百部根（二两） 升麻（半两） 桂心 五味子 甘草（炙） 紫菀 干姜（各一两）
上七味，蜜丸，桐子大。每服三十丸，日三次，知为度。忌生葱、海藻、菘菜。
〔《外》〕疗肺偏损胸中虚，肺偏痛、唾血气咳，款冬散。
款冬花 当归（各六分） 桂心 芎 五味子 附子（炮。各七分） 细辛 贝母（各四分）
干姜 生地（各八分） 白术 甘草（炙） 杏仁（去皮尖。各五分） 紫菀（三分）
上共为末，清酒服方寸匕，日二服。忌生葱、生菜、桃、李、雀肉、海藻、菘菜、猪肉、
芜荑。
按∶唾血咳血，属寒者少。今此二方，用姜附热剂，盖为肾足少阴脉是动病咳唾血者设也。
用者审之。
〔《脉》〕肺伤者，其人劳倦则咳唾血，其脉细紧浮数，皆吐血，此为躁扰嗔怒得之，脉伤
气壅所致。
经云∶肺脉不及，则令人喘，呼吸少气而咳，上气见血下者，此病皆肺虚，咳唾血之症，治
法并见气虚条。
治虚劳久嗽咯血。用五倍子焙为细末，每服一钱，用温茶一大口许调匀，食后米饮半盏调服。
〔《玄》〕肺经呕咳诸血，及痰中有血，初用生萝卜汁半盏，入盐少许，服之立效，如无生萝
卜，用萝卜子一钱，苏叶一钱，同煎服。次用鸡苏散加阿胶治之。（《本草》云∶萝卜大下气，
气下则血亦下也。）
〔《经》〕治咳嗽甚者，或有吐血。鲜桑白皮一斤，米泔浸三宿，净刮上黄皮锉细，入糯米四
两焙干，一处捣为末，每服一二钱，米饮调下。此方神效。
〔《本》〕治久嗽咯血，成肺痿，及吐白涎，胸膈满闷不食，扁豆散。
扁豆 生姜（各半两） 枇杷叶（去毛） 半夏 人参 白术（各一分） 白茅根（三分）
上锉，水三升，煎一升，去渣，下槟榔末一钱，和匀，分四服，不拘时候。
〔《千》〕治上气咳嗽喘息，喉中有物，唾血方。
生姜汁 杏仁（各二升） 糖 蜜（各一升） 猪膏（二合）
上五味，先以猪膏煎杏仁色黄出之，以纸拭令净。捣如膏。又和姜汁、蜜糖等合煎，令可丸。
每服如杏仁一枚，日夜六七服，渐次增加。
上后二方生姜多，肺虚及汗多亡阳与血下便者，忌用。
〔《素》〕少阴所谓咳唾则有血者，阳脉伤也。（脉解篇）
运气 咳唾血有二∶
一曰热伤肺。经云∶少阴司天，热淫所胜，民病唾血。又云∶少阳司天，火淫所胜，病咳唾
血。治以咸寒是也。
二曰湿伤肾。经云∶太阴司天，湿淫所胜，咳唾则有血，治以苦热是也。
〔丹〕治咯血。用白芨一两，藕节半两，为细末，每一钱，汤调服，神效。或云芨下咽至血窍，
则窍为芨末填而血止也。
〔《山》〕咯血。新棉灰半钱，酒调下。
针灸唾嗽血毒，取足少阴一经。经云∶肾足少阴之脉是动，则病咳唾有血。视盛虚热寒陷下
取之也。
〔东〕吐血内损∶地五会（三分，灸五壮） 鱼际（五分泻） 尺泽（一寸补）
〔《甲》〕唾血时寒热，泻鱼际，补尺泽。唾血振寒，嗌干，太渊主之。内伤唾血不足，
外无膏泽，地五会
灸。胸胁胀满，咳逆上气呼吸及唾浊沫脓血，库房主之。
〔《外》〕治上气唾脓血，灸两乳下黑肉际，各一十壮。
〔仲〕寸口脉数，其人咳，口中反有浊唾涎沫者何？师曰∶此为肺痿之病。若口中辟辟燥，咳
即胸中隐隐痛，脉反滑数，此为肺痈。咳唾脓血，脉数虚为肺痿，数实，为肺痈。
上肺痿唾脓血治法，散见本门诸方。若肺痿，但唾涎沫无脓血者，见咳嗽门。
肺脉微急，为肺寒热，怠惰咳唾血，引腰背胸，若鼻 肉不通。（经云∶急者多寒。
全文见治虚实法。）
〔《素》〕肺脉搏坚而长，当病吐血。（王注云∶肺虚极则咯逆故唾血。脉要精微篇）
〔《脉》〕唾血，脉紧强者死，滑者生。
手少阴筋病内急，心承伏梁，下为肘网。其成伏梁唾脓血者，死不治。（全文见筋 伏梁心之积，在脐上。）
心脉微缓，为伏梁在心，唾血。（全文见虚实法。）
〔罗〕肺痿辨 华严寺何上座，年未四十。四月间，因澡浴大汗出，还寺剃头伤风寒，头疼，
四肢困倦，就市中撮取通圣散服之，又发汗。头疼少减，再日复作，又以前药发之，汗数次，
四肢添劳重，喘促自汗恶风，咳而有血，懒于言语，饮食减少。求医治之，与药又多以生姜为引。
至六月间，精神愈困，饮食减少，形体羸瘦，或咳或唾，经血极多，请予治之，具说前由。诊
其脉浮数七八至，按之无力。予曰∶不救矣。或曰∶何为不救？予曰∶血之与汗，异名同类。夺
汗者无血，夺血者无汗。《金匮要略》云∶肺痿之病，从何得之？师曰∶或从汗出，或被快药下
利，重亡津液，故得之。今肺气已虚，又以辛药泻之，重虚其肺，不死何待。藏气法时论云∶
肺欲收，急食酸以收之，以酸补之，以辛泻之，盖不知《内经》之旨。仲景云∶医术浅狭，懵
然不知病源，为治乃误，发汗吐下之相反，其祸至速。世人但务彼翕习之荣，而莫见此倾危
之习，惟明者居然能护其本，近取诸身，夫何远之有焉。其僧不数日果亡。
百部根（二两） 升麻（半两） 桂心 五味子 甘草（炙，即蜜炙） 紫菀 干姜（各一两）
以上七味药，制成蜜丸，大小如梧桐子。每次服用三十丸，每日三次，以见效为度。忌食生葱、海藻、白菜。
〔出自《外台秘要》〕治疗肺脏偏于亏损导致胸中虚损，肺部偏痛、咳唾带血及气逆咳嗽的款冬散。
款冬花 当归（各六分） 桂心 川芎 五味子 附子（炮制过，各七分） 细辛 贝母（各四分）
干姜 生地黄（各八分） 白术 甘草（炙） 杏仁（去皮尖，各五分） 紫菀（三分）
以上药物共研为末，用清酒送服一方寸匕，每日两次。忌食生葱、生菜、桃、李、雀肉、海藻、白菜、猪肉、芜荑。
按语：咳唾带血或咳血，属于寒证的较少。如今这两个方剂，使用干姜、附子等热性药物，大概是针对足少阴肾经发生变动病症导致的咳唾带血而设立的。使用者需仔细斟酌。
〔出自《脉经》〕肺脏受损的人，在劳累疲倦时会咳唾带血，其脉象表现为细、紧、浮、数，这些都是吐血的症状，这是由于躁动烦扰、发怒所致，导致脉伤气壅。
经典记载：肺脉不及（虚弱），会导致人喘息，呼吸短促而咳嗽，气逆向上并见下部出血，这些病证都属于肺虚，是咳唾带血的症状，治疗方法均参见气虚条目的论述。
治疗虚劳久咳咯血。用五倍子焙干后研成细末，每次服用一钱，用温茶一大口调匀，饭后用米汤半盏调服。
〔出自《本草衍义》〕治疗肺经引起的呕吐咳嗽各种出血，以及痰中带血。初起时先用生萝卜汁半盏，加入少许盐，服用后立即见效；如果没有生萝卜，可用萝卜子一钱、苏叶一钱，共同煎煮服用。随后用鸡苏散加阿胶进行治疗。（《本草》记载：萝卜能强力下气，气下行则血也随之下降。）
〔出自《内经》相关论述〕治疗咳嗽严重的，或者有吐血的。鲜桑白皮一斤，用淘米水浸泡三个晚上，洗净刮去上面的黄皮并切碎，加入糯米四两焙干，一起捣成粉末，每次服用一二钱，用米汤调下。此方神效。
〔出自《本草纲目》〕治疗久咳咯血，形成肺痿，以及吐出白色涎沫，胸膈满闷不想进食的扁豆散。
扁豆 生姜（各半两） 枇杷叶（去毛） 半夏 人参 白术（各一分） 白茅根（三分）
以上药材切碎，用水三升，煎取一升，去掉药渣，加入槟榔末一钱，混合均匀，分四次服用，不拘泥于特定时间。
〔出自《千金方》〕治疗上气咳嗽喘息，喉中有异物感，咳唾带血的方子。
生姜汁 杏仁（各二升） 糖 蜜（各一升） 猪脂（二合）
以上五味药，先用猪脂煎炸杏仁至黄色后取出，用纸擦拭干净。捣烂如膏状。再与姜汁、蜜糖等混合煎煮，使其可以做成丸剂。每次服用如杏仁大小的量，白天黑夜服用六七次，逐渐增加剂量。
上述后两个方剂中生姜用量较多，对于肺虚及汗多亡阳（阳气随汗液大量流失）和便血者，禁止使用。
〔出自《素问》〕少阴经所说的咳唾带血，是因为阳脉受损。（见于《脉解篇》）
运气学说中，咳唾带血有两种情况：
一是热邪损伤肺脏。经典记载：少阴君天主管天时，热邪盛行，百姓患病出现咳唾带血。又说：少阳相火主管天时，火邪盛行，疾病表现为咳唾带血。治疗应当使用咸寒性质的药物。
二是湿邪损伤肾脏。经典记载：太阴湿土主管天时，湿邪盛行，咳唾带血，治疗应当使用苦热性质的药物。
〔出自朱丹溪〕治疗咯血。用白及一两，藕节半两，研成细末，每次服用一钱，用开水调服，效果神奇。有人说白及咽下到达血窍，血窍被白及粉末填满从而止血。
〔出自《山居本草》〕治疗咯血。新棉花灰半钱，用酒调服。
针灸治疗唾嗽带血毒邪，选取足少阴肾经这一条经脉。经典记载：肾足少阴经脉发生变动，就会生病表现为咳唾带血。根据脉气的盛虚、热寒、陷下等情况来选取穴位进行治疗。
〔出自王执中〕吐血内伤：地五会穴（针刺三分，艾灸五壮） 鱼际穴（针刺五分，用泻法） 尺泽穴（针刺一寸，用补法）
〔出自《甲乙经》〕咳唾带血伴有寒热症状，泻鱼际穴，补尺泽穴。咳唾带血伴有畏寒战栗、咽喉干燥，以太渊穴为主治。内伤导致的咳唾带血且正气不足，体表无光泽，灸地五会穴。胸胁胀满，咳嗽气逆，呼吸急促且咳出浑浊泡沫脓血，以库房穴为主治。
〔出自《外台秘要》〕治疗上气咳吐脓血，灸两侧乳头下方黑肉交界处，各灸十壮。
〔出自张仲景〕寸口脉数，其人咳嗽，口中反而有浑浊的唾沫涎沫，这是什么病？老师说：这是肺痿病。如果口中干燥，咳嗽时胸中隐隐作痛，脉象反而滑数，这是肺痈。咳唾脓血，脉数而虚的是肺痿，脉数而实的是肺痈。
上述肺痿咳吐脓血的治疗方法，分散在本门类的各个方剂中。如果是肺痿，只吐涎沫没有脓血的，参见咳嗽门类。
肺脉微急，表示肺有寒热，使人倦怠、咳唾带血，牵引腰背胸部疼痛，或者鼻息肉不通。（经典记载：脉急的多属寒证。全文详见治虚实法的论述。）
〔出自《素问》〕肺脉搏动坚实而长，应当病发吐血。（王冰注解说：肺极度虚弱则气逆故咳唾带血。见于《脉要精微论》）
〔出自《脉经》〕咳唾带血，脉象紧强的预后不良（死），脉象滑利的预后良好（生）。
手少阴心经筋病出现内部拘急，心脏伏梁积聚，向下延伸形成肘网。如果发展成伏梁并咳吐脓血，预后不良，难以治愈。（全文见筋痹、伏梁、心之积，位于脐上。）
心脉微缓，表示伏梁积聚在心，咳唾带血。（全文见虚实法的论述。）
〔出自罗天益〕肺痿辨证：华严寺何住持，年龄不到四十岁。四月间，因为洗澡大汗出，回到寺庙剃头时受风寒，头痛，四肢困倦，就在集市上买来通圣散服用，又发了汗。头痛稍减，第二天复发，又用前药发汗，多次发汗后，四肢更加沉重乏力，气喘自汗、怕风，咳嗽带血，懒于说话，饮食减少。求医治疗，医生用药又多以生姜为引子。到了六月，精神更加困顿，饮食减少，形体消瘦，有时咳嗽有时咳唾，月经量极大，请我诊治，详细说明了前因后果。诊察他的脉象浮数，七八次跳动一次，重按无力。我说：救不活了。有人问：为什么救不了？我说：血与汗，名称不同但同类。夺汗者无血，夺血者无汗。《金匮要略》说：肺痿病，是怎么得的？老师说：或者因为出汗，或者因为峻下药导致腹泻，严重耗伤津液，所以得病。现在肺气已虚，又用辛散药物发散，使肺更虚，不死还等什么？《藏气法时论》说：肺喜欢收敛，急需用酸味食物来收敛它，用酸味补益它，用辛味发散它。这里是不懂《内经》的宗旨。仲景说：医术浅薄狭隘，糊涂不知病源，治疗就出错，发汗、催吐、攻下的方法相反，祸患来得极快。世人只追求那些迎合世俗的虚荣，却看不到这种危险的习气，只有明智的人才能保护根本，就近取譬自身，有什么远呢。那位僧人没过几天果然去世了。
Radix Stemonae (2 liang) Rhizoma Cimicifugae (0.5 liang) Cortex Cinnamomi Radix Schisandrae Fructus Glycyrrhizae Preparata (Honey-fried) Flos Asteris Radium Gingeris (each 1 liang)
The above seven ingredients are processed into honey pills, sized like Sophora japonica seeds. Take 30 pills per dose, three times daily, until efficacy is observed. Avoid raw green onion, Sargassum, and Chinese cabbage.
[From *Waitai Miyao*] For treating Lung deficiency causing chest emptiness, unilateral Lung pain, hemoptysis with sputum, and cough with Qi rebellion, use the Kuantong Powder.
Flos Tussilaginis Radix Angelicae Sinensis (each 6 fen) Cortex Cinnamomi Radix Ligustici Chuanxiong Radix Schisandrae Radix Aconiti Lateralis Preparata (Pao, each 7 fen) Radix Asari Rhizoma et Radix Belleririci (each 4 fen) Radium Gingeris Radix Rehmanniae Recens (each 8 fen) Rhizoma Atractylodis Macrocephalae Fructus Glycyrrhizae Preparata (Honey-fried) Semen Pruni Armeniacae (de-skinned and de-seeded, each 5 fen) Flos Asteris (3 fen)
All ingredients are ground into powder. Take one fangcun bi (a square-inch measure) with clear wine, twice daily. Avoid raw green onion, raw vegetables, peach, plum, sparrow meat, Sargassum, Chinese cabbage, pork, and Elsholtzia.
Note: Hemoptysis or coughing up blood is rarely due to Cold. These two formulas use hot agents like Ziang (Dried Ginger) and Fuzi (Prepared Aconite Root), likely designed for conditions where the Foot-Shaoyin Kidney Meridian is affected, causing coughing and spitting of blood. Users should exercise caution.
[From *Maijing*] When the Lung is injured, fatigue induces coughing and spitting of blood. The pulse may be fine, tight, floating, or rapid; all indicate hematemesis/hemoptysis caused by agitation and anger, leading to vessel injury and Qi stagnation.
The Classics state: If the Lung pulse is deficient, it causes asthma, shortness of breath, cough, upward rushing Qi, and lower bleeding. These diseases belong to Lung deficiency and symptoms of coughing/spitting blood; treatment methods are detailed in the Qi Deficiency section.
For treating chronic cough and hemoptysis due to deficiency exhaustion: Roast Galla Chinensis until dry, grind into fine powder. Take 1 qian per dose, mixed with a large mouthful of warm tea, taken after meals with half a cup of rice water.
[From *Bencao Yanyi*] For vomiting and coughing with various bleeds from the Lung meridian, and blood in phlegm: Initially, take half a cup of fresh radish juice with a little salt for immediate effect. If fresh radish is unavailable, decoct 1 qian Raphani Semen and Perilla Folium together. Subsequently, treat with Jisu San plus Colla Corii Asini. (*Bencao* states: Radish strongly directs Qi downward; as Qi descends, Blood also descends.)
[From *Jingyi*] For severe cough or hematemesis: Take 1 jin of fresh Cortex Mori, soak in rice washing water for three nights, wash clean, scrape off yellow skin, and chop finely. Mix with 4 liang of glutinous rice, roast dry, and grind together into powder. Take 1-2 qian per dose with rice water. This formula is miraculous.
[From *Bencao Gangmu*] For chronic cough with hemoptysis progressing to Feiwei (Lung萎/Flaccidity), spitting white saliva, chest fullness, and anorexia, use Bidou San.
Semen Phaseoli Radiati Radix Zingiberis Recens (each 0.5 liang) Folium Eriobotryae (de-hairy) Rhizoma Pinelliae Radix Ginseng Rhizoma Atractylodis Macrocephalae (each 1 fen) Radix Imperatae (3 fen)
Chop herbs, decoct in 3 sheng of water until 1 sheng remains, strain, add 1 qian of Arecae Semen powder, mix well, and divide into four doses. Take at any time.
[From *Qianjin Fang*] For upper Qi cough, asthma, sensation of foreign body in throat, and hemoptysis:
Radix Zingiberis Recens Juice Semen Pruni Armeniacae (each 2 sheng) Sugar Mel (each 1 sheng) Medulla Suillae (2 he)
The above five ingredients: First, fry Semen Pruni Armeniacae in Medulla Suillae until yellow, remove, wipe clean with paper, and pound into paste. Mix with Radix Zingiberis Recens Juice, Mel, and Sugar, and decoct until pillable. Take a dose the size of one Semen Pruni Armeniacae, 6-7 times day and night, gradually increasing.
The latter two formulas contain much Ziang (Fresh Ginger); they are contraindicated for Lung deficiency, excessive sweating with Yang collapse, and those with rectal bleeding.
[From *Suwen*] What Shaoyin means by "coughing and spitting blood" is injury to the Yang pulses. (See *Maiejie Pian*)
In Yunqi (Five Movements and Six Qi) theory, hemoptysis has two types:
First, Heat injuring the Lung. The Classics state: When Shaoyin governs the year, excess Heat causes people to spit blood. Also: When Shaoyang governs, excess Fire causes cough and hemoptysis. Treat with salty-cold substances.
Second, Dampness injuring the Kidney. The Classics state: When Taiyin governs, excess Dampness causes cough and spitting blood. Treat with bitter-hot substances.
[From Zhu Danxi] For hemoptysis: Use 1 liang of Rhizoma Bletillae and 0.5 liang of Node Lotus Rhizome, grind to fine powder. Take 1 qian mixed with water. Miraculous effect. Some say Bletia powder fills the blood vessels upon swallowing, stopping the bleed.
[From *Shanju Bencao*] For hemoptysis: Take 0.5 qian of ash from new cotton, mixed with wine.
Acupuncture for toxic hemoptysis/cough selects the Foot-Shaoyin channel. The Classics state: Disturbance of the Foot-Shaoyin Kidney Meridian causes cough and spitting blood. Select points based on excess/deficiency, heat/cold, and sinking.
[Wang Zhizhong] For internal damage from hematemesis: Diwuhui (ST41? Note: Text says Diwuhui, usually BL60 or ST41 context dependent, here likely referring to a specific point in this context, often associated with foot/kidney in older texts or typo for another point, but sticking to text: Diwuhui) - Puncture 3 fen, Moxa 5 zhuang. Yuji (LU10) - Puncture 5 fen, reduce method. Chize (LU5) - Puncture 1 cun, tonify method.
[From *Jiayi Jing*] For hemoptysis with chills and fever, reduce Yuji (LU10), tonify Chize (LU5). For hemoptysis with tremors/chills and dry throat, Taiyuan (LU9) is primary. For internal injury hemoptysis with insufficiency and lack of luster, moxa Diwuhui. For chest/flank distension, cough with rebellious Qi, rapid breathing, and spitting turbid foam/pus/blood, Kukufang (ST22) is primary.
[From *Waitai Miyao*] For upper Qi spitting pus and blood, moxa the junction of black flesh below both nipples, 10 zhuang each.
[Zhang Zhongjing] If Cun Kou pulse is rapid, and the person coughs, yet has turbid saliva/phlegm in the mouth, what is this? Master says: This is Feiwei (Lung Flaccidity). If the mouth is dry, coughing causes hidden chest pain, and the pulse is slippery and rapid, this is Fei Yong (Lung Abscess). Coughing and spitting pus/blood with a rapid but empty pulse indicates Feiwei; rapid and solid pulse indicates Fei Yong.
Treatment methods for Feiwei with pus/blood are scattered in this category's formulas. For Feiwei with only saliva/phlegm and no pus/blood, see the Cough category.
If the Lung pulse is slightly urgent, it indicates Lung cold/heat, lethargy, hemoptysis, pulling pain in waist/back/chest, or nasal polyp obstruction. (Classics: Urgent pulses often indicate Cold. See full text in Treating Excess/Deficiency methods.)
[From *Suwen*] If the Lung pulse is firm and long, one should expect hematemesis. (Wang Bing notes: Extreme Lung deficiency leads to rebellious Qi, hence hemoptysis. See *Maiyao Jingwei Lun*)
[From *Maijing*] For hemoptysis, a tight and strong pulse indicates death; a slippery pulse indicates survival.
Hand-Shaoyin tendon disease with internal tension, Heart Fu Liang accumulation, extending down to form elbow nets. If it develops into Fu Liang with spitting pus/blood, it is incurable/deadly. (Full text in Tendon Bi, Fu Liang, Heart Accumulation, located above navel.)
If the Heart pulse is slightly slow, it indicates Fu Liang in the Heart and hemoptysis. (Full text in Treating Excess/Deficiency methods.)
[Luo Tianyi] Differentiation of Feiwei: He, Abbot of Huayan Temple, under 40 years old. In April, after bathing and profuse sweating, he shaved his head at the temple and caught wind-cold. Symptoms: headache, limb fatigue. He bought Tongsheng San from the market and took it, inducing further sweating. Headache reduced slightly, but recurred next day. Repeated sweating with the same medicine led to heavier limbs, asthma, spontaneous sweating, aversion to wind, cough with blood, reluctance to speak, and decreased appetite. Doctors treated him with ginger as a guide. By June, spirit was more exhausted, appetite lower, body emaciated, intermittent cough/sputum, extremely heavy menstruation. I diagnosed: Pulse floating and rapid, 7-8 beats per breath, weak on pressure. I said: Incurable. Someone asked why. I said: Blood and sweat are different names for the same substance. Depriving sweat deprives blood; depriving blood deprives sweat. *Jingui Yaolue* asks: How is Feiwei acquired? Master says: From sweating or purgatives causing severe fluid loss. Now Lung Qi is already deficient, and pungent drugs were used to disperse, further damaging the Lung. How can he not die? *Zangqi Fazhi Lun* states: Lung desires consolidation; use sour to consolidate, sour to tonify, pungent to disperse. They ignored the *Neijing*. Zhongjing said: Shallow medical knowledge leads to ignorance of disease origin, causing treatment errors. Opposing methods like sweating, vomiting, purging bring rapid disaster. People seek superficial glory, ignoring danger. Only the wise protect the root. Taking examples from oneself, what is far? The monk died days later.