今之医者，谓吐血为虚劳之病，此大谬也。夫吐血有数种。大概咳者成劳。不咳者不成
劳，间有吐时偶咳者，当其吐血之时，野狼狈颇甚，吐血即痊，皆不成劳，何也？其吐血一止，则
周身无病，饮食如故，而精神生矣。即使亡血之后，或阴虚内热，或筋骨疼痛，绵可服药而
痊。若咳嗽则血止而病仍在，日嗽夜嗽，痰壅气升，多则三年，少则一年而死知。盖咳嗽不
止，则肾中之元气震荡不宁，肺为肾之母，母病则子亦病故也。又肺为五脏之华盖。皆云∶
谷气之胃，以传于肺，五脏六腑，皆以受气，其清者为营，浊者为卫，是则脏腑皆取精于肺
。肺病，则不能输精于脏腑，一年而脏腑皆枯，三年而脏腑竭矣，故咳嗽为真劳不治之疾也
。然亦有咳嗽而不死者，其嗽亦有时稍缓，其饮食起居不甚变；又其人善于调摄，延至三年
之后，起居如旧，间或一发，静养即愈，此乃百中难得一者也。更有不咳之人，血证屡发，
肝竭肺伤，亦变咳嗽，久而亦死。此则不善调摄，以轻变重也。执此以决血证之死生，百不
一失矣。
妇科之最重者二端，堕胎与难产耳。世之治堕胎者，往往纯用滋补；治难产者，往往专
于攻
下。二者皆非也。盖半产之故非一端，由于虚滑者，十之一二；由于内热者，十之八九。盖
胎惟赖血以养，故得胎之后，经事不行者，因冲任之血皆为胎所吸，无余血下行也。苟血或
不足，则胎枯竭而下堕矣。其血所以不足之故，皆由内热火盛，阳旺而阴亏也。故古人养胎
之方，专以黄芩为主。又血之生，必由于脾胃。经云∶营卫之首，纳欲为宝，故又以白术佐
之。乃世之人，专以参 补气，熟地滞胃，气旺则火盛，胃湿则不运，生化之源衰，而血益
少矣。至于产育之事，乃天地化育之常，本无危险之理。险者千不得一，世之遭厄难者，乃
人事之未工也。其法有乎产妇，不可令早用力。盖胎必转而后下，早用力，而胎先下坠，断
难舒转，于是横生倒产之害生。又用力，则胞浆骤下，胎已枯涩，何由能产？此病不但产子
之家不知，即收生稳妇亦有不知者。至于用药之法，则交骨不开，胎元不转，种种诸症，各
有专方。其外或宜润，或宜降，或宜温，或宜凉，亦当随症施治。其大端以养血为主，盖血
足，则诸症自退也。至于易产强健之产妇，最多卒死。盖大脱血之后，冲任空虚，经脉娇脆
，健妇不以为意。轻举妄动，用力稍重，冲脉断裂，气冒血崩，死在顷刻。尤忌举手上头，
如是死者，吾见极多。不知者以为奇异，实理之常。生产之家，不可不知也。
现在的医生，认为吐血是虚劳病，这是极大的错误。吐血有好几种情况。大致说来，伴有咳嗽的会发展为虚劳；不咳嗽的则不会发展为虚劳。偶尔在吐血时出现咳嗽的人，虽然当时吐血的情景非常狼狈严重，但一旦吐血停止，身体就痊愈了，这都不属于虚劳。为什么呢？因为吐血一止，全身就没有其他病症，饮食恢复正常，精神也就恢复了。即使失血之后，出现阴虚内热或筋骨疼痛的情况，只要绵密服药就能痊愈。如果是咳嗽，那么血止住了但病根仍在，日夜咳嗽，痰多气逆，多的话三年，少的话一年就会死亡。这是因为咳嗽不止，肾中的元气就会震荡不安，肺是肾之母，母病则子亦病。另外，肺是五脏的华盖（保护脏器的屏障）。都说：胃受纳水谷之气，将其传输给肺，五脏六腑都从中获取精气，其中清轻的部分成为营气，重浊的部分成为卫气，这说明脏腑的精气都依赖于肺。如果肺生病，就不能将精气输送给脏腑，一年后脏腑都会枯竭，三年后脏腑精气耗尽，所以咳嗽是真正的虚劳且难以治愈的疾病。然而也有咳嗽而不死的，其咳嗽有时稍微缓解，饮食起居没有太大变化；加上此人善于调养，拖延到三年之后，起居如常，偶尔发作，静养即可痊愈，这是百中难得一例。更有不咳嗽的人，血证反复发作，导致肝竭肺伤，也转变为咳嗽，时间久了也会死亡。这是不善调养，使轻症变为重症。依据这些来判断血证患者的生死，几乎不会出错。
妇科中最严重的两个方面，是堕胎和难产。世上治疗堕胎的医生，往往单纯使用滋补药物；治疗难产的医生，往往专门使用攻下药物。这两种做法都是不对的。小产的原因不只一种，由于体质虚弱滑脱的，占十分之一二；由于体内有热的，占十分之八九。胎儿只依靠血液来滋养，所以受孕之后，月经停止，是因为冲任二脉的血都被胎儿吸收，没有多余的血液下行。如果血液不足，胎儿就会干枯而流产。血液之所以不足的原因，都是由内热火盛，阳气旺盛而阴液亏损造成的。所以古人养胎的方剂，专门以黄芩为主药。又因为血的生成，必然源于脾胃。经书说：营卫之首，以饮食欲望为宝，所以又用白术辅助它。然而世人专门用人参补气，熟地黄滋腻碍胃，气旺则火盛，胃湿则运化无力，生化之源衰败，血液反而更少。至于生育这件事，是天地化育的正常规律，本来没有危险的道理。危险的千中无一，世上遭遇厄难的人，是人事处理不当造成的。对于产妇的方法，不可以让她过早用力。因为胎儿必须转动位置后才能分娩，过早用力，胎儿先向下坠，很难再舒展转动，于是就会出现横生倒产的危害。如果过度用力，胞浆突然流出，胎儿已经干枯涩滞，怎么能产出来呢？这种病不仅生孩子的人家不知道，就连接生的稳婆也有不知道的。至于用药的方法，对于交骨不开、胎元不转等各种症状，各有专门的方剂。或者适宜润燥，或者适宜降气，或者适宜温补，或者适宜清凉，也都应当根据症状施治。其主要原则是以养血为主，因为血充足，各种症状自然消退。至于那些容易生产且身体强健的产妇，最多会发生猝死。因为在大量失血之后，冲任二脉空虚，经脉娇嫩脆弱，健壮的产妇不在意这一点，轻举妄动，用力稍重，就会导致冲脉断裂，气机上逆，血崩而死，顷刻之间毙命。尤其忌讳举手过头顶的动作，像这样死亡的，我见过非常多。不知情的人认为是奇异之事，其实是常理。生育的家庭不可不知道这些。
Current physicians consider hemoptysis (coughing up blood) to be a disease of consumptive disorder (Xu Lao), which is a grave error. Hemoptysis presents in several types. Generally, cases accompanied by cough develop into consumptive disorder, whereas those without cough do not. Occasionally, patients may cough slightly during the episode of hemoptysis; although the scene is extremely distressing at that moment, once the bleeding stops, they recover completely and do not develop consumptive disorder. Why? Because after the cessation of bleeding, there are no other systemic symptoms, appetite returns to normal, and spirit is restored. Even if post-hemorrhagic yin deficiency with internal heat or bone and tendon pain occur, they can be cured with continuous medication. However, if cough persists, the disease remains despite the cessation of bleeding. Day and night coughing, with phlegm obstruction and qi rebellion, leads to death within one year at the earliest, or three years at the latest. This is because persistent cough causes the primordial qi in the Kidney to become agitated and unsettled. Since the Lung is the mother of the Kidney, when the mother is diseased, the child is also affected. Furthermore, the Lung is the "Canopy" (Huagai) of the five zang organs. It is stated that: The Stomach receives the essence from grains and transmits it to the Lung; all five zang and six fu organs derive their qi from it. The clear portion becomes Ying (Nutritive) Qi, and the turbid portion becomes Wei (Defensive) Qi. Thus, the essence of all organs is derived from the Lung. If the Lung is diseased, it cannot distribute essence to the organs; after one year, the organs become withered, and after three years, they are exhausted. Therefore, cough represents a true consumptive disorder that is difficult to cure. Nevertheless, some patients with cough do not die; their cough may occasionally ease, diet and daily life remain largely unchanged, and if they manage their health well, they may survive beyond three years, resuming normal life, with occasional episodes resolving through rest. Such cases are rare, occurring perhaps once in a hundred. Conversely, some patients without cough suffer recurrent blood disorders, leading to Liver exhaustion and Lung injury, eventually developing cough and dying after a long period. This results from poor self-care, transforming a mild condition into a severe one. Based on these principles, the prognosis of blood disorders can be determined with high accuracy.
In gynecology, the two most critical issues are miscarriage and dystocia (difficult labor). Physicians treating miscarriage often rely solely on tonifying and nourishing methods, while those treating dystocia often focus exclusively on purging and downbearing methods. Both approaches are incorrect. The causes of spontaneous abortion (half-birth) vary; only ten to twenty percent are due to deficiency and laxity, whereas eighty to ninety percent are due to internal heat. The fetus relies entirely on blood for nourishment. After conception, menstruation ceases because the blood of the Chong and Ren meridians is absorbed by the fetus, leaving no surplus to flow downward. If blood is insufficient, the fetus withers and aborts. The insufficiency of blood is primarily caused by excessive internal fire, where yang is hyperactive and yin is deficient. Therefore, ancient formulas for nurturing the fetus primarily use Huangqin (Scutellariae Radix, 黄芩). Moreover, blood generation depends on the Spleen and Stomach. The Classics state: "The head of Ying and Wei, food desire is treasured," hence Baizhu (Atractylodis Macrocephalae Rhizoma, 白术) is used as an assistant. However, modern practitioners often use Renshen (Ginseng Radix, 人参) to boost qi and Shudi (Rehmanniae Radix Preparata, 熟地黄) to nourish blood. Excessive qi leads to fire, while dampness in the stomach impairs transformation and transportation. Consequently, the source of bio-transformation declines, and blood production decreases further. Regarding childbirth, it is a natural process of heaven and earth's generation and should not inherently be dangerous. Danger occurs in less than one in a thousand cases; those who encounter difficulties do so due to improper management. For parturients, one must not allow them to exert effort too early. The fetus must rotate before delivery; premature exertion causes the fetus to descend first, making rotation difficult and leading to malpresentations such as transverse or breech birth. Additionally, excessive straining causes amniotic fluid to rush out prematurely, leaving the fetus dry and unable to be delivered. This issue is unknown not only to families but also to many midwives. Regarding medication, specific formulas exist for conditions like non-opening of the pubic symphysis (Jiaogu) and failure of fetal rotation. Treatments may involve moistening, descending, warming, or cooling, depending on the syndrome. The primary principle is to nourish blood, as sufficient blood resolves various symptoms. However, robust women who deliver easily are prone to sudden death. After massive hemorrhage, the Chong and Ren meridians are empty, and the vessels are fragile. Unaware of this risk, strong women may move lightly or exert themselves excessively, causing rupture of the Chong vessel, qi rebellion, and blood collapse, leading to death within moments. Particularly, raising hands above the head is contraindicated. I have witnessed many such deaths. Those unaware consider this strange, but it is a common occurrence based on physiological principles. Families involved in childbirth must understand this.