〔薛〕妇人血膈，若气逆而血滞，用流气饮。（臂痛。）若恚怒而血逆，用小柴胡汤（伤寒
少阳。）加山栀、丹皮。血虚用四物汤、（通治。）参、术、柴胡、山栀、丹皮。若郁结而血伤，用
加味归脾（即归脾加山栀、丹皮。）兼加味逍遥。（结核。）脾虚不能生血，用六君子（杂病虚劳。）加归、
芎。胃虚不能生血，用补中益气汤。（杂病劳倦。）若肝虚而不能藏血，用补肝散；（两胁胀痛。）如
不应，兼以六味丸。（杂病虚劳。）若因脾肺虚，用补中益气汤；如不应，用六君子加芎、归。
一妇人患前证，胸膈痞闷。余曰∶此属脾经血虚，遂用四君加芎、归调补脾气，寻愈。又
因怒，兼两胁痞闷，头目不清，月经旬余未竭。用加味逍遥散加钓藤治之，复瘥。一
妇人患前证，胸膈作痛，面青目札，小便频数，或时寒热。此肝气滞而血凝，先用失笑
散二服，痛止，又用加味逍遥散而愈。 一妇人所患同前，泛用行气破血之剂，以致不
起。
牡丹煎 治妇人血膈。
牡丹皮 苦参 贝母（去心） 玄胡索 白芍药（各等分，为细末）
炼蜜丸梧子大，每服十五、二十丸，米饮吞下，无时。
抽刀散 治妇人血风、血气、血膈等候。（方见血崩。）
〔大〕夫妇人鼻衄者，由伤动血气所致也。凡血气调和则循环表里经络，涩则不散。
若劳伤损动，因而生热，气逆流溢，入于鼻者则成鼻衄也。只有产后见衄者不可治。凡
鼻衄虽多因热而得，此疾亦有因怒气而得之者。曾治赵恭人鼻衄不止，诸治不瘥，召予
治之，先用苏合香丸四粒，次用五苓散浓煎白茅花汤，调服即止，次用芎归汤调理。又
有一富室男子鼻血不止，六脉洪数。究竟云∶服丹药太过。遂用黄连、黄芩、大黄为末，水
煎服之愈。（调服亦可。）
〔薛〕前证若热郁于胃经，用犀角地黄汤。若伏暑于内，用黄连香薷饮。若大怒血
蓄于上，用小柴胡汤。若脾损不能摄血归源，用归脾汤。大凡杂证见血，多因阴分郁热，或
内有所伤，皆属五志所动。经曰∶诸见血，身热脉大者难治，是火邪胜也。身凉脉静者易
治，是正气复也。仍与后证同用。一妇人经素不调，因怒衄血。此肝火炽盛，用加味
小柴胡（热入血室。）加红花，二剂血止。又用加味逍遥散、（结核。）八珍汤（即八物汤，杂病虚劳。）兼
服三十余剂，经行如期。一妇人郁结而患前证，用加味归脾汤，（即归脾加山栀、丹皮。）其
血渐止，饮食渐进，用加味逍遥散，元气渐复，寒热渐止。后因怒仍衄，寒热往来，用
小柴胡汤（伤寒太阳。）加芎、归、丹皮而愈。一妇人因劳衄血，服凉血之剂，更致便血。或
以血下为顺，仍用治血。余曰∶此因脾气下陷而血从之，当升补脾气，庶使血归其经。不
信，果血益甚。余朝用补中益气，（杂病劳倦。）夕用加味归脾而愈。此证用寒凉止血，不补脾
肺而死者，多矣。
刺蓟散 治妇人鼻衄，血流不止。
刺蓟（二两） 桑耳 乱发灰 艾叶（各一两，炒） 生地黄（二两） 蒲黄（一两半）
上为细末，每服二钱，粥饮调下，无时。
伏龙肝散 治男子妇人五脏结热，吐血衄血，并皆治之。
伏龙肝 生地黄（各一斤） 竹茹（一升） 芍药 黄芩 当归 川芎 桂心 甘草（各二两）
上 咀，以水一斗三升，煮竹茹减三升，纳药煮取三升，分为三服。《千金方》无桂心。
《百问》有茅花汤，以白茅花浓煎饮之，立止。
一方 捣生白茅根取汁一合，饮之止。
又方 取生葱心塞鼻中即定。若因刺着并刀斧所伤，血不止者，并用之，立定。
又方 取釜底墨细研，入鼻中。
又方 取乱发灰细研，以竹管吹入鼻中，立止。
又方 取龙骨为末，吹入鼻中立止。
四物汤加侧柏、生地黄，治虚热吐血甚效。若脾经血虚，须用四君加芎、归。若脾
经气郁，须用归脾汤。若肝肾亏损，须用六味丸。若气血俱虚，须用十全大补汤。
犀角地黄汤主热郁不解，泛行经络，或流肠胃，随气涌泄，以致衄血、吐血，或为
便血，并皆治之。若实热炽甚，加炒黄芩。若去血过多，或脾肺之气亏损，不能摄血归源
者，急用四君子汤。怀抱郁结者，用归脾汤。
枇杷叶散 治暑毒攻心，衄血呕血，或吐泻作渴。黄连香薷饮亦可。
【薛己】妇人患血膈，如果是气机逆乱导致血液停滞，使用流气饮。（伴有臂痛。）如果是因愤怒导致血气上逆，使用小柴胡汤（伤寒少阳经病证）加山栀、丹皮。如果是血虚，使用四物汤（通用方剂）、人参、白术、柴胡、山栀、丹皮。如果是因郁结导致血伤，使用加味归脾汤（即归脾汤加山栀、丹皮），同时兼用加味逍遥散。（伴有结核肿块。）如果是脾虚不能生血，使用六君子汤（杂病虚劳证）加当归、川芎。如果是胃虚不能生血，使用补中益气汤（杂病劳倦证）。如果肝虚而不能藏血，使用补肝散；（伴有两胁胀痛。）如果无效，兼用六味丸（杂病虚劳证）。如果是因脾肺虚弱，使用补中益气汤；如果无效，使用六君子汤加川芎、当归。
有一位妇人患上述病症，胸膈痞闷。我说：这属于脾经血虚，于是使用四君子汤加川芎、当归调补脾气，不久痊愈。后来因为发怒，兼见两胁痞闷，头目不清爽，月经十多天未净。使用加味逍遥散加钩藤治疗，再次痊愈。
另一位妇人患上述病症，胸膈作痛，面色青暗，眼睛眨动频繁，小便频数，有时寒热交替。这是肝气滞涩而血液凝滞，先用失笑散服用两剂，疼痛停止，又用加味逍遥散而愈。
还有一位妇人所患相同，泛用行气破血的药物，导致病情恶化无法挽回。
牡丹煎：治疗妇人血膈。
牡丹皮、苦参、贝母（去心）、玄胡索、白芍药（各等分，研为细末）。
用炼蜜制成梧桐子大小的丸药，每次服用十五或二十丸，米汤送下，不限时间。
【张大复】妇女鼻衄，是由于损伤血气所致。凡是血气调和，则循环于表里经络，运行涩滞则不散。如果劳损伤动，因而产生内热，气机逆流溢出，进入鼻腔则成为鼻衄。只有产后出现鼻衄的不可治愈。大凡鼻衄虽然多因热邪引起，此病也有因怒气引起的。曾治疗赵恭人鼻衄不止，各种治疗均无效，请我诊治，先用苏合香丸四粒，再用五苓散浓煎白茅花汤，调服即止，随后用芎归汤调理。又有一位富家男子鼻血不止，六脉洪数。他说：服用丹药太过。于是用黄连、黄芩、大黄研为末，水煎服之而愈。（调服也可以。）
【薛己】上述病症，如果是热邪郁结于胃经，使用犀角地黄汤。如果是伏暑在内，使用黄连香薷饮。如果是大怒导致血液蓄积于上部，使用小柴胡汤。如果是脾脏受损不能摄血归源，使用归脾汤。大凡杂病见出血，多因阴分郁热，或内部有所损伤，都属于五志所动。《内经》说：凡是见血，身体发热、脉大的难治，这是火邪胜的表现。身体凉爽、脉静的易治，这是正气恢复的表现。仍与后文所述证候同用。
一位妇人平时月经不调，因发怒而鼻衄。这是肝火炽盛，使用加味小柴胡汤（热入血室）加红花，两剂血止。又用加味逍遥散（伴有结核肿块）、八珍汤（即八物汤，杂病虚劳证）兼服三十余剂，月经按期而行。
一位妇人因郁结而患上述病症，使用加味归脾汤（即归脾汤加山栀、丹皮），其血渐止，饮食渐进，后用加味逍遥散，元气渐复，寒热渐止。后来因发怒仍然鼻衄，寒热往来，用小柴胡汤（伤寒太阳经病证）加川芎、当归、丹皮而愈。
一位妇人因劳累而鼻衄，服用凉血药物，反而导致便血。有人认为血下行是顺症，仍用治血方法。我说：这是因为脾气下陷而血随之而下，应当升补脾气，使血回归经脉。病人不信，果然血更加严重。我早晨用补中益气汤（杂病劳倦证），晚上用加味归脾汤而愈。此证用寒凉止血，不补脾肺而死亡的，很多了。
刺蓟散：治疗妇人鼻衄，血流不止。
刺蓟（二两）、桑耳、乱发灰、艾叶（各一两，炒）、生地黄（二两）、蒲黄（一两半）。
以上研为细末，每次服用二钱，粥饮调下，不限时间。
伏龙肝散：治疗男子妇人五脏结热，吐血衄血，都进行治疗。
伏龙肝、生地黄（各一斤）、竹茹（一升）、芍药、黄芩、当归、川芎、桂心、甘草（各二两）。
以上切碎，用水一斗三升，煮竹茹减少三升，放入药物煮取三升，分为三次服用。《千金方》无桂心。《百问》有茅花汤，用白茅花浓煎饮用，立即停止。
一方：捣生白茅根取汁一合，饮用即止。
又一方：取生葱心塞入鼻孔即定。如果是因针刺以及刀斧所伤，血不止者，都用此法，立即停止。
又一方：取釜底墨细研，吹入鼻中。
又一方：取乱发灰细研，用竹管吹入鼻中，立即停止。
又一方：取龙骨为末，吹入鼻中立即停止。
四物汤加侧柏、生地黄，治疗虚热吐血非常有效。如果是脾经血虚，须用四君子汤加川芎、当归。如果是脾经气郁，须用归脾汤。如果是肝肾亏损，须用六味丸。如果是气血俱虚，须用十全大补汤。
犀角地黄汤主治热郁不解，泛行经络，或流肠胃，随气涌泄，以致衄血、吐血，或为便血，都进行治疗。如果实热炽盛，加炒黄芩。如果去血过多，或脾肺之气亏损，不能摄血归源者，急用四君子汤。怀抱郁结者，用归脾汤。
[Xue] For women suffering from Xue Ge (Blood Obstruction), if the condition is caused by Qi rebellion leading to blood stasis, use Liuqi Yin (Flowing Qi Decoction). (Accompanied by arm pain.) If it is caused by anger leading to blood and Qi rushing upward, use Xiaochaihu Tang (Minor Bupleurum Decoction) [Shaoyang syndrome of Cold Damage] with Zhizi (Gardeniae Fructus) and Danpi (Moutan Cortex). If there is Blood deficiency, use Siwu Tang (Four Substances Decoction) [General formula], Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Chaihu (Bupleuri Radix), Zhizi, and Danpi. If injury to blood is caused by depression and constraint, use Jiawei Guipi Tang (Modified Spleen-Restoring Decoction) [Guipi Tang added with Zhizi and Danpi], concurrently using Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). (Accompanied by tubercles/masses.) If Spleen deficiency fails to generate blood, use Liujunzi Tang (Six Gentlemen Decoction) [Deficiency-wasting disease] with Danggui (Angelicae Sinensis Radix) and Chuanxiong (Chuanxiong Rhizoma). If Stomach deficiency fails to generate blood, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) [Exhaustion due to overwork]. If Liver deficiency fails to store blood, use Bugan San (Liver-Nourishing Powder); (Accompanied by distending pain in both hypochondria.) If ineffective, concurrently use Liuwei Wan (Six-Ingredient Pill with Rehmannia) [Deficiency-wasting disease]. If the cause is Spleen and Lung deficiency, use Buzhong Yiqi Tang; if ineffective, use Liujunzi Tang with Chuanxiong and Danggui.
One woman suffered from the aforementioned syndrome, with chest and diaphragm fullness and oppression. I said: This belongs to Blood deficiency of the Spleen channel. Thus, I used Sijunzi Tang (Four Gentlemen Decoction) with Chuanxiong and Danggui to tonify and supplement Spleen Qi, and she recovered soon. Later, due to anger, she had accompanying fullness and oppression in both hypochondria, unclear head and eyes, and menstruation lasting more than ten days without stopping. She was treated with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) adding Gouteng (Uncariae Ramulus cum Uncis), and recovered again.
Another woman suffered from the aforementioned syndrome, with pain in the chest and diaphragm, cyanotic complexion, frequent blinking of the eyes, frequent urination, and intermittent chills and fever. This was due to stagnation of Liver Qi and coagulation of blood. First, Shixiao San (Pain-Stopping Powder) was administered for two doses, stopping the pain, followed by Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) until recovery.
Yet another woman had the same condition but indiscriminately used Qi-moving and blood-breaking agents, resulting in an untreatable deterioration.
Mudan Jian (Peony Paste): Treats Xue Ge (Blood Obstruction) in women.
Mudanpi (Moutan Cortex), Kushen (Sophorae Flavescentis Radix), Beimu (Fritillariae Thunbergii Bulbus) [decored], Yansuhu (Corydalis Rhizoma), Shaoyao (Paeoniae Radix Alba) (equal parts, ground into fine powder).
Make pills the size of wutong seeds with refined honey. Take 15 or 20 pills each time, swallowed with rice water, at any time.
Choudao San (Knife-Withdrawing Powder): Treats conditions such as Xue Feng (Blood Wind), Xue Qi (Blood and Qi disorders), and Xue Ge (Blood Obstruction) in women. (Formula see under Xue Beng [Metrorrhagia].)
[Da] Nasal hemorrhage (Bi Nu) in women is caused by damage to Blood and Qi. When Blood and Qi are harmonious, they circulate through the exterior and interior meridians; when sluggish, they do not disperse. If damaged by fatigue and strain, internal heat arises, causing Qi to flow backward and overflow into the nose, resulting in nasal hemorrhage. Only nasal hemorrhage occurring postpartum is considered untreatable. Although nasal hemorrhage is mostly caused by heat, this disease can also be caused by anger. I once treated Lady Zhao, who suffered from incessant nasal hemorrhage that did not respond to various treatments. Upon my consultation, I first administered four Suhe Xiang Wan (Styrax Pills), then used Wuling San (Five-Ingredient Powder with Poria) decocted strongly with Bai Mao Hua (Imperatae Rhizoma Flower) for oral administration, which stopped the bleeding immediately. Subsequently, Xiong Gui Tang (Chuanxiong and Danggui Decoction) was used for regulation. Another wealthy man suffered from incessant nasal bleeding with surging and rapid pulses throughout all six positions. He stated that he had taken too many alchemical pills. Therefore, Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), and Dahuang (Rhei Radix et Rhizoma) were ground into powder, decocted in water, and taken orally, resulting in a cure. (Oral administration with other medicines is also acceptable.)
[Xue] For the aforementioned syndromes, if heat is constrained in the Stomach channel, use Xijiao Dihuang Tang (Rhinohorn and Rehmannia Decoction). If summerheat is latent within, use Huanglian Xiangru Yin (Coptis and Elsholtzia Drink). If severe anger causes blood to accumulate in the upper body, use Xiaochaihu Tang (Minor Bupleurum Decoction). If Spleen damage fails to control blood and return it to its source, use Guipi Tang (Spleen-Restoring Decoction). Generally, bleeding in miscellaneous diseases is mostly due to constrained heat in the Yin aspect or internal injury, all triggered by the Five Emotions. The Classics state: "For all cases of bleeding, if the body is hot and the pulse is large, treatment is difficult; this indicates the predominance of Fire pathogenic factors." If the body is cool and the pulse is quiet, treatment is easy; this indicates the recovery of Righteous Qi. These should still be treated similarly to the subsequent syndromes.
One woman, whose menstruation was usually irregular, suffered from nasal hemorrhage due to anger. This was excessive Liver Fire. I used Jiawei Xiaochaihu Tang (Modified Minor Bupleurum Decoction) [Heat entering the Blood Chamber] with Honghua (Carthami Flos). After two doses, the bleeding stopped. Then, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) [Tubercles] and Bazhen Tang (Eight Treasures Decoction) [i.e., Bayi Tang, Deficiency-wasting disease] were taken concurrently for over thirty doses, restoring regular menstruation.
Another woman suffered from the aforementioned syndrome due to depression and constraint. I used Jiawei Guipi Tang (Modified Spleen-Restoring Decoction) [Guipi Tang added with Zhizi and Danpi]; her bleeding gradually stopped, and her diet improved. Subsequently, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) was used, gradually restoring Yuan Qi and stopping chills and fever. Later, due to anger, she still had nasal hemorrhage with alternating chills and fever. She was cured using Xiaochaihu Tang (Taiyang syndrome of Cold Damage) with Chuanxiong, Danggui, and Danpi.
Another woman suffered from nasal hemorrhage due to labor. After taking cooling-blood agents, she developed hematochezia. Some believed that downward bleeding was favorable and continued treating the blood. I said: This is due to sinking of Spleen Qi, causing blood to follow. One must raise and tonify Spleen Qi so that blood returns to its vessels. Disbelieving this, her bleeding indeed worsened. I prescribed Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) [Exhaustion due to overwork] in the morning and Jiawei Guipi Tang (Modified Spleen-Restoring Decoction) in the evening, resulting in a cure. Many have died from using cold-cooling agents to stop bleeding without tonifying the Spleen and Lungs.
Ciji San (Thistle Powder): Treats nasal hemorrhage in women with incessant blood flow.
Ciji (Cirsii Japonici Herba) [2 liang], Sang'er (Auriculariae Judaeae Fructus), Luangui (Ash of Human Hair), Aiye (Artemisiae Argyi Folium) [1 liang each, stir-fried], Shengdihuang (Rehmanniae Radix Recens) [2 liang], Puhuang (Typhae Pollen) [1.5 liang].
Grind all into fine powder. Take 2 qian each time, mixed with congee water, at any time.
Fulonggan San (Dragon's House Earth Powder): Treats five organs' accumulated heat in men and women, causing hematemesis and epistaxis, effective for both.
Fulonggan (Caulis Bambusae in Taenia) [1 jin], Shengdihuang (Rehmanniae Radix Recens) [1 jin], Zhuru (Bambusae Caulis in Taenia) [1 sheng], Shaoyao (Paeoniae Radix), Huangqin (Scutellariae Radix), Danggui (Angelicae Sinensis Radix), Chuanxiong (Chuanxiong Rhizoma), Guixin (Cinnamomi Cortex), Gancao (Glycyrrhizae Radix et Rhizoma) [2 liang each].
Cut into pieces. Use 13 sheng of water, boil Zhuru until reduced by 3 sheng, add other herbs, and boil to obtain 3 sheng. Divide into three doses. Qianjin Fang does not contain Guixin. Baiwen contains Maohua Tang; decoct Bai Mao Hua (Imperatae Rhizoma Flower) strongly and drink it to stop bleeding immediately.
Another prescription: Crush fresh Baomagen (Imperatae Rhizoma) to extract juice, take one he, and the bleeding stops.
Another prescription: Insert the heart of raw scallion into the nostril to stop bleeding. If caused by needle pricks or axe/knife injuries with incessant bleeding, apply this method to stop it immediately.
Another prescription: Grind Fu Di Mo (soot from the bottom of a cauldron) finely and blow it into the nose.
Another prescription: Grind Luangui Hui (Ash of Human Hair) finely and blow it into the nose with a bamboo tube to stop bleeding immediately.
Another prescription: Grind Longgu (Fossilized Bones) into powder and blow it into the nose to stop bleeding immediately.
Siwu Tang (Four Substances Decoction) added with Cebai (Platycladi Cacumen) and Shengdihuang (Rehmanniae Radix Recens) is very effective for treating hematemesis due to deficient heat. If there is Blood deficiency of the Spleen channel, use Sijunzi Tang (Four Gentlemen Decoction) with Chuanxiong and Danggui. If there is Qi constraint of the Spleen channel, use Guipi Tang (Spleen-Restoring Decoction). If there is Liver and Kidney depletion, use Liuwei Wan (Six-Ingredient Pill with Rehmannia). If there is dual deficiency of Qi and Blood, use Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction).
Xijiao Dihuang Tang (Rhinohorn and Rehmannia Decoction) treats unresolved heat constraint spreading through meridians or flowing into the intestines and stomach, surging with Qi and leaking out, causing epistaxis, hematemesis, or hematochezia, effective for all. If excess heat is intense, add Chao Huangqin (Stir-fried Scutellariae Radix). If excessive blood loss occurs, or if Spleen and Lung Qi are depleted and fail to control blood returning to its source, urgently use Sijunzi Tang (Four Gentlemen Decoction). For those with emotional depression and constraint, use Guipi Tang (Spleen-Restoring Decoction).
Pipaye San (Loquat Leaf Powder): Treats summer-toxin attacking the Heart, causing epistaxis, hematemesis, or vomiting/diarrhea with thirst. Huanglian Xiangru Yin (Coptis and Elsholtzia Drink) is also applicable.