生生子曰∶经云∶怒则伤肝，甚则呕血并飧泄。又曰∶心主血，肝藏血，脾统血。怒气上逆，
则脾气受伤，所藏所统之血，皆妄行而错乱也。古方有用芎附饮治之而效者，良由川芎、香附，能
调肝气，气和而血归经也。丹溪有用桂五钱为末，冷水调服者。缘桂能和荣卫，通血脉，木得桂而
枯，且又为从治之法，故不独恃寒凉为治也。必须参之脉证，如脉微弱虚软，精神疲惫，急当独参
汤进之。如脉洪大弦长有力，精神不倦，或觉胸中气塞，或血是紫黑块者，当以承气汤下之，此釜底
抽薪法也。若势缓而色鲜红，宜以葛可久十灰散、阿胶、血余灰之类止之。或调气，或下或止，全在
临症活法，勿得执一以戕生也。
滑伯仁曰∶血溢、血泄、诸蓄妄证，其治也，予率以桃仁、大黄行血破瘀之剂，以折其锐，而后
区别治之。或问∶失血复下，虚何以当行血破瘀之剂？予曰∶血既妄行，迷失其道，不去蓄利，则以妄
为常。曷以御之？且去者自去，生者自生，何虚之有。且如妇人行经，有五六日不止者，有十数日不止
者，可见去
者自去，生者自生也；乳妇亦然。
生生子曰∶时师治血，爱用寒凉，每每畏用温、补二法，亦偏见也。夫有寒当温，有虚当补，
圣哲不能废其规，但要体认切当，毋轻举也。假使胃寒，或久为寒凉所激，以至血不归经，不温
可乎？暴吐暴衄，昏运软倒，不补可乎？故王海藏治饮冷伤脾吐血，以理中汤理治中脘，分利阴
阳，此亦理治内衄之法也。《三因方》曰∶理中汤能止伤胃吐血，以其功最理中脘，分利阴阳，
安定血脉。葛可久治吐血昏运，用独参汤。仲景曰∶血脱益气。东垣曰∶阳生阴长。皆有旨趣，实
法在当用而用也。设若阴虚火动，咳嗽已久，肺有伏火，痰带血丝，或紫色血屑，又当滋阴润肺，
开郁清痰，而前剂未敢以轻试也。是知咳血、嗽血、痰带血丝，惟当滋阴润肺为先，暴吐昏运，却
宜补虚温脾为最。全在体察病源，勿致偏癖，斯为良师。
滑伯仁曰∶诸见血非寒证，皆以为血热所迫，遂至妄行；热皆复有所挟也，或挟风，或挟湿，或
挟气。又有因药石而发者。其本皆然，上中下治，各有所宜。在上，则栀子、黄芩、黄连、芍药、犀
角、蒲黄，而济以生地、牡丹皮之类。胃血，古人有胃风汤，正是
以阳明火邪，为风所扇，而血为之动。中间有桂，取其能伐木也，若苍术、地榆、白芍药之类，而济
以火剂。大肠血、以手阳明火邪，为风为湿也，治以火剂、风剂，风能胜湿也。如黄连、芩、芍药。
柏皮、荆芥、防风、羌活之类，兼用鸡冠花，则述类之义也。
又曰∶惊而动血者属心，怒而动血者属肝，忧而动血者属肺，思而动血者属脾，劳而动血者属肾。
生生子说：医经记载：“发怒会损伤肝脏，严重时会导致呕血和完谷不化的泄泻。”又说：“心主司血液，肝贮藏血液，脾统摄血液。”怒气上逆，就会损伤脾气，导致肝所藏、脾所统的血液都妄行错乱。古代方剂中有用芎附饮治疗而见效的，这主要是因为川芎、香附能够调理肝气，肝气调和则血液回归经脉。朱丹溪曾用桂枝五钱研为末，用冷水调服。因为桂枝能调和营卫，通行血脉，且根据“木得桂而枯”的理论，以及这是“从治”（顺其性而治）的方法，所以不仅仅依赖寒凉药物来治疗。必须结合脉象和证候来判断，如果脉象微弱虚软，精神疲惫，应当立即服用独参汤。如果脉象洪大弦长有力，精神不倦，或者感觉胸中气机堵塞，或者吐出的血是紫黑色的血块，应当用承气汤攻下，这是“釜底抽薪”的治疗方法。如果病情较缓且血色鲜红，适宜用葛可久的十灰散、阿胶、血余炭等药物止血。或者是调理气机，或者是攻下，或者是止血，全凭临症时的灵活变通，不要固执一端而伤害生命。
滑伯仁说：对于血溢、血泄以及各种蓄积妄行的病证，我的治疗方法通常是先用桃仁、大黄等行血破瘀的药剂，以挫败其锐势，然后再区别对待进行治疗。有人问：失血之后又用攻下法，身体虚弱怎么能承受行血破瘀的药剂呢？我说：血液既然妄行，迷失了正道，如果不去除蓄积的瘀血并疏通脉络，就会把妄行当作常态。用什么来抵御它呢？况且，去掉的自会去掉，新生的自会新生，有什么虚的呢？就像妇女行经，有五六天不止的，有十几天不止的，可见去者自去，生者自生；哺乳期的妇女也是如此。
生生子说：当时的医生治疗出血证，喜欢用寒凉药，常常畏惧使用温补两种方法，这也是偏见。如果有寒邪应当温煦，有虚损应当补益，即使是圣哲也不能废弃这些规则，只是要体察认识得当，不要轻易用药。假如胃寒，或者长期被寒凉药刺激，以至于血液不能归经，不用温法可以吗？突然大量吐血或鼻衄，出现昏厥、肢体软弱倒下，不用补法可以吗？所以王海藏治疗因饮冷伤脾导致的吐血，用理中汤调理中脘，分利阴阳，这也是调理内伤出血的方法。《三因方》说：理中汤能止住因伤胃导致的吐血，因为它最能调理中脘，分利阴阳，安定血脉。葛可久治疗吐血昏厥，用独参汤。张仲景说：血脱当益气。李东垣说：阳生阴长。这些都有深意，实际在于该用时就用。如果是阴虚火动，咳嗽已久，肺中有伏火，痰中带血丝，或是紫色血屑，又应当滋阴润肺，开郁清痰，前面的温补药剂不敢轻易尝试。由此可知，咳血、嗽血、痰带血丝，只应当以滋阴润肺为先；暴发性吐血伴昏厥，却适宜以补虚温脾为最。全在于体察病源，不要导致偏颇，这才是良医。
滑伯仁说：各种见血证并非都是寒证，都认为是血热逼迫，以至于妄行；热邪往往有所挟带，有的挟风，有的挟湿，有的挟气。又有因服药不当引发的。其根本原因虽然相同，但上、中、下三焦的治疗各有适宜之法。在上焦，则用栀子、黄芩、黄连、芍药、犀角、蒲黄，辅以生地、牡丹皮之类。胃部的出血，古人有用胃风汤治疗的，正是针对阳明火邪被风煽动，导致血液妄行。方中有桂枝，取其能伐肝木的作用，若用苍术、地榆、白芍药之类，辅以清热之剂。大肠出血，是因为手阳明火邪，被风、湿所挟，治疗用清热剂、祛风剂，风能胜湿。如黄连、黄芩、芍药、黄柏、荆芥、防风、羌活之类，兼用鸡冠花，这是取“述类”的意义。
Shengshengzi said: The Classics state, "Anger injures the Liver; in severe cases, it leads to hematemesis (vomiting blood) and飧泄 (diarrhea with undigested food)." It also states, "The Heart governs Blood, the Liver stores Blood, and the Spleen controls Blood." When anger causes Qi to rebel upwards, it damages the Spleen Qi. Consequently, the Blood stored by the Liver and controlled by the Spleen will flow recklessly and become disordered. In ancient prescriptions, Xiongfu Yin (Cnidium and Cyperus Decoction) was used with success. This is primarily because Chuanxiong Rhizoma (Chuanxiong) and Cyperi Rhizoma (Xiangfu) can regulate Liver Qi; when Liver Qi is harmonized, Blood returns to its vessels. Zhu Danxi once prescribed Cinnamomi Ramulus (Guizhi) five qian as powder, mixed with cold water for administration. This is because Guizhi can harmonize Ying and Wei (Nutritive and Defensive Qi), unblock blood vessels, and according to the theory that "Wood withers when encountering Cinnamon," along with being a method of "concordant treatment" (treating by following the nature of the pathogen), it shows that one should not rely solely on cold-cooling herbs for treatment. One must consider the pulse and symptoms together. If the pulse is weak, thready, and soft, and the spirit is exhausted, Dushen Tang (Single Ginseng Decoction) should be administered immediately. If the pulse is surging, wiry, long, and forceful, and the spirit is not fatigued, or if there is a sensation of Qi obstruction in the chest, or if the vomited blood consists of dark purple clots, Chengqi Tang (Gut-Draining Decoction) should be used to purge, which is the method of "removing firewood from under the cauldron" (treating the root cause). If the condition is mild and the blood color is bright red, Ge Keljiu's Shihui San (Ten Charred Powders Powder), Ejiao (Donkey-Hide Gelatin), or Xueyu Tan (Charred Human Hair) should be used to stop bleeding. Whether regulating Qi, purging, or stopping bleeding depends entirely on flexible clinical judgment; do not adhere rigidly to one method and harm life.
Hua Borun said: Regarding conditions such as blood extravasation, bloody discharge, and various signs of reckless bleeding due to accumulation, my usual treatment is to first use formulas containing Tao Ren (Persicae Semen) and Dahuang (Rhei Radix et Rhizoma) to move blood and break up stasis, thereby subduing the acute severity, before distinguishing and treating specifically. Someone asked: After loss of blood, how can the deficiency tolerate blood-moving and stasis-breaking agents? I replied: Since the blood is flowing recklessly and has lost its proper course, if we do not remove the accumulated stasis and promote circulation, the reckless flow will become the norm. How else can we control it? Moreover, what leaves will leave, and what generates will generate; where is the deficiency? Consider menstruation in women; some last for five or six days without stopping, others for ten-plus days. This shows that what goes goes, and what is generated is generated; this applies similarly to lactating women.
Shengshengzi said: Contemporary physicians treating bleeding disorders love using cold-cooling herbs and are often afraid to use warming and tonifying methods. This is also a biased view. If there is cold, it should be warmed; if there is deficiency, it should be tonified. Even sages cannot discard these principles, but one must understand them accurately and not act lightly. Suppose there is Stomach cold, or prolonged irritation by cold-cooling herbs leading to blood failing to return to its vessels; can warming be omitted? In cases of sudden massive hematemesis or epistaxis accompanied by fainting and flaccidity, can tonification be omitted? Therefore, Wang Haicang treated hematemesis caused by drinking cold damaging the Spleen using Lizhong Tang (Regulate the Middle Decoction) to regulate the Zhongwan area and separate Yin and Yang. This is also a method for treating internal bleeding. The *San Yin Fang* states: Lizhong Tang can stop hematemesis caused by Stomach injury because its function best regulates the middle Jiao, separates Yin and Yang, and stabilizes the blood vessels. Ge Keljiu treated hematemesis with fainting using Dushen Tang. Zhang Zhongjing stated: "When blood is depleted, benefit Qi." Li Dongyuan stated: "When Yang grows, Yin grows." All these have profound meaning; the practical application lies in using them when appropriate. However, if there is Yin deficiency with Fire hyperactivity, chronic cough, latent Fire in the Lungs, phlegm with blood streaks, or purple blood flakes, one should instead nourish Yin and moisten the Lungs, resolve stagnation, and clear phlegm. The previous warming/tonifying formulas dare not be tried lightly. Thus, it is known that for hemoptysis, expectoration of blood, or phlegm with blood streaks, nourishing Yin and moistening the Lungs should be prioritized. For sudden massive vomiting of blood with fainting, tonifying deficiency and warming the Spleen is most suitable. It all depends on investigating the source of the disease to avoid bias; this makes a good physician.
Hua Borun said: Various bleeding disorders are not all cold syndromes; they are generally considered to be forced by Heat in the Blood, causing reckless flow. Heat often coexists with other pathogens, such as Wind, Dampness, or Qi. There are also cases triggered by improper medication. Although the root causes may be similar, treatments for the Upper, Middle, and Lower Jiao differ. For the Upper Jiao, use Gardeniae Fructus (Zhizi), Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Paeoniae Radix Alba (Baishao), Rhinocerotis Cornu (Xijiao - note: now substituted with Buffalo Horn), and Polygoni Multiflori Caulis (Puhuang), supplemented by Rehmanniae Radix (Disheng) and Moutan Cortex (Mudanpi). For Stomach bleeding, ancients used Weifeng Tang (Stomach Wind Decoction), which addresses Yangming Fire pathogen fanned by Wind, causing blood disturbance. The formula contains Cinnamomi Ramulus (Guizhi) to subdue Wood (Liver). For other cases, use Atractylodis Rhizoma (Cangzhu), Sanguisorbae Radix (Diyu), and Paeoniae Radix Alba, supplemented by heat-clearing agents. For Large Intestine bleeding, it is due to Hand-Yangming Fire pathogen combined with Wind and Dampness. Treatment uses heat-clearing and wind-dispelling agents, as Wind can overcome Dampness. Examples include Coptidis Rhizoma, Scutellariae Radix, Paeoniae Radix Alba, Phellodendri Cortex (Huangbai), Schizonepetae Spica (Jingjie), Saposhnikoviae Radix (Fangfeng), and Notopterygii Rhizoma et Radix (Qianghuo). Adding Celosiae Cristatae Flos (Jiguanhua) follows the principle of "describing the category" (using herbs related to the symptom/form).
He also said: Bleeding triggered by fright belongs to the Heart; bleeding triggered by anger belongs to the Liver; bleeding triggered by worry belongs to the Lung; bleeding triggered by overthinking belongs to the Spleen; bleeding triggered by fatigue belongs to the Kidney.