治咳血，兼治吐衄，理瘀血，及二便下血。
花蕊石（三钱， 存性） 三七（二钱） 血余（一钱， 存性）
共研细，分两次，开水送服。
世医多谓三七为强止吐衄之药，不可轻用，非也。盖三七与花蕊石，同为止血之圣药，又同为化血之圣
药，且又化瘀血而不伤新血，以治吐衄，愈后必无他患。此愚从屡次经验中得来，故敢确实言之。即单用三七
四五钱，或至一两，以治吐血、衄血及大、小便下血皆效。常常服之，并治妇女经闭成 瘕。至血余，其化瘀
血之力不如花蕊石、三七，而其补血之功则过之。以其原为人身之血所生，而能自还原化，且 之为炭，而又
有止血之力也。
曾治一童子，年十五，大便下血，数月不愈，所下者若烂炙，杂以油膜，医者诿谓不治。后愚诊视其脉，
弦数无力。俾用生山药轧细作粥，调血余炭六七分服之，日二次，旬日全愈。
治咳血吐血，久不愈者。
生龙骨（一两，捣细） 生牡蛎（一两，捣细） 萸肉（一两，去净核） 三七（二钱，研细药汁送服）
服之血犹不止者，可加赭石细末五六钱。
张景岳谓∶“咳嗽日久，肺中络破，其人必咳血。”西人谓∶胃中血管损伤破裂，其人必吐血。龙骨、
牡蛎、萸肉，性皆收涩，又兼具开通之力（三药之性详既济汤来复汤与理郁升陷汤清带汤下），故能补肺络，
与胃中血管，以成止血之功，而又不至有遽止之患，致留瘀血为恙也。又佐以三七者，取其化腐生新，使损伤
之处易愈，且其性善理血，原为治衄之妙品也。
咳血之原由于肺，吐血之原由于胃，人之所共知也。而西人于吐血，论之尤详。其说谓∶胃中多回血管，
有时溃裂一二处而血出，其故或因胃本体自生炎证，烂坏血管，或因跌打外伤，胃
中血管断裂，其血棕黑而臭秽，危险难治，但此类甚少。常见之证，大概血管不曾溃裂，其血亦可自管中溢出，
其血多带黑色。因回血管之血色原紫黑，而溢出在胃，胃中酸汁又能令血色变黑也。若血溢自胃中血管，实时
吐出，其色亦可鲜红。其病原，或因胃致病，或因身虚弱血质稀薄，皆能溢出。有胃自不病，或因别经传入于
胃，如妇女倒经，是子宫之血传入于胃。又如肝脾胀大，血不易通行，回血管满溢，入胃则吐出，入大小肠则
便出。便与吐之路不同，其理一也。
或问∶《内经》谓∶阳明厥逆，则吐衄。西人谓∶胃中血管损伤破裂出血，则吐血。此二说亦相通乎？答
曰∶阳明厥逆，胃腑气血必有膨胀之弊，此血管之所以易破也。降其逆气，血管之破者自闭。设有不闭，则用
龙骨、牡蛎诸收涩之药以补之，防其溃烂，佐以三七、乳香、没药诸生肌之品以养之。此拙拟补络补管汤所以
效也。设使阳明未尝厥逆，胃中血管或因他故而破裂，则血在胃中，亦恒随饮食下行自大便出，不必皆吐出也。
此方原无三七，有乳香、没药各钱半。偶与友人××谈及，××谓∶“余治吐血，亦用兄补络补管汤，以三
七代乳香、没药，则其效更捷。”愚闻之遂欣然易之。
××又谓∶“龙骨、牡蛎能收敛上溢之热，使之下行，而上溢之血，亦随之下行归经。至萸肉为补肝之
妙药，凡因伤肝而吐血者，萸肉又在所必需也。且龙骨、牡蛎之功用神妙无穷。即脉之虚弱已甚，日服补药毫
无起象，或病虚极不受补者，投以大剂龙骨、牡蛎，莫不立见功效，余亦不知其何以能然也。”愚曰∶人身阳
之精为魂，阴之精为魄。龙骨能安魂，牡蛎能强魄。魂魄安强，精神自足，虚弱自愈也。是龙骨、牡蛎，固为
补魂魄精神之妙药也。
邑有吐血久不愈者，有老医于××，重用赤石脂二两，与诸
止血药治之，一剂而愈。后其子××向愚述其事，因诘之曰∶“重用赤石脂之义何据？”其子曰∶“凡吐血多因
虚火上升，然人心中之火，亦犹炉中之火，其下愈空虚，而火上升之力愈大，重用赤石脂，以填补下焦，虚火
自不上升矣。”愚曰∶“兄之论固佳，然犹有剩义。赤石脂重坠之力，近于赭石，故能降冲胃之逆，其粘涩之
力，近于龙骨、牡蛎，故能补血管之破。兼此二义，重用石脂之奥妙，始能尽悉。是以愚遇由外伤内，若跌碰
致吐血久不愈者，料其胃中血管必有伤损，恒将补络补管汤去萸肉，变汤剂为散剂，分数次服下，则龙骨、牡
蛎，不但有粘涩之力，且较煎汤服者，更有重坠之力，而吐血亦即速愈也。”其子闻之欣然曰∶“先严用此方
时，我年尚幼，未知详问，今闻兄言贶我多矣。”
曾治沧州马氏少妇，咳血三年，百药不效，即有愈时，旋复如故。后愚为诊视，其夜间多汗，遂用净萸肉、
生龙骨、生牡蛎各一两，俾煎服，拟先止其汗，果一剂汗止，又服一剂咳血亦愈。盖从前之咳血久不愈者，因
其肺中之络，或胃中血管有破裂处，萸肉与龙骨、牡蛎同用以涩之敛之，故咳血亦随之愈也。
又治本村表弟张×，年三十许，或旬日，或浃辰之间，必吐血数口，浸至每日必吐，亦屡治无效。其脉近
和平，微有芤象，亦治以此方，三剂全愈。后又将此方加三七细末三钱，煎药汤送服，以治咳血吐血久不愈者，
约皆随手奏效。若遇吐血之甚者，宜再加赭石五六钱，与此汤前三味同煎汤，送服三七细末更效。
邑张某家贫佣力，身挽鹿车运货远行，因枵腹努力太过，遂致大口吐血。卧病旅邸，恐即不起，意欲还里，
又乏资斧。乃勉强徒步徐行，途中又复连吐不止，目眩心慌，几难举步。腹中觉饥，怀有干饼，又难下咽。偶
拾得山楂十数枚，遂和干饼食之，觉精神顿爽，其病竟愈。盖酸者能敛，而山楂则酸敛之中，兼有
化瘀之力。与拙拟补络补管汤之意相近，故获此意外之效也。
附录∶
江苏崇明县蔡××来函∶
回忆毕业中学时，劳心过度，致患吐血，虽家祖世医，终难疗治。遍求名医延医，亦时止时吐。及肄业大
学时，吐血更甚，医者多劝辍学静养，方可望痊。乃辍学家居，服药静养，病仍如旧。计无所施，自取数世所
藏医书遍阅之，又汗牛充栋，渺茫无涯。况玉石混杂，瑜瑕莫辨，徒增望洋之叹也。幸今秋自周小农处购得
《衷中参西录》，阅至吐衄方补络补管汤，知为治仆病的方。抄出以呈家祖父，命将药剂减半煎服，颇见效验。
遂放胆照原方，兼取寒降汤之义加赭石六钱，连服三剂全愈。从前半月之间，必然反复，今已月余安然无恙，
自觉身体渐强，精神倍加。
治疗咳嗽咯血，兼治呕吐和鼻出血，化解瘀血，以及大小便下血。
花蕊石（三钱，煅存性） 三七（二钱） 血余（一钱，煅存性）
共同研磨成细粉，分两次服用，用开水送服。
世间的医生多认为三七是强力止住吐血和鼻血的药物，不可轻易使用，这是不对的。大概三七与花蕊石，同为止血的圣药，又同为化瘀血的圣药，而且能化瘀血而不损伤新血，用它来治疗吐血和鼻血，痊愈后必定没有其他隐患。这是我经过多次经验得来的，所以敢确切地说出来。即使单用三七四五钱，甚至到一两，用来治疗吐血、鼻血以及大、小便下血都有效。经常服用，还能治疗妇女因瘀血导致的经闭形成瘕块。至于血余，它化解瘀血的力量不如花蕊石、三七，但它补血的功效则超过它们。因为它原本是由人身之血所生，且能自我还原转化，而且制成炭后，又有止血的力量。
曾经治疗一个十五岁的童子，大便下血，几个月不好，排出的东西像烂肉烤肉一样，混杂着油膜，医生推脱说无法治疗。后来我诊视他的脉象，弦数而无力。让他用生山药轧碎煮粥，调入血余炭六七分服用，每天两次，十天完全痊愈。
治疗咳嗽咯血、吐血，长久不愈的患者。
生龙骨（一两，捣碎成细末） 生牡蛎（一两，捣碎成细末） 山茱萸（一两，去净果核） 三七（二钱，研成细末，用药汁送服）
如果服用后血仍然不止，可以加入赭石细末五六钱。
张景岳说：“咳嗽日久，肺中的络脉破损，这个人一定会咳血。”西方人认为：胃中的血管损伤破裂，这个人一定会吐血。龙骨、牡蛎、山茱萸，性质都是收涩的，同时又兼具开通的力量（这三味药的性质详见既济汤、来复汤、理郁升陷汤、清带汤之下），所以能够补益肺络和胃中血管，从而达成止血的效果，而又不会有骤然止血导致留下瘀血为患的弊端。又佐以三七，是取它化除腐坏组织促进新生，使受损的地方容易愈合，而且它的性质善于调理血液，原本是治疗鼻血的妙品。
咳嗽咯血的根源在于肺，吐血的根源在于胃，这是人们所共知的。而西方人对吐血论述得尤其详细。他们的说法是：胃中有许多回血管（静脉），有时溃裂一二处而出血，其原因可能是因为胃本体自身产生炎症，腐蚀烂坏血管，或者因为跌打外伤，胃中血管断裂，这种血呈棕黑色且臭秽，危险难治，但这类情况很少见。常见的证候，大概是血管没有溃裂，血液也可以从管壁中溢出，这种血多带有黑色。因为回血管的血色原本就是紫黑色的，而溢出在胃中，胃中的酸汁又能让血色变黑。如果血液从胃中血管溢出，实时吐出，其颜色也可以是鲜红的。其病因，可能是因为胃病引起，也可能因为身体虚弱、血质稀薄，都能导致溢出。有胃本身不生病，但因为其他经络传入于胃的情况，比如妇女倒经，是子宫的血液传入于胃。又如肝脾肿大，血液不易通行，回血管满溢，进入胃则吐出，进入大小肠则排出。排便和呕吐的途径不同，但道理是一样的。
有人问：《内经》说：阳明厥逆，就会发生吐血和鼻血。西方人说：胃中血管损伤破裂出血，就会吐血。这两种说法也是相通的吗？回答说：阳明厥逆，胃腑的气血必然有膨胀的弊病，这就是血管容易破裂的原因。降低上逆之气，破裂的血管自然闭合。假设有不闭合的，就用龙骨、牡蛎等收涩的药物来修补，防止其溃烂，佐以三七、乳香、没药等生肌的药物来滋养。这就是我拟定的补络补管汤之所以有效的缘故。假如阳明未曾厥逆，胃中血管因为其他原因而破裂，那么血在胃中，也常常随着饮食下行从大便排出，不一定都要吐出来。
这个方子原本没有三七，有乳香、没药各一钱半。偶然与朋友××谈到，××说：“我治疗吐血，也用您的补络补管汤，用三七代替乳香、没药，那么疗效更快捷。”我听了于是高兴地改用了它。
××又说：“龙骨、牡蛎能收敛上溢的热邪，使其下行，而上溢的血液，也随着热邪下行回归经脉。至于山茱萸是补肝的妙药，凡是因伤肝而导致吐血的，山茱萸又在所必需。而且龙骨、牡蛎的功效神妙无穷。即使脉象虚弱已极，每天服用补药毫无起色，或者病虚极不能受补的人，投以大剂量的龙骨、牡蛎，没有不立刻见到功效的，我也不知道它为什么能这样。”我说：人身阳的精微称为魂，阴的精微称为魄。龙骨能安魂，牡蛎能强魄。魂魄安强，精神自然充足，虚弱自然痊愈。所以龙骨、牡蛎，确实是补益魂魄精神的妙药。
县里有个吐血长久不愈的人，有位老医生姓××，重用赤石脂二两，配合各种止血药治疗他，一剂就痊愈了。后来他的儿子××向我叙述这件事，我便责问他：“重用赤石脂的依据是什么？”他的儿子说：“凡是吐血多因为虚火上升，然而人心中的火，也就像炉子里的火，下面越空虚，火上升的力量就越大，重用赤石脂，来填补下焦，虚火自然就不会上升了。”我说：“兄长的议论固然好，但还有未尽之意。赤石脂重坠的力量，接近于赭石，所以能降冲脉和胃气之上逆；它的粘涩力量，接近于龙骨、牡蛎，所以能修补血管的破损。兼有这两层含义，重用赤石脂的奥妙，才能完全知晓。所以我遇到由外伤内，比如跌碰导致吐血长久不愈的人，料定他胃中的血管必有损伤，常常将补络补管汤去掉山茱萸，将汤剂改为散剂，分几次服用，那么龙骨、牡蛎，不但有粘涩的力量，而且比煎汤服用者，更有重坠的力量，而吐血也就迅速痊愈了。”他的儿子听了高兴地说：“先父使用此方时，我还年幼，不知道详细询问，今天听兄长您的一番话，赐教太多了。”
曾经治疗沧州马家的少妇，咳嗽咯血三年，各种药物都不见效，即使有好转的时候，很快又恢复原状。后来我给她诊视，她夜间多汗，于是用净山茱萸、生龙骨、生牡蛎各一两，让她煎服，打算先止住她的汗，果然一剂汗止，又服一剂咳嗽咯血也痊愈了。大概从前咳嗽咯血长久不愈，是因为她肺中的络脉，或胃中的血管有破裂之处，山茱萸与龙骨、牡蛎同用，起到涩敛的作用，所以咳嗽咯血也随之痊愈。
又治疗本村表弟张某，年龄三十岁左右，每隔十天或十二天之间，一定要吐几口血，逐渐发展到每天必吐，也多次治疗无效。他的脉象接近平和，微有芤脉象，也用这个方子治疗，三剂完全痊愈。后来又将此方加入三七细末三钱，用药汤送服，用来治疗咳嗽咯血、吐血长久不愈的患者，大约都随手奏效。如果遇到吐血严重的，应该再加赭石五六钱，与此汤前三味药同煎汤，送服三七细末，效果更佳。
县里张某家贫靠出卖力气为生，拉着鹿车运货远行，因为空腹努力太过，导致大口吐血。卧病在旅馆，担心马上就不行了，想回家，又没有路费。于是勉强徒步慢慢走，途中又连续吐血不止，头晕眼花心慌，几乎难以举步。腹中觉得饿，怀里带着干饼，又难以下咽。偶然捡到十几枚山楂，于是和干饼一起吃，觉得精神顿时清爽，病竟然痊愈了。大概酸味能收敛，而山楂则在酸敛之中，兼有化瘀的力量。与我拟定的补络补管汤的意思相近，所以获得了这意外的疗效。
附录：
江苏崇明县蔡××来信：
回忆中学毕业时，劳心过度，导致患吐血，虽然家中祖辈世代行医，终究难以治愈。遍求名医延请医生，也是时好时坏。等到上大学时，吐血更严重，医生多劝停止学业静养，才有望痊愈。于是辍学在家，服药静养，病情仍如旧。计策无处施展，自己取出几代所藏的医书遍阅，又是汗牛充栋，渺茫无边。况且玉石混杂，瑜瑕莫辨，徒增望洋兴叹之感。幸好今年秋天从小农周先生处购得《衷中参西录》，读到吐血方补络补管汤，知道这是治疗我这种病的方子。抄出给祖父看，命他将药剂减半煎服，颇见效验。于是放胆照原方，兼取寒降汤的意思加赭石六钱，连服三剂完全痊愈。从前半月之间，必然反复，现在已经一个多月安然无恙，自觉身体渐强，精神加倍。
Treats hemoptysis (coughing up blood), and also treats hematemesis (vomiting blood) and epistaxis (nosebleed); resolves blood stasis, and treats bleeding from the lower orifices (hematochezia and hematuria).
*Huarui Shi* (Calcined Pyrite, 3 qian, charred but retaining its nature) *Sanqi* (Notoginseng Radix, 2 qian) *Xueyu* (Carbonized Human Hair, 1 qian, charred but retaining its nature)
Grind all together into a fine powder. Divide into two doses. Take with warm boiled water.
Physicians of the world often claim that *Sanqi* is a powerful medicine for stopping hematemesis and epistaxis, and should not be used lightly; this is incorrect. Essentially, both *Sanqi* and *Huarui Shi* are sacred medicines for stopping bleeding, and equally sacred medicines for transforming blood stasis. Moreover, they resolve blood stasis without damaging new blood. When used to treat hematemesis and epistaxis, there will surely be no other complications after recovery. I have derived this from repeated clinical experience, so I dare to state it definitively. Even using *Sanqi* alone, 4–5 qian or even up to 1 liang, is effective for treating hematemesis, epistaxis, and bleeding from the large and small intestines. Frequent use can also treat amenorrhea due to blood stasis forming masses in women. As for *Xueyu*, its power to resolve blood stasis is inferior to that of *Huarui Shi* and *Sanqi*, but its benefit in nourishing blood surpasses them. This is because it originates from human blood, has the ability to self-reduce and transform, and when carbonized, possesses hemostatic properties.
I once treated a fifteen-year-old boy who had been passing blood in his stool for several months without improvement. The excrement resembled rotten roasted meat mixed with oily membranes. Physicians dismissed it as incurable. Later, upon examining his pulse, I found it wiry, rapid, and weak. I prescribed him porridge made from raw *Shanyao* (Dioscoreae Rhizoma) ground finely, mixed with 6–7 fen of *Xueyu Tan* (Carbonized Human Hair). He took this twice daily and was completely cured within ten days.
For patients with chronic hemoptysis or hematemesis that does not heal:
*Sheng Longgu* (Raw Os Draconis, 1 liang, crushed to fine powder) *Sheng Muli* (Raw Concha Ostreae, 1 liang, crushed to fine powder) *Yurou* (Fructus Corni, 1 liang, pits removed) *Sanqi* (Radix Notoginseng, 2 qian, ground to fine powder, taken with decoction liquid)
If bleeding continues after taking this formula, add 5–6 qian of fine powder of *Zhe Shi* (Ochre).
Zhang Jingyue stated: "Chronic cough damages the collaterals in the lungs, causing the patient to cough up blood." Western medicine states: Damage and rupture of blood vessels in the stomach cause hematemesis. *Longgu*, *Muli*, and *Yurou* possess astringent properties but also have opening/unblocking capabilities (the properties of these three herbs are detailed under Jiji Tang, Laifu Tang, Liyu Shengxian Tang, and Qingdai Tang). Therefore, they can tonify lung collaterals and gastric blood vessels, achieving hemostasis, without the risk of abrupt cessation leading to retained blood stasis. *Sanqi* is added as an assistant herb to take advantage of its ability to eliminate necrotic tissue and promote regeneration, facilitating healing of damaged areas. Its nature is good at regulating blood, making it an excellent product for treating epistaxis.
It is common knowledge that the origin of hemoptysis lies in the lungs, while the origin of hematemesis lies in the stomach. Western medicine discusses hematemesis in particular detail. Their theory posits that there are many veins in the stomach; if one or two rupture, bleeding occurs. This may be due to inflammation in the stomach itself corroding the vessels, or due to external trauma causing vessel rupture. Such blood is brown-black and foul-smelling, dangerous and difficult to treat, but such cases are rare. Commonly observed cases involve vessels that have not ruptured, yet blood oozes from the vessel walls. This blood is often dark. Since venous blood is originally purple-black, and gastric acid turns it black further. However, if blood oozes from gastric vessels and is vomited immediately, it can appear bright red. Etiology includes stomach disease or general weakness with thin blood quality. There are cases where the stomach itself is not diseased, but blood enters from other meridians, such as retrograde menstruation (daojing), where uterine blood enters the stomach. Also, hepatosplenomegaly impedes blood flow, causing venous engorgement; blood entering the stomach causes vomiting, while blood entering the intestines causes defecation. Although the pathways differ, the underlying principle is the same.
Question: The *Neijing* states: "Yangming reversal leads to hematemesis and epistaxis." Western medicine states: "Rupture of gastric blood vessels leads to hematemesis." Are these two theories compatible? Answer: Yangming reversal implies distension of Qi and Blood in the stomach fu-organ, which makes vessels prone to rupture. Lowering the rebellious Qi allows ruptured vessels to close naturally. If they do not close, use astringents like *Longgu* and *Muli* to repair and prevent ulceration, assisted by flesh-regenerating agents like *Sanqi*, *Ruxiang* (Boswelliae Resina), and *Moyao* (Commiphora Resina). This explains the efficacy of my proposed Buluo Buguan Tang. If Yangming has not reversed, but gastric vessels rupture due to other causes, blood in the stomach often descends with food and exits via stool, rather than being vomited.
This original formula did not contain *Sanqi*; it contained 1.5 qian each of *Ruxiang* and *Moyao*. Upon discussing this with a friend, Mr. X, he said: "When I treat hematemesis, I also use your Buluo Buguan Tang, substituting *Sanqi* for *Ruxiang* and *Moyao*, resulting in faster efficacy." I happily adopted this modification.
Mr. X further stated: "*Longgu* and *Muli* can constrain ascending heat and guide it downward; ascending blood follows this path back to its channels. *Yurou* is an excellent liver-tonifying herb, essential for hematemesis caused by liver injury. Moreover, the functions of *Longgu* and *Muli* are profoundly mysterious. Even in cases of extreme pulse deficiency where daily tonics fail, or in patients too deficient to tolerate tonics, administering large doses of *Longgu* and *Muli* yields immediate results. I do not know why this is so." I replied: The essence of Yang in the human body is Hun (Ethereal Soul), and the essence of Yin is Po (Corporeal Soul). *Longgu* calms Hun, and *Muli* strengthens Po. When Hun and Po are calm and strong, Spirit (Jingshen) becomes sufficient, and deficiency heals naturally. Thus, *Longgu* and *Muli* are indeed miraculous medicines for tonifying Hun, Po, and Jingshen.
A resident of the county suffered from chronic hematemesis. An old physician surnamed X treated him with a heavy dose of 2 liang of *Chishizhi* (Halloysitum Rubrum) combined with other hemostatics, curing him in one dose. Later, his son Mr. X recounted this to me and asked about the rationale for the heavy dose of *Chishizhi*. His son answered: "Most hematemesis is due to deficient fire ascending. Just as fire in a stove rises more vigorously when the base is empty, using heavy *Chishizhi* fills the Lower Jiao, preventing deficient fire from ascending." I said: "Your reasoning is good, but incomplete. *Chishizhi* has a heavy-sinking property similar to *Zhe Shi*, allowing it to direct rebellious Chong and Stomach Qi downward. Its sticky-astringent property is similar to *Longgu* and *Muli*, enabling it to repair ruptured blood vessels. Only by understanding both aspects can one fully appreciate the subtlety of using heavy *Chishizhi*. Therefore, in cases of internal injury from external trauma, such as prolonged hematemesis from bruising, where I suspect gastric vessel damage, I modify Buluo Buguan Tang by removing *Yurou* and changing the decoction to a powder, taken in divided doses. In this form, *Longgu* and *Muli* possess not only astringent power but also greater heavy-sinking power than in decoctions, leading to rapid cure of hematemesis." The son replied joyfully: "My father used this formula when I was young, and I did not ask for details. Today, your words have bestowed great benefit upon me."
I once treated a young woman from the Ma family in Cangzhou who had suffered from hemoptysis for three years with no effect from various medicines. Although she occasionally improved, the condition quickly relapsed. Upon examination, I noted night sweats. I prescribed 1 liang each of purified *Yurou*, raw *Longgu*, and raw *Muli* to be decocted and taken. My intention was to stop the sweating first. Indeed, one dose stopped the sweat, and a second dose cured the hemoptysis. Previously, her chronic hemoptysis was due to ruptures in lung collaterals or gastric vessels. The combination of *Yurou*, *Longgu*, and *Muli* provided astringency and consolidation, thereby resolving the bleeding.
I also treated my cousin Zhang from the same village, aged thirty, who vomited blood every ten to twelve days, progressing to daily episodes despite multiple treatments. His pulse was nearly normal but slightly hollow (Kou pulse). I treated him with this formula, and he was completely cured in three doses. Later, I added 3 qian of fine *Sanqi* powder to this formula, taken with the decoction, for treating chronic hemoptysis and hematemesis. It proved effective almost immediately. For severe hematemesis, adding 5–6 qian of *Zhe Shi* to the first three ingredients of the decoction, taken with *Sanqi* powder, is even more effective.
A poor laborer surnamed Zhang in the county pulled a cart for long distances. Due to excessive effort on an empty stomach, he began vomiting large amounts of blood. Bedridden in an inn, fearing death and lacking funds to return home, he walked slowly. During the journey, he continued vomiting blood, experiencing dizziness, palpitations, and difficulty walking. Hungry but unable to swallow dry biscuits from his pocket, he accidentally found over a dozen hawthorn fruits (*Shanzha*). He ate them with the biscuit and felt his spirit instantly refresh; the illness miraculously healed. Sour flavors can astringe, and *Shanzha* possesses astringent properties combined with blood-stasis-resolving power. This aligns with the principle of Buluo Buguan Tang, yielding this unexpected result.
Appendix:
Letter from Cai XX, Chongming County, Jiangsu:
Recalling my time graduating from middle school, excessive mental exertion led to hematemesis. Despite my family's lineage of physicians, it remained incurable. Seeking famous doctors yielded only intermittent remission. During university, the condition worsened. Doctors advised dropping out to rest. I complied, resting and taking medicine, but the illness persisted. Desperate, I studied ancestral medical texts, but they were vast and confusing, mixing jade with stone. Fortunately, this autumn I purchased *Zhongzhong Canxi Lu* from Mr. Zhou Xiaonong. Reading about Buluo Buguan Tang for hematemesis/epistaxis, I recognized it as the correct formula for my condition. I showed it to my grandfather, who halved the dosage for decoction. It showed significant effect. Emboldened, I followed the original formula, incorporating the principle of Hanjiang Tang by adding 6 qian of *Zhe Shi*. After three doses, I was completely cured. Previously, I relapsed every half month; now, over a month later, I am safe, feeling stronger and more energetic.