〔大〕妇人吐血者，皆由脏腑伤损所致。夫血者外行于经络，内荣于脏腑。若伤损气
血经络，则血虚行失于常理，气逆者吐血，又怒则气逆，甚则呕血，然忧思惊恐内伤，气
逆上者，皆吐血也。
〔薛〕前证若脾经郁热，用犀角地黄汤。脾胃伏暑，用黄连香薷饮。（杂病伤暑。）心脾郁
热，用生地黄汤。心气耗损，用茯苓补心汤。肺气劳伤，用鸡苏散。思虑伤脾，用归脾汤。
（杂病健忘。）暴怒肝火，用加味小柴胡汤。（热入血室。）久怒肝伤，六味地黄丸。（杂病虚劳。）脾肺
虚热，用麦门冬饮。肝肾虚热，用六味地黄丸。气血俱虚，用十全大补汤。经云∶肺朝
百脉之气，肝统诸经之血。必用甘温之剂，补其阳气，使血各归其经。如大吐血病，毋论
其脉，急用独参汤救之。若潮热咳嗽而脉数者，元气虚而假热之脉也，皆由脾胃先损，须
用人参之类。《本草》云∶人参治脾胃不足，补中，温中，泻脾肺中火。东垣先生云∶脾
胃虚者，心火亢甚而乘土位，肺气受邪，须用黄 最多，人参、甘草次之。脾胃一虚，肺
气先绝，故用黄 以益皮毛而闭腠理，当治气血虚弱，用十全大补最善，若用寒凉止血，
胃气反伤，无不致祸。一老妇每作先饮食不进，或胸膈不利，或中脘作痛，或大便作
泻，或小便不利，余以为肝脾之证，用逍遥散加山栀、茯神、远志、木香而愈。后郁结
吐紫血，每作先倦怠烦热，以前药加炒黑黄连三分、吴茱萸二分，顿愈。复因怒吐赤血
甚多，燥渴垂死，此血脱也，法当补气。乃用人参一两，苓、术、当归各三钱，陈皮、炮
黑干姜各二钱，炙甘草、木香各一钱，一剂顿止。又用加味归脾汤调理而痊。一女子
怀抱素郁，胸满食少，吐血面赤，用六味丸及归脾加山栀、贝母、芍药而愈。一妇人
为哭母吐血咳嗽，发热盗汗，经水不行，此悲伤肺，思伤脾，朝服补中益气汤（杂病劳倦。）加
桔梗、贝母、知母。夕用归脾汤吞六味丸而愈。
鸡苏散 治妇人吐血，心烦昏闷。
鸡苏叶（一两） 阿胶 刺苏 生地黄（各一两） 黄 羚羊角屑 茜根 甘草（各半两）
麦门冬 黄芩 当归 伏龙肝（各七钱半）
上为粗末，每服四钱，水一盏，姜三片，竹茹半鸡子大，煎至六分，去滓温服。
又方 治妇人虚损气逆，吐血不止。
鸡苏叶 黄芩（各一两） 当归 赤芍药（各半两） 伏龙肝 阿胶（各二两）
上为粗末，每服四钱，水一盏，煎六分，去滓温服。
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（半合） 白蜜（一合）
上和煎三两沸，以一小盏，调炒面一钱服，无时。
《千金翼》治吐血百方不瘥，疗十十瘥，神验不传方。（详此药性，治热毒吐血有效。）
地黄汁（半升） 生大黄末（一方寸匕）
上煎地黄汁三两沸，调大黄末令匀，分为三服。
又方 伏龙肝研极细，每服二钱，新汲水调下，频服取效。
又方 白茅根（一握，长六寸，）以水一大盏，煎七分，去滓服。
又方 桂心（为末） 水调方寸匕，日夜可二十服。
又方 生地黄（三升切） 阿胶（二两，炒） 蒲黄（六合）
以水五升，煮取三升，分三服。予尝
治一人吐血，诊其脉，肝部弦，气口濡，此因怒极而得之。遂用苏合香丸和鸡苏丸服，即
效。《养生必用方》云∶凡吐血须煎干姜甘草汤与服，或四物、理中汤亦可，如此无不愈
者。服生地黄、竹茹、藕汁，去生便远。
柔脾汤 治虚劳吐血、衄血，下白、汗出方。（出《养生必用》）
甘草 白芍药 黄 （各一两） 熟地黄（三两）
上为末，每服四钱，水酒各一盏以上，煎至七分，去滓取清汁六分，温服，食前。
予尝治一女人，年十九岁，月经不行，以药通之，遂妄行而呕血，诸药不效。察其人肥，
脉不大不小，投以四生丸即安。又治一男子，因饱低头负重吐血，诸药无效，亦投四
生丸及青饼子即安，更不发。尝观初虞世治吐血，不喜用竹茹、生地黄、藕汁，然亦
不可拘泥此说。如阳乘于阴，血得热则流散，经水沸溢。宜服凉药以解之，大黄、犀角、生
地黄、生艾、藕汁等，岂得无效。若阴乘于阳，所谓天寒地冻，水凝成冰，宜服温药以
暖之，干姜、肉桂，岂能无功。学人更宜思之。
四生丸 疗吐血。凡吐血、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，煎到一盏，去滓温服，无时候。陈日华云∶
先公绍兴初，游福沟灵石寺，主僧留饭，食将竟，侍者赴堂斋罢来侍立，见桌子不稳，急
罄折稳之，举首即呕血，盖食饱拗伤肺也。明年再到寺，问旧年呕血者无恙否？主僧云∶得
四生丸服之愈。自得此方，屡施有验。
〔薛〕愚意前证乃内热暴患，用之有效。若人病久本原不足，须补脾以滋化源，否则
虚火上炎，金反受克，获生鲜矣。
疗热甚呕血者，以犀角地黄汤、《局方》小三黄汤，以白茅根煎浓汤饮之极妙。
犀角地黄汤 治内有瘀血，鼻衄吐血，面黄，大便黑。
芍药（七钱半） 生地黄（半斤） 牡丹皮（去心净，一两） 犀角屑（一两，如无，以川升麻代）
上 咀，每服五钱，水煎服。有热如狂者，加黄芩二两。
青饼子 治咯血。
青黛 杏仁（各一两，华佗方以牡蛎粉炒杏仁，去皮尖，牡蛎不用）
上一处同研成膏，熔黄蜡和作三十饼子，每服一饼子，用干柿半个夹定，以湿纸裹，煨
令香，同嚼，粥饮下，无时。
干姜甘草汤 若阴乘于阳，心肺经寒而呕血者宜服。
甘草 干姜（各半两）
上 咀，水煮顿服。《局方》理中汤亦妙。
花蕊石散 予尝见一妇人苦此疾，百药不效，以童子小便和酒，调下真花蕊石散，不
数服而愈。
乌金散 治吐血不已，每服二钱，米饮下。（即催生如神散，方见后。）
济生鸡苏散 治劳伤肺经，唾中有血，咽喉不利。
鸡苏叶 黄 （炒） 生地黄 阿胶（炒） 贝母 白茅根（各一钱） 桔梗（炒）
麦门冬（去心） 蒲黄（炒） 甘草（炙，各五分）
上姜水煎服。
生地黄散 治郁热衄血咯血吐血，阴虚而不能愈者。
枸杞子 柴胡 黄连（炒） 地骨皮 天门冬（去心） 白芍药 甘草（炒）
黄芩（炒） 黄 （炒） 生地黄 熟地黄（自制，各五分）
上水煎服。下血，加地榆。
三因茯苓补心汤 治面色黄悴，五心烦热，咳嗽血。
半夏 前胡 紫苏 茯苓 人参 枳壳（麸炒） 桔梗（炒） 甘草（炒） 干葛（各五分）
当归 川芎 陈皮 白芍药（各一钱） 熟地黄（自制，一钱半）
上姜枣水煎服。
麦门冬饮子 治气虚吐血，或气虚不能摄血。
五味子（杵，十个） 麦门冬（去心） 黄 （炒，各一钱） 当归身 人参 生地黄（各半钱）
上水煎服。
十全大补汤 治胃气虚弱，吐血衄血，便血不止，以致外证恶寒发热，自汗盗汗，食
少体倦。或寒热作渴，头疼眩晕，而似中风。或气血俱虚，胸腹胁痛。或骨节作痛，经候
不调。或寒热往来，发热晡热，或五心发热，咽干舌燥，或痰嗽喘促，胸膈虚痞。或呕吐
泄泻，手足冷热等证。（方见杂病虚劳门。）
【戴元礼】妇女吐血，都是由于脏腑受损引起的。血液在经络中运行，在内滋养脏腑。如果损伤了气血和经络，就会导致血虚且运行失去常理；气机上逆则引起吐血，发怒会使气机更加上逆，严重时甚至呕吐出血。然而，忧愁、思虑、惊恐等内伤因素导致气机上逆的，也都属于吐血的范畴。
【薛己】上述病症如果是脾经郁热所致，使用犀角地黄汤。脾胃有伏暑，使用黄连香薷饮。（参见杂病伤暑篇。）心脾郁热，使用生地黄汤。心气耗损，使用茯苓补心汤。肺气劳伤，使用鸡苏散。思虑损伤脾气，使用归脾汤。（参见杂病健忘篇。）暴怒导致肝火旺盛，使用加味小柴胡汤。（参见热入血室篇。）久怒导致肝体受损，使用六味地黄丸。（参见杂病虚劳篇。）脾肺虚热，使用麦门冬饮。肝肾虚热，使用六味地黄丸。气血俱虚，使用十全大补汤。医经说：肺朝百脉而主气，肝统摄诸经之血。必须使用甘温的药物，补益阳气，使血液各归其经脉。如果是大量吐血的患者，不论其脉象如何，应立即使用独参汤来急救。如果有潮热、咳嗽且脉数，这是元气虚弱导致的假热脉象，都因为脾胃先已受损，必须用人参之类的药物。《本草》记载：人参治疗脾胃不足，补益中气，温中，清泻脾肺之火。李东垣先生说：脾胃虚弱的人，心火亢盛而乘袭土位，肺气受邪，需要重用黄芪，人参、甘草次之。脾胃一旦虚弱，肺气首先衰竭，所以用黄芪来补益皮毛并固密腠理。应当治疗气血虚弱，使用十全大补汤最为适宜。如果使用寒凉药物止血，反而会损伤胃气，没有不造成祸患的。
有一位老妇人每次发病前饮食不进，或者胸膈不畅，或者中脘疼痛，或者大便泄泻，或者小便不利。我认为这是肝脾的病症，使用逍遥散加入山栀、茯神、远志、木香，治愈了。后来因郁结而吐出紫黑色的血，每次发病前先感到倦怠烦热，用前面的药方加入炒黑的黄连三分、吴茱萸二分，立刻痊愈。后来又因发怒吐出大量赤色血液，燥渴濒危，这是血脱的症状，治法应当补气。于是使用人参一两，茯苓、白术、当归各三钱，陈皮、炮黑干姜各二钱，炙甘草、木香各一钱，服用一剂后出血立刻停止。之后又用加味归脾汤调理而康复。
有一位女子平素怀抱抑郁，胸满食少，吐血面赤，使用六味丸及归脾汤加入山栀、贝母、芍药，治愈了。
有一位妇人因为哭丧母亲而吐血咳嗽，发热盗汗，月经停止。这是悲伤肺气，思虑伤脾。早晨服用补中益气汤（参见杂病劳倦篇）加入桔梗、贝母、知母。晚上服用归脾汤吞服六味地黄丸，治愈了。
鸡苏散：治疗妇女吐血，心烦昏闷。
药材：鸡苏叶（一两）、阿胶、刺苏、生地黄（各一两）、黄芪、羚羊角屑、茜根、甘草（各半两）、麦门冬、黄芩、当归、伏龙肝（各七钱半）。
制法与用法：以上药物捣成粗末，每次服用四钱，加水一盏，生姜三片，竹茹半个鸡蛋大小，煎至六分，去渣温服。
又一方：治疗妇女虚损气逆，吐血不止。
药材：鸡苏叶、黄芩（各一两）、当归、赤芍药（各半两）、伏龙肝、阿胶（各二两）。
制法与用法：以上药物捣成粗末，每次服用四钱，加水一盏，煎至六分，去渣温服。
治疗妇女热毒上攻，吐血不止。
药材：生藕汁、刺苏汁、生地黄汁（各三两）、生姜汁（半合）、白蜜（一合）。
制法与用法：混合在一起煎煮三沸，取一小盏，调拌炒面粉一钱服用，不限时间。
《千金翼方》：治疗吐血各种方法无效者，此方疗效极高，是神验且不传方的秘方。（根据药性分析，治疗热毒吐血有效。）
药材：地黄汁（半升）、生大黄末（一方寸匕）。
制法与用法：将地黄汁煎煮三沸，调入大黄末使其均匀，分为三次服用。
又一方：伏龙肝研成极细粉末，每次服用二钱，用新汲水调服，频繁服用以见效。
又一方：白茅根（一握，长六寸），用水一大盏，煎至七分，去渣服用。
又一方：桂心（研为末），用水调服一方寸匕，白天黑夜可服用二十次。
又一方：生地黄（三升，切碎）、阿胶（二两，炒）、蒲黄（六合）。
制法与用法：用水五升，煮取三升，分三次服用。我曾治疗一人吐血，诊察其脉象，肝部脉弦，气口脉濡，这是因为极度愤怒所致。于是使用苏合香丸配合鸡苏丸服用，立即见效。
《养生必用方》说：凡是吐血都需要煎干姜甘草汤服用，或者四物汤、理中汤也可以，这样没有不愈的。服用生地黄、竹茹、藕汁，离健康就远了。
柔脾汤：治疗虚劳吐血、鼻衄，下白浊、出汗的方子。（出自《养生必用方》）
药材：甘草、白芍药、黄芪（各一两）、熟地黄（三两）。
制法与用法：以上药物研为末，每次服用四钱，用水和酒各一盏以上，煎至七分，去渣取清汁六分，饭前温服。
我曾治疗一位十九岁的女子，月经不行，用药通经后，月经妄行并呕血，各种药物无效。观察她身体肥胖，脉象不大不小，投予四生丸即安顿。又治疗一名男子，因饱食后低头负重而吐血，各种药物无效，也投予四生丸及青饼子即安顿，不再复发。我曾观察初虞世治疗吐血，不喜欢使用竹茹、生地黄、藕汁，但也不可拘泥于这种说法。如果阳邪乘袭阴分，血液受热则流散，如同经水沸腾溢出。宜服用凉药来解除，大黄、犀角、生地黄、生艾、藕汁等，难道会无效吗？如果阴邪乘袭阳分，所谓天寒地冻，水凝成冰，宜服用温药来温暖它，干姜、肉桂，难道能没有功效吗？学习中医的人更应深思。
四生丸：治疗吐血。凡是吐血、鼻衄，阳乘于阴，血热妄行，宜服用此药。
药材：生荷叶、生艾叶、生柏叶、生地黄（各等分）。
制法与用法：以上药物捣烂研丸，如鸡蛋大小，每次服用一丸，用水三盏，煎至一盏，去渣温服，不限时候。陈日华说：他的父亲在绍兴初年，游览福沟灵石寺，住持僧留他吃饭。饭快吃完时，侍者参加完堂斋回来侍立，见桌子不稳，急忙弯腰扶稳桌子，抬头时即呕吐出血，这是因为吃饱饭后弯腰扭伤了肺。第二年再次到寺里，问去年呕血的人是否安好？住持僧说：得到四生丸服用后痊愈了。自从获得这个方子，多次施用都有验证。
【薛己】我意上述病症乃是内热突然发作，使用此方有效。如果病人患病日久，本原不足，必须补脾以滋生化之源，否则虚火上炎，金（肺）反而受克，获救的机会就很少了。
治疗热甚呕血者，用犀角地黄汤、《局方》小三黄汤，用白茅根煎浓汤饮用极好。
犀角地黄汤：治疗内有瘀血，鼻衄吐血，面色黄，大便黑。
药材：芍药（七钱半）、生地黄（半斤）、牡丹皮（去心净，一两）、犀角屑（一两，如果没有，可用川升麻代替）。
制法与用法：以上药物切碎，每次服用五钱，水煎服。如果有热像发狂的症状，加黄芩二两。
青饼子：治疗咯血。
药材：青黛、杏仁（各一两，华佗方是用牡蛎粉炒杏仁，去皮尖，不用牡蛎）。
制法与用法：以上药物一起研磨成膏，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，煨至香，同嚼碎，粥饮送下，不限时间。
干姜甘草汤：如果阴乘于阳，心肺经寒而呕血者宜服。
药材：甘草、干姜（各半两）。
制法与用法：以上药物切碎，水煮一次服完。《局方》理中汤也很好。
花蕊石散：我曾见过一位妇人苦于此疾，百药无效，用童子小便和酒，调服真花蕊石散，没几服就痊愈了。
乌金散：治疗吐血不止，每次服用二钱，米饮送下。（即催生如神散，方见后文。）
济生鸡苏散：治疗劳伤肺经，唾中有血，咽喉不利。
药材：鸡苏叶、黄芪（炒）、生地黄、阿胶（炒）、贝母、白茅根（各一钱）、桔梗（炒）、麦门冬（去心）、蒲黄（炒）、甘草（炙，各五分）。
制法与用法：以上药物用姜水煎服。
生地黄散：治疗郁热导致的衄血、咯血、吐血，阴虚而不能愈者。
药材：枸杞子、柴胡、黄连（炒）、地骨皮、天门冬（去心）、白芍药、甘草（炒）、黄芩（炒）、黄芪（炒）、生地黄、熟地黄（自制，各五分）。
制法与用法：以上药物水煎服。如果有下血症状，加地榆。
三因茯苓补心汤：治疗面色黄悴，五心烦热，咳嗽带血。
药材：半夏、前胡、紫苏、茯苓、人参、枳壳（麸炒）、桔梗（炒）、甘草（炒）、干葛（各五分）、当归、川芎、陈皮、白芍药（各一钱）、熟地黄（自制，一钱半）。
制法与用法：以上药物用姜枣水煎服。
麦门冬饮子：治疗气虚吐血，或气虚不能摄血。
药材：五味子（杵，十个）、麦门冬（去心）、黄芪（炒，各一钱）、当归身、人参、生地黄（各半钱）。
制法与用法：以上药物水煎服。
十全大补汤：治疗胃气虚弱，吐血衄血，便血不止，以致出现外证恶寒发热，自汗盗汗，食少体倦。或者寒热作渴，头疼眩晕，类似中风。或者气血俱虚，胸腹胁痛。或者骨节作痛，月经不调。或者寒热往来，午后发热，或者五心发热，咽干舌燥，或者痰嗽喘促，胸膈虚痞。或者呕吐泄泻，手足冷热等症状。（方剂见杂病虚劳门。）
[ Dai Yuanli ] Hematemesis in women is caused by damage to the Zang-Fu organs. Blood circulates externally in the meridians and nourishes internally the Zang-Fu organs. If the Qi, blood, and meridians are damaged, blood deficiency occurs and its circulation deviates from normal principles; upward rebellion of Qi leads to hematemesis. Anger causes Qi to rebel upwards, and severely, it may lead to vomiting blood. However, internal injuries caused by sorrow, overthinking, and fright, which result in upward rebellion of Qi, also fall under the category of hematemesis.
[ Xue Ji ] For the aforementioned conditions: if caused by stagnant heat in the Spleen Meridian, use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction). If there is latent summerheat in the Stomach and Spleen, use Huanglian Xiangru Yin (Coptis and Elsholtzia Decoction) [refer to Miscellaneous Diseases: Summerheat Injury]. If there is stagnant heat in the Heart and Spleen, use Shengdihuang Tang (Rehmannia Decoction). If Heart Qi is depleted, use Fuling Buxin Tang (Poria and Heart-Nourishing Decoction). If Lung Qi is injured by consumption, use Jisu San (Elsholtzia Powder). If overthinking injures the Spleen Qi, use Guipi Tang (Spleen-Restoring Decoction) [refer to Miscellaneous Diseases: Forgetfulness]. If violent anger causes Liver Fire to flare up, use Jiawei Xiaochaihu Tang (Modified Minor Bupleurum Decoction) [refer to Heat Entering the Blood Chamber]. If prolonged anger injures the Liver substance, use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) [refer to Miscellaneous Diseases: Consumption Deficiency]. If there is deficient heat in the Spleen and Lungs, use Maidong Yin (Ophiopogon Drink). If there is deficient heat in the Liver and Kidneys, use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia). If both Qi and Blood are deficient, use Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction). The Classics state: "The Lung governs Qi and directs all vessels; the Liver controls the blood of all meridians." One must use sweet-warm agents to tonify Yang Qi, causing blood to return to its respective vessels. In cases of massive hematemesis, regardless of the pulse, immediately use Dushen Tang (Single Ginseng Decoction) for emergency rescue. If there is tidal fever, cough, and a rapid pulse, this indicates a false heat pulse due to deficiency of Yuan Qi (Original Qi), stemming from prior damage to the Spleen and Stomach; one must use herbs like Ren Shen (Ginseng). The Materia Medica states: "Ren Shen treats insufficiency of the Spleen and Stomach, tonifies the Middle, warms the Middle, and drains fire from the Spleen and Lungs." Mr. Li Dongyuan stated: "In cases of Spleen and Stomach deficiency, Heart Fire becomes hyperactive and attacks the Earth position, affecting Lung Qi; Huang Qi (Astragalus) should be used most heavily, followed by Ren Shen and Gan Cao (Licorice)." Once the Spleen and Stomach are deficient, Lung Qi fails first; thus, Huang Qi is used to benefit the skin and hair and close the interstices. To treat Qi and Blood deficiency, Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction) is best. Using cold-cooling hemostatic agents will instead damage Stomach Qi, inevitably leading to disaster.
I once treated an elderly woman who, before each episode, had poor appetite, chest and diaphragm discomfort, epigastric pain, diarrhea, or dysuria. I diagnosed this as a Liver-Spleen disorder and prescribed Xiaoyao San (Free and Easy Wanderer Powder) with Shan Zhi (Gardenia), Fu Shen (Poria with Hostwood), Yuan Zhi (Polygala), and Mu Xiang (Aucklandia), resulting in a cure. Later, due to emotional constraint, she vomited dark purple blood. Before each episode, she felt fatigued and irritable with heat. I added Chao Hei Huang Lian (Stir-fried Black Coptis) 3 fen and Wu Zhu Yu (Evodia) 2 fen to the previous formula, achieving immediate relief. Subsequently, due to anger, she vomited a large amount of bright red blood, becoming dry-thirsty and near death. This was Blood Depletion; the method requires tonifying Qi. I used Ren Shen (Ginseng) 1 liang, Fu Ling (Poria), Bai Zhu (Atractylodes), and Dang Gui (Angelica) each 3 qian, Chen Pi (Tangerine Peel) and Pao Hei Gan Jiang (Charred Dried Ginger) each 2 qian, Zhi Gan Cao (Honey-fried Licorice) and Mu Xiang (Aucklandia) each 1 qian. One dose stopped the bleeding immediately. She was then regulated with Jiawei Guipi Tang (Modified Spleen-Restoring Decoction) and recovered.
I treated a young woman with chronic depression, chest fullness, poor appetite, hematemesis, and flushed face. She was cured using Liuwei Wan (Six-Ingredient Pill) combined with Guipi Tang (Spleen-Restoring Decoction) plus Shan Zhi (Gardenia), Bei Mu (Fritillaria), and Shao Yao (Peony).
I treated a woman who suffered hematemesis and cough after weeping for her mother, accompanied by fever, night sweats, and amenorrhea. This was Sadness injuring the Lung and Overthinking injuring the Spleen. She took Buchong Yiqi Tang (Tonifying the Middle and Augmenting Qi Decoction) [refer to Miscellaneous Diseases: Fatigue] with Jie Geng (Platycodon), Bei Mu (Fritillaria), and Zhi Mu (Anemarrhena) in the morning, and Guipi Tang (Spleen-Restoring Decoction) swallowing Liuwei Wan (Six-Ingredient Pill) in the evening, resulting in a cure.
Jisu San (Elsheteria Powder): Treats hematemesis in women with vexation and dizziness.
Ingredients: Jisu Ye (Elsheteria Leaf) (1 liang), Ejiao (Donkey-hide Gelatin), Cisuo (Perilla), Sheng Dihuang (Fresh Rehmannia Root) (each 1 liang), Huang Qi (Astragalus), Lingyangjiao Xie (Antelope Horn Shavings), Qian Gen (Madder Root), Gan Cao (Licorice) (each 0.5 liang), Maidong (Ophiopogon), Huang Qin (Scutellaria), Dang Gui (Angelica), Fulonggan (Draconite) (each 0.75 liang).
Preparation and Administration: Coarsely powder the above ingredients. Take 4 qian per dose, add 1 cup of water, 3 slices of fresh ginger, and bamboo shavings equivalent to half an egg yolk. Decoct until reduced to 60%, strain, and take warm.
Another Prescription: Treats deficiency injury with rebellious Qi and continuous hematemesis in women.
Ingredients: Jisu Ye (Elsheteria Leaf), Huang Qin (Scutellaria) (each 1 liang), Dang Gui (Angelica), Chi Shaoyao (Red Peony Root) (each 0.5 liang), Fulonggan (Draconite), Ejiao (Donkey-hide Gelatin) (each 2 liang).
Preparation and Administration: Coarsely powder the above ingredients. Take 4 qian per dose, add 1 cup of water. Decoct until reduced to 60%, strain, and take warm.
Treats hematemesis caused by heat-toxin attacking upwards in women.
Ingredients: Sheng Ou Zhi (Fresh Lotus Root Juice), Cisuo Zhi (Perilla Juice), Sheng Dihuang Zhi (Fresh Rehmannia Juice) (each 3 liang), Sheng Jiang Zhi (Fresh Ginger Juice) (0.5 he), Bai Mi (White Honey) (1 he).
Preparation and Administration: Mix and boil three times. Take a small cup, mix with 1 qian of stir-fried flour, and consume at any time.
Qianjin Yi Fang (Supplement to the Essential Prescriptions Worth a Thousand Gold): A miraculous, secret prescription for hematemesis refractory to hundred treatments, claiming ten cures out of ten. (Based on properties, effective for heat-toxin hematemesis.)
Ingredients: Dihuang Zhi (Rehmannia Juice) (0.5 sheng), Sheng Dahuang Mo (Raw Rhubarb Powder) (one square-inch spoonful).
Preparation and Administration: Boil Dihuang Zhi (Rehmannia Juice) three times, mix evenly with Dahuang Mo (Rhubarb Powder), divide into three doses.
Another Prescription: Grind Fulonggan (Draconite) to an extremely fine powder. Take 2 qian per dose, mix with fresh well-water, and take frequently until effective.
Another Prescription: Ba Mao Gen (Imperata Rhizome) (one handful, 6 cun long). Decoct in 1 cup of water until reduced to 70%, strain, and drink.
Another Prescription: Guixin (Cinnamon Bark) (powdered). Mix with water, take one square-inch spoonful. Can be taken up to 20 times day and night.
Another Prescription: Sheng Dihuang (Fresh Rehmannia Root) (3 sheng, chopped), Ejiao (Donkey-hide Gelatin) (2 liang, stir-fried), Puhuang (Typha Pollen) (6 he).
Preparation and Administration: Add 5 sheng of water, decoct to obtain 3 sheng, divide into three doses. I once treated a patient with hematemesis. His pulse was wiry in the Liver position and soggy in the Qi-Kou position, caused by extreme anger. I administered Suhexiang Wan (Styrax Pill) combined with Jisu Wan (Elsheteria Pill), yielding immediate effect.
Yangsheng Biyong Fang (Essentials for Health Preservation) states: For all hematemesis, Ganjiang Gancao Tang (Dried Ginger and Licorice Decoction) should be decocted and taken, or Siwu Tang (Four Substance Decoction) and Lizhong Tang (Regulate the Middle Decoction) are also suitable; such methods ensure recovery. Taking Sheng Dihuang (Fresh Rehmannia), Zhuru (Bamboo Shavings), and Ou Zhi (Lotus Root Juice) distances one from health.
Roupi Tang (Spleen-Soothing Decoction): Treats consumption-related hematemesis, epistaxis, leukorrhea, and sweating. (From Yangsheng Biyong Fang)
Ingredients: Gan Cao (Licorice), Shaoyao (Peony), Huang Qi (Astragalus) (each 1 liang), Shu Dihuang (Prepared Rehmannia Root) (3 liang).
Preparation and Administration: Powder the above ingredients. Take 4 qian per dose, add more than 1 cup each of water and wine. Decoct until reduced to 70%, strain to obtain 60% clear liquid, and take warm before meals.
I once treated a 19-year-old woman with amenorrhea. After using medicine to induce menstruation, her menses flowed excessively and she vomited blood. Various medicines failed. Observing that she was obese and her pulse was neither large nor small, I administered Sisheng Wan (Four Generations Pill), which brought relief. I also treated a man who vomited blood after bending forward while carrying a heavy load after a full meal. Various medicines failed. I administered Sisheng Wan (Four Generations Pill) and Qingbingzi (Green Cake), which brought relief and prevented recurrence. I observed that Chu Yushi, when treating hematemesis, disliked using Zhuru (Bamboo Shavings), Sheng Dihuang (Fresh Rehmannia), and Ou Zhi (Lotus Root Juice), but one should not rigidly adhere to this view. If Yang invades Yin, blood flows freely when heated, akin to boiling water overflowing. Cool medicines should be used to resolve this; Da Huang (Rhubarb), Xijiao (Rhinoceros Horn), Sheng Dihuang (Fresh Rehmannia), Sheng Ai Ye (Fresh Mugwort Leaf), and Ou Zhi (Lotus Root Juice) would surely be effective. If Yin invades Yang, described as heaven freezing and earth hardening, water turning to ice, warm medicines should be used to warm it; Gan Jiang (Dried Ginger) and Rou Gui (Cinnamon Bark) would surely have merit. Students should ponder this deeply.
Sisheng Wan (Four Generations Pill): Treats hematemesis. For all hematemesis and epistaxis where Yang invades Yin and blood heat causes reckless flow, this medicine is appropriate.
Ingredients: Sheng He Ye (Fresh Lotus Leaf), Sheng Ai Ye (Fresh Mugwort Leaf), Sheng Bai Ye (Fresh Biota Leaf), Sheng Dihuang (Fresh Rehmannia Root) (equal parts).
Preparation and Administration: Mash and grind into pills the size of a chicken egg. Take one pill per dose, add 3 cups of water, decoct until reduced to 1 cup, strain, and take warm at any time. Chen Rihua said: My father traveled to Lingshi Temple in Fugou in the early Shaoxing era. The abbot invited him to eat. As the meal ended, an attendant returned from the hall dining, saw the table was unstable, hurriedly bent down to steady it, and upon raising his head, vomited blood. This was because bending over after a full meal injured the Lung. The following year, he visited again and asked if the person who vomited blood last year was well. The abbot said he recovered after taking Sisheng Wan (Four Generations Pill). Since obtaining this prescription, I have applied it many times with verified results.
[ Xue Ji ] In my opinion, the aforementioned condition is a sudden onset of internal heat, and this prescription is effective. However, if a patient has been ill for a long time with root deficiency, one must tonify the Spleen to nourish the source of transformation; otherwise, deficient fire flares upward, Metal (Lung) is counter-controlled, and chances of survival are slim.
For vomiting blood due to severe heat, use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) or Xiao Sanhuang Tang (Minor Three Yellows Decoction) from Ju Fang, drinking thick decoctions of Bai Mao Gen (Imperata Rhizome) is excellent.
Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction): Treats internal blood stasis, epistaxis, hematemesis, yellow complexion, and black stools.
Ingredients: Shaoyao (Peony) (0.75 liang), Sheng Dihuang (Fresh Rehmannia Root) (0.5 jin), Mudan Pi (Tree Peony Bark) (decored and cleaned, 1 liang), Xijiao Xie (Rhinoceros Horn Shavings) (1 liang; if unavailable, replace with Chuan Shengma (Cimicifuga)).
Preparation and Administration: Cut into pieces. Take 5 qian per dose, decoct in water and take. If there is heat resembling madness, add Huang Qin (Scutellaria) 2 liang.
Qingbingzi (Green Cake): Treats hemoptysis.
Ingredients: Qingdai (Indigo Naturalis), Xingren (Apricot Seed) (each 1 liang; Hua Tuo's formula uses Oyster Shell Powder to stir-fry Apricot Seeds, remove skin and tips, do not use Oyster Shell).
Preparation and Administration: Grind together into a paste. Melt Yellow Wax and mix to form 30 cakes. Take one cake per dose, sandwich between half a dried persimmon, wrap in wet paper, bake until fragrant, chew together, and swallow with gruel drink at any time.
Ganjiang Gancao Tang (Dried Ginger and Licorice Decoction): Suitable for Yin invading Yang, cold in the Heart and Lung meridians causing hematemesis.
Ingredients: Gan Cao (Licorice), Gan Jiang (Dried Ginger) (each 0.5 liang).
Preparation and Administration: Cut into pieces, decoct in water, and take in one dose. Lizhong Tang (Regulate the Middle Decoction) from Ju Fang is also excellent.
Huarui Shi San (Flower Nodule Stone Powder): I once saw a woman suffering from this disease, refractory to hundred medicines. I mixed Tongzi Xiaobian (Boy's Urine) with wine, administered Zhen Huarui Shi San (True Flower Nodule Stone Powder), and she recovered after a few doses.
Wujin San (Black Gold Powder): Treats persistent hematemesis. Take 2 qian per dose, swallow with rice drink. (This is Cuisheng Rushen San (Miraculous Delivery Powder), see later.)
Jisheng Jisu San (Jisheng Elsheteria Powder): Treats Lung meridian injury from consumption, blood in saliva, and throat obstruction.
Ingredients: Jisu Ye (Elsheteria Leaf), Huang Qi (Astragalus) (stir-fried), Sheng Dihuang (Fresh Rehmannia Root), Ejiao (Donkey-hide Gelatin) (stir-fried), Beimu (Fritillaria), Bai Mao Gen (Imperata Rhizome) (each 1 qian), Jiegeng (Platycodon) (stir-fried), Maidong (Ophiopogon) (decored), Puhuang (Typha Pollen) (stir-fried), Gan Cao (Licorice) (honey-fried, each 0.5 fen).
Preparation and Administration: Decoct in ginger water and take.
Sheng Dihuang San (Fresh Rehmannia Powder): Treats epistaxis, hemoptysis, and hematemesis due to stagnant heat, in cases of Yin deficiency where healing is difficult.
Ingredients: Gouqizi (Goji Berry), Chaihu (Bupleurum), Huanglian (Coptis) (stir-fried), Digupi (Dogwood Bark), Tiandong (Asparagus Tuber) (decored), Shaoyao (Peony), Gan Cao (Licorice) (stir-fried), Huang Qin (Scutellaria) (stir-fried), Huang Qi (Astragalus) (stir-fried), Sheng Dihuang (Fresh Rehmannia Root), Shu Dihuang (Prepared Rehmannia Root) (homemade, each 0.5 fen).
Preparation and Administration: Decoct in water and take. For lower body bleeding, add Diyü (Sanguisorba).
Sanyin Fuling Buxin Tang (Three Causes Poria and Heart-Nourishing Decoction): Treats sallow and emaciated complexion, five-palm heat, and bloody cough.
Ingredients: Banxia (Pinellia), Qianhu (Peucedanum), Zisu (Perilla), Fuling (Poria), Renshen (Ginseng), Zhike (Bitter Orange) (bran-fried), Jiegeng (Platycodon) (stir-fried), Gan Cao (Licorice) (stir-fried), Gange (Kudzu Root) (each 0.5 fen), Dang Gui (Angelica), Chuanxiong (Ligusticum), Chenpi (Tangerine Peel), Shaoyao (Peony) (each 1 qian), Shu Dihuang (Prepared Rehmannia Root) (homemade, 1.5 qian).
Preparation and Administration: Decoct in ginger and jujube water and take.
Maidong Yinzi (Ophiopogon Drink): Treats Qi-deficiency hematemesis, or inability to control blood due to Qi deficiency.
Ingredients: Wuweizi (Schisandra) (pounded, 10 fruits), Maidong (Ophiopogon) (decored), Huang Qi (Astragalus) (stir-fried, each 1 qian), Dangguishen (Angelica Body), Renshen (Ginseng), Sheng Dihuang (Fresh Rehmannia Root) (each 0.5 qian).
Preparation and Administration: Decoct in water and take.
Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction): Treats weak Stomach Qi, hematemesis, epistaxis, persistent melena, leading to exterior symptoms of aversion to cold and fever, spontaneous sweating, night sweats, poor appetite, and fatigue. Or chills and fever with thirst, headache, vertigo, resembling stroke. Or Qi and Blood dual deficiency, chest/abdominal/hypochondriac pain. Or bone/joint pain, irregular menstruation. Or alternating chills and fever, afternoon fever, five-palm heat, dry throat and tongue, or phlegm-cough with panting, empty fullness in chest/diaphragm. Or vomiting and diarrhea, cold or hot hands and feet. (Prescription see Miscellaneous Diseases: Consumption Deficiency section.)