惊悸吐衄下血胸满瘀血病脉证并治第十二

Chapter 12, scaring, bleeding, fullness, blood stagnation

寸口脉动而弱，动即为惊，弱即为悸。

If the pulse is jumping and weak, the jumping pulse suggests scaring condition and the weak pulse then suggesting a palpitation condition.  

师曰：夫脉浮，目睛晕黄，衄未止，晕黄去，目睛慧了，知衄今止。

Master: if the pulse is floating, the person has yellow color in the eyes and has nose bleeding, then the overall condition indicates Blood disease. The yellow color in the eyes implies the nose bleeding problem remains. If the eyes become clear, the nose bleeding stop.  

又曰：从春至夏衄者太阳，从秋至冬衄者阳明。

If the nose bleeding occurs in spring and summer, the bleeding is a condition of Taiyang. If it occurs during autumn and the winter, it belongs to Yangming condition.

衄家不可汗，汗出必额上陷，脉紧急，直视，不能眴，不得眠。

If the person has nose bleeding, sweat therapy should not be used. Other wise, he will has shrink in the head muscles, staring eyes, hard to focus to see, hard to fall into sleep, and his pulse will be tight and urgent.

病人面无血色，无寒热，脉浮弦者，衄；脉沉弱，手按之绝者，下血；烦咳者，必吐血。

If the face is pale, the person has no cold or hot feeling, then if the pulse is floating and string, he will has nose bleeding. If the pulse is deep and weak, and it is hardly felt when press deep, he will have bleeding in the urine, or in stool or in vagina; if he has annoying cough, he will vomit blood.

夫吐血，咳逆，上气，其脉数，而有热，不得卧者，死。

If the person has vomiting blood, urgent cough with frequent pulse, has fever and difficult to fall into sleep, the one is to die.

 
夫酒客咳者，必致吐血，此因极饮过度所致也。

For person who has long history of wine or liquor drinking has cough, he will have blood in the vomiting. It is due to over drinking of the liquors.

亡血不可发其表，汗出则寒栗而振。

If the person loses blood, the sweat therapy is forbidden. Otherwise, the sweat therapy will cause chilly after sweat.

吐血不止者，柏叶汤主之。

For continuous blood vomiting, use Boye Tang to stop the bleeding.

 柏叶汤方

Boye Tang

柏叶，干姜  各三两，艾 三把

Poye (Cypress leaves) 45 gram, Granjiang 45 gram, Ai 10 grams.

右三味，以水五升，取马通汁一升合煮，取一升，分温再服。

Add the herbs and 1750 ml water and 250 ml Matong juice into a herbal pot. Bring to boil and keep in mild boiling until there is 250 ml herbal tea left. Collect the herbal tea, separate it into several parts. Drink each part with one hour interval.

 心气有余[1]，吐血、衄血，泻心汤主之。

If the bleeding (from vomiting or nose) is due to overwhelming of the Heart Qi, use Xiexin Tang.

 泻心汤方

Xiexin Tang

大黄二两，黄连，黄芩各一两

Dahuang 30 gram, Huanglian 15 gram, Huangqin 15 gram

右三味，以水三升，煮取一升，顿服之。

Add the herbs and 750 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is 250 ml herbal tea left. Collect the herbal tea, drink the tea once for all.

病人胸满、唇痿、舌青、口燥，但欲漱水，不欲咽，无寒热，脉微大来迟，腹不满，其人言我满，为有瘀血。

It is a blood stagnation condition if the person feels fullness in the chest, dry-shrink of the mouth lips, purple tint in the tongue, dry mouth, willing to hold water in mouth but no willing to swallow, no cold or hot feeling, no sign for fullness in abdomen but complains fullness, and his pulse is slightly big and slow.  

病者如热状，烦满，口干燥而渴，其脉反无热，此为阴伏，是瘀血也，当下之。

It is also a blood stagnation condition if the person appears having a Fire, feels fullness in the chest, dry mouth and thirsty, but the pulse does not show sign of Fire (no strong and  fasting or frequent pulse, but a weak and deep pulse). In this case, use bowel-cleansing therapy.

下血，先便后血，此远血也，黄土汤主之。下血，先血后便，此近血也，赤小豆当归散主之。

If the person has bleeding, the blood follows the stool, it is a far away bleeding[2], use Huangtu Tang. If the stool follows the blood, it is a nearby bleeding[3], use Chixiaodou Danggui San.

黄土汤方

Huangtu Tang

甘草，干地黄，白术，附子（炮），阿胶，黄芩各三两，中黄土半斤

Gancao 45 gram, Shendihuang 45 gram, Baishu 45 gram, Fuzi (processed) 45 gram, Ajiao 45 gram, Huangqin 45 gram, Yellow soil 125 gram.

右七味，以水八升，煮取三升，分温二服。

Add the herbs and 2000 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is 750 ml herbal tea left. Collect the herbal tea, drink half the tea each time for two times.

赤小豆当归散

（方见狐惑）

For the formula of Chixiaodou Danggui San, check Huhuo disease.

寸口脉弦而大，弦则为减，大则为芤，减则为寒，芤则为虚，寒虚相击，此名曰革，妇人则半产漏下，男子则亡血失精。

(Translation for this paragraph is omitted for the time being).
       

火邪者，桂枝去芍药，加蜀漆牡蛎龙骨，救逆汤主之。

(Translation for this paragraph is omitted for the time being).
       

【按】此方是治火逆惊狂者，与首条之脉动惊病不合，必是错简。

桂枝救逆汤方

Guizhi Jiuni Tang

桂枝  三两，甘草（炙）二两，生姜 三两，牡蛎（熬）五两，龙骨  四两，大枣  十二枚，蜀漆（洗去腥）三两

Guizhi 45 gram, Gancao (processed) 30 gram, fresh ginger 45 gram, Muli (processed) 78 gram, Longgu 60 gram, Chinese date 12 badges, Shuqi (wash) 45 gram.

右为末，以水一斗三升，先煮蜀漆，减一升，内诸药，煮取三升，温服一升。

Add the Shuqi and 3250 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is about 250 ml water evaporated. Add remaining herbs in the pot, continue to boiling until there is 750 ml herbal tea left. Drink one third of the herbal tea each time, three times a day.

心下悸者，半夏麻黄丸主之。

If the person feels palpitation in the upper abdomen, use Banxia Mahuang Wan

【按】此方是治寒水心下悸者，与首条之脉弱悸病不合，必是错简。

半夏麻黄丸方

Banxia Mahuang Wan

半夏  麻黄等分

Equal amount of Banxia and Mahuang

右二味，末之，炼蜜和丸，小豆大，饮服三丸，日三服。

Prepare the herbs into pills with honey, 0.5 cm in diameter. Drink 3 pills each time, three times a day.