止从肺出，他无可言耶？曰∶肺不独咳血，而亦唾血。盖肺主气，气逆为咳；肾主水，水化液为唾。肾
脉上入肺，循喉咙挟舌本，其支者从肺出，络心注胸中，故二脏相连，病则俱病，于是皆有咳唾血也。亦
有可分别者，涎唾中有少血散漫者，此肾从相火炎上之血也。若血如红缕在痰中，咳而出者，此肺络受热
伤之血也，其病难已。若咳白血，必死。白血浅红色，似肉似肺也。然肝亦唾血，肝藏血，肺藏气，肝
血不藏，乱气自两胁逆上，唾而出之。《内经》有血枯症，先唾血，为气竭伤肝也。又有咯血，咯与唾
少异。唾出于气，上无所阻；咯出于痰，气郁喉咙之下，上不得出，咯而乃出。求病所属之脏，咯、唾同
出于肾也。余尝治三人，不咳唾而血见口中，从齿缝舌下来者，每用滋肾水、泻相火治之，不旬日而愈。
又治一人，因忧病咳唾血，面黧黑色，药之不效。曰∶此必得喜可解。其兄求一足衣食地处之，于是大喜，
实时色退，不药而瘳。经曰∶治病必求其本。又曰∶无失气宜。是知药之治病，必得其病之气宜，苟不察
其得病之情，虽药亦不愈也。
出《金匮要略》，谓热在上焦，因咳为肺痿。痿得之或从汗出，或从呕吐，或从消渴，小便利数，或
从便难，或被快药下利，重亡津液，故寸口脉数，而咳，口中反有浊唾涎沫。原其意从《内经》痿条扩广，
在脏气不得布荣卫行津液，反怫郁为热，聚结涎沫浊唾而后
咳也。故附方或用炙甘草汤，或用生姜人参大枣汤主之，所治大意似之矣！至若又谓肺痿吐涎沫而不咳，
其人不渴，必遗尿，小便数，以上虚不能制下故也。此为肺中冷，咳多涎唾，甘草生姜汤以温之。若服汤
已，渴者，属消渴，则此所治便与前条上焦热者不同矣。上焦热则怫郁，而肺之玄府燥涩，气不利则咳，
津不布则渴；此云肺中冷者，非形寒饮冷之邪在其中，由上焦无阳故曰冷，阳气不足则不成热，不热则不咳
亦不渴，惟气虚不能制约其水道之行也。肺与肾连脏，肺虚则肾亦虚，故水入咽直达于肾，肾亦不以水精
四布于五脏，而径出于溺矣。
仅仅从肺脏出血，没有其他情况可以谈论了吗？回答说：肺脏不仅导致咳血，也会导致唾血。因为肺主气，气机上逆就会咳嗽；肾主水，水液代谢化为唾液。肾的经脉向上进入肺脏，沿着喉咙夹持舌根，其分支从肺脏分出，联络心脏注入胸中，所以这两个脏器相互连接，生病时往往同时受累，因此都有咳唾血的症状。也有可以区分的情况，如果涎唾中有少量血液散漫分布，这是肾脏因相火炎上导致的出血。如果血液像红线一样存在于痰液中，咳嗽而出，这是肺络受热损伤导致的出血，这种病情难以治愈。如果咳出白色血液，必定死亡。白血呈浅红色，看起来像肉又像肺组织。然而肝脏也会引起唾血，肝藏血，肺藏气，肝血不能固藏，紊乱的气机从两胁逆上，通过唾液吐出。《内经》中有血枯症，先出现唾血，是因为气竭伤及肝脏。又有咯血，咯与唾略有不同。唾出于气，上方没有阻碍；咯出于痰，气郁结在喉咙下方，上方无法排出，必须用力咯出才能出来。探究病症所属的脏腑，咯和唾都同属于肾脏。我曾经治疗过三个人，不咳嗽也不唾血，但口中见血，从齿缝和舌头下面流出来，每次都用滋补肾水、清泻相火的方法治疗，不到十天就痊愈了。又治疗一个人，因忧思患病而咳唾血，面色黧黑，用药无效。我说：这一定需要喜悦的情绪才能解除。他的兄长为他寻找了一个足以维持衣食的地方让他居住，于是此人非常高兴，脸色随即消退，不用吃药就好了。经书说：治病必须探求根本。又说：不要违背气候适宜的原则。由此可知，药物治病，必须顺应病邪的气候特性，如果不考察发病的具体情况，即使用药也无法治愈。
出自《金匮要略》，认为热在上焦，因咳嗽导致肺痿。肺痿的成因或是由于发汗过多，或是由于呕吐，或是由于消渴、小便频数，或是由于大便困难，或是被峻下药过度通便，导致津液严重耗损，所以寸口脉数，并且咳嗽，口中反而有浑浊的唾液和涎沫。推究其意是从《内经》关于痿证的条文扩展而来，在于脏气不能布散荣卫运行津液，反而郁结为热，聚结成涎沫浊唾然后引发咳嗽。所以附方中有的用炙甘草汤，有的用生姜人参大枣汤主治，所治的大致意思相似！至于又说肺痿吐涎沫但不咳嗽，病人不口渴，必然遗尿，小便频数，这是因为上焦虚弱不能制约下焦的缘故。这是肺中寒冷，咳嗽多涎唾，用甘草生姜汤来温补。如果服药后感到口渴，属于消渴症，那么这里所治疗的便与前条上焦热证不同了。上焦热则郁结，肺之玄府干燥涩滞，气机不利则咳嗽，津液不布则口渴；这里说肺中寒冷，并非形体受寒或饮冷之邪在其中，而是由上焦无阳气故称冷，阳气不足则不能生热，不热则既不咳嗽也不口渴，只有气虚不能制约水道的运行。肺与肾是相连的脏器，肺虚则肾也虚，所以水入咽直达于肾，肾也不能将水精四布于五脏，而是直接排出成为尿液。
Is bleeding originating solely from the Lung, with no other conditions to discuss? The response is: The Lung not only causes hemoptysis (coughing up blood) but also hematemesis via saliva (spitting blood). This is because the Lung governs Qi; when Qi rebels upward, it causes coughing. The Kidney governs Water; water metabolism transforms into saliva. The Kidney meridian enters the Lung, follows the throat, and clamps the base of the tongue; its branch emerges from the Lung, connects with the Heart, and pours into the chest. Thus, these two organs are interconnected, and when diseased, both are affected, leading to both coughing and spitting of blood. However, distinctions can be made: if a small amount of blood is scattered diffusely in saliva, this is blood caused by the flare-up of Ministerial Fire (Xiang Huo) from the Kidney. If the blood appears like red threads within phlegm and is coughed out, this is blood resulting from heat injuring the Lung collaterals, a condition that is difficult to cure. If white blood is coughed up, death is certain. White blood is pale red, resembling flesh or lung tissue. Nevertheless, the Liver can also cause spitting of blood. The Liver stores Blood, while the Lung stores Qi. When Liver Blood fails to be stored, chaotic Qi rebels upward from both hypochondriac regions and is expelled through saliva. The *Nei Jing* (Inner Canon) describes the syndrome of Blood Depletion (Xue Ku), where spitting of blood occurs first, due to Qi exhaustion injuring the Liver. There is also expectoration of blood (Ke Xue), which differs slightly from spitting (Tuo). Spitting arises from Qi, with no obstruction above; expectoration arises from Phlegm, where Qi is stagnant below the throat and cannot exit upward, requiring forceful expulsion to come out. Investigating the organ associated with the disease, both expectoration and spitting belong to the Kidney. I once treated three patients who did not cough or spit but had blood appearing in the mouth, flowing from between the teeth and under the tongue. Each time, I used methods to nourish Kidney Water and drain Ministerial Fire, resulting in recovery within ten days. I also treated one patient who suffered from coughing and spitting blood due to worry, with a dark, sallow complexion; medication was ineffective. I said: "This must be resolved through joy." His brother found him a place sufficient for food and clothing, causing great joy. Immediately, his complexion faded, and he recovered without medication. The Classics state: "In treating diseases, one must seek the root." And again: "Do not neglect the appropriateness of Qi (climate/environment)." From this, we know that medicinal treatment must align with the Qi characteristics of the disease. If the specific circumstances of the illness are not examined, even medication will fail to cure.
This passage originates from the *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet), stating that heat in the Upper Jiao (Upper Burner) leads to Lung Flaccidity (Fei Wei) due to coughing. Lung Flaccidity may result from excessive sweating, vomiting, Xiao Ke (Wasting and Thirsting syndrome) with frequent urination, constipation, or overuse of harsh purgatives, all of which severely deplete Body Fluids (Jin Ye). Consequently, the Cun Kou pulse is rapid, accompanied by coughing and the presence of turbid saliva and froth in the mouth. Tracing the intent, this expands upon the flaccidity syndromes in the *Nei Jing*. It occurs when Zang Qi fails to distribute Ying and Wei (Nutritive and Defensive Qi) and circulate Jin Ye, instead becoming stagnant and transforming into heat, aggregating into frothy saliva and turbid secretions before inducing cough. Therefore, supplementary formulas include Zhi Gan Cao Tang (Honey-Fried Licorice Decoction) or Sheng Jiang Ren Shen Da Zao Tang (Fresh Ginger, Ginseng, and Jujube Decoction); the general therapeutic principle is similar. Furthermore, it states that in Lung Flaccidity, if there is spitting of saliva without coughing, and the patient is not thirsty but suffers from enuresis and frequent urination, this is due to Upper Jiao deficiency failing to control the Lower Jiao. This indicates Cold in the Lung, characterized by coughing with abundant saliva, treated with Gan Cao Sheng Jiang Tang (Licorice and Fresh Ginger Decoction) to warm the Lung. If thirst develops after taking the decoction, it belongs to Xiao Ke (Wasting and Thirsting syndrome), distinguishing this treatment from the earlier Upper Jiao Heat syndrome. Upper Jiao Heat causes stagnation, drying and obstructing the Lung's Xuan Fu (pores/ventilation openings), leading to cough due to impaired Qi movement and thirst due to lack of fluid distribution. The mention of "Cold in the Lung" does not imply external cold or cold drinks invading the interior, but rather refers to Cold due to the absence of Yang Qi in the Upper Jiao. Insufficient Yang Qi fails to generate heat; without heat, there is neither cough nor thirst, only Qi deficiency failing to regulate water pathways. The Lung and Kidney are connected organs; Lung deficiency leads to Kidney deficiency. Thus, water entering the throat reaches the Kidney directly, and the Kidney fails to distribute water essence to the five Zang organs, excreting it directly as urine.