凡治吐血宜降气，不宜降火；宜行血，不宜止血；宜补肝，不宜伐肝。何谓宜降气不宜
降火
也？气有余便是火，气降则火降，火降则气不上升，血随气行，无滥出上窃之患矣。降火必
用寒凉之剂，反伤胃气，胃气伤，则不能统血，血愈不能归经矣。今之疗吐血者，大患有二
。一则专用寒凉，如芩、连、山栀、青黛、柿饼灰，四物汤加知、柏之类，往往伤脾作泄，
以致不救。一则专用人参，以致肺热，使肺愈伤，咳逆愈甚。亦有用参而获效者，此是气虚
嗽咳，气属阳，不由阴虚火炽所致，然亦百不一二也，宜以白芍、炙甘草制肝，枇杷叶、麦
冬、橘红、贝母、薄荷清肺，米仁、山药养脾，韭菜、降香、苏子下气，青蒿、鳖甲、银柴
胡、地骨皮补阴清热，枣仁、茯神养心，地黄、山萸、枸杞、牛膝补肾，此屡试辄验之方。
然阴无骤补之法，非多服不效。病家欲速其功，医者张皇无主，百药杂试，以致陨命，覆辙
相寻而不悟，悲夫！何谓宜行血不宜止血也？血不循经络者，气逆上壅也。夫血得热则行，得
寒则凝，故降气行血，则血循经络，不求止而自止矣。若有意止血则血凝。血凝则必发热恶
食，及胸胁痛，病日沉痼矣！何谓宜补肝不宜伐肝也？经曰∶五脏者，藏精气而不泻者也。肝
为将军之官，主藏血。吐血者，肝失其职也，养肝则肝气平而血有归，伐之则肝虚不能藏血
，血愈不止矣。此三者，乃余独得之要，当为斯世告之。
大凡治疗吐血，适宜降气，不适宜降火；适宜行血，不适宜止血；适宜补肝，不适宜伐肝。
为什么说适宜降气而不适宜降火呢？气有余便是火，气降则火降，火降则气不上升，血随气运行，就不会有血液妄行上溢的祸患了。降火必须使用寒凉的药物，反而损伤胃气，胃气受伤，就不能统摄血液，血液更加不能回归经脉了。如今治疗吐血的人，主要的弊病有两个。一是专门使用寒凉药物，如黄芩、黄连、山栀、青黛、柿饼灰，以及四物汤加入知母、黄柏之类，往往损伤脾胃导致腹泻，以至于无法挽救。二是专门使用人参，导致肺热，使肺更加受伤，咳嗽气逆更加严重。也有使用人参而获效的，这是气虚引起的咳嗽，气属阳，不是由阴虚火旺所致，然而这种情况百中无一二，适宜用白芍、炙甘草来制约肝气，枇杷叶、麦冬、橘红、贝母、薄荷来清肺，米仁、山药来养脾，韭菜、降香、苏子来下气，青蒿、鳖甲、银柴胡、地骨皮来补阴清热，枣仁、茯神来养心，地黄、山萸、枸杞、牛膝来补肾，这是屡次尝试都有效的方剂。然而阴精没有快速滋补的方法，不是多服无效。病人想要快速见效，医生慌张无主，各种药物混杂试用，以致丧命，重蹈覆辙而不觉悟，可悲啊！
为什么说适宜行血而不适宜止血呢？血液不循行经络，是因为气逆上壅。血得热则运行，得寒则凝滞，所以降气行血，血液就能循行经络，不求止而自然停止。如果有意识地强行止血，血液就会凝滞。血液凝滞就必然发热、厌恶饮食，以及胸胁疼痛，病情日益沉重顽固了！
为什么说适宜补肝而不适宜伐肝呢？《内经》说：五脏是藏精气而不泻的器官。肝为将军之官，主要功能是藏血。吐血的人，是肝失去了它的职能，滋养肝则肝气平和而血有所归，攻伐它则肝虚不能藏血，血液更加不止了。这三点，是我独自领悟的要诀，应当告知世间世人。
In general, the treatment of hematemesis (vomiting blood) should prioritize descending Qi (vital energy), rather than clearing fire; promoting blood circulation, rather than stopping bleeding; tonifying the Liver, rather than attacking the Liver.
Why is it appropriate to descend Qi but not clear fire? When Qi is in excess, it transforms into Fire. Descending Qi leads to the descent of Fire; once Fire descends, Qi does not ascend abnormally. Blood follows the movement of Qi, thus avoiding the disaster of blood rushing upward and overflowing. Clearing Fire necessarily requires cold and cool herbs, which inadvertently damage Stomach Qi. If Stomach Qi is damaged, it loses its ability to control blood, causing blood to fail to return to the vessels even more severely. Currently, practitioners treating hematemesis have two major pitfalls. The first is the exclusive use of cold and cool herbs, such as Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Shanzhi (Gardeniae Fructus), Qingdai (Indigo Naturalis), and persimmon cake ash, or formulas like Siwu Tang (Four Substances Decoction) added with Zhimu (Anemarrhenae Rhizoma) and Huangbai (Phellodendri Cortex). This often damages the Spleen, causing diarrhea, leading to untreatable conditions. The second is the exclusive use of Renshen (Ginseng Radix et Rhizoma), which causes Lung Heat, further injuring the Lung and worsening cough and rebellious Qi. There are cases where Renshen yields results; these are coughs caused by Qi deficiency. Since Qi belongs to Yang, this is not caused by Yin deficiency with blazing Fire. However, such cases account for less than one or two in a hundred. For these, it is appropriate to use Baishao (Paeoniae Radix Alba) and Zhi Gancao (Prepared Licorice Root) to subdue the Liver, Pipaye (Loquat Leaf), Maidong (Ophiopogonis Radix), Juhong (Tangerine Red Peel), Beimu (Fritillariae Bulbus), and Bohe (Menthae Haplocalycis Herba) to clear the Lung, Yiren (Coicis Semen) and Shanyao (Dioscoreae Rhizoma) to nourish the Spleen, Jiucui (Allii Tuberosi Rhizoma), Jiangxiang (Daemonorops Spica), and Suzi (Perillae Fructus) to direct Qi downward, Qinghao (Artemisiae Annuae Herba), Biejia (Testudinis Carapax et Plastrum), Yin Chaihu (Stellariae Radix), and Digupi (Lycii Cortex), Zaoren (Ziziphi Spinosae Semen), and Fushen (Poria cum Risus) to nourish the Heart, and Dihuang (Rehmanniae Radix), Shanzhuyu (Corni Fructus), Gouqi (Lycii Fructus), and Niuxi (Achyranthis Bidentatae Radix) to tonify the Kidney. This is a formula that has proven effective through repeated trials. However, there is no rapid method to tonify Yin; without prolonged administration, it will be ineffective. Patients desire quick results, doctors panic and lose their composure, trying various mixed medicines, leading to death. They repeat past mistakes without realizing them. How tragic!
Why is it appropriate to promote blood circulation but not stop bleeding? When blood does not follow the meridians, it is due to rebellious Qi obstructing upwards. Blood flows when heated and coagulates when cooled. Therefore, by descending Qi and promoting blood circulation, blood returns to the meridians, and bleeding stops naturally without the need for astringents. If one intentionally attempts to stop bleeding, blood coagulation occurs. Coagulated blood inevitably leads to fever, aversion to food, and pain in the chest and hypochondrium, causing the disease to become chronic and entrenched.
Why is it appropriate to tonify the Liver but not attack it? The Classics state: "The Five Zang organs store Essence and Qi and do not drain." The Liver is the official of the General, primarily responsible for storing blood. In hematemesis, the Liver fails in its duty. Nourishing the Liver calms Liver Qi, allowing blood to find its proper residence. Attacking the Liver causes Liver deficiency, impairing its ability to store blood, resulting in continued bleeding. These three principles are my unique insights, which I wish to share with the world.