失血脉芤，或兼涩象。转紧转危，渐缓渐愈。虚微细小，元气不支。数大浮洪，真阴不
足。双弦紧疾，死期可决。
龙雷之火，潜伏阴中，方其未动，不知为火也。及其一发，暴不可御，以故载血而上
溢。盖龙雷之性，必阴云四合，然后遂其升腾之势。若天清日朗，则退藏不动矣。故凡凉血
清火之药，皆以水制火之常法，施之于阴火，未有不转助其虐者也。吾为大开其局，则以健
脾中之阳气为一义。健脾之阳，一举有三善也∶一者，脾中之阳气旺，如天清日朗，而龙雷
潜伏也。一者，脾中之阳气旺，而胸中窒塞之阴气，则如太空不留纤翳也。一者，脾中之阳
气旺，而饮食运化精微，复生其已竭之血也。况乎地气必先蒸土为湿，然后上升为云。若土
燥而不湿，地气于中隔绝矣，天气不常清乎。古方治龙雷之火，每用桂附引火归元之法。然
施之于暴血之症，可暂不可常。盖已亏之血，不能制其悍，而未生之血，恐不可滋之扰耳。
究而论之，龙雷之火，全以收藏为主，以秋冬则龙雷潜伏也。用收藏药不效，略用燥烈为响
导，以示同气相求之义则可。既已收藏，岂敢漫用燥烈乎？夫大病须用大药，大药者，天地
春夏，而吾心寂然秋冬是也。昔人逃禅二字甚妙，夫禅而名之曰逃，其心境为何如哉。学人
若此症，必以崇土为先，土浓则浊阴不升，而血患自息，万物以土为根，元气以土为宅，不
可不亟讲矣。
荸荠酒饮
治大便下血。
荸荠捣汁半盅，将好酒半盅冲入，空心温服。
旱莲丸
治大便下血虚弱者。
旱莲草阴干为末，以槐花煎汤，调炒米粉糊丸如桐子大，每日服五钱，以人参五分煎
汤下，二服即愈。
牛膝酒煎
治男子茎中痛，及妇人血结少腹痛。
牛膝一大握；酒煮饮之。
旱莲车前汁（各方见《种福堂》）
治小便下血。
旱莲草 车前子（各等分）
将二味捣自然汁，每日空心服一杯。
桂扁猪脏饮（《种福堂》）
治大便下血，日夜数次，历年久病，服之立愈。
雄猪脏一条，洗净，桂圆肉二两，鲜白扁豆花四两。
将二味捣烂，用白糯米拌和，装入猪脏内，两头扎住，砂锅内炖烂。忌见铁器。然后将
人中白炙脆，研末蘸吃，用酱油蘸吃亦可。不论吃粥吃饭，空心皆可吃，吃四五条即愈。
甘草青盐丸
治大便下血。
甘草（一斤） 青盐（四两）
将甘草研细末，用滚水冲入青盐，将青盐水炼甘草末为丸，如桐子大，早晚服之，无不
见效。
甘草干姜汤
理中汤（方各见《伤寒》。）
加木香、当归各等分。
泻白散（方见《时方》）
失血导致脉象芤（浮大中空，如按葱管），或者兼见涩象（往来艰涩不畅）。脉象由缓转紧表示病情加重，由紧转缓表示逐渐痊愈。脉象虚微细小，说明元气不支。脉象数大浮洪，说明真阴不足。双弦且紧疾的脉象，死亡期限可以断定。
龙雷之火（指肝肾相火，潜藏于肾水中），潜伏在阴分之中，当它尚未发动时，人们不知道它是火邪。等到它一旦发作，猛烈得无法抵御，因此带动血液向上溢出。大概龙雷之性，必须阴云四合（乌云密布），然后才能施展其升腾之势。如果天空晴朗、阳光明媚，它就会退避隐藏而不活动。所以凡是凉血清火的药物，都是用水来克制火的常规方法，应用在阴火（虚火）上，没有不转而助长其肆虐的。我为此大开思路，将健脾中的阳气作为一条治则。健脾阳，一举有三重好处：第一，脾中的阳气旺盛，就像天空晴朗，龙雷之火就会潜伏。第二，脾中的阳气旺盛，胸中窒塞的阴气，就会像太空中不留一丝尘埃一样消散。第三，脾中的阳气旺盛，饮食运化精微物质，重新生成已经枯竭的血液。况且地气必须先蒸腾土壤为湿气，然后上升成为云。如果土壤干燥而没有湿气，地气就在中间隔绝了，天气怎么能经常晴朗呢？古方治疗龙雷之火，每用桂枝、附子引火归元的方法。然而应用在暴发性出血的症状上，可以暂时使用，不可长期服用。因为已经亏损的血液，不能制约其悍烈之气，而未生的血液，恐怕不宜滋腻扰动。归根结底来说，龙雷之火，完全以收藏为主，因为秋冬季节龙雷之火是潜伏的。使用收藏类药物无效时，略微使用燥烈性质的药物作为引导，以显示同气相求的意义是可以的。既然已经收藏，怎么敢随意使用燥烈药物呢？大病必须用大药，所谓大药，就是顺应天地春夏生发之气，而内心保持寂然如秋冬收藏的状态。古人“逃禅”二字非常妙，既然叫“逃”禅，其心境是怎样的呢？学习中医的人如果遇到这种病症，必须以崇土（补益脾胃）为先，土气浓厚则浊阴不升，而血证自然平息。万物以土为根，元气以土为宅，不可以不紧急讲求。
荸荠酒饮
治疗大便下血。
荸荠捣取汁液半盅，用好酒半盅冲入，空腹温服。
旱莲丸
治疗大便下血且体质虚弱者。
旱莲草阴干研为粉末，用槐花煎汤，调和炒米粉制成糊状丸药，大小如梧桐子，每日服用五钱，用人参五分煎汤送服，两服即可痊愈。
牛膝酒煎
治疗男子尿道疼痛，以及妇人血结少腹疼痛。
牛膝一大把，用酒煮后饮用。
旱莲车前汁（各方见《种福堂》）
治疗小便下血。
旱莲草、车前子（各等分）
将这两味药捣取自然汁，每日空腹服用一杯。
桂扁猪脏饮（《种福堂》）
治疗大便下血，日夜数次，多年久病，服用后立刻痊愈。
雄猪大肠一条，洗净，桂圆肉二两，鲜白扁豆花四两。
将桂圆肉和扁豆花捣烂，用白糯米拌和，装入猪肠内，两头扎紧，在砂锅内炖烂。忌接触铁器。然后将人中白炙脆，研成粉末蘸着吃，用酱油蘸着吃也可以。不论喝粥还是吃饭，空腹都可以吃，吃四五条即可痊愈。
甘草青盐丸
治疗大便下血。
甘草（一斤）、青盐（四两）
将甘草研成细末，用滚水冲入青盐，用青盐水炼甘草末为丸，大小如梧桐子，早晚服用，无不见效。
甘草干姜汤
理中汤（方剂各见《伤寒论》。）
加木香、当归各等分。
泻白散（方剂见《时方》）
Blood loss results in a Kou (Kou pulse: floating, large, and empty in the middle, felt like pressing on a scallion) pulse, or one that is additionally Se (Se pulse: rough and obstructed in flow). If the pulse becomes tight, the condition worsens critically; if it gradually relaxes, recovery ensues. A weak, minute, and small pulse indicates that Yuan Qi (Original Qi) cannot sustain itself. A rapid, large, floating, and surging pulse indicates insufficiency of True Yin. Bilateral Xian (Xian pulse: taut like a guitar string) and Jin (Jin pulse: tight) pulses that are rapid allow for the determination of the time of death.
The Fire of Dragon and Thunder lies dormant within the Yin aspect. Before it stirs, it is not recognized as Fire. Once it erupts, it is violent and uncontrollable, thereby driving blood to overflow upwards. The nature of Dragon and Thunder requires the gathering of Yin clouds before it can exert its ascending momentum. If the sky is clear and the sun bright, it retreats and remains still. Therefore, herbs that cool blood and clear fire represent the conventional method of using Water to control Fire. When applied to Yin Fire (Deficient Fire), they invariably end up assisting its destructive force. I have opened a new approach here, taking the strengthening of Spleen Yang as a primary principle. Strengthening Spleen Yang yields three benefits: First, when Spleen Yang is robust, akin to a clear sky, the Fire of Dragon and Thunder remains latent. Second, robust Spleen Yang clears the obstruction of Yin Qi in the chest, just as the vast sky holds no dust. Third, robust Spleen Yang facilitates the transformation and transportation of dietary essence, which regenerates depleted blood. Moreover, Earth Qi must first evaporate soil moisture to rise as clouds. If the soil is dry and lacks moisture, Earth Qi is severed internally, and Heaven Qi cannot remain clear. Ancient formulas treating the Fire of Dragon and Thunder often employ Gui Zhi (Cinnamon Twig) and Fu Zi (Aconite Root) to guide Fire back to its source (Yuan). However, this is suitable only temporarily for sudden hemorrhage, not for long-term use. Since the depleted blood cannot restrain its fierce nature, and ungenerated blood may be disturbed by cloying tonics, we must conclude that the Fire of Dragon and Thunder is primarily governed by storage and conservation, as it lies dormant in autumn and winter. If methods of storage and conservation fail, slightly employing drying and acrid-hot herbs as guides to demonstrate the principle of "same qi attracting same qi" is acceptable. Once stored, how dare one arbitrarily use drying and acrid-hot herbs? Major illnesses require major remedies. A major remedy aligns with the Spring and Summer of Heaven and Earth, while the mind remains silent and still like Autumn and Winter. The ancients’ use of the term "Tao Chan" (Fleeing to Zen) was exquisite; since it is called "fleeing," what must the state of mind be? For such cases, practitioners must prioritize fortifying the Earth element (Spleen/Stomach). When Earth is thick, turbid Yin does not ascend, and blood disorders subside naturally. All things take Earth as their root, and Yuan Qi takes Earth as its dwelling; this must be urgently studied.
Biqi Wine Drink
For hematochezia (blood in stool).
Crush fresh water chestnuts (Dioscorea cirrhosa rhizome) to extract half a cup of juice, mix with half a cup of good wine, and take warm on an empty stomach.
Hanlian Pill
For hematochezia in patients with deficiency and weakness.
Dry Hederae Herba (Eclipta Prostrata) in the shade and grind into powder. Decoct Sophorae Flos (Styphnolobium Japonicum Flower) in water, mix with fried rice flour paste to form pills the size of paulownia seeds. Take 5 qian daily, administered with a decoction of 5 fen of Ginseng Radix et Rhizoma Rubra (Red Ginseng). Two doses will result in cure.
Niuxi Wine Decoction
For pain in the urethra in men, and abdominal pain due to blood stagnation in the lower abdomen in women.
Take a large handful of Achyranthis Bidentatae Radix (Niuxi); boil in wine and drink.
Hanlian Cheqian Juice (See all formulas in *Zhongfutang*)
For hematuria (blood in urine).
Hederae Herba (Eclipta Prostrata) and Plantaginis Semen (Plantago Seed) in equal parts.
Crush both ingredients to extract natural juice; take one cup on an empty stomach daily.
Guibian Pig Intestine Drink (*Zhongutang*)
For chronic hematochezia occurring multiple times day and night over many years; brings immediate cure upon administration.
One male pig intestine, cleaned; two liang of Longan Aril (Dimocarpus Longan); four liang of fresh white Lablab Flower (Lablab Purpureus).
Mash the Longan aril and Lablab flower, mix with white glutinous rice, stuff into the pig intestine, tie both ends, and stew until soft in a clay pot. Avoid contact with iron. Then, roast Zhongrenbai (Calcinatus Natrii Sulfas) until crisp, grind into powder, and consume by dipping. Dipping in soy sauce is also acceptable. Can be taken on an empty stomach regardless of whether eating porridge or rice. Consuming four to five intestines leads to cure.
Gancao Qingyan Pill
For hematochezia.
Glycyrrhizae Radix et Rhizoma (Licorice Root) (one jin) and Cyan Salt (four liang).
Grind Licorice Root into fine powder. Dissolve Cyan Salt in boiling water, then use the saline solution to process the Licorice powder into pills the size of paulownia seeds. Take morning and evening; efficacy is guaranteed.
Gancao Ganjiang Tang
Lizhong Tang (Formulas see *Shanghan Lun*).
Add Mu Xiang (Vladimiria Root) and Dang Gui (Angelica Sinensis) in equal parts.
Xiebai San (Formula see *Shifang Miaofang*)