【脉】 脉涩濡弱为亡血；细弦而涩，按之虚，为脱血也。脉浮弱，按之而绝者
，为下血；
烦咳者，必吐血。脉沉弦，面无血色，无寒热者，必衄。沉为在里，营卫内结，胸满必吐血
。脉滑小弱者生，浮大牢数者死；又血温身热，脉躁者死，热为血气散故也。藏血，脉俱弦
者死，滑大者生。
【因】 外有肺痈、肺痿，亦能咳嗽脓血。劳亦能吐血。
【证治】 麻黄汤 治伤寒证大壅塞内热，火气不伸成衄。脉浮紧为寒。
桂枝汤 治证同前，脉浮缓为风。
五苓散 治伏暑，热流入经络。
黄芩芍药汤 治伤寒、风二证，脉微。
衄血方 治出于肺经。如不止，用寒水纸于胸、脑、大椎三处贴之。
犀角 升麻 山栀 黄芩 白芍 生地 丹参 紫参 阿胶 荆芥穗
研服亦良。萝卜头段捣饮，又汁滴之亦良。大椎、哑门灸之亦止。
咯唾血方 出于肾。亦有瘀血内积，肺气壅遏，不能下降。肺壅，非吐不可。
天冬 麦冬 知母 贝母 桔梗 熟地 远志 黄柏
有寒加干姜、肉桂。
呕痰涎血方 出于脾。
黄 黄连 白芍 当归 甘草 沉香 葛根
呕吐血方 出于胃。
犀角地黄汤 治实，及病余瘀血。
犀角（一两） 生地（八两） 白芍（三两） 丹皮（二两）
小建中汤加黄连 治虚及伤胃吐血。
三黄补血汤 治六脉大，按之虚，面赤善惊，上热，乃手少阴心之脉也。此气盛
而亡血，泻火补气，以坠气浮。
丹皮（一钱） 川芎（二钱） 熟地（二钱） 生地（三钱） 柴胡 当归（各一钱半） 升麻
黄（各一钱） 白芍（五钱）
人参饮子 治脾胃虚弱，衄血、吐血。又治吐血久不愈，于气冲三棱针出血，立
愈。
甘草（一钱） 麦冬（二钱） 当归（三钱） 黄 （一钱） 五味子（五个） 白芍（一钱）
救肺饮 治咳、吐血。
升麻 柴胡 白术 白芍（各一钱） 归尾 熟地 黄 人参（各二钱） 苏木 陈皮
甘草（各五分）
作一服。
清心莲子饮 治咳血兼痰。
凉血地黄汤 治肠 下血，水谷与血，另作一派。
知母（炒） 黄柏（炒，各一两） 槐子（炒） 青皮熟地 当归
如余证，同痢门法治之。
胃气汤 治风毒客肠胃，动则血下。
芍 术 参 归 桂 芎 苓（各等分）
尿血方 治心肾因房劳、忧思气结。
发灰，能消瘀血，通闭，醋汤下三钱。棕榈烧灰，米饮下亦可。
三汁丹 治小便出血。
水杨树脑 老鸦饭草 赤脚马兰
各自然汁，以水服之。
益阴散 治阳浮阴翳，咯血、衄血。
黄柏 黄连 黄芩（以蜜水浸，炙干） 白芍 人参 白术 干姜（各三钱） 甘草（炙，
六钱） 雨前茶（一两二钱） 香油釜炒红，米饮下三四钱，立安。
三黄丸 治衄血不止，大便结燥者，下之。
大黄（半两） 芒硝 地黄（二钱） 黄连 黄芩 山栀（各一钱）
老蜜炼丸。
咳血丹 治因身热，痰盛血虚。
青黛 栝蒌仁（二味治痰） 诃子 海石（涩） 杏仁（治嗽甚） 四物汤（治虚） 姜汁 童
便山栀
蜜调噙化。
呕血丹 治因火载血上，错经。
四物汤 山栀（炒） 郁金 童便 姜汁 韭汁 山茶花
痰加竹沥。喉中痛是气虚，加参、 、术、柏。
衄血丹（凉血）犀角地黄汤入郁金。
溺血丹 治热。
生地（四两） 苏木根 淡竹叶 山栀（炒） 滑石 甘草 蒲黄 藕节 当归
血虚，加四物、牛膝膏、通草。
下血丹 四物汤。热，加连（酒煮温）、山栀（炒）、秦艽、升麻、胶珠、白芷；虚
，加干姜（炮）、五倍子；寒，加辛升温散，一行一止。
神效方 治吐血，痰血，酒色过度者。
枇杷叶（去毛） 款冬 紫菀茸 杏仁（去皮尖） 鹿茸（炙如法） 桑白皮 木通（各一两）
大黄（半两）
炼蜜丸，临卧含化口中。
圣饼子 治咯血。
青黛（一钱） 杏仁（四十粒，去皮尖）
上杏仁，以黄蜡煎黄色，研细，入黛作捏饼子。每日柿一个，中破开入药合定，湿纸煨
，饮下。
罗面丹 治内损吐血。
飞罗面（略炒） 京墨（磨下，二钱）
越桃散 治下血及血痢。
山栀 槐花 大枣 干姜（各等分）
烧存性，研，米饮下三钱。
伏龙肝散 治便血。因内外有感，凝住在胃，随气下通，亦妄行之类。
伏龙肝（八两） 白术 阿胶 黄芩 干地黄 甘草（各三两）
煎服。
赤豆归散 治先血后便，谓之近血。
赤小豆（五两，浸令芽出，晒干） 当归（一两）
为末浆水下。
五灵脂散 治下血。
五灵脂（炒为末）
芎归汤下。
有血脱尽，色白而夭、不泽，脉濡。此大寒证，乃始同而末异。治宜辛温益血，甘热温
经，干姜类是也。
有阴结者便血。夫邪在五脏，则阴脉不和，阴不和则血留之，血无所禀，渗入肠间，其
脉虚涩，非肠风脏毒也。治宜生地黄汁、小蓟汁各一升、砂糖、地榆、阿胶、侧柏叶。
【脉象】
脉象涩、濡、弱，是失血的表现；脉象细、弦且涩，重按无力，是脱血的症状。脉象浮而弱，重按则脉搏消失的，是下部出血；伴有烦躁咳嗽的，必定吐血。脉象沉弦，面色苍白无血色，没有寒热感觉的，必定鼻衄。脉沉表示病位在里，营卫之气在体内郁结，胸部胀满必定吐血。脉象滑小且弱的预后良好，脉象浮大、牢实且数的预后不良（主死）；另外，血液发热、身体高热、脉象躁动的预后不良（主死），这是因为热气导致血气散乱的原因。藏血功能失常，如果脉象都呈现弦象的预后不良（主死），脉象滑大的预后良好。
【病因】
外部有肺痈、肺痿病症，也能引起咳嗽脓血。劳损也能导致吐血。
【证治】
麻黄汤：治疗伤寒证候中内部严重壅塞内热，火气不能舒展而导致的鼻衄。脉象浮紧属于寒邪。
桂枝汤：治疗的证候与上述相同，脉象浮缓属于风邪。
五苓散：治疗伏暑，热气流入经络。
黄芩芍药汤：治疗伤寒和风邪两种证候，脉象微弱。
衄血方：治疗源于肺经的鼻衄。如果不止血，用寒水纸贴在胸部、头部和大椎穴三处。
药材：犀角、升麻、山栀、黄芩、白芍、生地、丹参、紫参、阿胶、荆芥穗。研末服用也有效。萝卜头段捣汁饮用，或者将汁液滴入鼻腔也有效。灸大椎穴、哑门穴也能止血。
咯唾血方：病源出于肾。也有因瘀血内积，肺气壅遏，不能下降的情况。肺气壅滞，必须通过呕吐排出。
药材：天冬、麦冬、知母、贝母、桔梗、熟地、远志、黄柏。如果有寒象，加干姜、肉桂。
呕痰涎血方：病源出于脾。
药材：黄芪、黄连、白芍、当归、甘草、沉香、葛根。
呕吐血方：病源出于胃。
犀角地黄汤：治疗实证，以及病后残留的瘀血。
药材及剂量：犀角（一两）、生地（八两）、白芍（三两）、丹皮（二两）。
小建中汤加黄连：治疗虚证及伤胃引起的吐血。
三黄补血汤：治疗六脉洪大，重按无力，面赤易惊，上部有热，这是手少阴心经的脉象。这是气盛而失血，治疗方法是泻火补气，以沉降浮越之气。
药材及剂量：丹皮（一钱）、川芎（二钱）、熟地（二钱）、生地（三钱）、柴胡、当归（各一钱半）、升麻、黄芪（各一钱）、白芍（五钱）。
人参饮子：治疗脾胃虚弱引起的鼻衄、吐血。又治疗吐血久不愈者，可在气冲穴用三棱针刺破出血，立即痊愈。
药材及剂量：甘草（一钱）、麦冬（二钱）、当归（三钱）、黄芪（一钱）、五味子（五个）、白芍（一钱）。
救肺饮：治疗咳嗽、吐血。
药材及剂量：升麻、柴胡、白术、白芍（各一钱）、归尾、熟地、黄芪、人参（各二钱）、苏木、陈皮、甘草（各五分）。
作一剂服用。
清心莲子饮：治疗咳血兼有痰症。
凉血地黄汤：治疗肠道下血，水谷与血分开，各自成一派。
药材及剂量：知母（炒）、黄柏（炒，各一两）、槐子（炒）、青皮、熟地、当归。
如果有其他症状，按照痢疾门的法治之。
胃气汤：治疗风毒客居肠胃，动则血下行。
药材及剂量：芍药、白术、人参、当归、桂枝、川芎、茯苓（各等分）。
尿血方：治疗因房劳、忧思气结导致的心肾病变。
发灰：能消除瘀血，通闭阻，用醋汤送服三钱。棕榈烧成灰，用米饮送服也可以。
三汁丹：治疗小便出血。
药材：水杨树脑、老鸦饭草、赤脚马兰。
取各植物的自然汁，用水送服。
益阴散：治疗阳浮阴翳，咯血、衄血。
药材及剂量：黄柏、黄连、黄芩（用蜜水浸泡，炙干）、白芍、人参、白术、干姜（各三钱）、甘草（炙，六钱）、雨前茶（一两二钱）。香油在釜中炒红，用米饮送服三四钱，立即安宁。
三黄丸：治疗鼻衄不止，大便干结燥硬的，采用攻下法。
药材及剂量：大黄（半两）、芒硝、地黄（二钱）、黄连、黄芩、山栀（各一钱）。
用老蜜炼制成丸。
咳血丹：治疗因身体发热，痰多血虚引起的咳血。
药材：青黛、栝蒌仁（这两味药治痰）、诃子、海石（收敛）、杏仁（治剧烈咳嗽）、四物汤（治虚证）、姜汁、童便、山栀。
用蜂蜜调匀含化。
呕血丹：治疗因火载血上行，血液错行经脉。
药材：四物汤、山栀（炒）、郁金、童便、姜汁、韭汁、山茶花。
有痰加竹沥。喉中痛是气虚，加人参、白术、黄柏。
衄血丹（凉血）：犀角地黄汤加入郁金。
溺血丹：治疗热证。
药材及剂量：生地（四两）、苏木根、淡竹叶、山栀（炒）、滑石、甘草、蒲黄、藕节、当归。
血虚，加四物汤、牛膝膏、通草。
下血丹：四物汤。热证，加连翘（酒煮温服）、山栀（炒）、秦艽、升麻、胶珠、白芷；虚证，加干姜（炮制）、五倍子；寒证，加辛温发散药，一行一止。
神效方：治疗吐血、痰血，因酒色过度引起者。
药材及剂量：枇杷叶（去毛）、款冬、紫菀茸、杏仁（去皮尖）、鹿茸（按法炙烤）、桑白皮、木通（各一两）、大黄（半两）。
炼蜜为丸，临睡前含化于口中。
圣饼子：治疗咯血。
药材及剂量：青黛（一钱）、杏仁（四十粒，去皮尖）。
将杏仁用黄蜡煎至黄色，研细，加入青黛做成饼子。每天吃一个柿子，中间剖开放入药饼合定，用湿纸包裹煨熟，饮水送下。
罗面丹：治疗内伤吐血。
药材及剂量：飞罗面（略炒）、京墨（磨下，二钱）。
越桃散：治疗下血及血痢。
药材及剂量：山栀、槐花、大枣、干姜（各等分）。
烧至存性，研末，用米饮送服三钱。
伏龙肝散：治疗便血。因内外感受邪气，凝滞在胃，随气下行通畅，也是妄行之类。
药材及剂量：伏龙肝（八两）、白术、阿胶、黄芩、干地黄、甘草（各三两）。
煎服。
赤豆归散：治疗先血后便，称为近血。
药材及剂量：赤小豆（五两，浸泡令其发芽，晒干）、当归（一两）。
研为末，用浆水下服。
五灵脂散：治疗下血。
药材及剂量：五灵脂（炒为末）。
用芎归汤送服。
如果有血脱尽，面色苍白枯槁、无光泽，脉象濡软。这是大寒证，起初症状相同但结尾不同。治疗宜用辛温益血，甘热温经的方法，干姜类药物即是此类。
有阴结者会便血。邪气在五脏，则阴脉不和，阴脉不和则血液留滞，血液无所禀受，渗入肠间，其脉象虚涩，这不是肠风脏毒。治疗宜用生地黄汁、小蓟汁各一升、砂糖、地榆、阿胶、侧柏叶。
[Pulse]
A choppy (Se), soggy (Ru), and weak pulse indicates blood loss; a fine (Xi), wiry (Xian), and choppy pulse, which feels deficient upon deep pressure, indicates severe blood depletion. A floating (Fu) and weak pulse, where the pulse disappears upon deep pressure, indicates lower body bleeding; accompanied by irritability and coughing, it inevitably leads to hematemesis. A deep (Chen) and wiry pulse, with a pale complexion and absence of chills or fever, inevitably indicates epistaxis. A deep pulse indicates the pathology is in the interior, with Ying and Wei Qi constrained internally; chest fullness inevitably leads to hematemesis. A slippery (Hua), small, and weak pulse indicates survival, whereas a floating, large, firm (Lao), and rapid (Shu) pulse indicates death. Furthermore, if the blood feels warm, the body is hot, and the pulse is restless (Zao), it indicates death, as heat causes the dispersion of Qi and Blood. If the Zang organs fail to store blood and all pulses are wiry, it indicates death; if the pulses are slippery and large, it indicates survival.
[Etiology]
Exterior conditions such as Lung Abscess (Fei Yong) and Lung Withering (Fei Wei) can also cause coughing up of pus and blood. Laborious strain can also lead to hematemesis.
[Syndrome Differentiation and Treatment]
Mahuang Tang (Ephedra Decoction): Treats Taiyang disease syndromes characterized by severe internal obstruction and heat, where Fire Qi cannot extend, resulting in epistaxis. A floating and tight pulse indicates Cold.
Guizhi Tang (Cinnamon Twig Decoction): Treats the same syndrome as above, but with a floating and slow pulse indicating Wind.
Wuling San (Five-Ingredient Powder with Poria): Treats latent summerheat, where heat flows into the meridians.
Huangqin Shaoyao Tang (Scutellaria and Peony Decoction): Treats both Taiyang Cold and Wind syndromes, with a faint pulse.
Nuxue Fang (Epistaxis Formula): Treats epistaxis originating from the Lung Meridian. If bleeding does not stop, apply cold-water paper to the chest, head, and Dazhui (GV14).
Herbs: Xijiao (Rhinoceros Horn), Shengma (Cimicifugae Rhizoma), Shanzhi (Gardeniae Fructus), Huangqin (Scutellariae Radix), Baishao (Paeoniae Radix Alba), Shengdi (Rehmanniae Radix), Danshen (Salviae Miltiorrhizae Radix), Zican (Bupleuri Radix), Ejiao (Colla Corii Asini), Jingjie Sui (Schizonepetae Spica). Grind and take; this is also effective. Crush the root section of radish and drink the juice, or drip the juice into the nostrils; this is also effective. Moxibustion on Dazhui (GV14) and Yamen (GV15) can also stop bleeding.
Ketuoxue Fang (Formula for Coughing up Blood): Originates from the Kidney. It may also be caused by internal accumulation of blood stasis, causing Lung Qi obstruction and failure to descend. When Lung Qi is obstructed, vomiting is necessary to expel it.
Herbs: Tiandong (Asparagi Radix), Maidong (Ophiopogonis Radix), Zhimu (Anemarrhenae Rhizoma), Beimu (Fritillariae Cirrhosae Bulbus), Jiegeng (Platycodonis Radix), Shudi (Rehmanniae Radix Preparata), Yuanzhi (Polygalae Radix), Huangbai (Phellodendri Cortex). If there is Cold, add Ganjiang (Zingiberis Rhizoma) and Rougui (Cinnamomi Cortex).
Outou Tanxian Xue Fang (Formula for Vomiting Phlegm and Blood): Originates from the Spleen.
Herbs: Huangqi (Astragali Radix), Huanglian (Coptidis Rhizoma), Baishao (Paeoniae Radix Alba), Danggui (Angelicae Sinensis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Chenxiang (Aquilariae Lignum), Gegen (Puerariae Lobatae Radix).
Outouxue Fang (Formula for Vomiting Blood): Originates from the Stomach.
Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction): Treats Excess patterns and residual blood stasis after illness.
Dosages: Xijiao (1 liang), Shengdi (8 liang), Baishao (3 liang), Danpi (2 liang).
Xiaojianzhong Tang (Minor Construct the Middle Decoction) plus Huanglian: Treats Deficiency patterns and hematemesis due to Stomach injury.
Sanhuang Buxue Tang (Three-Yellow Blood-Nourishing Decoction): Treats cases where all six pulses are large but feel empty upon pressure, with a red face, susceptibility to fright, and upper body heat. This corresponds to the pulse of the Hand-Shaoyin Heart Meridian. This is Qi excess leading to blood loss; the treatment is to drain Fire and tonify Qi to sink floating Qi.
Dosages: Danpi (1 qian), Chuanxiong (2 qian), Shudi (2 qian), Shengdi (3 qian), Chaihu (1.5 qian), Danggui (1.5 qian), Shengma (1 qian), Huangqi (1 qian), Baishao (5 qian).
Renshen Yinzi (Ginseng Infusion): Treats hematemesis and epistaxis due to Spleen and Stomach deficiency. It also treats chronic hematemesis that has not healed; pricking the Qichong (ST30) acupoint with a three-edged needle to release blood will cure it immediately.
Dosages: Gancao (1 qian), Maidong (2 qian), Danggui (3 qian), Huangqi (1 qian), Wuweizi (5 berries), Baishao (1 qian).
Jiu Fei Yin (Lung-Saving Infusion): Treats coughing and hematemesis.
Dosages: Shengma (1 qian), Chaihu (1 qian), Baizhu (1 qian), Baishao (1 qian), Guiwei (2 qian), Shudi (2 qian), Huangqi (2 qian), Renshen (2 qian), Sumu (0.5 qian), Chenpi (0.5 qian), Gancao (0.5 qian).
Take as one dose.
Qingxin Lianzi Yin (Clear Heart Lotus Seed Infusion): Treats hemoptysis accompanied by phlegm.
Liangxue Dihuang Tang (Cool Blood and Rehmannia Decoction): Treats lower body bleeding from the intestines, where food/water and blood are separated into distinct streams.
Dosages: Zhimu (stir-fried, 1 liang), Huangbai (stir-fried, 1 liang), Huaizi (stir-fried), Qingpi, Shudi, Danggui.
For other symptoms, treat according to the methods in the Dysentery chapter.
Weiqi Tang (Stomach Qi Decoction): Treats wind-toxin lodging in the intestines and stomach, causing bleeding when moved.
Dosages: Shaoyao, Baizhu, Renshen, Danggui, Guizhi, Chuanxiong, Fuling (equal parts).
Niaoxue Fang (Hematuria Formula): Treats Heart and Kidney disorders due to sexual exhaustion, worry, and Qi stagnation.
Fa Hui (Hair Ash): Dissolves blood stasis and unblocks obstruction; take 3 qian with vinegar decoction. Zonglv (Livistona chinensis leaf ash) burned to ash, taken with rice water, is also effective.
Sanzhi Dan (Three-Juice Pill): Treats hematuria.
Herbs: Shuiyangshu Nao (Water Poplar Bud), Laoya Fan Cao (Old Crow Rice Grass), Chijiao Malan (Red-footed Horseweed).
Extract natural juices from each and take with water.
Yiyin San (Yin-Nourishing Powder): Treats floating Yang and obscured Yin, causing hemoptysis and epistaxis.
Dosages: Huangbai, Huanglian, Huangqin (soaked in honey water, stir-fried dry), Baishao, Renshen, Baizhu, Ganjiang (each 3 qian), Gancao (roasted, 6 qian), Yuqiancha (pre-Rain tea, 1.2 liang). Stir-fry sesame oil in a cauldron until red, take 3-4 qian with rice water for immediate relief.
Sanhuang Wan (Three-Yellow Pill): Treats persistent epistaxis with dry, constipated stool; use purgative method.
Dosages: Dahuang (0.5 liang), Mangxiao, Dihuang (2 qian), Huanglian, Huangqin, Shanzhi (each 1 qian).
Make pills with aged honey.
Kexue Dan (Hemoptysis Pill): Treats hemoptysis due to body heat, abundant phlegm, and blood deficiency.
Herbs: Qingdai (Indigo Naturalis), Gualou Ren (Trichosanthis Semen) [these two treat phlegm], Hezi (Terminalia Chebula Retius), Haishi (Fossilia Osseum), Xingren (Armeniacae Semen Amarum) [treats severe cough], Siwu Tang (Four Substances Decoction) [treats deficiency], Jiangzhi (Ginger Juice), Tongbian (Child's Urine), Shanzhi.
Mix with honey and dissolve in the mouth.
Ouxue Dan (Hematemesis Pill): Treats blood carried upward by Fire, flowing into incorrect channels.
Herbs: Siwu Tang, Shanzhi (stir-fried), Yujin (Curcumae Radix), Tongbian, Jiangzhi, Jiuji Zhi (Chinese Chive Juice), Shanchahua (Camellia Flower).
Add Zhuli (Bamboo Sap) if there is phlegm. Throat pain indicates Qi deficiency; add Renshen, Baizhu, Huangbai.
Nuxue Dan (Cooling Blood): Xijiao Dihuang Tang plus Yujin.
Niaoxue Dan (Hematuria Pill): Treats Heat patterns.
Dosages: Shengdi (4 liang), Sumugen (Sumu Root), Danzhuye (Lophatheri Herba), Shanzhi (stir-fried), Huashi (Talcum), Gancao, Puhuang (Typhae Pollen), Oujie (Nelumbinis Rhizomatis Node), Danggui.
If blood deficient, add Siwu Tang, Niuxi Gao (Achyranthes Bidentata Extract), Tongcao.
Xiaxue Dan (Lower Bleeding Pill): Siwu Tang. For Heat, add Lianqiao (wine-boiled and warmed), Shanzhi (stir-fried), Qinjiao, Shengma, Jiaozhu (Gelatinized Gelatin), Baizhi. For Deficiency, add Ganjiang (processed), Wubeizi. For Cold, add acrid-warm dispersing herbs; move and stop simultaneously.
Shenxiao Fang (Divine Efficacy Formula): Treats hematemesis and bloody phlegm due to excessive alcohol and sexual activity.
Dosages: Pipaye (Loquat Leaf, de-hairy), Kuandong (Farfarae Flos), Ziwan (Adenophorae Radix), Xingren (de-skinned and de-pitted), Lurong (Deer Antler, roasted properly), Sangbaipi (Morus Alba Bark), Mutong (Akebiae Caulis) (each 1 liang), Dahuang (0.5 liang).
Make pills with refined honey; dissolve in the mouth before bed.
Shengbingzi (Holy Cake): Treats hemoptysis.
Dosages: Qingdai (1 qian), Xingren (40 kernels, de-skinned and de-pitted).
Fry the almonds in yellow beeswax until yellow, grind finely, mix with Qingdai, and form into cakes. Take one persimmon daily, split open, insert the medicine cake, wrap in wet paper, and bake/roast. Swallow with water.
Luomian Dan (Flour Pill): Treats internal injury and hematemesis.
Dosages: Feiluomian (Fine Wheat Flour, lightly stir-fried), Jingmo (Beijing Ink, ground, 2 qian).
Yuetao San (Prunus Powder): Treats lower bleeding and bloody dysentery.
Dosages: Shanzhi, Huaihua (Sophorae Flos), Dazao (Jujubae Fructus), Ganjiang (each equal part).
Burn until carbonized but retaining properties, grind, and take 3 qian with rice water.
Fulonggan San (Dragon’s House Earth Powder): Treats melena. Caused by external and internal pathogenic factors condensing in the Stomach, following Qi downward, representing abnormal flow.
Dosages: Fulonggan (8 liang), Baizhu, Ejiao, Huangqin, Gan Dihuang, Gancao (each 3 liang).
Decoct and take.
Chidou Gui San (Red Bean and Angelica Powder): Treats blood appearing before stool, known as "Near Bleeding" (Jin Xue).
Dosages: Chixiaodou (5 liang, soaked until sprouted, dried), Danggui (1 liang).
Grind to powder, take with bean dregs water.
Wulingzhi San (Trogopterus Dung Powder): Treats lower bleeding.
Dosages: Wulingzhi (stir-fried and ground).
Take with Xionggui Tang.
If blood is completely depleted, the complexion is white and lifeless/lusterless, and the pulse is soggy. This is a Great Cold pattern, initially similar but ending differently. Treatment should use acrid-warm herbs to benefit blood and sweet-hot herbs to warm the meridians; Ganjiang-type herbs are suitable.
In cases of Yin Constriction, there is melena. When pathogens are in the Five Zang organs, the Yin pulses become discordant; if Yin is discordant, blood stagnates. Without proper nourishment, blood seeps into the intestines. The pulse is deficient and choppy; this is not Intestinal Wind or Zang Toxin. Treatment should use Shengdihuang Juice, Xiaoji Juice (each 1 sheng), Sugar, Diyü, Ejiao, and Ce Bai Ye.