许（五月）努力伤络，络血不时上溢，血上而瘀滞肺络，肺失清肃，咳逆痰稠，脘闷胁
痛，脉象弦数，治宜疏解佐以理络。
丹参 川郁金 旋复花 麋衔草 童便 参三七 新绛 炒白蒺 白茅根 泽兰
丝瓜络 炒苏子 藕节
徐左（合溪） 努力伤络，瘀血内蓄，咳吐紫瘀，体疲内热，脉象郁数，治宜疏化。
丹参 川郁金 泽兰 怀牛膝 参三七末 元胡 粉丹皮 茜根炭 桃仁 归尾
新绛 丝通草
蓄血瘀滞，咳吐不止，用治蓄血之法甚妥。
莫左 火盛刑金，肺失清肃，咳嗽伤络，痰中夹血，胸胁引痛，脘闷肢倦，脉形郁数，治宜清络。
炒苏子 旋复花 玫瑰花 川郁金 白杏仁 新绛 藉节 银花露 真川贝 丝瓜络 丝通草 青芦根
郦翁 掺用神机，肝胆气火偏旺，上刑肺金，肺失肃化之权，咳嗽震动，肺络交节见红，
木叩金鸣，阳络伤则血外溢是也，脉小弦数，右寸关弦滑数兼见。治宜清金平木，兼以理络。
南沙参 真川贝 丹皮 枇杷叶 麋衔草 炒苏子 旋复花 怀牛膝 玫瑰花 藕
节白杏仁 生蛤壳 丝瓜络 仙鹤草 青芦根
或用丹参、参三七、陈阿胶亦可。
如洋参、麦冬、燕窝、冬花、白芍、阿胶、女贞子、旱莲草之类随加，蓄血类伤寒，宜从《指掌》。
跌伤者亦从蓄血法。
活蝌蚪治吐血大灵，带活吞半碗许即愈。
白麋衔治吐血大效，浸陈好酒佳。
活曲 治伤血大效，浸陈酒佳。
许姓患者（五月就诊）因用力过度损伤络脉，导致络中血液不时上溢。血液上逆并在肺络中瘀滞，致使肺脏失去清肃下降的功能，出现咳嗽气逆、痰液粘稠，胃脘部闷胀、胁肋疼痛，脉象弦而数。治疗宜采用疏解之法，辅以调理络脉。
丹参、川郁金、旋复花、麋衔草、童便、参三七、新绛、炒白蒺藜、白茅根、泽兰、丝瓜络、炒苏子、藕节。
徐左（合溪）因用力过度损伤络脉，瘀血内蓄，咳嗽时吐出紫黑色瘀血，身体疲乏、体内发热，脉象郁滞而数。治疗宜采用疏理化瘀之法。
丹参、川郁金、泽兰、怀牛膝、参三七末、元胡、粉丹皮、茜根炭、桃仁、归尾、新绛、丝通草。
莫左因火邪旺盛克制肺金，肺脏失去清肃功能，咳嗽损伤络脉，痰中夹杂血液，胸胁牵引作痛，胃脘闷胀、肢体疲倦，脉形郁滞而数。治疗宜采用清泄络脉之法。
炒苏子、旋复花、玫瑰花、川郁金、白杏仁、新绛、藉节（注：疑为藕节或类似止血药，此处依原文保留）、银花露、真川贝、丝瓜络、丝通草、青芦根。
郦翁长期使用神机（注：指精神过度消耗或某种药物/疗法，此处依原文），导致肝胆气火偏旺，向上克制肺金，肺脏失去肃降转化的职权，咳嗽震动，肺络交接处见红（出血）。此为“木叩金鸣”，阳络受伤则血液外溢的表现，脉象细小弦数，右寸关部位呈现弦滑数之象。治疗宜清金平木，兼以调理络脉。
南沙参、真川贝、丹皮、枇杷叶、麋衔草、炒苏子、旋复花、怀牛膝、玫瑰花、藕节、白杏仁、生蛤壳、丝瓜络、仙鹤草、青芦根。
如西洋参、麦冬、燕窝、冬花、白芍、阿胶、女贞子、旱莲草等类药材，可根据情况加入。蓄血证类似于伤寒病中的蓄血证，宜参考《医宗金鉴·杂病心法要诀》（注：《指掌》通常指《医宗金鉴》，俗称《删补名医方论》或相关著作，此处依原文保留《指掌》）。
跌打损伤者亦按照治疗蓄血的方法处理。
活蝌蚪治疗吐血效果显著，带活吞服约半碗即可痊愈。
白麋衔治疗吐血效果极大，用陈年好酒浸泡更佳。
活曲（注：可能指六神曲或其他发酵制剂，此处依原文保留）治疗伤血效果显著，用陈年好酒浸泡更佳。
Patient Xu (seen in May) suffered damage to the collaterals due to excessive exertion, causing blood from the collaterals to overflow upwards intermittently. The upward flow of blood led to stasis in the lung collaterals, impairing the Lung's function of clearing and descending. Symptoms included cough with rebellious Qi, thick phlegm, epigastric fullness, hypochondriac pain, and a wiry and rapid pulse. Treatment should focus on dispersing and resolving, assisted by regulating the collaterals.
Salviae Miltiorrhizae Radix (Danshen), Curcumae Aromatae Rhizoma (Chuan Yujin), Inulae Flos (Xuan Fu Hua), Siegesbeckiae Herba (Mi Xian Cao), Child's Urine (Tong Bian), Panax Notoginseng Radix et Rhizoma (Shen Sanqi), Xin Jiang (New Crimson Fabric/Dye), Tribuli Fructus Stir Fry (Chao Bai Ji Li), Imperatae Rhizoma (Bai Mao Gen), Euphorbiae Lathyridis Semen (Zelan), Luffae Fructus Retinervus (Sigua Luo), Perillae Fructus Stir Fry (Chao Su Zi), Nelumbinis Nuciferae Petiolus (Oujie).
Xu Zuo (from Hexi) suffered collateral damage from excessive exertion, leading to internal accumulation of blood stasis. He presented with coughing up purple-black stagnant blood, physical fatigue, internal heat, and a suppressed and rapid pulse. Treatment should focus on dispersing and transforming stasis.
Salviae Miltiorrhizae Radix (Danshen), Curcumae Aromatae Rhizoma (Chuan Yujin), Euphorbiae Lathyridis Semen (Zelan), Achyranthis Bidentatae Radix (Huai Niuxi), Powder of Panax Notoginseng Radix et Rhizoma (Shen Sanqi Mo), Corydalis Rhizoma (Yuan Hu), Paeoniae Radix Rubra (Fen Danpi), Rubiae Radix et Rhizoma Charred (Qian Gen Tan), Persicae Semen (Taoren), Angelicae Sinensis Radix Tail (Gui Wei), Xin Jiang, Tinosporae Caulis (Sitongcao).
For persistent cough caused by blood stasis accumulation, employing methods for treating blood stasis is highly appropriate.
Mo Zuo presented with excessive Fire insulting Metal (Lung), impairing the Lung's clearing and descending function. Cough damaged the collaterals, resulting in blood mixed with sputum, radiating pain in the chest and hypochondrium, epigastric fullness, limb fatigue, and a suppressed and rapid pulse. Treatment should focus on clearing the collaterals.
Perillae Fructus Stir Fry (Chao Su Zi), Inulae Flos (Xuan Fu Hua), Rosae Rugosae Flos (Meiguihua), Curcumae Aromatae Rhizoma (Chuan Yujin), Armeniacae Semen Amarum (Bai Xingren), Xin Jiang, Jie Jie (Note: Likely Oujie or similar hemostatic herb, retained as per text), Lonicerae Japonicae Flos Dew (Yinhua Lu), True Fritillariae Bulbus (Zhen Chuanbei), Luffae Fructus Retinervus (Sigua Luo), Tinosporae Caulis (Sitongcao), Phragmitis Rhizoma Green (Qing Lugen).
Elder Li used "Shenji" (likely referring to mental exertion or specific therapy) excessively, causing Liver and Gallbladder Qi and Fire to become hyperactive and insult Lung Metal. This impaired the Lung's authority for descending and transformation. Violent coughing caused bleeding at the junctions of lung collaterals. This is described as "Wood striking Metal," where injury to Yang collaterals leads to external blood overflow. The pulse was small, wiry, and rapid; the right Cun and Guan positions showed wiry, slippery, and rapid qualities. Treatment should clear Metal and calm Wood, while regulating the collaterals.
Glehniae Radix (Nanshashen), True Fritillariae Bulbus (Zhen Chuanbei), Paeoniae Radix Rubra (Danpi), Eriobotryae Folium (Pipaye), Siegesbeckiae Herba (Mixiancao), Perillae Fructus Stir Fry (Chao Su Zi), Inulae Flos (Xuanfuhua), Achyranthis Bidentatae Radix (Huainiuxi), Rosae Rugosae Flos (Meiguihua), Nelumbinis Nuciferae Petiolus (Oujie), Armeniacae Semen Amarum (Baixingren), Tridacnidae Concha (Sheng Geqiao), Luffae Fructus Retinervus (Sigualuo), Agrimoniae Herba (Xianhecao), Phragmitis Rhizoma Green (Qinglugen).
Alternatively, Salviae Miltiorrhizae Radix (Danshen), Panax Notoginseng Radix et Rhizoma (Shen Sanqi), and aged Donkey-hide Gelatin (Chen Ejiao) may be used.
Herbs such as Codonopsis Radix (Yangshen - Note: likely American Ginseng based on context 'Yangshen' vs 'Dangshen', usually Yangshen refers to Xi Yang Shen/American Ginseng), Ophiopogonis Radix (Maidong), Swallow's Nest (Yanwo), Adenophorae Radix (Donghua), Paeoniae Radix Alba (Baishao), Donkey-hide Gelatin (Ejiao), Ligustri Lucidi Fructus (Nvzhenzi), and Ecliptae Herba (Hanliancao) can be added according to condition. Blood stasis patterns resemble those in Shanghan Lun; refer to *Zhi Zhang* (likely referring to *Yizong Jinjian*).
Traumatic injuries should also be treated using methods for blood stasis.
Live tadpoles are highly effective for treating hematemesis; swallowing about half a bowl alive results in cure.
White Siegesbeckiae Herba (Mi Xiancao) is very effective for hematemesis; soaking it in aged good wine is recommended.
Live Qu (Fermented Grain Product) is highly effective for treating injured blood; soaking it in aged wine is recommended.