心主血而藏神。虚则心烦不寐。精神衰弱。甚则五液干枯。夜热盗汗。脾统血而运液。虚则唇口燥烈。津
不到咽。甚则舌肉干枯。肌肤甲错。肝藏血而主筋。虚则血不养筋。筋惕肉 。甚则一身痉挛。手足螈 。
至于两颧嫩红。唇淡面白。尤其血虚之显然者也。治必辨其因虚致病者。养血为先。或佐润燥清火。或佐熄风
潜阳。随其利而调之。若因病致虚。去病为要。病去则虚者亦生。断不可骤进蛮补。补住其邪。使邪气
反留连而不去。
实者。瘀血蓄血是也。瘀由渐积。蓄由猝成。瘀在腠理。则乍寒乍热。瘀在肌内。则潮热盗汗。瘀在经络。
则身痛筋挛。瘀在三焦。上焦则胸膈肩膊刺疼。心里热。舌紫黯。中焦则脘腹串痛。腰脐间刺痛痹者。下
焦则少腹胀满刺痛。大便自利而黑如漆色。至若化肿化胀。成痨成臌。尤其瘀之深重者也。惟蓄血由外邪搏击。
如六淫时疫及犬咬蛇伤等因。皆能骤然蓄聚。《内经》所谓蓄血在上喜忘。蓄血在下如狂是也。皆当消瘀为
主。轻者通络。重则破血。寒瘀温通。热瘀凉通。瘀化则新血自生。若妇人切须详察。恐孕在疑似之间。
【荣斋按】“血实证”我意认为不能成立，何况本节所说，完全是“血瘀”，不能看作是“血实”，更不能看
作与血虚相对的“血实”。我从前感觉现代所说的“充血症”，也不能机械地看作血实。这里的瘀血蓄血，本
质上是血的病态；所谓“实”者。是“塞实”的实，不是“充实”的实。这一点，思想上应该明确。
心主司血液并藏纳神志。心血虚则出现心烦、失眠。精神衰弱。严重时五液干枯。夜间发热、盗汗。脾统摄血液并运化津液。脾气血虚则口唇干燥皲裂。津液无法到达咽喉。严重时舌体肌肉干枯。肌肤粗糙如鳞甲交错。肝藏血并主管筋脉。肝血虚则血液不能滋养筋脉。导致筋脉跳动、肌肉抽搐。严重时全身痉挛。手足抽搐掣动。至于两颧呈现娇嫩的红色。口唇色淡、面色苍白。这更是血虚的明显征象。治疗必须辨别是因虚致病还是因病致虚。若是因虚致病，以养血为优先。或佐以润燥清火之法。或佐以熄风潜阳之法。根据病情顺势调理。若是因病致虚，去除病邪是关键。病邪去除后，虚弱之体也能恢复。绝不可贸然进用峻补之剂。以免补药滞留体内使邪气反而留恋不去。
实证。指的是瘀血和蓄血。瘀血是逐渐积聚而成。蓄血是突然形成。瘀血在腠理（皮肤与肌肉之间的间隙），则忽冷忽热。瘀血在肌肉内部，则潮热盗汗。瘀血在经络，则身体疼痛、筋脉拘挛。瘀血在三焦。在上焦则胸膈及肩背刺痛。心中烦热。舌质紫暗。在中焦则脘腹部窜痛。腰脐之间刺痛且感觉麻木痹阻。在下焦则少腹胀满刺痛。大便通畅但颜色黑如漆色。至于发展为肿胀、鼓胀。形成劳损、臌胀。这更是瘀血深重严重的表现。而蓄血是由外邪搏击所致。如六淫时疫以及狗咬蛇伤等原因。都能导致骤然蓄聚。《内经》所说蓄血在上焦容易健忘。蓄血在下焦如同发狂。都是这种情况。都应当以消除瘀血为主。轻者疏通经络。重者破血逐瘀。寒性瘀血用温通法。热性瘀血用凉通法。瘀血化解后新血自然生成。若为女性患者必须详细检查。恐怕有怀孕的可能处于疑似状态。
【徐荣斋按语】“血实证”这一概念我认为不能成立。何况本节所述内容，完全是“血瘀”，不能看作是“血实”。更不能将其视为与血虚相对的“血实”。我过去觉得现代所说的“充血症”，也不能机械地等同于血实。这里的瘀血蓄血，本质上是血液的病态变化；所谓“实”者。是指“塞实”的实，不是“充实”的实。这一点在思想上应该明确。
The Heart governs Blood and houses the Shen (Spirit). When deficient, it manifests as mental restlessness and insomnia. The spirit becomes weak. In severe cases, the Five Fluids dry up. Night fever and night sweats occur. The Spleen controls Blood and transforms fluids. When deficient, the lips and mouth become dry and cracked. Body fluids fail to reach the throat. In severe cases, the flesh of the tongue dries up. The skin becomes rough and scaly like fish scales. The Liver stores Blood and governs the Tendons. When deficient, Blood fails to nourish the Tendons. This leads to tendon twitching and muscle fasciculation. In severe cases, whole-body spasms occur. The hands and feet exhibit clonic jerking (convulsions). As for the tender redness on both malar eminences, pale lips, and sallow complexion, these are particularly obvious signs of Blood deficiency. Treatment must distinguish whether the disease is caused by deficiency or whether deficiency is caused by disease. If the disease is caused by deficiency, nourishing Blood is the priority. One may assist with methods to moisten dryness and clear fire, or assist with methods to extinguish wind and subdue Yang, adjusting according to the favorable course of the condition. If deficiency is caused by disease, eliminating the pathogen is essential. Once the pathogen is removed, the deficient body will recover. One must absolutely not abruptly administer harsh tonics, lest the tonics retain the pathogen, causing the pathogenic factor to linger and not depart.
Excess patterns refer to Stagnant Blood (Yu Xue) and Accumulated Blood (Xu Xue). Stagnant Blood accumulates gradually. Accumulated Blood forms suddenly. If Stagnant Blood is in the Cou Li (interstices between skin and muscle), there is alternating chills and fever. If Stagnant Blood is within the muscles, there is tidal fever and night sweats. If Stagnant Blood is in the meridians, there is body pain and tendon contraction. If Stagnant Blood is in the San Jiao (Triple Burner): in the Upper Jiao, there is stabbing pain in the chest, diaphragm, shoulders, and arms; heat in the heart region; and a purple-dark tongue. In the Middle Jiao, there is wandering pain in the epigastrium and abdomen; stabbing pain and bi-syndrome (numbness/obstruction) between the waist and umbilicus. In the Lower Jiao, there is distension, fullness, and stabbing pain in the lower abdomen; free passage of stool but black in color like lacquer. As for developing into swelling or abdominal distension, forming consumptive diseases or drum-distension (ascites), these indicate especially deep and severe Stagnant Blood. However, Accumulated Blood is caused by external pathogens striking the body. Factors such as the Six Exogenous Pathogens, seasonal epidemics, dog bites, and snake bites can all cause sudden accumulation. As stated in the *Nei Jing* (Inner Canon), Accumulated Blood in the upper part leads to forgetfulness; Accumulated Blood in the lower part resembles madness. All these should be treated primarily by resolving Stagnant Blood. For mild cases, unblock the collaterals. For severe cases, break up Blood stasis. For cold-type stasis, use warming and unblocking methods. For heat-type stasis, use cooling and unblocking methods. Once the stasis resolves, new Blood generates naturally. In female patients, one must examine carefully, fearing that pregnancy might be present in ambiguous cases.
[Commentary by Rongzhai]: I believe the concept of "Blood Excess Syndrome" cannot be established. Moreover, what is described in this section is entirely "Blood Stasis," which cannot be viewed as "Blood Excess," nor can it be seen as the counterpart to Blood Deficiency in terms of "Blood Excess." I previously felt that the modern term "Congestion" also cannot be mechanically equated with Blood Excess. Here, Stagnant Blood and Accumulated Blood are essentially pathological states of Blood; the so-called "Excess" refers to "obstructive excess," not "abundant/fullness." This point should be clearly understood in thought.