妇人伤寒，或劳役，或怒气，发热适遇经行，以致热入血室，或血不止，或血不行，令
人昼则明了安静，夜则谵语如见鬼状者是也。若热因外邪，由表而入者，宜一柴胡饮，或三
柴胡饮，或四柴胡饮，或《良方》黄龙汤加生地，酌而用之。若或怒或劳，火由内生，其人
多汗而无表证者，宜保阴煎、清化饮、当归六黄汤之类加减主之。若病虽渐愈，但元气素弱
，而热有未退，血未止者，宜补阴益气煎，或补中益气汤。若脾气素弱，宜归脾汤；血气俱
弱者，宜十全大补汤，庶无误矣。若血热多滞者，宜小柴胡汤加丹皮、红花、当归。
凡血色有辨，固可以察虚实，亦可以察寒热。若血浓而多者，血之盛也；色淡而少者，
血之衰也。此固大概之易知者也。至于紫黑之辨，其证有如冰炭，而人多不解，误亦甚矣。
盖紫与黑相近，今人但见紫色之血，不分虚实，便谓内热之甚。不知紫赤鲜红，浓而成片成
条者，是皆新血妄行，多由内热；紫而兼黑，或散或薄，沉黑色败者，多以真气内损，必属
虚寒。由此而甚，则或如屋漏水，或如腐败之宿血，是皆紫黑之变象也。此肝脾大损，阳气
大陷之证，当速用甘温，如理阴煎、理中汤、归脾汤、四味回阳饮、补中益气汤之类，单救
脾土，则陷者举，脱者固，元气渐复，病无不愈。若尽以紫色作热证，则无不随药而毙矣。
凡肠 、便血之属，无不皆然，学人于此，最有不可忽者。
妇女患伤寒，或因过度劳累，或因愤怒导致气机逆乱，在发热期间恰逢月经来潮，致使热邪陷入血室（子宫及冲任脉），出现经血不止或经血凝滞不行的情况。这类病症表现为白天神志清醒、安静，到了夜晚则胡言乱语，如同看见鬼怪一般。如果热邪是由外感风寒等表邪由体表传入体内引起的，适宜选用一柴胡饮，或者三柴胡饮，或者四柴胡饮，或者《景岳全书·良方》中的黄龙汤加入生地黄，根据具体情况斟酌使用。如果是因愤怒或劳累导致火热之邪从体内产生，患者多汗且没有表证（如恶寒、头痛等）的，适宜选用保阴煎、清化饮、当归六黄汤等方剂进行加减治疗。如果病情虽然逐渐好转，但患者元气素来虚弱，而热邪尚未完全消退，经血仍未停止的，适宜选用补阴益气煎，或者补中益气汤。如果患者脾气素来虚弱，适宜选用归脾汤；如果气血都虚弱，适宜选用十全大补汤，这样才不会出错。如果血分有热且多有瘀滞的，适宜用小柴胡汤加入牡丹皮、红花、当归。
凡是观察血色，既可以辨别虚证和实证，也可以辨别寒证和热证。如果血液浓稠且量多，说明血分旺盛；颜色淡白且量少，说明血分衰少。这当然是大致容易知晓的情况。至于紫色与黑色的辨别，其病机性质截然相反（如冰与炭般不同），但很多人不理解，误治的情况非常多。紫色与黑色相近，现在的人只要见到紫色的血，不分虚实，就认为是内热非常严重。却不知道紫赤色、鲜红色，质地浓稠成片或成条状的，都是新血妄行，多由内热引起；而紫色兼带黑色，或者散漫稀薄，呈沉黑色败坏状的，多是因为真气内部受损，必定属于虚寒证。如果病情由此加重，那么血液可能像屋顶漏下的雨水一样淋漓不断，或者像腐败的陈旧血液一样，这些都是紫色和黑色的变象。这是肝脾严重受损，阳气下陷的证候，应当迅速使用甘温性质的药物，如理阴煎、理中汤、归脾汤、四味回阳饮、补中益气汤等，专门救助脾土，这样下陷的阳气得以升举，脱失的气血得以固摄，元气逐渐恢复，疾病没有不痊愈的。如果一概将紫色血当作热证治疗，那么没有不随着用药而死亡的。凡是肠风、便血等情况，无不都是如此，学习中医的人在这一点上，最不可忽视。
In women suffering from cold damage (Shanghan), or due to overexertion, or anger causing qi stagnation, if fever occurs coinciding with menstruation, heat may enter the blood chamber (the uterus and Chong and Ren meridians). This results in either continuous bleeding or cessation of menstrual flow. Such conditions manifest as clear consciousness and calmness during the day, but delirium and hallucinations resembling seeing ghosts at night. If the heat is caused by external pathogenic factors entering from the exterior, Yi Chaihu Yin (One Bupleurum Decoction), San Chaihu Yin (Three Bupleurum Decoction), Si Chaihu Yin (Four Bupleurum Decoction), or Huanglong Tang (Yellow Dragon Decoction) from *Liangfang* added with Shengdi Huang (Rehmanniae Radix) should be selected and used according to the specific situation. If the fire arises internally due to anger or exertion, and the patient sweats profusely without exterior signs (such as aversion to cold or headache), Baoyin Jian (Protect the Yin Decoction), Qinghua Yin (Clear and Transform Decoction), or Danggui Liu Huang Tang (Angelica Hexa-Yellow Decoction) should be used with modifications. If the illness is gradually improving but the patient has always had weak yuan qi (primordial qi), and the heat has not fully subsided nor the bleeding stopped, Buyin Yiqi Jian (Tonify Yin and Augment Qi Decoction) or Buzhong Yiqi Tang (Regulate the Middle and Augment Qi Decoction) is appropriate. If the spleen qi is inherently weak, Guipi Tang (Restore the Spleen Decoction) is suitable; if both qi and blood are weak, Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction) is indicated, thus avoiding errors. If there is blood heat with significant stasis, Xiao Chaihu Tang (Minor Bupleurum Decoction) added with Mudan Pi (Moutan Cortex), Honghua (Carthami Flos), and Danggui (Angelicae Sinensis Radix) is recommended.
Observing the color of blood allows one to distinguish between deficiency and excess syndromes, as well as cold and heat syndromes. Thick and abundant blood indicates an abundance of blood; pale and scanty blood indicates a deficiency of blood. These are generally easy to understand. However, the distinction between purple and black colors is critical, as their pathological natures are opposite (like ice and charcoal), yet many fail to comprehend this, leading to frequent misdiagnoses. Purple and black are similar; nowadays, people often see purple blood and, regardless of deficiency or excess, assume it indicates severe internal heat. They do not realize that bright red or purplish-red blood, which is thick and forms clots or strips, represents new blood flowing recklessly, usually due to internal heat. Conversely, blood that is purple mixed with black, or scattered and thin, appearing dark and necrotic, indicates damage to true qi internally and definitely belongs to deficiency-cold syndromes. If the condition worsens from this, the blood may resemble leaking roof water or putrid old blood; these are variations of purple and black manifestations. This signifies severe damage to the liver and spleen and a collapse of yang qi. One should promptly use sweet-warm herbs, such as Liyin Jian (Regulate the Yin Decoction), Lizhong Tang (Regulate the Middle Decoction), Guipi Tang (Restore the Spleen Decoction), Siwei Huiyang Yin (Four-Ingredient Return Yang Infusion), or Buzhong Yiqi Tang (Regulate the Middle and Augment Qi Decoction), to specifically tonify spleen earth. In this way, collapsed qi will be raised, and lost essence will be secured; as yuan qi gradually recovers, the disease will surely heal. If all purple blood is treated as a heat syndrome, death will inevitably follow the administration of medicine. This applies equally to conditions such as intestinal wind and hematochezia. Students of medicine must not neglect this point.