寶鑑Bogam

Formulas · Text · Donguibogam 東醫寶鑑

Blood

Hyeol

한글 혈  ·  Pinyin Xue

Blood is made in the middle burner from water and grain — and every bleeding is a heat until proven otherwise

血

The chapter the rest of the book keeps sending its readers to, and the home of the four formulas — Four Substances, Eight Substances, and their two children — that half the prescriptions in the Bogam are built from. It opens with where blood comes from: the middle burner receives the qi of food, transforms it, and reddens it, and the Lingshu's line is the chapter's first sentence. Then what blood does — the eye sees with it, the foot walks with it, the hand grips with it — and its relation to qi, which the Jikji puts as wind over water: the qi moves and the blood follows. The middle of the chapter is a catalogue of routes. Blood leaves by the nose, the mouth, the throat, the urine, the stool, the gums, the tongue, the skin as sweat, and all nine orifices at once, and each route has a section, a set of formulas, and a reading of which organ has failed. Danxi's rule governs all of them: every bleeding is a heat pattern, and the treatment cools and lowers. The chapter also knows what heat cannot explain — bound yin, the bleeding of cold, treated with aconite — and what to do when the blood has stopped and the patient is left empty. It ends with the black medicines, the ash formulas that stanch by charring, and with child's urine, which the Uigam says saves ninety-nine in a hundred where cold medicine kills nine in ten.

1.1 Yin Blood Is Engendered from Water and Grain 陰血生於水穀

1.1.1
Source원문

靈樞曰, 中焦受氣, 變化而赤, 是謂血. 又曰, 榮出於中焦. 又曰, 穀入於胃, 脉道乃行, 水入於經, 其血乃成.

Translation영역
The Lingshu says: the middle burner receives the qi, transforms it and reddens it, and this is called blood. It also says: the construction issues from the middle burner. And it says: when grain enters the stomach the vessels' road moves, and when water enters the channels the blood is formed.
Clinical note임상 주석
The chapter's first claim, and the tradition's whole account of where blood comes from: the stomach and spleen take what is eaten, and the middle burner turns it red. There is no other source. That is why every formula for blood loss in this chapter feeds the spleen as well as the blood, and why the Internal Damage chapter's whole method applies here.

Yeongchu 靈樞

1.1.2
Source원문

內經曰, 榮者, 水穀之精氣也. 和調於五藏, 灑陳於六府, 乃能入於脉也. 故循脉上下, 貫五藏, 絡六府也.

Translation영역
The Neijing says: the construction is the essential qi of water and grain. It harmonizes and regulates in the five viscera and is sprinkled and spread through the six bowels, and then it can enter the vessels. So it follows the vessels up and down, threads the five viscera and networks the six bowels.

Naegyeong 內經

1.2 Blood Is the Construction 血爲榮

1.2.1
Source원문

內經曰, 血爲榮, 榮於內. 目得血而能視, 足得血而能步, 掌得血而能握, 指得血而能攝.

Translation영역
The Neijing says: blood is the construction, and it constructs within. The eye obtains blood and can see; the foot obtains blood and can walk; the palm obtains blood and can grip; the fingers obtain blood and can hold.
Clinical note임상 주석
Four functions and one substance behind them. The passage is the tradition's plainest statement that blood is what makes the body work, and the Hair chapter and the Hands and Feet chapters each take their piece of it.

Naegyeong 內經

1.2.2
Source원문

劉宗厚曰, 榮者, 水穀之精也. 生化於脾, 總統於心, 藏受於肝, 宣布於肺, 施泄於腎, 灌漑一身. 目得之而能視, 耳得之而能聽, 手得之而能攝, 掌得之而能握, 足得之而能步, 藏得之而能液, 府得之而能傳注之於脉. 少則澁, 充則實, 常以飮食日滋, 故能陽生陰長, 取汁變化而赤爲血也. 是故血盛則形盛, 血弱則形衰矣.

Translation영역
Liu Zonghou said: the construction is the essence of water and grain. It is engendered and transformed in the spleen, commanded by the heart, stored and received in the liver, spread by the lung, discharged by the kidney, and irrigates the whole body. The eye obtains it and can see; the ear obtains it and can hear; the hand obtains it and can hold; the palm obtains it and can grip; the foot obtains it and can walk; the viscera obtain it and can make fluids; the bowels obtain it and can pass it on into the vessels. Scant, it is rough; full, it is replete. It is daily nourished by food and drink, and so the yang engenders and the yin grows, the juice is taken and transformed and reddened into blood. Hence where the blood is exuberant the form is exuberant, and where the blood is weak the form declines.
Clinical note임상 주석
Five organs and one job each — the spleen makes it, the heart drives it, the liver stores it, the lung spreads it, the kidney lets it out. That assignment is what the chapter's route-by-route sections rest on: bleeding from the nose is the lung's failure, from the mouth the stomach's, from the throat the kidney's.

Yu Jonghu (劉宗厚)

1.3 Blood Is the Mate of Qi 血爲氣配

1.3.1
Source원문

夫血譬則水也. 氣譬則風也. 風行水上, 有血氣之象焉. 盖氣者, 血之帥也. 氣行則血行, 氣止則血止, 氣溫則血滑, 氣寒則血澁, 氣有一息之不運, 則血有一息之不行. 病出於血, 調其氣, 猶可以導達, 病原於氣, 區區調血何加焉. 故人之一身, 調氣爲上, 調血次之, 是亦先陽後陰之義也. 《直指》

Translation영역
Blood, by comparison, is water; qi, by comparison, is wind. Wind moving over water — there is the image of blood and qi. For qi is the commander of blood. Where the qi moves the blood moves; where the qi stops the blood stops; where the qi is warm the blood is slippery; where the qi is cold the blood is rough. Where the qi fails to move for one breath, the blood fails to move for one breath. Where the disease comes from the blood, regulating the qi can still conduct it through; where the disease originates in the qi, what does fussing over the blood add? So in a person's whole body, regulating the qi comes first and regulating the blood second — which is also the sense of yang before yin.
Clinical note임상 주석
Wind over water — the chapter's one metaphor, and the tradition's most-quoted for the relation between the two. 氣者, 血之帥也, qi is the commander of blood, and everything the chapter says about moving or stopping blood is said through the qi. The practical consequence is 5.32 of the Medicine Use chapter: regulate the qi first even when the blood is the complaint. The Uterus chapter's cyperus formulas and this chapter's Sagung-san at 1.13 are that rule applied.

Jikji 直指

1.4 Pulse Method 脉法

1.4.1
Source원문

脉經曰, 脉得諸澁濡弱, 爲亡血.

Translation영역
The Pulse Classic says: a pulse found rough, soggy or weak is blood lost.

Maekgyeong 脉經

1.4.2
Source원문

脉訣曰, 諸證失血皆見芤脉, 脉貴沈細浮大難治.

Translation영역
The Pulse Verses say: in all patterns of blood loss the hollow pulse is seen; a pulse sunken and fine is prized, and floating and large is hard to treat.
Clinical note임상 주석
The hollow pulse — 芤, like pressing a scallion stalk, firm at the rim and empty in the middle — is the pulse of acute blood loss, and the rule that follows is the Pulse Diagnosis chapter's for the postpartum patient: after bleeding, a weak pulse is the good sign and a strong one means something is still wrong.

Maekgyeol 脉訣

1.4.3
Source원문

正傳曰, 芤爲失血, 澁爲少血. 又曰, 吐血之脉, 必大而芤, 大爲發熱, 芤爲失血.

Translation영역
The Jeongjeon says: hollow is blood lost, rough is blood scant. It also says: the pulse of vomiting blood must be large and hollow — large is fever, hollow is blood lost.

Jeongjeon 正傳

1.4.4
Source원문

靈樞曰, 衄而不止, 脉大者逆.

Translation영역
The Lingshu says: nosebleed that does not stop with a large pulse is contrary.

Yeongchu 靈樞

1.4.5
Source원문

內經曰, 脉至而搏, 血衄身熱者死. 又曰, 腹脹便血, 脉大時絶者死.

Translation영역
The Neijing says: a pulse arriving and beating, with nosebleed and fever, means death. It also says: abdominal distension with bloody stool and a pulse large and stopping at times means death.

Naegyeong 內經

1.4.6
Source원문

難經曰, 病若吐衄血, 脉當沈細, 反浮大而牢者死.

Translation영역
The Nanjing says: in vomiting and nosebleed of blood the pulse should be sunken and fine; if instead it is floating, large and firm, death.

Nangyeong 難經

1.4.7
Source원문

仲景曰, 脫血而脉實者, 難治.

Translation영역
Zhongjing says: blood deserted with a replete pulse is hard to treat.

Junggyeong 仲景

1.4.8
Source원문

丹溪曰, 吐衄血, 脉滑數者, 難治.

Translation영역
Danxi says: vomiting and nosebleed of blood with a slippery and rapid pulse is hard to treat.

Dansim 丹心

1.4.9
Source원문

吐唾血, 脉小弱者生, 實大者死.

Translation영역
In vomiting and spitting blood, a pulse small and weak means life; replete and large, death.

Maekgyeong 脉經

1.4.10
Source원문

諸失血證, 脉大且數者逆.

Translation영역
In all patterns of blood loss, a pulse large and rapid is contrary.
Clinical note임상 주석
Ten passages from seven sources and one rule: after blood is lost, a strong pulse is worse than a weak one. Six of them say it as death or contrary, and the reasoning is the Pulse Diagnosis chapter's at 4.10 — the pulse should match the state, and a full pulse in an emptied body means the heat that drove the bleeding is still there.

Maekgyeong 脉經

1.5 Heat Can Damage Blood 熱能傷血

1.5.1
Source원문

凡熱皆出於心, 熱甚則能傷血. 熱出於心, 洗心散所不可闕方見火門, 熱能傷血, 四順淸涼飮方見火門, 又不可無也. 《直指》

Translation영역
All heat issues from the heart, and where heat is severe it can damage blood. Heat issuing from the heart, Wash the Heart Powder cannot be dispensed with formula in the Fire chapter; heat being able to damage blood, Four Compliances Clear and Cool Drink formula in the Fire chapter likewise cannot be done without.

Jikji 直指

1.5.2
Source원문

丹溪曰, 諸見血皆熱證, 所謂知其要者, 一言而終, 是也. 又曰, 血見熱則行, 見寒則凝. 凡口鼻出血, 皆係陽盛陰虛. 有升無降, 血隨氣上, 越出上竅, 法當補陰抑陽, 氣降則血歸經也.

Translation영역
Danxi says: all appearance of blood is a heat pattern — what is called knowing the essential in a single word that ends the matter, this is it. He also says: blood meeting heat moves, meeting cold congeals. All bleeding from mouth and nose belongs to yang exuberant and yin vacuous; there is rising and no descending, the blood follows the qi upward and passes out through the upper orifices. The method must be to supplement the yin and restrain the yang, and when the qi descends the blood returns to its channels.
Clinical note임상 주석
諸見血皆熱證 — all appearance of blood is a heat pattern — and Danxi calls it the one word that settles the question. It governs the chapter: bleeding is treated by cooling and lowering, and the exceptions at 1.17 have to argue for themselves. 氣降則血歸經 — when the qi descends the blood returns to its channels — is the treatment in six graphs, and it is 1.3's rule turned to bleeding: do not chase the blood, bring down the qi that carried it.

Dansim 丹心

1.5.3
Source원문

凡血得熱則淖溢故鮮, 得寒則凝澁故瘀. 瘀者黑色也. 鮮者赤色也. 《三因》

Translation영역
Blood meeting heat is thinned and overflows, and so is fresh; meeting cold it congeals and roughens, and so is stagnant. Stagnant is black; fresh is red.
Clinical note임상 주석
Colour as the sign of cause, which 1.9 develops. Bright red blood has been driven out by heat; dark blood has sat and clotted, which is cold or stasis.

Samin 三因

1.6 The Seven Affects Stir the Blood 七情動血

1.6.1
Source원문

內經曰, 諸血者, 皆屬於心. 又曰, 大怒, 則形氣絶而血菀於上, 使人薄厥. 又曰, 怒則氣逆, 甚則嘔血.

Translation영역
The Neijing says: all blood belongs to the heart. It also says: in great anger the form and qi are cut off and the blood pools above, making the person fall in a sudden reversal. And it says: in anger the qi counterflows, and at its worst there is vomiting of blood.
Clinical note임상 주석
薄厥, the sudden reversal — collapse from a rush of blood to the head in a rage — is the Neijing's name for what is now recognized as a hypertensive crisis or a haemorrhagic stroke brought on by emotion. The chapter takes anger as the affect that bleeds.

Naegyeong 內經

1.6.2
Source원문

怒氣逆甚, 嘔血, 暴癉. 內逆, 肝肺相搏, 則血溢鼻口. 但怒氣致血證暴甚. 故經曰, 抑怒以全陰者, 是也. 否則五志之火動甚, 火載血上, 錯經妄行, 宜用保命生地黃散方見下. 《丹心》

Translation영역
Where the anger qi counterflows severely there is vomiting of blood and sudden jaundice. Counterflowing within, the liver and lung strike against each other and blood spills from nose and mouth. Blood patterns brought on by anger are sudden and severe, and so the classic says: restrain anger to keep the yin whole — this is it. Otherwise the fire of the five minds stirs greatly, the fire carries the blood upward, and it leaves its channels and moves recklessly; Protect Life Fresh Rehmannia Powder formula below is appropriate.

Dansim 丹心

1.6.3
Source원문

內傷七情者, 暴喜動心, 不能生血, 暴怒傷肝, 不能藏血, 積憂傷肺, 過思傷脾, 失志傷腎, 皆能動血. 又曰, 五志火動失血, 熱者, 解鬱湯, 虛者, 保命散方皆見下. 又曰, 大怒薄厥, 此怒傷肝而嘔血, 以黃連ㆍ香附ㆍ靑黛ㆍ柴胡ㆍ甘草, 平其肝則自愈矣. 《入門》

Translation영역
In internal damage from the seven affects: sudden joy stirs the heart and it cannot engender blood; sudden anger damages the liver and it cannot store blood; accumulated worry damages the lung; excessive thought damages the spleen; frustrated will damages the kidney — all can stir the blood. It is also said: where the fire of the five minds stirs and blood is lost, for the hot, Resolve Depression Decoction; for the vacuous, Protect Life Powder both formulas below. And: great anger with sudden reversal is anger damaging the liver with vomiting of blood; with coptis, cyperus, indigo, bupleurum and licorice, calm the liver and it recovers of itself.

Immun 入門

1.6.4
Source원문

暴喜傷心, 則氣緩而心不出血, 故肝無所受. 暴怒傷肝, 則氣逆而肝不納血, 故血無所歸. 又房勞過度, 以致陰火沸騰, 血從火起, 故錯經而妄行. 《正傳》

Translation영역
Sudden joy damaging the heart, the qi slackens and the heart does not send out blood, so the liver has nothing to receive. Sudden anger damaging the liver, the qi counterflows and the liver does not take in blood, so the blood has nowhere to return. And excessive sexual taxation brings the yin fire to the boil, the blood rises with the fire, and so it leaves its channels and moves recklessly.
Clinical note임상 주석
The five affects assigned to five organs, and two of them worked out in mechanism: joy slackens the heart so it does not push, anger jams the liver so it does not receive. The Fire chapter's 5.2.4 gives the same assignment for fire, and the two chapters are describing one thing from two sides.

Jeongjeon 正傳

1.7 Blood Loss from Internal Damage 內傷失血

1.7.1
Source원문

靈樞曰, 卒然多食飮則脹滿, 起居不節, 用力過度, 則陽絡脉傷, 陽絡脉傷則血外溢, 血外溢則衄血, 陰絡脉傷則血內溢, 血內溢則後血.

Translation영역
The Lingshu says: suddenly eating and drinking much brings distension and fullness; rising and resting without measure and using force past the limit damages the yang network vessels; the yang network vessels damaged, blood spills without, and blood spilling without is nosebleed. The yin network vessels damaged, blood spills within, and blood spilling within is bleeding from behind.
Clinical note임상 주석
Two directions from one cause. Strain damages the vessels; the outer vessels bleed up and out through the nose, the inner ones bleed down and out through the bowel. Sijaebaekchul-san at 1.14 is the formula for the strain itself.

Yeongchu 靈樞

1.7.2
Source원문

血出上七竅爲血溢, 大小便便血爲血泄. 《內經》

Translation영역
Blood issuing from the seven upper orifices is blood spillage; blood in stool and urine is blood discharge.
Clinical note임상 주석
The chapter's two great divisions named — 溢, spilling from above, and 泄, discharging from below — and 1.8 sorts every route into one or the other.

Naegyeong 內經

1.8 The Various Patterns of Blood Loss 失血諸證

1.8.1
Source원문

失血諸證, 妄行於上則吐衄, 衰涸於外則虛勞, 忘返於下則便紅. 積熱膀胱則癃閉, 尿血, 滲透腸間則爲腸風. 陰虛陽搏則爲崩中, 濕蒸熱瘀則爲滯下. 熱極腐化則爲膿血, 火極似水則血色紫黑. 熱勝於陰則發爲瘡瘍, 濕滯於血則發爲痛痒, 癮疹, 皮膚則爲冷痺. 蓄之在上, 其人喜忘, 蓄之在下, 其人喜狂. 《丹心》

Translation영역
In the patterns of blood loss: moving recklessly above, it is vomiting and nosebleed; declining and drying without, it is vacuity taxation; forgetting to return below, it is red stool. Accumulated heat in the bladder is dribbling blockage and bloody urine; seeping into the intestines it is intestinal wind. Yin vacuous and yang beating is flooding; damp steaming and heat stagnating is dysentery. Heat at its extreme rotting is pus and blood; fire at its extreme resembling water is blood coloured purple-black. Heat prevailing over yin breaks out as sores; damp stagnating in the blood breaks out as pain and itching and hidden rashes, and in the skin as cold impediment. Amassed above, the person is forgetful; amassed below, the person is manic.
Clinical note임상 주석
Danxi's map of everything blood can do wrong, in one passage. Every route the chapter will treat is here, and so are the conditions it sends elsewhere — flooding to the Uterus chapter, dysentery to the Stool chapter, sores to the Sores chapter. The last line is the chapter's 1.10 in miniature: retained blood high makes the patient forget, retained blood low makes them rave. The Shanghan tradition's amassed-blood patterns are those two.

Dansim 丹心

1.8.2
Source원문

其從肺而上溢于鼻者, 曰衄血, 從胃而上溢于口者, 曰嘔血吐血. 其咯血唾血者出于腎也. 咳血嗽血者, 出于肺也. 其痰帶血絲出者, 或從腎, 或從肺來也. 其出于小便者, 曰尿血, 曰血淋, 其出于大便者, 曰腸風, 曰血痔. 《正傳》

Translation영역
What spills upward from the lung to the nose is called nosebleed; what spills upward from the stomach to the mouth is called retching and vomiting of blood. Hawking and spitting of blood issue from the kidney; coughing blood issues from the lung; phlegm with threads of blood comes from either the kidney or the lung. What issues in the urine is called bloody urine or blood dribbling; what issues in the stool is called intestinal wind or bloody haemorrhoids.
Clinical note임상 주석
The routes and their organs, in the order the chapter will take them. Nose is lung, mouth is stomach, throat is kidney, cough is lung — and the Hoechun's four formulas at 1.15 divide the throat and lung routes still further.

Jeongjeon 正傳

1.8.3
Source원문

從汗空出謂之肌衄, 從齒齦出謂之齒衄, 從舌出謂之舌衄, 從委中出謂之膕血, 從九竅皆出謂之九竅出血. 《入門》

Translation영역
Issuing from the sweat pores is called flesh nosebleed; from the gums, tooth nosebleed; from the tongue, tongue nosebleed; from the back of the knee, hollow-of-the-knee blood; from all nine orifices at once, nine-orifice bleeding.
Clinical note임상 주석
衄 — nosebleed — extended to any bleeding from a surface: the skin, the gums, the tongue. The tradition's word for bleeding from the nose became its word for bleeding from anything that is not a wound, and the chapter's 1.19 to 1.22 take these one by one.

Immun 入門

1.9 Distinguishing Fresh from Old by the Colour of the Blood 辨血色新舊

1.9.1
Source원문

新血鮮紅, 舊血瘀黑. 又曰, 風證色靑, 寒證色黯, 暑證色紅, 濕證色如烟煤, 屋漏水. 《入門》

Translation영역
Fresh blood is bright red; old blood is stagnant and black. It is also said: in a wind pattern the colour is green, in cold dark, in summerheat red, and in damp like soot or the water from a leaking roof.

Immun 入門

1.9.2
Source원문

陽證溢出鮮血, 陰證下如豚肝. 《綱目》

Translation영역
In a yang pattern bright blood spills out; in a yin pattern what comes down is like pig's liver.
Clinical note임상 주석
如豚肝 — like pig's liver — is the chapter's standing image for clotted dark blood, and the Women chapter's Hwaeseseok-san at 1.27.1 uses it for the retained blood of childbirth. Bright is fresh and hot; liver-dark is old and clotted.

Gangmok 綱目

1.9.3
Source원문

初便褐色者重, 再便深褐色者愈重, 三便黑色者爲尤重, 色變者以其火燥也. 如羊血在日色中, 須臾變褐色, 久則漸變而爲黑色, 卽此意也. 《海藏》

Translation영역
Stool brown at the first passing is grave; deep brown at the second, graver; black at the third, gravest — the colour changing because the fire has dried it. As sheep's blood set in sunlight turns brown in a moment and slowly black over time, this is the same idea.
Clinical note임상 주석
The Haejang's experiment: blood left in the sun goes brown and then black, and so blood that has sat in the bowel does the same. Darker stool means older blood, and older blood means bleeding higher up — which is the reasoning behind melaena as a sign of upper gastrointestinal haemorrhage, arrived at by watching a dish of sheep's blood.

Haejang 海藏

1.10 The Amassed Blood Pattern 蓄血證

1.10.1
Source원문

蓄血, 卽瘀血積蓄也.

Translation영역
Amassed blood is stagnant blood accumulated and stored.

Donguibogam · Hyeol

1.10.2
Source원문

傷寒熱病, 身黃屎黑, 如狂喜忘者, 爲蓄血也. 《仲景》

Translation영역
In cold damage and heat disease, where the body is yellow and the stool black, with something like mania and forgetfulness, it is amassed blood.
Clinical note임상 주석
Zhongjing's four signs — jaundice, black stool, mania, forgetfulness — and the Shanghan tradition's amassed blood is the condition they name. Black stool is melaena; the mental signs are what a patient with a large retained bleed looks like.

Junggyeong 仲景

1.10.3
Source원문

海藏曰, 喜忘發狂, 身黃屎黑, 疾已甚也. 但小腹滿, 小便不利者, 輕也.

Translation영역
The Haejang says: forgetfulness and mania with the body yellow and the stool black is the disease already severe. Only fullness of the lower abdomen with the urine not passing is light.

Haejang 海藏

1.10.4
Source원문

蓄血外證, 痰嘔燥渴, 昏聵迷忘, 常喜湯水漱口. 《直指》

Translation영역
The outward signs of amassed blood are phlegmy retching, dryness and thirst, clouding and confusion and forgetfulness, and a constant wish to rinse the mouth with water.

Jikji 直指

1.10.5
Source원문

凡病日輕夜重, 便是瘀血. 又常喜漱水而不欲下咽. 《入門》

Translation영역
Any disease light by day and heavy by night is stagnant blood. Also, constantly wishing to rinse with water and not wishing to swallow it.
Clinical note임상 주석
漱水不欲咽 — rinsing the mouth and not swallowing — is the tradition's sign of blood stasis as against heat, and the Fire chapter's 5.21 uses it. A patient with real thirst drinks; one whose mouth is dry from stasis wants it wet and no more. 日輕夜重, light by day and heavy by night, is the second sign, and the Fire chapter's 5.8 reads night-fever the same way.

Immun 入門

1.10.6
Source원문

凡蓄血, 有上中下之別. 以衄嘔唾吐血, 爲上部, 血結胸中, 爲中部, 蓄血下焦, 爲下部. 血蓄上焦, 則善忘, 宜犀角地黃湯方見下. 血蓄中焦, 胸滿身黃, 漱水不欲嚥, 宜桃仁承氣湯方見傷寒. 血蓄下焦, 則發狂糞黑, 小腹硬痛, 宜抵當湯丸, 須取盡黑物爲效方見傷寒. 又生地黃湯通治三焦蓄血. 《海藏》

Translation영역
Amassed blood is distinguished into upper, middle and lower. Nosebleed, retching, spitting and vomiting of blood are the upper part; blood bound in the chest is the middle part; blood amassed in the lower burner is the lower part. Blood amassed in the upper burner brings forgetfulness — Rhinoceros Horn and Rehmannia Decoction formula below. Blood amassed in the middle burner brings fullness of the chest and a yellow body, rinsing with water and not wishing to swallow — Peach Kernel Order the Qi Decoction formula in the Cold Damage chapter. Blood amassed in the lower burner brings mania and black stool with the lower abdomen hard and painful — the Resist Decoction and Pill, taken until all the black matter is out formulas in the Cold Damage chapter. And Fresh Rehmannia Decoction treats amassed blood in all three burners.
Clinical note임상 주석
Three levels, three sign-sets, three formulas of increasing force. The lower burner gets the Resist Decoction — tabanus and leech — and 須取盡黑物爲效, taken until all the black matter is out, is the endpoint. Saengjihwang-tang at 1.10.1 is the Haejang's gentler version of the same for patients who cannot take it.

Haejang 海藏

1.10.7
Source원문

綱目曰, 瘀血燥結, 宜用玉燭散方見胞門.

Translation영역
The Gangmok says: stagnant blood with dryness and binding — Jade Candle Powder formula in the Uterus chapter is appropriate.

Gangmok 綱目

1.10.8
Source원문

下焦蓄血, 桃仁ㆍ五靈脂ㆍ生地黃ㆍ大黃ㆍ甘草, 利而逐之. 《直指》

Translation영역
For blood amassed in the lower burner, peach kernel, flying squirrel faeces, fresh rehmannia, rhubarb and licorice, to free and drive it out.

Jikji 直指

1.10.9
Source원문

沒藥ㆍ蘇木ㆍ水蛭ㆍ䖟蟲ㆍ五靈脂ㆍ(留尖)桃仁, 皆破瘀血. 《本草》

Translation영역
Myrrh, sappan, leech, tabanus, flying squirrel faeces and peach kernel (with the tip kept) all break stagnant blood.
Clinical note임상 주석
The six blood-breakers, from mildest to most violent. Peach kernel with the tip kept on is stronger than with it removed — the tip is where the action is held to concentrate.

Boncho 本草

1.10.10
Source원문

生韭汁, 善治胸膈間瘀血甚效. 《丹心》

Translation영역
Fresh leek juice treats stagnant blood between the chest and diaphragm well, with great effect.

Dansim 丹心

1.11 Good and Ill Fortune in Diseases of Blood 血病吉凶

1.11.1
Source원문

凡血逆行難治, 順行易治. 無潮熱者輕, 有潮熱者重, 潮盛脉大者死. 又曰, 九竅出血, 身熱不得臥者卽死. 又曰, 凡血證, 陽盛則身熱多渴, 陰盛則身涼不渴, 然血, 陰也. 身涼者, 易愈. 又曰, 如心肺脉破, 血若涌泉口鼻俱出者不治. 《入門》

Translation영역
Blood moving contrary is hard to treat; moving compliant, easy. Without tidal fever it is light; with tidal fever heavy; with the tide exuberant and the pulse large, death. It is also said: bleeding from the nine orifices with fever and inability to lie down is death at once. And: in any blood pattern, yang exuberant means fever and much thirst, yin exuberant means the body cool without thirst — but blood is yin, and a cool body recovers easily. And: where the vessels of heart and lung are broken and blood pours like a spring from mouth and nose together, it is not treated.
Clinical note임상 주석
Four prognostic rules, and the first is the chapter's: 逆行, blood going up, is bad; 順行, blood going down, is better. 1.11.3 explains why. The last — blood pouring from mouth and nose at once — is the presentation Cheukbaek-san and Chilsaeng-tang at 1.14 are kept for, and the Immun says plainly that it is not treated.

Immun 入門

1.11.2
Source원문

靈樞曰, 淫而脫形, 身熱, 色夭然白, 及後下血衃, 血衃篤重, 是爲逆. 又曰, 衄而不止, 脉大, 是爲逆. 又曰, 咳且溲血, 脫肉, 其脉小勁, 是爲逆. 又曰, 嘔血, 胸滿引背, 脉小而疾, 是爲逆. 又曰, 腹脹便血, 其脉大, 時絶, 是爲逆. 又曰, 咳溲血, 形肉脫, 脉搏, 是爲逆.

Translation영역
The Lingshu says: excess with the form deserting, fever, the complexion deathly white, and then clotted blood from behind — heavy clotted blood is contrary. It also says: nosebleed that does not stop with a large pulse is contrary. And: cough with bloody urine, the flesh deserted and the pulse small and hard, is contrary. And: vomiting blood with fullness of the chest drawing into the back and a pulse small and hurried is contrary. And: abdominal distension with bloody stool and a pulse large and stopping at times is contrary. And: cough with bloody urine, the flesh of the form deserted and the pulse beating, is contrary.

Yeongchu 靈樞

1.11.3
Source원문

東垣曰, 諸見血, 身熱脉大者難治, 難治者, 邪勝也. 身涼脉靜者易治, 易治者, 正氣復也. 又曰, 血溢上行, 或唾或嘔或吐, 皆凶也. 若變而下行, 爲惡痢者, 順也. 上行爲逆, 其治難, 下行爲順, 其治易. 故仲景云, 蓄血證, 下血者, 當自愈. 若無病之人, 忽然下血利者, 其病進也. 今病血證, 上行而復下行爲惡利者, 其邪欲去, 是知吉也.

Translation영역
Dongwon says: in any appearance of blood, fever with a large pulse is hard to treat — hard because the evil prevails; a cool body with a quiet pulse is easy to treat — easy because the right qi has recovered. He also says: blood spilling upward, whether spat or retched or vomited, is all inauspicious; if it changes and moves downward as a foul dysentery, that is compliant. Upward is contrary and its treatment hard; downward is compliant and its treatment easy. So Zhongjing said: in the amassed blood pattern, where blood passes below, it should recover of itself. But where a person with no illness suddenly passes blood below, the disease is advancing. Now in a blood pattern that went upward and then turns and goes downward as foul flux, the evil wishes to leave, and by this the good fortune is known.
Clinical note임상 주석
Why down is better than up: blood that leaves by the bowel is the evil leaving, and blood that comes up is the evil rising. The Purging chapter's whole method rests on this — the way out is below — and Dongwon adds the qualification that matters: sudden bleeding from the bowel in a well person is not the same thing.

Dongwon 東垣

1.11.4
Source원문

仲景曰, 吐血, 咳逆上氣, 脉數而有熱, 不得臥者死.

Translation영역
Zhongjing says: vomiting blood with cough, counterflow and qi ascent, a rapid pulse with heat, and inability to lie down means death.
Clinical note임상 주석
**Haemoptysis with breathlessness so severe the patient cannot lie flat is a medical emergency.**

Junggyeong 仲景

1.11.5
Source원문

無故忽然瀉下惡血, 名曰心絶, 爲難治.

Translation영역
Suddenly passing foul blood below for no cause is called the heart cut off, and is hard to treat.

Immun 入門

1.11.6
Source원문

傷寒太陽證, 衄血者, 病欲愈. 熱結膀胱, 而血自下者, 亦欲愈. 以此觀之, 則他病伏熱之人, 上焦瘀熱而作吐者, 亦其病之有瘳也. 雖然, 血旣吐而自止則可矣. 《直指》

Translation영역
In the greater yang pattern of cold damage, nosebleed means the disease is about to recover. Heat bound in the bladder with blood passing below of itself is likewise about to recover. Seen in this light, in other diseases where a person harbours heat and stagnant heat in the upper burner brings vomiting, the disease too is on the mend. Even so, this holds only where the blood, once vomited, stops of itself.
Clinical note임상 주석
The 紅汗 of 1.13 — nosebleed in a fever as the body's own resolution — stated as a general principle: bleeding that comes and stops may be the disease leaving. The last sentence is the whole qualification. Bleeding that does not stop is never good.

Jikji 直指

1.12 The Patterns of Blood Lost and Blood Deserted 亡血脫血證

1.12.1
Source원문

靈樞曰, 鼻頭色白者, 亡血也. 又曰, 衝脉爲血之海. 血海不足, 則身少血色, 面無精光. 又曰, 血脫者, 色白夭然不澤, 其脉空虛.

Translation영역
The Lingshu says: where the tip of the nose is white, blood is lost. It also says: the thoroughfare vessel is the sea of blood; where the sea of blood is insufficient, the body has little colour and the face no lustre. And: where blood has deserted, the complexion is white, deathly and without sheen, and the pulse is empty and vacuous.
Clinical note임상 주석
Pallor of the nose, the face and the whole body — the signs of anaemia, and the Lingshu reads them from the face first. 色白夭然不澤, white and deathly without sheen, is the look the tradition gives to blood loss, as against the yellow of jaundice or the green of collapse.

Yeongchu 靈樞

1.12.2
Source원문

內經曰, 臂多靑脉, 曰脫血. 又曰, 安臥脉盛, 謂之脫血.

Translation영역
The Neijing says: many green vessels on the arm is called blood deserted. It also says: lying at rest with an exuberant pulse is called blood deserted.
Clinical note임상 주석
Visible veins on the arm — the veins stand out because the flesh over them has thinned — and a pulse that races in a patient at rest. Both are signs of anaemia that a modern examination still uses.

Naegyeong 內經

1.12.3
Source원문

東垣曰, 六脉弦細而澁, 按之空虛, 其色必白而夭不澤者, 脫血也. 通用四物湯方見下ㆍ三才丸.

Translation영역
Dongwon says: the six pulses stringlike, fine and rough, empty under pressure, with the complexion white and deathly without sheen — this is blood deserted. Four Substances Decoction formula below and Three Powers Pill are used generally.
Clinical note임상 주석
The section closes on the two formulas for after the bleeding has stopped, and the first is the one this chapter is known for. Samul-tang is registered from another chapter; its entry is the root of the Bogam's blood formulary and the Women chapter's Samul variants are its descendants.

Dongwon 東垣

1.13 Nosebleed 衄血

1.13.1
Source원문

鼻通於腦, 血上溢於腦, 所以從鼻而出. 兼以陽明熱鬱, 則口鼻俱出也. 又曰, 衄血出於肺, 宜莎芎散ㆍ三黃補血湯ㆍ雞蘇散ㆍ陶氏生地芩連湯ㆍ保命生地黃散方見通治ㆍ淸衄湯ㆍ解鬱湯. 《入門》

Translation영역
The nose communicates with the brain; blood spilling upward into the brain therefore issues from the nose. Where yang brightness heat is depressed as well, it issues from mouth and nose together. It is also said: nosebleed issues from the lung — Cyperus and Chuanxiong Powder, Three Yellows Supplement the Blood Decoction, Chinese Artichoke Powder, Tao's Fresh Rehmannia, Scutellaria and Coptis Decoction, Protect Life Fresh Rehmannia Powder formula in the general treatment section, Clear the Nosebleed Decoction and Resolve Depression Decoction are appropriate.
Clinical note임상 주석
The nose as the brain's outlet, and a nosebleed as blood that has risen to the head and found its way out. The seven formulas are all registered at 1.13, and they range from the two qi-movers of Sagung-san to the rhinoceros horn of Tao's decoction.

Immun 入門

1.13.2
Source원문

丹溪曰, 衄血, 以凉血行血爲主, 犀角地黃湯, 入鬱金, 加片芩ㆍ升麻.

Translation영역
Danxi says: in nosebleed, cooling the blood and moving it is the mainstay — Rhinoceros Horn and Rehmannia Decoction with turmeric put in and slender scutellaria and cimicifuga added.
Clinical note임상 주석
凉血行血 — cool and move, together. Danxi's rule for nosebleed is not to stanch but to cool what drove the blood up and keep it moving so it does not clot on the way down. Cimicifuga in a formula for bleeding from above is there to lift the qi, on the reasoning of 1.5.2.

Dansim 丹心

1.13.3
Source원문

東垣曰, 衄血出於肺, 犀角ㆍ升麻ㆍ梔子ㆍ黃芩ㆍ芍藥ㆍ生芐ㆍ紫菀ㆍ丹參ㆍ阿膠之類, 主之.

Translation영역
Dongwon says: nosebleed issues from the lung — rhinoceros horn, cimicifuga, gardenia, scutellaria, peony, fresh rehmannia, aster, salvia and ass-hide glue and their kind govern it.

Dongwon 東垣

1.13.4
Source원문

內經曰, 脾移熱於肝, 則爲驚衄. 又曰, 春善病鼽衄. 又曰, 少陰所至爲衄衊. 又曰, 陽明厥逆, 喘咳身熱, 善驚, 衄吐血.

Translation영역
The Neijing says: the spleen passing heat to the liver makes fright nosebleed. It also says: in spring one readily suffers stuffy nose and nosebleed. And: what the lesser yin brings is nosebleed and bloody sweat. And: in yang brightness reversal there is panting and cough with fever, readiness to start, and nosebleed and vomiting of blood.

Naegyeong 內經

1.13.5
Source원문

衄不止, 以麝香散, 及諸藥塞鼻. 又用止血諸方法.

Translation영역
Where nosebleed does not stop, plug the nose with Musk Powder and the other medicines, and use the various methods of stopping bleeding.

Donguibogam · Hyeol

1.13.6
Source원문

傷寒, 當汗不汗, 熱盛迫血, 必爲衄, 宜麻黃升麻湯ㆍ麻黃桂枝湯ㆍ滑石丸. 鼻流涕久成衄, 宜犀角地黃湯. 《入門》

Translation영역
In cold damage where sweating was called for and not done, the heat grows exuberant and presses on the blood, and nosebleed surely follows — Ephedra and Cimicifuga Decoction, Ephedra and Cinnamon Twig Decoction and Talc Pill are appropriate. Where a running nose has gone on long and turned to nosebleed, Rhinoceros Horn and Rehmannia Decoction is appropriate.
Clinical note임상 주석
The 紅汗 case from 1.13's formulas: a fever that should have been sweated and was not bleeds through the nose instead, and the treatment finishes the sweat. Two ephedra formulas for a nosebleed is the chapter's one exception to Danxi's rule of cooling, and it is made only for this circumstance.

Immun 入門

1.13.12 Methods of Stopping Nosebleed 止衄法

1.13.12.1
Source원문

治鼻衄久不止, 諸藥無效, 神效. 以大白紙一張或二張, 作十數摺, 冷水浸濕, 置頂中, 以熱熨斗熨之, 至一二重紙乾, 則血立止. 《東垣》

Translation영역
Treats nosebleed long unstopped where all medicines have failed, with spirit-like effect. Take one or two sheets of large white paper, fold ten or more times, soak in cold water, set on the crown of the head, and iron it with a hot iron; when one or two layers have dried, the bleeding stops at once.
Clinical note임상 주석
Wet paper on the crown and a hot iron on the paper — what reaches the scalp is steam, and the reasoning is that the blood which rose to the head is drawn up and out through the top rather than the nose. The chapter's four external methods all work on the head or the extremities rather than the nose itself.

Dongwon 東垣

1.13.12.2
Source원문

治衄百藥不止. 用線緊扎手中指中節. 如左鼻出血, 扎右手中指. 右鼻出血, 扎左手中指. 如兩鼻出血, 左右俱扎之. 一方用色線. 《種杏》

Translation영역
Treats nosebleed that a hundred medicines have not stopped. Tie a thread tight around the middle joint of the middle finger — for the left nostril, the right middle finger; for the right nostril, the left; for both nostrils, both fingers. One version uses coloured thread.
Clinical note임상 주석
The finger ligature the Women chapter gives at 1.29.4.1 for postpartum nosebleed, with the side rule added: cross over. The tradition held that the channels cross at the head, so the left nostril is reached from the right hand.

Jonghaeng 種杏

1.13.12.3
Source원문

治衄不止. 白芨爲末, 冷水調, 塗山根上兩眉間也立止. 仍以冷水調三錢服之, 尤妙. 又方大蒜一枚, 細硏作餠子如錢大. 左鼻出血, 貼左脚心, 右鼻出血, 貼右脚心, 如兩鼻皆出, 貼兩脚心, 血止卽洗去. 《本草》

Translation영역
Treats nosebleed that does not stop. Bletilla powdered and mixed with cold water, applied at the root of the nose between the brows, and it stops at once; and 3 don of it stirred into cold water and taken besides, better still. Another formula: one bulb of garlic ground fine into a cake the size of a coin — for the left nostril stuck to the left sole, for the right to the right, for both to both — and washed off as soon as the bleeding stops.
Clinical note임상 주석
Garlic on the sole of the foot to stop a nosebleed. The reasoning is to draw the fire down — garlic is hot and pulls heat to where it is placed — and the same-side rule here is the opposite of the finger ligature's, because the foot is reached by a different channel. Bletilla, the first remedy, is a real haemostatic and the tradition's standing one for the lung; applied to the bridge of the nose it does little, but taken by mouth it may.

Boncho 本草

1.13.12.4
Source원문

洪寶丹, 治衄血不止. 取藥, 冷水調塗後頂上, 最絶血路. 方見回春

Translation영역
Great Treasure Elixir treats nosebleed that does not stop. Take the medicine, mix with cold water and apply to the back of the crown; it cuts the blood's road most completely. formula in the Hoechun

Hoechun 回春

1.14 Retching and Vomiting of Blood 嘔血吐血

1.14.1
Source원문

成椀有聲者爲嘔, 成盆無聲者爲吐. 《入門》

Translation영역
A bowlful with a sound is retching; a basinful without a sound is vomiting.
Clinical note임상 주석
The two words of the title distinguished by volume and noise. Retching is smaller and heard; vomiting is larger and silent. The distinction is worth having because the silent basinful is the graver.

Immun 入門

1.14.2
Source원문

嘔吐, 血出於胃. 實者, 犀角地黃湯, 虛者, 小建中湯方見虛勞, 加黃連主之. 《丹心》

Translation영역
In retching and vomiting the blood issues from the stomach. For the replete, Rhinoceros Horn and Rehmannia Decoction; for the vacuous, Minor Fortify the Centre Decoction formula in the Vacuity Taxation chapter with coptis added governs it.

Dansim 丹心

1.14.3
Source원문

千金曰, 吐血有三種, 有內衄, 有肺疽, 有傷胃. 內衄者, 出血如鼻衄, 但不從鼻孔出. 是近從心肺間, 流入胃中, 或如豆羹汁, 或如切䵄, 血凝停胃中, 因滿悶便吐, 或數斗至一石者, 是也. 得之於勞倦飮食過傷也. 肺疽者, 或飮酒之後, 毒熱滿悶, 吐之時, 血從吐後出, 或一合, 半升, 一升, 是也. 傷胃者, 因飮食大飽之後, 胃冷不能消化, 便煩悶强嘔吐, 使所食之物, 與氣共上衝蹙, 因傷裂胃口, 吐血鮮赤, 腹亦絞痛, 自汗, 其脉緊而數者, 爲難治.

Translation영역
The Qianjin says: vomiting of blood is of three kinds — internal nosebleed, lung welling abscess, and damage to the stomach. Internal nosebleed is bleeding like a nosebleed but not from the nostrils: it comes from near the heart and lung and flows into the stomach, like bean gruel or like minced liver, and the blood congeals and stands in the stomach; from fullness and oppression it is vomited, sometimes several mal up to a seok — this is it, and it is got from taxation and excess of food and drink. Lung welling abscess is toxic heat and fullness after drinking, and when vomiting comes, blood follows the vomit — a hop, half a seung, a seung. Damage to the stomach is after eating to great fullness, the stomach cold and unable to digest, with vexation and forced retching, so that what was eaten surges up with the qi and tears the mouth of the stomach; the blood vomited is bright red, the belly also gripes, there is spontaneous sweating, and where the pulse is tight and rapid it is hard to treat.
Clinical note임상 주석
Sun Simiao's three kinds, and the third is a Mallory-Weiss tear described exactly: eat too much, retch violently, tear the cardia, vomit bright blood with gripping pain and sweat. Sijaebaekchul-san at 1.14 is the formula for it, and the next passage assigns the other two. The first kind — blood that has pooled in the stomach from above and comes up dark and clotted — is bleeding from the oesophagus or upper stomach, and 或數斗至一石 is a large volume.

Cheongeum 千金

1.14.4
Source원문

傷胃吐血, 宜理中湯方見寒門, 加川芎ㆍ乾葛. 肺疽吐血, 宜葛黃丸. 內衄吐血, 實者, 三黃瀉心湯, 加生地黃, 虛者, 茯苓補心湯ㆍ人參救肺散.

Translation영역
For vomiting blood from stomach damage, Regulate the Centre Decoction formula in the Cold Damage chapter with chuanxiong and dried pueraria added. For vomiting blood from lung welling abscess, Pueraria and Coptis Pill. For vomiting blood from internal nosebleed, the replete take Three Yellows Drain the Heart Decoction with fresh rehmannia added, and the vacuous Poria Supplement the Heart Decoction and Ginseng Rescue the Lung Powder.
Clinical note임상 주석
The torn stomach gets a warming formula — Ijung-tang is ginseng, dry ginger, atractylodes and licorice — because the Qianjin said the stomach was cold. Everything else in the section cools, and this one case does not.

Donguibogam · Hyeol

1.14.5
Source원문

仲景曰, 酒客咳者, 必致吐血. 此因極飮過度所致, 卽肺疽之屬也.

Translation영역
Zhongjing says: a drinker who coughs will surely come to vomiting blood; this comes of extreme drinking past measure, and belongs to the class of lung welling abscess.

Junggyeong 仲景

1.14.6
Source원문

暴吐紫黑血成塊者, 此因熱傷, 血瘀於中, 吐出爲好, 四物湯合黃連解毒湯方見寒門調之. 又曰, 吐血, 覺胸中氣塞, 桃仁承氣湯方見寒門下之. 《丹心》

Translation영역
Sudden vomiting of purple-black blood in clots is from heat damage with blood stagnant in the centre, and vomiting it out is good; Four Substances Decoction combined with Coptis Resolve Toxin Decoction formula in the Cold Damage chapter regulates it. It is also said: in vomiting blood with a feeling of the qi blocked in the chest, Peach Kernel Order the Qi Decoction formula in the Cold Damage chapter purges it.
Clinical note임상 주석
吐出爲好 — vomiting it out is good. Dark clotted blood is old blood, and Danxi does not try to stop it coming; he lets it clear and treats what is left. The rule of 1.11 that down is better than up has this corollary: out is better than in.

Dansim 丹心

1.14.7
Source원문

火載血上, 錯經妄行, 四物湯, 加山梔ㆍ童便ㆍ薑汁. 薑汁, 童便, 吐血要藥也. 《丹心》

Translation영역
Fire carrying the blood upward so that it leaves its channels and moves recklessly — Four Substances Decoction with gardenia, child's urine and ginger juice added. Ginger juice and child's urine are the essential medicines for vomiting blood.
Clinical note임상 주석
薑汁, 童便, 吐血要藥 — the two essentials, and both are liquids added to a decoction rather than medicinals in it. The chapter's 1.28.8 gives the urine its own entry.

Dansim 丹心

1.14.8
Source원문

吐血火病也. 雖挾痰, 只治火則血止. 《入門》

Translation영역
Vomiting blood is a fire disease. Though phlegm be mixed in, treat only the fire and the bleeding stops.

Immun 入門

1.14.9
Source원문

汗乃心液, 熱則變紅, 而逆出上竅. 傷寒失汗, 則熱毒入藏, 化爲瘀血, 從口吐出, 多屬陽明. 凡見目紅骨熱, 神昏狂譫, 胸腹急滿, 皆血證也. 輕者, 犀角地黃湯, 加黃芩ㆍ梔子ㆍ茅根ㆍ藕節, 重者, 桃仁承氣湯ㆍ抵當湯丸方見寒門. 《入門》

Translation영역
Sweat is the heart's fluid; heated it turns red and comes out contrary through the upper orifices. In cold damage where the sweat was missed, the heat toxin enters the viscera, transforms to stagnant blood and is vomited from the mouth — mostly belonging to yang brightness. Wherever red eyes and heat in the bones, clouded spirit and manic delirium, and urgent fullness of chest and abdomen are seen, all are blood patterns. For the light, Rhinoceros Horn and Rehmannia Decoction with scutellaria, gardenia, imperata root and lotus root node added; for the heavy, Peach Kernel Order the Qi Decoction and the Resist Decoction and Pill formulas in the Cold Damage chapter.
Clinical note임상 주석
The Immun's account of vomited blood as sweat that was not allowed out — the same mechanism as 1.13.6's red sweat, applied to the mouth. The signs listed are those of the Cold Damage chapter's yang brightness heat, and the formulas are graded from cooling to purging to the leech-and-tabanus of the Resist.

Immun 入門

1.14.10
Source원문

吐血, 宜大薊飮子ㆍ蓮心散ㆍ是齋白朮散ㆍ天門冬湯. 口鼻俱出, 宜四生丸ㆍ蚌霜散ㆍ黑神散ㆍ側柏散ㆍ藕汁散ㆍ七生湯ㆍ淸熱解毒湯ㆍ花蘂石散ㆍ五神湯ㆍ狗膽丸.

Translation영역
For vomiting blood, Cirsium Drink, Lotus Plumule Powder, Shizhai's White Atractylodes Powder and Asparagus Decoction are appropriate. Where it issues from mouth and nose together, Four Fresh Ingredients Pill, Mussel Frost Powder, Black Spirit Powder, Arborvitae Powder, Lotus Root Juice Powder, Seven Fresh Ingredients Decoction, Clear Heat and Resolve Toxin Decoction, Flower Stamen Stone Powder, Five Spirits Decoction and Dog's Bile Pill are appropriate.

Donguibogam · Hyeol

1.14.20 The Sudden Reversal Pattern 薄厥證

1.14.20.1
Source원문

入門曰, 一人素無病, 忽吐血半斗, 脉弦急. 陳景魁示之曰, 薄厥證也. 得於大怒氣逆, 陰陽奔倂, 用六鬱湯而得愈方見積聚.

Translation영역
The Immun says: a man with no previous illness suddenly vomited half a mal of blood, the pulse stringlike and urgent. Chen Jingkui examined him and said: this is the sudden reversal pattern. It came of great anger with the qi counterflowing and yin and yang rushing together; Six Depressions Decoction was used and he recovered formula in the Accumulations chapter.
Clinical note임상 주석
A case for 1.6.1's 薄厥: a healthy man, a fit of rage, half a mal of blood. The pulse is stringlike — the liver's — and the formula is the Accumulations chapter's for bound qi rather than anything from this chapter, because what needed treating was the anger.

Immun 入門

1.15 Coughing, Wheezing, Spitting and Hawking of Blood 咳血嗽血唾血咯血

1.15.1
Source원문

咳血者, 咳甚出血, 本於肺, 龍腦雞蘇丸ㆍ雞蘇散方見上ㆍ玄霜膏.

Translation영역
Coughing of blood is blood brought out by severe coughing, and is rooted in the lung — Borneol and Chinese Artichoke Pill, Chinese Artichoke Powder formula above and Dark Frost Paste.

Immun 入門

1.15.2
Source원문

嗽血者, 痰嗽帶血, 本於脾, 六君子湯, 加桑白皮ㆍ片芩ㆍ枳殼ㆍ五味子, 有火者, 加味逍遙散六君子湯方見痰飮.

Translation영역
Wheezing of blood is phlegmy cough with blood in it, and is rooted in the spleen — Six Gentlemen Decoction with mulberry root bark, slender scutellaria, bitter orange and schisandra added; where there is fire, Augmented Free Wanderer Powder Six Gentlemen Decoction is in the Phlegm chapter.

Immun 入門

1.15.3
Source원문

唾血者, 鮮血隨唾而出, 本於腎, 滋陰降火湯方見火門. 唾中有紅絲, 乃是肺痿, 難治.

Translation영역
Spitting of blood is fresh blood coming out with the saliva, and is rooted in the kidney — Enrich the Yin and Downbear Fire Decoction formula in the Fire chapter. Red threads in the saliva are lung wilting, and hard to treat.
Clinical note임상 주석
肺痿, lung wilting — the tradition's name for the wasting lung disease, which is tuberculosis in most cases. Threads of blood in the saliva without a cough are its early sign, and the Immun says 難治 at once. **Blood-streaked sputum requires investigation for tuberculosis and malignancy.**

Immun 入門

1.15.4
Source원문

咯血者, 咯出血屑, 或咯而不出, 甚咯則出, 或帶紅絲, 細如線. 此精血竭也. 四物湯, 加竹瀝ㆍ薑汁ㆍ童便ㆍ靑黛, 或滋陰降火湯ㆍ保命生地黃散方見下ㆍ聖餠子. 《入門》

Translation영역
Hawking of blood is bringing up flecks of blood by clearing the throat, or hawking without bringing anything, or bringing it only on hawking hard, or with red threads fine as a hair. This is the essence and blood exhausted. Four Substances Decoction with bamboo sap, ginger juice, child's urine and indigo added, or Enrich the Yin and Downbear Fire Decoction, Protect Life Fresh Rehmannia Powder formula below and Sagely Cake.
Clinical note임상 주석
Four words, four organs, four formularies. Cough is the lung, wheeze the spleen, spit the kidney, hawk the essence — and the Immun's scheme is what the Hoechun's four decoctions at 1.15 follow. 咯, hawking, is the gravest because it is read as the deepest: blood that comes without effort from the bottom of the throat is blood the body has no more of.

Immun 入門

1.15.5
Source원문

先見紅後見痰, 多是陰虛火動, 痰不下降. 四物湯, 加貝母ㆍ天花粉, 以化痰, 山梔仁ㆍ麥門冬ㆍ牡丹皮, 以降火. 先痰嗽後見紅, 多是痰火積熱. 降痰火爲急, 宜山梔地黃湯.

Translation영역
Where red is seen first and phlegm after, it is mostly yin vacuity with fire stirring and the phlegm not descending — Four Substances Decoction with fritillaria and trichosanthes root to transform the phlegm and gardenia kernel, ophiopogon and moutan bark to downbear the fire. Where phlegmy cough comes first and red after, it is mostly phlegm fire with accumulated heat; downbearing the phlegm fire is urgent — Gardenia and Rehmannia Decoction is appropriate.
Clinical note임상 주석
The order of appearance as diagnosis, for the second time in the chapter after 1.9's stool. Blood before phlegm is the yin failing; phlegm before blood is heat that has built up. The Hoechun at 1.15.7 says the same in one line.

Immun 入門

1.15.6
Source원문

痰嗽, 涎帶血出, 此胃口熱, 血蒸而出, 重者山梔, 輕者藍實. 《丹心》

Translation영역
Phlegmy cough with blood in the spittle is heat at the mouth of the stomach steaming the blood out; for the heavy, gardenia; for the light, indigo seed.

Dansim 丹心

1.15.7
Source원문

先吐痰後見血, 是積熱, 宜淸肺湯. 先吐血後見痰, 是陰虛, 宜滋陰降火湯. 《回春》

Translation영역
Phlegm spat first and blood seen after is accumulated heat — Clear the Lung Decoction. Blood spat first and phlegm seen after is yin vacuity — Enrich the Yin and Downbear Fire Decoction.

Hoechun 回春

1.15.8
Source원문

咳嗽唾咯血, 宜龍腦雞蘇丸ㆍ河間生地黃散ㆍ淸火滋陰湯ㆍ淸咳湯ㆍ淸咯湯ㆍ淸唾湯ㆍ坎离膏方見下ㆍ玄霜雪梨膏ㆍ恩袍散.

Translation영역
For coughing, spitting and hawking of blood, Borneol and Chinese Artichoke Pill, Hejian's Fresh Rehmannia Powder, Clear Fire and Enrich the Yin Decoction, Clear the Cough Decoction, Clear the Hawking Decoction, Clear the Spitting Decoction, Kan and Li Paste formula below, Dark Frost and Snow Pear Paste and Grace Robe Powder are appropriate.

Donguibogam · Hyeol

1.16 Bloody Urine 尿血

1.16.1
Source원문

內經曰, 胞移熱於膀胱, 則癃尿血.

Translation영역
The Neijing says: the uterus passing heat to the bladder makes dribbling blockage and bloody urine.

Naegyeong 內經

1.16.2
Source원문

仲景曰, 熱在下焦, 則尿血.

Translation영역
Zhongjing says: heat in the lower burner makes bloody urine.

Junggyeong 仲景

1.16.3
Source원문

凡小便血出成淋作痛, 或雜尿而出者, 從膀胱中來也. 如血出不痛, 乃心移熱於小腸, 從精竅中出也. 《正傳》

Translation영역
Where blood passes with the urine as dribbling with pain, or mixed through the urine, it comes from the bladder. Where the blood comes without pain, it is the heart passing heat to the small intestine, and it issues from the essence orifice.
Clinical note임상 주석
Painful or painless — the one sign the section turns on. Blood with pain and dribbling is the bladder, which is 血淋, blood dribbling, and is treated in the Urine chapter; blood without pain is 尿血, bloody urine proper, and is treated here. Painless haematuria is the presentation that most concerns a modern physician, because it is the one that may be a tumour.

Jeongjeon 正傳

1.16.4
Source원문

小便出血而不痛者, 爲尿血非淋也. 是血從精竅中來, 乃心移熱於小腸. 四物湯, 加山梔ㆍ滑石ㆍ牛膝ㆍ芩ㆍ連, 或髮灰散ㆍ琥珀散. 《入門》

Translation영역
Blood passing with the urine without pain is bloody urine, not dribbling. The blood comes from the essence orifice, and it is the heart passing heat to the small intestine. Four Substances Decoction with gardenia, talc, achyranthes, scutellaria and coptis added, or Hair Ash Powder and Amber Powder.

Immun 入門

1.16.5
Source원문

小便出血, 是心伏熱在於小腸. 八正散方見小便, 加麥門冬煎服. 《鉤玄》

Translation영역
Blood passing with the urine is hidden heat of the heart in the small intestine. Eight Corrections Powder formula in the Urine chapter with ophiopogon added, decocted and taken.

Guhyeon 鉤玄

1.16.6
Source원문

尿血, 宜淸腸湯ㆍ淸熱滋陰湯ㆍ小薊飮子ㆍ薑蜜湯, 或四物湯合五苓散方見寒門煎服. 酒傷尿血, 茯苓調血湯. 色傷尿血, 鹿角膠丸ㆍ腎氣丸方見虛勞. 老人, 六味地黃丸方見虛勞. 婦人, 當歸散. 小兒, 立效散.

Translation영역
For bloody urine, Clear the Intestines Decoction, Clear Heat and Enrich the Yin Decoction, Cephalanoplos Drink and Ginger and Honey Decoction are appropriate, or Four Substances Decoction combined with Five Ingredients Powder with Poria formula in the Cold Damage chapter, decocted and taken. For bloody urine from wine damage, Poria Regulate the Blood Decoction. For bloody urine from sexual damage, Deer Antler Glue Pill and Kidney Qi Pill formula in the Vacuity Taxation chapter. For the old, Six Flavours Rehmannia Pill formula in the Vacuity Taxation chapter. For women, Angelica Powder. For children, Established Effect Powder.
Clinical note임상 주석
Six causes and six formularies for one sign, sorted by who the patient is: a drinker, a man who has overdone the bedchamber, an old person, a woman, a child. The chapter's treatment of bloody urine is the most patient-specific in it.

Donguibogam · Hyeol

1.16.7
Source원문

有實熱, 當歸承氣湯下之方見下.

Translation영역
Where there is replete heat, Angelica Order the Qi Decoction purges it formula in the Purging chapter.

Donguibogam · Hyeol

1.17 Bloody Stool 便血

1.17.1
Source원문

內經曰, 結陰者, 便血一升, 再結二升, 三結三升. 釋曰, 結陰之病, 陰氣內結不得外行, 血無所稟, 滲入腸間, 故便血也. 其脉虛澁者是也. 因血結不行故下也. 平胃地楡湯, 結陰丹主之.

Translation영역
The Neijing says: in bound yin there is bloody stool of one seung; bound again, two seung; bound a third time, three seung. The explanation says: the disease of bound yin is the yin qi bound within and unable to move without; the blood has nothing to draw on and seeps into the intestines, hence bloody stool. Its pulse is vacuous and rough. Because the blood is bound and does not move, it goes down. Calm the Stomach and Sanguisorba Decoction and Bound Yin Elixir govern it.
Clinical note임상 주석
結陰, bound yin — the chapter's one bleeding that is cold rather than hot, and the Neijing's count of seung is meant to say it gets worse with each recurrence. The pulse is vacuous and rough, not the rapid pulse of heat, and the formulas warm.

Naegyeong 內經

1.17.2
Source원문

靈樞曰, 邪在五藏, 則陰脉不和, 陰脉不和, 則血留之. 盖邪犯五藏, 則三陰脉絡不和而結聚, 血因停留, 溢則滲入腸間, 而爲便血. 《入門》

Translation영역
The Lingshu says: where the evil is in the five viscera the yin vessels are not harmonious, and where the yin vessels are not harmonious the blood lodges. When the evil offends the five viscera, the network vessels of the three yin are disharmonious and bind and gather, the blood stands because of it, and overflowing it seeps into the intestines and becomes bloody stool.

Immun 入門

1.17.3
Source원문

仲景曰, 先便後血者, 遠血也. 黃土湯主之. 先血後便者, 近血也. 赤小豆當歸散主之.

Translation영역
Zhongjing says: stool first and blood after is distant blood — Yellow Earth Decoction governs it. Blood first and stool after is near blood — Adzuki Bean and Angelica Powder governs it.
Clinical note임상 주석
The Jingui's rule in its own words, and the third time the chapter diagnoses from order of appearance. Blood that follows the stool has come from far up and travelled with it; blood that precedes it is from the rectum. The two formulas are registered at 1.17 and go opposite ways.

Junggyeong 仲景

1.17.4
Source원문

便血, 宜胃風湯方見大便ㆍ淸藏湯ㆍ楡砂湯ㆍ地楡散ㆍ連殼丸ㆍ加減四物湯ㆍ槐花散. 有實熱者, 當歸承氣湯. 日久便血, 元氣下陷者, 厚朴煎, 補中益氣湯方見內傷. 內傷飮食者, 平胃散方見內傷, 加枳殼ㆍ槐花ㆍ當歸ㆍ烏梅. 酒毒便血, 酒蒸黃連丸. 《諸方》

Translation영역
For bloody stool, Stomach Wind Decoction formula in the Stool chapter, Clear the Viscera Decoction, Sanguisorba and Amomum Decoction, Sanguisorba Powder, Coptis and Bitter Orange Pill, Modified Four Substances Decoction and Sophora Flower Powder are appropriate. Where there is replete heat, Angelica Order the Qi Decoction. Where bloody stool has gone on long and the origin qi has sunk, Magnolia Bark Preparation and Supplement the Centre and Boost the Qi Decoction formula in the Internal Damage chapter. Where it is internal damage from food, Calm the Stomach Powder formula in the Internal Damage chapter with bitter orange, sophora flower, angelica and mume added. For bloody stool from wine toxin, Wine-Steamed Coptis Pill.
Clinical note임상 주석
The chapter's longest formulary for one sign, and it is sorted by cause: heat, long duration, food, drink. The long-standing case gets Bojungikgi-tang — the bowel is read as having sunk, and the treatment lifts it.

Jebang 諸方

1.18 The Intestinal Afflux Pattern 腸澼證

1.18.1
Source원문

詳見後陰.

Translation영역
Treated in fuller detail in the Anus chapter.
Clinical note임상 주석
腸澼, intestinal afflux — the Neijing's name for bloody dysentery, and the Bogam keeps the heading here so the routes of bleeding stay in one list, then sends the reader to the Anus chapter for the treatment.

Donguibogam · Hyeol

1.19 Bleeding from the Gums 齒衄

1.19.1
Source원문

入門曰, 血從齒齦出, 謂之齒衄. 又曰, 牙床屬胃, 牙齒屬腎, 如陽明傳入少陰, 二經相倂, 血出於牙縫, 如吐者, 人多不覺其爲牙血, 以涼水漱口則血止, 少頃又來者是, 外用綠袍散, 內服解毒湯方見傷寒, 合犀角地黃湯, 或生地芩連湯方見下.

Translation영역
The Immun says: blood issuing from the gums is called tooth nosebleed. It also says: the gum belongs to the stomach and the tooth to the kidney; where yang brightness passes into lesser yin and the two channels join, blood issues from between the teeth as if vomited, and people mostly do not realize it is from the teeth. If rinsing with cold water stops it and it returns a moment later, that is it. Without, use Green Robe Powder; within, take Resolve Toxin Decoction formula in the Cold Damage chapter combined with Rhinoceros Horn and Rehmannia Decoction, or Fresh Rehmannia, Scutellaria and Coptis Decoction formula below.
Clinical note임상 주석
How to tell gum bleeding from vomited blood, when the patient cannot: rinse with cold water. If it stops and comes back, the gum is the source. A practical test, and the reason the section exists — blood in the mouth is not always from the stomach. The gum is the stomach and the tooth the kidney, so the treatment is for both channels.

Immun 入門

1.19.2
Source원문

齒衄, 宜荊槐散ㆍ鬱金散ㆍ小薊散.

Translation영역
For bleeding from the gums, Schizonepeta and Sophora Powder, Turmeric Powder and Cephalanoplos Powder are appropriate.

Donguibogam · Hyeol

1.20 Bleeding from the Tongue 舌衄

1.20.1
Source원문

入門曰, 血從舌出, 謂之舌衄, 宜蚊蛤散.

Translation영역
The Immun says: blood issuing from the tongue is called tongue nosebleed — Mosquito and Clam Powder is appropriate.

Immun 入門

1.20.2
Source원문

又方, 蒲黃炒爲末, 糝之卽止. 又槐花炒爲末, 糝之. 又赤小豆一升, 搗碎, 和水取汁, 服之. 《本草》

Translation영역
Another formula: cattail pollen stir-fried and powdered, dusted on, and it stops at once. Or sophora flower stir-fried and powdered, dusted on. Or 1 seung of adzuki bean pounded, mixed with water, the juice taken.

Boncho 本草

1.20.3
Source원문

又方, 髮灰二錢, 醋二合, 調服且糝之. 《綱目》

Translation영역
Another formula: 2 don of hair ash in 2 hop of vinegar, taken and also dusted on.
Clinical note임상 주석
The tongue is the heart's sprout, and its bleeding is the heart's — but every remedy here is local: powder dusted on the tongue. The chapter's theory and its practice part ways where the bleeding can be reached with a finger.

Gangmok 綱目

1.21 Bloody Sweat 血汗

1.21.1
Source원문

內經曰, 少陰所至, 爲衄衊. 釋曰, 衊, 血汗也.

Translation영역
The Neijing says: what the lesser yin brings is nosebleed and bloody sweat. The explanation says: 衊 is bloody sweat.

Naegyeong 內經

1.21.2
Source원문

河間曰, 膽受熱, 血妄行爲衄衊, 幷血汗, 宜定命散.

Translation영역
Hejian says: the gallbladder receiving heat, the blood moves recklessly as nosebleed and bloody sweat together — Fix the Life Powder is appropriate.

Hagan 河間

1.21.3
Source원문

三因曰, 無病者, 汗出汚衣, 甚如胚染, 名曰血汗, 亦曰紅汗. 由大喜傷心, 喜則氣散, 血隨氣行也. 宜黃芪建中湯方見虛勞, 兼服妙香散方見神門, 以金銀器, 入小麥, 麥門冬煎湯調下. 又産婦血汗, 宜葎草汁方.

Translation영역
The Samin says: where a person with no illness sweats and stains the clothes, at worst like dye, it is called bloody sweat, also red sweat. It comes of great joy damaging the heart — joy scatters the qi, and the blood moves with the qi. Astragalus Fortify the Centre Decoction formula in the Vacuity Taxation chapter is appropriate, with Marvellous Fragrance Powder formula in the Spirit chapter taken alongside, sent down in a decoction of wheat and ophiopogon made in a gold or silver vessel. And for bloody sweat in a woman after childbirth, the Japanese Hop Juice Formula.
Clinical note임상 주석
Haematidrosis, and the tradition's explanation is emotion — joy scatters the qi and the blood follows it out through the pores. The condition is real and rare, and stress is the usual trigger in the modern case reports too. 紅汗, red sweat, is also the name 1.13.6 gives to a nosebleed in a fever. The word covers two things that the chapter keeps apart by section.

Samin 三因

1.22 Bleeding from the Nine Orifices 九竅出血

1.22.1
Source원문

人卒大驚, 則九竅血皆溢出, 謂之九竅出血. 《本草》

Translation영역
Where a person takes a sudden great fright, blood spills from all nine orifices — this is called nine-orifice bleeding.

Boncho 本草

1.22.2
Source원문

傷寒少陰證, 醫者不識, 强發其汗, 則伏熱逼血, 從九竅而出, 名爲下厥上竭, 不治. 詳見寒門

Translation영역
In the lesser yin pattern of cold damage, where the physician does not recognize it and forces a sweat, the hidden heat presses on the blood and it issues from the nine orifices — called reversal below and exhaustion above, and not treated. treated in fuller detail in the Cold Damage chapter
Clinical note임상 주석
下厥上竭 — reversal below, exhaustion above — is the Shanghan tradition's name for the collapse that follows sweating a patient who should not have been sweated, and bleeding from every orifice is its sign. It is disseminated intravascular coagulation described from the outside, and the chapter says 不治. **Bleeding from multiple sites at once indicates coagulopathy and is a medical emergency.**

Donguibogam · Hyeol

1.22.3
Source원문

九竅出血, 宜側柏散方見上. 又百草霜ㆍ油髮(灰)ㆍ龍骨末, 或吹入, 或糝之. 《入門》

Translation영역
For nine-orifice bleeding, Arborvitae Powder formula above is appropriate. Or stove soot, hair ash and powdered dragon bone, blown in or dusted on.

Immun 入門

1.22.4
Source원문

卒驚悸, 九竅血皆溢出, 新屠猪羊血, 熱飮二升卽止. 又人有九竅, 四肢, 指岐間出血, 乃暴驚所爲, 取新生犢子臍中屎, 燒灰和水, 服日三四次. 又小薊, 搗取汁一盞, 酒半盞, 調和頓服, 乾者爲末, 冷水調服. 《本草》

Translation영역
Sudden fright and palpitation with blood spilling from all nine orifices: the blood of a freshly slaughtered pig or sheep drunk hot, 2 seung, and it stops at once. Also, where a person bleeds from the nine orifices, the four limbs and between the fingers, it is the work of sudden fright; take the dung from the navel of a newborn calf, burn it to ash, mix with water and take three or four times a day. Or cephalanoplos pounded for a cup of juice with half a cup of wine, mixed and taken at a draught; or the dried plant powdered and taken in cold water.
Clinical note임상 주석
Fresh animal blood drunk hot for a patient bleeding from everywhere — a like-for-like replacement, and 諸血, various bloods, is registered among the chapter's simples for this. The instinct to replace lost blood with blood is right; the route is not.

Boncho 本草

1.22.5
Source원문

又法, 井華水, 卒噀其面, 勿令病人先知之. 《本草》

Translation영역
Another method: dawn-drawn well water sprayed suddenly in the face, without letting the patient know beforehand.
Clinical note임상 주석
The startle, used for the third time in the book — the Women chapter's prolapse at 1.21.8 and the postpartum dizziness at 1.24.2 use the same cold spray. 勿令病人先知之: the point is the gasp, which cannot be produced if the patient expects it.

Boncho 本草

1.22.6
Source원문

指縫瘙痒成瘡, 有竅出血不止, 多年糞桶篐篾, 燒灰, 傅之卽止. 《得效》

Translation영역
Where itching between the fingers has become sores, with an opening that bleeds without stopping, the bamboo hoop from an old night-soil bucket burnt to ash and applied stops it at once.

Deukhyo 得效

1.22.7
Source원문

血自皮膚間濺出, 用煮酒甁上紙, 碎揉如楊花, 以手捏在出血處卽止. 《入門》

Translation영역
Where blood spurts from between the skin, take the paper from the top of a wine-boiling jar, rub it fine like willow floss, and press it with the hand on the bleeding place, and it stops at once.
Clinical note임상 주석
Paper rubbed to lint and pressed on a bleeding point — a dressing and pressure, which is the whole of first aid for a small bleed. The wine-jar paper is chosen for being clean and dry.

Immun 入門

1.22.8
Source원문

膕中出血不止, 乃血虛也. 宜服十全大補湯方見虛勞. 《入門》

Translation영역
Bleeding from the hollow of the knee that does not stop is blood vacuity. Perfect Major Supplementation Decoction formula in the Vacuity Taxation chapter should be taken.

Immun 入門

1.23 Blood Loss from Injury 傷損失血

1.23.1
Source원문

詳見諸傷.

Translation영역
Treated in fuller detail in the Injuries chapter.
Clinical note임상 주석
Bleeding from wounds is the one kind the chapter does not treat, because it is not a disease of the blood but of the body. The heading is kept so the routes stay complete.

Donguibogam · Hyeol

1.24 Dizziness from Blood Loss 失血眩暈

1.24.1
Source원문

海藏曰, 一切去血過多, 則必致眩暈悶絶. 凡崩中去血多, 拔牙齒去血多, 金瘡去血多, 産後去血多, 皆有此證. 宜大劑芎歸湯方見婦人煎服, 救之.

Translation영역
The Haejang says: any excessive loss of blood surely brings dizziness and oppressive collapse. Much blood lost in flooding, much lost in pulling a tooth, much lost from a metal wound, much lost after childbirth — all have this pattern. A large dose of Chuanxiong and Angelica Decoction formula in the Women chapter, decocted and taken, rescues it.
Clinical note임상 주석
Four causes and one result — the collapse of blood loss is the same whatever let the blood out. The Haejang lists a tooth extraction beside childbirth and a sword wound, which is the chapter's plainest statement that the source does not matter once the volume is gone.

Haejang 海藏

1.24.2
Source원문

吐衄太甚不止, 當防其血暈. 茅根, 燒烟, 將醋灑之, 令鼻嗅氣以遏其勢, 或驀然以冷水噀其面, 使驚則止. 《入門》

Translation영역
Where vomiting and nosebleed are extreme and do not stop, guard against blood dizziness. Burn imperata root and sprinkle vinegar on the smoke, and let the nose breathe the fumes to check its force; or spray cold water suddenly in the face so that fright stops it.

Immun 入門

1.24.3
Source원문

失血多, 眩暈不省, 宜生地芩連湯救之. 又全生活血湯方見胞門亦佳. 《入門》

Translation영역
Where much blood is lost and there is dizziness and loss of awareness, Fresh Rehmannia, Scutellaria and Coptis Decoction rescues it. Whole Life Quicken the Blood Decoction formula in the Uterus chapter is also good.

Immun 入門

1.24.4
Source원문

血暈者, 皆因去血過多, 虛而成暈, 脉微澁也. 急用芎歸湯救之, 繼用加味四物湯. 《回春》

Translation영역
Blood dizziness all comes of excessive blood loss, the vacuity making dizziness, the pulse faint and rough. Chuanxiong and Angelica Decoction rescues it urgently, and Augmented Four Substances Decoction follows.

Hoechun 回春

1.24.5
Source원문

吐衄血過多, 昏迷不省, 生地黃三五斤, 取汁連飮, 不暇取汁, 則生吃呷汁, 以滓塞鼻神效. 又好墨濃磨汁飮之, 仍點入鼻中. 《本草》

Translation영역
Where vomiting and nosebleed have lost too much blood and there is clouding and loss of awareness, 3 to 5 geun of fresh rehmannia, the juice taken and drunk in succession; and where there is no time to take the juice, chew it raw and sip the juice, and plug the nose with the dregs — spirit-like effect. Or good ink ground thick and drunk, and dropped into the nose as well.
Clinical note임상 주석
Three to five geun of rehmannia is two to three kilos, and 不暇取汁 — no time to press it — says how the chapter understood the emergency. The dregs go in the nose and the juice down the throat, and the patient is given the whole plant. **Collapse after blood loss requires immediate transfusion.**

Boncho 本草

1.25 Black Medicines Stop Bleeding 黑藥止血

1.25.1
Source원문

綱目曰, 燒灰, 諸黑藥, 皆能止血. 經曰, 北方黑色, 入通於腎. 夫血者, 心之色也. 血見黑卽止者, 由腎水能制心火故也.

Translation영역
The Gangmok says: burnt ashes and all black medicines can stop bleeding. The classic says: the north is black and enters and communicates with the kidney. Blood is the heart's colour, and that blood stops on seeing black is because the kidney's water can restrain the heart's fire.
Clinical note임상 주석
The theory behind the ash formulas of 1.25: black is water and red is fire, and water puts out fire. What the charring actually does is make an astringent, and the tradition arrived at the right practice by the wrong reasoning.

Gangmok 綱目

1.25.2
Source원문

止血, 宜五灰散ㆍ十灰散ㆍ十灰丸. 如百草霜ㆍ松烟墨ㆍ油髮(灰)ㆍ新綿(灰)ㆍ棕櫚(灰)ㆍ梔子ㆍ乾柿ㆍ荊芥ㆍ蓮房ㆍ蝟皮ㆍ牛角䚡之類, 皆可燒灰, 單服.

Translation영역
To stop bleeding, Five Ashes Powder, Ten Ashes Powder and Ten Ashes Pill are appropriate. And stove soot, pine-soot ink, hair ash, new cotton ash, palm bark ash, gardenia, dried persimmon, schizonepeta, lotus seed pod, hedgehog skin, ox horn core and their kind may all be burnt to ash and taken singly.
Clinical note임상 주석
Eleven things that can be burnt and given alone. Half are not medicinals — cotton, silk, hair, palm bark — and the list says that what matters is the charring, not what is charred.

Donguibogam · Hyeol

1.26 Prohibitions 禁忌

1.26.1
Source원문

內經曰, 醎走血, 血病無多食醎. 又曰, 久視傷血. 凡血少血虛之人, 鍼刺出血過多, 皆爲禁忌.

Translation영역
The Neijing says: salty runs to the blood, and in a disease of blood do not eat much salt. It also says: looking long damages the blood. In any person with blood scant or vacuous, needling that lets much blood is forbidden.
Clinical note임상 주석
Three prohibitions — salt, eyestrain, and bloodletting — and the third is the practical one. The acupuncture at 1.30 includes bleeding methods, and this section says who must not have them. 久視傷血, looking long damages the blood, follows from 1.2.1: the eye sees with blood, and overusing it spends what it runs on.

Naegyeong 內經

1.27 Methods of Using Medicines for Blood 治血藥法

1.27.1
Source원문

丹溪曰, 凡用血藥, 不可單行單止. 又不可純用寒涼藥, 必加辛溫升藥. 如用涼藥, 用酒煮酒炒之類, 乃寒因熱用也. 又曰, 久患血證, 血不歸元, 久服藥而無效者, 以川芎爲君則效.

Translation영역
Danxi says: in using blood medicines, one may not only move or only stop. Nor may one use purely cold and cooling medicines; acrid, warm and rising medicines must be added. Where cooling medicines are used, boil or fry them in wine and the like — this is cold used by way of heat. He also says: in a long-standing blood pattern where the blood does not return to its origin and long medication has had no effect, take chuanxiong as chief and it takes effect.
Clinical note임상 주석
Danxi's three rules for the whole chapter. Never only stop, never only move; never all cold; and where nothing has worked, lead with chuanxiong. The second rule is the Medicine Use chapter's 5.14 applied to blood, and the wine-frying of every cold medicinal in this chapter's formulas is its consequence. The first rule is the one that separates the tradition's haemostatics from the modern kind: a formula that only stops leaves a clot, and the clot is the next disease.

Dansim 丹心

1.27.2
Source원문

凡嘔吐血, 若出未多, 必有瘀於胸膈者. 當先消瘀而涼之止之. 消瘀, 宜犀角地黃湯, 涼血, 宜陶氏生地芩連湯, 止澁, 宜側柏散ㆍ狗膽丸. 《入門》

Translation영역
In any retching or vomiting of blood, if not much has come out there must be stasis in the chest and diaphragm; first disperse the stasis, then cool it and stop it. To disperse stasis, Rhinoceros Horn and Rehmannia Decoction; to cool the blood, Tao's Fresh Rehmannia, Scutellaria and Coptis Decoction; to stop and astringe, Arborvitae Powder and Dog's Bile Pill.
Clinical note임상 주석
Three steps in order — disperse, cool, stop — and the Immun names a formula for each. The order is Danxi's rule made into a sequence: stopping comes last, after what would clot has been cleared.

Immun 入門

1.27.3
Source원문

桃仁ㆍ紅花ㆍ蘇木ㆍ血竭ㆍ牡丹皮者, 血滯所宜. 蒲黃ㆍ阿膠ㆍ地楡ㆍ百草霜ㆍ棕櫚灰者, 血崩所宜. 乳香ㆍ沒藥ㆍ五靈脂ㆍ凌霄花者, 血痛所宜. 蓯蓉ㆍ鎻陽ㆍ牛膝ㆍ枸杞子ㆍ益母草ㆍ夏枯草ㆍ敗龜板者, 血虛所宜. 乳酪ㆍ血液之物, 血燥所宜. 乾薑ㆍ肉桂之屬, 血寒所宜. 生地黃ㆍ苦參之屬, 血熱所宜. 《丹心》

Translation영역
Peach kernel, safflower, sappan, dragon's blood and moutan bark suit stagnant blood. Cattail pollen, ass-hide glue, sanguisorba, stove soot and palm ash suit flooding. Frankincense, myrrh, flying squirrel faeces and campsis flower suit blood pain. Cistanche, cynomorium, achyranthes, lycium fruit, motherwort, prunella and old tortoise plastron suit blood vacuity. Milk, cream and blood-like substances suit blood dryness. Dry ginger and cinnamon and their kind suit blood cold. Fresh rehmannia and sophora root and their kind suit blood heat.
Clinical note임상 주석
Seven conditions of the blood and the medicinals for each — the chapter's materia medica in one passage. The categories are still the tradition's: stasis, haemorrhage, pain, deficiency, dryness, cold, heat.

Dansim 丹心

1.27.4
Source원문

治血, 防風爲上使, 連翹一云黃連爲中使, 地楡爲下使, 不可不知. 《丹心》

Translation영역
In treating blood, saposhnikovia is the envoy for above, forsythia one version says coptis the envoy for the middle, and sanguisorba the envoy for below — this must be known.
Clinical note임상 주석
Three guides for three levels: saposhnikovia carries a formula to the head, forsythia to the chest, sanguisorba to the bowel. The chapter's own formulas follow this — sanguisorba leads the bloody-stool prescriptions at 1.17, and saposhnikovia is in Saengjigeumryeon-tang for the head.

Dansim 丹心

1.27.5
Source원문

凡血結之證, 皆用醋湯, 和之爲妙. 《直指》

Translation영역
In any pattern of bound blood, vinegar decoction is used to harmonize it, which is best.

Jikji 直指

1.27.6
Source원문

(灸)甘草ㆍ(炮)乾薑 每三錢, 煎服, 治男女失血不能引氣歸元, 甚妙. 《丹心》

Translation영역
Mix-fried licorice and blast-fried dry ginger 3 don each, decocted and taken, treats blood loss in man or woman where the qi cannot be led back to its origin — very good.
Clinical note임상 주석
Zhongjing's Gamchogeongang-tang, two medicinals, given by Danxi for the aftermath of bleeding. Nothing in it touches the blood; it warms the centre so the qi can hold. The Women chapter's Jeungsonsamul-tang at 1.32.2 is built on the same pair.

Dansim 丹心

1.27.7
Source원문

血不足, 須用甘草, 血色瘀黑, 用熟地黃, 血色鮮紅, 用生地黃, 若脉洪實, 痛甚, 用酒大黃, 和血止痛, 用當歸. 《東垣》

Translation영역
Where blood is insufficient, licorice must be used; where the blood is dark and stagnant, cooked rehmannia; where the blood is bright red, fresh rehmannia; where the pulse is surging and replete with severe pain, wine-prepared rhubarb; to harmonize the blood and stop pain, angelica.
Clinical note임상 주석
Dongwon's five rules of thumb, and the two rehmannias are the ones to keep: cooked for dark blood, fresh for bright. It is 1.9's colour test turned into a prescription — dark blood is old and cold and gets the warm rehmannia, bright blood is hot and gets the cold one.

Dongwon 東垣

1.27.8
Source원문

大凡血見熱則行, 見寒則凝, 見黑一作灰則止. 《丹心》

Translation영역
In general, blood meeting heat moves, meeting cold congeals, and meeting black one version says ash stops.
Clinical note임상 주석
Three graphs for three actions, and the chapter's whole pharmacology is in them: heat moves it, cold clots it, ash stops it. The line closes 1.27 as it opened 1.5.

Dansim 丹心

1.28 Medicines for the General Treatment of Blood Diseases 通治血病藥餌

1.28.1
Source원문

一切失血諸病, 通用四物湯ㆍ補榮湯ㆍ保命生地黃散ㆍ淸熱滋陰湯方見上ㆍ坎离膏ㆍ固榮散ㆍ血餘散ㆍ側柏湯ㆍ童子尿.

Translation영역
For all diseases of blood loss, Four Substances Decoction, Supplement the Construction Decoction, Protect Life Fresh Rehmannia Powder, Clear Heat and Enrich the Yin Decoction formula above, Kan and Li Paste, Secure the Construction Powder, Blood Surplus Powder, Arborvitae Decoction and Child's Urine are used generally.
Clinical note임상 주석
Nine things for any bleeding, and the first is the formula the Bogam is built on. 坎离膏, Kan and Li Paste, named for the two trigrams of water and fire, is cross-referenced and not registered here.

Donguibogam · Hyeol

1.29 Simple Medicinals 單方

1.29.1
Source원문

凡二十二種.

Translation영역
Twenty-two kinds in all.
Clinical note임상 주석
Twenty-two simples, and they are the chapter's stanchers in their raw state — stove soot, dawn-drawn water, rehmannia, plantain, cattail pollen, the two thistles, madder, imperata, mugwort, sanguisorba, turmeric, bletilla, sophora, arborvitae, ink, lotus juice, leek juice, hair ash, animal blood and radish juice. Most appear in the formulas above.

Donguibogam · Hyeol

1.30 Acupuncture and Moxibustion Methods 鍼灸法

1.30.1
Source원문

衄吐血, 下血, 取隱白ㆍ大陵ㆍ神門ㆍ太谿. 《易老》

Translation영역
For nosebleed, vomiting blood and bleeding below, take Eunbaek (隱白, SP1), Daereung (大陵, PC7), Sinmun (神門, HT7) and Taegye (太谿, KI3).
Clinical note임상 주석
Four points on four channels, one each for spleen, pericardium, heart and kidney, and the Yeokro gives them for bleeding from any route. Eunbaek at the big toe is the tradition's standing point for bleeding — the spleen holds the blood, and its first point is where holding is restored.

Yeokro 易老

1.30.2
Source원문

衄血, 灸顖會ㆍ上星. 《資生》

Translation영역
For nosebleed, moxa Sinhoe (顖會, GV22) and Sangseong (上星, GV23).

Jasaenggyeong 資生

1.30.3
Source원문

衄宜灸大顀ㆍ瘂門, 卽止. 《丹心》

Translation영역
For nosebleed, moxa Daechu (大椎, GV14) and Amun (瘂門, GV15), and it stops at once.

Dansim 丹心

1.30.4
Source원문

衄不止, 以三稜針於氣衝出血, 立愈. 《東垣》

Translation영역
For nosebleed that does not stop, let blood with a three-edged needle at Gichung (氣衝, ST30), and it heals at once.
Clinical note임상 주석
Bleeding to stop bleeding — the three-edged needle at the groin for a nose that will not stop. The reasoning is to draw the blood down from the head to the lowest point on the stomach channel, and 1.26 says who must not have it done.

Dongwon 東垣

1.30.5
Source원문

衄血, 取上星ㆍ風府ㆍ瘂門ㆍ合谷ㆍ內庭ㆍ三里ㆍ照海. 《綱目》

Translation영역
For nosebleed, take Sangseong (上星, GV23), Pungbu (風府, GV16), Amun (瘂門, GV15), Hapgok (合谷, LI4), Naejeong (內庭, ST44), Samni (三里, ST36) and Johae (照海, KI6).

Gangmok 綱目

1.30.6
Source원문

吐血, 取風府ㆍ大顀ㆍ亶中ㆍ上脘ㆍ中脘ㆍ氣海ㆍ關元ㆍ三里. 《綱目》

Translation영역
For vomiting blood, take Pungbu (風府, GV16), Daechu (大椎, GV14), Danjung (膻中, CV17), Sangwan (上脘, CV13), Jungwan (中脘, CV12), Gihae (氣海, CV6), Gwanwon (關元, CV4) and Samni (三里, ST36).

Gangmok 綱目

1.30.7
Source원문

吐血, 灸大陵. 《得效》

Translation영역
For vomiting blood, moxa Daereung (大陵, PC7).

Deukhyo 得效

1.30.8
Source원문

嘔血, 取上脘ㆍ大陵ㆍ郄門ㆍ神門. 《東垣》

Translation영역
For retching blood, take Sangwan (上脘, CV13), Daereung (大陵, PC7), Geungmun (郄門, PC4) and Sinmun (神門, HT7).

Dongwon 東垣

1.30.9
Source원문

關脉芤, 大便出血數斗者, 以膈兪傷故也. 宜灸膈兪. 《脉經》

Translation영역
Where the bar pulse is hollow and several mal of blood have passed in the stool, it is because Gyeoksu (膈兪, BL17) is damaged. Moxa Gyeoksu.
Clinical note임상 주석
Gyeoksu, the back transport point of the diaphragm, is the tradition's meeting point of the blood, and the Maekgyeong attributes massive rectal bleeding to its injury. The point is still the one chosen for blood disorders of any kind.

Maekgyeong 脉經

1.30.10
Source원문

虛勞吐血, 灸中脘三百壯, 又吐血唾血, 灸肺兪隨年壯. 又口鼻出血不止, 名腦衄, 灸上星五十壯. 《得效》

Translation영역
For vomiting blood in vacuity taxation, moxa Jungwan (中脘, CV12) three hundred cones; and for vomiting and spitting blood, moxa Pyesu (肺兪, BL13) as many cones as the years of age. And for bleeding from mouth and nose that does not stop, called brain nosebleed, moxa Sangseong (上星, GV23) fifty cones.
Clinical note임상 주석
Three hundred cones at the stomach's alarm point — the Deukhyo's dose for the chronic case, and the chapter's heaviest moxa. 腦衄, brain nosebleed, is bleeding from mouth and nose together, and the point is at the front of the crown.

Deukhyo 得效

1.30.11
Source원문

下血不止, 量臍心與脊骨平, 於脊骨上, 灸七壯卽止. 《資生》

Translation영역
For bleeding below that does not stop, measure level from the centre of the navel to the spine, and on the spine there moxa seven cones, and it stops at once.
Clinical note임상 주석
A point found by measurement rather than by name — level with the navel on the spine, which is Myeongmun (命門, GV4) or near it. The chapter ends its acupuncture as the Women chapter ended its own, with a point located by the body rather than the chart.

Jasaenggyeong 資生

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Inner Landscape, Volume 2, Blood chapter. The Chinese text is collated against the public-domain Wikisource transcription and a printed edition; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.