夫血外行于经络,内荣于脏腑。若气血损伤,经络则虚。血行失于常理,气逆者吐血。
又怒则气逆,甚则呕血。然忧思、惊恐、内伤、气逆,火载血上,错经妄行,皆吐血也。
与男子吐血门参看处治,用药则一也。兹惟切要数方而已。
鸡苏散 治妇人吐血,烦心,昏闷。
鸡苏叶(一钱) 阿胶 刺苏 生地黄(各一钱) 黄 羚羊角屑 茜根 甘草 伏龙肝
麦门冬 当归 黄芩(各五分)
上咀,水盏半,姜三片、竹茹一弹丸,煎七分,温服。
鸡苏煎 治妇人虚损,气逆不止。
鸡苏叶 黄芩(各八分) 当归 赤芍药(各五分) 伏龙肝 阿胶(各一钱)
上咀,水煎服。
五汁煎 治妇人热毒上攻,吐血不止。
生藕汁 刺苏汁 生地黄汁(各三两) 生姜汁 白蜜(一合)
上和匀,煎数沸,无时以小盏调炒面尘一钱服。
养生方 治妇人虚劳,吐血、衄血、下白,自汗。
黄 白芍药 甘草(各一钱) 熟地黄(三钱)
上咀,水、酒各一盏,煎七分,食前温服。
四生丸 治吐血、衄血,阳乘于阴,血热妄行,宜服此药。
生荷叶 生艾叶 生柏叶 生地黄(各等分)
上烂研,丸如鸡子大。每服一丸,水三盏,煎一盏,无时服
犀角地黄汤 治内有瘀血,鼻衄,吐血,面黄,大便黑。
干姜甘草汤 治阴乘于阳,呕血,服凉血药不效用此。(二方并见前吐血门。)
青饼子 治咯血。
青黛(一两) 杏仁(一两,以牡蛎粉炒,去皮尖用)
上一处同研成膏,熔黄蜡和作三十饼子。各服一饼,用干柿半个夹定,以湿纸包煨令香,
同嚼,粥饮下无时。
千金方 治吐血,百药不效,此方如神。
地黄汁(半升) 生大黄末(方寸匕)
上煎地黄汁三、五服,调大黄末,令作三服。
龙肝散 治同前。
伏龙肝(即灶心土,研极细)
每服二钱,新汲水调下,频服取效。以上方皆治热甚者。
血液在经络中运行,向内滋养脏腑。如果气血受损,经络就会虚弱。血液运行失去常理,气机上逆就会导致吐血。
另外,愤怒会导致气机逆乱,严重时会出现呕血。然而,忧愁思虑、惊恐、内伤以及气机逆乱,导致火邪挟带血液上行,血液错乱妄行,这些都是吐血的原因。
治疗方法与男子吐血门参看处置相同,用药也是一样的。这里只列出几个关键的方剂。
鸡苏散:治疗妇人吐血,心烦,昏闷。
鸡苏叶(一钱) 阿胶 刺苏 生地黄(各一钱) 黄芪 羚羊角屑 茜根 甘草 伏龙肝
麦门冬 当归 黄芩(各五分)
以上药物切碎,用一碗半水,加入生姜三片、竹茹一个弹丸大小,煎至七分,温服。
鸡苏煎:治疗妇人虚损,气逆不止。
鸡苏叶 黄芩(各八分) 当归 赤芍药(各五分) 伏龙肝 阿胶(各一钱)
以上药物切碎,用水煎服。
五汁煎:治疗妇人热毒上攻,吐血不止。
生藕汁 刺苏汁 生地黄汁(各三两) 生姜汁 白蜜(一合)
混合均匀,煮沸数次,随时用小碗调取炒面灰一钱服用。
养生方:治疗妇人虚劳,吐血、鼻出血、白带多,自汗。
黄芪 白芍药 甘草(各一钱) 熟地黄(三钱)
以上药物切碎,用水和酒各一盏,煎至七分,饭前温服。
四生丸:治疗吐血、鼻出血,阳邪乘于阴分,血热妄行,适宜服用此药。
生荷叶 生艾叶 生柏叶 生地黄(各等分)
以上药物捣烂研细,制成如鸡蛋大小的丸子。每次服用一丸,用水三盏,煎至一盏,随时服用。
犀角地黄汤:治疗体内有瘀血,鼻出血,吐血,面色黄,大便黑。
干姜甘草汤:治疗阴邪乘于阳分,呕血,服用凉血药无效时使用。(这两个方剂均见前面的吐血门。)
青饼子:治疗咯血。
青黛(一两) 杏仁(一两,用牡蛎粉炒,去皮尖使用)
以上一起研磨成膏,熔化黄蜡调和做成三十个饼子。每次服用一个饼子,用半个干柿子夹住,用湿纸包裹煨烤至香,一同咀嚼,用米粥饮送下,随时服用。
千金方:治疗吐血,各种药物无效时,此方如神效。
地黄汁(半升) 生大黄末(一方寸匕)
以上煎煮地黄汁,分三到五次服用,调入大黄末,分为三次服用。
龙肝散:治疗同前。
伏龙肝(即灶心土,研极细)
每次服用二钱,用新汲水调服,频繁服用以取效。以上方剂都是治疗热证严重的情况。
Blood circulates externally in the meridians and collaterals (Jingluo) and internally nourishes the Zang-Fu organs. If Qi and Blood are damaged, the meridians and collaterals become deficient. When blood circulation deviates from normal physiology, rebellious Qi leads to hematemesis (vomiting blood).
Furthermore, anger causes Qi rebellion, which in severe cases results in vomiting blood. However, sorrow, overthinking, fright, internal injury, and Qi rebellion can cause Fire to carry blood upward, leading to erratic and reckless blood flow; all these conditions manifest as hematemesis.
The treatment principles refer to those for male patients with hematemesis, and the medicinal prescriptions are identical. Here, only a few essential formulas are listed.
Jisu San (Chicken Su Powder): Treats women with hematemesis, mental restlessness (Fanxin), and dizziness/obscuration.
* Jisuye (Leonurus Herba leaf, 1 qian)
* Ejiao (Donkey-hide Gelatin)
* Cisui (Leonurus japonicus herb)
* Shengdihuang (Rehmanniae Radix, fresh, 1 qian)
* Huangqi (Astragali Radix)
* Lingyangjiaoxie (Saiga Tataricae Cornu, shaved)
* Qiangen (Rubiae Radix et Rhizoma)
* Gancao (Glycyrrhizae Radix et Rhizoma)
* Fulonggan (Caulis Longii Cineratus)
* Maimendong (Ophiopogonis Radix)
* Danggui (Angelicae Sinensis Radix)
* Huangqin (Scutellariae Radix) (each 5 fen)
Crush the herbs. Decoct with 1.5 bowls of water, adding 3 slices of Shengjiang (Zingiberis Rhizoma Recens) and one pill-sized amount of Zhuru (Bambusae Caulis in Taeniam). Decoct until 0.7 remains, and take warm.
Jisu Jian (Chicken Su Decoction): Treats women with deficiency-damage and unremitting rebellious Qi.
* Jisuye (Leonurus Herba leaf)
* Huangqin (Scutellariae Radix) (each 8 fen)
* Danggui (Angelicae Sinensis Radix)
* Chishaoyao (Paeoniae Radix Rubra) (each 5 fen)
* Fulonggan (Caulis Longii Cineratus)
* Ejiao (Donkey-hide Gelatin) (each 1 qian)
Crush the herbs and decoct with water to take.
Wuzhi Jian (Five Juices Decoction): Treats women with attacking Heat-Toxin causing unremitting hematemesis.
* Sheng'ou zhi (Fresh Lotus Rhizome Juice)
* Cisui zhi (Leonurus japonicus Juice)
* Shengdihuang zhi (Rehmanniae Radix Fresh Juice) (each 3 liang)
* Shengjiang zhi (Zingiberis Rhizoma Recens Juice)
* Baimi (Apis Mellifera Honey) (1 he)
Mix evenly, boil a few times. Take 1 qian of fried flour ash mixed with a small cup, at any time.
Yangsheng Fang (Nourishing Life Formula): Treats women with consumptive disease (Xu Lao), hematemesis, epistaxis (Nuxue), leukorrhea (Xia Bai), and spontaneous sweating.
* Huangqi (Astragali Radix)
* Baishaoyao (Paeoniae Radix Alba)
* Gancao (Glycyrrhizae Radix et Rhizoma) (each 1 qian)
* Shudihuang (Rehmanniae Radix Praeparata) (3 qian)
Crush the herbs. Decoct with 1 bowl of water and 1 bowl of wine until 0.7 remains. Take warm before meals.
Sisheng Wan (Four Raw Pills): Treats hematemesis and epistaxis caused by Yang invading Yin, with reckless blood flow due to Blood-Heat. This formula is suitable.
* Shengheyeye (Nelumbinis Nelumbo Leaf, fresh)
* Sheng'aiye (Artemisiae Argyi Folium, fresh)
* Shengbaiye (Platycladi Cacumen, fresh)
* Shengdihuang (Rehmanniae Radix, fresh) (equal parts)
Mash and grind finely, form pills the size of a chicken egg. Take one pill per dose, decoct with 3 bowls of water until 1 bowl remains. Take at any time.
Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction): Treats intra-abdominal Blood stasis, epistaxis, hematemesis, sallow complexion, and black stool.
Ganjiang Gancao Tang (Dried Ginger and Licorice Decoction): Treats Yin invading Yang, vomiting blood, used when cooling-blood medicines are ineffective. (Both formulas are found in the preceding Hematemesis section.)
Qingbingzi (Green Cake): Treats hemoptysis (coughing up blood).
* Qingdai (Indigo Naturalis) (1 liang)
* Xingren (Pruni Armeniaci Semen) (1 liang, stir-fried with Ostmum Pulvis, remove skin and tips)
Grind together into a paste, mix with melted Huangla (Beeswax) to make thirty cakes. Take one cake per dose. Wrap half a dried persimmon around it, wrap in wet paper, and bake/roast until fragrant. Chew together and swallow with millet drink at any time.
Qianjin Fang (Thousand Gold Formula): Treats hematemesis when other medicines fail; this formula is miraculous.
* Dihuang zhi (Rehmanniae Radix Juice) (0.5 sheng)
* Sheng Dahuang mo (Rhei Radix et Rhizoma powder, fresh) (one cun bi measure)
Decoct the Dihuang zhi, divide into three to five doses. Mix with Dahuang mo, divide into three doses.
Longgan San (Dragon Liver Powder): Treats the same as above.
* Fulonggan (Caulis Longii Cineratus, i.e., Hearth Earth, ground extremely fine)
Take 2 qian per dose, mixed with fresh drawn water. Take frequently until effective. The above formulas all treat severe Heat conditions.