【内伤衄血之症】身无表邪,目睛或黄,五心烦热,鼻孔出血,此内伤衄血之症也。
随火上升,错经妄越,则内伤衄血之症作矣。
【内伤衄血之脉】左尺脉浮,肝肾阴虚;左寸沉数,心火妄动;右寸脉洪,肺家火旺
;右关脉数,脾胃积热。
【内伤衄血之治】肾阴不足,左尺脉浮者,犀角地黄汤、凉八味丸。肝火攻冲,清肝
饮。心火刑金,天王补心丹;热甚者,泻心汤。肺火上炎,泻白一物汤。膏粱积热,清胃汤,加
犀角地黄汤 治肾火上冲。
犀角 生地 丹皮 白芍药 山栀 黄柏
凉八味丸 治肾火上冲。
生地 山药 泽泻 丹皮 山萸肉 白茯苓 黄柏 知母
清肝饮
当归 川芎 生地 柴胡 黄芩 白芍药 丹皮 山栀 青皮
天王补心丹 治心血不足者。
人参 玄参 丹参 五味子 柏子仁 当归 远志 生地 黄连 天门冬 麦门冬 枣
泻心汤 治心火上炎。
黄连 甘草
泻白一物汤 即泻白散加黄芩。
清胃汤
升麻 黄连 生地 山栀 甘草 干葛 石膏 犀角
夫血从胃中呕出名吐血,从肺中咳出名嗽血,从鼻孔流出名衄血,分立三条,则经络各
别。夫胃中呕出之血,虽轻于肺中咳血,然有大吐不止而死者;鼻中流血,本为轻症,然有
鼻血不止,久久变症,故以三症同名血症,皆因火载上冲。下手真诀,必要先去血中之火,
家秘归经汤,以黄芩、黄柏与当归同用,则血中之火去,而血立刻归经。若咳嗽甚者,兼用
家秘泻白散;血不上冲,随以家秘肝肾丸,补其真阴。
家秘归经汤
当归 白芍药 黄芩 黄柏 丹皮 生地 甘草
大便结者,加大黄同煎,临服多磨犀角汁冲。
家秘肝肾丸
【内伤衄血的症状】身体没有表邪(外感病邪),眼睛发黄或视物昏黄,手足心发热,鼻孔出血,这就是内伤衄血的症状。
血液随着火势上升,经脉错乱妄行溢出,于是内伤衄血的病症就发作了。
【内伤衄血的脉象】左手尺部脉浮,提示肝肾阴虚;左手寸部脉沉而数,提示心火妄动;右手寸部脉洪大,提示肺家火旺;右手关部脉数,提示脾胃积热。
【内伤衄血的治疗】肾阴不足,左手尺部脉浮的,用犀角地黄汤、凉八味丸。肝火攻冲的,用清肝饮。心火刑克肺金(心火过旺灼伤肺阴)的,用天王补心丹;热势严重的,用泻心汤。肺火上炎的,用泻白一物汤。因膏粱厚味导致积热的,用清胃汤,加犀角地黄汤治疗肾火上冲。
犀角 生地 丹皮 白芍药 山栀 黄柏
凉八味丸 治疗肾火上冲。
生地 山药 泽泻 丹皮 山萸肉 白茯苓 黄柏 知母
清肝饮
当归 川芎 生地 柴胡 黄芩 白芍药 丹皮 山栀 青皮
天王补心丹 治疗心血不足的。
人参 玄参 丹参 五味子 柏子仁 当归 远志 生地 黄连 天门冬 麦门冬 枣
泻心汤 治疗心火上炎。
黄连 甘草
泻白一物汤 即泻白散加黄芩。
清胃汤
升麻 黄连 生地 山栀 甘草 干葛 石膏 犀角
从胃中呕出的血名叫吐血,从肺中咳出的血名叫嗽血,从鼻孔流出的血名叫衄血,分立为三条,则经络各不相同。从胃中呕出的血,虽然比从肺中咳出的血轻,但也有大吐不止而导致死亡的;鼻中流血,本来属于轻症,但也有鼻血不止,久而久之变生他症的,所以将这三种症状统称为血症,都是因为火气载血上冲所致。下手治疗的真诀,一定要先去血中之火,家秘归经汤,以黄芩、黄柏与当归同用,则血中之火去除,而血液立刻回归经脉。如果咳嗽严重的,兼用家秘泻白散;如果血不上冲,随即用家秘肝肾丸,补益其真阴。
家秘归经汤
当归 白芍药 黄芩 黄柏 丹皮 生地 甘草
大便结滞的,加大黄同煎,临服用时多磨犀角汁冲服。
家秘肝肾丸
[Symptoms of Internal Injury Nasal Bleeding] The body has no exterior pathogenic factors (exogenous pathogens), the eyes may appear yellow or vision is blurred, there is five-palm heat (heat sensation in the palms, soles, and chest), and bleeding from the nostrils. This constitutes the symptoms of internal injury nasal bleeding.
Blood rises following fire, meridians become disordered and blood overflows recklessly, thus the condition of internal injury nasal bleeding arises.
[Pulse Signs of Internal Injury Nasal Bleeding] The pulse at the left Chi position is floating, indicating Yin deficiency of the Liver and Kidney; the pulse at the left Cun position is deep and rapid, indicating reckless movement of Heart Fire; the pulse at the right Cun position is surging (Hong), indicating excessive fire in the Lung system; the pulse at the right Guan position is rapid, indicating accumulated heat in the Spleen and Stomach.
[Treatment of Internal Injury Nasal Bleeding] For insufficient Kidney Yin with a floating pulse at the left Chi position, use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) and Liang Bawei Wan (Cooling Eight-Ingredient Pill). For Liver Fire attacking upward, use Qinggan Yin (Liver-Clearing Drink). For Heart Fire punishing Metal (Heart Fire overacting on the Lungs), use Tianwang Buxin Dan (Emperor of Heaven's Special Pill to Tonify the Heart); if heat is severe, use Xiexin Tang (Drain the Heart Decoction). For Lung Fire flaming upward, use Xiebai Yiwu Tang (Single-Ingredient White-Draining Decoction). For accumulated heat due to rich and greasy food, use Qingwei Tang (Stomach-Clearing Decoction), combined with Xijiao Dihuang Tang to treat Kidney Fire rushing upward.
Rhino horn (Xijiao) Shengdi Danni Baishao Yao Shanzhi Huangbai
Liang Bawei Wan treats Kidney Fire rushing upward.
Shengdi Shanyao Zexie Danni Shanyurou Bai Fuling Huangbai Zhimu
Qinggan Yin
Danggui Chuanxiong Shengdi Chaihu Huangqin Baishao Yao Danni Shanzhi Qingpi
Tianwang Buxin Dan treats insufficiency of Heart Blood.
Renshen Xuanshen Danshen Wuweizi Baiziren Danggui Yuanzhi Shengdi Huanglian Tiandongong Maimendong Jujube
Xiexin Tang treats Heart Fire flaming upward.
Huanglian Gancao
Xiebai Yiwu Tang is Xiebai San added with Huangqin.
Qingwei Tang
Shengma Huanglian Shengdi Shanzhi Gancao Gange Shigao Xijiao
Blood vomited from the stomach is called hematemesis (vomiting blood); blood coughed up from the lungs is called hemoptysis (coughing blood); blood flowing from the nostrils is called epistaxis (nasal bleeding). These are divided into three categories, indicating distinct meridians and organs. Although blood vomited from the stomach is considered milder than blood coughed from the lungs, massive unceasing vomiting can lead to death; bleeding from the nose is originally a mild condition, but unceasing nasal bleeding can transform into other conditions over time. Therefore, these three symptoms are collectively termed "blood diseases," all caused by fire carrying blood upward. The essential principle of treatment is to first remove the fire within the blood. Ji Mi Guijing Tang (Secret Home Prescription for Returning Blood to Meridians), using Huangqin, Huangbai, and Danggui together, removes the fire within the blood, causing the blood to immediately return to its meridians. If cough is severe, combine with Ji Mi Xiebai San (Secret Home Prescription for Draining the Lungs); if blood does not rush upward, subsequently use Ji Mi Ganshen Wan (Secret Home Prescription for Tonifying Liver and Kidney) to tonify true Yin.
Ji Mi Guijing Tang
Danggui Baishao Yao Huangqin Huangbai Danni Shengdi Gancao
If stool is constipated, add Dahuang to decoct together; before administration, grind a large amount of Rhino horn juice to mix in.
Ji Mi Ganshen Wan