生生子曰∶咳血多是火郁肺中，治宜清肺降火，开郁消痰，咳止而血亦止也。不可纯用血药，使
气滞痰塞，而郁不开，咳既不止，血安止哉！设下午身热，而脉细数，此真阴不足，当清上补下。
生生子曰∶有侄女十岁，因毁齿动摇，以苎麻摘之，血因出不止，以小瓦盆盛之，一日夜积十一盆
，用
末药止其处，少顷复从口中吐出，身亦不倦，亦事之希觏也。可见人身之血，不可测量。诊其脉，皆
洪大有力。以三制将军末子二钱，用枳壳汤少加童便调下。是夜之半，去黑粪数块，其血顿止，再不复
发。后又见一男子，每齿根出血盈盆，一月一发，百药不效，历十余月。每发则昏昧，知其人好饮，
投前剂一服而安。
又一老妪患此，一发五七日，一日约有升余，投前剂亦安，所下皆有黑粪。是知此疾，多阳明热盛
所至者。缘冲、任二脉，皆附阳明，阳明者，多气多血之经也。故一发如潮涌。急则治其标，故投以
釜底抽薪之法，应手而愈。要知肾虚血出者，其血必点滴而出，齿或攸攸而疼，必不如此之暴且甚。
有余不足，最要详认。
有谓作诸禁鼓栗者，非也。诸禁鼓栗，乃斗牙战摇，似寒而实热也。夫颤振，乃兼木气而言，
惟手足肘前战动，外无凛栗之状。
生生子曰∶颤振者，人病手足摇动，如抖擞之状，筋脉约束不住，而莫能任持，风之象也。《内经
》云∶诸风掉眩，皆属肝木。木主风，风为阳气，阳主动，此木气太过，而克脾土，脾主四肢，四肢者，
诸阳之末，木气鼓之故动，经谓“风淫末疾”者此也，亦有头动而手足不动者，盖头乃诸阳之首，木气
上冲，故头独动而手足不动∶散于四末，则手足动而头不动也。皆木气太过，而兼火之化也。木之畏在金
，金者土之子，土为木克，何暇生金。《素问》曰∶“肝，一阳也，心，二阳也，肾，孤脏也。一水不
能胜二火。”由是木挟火势而寡于畏，反侮所不胜，直犯无惮，《难经》谓木横乘金者
是也。此病壮年鲜有，中年以后乃有之，老年尤多。夫老年阴血不足，少水不能灭盛火，极为难治，
前哲略不及之，惟张戴人治新寨马叟，作木火兼痰而治，得效。遇此症者，当参酌厥旨，而运其精
思云。
生生子说：咳血大多是由于火邪郁结在肺中，治疗应当清泻肺热、降逆火势、开通郁结、消除痰浊，咳嗽停止后出血自然也会停止。不能单纯使用止血药物，否则会导致气机阻滞、痰湿堵塞，使得郁结无法解开，咳嗽既然不停止，出血又怎能停止呢！如果患者下午身体发热，且脉象细而数，这是真阴不足的表现，应当清上焦之火并补益下焦之阴。
生生子说：我有一个十岁的侄女，因为换牙时牙齿松动，用苎麻去拔它，导致出血不止。我们用小瓦盆接血，一天一夜积了十一盆。我们在出血处敷上药末，过了一会儿血又从口中吐出，但病人身体并不疲倦，这也是世间罕见的事情。由此可见，人体的血量是不可估量的。诊察她的脉象，都是洪大有力。我们给她服用经过三次炮制的大黄粉二钱，用枳壳汤稍微加一点童便调服。当天半夜，排出了几块黑粪，出血立刻停止，再也没有复发。后来我又见到一个男子，每次牙龈出血都能装满一盆，每月发作一次，各种药物都无效，持续了十多个月。每次发作时都会神志昏沉，我知道他喜欢饮酒，于是给他服用前面的方剂，服药一次就安稳了。
后来又有一位老妇人患此病，每隔五到七天发作一次，每天大约出血一升多，服用前面的方剂也见效，所排出的也都是黑粪。由此可知，这种疾病大多是由阳明经热盛引起的。因为冲脉和任脉都依附于阳明经，阳明经是多气多血的经脉。所以出血像潮水一样涌出。急则治其标，所以采用釜底抽薪的方法（清除下部实热以止上部出血），药到病除。要知道如果是肾虚导致的出血，血液一定是点滴而出，牙齿可能会有隐隐作痛，绝不会如此突然且严重。有余和不足的情况，最需要仔细辨认。
有人说颤抖伴随禁闭和鼓栗（寒战），这不是颤振。所谓的禁闭和鼓栗，是指咬牙战抖，看起来像寒证但实际上是热证。而颤振，是兼有木气（肝风）而言的，只有手肘和膝盖前的部位颤抖动摇，外部没有寒冷战栗的样子。
生生子说：颤振，是指病人手足摇动，像抖动衣服一样的状态，筋脉约束不住肢体，不能保持静止，这是风的征象。《内经》说：“各种风病引起的掉眩（摇动眩晕），都属于肝木。”木主风，风属于阳气，阳气主动，这是因为木气太过，克制了脾土。脾主四肢，四肢是诸阳之末，被木气鼓动所以发生动摇，经文所说的“风淫末疾”就是这个意思。也有头部动摇而手足不动的，这是因为头是诸阳之首，木气上冲，所以只有头部动摇而手足不动；如果风气散播于四肢末端，则是手足动摇而头部不动。这些都是木气太过，并且兼有火的化生所致。木畏惧金，金是土的子孙，土被木克制，哪里还有余力去生金？《素问》说：“肝属一阳，心属二阳，肾是孤脏。一水不能胜二火。”因此木挟带火势而缺乏畏惧，反而侮弄其所不胜（金），直接侵犯而无顾忌，《难经》所说的木横逆乘金就是这种情况。这种病在壮年人中很少见，中年以后才有，老年人尤其多。因为老年人阴血不足，少水不能灭盛火，极难治疗，前代名医对此略而不谈，只有张戴人治疗新寨的马叟，将其作为木火兼痰来治疗，取得了效果。遇到这种病症的人，应当参考上述宗旨，运用精妙的思考来诊治。
Shengshengzi said: Hemoptysis (coughing up blood) is mostly caused by fire pathogen stagnating in the Lung. The treatment should focus on clearing Lung heat, descending rebellious fire, opening stagnation, and resolving phlegm; once the cough stops, the bleeding will also cease. One must not solely use hemostatic herbs, as this may cause Qi stagnation and phlegm obstruction, preventing the resolution of stagnation. If the cough does not stop, how can the bleeding stop? If the patient has afternoon fever and a fine, rapid pulse, this indicates deficiency of True Yin. In such cases, one should clear the Upper Jiao and tonify the Lower Jiao.
Shengshengzi said: I had a niece who was ten years old. Because her teeth were loose during the shedding of deciduous teeth, she pulled them out using *Boehmeria nivea* (Ramie) fibers, causing continuous bleeding. We collected the blood in small earthenware basins, accumulating eleven basins over one day and night. We applied powdered medicine to the wound site, but shortly after, the blood was vomited from the mouth again. However, the patient did not appear fatigued, which is a rare occurrence. This demonstrates that the volume of blood in the human body is immeasurable. Upon palpation, her pulses were all surging, large, and forceful. We administered two qian of *Rhei Radix et Rhizoma* (Rhubarb Root and Rhizome), processed three times, mixed with a decoction of *Aurantii Fructus Immaturus* (Bitter Orange Fruit) and a small amount of fresh urine from a healthy male child (Tongbian). By midnight that night, she passed several pieces of black stool, and the bleeding stopped immediately without recurrence. Later, I encountered a man whose gums bled enough to fill a basin each time, occurring once a month for over ten months despite various treatments. Each episode was accompanied by mental cloudiness. Knowing he enjoyed drinking alcohol, I prescribed the previous formula. He recovered after a single dose.
Another elderly woman suffered from the same condition, recurring every five to seven days, with daily blood loss exceeding one sheng. She also improved with the previous formula, passing black stools. Thus, it is known that this disease is often caused by excessive heat in the Yangming channel. The Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) are both attached to the Yangming channel. The Yangming channel is rich in Qi and Blood. Therefore, the bleeding surges like a tide. In acute conditions, treat the branch (symptoms); thus, employing the method of "removing firewood from under the cauldron" (clearing lower excess heat to stop upper bleeding) resulted in immediate recovery. It must be understood that if bleeding is due to Kidney deficiency, the blood will drip out slowly, and the teeth may ache faintly; it will never be so sudden and severe. Differentiating between excess and deficiency is crucial.
Some claim that tremors accompanied by locking of the jaw and shivering are not Zhenzhen (tremor/twitching). "Jin Gu Li" refers to grinding teeth and shivering, which appears cold but is actually heat. Zhenzhen, however, involves Wood Qi (Liver Wind). It manifests only as trembling of the hands, elbows, knees, and feet, without external signs of cold or shivering.
Shengshengzi said: Zhenzhen refers to a disease where the patient's hands and feet shake, resembling the act of shaking off dust. The sinews and vessels cannot restrain the limbs, making them unable to maintain stillness; this is a manifestation of Wind. The *Neijing* states: "All wind diseases involving shaking and dizziness belong to Liver Wood." Wood governs Wind; Wind belongs to Yang Qi, and Yang Qi is active. When Wood Qi is excessive, it overacts on Spleen Earth. The Spleen governs the four limbs, which are the extremities of all Yang channels. The movement is caused by the stirring of Wood Qi, which is what the classics refer to as "Wind invading the extremities causes disease." There are cases where only the head moves while the limbs remain still. This is because the head is the summit of all Yang channels; when Wood Qi rushes upward, only the head moves. If the Qi disperses to the four extremities, the hands and feet move while the head remains still. These are all cases of excessive Wood Qi combined with Fire transformation. Wood fears Metal. Metal is the offspring of Earth. If Earth is controlled by Wood, it has no spare capacity to generate Metal. The *Suwen* says: "The Liver is one Yang, the Heart is two Yang, and the Kidney is an isolated Zang organ. One Water cannot overcome two Fires." Consequently, Wood carries Fire and lacks fear (of Metal), instead insulting what it cannot conquer (Metal), attacking without restraint. This is what the *Nanjing* refers to as "Wood overflowing and overcoming Metal." This disease is rare in young adults, appearing after middle age, and is especially common in the elderly. Since the elderly suffer from insufficient Yin and Blood, and little Water cannot extinguish flourishing Fire, it is extremely difficult to treat. Previous masters rarely discussed it. Only Zhang Dairen treated an old man named Ma from Xinzhai, diagnosing it as a combination of Wood-Fire and Phlegm, achieving success. Those encountering this syndrome should refer to these principles and apply profound thought in their diagnosis and treatment.