《论》曰∶阳明病，下血谵语者，此为热入血室，是兼男女而言也。曰∶妇人中风，七八日，
续得寒热，发作有时，经水适断者，此为热入血室，其血必结，故使如疟状，发作有时，小柴胡汤
主之。曰∶妇人中风，脉
迟身凉，而证如结胸者，当刺期门。曰∶妇人伤寒，经水适来，昼日了了，暮则谵语者，无犯胃气
及上二焦，必自愈。
按:血室者，即冲任血海也，亦血分也。凡血分之病，有蓄血者，以血因热结而留蓄不行也；
有热入血室者，以邪入血分而血乱不调也。故血蓄者，去之则愈；血乱者，调之则安。调之之法，
则热者宜凉，陷者宜举，虚者宜滋，瘀者宜行，邪未散者宜解也。然此皆病在下焦，故曰无犯胃气
及上二焦。必自愈，是又不可不察。
凡邪气自表传里，必先入胸膈，以次渐从胁肋而后入胃，邪气入胃，乃为入腑，是以胸满者犹
属表证，胁满则半表半里也。大抵胸胁满者，以邪气初入于里，气郁不行，所以生满，尚未停聚为
实，故但从和解，以小柴胡之属则可愈矣。若果实邪在上，留滞不能散者，乃可吐之。华元化曰∶
四日在胸，吐之则愈。是因邪已收聚而未及散漫者，乃可吐也。在仲景用栀子豉汤，或瓜蒂散之属
，栀子豉汤可吐客热，瓜蒂散可吐实痰。其或一时药有不便，余有吐法在新方攻阵中，可以代之，
或即以和解之药探而吐之，无不可也。
一、腹满证，按华元化曰∶伤寒一日在皮，二日在肤，三日在肌，四日在胸，五日在腹，六日在
胃，入胃即为入腑，入腑即在腹也。若腹虽满而未甚者，犹是未全入腑，不可攻也。然腹满之证，
有虚实也，有寒热也，不可一概皆以实论。观《金匮要略》曰∶腹满不减，减不足言，当下之。是
不减者为实满也。又曰∶腹满时减，复如故，此虚寒从下上也，当以温药和之。是或进或退，时或
减而时复如故者，本非结聚实邪，此虚满也。大抵腹满之证，本属太阴，若是阳邪，则必咽干烦热
，脉实有力；若是阴邪，则必腹满吐食，畏寒自利，脉息无神，可以辨之。实热者可清可攻，虚寒
者宜温宜补也。
《黄帝内经》等医论中说：阳明病，出现下血和谵语的症状，这是热入血室的表现，这句话是兼指男性和女性而言的。又说：妇女患中风病，经过七八天，持续出现忽冷忽热的症状，且发作有定时，月经恰好中断，这是热入血室，体内的血液必然凝结，所以使病情像疟疾一样，发作有定时，用小柴胡汤主治。又说：妇女患中风病，脉象迟缓、身体凉爽，但症状像结胸病那样，应当针刺期门穴。又说：妇女患伤寒病，月经恰好来潮，白天神志清楚，到了晚上却出现谵语，此时不要损伤胃气以及上焦和中焦的气机，疾病必定会自行痊愈。
按语：血室，就是冲脉、任脉所主的血海，也属于血分的范畴。凡是血分的疾病，有蓄血证，是因为血液因热邪凝结而留滞不行；有热入血室证，是因为邪气侵入血分而导致血液紊乱不调。所以，对于血蓄（蓄血）的情况，祛除瘀血则痊愈；对于血乱（热入血室）的情况，调理血液则安宁。调理的方法，则是热者宜用凉法，下陷者宜用升举法，虚者宜用滋补法，瘀者宜用行血法，邪气未散者宜用解表法。然而这些病都在下焦，所以说不要损伤胃气以及上焦和中焦。说“必定会自愈”，这一点又是不可以不仔细考察的。
大凡邪气从体表传入体内，一定先进入胸膈，然后依次逐渐通过胁肋进而进入胃腑，邪气进入胃腑，才称为进入腑，因此胸满仍然属于表证，胁满则属于半表半里证。大概胸胁胀满，是因为邪气刚初入里，气机郁滞不能运行，所以产生胀满，尚未停聚成为实证，所以只需采用和解法，使用小柴胡汤之类的方剂就可以痊愈了。如果确实是实邪停留在上部，留滞而不能消散的，才可以采用吐法。华元化说：第四天邪气在胸，用吐法治疗即可痊愈。这是因为邪气已经聚集但未及扩散蔓延时，才可以采用吐法。在张仲景的著作中，使用栀子豉汤，或者瓜蒂散之类的方剂，栀子豉汤可以吐出客热，瓜蒂散可以吐出实痰。如果当时用药不便，我在新的方剂攻阵中有其他吐法，可以替代使用，或者直接用和解的药物试探性地引起呕吐，也是没有不可以的。
一、腹满证，参考华元化的说法：伤寒第一天在皮肤，第二天在肌肤，第三天在肌肉，第四天在胸，第五天在腹，第六天在胃，进入胃就是进入腑，进入腑就是在腹部。如果腹部虽然胀满但并不严重的，仍然是没有完全进入腑，不可采用攻下法。然而腹满这个病症，有虚证和实证的区别，有寒证和热证的区别，不能一概而论都当作实证来看待。看《金匮要略》中说：腹满持续不减，即使减轻也不足以说明问题，应当采用攻下法。这是指不减者为实满。又说：腹满时而减轻，过后又像原来一样，这是虚寒之气从下向上侵犯，应当用温药调和。这是指有时减轻、有时恢复原状的，本来就不是结聚的实邪，这是虚满。大概腹满的病证，本归属于太阴脾经，如果是阳邪致病，则必然伴有咽干、烦热、脉象实而有力的症状；如果是阴邪致病，则必然伴有腹满、呕吐食物、畏寒、自发性腹泻、脉息无神的症状，可以根据这些来辨别。实热证可以采用清热或攻下的方法，虚寒证宜用温补的方法。
According to medical treatises: In Yangming disease, if there is bleeding from the lower orifice accompanied by delirium, this is referred to as "Heat Entering the Blood Chamber" (Re Ru Xue Shi), a term that applies to both men and women. It is also stated: When a woman contracts Wind-stroke (Zhong Feng) and after seven or eight days continues to experience alternating chills and fever with regular paroxysms, and her menses happen to cease at that time, this is Heat Entering the Blood Chamber. The blood will necessarily coagulate, causing symptoms resembling malaria with regular paroxysms; Xiao Chai Hu Tang (Minor Bupleurum Decoction) should be used as the primary treatment. It is further stated: If a woman with Wind-stroke presents with a slow pulse and cool body, yet exhibits symptoms similar to Chest Binding (Jie Xiong), the Qimen acupoint (Liv 14) should be needled. Additionally, if a woman suffering from Cold Damage (Shang Han) has her menses commence during the illness, remains lucid during the day but becomes delirious at night, one must not injure the Stomach Qi nor interfere with the Upper and Middle Jiao; the condition will likely resolve spontaneously.
Commentary: The "Blood Chamber" refers to the Sea of Blood governed by the Chong and Ren vessels, which also pertains to the Blood aspect. Diseases of the Blood aspect include Blood Accumulation (Xu Xue), where blood stagnates due to heat-induced coagulation, and Heat Entering the Blood Chamber, where pathogenic factors invade the Blood aspect causing disorder and irregularity. Therefore, for Blood Accumulation, removing the stasis leads to recovery; for Blood Disorder, regulating the blood brings peace. Methods of regulation include: cooling for heat, lifting for sinking, nourishing for deficiency, promoting circulation for stasis, and resolving for lingering pathogens. Since these conditions reside in the Lower Jiao, it is said not to injure the Stomach Qi or the Upper and Middle Jiao. The assertion that the condition "will resolve spontaneously" requires careful examination.
Generally, when pathogenic factors transmit from the exterior to the interior, they first enter the Chest and Diaphragm, then gradually move through the Hypochondrium into the Stomach. Entry into the Stomach constitutes entry into the Fu organs. Thus, chest fullness still belongs to Exterior syndromes, while hypochondriac fullness belongs to Half-Exterior Half-Interior syndromes. Generally, chest and hypochondriac fullness arise because pathogenic factors have just entered the interior, causing Qi stagnation and impaired movement, resulting in fullness. As no solid accumulation has formed yet, only Harmonizing methods are needed; formulas such as Xiao Chai Hu Tang can effect a cure. If there is indeed a solid pathogen retained in the upper region that cannot dissipate, emesis may be employed. Hua Yuanhua stated: On the fourth day, the pathogen is in the chest; emesis will lead to recovery. This applies when the pathogen has gathered but not yet dispersed widely. In Zhang Zhongjing's works, Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) is used to expel residual heat via emesis, and Gua Di San (Melon Spore Powder) is used to expel solid phlegm. If medication is inconvenient at the moment, alternative emetic methods described in my new formula collections can be substituted, or one may use harmonizing agents to provoke vomiting, which is also acceptable.
I. Abdominal Fullness Syndrome: Referencing Hua Yuanhua: On the first day of Cold Damage, the pathogen is in the skin; on the second day, in the flesh; on the third day, in the muscles; on the fourth day, in the chest; on the fifth day, in the abdomen; on the sixth day, in the Stomach. Entry into the Stomach means entry into the Fu organs, which corresponds to the abdomen. If abdominal fullness is present but not severe, it indicates incomplete entry into the Fu organs, and purgative methods should not be used. However, abdominal fullness can be either Deficiency or Excess, Cold or Heat, and cannot be uniformly classified as Excess. According to *Jin Gui Yao Lue*: "If abdominal fullness does not decrease, even slightly, purgation is indicated." This refers to Excess Fullness. It also states: "If abdominal fullness decreases intermittently and then returns to its previous state, this is caused by Cold-Deficiency rising from below, and warming agents should be used to harmonize." This describes Deficiency Fullness, characterized by fluctuating severity rather than solid accumulation. Generally, abdominal fullness originates from the Taiyin Spleen. If caused by Yang pathogens, symptoms will include dry throat, vexatious heat, and a strong, forceful pulse. If caused by Yin pathogens, symptoms will include abdominal fullness, vomiting food, aversion to cold, spontaneous diarrhea, and a lifeless pulse. These distinctions allow for differentiation. Excess-Heat patterns may be treated with clearing or purging methods, while Deficiency-Cold patterns require warming and tonifying methods.