《千金翼》治舌上黑，有数孔出血如涌泉，此心脏病也方。
戎盐 黄芩 黄柏 大黄（各五两） 人参 桂心（各二两） 甘草（一两，炙）
上七味，末之，炼蜜丸，如梧子。每服十丸，日三服。仍烧铁烙之。
〔曾〕小儿九道出血，何为而然？盖人之所有者，血与气也，心者，血之主，肺
者，气之主，气主 之，血主濡之，荣养百骸，灌溉丝脉，升降上下，荣卫谐和，
自然顺适，一或不调，疾由生矣，或外为六淫所侵，内因七情所沮，气乃留而不行，
血乃壅而不濡，内外抑郁，不能流注以荣于身，必有妄动之患。叔和以芤脉为失血
之义，在七表属阳故也，阳明主乎多气多血，未有不因热而得，盖气血俱热，热郁
内逼，失其常度，是以妄行。有在襁褓患此证者，固非七情所伤，皆因乳母执着，
不自宽释，及啖辛辣之物，流于乳络，儿饮之后，停滞不散，郁蒸于内，亦能动血。
或居重帏暖阁，火气熏逼，不令常见风日，积温成热，热种则涌泄，或吐或衄，或
大小腑亦多血来者。有气虚而邪热乘之，则血不得循流故道，渗于诸经，亦生走失
之证，其面 白，脉沉微，血淡紫，口气缓，是也。又况婴孩脆弱，易虚易实，因
热内攻，血随气行，或壅而上逆，或下而忘返，遂有吐血、衄血、泻血、溺血之
证，然而血不苟动，因气使之，风不自生，因热而起，由是而论，可以类推。治法，
先明虚实，审得病源，随经施治，药饵无瘥，则不失其机要。实则小柴胡汤加生地
黄、丝茅根，或苦参亦好，并用水煎服。或 咀五苓散合五和汤，亦加丝茅根、苦
参、水煎，及投消毒饮。次用《局方》鸡苏丸、三黄丸、间服。虚则理中汤，及人
参芎归汤皆可服。间有医者见其血盛，以为热极，过投凉剂，遂使血寒不能归源而
妄流，其色紫黯而凝滞，或成小片，当服姜附之剂以温之，自然流畅，毋致妄行为佳。
小柴胡汤（潮热） 五苓散（惊） 五和汤（里热） 消毒饮（喉痹） 《局方》
鸡苏丸（大吐血） 三黄丸（里热） 理中汤（吐泻）
人参芎归汤 治九道血妄行。
人参（去芦） 川芎 当归（酒洗。各半两） 荆芥（二钱半）
上每服二钱，水一盏，煎七分，温服，无时。
黄芩丸 治小儿衄血、吐血、下血。
上，以黄芩为末，炼蜜、丸如鸡头大。三岁一丸，浓盐汤下。柏叶、石榴花，
为末吹鼻，治衄血吐血。一方，定州瓷器末，治呕血，破血止血。
茅花汤 治鼻衄不止，吐血下血。
用茅花一大把，水三盏，煎浓汁一盏，分二服，即瘥。无花，根梗代之。兼治
血痢黑痢。
《千金翼方》记载治疗舌面发黑，且有多处出血如泉水涌出般的症状，这是针对心脏病变的方剂。
戎盐、黄芩、黄柏、大黄（各五两）、人参、桂心（各二两）、甘草（一两，经蜜炙）
以上七味药，研成细末，用炼过的蜂蜜制成丸药，大小如梧桐子。每次服用十丸，每日三次。同时烧红铁器进行烙烫止血。
〔曾氏〕小儿九窍出血，为什么会这样？大概人体所拥有的是血与气。心是血的主宰，肺是气的主宰。气主要推动运行，血主要濡养滋润，营养全身骨骼脉络，灌溉细微经络，升降于上下，使营卫和谐协调，自然顺畅适宜。一旦不调和，疾病就会由此产生。或者外受六淫（风、寒、暑、湿、燥、火六种外感病邪）侵袭，内因七情（喜、怒、忧、思、悲、恐、惊七种情志变化）阻碍，导致气滞留而不能运行，血壅塞而不能濡养。内外郁结，不能流注以滋养身体，必然会有妄动出血的祸患。王叔和认为芤脉（浮大中空，如按葱管）代表失血的意义，因为它在七表脉中属于阳脉。阳明经主多气多血，没有不是因为热邪而导致的，大概是气血俱热，热邪郁结在内逼迫，失去了正常的度，所以血液妄行。有在婴儿期患此证的，固然不是七情所伤，都是因为乳母执着于心，不能自我宽慰释怀，以及食用辛辣食物，热气流入乳络，婴儿饮用后，停滞不散，郁蒸于体内，也能引动出血。或者居住在厚重的帷帐和温暖的阁楼上，火气熏蒸逼迫，不让常见风吹日晒，积温而成热，热邪种子则导致涌泄，有的呕吐，有的鼻衄，有的大小便也多有出血。有气虚而邪热乘虚而入的，则血不能循行常道，渗漏于各条经脉，也会产生走失之证，其面色苍白，脉象沉微，血色淡紫，口气缓弱，就是这种情况。更何况婴孩体质脆弱，易虚易实，因热邪内攻，血随气行，或壅滞而上逆，或下行而忘返，于是出现吐血、衄血、泻血、溺血的症状。然而血不轻易妄动，是因气使之然；风不自生，是因热而起。由这些道理推论，可以类推其他情况。治疗方法，先明确虚实，审察病因，根据经络施治，药物服用无效时，就不失其关键要点。实证用小柴胡汤加生地黄、白茅根，或者苦参也好，一并用水煎服。或者将五苓散与五和汤合用，也加入白茅根、苦参，水煎，并投予消毒饮。其次使用《太平惠民和剂局方》中的鸡苏丸、三黄丸，交替服用。虚证则理中汤，以及人参芎归汤都可以服用。间或有医生见其出血旺盛，认为是热极，过量投用凉性药剂，致使血寒不能归源而妄流，其颜色紫暗而凝滞，或形成小片，应当服用姜附类药剂以温之，自然流畅，不要导致妄行为佳。
小柴胡汤（主治潮热） 五苓散（主治惊悸） 五和汤（主治里热） 消毒饮（主治喉痹） 《局方》鸡苏丸（主治大吐血） 三黄丸（主治里热） 理中汤（主治吐泻）
人参芎归汤 治疗九窍血妄行。
人参（去芦头）、川芎、当归（酒洗。各半两）、荆芥（二钱半）
以上每服二钱，水一盏，煎至七分，温服，不拘时候。
黄芩丸 治疗小儿衄血、吐血、下血。
以上，以黄芩为细末，用炼蜜、制成如鸡头大小的丸药。三岁儿童服一丸，用浓盐水送下。柏叶、石榴花，研成细末吹入鼻腔，治疗衄血吐血。另一方法，定州瓷器末，治疗呕血，破血止血。
茅花汤 治疗鼻衄不止，吐血下血。
用茅花一大把，水三盏，煎取浓汁一盏，分两次服用，即刻痊愈。无花时，用根梗代替。兼治血痢黑痢。
The *Qianjin Yi Fang* records a prescription for treating blackness of the tongue with multiple holes bleeding like a gushing spring; this is a formula for Heart disease.
Rongyan (Halite), Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex), Dahuang (Rhei Radix et Rhizoma) (each 5 liang), Renshen (Ginseng Radix), Guixin (Cinnamomi Ramulus) (each 2 liang), Gancao (Licorice Radix et Rhizoma) (1 liang, honey-fried).
The above seven herbs are powdered, mixed with refined honey to make pills the size of a Chinese quince seed. Take ten pills per dose, three times daily. Additionally, apply hot iron cauterization.
[Zeng] Why do infants suffer from bleeding in the nine orifices? Essentially, what humans possess is Blood and Qi. The Heart is the master of Blood, and the Lungs are the master of Qi. Qi primarily governs movement, while Blood primarily nourishes and moistens, benefiting the bones and meridians, irrigating the collaterals, ascending and descending, harmonizing Ying and Wei, thus naturally smooth and appropriate. If harmony is disrupted, disease arises. This may be due to external invasion by the Six Excesses (Wind, Cold, Summerheat, Dampness, Dryness, Fire) or internal obstruction by the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright). Qi stagnates and fails to move; Blood becomes obstructed and fails to nourish. Internal and external depression prevents flow and nourishment of the body, inevitably leading to reckless bleeding. He Suhe considered the Kou pulse (hollow pulse) as indicative of blood loss because it belongs to Yang among the seven superficial pulses. The Yangming channel governs abundant Qi and Blood, and such conditions rarely occur without Heat. Generally, when both Qi and Blood are hot, Heat stagnates internally and forces outward, losing its normal measure, causing Blood to run recklessly. Infants suffering from this condition are not injured by emotions but rather because the wet nurse holds onto distress without self-comfort, or consumes spicy foods, allowing heat to flow into the milk channels. After the infant drinks, it stagnates and does not disperse, steaming internally, which can also agitate Blood. Alternatively, residing in heavy curtains and warm rooms, where fire-qi熏逼 (pursues and presses), preventing exposure to wind and sunlight, accumulates warmth into Heat. When Heat seeds, it causes gushing discharge: vomiting, epistaxis, or bleeding from the bowels and bladder. In cases of Qi deficiency where pathogenic Heat takes advantage, Blood cannot follow its proper course, leaking into the various meridians, resulting in leakage syndromes. Symptoms include pale complexion, deep and minute pulse, pale purple blood, and slow breath. Furthermore, infants are fragile, prone to deficiency and excess. Due to internal attacking Heat, Blood follows Qi; it may obstruct and reverse upward, or descend and fail to return, leading to hematemesis, epistaxis, hematochezia, and hematuria. However, Blood does not move recklessly without cause; it is driven by Qi. Wind does not generate spontaneously; it arises from Heat. By this reasoning, other cases can be inferred. Treatment methods require first distinguishing deficiency and excess, examining the source of disease, and treating according to the meridians. If medication fails, one has missed the key point. For excess patterns, use Xiaochaihu Tang (Minor Bupleurum Decoction) added with Shengdihuang (Rehmanniae Radix) and Simaogen (Imperatae Rhizoma), or Kushen (Sophorae Flavescentis Radix) is also good, decocted in water. Or combine Wuling San (Five-Ingredient Powder with Poria) and Wuhe Tang (Five-Harmony Decoction), adding Simaogen and Kushen, decocted in water, along with administering Xiaodu Yin (Detoxification Decoction). Subsequently, use Jisu Wan (Chicken Mint Pill) and Sanhuang Wan (Three-Yellow Pill) from the *Jufang*, taken alternately. For deficiency patterns, Lizhong Tang (Regulate the Middle Decoction) and Ren Shen Xiong Gui Tang (Ginseng, Ligusticum, and Angelica Decoction) are suitable. Occasionally, physicians see profuse bleeding and assume extreme Heat, over-administering cold agents, causing Blood to become cold, unable to return to its source, and flowing recklessly. The color becomes dark purple and stagnant, forming small clots. One should administer Jiangfu agents (Ginger and Aconite preparations) to warm it, ensuring natural flow and avoiding reckless bleeding.
Xiaochaihu Tang (Tidal Fever) Wuling San (Fright) Wuhe Tang (Interior Heat) Xiaodu Yin (Sore Throat) Jufang Jisu Wan (Severe Hematemesis) Sanhuang Wan (Interior Heat) Lizhong Tang (Vomiting and Diarrhea)
Ren Shen Xiong Gui Tang treats reckless bleeding in the nine orifices.
Renshen (Ginseng Radix, remove rhizome), Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix, wine-washed) (each half liang), Jingjie (Schizonepetae Spica) (2.5 qian).
Take two qian per dose, one lamp of water, decoct to seven-tenths, take warm, at any time.
Huangqin Wan (Scutellaria Pill) treats infantile epistaxis, hematemesis, and lower bleeding.
Powder Huangqin (Scutellariae Radix), mix with refined honey to make pills the size of a chicken head. Three-year-olds take one pill, swallowed with strong salt water. Baiye (Membranaceae Folium) and Shiliuhua (Punica Granatum Flower), powdered and insufflated into the nose, treat epistaxis and hematemesis. Another method: Dingzhou porcelain powder treats hematemesis and stops bleeding by breaking stasis.
Maohua Tang (Thatch Flower Decoction) treats persistent epistaxis, hematemesis, and lower bleeding.
Use a large handful of Maohua (Miscanthus flower), three lamps of water, decoct to obtain one lamp of concentrated juice, divide into two doses, and recover immediately. If flowers are unavailable, use roots and stems instead. Also treats bloody dysentery and black dysentery.