《经》曰∶营者，水谷之精也。调和于五脏，洒陈于六腑，乃能入于脉也。生化于
脾，总统于心，藏受于肝，宣布于肺，施泄于肾，濡润亘通，靡不由此。夫吐血者，是
营卫气逆也。《经》曰∶咳则有血者，阳脉伤也。夫心者，血之主；肺者，气之主。气
主嘘之，血主濡之，荣养百骸，溉灌筋脉，荣卫相济，升降上下，自然顺适，不失常
道。若一有所伤，疾斯作矣。或外干六淫，内因七情，气乃留而不行，血乃壅而不濡，
内外抑郁，不能流注，是以热极涌泄，宁无妄动之虞，郁久奔升难御猛行之锐，血犹水
也，决诸东则东流，决诸西则西流，气之使血，其势相然者耶！是以气逆而血亦逆矣。
且气有余便是火，火乘于血，得热妄行，流溢无拘，上奔而为吐血也。有因饮食太饱，
胃寒不能消化，故吐所食之物。气血相冲，因伤肺胃亦令吐血者，有之，然阳明主乎多
血。若为热郁内逼，任令妄行，故小儿吐血，属胃者，十有七八。更有尚在襁褓而吐
血者，多由重帏暖阁，火气熏迫或过啖辛辣，流于乳络，儿饮之后，停滞不散，积温
成热，热极上崩，是以或吐、或衄、或下为尿血者有矣。若久嗽气逆，面目浮肿而嗽吐
血者，是肺虚损也，随症治之。
治小儿吐下血。
阿胶（炒） 蛤粉（各一钱） 辰砂（水飞） 为末，用藕汁白蜜调服。
又方
消瘀止血，用藕节晒干，为末，人参白蜜同煎汤调服。
《黄帝内经》说：营气，是水谷精微化生的物质。它在五脏中调和，散布于六腑，然后才能进入脉管之中。营气化生于脾，统属于心，储藏受纳于肝，宣发布散于肺，施泄输布于肾，滋润濡养全身经络通畅，无不由此产生。所谓吐血，就是营卫之气逆乱所致。《黄帝内经》又说：咳嗽带血，是阳脉受损的表现。心，是血液的主宰；肺，是气的主宰。气主要发挥温煦作用，血主要发挥濡养作用，共同荣养骨骼肌肉，灌溉筋脉，营卫相互协调，升降有序，自然顺畅适宜，不违背正常规律。如果一旦受到损伤，疾病就会发生。或者是外感六淫邪气，或者内伤七情因素，导致气机停留而不能运行，血液壅滞而不能濡养，内外郁结，不能流畅注通，因此热极而涌出泄漏，难道没有妄动出血的忧虑吗？郁结久了，奔升之势难以抵御猛行的锐气，血就像水一样，决口在东则向东流，决口在西则向西流，这是气推动血的结果，它们的形势是相互呼应的！因此气逆乱，血也随之逆乱。况且气有余就会化为火，火邪侵犯血液，遇到热邪便妄行，流淌溢出不受拘束，向上冲奔而导致吐血。有因为饮食过饱，胃寒不能消化，所以吐出未消化的食物。气血相冲，因损伤肺胃也导致吐血的，这种情况也是有的，然而阳明经主司多血。如果是热邪郁结内逼，任凭血液妄行，所以小儿吐血，属于胃热的，十有七八。更有尚在襁褓中的婴儿出现吐血的，多由于厚重的帷帐温暖的房间，火气熏蒸逼迫，或者过量食用辛辣食物，热气流入乳络，婴儿饮用后，停滞不散，积温而成热，热极而上崩，因此有的呕吐，有的鼻衄，有的下行为尿血的情况都有。如果是久咳导致气逆，面目浮肿并且咳嗽吐血，这是肺虚损的表现，应当根据症状进行治疗。
治疗小儿吐血、便血。
阿胶（炒制） 蛤粉（各一钱） 辰砂（水飞法处理） 研为细末，用藕汁和白蜜调服。
另一个方子
消除瘀血止血，用藕节晒干，研为细末，用人参和白蜜同煎汤调服。
The *Classic of Medicine* (*Huangdi Neijing*) states: Ying Qi (Nutritive Qi) is the refined essence derived from food and drink. It harmonizes within the five Zang organs, spreads throughout the six Fu organs, and only then can it enter the vessels. It is generated by the Spleen, governed by the Heart, stored and received by the Liver, distributed by the Lung, and excreted by the Kidney. It moistens and nourishes, ensuring unobstructed flow, all originating from this mechanism. The occurrence of hematemesis (vomiting blood) is due to the rebellion of Ying and Wei (Defensive) Qi. The *Classic* also states: Coughing up blood indicates injury to the Yang vessels. The Heart is the master of Blood; the Lung is the master of Qi. Qi primarily provides warming, while Blood primarily provides nourishment. Together they nourish the bones and tissues, irrigate the sinews and vessels. Ying and Wei Qi complement each other, ascending and descending in order, naturally smooth and appropriate, adhering to the normal path. If injured in any way, disease arises. This may be due to external invasion by the Six Excesses (pathogenic factors) or internal disturbance by the Seven Emotions. Qi stagnates and fails to move, Blood becomes congested and fails to nourish. Internal and external depression prevents free flow and distribution. Thus, extreme heat surges and leaks; how could there not be the danger of reckless bleeding? After long-term stagnation, the rushing upward momentum is hard to control, resembling the fierce drive of rapid movement. Blood is like water; if breached on the east, it flows east; if breached on the west, it flows west. This is Qi causing Blood to move; their dynamics are mutually reinforcing! Therefore, when Qi rebels, Blood also rebels. Moreover, excess Qi transforms into Fire. Fire attacks Blood; encountering heat, it moves recklessly, overflowing without restraint, rushing upward to cause hematemesis. There are cases caused by overeating where cold in the Stomach fails to digest, leading to vomiting undigested food. When Qi and Blood clash, injuring the Lung and Stomach, hematemesis can occur. However, the Yangming channel governs abundant Blood. If heat is constrained internally, allowing reckless movement, thus among children with hematemesis, those attributable to the Stomach account for seven or eight out of ten. Furthermore, infants still in swaddling clothes who vomit blood often do so due to heavy curtains and warm rooms where fire-heat steams and presses, or from excessive consumption of pungent-spicy foods. Heat flows into the milk channels; after the infant drinks, it stagnates and does not disperse. Accumulated warmth generates heat; extreme heat bursts upward. Consequently, symptoms such as vomiting, epistaxis (nosebleed), or lower bleeding as hematuria (blood in urine) may occur. If chronic cough leads to Qi rebellion, accompanied by facial edema and hemoptysis/hematemesis during coughing, this indicates deficiency and damage of the Lung. Treatment should follow the specific symptoms.
To treat hematemesis and hematochezia/melena in children:
Ejiao (Donkey-hide Gelatin, processed by stir-frying) [1 qian]
Gefen (Clam Shell Powder) [1 qian]
Chensha (Cinnabar, prepared by water levigation)
Grind into powder. Take with juice of Lotus Rhizome (*Nelumbinis Rhizoma*) and white honey mixed together.
Another prescription:
To resolve stasis and stop bleeding, use dried Lotus Node (*Nelumbinis Nodus*), grind into powder. Decoct with Ginseng Root (*Ren Shen*) and white honey in water, then take the decoction.