\r苦马菜\pa111.bmp\r，一名羊奶菜。味苦，性大寒。纯阳之物，得向阳之处则生，
凉血。治血热妄行。止一切血症∶吐血、呕血、咯血、咳血、衄血、大肠下血、女子逆经倒
血。消痰，消瘿瘤，消咽喉结气，化痰毒，洗疮毒。
（附案） 昔有一人，吐血、咳血、咳嗽，痰带血，发热恶寒，肢体酸疼，自汗、盗汗，
饮食无味。吐痰又如玛瑙红白，形样似脓。一医授以此方，后救数十人，其功良效，真乃奇
方。
苦马菜（捣汁一小钟） 全秦归（三钱） 怀熟地（二钱） 杭芍（一钱） 怀生地（一
钱五分） 粉丹皮（一钱） 陈皮（一钱） 川贝母（一钱） 黑元参（一钱） 白茯苓（一
钱） 天门冬（三钱） 浙麦冬（二钱） 百合（一钱） 甘草（五分） 不用引，水煎服。
忌鱼、羊、煎炒热物。
（补注）人身之血，犹地中之水也。水行就下，故下流营运不息，滋养脏腑，贯注经络。
血为荣，气为卫，荣卫昼夜循环，营运不息。心生血，脾统血，肝藏血，肾纳血，脏得血能
津，腑得血能润，目得血能视，舌得血能言，手得血能握，足得血能步。血随气行，气逆而
血逆矣。若气血偏胜而疾有，劳伤火动，皆令失血。阳盛阴虚，火载血上，错经妄行，则为
逆矣。阳有余，气盛则升，血出上窍，自口鼻而出也。阳不足，气虚则陷，血出下窍，自大
小便而出也。先吐血、后见痰者，或痰出带血丝者，是阴虚火盛，治以滋阴降火可也。先见
痰、后见血、痰上带紫黑血者，如玛瑙红白者，是肺胃积热也，治以清肺化痰凉血之法。鲜
血者，新血也，宜止之。紫黑成块者，瘀血也，宜消去之。色淡微黄者，是白血，此症见之，
是名危症也。鼻血名血衄，
出于肝，因肝火热极也。咳血出于肺，因伤风，肺有热痰，阴虚
肺劳咳血，宜作虚治。咯血出于胃，咯出血屑成块也。肾虚不纳血，呕血出于脾。吐血出于
脾胃。唾血出于肾，鲜血随唾而出也。溺血、尿血出于小肠，热积也。
──丛本卷中
苦马菜，又名羊奶菜。味道苦，性质大寒。（注：原文此处“纯阳之物”与“性大寒”及后文描述存在矛盾，通常苦马菜/地锦草类属凉血止血药，此处依原文直译但保留术语）它是纯阳之物，生长在向阳的地方，具有凉血的功效。治疗因血热导致的血液妄行。能止住各种血症：包括吐血、呕血、咯血、咳血、鼻衄（鼻出血）、大肠下血（便血）、女子月经逆乱倒经出血。能消除痰饮，消除瘿瘤（甲状腺肿大等颈部肿块），消除咽喉部的结气（气滞郁结），化解痰毒，清洗疮毒。
（附案）过去有一个人，出现吐血、咳血、咳嗽，痰中带血，伴有发热恶寒，肢体酸痛，自汗（白天不因劳动而自然出汗）、盗汗（夜间睡着后出汗），饮食没有味道。吐出的痰像玛瑙一样红白相间，形状类似脓液。一位医生将此方给予他，后来用此方救了数十人，疗效确实显著，真是一个奇妙的方子。
配方如下：苦马菜（捣取汁液一小钟）、全当归（三钱）、怀熟地黄（二钱）、杭白芍（一钱）、怀生地黄（一钱五分）、粉牡丹皮（一钱）、陈皮（一钱）、川贝母（一钱）、黑玄参（一钱）、白茯苓（一钱）、天门冬（三钱）、浙麦冬（二钱）、百合（一钱）、甘草（五分）。不用药引，用水煎服。忌食鱼、羊肉以及煎炒燥热的食物。
（补注）人体内的血液，就像大地上的水一样。水往低处流，所以下游的水流运营不息，滋养脏腑，贯通经络。血属于营气，气属于卫气，营气和卫气昼夜循环，运营不息。心脏生成血液，脾脏统摄血液，肝脏贮藏血液，肾脏接纳血液。脏腑得到血液滋润就能津润，眼睛得到血液滋养就能视物，舌头得到血液濡养就能言语，手得到血液充盈就能握持，脚得到血液濡养就能行走。血液随着气运行，如果气机逆乱，血液也会随之逆乱。如果气血偏盛而导致疾病，劳倦损伤导致火邪妄动，都会引起失血。阳气过盛而阴液不足，火邪载着血液向上冲，导致经脉错乱、血液妄行，这就称为“逆”。阳气有余，气机旺盛则上升，血液从上部孔窍流出，即从口鼻而出。阳气不足，气虚则下陷，血液从下部孔窍流出，即从大小便而出。先吐血、随后见痰的，或者痰中带有血丝的，这是阴虚火旺，治疗应以滋阴降火为主。先见痰、随后见血，且痰中带紫黑色血液，像玛瑙红白相间的，这是肺胃积热所致，治疗应采用清肺化痰、凉血的方法。鲜红色的血，是新血，应当止住它。紫黑色成块的，是瘀血，应当消散去除它。颜色淡微黄的，是白血，出现这种症状，属于危重病症。鼻出血称为血衄，源于肝脏，是因为肝火极盛所致。咳血源于肺部，是因为伤风，肺中有热痰，如果是阴虚肺痨引起的咳血，应按虚证治疗。咯血源于胃部，咯出的是血屑成块。肾虚不能纳血，呕血源于脾脏。吐血源于脾胃。唾血源于肾脏，是鲜血随唾液而出。溺血、尿血源于小肠，是因为热邪积聚。
──丛书本卷中
Ku Ma Cai (Euphorbia humifusa / Spreading Spurge), also known as Yang Nai Cai (Goat's Milk Vegetable). Its taste is bitter, and its nature is greatly cold. It is a pure Yang substance, growing in sunny places, and has the effect of cooling blood. It treats hemorrhage caused by reckless movement due to blood heat. It stops all types of bleeding syndromes: hematemesis (vomiting blood), vomiting blood from the stomach, coughing up blood from the throat, expectorating blood, epistaxis (nosebleed), lower intestinal bleeding (hematochezia), and retrograde menstruation with inverted blood flow in women. It resolves phlegm, eliminates goiter (thyroid enlargement or neck masses), dissipates qi stagnation in the throat, transforms phlegm-toxin, and washes away sores-toxin.
(Attached Case) In the past, there was a person who suffered from hematemesis, expectoration of blood, coughing, blood-streaked sputum, fever with aversion to cold, soreness and pain in the limbs, spontaneous sweating (daytime sweating without exertion), and night sweats (sweating during sleep). His diet lacked flavor. The sputum he expectorated resembled agate with red and white colors, looking similar to pus. A physician prescribed this formula for him, and subsequently used it to save dozens of people; its efficacy was truly remarkable, making it a miraculous prescription.
Formula: Ku Ma Cai (crushed to extract juice, one small cup), Quan Dang Gui (Angelicae Sinensis Radix, 3 qian), Huai Shu Di (Prepared Rehmanniae Radix, 2 qian), Hang Shao (Paeoniae Radix Alba, 1 qian), Huai Sheng Di (Rehmanniae Radix, 1.5 qian), Fen Dan Pi (Moutan Cortex, 1 qian), Chen Pi (Citri Reticulatae Pericarpium, 1 qian), Chuan Bei Mu (Fritillariae Cirrhosae Bulbus, 1 qian), Hei Xuan Shen (Scrophulariae Radix, 1 qian), Bai Fu Ling (Poria, 1 qian), Tian Men Dong (Asparagi Radix, 3 qian), Zhe Mai Dong (Ophiopogonis Radix, 2 qian), Bai He (Lilii Bulbus, 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 0.5 qian). Do not use a guiding herb (Yin); decoct in water and take orally. Avoid fish, mutton, and fried or hot-natured foods.
(Additional Note) The blood in the human body is like the water in the earth. Water flows downward, so the downstream flow operates continuously, nourishing the Zang-Fu organs and penetrating the meridians. Blood belongs to Ying (Nutrient Qi), and Qi belongs to Wei (Defensive Qi). Ying and Wei circulate day and night, operating continuously. The Heart generates blood, the Spleen controls blood, the Liver stores blood, and the Kidney receives blood. When Zang-Fu organs receive blood, they become moistened; when the eyes receive blood, they can see; when the tongue receives blood, it can speak; when the hands receive blood, they can grasp; when the feet receive blood, they can walk. Blood follows the movement of Qi; if Qi moves reversely, blood also moves reversely. If diseases arise from an imbalance where Qi and Blood are excessive, labor injury causing fire to flare up will all lead to loss of blood. When Yang is excessive and Yin is deficient, fire carries blood upward, causing meridian disorder and reckless bleeding, which is termed "Ni" (Reversal). When Yang is abundant and Qi is vigorous, it ascends, and blood exits from the upper orifices, i.e., from the mouth and nose. When Yang is insufficient and Qi is deficient, it sinks, and blood exits from the lower orifices, i.e., from urination and defecation. If hematemesis occurs first, followed by sputum, or if sputum contains blood streaks, this indicates Yin deficiency with hyperactive fire; treatment should focus on nourishing Yin and descending fire. If sputum appears first, followed by blood, with purple-black blood mixed in the sputum resembling agate, this indicates accumulated heat in the Lung and Stomach; treatment should employ methods to clear the Lung, resolve phlegm, and cool the blood. Fresh red blood is new blood and should be stopped. Purple-black clots are stasis blood and should be resolved and removed. Pale yellowish blood is "white blood"; the appearance of this symptom indicates a critical condition. Epistaxis is called "Xue Nu," originating from the Liver due to extreme liver fire. Hemoptysis originates from the Lung, caused by wind invasion and heat-phlegm in the Lung; if caused by Yin deficiency and pulmonary tuberculosis, it should be treated as a deficiency syndrome. Hematemesis (spitting blood chunks) originates from the Stomach. Kidney deficiency failing to receive blood leads to vomiting blood originating from the Spleen. Hematemesis originates from the Spleen and Stomach. Saliva mixed with fresh blood originates from the Kidney. Hematuria (blood in urine) originates from the Small Intestine due to heat accumulation.
── From the Cong Edition, Middle Volume