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Use ginger juice and tongbian (child's urine) to allow turbid fluids to still be discharged through the turbid pathways. How then can blood reverse upwards? Contemporary physicians, upon encountering this syndrome, exclusively focus on nourishing yin and clearing fire, using cloying and astringent yin-nourishing herbs, thereby leaving no outlet for internal blood stasis. It is no wonder that the condition worsens with each treatment. After the previous formula has vigorously cleared the pathogen, it may damage the qi of the zang-fu organs. Therefore, the subsequent formula uses Xuduan (Dipsacus Root) to tonify the Liver, Yuanzhi (Polygala Root) to tonify the Heart, Shanyao (Chinese Yam Rhizome) to tonify the Spleen, and Maidong (Ophiopogon Tuber) to tonify the Lung. Still fearing that residual stasis remains, Chishao (Red Peony Root), Yimucao (Motherwort Herb), are added to promote circulation and cleanse stasis, while Chuanbeimu (Fritillaria Bulb) is added to clear heat and transform phlegm. Compared to the previous formula which combined purging and tonifying, this one yields miraculous effects rapidly. This formula has proven effective in every trial; both physicians and patients should widely disseminate it. Secondly, Gufeng Guyuan Tang (Drum Peak Decoction to Consolidate Original Qi) with Wuweizi (Schisandra Fruit). (Lupardenshen (Codonopsis Root), Zhi Huangqi (Honey-fried Astragalus Root), Jiu Chao Baishao (Wine-processed White Peony Root) each 3 qian, Guishen (Angelica Sinensis Root Body) 2 qian, Zhi Hei Gancao (Honey-fried Black Licorice Root) 1 qian, Hei Pa Jiang (Black Roasted Ginger) 5 fen mixed and pounded with Wuweizi (Schisandra Fruit) 3 fen, Chen Nanzao (Aged Southern Jujube) 2 pieces.) also treats hemorrhage caused by yang deficiency leading to yin/blood escaping. The etiology mostly belongs to internal emotional injury or irregular diet, causing initial disease of the Spleen and Stomach. Symptoms must include nausea, mental fatigue, spontaneous sweating, and cold limbs. Therefore, Renshen (Ginseng Root) and Huangqi (Astragalus Root) are used as sovereign drugs to consolidate original qi. When qi is consolidated, blood circulates within the meridians; without specifically stopping bleeding, the bleeding stops naturally. However, since blood escaping implies blood deficiency, Guizhi (Cinnamon Twig) and Baishao (White Peony Root), Gancao (Licorice Root) are used as minister drugs to tonify blood and nourish the stomach. Monk Shenrou stated: "Whenever one wishes to stop hematemesis, one must use charred dried ginger and Schisandra fruit." Thus, Paogan (Roasted Ginger) is added as an assistant; blood stops when it sees black. Wuweizi (Schisandra Fruit) is sour and astringent, capable of restraining rebellious qi. Nevertheless, if true yin loses its hold and escapes, it will inevitably cause yang to be repelled upwards, with blood following to overflow, resulting in severe vomiting and epistaxis, accompanied by nausea and dry retching, cold hands and feet, faint and thin pulses throughout the six positions, and yuan yang about to collapse in an instant. In such cases, one should immediately use Jingyue Zhenyin Jian (Jingyue's Formula to Anchor Yin). (Biezhi Renshen (Korean Ginseng Root) 3 qian, Fuzi (Prepared Aconite Root) 2 qian, Zigui (Cinnamon Bark) 8 fen, mixed and pounded with Dushudi (Prepared Rehmannia Root) 6 qian, Hei Pa Jiang (Black Roasted Ginger) 7 fen, Huainiuqi (Asparagus Tuber), Zexie (Alisma Rhizome) each 1.5 qian, Zhi Gancao (Honey-fried Licorice Root) 1 qian.) to tonify qi and secure collapse, nourish yin and draw down yang, thereby rescuing from the critical condition of qi collapsing following blood loss. The symptom of manic vomiting due to blood loss is frequently seen in clinical practice; one must not be unaware of this emergency rescue method.

[Rongzhai's Note]: "Shanghan with Blood Stasis" (Jiaxue Shanghan), Yu pointed out it is "also known as Shanghan with Blood Stasis" (Shanghan Jiayu). Mr. Xiushan stated more clearly: "There was pre-existing blood stasis inside; due to contracting a seasonal pathogen, the chronic illness is triggered, called Jiaxue (Clasping Blood). This differs from Taiyang disease where sweating is indicated but withheld, causing pathogenic factors to sink and violently knot, resulting in Xueyu (Blood Accumulation); although the presentation is similar, the nature is different." Here, we understand that this syndrome is distinct from Xueyu (Blood Accumulation) and also differs from Shanghan complicated by blood loss. However, inferring other cases from one example, seeking differences amidst similarities, and understanding the relevant syndrome differentiation and treatment are efforts we should strive for. Regarding Shanghan complicated by "blood loss," Mr. Lianchen has provided a detailed introduction, dividing it into six types: "Epistaxis" (Nuxue), "Hemoptysis" (Kexue), "Hematemesis" (Ou Xuexue), "Dental Bleeding" (Chixue), "Hematochezia" (Bianxue), and "Hematuria" (Niaoxue), with clear arguments and treatments that are the crystallization of his lifelong experience. Only the "Xueyu" (Blood Accumulation) syndrome was not mentioned, so the following supplement is made. Examining the *Shanghan Lun* (Treatise on Cold Damage): "Whenever Taiyang disease does not resolve, and the pathogen enters the fu organs from the channels, heat knots in the Bladder, blood coagulates and accumulates; blood stasis causes heart qi to knot, thus the person becomes like mad; if blood is passed downwards, recovery ensues, and the pathogen resolves through the downward passage of blood. If exterior symptoms remain unresolved, one should first resolve the exterior, preferably using Guizhi Tang (Cinnamon Twig Decoction). Once the exterior is resolved, but there is only urgency and binding in the lower abdomen, this is Xueyu (Blood Accumulation); treat with Tao Ren Cheng Qi Tang (Peach Kernel Cathartic Decoction) to purge." It also states: "In Taiyang disease for six or seven days, if exterior symptoms persist, and the pulse is faint and deep, the pathogenic factor is moving inward. If there is no chest binding, heat knots in the lower jiao. If the person is manic, has hardness and fullness in the lower abdomen, and urination is normal, this is because the Taiyang pathogen followed the channels to accumulate blood stasis internally. Treat with Didang Tang (Definite Decoction) to purge, and recovery will follow." From these two passages, the symptoms of "Xueyu" (Blood Accumulation) can be seen as: "like madness," "normal urination," "urgency and binding in the lower abdomen," and even "mania," "hardness and fullness in the lower abdomen." Xu Xueshi further supplemented: "If blood accumulates in the upper jiao, there is forgetfulness; if in the lower jiao, there is mania." As for treatment methods, two stages can be identified in the text: Tao Ren Cheng Qi Tang (Peach Kernel Cathartic Decoction) treats the stage of initial blood stasis knotting, while Didang Tang (Definite Decoction) treats the stage of established blood stasis. Observing the symptoms from the preceding and succeeding passages reveals a significant distinction in severity; the former mentions "urgency and binding in the lower abdomen," while the latter mentions "hardness and fullness in the lower abdomen"; "hardness and fullness" is originally heavier than "urgency and binding." The former says "like madness," the latter says "mania"; "mania" is originally heavier than "like madness." The former states "recovery follows if blood is passed downwards," while the latter requires purging the blood for recovery, which is heavier than blood passing downwards spontaneously. The former does not mention the pulse; I assume it would fall under floating and rapid examples, whereas the latter has a "faint and deep pulse," originally heavier than the former. The former uses plant-based medicines, while the latter uses animal-based medicines; the efficacy of animal-based medicines is originally more potent than that of plant-based medicines. These are obvious facts. *Shanghan Diyi Shu* (The First Book on Shanghan) analyzes this saying: "The syndrome of Xueyu (Blood Accumulation), although involving the blood level, must also be treated differently according to yin and yang. For instance, blood stasis in the upper jiao is yang; blood accumulation in the lower jiao is yin; if Taiyang fails to release the exterior, heat stasis occurs internally, and blood accumulates in the lower jiao, this is yang; if Taiyang is incorrectly purged, yang qi sinks, and blood accumulates in the lower jiao, this is yin. Upper jiao blood accumulation, due to inability to sweat, leads to blood accumulation; the Renying pulse must be tight, tightness being a sign of rapid and forceful qualities. Exterior signs include red face, dry tongue, irritability and desire for mania, or head shaking and staring eyes, bloody stool water, and spasms in all fingers except the index finger on both hands; suitable herbs include Xijiao (Rhinoceros Horn - now prohibited/replace with alternatives in modern context, e.g., Niuxi or Shui Niu Jiao), Taoren (Peach Kernel), Shengdi (Rehmannia Root), Chishao (Red Peony Root), Guiwei (Cinnamon Twig tip/Angelica Tail), Danpi (Moutan Cortex), Danshen (Salvia Root), Yujin (Curcuma Rhizome), etc., to clear and move. Lower jiao yang syndrome blood accumulation, i.e., the heat knotting in the Bladder syndrome referred to by Zhongjing, is treated by purging with Tao Ren (Peach Kernel) and Dahuang (Rhubarb Root). If lower jiao yin syndrome blood accumulation, it is due to incorrect purging causing yang qi to sink, injuring yin blood, and blood congealing due to cold. Signs include pale face, blue lips, furrowed brows, staring eyes, chills, locked jaw, white slippery tongue coating, bloody stool water, and spasms in all fingers except the index finger on both hands; warm tonification is suitable. Such as Renshen (Ginseng Root), Fuzi (Prepared Aconite Root), Baizhu (Atractylodes Macrocephala Rhizome), Danggui (Angelica Sinensis Root), Rougui (Cinnamon Bark), Taoren (Peach Kernel), Shengma (Cimicifuga Rhizome), Zhi Cao (Honey-fried Licorice Root), etc., to warm and tonify to raise yang qi." This is another medical method of grasping the cause and analyzing current manifestations, which is worth adopting.