咯血，不嗽而咯出血也。咯与唾少异，唾出于气，上无所阻；咯出于痰，气郁
于喉咙之下，滞不得出，咯而乃出。求其所属之脏，咯、唾同出于肾也。治咯血之
方，宜用童便、青黛，以泻手足少阳三焦与胆所合之相火，而姜汁为佐，用四物、
地黄、牛膝辈，以补肾阴安其血也。《撄宁生卮言》云∶咯血为病最重，且难治者，
以肺手太阴之经气多血少。又肺者金象，为清肃之脏，金为火所制，迫而上行，以
为咯血，逆之甚矣。上气见血，下闻病音，谓喘而咯血且咳嗽也。初得病，且宜白
扁豆散去半夏，加贝母，入生地黄、藕节尤佳。及浓磨京墨调黑神散、小乌沉汤各一钱。
或新掘生地黄净洗，生姜少许，捣汁去滓温进。又有以生姜一片，四面蘸百草霜含
咽，如百草霜已淡，吐出再蘸，如姜已无味，则吐出易之。劳瘵吐咯血，七珍散加
阿胶、当归各半钱，恶甜人更加百药煎半钱，仍调钟乳粉尤佳。一味钟乳粉，用糯
米饮调，吐血、嗽血亦治。因饱屈身伤肺，吐咯血者，白芨枇杷丸，或白芨莲须散。
治咯血，黄药子、汉防己各一两为末，每服一钱匕，水一盏，小麦二十粒同煎，食
后温服。白芨一两，藕节半两为末，每一钱汤调服。新绵灰半钱，酒调下。薏苡仁
为末，熟煮猪胰，切片蘸药，食后微空时取食之。青黛一钱，杏仁四十粒去皮尖，
以黄明蜡煎黄色，取出研细，二味同研匀，却以所煎蜡少许，溶开和之，捏作钱大
饼子，每服用干柿一个，中破开，入药，一饼合定，以湿纸裹，慢火煨熟，取出，糯
米粥嚼下。
咯血，是指不咳嗽而直接咳出血液的症状。咯血与唾沫略有不同：唾沫源于气机，向上排出时没有阻碍；咯血则源于痰液，气机郁结在喉咙下方，停滞无法排出，必须用力咯出才能出来。追溯其所属的脏腑，咯血和唾沫都同属于肾。治疗咯血的方剂，适宜使用童便（儿童尿液）、青黛，以泻除手足少阳三焦经与胆腑所合的相火，并辅以姜汁；配合四物汤、地黄、牛膝等药物，以补肾阴来安固血液。《撄宁生卮言》中说：咯血这种病最为严重，且难以治疗，是因为手太阴肺经的气多血少。另外，肺在五行中属金，是清肃的脏器，若被火邪克制，逼迫气血上行，从而导致咯血，这是非常逆乱的病理状态。“上气见血，下闻病音”，指的是气喘、咯血并且伴有咳嗽。刚患病时，适宜用白扁豆散去半夏，加入贝母，再放入生地黄、藕节效果更佳。或者浓磨京墨调服黑神散、小乌沉汤各一钱。或者取新挖掘的生地黄洗净，加少许生姜，捣烂取汁去渣后温服。又有方法是用一片生姜，四面蘸取百草霜含在口中咽下，如果百草霜的味道变淡，吐出后再蘸，如果生姜已无味，则吐出更换新的。因劳瘵（肺结核类慢性消耗性疾病）导致的吐咯血，可用七珍散加阿胶、当归各半钱，厌恶甜味的人再加百药煎半钱，若能调服钟乳粉效果更佳。单用一味钟乳粉，用糯米饮调服，吐血、嗽血也能治疗。因饱食后弯腰损伤肺部导致吐咯血的，可用白芨枇杷丸，或白芨莲须散。治疗咯血，可用黄药子、汉防己各一两研为末，每次服用一钱匕，用水一盏，小麦二十粒同煎，饭后温服。白芨一两，藕节半两研为末，每次一钱用汤水调服。新棉烧成的灰半钱，用酒调服。薏苡仁研为末，将猪胰煮熟切片，蘸取药物，在饭后微饥时食用。青黛一钱，杏仁四十粒去皮尖，用黄明蜡煎至黄色，取出研细，将这两味药同研均匀，再用刚才煎过的少许蜡溶化调和，捏成如铜钱大小的饼子，每次服用时取干柿一个，从中间破开，放入药饼，合定后用湿纸包裹，用慢火煨熟，取出后用糯米粥嚼服。
Hemoptysis refers to the symptom of coughing up blood without accompanying a dry cough. Hemoptysis differs slightly from saliva: saliva originates from Qi and is expelled upward without obstruction; hemoptysis originates from phlegm, where Qi stagnates below the throat, obstructed and unable to exit, requiring forceful expulsion to bring it out. Tracing its associated Zang organs, both hemoptysis and saliva are linked to the Kidney. For treating hemoptysis, formulas should utilize Tongbian (Child's urine) and Qingdai (Indigo Naturalis) to drain the Ministerial Fire (Xianghuo) combined with the Hand-Shaoyang Sanjiao (Triple Burner) and Foot-Shaoyang Gallbladder channels, using Jiangzhi (Ginger juice) as an assistant. Combined with Siwu Tang (Four Substance Decoction), Dihuang (Rehmanniae Radix), Niuxi (Achyranthis Bidentatae Radix), etc., to tonify Kidney Yin and stabilize the blood. *Yingning Sheng Zhiyan* states: Hemoptysis is a severe disease and difficult to treat because the Hand-Taiyin Lung channel has abundant Qi but scarce Blood. Furthermore, the Lung corresponds to Metal in the Five Elements and is a clear and descending organ. If constrained by Fire, forcing Qi and Blood upward, it results in hemoptysis, which is a severe reversal of physiological order. "Upper Qi manifests with blood, lower sounds indicate pathology" refers to wheezing accompanied by hemoptysis and coughing. In the initial stage of the disease, it is suitable to use Baibian Dou San (White Hyacinth Bean Powder) removing Banxia (Pinelliae Rhizoma), adding Beimu (Fritillariae Bulbus), and adding Shengdihuang (Rehmanniae Radix Recens) and Oujié (Nelumbinis Nodus) for better effect. Alternatively, grind Jingmo (Beijing Ink) thickly to mix with Heishen San (Black Divine Powder) or Xiaowuchen Tang (Little Black Sinking Decoction), one Qian each. Or take freshly excavated Shengdihuang, wash it clean, add a small amount of fresh ginger, crush to extract juice, remove dregs, and take warm. Another method involves taking a slice of fresh ginger, dipping all four sides into Baicaoshuang (Charred Grass Dust), holding it in the mouth to swallow. If the taste of Baicaoshuang fades, spit it out and dip again; if the ginger loses flavor, spit it out and replace it. For hemoptysis caused by Laozai (Consumption/Tuberculosis), use Shizhen San (Seven Treasures Powder) added with Ejiao (Donkey-hide Gelatin) and Danggui (Angelicae Sinensis Radix), half a Qian each. For those who dislike sweet tastes, add Baiyaojian (Myrobalan Pill), half a Qian. Mixing with Zhongru Fen (Ostreae Concha powder) is especially good. Using only Zhongru Fen mixed with Nuomiyin (Glutinous Rice Drink) also treats vomiting blood and sanguineous sputum. For hemoptysis caused by lung injury due to bending over after a full meal, use Baiji Pipa Wan (Bletilla Loquat Pills) or Baiji Lianxu San (Bletilla Lotus Stamen Powder). To treat hemoptysis, use Huangyaozi (Dioscoreae Hypoglaucae Rhizoma) and Hanfangji (Stephaniae Tetrandrae Radix), one Liang each, ground into powder. Take one Qianbi per dose, decoct with one cup of water and twenty grains of Xiaomai (Triticum aestivum), take warm after meals. Baiji (Bletillae Rhizoma) one Liang, Oujié (Nelumbinis Nodus) half a Liang, ground into powder; take one Qian mixed with liquid. Xinmian Hui (Ash of new cotton) half a Qian, taken with wine. Yiyiren (Coicis Semen) ground into powder; cook pig pancreas thoroughly, slice, dip in the medicine, and eat when slightly hungry after meals. Qingdai (Indigo Naturalis) one Qian, Xingren (Armeniacae Semen Amarum) forty grains, skin and tip removed, fried in Huangmingla (Yellow Beech Wax) until yellow, removed and ground fine. Mix these two ingredients evenly, then dissolve a small amount of the fried wax to bind them, knead into cakes the size of a coin. For each dose, take one dried persimmon, split open, insert the cake, seal it, wrap in wet paper, and slow-roast until cooked. Remove and chew down with glutinous rice porridge.