风,阳邪也。热,火气也。并入络中,则血溢络外。其证乍寒乍热,咳嗽口干烦躁者是
也,宜以辛凉入血之药治之。
《圣惠》荆芥地黄汤
荆芥穗为末,生地汁调服二钱。
骆隆吉曰∶风火既炽,当滋肾水。此以荆芥发阳邪,而以地黄养阴气也。
《圣济》荆芥穗散
荆芥穗 山栀仁 片芩 蒲黄
水煎五钱,温服,晚再服,以瘥为度。
郁热失血者,寒邪在表,闭热于经,血为热迫,而溢于络外也。勿用止血之药,
其表,郁热得舒,血亦自止。若表已解而热不消,血不止者,然后以清热降血之药治之。若
肺气已虚,客热不去,咳嗽咽干,吐血嗽血者,宜以甘润养血为主,而以辛药凉肺佐之,如
《宝鉴》大阿胶丸
阿胶(微炒) 生地黄 熟地黄 卷柏 干山药 五味子 鸡苏叶 大蓟(各
一两) 茯苓 柏子仁(另研) 百部 远志 人参 麦门冬 防风(各半两)
上为细末,炼蜜丸弹子大,煎小麦麦门冬汤下一丸,食后。
大蓟饮子 解郁热,止吐衄,亦治辛热物伤肺胃,呕吐血,名肺疽。
大蓟根(洗) 犀角(镑) 升麻 桑白皮(炙) 蒲黄(炒) 杏仁(去皮尖,各二钱)
各一两)
水二盅,生姜五片,煎至一盅,不拘时服。
《和剂》龙脑鸡苏丸 治胸中郁热咳嗽,吐血衄血,凉上膈,止虚烦。
鸡苏净叶(一斤,即龙脑薄荷) 生干地黄末(六两,后入) 麦冬(二两) 人参(二两)
(二两) 蒲黄(二两) 木通(二两) 黄 (一两) 柴胡(锉,同木通以沸汤大半升
浸一二宿,绞汁后入膏,二两) 甘草(一两半)
上为细末,以蜜二升,先炼一二沸,然后下生地黄末,不住手搅,时时入绞下柴胡木通
汁,慢慢熬成膏,勿令焦,然后以其余药末,同和为丸如豌豆大,每服二十丸,热水下。
侧柏散 治郁热内损心肺,吐血下血,其出如涌泉,口鼻俱流,须臾不救,服此
侧柏叶(蒸干,二两半) 荆芥穗(烧灰) 人参(各一两)
上为末,每服三钱,入白面二钱,新汲水调如稀糊啜服。
Wind is a pathogenic factor of the Yang nature. Heat is the Qi of Fire. When wind and heat merge into the collaterals, blood overflows outside the collaterals. The manifestations include alternating chills and fever, cough, dry mouth, and irritability; it should be treated with acrid-cool herbs that enter the blood level.
Jingjie Dihuang Tang (Schizonepeta and Rehmannia Decoction) from *Shenghui Fang* (Prescriptions of Holy Grace):
Grind Jingjie Sui (Schizonepetae Spica, 荆芥穗) into powder, mix with Shengdijie Zhi (Fresh Juice of Rehmanniae Radix, 生地汁), and take two qian.
Luo Longji stated: Since wind and fire are blazing, one should nourish Kidney Water. Here, Jingjie (Schizonepeta, 荆芥) disperses the Yang pathogen, while Dihuang (Rehmannia, 地黄) nourishes Yin Qi.
Jingjie Sui San (Schizonepeta Powder) from *Shengji Zonglu* (General Records of Holy Relief):
Ingredients: Jingjie Sui (Schizonepetae Spica, 荆芥穗), Shanzhiren (Gardeniae Semen, 山栀仁), Pianqin (Scutellariae Radix, 片芩), Puhuang (Typhae Pollen, 蒲黄).
Decoct five qian in water, take warm, and take again in the evening. Continue until recovery.
Hemorrhage due to constrained heat occurs when cold pathogens remain on the exterior, trapping heat within the meridians. Blood is forced by heat to overflow outside the collaterals. Do not use hemostatic drugs initially. Once the exterior syndrome is resolved and the constrained heat is relieved, bleeding will stop spontaneously. If the exterior syndrome has resolved but heat persists and bleeding continues, then treat with drugs that clear heat and descend blood. If Lung Qi is already deficient, and exogenous heat lingers, causing cough, dry throat, hemoptysis, or blood-streaked sputum, prioritize sweet-moistening methods to nourish blood, assisted by acrid drugs to cool the Lungs. For example, Da Ejiao Wan (Major Donkey-Hide Gelatin Pill) from *Baojian*.
Da Ejiao Wan (Major Donkey-Hide Gelatin Pill):
Ingredients: Ejiao (Colla Corii Asini, 阿胶, lightly stir-fried), Shengdihuang (Rehmanniae Radix Recens, 生地黄), Shudihuang (Rehmanniae Radix Praeparata, 熟地黄), Juanbai (Serpylli Herba, 卷柏), Ganshanyao (Dioscoreae Rhizoma, 干山药), Wuweizi (Schisandrae Fructus, 五味子), Jisuye (Elsholtziae Haplostachys Folium, 鸡苏叶), Daji (Leonuri Herba, 大蓟) — each 1 liang; Fuling (Poria, 茯苓), Baiziren (Platycladi Semen, 柏子仁, ground separately), Baitu (Stemonae Radix, 百部), Yuanzhi (Polygalae Radix, 远志), Renshen (Ginseng Radix et Rhizoma, 人参), Maidong (Ophiopogonis Radix, 麦门冬), Fangfeng (Saposhnikoviae Radix, 防风) — each 0.5 liang.
Grind all ingredients into fine powder. Mix with refined honey to form pills the size of a bullet. Take one pill after meals, washed down with a decoction of Xiaomai (Tritici Fructus, 小麦) and Maidong (Ophiopogonis Radix, 麦门冬).
Daji Yinzi (Great Thistle Drink): Relieves constrained heat, stops vomiting of blood and epistaxis. It also treats vomiting of blood caused by damage to the Lungs and Stomach from spicy and hot foods, a condition named Feiju (Lung Abscess).
Ingredients: Daji Gen (Leonuri Herba Root, 大蓟根, washed), Xijiao (Rhinocerotis Cornu, 犀角, shaved), Shengma (Cimicifugae Rhizoma, 升麻), Sangbaipi (Mori Cortex, 桑白皮, stir-fried), Puhuang (Typhae Pollen, 蒲黄, stir-fried), Xingren (Armeniacae Semen Amarum, 杏仁, skin and tip removed) — each 2 qian; [Text implies other ingredients at 1 liang each].
Decoct in two sheng of water with five slices of Shengjiang (Zingiberis Rhizoma Recens, 生姜) until one sheng remains. Take at any time.
Longnao Jisu Wan (Borneol and Elsholtzia Pill) from *Heji Jufang* (Formulas of the Bureau for the Care of the People): Treats cough due to constrained heat in the chest, hemoptysis, and epistaxis; clears upper jiao heat and stops deficiency vexation.
Ingredients: Jisu Jingye (Elsholtziae Haplostachys Folium, 鸡苏净叶, i.e., Longnao Bohe/Mentha haplostachys, 1 jin); Shenggandihuang Mo (Powder of Dried Rehmanniae Radix, 生干地黄末, added later, 6 liang); Maidong (Ophiopogonis Radix, 麦冬, 2 liang); Renshen (Ginseng Radix et Rhizoma, 人参, 2 liang); [Missing ingredient name, likely corresponding to 2 liang]; Puhuang (Typhae Pollen, 蒲黄, 2 liang); Mutong (Akebiae Caulis, 木通, 2 liang); Huang [Missing character, likely Huangqi/Astragali Radix or Huanglian/Coptidis Rhizoma] (1 liang); Chaihu (Bupleuri Radix, 柴胡, cut, soaked in half a sheng of boiling water with Mutong for one to two nights, juice squeezed out and added to the paste, 2 liang); Gancao (Glycyrrhizae Radix et Rhizoma, 甘草, 1.5 liang).
Grind all into fine powder. Use two sheng of honey, boil briefly, then add Shenggandihuang Mo, stirring constantly. Gradually add the squeezed juices of Chaihu and Mutong, slowly simmering into a paste without burning. Then mix with the remaining powders to form pills the size of peas. Take twenty pills per dose with warm water.
Cebai San (Biota Leaf Powder): Treats internal damage to the Heart and Lungs due to constrained heat, resulting in hemoptysis and hematochezia/hematuria. Bleeding may be profuse like a gushing spring, flowing from both mouth and nose, requiring immediate rescue. Take this formula.
Ingredients: Cebai Ye (Biota Tops, steamed and dried, 2.5 liang), Jingjie Sui (Schizonepetae Spica, burnt to ash, 1 liang), Renshen (Ginseng Radix et Rhizoma, 人参, 1 liang).
Grind into powder. Take three qian per dose, mixed with two qian of Baifan (Tapioca Flour, 白面), stirred into a thin paste with fresh well water, and drunk.