论曰∶邪热熏于肺则损肺,恚怒气逆伤于肝则损肝,肺肝伤动,令人唾血。如唾中有若
红缕者,属肺;如先苦胁下痛而唾鲜血者,属肝。可析而治之。
治肺气内伤,邪热熏积,咳唾有血。紫菀散方。
紫菀(去苗土) 款冬花 当归(切,焙) 桂(去粗皮) 芎 五味子(炒) 附
子(炮裂,
去皮脐) 细辛(去苗叶) 贝母(去心) 柏叶(炒) 白术 甘草(炙,锉) 生干地
黄(焙) 杏
仁(汤浸去皮尖、双仁,炒各一两)
上一十四味,捣罗为散。每服三钱匕,蜜汤调下,日三服,不拘时。
治肺伤唾血。羊肺汤方。
钟乳粉三两 半夏(生姜同捣作饼,曝干半两) 桂(去粗皮) 白石英(碎) 射干 桃
仁
(汤浸去双仁、皮尖,炒) 贝母(去心) 陈橘皮(去白,焙) 百部(切) 五味子(炒)
款冬
花甘草(炙,锉) 浓朴(去粗皮,生姜汁炙各一两)
上一十三味,粗捣筛。每服三钱匕,先用水二盏,煮羊肺一两,至一盏,去肺入药末,
煎取七分,去滓温服,日三夜一。
治心肺有热,唾血不止。石膏汤方。
石膏二两(碎) 浓朴(去粗皮,涂生姜汁炙) 麻黄(去根节) 五味子(炒一两) 杏
仁(
汤浸去皮尖、双仁,炒)各一两 半夏(生姜汁制,曝干半两) 小麦(洗二合)
上七味,粗捣筛。每服三钱匕,水一盏,生姜三片,同煎至七分,去滓,空心、日午、
夜卧温服。
治肺伤唾血。前胡汤方。
前胡(去芦头二两) 小麦 茅根(锉) 麦门冬(去心,焙) 麻黄(去根节) 石
膏(碎)
甘草(炙,锉各一两)
上七味,粗捣筛。每服三钱匕,水一盏,入生姜汁、生地黄汁各半合,同煎至七分,去
滓温服。
治忧恚气逆,肝气不足,唾血不止。矾石丸方。
矾石(熬令汁枯) 生干地黄(焙) 干姜(炮裂) 桂(去粗皮) 皂荚(炙,剖去
皮并子)
桔梗(锉,炒) 附子(炮裂,去皮脐各一两)
上七味,捣罗为末,炼蜜和丸如梧桐子大。每服二十丸,温水下,日三。
治恚怒伤肝,唾血烦满,胁下痛。阿胶散方。
阿胶(炙令燥二两) 甘草(炙,锉一两)
上二味,捣罗为散。每服三钱匕,以水一盏,入生地黄汁二合,煎至七分,和滓温服,
不拘时。
治肺热唾血。白前汤方。
白前 桑根白皮(锉) 桔梗(锉,炒二两) 甘草(炙,锉一两)
上四味,粗捣筛。每服三钱匕,水一盏,煎至七分,去滓,不拘时温服。
治肺肝内伤,卒唾血。生地黄饮方。
生地黄(二十两捣绞取汁) 阿胶(二两每片如两指大)
上二味,每以胶一片,入地黄汁一盏内,饭甑蒸之,取出放温。旋服。
治忧恚伤肝唾血,胸胁疼痛。地黄煎方。
生地黄汁(五升)
上一味,于银石器内,慢火煎至三升,入白蜜一盏,酒一盏,再煎至三升,每食后温服
半盏。
治唾血不止。蒲黄散方。
蒲黄(一两)
上一味,研细。每服三钱匕,冷水调下,不拘时候。
论述说:邪热熏蒸于肺,就会损伤肺脏;愤怒导致气机逆乱,就会损伤肝脏。肺和肝受到损伤,就会导致人唾血。如果唾液中带有像红线一样的血丝,病位属于肺;如果先感到胁下疼痛,随后吐出鲜红的血液,病位属于肝。可以据此分析并分别治疗。
治疗肺气内伤,邪热积聚,咳嗽吐痰带血。紫菀散方。
紫菀(去除苗土) 款冬花 当归(切片,焙干) 桂枝(去除粗皮) 川芎 五味子(炒) 附子(炮制裂开,去皮和脐) 细辛(去苗叶) 贝母(去心) 侧柏叶(炒) 白术 甘草(炙,锉碎) 生干地黄(焙干) 杏仁(用汤浸泡去皮尖、双仁,炒,各一两)
以上十四味药,捣碎过筛成散剂。每次服用三钱匕,用蜜水调服,每日三次,不限时间。
治疗肺脏受伤导致的唾血。羊肺汤方。
钟乳粉三两 半夏(与生姜同捣做成饼状,晒干半两) 桂枝(去除粗皮) 白石英(捣碎) 射干 桃仁(用汤浸泡去双仁、皮尖,炒) 贝母(去心) 陈皮(去白,焙干) 百部(切片) 五味子(炒) 款冬花 甘草(炙,锉碎) 厚朴(去除粗皮,用生姜汁炙,各一两)
以上十三味药,粗捣后筛选。每次服用三钱匕,先用二盏水煮一两羊肺,煮至一盏时,去掉羊肺加入药末,煎取七分,去渣温服,白天三次,夜间一次。
治疗心肺有热,唾血不止。石膏汤方。
石膏二两(捣碎) 厚朴(去除粗皮,涂生姜汁炙) 麻黄(去根节) 五味子(炒一两) 杏仁(用汤浸泡去皮尖、双仁,炒)各一两 半夏(用生姜汁处理,晒干半两) 小麦(洗净二合)
以上七味药,粗捣后筛选。每次服用三钱匕,用水一盏,生姜三片,同煎至七分,去渣,空腹、中午、睡前温服。
治疗肺脏受伤导致的唾血。前胡汤方。
前胡(去芦头二两) 小麦 茅根(锉碎) 麦门冬(去心,焙干) 麻黄(去根节) 石膏(捣碎) 甘草(炙,锉碎各一两)
以上七味药,粗捣后筛选。每次服用三钱匕,用水一盏,加入生姜汁、生地黄汁各半合,同煎至七分,去渣温服。
治疗因忧愤气机逆乱,肝气不足,导致唾血不止。矾石丸方。
矾石(熬至汁液枯干) 生干地黄(焙干) 干姜(炮制裂开) 桂枝(去除粗皮) 皂荚(炙,剖开去皮和子) 桔梗(锉碎,炒) 附子(炮制裂开,去皮和脐各一两)
以上七味药,捣碎过筛成粉末,用炼蜜调和制成梧桐子大小的丸剂。每次服用二十丸,温水送下,每日三次。
治疗因愤怒伤肝,导致唾血、烦闷胀满、胁下疼痛。阿胶散方。
阿胶(炙至干燥二两) 甘草(炙,锉碎一两)
以上两味药,捣碎过筛成散剂。每次服用三钱匕,用水一盏,加入生地黄汁二合,煎至七分,连同药渣一起温服,不限时间。
治疗肺热导致的唾血。白前汤方。
白前 桑白皮(锉碎) 桔梗(锉碎,炒二两) 甘草(炙,锉碎一两)
以上四味药,粗捣后筛选。每次服用三钱匕,用水一盏,煎至七分,去渣,不限时间温服。
治疗肺肝内伤,突然唾血。生地黄饮方。
生地黄(二十两捣碎绞取汁) 阿胶(二两,每片如两指大)
以上两味药,每次取一片阿胶,放入一盏地黄汁中,在饭甑上蒸熟,取出放温。随时服用。
治疗因忧愤伤肝导致唾血,胸胁疼痛。地黄煎方。
生地黄汁(五升)
以上一味药,在银或石器皿中,用慢火煎至三升,加入白蜜一盏,酒一盏,再煎至三升,每次饭后温服半盏。
Commentary states: When pathogenic heat steams the Lung, it damages the Lung; when anger causes Qi rebellion, it damages the Liver. Damage to the Lung and Liver leads to expectoration of blood. If the sputum contains thread-like red streaks, the pathology belongs to the Lung; if there is pain in the hypochondrium preceding the expectoration of bright red blood, the pathology belongs to the Liver. Treatment can be differentiated accordingly.
For Lung Qi internal injury with accumulation of pathogenic heat, resulting in coughing and expectoration of blood. Ziwan San (Aster Powder) Formula.
Ziwan (Radix Asteris, cleaned of seedlings and soil) Kuaodonghua (Flos Hederae Helixis) Danggui (Radix Angelicae Sinensis, sliced, dried by baking) Guizhi (Ramulus Cinnamomi, bark removed) Xiong (Radix Chuanxiong) Wuweizi (Fructus Schisandrae Chinensis, stir-fried) Fuzi (Radix Aconiti Lateralis Preparata, cracked by processing, skin and umbilicus removed) Xixin (Herba Asari, seedlings and leaves removed) Beimu (Bulbus Fritillariae Cirrhosae, heart removed) Baye (Cacumen Platycladi, stir-fried) Baizhu (Rhizoma Atractylodis Macrocephalae) Gancao (Radix Glycyrrhizae Uralensis, honey-fried, cut into pieces) Shenggan Dihuang (Radix Rehmanniae Preparata, dried by baking) Xingren (Semen Pruni Armeniacae, soaked in water, skin and tip removed, double kernels removed, stir-fried, each one tael).
The above fourteen ingredients are crushed, sifted, and made into a powder. Take three qianbi per dose, mixed with honey water, taken three times daily, at any time.
For expectoration of blood due to Lung injury. Yangfei Tang (Sheep Lung Decoction) Formula.
Zhongrufen (Concha Ostreae Pulveratum) Banxia (Rhizoma Pinelliae Preparata, pounded together with fresh ginger into cakes, dried, half a tael) Guizhi (Ramulus Cinnamomi, bark removed) Baishiyin (Quartzum Album, crushed) Shegan (Rhizoma Belamcandae) Taoren (Semen Persicae, soaked in water, double kernels and tips removed, stir-fried) Beimu (Bulbus Fritillariae Cirrhosae, heart removed) Chenpi (Pericarpium Citri Reticulatae, white pith removed, dried by baking) Bubu (Herba Stemonae) Wuweizi (Fructus Schisandrae Chinensis, stir-fried) Kuaodonghua (Flos Hederae Helixis) Gancao (Radix Glycyrrhizae Uralensis, honey-fried, cut into pieces) Houpo (Cortex Magnoliae Officinalis, bark removed, processed with fresh ginger juice, each one tael).
The above thirteen ingredients are coarsely crushed and sifted. Take three qianbi per dose. First, boil one tael of sheep lung in two liang of water until reduced to one liang. Remove the lung, add the powdered herbs, and decoct until seven parts remain. Strain and take warm, three times during the day and once at night.
For heat in the Heart and Lung causing persistent expectoration of blood. Shigao Tang (Gypsum Decoction) Formula.
Shigao (Gypsum Fibrosum, crushed, two taels) Houpo (Cortex Magnoliae Officinalis, bark removed, processed with fresh ginger juice) Mahuang (Herba Ephedrae, roots and joints removed) Wuweizi (Fructus Schisandrae Chinensis, stir-fried, one tael) Xingren (Semen Pruni Armeniacae, soaked in water, skin and tip removed, double kernels removed, stir-fried, each one tael) Banxia (Rhizoma Pinelliae Preparata, processed with fresh ginger juice, dried, half a tael) Xiaomai (Fructus Tritici Levis, washed, two he).
The above seven ingredients are coarsely crushed and sifted. Take three qianbi per dose with one liang of water and three slices of fresh ginger. Decoct until seven parts remain, strain, and take warm on an empty stomach, at noon, and before sleep.
For expectoration of blood due to Lung injury. Qianhu Tang (Peucedani Radix Decoction) Formula.
Qianhu (Radix Peucedani, rhizome removed, two taels) Xiaomai (Fructus Tritici Levis) Maogen (Radix Imperatae, cut into pieces) Maimendong (Radix Ophiopogonis, heart removed, dried by baking) Mahuang (Herba Ephedrae, roots and joints removed) Shigao (Gypsum Fibrosum, crushed) Gancao (Radix Glycyrrhizae Uralensis, honey-fried, cut into pieces, each one tael).
The above seven ingredients are coarsely crushed and sifted. Take three qianbi per dose with one liang of water, adding half he of fresh ginger juice and fresh Rehmannia root juice. Decoct until seven parts remain, strain, and take warm.
For expectoration of blood persisting due to emotional distress causing Qi rebellion and deficiency of Liver Qi. Fanshi Wan (Alum Pill) Formula.
Fanshi (Alumen, boiled until juice is dry) Shenggan Dihuang (Radix Rehmanniae Preparata, dried by baking) Jiangjiang (Rhizoma Zingiberis Preparata, cracked by processing) Guizhi (Ramulus Cinnamomi, bark removed) Zhaojiao (Fructus Gleditsiae Sinensis, roasted, split, skin and seeds removed) Jiegeng (Radix Platycodonis, cut into pieces, stir-fried) Fuzi (Radix Aconiti Lateralis Preparata, cracked by processing, skin and umbilicus removed, each one tael).
The above seven ingredients are crushed, sifted into powder, and mixed with refined honey to form pills the size of Sophora japonica seeds. Take twenty pills per dose with warm water, three times daily.
For expectoration of blood, irritability, fullness, and hypochondriac pain due to anger damaging the Liver. Ejiao San (Donkey-Hide Gelatin Powder) Formula.
Ejiao (Corium Corii Asini, honey-fried until dry, two taels) Gancao (Radix Glycyrrhizae Uralensis, honey-fried, cut into pieces, one tael).
The above two ingredients are crushed, sifted, and made into a powder. Take three qianbi per dose with one liang of water and two he of fresh Rehmannia root juice. Decoct until seven parts remain, mix with the dregs, and take warm, at any time.
For expectoration of blood due to Lung heat. Baiqian Tang (Cynanchi Stauntonii Radix Decoction) Formula.
Baiqian (Radix Cynanchi Stauntonii) Sangbaipi (Cortex Mori Radicis, cut into pieces) Jiegeng (Radix Platycodonis, cut into pieces, stir-fried, two taels) Gancao (Radix Glycyrrhizae Uralensis, honey-fried, cut into pieces, one tael).
The above four ingredients are coarsely crushed and sifted. Take three qianbi per dose with one liang of water. Decoct until seven parts remain, strain, and take warm, at any time.
For sudden expectoration of blood due to internal injury of the Lung and Liver. Shengdihuang Yin (Fresh Rehmannia Root Drink) Formula.
Shengdihuang (Radix Rehmanniae Recens, twenty taels, crushed and juiced) Ejiao (Corium Corii Asini, two taels, each piece as large as two fingers).
The above two ingredients: take one piece of gelatin per dose, place it in one liang of Rehmannia root juice, steam in a rice steamer, remove, and let cool to warm temperature. Take as needed.
For expectoration of blood and chest/hypochondriac pain due to emotional distress damaging the Liver. Dihuang Jian (Rehmannia Decoction) Formula.
Shengdihuangzhi (Jucius Radicis Rehmanniae Recens, five sheng).
The above single ingredient is slowly decocted in a silver or ceramic vessel from five sheng to three sheng. Add one zhan of white honey and one zhan of wine, then decoct again until three sheng remain. Take half a zhan warm after meals.
For persistent expectoration of blood. Puhuang San (Pollen Typhae Powder) Formula.
Puhuang (Pollen Typhae, one tael).
The above single ingredient is ground into fine powder. Take three qianbi per dose mixed with cold water, at any time.