吐红薄厥之症，初治用犀角地黄汤不效者，以犀、地虽有凉血止血之功，而其力尚缓故
也。凡吐血正涌之时，法宜重在止血，宜以炒蒲黄、炒侧柏叶、棕灰三味为主，佐以紫菀、
犀角、地黄、白芍之类；若血势过盛不止者，再用清金散、碧玉丹，一坠其火即降；更不止，再
加童便。甚至血势涌溢，并汤药无隙可进者，须以热酒濯其两足，自能引火下行，而血渐止，然
后投以上药可也。
余于劳嗽症，尝列四候以为准。夫四候者，肺有伏逆之火，膈有胶固之痰，皆畏非时之
感，胸多壅塞之气。然此四候，以肺火伏逆为主，余三候则相因而至。盖肺为五脏之天，司
治节之令，秉整肃之化，外输精于皮毛，内通调乎四渎。故饮食水谷之精微，由脾气蒸发以
后，悉从肺为主，上荣七窍，下封骨髓，中和血脉，油然沛然，施于周身，而何痰涎之可成
哉？惟肺为火薄，则治节无权，而精微不布于上下，留连膈膜之间，滞而为痰，痰老则胶固
而不可解，气无以宣之也。又肺主皮毛，外行卫气，气薄而无以卫外，则六气所感，怯弱难
御，动辄受损，则本病而复标邪乘之。或本火标风，则风助火势，而清火易滞其气，驱风必
燥其营；本火标寒，则寒火结聚，而散寒则火煽，降火必寒收；本火标暑，则暑火同气；本
火标湿，则湿火交煎。虚劳一遇此等标邪触发，或兼伤寒，或兼疟痢，必至轻者重而重者危。故
于时已至而气未至，时未至而气先至，或至而太过、至而不及等，皆属虚风贼邪，所宜急防
之也。胸者，心肺交加之部，火炎攻肺，而气不得以下输，则气多壅塞，尤不当以宽胸理气
之剂开之。总之，肺气一伤，百病蜂起，风则喘，痰则嗽，火则咳，血则咯，以清虚之脏，
纤芥不容，难护易伤故也。故于心肾不交之初，火虽乘金，水能救母，金未大伤者，预当防
维清肃之令，以杜其渐，而况劳嗽已成，可不以保肺为治哉！
吐血、鼻衄及因血逆上冲导致昏厥的症状，初期治疗若使用犀角地黄汤无效，是因为虽然犀角和生地黄具有凉血止血的功效，但药力尚且缓慢。凡是在吐血正汹涌之时，治法应当重在止血，适宜以炒蒲黄、炒侧柏叶、棕榈灰这三味药为主，佐以紫菀、犀角、生地黄、白芍等药物；如果血势过盛不止，再使用清金散、碧玉丹，一旦降下火势，血液自会下降；如果仍不止血，再加用童便（童子尿）。甚至血势涌溢，连汤药都无法服下的时候，必须用热酒浸泡双足，自然能引火下行，从而使血液逐渐停止，然后再投予上述药物即可。
我在论述劳嗽症时，曾列出四种证候作为准则。所谓这四种证候，是肺中有潜伏逆上的火邪，膈间有胶固难化的痰浊，都畏惧非季节性的外感邪气，胸部多有壅塞之气。然而这四种证候中，以肺火潜伏逆上为主，其余三种证候则随之而来。因为肺是五脏的天盖，主管治理调节的职能，秉承整肃清净的化育功能，向外输布精气于皮毛，向内通调水道于四渎。所以饮食水谷的精微物质，经过脾气的蒸腾气化后，全部由肺主导，向上滋润七窍，向下封闭骨髓，调和血脉，充沛地施用于全身，哪里还会形成痰涎呢？只有当肺被火邪逼迫，治理调节的权力丧失，精微物质不能布散于上下，滞留于膈膜之间，停滞而成为痰，痰久则胶固难以化解，气机无法宣通。另外，肺主皮毛，向外运行卫气，如果气薄而不能护卫体表，那么六淫邪气侵袭，身体怯弱难以抵御，动辄受损，就会导致本病未愈而标邪乘虚而入。或者是本有火邪兼夹风邪，则风助火势，而清火容易阻滞气机，驱风必然耗伤营阴；本有火邪兼夹寒邪，则寒火结聚，散发寒邪则火势更旺，降火则寒气收敛；本有火邪兼夹暑邪，则暑火同气相求；本有火邪兼夹湿邪，则湿火交煎互扰。虚劳之人一旦遇到这些标邪触发，或者兼夹伤寒，或者兼夹疟疾痢疾，必定导致轻者变重，重者转危。所以在时令已到而邪气未至，或时令未到而邪气先至，或邪气太过、不及等情况，都属于虚风贼邪，应当紧急防范。胸廓是心肺相交加临的部位，火炎上攻肺脏，气机不得向下输布，则气多壅塞，尤其不应当用宽胸理气的药剂来开泄它。总之，肺气一旦受伤，百病蜂拥而起，风邪致喘，痰浊致嗽，火邪致咳，血溢致咯，因为肺是清虚之脏，纤尘不容，难以保护而易受损伤的缘故。所以在心肾不交的初期，虽然火邪乘袭肺金，但肾水能救母（肺），肺金尚未大伤时，预先应当防范维护清肃的职能，以杜绝其渐成之势，何况劳嗽已经形成，怎能不以保肺为治疗原则呢！
The syndrome of hematemesis, epistaxis, and *bo jue* (syncope due to blood rebellion upward), if initial treatment with Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) proves ineffective, is because although Rhinoceros Horn (*Xijiao*) and Rehmannia Root (*Dihuang*) possess the efficacy of cooling blood and stopping bleeding, their action is relatively slow. Whenever hematemesis is surging vigorously, the therapeutic principle should prioritize stopping bleeding. It is appropriate to use Chao Puhuang (Stir-fried Spore of Typha Pollen), Chao Cebaiye (Stir-fried Leaf of Platycladus Orientalis), and Zonghui (Charred Palm Fiber) as the main ingredients, assisted by Ziwan (Aster Root), Rhinoceros Horn (*Xijiao*), Rehmannia Root (*Dihuang*), and White Peony Root (*Baishao*). If the bleeding remains excessive and uncontrolled, Qingjin San (Clear Metal Powder) and Biyu Dan (Jade Green Pill) may be used; once the fire pathogen is descended, the blood will subside. If bleeding persists, Tongbian (Child's Urine) can be added. In extreme cases where blood surges so violently that decoctions cannot be retained, soaking both feet in hot wine is required to naturally guide the fire downward, allowing the bleeding to gradually cease, after which the aforementioned medications can be administered.
In my discussion on Lao Sou Syndrome (Chronic Cough due to Consumption), I have established four key manifestations as criteria. These four manifestations are: latent rebellious fire in the Lung, tenacious phlegm fixed in the diaphragm, susceptibility to non-seasonal exogenous pathogens, and frequent qi stagnation in the chest. Among these four, the latent rebellious fire in the Lung is primary, while the other three arise consequentially. The Lung serves as the canopy of the five zang organs, governing the regulation and distribution functions, inheriting the transformation of integrity and cleanliness. It transmits essence outward to the skin and hair and regulates water passages inward. Thus, the refined essences from food and drink, after vaporization by the Spleen's qi, are primarily directed by the Lung to nourish the seven orifices above, seal the bone marrow below, harmonize the blood vessels, and abundantly distribute throughout the body. Under such conditions, how could phlegm-saliva form? Only when the Lung is constrained by fire does its regulatory power fail, causing refined essences to fail to distribute up and down, remaining between the diaphragm and membrane, stagnating into phlegm. As phlegm ages, it becomes tenacious and insoluble, preventing qi from diffusing. Furthermore, the Lung governs the skin and hair and circulates defensive qi outward. If the qi is deficient and unable to defend the exterior, the six climatic factors can invade easily; the body becomes weak and difficult to resist, suffering damage frequently, leading to the original disease persisting while secondary pathogens take advantage. If the root is fire and the branch is wind, wind aids fire; clearing fire may stagnate qi, while dispelling wind may dry the nutritive level. If the root is fire and the branch is cold, cold and fire knot together; dispersing cold fans the fire, while descending fire causes cold contraction. If the root is fire and the branch is summerheat, they share the same qi; if the root is fire and the branch is dampness, they scorch each other. When deficiency consumption encounters such secondary pathogens triggering an attack, whether complicated by Shanghan (Cold Damage) or Nuli (Malaria and Dysentery), mild cases become severe, and severe cases become critical. Therefore, situations where the season arrives but the pathogen has not, or the pathogen arrives before the season, or the pathogen is excessive or insufficient upon arrival, all belong to deficient wind and thief pathogens, which must be urgently prevented. The chest is the region where the Heart and Lung intersect. When fire flares and attacks the Lung, qi cannot descend, resulting in qi stagnation. It is particularly inappropriate to use formulas for widening the chest and regulating qi to open it. In summary, once Lung qi is injured, myriad diseases arise like bees swarming: wind causes wheezing, phlegm causes coughing, fire causes hacking cough, and blood leakage causes spitting blood. This is because the Lung is a pure and empty organ, intolerant of even the slightest impurity, making it hard to protect and easy to injure. Therefore, at the initial stage of Heart-Kidney Non-Interaction, although fire may assault Metal (Lung), Water (Kidney) can save its mother (Metal). If Metal is not severely damaged, one should preemptively guard and maintain the clear and descending function to prevent gradual deterioration. How much more so when Lao Sou Syndrome has already formed; one must certainly treat by preserving the Lung!