桃仁五十粒（去皮尖，研） 大黄四两 芒硝 甘草 桂枝一两
此方《准绳》以为当用桂，喻西江等以为当用枝。予则以为主治注中有“外症不解”一
语，此四字最为着眼，有桃仁、大黄、芒硝、甘草以治里，必当用桂枝以解表。仲景立方固
无遗
水蛭三十个（猪脂熬黑） 虻虫三十个（去头足翅） 桃仁二十枚（去皮尖，研） 大
黄四两（酒浸）
此症虽瘀热结于少腹极阴之处，不得以里症名之，盖膀胱乃太阳本经之病，非由太阳传
里之症。但水蛭、虻虫二味，人不敢用，即代抵当丸，尚嫌其太峻。
槐花（炒） 侧柏叶（杵） 荆芥（炒黑） 枳壳（炒）
等分为末，每三钱米饮下。
陈修园云∶“五脏各有守经之血，六腑无血，试看猪、羊肠胃中，岂有一丝一点之血？
世人谓巨口吐红为胃血者，妄也。”此说颇有识解，惜其但见得一层，尚遗漏一层。予特申
明之，夫五脏主藏，故各有守脏之血；六腑主传，故无守腑之血。方其无病之时，胃中纳水
谷，大小肠传糟粕。肠胃中本无血也，血但流灌于腑外，以荣养之。《经》所谓“洒陈六腑”，
此一语不得滑口读过。迨至火势冲激，或湿热熏蒸，逼血入于腑中，腑不能容，随受亦随出
矣。故血淋、尿血，血之由小肠而出者也；泻血、痔血，血之由大肠而出者也。大小肠既有
血症，而胃独无血症，有是理乎？胃经之血随火上升，直从食管而出，往往盈碗、盈盆。至
内伤之血，则由肺经气管而出，自是两途。故胃血易治，肺血难治。数千年来，从未有将无
血而有血之故彻底发明者，予故因论槐花散一方，而详及之。
槐花散，寒凉太过，肠风下血，中气必虚，再用阴寒，血更凝结。方中去柏叶，加参、
术、当归、陈皮、甘草，庶有瘳乎？
此方在《准绳》中认为应当使用桂心，喻西江等人认为应当使用桂枝。我则认为主治说明中有“外症不解”这一句话，这四个字最为关键，有桃仁、大黄、芒硝、甘草来治疗里证，必定当用桂枝来解表。张仲景创立方剂固然没有遗漏。
水蛭三十个（用猪脂熬至黑色） 虻虫三十个（去掉头足翅） 桃仁二十枚（去皮尖，研碎） 大黄四两（酒浸）
此症虽然是瘀热结聚于少腹极阴之处，不能将其称为里证，因为膀胱是太阳本经的病，不是由太阳传变入里的病症。只是水蛭、虻虫这两味药，人们不敢使用，即使是代抵当丸，还嫌其药性太峻猛。
等分为末，每次三钱，用米汤送服。
陈修园说：“五脏各有守经之血，六腑没有血，请看猪、羊的肠胃中，难道有一丝一毫的血吗？世人谓大口吐血为胃血，这是荒谬的。”这种说法很有见识，可惜只看到了一层，还遗漏了一层。我特意加以阐明，五脏主藏精，所以各有守护脏器的血；六腑主传导，所以没有守护腑器的血。在没有病的时候，胃中容纳水谷，大小肠传导糟粕。肠胃中本来就没有血，血只是流灌于腑外，以荣养它们。《内经》所说的“洒陈六腑”，这句话不能轻易滑过不读。等到火势冲激，或湿热熏蒸，逼迫血液进入腑中，腑不能容纳，随即受纳随即排出。所以血淋、尿血，是血从小肠排出的；泻血、痔血，是血从大肠排出的。大小肠既然有血症，而胃唯独没有血症，有这样的道理吗？胃经的血随着火气上升，直接从食管而出，往往满碗、满盆。至于内伤引起的出血，则是从肺经气管而出，自然是两条途径。所以胃血容易治疗，肺血难治。几千年来，从未有人将无血而有血的缘故彻底阐明，我因此借评论槐花散一方，而详细谈及此事。
槐花散，寒凉太过，肠风下血，中气必然虚弱，再用阴寒药物，血会更加凝结。方中去掉柏叶，加入人参、白术、当归、陈皮、甘草，或许会有痊愈吧？
Tao Ren (Persicae Semen) fifty grains (remove skin and sharp ends, grind) Da Huang (Rhei Radix et Rhizoma) four liang Mang Xiao (Natrii Sulfas) Gan Cao (Glycyrrhizae Radix et Rhizoma) Gui Zhi (Cinnamomi Ramulus) one liang.
This formula in *Zhun Sheng* is considered to use Gui Xin (Cinnamomi Cortex), while Yu Xijiang and others consider it should use Gui Zhi (Cinnamomi Ramulus). I believe that the main indication contains the phrase "external symptoms unresolved," these four characters are most crucial. With Tao Ren (Persicae Semen), Da Huang (Rhei Radix et Rhizoma), Mang Xiao (Natrii Sulfas), and Gan Cao (Glycyrrhizae Radix et Rhizoma) treating the interior syndrome, Gui Zhi (Cinnamomi Ramulus) must be used to release the exterior. Zhang Zhongjing's creation of formulas was indeed without omission.
Shui Zhi (Hirudo) thirty pieces (boiled with pig fat until black) Meng Chong (Blephararis or similar insect) thirty pieces (remove head, feet, and wings) Tao Ren (Persicae Semen) twenty seeds (remove skin and sharp ends, grind) Da Huang (Rhei Radix et Rhizoma) four liang (soaked in wine).
Although this syndrome involves blood stasis and heat knotting in the lower abdomen at a deeply yin location, it cannot be named an interior syndrome, because the Bladder is the disease of the Taiyang primary channel, not a syndrome transmitted from Taiyang to the interior. However, Shui Zhi (Hirudo) and Meng Chong are two herbs that people dare not use; even Dai Dang Wan (Substitute Dredging Pill) is still considered too harsh.
Huai Hua (Sophorae Flos) (stir-fried) Ce Bai Ye (Platycladi Cacumen) (pounded) Jing Jie (Schizonepetae Spica) (stir-fried until black) Zhi Ke (Aurantii Fructus Immaturus) (stir-fried).
Pulverize equally into powder, take three qian each time, administered with rice water.
Chen Xiuyuan said: "Each of the Five Zang organs has blood guarding its channels, but the Six Fu organs have no blood. Look at the intestines and stomach of pigs and sheep, is there not a trace of blood? People who claim that vomiting large amounts of blood is stomach blood are mistaken." This view shows insight, but unfortunately only sees one layer, missing another. I specifically clarify it: The Five Zang organs govern storage, so each has blood guarding the zang; the Six Fu organs govern transmission, so they have no blood guarding the fu. When free from disease, the Stomach receives water and grain, and the Small and Large Intestines transmit waste. There is originally no blood in the intestines and stomach; blood merely flows around the outside of the fu organs to nourish them. The *Jing* (Classic) says "sprinkle and arrange the Six Fu organs"; this phrase should not be read over casually. When fire heat rushes and attacks, or damp-heat steams and薰s, forcing blood into the fu organs, the fu cannot contain it, so it is received and then expelled immediately. Therefore, Blood Lin (Dysuria with Blood) and Hematuria are blood exiting from the Small Intestine; Bloody Diarrhea and Hemorrhoidal Bleeding are blood exiting from the Large Intestine. If the Small and Large Intestines both have blood syndromes, can it be that the Stomach alone has no blood syndrome? Is this logical? Blood from the Stomach Channel rises with fire, exiting directly from the esophagus, often filling bowls and basins. As for bleeding due to internal injury, it exits from the Lung Channel trachea; these are naturally two different pathways. Therefore, stomach blood is easy to treat, while lung blood is difficult to treat. For thousands of years, no one has thoroughly elucidated the reason for having blood where there is none. Thus, through discussing the Huai Hua San (Sophorae Flos Powder) formula, I elaborate on this matter.
Huai Hua San (Sophorae Flos Powder) is overly cold and cooling. For Intestinal Wind Lowering Blood (Intestinal Wind causing bloody stool), the Middle Qi must be deficient; using more yin-cold substances will cause the blood to coagulate further. Remove Ce Bai Ye (Platycladi Cacumen) from the formula, add Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Dang Gui (Angelicae Sinensis Radix), Chen Pi (Citri Reticulatae Pericarpium), and Gan Cao (Glycyrrhizae Radix et Rhizoma); perhaps there will be improvement?