病有胸胁支满者，妨于食，病至则先闻腥臊臭，出清液，先唾血，四肢清，目眩，时时前、后血，何
以名之？（支满者，满如支膈也。肺主气，其臭腥，肝主血，其臭臊，肺其不能平肝，则肝肺俱
逆于上，浊气不降，清气不升，故闻腥臊而吐清液也。口中唾血，血不归经也。四肢清冷，气不能周也。
头目眩运，失血多而气随血去也。气既乱，故于前阴、后阴，血不时见，而月信反无期矣。）病名血枯。
此得之年少时有所大脱血，若醉入房中，气竭肝伤，故月事衰少不来也。（血枯者，月水断绝也。致此之由，
其原有二∶一则以少时有所大脱血，如胎产既多，及崩、淋、吐、衄之类，皆是也；一则以醉后行房，血
盛而热，因而纵肆，则阴精尽泄，精去则气去，故中气竭也，夫肾主闭，脏肝主疏泄，不惟伤肾，而且伤肝。
及至其久，则三阴俱亏，所以有先见诸证如上所云，而终必至于血枯，则月事衰少不来也。此虽以女子为言，
丈夫有犯前证，亦不免为精枯之病，则劳损之属皆是也。）治之何术？以四乌 骨、一 茹，二物并合之，丸
以雀卵，大如小豆，以五丸为后饭，饮以鲍鱼汁，利肠中及伤肝也。（后饭者，先药后饭也，乌 ，即乌
贼也，骨名海螵蛸，其气味咸温下行，故主女子赤白漏下及血闭、血枯，其性涩，故亦能令人有子。 茹，亦
名茹芦，即茜草也，气味甘寒无毒，能止血治崩，又能益精气，活血通经脉，作 茹者
非，盖 茹有毒，岂血枯者所宜？未之详耳。雀，即麻雀也。雀卵气味甘温，能补益精血，主男子阴痿不起，
故可使多精有子，及女子带下、便溺不利。鲍鱼，即今之淡干鱼也。诸鱼皆可为之，惟石首鲫鱼者为胜。其气
味辛温无毒。鱼本水中之物，故其性能入水脏，通血脉，益阴气，煮汁服之，能同诸药通女子血闭也，以上四
药，皆通血脉，血主于肝，故凡病伤肝者，亦皆可用之，血枯一症，与血膈相似，皆经闭不通之候。然而枯之
与膈，则相反有如冰炭。夫枯者，枯竭之谓，血虚之极也。膈者，阻隔之谓，血本不虚，而或气，或寒，
或积，有所逆也。膈者，病发于暂，其证
则或痛或实，通之则血行而愈，可攻者也，枯者，其来也渐，冲在内竭，其症无形，必不可通者也。今人每
用四物加桃仁、红花，甚至硝、朴、棱、莪之类，无所不至，夫血既枯矣，只当补养阴气，使其血充则勿招自
至，奚俟通也？若勉强逼之，则枯者愈枯，不危何待？）
有一种病症表现为胸胁部胀满支撑感，妨碍进食。发病时先闻到腥臊气味，流出清稀液体，先吐出唾血，四肢发冷，头晕目眩，时常出现前阴或后阴出血。这是什么病呢？（所谓支满，是指胀满如同有东西支撑膈膜。肺主气，其味为腥；肝主血，其味为臊。若肺气不能制约肝木，则肝肺之气俱逆于上，浊气不降，清气不升，所以会闻到腥臊气味并吐出清液。口中唾血，是因为血液不循常道运行。四肢发冷，是因为阳气不能周流全身。头目眩晕，是因为失血过多导致气随血脱。气机既已紊乱，所以在前阴和后阴处血液不时外溢，而月经反而没有定期了。）这种病名叫血枯。（此病是由于年轻时曾有大出血，或者醉酒后行房事，导致气竭肝伤，所以月经衰少甚至闭经不来。）（血枯，即月经断绝。导致这种情况的原因主要有二：一是年轻时曾有大量失血，如多次生育、崩漏、淋证、吐血、衄血等都属于此类；二是醉酒后行房，此时血盛且热，因而放纵情欲，导致阴精尽泄，精去则气去，所以中气衰竭。肾主封藏，肝主疏泄，这不仅伤了肾，也伤了肝。久而久之，三阴经都亏损，所以先出现上述各种症状，最终必然导致血枯，月经衰少不来。这里虽然以女子为例，男子如果犯了前面的病因，也不免患上精枯的病，属于劳损一类。）治疗用什么方法？用四份乌贼骨和一份茜草，将这两味药混合，用麻雀卵做丸剂，大小如小豆，每次服五丸，在饭后服用，用鲍鱼汁送服，这样可以通利肠道并修复受损的肝脏。（后饭，意思是先服药后进食。乌贼，就是乌贼鱼，其骨名为海螵蛸，气味咸温，性下行，所以主治女子赤白带下及血闭、血枯，因其性涩，所以也能帮助受孕。茹芦，即茜草，气味甘寒无毒，能止血治疗崩漏，又能补益精气，活血通经脉。说是“茹”的不是，因为茹有毒，岂是血枯者所宜？只是以前未曾详考罢了。雀，即麻雀。雀卵气味甘温，能补益精血，主治男子阳痿不起，所以能使多精有子，以及女子带下、小便不利。鲍鱼，即现在的淡干鱼。各种鱼都可以制作，只有石首鱼和鲫鱼做的最好。气味辛温无毒。鱼本是水中生物，所以其性能入水脏，通血脉，益阴气，煮汁服用，能配合其他药物通治女子血闭。以上四种药，都能通血脉，血由肝所主，所以凡是伤肝的病，也都适用。血枯这一症，与血膈相似，都是经闭不通的表现。然而枯与膈，性质相反犹如冰炭。所谓枯，是指枯竭，是血虚到了极点。所谓膈，是指阻隔，血本不虚，而是因为气滞、寒凝或积滞有所逆乱。膈证，发病短暂，症状或痛或实，通利则血行而愈，是可以攻逐的。枯证，来势缓慢，冲任在内枯竭，症状无形，绝对不可通利。现在的人常用四物汤加桃仁、红花，甚至使用芒硝、朴硝、三棱、莪术之类，无所不用。既然血已经枯竭，只应当补养阴气，使血液充盈则月经自然到来，何必强行通利呢？如果勉强逼迫它，那么枯竭的会更枯竭，不危险还等待什么呢？）
There is a disease characterized by distension and fullness in the chest and hypochondrium, which interferes with eating. Upon onset, the patient first perceives fishy and rank odors, secretes clear fluid, expectorates blood in saliva, experiences cold limbs, dizziness, and frequent bleeding from either the anterior or posterior orifice. What is this disease called? (Distension refers to a feeling of fullness as if obstructed by a support. The Lung governs Qi, its odor is fishy; the Liver governs Blood, its odor is rank. If Lung Qi fails to subdue Liver Wood, both Liver and Lung Qi rebel upwards, turbid Qi fails to descend, and clear Qi fails to ascend, hence the perception of fishy and rank odors and the vomiting of clear fluid. Saliva mixed with blood indicates that Blood does not follow its normal channels. Cold limbs indicate that Yang Qi cannot circulate throughout the body. Dizziness of the head and eyes results from excessive blood loss causing Qi to depart with the Blood. Since Qi mechanism is chaotic, blood appears intermittently from the anterior and posterior orifices, while menstruation becomes irregular.) This disease is named "Blood Depletion" (Xue Ku). It arises from significant blood loss in youth, or sexual intercourse while intoxicated, leading to exhaustion of Qi and injury to the Liver, resulting in scanty or absent menstruation. (Blood Depletion refers to the cessation of menses. There are two main causes: First, significant blood loss in youth, such as multiple pregnancies, metrorrhagia, leukorrhea, hematemesis, or epistaxis. Second, sexual intercourse after intoxication; when Blood is abundant and heat is generated, indulgence leads to the complete depletion of Yin Essence. When Essence is lost, Qi is lost, thus exhausting Middle Qi. The Kidney governs closure, and the Liver governs dispersion; this injures both the Kidney and the Liver. Over time, the Three Yin meridians are depleted, leading to the aforementioned symptoms and ultimately to Blood Depletion, where menstruation becomes scanty or ceases. Although described here regarding women, men suffering from similar etiologies will inevitably suffer from Essence Depletion, belonging to the category of consumptive diseases.) What is the treatment method? Use four parts of Sepiae Endoconcha (Hai Piao Xiao) and one part of Radix Rubiae (Qian Cao), combine these two substances, form pills using sparrow eggs, sized like small beans. Take five pills per dose, administered after meals, with dried cuttlefish (Bao Yu) decoction as the vehicle, to benefit the intestines and heal liver injury. ("After meal" means taking medicine before eating. Sepia refers to the cuttlefish; its bone is named Hai Piao Xiao. Its flavor is salty and warm, with a descending nature, thus treating leukorrhea, blood stasis, and blood depletion in women. Due to its astringent nature, it also promotes fertility. Qian Cao, also known as Ru Lu, is Rubia cordifolia. Its flavor is sweet and cold, non-toxic; it stops bleeding, treats metrorrhagia, tonifies Essence and Qi, invigorates Blood, and unblocks meridians. The herb referred to as "Ru" is incorrect, as Ru is toxic and unsuitable for blood depletion; this was likely due to lack of detailed examination. Sparrow eggs have a sweet and warm flavor, tonifying Essence and Blood, treating male impotence, promoting fertility, and addressing female leukorrhea and difficult urination. Bao Yu refers to dried salted fish. Various fish can be used, but those from Sciaenidae or Carassius auratus are superior. Its flavor is pungent and warm, non-toxic. As aquatic creatures, their nature enters the Water Zang organs, unblocks blood vessels, and nourishes Yin Qi. Decoction taken with other herbs helps treat female blood stasis. All four ingredients above unblock blood vessels. Since Blood is governed by the Liver, they are applicable to any disease injuring the Liver. Blood Depletion resembles Blood Obstruction (Xue Ge), both presenting as amenorrhea. However, Depletion and Obstruction are opposites, like ice and charcoal. Depletion implies exhaustion, extreme Blood deficiency. Obstruction implies blockage; Blood is not deficient, but blocked by Qi stagnation, Cold, or accumulation. Obstruction is acute, presenting with pain or excess signs; unblocking resolves it, making it suitable for purgative treatment. Depletion develops gradually, with internal exhaustion of Chong and Ren meridians, presenting without有形 signs, and absolutely contraindicated for unblocking/purging. Currently, physicians often use Si Wu Tang plus Persicae Semen (Tao Ren) and Carthami Flos (Hong Hua), even employing Mirabilite (Xiao Ming Fan), Glauber's Salt (Pu Xiao San), Bupleuri Radix (San Leng), and Curcumae Rhizoma (E Zhu). Since Blood is already depleted, one should only tonify Yin Qi; once Blood is replenished, menstruation will return naturally. Why force unblocking? Forcing it will exacerbate depletion, leading to danger.)