失血身凉脉小顺，大疾身热卧难凶，口鼻涌出而不止，大下溃腐命多倾。
【注】大疾，脉大疾也。卧难，不能卧也。大衄、大下，血出如涌泉不止，内溃腐尸之气，则命倾也。
阳乘阴热血妄行，血犯气分不归经，血病及腑渗入浊，由来脏病溢出清。热伤失血
宜清热，劳伤理损自然平，努即内伤初破逐，久与劳伤治法同。
【注】凡失血之证，阳盛乘阴，则血为热迫，血不能安于脉中而妄行气分，不能回归
经脉也。若血病伤及于腑者，则血渗入肠胃浊道，上从咽出，下从二便而出也。血病伤
及于脏者，则血溢出胸中清道，上从喉出，下从精窍而出也。夫血藏于脏内，行于脉中，躯
壳之中不可得而见也。非有损伤，不能为病。而损伤之道有三∶一曰热伤，宜以清热为主；
一曰劳伤，宜以理损为主；一曰努伤，初宜以破逐为主，久亦宜以理损为主也。
犀角地黄汤
热伤一切失血病，犀角地黄芍牡丹，胸膈满痛加桃大，热甚吐衄入芩连，因怒呕血
柴栀炒，唾血元参知柏煎，咯加二冬嗽二母，涎壅促嗽郁金丸。
【注】热伤一切失血之病，皆宜犀角地黄汤。若胸膈满痛，是为瘀血，加桃仁、大黄。
若吐血热盛，加黄芩、黄连。因怒致吐血及呕血者，加柴胡、炒栀，唾血加元参、黄柏、
知母，咯血加天冬、麦冬，嗽血加知母、贝母。涎壅气促，阵阵急嗽带出血者，宜郁金
丸，方在后。
加味救肺饮加郁金汤
劳伤吐血救肺饮，嗽血加调郁金汤。形衰无热气血弱，人参养荣加麦良。
【注】救肺饮，即虚劳门之加味救肺饮加调郁金末也。若气血虚弱不见火象，宜用人
参养荣汤加麦门冬也。
芎归饮
饱食用力或持重，努破脉络血归芎，呕血漉漉声上逆，跌扑堕打有瘀行。
【注】饱食用力，或因持重努伤脉络，失血涌吐，宜用芎归饮，引血归经，及呕血跌
扑堕打，伤其脉络，令人大吐者，亦皆宜之。其有瘀血者，或加大黄以下之，或加桃仁、红
花以破之，或加郁金、黄酒以行之。
参地煎
参地衄吐血不已，热随血减气随亡，气虚人参为君主，血热为君生地黄。
【注】参地煎，即人参。生地黄也。凡因热伤衄、吐血不已者，则热已随血减，然气
亦随血亡也。气虚甚者，当倍人参为君。血热者，宜倍生地为君。时时煎服自止也。
泻肺丸
嗽血壅逆虚苏子，积热痰黄泻肺丸，蒌仁半贝金葶杏，三黄惟大有除添。
【注】嗽血痰壅气逆，形气虚者，苏子降气汤降之，方见诸气门。痰黄积热，形气实
者，用泻肺丸下之，即栝蒌仁、半夏、浙贝母、郁金、苦葶苈子、杏仁、黄连、黄芩、大
黄也。惟大黄形气实者加之，若形气虚者，或大便溏泻，则减去不用。
保肺汤
保肺肺痈吐脓血，白芨薏苡贝金陈，苦梗苦葶甘草节，初加防风溃 参。
【注】保肺汤，即白芨、薏苡仁。贝母、金银花、陈皮、苦桔梗、苦葶苈、甘草节也。
初起加防风、溃后加生黄 ，人参。
牛膝四物汤
尿血同出痛淋血，尿血分出尿血名，尿血精窍牛四物，淋血八正地金通。
【注】淋血、尿血二证，若尿与血同出而痛，名曰淋血。尿与血分出，名曰尿血。尿
血为精窍之病，用四物倍加牛膝。淋血为尿窍之病，用八正散，加木通生地、郁金治之。
珀珠散
尿血诸药而不效，块血窍滞茎急疼，珀珠六一朱砂共，引煎一两整木通。
【注】尿血一证，乃精窍为病，每次因忍精不泄，提气采战，或因老年竭欲而成。服
诸药不效者，所尿之血成块，窍滞不利，茎
中急疼欲死者，用珀珠散，日三服，每服三钱，引用整木通去粗皮黄色者，煎汤调服。其
方即琥珀末一钱，珍珠末五分，朱砂末五分，飞滑石六钱，甘草末一钱，合均，分三服。若
其人大便结燥不通，以八正散加牛膝、郁金下之。有热尿涩，以导赤散加牛膝、郁金清
之。利后仍服此药，自有奇功。
槐花散
便血内热伤阴络，风合肠风湿脏疡，槐花侧枳连炒穗，风加秦防湿楝苍。
【注】便血二证，肠风、脏毒。其本皆热伤阴络，热与风合为肠风，下血多清；热与
湿合为脏毒，下血多浊，均宜槐花散，即炒槐花、炒侧柏叶。醋炒枳壳、川黄连、炒荆
芥穗，为末，乌梅汤调服。肠风，加秦艽、防风。脏毒，加炒苦楝、炒苍术。若大肿大痛，
大便不通，当以脏毒未溃之疡治之，非脏毒下血之病也。
升阳去湿和血汤
便血日久凉不应，升补升 苍桂秦，归芍丹陈二地草，热加萸连虚人参。
【注】便血日久，服凉药不应，宜升补，用升阳去湿和血汤。即升麻。黄 、苍术、肉
桂、秦艽、当归、白芍、丹皮，陈皮、生地、熟地、生甘草、炙甘草也。有热，稍加吴茱
萸、炒川连。虚加人参可也。
失血患者若身体凉爽、脉象细小，为顺证；若脉象大而急促、身体发热且难以平卧，则为凶险之证。若口鼻出血涌出且不止，或大便下血伴有腐败溃烂之气，多会导致死亡。
阳气亢盛乘袭阴分，血液受热妄行，侵入气分而不能回归经脉。若血病波及六腑，则血液渗入浊道（如肠胃）；若源于五脏病变，则血液从清道溢出。对于热邪损伤导致的失血，应当采用清热法；对于劳损导致的失血，应当调理损伤以使其自然平复；对于因努责用力导致的内伤初起，应当逐除瘀血；久病与劳损的治疗法则相同。
犀角地黄汤：适用于热邪损伤引起的一切失血病症。方由犀角、生地黄、芍药、牡丹皮组成。若胸膈满痛，加入桃仁、大黄；若热势极盛导致吐血、衄血，加入黄芩、黄连；若因愤怒导致呕血，使用炒柴胡、炒栀子；唾血者，用玄参、知母、黄柏煎服；咯血者，加入天冬、麦冬；咳嗽带血者，加入知母、贝母；痰涎壅盛、气促咳嗽者，服用郁金丸。
加味救肺饮加郁金汤：劳损导致的吐血使用救肺饮，咳嗽带血者加用调郁金汤。若形体衰弱、无热象、气血虚弱者，用人参养荣汤加麦门冬效果良好。
芎归饮：因饱食后用力或持重物，努责导致脉络破损而出血，宜用芎归饮引血归经。若呕血声音漉漉、气机上逆，或因跌扑坠落殴打导致体内有瘀血而行血者，也适宜使用此方。
参地煎：人参和生地黄用于治疗衄血、吐血不止。若热随血减而气随血亡，气虚甚者，以人参为君药；血热甚者，以生地黄为君药。时时煎服即可止血。
泻肺丸：咳嗽带血、痰壅气逆且形气虚弱者，用苏子降气汤降气；若积热痰黄、形气实者，用泻肺丸攻下。泻肺丸由瓜蒌仁、半夏、浙贝母、郁金、苦葶苈子、杏仁、黄连、黄芩、大黄组成。仅在大黄适用于形气实者时添加，若形气虚弱或大便溏泻，则减去不用。
保肺汤：治疗肺痈吐脓血。方由白及、薏苡仁、贝母、金银花、陈皮、苦桔梗、苦葶苈、甘草节组成。初起阶段加防风，溃破后加黄芪、人参。
牛膝四物汤：尿血与疼痛同时出现为淋血，尿血分开排出为尿血。尿血属精窍病变，用四物汤倍加牛膝；淋血属尿窍病变，用八正散加木通、生地黄、郁金治疗。
珀珠散：若尿血诸药无效，出现血块、窍道阻滞、阴茎中急痛欲死者，用珀珠散。每日三次，每次三钱，引用整根木通（去粗皮黄色部分）煎汤调服。方由琥珀末一钱、珍珠末五分、朱砂末五分、飞滑石六钱、甘草末一钱混合均匀，分三次服用。若患者大便干结不通，用八正散加牛膝、郁金攻下；若有热尿涩，用导赤散加牛膝、郁金清热。利后仍服此药，自有奇效。
槐花散：便血因内热损伤阴络，风邪结合肠风湿毒所致。方由炒槐花、炒侧柏叶、醋炒枳壳、川黄连、炒荆芥穗组成，研末，乌梅汤调服。肠风证加秦艽、防风；脏毒证加炒苦楝、炒苍术。若大腹肿胀疼痛、大便不通，应按未溃的脏毒疮疡治疗，而非单纯的脏毒下血病。
升阳去湿和血汤：便血日久，服用凉药无效者，宜用升补法，使用升阳去湿和血汤。方由升麻、黄芪、苍术、肉桂、秦艽、当归、白芍、丹皮、陈皮、生地、熟地、生甘草、炙甘草组成。有热者，稍加吴茱萸、炒川连；虚者加人参即可。
If a patient with hemorrhage has a cool body and a fine pulse, it is a favorable sign (Shun); if the pulse is large and rapid, the body is hot, and lying down is difficult, it is an ominous sign (Xiong). If blood gushes from the mouth and nose without stopping, or if there is profuse bloody stool with a putrefactive odor, death is likely.
When Yang hyperactivity invades Yin, blood acts recklessly due to heat, invading the Qi level and failing to return to the meridians. If the blood disease affects the Fu organs, blood seeps into the turbid pathways (such as the intestines and stomach); if it originates from Zang organ pathology, blood overflows from the clear pathways. For hemorrhage caused by heat injury, clearing heat is indicated; for hemorrhage caused by labor injury, regulating the damage to restore natural balance is indicated; for initial internal injury caused by straining, dispelling stasis is indicated; the treatment for chronic conditions is the same as for labor injuries.
Xijiao Dihuang Tang: Indicated for all types of hemorrhage caused by heat injury. The formula consists of Rhinoceros Horn (now substituted with Water Buffalo Horn), Rehmanniae Radix Preparata, Paeoniae Radix Alba, and Moutan Cortex. If there is fullness and pain in the chest and diaphragm, add Persicae Semen and Rheum Radix et Rhizoma. If heat is severe causing hematemesis or epistaxis, add Scutellariae Radix and Coptidis Rhizoma. If vomiting blood is caused by anger, use Bupleuri Radix and Gardeniae Fructus stir-fried. For spitting blood, decoct Withaniae Radix, Anemarrhenae Rhizoma, and Phellodendri Cortex. For coughing up blood, add Asparagi Radix and Ophiopogonis Radix. For coughing with phlegm obstruction and shortness of breath, administer Yujin Wan.
Jiawei Jiufei Yin plus Yujin Tang: Use Jiufei Yin for labor-induced hematemesis; add Tiaoyu Jin Tang for hemoptysis. If the physique is weak, without heat signs, and Qi and Blood are deficient, Renshen Yangrong Tang plus Ophiopogonis Radix is effective.
Xiongui Yin: Used when straining after a full meal or lifting heavy objects damages the collaterals, causing bleeding. It guides blood back to the meridians. It is also suitable for loud, gurgling hematemesis with rebellious Qi, or bleeding due to falls and blows resulting in blood stasis.
Shendi Jian: Ginseng and Rehmanniae Radix Preparata are used for persistent epistaxis or hematemesis. If heat decreases with blood loss but Qi also perishes with blood, for severe Qi deficiency, Ginseng is the sovereign herb; for blood heat, Rehmanniae Radix Preparata is the sovereign herb. Decoct and take frequently to stop bleeding.
Xiefei Wan: For hemoptysis with phlegm obstruction and rebellious Qi in patients with deficient Qi and physique, use Su Zi Jiangqi Tang to descend Qi. For those with accumulated heat, yellow phlegm, and robust Qi and physique, use Xiefei Wan to purge. Xiefei Wan consists of Trichosanthis Semen, Pinelliae Rhizoma, Fritillariae Thunbergii Bulbus, Curcumae Radix, Semen Lepidii et Descurainiae, Pruni Semen, Coptidis Rhizoma, Scutellariae Radix, and Rheum Radix et Rhizoma. Add Rheum only if the patient's Qi and physique are robust; omit if Qi and physique are deficient or if there is loose stool.
Baofei Tang: Treats lung abscess with expectoration of pus and blood. Ingredients include Bletillae Rhizoma, Coicis Semen, Fritillariae Cirrhosae Bulbus, Lonicerae Japonicae Flos, Citri Reticulatae Pericarpium, Platycodonis Radix, Semen Lepidii et Descurainiae, and Glycyrrhizae Radix et Rhizoma cum Stipite. Add Saposhnikoviae Radix in the early stage; add Astragali Radix and Ginseng Radix et Rhizoma after ulceration.
Niuxi Siwu Tang: Hematuria accompanied by pain is termed Linxue (blood strangury); hematuria without pain or separate from urine is termed Xiaoxue (blood in urine). Xiaoxue is a disease of the essence orifice, treated with Siwu Tang doubled with Achyranthis Bidentatae Radix. Linxue is a disease of the urinary orifice, treated with Bazheng San plus Akebiae Caulis, Rehmanniae Radix Preparata, and Curcumae Radix.
Pozhu San: For hematuria unresponsive to other medications, presenting with blood clots, orifice obstruction, and urgent pain in the penis, use Pozhu San. Take three times daily, 3 qian each time, with a decoction of whole Akebiae Caulis (scraped of rough yellow skin) as the guide. The formula consists of Succinum (1 qian), Margarita (5 fen), Cinnabaris (5 fen), Talcum (6 qian), and Glycyrrhizae Radix et Rhizoma (1 qian), mixed evenly and divided into three doses. If the patient has dry, obstructed stools, purge with Bazheng San plus Achyranthis Bidentatae Radix and Curcumae Radix. If there is heat and dysuria, clear with Daochi San plus Achyranthis Bidentatae Radix and Curcumae Radix. Continued use after urination yields miraculous results.
Huaihua San: Hematochezia caused by internal heat damaging the Yin collaterals, combined with wind-dampness affecting the intestines and viscera. The formula consists of Stir-fried Sophorae Flavescentis Flos, Stir-fried Platycladi Cacumen, Vinegar-stir-fried Aurantii Fructus, Chuanlianzi (Coptidis Rhizoma - *Note: Text says Chuan Lian, usually implies Coptis or Melia, context suggests Coptis for heat*), and Stir-fried Schizonepetae Spica. Mix into powder and take with Wu Mei Tang. For Changfeng (Intestinal Wind), add Gentianae Macrophytae Radix and Saposhnikoviae Radix. For Zangdu (Visceral Toxin), add Stir-fried Meliae Cortex and Stir-fried Atractylodis Rhizoma. If there is abdominal distension, swelling, pain, and constipation, treat as an un-ulcerated Zangdu abscess, not simple hematochezia.
Shengyang Qushi Hexue Tang: For chronic hematochezia unresponsive to cooling herbs, use ascending and tonifying methods with Shengyang Qushi Hexue Tang. Ingredients include Cimicifugae Rhizoma, Astragali Radix, Atractylodis Rhizoma, Cinnamomi Cortex, Gentianae Macrophytae Radix, Angelicae Sinensis Radix, Paeoniae Radix Alba, Moutan Cortex, Citri Reticulatae Pericarpium, Rehmanniae Radix, Rehmanniae Radix Preparata, Raw Glycyrrhizae Radix et Rhizoma, and Honey-fried Glycyrrhizae Radix et Rhizoma. If there is heat, slightly add Evodiae Fructus and Stir-fried Coptidis Rhizoma. If deficient, add Ginseng Radix et Rhizoma.