（大衄 舌衄 齿衄 耳衄 眼衄 肌衄）
衄者。血从经络中渗出而行于清道也。伤寒衄血。责热在表。有麻黄、越婢等法。杂病衄血。
责热在里。经络热甚。阳气壅重。迫血妄行而出于鼻。从无发散之理。若因七情喜怒。劳役过伤
而致者。无论是何经络。并宜茅花煎汤。调止衄散。或四物加犀角、丹皮、沉香。六脉弦细而涩。
按之空虚。色白不泽者。脱血也。此大寒证。理中汤加黄 。六脉俱大。按之空虚。心动面赤。
善惊上热。乃手少阴心火旺。而上熏于肺脉也。三黄补血汤。实热衄血。脉实大便秘者。犀角地
黄汤加木香、大黄。衄血过多。屡服犀角地黄汤不止。此内虚寒而外假热也。千金当归汤。兼标
本而治之。若至夜发。此因多汗。卫气大虚。不能固其营血也。当归补血汤。不效。加木香。更
不效。必是血虚火旺。大剂保元汤。若误用凉血药。致瘀热内结。胸中作痛者。一味木香酒磨。
顿服钱许立效。内伤劳役之人。喘嗽面赤。发热头痛而衄。此肺经气虚。失护卫之职。致心包火
炎。经脉热甚。故行清道。当归补血汤加薄荷、荆芥。不应。补中益气倍黄 。慎不可用辛热之
药。兼有风寒。小建中加葱、豉。清道闭塞。流入胃脘。吐出清血。或衄血不尽。瘀积停留。致
面目痿黄。大便黑
色者。犀角地黄汤。 扑而衄不止。小乌沉汤调黑神散。伏暑而衄。五苓散加茅花。久衄不止。
热在下焦血分。六味丸加五味子作汤。不效。加童便。有先因衄血。衄止而变生诸证。或寒热间
作。或喘急无寐。病状不一。渐成劳惫。当于虚损诸证详之。曾病衄。后血因旧路。或一月三四
衄。又有洗面即衄。日以为常。并宜止衄散。茅花煎汤调下。大衄不止。面浮肿者。苏子降气汤。
使血随气下。得力全在肉桂一味。久衄不已。须加气药。如木香、香附之类。盖血无气引。则血
不归经也。有头风才发。则衄不止。用童便浸川芎一两。童便制香附二两。炙甘草半两。共为末。
每服三钱。清茶调下。间用搐鼻法。
〔诊〕衄血脉浮大数者。为邪伏于经。宜发汗。大而虚者。为脾虚不能统摄。宜补气。小而数
者。为阴虚火乘。宜摄火。弦涩为有瘀积。宜行滞。凡衄血之脉。数实或坚劲。或急疾不调。皆
难治。久衄脉虚大。头额痛甚。鼻流淡黄水者死。
大衄 大衄血者。口鼻俱出也。此积劳伤脾所致。补中益气倍黄 、当归。不应。归脾汤加
童便、藕节。
舌衄 舌上忽出血如线。先用蒲黄煎汤漱之。次用槐花炒研掺之。黄 六一汤合生脉散服之。
热壅舌上出血如泉。用文蛤一味为散掺之。虚热舌胀大。出血不止。生干姜末、蒲黄末掺之。
齿衄 血从齿缝中或齿龈中出者。曰齿衄。又谓牙宣。有风壅。有肾虚。有胃火。风壅者。
或齿龈微肿。或牵引作痛。消风散加犀角、连翘。外擦青盐、 本末。肾虚者。口不臭。齿浮动。
齿缝中点滴而出。若隐隐作痛者。虚风袭入肾经。肾主骨。齿乃骨之余也。宜盐汤下小安肾丸。
不痛。肾虚而有火也。六味丸加骨碎补。外用青盐炒香附末擦之。胃热者。牙疼而龈间出血如涌。
齿不动摇。其人必好饮。或多啖炙爆所致。口臭不可近。宜清胃散。甚者服调胃承气汤。
耳衄 耳中出血为耳衄。两关弦数。饮酒多怒人属肝火。柴胡清肝散。尺脉弱或躁。属阴虚。
生料六味丸加五味子。更以龙骨烧灰。吹入即止。
眼衄 血从目出。乃积热伤肝。或误药扰动阴血所致。暴病发热见此。栀子豉汤加犀角、秦
皮、丹皮、赤芍。误药成坏病见之。虽用独参、保元、生料六味。皆不可救。
肌衄 血从毛孔出者为肌衄。脉数。当归补血汤。脉浮。黄 建中汤。脉弱。保元汤。脉盛。
当归六黄汤。滑伯仁治一妇。体肥气盛。因无子。常服暖子宫药。积久火盛迫血。上行为衄。衄
必升余。医者犹以为上实下虚。用丹剂镇坠之。经云。上者下之。今血气俱盛。溢而上行。法当
下导。奈何实实耶。即与桃核承气三四下。瘀积既去。继服既济汤二十余剂而愈。
一膏粱过饮致衄。医曰。诸见血为热。以清凉饮子投之即止。越数日其疾复作。又曰。药不
胜病故也。遂投黄连解毒汤。或止或作。易数医。皆用苦寒之剂。向后饮食起居。渐不及初。肌
寒而躁。言语无声。口气秽臭。其衄之余波未绝。或曰。诸见血为热。热而寒。正理也。今不愈
而反害之。何耶。盖医惟知见血为热。而以苦寒攻之。不知苦寒专泻脾土。脾土为人之本。火病
而泻其土。火未除而土已病。病则胃虚。虚则营气不能滋荣百脉。元气不循天度。气随阴化。故
声不扬而肌寒也。惟当甘温大补脾土。斯可向安矣。
石顽治朱圣卿。鼻衄如崩。三日不止。较之向来所发之势最剧。服犀角、地黄、芩、连、知、
柏、石膏、山栀之属转盛。第四日邀余诊之。脉弦急如循刀刃。此阴火上乘。载血于上。得寒凉
之药。转伤胃中清阳之气。所以脉变弦紧。与生料
六味加五味子作汤。另用肉桂末三钱。飞罗面糊。分三丸。用煎药调下。甫入喉。其血顿止。少
顷。口鼻去血块数枚而愈。自此数年之患。绝不再发。
衄血，是指血液从经络中渗出，在清窍通道中运行而出。伤寒病中的衄血，责任在于热邪在表，可用麻黄汤、越婢汤等治法。杂病中的衄血，责任在于热邪在里，经络热势极盛，阳气壅滞沉重，逼迫血液妄行而从鼻出，绝无使用发散解表之理。若因七情喜怒、劳役过度损伤所致者，无论涉及哪条经络，都适宜用茅花煎汤，调服止衄散；或者用四物汤加犀角、牡丹皮、沉香。如果六脉弦细而涩，重按感觉空虚，面色苍白无光泽，这是脱血证，属于大寒证，宜用理中汤加黄芪。如果六脉俱大，重按空虚，伴有心悸、面赤、易惊、上部发热，这是手少阴心经火旺，向上熏蒸肺脉所致，宜用三黄补血汤。实热导致的衄血，脉象实大且大便秘结者，宜用犀角地黄汤加木香、大黄。衄血量过多，多次服用犀角地黄汤仍不止血，这是内里虚寒而外部呈现假热，宜用千金当归汤，兼顾标本治疗。如果是夜间发作，这是因为多汗导致卫气大虚，不能固摄营血，宜用当归补血汤；若不效，加木香；再无效，必定是血虚火旺，需用大剂量的保元汤。如果误用凉血药，导致瘀热内结，胸中疼痛，单用木香酒磨，顿服一钱左右，立见疗效。内伤劳役之人，出现喘咳、面赤、发热头痛并伴有衄血，这是肺经气虚，失去护卫职能，导致心包之火炎上，经脉热势极盛，故血液行于清道，宜用当归补血汤加薄荷、荆芥；若不应，改用补中益气汤倍加黄芪。切不可使用辛热药物。兼有风寒者，用小建中汤加葱白、豆豉。清道闭塞，血液流入胃脘，吐出清血，或衄血不尽，瘀血停留，导致面目萎黄、大便黑色者，宜用犀角地黄汤。被击打后衄血不止，用小乌沉汤调服黑神散。伏暑导致的衄血，用五苓散加茅花。久衄不止，热在下焦血分，用六味丸加五味子煎汤；若不效，加童便。有先因衄血，衄血停止后变生各种证候，或寒热交替发作，或喘急失眠，病状不一，逐渐形成劳损疲惫，应当参照虚损诸证详细诊治。曾经患过衄血的人，后来血液沿旧路复发，或一月衄血三四次，又有洗脸即衄血，日复一日成为常态的，都适宜用止衄散，茅花煎汤调服。大衄不止，面部浮肿者，用苏子降气汤，使血液随气下行，药效关键在于肉桂一味。久衄不已，须加入气药，如木香、香附之类。因为血没有气的引导，就不能回归经脉。有头风刚发作，则衄血不止，用童便浸泡川芎一两，童便制香附二两，炙甘草半两，共为末，每次服三钱，清茶调下。间或用搐鼻法。
〔诊法〕衄血脉象浮大数者，为邪气潜伏于经络，宜发汗。脉大而虚者，为脾虚不能统摄血液，宜补气。脉小而数者，为阴虚火乘，宜摄火。脉弦涩为有瘀积，宜行滞。凡是衄血的脉象，若数实或坚劲，或急疾不调，都难治。久衄脉虚大，头额痛甚，鼻流淡黄水者，预后不良（死证）。
大衄：大衄血，指出血同时从口和鼻流出。这是由于积劳损伤脾脏所致。宜用补中益气汤倍加黄芪、当归；若不应，用归脾汤加童便、藕节。
舌衄：舌上忽然出血如线状，先用蒲黄煎汤漱口，再用炒研后的槐花粉末掺敷。服用黄芪六一汤合生脉散。若热邪壅滞舌上，出血如泉涌，单用文蛤一味研散掺敷。虚热导致舌体肿大，出血不止，用生干姜末、蒲黄末掺敷。
齿衄：血液从齿缝或齿龈中流出，称为齿衄，又称牙宣。原因有风壅、肾虚、胃火三种。风壅者，或齿龈微肿，或牵引作痛，用消风散加犀角、连翘。外用青盐、藁本末擦涂。肾虚者，口不臭，牙齿松动，齿缝中点滴出血。若隐隐作痛，是虚风袭入肾经。肾主骨，牙齿是骨之余，宜用盐汤送服小安肾丸。若不痛，是肾虚而有火，用六味丸加骨碎补。外用青盐炒香附末擦涂。胃热者，牙疼且牙龈间出血如涌，牙齿不松动。此人必好饮酒，或多食烤炸食物所致。口臭不可近人，宜用清胃散。严重者服调胃承气汤。
耳衄：耳中出血为耳衄。两手关脉弦数，饮酒多怒者属肝火，用柴胡清肝散。尺脉弱或躁动，属阴虚，用生料六味丸加五味子。另将龙骨烧灰，吹入耳中即可止血。
眼衄：血液从眼中流出，是积热伤肝，或误药扰动阴血所致。暴病发热见此证，用栀子豉汤加犀角、秦皮、牡丹皮、赤芍。误药导致坏病见此证，即使使用独参汤、保元汤、生料六味丸，都不可救。
肌衄：血液从毛孔中流出称为肌衄。脉数者，用当归补血汤。脉浮者，用黄芪建中汤。脉弱者，用保元汤。脉盛者，用当归六黄汤。滑伯仁治疗一位妇女，身体肥胖气盛，因无子嗣，常服暖子宫药，日久火盛逼迫血液，上行变为衄血，衄血必伴随余血上升。医者仍认为是上实下虚，用丹剂镇坠。《内经》说：上者下之。如今血气俱盛，溢出而上行，治法应当下导，为何反而实证更实呢？随即给予桃核承气汤攻下三四次，瘀积去除后，继服既济汤二十余剂而愈。
另一位因膏粱厚味过度饮食导致衄血。医生说：诸见血证多为热，投以清凉饮子即止。过了几天疾病复发。又说：药不胜病，于是投以黄连解毒汤。有时止有时发。更换多位医生，都用苦寒药剂。之后饮食起居，逐渐不如从前，肌肉寒冷而烦躁，言语无声，口气秽臭。衄血的余波未绝。有人说：诸见血为热，热证用寒药，是正理。现在不愈反而害病，为什么？大概医生只知道见血为热，而用苦寒攻伐，不知苦寒专泻脾土。脾土是人的根本，火病而泻其土，火未除而土已病。土病则胃虚，虚则营气不能滋养百脉，元气不循天道，气随阴化，所以声音不扬而肌肉寒冷。只应当用甘温大补脾土，才能趋向安宁。
石顽治疗朱圣卿，鼻衄如崩，三日不止，比向来发作的势头最剧烈。服用犀角、地黄、黄芩、黄连、知母、黄柏、石膏、山栀等寒凉药物后，病情反而加重。第四天邀请我诊治。脉象弦急如触摸刀刃，这是阴火上冲，载血上行。得到寒凉药物，反而伤了胃中清阳之气，所以脉变弦紧。给予生料六味丸加五味子煎汤，另用肉桂末三钱，飞罗面糊制成三丸，用煎药调服。刚入喉，血立刻停止。过了一会儿，口鼻排出数枚血块而痊愈。从此数年之患，绝不再发。
(Great Nuxue, Tongue Nuxue, Tooth Nuxue, Ear Nuxue, Eye Nuxue, Muscle Nuxue)
Nuxue (epistaxis/nosebleed) refers to blood seeping from the meridians and flowing through the clear orifices. In Shanghan (Cold Damage) disease, nuxue is attributed to heat in the exterior; methods such as Mahuang Tang (Ephedra Decoction) and Yuespi Tang are applicable. In miscellaneous diseases, nuxue is attributed to heat in the interior, where extreme heat in the meridians causes yang qi to become congested and heavy, forcing blood to move recklessly and exit from the nose. There is no rationale for using dispersing methods. If caused by emotional disturbances (seven emotions), anger, or excessive labor injury, regardless of which meridian is involved, it is appropriate to decoct Maohua (Carpobambus Flower) and take it with Zhi Nü San (Stop Epistaxis Powder), or use Siwu Tang (Four Substances Decoction) added with Xijiao (Rhinoceros Horn, now substituted with water buffalo horn), Mudan Pi (Tree Peony Bark), and Chenxiang (Agarwood). If the six pulses are wiry, fine, and choppy, feeling empty upon deep pressure, and the complexion is pale and lusterless, this is Blood Loss Syndrome (Tuoxue), representing a severe cold syndrome. Lizhong Tang (Regulate the Middle Decoction) added with Huangqi (Astragalus Root) should be used. If all six pulses are large but feel empty upon deep pressure, accompanied by palpitations, flushed face, susceptibility to fright, and upper body heat, this indicates hyperactivity of Heart Fire in the Hand Shaoyin meridian, steaming upwards into the Lung meridian. Sanhuang Buxue Tang (Three-Yellow Blood-Nourishing Decoction) should be used. For true heat nuxue with solid, large pulses and constipation, Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) added with Muxiang (Aucklandia Root) and Dahuang (Rhubarb Root) is indicated. If nuxue is excessive and persists despite repeated doses of Xijiao Dihuang Tang, this indicates internal deficiency-cold with external false-heat; Qianjin Danggui Tang (Dangui Decoction from Essential Prescriptions Worth a Thousand Gold) should be used to treat both root and branch. If onset occurs at night, it is due to profuse sweating causing significant deficiency of Wei Qi (Defensive Qi), failing to secure Ying Blood (Nutritive Blood); Danggui Buxue Tang (Dangui Blood-Nourishing Decoction) is indicated. If ineffective, add Muxiang; if still ineffective, it must be Blood Deficiency with Fire Hyperactivity, requiring a large dose of Baoyuan Tang (Preserve Origin Decoction). If cooling-blood herbs are mistakenly used, causing stasis-heat to knot internally and chest pain, grinding Muxiang in wine and taking it in one dose (approx. 1 qian) yields immediate effect. In cases of internal injury and labor fatigue, presenting with wheezing, cough, flushed face, fever, headache, and nuxue, this is Lung Qi deficiency failing to perform its guarding function, leading to inflammation of Pericardium Fire and extreme heat in the meridians, causing blood to flow through the clear orifices. Danggui Buxue Tang added with Bohe (Mint) and Jingjie (Schizonepeta Spike) is indicated. If ineffective, switch to Buzhong Yiqi Tang (Center-Supplementing Qi-Boosting Decoction) with doubled Huangqi.辛热 (Acrid-Warm) herbs must strictly be avoided. If complicated by wind-cold, Xiaojianzhong Tang (Minor Construct the Middle Decoction) added with Congbai (Green Onion White) and Chidou Chi (Fermented Soybean) is used. If the clear orifices are blocked and blood flows into the stomach, vomiting clear blood, or incomplete nuxue leaves stasis that causes sallow complexion and black stool, Xijiao Dihuang Tang is indicated. If nuxue persists after trauma, Xiaowuchen Tang (Minor Black Sink Decoction) mixed with Heishen San (Black Divine Powder) is used. For nuxue due to latent summerheat, Wuling San (Five-Ingredient Powder with Poria) added with Maohua is used. For chronic persistent nuxue with heat in the Lower Jiao Blood level, Liuwei Wan (Six-Ingredient Pill) added with Wuweizi (Schisandra Berry) decocted as soup is used; if ineffective, add Tongbian (Child's Urine). If nuxue stops but various syndromes arise subsequently, such as alternating chills and fever, or wheezing urgency with insomnia, with varying symptoms gradually leading to consumptive fatigue, one should consult detailed treatments for deficiency-consumption syndromes. For those who have previously suffered nuxue, where blood recurs along the old path, occurring three or four times a month, or bleeding upon washing the face becoming a daily routine, Zhi Nü San (Stop Epistaxis Powder) decocted with Maohua is appropriate. For great nuxue uncontrolled with facial edema, Suzi Jiangqi Tang (Perilla Seed Descending Qi Decoction) is used to make blood follow the qi downward; the efficacy relies entirely on Rougui (Cinnamon Bark). For chronic nuxue, qi-moving herbs such as Muxiang and Xiangfu (Cyperus Rhizome) must be added, because without qi guidance, blood does not return to the vessels. In cases where Toufeng (Head Wind/Migraine) just starts, causing persistent nuxue, soak 1 liang of Chuanxiong (Sichuan Lovage Rhizome) in Tongbian, and process 2 liang of Xiangfu with Tongbian, plus 0.5 liang of Zhi Gancao (Honey-fried Licorice Root), grind into powder, take 3 qian per dose with clear tea. Intermittently use the nasal insufflation method.
[Diagnosis] If the pulse in nuxue is floating, large, and rapid, it indicates pathogenic factors lurking in the meridians, and sweating is indicated. If large and deficient, it indicates Spleen deficiency failing to control blood, and tonifying qi is indicated. If small and rapid, it indicates yin deficiency with fire encroaching, and subduing fire is indicated. Wiry and choppy pulses indicate stasis accumulation, and moving stagnation is indicated. Generally, if the pulse in nuxue is rapid and solid, hard and stiff, or hurried and irregular, it is difficult to treat. In chronic nuxue, if the pulse is deficient and large, accompanied by severe forehead/head pain and dripping of pale yellow fluid from the nose, the prognosis is fatal.
Great Nuxue: Great nuxue involves simultaneous bleeding from the mouth and nose. This is caused by accumulated fatigue injuring the Spleen. Buzhong Yiqi Tang with doubled Huangqi and Danggui (Angelica Sinensis) is indicated; if ineffective, Guipi Tang (Restore the Spleen Decoction) added with Tongbian and Ou Jie (Lotus Node) is used.
Tongue Nuxue: Sudden thread-like bleeding from the tongue should first be rinsed with decocted Puhuang (Pollen Typhae), then dusted with fried and ground Huaihua (Sophora Flower). Take Huangqi Liuyi Tang (Astragalus Six-to-One Decoction) combined with Shengmai San (Generate the Pulse Powder). If heat congestion causes fountain-like bleeding from the tongue, use only Wen Ge (Clam Shell) ground into powder for dusting. For tongue swelling and continuous bleeding due to deficient heat, apply raw dried Ginger powder and Puhuang powder.
Tooth Nuxue: Bleeding from between teeth or gums is called Tooth Nuxue, also known as Ya Xuan (Gum Recession/Disease). Causes include Wind Congestion, Kidney Deficiency, and Stomach Fire. In Wind Congestion, gums may be slightly swollen or painful upon traction; Xiaofeng San (Extinguish Wind Powder) added with Xijiao and Lianqiao (Forsythia Fruit) is used. Externally rub Qingyan (Green Salt) and Gaoben (Ligusticum Root) powder. In Kidney Deficiency, there is no foul odor, teeth are loose, and bleeding drips from gum gaps. If dull pain exists, it is deficient wind invading the Kidney meridian. The Kidney governs bones, and teeth are the surplus of bones; take Xiao An Shen Wan (Small Calming Kidney Pill) with salt water. If painless, it is Kidney Deficiency with Fire; Liuwei Wan (Six-Ingredient Pill) added with Gusuibu (Drynaria Rhizome) is used. Externally rub Qingyan with fried Xiangfu powder. In Stomach Heat, teeth ache and gums bleed like a surge, teeth do not loosen, and the patient likely enjoys alcohol or fried foods. Foul breath makes others avoid them; Qingwei San (Clear Stomach Powder) is indicated. In severe cases, Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction) is taken.
Ear Nuxue: Bleeding from the ear is Ear Nuxue. Wiry and rapid pulses at both Guan positions in drinkers prone to anger indicate Liver Fire; Chaihu Qinggan San (Bupleurum Clearing Liver Powder) is used. Weak or restless Chi pulses indicate Yin Deficiency; Shengliao Liuwei Wan (Raw Material Six-Ingredient Pill) added with Wuweizi is used. Additionally, burn Longgu (Fossilized Bone) to ash and insufflate into the ear to stop bleeding.
Eye Nuxue: Blood exiting the eye is caused by accumulated heat injuring the Liver, or by mistaken medication disturbing Yin Blood. It appears in acute febrile diseases. Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) added with Xijiao, Qinpi (Ash Bark), Mudan Pi, and Chishao (Red Peony Root) is used. If seen in complex diseases caused by mistaken medication, even with Dushen Tang (Single Ginseng Decoction), Baoyuan Tang, or Shengliao Liuwei Wan, it is incurable.
Muscle Nuxue: Blood exiting pores is Muscle Nuxue. With rapid pulses, use Danggui Buxue Tang. With floating pulses, use Huangqi Jianzhong Tang (Astragalus Construct the Middle Decoction). With weak pulses, use Baoyuan Tang. With full/exuberant pulses, use Danggui Liuhuang Tang (Danggui Six-Yellow Decoction). Hua Borén treated a woman who was obese with vigorous qi. Due to infertility, she frequently took uterine-warming medicines, causing long-term fire hyperactivity forcing blood upward into nuxue, accompanied by residual blood rising. Physicians still considered it Upper Excess and Lower Deficiency, using cinnabar preparations to suppress. The Classic states: "What is above, direct below." Now, with both blood and qi exuberant, overflowing and rising, the method should be to guide downward. Why exacerbate excess? He immediately administered Taohe Chengqi Tang (Peach Kernel and Magnolia Bark Decoction) to purge three or four times. After stasis was removed, Ji Ji Tang (Ji Ji Decoction) was taken for over twenty doses, resulting in recovery.
Another case involved nuxue caused by excessive rich diet. The physician said: "All blood manifestations are heat," and administered Qingliang Yinzi (Cooling Drink), which stopped the bleeding. Days later, it recurred. The physician said: "The medicine could not overcome the disease," and administered Huanglian Jiedu Tang (Coptis Detoxification Decoction). It stopped intermittently. Several physicians changed, all using bitter-cold agents. Gradually, diet and lifestyle deteriorated compared to before; muscles became cold and irritable, speech became silent, and breath smelled foul. The residual wave of nuxue had not ceased. Someone said: "All blood manifestations are heat; treating heat with cold is correct logic. Why does it fail and cause harm?" The reason is that physicians only know blood manifestation implies heat and attack with bitter-cold, unaware that bitter-cold specifically drains Spleen Earth. Spleen Earth is the root of humanity. In fire disease, draining earth harms the earth before the fire is eliminated. Earth disease leads to Stomach deficiency; deficiency prevents Ying Qi from nourishing the hundred vessels; Yuan Qi fails to follow natural laws; qi transforms with yin, hence voice is suppressed and muscles are cold. Only by using sweet-warm herbs to greatly tonify Spleen Earth can peace be restored.
Shiwan treated Zhu Shengqing, whose epistaxis was torrential, lasting three days without stopping, more severe than previous episodes. Taking Xijiao, Dihuang, Huangqin, Huanglian, Zhimu, Huangbai, Shigao (Gypsum), and Shanzhi (Gardenia) aggravated the condition. On the fourth day, I examined him. The pulse was wiry and urgent like touching a knife edge, indicating Min Fire surcharging upward, carrying blood up. Cold-cool medicines injured the clear Yang qi in the Stomach, changing the pulse to wiry and tight. I prescribed Shengliao Liuwei Wan added with Wuweizi decocted as soup, separately preparing three pills from 3 qian of Rougui (Cinnamon Bark) powder and Feiluo Mian (Fine Wheat Flour) paste, taken down with the decoction. Upon entering the throat, bleeding stopped instantly. Shortly after, several blood clots were expelled from the mouth and nose, and he recovered. Since then, this multi-year affliction never recurred.