痰盛身热,多是血虚,入方∶青黛、栝蒌仁、诃子、海石、山栀,上为末,姜汁蜜丸,噙化。嗽甚者,加杏仁,后
以八物汤调理。痰带血丝出者,用童便、竹沥。先吐红,后吐痰,多是阴虚,火逆痰上,四物汤起料,加痰火药。
先痰嗽,后见红,多是痰积热,降痰火为急。肥人咳嗽,发寒热,吐血,以琼玉膏。一人因忧患病,咳吐血,面
黧黑色,药之十日不效,谓其兄陈状元曰∶此病得之失志而伤肾,必用喜解乃可愈,即求一足衣食地处之,于是大喜,
实时色退,不药而愈,所以言治病必求其本,虽药得其所病之气,宜苟不得其致病之情,则方终不效也。
火载血上,错经妄行,脉大者发热,喉中痛者是气虚,用参、 蜜炙、黄柏、荆芥、生地黄、当归治之。呕血用
韭汁、童便、姜汁,磨郁金同饮。火载血上,错行妄行,用四物汤加炒山栀、童便、姜汁。山茶花、郁金末,入童
便、姜汁、酒,治吐血。经血逆行,或吐,或唾衄,或血腥,以韭汁服立效。痰带血丝出,用童便、竹沥,后用犀
角地黄汤。又方∶用韭汁、童便二物,另用郁金细研,入二物内服之,其血自清。又方∶治吐衄血上行,郁金为
末、姜汁、童便、好酒调服。如无郁金,则以山茶花代之。
吐血挟痰,吐出一碗、两碗,只补阴降火,四物汤加火剂之类。挟痰者,用血药,则泥而不行,治火即自止,吐血,火
病也。或暴吐紫血一两碗者,无虑,吐出好,此热伤血死于中,用四物汤加解毒之类。吐血不止,炒黑干姜末、童便
调服。喉脘痰血,用荆芥散。舌上无故出血如线,槐花炒研末,干糁之,胃中清血,非蓝实不除。山栀最清胃脘
之血。吐血,觉胸中气塞上,便吐紫血者,桃仁承气汤下之。治吐血,以趾桂五钱为末,冷水调服。痰涎带出
血,此胃口中清血,为热蒸而出。重者,用山栀;轻者,用蓝实。治吐血以童便一分,酒半分,擂柏叶温饮,非酒不
行。咳嗽吐血,鸡苏丸或作汤服。血妄行,解毒四物汤。甚者,入炒干姜数片。吐血用童便调香附末,或白芨
末服之。吐血咳嗽∶红花 杏仁(去皮尖) 枇杷叶(姜炙去毛) 紫菀茸 鹿茸 炙桑白皮 木通(各一两) 大黄
(半两),用蜜丸,噙化。血从上出,皆阳盛阴虚,有升无降,阳盛阴虚,故血不得下行,因炎上之势,而上出,脉必
大而芤。大者,发热;芤者,血滞与失血。大法∶补水抑火,使复其位,四物汤加炒山栀仁、童便、姜汁、郁金、竹沥。
《大全良方》四生丸甚妙。不咳不唾血,散见口中从齿缝舌下来,每用益肾水、泻相火治之,不旬日愈。一壮年患嗽(已
见《医要》)。
痰多且身体发热,大多是因为血虚。处方:青黛、栝蒌仁、诃子、海浮石、山栀子,以上药物研为细末,用姜汁和蜂蜜制成丸剂,含服化咽。咳嗽严重的,加入杏仁,随后用八物汤进行调理。痰中带有血丝吐出的,使用童便(儿童尿液)、竹沥。先吐血后吐痰的,大多属于阴虚,火气上逆导致痰随气升,以四物汤为基础方,加入清热化痰降火的药物。先有痰嗽,后出现吐血,大多是因为痰积郁热,当务之急是降泄痰火。肥胖之人咳嗽,伴有寒热往来及吐血,使用琼玉膏治疗。有一人因忧愁患病,咳嗽并吐血,面色黧黑,服药十日无效,他对兄长陈状元说:“此病源于失意伤肾,必须通过喜悦来化解才能痊愈。”于是为他寻找一个衣食无忧的地方安置他,此人因此大喜,面色随即消退,未再用药而痊愈。所以说治病必须探求根本,虽然药物针对了疾病的性质,但如果不能了解致病的情志因素,方药终究不会见效。
火邪载血上行,血液错乱妄行,脉象大且发热、咽喉疼痛的,属于气虚,用人参、蜜炙甘草、黄柏、荆芥、生地黄、当归治疗。呕血者,用韭菜汁、童便、姜汁,磨郁金粉末同饮。火邪载血上行,血液错乱妄行,用四物汤加炒山栀子、童便、姜汁。山茶花、郁金粉末,调入童便、姜汁、酒中,治疗吐血。经血逆行,或吐血,或唾血、鼻衄,或口中血腥味重,服用韭菜汁可立即见效。痰中带血丝吐出,先用童便、竹沥,随后用犀角地黄汤。另一方法:用韭菜汁、童便两味药,另取郁金细细研磨,混入这两味药中服用,出血自然停止。又一方:治疗吐血、衄血向上涌出,将郁金研为末,用姜汁、童便、好酒调服。如果没有郁金,可以用山茶花代替。
吐血夹杂痰液,一次吐出一碗或两碗,只需补阴降火,用四物汤加清热泻火的药物。如果夹杂痰湿,单纯使用活血养血药则会滋腻阻碍气机运行,只要清治火热,出血自止,因为吐血本质上是火病。如果是突然吐出紫黑色血液一两碗的,不必担忧,这是热邪损伤血液致其瘀死于体内,排出为好,用四物汤加解毒类药物。吐血不止,用炒黑的干姜末,配合童便调服。喉部与胃脘部的痰血,用荆芥散治疗。舌头上无故出血如线状,用槐花炒研成末,直接撒在患处。胃中的清血(非浊血),不用蓝实(板蓝根等靛类药材)不能清除。山栀子最能清泄胃脘之血。吐血时,感觉胸中气塞上冲,随即吐出紫血的,用桃仁承气汤攻下。治疗吐血,用桂枝五钱研为末,冷水调服。痰涎中带血,这是胃口中的清血,因热气蒸腾而出。病情重的,用山栀子;轻的,用蓝实。治疗吐血用一份童便、半份酒,研磨侧柏叶温服,没有酒则不行。咳嗽吐血,服用鸡苏丸或煎汤服。血液妄行,用解毒四物汤。病情严重的,加入炒干姜数片。吐血用童便调服香附末,或白芨末服用。吐血伴咳嗽:红花、杏仁(去皮尖)、枇杷叶(姜炙去毛)、紫菀茸、鹿茸、炙桑白皮、木通(各一两)、大黄(半两),用蜂蜜制成丸剂,含服化咽。血液从上部溢出,都是阳盛阴虚,只有上升没有下降,因为阳盛阴虚,所以血液不能下行,顺着炎上的趋势而上出,脉象必然大而芤。脉大,表示发热;脉芤,表示血滞或失血。基本法则:补水抑火,使气血恢复正常运行位置,用四物汤加炒山栀子仁、童便、姜汁、郁金、竹沥。《大全良方》中的四生丸非常巧妙。不咳嗽也不唾血,血液零星从齿缝舌头处流出,每次都用益肾水、泻相火的方法治疗,不到十天即可痊愈。有一位壮年患咳嗽的人(已见于《医要》)。
Phlegm abundance accompanied by body heat is mostly due to Blood deficiency. Formula: add Qingdai (Indigo Naturalis), Gualou Ren (Trichosanthis Semen), Hezi (Terminalia Chebula Fruit), Haishi (Aragonitum), and Zhizi (Gardeniae Fructus). Grind these into powder, make pills with Ginger Juice and Honey, and hold in the mouth to dissolve. For severe cough, add Xingren (Armeniacae Semen Amarum), and subsequently regulate with Bawu Tang (Eight-Ingredient Decoction). If phlegm with blood streaks is expectorated, use Tongbian (Child's Urine) and Zhuli (Bamboo Sap). If hematemesis occurs first followed by phlegm expulsion, it is mostly Yin deficiency with Fire rebellion driving phlegm upward; start with Siwu Tang (Four-Substance Decoction) as the base, adding herbs for Phlegm-Fire. If phlegm-cough precedes bleeding, it is mostly Heat accumulated from Phlegm stagnation; urgently lowering Phlegm-Fire is the priority. For obese individuals with cough, alternating chills and fever, and hematemesis, use Qiongyu Gao (Jade Jade Paste). One person fell ill due to sorrow, coughing and spitting blood, with a sallow-black complexion. After ten days of medication without effect, he told his brother, Scholar Chen: "This disease stems from lost ambition injuring the Kidney; it must be resolved through joy to heal." Thus, a place with sufficient food and clothing was provided for him. He became greatly joyful, his complexion faded immediately, and he recovered without further medication. This illustrates that treating disease requires seeking its root; even if the medicine matches the pathogenic Qi, if the emotional cause of the disease is not addressed, the prescription will ultimately be ineffective.
Fire carrying Blood upward causes chaotic and erratic flow. If the pulse is large with fever and throat pain, it indicates Qi deficiency; treat with Renshen (Ginseng Radix et Rhizoma), Zhi Gancao (Honey-fried Licorice Root), Huangbai (Phellodendri Cortex), Jingjie (Schizonepetae Herba), Sheng Dihuang (Rehmanniae Radix Recens), and Danggui (Angelicae Sinensis Radix). For hematemesis (vomiting blood), use Jiuzhi (Allii Tuberosi Juice), Tongbian (Child's Urine), and Jiangzhi (Ginger Juice), mixed with ground Yujin (Curcumae Radix) and drunk together. For Fire carrying Blood upward causing chaotic flow, use Siwu Tang (Four-Substance Decoction) plus Chao Zhizi (Stir-fried Gardeniae Fructus), Tongbian (Child's Urine), and Jiangzhi (Ginger Juice). Chaohua (Camellia Japonica Flower) and Yujin (Curcumae Radix) powder, mixed with Tongbian (Child's Urine), Jiangzhi (Ginger Juice), and wine, treats hematemesis. For retrograde menstruation, manifesting as vomiting blood, spitting blood, nasal epistaxis, or a bloody taste in the mouth, taking Jiuzhi (Allii Tuberosi Juice) yields immediate results. For phlegm with blood streaks, use Tongbian (Child's Urine) and Zhuli (Bamboo Sap) first, followed by Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction). Another formula: use two parts Jiuzhi (Allii Tuberosi Juice) and Tongbian (Child's Urine); separately grind Yujin (Curcumae Radix) finely and mix into the two liquids for ingestion, which clears the blood. Another formula: for upward hematemesis and epistaxis, take Yujin (Curcumae Radix) powder, mix with Jiangzhi (Ginger Juice), Tongbian (Child's Urine), and good wine for oral administration. If Yujin (Curcumae Radix) is unavailable, substitute with Chaohua (Camellia Japonica Flower).
Hematemesis complicated by phlegm, expelling one or two bowls at a time, requires only nourishing Yin and descending Fire; use Siwu Tang (Four-Substance Decoction) combined with Fire-clearing agents. If complicated by Phlegm-Dampness, using Blood-invigorating herbs causes stagnation and lack of movement; treating the Fire stops the bleeding naturally, as hematemesis is essentially a Fire disease. If suddenly vomiting one or two bowls of dark purple blood, do not worry; improvement after expulsion indicates Heat damaging Blood leading to coagulation in the middle Jiao; use Siwu Tang (Four-Substance Decoction) added with Detoxifying agents. For unceasing hematemesis, use Chao Heiganjiang (Charred Dried Ginger Rhizome) powder mixed with Tongbian (Child's Urine). For phlegm-blood in the throat and stomach, use Jingjie San (Schizonepeta Powder). For spontaneous linear bleeding on the tongue, use Chao Huaihua (Stir-fried Sophorae Flos) powder applied dry; if it is clear blood from the Stomach, Lan Shi (Isatis Root) is required for removal. Zhizi (Gardeniae Fructus) best clears Stomach blood. For hematemesis where chest qi feels obstructed and rises, followed by vomiting purple blood, administer Tao Ren Chengqi Tang (Peach Kernel and Magnolia Bark Decoction) to purge downward. To treat hematemesis, use Guizhi (Cinnamon Twig) five qian ground to powder, mixed with cold water for oral administration. For phlegm-saliva mixed with blood, this is clear blood from the Stomach mouth steamed out by Heat. Severe cases use Zhizi (Gardeniae Fructus); mild cases use Lan Shi (Isatis Root). To treat hematemesis, mix one part Tongbian (Child's Urine) with half part wine, pound Ce Bai Ye (Biota Tops) and drink warm; wine is essential. For cough with hematemesis, take Jisu Wan (Mint Pill) or decoct it. For erratic Blood flow, use Jiedu Siwu Tang (Detoxifying Four-Substance Decoction). In severe cases, add several slices of Chao Ganjiang (Stir-fried Dried Ginger Rhizome). For hematemesis, mix Xiangfu (Cyperi Rhizoma) powder or Baiji (Bletillae Rhizoma) powder with Tongbian (Child's Urine) for oral administration. Hematemesis with cough: Honghua (Carthami Flos), Xingren (Armeniacae Semen Amarum, peeled and cored), Pipaye (Eriobotryae Folium, ginger-fried and de-hairy), Ziwan (Asteris Radix), Lurong (Deer Antler), Zhi Sangbaipi (Honey-fried Mulberry Root Bark), Mutong (Akebiae Caulis) (each 1 liang), Dahuang (Rhei Radix et Rhizoma, 0.5 liang). Make pills with honey and hold in the mouth to dissolve. Bleeding from the upper orifices is always due to Excess Yang and Deficiency Yin, with ascending but no descending; because of Excess Yang and Deficiency Yin, Blood cannot descend and flows upward following the rising nature of Fire. The pulse must be large and Kou (Hollow). Large indicates Fever; Kou indicates Blood stasis or Blood loss. The general principle: Nourish Water to suppress Fire, restoring proper position; use Siwu Tang (Four-Substance Decoction) plus Chao Zhiren (Stir-fried Gardeniae Fructus), Tongbian (Child's Urine), Jiangzhi (Ginger Juice), Yujin (Curcumae Radix), and Zhuli (Bamboo Sap). Sisheng Wan (Four Generations Pill) from Daquan Liangfang is excellent. For non-coughing, non-spitting blood that appears scattered in the mouth, flowing from between teeth and under the tongue, treat each time by nourishing Kidney Water and draining Ministerial Fire; recovery occurs within ten days. A young adult suffering from cough (already recorded in Yi Yao).