Written By Jun Heo(許浚, 1539~1615), Translated by Namil Kim, Wung Seok Cha et al., Published by Ministry of Health & Welfare (Korea)
13-1 Methods for Stopping Epistaxis 止衄法 코피를 멎게 하는 법
① This method is wonderfully effective in treating epistaxis that does not stop for a long time when every medicine is ineffective. Fold 1~2 wide white sheets of paper about ten times and soak them in cold water. Put this paper on the vertex and foment with a hot iron. Epistaxis stops immediately when 1~2 folds of paper dry.
② When treating epistaxis that does not stop even after taking medicines, bind the middle joint of the middle finger with a thread. If it bleeds on the left, bind the middle joint of the right hand; if it bleeds on the right, bind the middle joint of the left
hand; if it bleeds on both sides, bind both hands. Sometimes one can use colored thread.
③ To treat epistaxis that does not stop, grind Bletillae Rhizoma into powder, mix it into cold water and apply on the bridge of the nose [it is the middle of the forehead], then it will stop immediately. Mix 3 don into cold water and drink. It will be more effective. Grind garlic into fine powder and make a little lump the size of a coin. If it bleeds on the left, stick it on the middle of the left sole. If it bleeds on the right, stick it on the middle of the right sole. If it bleeds on both sides, stick it on the middle of both soles.
④ Immensely Treasured Paste is used to treat epistaxis that does not stop. Add the medicine to cold water and apply to GV19. It stops bleeding. [The prescription is mentioned in the Recovery from the Myriad Diseases (回春)]
14 Epistaxis and Hematemesis 嘔血吐血구혈, 토혈
① When the patient vomits a bowl of blood making loud noise, it is called vomiting blood; if one vomits a bowl of blood without sound, it is called hematemesis.
② Vomiting blood and hematemesis are from the stomach. If the patient has excessiveness, use a Rhinocerotis Cornu and Rehmannia Decoction; if the patient has deficiency, use a Minor Build the Center Decoction [the prescription is mentioned in the chapter on Deficiency Vexation] with Coptidis Rhizoma (黃連) added.
③ In the Essential Formulas Worth a Thousand Gold for Emergencies (千金) it is said, “There are three kinds of hematemesis, bleeding from the mouth, pulmonary cellulitis, and impairment of the stomach. When bleeding from the mouth, the patient bleeds like epistaxis but it is not from the nostrils. Blood between the heart and the lungs flows into the stomach and becomes like red-bean juice or clotted blood. This is accumulated in the stomach and vomited when the patient feels fullness and oppression. Its quantity ranges from several mal (斗) to one seom (石), and it is mainly caused by overexertion, fatigue, and overeating. Pulmonary cellulitis is vomiting blood with vomitus when the patient feels fullness and oppression due to toxic heat after drinking alcohol. The patient vomits 1 hop (合), half doe (升) or 1 doe (升). Impairment of the stomach occurs after overeating, when the stomach becomes cold and cannot digest. The patient feels vexation, oppression and compulsive vomiting. Food and qi surge up together and tear the opening of the stomach. Therefore, the patient vomits red fresh blood, feels gripping pain in the abdomen, sweats spontaneously, and has a tight pulse. It is difficult to cure.”
④ To treat hematemesis due to impairment of the stomach, use an Order the Center Decoction (理中湯) [the prescription is mentioned in the chapter on Cold] with Cnidii Rhizoma (川芎) and Puerariae Radix (葛根). To treat hematemesis due to pulmonary cellulitis, use a Kudzu and Coptis Pill (葛黃丸). To treat hematemesis due to bleeding from the mouth, if the patient has excessiveness, use a Three Yellows Drain Heart Decoction with Rehmanniae Radix Crudus (生地黃); if the patient has a deficiency, use a Poria Tonify Heart Decoction or Ginseng Powder to Rescue the Lungs.
⑤ Zhongjing (仲景) said, “If a habitual drinker coughs, one will certainly vomit blood. It is because of excessive drinking, thus it is regarded to be pulmonary cellulitis.”
⑥ When the patient vomits purple-black blood clots suddenly, it indicates that one is damaged by heat and has static blood inside, so it is recommendable to induce vomiting. Treat with a Four Substances Decoction (四物湯) mixed with a Coptis Detoxification Decoction. [The prescription is mentioned in the chapter on Cold]. Moreover, if qi is blocked in the chest due to hematemesis, use a Peach Pit Order Qi Decoction [the prescription is mentioned in the chapter on Cold] in order to purge.
⑦ When Fire carries up blood, the blood gets out of the meridians and vessels and moves frantically, use a Four Substances Decoction (四物湯) with Gardeniae Fructus (梔子), child’s urine, and Zingiberis Rhizoma Crudus (生薑) juice. Zingiberis Rhizoma Crudus (生薑) juice and a child’s urine are important medicines for treating hematemesis.
⑧ Hematemesis is a disease of Fire. Although the patient has phlegm, bleeding will stop by controlling the Fire.
⑨ Sweat is the humor of the heart. It turns red and moves up to the orifices of the upper part of the body when the patient has heat. In Cold Damage, if the doctor promotes sweating by mistake, heat toxins enter the five viscera and produce static blood. Usually, it is vomited through the mouth; therefore, it is mostly considered to be a yang brightness disease. Red eyes, bone fever, loss of consciousness, madness, delirium, feelings of fullness in the chest, and abdomen are all considered to be blood syndrome. If the disease is mild, use a Rhinocerotis Cornu and Rehmannia Decoction with Scutellariae Radix (黃芩), Gardeniae Fructus (梔子), Imperatae Rhizoma (白茅根), Nelumbinis Rhizomatis Nodus (藕節); if the disease is severe, use a Peach Pit Order Qi Decoction, Resist and Endure Decoction, or Appropriate Resistance Pill. [The prescriptions are mentioned in the chapter on Cold].
⑩ To treat hematemesis, a Thistle Pill, Lotus Plumule Powder, Shizhai’s White Atractylodes Powder, or Asparagus Decoction should be used. When the blood comes out through both the nose and mouth, use a Four Fresh Ingredients Pill, Clam Frost Powder, Dark Spirit Powder, Biota Leaves Powder, Lotus Root Juice Powder, Seven Fresh Substances Decoction, Clear Heat and Resolve Toxicity Decoction, Ophicalcite Powder, Five Spirits Decoction, or Canitis Fel Pill.
- Kudzu and Coptis Pill 葛黃丸 갈황환: It is also called a Kudzu and Coptis Pill. It is used for the patient who looks dead because of hematemesis and epistaxis caused by accumulated heat after excessive drinking. 4 nyang of Coptidis Rhizoma (黃連), 2 nyang of Puerariae Flos (葛花) (you can use Puerariae Radix (葛根) instead). Grind these medicines into powder, knead with paste made of water boiled down with Rhei Radix et Rhizoma (大黃), then make pills as big as the seed of the royal foxglove tree. Take 100 pills with warm water.
- Three Yellows Drain Heart Decoction 三黃瀉心湯 삼황사심탕: ① It treats excessive hematemesis. Excessive hematemesis is due to excessive heat. 3 don of Rhei Radix et Rhizoma (大黃), 1 don of Coptidis Rhizoma (黃連) and Scutellariae Radix (黃芩) each, and 2 don of Rehmanniae Radix Crudus (生地黃). Mince these drugs to make one package and decoct with water. ② If there is hematemesis or epistaxis due to a deficiency of heart-qi, prescribe a Drain Heart Decoction. If only heart-qi is deficient, hematemesis or epistaxis does not result. Pathogenic heat invades where there is a deficiency; therefore, there is hematemesis and epistaxis. Purge heat by cold and tonify the heart by bitterness. These medicines share these two effects.
- Poria Tonify Heart Decoction 茯苓補心湯 복령보심탕: It treats hematemesis due to excessive anxiety. 2 don of Paeoniae Radix Alba (白芍藥), 1.5 don of Rehmanniae Radix Preparata (熟地黃), 1.3 don of Angelica Gigantis Radix (當歸), 7 pun of Cnidii Rhizoma (川芎), Poria Sclerotium (白茯苓), Ginseng Radix (人蔘), Angelicae Decursivae Radix (前胡) and Pinelliae Tuber (半夏) each, and 5 pun of Citrus Unshius Pericarpium (陳皮), Aruantii Fructus Immaturus (枳殼), Platycodonis Radix (桔梗), Puerariae Radix (葛根), Perillae Folium and Glycyrrhizae Radix (甘草) each. Mince these drugs to make 1 package, and boil with 5 pieces of Zingiberis Rhizoma Crudus (生薑) and 2 Zizyphi Fructus (大棗).
- Ginseng Powder to Rescue the Lungs 人參救肺散 인삼구폐산: It is also called Powder to Rescue the Pulse. It treats hematemesis due to a consumptive disease. 1 don of Ginseng Radix (人蔘), Astragali Radix (黃芪), Paeoniae Radix Alba (白芍藥), Rehmanniae Radix Preparata (熟地黃) and Angelica Gigantis Radix (當歸) (fine roots) each, and 5 pun of Cimicifugae Rhizoma (升麻), Bupleuri Radix (柴胡), Atractylodis Rhizoma (蒼朮), Citrus Unshius Pericarpium (陳皮), Sappan Lignum (蘇木) and Glycyrrhizae Radix (甘草) (baked) each. Mince these drugs to make as 1 package, and decoct in water.
- Thistle Pill 大薊飮子 대계음자: It is also called Large Thistle Powder. It treats blood vomiting and hematemesis caused by hot and pungent foods that damage the lungs and stomach. This latter is pulmonary cellulitis. 1 don of Cirsii Radix (大薊), Mori Cortex (桑白皮), Rhinocertis Cornu (犀角), Cimicifugae Rhizoma (升麻), Typhae Pollen (蒲黃) (stir-baked), Armeniacae Semen (杏仁), Platycodonis Radix (桔梗) and Glycyrrhizae Radix (甘草) each. Mince these drugs to make 1 package, decoct with water.
- Lotus Plumule Powder 蓮心散 연심산: It treats hematemesis caused by excessive worries. 50 Nelumbinis Plumula (蓮子心) and 50 grains of waxy rice. Grind these drugs into powder and mix with alcohol before taking.
- Shizhai’s White Atractylodes Powder 是齋白朮散 시재백출산: It treats hematemesis due to stomach damage caused by overeating or making efforts when carrying a heavy load. 2 don of Atractylodis Rhizoma Alba (白朮), 1 don of Ginseng Radix (人蔘), Poria Sclerotium (白茯苓) and Astragali Radix (黃芪) each, 7.5 pun of Dioscoreae Rhizoma (山藥) and Lilii Bulbus (百合) each, 5pun of Glycyrrhizae Radix (甘草), and 2.5 pun of Angelicae Decursivae Radix (前胡) and Bupleuri Radix (柴胡) each. Mince these drugs to make 1 package, and boil in water with 3 pieces of Zingiberis Rhizoma Crudus (生薑) and 2 Zizyphi Fructus (大棗).
- Asparagus Decoction 天門冬湯 천문동탕: It treats hematemesis or epistaxis caused by heart damage due to excessive thoughts. 7 pun of Asparagi Tuber (天門冬), Polygalae Radix (遠志), Paeoniae Radix Alba (白芍藥), Nelumbinis Rhizomatis Nodus (藕節), Liriopis Tuber (麥門冬), Astragali Radix (黃芪), Asini Corii Colla (阿膠珠), Myrrha, Angelica Gigantis Radix (當歸) and Rehmanniae Radix Crudus (生地黃) each, and 3 pun of Ginseng Radix (人蔘) and Glycyrrhizae Radix (甘草) each. Mince these drugs to make 1 package, and decoct with 3 pieces of Zingiberis Rhizoma Crudus (生薑) and water.
- Four Fresh Ingredients Pill 四生丸 사생환: It treats hematemesis or epistaxis. Yang attaches itself to the yin, so blood moves frenetically. Use the same quantities of crude Nelumbinis Folium (荷葉), crude Artemisiae Argyi Folium (艾葉), crude Thujae Orientalis Folium (側柏葉), and leaves of Rehmanniae Radix Crudus (生地黃). Mash these drugs and make into an egg size. Take 1 ball and decoct in water or melt in salt water. In some prescriptions, there is not Nelumbinis Folium (荷葉) but crude Menthae Herba (薄荷) instead.
- Clam Frost Powder 蚌霜散 방상산: It treats hematemesis caused by injury. It also cures cases for the patient who after drinking and overeating, puts his/her head down and the damaged blood flows out through the mouth and nose. [The prescription is mentioned in the chapter Common Wounds]
- Dark Spirit Powder 黑神散 흑신산: It treats excessive hematemesis and bleeding through the mouth and nose due to injuries. Grind Fulvis Fumi Carbonisatus (百草霜) that is found under an iron pot in the remote countryside. Mix 2 don in thin gruel prepared with waxy rice. In another prescription, it is said to mix 3 don in cold water.
- Biota Leaves Powder 側柏散 측백산: It treats hematemesis and vaginal bleeding due to internal damage of the heart and lungs when blood gushes out from the mouth and nose. If it isn’t treated immediately, the patient will die; however, if one takes this medicine, one will be in a stable condition at once. 2.5 nyang of Thujae Orientalis Folium (側柏葉) (steamed then dried), 1 nyang of Schizonepetae Spica (荊芥穗) (ashes), Ginseng Radix (人蔘) each. Grind these drugs, mix 3 don of each drugs with 2 don of flour and fresh drawn water, make a thin gruel and drink.
- Lotus Root Juice Powder 藕汁散 우즙산: It treats hematemesis or epistaxis that does not stop. 3 hop of the fresh juice of raw Nelumbinis Rhizoma (蓮根), juice of Rehmanniae Radix Crudus (生地黃), juice of Cirsii Radix (大薊) each, and half spoon of honey l (crude). Knead these drugs and take in one little cup at a time.
- Seven Fresh Substances Decoction 七生湯 칠생탕: It treats bleeding through the mouth and nose, when no medicine has effect. 1 nyang of Rehmanniae Radix Crudus (生地黃), Nelumbinis Folium (crude), Nelumbinis Rhizomatis Nodus (藕節) (crude), Garlic chives (韭) (crude) and Imperatae Rhizoma (白茅根) (crude) each, and 5 don of Zingiberis Rhizoma Crudus (生薑). Pound these drugs and make 1 bowl of juice. Take it with ground Atramentum (京墨).
- Clear Heat and Resolve Toxicity Decoction 淸熱解毒湯 청열해독탕: It treats hematemesis or epistaxis. 2 don of Cimicifugae Rhizoma (升麻), 1.5 don of Rehmanniae Radix Crudus (生地黃), 7 pun of Phellodendri Cortex (黃柏), Paeoniae Radix (赤芍藥) and Moutan Cortex (牧丹皮) each, and 5 pun of Puerariae Radix (葛根), Coptidis Rhizoma (黃連), Scutellariae Radix (黃芩), Platycodonis Radix (桔梗), Gardeniae Fructus (梔子), Forsythiae Fructus and Glycyrrhizae Radix (甘草) each. Mince these drugs to make 1 package, and decoct in water with 3 pieces of Zingiberis Rhizoma Crudus (生薑).
- Ophicalcite Powder 花蘂石散 화예석산: It treats hematemesis due to consumptive diseases, when the patient vomits a great amount of blood because the five viscera are completely damaged. Heat Ophicalcite and grind into fine powder. Decoct 3 don or 5 don of this powder in one cup of a child’s urine and take it warm. If men take half cup of alcohol with the child’s urine, or women take half cup of vinegar with the child’s urine, static blood changes into a yellow liquid and comes out. Then continue to treat with other medicines.
- Five Spirits Decoction 五神湯 오신탕: It treats hematemsis in women. 1 cup of fresh juice of raw Nelumbinis Rhizoma (蓮根), juice of Cirsii Radix (大薊), juice of Rehmanniae Radix Crudus (生地黃), honey each, half cup of Zingiberis Rhizoma Crudus (生薑) juice. Decoct these drugs together, boil 2~3 times. Take 1 little cup mixed with 1 don of flour.
- Canitis Fel Pill 狗膽丸 구담환: It treats continuous hematemesis that does not stop. Grind Trogopterorum Faeces (五靈脂) into powder and knead with a dog’s gall to make a pill the size of Euryales Semen. Melt one pill in Zingiberis Rhizoma Crudus (生薑) wine and take it. Do not gargle when taking and have rice gruel quickly, but do not eat too much.
- A Prescription 一方 또 다른 처방: It treats hematemesis that does not stop. If the patient cannot smell one’s own blood, he oe she can be cured; but if the patient can smell his own blood, he or she cannot be cured. Put the blood of the patient in a ceramic pot, put the pot over the fire and dry, and grind it into powder. Mix 1 don or 1.2 don with an infusion of Liriopis Tuber (麥門冬) and take it. The bleeding will stop at once.
14-1 Minor Syncope 薄厥證 박궐증
In the Introduction to Medicine (入門), it is said, “A patient who used to be healthy vomited half mal of blood suddenly and his pulse was string-like and tense. Chen Jingkui saw that and said, ‘This is a minor syncope syndrome. It occurs after great anger and then qi counterflows and yin and yang quarrel.’ He used a Six Depressions Decoction [the prescription is mentioned in the chapter on Accumulation] and the patient was cured.
