一治血淋
阿胶（炒二两） 猪苓 泽泻 滑石 赤茯苓（各一两） 车前子（五钱）
上锉。水煎。空心服。
夫关格者。谓膈中觉有所碍。欲升不升。欲降不降。饮食不下。此为气之横格。必用吐
其气之横格。必在吐出痰也。有痰。以二陈汤探吐之。吐中便有降。有气虚不运者。补气药
中。用升降法。
丹溪曰。此症多死。寒在上。热在下也。寒在胸中。遏绝不散。无入之理。故曰格。热
在下焦。填塞不通。无出之由。故曰关。格则吐逆。关则不得小便。
内经曰。人迎与气口俱盛四倍以上为关格。关格之脉羸。不能极于天地之精气。则死矣
一论关格。上焦痰壅。两手脉盛是也。
枳缩二陈汤
枳实（麸炒一钱） 砂仁（七分） 白茯苓（去心） 贝母（去心） 陈皮 苏子 栝蒌仁（各
一钱
）浓朴（七分） 川芎（八分） 木香（五分） 沉香（五分） 香附（童便炒七分） 甘草（三分
）
上锉一剂。生姜三片。水煎。入竹沥磨沉木香服。
一阴阳关格。前后不通寻常通利大府。小水自行。中有转胞一症。诸药不效。失救则胀
满闷乱而死
予尝以甘遂末。水调敷脐下。内以甘草节。煎汤饮之。及药汁至脐。二药相反。胞自转
矣。小水来如涌泉。此救急之良诀也。
一、治疗血淋证
阿胶（炒制二两） 猪苓 泽泻 滑石 赤茯苓（各一两） 车前子（五钱）
以上药材切碎。加水煎煮。空腹服用。
所谓关格病，是指胸膈之间感觉有阻碍，气机想要上升却升不上去，想要下降却降不下来，饮食无法下咽。这属于气机横逆阻隔的病症。必须使用催吐法来解除气机的横逆阻隔。催吐的关键在于吐出痰涎。如果有痰，用二陈汤（Erchen Tang, Two-Cured Decoction）探引呕吐。在呕吐的过程中，气机自然随之而降。如果是气虚导致气机运行不畅者，在补气药中运用升降气机的方法。
朱丹溪说：此症大多致死，是因为寒邪在上焦，热邪在下焦。寒邪停留在胸中，遏制郁结不散，没有进入的途径，所以称为“格”。热邪在下焦，填塞不通，没有排出的途径，所以称为“关”。格证表现为呕吐逆乱，关证表现为小便不通。
《黄帝内经》说：人迎脉与气口脉都盛大四倍以上，就是关格。关格的脉象虚弱，不能汲取天地间的精气，就会死亡。
二、论述关格证
上焦痰浊壅盛，双手脉搏动盛大即是此证的表现。
枳缩二陈汤（Zhisuo Erchen Tang）
枳实（麸炒一钱） 砂仁（七分） 白茯苓（去心） 贝母（去心） 陈皮 苏子 栝蒌仁（各一钱） 厚朴（七分） 川芎（八分） 木香（五分） 沉香（五分） 香附（童便炒七分） 甘草（三分）
以上药材为一剂切碎。加生姜三片，加水煎煮。加入竹沥（Bamboo Sap），磨入沉香和木香粉服用。
三、阴阳关格证
前后二便不通。通常通利大肠，小便自然会自行通畅。其中有一种转胞（Torsion of the Urinary Bladder）的病症，各种药物无效，若延误救治则会因腹胀满闷乱而死。
我曾经用甘遂末（Gansui Powder），用水调匀敷在脐下，内服甘草节（Licorice Joint）煎成的汤剂。当药力到达脐部时，由于这两味药性相反相激，膀胱自然扭转复位。小便随即像涌泉一样流出，这是急救的良方秘诀。
I. Treatment for Hematuria (Blood Dysuria)
Donkey-hide Gelatin (Jiao'ao), stir-fried, two taels; Polyporus (Zuling); Alisma (Zexie); Talcum (Huashi); Red Poria (Chifuling), one tael each; Plantago Seed (Cheqianzi), five qian.
The above herbs are coarsely crushed. Decoct in water and take on an empty stomach.
The condition known as Guan-Ge (Obstruction and Repletion) refers to a sensation of obstruction in the chest and diaphragm, where Qi desires to ascend but cannot, and desires to descend but cannot, resulting in the inability to ingest food and drink. This is due to the horizontal blockage of Qi. It is necessary to use emesis to resolve this horizontal blockage of Qi. The key to emesis lies in expelling phlegm. If phlegm is present, use Erchen Tang (Two-Cured Decoction) to induce vomiting. Within the process of vomiting, there is naturally a descending action. For those with Qi deficiency failing to move Qi, employ methods of ascending and descending Qi within tonifying Qi formulas.
Zhu Danxi stated: This syndrome often results in death; cold is located in the upper jiao, and heat is located in the lower jiao. Cold stagnates in the chest, obstructing and preventing dispersion, leaving no path for entry; thus it is called Ge (Repletion/Obstruction). Heat fills the lower jiao, blocking passage, leaving no outlet; thus it is called Guan (Closure/Blockage). Ge manifests as vomiting and reflux; Guan manifests as the inability to urinate.
The Huangdi Neijing states: When both the Renying pulse and the Qikou pulse are four times or more than their normal strength, it is Guan-Ge. If the pulse of Guan-Ge is emaciated, unable to exhaust the essence and qi of heaven and earth, death will ensue.
II. Discussion on Guan-Ge Syndrome
Upper jiao phlegm turbidity congestion, characterized by surging pulses in both hands, is indicative of this condition.
Zhishuo Erchen Tang (Zhishuo Two-Cured Decoction)
Aurantium Fructus Immaturus (Zhishi), bran-fried, one qian; Amomum Fruit (Sharen), seven fen; White Poria (Baifuling), pith removed; Fritillaria Bulb (Beimu), pith removed; Citrus Peel (Chenpi); Perilla Fruit (Suzi); Trichosanthes Seed (Gualouren), one qian each; Magnolia Bark (Houpo), seven fen; Ligusticum Rhizome (Chuanxiong), eight fen; Aucklandia Root (Muxiang), five fen; Aquilaria Wood (Chenxiang), five fen; Cyperus Rhizome (Xiangfu), stir-fried with infant urine, seven fen; Licorice Root (Gancao), three fen.
Coarsely crush one dose. Add three slices of fresh ginger, decoct in water. Add Bamboo Sap (Zhuli), and grind in Aucklandia Root and Aquilaria Wood powder before taking.
III. Yin-Yang Guan-Ge Syndrome
Obstruction of both anterior and posterior orifices. Generally, if the large intestine is unblocked, urination will resume spontaneously. Among these cases, there is a syndrome of "Torsion of the Urinary Bladder" (Zhuanbao), where various medicines fail, and if rescue is delayed, death occurs due to abdominal distension, fullness, and mental confusion.
I once used Gansui Powder (Gansui Mo), mixed with water and applied externally below the umbilicus, while internally administering a decoction of Licorice Joints (Ganzhijie). When the medicinal effect reached the umbilicus, the antagonistic nature of these two substances caused the bladder to rotate back into place. Urine then flowed out like a gushing spring. This is an excellent secret method for emergency rescue.