全婴论云夫吐血者荣卫气逆也荣者血也卫者气也荣卫相济不失常道一有所胜则致妄行血
也决之东则东流决之西则西流气之使血其势如此巢氏云血者是有热气盛而血虚热乘于血血性
得热则流散妄行气逆则血随气上故令吐血也又或饮食太饱之后脾胃内冷不能消化忽吐所食之
物气血相冲因伤肺胃亦令吐血若久嗽气逆面目浮肿而嗽吐血者是虚损也
衄血者是五脏热结所为也血随气行通流脏腑冷热调和不失常度无有壅滞亦不流溢血得寒
而凝
结得热而流散热乘于血血随气发溢于鼻窍也又有因伤寒瘟疫诸阳受病不得其汗热伤于五脏故
从而出也
大便下血者是大肠热结损伤所为也藏气既伤风邪自入或蓄热或积冷或湿毒于脾胃或疳食
伤于脏
腑因兹冷热交系疳湿互作致动血气停留于内凝滞无归渗入肠中故大便下血也或有腹胀冷气在
内攻冲亦令大便下血又因风冷乘虚客入脾胃或瘀血在于肠胃湿毒下如豆汁又疳伤于脏亦能便
血若上焦心肺积热施注大肠亦令大便下血也亡血脾弱必渴久则血虚其人必肌体萎黄头发不黑
矣
溺血者盖心主血与小肠相合血之流行周遍经络循环脏腑若热聚膀胱血渗入脬故小便血出
也
黄芩汤 治小儿衄血吐血下血
上以黄芩为末炼蜜丸如鸡头大三岁一丸浓盐汤下柏叶石榴花为末吹鼻治衄血吐血一方定
州瓮器末治呕血破血止血
柏枝饮 治小儿衄血吐血
柏枝(干者) 藕节(干者)
上等分为末三岁半钱藕汁入蜜沸汤调下一方白芍药为末磨犀角汁调治咯血衄血
龙胆丸 治小儿衄不止
黄连 龙胆草
上等分为末糊丸如小豆大三岁三十丸或作散子以浓盐水送下
柏皮汤 治小儿衄血
柏皮(一两) 栀子(一两) 甘草(炙半两)
上 咀三岁一钱水一小盏煎三分去滓
一方剪金花叶阴干水煎服
一方白芨末水调涂鼻上并囟门立止
辰胶散 治小儿吐血
阿胶(炒) 蛤粉(等分) 辰砂(少许)
上为末和粉红色三岁一钱藕汁和蜜调下
胶黄散 治小儿大衄口鼻耳出血不止十五六岁儿阳盛多此病
阿胶(一两) 蒲黄(半两)
上为末三岁半钱生地黄汁微煎调下食前
五倍丸 治小儿大便下血如肠风脏毒
上以五倍干为末炼蜜丸如小豆大三岁三十丸米汤空心下
诃灰散 治小儿因疳大便有血
上以诃子烧灰存性一半为末米汤调下食前三岁一钱
桃胶丸 治小儿小便出血阴茎中痛
上以桃胶一块如枣大水一盏半煎三分日进三服下石子如豆石尽止药
火府散 治小儿小便出血
木通 生地黄 甘草 黄芩
上为末水一盏煎六分不时温服
《全婴论》说:吐血,是营卫之气逆乱所致。营气就是血,卫气就是气。营卫相互协调,不违背正常规律;一旦一方偏胜,就会导致血液妄行。就像开渠引水,决口在东就向东流,决口在西就向西流,这是气在推动血液,其形势就是这样。巢元方说:血之所以妄行,是因为热气盛而血虚,热邪侵袭血液,血性受热则流动散漫、妄行;气机逆乱则血随气上冲,所以导致吐血。或者在饮食过饱之后,脾胃内部寒冷,不能消化食物,忽然吐出所食之物,气血相冲撞,因而损伤肺胃,也导致吐血。如果久咳导致气逆,面目浮肿且咳嗽时吐血,这是虚损证。
衄血(鼻出血),是由于五脏热结所致。血随着气运行,通畅地流经脏腑,若冷热调和,不违背常度,就没有壅滞,也不会外溢。血遇寒则凝结,遇热则流动散漫。热邪侵袭血液,血随气发动,溢出鼻窍。又有因伤寒、瘟疫等阳经受病,不得发汗,热邪损伤五脏,从而从鼻而出的情况。
大便下血,是大肠热结损伤所致。脏腑之气既已受伤,风邪自然侵入;或者蓄积热邪,或者积存冷邪,或者湿毒蕴结于脾胃,或者疳积损伤了脏腑,因此冷热交错,疳湿互作,导致动血之气停留于内,凝滞无所归依,渗入肠中,所以大便下血。或者有腹胀,冷气在内攻冲,也导致大便下血。又因风冷乘虚侵入脾胃,或者瘀血存在于肠胃,湿毒下注如豆汁状,或者疳积损伤脏腑,也能引起便血。若上焦心肺积热,施注于大肠,也导致大便下血。失血后脾脏虚弱必然口渴,时间久了血虚,其人必定肌肤萎黄,头发不黑。
尿血(溺血),是因为心主血并与小肠相合,血的流行遍布经络,循环脏腑。如果热邪聚集在膀胱,血渗入膀胱(脬),所以小便带血而出。
黄芩汤:治疗小儿衄血、吐血、下血。
以上药味将黄芩研为细末,用炼蜜制成梧桐子大小的丸剂,三岁的儿童每次服用一丸,用浓盐汤送服。
另有方法:将柏叶、石榴花研为细末,吹入鼻腔,治疗衄血、吐血。
一方:使用定州瓮器底部的陶土末,治疗呕血、破血、止血。
柏枝饮:治疗小儿衄血、吐血。
侧柏枝(干燥者)、藕节(干燥者)。
上等分研为细末,三岁的儿童每次服用半钱,用藕汁加入蜂蜜,沸水调匀后服用。
另一方:将白芍药研为细末,磨犀角汁调匀,治疗咯血、衄血。
龙胆丸:治疗小儿衄血不止。
黄连、龙胆草。
上等分研为细末,用米糊制成小豆大小的丸剂,三岁的儿童每次服用三十丸,也可以做成散剂,用浓盐水送服。
柏皮汤:治疗小儿衄血。
侧柏皮(一两)、栀子(一两)、甘草(炙制,半两)。
以上药物切碎,三岁的儿童每次服用一钱,加水一小盏,煎至三分,去渣服用。
一方:剪取金花叶,阴干后用水煎服。
一方:将白及研为细末,用水调匀涂抹于鼻梁上方及囟门处,立即止血。
辰胶散:治疗小儿吐血。
阿胶(炒制)、蛤粉(等分)、辰砂(少许)。
以上研为细末,混合成粉红色,三岁的儿童每次服用一钱,用藕汁和蜂蜜调匀后服用。
胶黄散:治疗小儿大量衄血,口、鼻、耳出血不止。十五六岁的儿童阳气旺盛,多患此病。
阿胶(一两)、蒲黄(半两)。
以上研为细末,三岁的儿童每次服用半钱,用生地黄汁微煎后调匀,饭前服用。
五倍丸:治疗小儿大便下血,如肠风、脏毒之症。
以上将五倍子焙干研为细末,用炼蜜制成小豆大小的丸剂,三岁的儿童每次服用三十丸,空腹时用米汤送服。
诃灰散:治疗小儿因疳积导致大便有血。
以上将诃子烧成炭灰但保留药性,取一半研为细末,用米汤调匀,饭前服用,三岁的儿童每次服用一钱。
桃胶丸:治疗小儿小便出血,阴茎疼痛。
以上取一块如枣大的桃胶,加水一盏半,煎至三分,每日三次服用。服药后排出石子样物质,如豆粒大小,排尽后停药。
Quan Ying Lun states: Hematemesis (vomiting blood) is caused by the rebellion of Ying and Wei Qi. Ying Qi refers to Blood, while Wei Qi refers to Qi. When Ying and Wei coordinate with each other without deviating from the normal pathway, if one side becomes excessive, it leads to the reckless movement of Blood. It is like opening a channel for water; if the breach is on the east, it flows east; if on the west, it flows west. This is the Qi driving the Blood, and its momentum is thus. Chao Yuanfang stated: The reason for reckless bleeding is that Heat Qi is abundant while Blood is deficient. Heat pathogen invades the Blood; since Blood nature tends to flow and scatter when heated, it moves recklessly. When Qi rebels, Blood follows Qi upward, thus causing hematemesis. Alternatively, after overeating, the Spleen and Stomach become internally cold and fail to digest food. Suddenly vomiting the ingested food causes Qi and Blood to clash, thereby injuring the Lung and Stomach, also leading to hematemesis. If chronic coughing leads to Qi rebellion, accompanied by facial and ocular edema and coughing up blood, this is a deficiency-consumption syndrome.
Epistaxis (nosebleed) is caused by heat accumulation in the Five Zang organs. Blood flows with Qi, circulating freely through the Zang organs. If Cold and Heat are harmonized and do not deviate from the norm, there will be no stagnation or overflow. Blood coagulates when exposed to Cold and flows/scatters when exposed to Heat. When Heat pathogen attacks the Blood, Blood follows the movement of Qi and overflows from the nasal orifice. There are also cases due to Taiyang disease or plague affecting the Yang meridians, where sweat is not induced, Heat injures the Five Zang organs, and consequently, blood issues forth.
Hematochezia (blood in stool) is caused by heat accumulation and injury in the Large Intestine. Once the organ Qi is damaged, Wind pathogen naturally enters. Or, accumulated Heat, accumulated Cold, or Damp-Toxin may reside in the Spleen and Stomach, or malnutrition (Gan syndrome) may damage the Zang organs. Consequently, Cold and Heat intermingle, and Gan-Dampness interacts, causing the blood-moving Qi to remain inside, stagnating without a proper destination, seeping into the intestines, thus resulting in hematochezia. Abdominal distension with internal Cold Qi attacking and rushing can also cause hematochezia. Furthermore, Wind-Cold invading the Spleen and Stomach due to deficiency, or blood stasis in the intestines and stomach, or Damp-Toxin flowing downward resembling bean curd residue, or Gan injury to the Zang organs can also lead to blood in the stool. If Heat accumulates in the Upper Jiao (Heart and Lung) and transmits to the Large Intestine, it also causes hematochezia. After significant blood loss, Spleen weakness inevitably leads to thirst. Over time, Blood deficiency results in emaciated and yellowish skin and blackened hair loss.
Hematuria (blood in urine) occurs because the Heart governs Blood and pairs with the Small Intestine. Blood circulates throughout the meridians and Zang organs. If Heat gathers in the Bladder, Blood seeps into the bladder sac (Pao), thus causing blood to appear in the urine.
Huangqin Tang (Scutellaria Decoction): Treats pediatric epistaxis, hematemesis, and lower bleeding.
Take Scutellariae Radix (Huangqin), grind into powder, and make pills with refined honey the size of chicken heads. For three-year-olds, administer one pill per dose, taken down with strong salt water.
Another method: Grind Cacumen Platycladi (Baiye) and Pomegranate Flower (Shiliuhua) into powder and insufflate into the nose to treat epistaxis and hematemesis.
One formula: Use the end of pottery jars from Dingzhou (Wengqi Mo) to treat hematemesis, broken blood, and stop bleeding.
Baizhi Yin (Cacumen Platycladi Drink): Treats pediatric epistaxis and hematemesis.
Dried Cacumen Platycladi (Baizhi) and dried Rhizoma Nymphaeae (Oujie).
Grind equal parts into powder. For three-year-olds, administer half a qian per dose. Mix with lotus root juice and honey, then stir with boiling water.
Another formula: Grind Radix Paeoniae Alba (Baishaoyao) into powder and mix with ground Rhinocerotis Cornu (Xijiao) juice to treat hemoptysis and epistaxis.
Longdan Wan (Gentian Pills): Treats persistent pediatric epistaxis.
Radix Coptidis (Huanglian) and Radix Gentianae Longdancao (Longdancao).
Grind equal parts into powder, bind with rice paste into pills the size of small beans. For three-year-olds, administer thirty pills per dose. Alternatively, prepare as a powder and take down with strong salt water.
Bapi Tang (Cacumen Platycladi Decoction): Treats pediatric epistaxis.
Cortex Platycladi (Bapi, 1 liang), Fructus Gardeniae (Zhizi, 1 liang), and Glycyrrhizae Radix et Rhizoma (Gancao, roasted, 0.5 liang).
Cut the herbs. For three-year-olds, administer one qian per dose. Add one zhan of water, decoct until reduced to one-third, strain, and drink.
One formula: Pick leaves of Jasminum polyanthum (Jinhua Ye), dry in shade, and decoct with water.
One formula: Grind Rhizoma Bletillae (Baiji) into powder, mix with water, apply to the upper nose bridge and fontanelle to stop bleeding immediately.
Chenjiao San (Cinnabar and Donkey-Hide Gelatin Powder): Treats pediatric hematemesis.
Colla Corii Asini (Ejiao, fried), Calx Testudinis et Carapacis (Ge Fen, equal parts), and Cinabrium (Chensha, a small amount).
Grind into powder, mix to form a pink color. For three-year-olds, administer one qian per dose. Mix with lotus root juice and honey.
Jiaohuang San (Gelatin and Scutellaria Powder): Treats severe pediatric epistaxis with continuous bleeding from mouth, nose, and ears. Children aged fifteen or sixteen often suffer from this due to excess Yang.
Colla Corii Asini (Ejiao, 1 liang), Spora Typhae (Puhuang, 0.5 liang).
Grind into powder. For three-year-olds, administer half a qian per dose. Mix with fresh Radix Rehmanniae (Sheng Dihuang) juice, slightly warm, and take before meals.
Wubei Wan (Chinese Gall Pills): Treats pediatric hematochezia resembling Changfeng (intestinal wind) or Zangdu (visceral toxin).
Dry Chinese Gall (Wubeizi), grind into powder, and make pills with refined honey the size of small beans. For three-year-olds, administer thirty pills per dose, taken on an empty stomach with rice soup.
Hehui San (Areca Seed Ash Powder): Treats pediatric hematochezia due to Gan syndrome.
Burn Arecae Semen (Hezi) to ash but retain its properties. Take half, grind into powder, mix with rice soup, and take before meals. For three-year-olds, administer one qian per dose.
Taojiao Wan (Peach Gum Pills): Treats pediatric hematuria with pain in the penis.
Take a piece of Peach Gum (Taojiao) the size of a jujube. Add one and a half zhan of water, decoct until reduced to one-third. Take three times daily. Stop medication once stone-like particles, the size of beans, are expelled.
Huofu San (Fire Mansion Powder): Treats pediatric hematuria.
Akebiae Caulis (Mutong), Radix Rehmanniae Preparata (Sheng Dihuang - *Note: Text says Sheng Dihuang*), Radix Glycyrrhizae (Gancao), and Radix Scutellariae (Huangqin).
Grind into powder. Add one zhan of water, decoct until reduced to six-tenths. Take warm occasionally.