论曰伤寒病在表，当汗不汗，邪无所出，热结在里，皆成瘀血，然太阳病不解，热结膀
胱，其人如狂者，少腹硬满，小便自利，下血乃愈，又阳明病其人喜忘者，木有瘀血，大便
虽硬反易，其色必黑，凡病患腹不满，其人自言满者，亦为瘀血在里，皆宜下之，使瘀血得
下即愈，诊其脉沉结者，瘀血之病也。
治伤寒阳明证，其人喜忘者，必有蓄血，所以然者，本有瘀血，故令喜忘，大便虽硬反
易，其色必黑，宜抵当汤方
水蛭（三十枚熬） 虻虫（三十枚去翅足炒） 桃仁（二十一枚去皮尖麸炒） 大黄（一
两酒洗锉炒）
上四味，锉如麻豆大，以水五盏，煮取三盏，去滓温服一盏，不下更服。
治伤寒太阳病不解，热结膀胱，其人如狂，血自下者愈，其外不解者，尚未可攻，当先
解其外，外已解，但少腹急结者，乃可攻之，宜桃仁承气汤方
桃仁（汤去皮尖双仁十二枚） 大黄（锉一两） 桂（去粗皮半两） 甘草（炙半两） 芒
硝（半两）
上五味，先锉四味如麻豆大，以水三盏，煎取一盏半，去滓下芒硝，再煎数沸，分温三
服，以微利为度，未利移时再服。
治伤寒八九日至十二日，病不解，发热如狂，少腹满闷，其脉沉结，内有瘀血，桃仁丸
方桃仁（汤浸去皮尖双仁微炒研细） 水蛭（粳米同炒微焦用） 虻虫（各一分去翅足
炒） 大黄（生锉一两）
上四味，除桃仁，捣罗为细末，入桃仁同研匀，炼蜜为丸，如梧桐子大，每服二十丸，
煎桃仁汤下，如人行五七里，瘀血下为效，未下再服。
治伤寒太阳病，随经入里，瘀热内积，蓄血喜忘如狂，大黄芍药汤方
大黄（锉炒半两） 芍药 牡丹皮 犀角（镑屑各一两） 生干地黄（一两半）
上五味，锉如麻豆大，每服五钱匕，用水二盏，煎取一盏，去滓温服。
治伤寒数日不得汗，内有蓄血，芍药汤方
芍药 牡丹皮（各一两） 生干地黄（一两半） 犀角（镑屑一两）
上四味，粗捣筛，每服三钱匕，用水一盏半，煎至八分，去滓食后温服。
治伤寒及温病，应发汗而不发，内有蓄血，及鼻衄吐血不尽，内余瘀血，面黄大便黑，
芍药地黄汤方
芍药（三分） 牡丹皮（二两） 犀角（镑屑一两） 地黄（二两）
上三味，锉如麻豆大，每服三钱匕，用水一盏，煎至七分，去滓下生地黄汁三合，搅令
匀，食后温服，如狂者，加黄芩一两，去黑心用
治伤寒内有瘀血，大便不利，小腹急痛，大黄汤方
大黄（锉炒一两） 桃仁（汤浸去皮尖双仁麸炒黄研半两） 水蛭（米炒黄一分） 木
通（半两锉）
上四味，除桃仁外，粗捣筛，入桃仁同研令匀，每服二钱匕，以水一盏，煎至七分，去
滓温服，不计时候。
论述说：伤寒病邪在体表，应当发汗却未发汗，导致邪气没有出路，热邪结聚在体内，都会形成瘀血。然而，如果太阳病未能解除，热邪结聚在膀胱，患者出现神志恍惚如狂的症状，小腹部坚硬胀满，但小便通畅自如，只有排出瘀血才能痊愈；另外，如果是阳明病，患者喜欢遗忘（健忘），这是因为体内有瘀血，大便虽然干硬反而容易排出，颜色必定发黑。凡是病人腹部并不胀满，却自己诉说胀满的，也是瘀血在体内的表现，这些都适宜用攻下法治疗，使瘀血排出即可痊愈。诊察其脉象沉而结滞的，是瘀血的病证。
治疗伤寒阳明证，患者喜欢遗忘的，必定有蓄血。之所以这样，是因为原本就有瘀血，所以导致健忘。大便虽然干硬反而容易排出，颜色必定发黑，适宜使用抵当汤方。
水蛭（三十枚，熬制） 虻虫（三十枚，去除翅足后炒制） 桃仁（二十一枚，去皮尖，用麸皮炒制） 大黄（一两，酒洗后锉碎炒制）
以上四味药，锉成类似麻子和豆粒的大小，用水五盏，煮取三盏，去掉药渣，温服一盏，如果瘀血未下，再服用。
治疗伤寒太阳病未能解除，热邪结聚在膀胱，患者出现神志恍惚如狂的症状，如果瘀血能自行排出则痊愈；如果表证仍未解除，尚不可攻里，应当先解表，表证解除后，如果仅剩下小腹部急迫结痛，才可以攻里，适宜使用桃仁承气汤方。
桃仁（汤浸去皮尖，双仁者十二枚） 大黄（锉碎一两） 桂枝（去除粗皮半两） 甘草（炙制半两） 芒硝（半两）
以上五味药，先将前四味锉成类似麻子和豆粒的大小，用水三盏，煎取一盏半，去掉药渣后加入芒硝，再煮沸数次，分三次温服，以轻微腹泻为度，如果未通利，过一段时间再服用。
治疗伤寒病程从八天到十二天，病邪未解，发热且神志如狂，小腹部胀闷，脉象沉而结滞，体内有瘀血，适宜使用桃仁丸方。
桃仁（汤浸去皮尖，双仁者微炒后研细） 水蛭（与粳米同炒至微焦后使用） 虻虫（各一分，去除翅足后炒制） 大黄（生锉一两）
以上四味药，除去桃仁，将其他药物捣碎过筛成细末，加入桃仁一同研磨均匀，用炼蜜制成梧桐子大小的丸剂，每次服用二十丸，煎煮桃仁汤送服，大约行走五七里路的时间，如果瘀血下行即为有效，若未下行可再服用。
治疗伤寒病邪随经络入里，瘀热内积，蓄血导致健忘、神志如狂，适宜使用大黄芍药汤方。
大黄（锉碎炒制半两） 芍药 牡丹皮 犀角（镑成屑，各一两） 生干地黄（一两半）
以上五味药，锉成类似麻子和豆粒的大小，每次服用五钱匕，用水二盏，煎取一盏，去掉药渣温服。
治疗伤寒数日不得发汗，体内有蓄血，适宜使用芍药汤方。
芍药 牡丹皮（各一两） 生干地黄（一两半） 犀角（镑成屑一两）
以上四味药，粗捣筛过，每次服用三钱匕，用水一盏半，煎至八分，去掉药渣饭后温服。
治疗伤寒及温病，应当发汗而未发汗，体内有蓄血，以及鼻出血、吐血不尽，体内残留瘀血，面色发黄、大便发黑，适宜使用芍药地黄汤方。
芍药（三分） 牡丹皮（二两） 犀角（镑成屑一两） 地黄（二两）
以上三味药，锉成类似麻子和豆粒的大小，每次服用三钱匕，用水一盏，煎至七分，去掉药渣后加入新鲜地黄汁三合，搅拌均匀，饭后温服。如果出现神志如狂的症状，加黄芩一两，去心后使用。
治疗伤寒体内有瘀血，大便不通利，小腹部急痛，适宜使用大黄汤方。
大黄（锉碎炒制一两） 桃仁（汤浸去皮尖，双仁者麸炒黄后研半两） 水蛭（米炒黄一分） 木通（半两，锉碎）
以上四味药，除桃仁外，其余粗捣筛过，加入桃仁一同研磨均匀，每次服用二钱匕，用水一盏，煎至七分，去掉药渣温服，不限时间。
Commentary states: When pathogenic factors of Shanghan (Cold Damage) are in the exterior, sweating should be induced. If sweating is not performed, the pathogen has no outlet, heat becomes constrained within, and all result in blood stasis. However, if Taiyang disease (disease of the Bladder channel) is unresolved, heat constrains in the Bladder, the patient appears manic-like, with hardness and fullness in the lower abdomen, yet urination is normal; only after bleeding does the condition resolve. Furthermore, in Yangming disease (disease of the Stomach and Large Intestine channels), if the patient suffers from forgetfulness, it is due to blood stasis; although the stool is hard, it is surprisingly easy to pass, and its color must be black. In any case where a patient's abdomen is not distended but they complain of fullness, this also indicates blood stasis within; all such cases are suitable for purgation therapy, and the condition resolves once the blood stasis is expelled. If the pulse is deep and knotted, it indicates a disease of blood stasis.
To treat Yangming syndrome of Shanghan where the patient suffers from forgetfulness, there must be accumulated blood. The reason is that blood stasis already existed, causing forgetfulness. Although the stool is hard, it is easy to pass, and its color is black. Diding Tang (Diding Decoction) is indicated.
Shuizhi (Hirudo, thirty pieces, roasted) Mengchong (Ophryognathia, thirty pieces, wings and legs removed, roasted) Taoren (Prunus persica seed, twenty-one pieces, skin and tip removed, bran-roasted) Dahuang (Rhei Radix et Rhizoma, one liang, wine-washed, cut, and roasted)
The above four herbs are cut into sizes similar to hemp seeds and beans. Boil in five sheng of water until three sheng remain, strain, and take one sheng warm. If the blood stasis is not expelled, administer again.
To treat unresolved Taiyang disease of Shanghan where heat constrains in the Bladder, causing manic-like behavior: if blood discharges spontaneously, the patient recovers. If the exterior syndrome is still unresolved, internal attack is not yet permissible; first resolve the exterior. Once the exterior is resolved, if only urgency and binding pain in the lower abdomen remain, then attack internally. Tao Ren Cheng Qi Tang (Tao Ren Decoction for Directing Downward) is indicated.
Taoren (Prunus persica seed, twelve double-kernel pieces, soaked in water, skin and tip removed) Dahuang (Rhei Radix et Rhizoma, cut, one liang) Gui (Cinnamomi Ramulus, bark removed, half liang) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, half liang) Mangxiao (Natrii Sulfas, half liang)
The above five herbs: first cut the first four into sizes similar to hemp seeds and beans. Boil in three sheng of water until one and a half sheng remain, strain, add Mangxiao, boil briefly, divide into three warm doses. Take until slight loose stools occur. If no loosening occurs, wait a while and take again.
To treat Shanghan persisting from eight to twelve days without resolution, presenting with fever and manic-like behavior, lower abdominal fullness, and a deep, knotted pulse indicating internal blood stasis, Tao Ren Wan (Tao Ren Pill) is indicated.
Taoren (Prunus persica seed, soaked in water, skin and tip removed, double-kernel, lightly roasted and finely ground) Shuizhi (Hirudo, stir-fried with rice grains until slightly scorched) Mengchong (Ophryognathia, each one fen, wings and legs removed, roasted) Dahuang (Rhei Radix et Rhizoma, raw, cut, one liang)
The above four herbs: excluding Taoren, pound and sieve the others into fine powder. Mix with Taoren and grind evenly. Form pills using refined honey, sized like sophora seeds. Take twenty pills per dose, washed down with decocted Tao Ren soup. After walking approximately five to seven li, if blood stasis is expelled, it is effective. If not, take again.
To treat Shanghan where pathogens enter the interior via the channels, accumulating heat and blood stasis, causing forgetfulness and manic-like behavior, Da Huang Shao Yao Tang (Da Huang and Peony Decoction) is indicated.
Dahuang (Rhei Radix et Rhizoma, cut, fried, half liang) Shaoyao (Paeoniae Radix) Mudanpi (Moutan Cortex) Xijiao (Rhinocerotis Cornu, shaved into flakes, each one liang) Shenggan Dihuang (Rehmanniae Radix Preparata, one and a half liang)
The above five herbs are cut into sizes similar to hemp seeds and beans. Take five qianbi per dose, boil in two sheng of water until one sheng remains, strain, and take warm.
To treat Shanghan persisting for several days without sweating, with internal accumulated blood, Shao Yao Tang (Peony Decoction) is indicated.
Shaoyao (Paeoniae Radix) Mudanpi (Moutan Cortex, each one liang) Shenggan Dihuang (Rehmanniae Radix Preparata, one and a half liang) Xijiao (Rhinocerotis Cornu, shaved into flakes, one liang)
The above four herbs are coarsely crushed and sifted. Take three qianbi per dose, boil in one and a half sheng of water until eight-tenths remain, strain, and take warm after meals.
To treat Shanghan and Wenbing (Warm Diseases) where sweating should have been induced but was not, resulting in internal accumulated blood, or where epistaxis and hematemesis were incomplete leaving residual internal blood stasis, manifesting as yellowish complexion and black stool, Shao Yao Di Huang Tang (Peony and Rehmannia Decoction) is indicated.
Shaoyao (Paeoniae Radix, three fen) Mudanpi (Moutan Cortex, two liang) Xijiao (Rhinocerotis Cornu, shaved into flakes, one liang) Dihuang (Rehmanniae Radix, two liang)
The above three herbs are cut into sizes similar to hemp seeds and beans. Take three qianbi per dose, boil in one sheng of water until seven-tenths remain, strain, add three he of fresh Dihuang juice, mix well, and take warm after meals. If manic-like symptoms occur, add Huangqin (Scutellariae Radix, one liang), removing the dark heart.
To treat Shanghan with internal blood stasis, difficult defecation, and urgent lower abdominal pain, Da Huang Tang (Da Huang Decoction) is indicated.
Dahuang (Rhei Radix et Rhizoma, cut, fried, one liang) Taoren (Prunus persica seed, soaked in water, skin and tip removed, double-kernel, bran-roasted yellow, ground, half liang) Shuizhi (Hirudo, stir-fried with rice until yellow, one fen) Mutong (Akebiae Caulis, half liang, cut)
The above four herbs: excluding Taoren, coarsely crush and sift the others. Add Taoren and grind evenly. Take two qianbi per dose, boil in one sheng of water until seven-tenths remain, strain, and take warm at any time.