夫心者，主血；肝者，藏血。忧愁思虑则伤心，恚怒气逆上而不下，则伤肝。肝心二
脏伤，故血流散不止，气逆则呕而出血。
唾血者，由伤损肺。肺者，为五脏上盖，易为伤损。若为热气所加，则唾血。唾出如红缕
者，此伤肺也。胁下痛，唾鲜血者，此伤肝也。
此由五脏伤损所为。脏气既伤，则风邪易入，热气在内，亦大便下鲜血而复吐。冷气在
内，亦大便血下，其色如小豆汁，出时疼而不甚痛。前便后下血者，血来远；前下血后便者，
血来近。远近言病在上焦、下焦也。令人面无血色，时寒时热，脉浮弱，按之绝者，下血。
心主于血，与小肠合。若心家有热，结于小肠，故小便血也。下部脉急而弦者，风邪入于
少阴，则尿血；尺脉微而芤，亦尿血。
凡荣卫大虚，腑脏易损，血脉空竭，因而恚怒失节，惊忿过度，暴气逆溢，致令腠理开张，
血脉流散也。言九窍出血，喘咳而上气逆，其脉数有热不得卧者，死。
《原病式》曰∶血溢者，上出也。心养于血，故热甚则血有余而妄行。或谓呕吐紫凝血
为寒者，误也。此非冷凝，由热甚消烁，以为稠浊。而热甚则水化制之，故赤兼黑而为紫也。
衄者，阳热怫郁于足阳明而上热，则血妄行，血衄也。
衄 血污，血出也。污者，浊也。心火热极则血有余，热气上甚则为血溢，热势亢极则燥
而污浊，害承乃制，则血兼黑而为紫也。
血泄，热客下焦而大小便血也。
心主司血液的运行；肝主贮藏血液。忧愁思虑过度会损伤心脏，愤怒导致气机逆乱上行而不能下行，则会损伤肝脏。肝脏和心脏这两脏受到损伤，因此血液流散不止，气机上逆则引发呕吐并伴有出血。
唾血（口中吐出混有血液的唾液），是由于肺部受损所致。肺位于五脏的最上方，如同盖子一样，容易受到损伤。如果受到热邪侵袭，就会出现唾血。唾出的血像红色的丝线一样，这是肺脏受伤的表现。胁肋下方疼痛，吐出鲜红的血液，这是肝脏受伤的表现。
心主管血脉，其征候反映在舌头上。如果心脏有热邪，舌头上的血管就会破裂出血，血流如涌泉般喷涌。
这些症状都是由五脏受损引起的。脏腑之气既然已经受伤，风邪就容易侵入体内，热气蕴结在内，也会导致大便排出鲜血并且伴有呕吐。寒气蕴结在内，也会导致大便下血，血色像豆汁一样，排出时感到疼痛但疼痛程度不剧烈。先排便后出血的，说明病位较远（在上焦）；先出血后排便的，说明病位较近（在下焦）。这里所说的“远近”是指病变部位在上焦还是下焦。使人面色苍白无血色，时而发冷时而发热，脉象浮而弱，重按则感觉不到脉搏的，属于下血证。
心主司血液，与小肠相表里配合。如果心家（心脏）有热邪，热邪结聚在小肠，就会导致小便带血。下部脉象急迫且弦硬的，是风邪侵入少阴经，会导致尿血；尺部脉象微弱且中空（芤脉），也会发生尿血。
凡是营气和卫气严重虚弱，腑脏容易受损，血脉空虚枯竭，再加上因愤怒失去节制，惊吓和愤恨过度，导致暴怒之气逆乱溢满，致使腠理（皮肤毛孔）张开，血脉流散失控。如果出现九窍（眼、耳、鼻、口、前后二阴）出血，气喘咳嗽且气机上逆，脉象数（快）且有热象不能安卧的，预后不良，主死。
肝贮藏血液，心的津液表现为汗。意思是说，当肝脏和心脏同时受到邪气损伤时，血液就会从肌肤腠理间渗出而出。
《原病式》中说：血溢，是指血液向上溢出。心依赖血液来滋养，所以热邪极盛时，血液有余而妄行。有人将呕吐出紫黑色的凝固血液认为是寒证，这是错误的。这并非因为寒冷凝结，而是因为热邪极盛消耗煎熬血液，使其变得稠厚浑浊。而且热邪极盛会克制水气（肾水），所以血色红中带黑而呈现紫色。衄血（鼻出血等），是因为阳热郁结在足阳明胃经，导致上部热盛，血液妄行，形成衄血。
衄，指血污，即血液流出。污，指浊。心火极盛时，血液有余，热气上冲过甚则导致血液外溢，热势亢盛至极则使血液干燥而污浊，等到病情发展到极点受到制约时，血液兼杂黑色而呈现紫色。
The Heart governs the blood; the Liver stores the blood. Excessive worry and overthinking damage the Heart, while anger causing Qi rebellion to ascend without descending damages the Liver. When both the Liver and Heart are damaged, the blood flows and scatters uncontrollably; Qi rebellion leads to vomiting accompanied by bleeding.
Hemoptysis (spitting up blood mixed with saliva) results from damage to the Lung. The Lung is the uppermost cover among the five Zang organs and is easily damaged. If affected by pathogenic heat, hemoptysis occurs. Spitting blood resembling red threads indicates Lung injury. Pain in the hypochondrium accompanied by spitting fresh red blood indicates Liver injury.
The Heart governs the blood vessels and its manifestations are reflected on the tongue. If there is heat in the Heart, blood will bleed from the tongue as if gushing from a spring.
These conditions are caused by damage to the five Zang organs. Once the Qi of the Zang organs is injured, Wind pathogens easily invade, and internal heat can also cause fresh red blood to appear in the stool accompanied by vomiting. Internal cold can also cause blood in the stool, with a color resembling bean juice; it is painful upon discharge but not severely so. Blood appearing after defecation indicates the lesion is distant (in the Upper Jiao); blood appearing before defecation indicates the lesion is near (in the Lower Jiao). "Distant" and "near" refer to lesions in the Upper or Lower Jiao respectively. These symptoms cause a pale complexion, alternating chills and fever, a floating and weak pulse that disappears upon deep pressure, characteristic of lower gastrointestinal bleeding.
The Heart governs blood and pairs with the Small Intestine. If heat accumulates in the Heart and binds to the Small Intestine, it causes hematuria (blood in urine). A rapid and wiry pulse at the lower position indicates Wind pathogen invading the Shaoyin channel, leading to hematuria; a faint and hollow (Kou) pulse at the Chi position also leads to hematuria.
When Ying (Nutritive) and Wei (Defensive) Qi are severely deficient, the Fu and Zang organs become easily damaged, and the blood vessels are emptied. This state, combined with uncontrolled anger, excessive fright and resentment, and violent rebellious Qi overflowing, causes the Couli (skin pores) to open and the blood vessels to scatter uncontrollably. If bleeding occurs from the nine orifices, accompanied by asthma, coughing, Qi rebellion, a rapid pulse with heat, and inability to lie down, the prognosis is fatal.
The Liver stores blood, and the fluid of the Heart manifests as sweat. This means that when both the Liver and Heart are injured by pathogens, blood exudes from the skin and Couli.
The *Yuan Bing Shi* states: "Blood overflow" refers to blood flowing upward. The Heart nourishes itself with blood; thus, when heat is extreme, blood becomes excessive and flows recklessly. Some claim that vomiting purple, coagulated blood indicates cold; this is an error. It is not due to cold condensation, but rather because extreme heat consumes and scorches the blood, making it thick and turbid. Furthermore, extreme heat controls Water (Kidney), so the blood appears red mixed with black, becoming purple. "Nuxue" (epistaxis/nosebleed) occurs when Yang heat stagnates in the Foot-Yangming Stomach channel, causing upper heat and reckless blood flow.
"Nuxue" refers to bloody discharge. "Wu" means turbid. When Heart fire is extreme, blood is excessive; excessive rising heat causes blood overflow. When heat reaches its peak, it dries and turbidifies the blood; when the condition reaches extremity and is controlled, the blood mixes with black to become purple.
"Xixie" (blood leakage) refers to heat lodging in the Lower Jiao, causing blood in both stool and urine.