盖闻粗举其凡曰略。瘟疫中杂症亦复不少，而略之可乎？是盖有说焉。吴又可《瘟疫论》中
已言者不载，伤寒杂症门中治法，可以裁取通融者不载，未曾经验与抄袭他人者不载。除此四者，
虽欲不略而不能矣。盖未敢师心也，无庸多赘也，若讳言略而详之，是为画蛇添足。
衄血症治多端，伤寒书中亦详哉其言之矣。瘟疫衄血治法，凡可以取用伤寒门
者，皆不采入。兹第论汗散一条。仲景治太阳风寒在表而致衄者，用麻桂以汗之。然又论曰，衄
家不可发汗。二者似乎相反，而海藏解之，则谓衄家不可发汗者，盖为脉微也。若脉不微而浮紧、
浮缓者，又当发散之矣。盖衄家之发散，散其经中之邪，使不得壅盛于经，迫而妄行。是麻、桂原
非止衄之药，而其邪得散，则不治衄，而衄自止矣。至于瘟邪在表，而致衄者，不唯麻、桂不
可服，即苏、芷、防风，亦无所可用。羌、柴性升，衄时似亦不宜。惟服绿糖饮，（见前。）往往
取效。或加鲜姜数片，红枣数枚（去核。）更妙。盖绿豆清凉而非苦寒之品。洋糖发散而无升举之虞。
再加姜、枣以调和营卫，而表岂有不解者哉！且散而不升，而亦岂有稍防于衄者哉！或服不即汗，
于煮豆时，再加浮萍二三钱。
衄出于肺，行清道。吐出于胃，行浊道。衄血之热在经主表，吐血之热在腑主里。血之存于胃
中者，为守营之血，守而不走。诸阳受热，当汗不汗，热毒深入于中，其血为火所逼而上逆，随从
肺窍出于咽而为吐矣。亦有蓄血上焦而吐者，瘟疫
患此，始终一于为热。实者，犀角地黄汤，稍虚者，黄芩芍药等汤加减出入，便可奏效。仲景治
坏病篇麻黄升麻汤，虽治阴阳错杂之唾血，但不善用之，反致害事。至《金匮》之升麻鳖甲汤，虽
李云此方治疫疠时症，但亦用升麻，似非吐血者所宜。愚意，凡吐衄等症，药性之升者，总在所
禁也。
大抵概括其要点称为“略”。瘟疫中的杂症也不少，但加以简略可以吗？这其中有说法。吴又可《瘟疫论》中已经论述过的内容不收录；伤寒杂症门类中治疗方法可以裁取融通的不收录；未曾亲自经验与抄袭他人的内容不收录。除了这四种情况之外，虽然想要不简略也不可能了。这是因为不敢主观臆断，也无需多言赘述，如果忌讳说“略”而强行详细叙述，那就是画蛇添足。
衄血症的治疗方法多种多样，伤寒书中对此也已经讲得很详细了。对于瘟疫引起的衄血治疗方法，凡是可以在伤寒门类中取用的，都不再采录。这里只讨论汗散（发汗解表）这一条。张仲景治疗太阳经受风寒侵袭在表而导致衄血的，使用麻黄汤或桂枝汤来发汗。然而他又论述说，经常衄血的人不可发汗。这两者似乎相反，但海藏（张元素）对此进行了解释，他认为经常衄血的人不可发汗，是因为脉象微细的缘故。如果脉象不微细而是浮紧或浮缓的，又应当进行发散治疗。所谓对经常衄血者的发散，是疏散经络中的邪气，使其不得在经络中壅盛，逼迫血液妄行。因此，麻黄、桂枝原本不是止血药，但邪气得散，则不用专门治衄血，衄血自然停止。至于瘟邪在表导致衄血的，不仅麻黄、桂枝不可服用，即紫苏、白芷、防风等药，也没有可用的。羌活、柴胡药性升提，在衄血时似乎也不适宜。只有服用绿豆糖饮（见前文），往往能取得疗效。或者加入鲜姜几片，红枣几枚（去核），效果更好。因为绿豆清凉而非苦寒之品，白糖发散而无升举之虞。再加入姜、枣以调和营卫，表证难道有不解除的吗！而且药性发散而不升提，又怎么会稍加防备于衄血呢！如果服药后没有立即出汗，在煮豆时，再加浮萍二三钱。
衄血出于肺，运行于清道。吐血出于胃，运行于浊道。衄血的热邪在经主表，吐血的热邪在腑主里。存在于胃中的血，是守营之血，守持而不走窜。诸阳受热，当汗出而不汗出，热毒深入体内，血液被火邪逼迫而上逆，随从肺窍出于咽喉而为吐血。也有蓄血在上焦而吐血的，瘟疫患者患此病，从头到尾都表现为热证。实证用犀角地黄汤，稍虚的用黄芩芍药汤等加减出入，便可奏效。张仲景在《伤寒论》治坏病篇中的麻黄升麻汤，虽然治疗阴阳错杂的唾血，但如果使用不当，反而会导致害事。至于《金匮要略》中的升麻鳖甲汤，虽然李云说此方治疗疫疠时症，但也使用了升麻，似乎不适合吐血患者。我的意见是，凡吐衄等症状，药性升提的药物，总是在禁忌之列。
Generally, summarizing the main points is called "brief" (lüe). There are also many miscellaneous diseases in plague (wenyi), but is it acceptable to treat them briefly? There is a reason for this. Content already discussed in Wu Youke's *Treatise on Plague* (*Wenyi Lun*) is not recorded; methods of treatment from the section on cold damage and miscellaneous diseases that can be adapted and integrated are not recorded; content that has not been personally experienced or plagiarized from others is not recorded. Apart from these four categories, even if one wishes not to be brief, it is impossible. This is because I dare not act subjectively, nor is there any need for excessive elaboration. If one were to shy away from using the term "brief" and instead provide exhaustive details, it would be like drawing legs on a snake (adding superfluous details).
There are numerous treatments for epistaxis (nuxue), which have been discussed in detail in texts on cold damage. For the treatment of epistaxis caused by plague, any methods applicable from the cold damage section are not included here. Here, we only discuss the category of diaphoresis (han san - releasing the exterior through sweating). Zhang Zhongjing treated epistaxis caused by wind-cold in the Taiyang (Greater Yang) channel at the exterior level using Mahuang Tang (Ephedra Decoction) or Guizhi Tang (Cinnamon Twig Decoction) to induce sweating. However, he also stated that individuals prone to frequent epistaxis should not undergo diaphoresis. These two statements seem contradictory, but Haicang (Zhang Yuansu) explained that the prohibition against diaphoresis for those prone to epistaxis applies when the pulse is faint (wei). If the pulse is not faint but floating-tight (fu jin) or floating-slow (fu huan), then dispersing treatment is indicated. The purpose of dispersing treatment for those prone to epistaxis is to scatter pathogenic factors within the meridians, preventing them from becoming congested and forcing blood to flow recklessly. Therefore, Mahuang (Ephedrae Herba) and Guizhi (Cinnamomi Ramulus) are originally not hemostatic agents; once the pathogen is dispersed, the epistaxis stops spontaneously without specific hemostatic intervention. Regarding epistaxis caused by plague pathogens at the exterior level, not only are Mahuang and Guizhi contraindicated, but also Zisu (Perillae Folium), Baizhi (Angelicae Dahuricae Radix), and Fangfeng (Saposhnikoviae Radix) are of no use. Qianghuo (Notopterygii Rhizoma et Radix) and Chaihu (Bupleuri Radix) have ascending properties and seem unsuitable during active epistaxis. Only the consumption of Lüdou Tang Yin (Mung Bean Sugar Drink) (see previous section) often yields effective results. Adding a few slices of fresh ginger (Shengjiang) and several red dates (Dazao) (pitted) is even better. Mung bean (Ludou) is cooling but not bitter-cold; white sugar (Yangtang) has a dispersing effect without the risk of causing upward rising. Adding ginger and jujube harmonizes Ying (Nutrient) and Wei (Defensive) Qi, ensuring the exterior syndrome resolves. Moreover, since the action is dispersing rather than ascending, it does not exacerbate epistaxis. If sweating does not occur immediately after ingestion, add 2-3 qian (approx. 6-9 grams) of Fuping (Spirodela Polyrrhiza) while boiling the beans.
Epistaxis originates from the Lung and travels through the clear pathways. Hematemesis originates from the Stomach and travels through the turbid pathways. The heat associated with epistaxis resides in the channels and pertains to the exterior; the heat associated with hematemesis resides in the fu organs and pertains to the interior. Blood retained in the Stomach is "guarding Ying blood," which remains stationary and does not wander. When the various Yang aspects are affected by heat, and sweating should occur but does not, toxic heat penetrates deeply into the interior. The blood is forced upward by fire pathogens, follows the Lung orifices, exits through the throat, and manifests as hematemesis. There are also cases of blood accumulation in the upper Jiao leading to hematemesis. In plague patients suffering from this condition, the pathology is consistently heat throughout. For excess patterns, Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) is used; for slightly deficient patterns, modifications of Huangqin Shaoyao Tang (Scutellaria and Peony Decoction) etc., can achieve efficacy. Zhang Zhongjing's Mahuang Shengma Tang (Ephedra and Cimicifuga Decoction) in the chapter on treating mishandled diseases treats spitting of blood due to complex yin-yang disorders, but improper use can cause harm. As for Shengma Biejia Tang (Cimicifuga and Turtle Shell Decoction) in the *Jin Gui Yao Lue*, although Li Yun stated it treats epidemic pestilence, it contains Shengma (Cimicifugae Rhizoma), which seems unsuitable for hematemesis. My opinion is that for all conditions involving hematemesis and epistaxis, herbs with ascending properties are generally contraindicated.