仲景曰∶病患胸满，唇痿，舌青，口燥，但欲漱水，不欲咽，无寒热，脉微大来迟，腹不满，其人言我满，为有瘀
血，此乃因寒而瘀，瘀未甚也。仲景未立方治，但宜通，不拘一方，故略之，拟备大法。
当归 桂枝 干姜 艾叶 川芎 白芍 阿胶 芥穗
仲景曰∶病者如有热状、烦满、口干燥而渴，其脉反无热，此为阴伏，是瘀血也，当下之。吾为之解曰∶不发热，
知非外感，血瘀不养心，故烦。滞冲任胃脉之气，故满。以其干燥而渴，故知所瘀之地在冲任，胃气因之而生火上炎也。
脉无洪数之象，故知是瘀久气郁，热伏阴分也。下之不出方，因事制宜也。窃谓烦甚而胸中痞痛者，与泻心汤加归、芎、
生姜、白芍治之。
泻心汤加味
大黄（酒炒） 淡黄芩 酒白芍 生姜 黄连（姜汁炒） 炒当归 细抚芎
腹满甚，痛而拒按者，与桃仁承气汤。
仲景桃仁承气汤
桃仁 大黄 芒硝 桂枝
其烦满渴饮杀是者，拟备大法。
嫩白薇 川芎 黄柏炭 宝珠花（研冲） 大丹参 牛膝 川贝 淡姜汁（冲）
（〔批〕大抵血瘀属实，为有余之证，脉必沉紧滑数。血枯属虚为不足之证，脉必散大浮芤，识此辨之可无误矣。）
妇人、室女，因血气瘀滞而经闭者，其脉反见滑数，数则为有热，滑则为有余，虽未见吐衄诸证，然属之经脉逆转，
治宜降逆通瘀。陈氏曰∶经脉逆转者，宜《金匮》麦门冬汤，加牛膝、茜草之类。
《金匮》麦门冬汤
麦门冬 人参 粳米 炙甘草 半夏 大枣
通瘀行经之品，随时因其虚实而加之。瘀多者，减去参，逆甚而气满者，并去甘草；渴甚舌光剥者，重加白蜜以滋
肾阴。
张仲景说：患者胸部胀满，嘴唇枯萎萎缩，舌色发青，口中干燥，只想含水漱口而不愿咽下，没有恶寒发热的表证，脉象微大且来势迟缓，腹部外观并无胀满，但患者自述感到胀满，这是有瘀血的表现。这通常是因为寒邪导致血液凝滞，但瘀血程度尚不严重。张仲景在此未列出具体方剂进行治疗，只是指出应当采用通利之法，不拘泥于某一固定方子，因此此处省略具体方药，仅拟定通用的治疗大法。
张仲景说：病人好像有发热症状，心中烦闷胀满，口唇干燥且口渴，但其脉象反而没有热象，这称为“阴伏”，即瘀血阻滞，应当使用攻下法治疗。我对此解释如下：不发热，说明不是外感病邪；血瘀不能滋养心脏，所以心烦；瘀血阻滞冲脉、任脉及胃经的气机，所以感到胀满；因为口唇干燥且口渴，所以知道瘀血所在的部位在冲脉和任脉，胃气因此生火并向上炎升。脉象没有洪大数急之象，所以知道是瘀血日久、气机郁结，热邪潜伏在阴分所致。这里没有给出具体方剂，是因为需要根据具体情况灵活制宜。我认为如果心烦严重且胸中痞塞疼痛的，可用泻心汤（Xixin Tang, Heart-Draining Decoction）加入当归、川芎、生姜、白芍来治疗。
加味泻心汤
大黄（用酒炒制）、淡黄芩、酒白芍、生姜、黄连（用姜汁炒制）、炒当归、细抚芎（川芎的一种）。
如果腹部胀满严重，疼痛且拒绝按压的，可用桃仁承气汤（Taoren Chengqi Tang, Peach Kernel Decoction to Inherit Qi）。
对于那些心烦胀满、口渴饮水不止的患者，拟定通用治疗大法如下：
嫩白薇、川芎、黄柏炭、宝珠花（研碎冲服）、大丹参、牛膝、川贝、淡姜汁（冲服）。
（批注：大抵而言，血瘀属于实证，是有余的病证，脉象必定沉紧滑数。血枯属于虚证，是不足的病证，脉象必定散大浮芤，认清这一点进行辨别就不会出错。）
妇女或未婚女子，因气血瘀滞而导致月经闭止的，其脉象反而出现滑数，数脉主热，滑脉主有余，虽然未见吐血、衄血等症状，但这属于经脉之气逆乱，治疗应当降逆并疏通瘀血。陈氏说：经脉之气逆乱的，适宜使用《金匮要略》中的麦门冬汤（Maidong Tang, Ophiopogon Decoction），加入牛膝、茜草之类的药物。
《金匮要略》麦门冬汤
麦门冬、人参、粳米、炙甘草、半夏、大枣。
在通瘀行经的药物中，随时根据患者的虚实情况加减。瘀血多的，减去人参；气逆严重且腹胀的，去掉甘草；口渴严重且舌面光剥无苔的，加重白蜜以滋补肾阴。
Zhang Zhongjing stated: When a patient presents with chest fullness, withered lips, a bluish tongue, dry mouth, and a desire only to rinse the mouth with water without swallowing, accompanied by no aversion to cold or fever, and a pulse that is slightly large but slow in arrival, while the abdomen appears non-distended externally though the patient complains of internal fullness, this indicates the presence of blood stasis (Blood Stasis). This condition arises from cold causing stagnation, yet the stasis is not severe. Zhang Zhongjing did not prescribe a specific formula here, merely stating that the treatment should focus on promoting circulation without being confined to a single fixed prescription; thus, specific formulas are omitted, and only general therapeutic principles are outlined.
Danggui (Angelicae Sinensis Radix), Guizhi (Cinnamomi Ramulus), Ganjiang (Zingiberis Rhizoma), Aye (Artemisiae Argyi Folium), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Ejiao (Colla Corii Asini), Jingjie Sui (Schizonepetae Spica).
Zhang Zhongjing stated: If a patient exhibits symptoms resembling heat, such as irritability, fullness, dry mouth, and thirst, yet the pulse lacks signs of heat, this is termed "Yin Fu" (Hidden Yin/Concealed Heat), indicating blood stasis, which requires purgative treatment. My interpretation is as follows: The absence of fever indicates it is not an external contraction. Blood stasis fails to nourish the heart, leading to irritability. Stagnation of qi in the Chong (Penetrating Vessel) and Ren (Conception Vessel) meridians, along with the stomach meridian, causes fullness. Due to the dryness and thirst, we know the site of stasis lies within the Chong and Ren vessels, where stomach qi generates fire that flares upward. The absence of a surging and rapid pulse indicates that the heat has been concealed in the yin aspect due to prolonged stasis and qi depression. No specific formula is provided here because treatment must be adapted to individual circumstances. I propose that for cases with severe irritability and epigastric oppression/pain, Xixin Tang (Heart-Draining Decoction) modified with Danggui, Chuanxiong, Shengjiang (Fresh Ginger), and Baishao should be used.
Modified Xixin Tang
Dahuang (Rhei Radix et Rhizoma, stir-fried with wine), Dan Huangqin (Scutellariae Radix, mild grade), Jiubaishao (Paeoniae Radix Alba, treated with wine), Shengjiang (Zingiberis Rhizoma Recens), Huanglian (Coptidis Rhizoma, stir-fried with ginger juice), Chao Danggui (Angelicae Sinensis Radix, stir-fried), Xi Fuxiong (Ligustici Chuanxiong Rhizoma, fine variety).
For cases with severe abdominal distension, pain, and tenderness upon pressure (refusal to be pressed), Taoren Chengqi Tang (Peach Kernel Decoction to Inherit Qi) should be administered.
Zhang Zhongjing's Taoren Chengqi Tang
Taoren (Persicae Semen), Dahuang (Rhei Radix et Rhizoma), Mangxiao (Natrii Sulfas), Guizhi (Cinnamomi Ramulus).
For patients suffering from severe irritability, fullness, and excessive thirst requiring constant drinking, the following general therapeutic principle is proposed:
Nen Baiwei (Anemarrhenae Rhizoma, tender), Chuanxiong (Ligustici Chuanxiong Rhizoma), Huangbai Tan (Phellodendri Cortex, charred), Baozhu Hua (Bauhinia Flower, ground and taken with decoction), Da Danshen (Salviae Miltiorrhizae Radix et Rhizoma), Niuxi (Achyranthis Bidentatae Radix), Chuanbei (Fritillariae Cirrhosae Bulbus), Dan Jiangzhi (Ginger Juice, mild strength, taken with decoction).
(Commentary: Generally speaking, blood stasis belongs to excess syndromes, characterized by a pulse that is necessarily deep, tight, slippery, and rapid. Blood deficiency/kwashiorkor belongs to deficiency syndromes, characterized by a pulse that is necessarily scattered, large, floating, and hollow. Recognizing this distinction ensures accurate diagnosis.)
In women or unmarried girls, amenorrhea caused by qi and blood stagnation often presents with a slippery and rapid pulse. A rapid pulse indicates heat, and a slippery pulse indicates excess. Although symptoms such as hematemesis or epistaxis may not be present, this condition involves the reversal of meridian qi flow. Treatment should focus on directing qi downward and unblocking stasis. Chen Shi stated: For reversed meridian qi flow, Maidong Tang (Ophiopogon Decoction) from the *Jin Gui Yao Lue* should be used, supplemented with herbs like Niuxi and Qiancao.
*Maidong Tang* from *Jin Gui Yao Lue*
Maidong (Ophiopogonis Radix), Renshen (Ginseng Radix et Rhizoma), Jingsmi (Oryza Sativa), Zhi Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Banxia (Pinelliae Rhizoma), Dazao (Ziziphi Jujubae Fructus).
Herbs that promote circulation and menstruation should be added or subtracted according to the patient's deficiency or excess status at any given time. If stasis is heavy, reduce or remove Renshen. If qi reversal is severe with abdominal fullness, remove Zhi Gancao. If thirst is extreme with a peeled/glossy tongue, heavily add Baimi (White Honey) to nourish kidney yin.