犀角（镑，一钱五分） 生地黄（四钱） 牡丹皮 麦冬 白芍（各一钱五分）
水煎服。
衄者，鼻中出血也。寒气初客于经，则血凝滞而不行，何得有衄？今见衄者，是寒邪将
散，荣血周流，病当解也。古人谓血为红汗是也。然衄症亦有表里之殊，寒邪在经，头痛发
热而衄者，表也，宜微汗之，加味香苏散主之。若邪气入里，燥渴烦心而成衄者，宜急清之
犀角地黄汤主之。或问曰∶动阴血与鼻衄，何以别之？答曰∶动阴血者，乃传经里证，热
极而反发厥，医家误认为寒，投以干姜、附子，以火济火，迫血妄行，或从耳、目、口、鼻
涌出，名曰动阴血，又谓下厥上竭，为难治。与鼻衄症，天渊相隔矣。
便脓血者，热迫血而下行也，此传经热邪所致也，法当清之。若瘀血凝聚，少腹痛，拒
按，小便自利者，下之。然亦有阴寒为病，下利脓血者，此下焦虚寒，肠胃不固，譬如天寒
地冻，水凝成冰，非温剂不化，附子理中汤加归、芍主之。斯二者，一为血热，一为血寒，
临证时不可不辨。
蓄血者，瘀血蓄于下焦也。仲景云∶太阳证不解，热结膀胱，其人如狂，血自下者愈。
其外不解者，尚未可攻，当先解外，外解已，但少腹急结者，乃可攻之，宜桃核承气汤。此
表证甫除，瘀积始聚，为蓄血之轻者，故用前方。若表邪已尽，里热既深，乃蓄血之重者，
则用抵当汤攻之。但蓄血证与溺涩、燥粪证，相似而不同，宜分别施治。凡伤寒少腹胀满，
按之不痛，小便不利者，为溺涩也。若按之绕脐硬痛，小便短涩，大便不通者，此有燥屎也
若按之少腹硬痛，小便自利，或大便黑色，喜忘，如狂者，为蓄血也。此辨证之大法也。
犀角（镑成细末，一钱五分） 生地黄（四钱） 牡丹皮 麦冬 白芍（各一钱五分）
用水煎煮后服用。
鼻衄，是指鼻腔出血。寒气初侵经络时，血液凝滞而不运行，怎么会出现鼻衄呢？现在出现鼻衄，说明寒邪即将解散，营血恢复周流，疾病应当解除。古人所说的“血即红汗”就是这个道理。然而，鼻衄病症也有表证和里证的区别。如果是寒邪在经络，伴有头痛、发热而鼻衄的，属于表证，适宜用微发汗的方法治疗，以加味香苏散为主方。如果邪气入里，因燥渴、心烦而成鼻衄的，适宜紧急清热，以犀角地黄汤为主方。有人问：动阴血与鼻衄，如何区别？回答说：动阴血，是传经里的证候，热极反而发生厥逆，医生误认为是寒证，投用干姜、附子，以火助火，逼迫血液妄行，或者从耳、目、口、鼻涌出，名叫动阴血，又叫做下厥上竭，属于难治之症。这与鼻衄症，相差如天渊之别。
大便排出脓血，是热邪逼迫血液下行所致，这是由传经的热邪引起的，治法应当清热。如果是瘀血凝聚，少腹疼痛，拒按，小便自利的，应当用攻下法。然而也有因阴寒致病，下利脓血的，这是下焦虚寒，肠胃不固，就像天寒地冻，水凝结成冰一样，不用温补药剂不能化解，以附子理中汤加当归、白芍为主方。这两种情况，一个是血热，一个是血寒，临证时不可不加以辨别。
蓄血，是瘀血蓄积在下焦。张仲景说：太阳病证不解，热邪结于膀胱，病人神志如狂，血液自行排下的就会痊愈。如果表证未解，还不可以攻下，应当先解表，表解之后，只有少腹急迫结聚的，才可以攻下，适宜用桃核承气汤。这是表证刚除，瘀积才开始聚集，属于蓄血的轻证，所以用前面的方剂。如果表邪已经完全解除，里热已经深入，这是蓄血的重证，则用抵当汤攻下。但是蓄血证与小便涩滞、燥屎内结证，相似而不同，应当分别施治。凡是伤寒病见少腹胀满，按压不痛，小便不利的，是小便涩滞。如果按压绕脐硬痛，小便短涩，大便不通的，这是有燥屎。如果按压少腹硬痛，小便自利，或者大便黑色，健忘，神志如狂的，是蓄血。这是辨证的大法。
Rhino Horn (sliced, 1.5 qian) Sheng Dihuang (Rehmanniae Radix Praeparata, 4 qian) Mudanpi (Moutan Cortex) Maidong (Ophiopogonis Radix) Baishao (Paeoniae Radix Alba) (each 1.5 qian)
Decoct in water and take orally.
Bi nosebleed (Nosebleed) refers to bleeding from the nasal cavity. When cold pathogen initially invades the meridians, blood coagulates and stagnates without flowing; how can nosebleed occur? The appearance of nosebleed now indicates that the cold pathogen is about to dissipate, Ying blood (Nutritive Blood) resumes its circulation, and the disease should resolve. This aligns with the ancient saying that "blood is red sweat." However, nosebleed cases differ between exterior and interior patterns. If the cold pathogen is in the meridians, accompanied by headache, fever, and nosebleed, it is an exterior pattern, suitable for mild diaphoresis (releasing the exterior through sweating), primarily treated with Jia Wei Xiang Su San (Modified Elsholtzia and Perilla Powder). If the pathogen enters the interior, causing dryness, thirst, irritability, and nosebleed, urgent clearing of heat is required, primarily treated with Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction). One might ask: How to distinguish Dong Yin Xue (Disturbance of Yin Blood) from nosebleed? The answer is: Dong Yin Xue is a transmitted interior syndrome where extreme heat causes counterflow cold (Jue Ni); if physicians mistakenly diagnose it as cold and administer Gan Jiang (Dried Ginger) and Fuzi (Prepared Aconite Root), adding fire to fire, forcing blood to flow recklessly, leading to bleeding from the ears, eyes, mouth, or nose, it is called Dong Yin Xue, also known as Lower Counterflow and Upper Exhaustion, which is difficult to treat. This is vastly different from nosebleed.
Passing pus and blood in stool results from heat forcing blood downward, caused by transmitted heat pathogens; the treatment method should be clearing heat. If stasis blood condenses, causing lower abdominal pain, tenderness upon pressure, and normal urination, purgation (attacking with purgatives) is indicated. However, there are also cases of dysentery with pus and blood due to yin-cold pathology, resulting from deficiency-cold in the lower jiao and instability of the intestines and stomach. Like water freezing into ice during cold weather and frozen ground, it cannot be resolved without warm tonifying agents; this is primarily treated with Fuzi Lizhong Tang (Aconite and Poria Decoction) added with Dang Gui (Angelica Sinensis) and Baishao (White Peony Root). These two conditions—one involving blood-heat and the other blood-cold—must be clearly distinguished during clinical practice.
Xu Xue (Accumulated Blood) refers to stasis blood accumulating in the lower jiao. Zhang Zhongjing stated: If Taiyang syndrome does not resolve, heat binds to the Bladder, and the patient exhibits manic behavior; if blood discharges spontaneously, recovery occurs. If the exterior remains unresolved, attack is contraindicated; one must first resolve the exterior. Once the exterior is resolved, if only lower abdominal urgency and binding remain, attack may proceed, preferably using Taohe Chengqi Tang (Peach Kernel and Magnolia Bark Decoction). This represents a mild case of Xu Xue where exterior signs have just been cleared and stasis begins to gather. If exterior pathogens are completely gone and interior heat is profound, it is a severe case of Xu Xue, treated with Didang Tang (Definite Attack Decoction). However, Xu Xue syndrome resembles but differs from Lin syndrome (difficulty/painful urination) and Dry Stool syndrome; treatments must be differentiated. In Typhoid diseases, if the lower abdomen is distended and full but painless upon pressure, with difficulty urinating, it is Lin syndrome. If pressure around the navel reveals hardness and pain, with scanty urine and constipation, it is Dry Stool. If pressure on the lower abdomen reveals hardness and pain, with normal urination, or black stools, forgetfulness, and manic behavior, it is Xu Xue. This is the general principle of differentiation.