〔大〕妇人吐血者，皆由脏腑伤损所致。夫血者外行于经络，内荣于脏腑。若伤损气
血经络，则血虚行失于常理，气逆者吐血，又怒则气逆，甚则呕血，然忧思惊恐内伤，气
逆上者，皆吐血也。
〔薛〕前证若脾经郁热，用犀角地黄汤。脾胃伏暑，用黄连香薷饮。（杂病伤暑。）心脾郁
热，用生地黄汤。心气耗损，用茯苓补心汤。肺气劳伤，用鸡苏散。思虑伤脾，用归脾汤。
（杂病健忘。）暴怒肝火，用加味小柴胡汤。（热入血室。）久怒肝伤，六味地黄丸。（杂病虚劳。）脾肺
虚热，用麦门冬饮。肝肾虚热，用六味地黄丸。气血俱虚，用十全大补汤。经云∶肺朝
百脉之气，肝统诸经之血。必用甘温之剂，补其阳气，使血各归其经。如大吐血病，毋论
其脉，急用独参汤救之。若潮热咳嗽而脉数者，元气虚而假热之脉也，皆由脾胃先损，须
用人参之类。《本草》云∶人参治脾胃不足，补中，温中，泻脾肺中火。东垣先生云∶脾
胃虚者，心火亢甚而乘土位，肺气受邪，须用黄 最多，人参、甘草次之。脾胃一虚，肺
气先绝，故用黄 以益皮毛而闭腠理，当治气血虚弱，用十全大补最善，若用寒凉止血，
胃气反伤，无不致祸。一老妇每作先饮食不进，或胸膈不利，或中脘作痛，或大便作
泻，或小便不利，余以为肝脾之证，用逍遥散加山栀、茯神、远志、木香而愈。后郁结
吐紫血，每作先倦怠烦热，以前药加炒黑黄连三分、吴茱萸二分，顿愈。复因怒吐赤血
甚多，燥渴垂死，此血脱也，法当补气。乃用人参一两，苓、术、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、芍药而愈。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，朝服补中益气汤（杂病劳倦。）加
桔梗、贝母、知母。夕用归脾汤吞六味丸而愈。
鸡苏散 治妇人吐血，心烦昏闷。
鸡苏叶（一两） 阿胶 刺苏 生地黄（各一两） 黄 羚羊角屑 茜根 甘草（各半两）
麦门冬 黄芩 当归 伏龙肝（各七钱半）
上为粗末，每服四钱，水一盏，姜三片，竹茹半鸡子大，煎至六分，去滓温服。
又方 治妇人虚损气逆，吐血不止。
鸡苏叶 黄芩（各一两） 当归 赤芍药（各半两） 伏龙肝 阿胶（各二两）
上为粗末，每服四钱，水一盏，煎六分，去滓温服。
治妇人热毒上攻，吐血不止。
生藕汁 刺苏汁 生地黄汁（各三两） 生姜汁（半合） 白蜜（一合）
上和煎三两沸，以一小盏，调炒面一钱服，无时。
《千金翼》治吐血百方不瘥，疗十十瘥，神验不传方。（详此药性，治热毒吐血有效。）
地黄汁（半升） 生大黄末（一方寸匕）
上煎地黄汁三两沸，调大黄末令匀，分为三服。
又方 伏龙肝研极细，每服二钱，新汲水调下，频服取效。
又方 白茅根（一握，长六寸，）以水一大盏，煎七分，去滓服。
又方 桂心（为末） 水调方寸匕，日夜可二十服。
又方 生地黄（三升切） 阿胶（二两，炒） 蒲黄（六合）
以水五升，煮取三升，分三服。予尝
治一人吐血，诊其脉，肝部弦，气口濡，此因怒极而得之。遂用苏合香丸和鸡苏丸服，即
效。《养生必用方》云∶凡吐血须煎干姜甘草汤与服，或四物、理中汤亦可，如此无不愈
者。服生地黄、竹茹、藕汁，去生便远。
柔脾汤 治虚劳吐血、衄血，下白、汗出方。（出《养生必用》）
甘草 白芍药 黄 （各一两） 熟地黄（三两）
上为末，每服四钱，水酒各一盏以上，煎至七分，去滓取清汁六分，温服，食前。
予尝治一女人，年十九岁，月经不行，以药通之，遂妄行而呕血，诸药不效。察其人肥，
脉不大不小，投以四生丸即安。又治一男子，因饱低头负重吐血，诸药无效，亦投四
生丸及青饼子即安，更不发。尝观初虞世治吐血，不喜用竹茹、生地黄、藕汁，然亦
不可拘泥此说。如阳乘于阴，血得热则流散，经水沸溢。宜服凉药以解之，大黄、犀角、生
地黄、生艾、藕汁等，岂得无效。若阴乘于阳，所谓天寒地冻，水凝成冰，宜服温药以
暖之，干姜、肉桂，岂能无功。学人更宜思之。
四生丸 疗吐血。凡吐血、衄血，阳乘于阴，血热妄行，宜服此药。
生荷叶 生艾叶 生柏叶 生地黄（各等分）
上烂研丸如鸡子大，每服一丸，水三盏，煎到一盏，去滓温服，无时候。陈日华云∶
先公绍兴初，游福沟灵石寺，主僧留饭，食将竟，侍者赴堂斋罢来侍立，见桌子不稳，急
罄折稳之，举首即呕血，盖食饱拗伤肺也。明年再到寺，问旧年呕血者无恙否？主僧云∶得
四生丸服之愈。自得此方，屡施有验。
〔薛〕愚意前证乃内热暴患，用之有效。若人病久本原不足，须补脾以滋化源，否则
虚火上炎，金反受克，获生鲜矣。
疗热甚呕血者，以犀角地黄汤、《局方》小三黄汤，以白茅根煎浓汤饮之极妙。
犀角地黄汤 治内有瘀血，鼻衄吐血，面黄，大便黑。
芍药（七钱半） 生地黄（半斤） 牡丹皮（去心净，一两） 犀角屑（一两，如无，以川升麻代）
上 咀，每服五钱，水煎服。有热如狂者，加黄芩二两。
青饼子 治咯血。
青黛 杏仁（各一两，华佗方以牡蛎粉炒杏仁，去皮尖，牡蛎不用）
上一处同研成膏，熔黄蜡和作三十饼子，每服一饼子，用干柿半个夹定，以湿纸裹，煨
令香，同嚼，粥饮下，无时。
干姜甘草汤 若阴乘于阳，心肺经寒而呕血者宜服。
甘草 干姜（各半两）
上 咀，水煮顿服。《局方》理中汤亦妙。
花蕊石散 予尝见一妇人苦此疾，百药不效，以童子小便和酒，调下真花蕊石散，不
数服而愈。
乌金散 治吐血不已，每服二钱，米饮下。（即催生如神散，方见后。）
济生鸡苏散 治劳伤肺经，唾中有血，咽喉不利。
鸡苏叶 黄 （炒） 生地黄 阿胶（炒） 贝母 白茅根（各一钱） 桔梗（炒）
麦门冬（去心） 蒲黄（炒） 甘草（炙，各五分）
上姜水煎服。
生地黄散 治郁热衄血咯血吐血，阴虚而不能愈者。
枸杞子 柴胡 黄连（炒） 地骨皮 天门冬（去心） 白芍药 甘草（炒）
黄芩（炒） 黄 （炒） 生地黄 熟地黄（自制，各五分）
上水煎服。下血，加地榆。
三因茯苓补心汤 治面色黄悴，五心烦热，咳嗽血。
半夏 前胡 紫苏 茯苓 人参 枳壳（麸炒） 桔梗（炒） 甘草（炒） 干葛（各五分）
当归 川芎 陈皮 白芍药（各一钱） 熟地黄（自制，一钱半）
上姜枣水煎服。
麦门冬饮子 治气虚吐血，或气虚不能摄血。
五味子（杵，十个） 麦门冬（去心） 黄 （炒，各一钱） 当归身 人参 生地黄（各半钱）
上水煎服。
十全大补汤 治胃气虚弱，吐血衄血，便血不止，以致外证恶寒发热，自汗盗汗，食
少体倦。或寒热作渴，头疼眩晕，而似中风。或气血俱虚，胸腹胁痛。或骨节作痛，经候
不调。或寒热往来，发热晡热，或五心发热，咽干舌燥，或痰嗽喘促，胸膈虚痞。或呕吐
泄泻，手足冷热等证。（方见杂病虚劳门。）
【大】妇人出现吐血症状，都是由于脏腑受损引起的。血液在体外运行于经络之中，在体内滋养着脏腑。如果损伤了气血和经络，就会导致血虚且运行失去常理；气机上逆则引发吐血，此外发怒也会导致气机逆乱，严重时甚至呕吐出血。然而，忧愁、思虑、惊恐等内伤因素导致气机上逆的，也都属于吐血的范畴。
【薛】上述病症若因脾经郁热所致，使用犀角地黄汤。若为脾胃潜伏暑邪，使用黄连香薷饮。（参见杂病伤暑篇。）若为心脾郁热，使用生地黄汤。若为心气耗损，使用茯苓补心汤。若为肺气劳损，使用鸡苏散。若为思虑伤脾，使用归脾汤。（参见杂病健忘篇。）若为暴怒导致的肝火旺盛，使用加味小柴胡汤。（参见热入血室篇。）若为长期愤怒导致肝损伤，使用六味地黄丸。（参见杂病虚劳篇。）若为脾肺虚热，使用麦门冬饮。若为肝肾虚热，使用六味地黄丸。若为气血俱虚，使用十全大补汤。医经云：肺朝百脉而主气，肝统摄诸经之血。必须使用甘温的药物，补益阳气，使血液各自回归其经脉。如果是大量吐血的患者，不论其脉象如何，应立即使用独参汤进行急救。如果出现潮热咳嗽且脉数，这是元气虚弱而出现的假热脉象，皆由脾胃先受损引起，必须用人参之类的药物。《本草》记载：人参治疗脾胃不足，补中气，温中焦，清泻脾肺中的火邪。东垣先生说：脾胃虚弱的人，心火亢盛从而乘袭土位，肺气受邪，必须重用黄芪，人参、甘草次之。脾胃一旦虚弱，肺气首先衰竭，所以使用黄芪来补益皮毛并固密腠理。应当治疗气血虚弱，使用十全大补汤最为适宜，如果使用寒凉药物止血，反而损伤胃气，没有不导致祸患的。
一位老妇人每次发病前饮食不进，或者胸膈不适，或者中脘部疼痛，或者大便泄泻，或者小便不利，我认为这是肝脾的病症，使用逍遥散加入山栀、茯神、远志、木香而痊愈。后来因郁结吐出紫黑色血液，每次发病前先感到倦怠烦热，用前面的药方加入炒黑的黄连三分、吴茱萸二分，立刻痊愈。后来又因发怒吐出大量鲜红色血液，口干渴欲死，这是血脱的症状，治法应当补气。于是使用人参一两，茯苓、白术、当归各三钱，陈皮、炮黑干姜各二钱，炙甘草、木香各一钱，服用一剂后出血立刻停止。之后又使用加味归脾汤调理而康复。
一位女子平素怀抱忧郁，胸满食少，吐血面赤，使用六味丸及归脾汤加入山栀、贝母、芍药而痊愈。
一位妇人因为哭丧母亲而吐血咳嗽，发热盗汗，月经停止，这是悲伤肺、思虑伤脾的表现，早晨服用补中益气汤（参见杂病劳倦篇）加入桔梗、贝母、知母。晚上服用归脾汤吞服六味丸而痊愈。
鸡苏散 治疗妇人吐血，心烦昏闷。
鸡苏叶（一两） 阿胶 刺苏 生地黄（各一两） 黄芪 羚羊角屑 茜根 甘草（各半两）
麦门冬 黄芩 当归 伏龙肝（各七钱半）
以上药材制成粗末，每次服用四钱，加水一盏，生姜三片，竹茹半个鸡蛋大小，煎煮至六分，去渣温服。
又一方 治疗妇人虚损气逆，吐血不止。
鸡苏叶 黄芩（各一两） 当归 赤芍药（各半两） 伏龙肝 阿胶（各二两）
以上药材制成粗末，每次服用四钱，加水一盏，煎煮至六分，去渣温服。
治疗妇人热毒上攻，吐血不止。
生藕汁 刺苏汁 生地黄汁（各三两） 生姜汁（半合） 白蜜（一合）
混合后煎煮三沸，取一小盏，调入炒面粉一钱服用，不拘时候。
《千金翼》治疗吐血各种方法无效者，此方疗效十治十愈，是神验且不传的方子。（根据药性分析，此方对热毒吐血有效。）
地黄汁（半升） 生大黄末（一方寸匕）
将地黄汁煎煮三沸，调入大黄末使其均匀，分为三次服用。
又一方 伏龙肝研磨极细，每次服用二钱，用新汲水调服，频繁服用以见效。
又一方 白茅根（一握，长六寸），用水一大盏，煎煮至七分，去渣服用。
又一方 桂心（研为末），用水调服一方寸匕，白天黑夜可服用二十次。
又一方 生地黄（三升切块） 阿胶（二两，炒） 蒲黄（六合）
用水五升，煮取三升，分为三次服用。我曾治疗一人吐血，诊察其脉象，肝部脉弦，气口脉濡，这是因为极度愤怒所致。于是使用苏合香丸配合鸡苏丸服用，立即见效。《养生必用方》说：凡是吐血都需要煎煮干姜甘草汤服用，或者四物汤、理中汤也可以，这样没有不痊愈的。服用生地黄、竹茹、藕汁，会离康复越来越远。
柔脾汤 治疗虚劳吐血、鼻衄，下白浊、出汗的方子。（出自《养生必用》）
甘草 白芍药 黄芪（各一两） 熟地黄（三两）
以上药材研为末，每次服用四钱，用水和酒各一盏以上，煎煮至七分，去渣取清汁六分，饭前温服。
我曾治疗一名十九岁的女子，月经不行，用药通经后，月经妄行并呕血，各种药物无效。观察其人形体肥胖，脉象不大不小，投以四生丸即安顿。又治疗一名男子，因为饱食后低头负重而吐血，各种药物无效，也投以四生丸及青饼子即安顿，不再复发。曾观察初虞世治疗吐血，不喜欢使用竹茹、生地黄、藕汁，但也不可拘泥于此说法。如阳邪侵犯阴分，血液受热则流散，如同经水沸腾溢出。宜服用凉药来解除，大黄、犀角、生地黄、生艾、藕汁等，难道会无效吗？若阴邪侵犯阳分，所谓天寒地冻，水凝成冰，宜服用温药来温暖它，干姜、肉桂，难道能没有功效吗？学习的人更应深思。
四生丸 治疗吐血。凡是吐血、鼻衄，阳乘于阴，血热妄行，宜服用此药。
生荷叶 生艾叶 生柏叶 生地黄（各等分）
以上药材捣烂研丸，如鸡蛋大，每次服用一丸，用水三盏，煎至一盏，去渣温服，不拘时候。陈日华说：他的父亲在绍兴初年，游览福沟灵石寺，住持僧留饭，吃饭将结束时，侍者赴堂斋罢回来侍立，见桌子不稳，急忙弯腰折身稳住桌子，抬头时即呕血，这是因为吃饱后用力拗伤肺部所致。第二年再次到寺里，问去年呕血的人是否安好？住持僧说：得到四生丸服用后痊愈。自从得到这个方子，多次施予都有验证。
【薛】我的意思是上述病症乃是内热突发，使用此方有效。如果病人久病本原不足，必须补脾以滋生化之源，否则虚火上炎，金反被克，获得生存就很少了。
治疗热甚呕血者，用犀角地黄汤、《局方》小三黄汤，用白茅根煎浓汤饮用极好。
犀角地黄汤 治疗内有瘀血，鼻衄吐血，面色黄，大便黑。
芍药（七钱半） 生地黄（半斤） 牡丹皮（去心净，一两） 犀角屑（一两，如无，以川升麻代）
以上药材切碎，每次服用五钱，水煎服。有热如狂者，加黄芩二两。
青饼子 治疗咯血。
青黛 杏仁（各一两，华佗方以牡蛎粉炒杏仁，去皮尖，牡蛎不用）
以上一起同研成膏，熔化黄蜡和作三十个饼子，每次服用一个饼子，用干柿半个夹定，用湿纸包裹，煨至香，同嚼，粥饮送下，不拘时候。
干姜甘草汤 若阴乘于阳，心肺经寒而呕血者宜服。
甘草 干姜（各半两）
以上药材切碎，水煮顿服。《局方》理中汤也很好。
花蕊石散 我曾看见一位妇人苦于这个疾病，百药无效，用童子小便和酒，调下真花蕊石散，没几服就痊愈了。
乌金散 治疗吐血不已，每次服用二钱，米饮送下。（即催生如神散，方见后。）
济生鸡苏散 治疗劳伤肺经，唾中有血，咽喉不利。
鸡苏叶 黄芪（炒） 生地黄 阿胶（炒） 贝母 白茅根（各一钱） 桔梗（炒）
麦门冬（去心） 蒲黄（炒） 甘草（炙，各五分）
以上用姜水煎服。
生地黄散 治疗郁热衄血咯血吐血，阴虚而不能愈者。
枸杞子 柴胡 黄连（炒） 地骨皮 天门冬（去心） 白芍药 甘草（炒）
黄芩（炒） 黄芪（炒） 生地黄 熟地黄（自制，各五分）
以上用水煎服。下血，加地榆。
三因茯苓补心汤 治疗面色黄悴，五心烦热，咳嗽血。
半夏 前胡 紫苏 茯苓 人参 枳壳（麸炒） 桔梗（炒） 甘草（炒） 干葛（各五分）
当归 川芎 陈皮 白芍药（各一钱） 熟地黄（自制，一钱半）
以上用姜枣水煎服。
麦门冬饮子 治疗气虚吐血，或气虚不能摄血。
五味子（杵，十个） 麦门冬（去心） 黄芪（炒，各一钱） 当归身 人参 生地黄（各半钱）
以上用水煎服。
十全大补汤 治疗胃气虚弱，吐血衄血，便血不止，以致外证恶寒发热，自汗盗汗，食少体倦。或寒热作渴，头疼眩晕，而似中风。或气血俱虚，胸腹胁痛。或骨节作痛，经候不调。或寒热往来，发热晡热，或五心发热，咽干舌燥，或痰嗽喘促，胸膈虚痞。或呕吐泄泻，手足冷热等证。（方见杂病虚劳门。）
[Da] When women experience hematemesis (vomiting blood), it is invariably caused by damage to the Zang-Fu organs. Blood circulates externally within the meridians and nourishes internally the Zang-Fu organs. If the Qi, Blood, and meridians are damaged, Blood deficiency occurs and its circulation deviates from normal principles; upward rebellion of Qi leads to hematemesis. Furthermore, anger causes Qi rebellion, which in severe cases results in vomiting blood. However, internal injuries caused by worry, overthinking, fear, and fright that lead to upward rebellion of Qi also manifest as hematemesis.
[Xue] For the aforementioned conditions: if due to stagnant heat in the Spleen Meridian, use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction). If due to latent summerheat in the Stomach and Spleen, use Huanglian Xiangru Yin (Coptis and Elsholtzia Decoction) [refer to Miscellaneous Diseases: Summerheat Injury]. If due to stagnant heat in the Heart and Spleen, use Shengdihuang Tang (Rehmannia Decoction). If due to depletion of Heart Qi, use Fuling Buxin Tang (Poria Nourishing the Heart Decoction). If due to consumptive injury of Lung Qi, use Jisu San (Elsholtzia Powder). If due to overthinking injuring the Spleen, use Guipi Tang (Restore the Spleen Decoction) [refer to Miscellaneous Diseases: Forgetfulness]. If due to sudden anger causing Liver Fire hyperactivity, use Jiawei Xiaochaihu Tang (Modified Minor Bupleurum Decoction) [refer to Heat Entering the Blood Chamber]. If due to chronic anger damaging the Liver, use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) [refer to Miscellaneous Diseases: Consumptive Disease]. If due to deficient heat in the Spleen and Lungs, use Maimendong Yin (Ophiopogon Drink). If due to deficient heat in the Liver and Kidneys, use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia). If due to deficiency of both Qi and Blood, use Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction). The Classics state: "The Lung governs Qi and directs all vessels; the Liver controls the Blood of all meridians." One must use sweet-warm agents to tonify Yang Qi, ensuring Blood returns to its respective vessels. In cases of massive hematemesis, regardless of the pulse, immediately use Dushen Tang (Single Ginseng Decoction) for rescue. If tidal fever and coughing are present with a rapid pulse, this indicates a false-heat pulse due to deficiency of Yuan Qi, stemming primarily from prior damage to the Spleen and Stomach; herbs such as Renshen (Ginseng Root) are required. *Bencao* states: "Renshen treats insufficiency of the Spleen and Stomach, tonifies the Middle, warms the Middle, and drains fire from the Spleen and Lungs." Mr. Dongyuan said: "In cases of Spleen and Stomach deficiency, Heart Fire becomes hyperactive and attacks the Earth element, affecting Lung Qi; one must heavily use Huangqi (Astragalus Root), with Renshen and Gancao (Licorice Root) being secondary." Once the Spleen and Stomach are weak, Lung Qi fails first; thus, Huangqi is used to benefit the skin and hair and close the interstices. To treat Qi and Blood deficiency, Shiquan Dabu Tang is most effective. If cold-cooling hemostatics are used, they will instead injure Stomach Qi, inevitably leading to disaster.
An elderly woman, before each episode, would lose her appetite, feel chest oppression, suffer epigastric pain, have loose stools, or experience dysuria. I diagnosed this as a Liver-Spleen disorder and treated her with Xiaoyao San (Free and Easy Wanderer Powder) added with Zhizi (Gardenia Fruit), Fushen (Poria with Hostwood), Yuanzhi (Polygala Root), and Muxiang (Aucklandia Root), resulting in a cure. Later, due to emotional constraint, she vomited dark purple blood. Before each episode, she felt fatigued and irritable with heat. I used the previous prescription added with stir-fried black Huanglian (Coptis Rhizome, 3 fen) and Wuzhuyu (Evodia Fruit, 2 fen), resulting in an immediate cure. Subsequently, due to anger, she vomited a large amount of bright red blood, became extremely dry-thirsty and near death. This was Blood exhaustion; the method should be to tonify Qi. I prescribed Renshen (1 liang), Fuling (Poria), Baizhu (Atractylodes Macrocephala Rhizome), and Danggui (Angelica Sinensis Root) (each 3 qian), Chenpi (Tangerine Peel) and Paohei Ganjiang (Baked Black Ginger) (each 2 qian), Zhi Gancao (Honey-fried Licorice Root) and Muxiang (each 1 qian). One dose stopped the bleeding immediately. She was then regulated with Jiawei Guipi Tang (Modified Restore the Spleen Decoction) and recovered.
A young woman who had been chronically depressed presented with chest fullness, poor appetite, hematemesis, and a red face. She was cured using Liuwei Wan (Six-Ingredient Pill) combined with Guipi Tang added with Zhizi, Beimu (Fritillaria Bulb), and Shaoyao (Peony Root).
A woman cried for her deceased mother, resulting in hematemesis, coughing, fever, night sweats, and amenorrhea. This was Sadness injuring the Lung and Overthinking injuring the Spleen. In the morning, she took Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Jiegeng (Platycodon Root), Beimu, and Zhimu (Anemarrhena Rhizome). In the evening, she took Guipi Tang taken with water to swallow Liuwei Wan, resulting in a cure.
Jisu San (Elsholtzia Powder) treats hematemesis in women accompanied by vexation and dizziness.
Jisu Ye (Elsholtzia Leaf, 1 liang), Ejiao (Donkey-hide Gelatin), Cisu (Perilla Leaf), Shengdihuang (Fresh Rehmannia Root) (each 1 liang), Huangqi (Astragalus Root), Lingyangjiao Xie (Antelope Horn Shavings), Qiangen (Madder Root), Gancao (Licorice Root) (each 0.5 liang), Maimendong (Ophiopogon Tuber), Huangqin (Scutellaria Root), Danggui (Angelica Sinensis Root), Fulonggan (Stove Earth) (each 7.5 qian).
Grind into coarse powder. Take 4 qian per dose, add 1 cup of water, 3 slices of ginger, and bamboo shavings equivalent to half an egg. Decoct until reduced to 60%. Strain and take warm.
Another formula treats deficiency injury with rebellious Qi and continuous hematemesis in women.
Jisu Ye (Elsholtzia Leaf), Huangqin (Scutellaria Root) (each 1 liang), Danggui (Angelica Sinensis Root), Chishao Yao (Red Peony Root) (each 0.5 liang), Fulonggan (Stove Earth), Ejiao (Donkey-hide Gelatin) (each 2 liang).
Grind into coarse powder. Take 4 qian per dose, add 1 cup of water. Decoct until reduced to 60%. Strain and take warm.
Treats hematemesis caused by heat-toxin attacking upwards in women.
Sheng Ou Zhi (Fresh Lotus Root Juice), Cisu Zhi (Perilla Leaf Juice), Shengdihuang Zhi (Fresh Rehmannia Root Juice) (each 3 liang), Shengjiang Zhi (Fresh Ginger Juice, 0.5 he), Baimi (White Honey, 1 he).
Mix and boil three times. Take one small cup, mixed with 1 qian of fried flour. Take at any time.
*Qianjin Yi* treats hematemesis refractory to hundreds of methods. This formula cures ten out of ten cases; it is a miraculous, unshared prescription. (Based on properties, it is effective for heat-toxin hematemesis.)
Dihuang Zhi (Rehmannia Juice, 0.5 sheng), Sheng Dahuang Mo (Raw Rhubarb Powder, 1 fangcun bi).
Boil Dihuang Zhi until boiling three times, mix evenly with Dahuang Mo. Divide into three doses.
Another formula: Grind Fulonggan (Stove Earth) to extreme fineness. Take 2 qian per dose, mix with fresh well-water. Take frequently until effective.
Another formula: Baimaogen (Imperata Rhizome, one handful, 6 cun long). Add 1 cup of water, decoct to 70%. Strain and take.
Another formula: Guixin (Cinnamon Twig, powdered). Mix with water, take 1 fangcun bi. Can be taken up to 20 times day and night.
Another formula: Shengdihuang (Fresh Rehmannia Root, 3 sheng, cut), Ejiao (Donkey-hide Gelatin, 2 liang, stir-fried), Puhuang (Typha Pollen, 6 he).
Add 5 sheng of water, boil to obtain 3 sheng. Divide into three doses. I once treated a patient with hematemesis; his pulse was wiry in the Liver position and soggy in the Qi-Kou position. This was caused by extreme anger. I administered Suhexiang Wan (Styrax Pill) combined with Jisu Wan (Elsholtzia Pill), resulting in immediate efficacy. *Yangsheng Biyong Fang* states: "For all hematemesis, one must decoct Ganjiang Gancao Tang (Ginger and Licorice Decoction) to take, or Siwu Tang (Four Substance Decoction), Lizhong Tang (Regulate the Middle Decoction) can also be used; there is no case that does not heal." Taking Shengdihuang, Zhuru (Bamboo Shavings), or Ou Zhi (Lotus Root Juice) distances one from recovery.
Roupi Tang (Spleen-Soothing Decoction) treats consumptive disease with hematemesis, epistaxis, leukorrhea, and sweating. (From *Yangsheng Biyong*)
Gancao (Licorice Root), Shaoyao Yao (Peony Root), Huangqi (Astragalus Root) (each 1 liang), Shudihuang (Prepared Rehmannia Root, 3 liang).
Grind into powder. Take 4 qian per dose, add more than 1 cup each of water and wine. Decoct to 70%. Strain to obtain 60% clear juice. Take warm before meals.
I once treated a 19-year-old woman with amenorrhea. After using medicine to induce menstruation, her menses flowed excessively and she vomited blood. Various medicines were ineffective. Observing her obesity and a pulse neither large nor small, I administered Sisheng Wan (Four Raw Pills), resulting in stabilization. I also treated a man who vomited blood after bending forward while carrying a heavy load after a full meal. Various medicines failed. I administered Sisheng Wan and Qingbingzi (Green Cake), resulting in stabilization with no recurrence. I observed that Chu Yushi, when treating hematemesis, disliked using Zhuru, Shengdihuang, and Ou Zhi, but one should not adhere rigidly to this view. If Yang invades Yin, Blood flows freely when heated, like boiling water overflowing. It is appropriate to take cooling medicines to resolve this; Dahuang, Xijiao, Shengdihuang, Sheng Aiye (Fresh Mugwort Leaf), and Ou Zhi—would they not be effective? If Yin invades Yang, described as heaven freezing and earth hardening, water turning to ice, it is appropriate to take warming medicines to warm it; Ganjiang and Rougui (Cinnamon Bark)—could they fail to work? Students should ponder this further.
Sisheng Wan (Four Raw Pills) treats hematemesis. For all hematemesis and epistaxis where Yang invades Yin and Blood Heat causes reckless flow, this medicine is suitable.
Sheng Heye (Fresh Lotus Leaf), Sheng Aiy e (Fresh Mugwort Leaf), Sheng Baiye (Fresh Biota Tops), Shengdihuang (Fresh Rehmannia Root) (equal parts).
Mash and grind into pills the size of a chicken egg. Take one pill per dose, with 3 cups of water. Decoct to 1 cup. Strain and take warm. Take at any time. Chen Rihua said: "My father, in the early Shaoxing era, visited Ling Shi Temple in Fu Gou. The abbot invited him for a meal. As the meal ended, an attendant returned from the hall dining area and stood in attendance. Seeing the table unstable, he quickly bent down to steady it. Upon raising his head, he vomited blood. This was because eating too much and straining injured the Lung. The following year, upon returning to the temple, he asked if the man who vomited blood the previous year was well. The abbot said he recovered after taking Sisheng Wan. Since obtaining this formula, I have applied it many times with verified results."
[Xue] My opinion is that the aforementioned condition is a sudden onset of internal heat, for which this formula is effective. If a patient has been ill for a long time with root deficiency, one must tonify the Spleen to nourish the source of transformation; otherwise, deficient Fire flares upward, Metal is counter-controlled, and survival becomes rare.
To treat vomiting blood due to severe heat, use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) or *Ju Fang* Xiao Sanhuang Tang (Minor Three-Yellow Decoction from the Bureau Formulary), drinking thick decoction of Baimaogen (Imperata Rhizome) is excellent.
Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) treats internal Blood stasis, epistaxis, hematemesis, yellow complexion, and black stools.
Shaoyao (Peony Root, 7.5 qian), Shengdihuang (Fresh Rehmannia Root, 0.5 jin), Mudan Pi (Tree Peony Bark, heart removed and cleaned, 1 liang), Xijiao Xie (Rhinoceros Horn Shavings, 1 liang; if unavailable, replace with Chuan Shengma (Corydalis Rhizome)).
Cut into pieces. Take 5 qian per dose, decoct in water. If heat with manic behavior is present, add Huangqin (Scutellaria Root, 2 liang).
Qingbingzi (Green Cake) treats hemoptysis.
Qingdai (Indigo Naturalis), Xingren (Apricot Seed) (each 1 liang; Hua Tuo's formula uses Oyster Shell Powder to stir-fry Apricot Seeds, remove skin and tips, do not use Oyster Shell).
Grind together into a paste. Melt Yellow Wax and mix to form thirty cakes. Take one cake per dose, sandwiched between half a dried persimmon. Wrap in wet paper and bake until fragrant. Chew together and swallow with gruel drink. Take at any time.
Ganjiang Gancao Tang (Ginger and Licorice Decoction) is suitable for Yin invading Yang, Cold in the Heart and Lung meridians causing hematemesis.
Gancao (Licorice Root), Ganjiang (Dried Ginger) (each 0.5 liang).
Cut into pieces. Decoct in water and take in one dose. *Ju Fang* Lizhong Tang (Regulate the Middle Decoction) is also excellent.
Huarui Shi San (Flower-like Rock Powder): I once saw a woman suffering from this disease, refractory to hundreds of medicines. Using urine from a healthy boy mixed with wine to administer Zhen Huarui Shi San (True Flower-like Rock Powder), she recovered after a few doses.
Wujin San (Black Gold Powder) treats persistent hematemesis. Take 2 qian per dose, swallow with rice drink. (This is the same as Cisheng Rushen San (Divinely Effective Delivery Powder), see formula later.)
Jisheng Jisu San (Jisheng Elsholtzia Powder) treats consumptive injury to the Lung Meridian, blood in saliva, and throat obstruction.
Jisu Ye (Elsholtzia Leaf), Huangqi (Astragalus Root, stir-fried), Shengdihuang (Fresh Rehmannia Root), Ejiao (Donkey-hide Gelatin, stir-fried), Beimu (Fritillaria Bulb), Baimaogen (Imperata Rhizome) (each 1 qian), Jiegeng (Platycodon Root, stir-fried), Maimendong (Ophiopogon Tuber, heart removed), Puhuang (Typha Pollen, stir-fried), Gancao (Licorice Root, honey-fried) (each 5 fen).
Decoct in water with ginger.
Shengdihuang San (Rehmannia Powder) treats nasal bleeding, hemoptysis, and hematemesis due to stagnant heat, or those unable to heal due to Yin deficiency.
Gouqizi (Goji Berry), Chaihu (Bupleurum Root), Huanglian (Coptis Rhizome, stir-fried), Digupi (Dogwood Bark), Tianmendong (Asparagus Tuber, heart removed), Shaoyao (Peony Root), Gancao (Licorice Root, stir-fried), Huangqin (Scutellaria Root, stir-fried), Huangqi (Astragalus Root, stir-fried), Shengdihuang (Fresh Rehmannia Root), Shudihuang (Prepared Rehmannia Root, homemade) (each 5 fen).
Decoct in water. For lower body bleeding, add Diyü (Sanguisorba Root).
Sanyin Fuling Buxin Tang (Three Causes Poria Nourishing the Heart Decoction) treats sallow and emaciated complexion, five-palm heat, and coughing blood.
Banxia (Pinellia Tuber), Qianhu (Peucedanum Root), Zisu (Perilla Leaf), Fuling (Poria), Renshen (Ginseng Root), Zhike (Bitter Orange, bran-fried), Jiegeng (Platycodon Root, stir-fried), Gancao (Licorice Root, stir-fried), Gange (Kudzu Root) (each 5 fen), Danggui (Angelica Sinensis Root), Chuanxiong (Ligusticum Rhizome), Chenpi (Tangerine Peel), Shaoyao (Peony Root) (each 1 qian), Shudihuang (Prepared Rehmannia Root, homemade, 1.5 qian).
Decoct in water with ginger and jujube.
Maimendong Yinzi (Ophiopogon Drink) treats Qi deficiency hematemesis, or inability to control Blood due to Qi deficiency.
Wuweizi (Schisandra Berry, pounded, 10 fruits), Maimendong (Ophiopogon Tuber, heart removed), Huangqi (Astragalus Root, stir-fried) (each 1 qian), Dangguishen (Ginseng Root tip), Renshen (Ginseng Root), Shengdihuang (Fresh Rehmannia Root) (each 0.5 qian).
Decoct in water.
Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction) treats Stomach Qi weakness, hematemesis, epistaxis, continuous melena, leading to exterior symptoms of aversion to cold and fever, spontaneous sweating, night sweats, poor appetite, and fatigue. Or alternating chills and fever with thirst, headache and vertigo resembling stroke. Or deficiency of both Qi and Blood with chest, abdominal, and hypochondriac pain. Or bone and joint pain, irregular menstruation. Or alternating chills and fever, afternoon fever, or heat in the five centers, dry throat and tongue, or phlegm-cough with panting, empty fullness in the chest and diaphragm. Or vomiting and diarrhea, cold or hot hands and feet. (See formula in Miscellaneous Diseases: Consumptive Disease section.)