血气即阴阳也，不论男女长幼均具之。人之有病皆知调气，而血之一字念不到焉。至于
调气不愈，加以消痰、逐水，无所不至，其病自如是，皆血之为患，伏于冥冥之中而不可测
识矣。假如妇人得病于经水来去之时，固有可验而知者，其若经脉久遏而不行，与夫协热而
伤血，变生他证，如之何而见之？况世俗循习，其能以男子之诊为血证乎？夫肝藏血而心主
之，动则血运于诸经，静则血归于肝脏。肝受血则能视，足受血则能步，掌受血则能握，指
受血则能摄。故血凝于肤者为痹，凝于脉者为泣，凝于足者为厥。凡神志昏昏，惊狂冒闷，
烦渴呕吐，语短内疼，鼻衄唾红，眼红面赤，骨热肤哄，肠垢尿多，胸满顽痰，谵语多汗，
甚至四肢厥冷，懵不知人，不问男子妇人，皆血证耳。据脉验之，挟血者，脉来乍涩乍数，
闪灼明灭，或沉细而隐伏也。若夫血与热交攻，则左手寸关按之洪盛。盖心主血，肝藏血，
固如是尔。经曰∶血上逆则忘，血下蓄则狂。上焦淤血，小便必难；下焦淤血，小便必自利。
血之所在，当以此推。《活人总括》所载小柴胡汤、犀角地黄汤、桃仁承气汤，皆其要药。
血结者，汤剂中入醋为佐，特于此而申言之。然犹有所谓血鳖、气鳖、酒鳖者，又不可不知
也。盖平时酷酒，血入于酒，则为酒鳖；平时任气，血凝于气，则为气鳖；虚劳痼冷，败血
化生，则为血鳖。摇头掉尾，如虫之行，上侵人之喉，下蚀人之肛，或附于背胁，或隐于胸
腹，其大则如鳖，其小则如钱，良可怪也。治法用芜荑炒煎为妙，或生硫黄为末，老酒调下。
二者可以杀其毒。嗣此则以理中汤、沉香降气汤各半，温胃益血，常常服饵，以消胜之。如
其不以温和为主，日从事于雷丸、锡灰之剂焉，君子未保其往。（《活人书》云∶伤寒太阳证，
衄血者病欲愈。热结膀胱，而血自下者，亦欲愈。以此观之，他病伏热之人，上焦淤血而作
吐者，亦其病之有瘳也。虽然血既吐，而自止则可矣。）
血气就是阴阳，不论男女老少都具备。人们生病都知道调理气机，却很少想到“血”这一方面。至于调气无效后，又加上消痰、逐水等治法，无所不用其极，但病情依然如此，这其实都是血在暗中作祟，潜伏于不可测识之处。假如妇人在月经来去之时得病，固然有可以验证并知晓的情况；若是经脉长期阻滞而不行，或者因协热而伤血，变生其他证候，又该如何识别呢？况且世俗沿袭的惯例，谁能用诊治男子的方法来诊断女子的血证呢？肝藏血而心主血，活动时血液运行于各条经络，静止时血液回归肝脏。肝得到血的滋养就能视物，脚得到血的滋养就能行走，手掌得到血的滋养就能握持，手指得到血的滋养就能摄取。所以，血凝滞于皮肤就形成痹证，凝滞于脉道就导致血流不畅（泣），凝滞于足部就导致厥逆。凡是神志昏沉、惊狂闷乱、烦渴呕吐、言语短促且内部疼痛、鼻出血或唾液中带血、眼睛发红面色赤红、骨骼发热皮肤烘热、肠道排泄垢腻小便频多、胸中胀满顽痰、胡言乱语多汗，甚至四肢厥冷、昏迷不知人事，无论男子妇人，都属于血证。根据脉象验证，挟有血瘀者，脉象时而涩滞时而快速，忽明忽暗，或者沉细而隐伏。如果是血与热相互交攻，则左手寸关部按之洪大盛实。因为心主血，肝藏血，本来就是这样。经书说：血上逆则健忘，血下蓄积则发狂。上焦有淤血，小便必定困难；下焦有淤血，小便必定通利。血所在的位置，应当据此推断。《活人总括》所载的小柴胡汤、犀角地黄汤、桃仁承气汤，都是治疗此类病症的重要方药。对于血结者，在汤剂中加入醋作为辅助，特别在此加以说明。然而还有所谓的血鳖、气鳖、酒鳖，也不可不知道。平时酗酒，血进入酒中，就成为酒鳖；平时任性使气，血凝滞于气中，就成为气鳖；虚劳痼冷，败血化生，就成为血鳖。它们摇头摆尾，像虫子一样爬行，上侵人的咽喉，下蚀人的肛门，或者附着在背胁，或者隐藏在胸腹，大的像鳖，小的像铜钱，确实很奇怪。治疗方法用芜荑炒煎效果最好，或者将生硫黄研末，用老酒调服。这两种方法可以杀灭其毒性。此后则以理中汤、沉香降气汤各半量配合使用，温胃益血，经常服用，以消除胜邪。如果不以温和为主，每天从事于雷丸、锡灰之类的药剂，君子未必能保证其后果。（《活人书》说：伤寒太阳证，出现衄血的是病欲愈。热结膀胱，而血自行下泄的，也是病欲愈。由此看来，其他病伏热之人，上焦淤血而作吐的，也是病情好转的表现。虽然血已经吐出，如果能自止就可以了。）
Blood and Qi are Yin and Yang; they are possessed by all people, regardless of gender or age. When people fall ill, they know to regulate Qi, but rarely consider Blood. When regulating Qi fails, treatments such as resolving phlegm (Xiao Tan) and driving out water (Zhu Shui) are employed to the extreme, yet the disease persists. This is because Blood is the culprit, lurking in the unseen and unfathomable depths. For instance, if a woman falls ill during her menstrual flow, there are indeed signs that can be verified and understood. However, what if the menses have been obstructed for a long time and do not flow, or if heat injures the blood due to combined pathogenic factors, leading to other syndromes? How should these be identified? Moreover, following世俗 conventions, who can diagnose Blood syndromes in men using the same methods as for women? The Liver stores Blood, while the Heart governs it. When active, Blood circulates through the meridians; when at rest, it returns to the Liver. When the Liver receives Blood, vision is enabled; when the feet receive Blood, walking is possible; when the palms receive Blood, grasping is possible; when the fingers receive Blood, holding is possible. Therefore, if Blood stagnates in the skin, Bi syndrome (Obstruction Syndrome) results; if it stagnates in the vessels, flow becomes sluggish (Qi); if it stagnates in the feet, Jue (Cold Extremities) occurs. Whenever there is mental confusion, fright and mania, chest oppression, thirst, vomiting, shortness of speech with internal pain, epistaxis (Niu Xue) or hemoptysis, red eyes and flushed face, bone fever and hot skin, foul intestinal discharge with frequent urination, chest fullness with stubborn phlegm, delirium with excessive sweating, or even cold extremities and unconsciousness, whether in men or women, these are all Blood syndromes. Examining the pulse, if Blood is involved, the pulse may be intermittent and rapid, flickering like light and shadow, or deep, fine, and hidden. If Blood and Heat attack each other, the Cun and Guan positions on the left hand will feel surging and excess upon pressure. This is because the Heart governs Blood and the Liver stores Blood, as stated. The Classics say: "When Blood rebels upward, forgetfulness occurs; when Blood accumulates downward, mania ensues." If there is Blood stasis in the Upper Jiao, urination will necessarily be difficult; if there is Blood stasis in the Lower Jiao, urination will necessarily be free. The location of Blood can be deduced from this. Xiao Chai Hu Tang (Minor Bupleurum Decoction), Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction), and Tao Ren Cheng Qi Tang (Peach Kernel and Cathartic Decoction), as recorded in *Huoren Zongguo*, are essential formulas for these conditions. For Blood knotting, adding vinegar to decoctions as an adjunct is particularly emphasized here. However, one must also know about Blood Bi, Qi Bi, and Wine Bi. Chronic alcohol consumption causes Blood to enter the Wine, forming Wine Bi; chronic emotional repression causes Blood to stagnate within Qi, forming Qi Bi; chronic deficiency-cold and wasting disorders cause failed Blood to transform, forming Blood Bi. These entities shake their heads and tails, moving like insects, invading the throat from above, eroding the anus from below, attaching to the back and flanks, or hiding in the chest and abdomen. They range in size from that of a turtle to that of a coin, which is truly strange. The treatment method involves frying and decocting *Melioidosis Fructus* (Wu Yi) for best effect, or grinding raw *Sulfur* (Sheng Liu Huang) into powder and taking it with aged wine. Both methods can neutralize their toxicity. Subsequently, Li Zhong Tang (Regulate the Middle Decoction) and Chen Xiang Jiang Qi Tang (Aucklandia Descending Qi Decoction) should be used in equal halves to warm the Stomach and benefit Blood, taken regularly to eliminate the excess pathogen. If one does not adhere to gentle and warming methods, but instead daily employs agents like *Allosciuriae Spermium* (Lei Wan) or Tin Ash, a gentleman cannot guarantee the outcome. (*Huoren Shu* states: In Taiyang syndrome of Cold Damage, epistaxis indicates the disease is about to heal. If Heat binds in the Bladder and Blood flows down spontaneously, it also indicates healing. From this perspective, in other diseases with latent Heat, vomiting caused by Upper Jiao Blood stasis also indicates improvement. Although Blood has been vomited, if it stops spontaneously, it is acceptable.)