有一种小腹胀满。小便自利。（或有漱水不欲咽者。然必以小便为验。） 其人如狂。为蓄血
。一名热入血室。男女俱有此血室。在男子则下血谵语。在女子则经水适来适断。其血必结。（
如结胸状）其病必日轻夜重。小柴胡汤加归尾调之。男子谵语。其血自下者结。（结当作吉。颇
有下后即死者。但血来必骤而多。）结而如狂发黄者。桃仁承气汤。邪犯心胃者。犀角地黄汤。
（谦按。结当作吉四字。恐欠妥协。又云颇有下后即死者。症之凶危已极。何吉之有哉。况
内经云男子便血如注者谓之结。阴一结一升。再结二升。三结三升之旨。其结不当作吉解。又显
然可据矣。）
桃仁承气汤
桃仁（泡去皮尖） 桂枝 白芍（酒炒） 大黄（红花酒制） 芒硝
上加生姜三片。或加柴胡青皮枳实炙甘草。
犀角地黄汤
治主脉浮。客脉芤。浮芤相合。血积胸中。热之甚。血在上焦。此方主之。
犀角（使） 大黄（君） 生地（臣） 黄芩（佐） 黄连（佐）
又方
犀角（使） 生地（君） 白芍（臣） 丹皮（佐）
上方如无犀角。以升麻代之。热多者加黄芩。脉大来迟腹不满。自言满者。无热也。不用黄
芩。升麻与犀角。性味主治不同。以升麻代之者。以其能引入阳明也。但蓄血症不得以升麻代之
耳。此方并治疮疹火盛。
有一种症状表现为小腹部胀满，小便通畅自如。（或者伴有想漱口但不想吞咽的情况，但必须以小便通利作为判断依据。）患者出现神志狂乱的表现，这是蓄血证。这一证候又被称为热入血室。男性和女性都有“血室”，在男性身上表现为下血和胡言乱语；在女性身上则表现为月经刚好来潮或突然中断，血液必然凝结。（其状态如同结胸证一样）病情必定是白天较轻、夜间加重。用小柴胡汤加入当归尾来调理。如果男性出现胡言乱语，且瘀血自行排出，这属于吉兆（此处原文注解说“结”字应作“吉”解，但编者按认为此说欠妥，指出常有瘀血排出后反而死亡的案例，说明病情凶险至极，何来吉利之说？况且《内经》中提到男子便血如注称为“结”，有阴气一结、再结、三结的论述，“结”字不应解释为“吉”，这一点显而易见且有据可查）。如果瘀血凝结且出现神志狂乱、皮肤发黄的症状，使用桃仁承气汤。如果是邪气侵犯心胃部位，使用犀角地黄汤。
桃仁承气汤
组成：桃仁（浸泡后去皮尖）、桂枝、白芍（酒炒）、大黄（用红花酒制）、芒硝。
煎服法：上方加生姜三片同煎。也可以根据情况加入柴胡、青皮、枳实、炙甘草。
犀角地黄汤
主治：主脉浮，客脉芤。浮脉与芤脉相合，表示血液积聚在胸中，热势极盛。血液病变位于上焦，此方为主治方剂。
组成：犀角（使药）、大黄（君药）、生地（臣药）、黄芩（佐药）、黄连（佐药）。
另一个方子
组成：犀角（使药）、生地（君药）、白芍（臣药）、丹皮（佐药）。
备注：如果上述方剂中没有犀角，可以用升麻代替。热象明显的加上黄芩。如果脉象大而迟缓，腹部不胀满，但患者自述腹满，这是没有实热的表现，不用黄芩。升麻与犀角的性味和主治功能不同，之所以用升麻代替，是因为升麻能引药进入阳明经。但是，对于蓄血证来说，不能用升麻来代替犀角。这个方子同时也治疗疮疹火毒炽盛的病症。
There is a condition characterized by fullness and distension in the lower abdomen, with urination being free and unobstructed. (There may be a desire to rinse the mouth without swallowing, but patency of urination must be taken as the diagnostic criterion.) The patient exhibits manic behavior, which indicates Blood Stasis (Blood Accumulation). This pattern is also known as Heat Entering the Blood Chamber (Xue Shi). Both men and women possess the "Blood Chamber." In men, it manifests as bleeding from below and delirious speech; in women, it occurs when menstruation has just started or suddenly stopped, causing the blood to coagulate. (The presentation resembles Chest Binding/Jie Xiong syndrome.) The disease severity is typically lighter during the day and heavier at night. It is treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Dang Gui Wei (Tail of Angelica Sinensis) to regulate it. If a man presents with delirium and the blood discharges spontaneously, this is considered auspicious [Note: The original text suggests 'Jie' should be read as 'Ji' (auspicious), but the commentator argues against this, noting that death often follows discharge, indicating extreme danger, not auspiciousness. Furthermore, the *Nei Jing* refers to profuse rectal bleeding as 'Jie' (binding/knotting), implying accumulation rather than relief]. If there is coagulation accompanied by mania and jaundice, Tao Ren Cheng Qi Tang (Peach Kernel Drain the Extremities Decoction) is used. If the pathogenic factor invades the Heart and Stomach, Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) is indicated.
Tao Ren Cheng Qi Tang (Peach Kernel Drain the Extremities Decoction)
Ingredients: Tao Ren (Peach Kernel, soaked, skin and tips removed), Guizhi (Cinnamon Twig), Baishao (White Peony Root, stir-fried with wine), Dahuang (Rhubarb Root and Rhizome, processed with Hong Hua wine), Mangxiao (Mirabilite).
Preparation: Add three slices of Sheng Jiang (Fresh Ginger) to the above herbs. Alternatively, Chai Hu (Bupleurum Root), Qing Pi (Aurantii Fructus Pericarpium), Zhi Shi (Immature Bitter Orange), and Zhi Gan Cao (Honey-fried Licorice Root) may be added.
Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction)
Indications: The principal pulse is Floating (Fu), and the guest pulse is Hollow (Kou). The combination of Floating and Hollow pulses indicates blood accumulation in the chest with severe heat. When the blood pathology is located in the Upper Jiao (Upper Burner), this decoction is the primary treatment.
Ingredients: Xi Jiao (Rhinoceros Horn, Minister herb), Dahuang (Rhubarb Root and Rhizome, Sovereign herb), Sheng Di (Rehmannia Root, Deputy herb), Huang Qin (Scutellaria Root, Assistant herb), Huang Lian (Coptis Rhizome, Assistant herb).
Another Formula
Ingredients: Xi Jiao (Rhinoceros Horn, Minister herb), Sheng Di (Rehmannia Root, Sovereign herb), Baishao (White Peony Root, Deputy herb), Dan Pi (Moutan Bark, Assistant herb).
Note: If Xi Jiao is unavailable in the above formula, Sheng Ma (Cimicifugae Rhizoma) may be used as a substitute. If heat is predominant, add Huang Qin. If the pulse is large but slow, the abdomen is not distended, yet the patient complains of fullness, this indicates an absence of excess heat; therefore, Huang Qin should not be used. Sheng Ma and Xi Jiao differ significantly in nature, flavor, and therapeutic action. Sheng Ma is used as a substitute because it guides the medicine into the Yangming channel. However, for Blood Stasis patterns, Sheng Ma cannot replace Xi Jiao. This formula also treats sores and rashes caused by excessive fire-toxin.