论曰∶《内经》言,藏真通于心,血脉之气行焉。又曰,肝藏血,人卧血归于肝。盖血
虽藏于肝,而心则行之也。若肝心二脏俱伤于邪,故血随心液为汗而出。
治肝心伤邪,血汗。人参汤方。
人参 桂(去粗皮) 甘草(炙,锉) 白 赤芍药(各一两) 黄芩(去黑心) 芎
当
归
上九味,粗捣筛。每服七钱匕,水一盏,煎至七分,去滓温服,不拘时。
治血汗从肤腠出。神白散方。
人中白
上一味,不拘多少,刮在新瓦上,用火逼干,研令极细。每服二钱匕,入麝香少许,温
酒调下。
治血汗。如圣散方。
郁李仁(去皮尖)
上一味,研细。每服一钱匕,研鹅梨汁调下。
治血汗,鼻衄不断。吹鼻散方。
人中白
上一味,瓦上焙干,研为细末。每以少许吹入鼻中,立瘥。
治吐血或汗血尿血。竹茹汤方
淡竹茹 人参 芍药 桔梗(锉炒) 生干地黄(焙) 当归(切焙) 甘草(炙锉) 桂
(去粗皮) 芎 (各一两)
上九味。粗捣筛。每服五钱匕。水一盏半。煎至一盏。去滓不拘时温服。
论曰内经谓脾移热于肝,则为惊衄,盖脾土也,肝木也,土本畏木,今脾移热于肝,则
是土气反盛,热往乘木,肝所藏者血,其神为魂,虚热胜之,故惊而衄也,从春至夏者为太
阳衄,从秋至冬者为阳明衄,巢元方曰,寸口微芤者衄,寸脉微苦寒为衄,寸脉微弱,尺脉
涩,发热,而弱为无血、必厥。其人微呕,夫厥当眩,不眩而反头痛,痛为实,下虚上实必
衄,凡是之类,皆其脉也,孙思邈曰,鼻头白者亡血,设令微赤,非时者死,病患色白皆亡
血也,凡时行衄不宜断之,如一二升以上恐多者,即以龙骨末吹之,凡是之类,皆其候也,
以至九窍血俱出者,谓之大衄,胆移热于脑,热盛则阳络溢,阳络溢则衄血血汗者,谓之衄
,治之各有方论。
论述说:《内经》提到,五脏的真气通于心,血脉之气随之运行。又说,肝藏血,人卧睡时血液回归于肝。大概血液虽然储藏于肝,但由心来推动运行。如果肝、心两脏同时受到邪气损伤,那么血液就会随着汗液从体表排出。
治疗肝、心受邪导致的血汗证,用人参汤方。
人参、桂枝(去除粗皮)、甘草(炙烤,切碎)、白芍药、赤芍药(各一两)、黄芩(去除黑心部分)、川芎、当归。
以上九味药,捣碎并过粗筛。每次服用七钱匕,用水一盏,煎煮至七分满,去渣后温服,不拘时间。
治疗血汗从皮肤腠理排出的神白散方。
人中白。
以上一味药,不限数量,刮在崭新的瓦片上,用火烘烤至干,研磨成极细的粉末。每次服用二钱匕,加入少许麝香,用温酒调服。
治疗血汗的如圣散方。
郁李仁(去除皮和尖)。
以上一味药,研磨细。每次服用一钱匕,用鹅梨汁调和送服。
治疗血汗且鼻衄不止的吹鼻散方。
人中白。
以上一味药,在瓦片上焙干,研磨为细末。每次取少量吹入鼻中,立即痊愈。
治疗吐血或汗血、尿血的竹茹汤方。
淡竹茹、人参、芍药、桔梗(切碎炒制)、生干地黄(焙干)、当归(切片焙干)、甘草(炙烤切碎)、桂枝(去除粗皮)、川芎(各一两)。
以上九味药,捣碎并过粗筛。每次服用五钱匕,用水一盏半,煎煮至一盏满,去渣后不拘时间温服。
论述说:《内经》称脾将热邪转移给肝,就会出现惊悸和鼻衄。这是因为脾属土,肝属木,土本来畏惧木,现在脾将热邪移交给肝,则是土气反而强盛,热气乘袭肝木。肝所藏的是血,其神志为魂,虚热胜过了正气,所以出现惊悸和鼻衄。从春季到夏季发生的称为太阳衄,从秋季到冬季发生的称为阳明衄。巢元方说,寸口脉微而芤是鼻衄的征象;寸脉微弱伴有恶寒是鼻衄;寸脉微弱,尺脉涩,发热而脉弱,这是无血的表现,必定会出现厥逆。病人轻微呕吐,厥逆应当眩晕,如果不眩晕反而头痛,疼痛属实证,下虚上实必定导致鼻衄。凡是这些情况,都是相关的脉象。孙思邈说,鼻头色白的人亡失血液,假如微微发红,非正常时节出现的则主死,病患面色苍白都是亡血的表现。凡是流行病期间的鼻衄不宜强行止住,如果出血量在一二升以上恐怕过多,就用龙骨末吹入鼻中。凡是这些情况,都是相关的症候。至于九窍都出血的,称为大衄。胆将热邪转移给脑,热盛则阳络溢出,阳络溢出则导致衄血、血汗,这都称为衄,治疗各有方论。
Discourse states: The *Neijing* (Inner Canon) mentions that the true qi of the zang organs connects to the Heart, and the qi of the blood vessels flows accordingly. It also states that the Liver stores blood, and when a person lies down, blood returns to the Liver. Generally, although blood is stored in the Liver, it is propelled by the Heart. If both the Liver and Heart are injured by pathogenic factors, blood will exit along with sweat from the body surface.
To treat blood sweating caused by injury to the Liver and Heart by pathogens, use Renshen Tang (Ginseng Decoction).
Renshen (Ginseng Radix et Rhizoma), Guizhi (Cinnamon Twig, removed coarse bark), Gancao (Licorice Root, roasted and chopped), Baishao (White Peony Root), Chishao (Red Peony Root) (each 1 liang), Huangqin (Scutellaria Root, removed black heart), Xiong (Ligusticum Rhizome), Danggui (Angelica Sinensis Root).
The above nine ingredients are coarsely pounded and sifted. Each dose consists of 7 qianbi, boiled in one dan of water until reduced to 0.7 dan. Strain and take warm, at any time.
To treat blood sweating exiting from the skin and interstices, use Shenbai San (Divine White Powder).
Renzhongbai (Calcinata Aluminis).
One ingredient, quantity unspecified. Scrape onto a new tile and dry over fire, then grind into an extremely fine powder. Each dose is 2 qianbi, mixed with a small amount of Shexiang (Musk) and taken with warm wine.
To treat blood sweating, use Rusheng San (Like-Sage Powder).
Yuliren (Prunus Armeniaca Seed, removed peel and tip).
One ingredient, ground finely. Each dose is 1 qianbi, taken with juice from Goose Pear (Pyrus ussuriensis Maxim.).
To treat blood sweating and continuous nosebleed, use Chuibi San (Blowing Nose Powder).
Renzhongbai (Calcinata Aluminis).
One ingredient, baked on a tile until dry, ground into a fine powder. Apply a small amount into the nose each time; recovery is immediate.
To treat hematemesis or blood sweating and hematuria, use Zhuru Tang (Bamboo Shavings Decoction).
Dan Zhuru (Bamboo Shavings), Renshen (Ginseng Radix et Rhizoma), Shaoyao (Peony Root), Jiegeng (Platycodon Root, chopped and stir-fried), Sheng Gan Dihuang (Rehmanniae Radix Preparata, dried and roasted), Danggui (Angelica Sinensis Root, sliced and roasted), Gancao (Licorice Root, roasted and chopped), Guizhi (Cinnamon Twig, removed coarse bark), Xiong (Ligusticum Rhizome) (each 1 liang).
The above nine ingredients are coarsely pounded and sifted. Each dose is 5 qianbi, boiled in 1.5 dan of water until reduced to 1 dan. Strain and take warm, at any time.
Discourse states: The *Neijing* says that if Spleen heat transfers to the Liver, it results in palpitations and nosebleeds. This is because the Spleen belongs to Earth and the Liver to Wood; Earth naturally fears Wood. Now, if Spleen heat transfers to the Liver, Earth qi becomes excessive, and heat attacks Wood. The Liver stores blood, and its spirit is Hun (Ethereal Soul). When deficient heat prevails, it causes palpitations and nosebleeds. Those occurring from Spring to Summer are called Taiyang nosebleeds; those from Autumn to Winter are called Yangming nosebleeds. Chao Yuanfang stated that a faint and cunkou pulse indicates nosebleed; a faint cunkou pulse with aversion to cold indicates nosebleed; a faint cunkou pulse, choppy chi pulse, fever, and weak pulse indicate blood deficiency and必然 lead to Jue (cold extremities). The patient may have slight vomiting. Jue should involve dizziness; if there is no dizziness but instead headache, the pain indicates excess. Lower deficiency and upper excess inevitably lead to nosebleeds. All such cases relate to these pulses. Sun Simiao said that a white nasal tip indicates loss of blood; if slightly red out of season, death ensues. Patients with pale complexions all suffer from blood loss. In epidemic diseases, nosebleeds should not be forcibly stopped. If bleeding exceeds one or two sheng, causing concern for excessive loss, Longgu (Fossilized Bones) powder can be blown into the nose. All such cases relate to these signs. As for bleeding from all nine orifices, it is called Da Nu (Major Nosebleed). If Gallbladder heat transfers to the Brain, excessive heat causes overflow of Yang collaterals. Overflow of Yang collaterals leads to Nu blood and blood sweating, collectively termed Nu. Treatments vary according to specific formulas and discourses.