血之道 化中焦 经曰∶中焦受气取汁，变化而赤，是谓血。
本冲任 中溉浇 血之流溢，半随冲任而行于经络。
温肌腠 外逍遥 血之流溢，半散于脉外而充肌腠皮毛。
六淫逼 经道摇 六淫者，风、寒、暑、湿、燥、火也。经，常也。道，路也。言血所
常行之路也，外邪伤之则摇动。
宜表散 麻芍条 外伤宜表散。东垣治一人内蕴虚热，外感大寒而吐血。法仲景麻黄汤
加补剂，名麻黄人参芍药汤，一服而愈。
七情病 溢如潮 七情者，喜、怒、哀、惧、爱、恶、欲也。七情之动，出于五志。医
书恒谓五脏各有火，五志激之则火动，火动则血随火而溢。然五志受伤既久，则火为虚火，
宜以甘温之法治之。
引导法 草姜调 甘草干姜汤，如神，或加五味子二钱。火盛者，加干桑皮三钱、小麦
一两。时医因归脾汤有引血归脾之说，谓引血归脾即是归经。试问脾有多大，能容离经之血
成斗成盆，尽返而归于内而不裂破乎?市医固无论矣，而以名医自负者，亦蹈此弊，实可痛恨!
温摄法 理中超 理中汤，加木香、当归煎服。凡吐血服凉药及滋润益甚，外有寒冷之
象者，是阳虚阴走也，必用此方。血得暖则循行经络矣。此法出《仁斋直指》。
凉泻法 令瘀销 火势盛，脉洪有力，寒凉之剂原不可废。但今人于血症，每用藕节、
黑栀、白芨、旧墨之类以止涩之，致留瘀不散，以为咳嗽虚痨之基。《金匮》泻心汤，大黄
倍于芩连，为寒以行瘀法。柏叶汤治吐不止，为温以行瘀法。二方为一温一寒之对子。
赤豆散 下血标 粪前下血为近血，《金匮》用当归赤小豆散。
若黄土 实翘翘 粪后下血为远血，《金匮》用黄土汤。
一切血 此方饶 黄土汤，不独粪后下血方也。凡吐血、衄血、大便血、小便血、妇人
血崩及血痢久不止，可以统治之。以此方暖中宫土脏，又以寒热之品互佐之，步步合法也。
五脏有血，六腑无血。观剖诸兽腹心下夹脊，包络中多血，肝内多血，心、脾、肺、肾中各
有血，六腑无血。近时以吐血多者，谓为吐胃血，皆耳食昔医之误，凡吐五脏血必死。若吐
血、衄血、下血，皆是经络散行之血也。
血生成的途径，源于中焦。《内经》说：中焦接受水谷之气，提取精微物质，经过变化变成红色，这就叫做血。
血的运行本于冲脉和任脉，中间灌溉周身。血液的流溢，一半随着冲脉和任脉在经络中运行。
温煦肌肉和腠理，在外周自由舒展。血液的流溢，另一半散布在脉管之外，以充养肌肉、腠理和皮毛。
六淫邪气逼迫，导致经脉通道动摇。六淫，指的是风、寒、暑、湿、燥、火六种外感病邪。经，指常道；道，指路径。意思是血液通常运行的路径，如果受到外邪伤害，就会发生动摇紊乱。
适宜使用解表发散的方法，参考麻黄人参芍药汤。外伤引起的出血适宜用解表发散法。李东垣曾治疗一个人，体内蕴藏虚热，又外感大寒而吐血。遵循张仲景的法度，在麻黄汤中加入补益药物，命名为麻黄人参芍药汤，服用一次就痊愈了。
七情致病，出血如洪水泛滥。七情，指的是喜、怒、哀、惧、爱、恶、欲七种情绪。七情的波动，产生于五志（心、肝、脾、肺、肾的情志活动）。医书常说五脏各有相火，五志被激发则火动，火动则血液随火势而溢出。然而五志受伤时间久了，火就变成了虚火，适宜用甘温的方法来治疗。
引导止血法，用甘草和干姜调和。甘草干姜汤效果神奇，或者加入二钱五味子。如果火势旺盛，加入三钱干桑白皮、一两小麦。当时的医生因为归脾汤有“引血归脾”的说法，认为引血归脾就是让血回归经脉。试问脾有多大，能容纳成斗成盆的离经之血，全部返还到内部而不破裂呢？市井庸医固且不论，那些自诩为名医的人，也陷入这种弊端，实在令人痛恨！
温摄止血法，道理高超。理中汤，加入木香、当归煎服。凡是吐血患者服用凉药及滋润药物后病情加重，且外表有寒冷征象的，这是阳虚阴血走泄的表现，必须使用这个方剂。血液得到温暖就能在经络中正常循行了。这种方法出自《仁斋直指方》。
凉泻化瘀法，使瘀血消散。如果火势旺盛，脉象洪大有力，寒凉的药物原本是不可废弃的。但是如今的人在血症治疗中，常常使用藕节、黑栀子、白芨、旧墨之类的药物来止涩，导致瘀血滞留不散，成为咳嗽虚劳的基础。《金匮要略》中的泻心汤，大黄用量倍于黄芩和黄连，这是用寒凉药来行散瘀血的方法。柏叶汤治疗吐血不止，是用温热药来行散瘀血的方法。这两个方子是一温一寒的对偶方。
赤豆散，针对下血的标症。大便前下血称为近血，《金匮要略》使用当归赤小豆散。
如果用黄土汤，确实巧妙。大便后下血称为远血，《金匮要略》使用黄土汤。
一切出血病症，此方丰富多样。黄土汤，不仅仅是治疗大便后下血的方子。凡是吐血、鼻衄、大便出血、小便出血、妇人血崩以及血痢久治不愈的，都可以统摄治疗。以此方温暖中宫脾土，又以寒热性质的药物互相佐助，步步符合法度。
五脏有血，六腑无血。观察剖开各种兽类的腹部，心脏下方夹脊处，心包络中多血，肝脏内多血，心、脾、肺、肾中各有血，而六腑没有血。近来有人因为吐血多，就说是吐胃血，这都是听信古代医生错误说法的结果。凡是大吐五脏的血必然死亡。至于吐血、鼻衄、下血，都是经络中散行的血液。
The pathway of blood generation originates from the Middle Jiao (Middle Burner). The *Neijing* states: "The Middle Jiao receives Qi and extracts essences, transforms them into red, which is called Blood."
Blood flow is rooted in the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel), irrigating the body centrally. Half of the flowing blood travels along the meridians with the Chong and Ren vessels.
It warms the muscles and couli (interstices), freely circulating externally. The other half of the flowing blood disperses outside the vessels to nourish the muscles, couli, and skin/hair.
When invaded by the Six Excesses (Wind, Cold, Summerheat, Dampness, Dryness, Fire), the pathways of the meridians are shaken. The "Six Excesses" refer to Wind, Cold, Summerheat, Dampness, Dryness, and Fire. "Jing" refers to the constant path; "Dao" refers to the route. This means the usual routes where blood flows; when injured by external pathogens, these routes become disturbed.
Appropriate treatment involves releasing the exterior and dispersing, referencing Mahuang Renshen Shaoyao Tang (Ephedra, Ginseng, and Peony Decoction). For bleeding caused by external injuries, exterior-releasing and dispersing methods are suitable. Li Dongyuan treated a patient who had internal deficiency-heat and external severe cold invasion resulting in hematemesis. Following Zhang Zhongjing's method, he added tonifying agents to Mahuang Tang (Ephedra Decoction), naming it Mahuang Renshen Shaoyao Tang, which cured the patient after one dose.
Diseases caused by the Seven Emotions (Joy, Anger, Sorrow, Fear, Love, Dislike, Desire) cause bleeding like surging tides. The movement of the Seven Emotions arises from the Five Wills (emotional activities associated with the Zang organs). Medical texts often state that each Zang organ has its own ministerial fire; when stimulated by the Five Wills, the fire moves, causing blood to overflow following the fire. However, if the Five Wills are injured for a long time, the fire becomes deficient fire, and sweet-warm methods should be used.
Guidance and retention methods use Gancao (Licorice Root) and Ganjiang (Dried Ginger) to harmonize. Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction) is miraculous, or add two qian of Wuweizi (Schisandra Berry). If fire is excessive, add three qian of Sangbaipi (Mulberry Bark) and one liang of Xiaomai (Wheat). Contemporary physicians, citing the concept of "guiding blood back to the Spleen" in Guipi Tang (Restore the Spleen Decoction), claim that guiding blood to the Spleen is equivalent to returning blood to the vessels. One must ask: how large is the Spleen? Can it hold buckets or basins of blood leaving the vessels, returning them entirely inside without rupture? While quack doctors are beyond discussion, even those proud of being famous doctors fall into this error, which is truly lamentable!
Warmth and retention methods are profound in principle. Lizhong Tang (Regulate the Middle Decoction) with Muxiang (Aucklandia Root) and Danggui (Angelica Sinensis) decocted and taken orally. For any hematemesis where taking cooling and moistening medicines worsens the condition, and there are external signs of cold, this indicates Yang deficiency with Yin/Blood leakage; this formula is essential. When blood is warmed, it circulates normally in the meridians. This method comes from *Renzhai Zhizhi Fang*.
Cooling and purging methods eliminate stasis. If fire is excessive and the pulse is洪大 (surging and forceful), cooling agents are indispensable. However, nowadays, in treating blood diseases, people often use Oujie (Lotus Node), Heizhi (Charred Gardenia), Baiji (Bletilla Rhizome), and old ink to stop bleeding, causing stasis to remain unresolved, laying the foundation for cough and consumptive disease. Xie Xin Tang (Drain the Heart Decoction) in the *Jinkui Yaolue* uses twice as much Dahuang (Rhubarb Root) as Huangqin (Scutellaria Root) and Huanglian (Coptis Rhizome); this is using cold to move stasis. Baixie Tang (Artemisia Leaf Decoction) treats persistent hematemesis; this is using warmth to move stasis. These two formulas form a pair of warm and cold treatments.
Chidou San (Red Bean Powder) addresses the manifestation of lower blood loss. Blood appearing before stool is called "near blood"; the *Jinkui Yaolue* uses Danggui Chixiaodou San (Angelica and Red Bean Powder).
If using Huangtu Tang (Yellow Earth Decoction), it is truly ingenious. Blood appearing after stool is called "far blood"; the *Jinkui Yaolue* uses Huangtu Tang.
For all types of bleeding, this formula is versatile. Huangtu Tang is not only for far blood. It can treat hematemesis, epistaxis, hematochezia, hematuria, uterine bleeding (blood flooding), and chronic bloody dysentery. By warming the central palace (Spleen/Stomach) and earth organs, and mutually assisting with cold and hot substances, every step conforms to the principles.
The Five Zang organs have blood; the Six Fu organs do not. Observing dissected animal abdomens, below the heart and flanking the spine, the Pericardium contains much blood, the Liver contains much blood, and the Heart, Spleen, Lungs, and Kidneys each contain blood, while the Six Fu organs lack blood. Recently, some claim that massive hematemesis is vomiting stomach blood, which is an error derived from mishearing ancient doctors. Vomiting blood from the Five Zang organs invariably leads to death. As for hematemesis, epistaxis, and lower bleeding, these are all blood from the dispersed circulation of the meridians.