〔薛〕妇人血膈，若气逆而血滞，用流气饮。（臂痛。）若恚怒而血逆，用小柴胡汤（伤寒
少阳。）加山栀、丹皮。血虚用四物汤、（通治。）参、术、柴胡、山栀、丹皮。若郁结而血伤，用
加味归脾（即归脾加山栀、丹皮。）兼加味逍遥。（结核。）脾虚不能生血，用六君子（杂病虚劳。）加归、
芎。胃虚不能生血，用补中益气汤。（杂病劳倦。）若肝虚而不能藏血，用补肝散；（两胁胀痛。）如
不应，兼以六味丸。（杂病虚劳。）若因脾肺虚，用补中益气汤；如不应，用六君子加芎、归。
一妇人患前证，胸膈痞闷。余曰∶此属脾经血虚，遂用四君加芎、归调补脾气，寻愈。又
因怒，兼两胁痞闷，头目不清，月经旬余未竭。用加味逍遥散加钓藤治之，复瘥。一
妇人患前证，胸膈作痛，面青目札，小便频数，或时寒热。此肝气滞而血凝，先用失笑
散二服，痛止，又用加味逍遥散而愈。 一妇人所患同前，泛用行气破血之剂，以致不
起。
牡丹煎 治妇人血膈。
牡丹皮 苦参 贝母（去心） 玄胡索 白芍药（各等分，为细末）
炼蜜丸梧子大，每服十五、二十丸，米饮吞下，无时。
抽刀散 治妇人血风、血气、血膈等候。（方见血崩。）
〔大〕夫妇人鼻衄者，由伤动血气所致也。凡血气调和则循环表里经络，涩则不散。
若劳伤损动，因而生热，气逆流溢，入于鼻者则成鼻衄也。只有产后见衄者不可治。凡
鼻衄虽多因热而得，此疾亦有因怒气而得之者。曾治赵恭人鼻衄不止，诸治不瘥，召予
治之，先用苏合香丸四粒，次用五苓散浓煎白茅花汤，调服即止，次用芎归汤调理。又
有一富室男子鼻血不止，六脉洪数。究竟云∶服丹药太过。遂用黄连、黄芩、大黄为末，水
煎服之愈。（调服亦可。）
〔薛〕前证若热郁于胃经，用犀角地黄汤。若伏暑于内，用黄连香薷饮。若大怒血
蓄于上，用小柴胡汤。若脾损不能摄血归源，用归脾汤。大凡杂证见血，多因阴分郁热，或
内有所伤，皆属五志所动。经曰∶诸见血，身热脉大者难治，是火邪胜也。身凉脉静者易
治，是正气复也。仍与后证同用。一妇人经素不调，因怒衄血。此肝火炽盛，用加味
小柴胡（热入血室。）加红花，二剂血止。又用加味逍遥散、（结核。）八珍汤（即八物汤，杂病虚劳。）兼
服三十余剂，经行如期。一妇人郁结而患前证，用加味归脾汤，（即归脾加山栀、丹皮。）其
血渐止，饮食渐进，用加味逍遥散，元气渐复，寒热渐止。后因怒仍衄，寒热往来，用
小柴胡汤（伤寒太阳。）加芎、归、丹皮而愈。一妇人因劳衄血，服凉血之剂，更致便血。或
以血下为顺，仍用治血。余曰∶此因脾气下陷而血从之，当升补脾气，庶使血归其经。不
信，果血益甚。余朝用补中益气，（杂病劳倦。）夕用加味归脾而愈。此证用寒凉止血，不补脾
肺而死者，多矣。
刺蓟散 治妇人鼻衄，血流不止。
刺蓟（二两） 桑耳 乱发灰 艾叶（各一两，炒） 生地黄（二两） 蒲黄（一两半）
上为细末，每服二钱，粥饮调下，无时。
伏龙肝散 治男子妇人五脏结热，吐血衄血，并皆治之。
伏龙肝 生地黄（各一斤） 竹茹（一升） 芍药 黄芩 当归 川芎 桂心 甘草（各二两）
上 咀，以水一斗三升，煮竹茹减三升，纳药煮取三升，分为三服。《千金方》无桂心。
《百问》有茅花汤，以白茅花浓煎饮之，立止。
一方 捣生白茅根取汁一合，饮之止。
又方 取生葱心塞鼻中即定。若因刺着并刀斧所伤，血不止者，并用之，立定。
又方 取釜底墨细研，入鼻中。
又方 取乱发灰细研，以竹管吹入鼻中，立止。
又方 取龙骨为末，吹入鼻中立止。
四物汤加侧柏、生地黄，治虚热吐血甚效。若脾经血虚，须用四君加芎、归。若脾
经气郁，须用归脾汤。若肝肾亏损，须用六味丸。若气血俱虚，须用十全大补汤。
犀角地黄汤主热郁不解，泛行经络，或流肠胃，随气涌泄，以致衄血、吐血，或为
便血，并皆治之。若实热炽甚，加炒黄芩。若去血过多，或脾肺之气亏损，不能摄血归源
者，急用四君子汤。怀抱郁结者，用归脾汤。
枇杷叶散 治暑毒攻心，衄血呕血，或吐泻作渴。黄连香薷饮亦可。
【薛己】妇人患血膈，如果是气机逆乱导致血液瘀滞，使用流气饮。（伴有臂痛。）如果是因愤怒导致血气上逆，使用小柴胡汤（伤寒少阳经受邪）加山栀、丹皮。若是血虚，使用四物汤（通用方）、人参、白术、柴胡、山栀、丹皮。如果是因郁结导致血伤，使用加味归脾汤（即归脾汤加山栀、丹皮），同时兼用加味逍遥散。（伴有结核肿块。）若是脾虚不能生血，使用六君子汤（杂病虚劳证）加当归、川芎。若是胃虚不能生血，使用补中益气汤（杂病劳倦证）。若是肝虚而不能藏血，使用补肝散；（伴有两胁胀痛。）如果无效，兼用六味丸。（杂病虚劳证。）若是因脾肺虚弱，使用补中益气汤；如果无效，使用六君子汤加川芎、当归。
有一位妇人患上述病症，胸膈痞闷。我说：这属于脾经血虚，于是用四君子汤加川芎、当归调补脾气，不久痊愈。后来因为发怒，兼见两胁痞闷，头目不清爽，月经十几天未净。用加味逍遥散加钩藤治疗，再次痊愈。
又一位妇人患上述病症，胸膈作痛，面色青暗，眼睛拘急，小便频数，有时寒热交替。这是肝气滞涩而血液凝滞，先用失笑散服用两剂，疼痛停止，又用加味逍遥散而痊愈。
还有一位妇人所患与前人相同，但泛用行气破血的药物，导致病情恶化不治身亡。
牡丹煎：治疗妇人血膈。
牡丹皮、苦参、贝母（去心）、玄胡索、白芍药（各等分，研为细末）。
用炼蜜制成梧桐子大小的丸药，每次服用十五至二十丸，米汤送下，不拘时间。
抽刀散：治疗妇人血风、血气、血膈等症候。（方剂见“血崩”条下。）
【张大复】妇女鼻衄，是由于损伤气血所致。凡是气血调和，则循环于表里经络，脉道通畅而不涩滞。若因劳损损伤气血，因而产生内热，气机逆流溢出，进入鼻腔则形成鼻衄。只有产后出现鼻衄的不可治愈。大凡鼻衄虽然多因热邪引起，此病也有因怒气引发的。曾治疗赵恭人鼻衄不止，各种治疗均无效，召我去诊治，先用苏合香丸四粒，接着用五苓散浓煎白茅花汤调服，鼻血立即停止，随后用芎归汤调理。又有一位富家男子鼻血不止，六脉洪数。究其原因是服用丹药太过。于是用黄连、黄芩、大黄研为细末，水煎服之而愈。（调服也可以。）
【薛己】上述病症，如果是热邪郁结在胃经，使用犀角地黄汤。如果是伏暑在内，使用黄连香薷饮。如果是大怒导致血液蓄积于上部，使用小柴胡汤。如果是脾脏受损不能摄血归源，使用归脾汤。大凡杂病见出血，多因阴分郁热，或内部有所损伤，都属于五志所动。《内经》说：凡是见出血，身体发热、脉象大的难治，这是火邪胜的表现。身体凉爽、脉象平静的易治，这是正气恢复的表现。仍与后述证候同用。
一位妇人平时月经不调，因发怒导致鼻衄。这是肝火炽盛，用加味小柴胡汤（热入血室）加红花，两剂后血止。又用加味逍遥散、八珍汤（即八物汤，杂病虚劳证）兼服三十余剂，月经按期而行。
一位妇人因郁结患上述病症，用加味归脾汤（即归脾汤加山栀、丹皮），其血逐渐停止，饮食逐渐增加，再用加味逍遥散，元气逐渐恢复，寒热逐渐停止。后来因发怒仍然鼻衄，寒热往来，用小柴胡汤（伤寒太阳经证）加川芎、当归、丹皮而痊愈。
一位妇人因劳累导致鼻衄，服用凉血药物，反而导致便血。有人以为血下行是顺证，仍用治血方法。我说：这是因为脾气下陷而血随之而下，应当升提补益脾气，才能使血回归经脉。病人不信，果然血更加严重。我早晨用补中益气汤（杂病劳倦证），晚上用加味归脾汤而痊愈。此证使用寒凉止血，不补脾肺而死去的，很多了。
刺蓟散：治疗妇人鼻衄，血流不止。
刺蓟（二两）、桑耳、乱发灰、艾叶（各一两，炒）、生地黄（二两）、蒲黄（一两半）。
以上研为细末，每次服用二钱，粥饮调下，不拘时间。
伏龙肝散：治疗男子妇人五脏结热，吐血衄血，都加以治疗。
伏龙肝、生地黄（各一斤）、竹茹（一升）、芍药、黄芩、当归、川芎、桂心、甘草（各二两）。
以上切碎，用水一斗三升，煮竹茹减少三升，放入其他药物煮取三升，分为三次服用。《千金方》没有桂心。《百问》有茅花汤，用白茅花浓煎饮用，立止。
一方：捣生白茅根取汁一合，饮用即止。
又一方：取生葱心塞入鼻孔中即定。如果是因针刺以及刀斧所伤，血不止者，都用此法，立即停止。
又一方：取锅底墨细研，纳入鼻孔中。
又一方：取乱发灰细研，用竹管吹入鼻孔中，立即停止。
又一方：取龙骨为细末，吹入鼻孔中立即停止。
四物汤加侧柏、生地黄，治疗虚热吐血非常有效。若是脾经血虚，须用四君子汤加川芎、当归。若是脾经气郁，须用归脾汤。若是肝肾亏损，须用六味丸。若是气血俱虚，须用十全大补汤。
犀角地黄汤主治热郁不解，泛行经络，或流肠胃，随气涌泄，以致衄血、吐血，或为便血，都加以治疗。若是实热炽盛，加炒黄芩。若是失血过多，或脾肺之气亏损，不能摄血归源者，急用四君子汤。怀抱郁结者，用归脾汤。
[Xue Ji] For women suffering from Xue Ge (Blood Obstruction), if the condition is caused by Qi counterflow leading to Blood stasis, use Liuqi Yin (Flowing Qi Decoction). (Accompanied by arm pain.) If it is caused by anger leading to Blood and Qi rushing upward, use Xiaochaihu Tang (Minor Bupleurum Decoction) [Shanghan Shaoyang syndrome] with Zhizi (Gardeniae Fructus) and Danpi (Moutan Cortex). If there is Blood deficiency, use Siwu Tang (Four Substances Decoction) [General formula], along with Renshen (Ginseng Radix), Baizhu (Atractylodis Rhizoma), Chaihu (Bupleuri Radix), Zhizi, and Danpi. If it is caused by emotional constraint injuring the Blood, use Jiawei Guipi Tang (Modified Spleen-Invigorating Decoction) [Guipi Tang added with Zhizi and Danpi], simultaneously combined with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). (Accompanied by tubercles/lumps.) If Spleen deficiency fails to generate Blood, use Liujunzi Tang (Six Gentlemen Decoction) [Miscellaneous diseases: deficiency and fatigue] with Danggui (Angelicae Sinensis Radix) and Chuanxiong (Chuanxiong Rhizoma). If Stomach deficiency fails to generate Blood, use Buzhong Yiqi Tang (Center-Supplementing Qi-Augmenting Decoction) [Miscellaneous diseases: labor-induced fatigue]. If Liver deficiency fails to store Blood, use Bu Gan San (Liver-Nourishing Powder); (Accompanied by distending pain in both hypochondria.) If ineffective, combine with Liuwei Wan (Six-Ingredient Pill with Rehmannia). [Miscellaneous diseases: deficiency and fatigue]. If caused by Spleen and Lung deficiency, use Buzhong Yiqi Tang; if ineffective, use Liujunzi Tang plus Chuanxiong and Danggui.
One woman suffered from the aforementioned condition with chest and diaphragm fullness and oppression. I said: This belongs to Blood deficiency of the Spleen meridian. Thus, I used Sijunzi Tang (Four Gentlemen Decoction) plus Chuanxiong and Danggui to regulate and tonify Spleen Qi, and she recovered quickly. Later, due to anger, she had accompanying fullness in both hypochondria, unclear head and eyes, and menstruation lasting over ten days without stopping. She was treated with Jiawei Xiaoyao San plus Gouteng (Uncariae Ramulus cum Uncis), and recovered again.
Another woman suffered from the aforementioned condition with chest and diaphragm pain, bluish complexion, eye twitching, frequent urination, and intermittent chills and fever. This was Liver Qi stagnation causing Blood coagulation. First, using Shixiao San (Pain-Stopping Powder) for two doses stopped the pain, then Jiawei Xiaoyao San cured her.
Yet another woman had the same condition as above but indiscriminately used Qi-moving and Blood-breaking agents, leading to an untreatable deterioration.
Mudan Jian (Peony Paste): Treats women's Xue Ge.
Mudanpi (Moutan Cortex), Kushen (Sophorae Flavescentis Radix), Beimu (Fritillariae Bulbus) [core removed], Yanshusu (Corydalis Rhizoma), Baishaoyao (Paeoniae Radix Alba) [equal parts, ground into fine powder].
Make pills the size of wutong seeds. Take 15–20 pills each time, swallowed with rice water, at any time.
Choudao San (Knife-Withdrawing Powder): Treats women's Xue Feng (Blood Wind), Xue Qi (Blood Qi), and Xue Ge conditions. (Formula see under "Metrorrhagia".)
[Zhang Dapu] Women's Bi Nu (Nosebleed) is caused by injury to Blood and Qi. When Blood and Qi are harmonious, they circulate through the exterior and interior meridians smoothly without obstruction. If labor or injury damages them, internal heat arises, Qi flows counter-current and overflows, entering the nose causes Bi Nu. Only postpartum Bi Nu is considered untreatable. Although most Bi Nu is caused by heat, this disease can also be caused by anger. I once treated Lady Zhao who suffered from incessant nosebleeds; various treatments failed. Summoned to treat her, I first administered four Suhe Xiang Wan (Styrax Pills), then used Wuling San (Five-Ingredient Powder with Poria) decocted strongly with Bai Mao Hua (Imperatae Rhizoma Flower) mixed and taken orally, which stopped the bleeding immediately. Subsequently, Xiong Gui Tang (Ligusticum and Angelica Decoction) was used for regulation. Another wealthy man suffered from incessant nosebleeds with surging and rapid pulses throughout all six positions. Upon inquiry, he admitted to excessive consumption of alchemical pills. Thus, Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), and Dahuang (Rhei Radix et Rhizoma) were ground into powder, decocted in water, and taken orally, curing him. (Mixing and taking orally is also acceptable.)
[Xue Ji] For the aforementioned conditions, if Heat is constrained in the Stomach meridian, use Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction). If Summerheat is latent internally, use Huanglian Xiangru Yin (Coptis and Elsholtzia Decoction). If severe anger causes Blood accumulation in the upper body, use Xiaochaihu Tang. If Spleen damage fails to control Blood returning to its source, use Guipi Tang. Generally, bleeding in miscellaneous diseases is mostly due to constrained Heat in the Yin aspect, or internal injury, all belonging to movements of the Five Emotions. The Classics state: "For all cases of bleeding, if the body is hot and the pulse is large, it is difficult to treat; this indicates Fire pathogen dominance." If the body is cool and the pulse is quiet, it is easy to treat; this indicates recovery of Zheng Qi (Upright Qi). These should still be treated similarly to the following conditions.
One woman with irregular menstruation suffered nosebleeds due to anger. This was excessive Liver Fire. She was treated with Jiawei Xiaochaihu Tang (Heat entering the Blood Chamber) plus Honghua (Carthami Flos), stopping the bleeding in two doses. Then, Jiawei Xiaoyao San and Bazhen Tang (Eight-Treasure Decoction) [Eight Substances Decoction, Miscellaneous diseases: deficiency and fatigue] were taken concurrently for over thirty doses, restoring regular menstruation.
One woman suffering from the aforementioned condition due to emotional constraint was treated with Jiawei Guipi Tang (Guipi Tang added with Zhizi and Danpi). Her bleeding gradually stopped, and appetite improved. Using Jiawei Xiaoyao San, her Yuan Qi (Original Qi) gradually recovered, and chills/fever ceased. Later, due to anger, nosebleeding recurred with alternating chills and fever. She was cured with Xiaochaihu Tang [Shanghan Taiyang syndrome] plus Chuanxiong, Danggui, and Danpi.
One woman suffered nosebleeds due to labor. After taking Blood-cooling agents, she developed hematochezia. Some believed downward bleeding was favorable and continued treating the blood. I said: This is due to Spleen Qi sinking, carrying the blood with it. One must raise and tonify Spleen Qi so that Blood returns to its vessels. Disbelieving, her bleeding worsened. I treated her in the morning with Buzhong Yiqi Tang [Miscellaneous diseases: labor-induced fatigue] and in the evening with Jiawei Guipi Tang, curing her. Many have died from using cold-cooling hemostatics for this condition without tonifying Spleen and Lung.
Ciji San (Thistle Powder): Treats women's Bi Nu with incessant flowing blood.
Ciji (Cirsii Japonici Herba) [2 liang], Sang'er (Auriculariae Judae Fructus), Luangui Hui (Ash of Tangled Hair), Aiye (Artemisiae Argyi Folium) [each 1 liang, stir-fried], Shengdihuang (Rehmanniae Radix Recens) [2 liang], Puhuang (Typhae Pollen) [1.5 liang].
Grind all into fine powder. Take 2 qian each time, mixed with congee water, at any time.
Fulonggan San (Dragon's House Earth Powder): Treats men and women with constrained Heat in the five Zang organs, hematemesis, and epistaxis.
Fulonggan (Caulis Bambusae in Taenia) [1 jin], Shengdihuang [1 jin], Zhuru (Bambusae Caulis in Taenia) [1 sheng], Shaoyao (Paeoniae Radix), Huangqin, Danggui, Chuanxiong, Guixin (Cinnamomi Ramulus), Gancao (Glycyrrhizae Radix et Rhizoma) [each 2 liang].
Cut into pieces. Use 13 sheng of water, boil Zhuru until reduced by 3 sheng, add other medicines, boil to obtain 3 sheng, divide into three doses. Qianjin Fang does not include Guixin. Baiwen includes Maohua Tang (Imperata Decoction); drink strong decoction of white imperata flowers to stop bleeding immediately.
Another prescription: Crush fresh Baomagen (Imperatae Rhizoma) to extract juice, take one he, stops bleeding.
Another prescription: Insert raw green onion heart into the nostrils to stop bleeding. If caused by needle pricks or axe/knife injuries with incessant bleeding, apply these methods to stop immediately.
Another prescription: Grind Fu Di Mo (Kettle Bottom Ink) finely, insufflate into the nostrils.
Another prescription: Grind Luangui Hui finely, insufflate into the nostrils with a bamboo tube to stop immediately.
Another prescription: Grind Longgu (Fossil Bones) into powder, insufflate into the nostrils to stop immediately.
Siwu Tang plus Ce Bai Ye (Biota Top) and Shengdihuang is very effective for treating hematemesis due to deficient Heat. If Spleen meridian Blood deficiency, use Sijunzi Tang plus Chuanxiong and Danggui. If Spleen meridian Qi constraint, use Guipi Tang. If Liver and Kidney deficiency, use Liuwei Wan. If Qi and Blood are both deficient, use Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction).
Xijiao Dihuang Tang governs unresolved constrained Heat spreading through meridians or flowing into intestines/stomach, gushing out with Qi, causing epistaxis, hematemesis, or hematochezia. If Excess Heat is intense, add Chao Huangqin (Stir-fried Scutellariae Radix). If excessive blood loss occurs, or Spleen/Lung Qi is damaged failing to control Blood return to source, urgently use Sijunzi Tang. For those with emotional constraint, use Guipi Tang.
Pipaye San (Loquat Leaf Powder): Treats Summer-toxin attacking the Heart, causing epistaxis, hematemesis, or vomiting/diarrhea with thirst. Huanglian Xiangru Yin is also applicable.