（龟鳖）泻肝分积热除劳嗽骨蒸
鳖甲（专入肝）。味咸气平。色青。书虽载属补肝。（青入肝。）与龟载属补肾（黑入肾。）
各别
。然究皆属除热削肝之品。（介虫皆属阴寒。故能除热。）非真滋肝药也。凡厥阴血分积热。
而见劳嗽骨蒸。寒热往来。温疟疟母。及腰腹胁坚。血瘕痔核。经阻产难。疡痈疮肿。惊痫
斑痘等症。服此咸平。能以消除。（诸症皆就阴虚邪入而论。故用鳖甲入阴除热散结。）若肝
虚无热。切忌。鳖以七肋九肋者佳。以其得阳之数耳！其用必取乎肋。以肋属肝故耳。但食
品中惟鳖叵测。如三足两头。并项强腹赤。皆有大毒。能以杀人。不可不慎。
人身气以卫外。血以营内。有气以统血。则血始能灌溉一身。而凡目得藉血以视。耳得
藉血
以听。手得藉血以摄。掌得藉血以握。足得藉血以步者。靡不本其气之所运。有血以附气。
则气始能升降出入。而凡伎巧能强。治节能出。水谷能腐。谋虑能断。二便能通。万事能应
者。靡不本其血之所至。此有血不可无气以统。而有气不可无血以附也。第血有盛于气。则
血泣而不流。故有必用温暖之药以行之。气胜于血。则血燥而不通。故有必赖清凉之药以行
之。若使气血并胜。挟有积热。而致瘀块不消。根深蒂固。经年累月不愈者。则又不得不赖
破气损血之药以下。俾气血无乖。而病自可以愈。又按血盛于气。则气失其所司。而血愈寒
愈滞。故凡用药治血。必得其气稍浓以为之主。而凡味浓气薄之品。自不得以相兼。如血
有凝于肝。症见恶寒战栗。其可不用肉桂以治乎？风郁血闭。其可不用川芎以治乎？肌肤灼
热。吐衄肠风。其可不用荆芥以治乎？经闭不通。其可不用苍耳子以治乎？阴肿崩瘕。其可
不
用海螵蛸以治乎。目翳不散。其可不用谷精草兔屎以治乎？风痹乳阻。其可不用王不留行以
治
乎？恶露不净。其可不用大小蓟以治乎？血晕血滞。其可不用沙糖以治乎？此肝经血滞之当
温也。若使肝经血滞。而更见有脾气不运。则伏龙肝似不能离。肌肉不生。则白蜡似不能舍
。水肿症瘕。则泽兰似不能却。蛊毒恶气。则百草霜似不能去。子肿不消。则天仙藤似不能
别。胃滞不通。则韭菜汁似不可废。血脉不通。周身痛痹。则酒酿似不能除。肌肉不生。目
翳不开。则炉甘石似不能少。血脱不固。溃疡肉消。则赤石脂似不能削。是症有兼脾胃如此
。且或见有心腹卒痛。则延胡索不得不用。神气不畅。则安息香不得不急。骨碎血瘀。则骨
碎补不得不进。是症有兼心肺者又如此矣。若于肝经血滞。而更见有鼻衄血脱之不得不用乌
墨以止。筋骨血瘀之不得不用续断以通。肺痿血痢之不得不用鸡苏以散。肾寒血瘀之不得
不用阳起石以宣。目赤精遗之不得不用白蒺藜以解。督脉不通之不得不用鹿茸以温。瘀块坚
硬。 癖 羸之不得不用海狗肾以软。是症有兼肾经者又如此矣。至于心经血滞。而症见有
癖冷痛。在书已有桂心可用。见有痈疡痛迫。在书已有乳香可除。凡此止就温血大概。略
为分晰。而究其要。则又在临症审脉。分别无差。庶于用药治血之理。自不致有天渊之隔矣
。
（龟甲和鳖甲）能清泻肝脏分位的积热，消除虚劳咳嗽和骨蒸潮热。
鳖甲（专门入肝经）。味道咸，气性平，颜色青。医书虽然记载它属于补肝药（因为青色入肝），与龟甲记载属于补肾药（因为黑色入肾）各不相同。然而究其本质，它们都属于清除热邪、削弱肝火亢盛的药物。（介壳类虫属阴寒性质，所以能清热。）并非真正的滋补肝阴的药物。凡是厥阴肝经血分中有积热，而出现虚劳咳嗽、骨蒸潮热、寒热往来、温疟或疟母（疟疾形成的肿块）、腰腹胁肋部坚硬、血瘕（腹部结块）、痔核、月经阻滞、难产、疮疡痈肿、惊痫、斑痘等症状，服用此药味咸性平的鳖甲，能够消除这些病症。（上述诸症都是从阴虚邪气内入的角度论述的，所以使用鳖甲进入阴分以清热散结。）如果肝虚无热，切忌使用。鳖甲以七条肋骨或九条肋骨者为佳，因为它符合阳数的规律！其药用部分必须取用肋骨，因为肋骨归属于肝的缘故。但是作为食品中的鳖不可不谨慎，如出现三只脚、两个头，以及颈部僵硬腹部发红的，都有大毒，能致人死亡，不可不慎。
人体的气用来护卫体表，血用来营养体内。有气来统摄血液，血液才能灌溉全身。因此眼睛依赖血来看视，耳朵依赖血来听声，手依赖血来持握，手掌依赖血来抓握，脚依赖血来行走，无不根本于气的运行。有血依附于气，气才能升降出入。因此技艺灵巧有力，治理技能出众，水谷能够消化腐熟，谋虑能够决断，二便能够通畅，万事能够应对，无不根本于血的到达。这就是血不能没有气来统摄，而气不能没有血来依附的道理。只是如果血盛于气，则血液凝涩而不流动，所以必须用温暖的药物来推动它；如果气胜于血，则血液干燥而不通利，所以必须依靠清凉的药物来推动它。如果气血都偏盛，夹杂有积热，导致瘀块不消，根深蒂固，经年累月不愈的，则又不得不依靠破气损血的药物来攻下，使气血不再乖逆，病自然可以痊愈。
另外，血盛于气，则气失去其所司掌的作用，而血越发寒冷越发停滞。所以凡是用药治血，必须得到气稍浓的药物作为主导，而那些味浓气薄的药物，自然不得与之相兼。例如：血凝滞于肝，症状见恶寒战栗，难道可以不使用肉桂来治疗吗？风邪郁闭导致血闭，难道可以不使用川芎来治疗吗？肌肤灼热，吐血衄血，肠风下血，难道可以不使用荆芥来治疗吗？经闭不通，难道可以不使用苍耳子来治疗吗？阴肿、崩漏、瘕块，难道可以不使用海螵蛸来治疗吗？目翳不散，难道可以不使用谷精草和兔屎来治疗吗？风痹、乳汁阻滞，难道可以不使用王不留行来治疗吗？恶露不净，难道可以不使用大蓟和小蓟来治疗吗？血晕、血滞，难道可以不使用砂糖来治疗吗？这是肝经血滞应当温治的情况。
如果肝经血滞，而又见到脾气不运化，则伏龙肝似乎不能离弃；肌肉不生，则白蜡似乎不能舍弃；水肿、症瘕，则泽兰似乎不能驱除；蛊毒恶气，则百草霜似乎不能去除；子肿不消，则天仙藤似乎不能辨别（处理）；胃滞不通，则韭菜汁似乎不可废弃；血脉不通，周身痛痹，则酒酿似乎不能消除；肌肉不生，目翳不开，则炉甘石似乎不能减少；血脱不固，溃疡肉消，则赤石脂似乎不能削减。这是病症兼及脾胃的情况。并且有时见到心腹突然疼痛，则延胡索不得不使用；神气不畅，则安息香不得不急用；骨碎血瘀，则骨碎补不得不进服。这是病症兼及心肺的情况又如此。如果在肝经血滞的基础上，又见到鼻衄、血脱，则乌墨不得不使用来止血；筋骨血瘀，则续断不得不使用来通络；肺痿、血痢，则鸡苏不得不使用来消散；肾寒、血瘀，则阳起石不得不使用来宣通；目赤、精遗，则白蒺藜不得不使用来解表散热；督脉不通，则鹿茸不得不使用来温补；瘀块坚硬，癖积羸瘦，则海狗肾不得不使用来软坚。这是病症兼及肾经的情况又如此。至于心经血滞，而症状见到癖积冷痛，在书中已有桂心可用；见到痈疡疼痛紧迫，在书中已有乳香可除。以上只是就温血的大概情况，略微进行分辨，而究其要点，则在于临证时审察脉象，分别无误，这样对于用药治血的道理，自然不会造成天壤之别了。
(Guijia and Biejia) can clear accumulated heat in the Liver branch, eliminate consumptive cough (Laosou), and bone-steaming fever (Guzheng).
Biejia (Tartar Testudinis Carapax et Plastrum) (specifically enters the Liver meridian). It has a salty taste and neutral qi. Its color is green. Although medical texts record it as tonifying the Liver (because green enters the Liver), distinct from Guijia (Chelonis Carapax et Plastrum) which is recorded as tonifying the Kidney (because black enters the Kidney). However, upon investigation, both belong to substances that clear heat and subdue Liver hyperactivity. (Shelled creatures are of Yin-cold nature, thus they can clear heat.) They are not truly nourishing herbs for the Liver. Whenever there is accumulated heat in the blood aspect of the Jueyin Liver meridian, manifesting as consumptive cough, bone-steaming fever, alternating chills and fever, warm malaria or malarial mass (Nuemu), hardness in the waist, abdomen, and hypochondrium, blood masses (Xuejia), hemorrhoidal nodes, menstrual obstruction, difficult labor, sores, carbuncles, ulcers, convulsions, epilepsy, macules, and smallpox, taking this salty and neutral Biejia can eliminate these conditions. (These symptoms are discussed from the perspective of Yin deficiency with pathogenic invasion, hence Biejia is used to enter the Yin aspect to clear heat and dissipate nodules.) If the Liver is deficient without heat, it is strictly contraindicated. Biejia with seven or nine ribs is superior, as it corresponds to the number of Yang! The medicinal part must be taken from the ribs, because ribs belong to the Liver. However, regarding Bie (soft-shelled turtle) as food, one must be cautious; those with three legs, two heads, stiff necks, and red abdomens possess great toxicity and can cause death, so caution is essential.
Human Qi guards the exterior, while Blood nourishes the interior. With Qi to control Blood, Blood can irrigate the whole body. Thus, the eyes rely on Blood to see, the ears rely on Blood to hear, the hands rely on Blood to grasp, the palms rely on Blood to hold, and the feet rely on Blood to walk, all fundamentally based on the movement of Qi. With Blood adhering to Qi, Qi can ascend, descend, exit, and enter. Thus, dexterity and strength, governance skills, digestion of water and grain, planning and decision-making, patency of the bowels and bladder, and responsiveness to myriad affairs, all fundamentally depend on the presence of Blood. This indicates that Blood cannot exist without Qi to control it, and Qi cannot exist without Blood to adhere to it. However, if Blood is excessive relative to Qi, Blood becomes stagnant and does not flow, necessitating the use of warming herbs to promote its movement. If Qi is excessive relative to Blood, Blood becomes dry and obstructed, necessitating the reliance on cooling herbs to promote its movement. If both Qi and Blood are excessive, accompanied by accumulated heat, leading to persistent stasis masses that are deeply rooted and unhealed for years, then one must rely on herbs that break Qi and damage Blood to purge them, ensuring Qi and Blood do not become discordant, allowing the disease to heal.
Furthermore, if Blood is excessive relative to Qi, Qi loses its governing function, and Blood becomes colder and more stagnant. Therefore, when using herbs to treat Blood, one must employ herbs with stronger Qi as the principal agents; herbs with strong flavor but weak Qi should not be combined. For instance: if Blood stagnates in the Liver, manifesting as aversion to cold and shivering, should one not use Rougui (Cinnamomi Cortex)? If wind depression causes blood closure, should one not use Chuanxiong (Ligustici Chuanxiong Rhizoma)? If skin burns with heat, hematemesis, epistaxis, and intestinal wind bleeding occur, should one not use Jingjie (Schizonepetae Herba)? If menstruation is closed and obstructed, should one not use Can'erzi (Xanthii Fructus)? If there is yin swelling, metrorrhagia, and masses, should one not use Haipiaoxiao (Sepiae Endoconcha)? If eye nebula does not disperse, should one not use Gujingcao (Galegae Herba) and rabbit feces? If wind-bi and milk duct obstruction occur, should one not use Wangbuliuxing (Vaccariae Semen)? If lochia is not clean, should one not use Daji (Taraxaci Herba) and Xiaoji (Herba Cirsii Japonici)? If blood fainting and blood stasis occur, should one not use Shatang (Saccharum)? This describes the situation where Liver meridian blood stasis requires warming treatment.
If Liver meridian blood stasis is accompanied by Spleen Qi failing to transport, Fulonggan (Caulis Longan Arillus? Note: Text says 伏龙肝 - Fulonggan/Hearth Earth) seems indispensable; if muscles do not regenerate, Baila (Beeswax) seems inseparable; if edema and masses occur, Zelan (Agastachis Herba) seems unable to be dispelled; if gu poison and evil qi are present, Baicaoshuang (Carbonized Herbs) seem unable to be removed; if fetal edema does not resolve, Tianxianteng (Aristolochiae Manshuriensis Caulis) seems unable to be distinguished (handled); if stomach stagnation and obstruction occur, Jiucai juice (Allii Tuberosi Juice) seems indispensable; if blood vessels are obstructed and whole-body bi-pain occurs, Jiuniang (Fermented Rice Wine) seems unable to eliminate; if muscles do not regenerate and eye nebula does not open, Luganshi (Calamina) seems indispensable; if blood loss is unconsolidated and ulcer flesh wastes away, Chishizhi (Halloysit Rubra) seems indispensable. These are cases where symptoms involve the Spleen and Stomach. Furthermore, if sudden heart and abdominal pain occurs, Yanhusuo (Corydalis Rhizoma) must be used; if Shen Qi (Spirit Qi) is not smooth, Anshixiang (Styrax) must be urgently employed; if bones are broken and blood is stasis, Gusuibu (Drynariae Rhizoma) must be advanced. These are cases where symptoms involve the Heart and Lungs. If Liver meridian blood stasis is accompanied by epistaxis and blood loss, Wumo (Myrobalani Fructus) must be used to stop bleeding; if sinews and bones have blood stasis, Xuduan (Dianthi Radix) must be used to unblock; if lung flaccidity and bloody dysentery occur, Jisu (Menthae Haplocalycis Herba) must be used to dissipate; if Kidney cold and blood stasis occur, Yangqishi (Quinghai Stone) must be used to ventilate; if eyes are red and essence leaks, Baijili (Tribuli Fructus) must be used to resolve; if the Du meridian is obstructed, Lurong (Cervi Cornu Pantotrichum) must be used to warm; if stasis masses are hard and pi-accumulation causes emaciation, Hai gou shen (Pooecetes Gracilis Penis? Note: Text says 海狗肾 - Haigoushen/Phoca Penis et Testis) must be used to soften. These are cases where symptoms involve the Kidney meridian. As for Heart meridian blood stasis, if symptoms show pi-accumulation with cold pain, Guixin (Cinnamomi Ramulus) is available in texts; if sores and ulcers cause pressing pain, Ruxiang (Olibanum) is available in texts. These merely outline the general principles of warming blood, providing a brief analysis. Ultimately, the key lies in examining the pulse during clinical practice and distinguishing without error, so that the principles of using herbs to treat blood will not differ by a heaven and earth's distance.