答曰。气属乎阳。血属乎阴。阴盛则阳亏。阳盛则阴亏。经所谓阳胜则阴病。阴胜则阳病。
诸吐血衄血。繇阳气胜。阴之气被伤。血失常道。或从口出。或从鼻出。皆谓之妄行。其脉
洪数者逆。微细者顺。阳明之经。行络于颐颔。阳明受邪。热血从齿出也。脾气通于口。
心
气通于舌。心脾二经被伤。血故从舌出也。营血内通于脏腑。外萦于经络。藏则舍于肝经。
行则出于心脏。又心之液为汗。令肝心二脏俱虚。血随汗液出也。
内补芎归汤。治妇人血气羸弱。或崩伤过多。少气伤绝。腹中拘急。四肢烦热。面目无色。
及唾血吐血。
芎 熟地(各四两) 白芍(五两) 桂心(二两) 甘草 干姜(各三两) 大枣(四十枚) 当
归(二两)
上为粗末。每服五钱。水一盏半。煎至八分。去滓温服。不拘时。柔脾汤。治吐血下血衄血
。
白芍 黄 甘草(各一两) 熟地(三两)
上为 咀。每服三钱。水酒各一盏。煎八分。去滓通口服。不拘时。
琥珀散。治小便出血。
上为粗末。每服五钱。水二盏。煎一盏。去渣温服。
答曰。天食人以五气。地食人以五味者。酸苦甘辛咸是也。五味各有所入。酸入肝。辛入肺
。苦入心。甘入脾。咸入肾。是谓五入也。肝藏血。妇人以血为主。所以偏喜酸物食者。酸
入肝而养血。血得其酸物。所以舍藏也。血虚多热。邪热蓄于上焦。烦躁内生。妇人虚烦。
往往多嗜冷物也。
茯苓半夏汤。治妊娠恶阻。心中愦闷。呕吐恶心。好啖咸酸物。
旋复花 陈皮 桔梗 白芍 人参 甘草(炙) 芎 (各半两) 赤茯苓(三分) 干熟地 半
夏(汤洗十遍一两一分)
上为粗末。每服二钱。水盏半。姜四片。煎八分。去滓。食前稍热服。清平汤。治血虚口燥
。咽干喜饮。
人参 半夏 麦门冬 芍药 白术 甘草 当归 茯苓 柴胡(各等分)
上 咀每服二钱。水盏半。烧生姜一块切破。薄荷少许。同煎七分。去滓热服。不拘时。
回答说:气属于阳,血属于阴。阴气盛则阳气亏虚,阳气盛则阴气亏虚。《内经》所谓“阳胜则阴病,阴胜则阳病”。
各种吐血、衄血(鼻出血),是由于阳气偏胜,损伤了阴气,导致血液失去正常的运行轨道。有的从口而出,有的从鼻而出,都称为妄行(血液不循常道而外溢)。脉象洪大数急的为逆证,脉象微细的为顺证。阳明经的经脉,联络于面颊和下颌部位。阳明经受邪,热血便从齿缝中渗出。脾气通于口,心气通于舌。心和脾两经受到损伤,血液因此从舌上渗出。营血在内连通脏腑,在外缠绕经络。贮藏时寄居于肝经,运行时出于心脏。另外,心的液为汗。如果肝、心两脏都虚弱,血液就会随着汗液排出。
内补芎归汤,治疗妇人气血虚弱,或者崩漏、外伤失血过多,导致少气乏力甚至昏厥,腹中拘急疼痛,四肢烦热,面色苍白无华,以及唾血、吐血。
药材及用量:川芎、熟地黄(各四两)、白芍药(五两)、桂心(二两)、甘草、干姜(各三两)、大枣(四十枚)、当归(二两)。
以上药物捣成粗末。每次服用五钱,加水一盏半,煎煮至八分满,去渣滓,温服。不拘时间。
以上药物切碎。每次服用三钱,加水、酒各一盏,煎煮至八分满,去渣滓,通口服下。不拘时间。
以上药物捣成粗末。每次服用五钱,加水二盏,煎煮至一盏,去渣滓,温服。
回答说:天以五气养人,地以五味养人,即酸、苦、甘、辛、咸这五种味道。五味各有其归属,酸入肝,辛入肺,苦入心,甘入脾,咸入肾,这叫做“五入”。肝藏血,妇人以血为本,所以偏爱吃酸味食物,是因为酸味入肝而养血。血液得到酸味食物的滋养,所以能安守于肝脏之中。血虚多生内热,邪热蓄积在上焦,导致烦躁内生,妇人因虚烦,往往喜欢嗜食冷物。
茯苓半夏汤,治疗妊娠恶阻,心中烦闷不适,呕吐恶心,喜欢吃咸酸食物。
药材及用量:旋覆花、陈皮、桔梗、白芍药、人参、炙甘草、川芎(各半两)、赤茯苓(三分)、干熟地黄、半夏(汤洗十遍,一两一分)。
以上药物捣成粗末。每次服用二钱,加水一盏半,生姜四片,煎煮至八分满,去渣滓,饭前稍热时服用。
Answer: Qi belongs to Yang, and Blood belongs to Yin. When Yin is excessive, Yang becomes deficient; when Yang is excessive, Yin becomes deficient. As stated in the *Classic of Internal Medicine* (Huangdi Neijing), "When Yang prevails, Yin suffers disease; when Yin prevails, Yang suffers disease."
Various forms of hematemesis (vomiting blood) and epistaxis (nosebleed) arise from an excess of Yang, which injures Yin, causing Blood to deviate from its normal pathways. It may exit from the mouth or from the nose, all referred to as "reckless movement" (blood flowing outside its normal channels). A pulse that is flooding and rapid indicates a unfavorable prognosis (ni), whereas a pulse that is fine and weak indicates a favorable prognosis (shun). The Stomach Meridian of Foot-Yangming connects with the cheeks and jaw. When this meridian is invaded by pathogenic factors, hot blood oozes from the teeth. The Spleen's qi opens into the mouth, and the Heart's qi opens into the tongue. When the Heart and Spleen meridians are injured, blood exits from the tongue. Ying Blood (nutritive blood) internally connects with the Zang-Fu organs and externally winds around the meridians. When stored, it resides in the Liver Meridian; when circulating, it emerges from the Heart. Furthermore, the fluid of the Heart is sweat. If both the Liver and Heart viscera are deficient, Blood will be discharged along with sweat.
Neibu Xionggui Tang (Internal Supplementing Ligusticum and Angelica Decoction) treats women with weakened Qi and Blood, or those who have suffered excessive bleeding from metrorrhagia (beng lou) or trauma, resulting in shortness of breath, fatigue, abdominal tension and pain, vexatious heat in the four limbs, pallor of the face and eyes, as well as hemoptysis (spitting blood) and hematemesis.
Ingredients: Chuanxiong Rhizoma (Chuanxiong), Rehmanniae Radix Preparata (Shudi) (each 4 liang); Paeoniae Radix Alba (Baishao) (5 liang); Cinnamomi Cortex (Guixin) (2 liang); Glycyrrhizae Radix et Rhizoma (Gancao), Zingiberis Rhizoma Recens (Ganjiang) (each 3 liang); Jujubae Fructus (Dazao) (40 pieces); Angelicae Sinensis Radix (Danggui) (2 liang).
Crush the above ingredients into coarse powder. Take 5 qian per dose, add 1.5 zhan of water, decoct until 0.8 zhan remains, strain, and take warm. Time is not restricted.
Roupi Tang (Splea-Softening Decoction) treats hematemesis, hematochezia (blood in stool), and epistaxis.
Ingredients: Paeoniae Radix Alba (Baishao), Astragali Radix (Huangqi), Glycyrrhizae Radix et Rhizoma (Gancao) (each 1 liang); Rehmanniae Radix Preparata (Shudi) (3 liang).
Cut the above ingredients into small pieces. Take 3 qian per dose, add 1 zhan of water and 1 zhan of wine, decoct until 0.8 zhan remains, strain, and take orally. Time is not restricted.
Hupo San (Amber Powder) treats hematuria (blood in urine).
Crush the above ingredients into coarse powder. Take 5 qian per dose, add 2 zhan of water, decoct until 1 zhan remains, strain, and take warm.
Answer: Heaven nourishes humans with the Five Qi, and Earth nourishes humans with the Five Flavors, namely Sour, Bitter, Sweet, Acrid, and Salty. Each flavor has its specific entry point: Sour enters the Liver, Acrid enters the Lung, Bitter enters the Heart, Sweet enters the Spleen, and Salty enters the Kidney. This is called the "Five Entries." The Liver stores Blood, and for women, Blood is primary. Therefore, a preference for sour foods occurs because Sour enters the Liver and nourishes Blood. With the aid of sour substances, Blood can reside and be stored properly. Blood deficiency often generates internal heat, and pathogenic heat accumulates in the Upper Jiao, causing internal vexation. Due to deficiency-vexation, women often crave cold foods.
Fuling Banxia Tang (Poria and Pinellia Decoction) treats nausea and vomiting during pregnancy (egzu), mental restlessness, vomiting, and aversion to nausea, with a craving for salty and sour foods.
Ingredients: Inulae Flos (Xuanjinhua), Citri Reticulatae Pericarpium (Chenpi), Platycodonis Radix (Jiegeng), Paeoniae Radix Alba (Baishao), Ginseng Radix et Rhizoma (Renshen), Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gancao), Chuanxiong Rhizoma (Chuanxiong) (each 0.5 liang); Polyporus (Chifuling) (3 fen); Rehmanniae Radix Preparata (Dry Shudi), Pinelliae Rhizoma Praeparatum (Banxia) (washed ten times in boiling water, 1 liang 1 fen).
Crush the above ingredients into coarse powder. Take 2 qian per dose, add 1.5 zhan of water and 4 slices of fresh ginger, decoct until 0.8 zhan remains, strain, and take slightly warm before meals.
Qingping Tang (Clear and Peaceful Decoction) treats dry mouth and throat due to Blood deficiency, accompanied by a desire to drink.
Ingredients: Ginseng Radix et Rhizoma (Renshen), Pinelliae Rhizoma Praeparatum (Banxia), Ophiopogonis Radix (Maimendong), Paeoniae Radix (Shaoyao), Atractylodis Macrocephalae Rhizoma (Baizhu), Glycyrrhizae Radix et Rhizoma (Gancao), Angelicae Sinensis Radix (Danggui), Polyporus (Fuling), Bupleuri Radix (Chaihu) (equal parts).
Cut the above ingredients into small pieces. Take 2 qian per dose, add 1.5 zhan of water, one piece of roasted fresh ginger (broken), and a small amount of Mentha Haplocalyx (Bohe). Decoct together until 0.7 zhan remains, strain, and take hot. Time is not restricted.