解毒汤加当归煎服之，次以草茎纳鼻中，出血半升。临晚，又以益肾散利数行，乃愈。
何伯庸治邵某者，吐血数斗而仆，气已绝矣。何见其血色，曰∶未死也。以独参汤灌之而愈。（《云南通志》。）
朱丹溪治一男子，家贫而多劳，十一月得寒病，时吐三两口血，六脉紧涩。一日，食减中痞，医投温胆汤、
枳桔汤，三日后，发微热，口干不渴，口中有痰。此感寒也。询之，云∶因十日前，霜中曾三四次渡溪水，心
下有悲泣事，腹亦饥。遂以小建中汤去白芍加桔梗、陈皮、半夏，四帖而安。
秀州进士陆宁，忽得疾，吐血不止，气促惊颤，狂躁跳跃，双目直视，至深夜欲拔户而出，如是雨夜，诸
医遍用古方，极治不瘳。举家哀诉所供观音，梦投一方，当归根末，用益智一两，生米二钱，青皮半两，调服，
觉取笔记，明日疗治病愈。（《辛志》。）
薛立斋治一妇人，素性急，患肝风之症，常服搜风顺气丸、秦艽汤之类，后大怒吐血，唇口牵紧，小便频
数，或时自遗，此肝火旺而血妄行，遂用小柴胡汤加山栀、丹皮渐愈。一年之后，又大怒吐血，误用降火祛风
化痰之剂，大便频数，胸中少食。用清气化痰之剂，呕而不食，头晕口干，不时吐痰。用导痰降火之类，
痰如涌出，四肢常冷。薛曰∶呕而不食，胃气虚弱也；头晕口干，中气不能上升也；痰出如涌，脾气不能摄涎
也；四肢逆冷，脾气不能营运也。用补中益气加茯苓、半夏治之，诸症渐愈。又用加味归脾汤，兼服而安。
一老妇每吐血，先饮食不进，或胸膈不利，或中脘作痛，或大便作泻，或小便不利，此肝肺之症，用逍遥
散加山栀、茯神、远志、木香而愈。后郁结，吐紫血，每先作倦怠烦热，以前药加炒黑黄连三分，吴茱萸二分，
顿服。复因怒，吐血甚多，燥渴垂死，此血脱也，法当补气，乃用人参一两，茯苓、当归各三钱，陈皮、炮黑
干姜各二钱，炙甘草、木香各一钱，一剂顿止。又用加味归脾汤，调理而痊。
一女子怀抱素郁，胸满食少，吐血面赤，用六味丸及归脾加山栀、贝母、白芍而愈。
一妇人为哭母吐血，咳嗽发热，盗汗，经水不行，此悲伤肺，思伤脾，朝服补中益气丸，桔梗、贝母、知
母，夕用归脾汤送六味丸而愈。
陈良甫治一妇人，月经不利，忽妄行呕血。察其形脉如常，用四生丸即安。（生荷叶、生艾叶、生柏叶、生
地黄。）一男子饱食负重而吐血，用前汤及青饼子而愈。世治吐血，并用竹茹、地黄、藕汁，亦不可泥。如阳
乘于阴，血得热则必流散，经水沸溢，理宜凉解，大黄、犀角之类。如阴乘于阳，所谓天寒地冻，水凝成冰，
须当温散，干姜、肉桂之类。
陈日华云∶先公绍兴初，常游福青灵石寺，主僧留饮食将竟，侍者赴堂斋罢，来侍立，见桌子上不稳，急
罄折扳之，举首即吐血，盖食饱拗破肺也。明年再到寺，问去年吐血者无恙否？主僧言∶服得四生丸遂愈。自
得此方，屡救人有效。薛意前症乃内热暴患，用之有效。若人病久，本元不足，须补脾以滋化源，否则虚火上
炎，金反受克，获生鲜矣。
仆常治一人吐血，诊其脉，肝部强，气口濡，此因怒极而得之，遂用苏合香丸和鸡苏丸即效。
易思兰治吴大司马，甲戌季春，卧病两月，发热咳嗽，痰喘气急，胸膈痞满，手足面目俱浮肿。众惟清金
宁咳，又以胃脾久虚发肿。用利水兼补剂，病益甚。诊其脉，左寸浮而无力，右关弦张，推之于外，内见洪大
而芤，侵过寸部一分，左尺沉弱无力，右寸沉而带芤，气口脉按之紧而且牢，时或一驶，右关中和无力，右尺
稳稳不动。夫心乃一身之主，肾为性命之原，二脉不动，虽危不妨，惟以右寸并气口断之，寸口沉而芤，非痰
乃血也。书云∶弦驶而紧，沉细而牢，六部见之，皆为积聚。今气口紧而驶，此积血在肺胃间，壅滞其气，气
滞则血凝，乃积血症也。时值季春，地气上升，因用越法治之，进以畅胃豁痰汤，苏梗、桔梗、苍术各四分，
香附、贝母各五分，连翘三分，前胡、抚芎、赤芍各六分。辰时服药，至午未时气急，小便全无。将暮，吐紫
黑血二三升，臭不可闻，症顿减八九，六脉豁然。曰∶半夜时当有汗，可预防之，无令太过。至期果然，脉气
和平。惟咳嗽常有二三声，以桔枳二陈汤加香附、归尾、茜根、茅根、童便，调治三日，上部之疾全愈。但脾
肾之脉无力，饮食少味，四肢倦怠，再用六味丸，早晚百丸，午以补中益气汤加麦冬、酒连调其中，半月后，
气体充实而痊。凡血在肝脾，当用血药，血在肺胃，宜用气药，开提其气，解散其郁，以引经药道之，血随气
升，自然越出而安矣。至于辰时服药，而午时小便全无者，随药气上升而不降，非津液竭也。又至半夜而汗出，
盖汗为心液，心属火为阳，阳气至子时发动，阳动则汗出，所谓一通则百通也。次年冬，公总漕河，因阅新
堤，步行数十里，劳神过度，汗透重裘，衣湿身凉，饮姜汁热酒十余杯，当即头眩目昏，胸满燥渴，大吐鲜血
四五口，一老医以却药止之。三日后，胸膈气满，左胁闷痛，饮食渐少，午后燥热，嗽咳连声。半月后，面目
手足肿胀，有进滋阴降火之剂者，有进补脾消食之剂，左胁益痛，难以转侧，此盖前病复作也。但昔之积在肺
胃，今之积在左胁，昔病在春，地气上升，当用吐法。今乃寒冬，天地收藏，岂敢轻伐天和。须先以疏导之剂，
通其经络，后以荡涤之药，逐血下行，徐徐调和荣卫可也。面目浮肿，非水肿也，乃血病气无所附，气浮于外
矣。只去其血积，则气自归经，而肿即消矣。不信，乃日服去水消肿之剂，泄去真阴，小便全无，虚烦作燥，
气喘痰塞，不月而殁。殓时口中涌出紫血数升，众始谓所言不诬。
瑞昌王孙镇国将军，久患腹痛，诸药不效，饮烧酒数杯顿止。时孟夏，诊其脉，左寸沉大有力，此积血症
也。不信，至仲冬，其疾大作，面红目碧，眼胞浮，神乱气促，腹痛，饮烧酒亦不止。其脉与初诊无异，惟人
迎气口洪滑浸上，知其有欲吐之意，投以盐汤一盏，遂大吐。吐出血饼大如杯者，如枣栗者各数十，兼有白饭
清水，瘀血如笔管者二三条。吐讫，胸中宽快，仍不服药。次日黎明，口臭气塞，四肢厥冷，昏不知人，胸间
微热而已。复诊，幸两尺犹存，根本尚在，急以灯火爆曲池、虎口、中脘、气海。病者略知痛，即令人扶坐，
勿令睡倒，随进独参汤二服，手足微温。继用人参五钱，附子二钱，作理中汤，日与饮之，六脉微见。过七日，
方开眼识人，小便始通，即以补中益气汤、六味地黄丸兼服之，半月而瘥。是症诊得肝脉弦大而坚者，血有余
也；时或一驶，血积而不行也；肺脉浮大，金受火邪，气弱不能运血也；脾脉微涩，脾主思，思则气结，土不
能生金也。既吐之后，血犹有余，气愈不足，故宜人参助气，白术健脾，附子助阳，干姜暖血，甘草和中，开
通经络流行血气也。
陆晦庵曰∶昔余患吐血，暴涌如潮，七八日不止，诸医莫救。有云间沈四雅寓吴中，延治，慨然担当，方
用人参三两，附子一两，肉桂一钱，举家惊惶，未敢轻用。越二日，其血益甚，更请视脉，求其改用稍缓之方。
彼云∶病势较前更剧，前方正宜改定，始克有济。更加人参至五两，附子至二两，家人愈惊。彼曰∶喘呕脱血，
数日不止，且头面哄热，下体厥冷，正阳欲脱亡之兆，命在呼吸，若今日不进，来日不可为矣。家人恳裁参、
附，坚执不允，谕放胆煎服，坐候成功。家人见其如此，料可无虞，遂根据方求服。彼欣然出熟附子二十余块，
授咀面称二两，同参五两，煎成入童便、地黄汁一大碗，调肉桂末冷服。少顷，下体至足微汗，便得熟睡。睡
觉，血止喘定，周身柔和，渐渐转侧，因馈十二金，求其收功。不受，加至二十金始受。一医见其收功，心甚
疑骇，病患居恒常服参两许，今虽五两，止前数沸，犹可当之，至血症用附子二两，从古未闻。因密访其制药
者云∶惯用附子汁收入甘草，其附已经煎过十余次，虽用二两，不抵未煎者二三钱。始知方士之术如此。（出
《张氏医通》。）
马元仪治表侄妇，胸满不舒，盖得之悒郁伤津，而阳不化也。医者不察，遽投大剂辛香开痞之药，遂至吐
血盈盆，三日不止，已濒于危。或与凉血滋阴之剂，连进无功。脉之，右关尺搏击碍指，此症非受病魔，乃受
药魔也。夫积郁之体，津液素伤，又药热与胃热相合为虐，血得热则妄行，但图凉血滋阴，其何能济？经云∶
热淫于内，治以苦寒，苦能胜辛，寒能胜热，所谓不重医病，而重医药者是也。急令煎九制大黄与之，诸症顿
平，调理而愈。
戴叔能曰∶予得血病，服药者经年。朱碧山视之曰∶此阴虚证也，徐补之则愈，急止则大害。从之，用其
法不二月而愈。（《九灵山房集》。）
立斋治一妇人，性躁急，瘰 后吐血发热，两胁胀痛，日晡为甚，以为怒气伤肝，气血俱虚，遂朝用逍遥
散，倍加炒黑山栀、黄柏、贝母、桔梗、麦冬、五味，夕用归脾汤送地黄丸，诸症并愈。
缪仲淳治王司丞逊之，患吐血。诊之云∶多服童便自愈。别去，贻书门人张选卿曰∶逊之旋已勿药矣，但
相公年尊，右手脉弱甚，此非细故，可致意逊之预为计。时文肃公尚无恙，不两月而逊之疾瘳，文肃一病不起。
萧万舆治陈克辉，英年气盛，连宵痛饮，复啖炙爆，数日胃口嘈杂，呕血碗许，六脉洪缓有神，无别症，
投以犀角地黄汤，入芩、连、花粉，三剂，仍令恣饮藕汤而愈。
冯思才内，年五旬，偶因外事忤意，怒火激血上越，日吐数盆，脉洪缓，投以逍遥散去术，加黄连、山栀、
丹皮，四剂而愈。
连蜚天素弱攻苦，便赤梦遗，灯宵竞逐，偶触事忤意，遂患吐血，痰嗽甚多，初服降火清金之剂不瘥。至
二十一日，诊之，两寸洪大虚阔，关尺浮弦无力，曰∶血症本非难治，但元气虚脱上浮，肝肾皆得克脉，幸不
数烦，久服参、 之剂，方得平服。若用苦寒，必致不起。用加减八珍汤，彼疑参难疗血，及二十四日增剧，
投以前剂四贴血止，经旬潮热亦退。惟脉未复，每多言，痰嗽不止，少劳，梦遗顿作，此心脾不交，阴阳虚
极，服丸剂七斤余，汤药八十余剂而愈。
陈子珍亦患前症，治数月不痊。诊之，与蜚天病源同，疑投参、术、熟地性温，参、术助火，仍
服苦寒清金之
剂，经年渐愈。至次夏，忽呕血不止，又用止寒之剂，致肠结胀痛。逾旬，延疡医，令其针刺肛门，溃浓数盂而殁。
沈明生治孙子南媳，赋质瘦薄，脉息迟微，春末患吐红，以为脾虚不能摄血，投归脾数剂而止。虑后复作，
索丸方调理，仍以归脾料合大造丸中数味与之。复四五日后，偶值一知医者谈及，乃骇曰∶诸见血为热，恶可
用参、 、河车温补耶？血虽止，不日当复来矣。延诊，因亟令停服，进以花粉、知母之属。五六剂后，血忽
大来，势甚危笃，此友遂敛手不治，以为热毒已深，噬脐无及。子南晨诣，愠形于色，咎以轻用河车，而盛称
此友先识。初不言曾服凉药，且欲责效于师，必愈乃已。沈自讼曰∶既系热症，何前之温补，如鼓应桴？今只
增河车一味，岂遂为厉如是？且斤许药中，干河车仅用五钱，其中地黄、龟板滋阴之药反居大半，才服四五日，
每服二钱，积而计之，河车不过两许耳。遂不复致辨，往诊其脉，较前转微，乃笑曰∶无伤也，仍当大补耳。
其家咸以为怪，然以为系铃解铃，姑听之。因以归脾料倍用参、 ，一剂而熟睡，再剂而红止。于是始悟血之
复来，由于寒凉速之也。因叹曰∶医道实难矣，某固不敢自居识者，然舍症从脉，得之先哲格言，血脱益气，
亦非妄逞臆见。今人胸中每持一胜算，见前人用凉辄曰∶此寒症也，宜用热。见前人用热，则火症也，应
用凉。因攻之不灵，从而投补，因补者不效，随复用攻，立意翻新，初无定见，安得主人病患一一精医察理，
而不为簧鼓动摇哉。在前人，蒙谤之害甚微，在病者，受误之害甚钜，此张景岳不失人情之论所由作也。
顾德生令郎患吐血，咸以其髫龄秀质， 于帷房，阴虚火动所致，日进二冬二地之属。时沈初寓吴门，与
顾有倾盖惧，虽心识其非，然投分日浅，且制于一齐众楚之势，难以口舌争也。乃贻书曰∶经云，阴虚生内热，
热逼血而错经妄行。丹溪云，血随气上，是阳盛阴虚，有升无降，涌出上窍，法当补阴抑阳。又云，精神困倦，
大吐不止，是气虚不能摄血。东垣云，甘温能除大热，热除而血自归经。又云，血脱补气，阳生阴长之理。细
究前言，或言清润，或言温补，均系先贤成法。以愚管见，当以法合病，不当以病合法。如或血症初得，所吐
不多，口燥唇干，未投凉药，宜从火治，补阴益阳之法也。若失血有日，所去过多，气短神衰，已投凉剂，宜
解毒汤中加入当归煎煮服用，随后将草茎插入鼻孔中，流出半升血液。到了傍晚，又服用益肾散通利大便数次，病才痊愈。
何伯庸治疗邵某，此人吐血数斗后昏倒，气息已绝。何伯庸观察其血色，说：“还没有死。”于是用独参汤灌服，病人痊愈。（出自《云南通志》。）
朱丹溪治疗一名男子，家境贫寒且劳作过度，十一月患寒病，时常吐出两三口血，六脉紧涩。一天，饮食减少，心中痞闷，医生投予温胆汤、枳桔汤，三天后，出现轻微发热，口干但不想喝水，口中有痰。这是感受寒邪所致。询问得知，十天前曾在霜雪中三四次渡过溪水，心中又有悲伤哭泣之事，腹部也饥饿。于是用小建中汤去掉白芍，加入桔梗、陈皮、半夏，服用四帖后病情安定。
秀州进士陆宁，突然患病，吐血不止，气促惊颤，狂躁跳跃，双目直视，到深夜想要破门而出，像这样在雨夜持续，众医生遍用古方，极力治疗却未见效。全家悲哀地诉说并供奉观音，梦中得到一方：当归根磨成粉末，用益智仁一两，生米二钱，青皮半两，调服，醒来取笔记下，第二天治病痊愈。（出自《辛志》。）
薛立斋治疗一名妇人，平素性情急躁，患有肝风病症，常服用搜风顺气丸、秦艽汤之类药物，后来大怒吐血，嘴唇和口角牵拉紧绷，小便频数，有时自行遗尿，这是肝火旺盛导致血液妄行，于是用小柴胡汤加入山栀、丹皮，逐渐痊愈。一年之后，又大怒吐血，误用降火祛风化痰的药物，导致大便频数，胸中进食少。再用清气化痰的药物，呕吐而不进食，头晕口干，不时吐痰。再用导痰降火之类的药物，痰液如涌出般多，四肢经常发冷。薛立斋说：“呕吐而不进食，是胃气虚弱；头晕口干，是中气不能上升；痰出如涌，是脾气不能摄持涎沫；四肢逆冷，是脾气不能营运。”于是用补中益气汤加入茯苓、半夏治疗，各种症状逐渐痊愈。后又用加味归脾汤，兼服而安顿。
一位老妇人每次吐血，先表现为饮食不进，或者胸膈不利，或者中脘作痛，或者大便泄泻，或者小便不利，这是肝肺的病症，用逍遥散加入山栀、茯神、远志、木香而痊愈。后来因郁结，吐出紫血，每次发作前先感到倦怠烦热，用以前的药方加入炒黑黄连三分，吴茱萸二分，顿服。又因愤怒，吐血甚多，燥渴垂危，这是血脱之症，治法应当补气，于是用人参一两，茯苓、当归各三钱，陈皮、炮黑干姜各二钱，炙甘草、木香各一钱，一剂药后血立刻停止。又用加味归脾汤，调理而痊愈。
一名女子平素怀抱忧郁，胸满食少，吐血面赤，用六味丸及归脾汤加入山栀、贝母、白芍而痊愈。
一名妇人为哭母亲吐血，咳嗽发热，盗汗，月经不行，这是悲伤伤肺，思虑伤脾，早晨服用补中益气丸，配合桔梗、贝母、知母，晚上用归脾汤送服六味丸而痊愈。
陈良甫治疗一名妇人，月经不畅，忽然妄行呕血。观察其形体脉象如常，用四生丸即安（生荷叶、生艾叶、生柏叶、生地黄）。一名男子饱食负重后吐血，用前面的汤药及青饼子而痊愈。世医治吐血，并用竹茹、地黄、藕汁，也不可拘泥。如果阳乘于阴，血得热则必然流散，经水沸溢，理应凉解，用大黄、犀角之类。如果阴乘于阳，所谓天寒地冻，水凝成冰，须当温散，用干姜、肉桂之类。
陈日华说：“先父在绍兴初年，常游览福青灵石寺，住持僧人留饮食即将结束，侍者赴堂斋罢，来侍立，见桌子上不稳，急忙弯腰去扳正它，抬头就吐血，这是因为吃饱了强行扭转身体损伤了肺。第二年再到寺里，问去年吐血的人是否安好？住持僧人说：‘服用四生丸便痊愈了。’自从得到这个方子，多次救人有效。薛立斋认为前症乃是内热暴患，用此方有效。如果人病久，本元不足，须补脾以滋生化之源，否则虚火上炎，金反受克，获得生机很少了。”
我常治疗一人吐血，诊其脉，肝部脉强，气口脉濡，这是因极度愤怒而得的，于是用苏合香丸和鸡苏丸即见效。
易思兰治疗吴大司马，甲戌年季春，卧病两个月，发热咳嗽，痰喘气急，胸膈痞满，手足面目俱浮肿。众人只知清金宁咳，又以胃脾久虚发肿为由。用利水兼补剂的药，病更加严重。诊其脉，左寸浮而无力，右关弦张，推之于外，内见洪大而芤，侵过寸部一分，左尺沉弱无力，右寸沉而带芤，气口脉按之紧而且牢，时或一驶，右关中和无力，右尺稳稳不动。心乃一身之主，肾为性命之原，二脉不动，虽然危险不妨碍，只以右寸并气口断之，寸口沉而芤，不是痰而是血。书云：“弦驶而紧，沉细而牢，六部见之，皆为积聚。”现在气口紧而驶，这是积血在肺胃之间，壅滞其气，气滞则血凝，乃是积血症。当时正值季春，地气上升，因此用越法治之，进以畅胃豁痰汤，苏梗、桔梗、苍术各四分，香附、贝母各五分，连翘三分，前胡、抚芎、赤芍各六分。辰时服药，至午未时气急，小便全无。将暮，吐紫黑血二三升，臭不可闻，症状顿时减轻八九，六脉豁然开朗。说：“半夜时应当有汗，可预防它，不要让它太过。”到了时期果然如此，脉气和平。只有咳嗽常有二三声，用桔枳二陈汤加入香附、归尾、茜根、茅根、童便，调治三日，上部之疾全愈。但脾肾之脉无力，饮食少味，四肢倦怠，再用六味丸，早晚各一百丸，中午用补中益气汤加入麦冬、酒连调其中，半月后，气体充实而痊愈。凡血在肝脾，当用血药，血在肺胃，宜用气药，开提其气，解散其郁，以引经药道之，血随气升，自然越出而安矣。至于辰时服药，而午时小便全无者，是随药气上升而不降，并非津液枯竭。又至半夜而汗出，盖汗为心液，心属火为阳，阳气至子时发动，阳动则汗出，所谓一通则百通也。次年冬，公总漕河，因阅新堤，步行数十里，劳神过度，汗透重裘，衣湿身凉，饮姜汁热酒十余杯，当即头眩目昏，胸满燥渴，大吐鲜血四五口，一老医以却药止之。三日后，胸膈气满，左胁闷痛，饮食渐少，午后燥热，嗽咳连声。半月后，面目手足肿胀，有进滋阴降火之剂者，有进补脾消食之剂，左胁益痛，难以转侧，这大概是前病复作。但昔之积在肺胃，今之积在左胁，昔病在春，地气上升，当用吐法。今乃寒冬，天地收藏，岂敢轻伐天和。须先以疏导之剂，通其经络，后以荡涤之药，逐血下行，徐徐调和荣卫可也。面目浮肿，非水肿也，乃血病气无所附，气浮于外矣。只去其血积，则气自归经，而肿即消矣。不信，乃日服去水消肿之剂，泄去真阴，小便全无，虚烦作燥，气喘痰塞，不月而殁。殓时口中涌出紫血数升，众始谓所言不诬。
瑞昌王孙镇国将军，久患腹痛，诸药不效，饮烧酒数杯顿止。时孟夏，诊其脉，左寸沉大有力，这是积血症。不信，至仲冬，其疾大作，面红目碧，眼胞浮，神乱气促，腹痛，饮烧酒亦不止。其脉与初诊无异，惟人迎气口洪滑浸上，知其有欲吐之意，投以盐汤一盏，遂大吐。吐出血饼大如杯者，如枣栗者各数十，兼有白饭清水，瘀血如笔管者二三条。吐讫，胸中宽快，仍不服药。次日黎明，口臭气塞，四肢厥冷，昏不知人，胸间微热而已。复诊，幸两尺犹存，根本尚在，急以灯火爆曲池、虎口、中脘、气海。病者略知痛，即令人扶坐，勿令睡倒，随进独参汤二服，手足微温。继用人参五钱，附子二钱，作理中汤，日与饮之，六脉微见。过七日，方开眼识人，小便始通，即以补中益气汤、六味地黄丸兼服之，半月而瘥。是症诊得肝脉弦大而坚者，血有余也；时或一驶，血积而不行也；肺脉浮大，金受火邪，气弱不能运血也；脾脉微涩，脾主思，思则气结，土不能生金也。既吐之后，血犹有余，气愈不足，故宜人参助气，白术健脾，附子助阳，干姜暖血，甘草和中，开通经络流行血气也。
陆晦庵说：“过去我患吐血，暴涌如潮，七八日不止，众医无法救治。有云间沈四雅寓居吴中，延请他治疗，他慨然担当，方用人参三两，附子一两，肉桂一钱，全家惊慌，不敢轻易使用。过了两天，其血更甚，再请他看脉，求他改用稍缓的方子。他说：‘病势较前更剧，前方正宜改定，始克有济。’更加人参至五两，附子至二两，家人更加惊恐。他说：‘喘呕脱血，数日不止，且头面哄热，下体厥冷，正是阳欲脱亡之兆，命在呼吸，若今日不进，来日不可为矣。’家人恳请裁减参、附，他坚决不允，谕令放胆煎服，坐候成功。家人见其如此，料可无虞，于是依方求服。他欣然取出熟附子二十余块，授意捣碎称二两，同参五两，煎成入童便、地黄汁一大碗，调肉桂末冷服。少顷，下体至足微汗，便得熟睡。睡觉，血止喘定，周身柔和，渐渐转侧，于是馈赠十二金，求其收功。他不接受，加至二十金才接受。一医见其收功，心里很怀疑骇异，病患平素常服参一两许，现在虽五两，止前几沸，还可抵挡，至血症用附子二两，从古未闻。于是密访制药者说：‘惯用附子汁收入甘草，其附已经煎过十余次，虽用二两，不抵未煎者二三钱。’始知方士之术如此。（出自《张氏医通》。）”
马元仪治疗表侄妇，胸满不舒，这是由于忧郁伤津，而阳不化所致。医者不察，遽投大剂辛香开痞之药，遂至吐血盈盆，三日不止，已濒于危。或与凉血滋阴之剂，连进无功。脉之，右关尺搏击碍指，此症非受病魔，乃受药魔也。夫积郁之体，津液素伤，又药热与胃热相合为虐，血得热则妄行，但图凉血滋阴，其何能济？经云：“热淫于内，治以苦寒，苦能胜辛，寒能胜热，所谓不重医病，而重医药者是也。”急令煎九制大黄与之，诸症顿平，调理而愈。
戴叔能说：“我患血病，服药者经年。朱碧山看后说：‘这是阴虚证，徐补之则愈，急止则大害。’听从他的方法，不到二月而痊愈。（出自《九灵山房集》。）”
立斋治疗一名妇人，性躁急，瘰疬后吐血发热，两胁胀痛，日晡为甚，以为是怒气伤肝，气血俱虚，于是早晨用逍遥散，倍加炒黑山栀、黄柏、贝母、桔梗、麦冬、五味，晚上用归脾汤送地黄丸，各种症状并愈。
缪仲淳治疗王司丞逊之，患吐血。诊后说：“多服童便自愈。”告别后，写信给门人张选卿说：“逊之随即已不用药了，但相公年尊，右手脉弱甚，这不是小事，可致意逊之预为计议。”当时文肃公尚无恙，不两月而逊之疾瘳，文肃一病不起。
萧万舆治疗陈克辉，英年气盛，连宵痛饮，复啖炙爆，数日胃口嘈杂，呕血碗许，六脉洪缓有神，无别症，投以犀角地黄汤，入芩、连、花粉，三剂，仍令恣饮藕汤而愈。
冯思才内人，年五旬，偶因外事忤意，怒火激血上越，日吐数盆，脉洪缓，投以逍遥散去术，加黄连、山栀、丹皮，四剂而愈。
连蜚天素弱攻苦，便赤梦遗，灯宵竞逐，偶触事忤意，遂患吐血，痰嗽甚多，初服降火清金之剂不瘥。至二十一日，诊之，两寸洪大虚阔，关尺浮弦无力，说：“血症本非难治，但元气虚脱上浮，肝肾皆得克脉，幸不数烦，久服参、术之剂，方得平服。若用苦寒，必致不起。”用加减八珍汤，他疑参难疗血，及二十四日增剧，投以前剂四贴血止，经旬潮热亦退。惟脉未复，每多言，痰嗽不止，少劳，梦遗顿作，此心脾不交，阴阳虚极，服丸剂七斤余，汤药八十余剂而愈。
陈子珍亦患前症，治数月不痊。诊之，与蜚天病源同，疑投参、术、熟地性温，参、术助火，仍服苦寒清金之剂，经年渐愈。至次夏，忽呕血不止，又用止寒之剂，致肠结胀痛。逾旬，延疡医，令其针刺肛门，溃浓数盂而殁。
沈明生治疗孙子南媳，赋质瘦薄，脉息迟微，春末患吐红，以为脾虚不能摄血，投归脾数剂而止。虑后复作，索丸方调理，仍以归脾料合大造丸中数味与之。复四五日后，偶值一知医者谈及，乃骇曰：“诸见血为热，恶可用参、术、河车温补耶？血虽止，不日当复来矣。”延诊，因亟令停服，进以花粉、知母之属。五六剂后，血忽大来，势甚危笃，此友遂敛手不治，以为热毒已深，噬脐无及。子南晨诣，愠形于色，咎以轻用河车，而盛称此友先识。初不言曾服凉药，且欲责效于师，必愈乃已。沈自讼曰：“既系热症，何前之温补，如鼓应桴？今只增河车一味，岂遂为厉如是？且斤许药中，干河车仅用五钱，其中地黄、龟板滋阴之药反居大半，才服四五日，每服二钱，积而计之，河车不过两许耳。”遂不复致辨，往诊其脉，较前转微，乃笑曰：“无伤也，仍当大补耳。”其家咸以为怪，然以为系铃解铃，姑听之。因以归脾料倍用参、术，一剂而熟睡，再剂而红止。于是始悟血之复来，由于寒凉速之也。因叹曰：“医道实难矣，某固不敢自居识者，然舍症从脉，得之先哲格言，血脱益气，亦非妄逞臆见。今人胸中每持一胜算，见前人用凉辄曰：‘此寒症也，宜用热。’见前人用热，则火症也，应用凉。因攻之不灵，从而投补，因补者不效，随复用攻，立意翻新，初无定见，安得主人病患一一精医察理，而不为簧鼓动摇哉。在前人，蒙谤之害甚微，在病者，受误之害甚钜，此张景岳不失人情之论所由作也。”
顾德生令郎患吐血，咸以其髫龄秀质，溺于帷房，阴虚火动所致，日进二冬二地之属。时沈初寓吴门，与顾有倾盖惧，虽心识其非，然投分日浅，且制于一齐众楚之势，难以口舌争也。乃贻书曰：“经云，阴虚生内热，热逼血而错经妄行。丹溪云，血随气上，是阳盛阴虚，有升无降，涌出上窍，法当补阴抑阳。又云，精神困倦，大吐不止，是气虚不能摄血。东垣云，甘温能除大热，热除而血自归经。又云，血脱补气，阳生阴长之理。细究前言，或言清润，或言温补，均系先贤成法。以愚管见，当以法合病，不当以病合法。如或血症初得，所吐不多，口燥唇干，未投凉药，宜从火治，补阴益阳之法也。若失血有日，所去过多，气短神衰，已投凉剂，宜...”
Jiedu Tang (Detoxification Decoction) was decocted with added Danggui Radix Angelicae Sinensis (Dong Quai) and administered orally. Subsequently, a grass stem was inserted into the nasal cavity, resulting in the discharge of half a sheng of blood. In the evening, Yishen San (Kidney-Nourishing Powder) was given to promote bowel movements several times, after which the patient recovered.
He Boyong treated a patient surnamed Shao who had vomited several dou of blood and collapsed, with breath already ceased. Observing the color of the blood, He said, "The patient is not dead." He administered Dushen Tang (Single Ginseng Decoction) by force-feeding, and the patient recovered. (From *Yunnan Tongzhi*.)
Zhu Danxi treated a man who was poor and overworked. In November, he contracted a cold syndrome, occasionally vomiting two or three mouthfuls of blood. His six pulses were tight and choppy. One day, his appetite decreased, and he felt epigastric fullness. The physician prescribed Wendan Tang (Gallbladder-Warming Decoction) and Zhijie Tang (Bitter Orange and Platycodon Decoction). Three days later, he developed a slight fever, dry mouth without thirst, and phlegm in the mouth. This was due to cold pathogen invasion. Upon inquiry, it was learned that ten days prior, he had crossed a stream in the frost three or four times, had sorrowful matters causing weeping in his heart, and his abdomen was hungry. Thus, Xiaojianzhong Tang (Minor Construct the Middle Decoction) was used, removing Shaoyao Paeoniae Radix Alba (White Peony Root), and adding Jiegeng Radix Platycodi (Balloon Flower Root), Chenpi Pericarpium Citri Reticulatae (Tangerine Peel), and Banxia Rhizoma Pinelliae (Pinellia Tuber). After four doses, the condition stabilized.
Lu Ning, an Jinshi (Metropolitan Graduate) from Xiuzhou, suddenly fell ill with continuous hematemesis, shortness of breath,惊颤 (startle and tremor), manic restlessness, jumping, fixed staring eyes, and at late night attempted to break out through the door. This persisted through rainy nights. Various physicians used ancient prescriptions extensively but failed to cure him. The whole family mournfully prayed to Guanyin Bodhisattva. A prescription appeared in a dream: Dangguigen powder (Powder of Angelica Sinensis Root), Zhiyi Ren Fructus Alpiniae Oxyphyllae (Alpinia Fruit) 1 liang, raw rice 2 qian, Qingpi Pericarpium Citri Reticulatae Viride (Green Tangerine Peel) 0.5 liang, mixed and taken orally. He woke up, recorded the prescription, and cured the disease the next day. (From *Xin Zhi*.)
Xue Lizhai treated a woman who was naturally irritable and suffered from Liver Wind syndrome. She frequently took Soushun Fengqi Wan (Search for Smoothness and Dispel Wind Pills) and Qinjiao Tang (Gentiana Macrophylla Decoction). Later, after a fit of rage, she vomited blood, her lips and mouth pulled tight, urination frequent with occasional incontinence. This indicated excessive Liver Fire causing reckless blood movement. Xue prescribed Xiaochaihu Tang (Minor Bupleurum Decoction) with added Zhizi Fructus Gardeniae (Gardenia Fruit) and Danmu Cortex Moutan (Moutan Bark). The condition gradually improved. One year later, she vomited blood again after a fit of rage. Mistakenly using herbs to descend fire, dispel wind, and resolve phlegm, she developed frequent stools and reduced intake in the chest. Using Qi Hua Tan (Clear Qi and Resolve Phlegm) agents caused vomiting and refusal of food, dizziness, dry mouth, and intermittent expectoration. Using Dao Tan Jiang Huo (Guide Phlegm and Descend Fire) agents resulted in profuse expectoration and cold limbs. Xue stated: "Vomiting without eating indicates weak Stomach Qi; dizziness and dry mouth indicate Middle Qi failing to ascend; profuse expectoration indicates Spleen Qi failing to hold saliva; cold limbs indicate Spleen Qi failing to circulate." He treated her with Buzhong Yiqi Tang (Center-Supplementing Qi-Boosting Decoction) plus Fuling Poria (Poria) and Banxia Rhizoma Pinelliae (Pinellia Tuber). Symptoms gradually resolved. Subsequently, Jiawei Guipi Tang (Modified Return to the Spleen Decoction) was used concurrently, leading to stability.
An elderly woman experienced recurrent hematemesis, initially presenting with loss of appetite, chest diaphragm discomfort, epigastric pain, diarrhea, or dysuria. This was identified as a Liver-Lung disorder. She was cured with Xiaoyao San (Free Wanderer Powder) plus Zhizi Fructus Gardeniae (Gardenia Fruit), Fushen Poria Cum Radix Pini (Poria with Pine Root), Yuanzhi Radix Polygalae (Polygala Root), and Muxiang Radix Aucklandiae (Aucklandia Root). Later, due to depression, she vomited purple blood, preceded by fatigue and irritability. The previous formula was modified with Chaohei Huanglian Rhizoma Coptidis (Charred Coptis Rhizome) 3 fen and Wuzhuyu Fructus Evodiae (Evodia Fruit) 2 fen, taken in one dose. Again, due to anger, she vomited large amounts of blood, becoming extremely thirsty and near death, indicating Blood Depletion. The treatment principle was to tonify Qi. She was given Renshen Radix Ginseng (Ginseng Root) 1 liang, Fuling Poria (Poria) and Danggui Radix Angelicae Sinensis (Angelica Root) each 3 qian, Chenpi Pericarpium Citri Reticulatae (Tangerine Peel) and Pahei Ganjiang Rhizoma Zingiberis Recens Ustus (Charred Ginger Root) each 2 qian, Zhi Gancao Radix Glycyrrhizae Preparata (Prepared Licorice Root) and Muxiang Radix Aucklandiae (Aucklandia Root) each 1 qian. One dose stopped the bleeding immediately. Jiawei Guipi Tang (Modified Return to the Spleen Decoction) was then used for convalescence.
A young woman with chronic depression presented with chest fullness, poor appetite, hematemesis, and flushed face. She was cured with Liuwei Wan (Six-Ingredient Pill) and Guipi Tang (Return to the Spleen Decoction) plus Zhizi Fructus Gardeniae (Gardenia Fruit), Beimu Bulbus Fritillariae Cirrhosae (Fritillaria Bulb), and Shaoyao Radix Paeoniae Alba (White Peony Root).
A woman vomited blood after weeping for her mother, accompanied by cough, fever, night sweats, and amenorrhea. This was attributed to Sadness injuring the Lung and Overthinking injuring the Spleen. She took Buzhong Yiqi Wan (Center-Supplementing Qi-Boosting Pills) in the morning with Jiegeng Radix Platycodi (Balloon Flower Root), Beimu Bulbus Fritillariae Cirrhosae (Fritillaria Bulb), and Zhimu Rhizoma Anemarrhenae (Anemarrhena Rhizome), and Guipi Tang (Return to the Spleen Decoction) with Liuwei Wan (Six-Ingredient Pill) in the evening. She recovered.
Chen Liangfu treated a woman with irregular menstruation who suddenly vomited blood. Her form and pulse appeared normal. Si Sheng Wan (Four Raw Ingredients Pill) brought immediate relief. (Ingredients: Raw He Ye Folium Nelumbinis (Lotus Leaf), Ai Ye Folium Artemisiae Argyi (Mugwort Leaf), Bai Ye Folium Platycladi (Oriental Arborvitae Leaf), Raw Di Huang Radix Rehmanniae Preparata (Prepared Rehmannia Root)). A man vomited blood after overeating and carrying heavy loads. He was cured with the aforementioned decoction and Qing Bing Zi (Green Cake Pill). In treating hematemesis, relying solely on Zhuru Caulis Bambusae in Taeniis (Bamboo Sap), Dihuang Radix Rehmanniae Preparata (Prepared Rehmannia Root), and Ou Jian Juice of Nymphaeae Album (Water Lily Juice) is inflexible. If Yang invades Yin, heat causes blood to scatter, like boiling water overflowing; cooling and resolving methods are appropriate, using Dahuang Radix et Rhizoma Rhei (Rhubarb Root) and Xijiao Cornu Rhinocerotis (Rhino Horn). If Yin invades Yang, akin to freezing water, warming and dispersing methods are needed, using Ganjiang Rhizoma Zingiberis Recens Ustus (Charred Ginger Root) and Rougui Cortex Cinnamomi (Cinnamon Bark).
Chen Rihua stated: "My father, in the early Shaoxing era, visited Lingshi Temple in Fuqing. As the host monk finished serving food, an attendant stood nearby. Seeing a table wobble, he bent down to steady it, looked up, and vomited blood. This was because a full stomach was twisted, damaging the Lung. The following year, he asked if the patient had recovered. The host monk said he recovered with Si Sheng Wan (Four Raw Ingredients Pill). Since obtaining this formula, he has saved many people effectively. Xue Lizhai believed these cases were acute internal heat, for which this formula is effective. However, in chronic illness with deficient Yuan Qi, the Spleen must be tonified to nourish the source of transformation; otherwise, deficiency fire flares up, Metal is overcome, and survival is unlikely."
I once treated a patient with hematemesis. His Liver pulse was strong, and the Qi Kou (Radial Pulse) was soft. This was caused by extreme anger. Suhe Xiang Wan (Styrax Pill) combined with Jisu Wan (Elsholtzia Pill) proved effective.
Yi Silan treated Grand Marshal Wu. In the late spring of the Jiaxu year, he had been bedridden for two months with fever, cough, phlegm-wheezing, shortness of breath, chest fullness, and edema of hands, feet, face, and eyes. Physicians focused only on clearing Metal and calming cough, attributing edema to long-term Stomach and Spleen deficiency. They used diuretics combined with tonics, worsening the condition. His pulse showed Left Cun floating and weak, Right Guan wiry and tense, extending outward with interior Hongda (Surging and Large) and Kou (Hollow) qualities, crossing the Cun position by one fen. Left Chi was deep, weak, and powerless. Right Cun was deep with Kou quality. Qi Kou was tight and firm, occasionally rapid. Right Guan was harmonious but weak. Right Chi was stable and unmoving. The Heart is the master of the body; the Kidney is the root of life. If these two pulses are unmoving, danger is manageable. Judging by Right Cun and Qi Kou: Deep and Kou at Cun indicates Blood stasis, not Phlegm. Classics state: "Wiry, rapid, tight, deep, fine, and firm pulses appearing in all six positions indicate accumulation." Now, Qi Kou is tight and rapid, indicating accumulated Blood between Lung and Stomach, obstructing Qi. Qi stagnation leads to Blood coagulation, constituting a Blood Accumulation syndrome. It was late spring, Earth Qi rising. Treatment followed Yue Fa (Expelling Method). Changwei Huotan Tang (Unblock Stomach and Expel Phlegm Decoction) was administered: Sugen Herba Perillae (Perilla Stem), Jiegeng Radix Platycodi (Balloon Flower Root), Cangzu Rhizoma Atractylodis (Atractylodes Rhizome) each 4 fen; Xiangfu Rhizoma Cyperi (Cyperus Rhizome), Beimu Bulbus Fritillariae Cirrhosae (Fritillaria Bulb) each 5 fen; Lianqiao Fructus Forsythiae (Forsythia Fruit) 3 fen; Qianhu Radix Peucedani (Peucedanum Root), Fujiong Rhizoma Chuanxiong (Sichuan Lovage Rhizome), Chishao Radix Paeoniae Rubra (Red Peony Root) each 6 fen. Taken at Chen hour (7-9 AM), by Wu-Wei hours (11 AM-1 PM), shortness of breath worsened, and urination ceased. At dusk, he vomited 2-3 sheng of dark purple-black blood, foul-smelling. Symptoms reduced by 80-90%, and pulses opened up. Prediction: Sweating would occur at midnight. Indeed, pulses normalized. Only occasional cough remained. Jie Zhi Erchen Tang (Platycodon, Bitter Orange, and Two-Chen Decoction) plus Xiangfu Rhizoma Cyperi (Cyperus Rhizome), Guiwei Radix Angelicae Sinensis (Angelica Root Tail), Qian Gen Radix Rubiae (Madder Root), Maogen Herba Imperatae (Imperata Rhizome), and Tongbian Child's Urine were used for three days, curing upper body ailments. However, Spleen and Kidney pulses were weak, diet was poor, limbs fatigued. Liuwei Wan (Six-Ingredient Pill) was given morning and evening (100 pills each time). Buzhong Yiqi Tang (Center-Supplementing Qi-Boosting Decoction) plus Maidong Radix Ophiopogonis (Ophiopogon Root) and Jiu Lian Radix Et Rhizoma Coptidis (Wine-processed Coptis Rhizome) was given at noon. After half a month, vitality returned, and he recovered. For Blood in Liver/Spleen, Blood-invigorating herbs are used; for Blood in Lung/Stomach, Qi-moving herbs are preferred to lift Qi, resolve stagnation, and guide via channel-specific herbs, allowing Blood to rise with Qi and exit safely. No urine at Wu hour after Chen hour dosing was due to medicinal Qi ascending rather than descending, not fluid exhaustion. Midnight sweating occurred because Sweat is the fluid of the Heart (Fire/Yang); Yang activates at Zi hour (11 PM-1 AM), causing sweat—"one opens, all open."
The following winter, the Marshal inspected new dikes, walked dozens of miles, overexerted mentally, sweated through thick furs, clothes wet, body cold. He drank over ten cups of hot ginger juice wine. Immediately, he experienced dizziness, blurred vision, chest fullness, dry thirst, and vomited 4-5 mouthfuls of bright red blood. An old physician stopped the bleeding with astringents. Three days later, chest fullness, left hypochondriac pain, reduced appetite, afternoon tidal fever, and continuous cough developed. Half a month later, facial and limb edema appeared. Some suggested Yin-nourishing and Fire-descending agents; others suggested Spleen-tonifying and digestion-promoting agents. Left hypochondriac pain worsened, turning difficult. This was a recurrence. Previously, accumulation was in Lung/Stomach (Spring, Earth Qi rising, suitable for emesis); now, accumulation is in left hypochondrium (Winter, Heaven/Earth storing, do not lightly attack Harmony). First, dredge meridians; then purge Blood downward; slowly harmonize Ying and Wei. Facial edema was not Water Edema but Qi floating externally due to Blood disease lacking attachment. Removing Blood accumulation allows Qi to return to channels, resolving edema. Disbelieving this, he took daily diuretic and edema-reducing agents, depleting True Yin, ceasing urination, causing empty irritability, panting, and phlegm obstruction. He died within a month. During embalming, liters of purple blood gushed from his mouth, confirming the diagnosis.
Prince Zhen Guo Jiang Jun of Ruichang suffered chronic abdominal pain unresponsive to drugs. Drinking Shaojiu (Burning Wine) stopped it instantly. In early summer, pulse Left Cun was deep, large, and forceful—indicating Blood Accumulation. Disbelieving this, by mid-winter, the disease flared: red face, greenish eyes, swollen eyelids, confusion, shortness of breath, abdominal pain, unrelieved by wine. Pulse similar to initial, except Renying and Qi Kou were surging and slippery, indicating desire to vomit. A cup of Yan Tang (Salt Solution) induced massive vomiting. He vomited blood clots the size of cups and dates/jujubes, white rice, clear water, and 2-3 strips of瘀血 (stagnant blood) like brush handles. Chest felt relieved post-vomit; no further medicine taken. Next dawn, bad breath, blocked Qi, cold limbs, unconsciousness, slight chest heat. Re-examination: Chi pulses still present, root intact. Urgently applied moxibustion (lamp fire) to Quchi LI11, Hubi (Hegu LI4), Zhongwan CV12, Qihai CV6. Patient felt slight pain, sat up with assistance, did not lie down. Dushen Tang (Single Ginseng Decoction) given twice, limbs warmed slightly. Then Renshen Radix Ginseng (Ginseng Root) 5 qian, Fuzii Radix Aconiti Lateralis Preparata (Prepared Lateral Root of Aconite) 2 qian, made into Lizhong Tang (Regulate the Middle Decoction), given daily. Six pulses became faintly visible. After seven days, eyes opened, recognized people, urination resumed. Buzhong Yiqi Tang (Center-Supplementing Qi-Boosting Decoction) and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) given concurrently. Recovered in half a month. Diagnosis: Liver pulse wiry-large-firm indicates excess Blood; occasional rapidity indicates stagnant Blood not moving; Lung pulse floating-large indicates Metal受火邪 (affected by Fire Pathogen), weak Qi unable to move Blood; Spleen pulse faint-choppy indicates Spleen governs Thought, Thought causes Qi knot, Earth fails to generate Metal. Post-vomit, Blood still excess, Qi increasingly deficient. Hence, Renshen Radix Ginseng (Ginseng Root) boosts Qi, Baizhu Rhizoma Atractylodis Macrocephalae (Atractylodes Macrocephala Rhizome) strengthens Spleen, Fuzii Radix Aconiti Lateralis Preparata (Prepared Lateral Root of Aconite) assists Yang, Ganjiang Rhizoma Zingiberis Recens Ustus (Charred Ginger Root) warms Blood, Gancao Radix Glycyrrhizae Preparata (Prepared Licorice Root) harmonizes middle, opening meridians to circulate Blood and Qi.
Lu Hui'an said: "Once I suffered hematemesis, surging like a tide, lasting 7-8 days, incurable by physicians. Shen Siya from Yunjian, residing in Wu, agreed to treat me. Formula: Renshen Radix Ginseng (Ginseng Root) 3 liang, Fuzii Radix Aconiti Lateralis Preparata (Prepared Lateral Root of Aconite) 1 liang, Rougui Cortex Cinnamomi (Cinnamon Bark) 1 qian. Family panicked, dared not use. Two days later, bleeding worsened. Asked for milder formula. He said: 'Condition worse, original formula needs adjustment to succeed.' Increased Renshen Radix Ginseng (Ginseng Root) to 5 liang, Fuzii Radix Aconiti Lateralis Preparata (Prepared Lateral Root of Aconite) to 2 liang. Family more terrified. He said: 'Panting, vomiting, blood loss, days without stop, head/face hot, lower body cold—signs of Yang collapse imminent, life hanging by a breath. If not taken today, tomorrow too late.' Family begged to reduce Ginseng/Aconite; he refused firmly, ordered bold administration. Family complied. He took 20+ pieces of Shu Fuzii Radix Aconiti Lateralis Preparata (Prepared Lateral Root of Aconite), crushed, weighed 2 liang, with 5 liang Ginseng, decocted, added Tongbian Child's Urine and Dihuang Radix Rehmanniae Preparata (Prepared Rehmannia Root) juice, mixed with Rougui Cortex Cinnamomi (Cinnamon Bark) powder, taken cold. Soon, mild sweat from lower body to feet, fell into deep sleep. Woke, bleeding stopped, panting settled, body relaxed, turned easily. Offered 12 taels for completion; refused. Raised to 20 taels, accepted. Another physician, seeing success, doubted: Patient usually takes 1 liang Ginseng; 5 liang is acceptable, but 2 liang Aconite for blood disease is unheard of. Investigated maker: 'Usually processes Aconite juice with Licorice; this Aconite boiled 10+ times. 2 liang here equals 2-3 qian of raw material.' Learned alchemist techniques. (From *Zhang Shi Yi Tong*.)"
Ma Yuanyi treated niece-in-law with chest fullness, caused by depression injuring fluids and Yang failing to transform. Physician ignored this, gave large doses of pungent-aromatic痞-opening drugs, causing hematemesis filling a basin, lasting 3 days, near death. Cool-blood/nourish-Yin agents failed. Pulse Right Guan/Chi beat against fingers. Not disease demon, but drug demon. Depressed constitution, fluids injured; drug heat combines with Stomach heat, causing reckless blood movement. Cooling/nourishing cannot help. Classics: "Heat rampant inside, treat with bitter-cold. Bitter overcomes pungent, cold overcomes heat." Urgently decocted Jiuzhi Dahuang Radix et Rhizoma Rhei (Nine-Processed Rhubarb Root). Symptoms flattened, recovered with regulation.
Dai Shuneng said: "I suffered blood disease, medicated for a year. Zhu Bishan viewed: 'Yin Deficiency. Slow tonification cures; hasty stopping causes harm.' Followed method, cured in <2 months. (From *Jiu Lingshan Fang Ji*.)"
Lizhai treated a woman, irritable, post-lump hematemesis with fever, distending pain in hypochondria, worse at sunset. Anger injuring Liver, Qi/Blood deficiency. Morning: Xiaoyao San (Free Wanderer Powder) with extra Chaohei Zhizi Fructus Gardeniae (Charred Gardenia Fruit), Huangbai Cortex Phellodendri (Phellodendron Bark), Beimu Bulbus Fritillariae Cirrhosae (Fritillaria Bulb), Jiegeng Radix Platycodi (Balloon Flower Root), Maidong Radix Ophiopogonis (Ophiopogon Root), Wuweizi Fructus Schisandrae (Schisandra Fruit). Evening: Guipi Tang (Return to the Spleen Decoction) with Dihuang Radix Rehmanniae Preparata (Prepared Rehmannia Root). All symptoms resolved.
Miao Zhongchun treated Wang Siceng Xunzhi with hematemesis. Diagnosed: "More Tongbian Child's Urine will self-heal." Left, wrote to disciple Zhang Xuanqing: "Xunzhi stopped meds, but Minister is old, Right Hand pulse very weak, not trivial. Advise Xunzhi to prepare." Wen Su Gong was well then; Xunzhi recovered in <2 months, Wen Su Gong died of another illness.
Xiao Wanyu treated Chen Kehui, young and vigorous, drank all night, ate roasted/fried foods. Days later, gastric discomfort, vomited bowl of blood. Six pulses surging-slow-spirited, no other symptoms. Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) with Huangqin Radix Scutellariae (Scutellaria Root), Huanglian Rhizoma Coptidis (Coptis Rhizome), Huafen Radix Trichosanthis (Trichosanthes Root). Three doses, allowed free lotus soup drinking. Recovered.
Feng Sicai's wife, 50 years old, angered by external matter, Fire stirred Blood upward, vomited basins daily. Pulse surging-slow. Xiaoyao San (Free Wanderer Powder) minus Baizhu Rhizoma Atractylodis Macrocephalae (Atractylodes Macrocephala Rhizome), plus Huanglian Rhizoma Coptidis (Coptis Rhizome), Zhizi Fructus Gardeniae (Gardenia Fruit), Danmu Cortex Moutan (Moutan Bark). Four doses cured.
Lian Feitian, weak and hardworking, red urine, nocturnal emission, chased lights at night, angered by matter, hematemesis with much phlegm-cough. Initial Fire-descending/Metal-clearing agents failed. 21st day: Cun pulses surging-large-empty, Guan/Chi floating-wiry-weak. "Blood disease not hard to treat, but Yuan Qi deficient floating up, Liver/Kidney have overcoming pulses. Fortunately not frequent, long-term Renshen Radix Ginseng (Ginseng Root)/Baizhu Rhizoma Atractylodis Macrocephalae (Atractylodes Macrocephala Rhizome) needed to calm. Bitter-cold will cause death." Jiawei Bazhen Tang (Modified Eight-Treasure Decoction) used. Suspected Ginseng doesn't treat blood. 24th day worsened, previous 4 doses stopped bleeding, tidal fever retreated after 10 days. Pulse not recovered, talkative, phlegm-cough continues, slight labor causes emission. Heart-Spleen non-interaction, extreme Yin/Yang deficiency. Took >7 jin pills, >80 doses decoction. Cured.
Chen Zizhen had same symptom, treated months without cure. Pulse same as Feitian. Suspected Renshen Radix Ginseng (Ginseng Root)/Baizhu Rhizoma Atractylodis Macrocephalae (Atractylodes Macrocephala Rhizome)/Shudi Radix Rehmanniae Preparata (Prepared Rehmannia Root) warm nature, Ginseng/Baizhu aid Fire, continued bitter-cold/Metal-clearing agents. Gradually cured over a year. Next summer, sudden continuous hematemesis. Used cold-stopping agents, causing intestinal knot/pain. 10+ days later, surgeon punctured anus, drained pus, died.
Shen Mingsheng treated Sun Zinan's daughter-in-law, thin constitution, slow-faint pulse. Late Spring hematemesis. Spleen deficiency failing to control Blood. Guipi Tang (Return to the Spleen Decoction) stopped bleeding. Fearing recurrence, requested pill formula. Combined Guipi ingredients with Dazao Wan (Great Creation Pill). 4-5 days later, knowledgeable friend exclaimed: "All blood manifestations are Heat! How can Renshen Radix Ginseng (Ginseng Root)/Baizhu Rhizoma Atractylodis Macrocephalae (Atractylodes Macrocephala Rhizome)/Heche Placenta Humanis (Human Placenta) warm-tonic be used? Blood stopped, will return soon." Consulted, told to stop, given Huafen Radix Trichosanthis (Trichosanthes Root)/Zhimu Rhizoma Anemarrhenae (Anemarrhena Rhizome). 5-6 doses later, massive bleeding, critical. Friend withdrew, deemed deep Heat-Toxin incurable. Zinan visited, angry, blamed light use of Heche Placenta Humanis (Human Placenta), praised friend's foresight. Initially hid taking cool meds, demanded teacher cure. Shen reasoned: "If Heat, why did warm-tonic work instantly? Adding Heche Placenta Humanis (Human Placenta) shouldn't be so severe. In ~1 jin medicine, only 5 qian Heche Placenta Humanis (Human Placenta); Dihuang Radix Rehmanniae Preparata (Prepared Rehmannia Root)/Guiban Carapax et Plastrum Testudinis (Turtle Shell) Yin-nourishers dominate. 4-5 days, 2 qian/dose, total Heche Placenta Humanis (Human Placenta) ~1 liang." Stopped arguing, checked pulse, weaker. Smiled: "No harm, still need major tonification." Family puzzled, thought "ring the bell, untie the bell," listened. Guipi ingredients with doubled Renshen Radix Ginseng (Ginseng Root)/Baizhu Rhizoma Atractylodis Macrocephalae (Atractylodes Macrocephala Rhizome). One dose deep sleep, two doses bleeding stopped. Realized recurrence due to Cold-Cool hastening. Sighed: "Medicine is hard. I dare not claim wisdom, but abandoning symptoms for pulse follows ancients' maxims. Blood depletion requires Qi tonification, not whim. People hold preconceptions: see cool meds, say 'Cold, use Heat'; see Heat meds, say 'Fire, use Cool'. Attack fails, try tonify; tonify fails, attack again. Novel ideas, no fixed view. How can patients understand medicine/reason, not be swayed? Ancients suffer little slander; patients suffer great error. This is why Zhang Jingyue wrote 'Not Losing Human Sentiment'."
Gu Desheng's son had hematemesis. Believed youthful elegance, indulgence in bedroom caused Yin Deficiency/Fire Movement. Daily Er Dong (Dongting/Dongbei) and Er Di (Dihuang/Shudi) agents. Shen Chu stayed in Wu, knew Gu, knew wrong, but shallow friendship, overwhelmed by crowd opinion, couldn't argue verbally. Wrote: "Classics: Yin Deficiency generates internal heat, heat forces blood erratic movement. Danxi: Blood rises with Qi, Yang excess/Yin deficiency, ascends no descends, erupts upper orifices. Treat by nourishing Yin suppressing Yang. Also: Fatigue, massive hematemesis, Qi deficiency failing to control blood. Dongyuan: Sweet-warm removes great heat, heat removed, blood returns to channels. Also: Blood depletion tonifies Qi, Yang generates Yin. Studying words, some clear-moisten, some warm-tonify, all ancient methods. My view: Match method to disease, not disease to method. Early blood disease, little vomit, dry mouth/lips, no cool meds yet: follow Fire treatment, nourish Yin benefit Yang. If lost blood days, excessive loss, short breath/spirit decline, cool meds already used: ..."