Written By Jun Heo(許浚, 1539~1615), Translated by Namil Kim, Wung Seok Cha et al., Published by Ministry of Health & Welfare (Korea)
15 Hemoptysis and Spitting of Blood 咳血, 嗽血, 唾血, 咯血 해혈, 수혈, 타혈, 각혈
① Hemoptysis is when the patient coughs violently and bleeds at the same time. Its cause lies in the lungs. Use a Borneol and Artichoke Pill, Chicken and Perilla Powder [prescription is mentioned later], or Fantastic Persimmon Frost Paste.
② Cough with bloody sputum (嗽血) is when the patient coughs up bloody sputum. Its cause lies in the spleen. Use a Six Gentlemen Decoction with Mori Cortex (桑白皮), Scutellariae Radix (黃芩) (a thick one which inside breaks easily), Aruantii Fructus Immaturus (枳殼), and Schisandrae Fructus (五味子). If the patient has Fire, use Augmented Wander Free Powder. [The Six Gentlemen Decoction is mentioned in the chapter on Phlegm].
③ Spitting of blood is when there is fresh blood in the saliva. Its cause lies in the kidneys. Use a Decoction to Tonify yin and Direct Fire Downward. [The prescription is mentioned in the chapter on Fire]. If there is red blood in the saliva, this is due to lung atropy. It is difficult to cure.
④ Hemoptysis is when the patient spits blood out or when the patient cannot easily spit blood but only spits it out by force. Sometimes red blood like thin thread comes out. This is because the essence and blood are exhausted. Use a Four Substances Decoction with Bambusae Caulis in Liquamen, Zingiberis Rhizoma Crudus (生薑) juice, a child’s urine, and Indigo Pulverata Levis, or a Decoction to Tonify Yin and Direct Fire Downward, Preserve Life Rehmannia Powder [presciption is mentioned later], and Holy Pancake Pill.
⑤ If blood comes out before sputum, it is mostly caused by a yin deficiency with the stirring of Fire. This keeps phlegm from going down. Add Bulbus Fritillariae Cirrhosae (貝母) and Trichosanthis Radix to a Four Substances Decoction to resolve phlegm; add Gardeniae Fructus (梔子), Liriopis Tuber (麥門冬) and Moutan Cortex (牧丹皮) to subdue Fire. Expelling phlegm before vomiting blood is mostly because of accumulated heat caused by phlegm Fire. The phlegm Fire must be made to come down immediately, so use a Gardenia and Rehmannia Decoction.
⑥ If the patient expels phlegm and there is blood in his/her saliva, this is because heat in the entrance of stomach makes blood boil up and come out. If the symptom is serious, use Gardeniae Fructus (梔子); if it is mild, use Polygoni Tinctori Fructus (藍實).
⑦ If the patient vomits sputum before blood, this is because of accumulated heat; therefore, use a Clear Lungs Decoction. If the patient vomits blood before sputum, this is because of a yin deficiency; therefore, use a Decoction to Tonify Yin and Direct Fire Downward.
⑧ To treat hemoptysis or spitting of blood, use a Borneol and Artichoke Pill, Hejian’s Rehmannia Powder, Clear Fire and Nourish Yin Decoction, Clear Cough Decoction, Settle Cough Decoction, Clear Saliva Decoction, Water and Fire Paste [prescriptions are mentioned later], Fantastic Persimmon Frost and Snow Pear Paste, or Robe of Grace Powder.
- Borneol and Artichoke Pill 龍腦雞蘇丸 용뇌계소환: It cures hemoptysis and the spitting of blood. 1 geun of Menthae Herba (薄荷), 4 nyang of Liriopis Tuber (麥門冬), 2 nyang of Typhae Pollen (蒲黃) and Asini Corii Colla (阿膠珠) each, 1.5 nyang of Glycyrrhizae Radix (甘草), and 1nyang of Ginseng Radix (人蔘) and Astragali Radix (黃芪). Grind these drugs into powder. Seperately, mince 2 nyang of Bupleuri Radix (柴胡) and Akebiae Caulis (木通) each, soak these drugs in half bowl of boiled water for 2 days, and take this juice. Boil down 2 geun of honey once or twice, add 6 nyang of Rehmanniae Radix (地黃) powder, and mix evenly. Put Bupleuri Radix (柴胡) and Akebiae Caulis (木通) juice here, boil down in low heat, and it becomes a plaster. Knead this plaster with the powder made previously and make pills the size of peas. Take 20 pills with boiled water.
• Fantastic Persimmon Frost Paste 玄霜膏 현상고: It treats hemoptysis, hematemesis, or a cough due to fatigue marvelously. 4 nyang of the juice of Mume Fructus Praeparatum (烏梅), pear juice, powder of dried persimmon, white sugar, honey, and the juice of Raphani Radix each; 1 nyang of Zingiberis Rhizoma Crudus (生薑) juice, 8 nyang of Poria Sclerotium Rubra (赤茯苓) powder (soaked in milk and dried in the sun for nine times), and 2 nyang of Farfarae Flos and Asteris Radix powder each. Put these drugs in porcelain and boil down to make a plaster. Make pills as big as a bullet. Take one pill at bedtime, put it in the mouth, and let it melt and then swallow.
• Augmented Wander Free Powder 加味逍遙散 가미소요산: It treats sputum with blood. 1.5 don of Moutan Cortex (牧丹皮) and Atractylodis Rhizoma Alba (白朮) each, 1 don of Angelica Gigantis Radix (當歸), Paeoniae Radix (赤芍藥), Persicae Semen (桃仁) and Bulbus Fritillariae Cirrhosae (貝母) each, 8 pun of Gardeniae Fructus (梔子) and Scutellariae Radix (黃芩) each, 7 pun of Platycodonis Radix (桔梗), 5 pun of Citri Unshius Pericarpium Immaturus (靑皮), and 3 pun of Glycyrrhizae Radix (甘草). Mince these drugs to make 1 package and decoct with water.
• Holy Pancake Pill 聖餠子 성병자: It treats hemoptysis. Mix 40 grains of Armeniacae Semen (杏仁) (peeled, tip removed, ground into powder and stirred with Cera Flava (黃蠟)) with 1 don of Indigo Pulverata Levis, mash and make into a little piece of cake. Divide a dried persimmon and put the piece of cake inside, wrap this persimmon with wet paper, and bury in ashes in order to bake. Mash this and mix with thin rice gruel.
• Gardenia and Rehmannia Decoction 山梔地黃湯 산치지황탕: It is used when the patient vomits phlegm before vomiting blood. The phlegm must be come down first. 1.2 don of Gardeniae Fructus (梔子), 1 don of Rehmanniae Radix Crudus (生地黃), Paeoniae Radix (赤芍藥), Anemarrhenae Rhizoma (知母), Bulbus Fritillariae Cirrhosae (貝母) and Trichosanthis Semen (瓜蔞仁) each, and 5 pun of Trichosanthis Radix (天花粉) and Moutan Cortex (牧丹皮), Liriopis Tuber (麥門冬) each. Mince these drugs to make 1 package and decoct in water.
• Clear Lungs Decoction 淸肺湯 청폐탕: If phlegm comes out before blood, this is because of accumulated heat. 7 pun of Poria Sclerotium Rubra (赤茯苓), Citrus Unshius Pericarpium (陳皮), Angelica Gigantis Radix (當歸), Rehmanniae Radix Crudus (生地黃), Paeoniae Radix (赤芍藥), Asparagi Tuber (天門冬), Liriopis Tuber (麥門冬), Scutellariae Radix (黃芩), Gardeniae Fructus (梔子), Asteris Radix, Asini Corii Colla (阿膠珠) and Mori Cortex (桑白皮) each, and 3 pun of Glycyrrhizae Radix (甘草). Mince these drugs to make 1 package, decoct with 2 Zizyphi Fructus (大棗), 1 Mume Fructus Praeparatum (烏梅), and water.
• Hejian’s Rehmannia Powder 河間生地黃散 하간생지황산: It cures epistaxis, hematemesis, hemoptysis, and the spitting of blood caused by depressed heat. 7 pun of Lycii Fructus, Bupleuri Radix (柴胡), Coptidis Rhizoma (黃連), Lycii Radicis Cortex (地骨皮), Asparagi Tuber (天門冬), Paeoniae Radix Alba (白芍藥), Scutellariae Radix (黃芩), Astragali Radix (黃芪), Rehmanniae Radix Crudus (生地黃), Rehmanniae Radix Preparata (熟地黃), and Glycyrrhizae Radix (甘草) each. Mince these drugs to make 1 package and decoct in water.
• Clear Fire and Nourish Yin Decoction 淸火滋陰湯 청화자음탕: It cures the vomiting of blood, hematemesis, hemoptysis, spitting of blood, and hemoptysis. Gather 7 pun of Asparagi Tuber (天門冬), Liriopis Tuber (麥門冬), Rehmanniae Radix Crudus (生地黃), Moutan Cortex (牧丹皮), Paeoniae Radix (赤芍藥), Gardeniae Fructus (梔子), Coptidis Rhizoma (黃連), Dioscoreae Rhizoma (山藥), Corni Fructus, Alismatis Rhizoma, Poria Sclerotium Rubra (赤茯苓) and Glycyrrhizae Radix (甘草) each. Mince these drugs to make 1 package, decoct in water, and add a child’s urine before drinking.
• Clear Cough Decoction 淸咳湯 청해탕: It cures hemoptysis. 1 don of Angelica Gigantis Radix (當歸), Paeoniae Radix Alba (白芍藥), Persicae Semen (桃仁) and Bulbus Fritillariae Cirrhosae (貝母) (stir-baked) each, 8 pun of Atractylodis Rhizoma Alba (白朮), Moutan Cortex (牧丹皮), Scutellariae Radix (黃芩) and Gardeniae Fructus (梔子) (stir-baked until it becomes black) each, 5 pun of Citri Unshius Pericarpium Immaturus (靑皮) and Platycodonis Radix (桔梗) each, and 3 pun of Glycyrrhizae Radix (甘草). Mince these drugs to make 1 package and decoct in water.
• Settle Cough Decoction 淸咯湯 청각탕: It treats hemoptysis. 1 don of Citrus Unshius Pericarpium (陳皮), Pinelliae Tuber
(半夏), Poria Sclerotium (白茯苓), Anemarrhenae Rhizoma (知母), Bulbus Fritillariae Cirrhosae (貝母) and Rehmanniae Radix Crudus (生地黃) each, 7 pun of Platycodonis Radix (桔梗) and Gardeniae Fructus (梔子) (stir-baked until it becomes black) each, 5 pun of Armeniacae Semen (杏仁) and Asini Corii Colla (阿膠珠) each, 1.5 don of Mori Cortex (桑白皮), 5 pun of Glycyrrhizae Radix (甘草), and 2 pun of Cinnamomi Ramulus (薄桂). Mince these drugs to make 1 package and decoct in water with 3 pieces of Zingiberis Rhizoma Crudus (生薑).
• Clear Saliva Decoction 淸唾湯 청타탕: It cures the spitting of blood. 1 don of Anemarrhenae Rhizoma (知母), Bulbus Fritillariae Cirrhosae (貝母), Platycodonis Radix (桔梗), Phellodendri Cortex (黃柏) (soaked in salt water and stir-baked until it becomes brown), Rehmanniae Radix Preparata (熟地黃), Scrophulariae Radix (玄蔘), Polygalae Radix (遠志), Asparagi Tuber (天門冬) and Liriopis Tuber (麥門冬) each, and 5 pun of Zingiberis Rhizoma (乾薑) (stir-baked until it becomes black). Mince these drugs to make 1 package and decoct in water.
• Fantastic Persimmon Frost and Snow Pear Paste 玄霜雪梨膏 현상설리고: It cures hemoptysis, the spitting of blood, and hematemesis. It also treats a chronic cough due to excessive worries that stir the Fire. 60 Pyri Fructus Succus (core removed, peeled, make 20 doe of juice, do not use sour ones), 5 doe of raw Nelumbinis Rhizoma (蓮根) juice, 5 doe of Rehmanniae Radix Crudus (生地黃) juice, 2.5 doe of Liriopis Tuber (麥門冬) decoction, 2.5 doe of fresh Raphani Radix juice, and 5 doe of Imperatae Rhizoma (白茅根) juice. Mix these drugs, filter several times, remove the grounds and boil down. Add 1 geun of boiled down honey, 8 nyang of wheat-gluten, 8 nyang of powder of dried persimmon, half cup of Zingiberis Rhizoma Crudus (生薑) juice and boil down one more time. Make a plaster like a thin paste. Take 3~5 spoons three times per day, anytime.
• Robe of Grace Powder 恩袍散 은포산: It cures hemoptysis, spitting of blood, and hematemesis. 1 nyang each of crude Typhae Pollen (蒲黃) of good quality and Menthae Herba (薄荷). Grind these drugs into powder and add 3 don in a Mori Cortex (桑白皮) decoction.
