowing downward. Wind affects yang channels, and dampness affects yin channels. Cao's *Bi Yong Fang* states: For hematemesis, dried Ginger (Zingiberis Rhizoma) and Licorice (Glycyrrhizae Radix) decoction should be taken, or Sizhu Li Zhong Tang is also acceptable. Such treatments invariably lead to recovery. If Rehmannia Root, Bamboo Shavings (Bambusae Caulis in Taenia), or Lotus Root Juice are taken, recovery will be far off.