用姜汁、童便、青黛入血药中用，如四物汤、地黄膏、牛膝膏之类。传尸劳瘵，寒热交攻，久嗽咯血，日见羸
瘦，先以三拗汤与莲心散煎，万不失一。又治咯血，用黑豆、陈皮、甘草煎服。
大抵与吐血同。大概是血被热气所逼，而随气上行，以散气退热为主。凉血行血为主。入方∶以犀角地黄汤入
郁金同用，犀角、赤芍药、牡丹皮、生地黄、如无犀角，升麻代之。经血错行，或血腥，或吐血、唾血，用韭叶汁服之
立效。大凡用犀角能解毒。衄血不止，以养胃汤煎服一帖见效。鼻衄呕血，及伤寒强发少阴汗者，犀角地黄汤加
黄芩。内伤病似伤寒证，汗下后衄血大出不止，真武汤。若烦躁吸水，脉沉细而微，足冷，面脱白红色，此阳脱阴虚。
属热。血虚。溺血属热，炒山栀煎服，或小蓟、琥珀。有血虚者，四物汤加牛膝膏。尿血实者，可下，当
归承气汤下之，后以四物汤加炒山栀服之。妇女无故尿血，龙骨一两，酒调方寸匕。大抵溲血、淋血、便血三
者，虽以前后阴所出之不同，然于受病则一也，故治法分标本亦一也。其散血、止血，无殊于数十品之间，惟引导佐使，
各得其乡者，为少异耳。
有热、有虚。治血不可纯用寒凉药。当寒因热用，必于寒凉药中用辛味升温之药，如酒浸炒凉药，酒煮黄连丸之
类。有热，四物汤加炒山栀、升麻、秦艽、胶珠。大肠湿热下血，久属虚，当温散四物汤加炮干姜、升麻。又
方∶用白芷、五倍子末，饭丸。又方∶干柿烧灰存性，米
饮下二三钱。积热便血∶苍术（一两半） 陈皮（一两半） 黄连 黄柏 条芩（以上各七钱半） 连翘（五钱）
上末之，以生地黄膏六两搜丸。又方∶苍术 地黄 上同擂碎为细末，以饭为丸，忌铁器。治便血过多，四物汤加
皮。又方∶茄蒂烧灰存性，山栀炒研末，饭丸，每服百丸，米汤清早下。便血人，久远伤血致虚，并麻风面生癣疮∶
龟板 升麻 香附（以上各五钱） 白芍药（一两半） 侧柏（一两） 椿根皮（七钱半） 上末之，以
粥为丸，用四物汤加白术、黄连、甘草、陈皮等煎汤下之。脉缓大，口渴便血，月经紫色，劳伤而挟湿者∶白术（五钱
）地黄（三钱） 黄柏（炒三钱） 白芍药 香附 地榆（以上各二钱） 黄芩（一钱） 上末之，炊饼丸。
治大便下血效甚，《宣明方》地榆散。阳虚阴乏之人，久年便血，不时面带黄柏皮色者，理
中汤加附子，百草霜为丸服。戴云∶咳血者，嗽出痰内有血者是也；呕血者，呕全血也；咯血者，每咯出皆是血疙瘩
也；衄血者，鼻中出血也；溺血者，小便出血也；下血者，大便出血也。虽有名色之分，俱是热证，但有虚实、新旧不
同，或妄言寒者，误也。
使用姜汁、童便（儿童小便）、青黛加入补血药中服用，例如四物汤、地黄膏、牛膝膏等方剂。对于传尸劳瘵（一种具有传染性的慢性消耗性疾病），出现寒热交替、长期咳嗽咯血、日渐消瘦的症状，先用三拗汤与莲心散煎服，效果万无一失。又治疗咯血，用黑豆、陈皮、甘草煎服。
大抵上，咯血的治疗原则与吐血相同。大概是血液被热气逼迫，随着气机上逆，因此以理气退热为主要治法。以凉血行血为主。在方剂中加入：犀角地黄汤配合郁金同用，药物包括犀角、赤芍药、牡丹皮、生地黄；如果没有犀角，可以用升麻代替。经血错行，或者出现血腥味、吐血、唾血，服用韭叶汁可立即见效。大凡使用犀角能够解毒。鼻衄不止，服用养胃汤一帖即可见效。鼻衄伴呕血，以及伤寒病强行发少阴汗导致的症状，用犀角地黄汤加黄芩。内伤病类似伤寒证，经过发汗或攻下治疗后，鼻衄大量出血不止，用真武汤。如果出现烦躁、想吸水喝、脉象沉细而微弱、脚冷、面色苍白带红，这是阳气脱失、阴虚的表现。
属于热证。血虚。尿血属于热证，用炒山栀煎服，或者用小蓟、琥珀。有血虚情况的，用四物汤加牛膝膏。尿血属实证的，可以攻下，用当归承气汤攻下，之后再用四物汤加炒山栀服用。妇女无故尿血，用一两龙骨，酒调服方寸匕。大抵溺血（小便出血）、淋血（排尿涩痛出血）、便血这三者，虽然从前阴或后阴排出的部位不同，但致病原因是一致的，所以治疗分标本的原则也是一样的。其散血、止血的方法，在这几十种药物之间没有太大区别，只是在引导、辅助和使药的配伍上，根据各药归经的不同略有差异而已。
有热证、有虚证。治疗出血不可单纯使用寒凉药物。应当“寒因热用”，必须在寒凉药中加入辛温的药物，比如用酒浸炒的寒凉药，或者酒煮黄连丸之类。有热证的，用四物汤加炒山栀、升麻、秦艽、阿胶珠。大肠湿热引起的下血，日久属于虚证，应当温散，用四物汤加炮干姜、升麻。另一个方子：用白芷、五倍子研末，饭丸服用。又一个方子：干柿烧灰存性，米饮送服二三钱。积热便血：苍术（一两半）、陈皮（一两半）、黄连、黄柏、条芩（以上各七钱半）、连翘（五钱）。以上研为细末，用生地黄膏六两调和制成丸剂。又一个方子：苍术、地黄，一起捣碎为细末，用米饭做丸，忌用铁器。治疗便血过多，用四物汤加地榆皮。又一个方子：茄蒂烧灰存性，山栀炒研为末，饭丸，每次服用一百丸，清晨用米汤送下。便血日久伤血导致虚损，以及麻风病患者面部生癣疮：龟板、升麻、香附（以上各五钱）、白芍药（一两半）、侧柏（一两）、椿根皮（七钱半）。以上研为细末，用粥调和制成丸剂，用四物汤加白术、黄连、甘草、陈皮等煎汤送服。脉象缓大，口渴便血，月经颜色紫暗，因劳伤兼夹湿气的：白术（五钱）、地黄（三钱）、黄柏（炒三钱）、白芍药、香附、地榆（以上各二钱）、黄芩（一钱）。以上研为细末，用蒸饼做丸。治疗大便下血效果很好，《宣明方》的地榆散。阳虚阴乏的人，多年便血，不时面带黄柏皮颜色的，用理中汤加附子，百草霜做丸服用。戴元礼说：咳血，是咳嗽时痰中带血；呕血，是呕吐出全血；咯血，是每次咯出的都是血块；衄血，是鼻子出血；溺血，是小便出血；下血，是大便出血。虽然名称和表现有所不同，但都属于热证，只是有虚实、新久之分，如果妄言是寒证，就是错误的。
Use Ginger Juice, Tongbian (Child's Urine), and Qingdai (Indigo Naturalis) added to blood-nourishing medicines for administration, such as Sini Tang (Four Substance Decoction), Dihuang Gao (Rehmannia Paste), and Niuxi Gao (Achyranthes Paste). For Chuanshi Laozhai (Consumptive Disease with Infectious Nature), characterized by alternating chills and fever, chronic cough with hemoptysis, and progressive emaciation, first administer San'ao Tang (Three Unblocking Decoction) combined with Lianxin San (Lotus Plumule Powder) decocted together; this method is infallible. Another treatment for hemoptysis involves decocting Heidou (Black Soybean), Chenpi (Citrus Peel), and Gancao (Licorice Root) for oral administration.
Generally, the treatment principles for hemoptysis are similar to those for hematemesis. It is generally believed that blood is forced upward by heat qi, following the ascent of qi; therefore, the primary treatment focuses on dissipating qi and reducing heat. The main approach is to cool the blood and promote blood circulation. Add to the formula: Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) used in conjunction with Yujin (Curcuma Aromatica Rhizome). The ingredients include Xijiao (Rhino Horn), Chishao Yao (Red Peony Root), Mudan Pi (Moutan Cortex), and Sheng Dihuang (Raw Rehmannia Root); if Xijiao is unavailable, Shengma (Cimicifuga Rhizome) may be used as a substitute. For abnormal menstrual bleeding, or cases involving bloody sputum, hematemesis, or spitting blood, administering Jiuye Zhi (Chinese Chive Leaf Juice) yields immediate results. Generally, the use of Xijiao can detoxify. For persistent epistaxis, one dose of Yangwei Tang (Stomach-Nourishing Decoction) taken orally shows effectiveness. For epistaxis accompanied by hematemesis, or conditions resulting from forcibly inducing sweat in Shaoyin syndrome during Shanghan (Cold Damage), add Huangqin (Scutellaria Root) to Xijiao Dihuang Tang. In internal injury cases mimicking Shanghan syndrome, where massive epistaxis persists after sweating or purging therapies, use Zhenwu Tang (True Warrior Decoction). If restlessness, thirst for water, a deep and fine pulse, cold feet, and a pale face with red patches occur, this indicates Yang collapse and Yin deficiency.
This category pertains to Heat syndromes and Blood deficiency. Hematuria belongs to Heat syndromes; it can be treated by decocting Chao Zhizi (Fried Gardenia Fruit) or using Xiaojix (Little Thistle Herb) and Hupo (Amber). For cases with Blood deficiency, use Sini Tang (Four Substance Decoction) plus Niuxi Gao (Achyranthes Paste). For excess-type hematuria, purgation is indicated; administer Danggui Chengqi Tang (Angelica and Rhubarb Decoction) for purgation, followed by Sini Tang (Four Substance Decoction) with fried Zhizi (Gardenia Fruit). For women experiencing spontaneous hematuria, use one liang of Longgu (Fossilized Bones), mixed with wine and administered as a "fangcunbi" (a measure roughly equivalent to a tablespoon). Generally, although Nixue (hematuria), Linxue (bleeding with painful urination), and Bianxue (hematochezia) differ in their exit pathways (anterior vs. posterior orifices), their pathogenesis is identical; thus, the principle of treating root and branch is also the same. Their methods for dissipating blood and stopping bleeding do not differ significantly among dozens of herbs; the slight variations lie only in the guiding, assisting, and messenger herbs, which are selected according to their specific meridian tropisms.
There are Heat syndromes and Deficiency syndromes. Treatment of bleeding should not rely solely on cold and cooling medicines. One should employ "treating heat with heat methodology" (Han Yin Re Yong), meaning adding acrid-warm drugs to cold-cooling formulas, such as cold medicines soaked or stir-fried in wine, or Jiu Zhu Huanglian Wan (Wine-Boiled Coptis Pill). For Heat syndromes, use Sini Tang (Four Substance Decoction) plus fried Zhizi (Gardenia Fruit), Shengma (Cimicifuga Rhizome), Qinjiao (Gentiana Macrophylla Root), and Jiaozhu (Charred Gelatin). For lower gastrointestinal bleeding due to Damp-Heat in the Large Intestine, which becomes deficient over time, warm dispersal is required; use Sini Tang (Four Substance Decoction) plus Pao Ganjiang (Pared Ginger) and Shengma (Cimicifuga Rhizome). Another formula: use Baizhi (Angelica Dahurica Root) and Wubeizi (Galla Chinensis) powdered, formed into pills with rice paste. Another formula: burn dried persimmons to ash while preserving their nature, and take two to three qian with rice drink. For constipation-heat type hematochezia: Cangzhu (Atractylodes Rhizome, 1.5 liang), Chenpi (Citrus Peel, 1.5 liang), Huanglian (Coptis Rhizome), Huangbai (Phellodendron Bark), Tiaoqin (Scutellaria Root, each 0.75 liang), Lianqiao (Forsythia Fruit, 0.5 liang). Grind these into powder, and bind with six liang of Shengdihuang Gao (Raw Rehmannia Paste) to form pills. Another formula: Cangzhu (Atractylodes Rhizome) and Dihuang (Rehmannia Root), pounded together into fine powder, formed into pills with rice paste; avoid iron vessels. To treat excessive hematochezia, use Sini Tang (Four Substance Decoction) plus Diyu Pi (Ulmus Bark). Another formula: burn Qidi (Eggplant Stems) to ash while preserving their nature, mix with fried and powdered Zhizi (Gardenia Fruit), form into pills with rice paste; take one hundred pills each time, administered early in the morning with clear rice soup. For chronic hematochezia leading to Blood deficiency, and for leprosy patients with facial tinea-like sores: Guiban (Tortoise Shell), Shengma (Cimicifuga Rhizome), Xiangfu (Cyperus Rhizome, each 0.5 liang), Baishaoyao (White Peony Root, 1.5 liang), Ce Bai Ye (Biota Tops, 1 liang), Chun Gen Pi (Toona Bark, 0.75 liang). Grind into powder, bind with congee to form pills, and swallow with a decoction of Sini Tang (Four Substance Decoction) plus Baizhu (Atractylodes Macrocephala Rhizome), Huanglian (Coptis Rhizome), Gancao (Licorice Root), and Chenpi (Citrus Peel). For slow and large pulses, thirst, hematochezia, purple menstrual blood, and fatigue injury complicated by Dampness: Baizhu (Atractylodes Macrocephala Rhizome, 0.5 liang), Dihuang (Rehmannia Root, 0.3 liang), Huangbai (Phellodendron Bark, fried 0.3 liang), Baishaoyao (White Peony Root), Xiangfu (Cyperus Rhizome), Diyu (Sanguisorba Root, each 0.2 liang), Huangqin (Scutellaria Root, 0.1 liang). Grind into powder, bind with steamed wheat dough to form pills. This is highly effective for lower gastrointestinal bleeding; see Dihuang San (Sanguisorba Powder) from *Xuanming Fang*. For individuals with Yang deficiency and Yin insufficiency suffering from long-term hematochezia, presenting with a yellowish-brown skin tone resembling Phellodendron bark, use Lizhong Tang (Regulate the Middle Decoction) plus Fuzi (Prepared Aconite Root), formed into pills with Baicaoshuang (Soot from Chimneys). Dai Yun stated: Kexue (Coughing blood) refers to blood mixed with phlegm expelled by coughing; Outouxue (Vomiting blood) refers to vomiting whole blood; Kaoxue (Spitting blood) refers to expelling blood clumps upon spitting; Nuxue (Epistaxis) refers to bleeding from the nose; Niaoxue (Hematuria) refers to blood in urine; Xiaxue (Lower GI bleeding) refers to blood in stool. Although named differently, all belong to Heat syndromes, differing only in deficiency/excess and acute/chronic nature. Asserting they are Cold syndromes is erroneous.