怔忡心血少也。其原起于肾水不足。不能上升。以致心火不能下降。大剂归脾汤。去木香。加
麦冬五味枸杞。吞都气丸。（治怔忡大法。无逾此旨矣）如怔忡而实挟包络一种有余之火兼
痰者。则加生地黄连川贝之类以清之。
（予治后窑简长鳞之弟。先用归脾都气三十余剂。后加生地连贝。一清即愈。）
（绛雪丹书一卷。论详而法备的是血症准绳。须细体之。）
吐血。世皆知火症。便以寒凉温润之剂投之。土死金衰。木势转炽。病反剧矣。除是瘀血抑
蓄。折士而奔注。与伤寒变热。追窍而出者。余俱当以大剂参 回其气。气回则血循经络矣。待
稍定。即以重料六味左归等饮。于水中养木。亦须加人参使气自阴生也。（天地之理。阳统乎阴。
血随乎气。故治血必先理气。血脱必先益气。盖有形之血。不能速生。无形之气。所当急固。无
形自能生有形也。特不可施于伤寒与蓄血者耳。）瘀血而吐。必先胸痛。（血色必紫或黑而成块。
脉必涩滞。）四物汤加大黄（须醋制）桃仁丹皮香附以行之。后用六君子汤。加当归以调之。（
紫黑尽。血鲜红者见。即当用此。）伤寒必骤涌出。然伤寒大抵从鼻来者多。来而即住者。不药
可望愈。一来不止者不治。（此即红汗是也。红汗至而热解。衄是妙事。如衄而不解。病转深矣。衄
而不止。病愈危矣。）其余俱属七情饥饱劳力等因。必见恶心。（验症分明。）一味固元汤主之
。倪漱山曰。七情内伤。脾胃先病。固元之后。即继补中益气归脾等饮。寒凉断不可用。若治以
童便秋石等。工之粗而庸甚者也。（有一种阴虚于下。格阳于上。则真阳失守。血随而溢。以致大
吐大衄。六脉细脱。手足厥冷。危在顷刻。而血不能止者。速宜用附子肉桂牛膝泽泻熟地甘草。
以镇其阴。 使孤阳有归。则血自安也。如呕恶加炒黑干姜。脉微气脱加人参。如格阳喉痹上热者。
当以前汤冷服。此症甚多。不可不知。）
固元汤
人参 黄 （蜜炙） 归身 甘草 煨姜 大枣 白芍（酒浸洗炒）
四物汤
川芎 当归 白芍 熟地
上方加肉桂名五物煎。加大黄名清热凉血饮。加柴胡丹皮山栀名加味四物汤。
怔忡（心中悸动不安的病证）是由于心血不足所致。其根源在于肾水亏虚，不能上济于心，导致心火不能下交于肾。治疗应使用大剂量的归脾汤（补益心脾的方剂），去掉木香，加入麦冬、五味子、枸杞子，并吞服都气丸。（这是治疗怔忡的大法，没有超过这个宗旨的了。）如果怔忡确实兼有包络（心包）的一种有余之火并且夹杂痰浊，则加入生地黄、黄连、川贝母等药物来清热化痰。（我治疗后窑简长鳞的弟弟，先用归脾汤和都气丸三十多剂，后来加入生地黄、黄连、川贝母，一清火即痊愈。）
《绛雪丹书》一卷，论述详细且方法完备，确实是血症的准绳，必须仔细体会它。
吐血，世人都知道是火症，便用寒凉温润的药物投治。这会导致脾土死亡、肺金衰弱，肝木之势反而更加炽盛，病情反而加重了。除非是瘀血郁积，折损脾气而奔注出血，或者像伤寒变热，逼迫血液从窍道而出者，其余情况都应当用大剂量的人参来回阳救逆、补气固脱。气回则血就能循行于经络之中。待病情稍定，立即用重剂量的六味地黄丸、左归饮等方剂，通过滋补肾水来涵养肝木，也必须加入人参，使气从阴中生发。（天地间的道理，阳统帅阴，血随气而行。所以治血必须先理气，血脱失必须先益气。因为有形之血不能快速生成，无形之气应当紧急固护。有了无形之气自然能化生有形之血。只是这种方法不可用于伤寒和蓄血证罢了。）如果是瘀血导致的吐血，必定先有胸痛。（血色一定是紫色或黑色并结成块状，脉象一定涩滞不畅。）用四物汤加大黄（必须用醋制）、桃仁、牡丹皮、香附来活血行气。之后用六君子汤，加入当归来调理。（直到紫黑色的瘀血排尽，鲜红色的新血出现时，才应当使用此方。）伤寒引起的吐血必定突然大量涌出，然而伤寒大多从鼻衄（流鼻血）而来，来了就停止的，不吃药有望自愈。一来就不止的，属于不治之症。（这就是所谓的“红汗”。红汗出了而热邪解除，衄血是妙事；如果衄血后病不解，病情就会加深；如果衄血不止，病情就极其危险了。）其余的情况都属于七情内伤、饥饱失调、劳力过度等原因，必定伴有恶心症状。（症状验证分明。）用一味固元汤主治。倪漱山说：七情内伤，脾胃首先生病，在固元之后，接着继用补中益气汤、归脾汤等方剂，绝对不可使用寒凉药物。如果用童便、秋石等药物治疗，那是医术粗陋庸俗的表现。（有一种情况是阴虚于下，格拒阳气于上，导致真阳失守，血随之溢出，以致大吐大衄，六脉细微欲绝，手足厥冷，危在旦夕，而血无法止住。此时应立即使用附子、肉桂、牛膝、泽泻、熟地黄、甘草，以镇摄浮越之阴，使孤阳有所回归，则血自安。如果伴有呕吐恶寒，加炒黑的干姜；脉微气脱加人参；如果是格阳导致的喉痹上部发热，应当将上述汤药冷服。这种病症很多，不可不知道。）
Palpitations (a syndrome characterized by a sensation of heart palpitation and unease) are caused by a deficiency of Heart Blood. The root cause lies in the insufficiency of Kidney Water, which fails to ascend, thereby preventing Heart Fire from descending. Treatment should employ a large dose of Guizhi Tang (Cinnamon Twig Decoction - *Note: Text says Guipi Tang, corrected to Guipi Tang below*), removing Xiangru (Aucklandiae Radix), adding Maidong (Ophiopogonis Tuber), Wuweizi (Schisandrae Fructus), Gouqizi (Lycii Fructus), and swallowing Duqi Wan (Kidney-Nourishing Pill). (This is the general principle for treating palpitations; nothing exceeds this guideline.) If palpitations are indeed accompanied by an excess fire in the Pericardium (Pericardium) along with phlegm, then add Shengdihuang (Rehmanniae Radix), Huanglian (Coptidis Rhizoma), and Chuanbeimu (Fritillariae Cirrhosae Bulbus) to clear heat and resolve phlegm. (I treated the younger brother of Jian Changlin from Houyao using Guipi Tang and Duqi Wan for over thirty doses, later adding Shengdihuang, Huanglian, and Chuanbeimu; clearing the heat resulted in immediate recovery.)
The volume "Jiangxue Danshu" discusses details comprehensively and provides complete methods; it is indeed the standard for blood disorders and must be carefully studied.
Hematemesis (vomiting blood) is generally known by the world as a Fire syndrome, so cold and moistening agents are often administered. This causes the Earth (Spleen) to die and Metal (Lung) to weaken, while Wood (Liver) becomes even more vigorous, causing the disease to worsen. Unless it is due to stagnant Blood obstructing and damaging the Spleen Qi, leading to violent bleeding, or similar to Heat transforming in Cold Damage (Shanghan), forcing blood out through orifices, all other cases should be treated with a large dose of Renshen (Ginseng Radix et Rhizoma) to restore Qi. Once Qi is restored, Blood will return to circulating within the meridians. After the condition stabilizes slightly, heavy doses of Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) and Zuogui Yin (Left Restoring Decoction) should be used to nourish Water to nurture Wood. Renshen must also be added to generate Qi from Yin. (The principle of Heaven and Earth is that Yang commands Yin, and Blood follows Qi. Therefore, treating blood disorders requires first regulating Qi; when Blood is lost, Qi must first be tonified. Because tangible Blood cannot be generated quickly, intangible Qi must be urgently secured. With intangible Qi, tangible matter can naturally be generated. However, this method should not be applied to Shanghan or Blood Stasis syndromes.) If hematemesis is caused by Blood Stasis, there must necessarily be chest pain beforehand. (The blood color will definitely be purple or black and form clots; the pulse will definitely be choppy and sluggish.) Use Siwu Tang (Four-Substance Decoction) combined with Dahuang (Rhei Radix et Rhizoma - must be processed with vinegar), Taoren (Persicae Semen), Mudanpi (Moutan Cortex), and Xiangfu (Cyperi Rhizoma) to promote circulation. Afterwards, use Liujunzi Tang (Six-Gentlemen Decoction) with Danggui (Angelicae Sinensis Radix) to regulate. (Use this only after the purple-black blood has completely cleared and fresh red blood appears.) Hematemesis caused by Shanghan usually erupts suddenly. However, most cases of Shanghan involve epistaxis (nosebleed); if it stops immediately upon occurring, recovery is possible without medication. If it does not stop once it begins, it is incurable. (This is what is called "Red Sweat." When Red Sweat occurs and fever resolves, epistaxis is a favorable sign; if epistaxis does not resolve the disease, the condition deepens; if epistaxis continues unceasingly, the condition becomes critical.) The remaining cases belong to internal injuries from the Seven Emotions, improper diet, or physical exertion, and must present with nausea. (The symptoms are clearly verifiable.) Treat primarily with Yiwei Gu Yuan Tang (Single-Herb Solidify Origin Decoction). Ni Shushan said: Internal injury from the Seven Emotions first damages the Spleen and Stomach. After solidifying the Origin, continue with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Guipi Tang; cold-natured herbs must absolutely not be used. Treating with Tongbian (Child's Urine) or Qiushi (Natrii Nitras et Natrii Sulfatis Preparatio) represents crude and vulgar medical practice. (There is a type where Yin is deficient at the lower jiao, repelling Yang to the upper jiao, causing True Yang to lose its post, and Blood spills accordingly, resulting in massive hematemesis and epistaxis. The six pulses are fine and faint, hands and feet are cold, danger is imminent, and blood cannot be stopped. In such cases, rapidly use Fuzi (Aconiti Lateralis Radix Praeparata), Rougui (Cinnamomi Cortex), Niuxi (Achyranthis Bidentatae Radix), Zexie (Alismatis Rhizoma), Shudihuang (Rehmanniae Radix Preparata), and Gancao (Glycyrrhizae Radix et Rhizoma) to stabilize Yin, allowing the lone Yang to find its return, thus calming the blood. If vomiting and aversion to food occur, add Chao Heiganjiang (Charred Dried Ginger); if the pulse is minute and Qi is depleted, add Renshen; if there is upper heat due to throat obstruction from repelled Yang, administer the aforementioned decoction cold. This syndrome is common and must not be overlooked.)
Gu Yuan Tang
Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix - honey-fried), Danggui Shen (Angelicae Sinensis Radix - root portion), Gancao (Glycyrrhizae Radix et Rhizoma), Wei Jiang (Prepared Ginger), Dazao (Ziziphi Jujubae Fructus), Baishao (Paeoniae Radix Alba - wine-soaked, washed, fried).
Siwu Tang
Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Shudihuang (Rehmanniae Radix Preparata).
Adding Rougui (Cinnamomi Cortex) to the above formulas creates Wuwu Jian (Five-Element Decoction). Adding Dahuang (Rhei Radix et Rhizoma) creates Qingre Liangxue Yin (Clear Heat and Cool Blood Decoction). Adding Chaihu (Bupleuri Radix), Mudanpi (Moutan Cortex), and Zhizi (Gardeniae Fructus) creates Jiawei Siwu Tang (Modified Four-Substance Decoction).