一、咯血唾血，古皆云出于肾；痰涎之血，云出于于脾。此亦未必然也。凡咯血者，于
喉中微咯即出，非若咳血、嗽血之费力而甚也。大都咳嗽而出者出于脏，出于脏者其来远；
一咯而出者出于喉，出于喉者其来近，其来远者，内伤已甚，其来近者，不过在经络之间，
所以凡见咯血、唾血及痰涎中带血者，多无咳嗽发热，气喘骨蒸等证，此其轻重为可知矣。
治此之法，凡因火者，亦不过微清脾肺之火；或因劳倦而致者，但为养营补阴，则自无不愈
。
一、劳损之渐者，必初因酒色劳伤过度，以致痰中或见血丝，此则本于肝脾肾经。当于
未咳未嗽之先，速为调理，宜生地、熟地、天冬、麦冬、枣仁、茯神、茜根、贝母、甘草之
属主之。或有火者，宜加黄柏、知母，仍须加意谨慎，庶无后患，否则必渐甚也。
一、清晨初起时，每于痰中有淡紫凝血，或块或片，常见数口者，此多以操心动火，或
多思郁，或由过饮，但无咳嗽发热等证，即不足虑，此不过致动络血而然，惟天王补心丹，
或二阴煎之类最所宜也。
薛立斋曰∶若脾经气滞而痰中有血者，宜加味归脾汤。若肝经血热而痰中有血，宜加味
逍遥散。若肝肾阴虚而痰中有血，宜六味地黄丸。若过服寒凉而唾痰有血者，宜四君子类。
一、咯血和唾血，古人常说源于肾脏；痰涎中带血，则说源于脾脏。这种说法也不一定完全正确。凡是咯血的人，血液是从喉咙中轻微用力咯出即出，不像咳血、嗽血那样费力且严重。大抵而言，通过咳嗽排出的血，病源在脏腑，源于脏腑的病位较深；只需咯出即来的血，病源在喉咙，源于喉咙的病位较浅。病位深的，说明内伤已经很严重；病位浅的，不过是在经络之间。所以，凡是见到咯血、唾血以及痰涎中带血的患者，大多没有咳嗽、发热、气喘、骨蒸（阴虚发热）等症状，由此可知其病情的轻重。治疗此法，如果是因火邪引起的，也不过是轻微清泻脾肺之火；如果是因劳累倦怠导致的，只需滋养营血、补益阴液，自然无不痊愈。
二、劳损逐渐形成的过程，必定起初是因为酒色过度、劳力损伤，导致痰中出现血丝，这根源在于肝、脾、肾三经。应当在尚未出现咳嗽之前，迅速进行调理，宜用生地、熟地、天冬、麦冬、枣仁、茯神、茜根、贝母、甘草等药物为主方。如果伴有火邪，宜加黄柏、知母，但仍须格外谨慎，才能避免后患，否则病情必然会逐渐加重。
三、清晨刚起床时，痰中常带有淡紫色的凝固血液，或成块状，或成片状，常见仅吐出几口，这种情况多因操心动火，或多思郁结，或因饮酒过量所致。只要没有咳嗽、发热等症状，就无需担忧，这不过是扰动络脉之血而已，最适宜使用天王补心丹，或者二阴煎之类的方剂。
薛立斋说：如果是脾经气机阻滞而痰中带血者，宜用加味归脾汤。如果是肝经血热而痰中带血者，宜用加味逍遥散。如果是肝肾阴虚而痰中带血者，宜用六味地黄丸。如果是过服寒凉药物而导致唾痰带血者，宜用四君子汤类方剂。
1. Hemoptysis (coughing up blood from the throat) and spitting of blood are traditionally said by ancient texts to originate from the Kidney; blood in phlegm and saliva is said to originate from the Spleen. This is not necessarily true. In cases of hemoptysis, the blood is expectorated with slight effort from the throat, unlike ke-xue (coughing up blood from the lungs) or sou-xue (spitting blood), which require significant effort and are more severe. Generally speaking, blood expelled through coughing originates from the Zang organs; since it comes from the Zang organs, its source is distant (deep). Blood that appears simply by spitting/hawking originates from the throat; since it comes from the throat, its source is proximate (superficial). A distant source indicates severe internal injury, whereas a proximate source implies the pathology is merely within the meridians and collaterals. Therefore, patients presenting with hemoptysis, spitting of blood, or blood in saliva/phlegm usually lack symptoms such as cough, fever, panting, or bone-steaming fever (yin deficiency heat). The severity can thus be determined. The treatment for this condition: if caused by fire, one need only mildly clear the fire of the Spleen and Lung; if caused by fatigue and overexertion, one should nourish Ying (nutritive Qi) and tonify Yin, and recovery will naturally follow.
2. The gradual onset of Lao Sun (consumptive disease due to overstrain) invariably begins with excessive indulgence in alcohol and sexual activity, or physical overexertion, leading to blood streaks in the phlegm. This pathology roots in the Liver, Spleen, and Kidney meridians. One must intervene promptly to regulate the body before coughing or spitting occurs. The primary prescription should include Sheng Di Huang (Rehmanniae Radix), Shu Di Huang (Rehmanniae Radix Preparata), Tian Dong (Asparagi Radix), Mai Dong (Ophiopogonis Radix), Zao Ren (Ziziphi Spinosae Semen), Fu Shen (Poria with Hostwood), Qian Cao Gen (Rubiae Cordifoliae Radix), Bei Mu (Fritillariae Cirrhosae Bulbus), and Gan Cao (Glycyrrhizae Radix et Rhizoma). If fire signs are present, add Huang Bo (Phellodendri Cortex) and Zhi Mu (Anemarrhenae Rhizoma). Caution must still be exercised to prevent future complications; otherwise, the condition will inevitably worsen gradually.
3. Upon waking in the early morning, pale purple coagulated blood clots or flakes are often found in the phlegm, typically appearing in small amounts (a few mouthfuls). This is mostly caused by mental exertion generating fire, excessive thinking and depression, or overindulgence in alcohol. As long as there are no symptoms of cough or fever, there is no cause for concern. This is merely due to the disturbance of collateral vessels causing bleeding. The most suitable treatments are Tian Wang Bu Xin Dan (Emperor of Heaven’s Special Pill to Tonify the Heart) or Er Yin Jian (Two Yin Decoction).
Xue Lizhai stated: If blood in the phlegm is due to Qi stagnation in the Spleen meridian, Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction) is indicated. If blood in the phlegm is due to blood heat in the Liver meridian, Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) is indicated. If blood in the phlegm is due to Yin deficiency of the Liver and Kidney, Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) is indicated. If blood in saliva/phlegm results from the excessive use of cold-natured drugs, Si Jun Zi Tang class formulas (Four Gentlemen Decoction variants) are indicated.