劳嗽吐血之症，其难于脾肺之交，不必遍论五脏，但取其要处言之。夫虚症总由相火上
炎，
物能制木之过，又能滋木之枯，此治金木之交也。至于木得火势而上乘于金，金失降下之令
，已不能浚水之源，木强土受其克，水寡于畏，亦乘风木之势而上乘，淆混于胸膈而为痰涎
，壅塞胶固稠腻不可开，以碍清肃之化。此因木土不交，水又乘之而肆虐。粗工每以陈、半
、香、朴治痰之标，殊不知此乃水乘木火而上泛为痰，比之杂症二陈所主之痰，天渊不同。
余但于清金剂中，加牛膝、车前、泽泻，以导水下行，土自安位，金水准调，天地清肃矣。
此调木土之交，及水土之变也。
有不从劳嗽，而吐血先之者，心火、肝木之为病主也。然又有煎厥、薄厥之分。煎厥者
，从
为火，火热为风，风火相薄，厥逆上冲，血遂菀乱涌出，其势较急。煎厥单动于心火，不得
风助，故无势而缓。薄厥兼动于肝火，火得风助，故有势而急。大抵性急多盛怒者，往往成
薄厥。且是症也，又当防其瘀血渗入肺系，郁而不散，以至积阳为热，积阴为疰，喘嗽交加
，病日以深而成劳嗽也。大凡治吐血，宜以清金保肺为主，金令既肃，肝木得其平，而火自
不敢肆。至于骨蒸之久，煎灼真阴，火炎伤肺，亦宜急化其源，庶乎水得所养，而火渐熄，
不至为劳嗽之渐也。
劳嗽吐血这一病症，其难点在于脾与肺的相互关系，不必遍论五脏，只需抓住关键之处来论述。虚证总由相火上炎引起，（此处原文似有脱漏或语意跳跃，结合上下文逻辑推断：若指治法，则意为）药物若能制约木气过亢，又能滋养木气的枯槁，这就是治疗金（肺）与木（肝）之间关系的方法。至于木气因火势而上乘侵犯金气，导致金气失去肃降的功能，已经不能疏通水液的源头；木气强盛克制土气，导致水气缺乏制约，也乘着风木之势上逆，在胸膈间混淆混杂成为痰涎，壅塞胶固、稠腻难以化解，从而阻碍了清肃的生理功能。这是因为木与土不交，水气又趁机肆虐。庸医往往用陈皮、半夏、香附、厚朴来治疗痰证的表象，殊不知这是水气乘着木火之气上泛形成的痰，这与杂病中二陈汤所主治的痰证，有着天壤之别。我仅在清金剂中加入牛膝、车前子、泽泻，以引导水液下行，土气自然安守本位，金气与水气协调平衡，天地般的清肃之气就恢复了。这是调理木与土的交济，以及水与土的变化。
有不从劳嗽引发，而是先出现吐血的，这是心火和肝木致病为主。然而又有煎厥和薄厥的区别。煎厥者，源于火，火热化为风，风火相互搏击，厥逆之气上冲，血液随即郁乱涌出，病情势头较急。如果煎厥只动于心火，没有风邪辅助，所以势头缓和。薄厥兼动于肝火，火得到风邪辅助，所以势头急迫。大抵性情急躁、容易大怒的人，往往形成薄厥。而且这个病症，还应当防止瘀血渗入肺系，郁结不散，以至于积阳化为热，积阴化为疰病，喘咳交替发作，病情日益加深而成为劳嗽。大凡治疗吐血，应当以清金保肺为主，肺金令行肃降，肝木得以平和，而火气自然不敢放肆。至于骨蒸日久，煎熬灼伤真阴，火炎上伤肺，也应当紧急化解其根源，这样水液得到滋养，火气逐渐熄灭，不至于发展为劳嗽的开端。
The syndrome of tuberculous cough with hemoptysis is difficult to treat due to the interaction between the Spleen and Lung. It is unnecessary to discuss all five Zang organs; one need only address the key aspects. Deficiency syndromes generally arise from the flaming up of Ministerial Fire. [Note: The source text contains a logical gap here, implying a treatment principle]. If herbs can restrain the excess of Wood (Liver) and nourish its dryness, this constitutes treating the interaction between Metal (Lung) and Wood (Liver). When Wood, driven by Fire, overacts upon Metal, Metal loses its descending function and fails to dredge the source of Water. Strong Wood overacts on Earth, causing Water to lack restraint; consequently, Water follows the momentum of Wind-Wood and rebels upward, mixing in the chest and diaphragm to form phlegm-saliva. This phlegm becomes obstructed, tenacious, thick, and greasy, difficult to resolve, thereby hindering the clear and descending transformation. This results from the failure of Wood and Earth to interact, compounded by the rampant action of Water. Incompetent physicians often use Chenpi (Exocarpium Citri Reticulatae), Banxia (Rhizoma Pinelliae), Xiangfu (Rhizoma Cyperi), and Houpo (Cortex Magnolia Officinalis) to treat the branch symptoms of phlegm. They fail to realize that this phlegm arises from Water rebelling upward under the influence of Wood and Fire, which is worlds apart from the phlegm treated by Erchen Tang (Two-Chen Decoction) in miscellaneous diseases. I merely add Niuxi (Radix Achyranthis Bidentatae), Cheqiancao (Herba Plantaginis), and Zexie (Rhizoma Alismatis) to formulas that Clear Metal, guiding Water downward. Earth then remains in its proper position, Metal and Water are harmonized, and the clear and descending atmosphere is restored. This addresses the interaction of Wood and Earth, as well as the changes in Water and Earth.
In cases where hemoptysis occurs without preceding tuberculous cough, the primary pathogens are Heart Fire and Liver Wood. However, there are distinctions between Jian Jue (Frying Syncope) and Bo Jue (Thinning Syncope). Jian Jue originates from Fire; intense heat transforms into Wind, and Wind and Fire clash violently. The rebellious Qi rushes upward, causing blood to become chaotic and gush out, presenting an urgent clinical picture. If Jian Jue involves only Heart Fire without the assistance of Wind, the momentum is mild and slow. Bo Jue involves both Liver Fire and Wind; since Fire is assisted by Wind, the momentum is rapid and severe. Generally, individuals with irritable temperaments prone to extreme anger often develop Bo Jue. Furthermore, in this syndrome, one must guard against blood stasis infiltrating the Lung system. If it stagnates and does not disperse, Yang accumulation generates Heat, and Yin accumulation leads to Zhu disease (chronic wasting condition). Wheezing and coughing may alternate, deepening the illness until it becomes tuberculous cough. Generally, the treatment of hemoptysis should prioritize Clearing Metal and Protecting the Lung. Once the Lung's descending function is established, Liver Wood becomes balanced, and Fire dare not act recklessly. In cases of prolonged bone-steaming fever, which scorches True Yin, and Fire flares up damaging the Lung, it is imperative to urgently resolve the root cause. Thus, Water receives nourishment, Fire gradually subsides, and the progression toward tuberculous cough is prevented.