下血，其法不可纯用寒凉药，必于寒凉药中加辛味为佐。久不愈者，后用温剂
，必兼升举，药中加酒浸炒凉药，和酒煮黄连丸之类，寒因热用故也。有热，四物加炒山栀
麻、秦艽、阿胶珠，去大肠湿热；属虚者，当温散，四物加炮干姜、升麻。凡用血药，不
入方
白芷 五倍子
上为末，粥丸梧子大。服五十丸，米汤下。
〔附录〕下血当别其色，色鲜红为热，以连蒲散。又若内蕴热毒，毒瓦斯入肠胃，或因饮酒
过多，及淡糟藏炙爆引血入大肠，故下血鲜红
，宜黄连丸，或一味黄连煎。余若大下不至者，宜四物汤加黄连、槐花，仍取血见愁少许，
生姜捣取汁，和米大服。于血见愁草中，加入侧柏叶，与生姜同捣汁，尤好。毒暑入肠胃下
血者，亦宜加味黄连、槐花入煎服。血色瘀者为寒，血逐气走，冷寒入客肠胃，故上瘀血，
宜理中汤温散。若风入肠胃，纯下清血，或湿毒，
并宜胃风散加枳壳、荆芥、槐花。 扑损恶，血入肠胃，下血浊如瘀血者，宜
黑神散加老黄茄为末，酒调下。《内经》云∶“下血为内伤络脉所致”，用枳壳一味服；又
方∶用黄连
附方
血余灰 鞋底灰 猪牙皂角灰（等分）
上为末。酒调三钱匕。
又方 治下血劫剂。
百药煎（一两，取一半烧为灰）
上为末，糊丸如梧子大。服六十丸，空心米汤下。
槐花散 治肠胃不调，胀满下血。
苍术 浓朴 陈皮 当归 枳壳（各一两） 槐花（二两） 甘草（半两） 乌梅（半两）
上以水煎，空心服。
又方 治下鲜血。
栀子仁（烧灰）
上为末。水和一钱匕，服。
又方 治粪前有血，面色黄。
石榴皮
上为末。煎茄子枝汤，调一钱匕。
又方 治粪后下血不止。
艾叶（不以多少）
上以生姜汁三合，和服。
又方
槐花 荆芥穗（等分）
上为末。酒调下一钱匕，仍空心食猪血，妙。
又方 治脏毒下血。
苦楝（炒令黑）
上为末，蜜丸。米饮下二十丸，尤炒。
又方 治卒下血。
赤小豆（一升，捣碎）
水二升，绞汁饮之。
乌梅丸 治便血，下血。
乌梅（三两，烧灰存性）
上为末，醋糊丸梧子大。空心服七十丸，米汤下。
酒煮黄连丸 见泄泻类。
黄连丸
黄连（二两） 赤茯苓（一两） 阿胶（二两）
上用黄连、茯苓为末，调阿胶，众手丸。每三十丸，食后饮下。
黄连香薷饮 见中暑。
理中汤 见中寒。
胃风汤 见下痢。
黑神散
百草霜（研细）
上用酒调下。
Hematochezia (bleeding from the rectum) should not be treated solely with cold-natured herbs; pungent-flavored herbs must be added as assistants to the cold-natured formula. If the condition persists for a long time, warm-natured agents should be used subsequently, combined with methods to lift and raise Qi. Cold-natured herbs soaked and stir-fried in wine should be added to the prescription, or formulas such as Huanglian Wan (Coptis Pill) boiled in wine may be used; this follows the principle of "using cold nature with heat application." If there is heat, Siwu Tang (Four Substances Decoction) can be modified by adding Chao Shanzhi (Stir-fried Gardenia Fruit), Mahuang (Ephedrae Herba), Qinjiao (Gentianae Macrophyllae Radix), and Ejiao Zhu (Processed Donkey-hide Gelatin) to clear damp-heat from the Large Intestine. For deficiency patterns, warming and dispersing methods are appropriate, using Siwu Tang (Four Substances Decoction) modified with Pao Ganjiang (Prepared Dried Ginger) and Shengma (Cimicifugae Rhizoma). Whenever blood-invigorating or hemostatic herbs are used... [Text gap/fragment] Baizhi (Angelicae Dahuricae Radix) and Wubeizi (Chinese Gall), processed into fine powder, mixed with rice porridge to form pills the size of wu zi (cibotium seeds). Take 50 pills, washed down with rice soup.
[Appendix] Hematochezia should be differentiated by color: bright red indicates heat, treat with Lianpu San (Coptis and Phragmites Powder). If internal accumulation of heat-toxin exists, where toxic qi invades the intestines and stomach, or due to excessive alcohol consumption, or ingestion of bland fermented foods, pickled items, roasted, or fried foods that draw blood into the Large Intestine, resulting in bright red bleeding, Huanglian Wan (Coptis Pill) or a decoction of single-ingredient Huanglian (Coptidis Rhizoma) is suitable. In other cases where massive bleeding does not cease, Siwu Tang (Four Substances Decoction) plus Huanglian (Coptidis Rhizoma) and Huaihua (Sophorae Flos) is appropriate, along with a small amount of Xuejianchou (Achyranthes Root or similar herb known as 'Blood Sees Sorrow'), and juice extracted from fresh Shengjiang (Zingiberis Rhizoma Recens) crushed together, taken in doses the size of rice grains. Adding Ce Bai Ye (Platycladi Cacumen) to the Xuejianchou grass and crushing it together with Shengjiang (Zingiberis Rhizoma Recens) yields an even better result. For hematochezia caused by toxic summer-heat invading the intestines and stomach, modified Huanglian (Coptidis Rhizoma) and Huaihua (Sophorae Flos) decoctions are also suitable. Dark, clotted blood indicates cold; blood moves with Qi, and cold pathogenic factors lodge in the intestines and stomach, causing upper abdominal stasis; Lizhong Tang (Regulate the Middle Decoction) is suitable for warming and dispersing. If wind invades the intestines and stomach, presenting with pure clear blood, or if caused by damp-toxin, Weifeng San (Stomach Wind Powder) modified with Zhike (Aurantii Fructus) and Jingjie (Schizonepetae Spica) and Huaihua (Sophorae Flos) is appropriate. For traumatic injuries where evil blood enters the intestines and stomach, presenting with turbid bloody stool resembling stasis, Heishen San (Black Divine Powder) modified with Lao Huangqie (Old Eggplant) powdered and taken with wine is suitable. The *Neijing* states: "Hematochezia is caused by internal injury to collateral vessels"; use single-ingredient Zhike (Aurantii Fructus); another formula uses Huanglian (Coptidis Rhizoma)...
Supplementary Formulas:
Xueyu Hui (Ash of Human Hair), Xiedi Hui (Ash of Shoe Soles), Zhuya Zaojiao Hui (Ash of Pig's Tooth Gleditsia Sinensis Fruit) (equal parts). Process into powder. Mix with wine and take three qian bi (approx. 9g).
Another Formula: Emergency treatment for hematochezia.
Baiyao Jian (Fermented Medicated Leaven) (1 liang, half burnt to ash). Process into powder, made into pills the size of wu zi (cibotium seeds) with paste. Take 60 pills on an empty stomach with rice soup.
Huaihua San (Sophorae Flos Powder): Treats intestinal and stomach disharmony, distension, fullness, and hematochezia.
Cangzhu (Atractylodis Rhizoma), Nongpo (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium), Danggui (Angelicae Sinensis Radix), Zhike (Aurantii Fructus) (each 1 liang), Huaihua (Sophorae Flos) (2 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (half liang), Wumei (Mume Fructus) (half liang). Decoct in water, take on an empty stomach.
Another Formula: Treats bright red blood in stool.
Zhizi Ren (Gardeniae Semen), burnt to ash. Process into powder. Mix with water and take one qian bi (approx. 3g).
Another Formula: Treats blood before stool, yellow complexion.
Shiliu Pi (Punicae Granati Cortex). Process into powder. Decoct eggplant branch tea, mix with powder and take one qian bi (approx. 3g).
Another Formula: Treats persistent bleeding after stool.
Aiye (Artemisiae Argyi Folium) (as needed). Mix with 3 he (approx. 60ml) of Shengjiang Jiang (Zingiberis Rhizoma Recens Juice) and take.
Another Formula:
Huaihua (Sophorae Flos), Jingjie Sui (Schizonepetae Spica) (equal parts). Process into powder. Mix with wine and take one qian bi (approx. 3g). Eat pig blood on an empty stomach afterwards; this is excellent.
Another Formula: Treats zangdu (visceral toxin) hematochezia.
Kelian (Meliae Cortex), stir-fried until black. Process into powder, honey-made pills. Take 20 pills with rice drink. Stir-frying is especially recommended.
Another Formula: Treats sudden hematochezia.
Chixiaodou (Vigna angularis Seed) (1 sheng, approx. 200g, crushed). Add 2 sheng (approx. 400ml) of water, extract juice and drink.
Wumei Wan (Mume Pill): Treats melena and hematochezia.
Wumei (Mume Fructus) (3 liang, burnt to ash preserving its nature). Process into powder, make pills the size of wu zi (cibotium seeds) with vinegar paste. Take 70 pills on an empty stomach with rice soup.
Jiu Zhu Huanglian Wan (Wine-Boiled Coptis Pill): See Diarrhea category.
Huanglian Wan (Coptis Pill):
Huanglian (Coptidis Rhizoma) (2 liang), Chi Fuling (Poria with Red Core) (1 liang), Ejiao (Donkey-hide Gelatin) (2 liang). Process Huanglian and Fuling into powder, blend with Ejiao, and roll into pills by hand. Take 30 pills after meals with water.
Huanglian Xiangru Yin (Coptis and Elsholtzia Drink): See Summerheat category.
Lizhong Tang (Regulate the Middle Decoction): See Cold Damage to the Middle Jiao category.
Weifeng Tang (Stomach Wind Decoction): See Dysentery category.
Heishen San (Black Divine Powder):
Baicaoshuang (Fuligo Silicea) (finely ground). Mix with wine and take.