治同前证。
水蛭（一两，不用炙） 生黄 （一两半） 生三棱（五钱） 生莪术（五钱） 当归（六钱） 知母（六钱）
生桃仁（六钱，带皮尖）
上药七味，共为细末，炼蜜为丸桐子大，开水送服二钱，早晚各一次。
仲景抵当汤、大黄 虫丸、百劳丸，皆用水蛭，而后世畏其性猛，鲜有用者，是未知水蛭之性也。《神农
本草经》曰∶水蛭气味咸平无毒，主逐恶血、瘀血、月闭，破 瘕、积聚、无子、利
水道。徐灵胎注云∶凡人身瘀血方阻，尚有生气者易治，阻之久则生气全消而难治。盖血既离经，与正气全不
相属，投之轻药，则拒而不纳，药过峻，又转能伤未败之血，故治之极难。水蛭最善食人之血，而性又迟缓善
入。迟缓则生血不伤，善入则坚积易破，借其力以消既久之滞，自有利而无害也。观《神农本草经》之文与徐
氏之注，则水蛭功用之妙，为何如哉！特是徐氏所谓迟缓善入者，人多不解其理。盖水蛭行于水中，原甚迟缓。
其在生血之中，犹水中也，故生血不伤也。着人肌肉，即紧贴善入。其遇坚积之处，犹肌肉也，故坚积易消也。
方中桃仁不去皮尖者，以其皮赤能入血分，尖乃生发之机，又善通气分。杨玉衡《寒温条辨》曾有斯说。
愚疑其有毒，未敢遽信。遂将带皮生桃仁，嚼服一钱，心中安然，以后始敢连皮尖用之。至于不炒用，而生用
者，凡果中之仁，皆含生发之气，原可借之以流通既败之血也。《神农本草经百种录》注曰∶桃得三月春和之
气以生，而花鲜明似血，故凡血瘀血枯之疾，不能调和畅达者，此能入于其中而和之散之。然其生血之功少，
而去瘀之功多者，盖桃核本非血类，实不能有所补益。若 瘕皆已败之血，非生气不能流通，桃之生气在于仁，
而味苦又能开泄，故能逐旧而不伤新也。夫既借其生气以流通气血，不宜炒用可知也。若入丸剂，蒸熟用之亦可。
【附方】秘传治女子干病方，用红HT 螺（榆树内红虫大如蚕）二个，樗树（此树如椿而味臭俗名臭椿）荚
二个，人指甲全的，壮年男子发三根。用树荚夹HT 螺、指甲以发缠之，将发面馒头如大橘者一个，开一孔，去
中瓤俾可容药。纳药其中，仍将外皮原开下者杜孔上，木炭火煨存性为细末，用黄酒半斤炖开，兑童便半茶盅
送服。忌腥冷、惊恐、恼怒。此方用过数次皆验，瘀血开时必吐衄又兼下血，不必惊恐，移时自愈。以治经水
一次未来者尤效。
治疗与前文所述相同的病证。
水蛭（一两，不用炙烤） 生黄芪（一两半） 生三棱（五钱） 生莪术（五钱） 当归（六钱） 知母（六钱）
生桃仁（六钱，保留皮和尖端）
以上七味药，共同研磨成细末，用炼蜜制成如梧桐子大小的丸剂，开水送服二钱，早晚各一次。
张仲景的抵当汤、大黄䗪虫丸、百劳丸，都使用水蛭，但后世医家畏惧其药性猛烈，很少有人使用，这是不了解水蛭的药性所致。《神农本草经》记载：水蛭气味咸平，无毒，主治驱除恶血、瘀血、闭经，破除癥瘕、积聚、不孕症，通利水道。徐灵胎注释说：凡是人体内的瘀血刚刚阻滞，尚存有生机的容易治疗；阻滞时间久则生机完全消失而难以治疗。因为血液一旦离开经脉，就与正气完全不相隶属，投以轻缓的药物，则会被排斥而不被接纳；用药过于峻猛，又会转而损伤尚未败坏的血液，所以治疗起来极难。水蛭最善于吸食人的血液，而其性质又迟缓且善于潜入。迟缓则不伤害新生的血液，善于潜入则坚硬的积块容易攻破，借助它的力量来消除长久停滞的瘀血，自然是有利而无害的。观察《神农本草经》的条文与徐氏的注释，那么水蛭功用的奇妙之处，是多么显著啊！只是徐氏所说的“迟缓善入”，人们大多不理解其中的道理。大概水蛭在水中游动，原本就很迟缓。它在新鲜的血液中活动，就像在水中一样，所以不伤害生血。附着在人的肌肉上，就紧贴并善于深入。它遇到坚硬积块的地方，就像在肌肉中一样，所以坚硬的积块容易消散。方中桃仁不去掉皮和尖的原因，是因为它的皮色赤能进入血分，尖是生发的机窍，又善于疏通气分。杨玉衡在《寒温条辨》中曾有这种说法。我怀疑它有毒素，不敢贸然相信。于是尝试嚼服带皮的生桃仁一钱，心中安然无恙，从此以后才敢连皮带尖一起使用。至于不炒制而生的原因，是因为凡果实中的仁，都含有生发之气，原本就可以借助它来流通已经败坏的血液。《神农本草经百种录》注释说：桃子得三月春和之气而生，花朵鲜明似血，所以凡是血瘀血枯的疾病，不能调和畅达的，此药能进入其中调和疏散。然而它补益生血的功劳少，而去瘀的功劳多，大概桃核本来不属于血类，确实不能有所补益。如果癥瘕都是已经败坏的血液，没有生气就不能流通，桃子的生气在于仁，而且味道苦又能开泄，所以能驱逐旧血而不伤害新血。既然借助它的生气来流通气血，就不宜炒制使用，这是显而易见的。如果放入丸剂中，蒸熟使用也可以。
【附方】秘传治疗女子干血痨病的方子，用红蠡螺（榆树内红色的虫子，大如蚕）二个，樗树（这棵树像椿树但味道臭，俗名臭椿）荚二个，完整的人指甲，壮年男子头发三根。用树荚夹住红蠡螺、指甲，用头发缠绕，将发面馒头做成像橘子大小一个，挖开一个孔，去掉中间瓤以便容纳药物。将药物纳入其中，仍将外皮原开的孔封住，用木炭火煨至存性，研成细末，用黄酒半斤炖开，兑入童便半茶盅送服。忌食腥冷食物，避免惊恐、恼怒。此方用过数次都很有效，瘀血开通时必定会出现吐血、衄血以及下血的情况，不必惊恐，过一会儿自然会痊愈。用来治疗月经一次未来的情况尤其有效。
Treats the same syndrome as described previously.
Shuizhi (Leech, *Hirudo nipponica*, 1 liang, not roasted) Sheng Huangqi (Astragali Radix, 1.5 liang) Sheng Sanleng (Sparganii Rhizoma, 5 qian) Sheng Ezhu (Curcumae Rhizoma, 5 qian) Danggui (Angelicae Sinensis Radix, 6 qian) Zhimu (Anemarrhenae Rhizoma, 6 qian)
Sheng Taoren (Persicae Semen, 6 qian, with skin and tip retained)
The above seven herbs are ground into a fine powder together. Honey pills of tung tree seed size are made using refined honey. Take 2 qian with warm water, once in the morning and once in the evening.
Zhang Zhongjing's Didang Tang (Echinops Decoction), Dahuang Zhechong Wan (Rhubarb and Ground Beetle Pill), and Bailao Wan (Bailao Pill) all use Shuizhi (Leech). However, later generations feared its fierce nature and rarely used it; this is due to ignorance of the properties of Shuizhi. The *Shennong Bencao Jing* (Divine Farmer's Materia Medica) states: "Shuizhi has a salty and neutral flavor, is non-toxic, and treats evil blood, stasis, amenorrhea, breaks masses and accumulations, infertility, and promotes urination." Xu Lingtai commented: "When blood stasis in the body is just obstructed but still retains vitality, it is easy to treat; if obstruction lasts long, vitality is completely exhausted, making it difficult to treat. Once blood leaves the vessels, it no longer belongs to the healthy qi. Light medicines will be rejected and not absorbed; overly harsh medicines will damage the unspoiled blood. Thus, treatment is extremely difficult." Shuizhi is best at consuming human blood, and its nature is slow yet adept at penetrating. Its slowness ensures it does not harm new blood; its penetration allows it to easily break hard accumulations. By borrowing its strength to eliminate long-standing stagnation, there is naturally benefit without harm. Observing the text of the *Shennong Bencao Jing* and Xu's commentary, how wonderful are the functions of Shuizhi! However, many people do not understand the principle behind Xu's description of "slow yet adept at penetrating." Generally, Shuizhi moves slowly in water. When acting within fresh blood, it is like being in water, thus not harming new blood. When adhering to human muscle, it sticks closely and penetrates well. When encountering hard accumulations, it acts like it is in muscle, thus breaking them easily. In this formula, Taoren (Persicae Semen) is not stripped of its skin and tip because the red skin enters the blood level, and the tip is the mechanism of growth/vitality, also adept at circulating the qi level. Yang Yuheng mentioned this view in his *Hanwen Tiaobian*. I suspected it might be toxic and did not dare to believe it immediately. I then chewed and swallowed 1 qian of raw Taoren with skin and tip; my heart felt calm and safe. Only after that did I dare to use it with skin and tip. As for using it raw rather than stir-fried: generally, kernels of fruits contain vital energy (shengfa zhi qi), which can be borrowed to circulate spoiled blood. The annotation in *Shennong Bencao Jing Baizhong Lu* says: "Peaches grow by absorbing the harmonious qi of March spring, and their flowers are bright and resemble blood. Therefore, for diseases of blood stasis or blood dryness that cannot be harmonized and circulated freely, this herb can enter and harmonize/disperse them." However, its merit in nourishing new blood is small, while its merit in removing stasis is great. This is because peach pits are not of the blood category and truly cannot provide tonification. If masses consist of spoiled blood, they require vital energy to circulate. The vital energy of the peach lies in the kernel, and its bitter taste can open and drain. Thus, it can expel old blood without injuring new blood. Since it borrows vital energy to circulate qi and blood, it is evident that it should not be stir-fried. If used in pills, steaming it until cooked is also acceptable.
[Attached Formula] Secret Formula for Treating Female Ganxue Lao (Dry Blood Consumption): Use two Hongli Luo (Red Snail/Leech-like insect found inside elm trees, large as silkworms), two pods of Chushu (Tree similar to Toona but with foul odor, commonly known as Chinese Mahogany/Odorous Chinaberry), complete human fingernails, and three hairs from a strong adult male man. Wrap the Hongli Luo and nails with hair, sandwiched between the pods. Take one mantou (steamed bun) made of dough and hair, make a hole in it, remove the inner pulp to accommodate the medicine. Place the medicine inside, seal the original opening with the outer skin. Roast over charcoal fire until the substance remains (preserving efficacy), then grind into a fine powder. Take with half jin of yellow wine heated, mixed with half a teacup of child's urine. Avoid greasy/cold foods, fright, anger, and resentment. This formula has been effective several times. When blood stasis opens up, vomiting blood, epistaxis, and lower bleeding will occur; do not be frightened, and it will heal spontaneously after a while. It is especially effective for treating cases where menstruation has failed to arrive once.