[总诀]血随气布要循经,气上因而血沸腾。降逆消瘀为妙诀,莫施补剂致痨蒸。
骤然吐血,兼见头痛寒热者,外感伤经脉也。宜麻黄芍药汤。
藕节(二钱) 枯芩(一钱) 生地(二钱) 川芎(五分) 白芍(三钱) 当归(三钱) 麻黄(八
分) 丹皮(二钱) 香附(三钱) 麦冬(三钱) 杏仁(三钱) 蒲黄(一钱) 枳壳(一钱) 甘草(一
钱)
歌曰∶失血头痛外感伤,藕芩地芍与麻黄。
归芎香附丹蒲杏,枳草和冬煮与尝。
吐血口渴,脉洪数而溺赤者,火热伤阴分也。宜加味四生丸。
生地(三钱) 艾叶(一钱) 柏叶(三钱) 荷叶(三钱) 丹皮(三钱) 枯芩(三钱)
酒军(七分) 知母(三钱) 花粉(三钱) 牛膝(一钱) 茅根(三钱) 马通(即白马屎一
两泡取水)
歌曰∶脉洪失血渴难当,知地丹芩与大黄。
牛膝马通花粉入,茅荷艾柏叶同尝。
吐血口和,脉弦微而溺清者,阳虚而阴脱也。宜变化理中汤。
党参(二钱) 黄 (二钱) 黑姜(八分) 甘草(一钱) 白芍(二钱) 白术(二钱)
五味(五分) 当归(三钱) 木香(一钱) 侧柏(二钱) 醋艾(一钱) 马通(即白马屎一两
泡取水)
歌曰∶脉微血脱溺还清,姜草参 芍共烹。
术味马通归柏艾,木香加入病能轻。
吐后口渴,血带黑而腹痛者,瘀血积腹里也。宜加味四物汤。
生地(三钱) 当归(三钱) 川芎(一钱) 桃仁(研,三钱) 白芍(三钱) 大黄(一钱) 丹皮(
三钱) 香附(三钱) 枳壳(一钱) 降香(一钱)
歌曰∶血方吐过口旋干,腹痛瘀停归地餐。
芎枳降香香附子,大黄加芍佐桃丹。
吐血之前,必先大发恶心者,血潮而凌心也。宜郁金丹皮汤。
郁金(二钱) 生地(三钱) 麦冬(三钱) 牛膝(二钱) 五味(七分) 丹皮(二钱) 炒栀(
二钱) 当归(二钱) 白芍(二钱) 玉竹(二钱) 枣仁(二钱) 知母(一钱) 木香(二钱)
朱砂(研冲服八分)
歌曰∶吐血之前发恶心,木香知味芍归寻。
朱砂牛地冬和枣,玉竹丹栀与郁金。
(伯未按,鲜蚕豆叶、捣汁和陈皮酒炖温服。)
先行咳嗽,然后得吐血证者,肺燥伤阴脉也。宜清燥和血汤。
生地(三钱) 麦冬(三钱) 百合(二钱) 五味(五分) 当归(三钱) 贝母(二钱) 杏仁(
三钱) 续断(二钱) 藕节(二钱) 荆芥(一钱) 竹茹(二钱) 蒲黄(一钱) 红花(五分)
降香(一钱)
歌曰∶先行咳嗽血方来,地合归冬杏贝裁。
续降芥茹同五味,红花藕节与蒲灰。
(伯未按∶枇杷叶膏可时冲服。)
先行吐血,然后得咳嗽证者,阴阳不相符也。宜调阴和阳汤。
当归(二钱) 白芍(二钱) 生地(二钱) 阿胶(一钱) 五味(七分) 百合(二钱) 贝母(
二钱) 杏仁(二钱) 沉香(五分) 牛膝(一钱) 白薇(二钱) 蒲黄(一钱) 牡蛎(二钱)
降香(一钱)
歌曰∶先行吐血咳相随,药用阿胶地芍归。
味合降沉和贝杏,蒲黄牡蛎膝兼薇。
吐血之后,肌肉鱼鳞甲错者,腹中有干血也。宜大黄 虫丸。
大黄(一钱) 桃仁(一钱) 甘草(一钱) 虻虫(炒,一钱) 蛴螬(一钱) 阿胶(一钱) 当归(
一钱) 炒荆芥(一钱) 水蛭(炒,二条) 虫(炒,一钱)
歌曰∶血干肌肉似鱼鳞,蛭 螬虻效若神。
黄与胶归分佐使,再加芥草与桃仁。
大便下血,其下在粪之前者,肠风疮痔类也。宜赤豆加味散。
当归(三钱) 地榆(三钱) 银花(一钱) 防己(一钱) 麦冬(三钱) 牛蒡子(三钱) 丹
皮(三钱) 白芍(二钱) 槐角(三钱) 棕灰(一钱) 杏仁(三钱) 黄柏(二钱) 甘草(一钱)
赤豆(芽,三钱)
歌曰∶痔疮下血用归榆,赤豆银防冬芍俱。
牛蒡棕槐丹杏共,寸冬黄柏草梢须。
大便下血,其下在粪之后者,肝脾不统血也。宜仲景黄土汤。
白术(三钱) 附子(二钱) 炙草(二钱) 生地(三钱) 黄芩(二钱) 阿胶(二钱) 灶
心土(三钱)
歌曰∶肝脾失驭血违经,便后长流势不停。
术附地芩胶共草,汤煎黄土服之灵。
通身汗血,甚则沾衣尽赤者,火甚而血溢也。宜加味六黄汤。
当归(三钱) 黄连(二钱) 黄芩(三钱) 黄柏(二钱) 蝉蜕(一钱) 酒军(一钱) 生
地(三钱) 黄 (二钱) 熟地(三钱) 白芍(三钱) 竹茹(二钱) 杏仁(三钱) 甘草(一
钱) 地骨皮(二钱)
歌曰∶通身汗出血沾衣,两地芩连芍与归。
地骨竹茹蝉杏草,生军 柏汗当稀。
鼻中流血,以及齿缝出血者,胃中之燥热也。宜清凉甘露饮。
生地(三钱) 熟地(三钱) 麦冬(三钱) 天冬(三钱) 黄芩(三钱) 枳壳(一钱) 石
斛(三钱) 茵陈(三钱) 藕节(三钱) 蒲黄(一钱) 牛膝(二钱) 甘草(一钱) 枇杷叶(
去毛蜜炙,二钱)
歌曰∶鼻中流血要清凉,芩枳茵陈两地黄。
藕斛枇杷牛膝共,二冬和草煮成汤。
【总诀】血液随气运行,必须遵循经脉的规律;气机上逆导致血液沸腾妄行。治疗的关键在于降逆气和消除瘀血,切勿使用补益药剂,以免导致虚劳发热。
如果突然吐血,并伴有头痛、恶寒、发热等症状,这是外感邪气损伤经脉所致。适宜使用麻黄芍药汤。
药材:藕节(二钱)、枯芩(即黄芩,一钱)、生地(二钱)、川芎(五分)、白芍(三钱)、当归(三钱)、麻黄(八分)、丹皮(二钱)、香附(三钱)、麦冬(三钱)、杏仁(三钱)、蒲黄(一钱)、枳壳(一钱)、甘草(一钱)。
歌诀曰:失血伴头痛因外感伤经,用藕节、黄芩、生地、白芍与麻黄。
加上当归、川芎、香附、丹皮、蒲黄、杏仁,再用枳壳、甘草和麦冬煎煮服用。
如果吐血且口渴,脉象洪大数急,小便颜色深红,这是火热之邪损伤阴分所致。适宜使用加味四生丸。
药材:生地(三钱)、艾叶(一钱)、柏叶(三钱)、荷叶(三钱)、丹皮(三钱)、枯芩(三钱)、酒军(即酒制大黄,七分)、知母(三钱)、花粉(即天花粉,三钱)、牛膝(一钱)、茅根(三钱)、马通(即白马粪便一两,泡水取汁)。
歌诀曰:脉象洪大、失血且口渴难耐,用知母、生地、丹皮、黄芩和大黄。
加入牛膝、马通汁、天花粉,再同茅根、荷叶、艾叶、侧柏叶一起煎服。
如果吐血但口中和缓不渴,脉象弦细微弱,小便清长,这是阳气虚弱而阴血脱失所致。适宜使用变化理中汤。
药材:党参(二钱)、黄芪(二钱)、黑姜(即炮姜,八分)、甘草(一钱)、白芍(二钱)、白术(二钱)、五味子(五分)、当归(三钱)、木香(一钱)、侧柏(二钱)、醋艾(即醋炒艾叶,一钱)、马通(即白马粪便一两,泡水取汁)。
歌诀曰:脉象微弱、血脱且小便清亮,用干姜、甘草、人参、黄芪、白芍共同煎煮。
加入白术、五味子、马通汁、当归、侧柏叶、艾叶,再加入木香可使病情减轻。
如果吐血后口渴,血色发黑且腹痛,这是瘀血积聚在腹部所致。适宜使用加味四物汤。
药材:生地(三钱)、当归(三钱)、川芎(一钱)、桃仁(研碎,三钱)、白芍(三钱)、大黄(一钱)、丹皮(三钱)、香附(三钱)、枳壳(一钱)、降香(一钱)。
歌诀曰:血刚吐完不久就口干,腹痛是瘀血停滞,用当归和生地来调理。
川芎、枳壳、降香、香附子,再加黄大豆、白芍辅助桃仁和丹皮。
如果在吐血之前,先出现严重的恶心感,这是血气上潮侵犯心神所致。适宜使用郁金丹皮汤。
药材:郁金(二钱)、生地(三钱)、麦冬(三钱)、牛膝(二钱)、五味子(七分)、丹皮(二钱)、炒栀子(二钱)、当归(二钱)、白芍(二钱)、玉竹(二钱)、枣仁(即酸枣仁,二钱)、知母(一钱)、木香(二钱)、朱砂(研末冲服,八分)。
歌诀曰:吐血前发生恶心,用木香、知母、五味子、白芍、当归寻找病因。
朱砂、牛膝、生地、麦冬和酸枣仁,加上玉竹、丹皮、栀子和郁金。
(作者按语未采纳此法:可用鲜蚕豆叶捣汁,与陈皮酒炖温后服用。)
如果先出现咳嗽,随后才发生吐血症状,这是肺燥损伤阴脉所致。适宜使用清燥和血汤。
药材:生地(三钱)、麦冬(三钱)、百合(二钱)、五味子(五分)、当归(三钱)、贝母(二钱)、杏仁(三钱)、续断(二钱)、藕节(二钱)、荆芥(一钱)、竹茹(二钱)、蒲黄(一钱)、红花(五分)、降香(一钱)。
歌诀曰:先有咳嗽然后血方来,用地黄、百合、当归、麦冬、杏仁、贝母裁制。
续断、荆芥、竹茹同五味子,红花、藕节与蒲黄灰一起使用。
(作者按语:枇杷叶膏可以时常冲服。)
如果先发生吐血,随后才出现咳嗽症状,这是阴阳不相协调所致。适宜使用调阴和阳汤。
药材:当归(二钱)、白芍(二钱)、生地(二钱)、阿胶(一钱)、五味子(七分)、百合(二钱)、贝母(二钱)、杏仁(二钱)、沉香(五分)、牛膝(一钱)、白薇(二钱)、蒲黄(一钱)、牡蛎(二钱)、降香(一钱)。
歌诀曰:先吐血后咳嗽相随,药用阿胶、生地、白芍、当归。
五味子合降香、沉香调和贝母和杏仁,蒲黄、牡蛎、牛膝兼用白薇。
如果吐血之后,肌肉干枯如鱼鳞甲错,这是腹中有干血(陈旧性瘀血)所致。适宜使用大黄䗪虫丸。
药材:大黄(一钱)、桃仁(一钱)、甘草(一钱)、虻虫(炒,一钱)、蛴螬(一钱)、阿胶(一钱)、当归(一钱)、炒荆芥(一钱)、水蛭(炒,两条)、䗪虫(即土鳖虫,炒,一钱)。
歌诀曰:血干导致肌肉似鱼鳞,水蛭、土鳖虫、虻虫效果若神。
大黄与阿胶、当归作为佐使,再加荆芥、甘草和桃仁。
大便下血,血液排在粪便之前的,属于肠风、疮痔之类。适宜使用赤豆加味散。
药材:当归(三钱)、地榆(三钱)、银花(即金银花,一钱)、防己(一钱)、麦冬(三钱)、牛蒡子(三钱)、丹皮(三钱)、白芍(二钱)、槐角(三钱)、棕灰(即棕榈炭,一钱)、杏仁(三钱)、黄柏(二钱)、甘草(一钱)、赤豆芽(三钱)。
歌诀曰:痔疮下血用当归和地榆,赤豆、金银花、防己、麦冬、白芍都有。
牛蒡子、棕榈炭、槐角、丹皮、杏仁共用,寸冬(麦冬)、黄柏、甘草梢必需。
大便下血,血液排在粪便之后的,这是肝脾不能统摄血液所致。适宜使用张仲景的黄土汤。
药材:白术(三钱)、附子(二钱)、炙甘草(二钱)、生地(三钱)、黄芩(二钱)、阿胶(二钱)、灶心土(即伏龙肝,三钱)。
歌诀曰:肝脾失去驾驭能力导致血违经而行,便后流血势态不停止。
白术、附子、生地、黄芩、阿胶共配甘草,煎煮黄土汤服用有效。
全身出汗带血,甚至沾湿衣服全部变红的,这是火邪炽盛导致血液溢出所致。适宜使用加味六黄汤。
药材:当归(三钱)、黄连(二钱)、黄芩(三钱)、黄柏(二钱)、蝉蜕(一钱)、酒军(即酒制大黄,一钱)、生地(三钱)、黄芪(二钱)、熟地(三钱)、白芍(三钱)、竹茹(二钱)、杏仁(三钱)、甘草(一钱)、地骨皮(二钱)。
歌诀曰:全身汗出血沾湿衣服,用地黄、黄芩、黄连、白芍和当归。
地骨皮、竹茹、蝉蜕、杏仁、甘草,生大黄和黄柏让汗血逐渐稀少。
鼻子流血,以及牙缝出血的,这是胃中燥热所致。适宜使用清凉甘露饮。
药材:生地(三钱)、熟地(三钱)、麦冬(三钱)、天冬(三钱)、黄芩(三钱)、枳壳(一钱)、石斛(三钱)、茵陈(三钱)、藕节(三钱)、蒲黄(一钱)、牛膝(二钱)、甘草(一钱)、枇杷叶(去毛蜜炙,二钱)。
歌诀曰:鼻中流血要清凉,用黄芩、枳壳、茵陈和两地黄(生地、熟地)。
藕节、石斛、枇杷叶、牛膝共用,二冬(麦冬、天冬)和甘草煮成汤。
[General Principle] Blood follows Qi in its distribution and must circulate according to the meridians; when Qi rebels upward, blood boils and flows recklessly. The exquisite principle is to direct rebellious Qi downward and eliminate stasis; do not apply tonifying agents lest they cause consumptive fever.
If hematemesis occurs suddenly accompanied by headache, aversion to cold, and fever, it is due to external pathogens injuring the meridians. Mahuang Shaoyao Tang (Ephedra and White Peony Decoction) is suitable.
Herbs: Nelumbinis Plumulae Caulis (Ou Jie, 2 qian), Scutellariae Radix (Ku Qin, 1 qian), Rehmanniae Radix (Sheng Di, 2 qian), Chuanxiong Rhizoma (Chuan Xiong, 5 fen), Paeoniae Radix Alba (Bai Shao, 3 qian), Angelicae Sinensis Radix (Dang Gui, 3 qian), Ephedrae Herba (Ma Huang, 8 fen), Moutan Cortex (Dan Pi, 2 qian), Cyperi Rhizoma (Xiang Fu, 3 qian), Ophiopogonis Radix (Mai Dong, 3 qian), Armeniacae Semen (Xing Ren, 3 qian), Polygoni Multiflori Caulis (Pu Huang, 1 qian), Aurantii Fructus Immaturus (Zhi Ke, 1 qian), Glycyrrhizae Radix et Rhizoma (Gan Cao, 1 qian).
Song says: Hematemesis with headache indicates external pathogen injury; use Ou Jie, Ku Qin, Sheng Di, Bai Shao, and Ma Huang.
Add Dang Gui, Chuan Xiong, Xiang Fu, Dan Pi, Pu Huang, Xing Ren, Zhi Ke, Gan Cao, and Mai Dong, decoct and take.
If hematemesis is accompanied by thirst, a surging and rapid pulse, and dark red urine, it is due to fire-heat injuring the Yin aspect. Jiawei Sisheng Wan (Modified Four Living Pills) is suitable.
Herbs: Rehmanniae Radix (Sheng Di, 3 qian), Artemisiae Argyi Folium (Ai Ye, 1 qian), Platycladi Cacumen (Bai Ye, 3 qian), Nelumbinis Folium (He Ye, 3 qian), Moutan Cortex (Dan Pi, 3 qian), Scutellariae Radix (Ku Qin, 3 qian), Rheum Palmatum prepared with wine (Jiu Jun, 7 fen), Anemarrhenae Rhizoma (Zhi Mu, 3 qian), Trichosanthis Radix (Hua Fen, 3 qian), Achyranthis Bidentatae Radix (Niu Xi, 1 qian), Imperatae Rhizoma (Mao Gen, 3 qian), Equi Feces (Ma Tong, 1 liang soaked for juice).
Song says: Surging pulse, hematemesis, and unbearable thirst; use Zhi Mu, Sheng Di, Dan Pi, Ku Qin, and Da Huang.
Add Niu Xi, Ma Tong juice, Hua Fen, Mao Gen, He Ye, Ai Ye, and Bai Ye, decoct and take together.
If hematemesis occurs but the mouth feels neutral without thirst, the pulse is wiry, fine, and faint, and urination is clear, it is due to Yang deficiency and Yin-blood depletion. Bianhua Lizhong Tang (Modified Regulation of the Middle Decoction) is suitable.
Herbs: Codonopsis Radix (Dang Shen, 2 qian), Astragali Radix (Huang Qi, 2 qian), Zingiberis Rhizoma Preparatum (Hei Jiang, 8 fen), Glycyrrhizae Radix et Rhizoma (Gan Cao, 1 qian), Paeoniae Radix Alba (Bai Shao, 2 qian), Atractylodis Macrocephalae Rhizoma (Bai Zhu, 2 qian), Schisandrae Fructus (Wu Wei, 5 fen), Angelicae Sinensis Radix (Dang Gui, 3 qian), Aucklandiae Radix (Mu Xiang, 1 qian), Platycladi Cacumen (Ce Bai, 2 qian), Artemisiae Argyi Folium prepared with vinegar (Cu Ai, 1 qian), Equi Feces (Ma Tong, 1 liang soaked for juice).
Song says: Faint pulse, blood depletion, and clear urination; decoct Hei Jiang, Gan Cao, Dang Shen, Huang Qi, and Bai Shao together.
Add Bai Zhu, Wu Wei, Ma Tong juice, Dang Gui, Ce Bai, Ai Ye, and Mu Xiang to alleviate the condition.
If thirst occurs after hematemesis, the blood is black, and abdominal pain is present, it is due to blood stasis accumulating in the abdomen. Jiawei Siwu Tang (Modified Four Substances Decoction) is suitable.
Herbs: Rehmanniae Radix (Sheng Di, 3 qian), Angelicae Sinensis Radix (Dang Gui, 3 qian), Chuanxiong Rhizoma (Chuan Xiong, 1 qian), Persicae Semen (Tao Ren, ground, 3 qian), Paeoniae Radix Alba (Bai Shao, 3 qian), Rheum Palmatum (Da Huang, 1 qian), Moutan Cortex (Dan Pi, 3 qian), Cyperi Rhizoma (Xiang Fu, 3 qian), Aurantii Fructus Immaturus (Zhi Ke, 1 qian), Dalbergiae Odoriferae Lignum (Xiang, 1 qian).
Song says: Thirst arises shortly after bleeding stops; abdominal pain indicates stasis, treat with Dang Gui and Sheng Di.
Use Chuan Xiong, Zhi Ke, Xiang, Xiang Fu, Da Huang, Bai Shao, Tao Ren, and Dan Pi.
If severe nausea precedes hematemesis, it is due to blood flooding and harassing the Heart. Yujin Danpi Tang (Curcuma and Moutan Decoction) is suitable.
Herbs: Curcumae Radix (Yu Jin, 2 qian), Rehmanniae Radix (Sheng Di, 3 qian), Ophiopogonis Radix (Mai Dong, 3 qian), Achyranthis Bidentatae Radix (Niu Xi, 2 qian), Schisandrae Fructus (Wu Wei, 7 fen), Moutan Cortex (Dan Pi, 2 qian), Gardeniae Fructus stir-fried (Chao Zhi, 2 qian), Angelicae Sinensis Radix (Dang Gui, 2 qian), Paeoniae Radix Alba (Bai Shao, 2 qian), Polygonati Odorati Rhizoma (Yu Zhu, 2 qian), Ziziphi Spinosae Semen (Zao Ren, 2 qian), Anemarrhenae Rhizoma (Zhi Mu, 1 qian), Aucklandiae Radix (Mu Xiang, 2 qian), Cinnabaris (Zhu Sha, ground, taken with medicine, 8 fen).
Song says: Nausea before hematemesis; seek Mu Xiang, Zhi Mu, Wu Wei, Bai Shao, and Dang Gui.
Combine Zhu Sha, Niu Xi, Sheng Di, Mai Dong, Zao Ren, Yu Zhu, Dan Pi, Zhi, and Yu Jin.
(Note: The author did not adopt this method; fresh Vicia faba leaves can be crushed for juice, stewed warm with Chen Pi wine.)
If coughing precedes hematemesis, it is due to Lung dryness injuring the Yin vessels. Qingzao Hexue Tang (Clear Dryness and Harmonize Blood Decoction) is suitable.
Herbs: Rehmanniae Radix (Sheng Di, 3 qian), Ophiopogonis Radix (Mai Dong, 3 qian), Lilii Bulbus (Bai He, 2 qian), Schisandrae Fructus (Wu Wei, 5 fen), Angelicae Sinensis Radix (Dang Gui, 3 qian), Fritillariae Cirrhosae Bulbus (Bei Mu, 2 qian), Armeniacae Semen (Xing Ren, 3 qian), Dipsaci Radix (Xu Duan, 2 qian), Nelumbinis Plumulae Caulis (Ou Jie, 2 qian), Schizonepetae Spica (Jing Jie, 1 qian), Bambusae Caulis Preparatus (Zhu Ru, 2 qian), Polygoni Multiflori Caulis (Pu Huang, 1 qian), Carthami Flos (Hong Hua, 5 fen), Dalbergiae Odoriferae Lignum (Xiang, 1 qian).
Song says: Cough precedes blood arrival; prepare with Di, He, Gui, Dong, Xing, and Bei.
Combine Xu Duan, Jing Jie, Zhu Ru, Wu Wei, Hong Hua, Ou Jie, and Pu Huang.
(Note: Loquat leaf paste can be taken intermittently.)
If hematemesis precedes coughing, it is due to Yin and Yang failing to harmonize. Tiaoyin Heyang Tang (Harmonize Yin and Yang Decoction) is suitable.
Herbs: Angelicae Sinensis Radix (Dang Gui, 2 qian), Paeoniae Radix Alba (Bai Shao, 2 qian), Rehmanniae Radix (Sheng Di, 2 qian), Asini Corii Colla (E Jiao, 1 qian), Schisandrae Fructus (Wu Wei, 7 fen), Lilii Bulbus (Bai He, 2 qian), Fritillariae Cirrhosae Bulbus (Bei Mu, 2 qian), Armeniacae Semen (Xing Ren, 2 qian), Aquilariae Lignum Resinatum (Chen Xiang, 5 fen), Achyranthis Bidentatae Radix (Niu Xi, 1 qian), Cynanchi Atrati Radix (Bai Wei, 2 qian), Polygoni Multiflori Caulis (Pu Huang, 1 qian), Ostreae Concha (Mu Li, 2 qian), Dalbergiae Odoriferae Lignum (Xiang, 1 qian).
Song says: Hematemesis first, then cough follows; use E Jiao, Sheng Di, Bai Shao, and Dang Gui.
Combine Wu Wei, Xiang, Chen Xiang, Bei Mu, Xing Ren, Pu Huang, Mu Li, Niu Xi, and Bai Wei.
If after hematemesis the muscles are dry and scaly like fish scales, it is due to dried blood accumulating in the abdomen. Dahuang Zhechong Wan (Rhubarb and Ground Beetle Pill) is suitable.
Herbs: Rheum Palmatum (Da Huang, 1 qian), Persicae Semen (Tao Ren, 1 qian), Glycyrrhizae Radix et Rhizoma (Gan Cao, 1 qian), Blatta Orientalis (Meng Chong, stir-fried, 1 qian), Otiorhynchi Larva (Qi Lao, 1 qian), Asini Corii Colla (E Jiao, 1 qian), Angelicae Sinensis Radix (Dang Gui, 1 qian), Stir-fried Schizonepetae Spica (Chao Jing Jie, 1 qian), Hirudo (Shui Zhi, stir-fried, 2 pieces), Eupolyphaga Seu Steleophaga (Zhe Chong, stir-fried, 1 qian).
Song says: Dried blood makes muscles resemble fish scales; Shui Zhi, Zhe Chong, and Meng Chong are effective as if divine.
Da Huang, E Jiao, and Dang Gui act as assistants; add Jing Jie, Gan Cao, and Tao Ren.
Hematochezia where blood appears before stool belongs to Chang Feng or hemorrhoids. Chidou Jiawei San (Red Bean Modified Powder) is suitable.
Herbs: Angelicae Sinensis Radix (Dang Gui, 3 qian), Sanguisorbae Radix (Di Yu, 3 qian), Lonicerae Japonicae Flos (Yin Hua, 1 qian), Stephaniae Tetrandrae Radix (Fang Ji, 1 qian), Ophiopogonis Radix (Mai Dong, 3 qian), Arctii Fructus (Niu Bang Zi, 3 qian), Moutan Cortex (Dan Pi, 3 qian), Paeoniae Radix Alba (Bai Shao, 2 qian), Sophorae Flos (Huai Jiao, 3 qian), Palmae Fructus Carbonis (Zong Hui, 1 qian), Armeniacae Semen (Xing Ren, 3 qian), Phellodendri Cortex (Huang Bo, 2 qian), Glycyrrhizae Radix et Rhizoma (Gan Cao, 1 qian), Phaseoli Vulgaris Germin (Chi Dou Ya, 3 qian).
Song says: For hemorrhoidal bleeding, use Dang Gui and Di Yu; Chi Dou, Yin Hua, Fang Ji, Mai Dong, and Bai Shao are all included.
Niu Bang Zi, Zong Hui, Huai Jiao, Dan Pi, and Xing Ren are combined; Mai Dong, Huang Bo, and Gan Cao tip are essential.
Hematochezia where blood appears after stool is due to Liver and Spleen failing to control blood. Zhongjing Huangtu Tang (Yellow Earth Decoction by Zhang Zhongjing) is suitable.
Herbs: Atractylodis Macrocephalae Rhizoma (Bai Zhu, 3 qian), Aconiti Lateralis Radix Preparata (Fu Zi, 2 qian), Glycyrrhizae Radix et Rhizoma Praeparata (Zhi Cao, 2 qian), Rehmanniae Radix (Sheng Di, 3 qian), Scutellariae Radix (Huang Qin, 2 qian), Asini Corii Colla (E Jiao, 2 qian), Caudex Longanae (Zao Xin Tu, 3 qian).
Song says: Liver and Spleen fail to govern, blood deviates from vessels, flowing continuously after stool.
Bai Zhu, Fu Zi, Sheng Di, Huang Qin, E Jiao, and Gan Cao are decocted with Huang Tu for effective administration.
Whole-body sweating of blood, even staining clothes entirely red, is due to excessive fire causing blood extravasation. Jiawei Liu Huang Tang (Modified Six Yellow Decoction) is suitable.
Herbs: Angelicae Sinensis Radix (Dang Gui, 3 qian), Coptidis Rhizoma (Huang Lian, 2 qian), Scutellariae Radix (Huang Qin, 3 qian), Phellodendri Cortex (Huang Bo, 2 qian), Bombyx Batryticatus (Chan Tui, 1 qian), Rheum Palmatum prepared with wine (Jiu Jun, 1 qian), Rehmanniae Radix (Sheng Di, 3 qian), Astragali Radix (Huang Qi, 2 qian), Rehmanniae Radix Preparata (Shu Di, 3 qian), Paeoniae Radix Alba (Bai Shao, 3 qian), Bambusae Caulis Preparatus (Zhu Ru, 2 qian), Armeniacae Semen (Xing Ren, 3 qian), Glycyrrhizae Radix et Rhizoma (Gan Cao, 1 qian), Lycii Cortex (Di Gu Pi, 2 qian).
Song says: Whole-body bloody sweat stains clothes; combine Di, Huang Qin, Huang Lian, Bai Shao, and Dang Gui.
Di Gu Pi, Zhu Ru, Chan Tui, Xing Ren, Gan Cao, Sheng Jun, and Huang Bo make bloody sweat sparse.
Epistaxis and gingival bleeding are due to dryness-heat in the Stomach. Qingliang Ganlu Yin (Cooling Sweet Dew Drink) is suitable.
Herbs: Rehmanniae Radix (Sheng Di, 3 qian), Rehmanniae Radix Preparata (Shu Di, 3 qian), Ophiopogonis Radix (Mai Dong, 3 qian), Asparagi Radix (Tian Dong, 3 qian), Scutellariae Radix (Huang Qin, 3 qian), Aurantii Fructus Immaturus (Zhi Ke, 1 qian), Dendrobii Caulis (Shi Hu, 3 qian), Artemisiae Scopariae Herba (Yin Chen, 3 qian), Nelumbinis Plumulae Caulis (Ou Jie, 3 qian), Polygoni Multiflori Caulis (Pu Huang, 1 qian), Achyranthis Bidentatae Radix (Niu Xi, 2 qian), Glycyrrhizae Radix et Rhizoma (Gan Cao, 1 qian), Eriobotryae Folium (Pi Pa Ye, honey-fried, 2 qian).
Song says: Epistaxis requires cooling; use Huang Qin, Zhi Ke, Yin Chen, and two types of Di.
Combine Ou Jie, Shi Hu, Pi Pa Ye, Niu Xi, Tian Dong, Mai Dong, and Gan Cao to decoct into a drink.