骆龙声方云∶腹中论曰∶有病胸胁支满者,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,病名血枯。此得之年少时有所大脱血,或醉而入房,亏损肾肝
。盖肝藏血,受天一之气以为滋荣,其经上贯膈,布胁肋。若脱血失精,肝气已伤,肝血枯
竭,不能荣养而(胸胁满症,人皆伐肝,岂知血枯之人宜养肝血也。当须识此)肝病。传脾则
妨食而腥臊臭,出清液。若肝病而肺乘之则唾血,
四肢清,目眩,时时前后血出,皆肝病血伤之症也。然其治法,又当取乎脾土。
按立斋云∶前症若饮食起居失宜而脾胃虚损,当滋化源。若以脾土虚寒而不能生血,宜
补命
门火。若服食 燥,郁内火作而津液消烁,宜清热养血。若脾胃亏损而气血空虚,宜补中益
气。若胃热消中而血液耗损,宜清脾胃之火。若大便闭涩,小便清利而经不行,宜补心养血
。此治血枯大法,以调养真元为主。若泛用苦寒峻剂,以通导癸水为快捷方式法门,殊不知愈通
则愈闭,其生生之源斫削殆尽,直至风消息贲,难于措手矣。
寇宗 云∶夫人之生以气血为本,故人之病未有不先伤其气血者。若室女童男积想在心
,思
虑过度,多致劳损。男子则神色先散,女子则月水先闭。盖忧愁思虑则伤心,而血逆竭,神
色先散,月水先闭。且心病不能养脾,故不嗜食。脾虚则金亏,故发嗽。肾水绝则木气不荣
,而四肢干痿,故多怒,鬓发焦,筋骨痿。若五脏传遍则死。自能改易心志,用药扶持,庶
可保生。
按经云∶五谷入于胃,其糟粕、津液、宗气分为三队,故宗气积于胸中,出于喉咙,以
贯心
肺而行呼吸。荣气者,泌其津液,注之于脉,化以为血,以荣四末,内养五脏六腑。若服苦
寒之剂,复伤胃气,必致不起。
骆龙声在方书中说道:《黄帝内经·腹中论》记载:有人出现胸胁部支撑胀满的症状,影响进食;发病时先闻到腥臊气味,流出清稀液体,先吐出带血的唾液,四肢发冷,头晕目眩,时常大小便出血,这种病名叫“血枯”。这是因为年轻时曾有过大量失血,或者醉酒后行房事,导致肾肝亏损。肝脏贮藏血液,接受天一之气以滋养荣润,其经脉向上穿过膈肌,分布于胁肋部位。如果失血耗精,肝气已经受伤,肝血枯竭,无法进行正常的荣养(关于胸胁满闷的症状,人们往往采用伐肝的方法,哪里知道血枯的患者应当滋养肝血呢?必须认识到这一点)。肝病传变至脾,则妨碍饮食并出现腥臊臭味、流出清液。如果肝病而肺金乘袭,则会出现吐唾血、四肢发冷、头晕目眩、时常大小便出血等症状,这些都是肝损伤导致血液受损的表现。然而治疗此病的方法,又应当取法于健脾土。
按李梴(立斋)所说:上述症状如果是由于饮食起居不适宜导致脾胃虚损,应当滋生化之源。如果是因脾土虚寒而不能生血,宜补命门之火。如果是因服用燥热药物,导致内火郁结而津液消烁,宜清热养血。如果是脾胃亏损导致气血空虚,宜补中益气。如果是胃热消中导致血液耗损,宜清脾胃之火。如果是大便闭涩,小便清利而月经不行,宜补心养血。这是治疗血枯的大法,以调养真元为主。如果滥用苦寒峻猛的药物,把通导月经当作快捷法门,却不知道越通越闭塞,生生之源被砍削殆尽,直到出现风邪消竭、贲豚发作等危重情况,就难以措手了。
寇宗奭说:人的生存以气血为根本,所以人的疾病没有不先损伤气血的。如果是童男童女心中积存妄想,思虑过度,多导致劳损。男子则神色先散乱,女子则月经先闭止。因为忧愁思虑会伤心,导致血液逆乱枯竭,神色先散乱,月经先闭止。而且心病不能养脾,所以不喜欢吃东西。脾虚则肺气亏虚,所以发生咳嗽。肾水枯竭则肝木之气不得荣养,导致四肢干枯痿软,所以容易发怒,鬓发焦枯,筋骨痿弱。如果五脏病变传遍全身就会死亡。如果能自行改变心志,用药扶持,或许可以保全生命。
按经典记载:五谷进入胃中,其糟粕、津液、宗气分为三队,所以宗气积聚在胸中,出于喉咙,贯通心肺而行呼吸。营气,分泌津液,注入脉中,化生为血液,以荣养四肢末端,向内滋养五脏六腑。如果服用苦寒的药物,再次损伤胃气,必然导致病情恶化甚至死亡。
Luo Longsheng stated in his medical writings: The *Abdominal Discussion* chapter of the *Huangdi Neijing* (Yellow Emperor's Inner Canon) records: "There is a disease characterized by distension and fullness in the chest and hypochondrium, which interferes with eating. Upon onset, the patient first perceives a fishy or foul odor, secretes clear fluid, expectorates blood-stained saliva, experiences cold limbs, dizziness, and frequent bleeding from both the upper and lower orifices. This disease is named 'Blood Depletion' (Xue Ku). It arises from significant blood loss in youth, or from sexual intercourse while intoxicated, leading to kidney and liver deficiency. The Liver stores Blood and receives the Qi of Heaven One for nourishment and flourishing; its meridian passes upward through the diaphragm and spreads over the hypochondrium. If blood is lost and essence is depleted, the Liver Qi is injured, and Liver Blood becomes exhausted, failing to provide proper nourishment. [Regarding symptoms of chest and hypochondriac fullness, people often employ methods to suppress the Liver, not realizing that patients with Blood Depletion require nourishment of Liver Blood. One must recognize this.] When Liver disease transmits to the Spleen, it hinders digestion and causes fishy odors and clear secretions. If Liver disease allows Lung Metal to overcome it, symptoms such as expectoration of blood, cold limbs, dizziness, and frequent bleeding occur; all these are signs of Liver injury affecting the Blood. However, the treatment method should focus on strengthening Earth (Spleen)."
According to Li Chen (Zhai), regarding the aforementioned symptoms: If they result from improper diet and lifestyle causing Spleen and Stomach deficiency, one should nourish the source of transformation and transportation. If Spleen Earth deficiency and cold prevent blood generation, one should tonify the Fire of the Gate of Vitality (Ming Men). If dry-hot substances have been ingested, causing internal fire stagnation and consumption of body fluids, one should clear heat and nourish blood. If Spleen and Stomach damage leads to emptiness of Qi and Blood, one should tonify the Middle and benefit Qi. If Stomach heat and excessive hunger consume blood, one should clear the fire of the Spleen and Stomach. If constipation occurs with clear and profuse urination and amenorrhea, one should tonify the Heart and nourish blood. These are the general principles for treating Blood Depletion, primarily focusing on nurturing the True Yuan (Original Energy). If harsh bitter-cold purgatives are indiscriminately used to promote menstruation as a quick fix, one fails to realize that increased flow leads to greater obstruction, destroying the source of life until conditions like wind exhaustion or rising abdominal masses (Ben Teng) arise, making treatment difficult.
Kou Zongshi stated: Human life is based on Qi and Blood; therefore, no disease occurs without first damaging Qi and Blood. If young men and women harbor obsessive thoughts and engage in excessive mental labor, it often leads to consumptive disorders. In men, the spirit and complexion scatter first; in women, menstruation ceases first. Worry and anxiety injure the Heart, causing blood to reverse and become exhausted, scattering the spirit and complexion, and stopping menstruation. Furthermore, Heart disease fails to nourish the Spleen, leading to anorexia. Spleen deficiency causes Lung Metal to be deficient, resulting in cough. Exhaustion of Kidney Water means Wood Qi lacks nourishment, leading to dry and flaccid limbs, irritability, scorched hair, and weak sinews and bones. If the pathology spreads through all five Zang organs, death ensues. If the patient can change their mindset and receive medicinal support, life may be preserved.
According to the classics: When grains enter the Stomach, their dregs, fluids, and Zong Qi (Gathering Qi) divide into three streams. Thus, Zong Qi accumulates in the chest, emerges from the throat, penetrates the Heart and Lungs, and governs respiration. Ying Qi (Nutritive Qi) secretes fluids, injects them into the vessels, transforms them into blood, and nourishes the four extremities internally, while nourishing the five Zang and six Fu organs. If bitter-cold medicines are taken, further injuring Stomach Qi, it will inevitably lead to fatal consequences.