黄湛侯素有失血病。一晨起至书房。陡爆一口。倾血一盆。
喉间气涌。神思飘荡。壮热如蒸。颈筋 劲。诊其脉。尺中甚乱。
曰。此昨晚太犯房劳。自不用命也。因出验血。见色如太阳之红。其仆云。此血如宰猪后半之血。其来甚远。
不识痴人有此确喻。再至寝室。谓曰。少阴之脉。萦舌本。少阴者肾也。今肾中之
血。汹涌而出。舌本已硬。无法可以救急。因谛思良久。曰。只有一法。不得已用丸药一服。坠安元气。
若气转丹田。尚可缓图。因煎人参浓汤。下黑锡丹三十粒。喉间 有声。渐下入腹。顷
之。舌柔能言。但声不出。余亟用润下之剂。以继前药。遂与阿胶一味。重两许。溶化。分三次热服。溉以热
汤。半日服尽。身热渐退。劲筋渐消。进粥。与补肾药。连服五日。声出喉清。人事向
安。但每日尚出深红之血盏许。因时令大热。遵内经热淫血溢。
治以咸寒之旨。于补肾药中。多加秋石。服之遂愈。
胡卣臣先生曰。此等治法。全在批 导 处用意。未许向痴人说梦。
闻君求有失血疾。时一举发。其出颇多。咳嗽生痰。上气。面青少泽。其脉厥阴肝部独伤。原于忿怒之
火无疑。合色脉谛详。总是阴血不足也。但从前所用之药。本以生血。反滋其痰。本以驱痰。转耗其血。似
是而非。谁其辨之。夫脉之充也。色之华也。皆气与血为之也。以脱血故。致令气亦易脱。每每上升胸
膈。喘促胀闷。不利于语言行持。虽举发有时。然非细故矣。乃用行气药以取快。何异操刀使割耶。诚欲气
不上升。无过于血日滋长。暗将浮游之气。摄入不息之途。乃为良治。然胸膈肺胃间。顽痰胶结。既阻循环。又
难培养。似乎痰不亟除。别无生血之法矣。不知此证而欲除痰。痰未必除。气已先尽。不得之数
也。从来痰药入腹。其痰不过暂开复闭。劳而无功。吾于此每用乘机利导之法。先以微阳药开其痰。继以
纯阴峻投。如决水转石。亟过痰之关隘。迨至痰之开者复闭。所用生血之药。早已从
天而下。日续一日。久久而血生。血生而气返血室。如浪子归家。转能兴家。所借以驱胶结之痰者。即此
气也。此际始加除痰之药。庶几痰去气存。累年之疾。至是始得痊安耳。然饮食最宜
致慎。不但肥甘生痰。浓味伤阴已也。人身自平旦至日中。行阳二十五度。饮食易消。故不成痰。自日中至
合夜。行阴二十五度。饮食不消。故易成痰。释教以过午戒食。其大药王护身之一则欤。进之调摄。尤为紧
关。盖贤人尝以秋冬养阴。秋者于时为收。冬者于时为藏。法天地之收藏。而宁茹毋吐。宁拒毋迎。宁
早卧。毋早兴。蛰虫尚知闭户。岂君子可无居室之功耶。况乎欲血不再脱。尤贵退藏于密耶。又况乎厥阴肝
木受病。其憔悴之色。见于三时者。犹可诿之病色。至春月发荣之时。更何诿耶。然春月之荣。不自春月
始也。始于秋冬收藏之固。设冬月水脏所储者少。春月木即欲发荣。其如泉竭。不足以溉苞稂何。故失
此不治。至春病危始图之。则万无及矣。
胡卣臣先生曰。扪虱而谈。可惊四座。
黄湛侯平素就有失血（指各种出血性疾病，此处特指吐血）的旧疾。一天早晨起床来到书房，突然猛烈地吐出一口血，量多到倾满了一盆。
喉咙间气机向上冲涌，神志恍惚飘忽不定，身体高热如同蒸笼一般，颈部筋脉僵硬强劲。诊察他的脉搏，尺部脉象非常紊乱。
我说：“这是昨晚房事过度，不知爱惜生命所致。”于是查看他吐出的血液，颜色像太阳红一样鲜红。他的仆人说道：“这血就像杀猪后放出来的血，来源很远。”
我不明白这个痴人竟有如此确切的比喻。再走到寝室，对他说：“少阴肾经的经脉环绕舌根。少阴指的是肾。现在肾中的血液汹涌而出，舌根已经僵硬，没有方法可以急救。”于是仔细思考了很久，说：“只有一种办法，不得已使用丸药一服，以镇坠安定元气。如果气机能转归丹田，还可以慢慢图谋救治。”于是煎煮浓重的人参汤，送服黑锡丹三十粒。喉间发出咕噜声，药液逐渐进入腹部。片刻之后，舌头变软能够说话，只是声音发不出来。我急忙使用润下（滋润肠道、通导大便）的药剂来接续前面的药物。随即给予阿胶一味，重量约一两，溶化后分三次热服，并用热汤送服。半天内服完。身体发热逐渐消退，颈部筋脉僵硬逐渐缓解。进食粥食，并服用补肾药物，连续服用五天，声音发出，喉咙清爽，人事趋向安宁。但每天仍然排出深红色的血约一杯的量。因为时令大热，遵循《内经》“热淫于内，治以咸寒”的原则，在补肾药中多加入秋石（人尿加工制成的结晶），服用后便痊愈了。
胡卣臣先生说：“这种治法，全在于把握引导的关键处用心思，不允许向愚钝之人说梦话。”
闻君请求治疗失血疾病，时常发作一次，出血量很多，伴有咳嗽生痰，气逆上冲，面色青暗缺乏光泽。其脉象显示厥阴肝部的脉独受损，根源在于愤怒之火，毫无疑问。综合色脉仔细详查，总是阴血不足。但是从前所用的药物，本意是生血，反而滋生了痰湿；本意是驱除痰湿，转而耗伤了血液。似是而非，谁能辨别呢？脉象的充盈、面色的光华，都是靠气和血来维持的。因为脱血，导致气也容易随之外脱。每每气机上冲胸膈，造成喘促胀闷，不利于语言和行走活动。虽然发作有时，但这并非小问题。竟然使用行气药来求取一时痛快，这与拿着刀割肉有什么区别呢？真正想让气不上升，没有比让血液日益滋长更好的方法了，暗中将浮游不定的气，摄入不息的生命途径中，这才是良好的治疗。然而胸膈肺胃之间，顽痰胶结，既阻碍了气血循环，又难以培养正气。似乎如果不紧急去除痰湿，就没有其他生血的方法了。不知道此证想要除痰，痰未必能除，气却先耗尽，这是不得要领的做法。历来痰药进入腹中，痰湿不过是暂时开通随即再次闭塞，劳而无功。我对此症每用乘机利导的方法，先用微阳药物开通痰湿，继之以纯阴药物峻猛投用，如同决堤放水、转动巨石，迅速通过痰湿的关隘。等到痰湿开通之处再次闭塞时，所准备的生血药物，早已从天而降（指药效发挥），日复一日，久而久之血液生成，血液生成而气返回血室，如同浪子回家，反而能振兴家业。借此气来驱散胶结的痰湿。此时才加入除痰的药物，这样痰去而气存，多年的疾病，至此才得以痊愈安康。然而饮食最应该谨慎，不仅肥甘厚味会生痰，浓烈滋味也会伤阴。人体从清晨到中午，运行阳气二十五度，饮食容易消化，所以不成痰。从中午到夜晚，运行阴气二十五度，饮食不易消化，所以容易成痰。佛教有过午不食的戒律，这大概是药师护身的一个法则吧。进一步讲调摄养生，尤为关键。大概贤人主张在秋冬季节养阴，秋季在时令上属于收敛，冬季在时令上属于闭藏。效法天地的收藏之道，宁可茹素清淡不要吐故纳新（此处喻指节制欲望与消耗），宁可拒绝诱惑不要迎合，宁可早睡不要早起。冬眠的虫子尚且知道关闭门户，难道君子可以不修持居室的功夫吗？况且想要血液不再脱失，尤其贵在退藏于密（指隐居静养，积蓄精气）。更何况厥阴肝木受病，其憔悴的神色，出现在春夏秋三季时，还可以推托说是病态的脸色，到了春季万物发荣之时，又有什么可推托的呢？然而春季的发荣，并不是从春季才开始的，而是始于秋冬收藏的坚固。如果冬季水脏（肾）所储存的精气很少，春季木（肝）即使想要发荣，又能奈泉水枯竭、不足以灌溉草木何？所以失去这个时机不治疗，到了春季病情危重才开始谋划，那就绝对来不及了。
胡卣臣先生说：“摸着虱子谈论医理，足以让四座震惊。”
Huang Zhanhou had a chronic history of blood loss (hemorrhage). One morning, upon rising and entering his study, he suddenly vomited a mouthful of blood in a violent burst, the volume filling a basin.
Qi surged upward in the throat, consciousness drifted and was disoriented, body heat was intense as if steaming, and the neck tendons were stiff and rigid. Palpating his pulse, the Chi position (Kidney area) was extremely chaotic.
I said, "This is due to excessive sexual activity last night and disregard for one's life." I examined the vomited blood and saw its color was bright red like the sun. His servant remarked, "This blood resembles the blood drained from a slaughtered pig; it comes from far away."
I did not understand how this simpleton could offer such an accurate metaphor. Proceeding to the bedroom, I told him, "The Shaoyin Kidney meridian wraps around the root of the tongue. Shaoyin refers to the Kidney. Now, blood from within the Kidney is gushing out, and the root of the tongue has become stiff. There is no method to save this emergency." After pondering carefully for a long time, I said, "There is only one method. Reluctantly, use one dose of pill medicine to settle and stabilize the Yuan Qi (Original Qi). If the Qi can return to the Dantian, we may still plan for a gradual recovery." Thus, I decocted a thick concentrated soup of Renshen (Ginseng Root) and administered thirty pills of Heixi Dan (Black Tin Pill) with it. A gurgling sound was heard in the throat as the medicine gradually entered the abdomen. In a short while, the tongue softened and speech resumed, though voice remained absent. I urgently used a moistening and purgative agent to follow up the previous medicine. I then prescribed Ejiao (Donkey-hide Gelatin), weighing approximately one tael, dissolved it, and divided it into three doses taken hot, washed down with hot water. Within half a day, the dosage was completed. The body heat gradually subsided, and the stiffness of the neck tendons gradually diminished. Porridge was introduced, along with Kidney-tonifying medicine, taken continuously for five days. Voice returned, the throat cleared, and general condition stabilized. However, about a cup of dark red blood was still discharged daily. Given the severe summer heat, following the principle from the *Neijing* ("When Heat dominates internally, treat with salty-cold"), I added Qiu Shi (Processed Human Urine Crystals) in large quantities to the Kidney-tonifying prescription. Upon taking this, the patient recovered.
Mr. Hu Youchen stated, "Such treatment methods rely entirely on skillful guidance at critical junctures; they are not suitable for explaining to the obtuse."
Wen Jun sought treatment for his blood-loss disease, which flared up frequently with significant bleeding, accompanied by coughing with phlegm, rebellious Qi ascending, a cyan complexion lacking luster. His pulse indicated isolated injury in the Jueyin Liver region, undoubtedly originating from Fire caused by anger. Combining complexion and pulse for detailed analysis, it is fundamentally Yin Blood deficiency. However, the medicines previously used, intended to generate blood, instead nourished phlegm; those intended to expel phlegm, conversely consumed blood. They seemed correct but were actually wrong; who could distinguish this? The fullness of the pulse and the brilliance of the complexion are both sustained by Qi and Blood. Due to blood loss, Qi also easily escapes. Often, Qi rises to the chest and diaphragm, causing panting, distension, and oppression, making speech and movement difficult. Although attacks occur intermittently, this is no minor matter. Using Qi-moving medicines to seek temporary relief is akin to wielding a knife to cut flesh. To truly prevent Qi from ascending, nothing surpasses the daily nourishment of blood, secretly guiding floating Qi into the unceasing pathways of life. This constitutes good treatment. However, between the chest, diaphragm, lungs, and stomach, stubborn phlegm is glued together, obstructing circulation and hindering nourishment. It seems that unless phlegm is urgently removed, there is no other way to generate blood. Yet, in this syndrome, attempting to remove phlegm may fail to eliminate it, while Qi is exhausted first, which is misguided. Historically, when phlegm-resolving medicines enter the abdomen, the phlegm is merely temporarily opened before closing again, resulting in labor without merit. For this condition, I always employ opportunistic guidance: first using mild Yang medicines to open the phlegm, followed by vigorous administration of pure Yin medicines, like releasing floodwaters or rolling boulders, swiftly passing through the phlegm's barriers. By the time the opened phlegm closes again, the blood-generating medicines have already descended from heaven (taken effect), day after day. Over time, blood is generated; once blood is generated, Qi returns to the Blood Chamber, like a prodigal son returning home, capable of revitalizing the family. It is this Qi that helps drive away the glued phlegm. Only at this stage should phlegm-expelling medicines be added, so that phlegm is removed while Qi remains, allowing years-long ailments to finally heal. However, diet must be strictly cautious. Not only do rich, sweet foods generate phlegm, but strong flavors also damage Yin. From dawn to noon, the body circulates Yang twenty-five times; food digests easily, thus not forming phlegm. From noon to nightfall, the body circulates Yin twenty-five times; food does not digest well, thus easily forming phlegm. Buddhism's precept of abstaining from eating after noon is likely one of the physician's protective measures. Furthermore, lifestyle regulation is crucial. Sages advocate nourishing Yin in Autumn and Winter. Autumn corresponds to gathering; Winter corresponds to storing. Following Heaven and Earth's principles of storage, one should prefer retention over expulsion, rejection over acceptance, early sleep over early rising. Even hibernating insects know to close their doors; how much more should a gentleman cultivate the art of dwelling quietly? Moreover, to prevent further blood loss, it is especially precious to retreat and store essence deeply. Additionally, since the Jueyin Liver Wood is diseased, its emaciated appearance during Spring, Summer, and Autumn can be dismissed as mere illness signs. But during Spring, when things flourish, what excuse remains? However, Spring's flourishing does not begin in Spring; it starts from the solidity of Autumn and Winter storage. If the Water Organ (Kidney) stores little during Winter, even if Wood (Liver) wishes to flourish in Spring, what can it do against dried-up springs insufficient to irrigate weeds? Therefore, failing to treat this at the right time, waiting until the illness becomes critical in Spring to plan treatment, will absolutely be too late.
Mr. Hu Youchen stated, "Discussing medical theories while picking lice can astonish the entire audience."