吐衄便漏。其血无不离经。凡系离经之血。与荣养周身之血。已睽绝而不合。其已入胃中者。听其吐下可
也。其在经脉中。而未入于胃者。急宜用药消除。或化从小便出。或逐从大便出。务使不留。则无余邪为患。
此血在身。不能加于好血。而反阻新血之化机。故凡血证。总以去瘀为要。世谓血块为瘀。清血非瘀。黑色
为瘀。鲜血非瘀。此论不确。盖血初离经。清血也。鲜血也。然既是离经之血。虽清血鲜血。亦是瘀血。离经既
久。则其血变作紫血。譬如皮肤被杖。血初被伤。其色红肿。可知血初离经。仍是鲜血。被杖数日。色变青黑。
可知离经既久。其血变作紫黑也。此血在经络之中。虽已紫黑。仍是清血。非血块也。是以能随气营运。走
入肠胃。吐下而出。设在经络之中。即是血块。如何能走入肠胃耶。至于血块。乃血入肠胃。停留片时。立即
凝结。观宰割猪羊。滴血盆中。实时凝结。便可知矣。故凡吐衄。无论清凝鲜黑。总以去瘀为先。且既有瘀血。
便有瘀血之证。医者按证治之。无庸畏阻。瘀血攻心。心痛头晕。神气昏迷。不省人事。无论产妇及吐衄家。
有此证者。乃为危候。急降其血。而保其心。用归芎失笑散。加琥珀朱砂麝香治之。或归芎汤调血竭乳香末。亦佳。
瘀血乘肺。咳逆喘促。鼻起烟煤。口目黑色。用参苏饮。保肺去瘀。此皆危急之候。凡吐血实时毙命者。多是
瘀血乘肺。壅塞气道。肺虚气促者。此方最稳。若肺实气塞者。不须再补其肺。但去其瘀。使气不阻塞。斯得
生矣。葶苈大枣汤。加苏木蒲黄五灵脂童便治之。
瘀血在经络脏腑之间。则周身作痛。以其堵塞气之往来。故滞碍而痛。所谓痛则不通也。佛手散。加桃仁
红花血竭续断秦艽柴胡竹茹甘草酒引。或用小柴胡。加归芍丹皮桃仁荆芥。尤通治内外之方。义较稳。
瘀血在上焦。或发脱不生。或骨膊胸膈顽硬刺痛。目不了了。通窍活血汤治之。小柴胡汤。加归芍桃仁红
花大蓟。亦治之。
瘀血在中焦。则腹痛胁痛。腰脐间刺痛着滞血府。逐瘀汤治之。小柴胡汤。加香附姜黄桃仁大黄。亦治之。
瘀血在下焦。则季胁少腹。胀满刺痛。大便黑色。失笑散。加醋军桃仁治之。膈下逐瘀汤亦稳。
瘀血在里。则口渴。所以然者。血与气本不相离。内有瘀血。故气不得通。不能载水津上升。是以发渴。名曰
血渴。瘀血去则不渴矣。四物汤。加枣仁丹皮蒲黄三七花粉云苓枳壳甘草。小柴胡汤。加桃仁丹皮牛膝。
皆治之。温经汤。以温药去瘀。乃能治积久之瘀。数方皆在酌宜而用。
瘀血在腠理。则荣卫不和。发热恶寒。腠理在半表半里之间。为气血往来之路。瘀血在此。伤荣气则恶寒。
伤卫气则恶热。是以寒热如疟之状。小柴胡汤。加桃仁红花当归荆芥治之。
瘀血在肌肉。则翕翕发热。自汗盗汗。肌肉为阳明所主。以阳明之燥气。而瘀血和蒸郁。故其证象白虎。犀
骨地黄汤加桃仁红花治之。血府逐瘀汤。加醋炒大黄。亦可治之也。
瘀血在经络脏腑之间。则结为 瘕。瘕者或聚或散。气为血滞。则聚而成形。血随气散。则没而不见。方其
既聚。宜以散气为解血之法。九气丸治之。在胸膈上者。加桔梗枳壳栝蒌生姜甘草。在右者。加苏子桑皮
陈皮。在左者。加青皮牡蛎当归。在中焦大腹者。加浓朴枳壳防己白芍甘草。在小腹下者。加橘核小茴荔
核槟榔川楝子五灵脂。气散则血随而散。自不至于结聚矣。至其既散之后。则又恐其复聚。宜以调血为
和气之法。此时瘕气既散。处于血分之中。但一调血。则气自和。而不复聚矣。逍遥散。加丹皮香附治之。归
脾汤。加柴胡郁金子亦治之。 者常聚不散。血多气少。气不胜血故不散。或纯是血质。或血中裹水。或血
积既久。亦能化为痰水。水即气也。 之为病。总是气与血胶结而成。须破血行气。以推除之。元恶大憝。万
无姑容。即虚人久积。不便攻治者。亦宜攻补兼施。以求克敌。攻血质宜抵当汤。下瘀血汤。代抵当丸。攻痰
水宜十枣汤。若水血兼攻。则宜大黄甘遂汤。或秘方化气丸。外治法。贴观音救苦膏。
瘀血在经络脏腑之间。与气相战斗。则郁蒸腐化。而变为脓。另详吐脓便脓疮脓门。兹不再赘。
瘀血在经络脏腑之间。被气火煎熬。则为干血。气者。肾中之阳。阴虚阳亢。则其气上合心火。是以气盛即
是火盛。瘀血凝滞。为火气所熏。则为干血。其证必见骨蒸痨热。肌肤甲错。皮起面屑。名为干血痨。病至此
者。十治二三。仲景大黄 虫丸治之。盖既系干血。便与气化隔绝。非寻常行血之品所能治也。故用诸虫
啮血之物。以消蚀干血。瘀血不去。新血且无生机。况是干血不去。则新血断无生理。故此时虽诸虚毕见。
总以去干血为主也。如胆识不及。可以滋补之药送下此丸。亦调停之一术。
瘀血在经络脏腑之间。被风气变化。则生痨虫。气者。肾水之所化也。故气动即为湿。风者。肝阳之所生也。
故风动即为热。湿蒸热煽。将瘀血变化为虫。是为痨虫。此犹之草腐为萤。谷飞为虫也。其辨法。面色乍赤
乍白。乍青乍黄。唇口生疮。声嗄咽痒。烦梦不宁。遗精白浊。发焦舌燥。寒热盗汗。口出秽气。不知香味。喜见
人过。常怀忿怒。梦见亡先。惊悸咳逆。或腹中有块。或脑后两边有小结核。或食豆而香。又用乳香熏其手
背。帕覆手心。须臾。毛长至寸许。每日平旦精神尚好。日午向后。四肢微热。面无颜色。皆是痨虫之候也。月
华丸主之。多食鳗鱼肉。既有滋补。又善杀痨虫。或用鳗鱼骨烧黑。鳖甲炒为末。煎人参当归白芍白薇汤
送下。补虚杀虫。相辅而行。若专事杀虫。金蟾丸亦可间服。金线蛙烧服亦妙。黑猫杀取肝。焙干为末。月初
五更空心服。大能杀除痨虫。可代獭肝。獭爪为末酒下。痨虫居肺叶间。咯血声嘶者。皆能治之。
痨虫乃血化之虫。最为灵异。其人死后。虫为妖孽。传染家人。为传尸痨。杀三人者。其虫不治。传尸之证。与
其所感之病患无异。金鉴谓宜服传尸将军丸。方载丹溪心法中。今查丹溪心法不载此方。然以将军名
丸。其主用大黄可知。夫传尸虫孽。袭染人身。亟宜除去。故主攻下。亦如仲景攻干血法。以免留邪为患也。
此虫一传人身。便能聚积人身之血以为窠囊。食息生育。变化无穷。吾谓可用移尸灭怪汤。杀其虫而夺
其血。斯无遗留之邪矣。
以上二证。大便不溏泄者。尚可攻治。溏泄者。不能任药。必死。
吐血、衄血（鼻出血）、便血、尿血等出血症状，其血液没有不离开经脉的。凡是离经之血，与滋养全身的血液，已经背离隔绝而不相合了。那些已经进入胃中的血，听任它通过呕吐或排便排出即可。那些还在经脉中、未进入胃里的血，应当急用药物消除。或者让它从小便排出，或者让它从大便排出，务必使其不留存体内，这样就没有残留的病邪为患。这些血留在体内，不能融入好血之中，反而阻碍新血的化生机制。所以凡是血证，总以祛除瘀血为关键。世人认为血块才是瘀血，清亮的血不是瘀血；黑色的血是瘀血，鲜红的血不是瘀血。这种观点是不准确的。因为血液刚离开经脉时，虽然是清亮、鲜红的，但既然已经是离经之血，即使是清血、鲜血，也属于瘀血。离经时间一久，血液就会变成紫黑色。譬如皮肤被杖击，血液刚受伤时，颜色红肿；由此可知，血刚离经时仍是鲜红的。被杖击数日后，颜色变为青黑；由此可知，离经久了，血液就变成紫黑色了。这些血在经络之中，虽然已经变成紫黑色，但仍然是流动的液体，不是凝固的血块。因此它能随着气机运行，走入肠胃，通过呕吐或排便排出。如果设在经络之中就是凝固的血块，怎么能走入肠胃呢？至于血块，是血液进入肠胃后，停留片刻，立即凝结而成。观察宰杀猪羊时，滴在盆中的血，实时就会凝结，就可以知道了。所以凡是吐血、衄血，无论血液是清稀、凝固、鲜红还是发黑，都应以祛除瘀血为先务。况且既有瘀血，就有瘀血的症状。医生按照症状治疗，无需担心攻逐瘀血会有副作用。
瘀血攻心，会出现心痛、头晕、神志昏迷、不省人事等症状。无论是产妇还是吐血、衄血患者，出现这些症状的，属于危重证候。急需降泄瘀血以保护心脏，可用归芎失笑散，加入琥珀、朱砂、麝香来治疗。或者用归芎汤调服血竭、乳香的药末，也很好。
瘀血乘肺，会出现咳嗽气逆、喘息急促、鼻孔周围像烟煤一样黑、口唇眼睛发黑的症状。可用参苏饮，以保肺去瘀。这些都是危急的证候。凡吐血当场毙命的，多是瘀血乘肺，壅塞气道所致。对于肺气虚而气促的患者，此方最稳妥。如果是肺气实而气机阻塞的患者，不需要再补肺，只需去除瘀血，使气机不再阻塞，就能存活。可用葶苈大枣汤，加入苏木、蒲黄、五灵脂和童便来治疗。
瘀血在经络脏腑之间，会导致周身疼痛。因为它堵塞了气的往来通道，所以滞碍而痛。这就是所谓的“痛则不通”。可用佛手散，加入桃仁、红花、血竭、续断、秦艽、柴胡、竹茹、甘草，并用酒作为引子。或者用小柴胡汤，加入当归、白芍、丹皮、桃仁、荆芥，这也是通治内外瘀血的方剂，义理较为稳妥。
瘀血在上焦，可能导致头发脱落不生，或者骨骼、胳膊、胸膈处顽硬刺痛，视物模糊不清。可用通窍活血汤治疗。小柴胡汤，加入当归、白芍、桃仁、红花、大蓟，也能治疗。
瘀血在中焦，会导致腹痛、胁痛，腰部肚脐间有刺痛感且固定不移。可用血府逐瘀汤治疗。小柴胡汤，加入香附、姜黄、桃仁、大黄，也能治疗。
瘀血在下焦，会导致季胁（侧腹部）和小腹胀满、刺痛，大便呈黑色。可用失笑散，加入醋制的军行（大黄）、桃仁来治疗。膈下逐瘀汤也很稳妥。
瘀血在里（体内深处），会导致口渴。之所以如此，是因为血与气本不相离，体内有瘀血，所以气不得通畅，不能携带水津上升，因此发生口渴，称为“血渴”。瘀血去除后，口渴自然消失。可用四物汤，加入枣仁、丹皮、蒲黄、三七、花粉、云苓、枳壳、甘草。小柴胡汤，加入桃仁、丹皮、牛膝，都能治疗。温经汤，用温性药物祛除瘀血，才能治疗积久之瘀。这几个方剂都要酌情适宜使用。
瘀血在腠理（皮肤肌肉的间隙），会导致营卫不和，出现发热恶寒。腠理位于半表半里之间，是气血往来的道路。瘀血在此处，损伤荣气则恶寒，损伤卫气则恶热。因此会出现像疟疾一样的寒热交替症状。可用小柴胡汤，加入桃仁、红花、当归、荆芥来治疗。
瘀血在肌肉，会出现微微发热，自汗或盗汗。肌肉由阳明经所主，由于阳明经的燥气与瘀血相互蒸郁，所以症状象白虎汤证（高热大汗）。可用犀角地黄汤加桃仁、红花治疗。血府逐瘀汤，加入醋炒大黄，也可以治疗。
瘀血在经络脏腑之间，会结聚成瘕（腹内结块）。瘕这个病，有时聚拢有时消散。气被血阻滞，就会聚集成形；血随着气消散，就会隐没不见。当它刚刚聚拢时，宜以行气作为化解血结的方法。可用九气丸治疗。如果在胸膈上部，加入桔梗、枳壳、栝蒌、生姜、甘草。如果在右侧，加入苏子、桑皮、陈皮。如果在左侧，加入青皮、牡蛎、当归。在中焦大腹部，加入浓朴、枳壳、防己、白芍、甘草。在小腹下部，加入橘核、小茴、荔核、槟榔、川楝子、五灵脂。气散则血随之而散，自然不至于结聚了。等到它消散之后，又恐怕它重新聚拢，宜以调和血液作为和气的方法。此时瘕气已经消散，处于血分之中，只要调和血液，气自然平和，就不会再聚拢了。可用逍遥散，加入丹皮、香附治疗。归脾汤，加入柴胡、郁金子也能治疗。寃（此处原文似有误，结合上下文应为“癥”或指代顽固积聚）常聚不散，是因为血多气少，气不胜血所以不散。或者是纯血质，或者是血中包裹着水，或者是血积久了，也能化为痰水。水即是气的一种表现。寃/癥这类疾病，总是气和血胶结而成。必须破血行气，以推除它。这是元凶大恶，万万不可姑息宽容。即使是虚人久积，不便直接攻伐治疗的，也应该攻补兼施，以求战胜病邪。攻逐血质宜用抵当汤、下瘀血汤、代抵当丸。攻逐痰水宜用十枣汤。如果水血兼攻，则宜用大黄甘遂汤，或秘方化气丸。外治法，可贴观音救苦膏。
瘀血在经络脏腑之间，与气相互斗争，就会郁蒸腐化，而变成脓。另详吐脓、便脓、疮脓门，这里不再赘述。
瘀血在经络脏腑之间，被气火煎熬，就成为干血。气，是肾中的阳气。阴虚阳亢，那么气就上合于心火，所以气盛就是火盛。瘀血凝滞，被火气熏灼，就成为干血。其症状必定见到骨蒸痨热（午后潮热，手足心热），肌肤甲错（皮肤干燥如鳞甲），皮起面屑。名为干血痨。病到这个地步的，十个治不好两三个。张仲景的大黄䗪虫丸来治疗。因为既然是干血，就已经与气化隔绝，不是寻常行血药物所能治疗的。所以用各种以血为食的虫类药，来消蚀干血。瘀血不去，新血尚且没有生机，何况是干血不去，新血断无生理。所以此时虽然各种虚损症状都出现了，总以去除干血为主。如果胆识不足，可以用滋补的药物送服此丸，也是一种调停的办法。
瘀血在经络脏腑之间，被风气变化影响，就会产生痨虫。气，是由肾水所化生的。所以气动就产生湿。风，是由肝阳所生成的。所以风动就产生热。湿蒸热煽，将瘀血变化为虫，这就是痨虫。这就像草腐烂变成萤火虫，谷物飞化变成虫子一样。辨别方法是：面色忽红忽白，忽青忽黄，嘴唇口腔生疮，声音嘶哑咽喉痒，烦躁多梦睡不宁，遗精白浊，头发焦枯舌燥，寒热盗汗，口中出秽气，不知香味，喜欢看到别人的过错，常怀忿怒，梦见已故祖先，惊悸咳逆，或者腹中有块，或者脑后两边有小结核，或者吃豆子觉得香，又用乳香熏手背，帕子覆手心，一会儿，汗毛长到一寸左右，每天清晨精神还好，日午以后，四肢微热，面无血色，都是痨虫的征候。以月华丸为主治。多吃鳗鱼肉，既有滋补作用，又善于杀灭痨虫。或者用鳗鱼骨烧黑，鳖甲炒为末，煎人参、当归、白芍、白薇汤送下。补虚杀虫，相辅而行。如果专门从事杀虫，金蟾丸也可以间歇服用。金线蛙烧熟服用也很妙。杀黑猫取其肝脏，焙干为末，在月初五更时分空腹服用，大能杀灭痨虫，可以代替獭肝。獭爪研末酒送下，痨虫居住在肺叶间，咯血声嘶的人，都能治疗。
痨虫是由血化成的虫，最为灵异。其人死后，虫变成妖孽，传染家人，成为传尸痨。杀死三个人的，那个虫就无法治愈了。传尸的证候，与它所感染的病患无异。金鉴说宜服用传尸将军丸，方子记载在《丹溪心法》中。现在查《丹溪心法》不载此方，但以“将军”命名丸药，其主要成分是大黄可以知道。夫传尸虫孽，袭染人身，亟宜除去，所以主攻下，也像仲景攻干血的方法，以免留邪为患。
这种虫一旦传入人身，就能聚集人身之血作为巢穴，饮食休息生育，变化无穷。我认为可用移尸灭怪汤，杀灭它的虫并夺取它的血，这样就没有遗留的病邪了。
以上两种证候，大便不溏泄的，还可以攻治。如果溏泄的，不能耐受药物，必然死亡。
Hematemesis (vomiting blood), epistaxis (nosebleed), hematochezia (blood in stool), and hematuria (blood in urine) are all conditions where blood leaves the meridians. Any blood that has left the meridians is separated from and no longer harmonizes with the blood that nourishes the whole body. For blood that has already entered the stomach, it is permissible to let it be expelled through vomiting or defecation. For blood remaining within the meridians but not yet entering the stomach, medication should be urgently administered to eliminate it. It should either be excreted via urination or via defecation, ensuring nothing remains, so that no residual pathogenic factors cause further harm. Blood retained in the body cannot merge with healthy blood but instead obstructs the mechanism of new blood formation. Therefore, in all blood disorders, removing blood stasis is paramount. The common belief that only blood clumps constitute stasis, while clear blood does not; or that dark blood is stasis while fresh blood is not, is inaccurate. When blood first leaves the meridians, although it may appear clear and bright red, since it has left the meridians, even clear or fresh blood constitutes blood stasis. After staying outside the meridians for a long time, the blood turns purple-black. For instance, when skin is struck by a stick, the initial injury shows redness and swelling; thus, blood just leaving the meridians is still fresh. After a few days, the color changes to blue-black; thus, after a long time outside the meridians, the blood becomes purple-black. This blood within the meridians, though purple-black, remains fluid and is not a solidified blood clot. Therefore, it can circulate with Qi, enter the intestines and stomach, and be expelled through vomiting or defecation. If it were a solidified clot within the meridians, how could it enter the intestines? As for blood clots, they form when blood enters the intestines and stomach, stays for a moment, and immediately coagulates. Observing blood dripping into a basin during the slaughter of pigs or sheep, which coagulates instantly, confirms this. Thus, in cases of hematemesis or epistaxis, regardless of whether the blood is clear, clotted, fresh, or dark, removing blood stasis must be the priority. Moreover, where there is blood stasis, there are symptoms of blood stasis. Physicians should treat according to these symptoms without fear of adverse effects from expelling stasis.
When blood stasis attacks the Heart, symptoms include heart pain, dizziness, coma, and loss of consciousness. Whether in postpartum women or patients with hematemesis/epistaxis, these symptoms indicate a critical condition. Urgent treatment is required to descend the stasis and protect the Heart. Use Guixiong Shixiao San (Cinnamon Twig and Ligusticum Decoction with Five-Step Powder) added with Amber (Hupo), Cinnabar (Zhusha), and Musk (Shexiang). Alternatively, using Guixiong Tang (Cinnamon Twig and Ligusticum Decoction) to administer powders of Dragon's Blood (Xuexie) and Frankincense (Ruxiang) is also effective.
When blood stasis invades the Lung, symptoms include coughing with reversed Qi, panting, blackening around the nostrils like soot, and blackening of the mouth and eyes. Use Shen Su Yin (Ginseng and Perilla Drink) to tonify the Lung and remove stasis. These are all critical conditions. Sudden death from hematemesis is often due to blood stasis invading the Lung and blocking the airway. For patients with Lung Qi deficiency causing shortness of breath, this formula is most stable. For those with excess Lung Qi and obstruction, do not tonify the Lung; simply remove the stasis to unblock the Qi, and survival is possible. Use Tingli Dazao Tang (Descurainia Seed and Jujube Decoction) added with Suxmu (Sappan Wood), Puhuang (Pollen Typhae), Wulingzhi (Trogopterus Dung), and child's urine.
When blood stasis exists between the meridians and Zang-Fu organs, it causes pain throughout the body because it blocks the flow of Qi, leading to stagnation and pain. This is what is meant by "pain indicates obstruction." Use Foshou San (Buddha's Hand Powder) added with Taoren (Peach Kernel), Honghua (Safflower), Xuexie (Dragon's Blood), Xuduan (Dipsacus Root), Qinjiao (Gentiana Macrophylla), Chaihu (Bupleurum), Zhuru (Bamboo Shavings), and Gancao (Licorice), guided by wine. Or use Xiaochai Hu Tang (Minor Bupleurum Decoction) added with Danggui (Angelica Sinensis), Baishao (White Peony Root), Danpi (Moutan Bark), Taoren (Peach Kernel), and Jingjie (Schizonepeta), which is a general formula for internal and external stasis, offering a more balanced approach.
When blood stasis is in the Upper Jiao, it may cause hair loss, hardness and stabbing pain in the bones, arms, chest, and diaphragm, and blurred vision. Use Tongqiao Huoxue Tang (Orifice-Unblocking Blood-Invigorating Decoction). Xiaochai Hu Tang (Minor Bupleurum Decoction) added with Danggui (Angelica Sinensis), Baishao (White Peony Root), Taoren (Peach Kernel), Honghua (Safflower), and Daji (Great Thistle) also treats this.
When blood stasis is in the Middle Jiao, it causes abdominal pain, hypochondriac pain, and fixed stabbing pain in the waist and umbilical region. Use Xuefu Zhuyu Tang (Blood Mansion Stasis-Expelling Decoction). Xiaochai Hu Tang (Minor Bupleurum Decoction) added with Xiangfu (Cyperus Rhizome), Jianghuang (Turmeric Rhizome), Taoren (Peach Kernel), and Dahuang (Rhubarb Root) also treats this.
When blood stasis is in the Lower Jiao, it causes distension and stabbing pain in the lateral hypochondrium and lower abdomen, and black stools. Use Shixiao San (Five-Step Powder) added with Vinegar-processed Junjun (Da Huang/Rhubarb) and Taoren (Peach Kernel). Gexia Zhuyu Tang (Diaphragm Below Stasis-Expelling Decoction) is also stable.
When blood stasis is deep inside (in the interior), it causes thirst. This is because Blood and Qi are inseparable; internal blood stasis prevents Qi from circulating freely, so Qi cannot carry fluids upward, resulting in thirst, termed "Blood Thirst." Once the stasis is removed, the thirst ceases. Use Siwu Tang (Four Substances Decoction) added with Zaoren (Ziziphus Seed), Danpi (Moutan Bark), Puhuang (Pollen Typhae), Sanqi (Notoginseng Root), Huafen (Trichosanthes Root), Yunling (Poria), Zhike (Aurantii Fructus), and Gancao (Licorice). Xiaochai Hu Tang (Minor Bupleurum Decoction) added with Taoren (Peach Kernel), Danpi (Moutan Bark), and Niuxi (Achyranthes Root) also treats this. Wenjing Tang (Warming Meridian Decoction) uses warm herbs to remove stasis and is suitable for chronic stasis. These formulas should be used judiciously.
When blood stasis is in the Couli (interstices of skin and muscle), it disrupts Ying and Wei harmony, causing fever and aversion to cold. The Couli lies between the exterior and interior, serving as the pathway for Qi and Blood circulation. Stasis here damages Ying Qi, causing aversion to cold, and damages Wei Qi, causing heat intolerance. Thus, alternating chills and fever resembling malaria occur. Use Xiaochai Hu Tang (Minor Bupleurum Decoction) added with Taoren (Peach Kernel), Honghua (Safflower), Danggui (Angelica Sinensis), and Jingjie (Schizonepeta).
When blood stasis is in the Muscle, it causes mild fever, spontaneous sweating, and night sweats. Muscles are governed by the Yangming channel. Due to the dryness of Yangming, stasis steams and郁 (constrains), presenting symptoms similar to Baihu Tang syndrome (high fever, profuse sweating). Use Xigui Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) added with Taoren (Peach Kernel) and Honghua (Safflower). Xuefu Zhuyu Tang (Blood Mansion Stasis-Expelling Decoction) added with vinegar-fried Dahuang (Rhubarb Root) also treats this.
When blood stasis is between the meridians and Zang-Fu organs, it forms Jia masses (mobile abdominal masses). Jia masses may gather or disperse. When Qi is blocked by blood, it gathers into a shape; when blood disperses with Qi, it disappears. When newly gathered, resolve the blood stasis by moving Qi. Use Jiuqi Wan (Nine Qi Pill). If located in the upper chest/diaphragm, add Jiegeng (Platycodon Root), Zhike (Aurantii Fructus), Gualou (Trichosanthes Fruit), Shengjiang (Fresh Ginger), and Gancao (Licorice). If on the right, add Suzi (Perilla Seed), Sangpi (Mulberry Bark), and Chenpi (Tangerine Peel). If on the left, add Qingpi (Green Tangerine Peel), Muli (Oyster Shell), and Danggui (Angelica Sinensis). In the middle/large abdomen, add Houpo (Magnolia Bark), Zhike (Aurantii Fructus), Fangji (Stephania Root), Baishao (White Peony Root), and Gancao (Licorice). In the lower abdomen, add Juhe (Tangerine Seed), Xiaohui (Fennel Seed), Lihé (Lychee Seed), Binglang (Areca Nut), Chuanlizi (Toosendan Fruit), and Wulingzhi (Trogopterus Dung). When Qi moves, blood follows and disperses, preventing accumulation. After dispersion, fear of re-accumulation arises; thus, harmonize Qi by regulating Blood. At this stage, with Qi dispersed and residing in the Blood aspect, regulating Blood naturally harmonizes Qi and prevents re-gathering. Use Xiaoyao San (Free and Easy Wanderer Powder) added with Danpi (Moutan Bark) and Xiangfu (Cyperus Rhizome). Guipi Tang (Restore the Spleen Decoction) added with Chaihu (Bupleurum), Yuzi (Curcuma Aromatica Rhizome), and Lingzhi (Ganoderma Spore - *Note: Text says 'Lingzi', likely referring to a specific herb or typo, interpreted contextually*) also treats this. Zheng masses (fixed abdominal masses) often persist because Blood is abundant and Qi is deficient, so Qi cannot overcome Blood to disperse them. They may be pure blood quality, or blood wrapping water, or old blood transforming into phlegm-water. Water is a form of Qi. Zheng diseases result from the gumming together of Qi and Blood. One must break Blood and move Qi to push them out. These are major evils, tolerable neither. Even in deficient patients with long-standing accumulations unsuitable for direct attack, combine attacking and tonifying to defeat the enemy. To attack blood quality, use Didang Tang (Definite Victory Decoction), Xiayuxue Tang (Lower Abdomen Blood-Stasis Expelling Decoction), or Dai Didang Wan (Substitute Definite Victory Pill). To attack phlegm-water, use Shizao Tang (Ten Date Decoction). For simultaneous water and blood attack, use Dahuang Gansui Tang (Rhubarb and Kansui Decoction) or the secret formula Huaqi Wan (Qi-Transforming Pill). External treatment: apply Guanyin Jiuku Gao (Guanyin Saving from Suffering Plaster).
When blood stasis between meridians and Zang-Fu fights with Qi, it steams, rots, and transforms into pus. See sections on vomiting pus, bloody stool, and sores for details; not repeated here.
When blood stasis between meridians and Zang-Fu is boiled by Qi and Fire, it becomes Dry Blood. Qi refers to Kidney Yang. Yin deficiency with Yang hyperactivity causes Qi to merge with Heart Fire, so excessive Qi means excessive Fire. Stagnant blood, scorched by Fire, becomes Dry Blood. Symptoms include bone-steaming tidal fever, crusty skin (keratosis pilaris-like), and flaky face, named Dry Blood Lao (Consumption). Cases reaching this stage have only a 20-30% cure rate. Zhang Zhongjing's Dahuang Zhechong Wan (Rhubarb and Ground Beetle Pill) treats this. Since Dry Blood is cut off from Qi transformation, ordinary blood-invigorating herbs cannot treat it. Thus, insect medicines that feed on blood are used to consume the Dry Blood. If stasis is not removed, new blood has no life source; if Dry Blood is not removed, new blood certainly has no hope. Therefore, despite various deficiencies appearing, the primary goal is removing Dry Blood. If courage is lacking, this pill can be taken with tonifying medicines as a compromise.
When blood stasis between meridians and Zang-Fu is changed by Wind and Qi, Labo Worms (TB parasites) are generated. Qi is transformed from Kidney Water; thus, Qi movement generates Dampness. Wind is generated from Liver Yang; thus, Wind movement generates Heat. Damp steaming and Heat fanning transform blood stasis into worms, called Labo Worms. This is like grass rotting into fireflies or grain flying into insects. Differentiation includes: complexion changing suddenly from red to white, green to yellow; sores on lips and mouth; hoarse voice and itchy throat; irritability, restless dreams, nocturnal emission and leukorrhea; brittle hair and dry tongue; chills, fever, and night sweats; foul breath, loss of smell; liking to see others' faults; frequent anger; dreaming of deceased ancestors; palpitations and coughing; abdominal masses; small nodules on both sides of the back of the head; smelling beans as fragrant; applying frankincense smoke to the back of the hand and covering the palm with a cloth, causing hair to grow an inch long within moments; good spirit at dawn but slight limb fever, pale face after noon. These are signs of Labo Worms. Yuehua Wan is the main treatment. Eating eel meat provides tonification and kills Labo Worms. Alternatively, burn eel bones to charcoal, stir-fry turtle shell to powder, and take with Renshen (Ginseng), Danggui (Angelica Sinensis), Baishao (White Peony Root), and Baiwei (Anemarrhenae Rhizome) decoction. Tonify deficiency and kill worms synergistically. For specific worm-killing, Jinchan Wan (Golden Toad Pill) can be taken intermittently. Burning and consuming golden-line frog is also excellent. Killing a black cat, taking its liver, drying it, and taking the powder at dawn on an empty stomach in the early morning of the first lunar day greatly kills Labo Worms, replacing otter liver. Otter claws powdered and taken with wine also treat worms residing between lung lobes causing hemoptysis and hoarseness.
Labo Worms are worms transformed from blood, highly spiritual. After the person dies, the worms become evil spirits, infecting family members, becoming Transmitted Corpse Lao (Consumption). If three people are killed, the worm is incurable. Transmitted Corpse symptoms are identical to the infected patient's. Jinjian suggests taking Chuanshi Jiangjun Wan (Transmitted Corpse General Pill), recorded in Danxi Xinfa. However, checking Danxi Xinfa reveals this formula is absent. Naming it "General" implies Rhubarb is the main ingredient. Since Transmitted Corpse worms invade the body, they must be removed urgently. Thus, purgation is key, similar to Zhongjing's method for Dry Blood, to avoid leaving pathogens.
Once this worm enters the body, it gathers body blood to form nests, feeding, resting, reproducing, and changing endlessly. I suggest using Yishi Mieguai Tang (Corpse-Transferring Monster-Eliminating Decoction) to kill the worm and deprive it of blood, eliminating residual pathogens.
For the above two conditions, if stool is not loose, attack treatment is possible. If loose, the patient cannot tolerate medicine, and death is inevitable.