溺血 热也，又因房劳过度，忧思气结，心肾不交。
生地黄 小蓟根 淡竹叶 栀子仁（炒） 藕节 甘草 活石 通草 蒲黄（炒） 川归
血虚加四物汤、牛膝膏；
发灰能消瘀血、通关，醋汤二钱；
棕榈灰（亦治，烧灰米饮下；）
赤脚马兰汁、老鸦饭、水杨柳脑（并治）。
吐衄唾血下血，脉浮大而数者死。
吐血脉紧弦者死。
中恶吐血脉沉细数者死。
藏血脉俱弦者死。
下脓血，脉绝者死；血温身热脉躁者死。
霍乱 脉滑者霍乱，弦滑者宿食。洪者热，细者死，微迟者死，弦甚者死。
其气有三∶火风湿。承胃之虚，吐为热也；泻为湿也；风胜则动，故转筋
也。甚则转筋入腹者死。
干霍乱 则心腹胀满绞痛，欲吐不吐，欲利不利，须臾则死，急以盐汤大吐之。
热则五苓散；寒则理中汤；转筋霍乱则二陈汤加白术、甘草、桂枝。
干霍乱者，系内有积，外有邪气，和解散治之。二陈汤、和解散、加川芎、防风、白芷、苍术也。
下利 脉滑，按之虚绝者，必下利。
寸脉浮数，尺中自涩，必下清脓血。沉弦者下重。微弱数者自止。迟而滑者
实也，可下之。数而滑者有宿食，可下。或谵语，或腹坚痛，脉沉紧者，可下。
脉迟或肠鸣，心下急痛、大孔痛，可温。由风湿热也，轻则飧泄，重则下利脓血。
在表者，发之。表者，身热也。柴胡去参主之。
有里者，下之，或后重，或积也。在上者，涌之，或痰气也。在下者竭之，
去者送之，盛者和之，过者止之。
后重则宜下之，乃热物薮也，脉洪者是。又气不通，宜加槟榔、木香。
腹痛则宜和胃气，以川归、浓朴、桂、芍药、茯苓和之。
身重则除湿，脉弦则去风。大柴胡主之。血脓稠粘，以重药竭之，热甚也。
身冷自汗，以毒药温之。身冷自汗，下无声，小便清利，大便不禁，气难布
息，脉沉微，呕吐，虽里急后重，谓寒邪在内而气散也，可浆水散温之。
溏为利，宜温之（结粪也），风邪内缩宜汗之。有厥阴动利不止，脉沉细，
手足厥逆，涕唾脓血，此难治，宜麻黄汤、小续命汤汗之。
黄芩芍药汤 治泻利腹痛后重，身热，脉洪疾。
黄芩（一两） 芍药（一两） 甘草（五钱）
痛甚加桂少许；下利脓血加归连五钱；里急后重加槟榔、木香；前证重者，
大黄一两酒浸半日，煎服以利为度。
黄连当归汤 治下血腹不痛，谓之湿毒；痛热毒也。
连归（半两） 热毒加大黄（一两） 芍药（二钱半） 腹痛加桂。
白术芍药汤 治脾受湿，水泄；微满困弱，暴下无数，是大势来，宜宣和也。
白术 芍药 甘草
腹痛甚加黄芩桂；脉弦、头痛加苍术防风；痒与下血加苍术地榆；心下痞加枳实。
凡痢疾腹痛 伤食微加大黄；腹胀加朴；渴加茯苓。冬月减芍药一半，
夏月加芩。见脓血在大便前者，黄柏为君，地榆为佐，加归尾；脓血在大便后
者，制芩、归稍；脓血相杂下者，制大黄。腹不痛，白芍药半之。
身倦，目不欲开，口不欲言，四君子；沉重，制苍术；不思食者，木香、藿香。
诃子散 治虚滑久不已。
木香 黄连 甘草 诃子皮 术芍汤下。
桃花汤 治冷利腹痛，下鱼脑白。
赤石脂（ ） 干姜（炮） 饼丸饮下。
浆水散 治暴泄如水，身冷脉微自汗。
半夏（一两） 附子（炮） 干姜（五钱） 良姜（三钱） 桂（三钱） 甘草为末，浆水煎，和滓服。
小续命汤 治风邪内缩。方见前。
椿皮丸 治酒积利、久利湿也。
黄连茱萸粟壳丸 止利。
小柴胡去参汤 治身热挟外感者。
保和丸 治食积利。
乳香没药桃仁活石丸 治瘀血利，木香槟榔汤下。
茯苓汤 治伤冷冻饮料水变成白利，腹痛减食。
茯苓 猪苓 泽泻（一钱） 川归 桂（五分） 苍术（五分） 甘草 芍药（二钱） 升麻 柴胡 黄芩（五分）
李先生和血汤 治肠 下血，另作一派，腹中大痛，此乃阳明热毒也。
生地 熟地（五分） 甘草（生五分炙五分） 芍药（一钱半） 黄 （一钱） 升麻（一钱）
牡丹皮（五分） 苍术 秦艽 桂 当归 陈皮（三钱） 作一服。
腹中不痛，腰沉，谓之湿毒下血，加羌活 独活 防风 葛根 槐花（各三钱）
益智和中汤 治前证腹痛皮恶寒，脉俱弦，按之无力，关甚紧弦，内寒明矣。
升麻 芍药（钱半） 川归 黄 甘草（一钱） 葛根 柴胡 牡丹皮 肉桂 半夏
干姜 益智（一钱五分）
噤口利 谓下利而呕、不纳食，是谓噤口，痢止口不纳，食下便又不利。
人参姜汁煮焙干，半夏半之，入香附末丸。
又缩砂蜜调抹口上，呕不纳食谓之噤口。
又人参、黄连浓煎细呷之。
凡利下外有滞下、疳利、劳瘵利、湿食疮利。
血利则有瘀血、血枯、肺痿、风。
Hematuria (Blood in Urine): It is due to Heat, and also caused by excessive sexual activity, worry and thought leading to Qi stagnation, resulting in the failure of communication between the Heart and Kidney.
[Prescription] Shengdi Huang (Rehmanniae Radix), Xiao Ji Gen (Cephalopteri Radix), Dan Zhu Ye (Lophatheri Folium), Zhi Zi Ren (Gardeniae Semen [stir-fried]), Ou Jie (Nelumbinis Nodeus), Gan Cao (Glycyrrhizae Radix et Rhizoma), Hua Shi (Talcum), Tong Cao (Tetrapanacis Medulla), Pu Huang (Typhonii Pollen [stir-fried]), Chuan Gui Dang (Angelicae Sinensis Radix).
If blood deficiency, add Si Wu Tang (Four Substances Decoction) and Niu Xi Gao (Achyranthes Bidentata Paste);
Fa Hui (Hair Ash) can resolve blood stasis and unblock orifices; take two qian with vinegar decoction;
Zong Lu Hui (Livistona Chinensis Ash) also treats this; burn to ash and take with rice water;
Chi Jiao Ma Lan Zhi (Chrysanthemum Indicum Juice), Lao Ya Fan (Dichroa Febrifuga Root), Shui Yang Liu Nao (Salix Matsudana Bud) (all treat this).
Hematemesis (Vomiting Blood), Epistaxis (Nosebleed), Hemoptysis (Spitting Blood), and Hematochezia (Blood in Stool): If the pulse is floating, large, and rapid, it is a death sign.
If the pulse for hematemesis is tight and wiry, it is a death sign.
If sudden poisoning (Zhong E) causes vomiting blood and the pulse is deep, fine, and rapid, it is a death sign.
If the pulses of the zang organs are all wiry, it is a death sign.
If passing pus and blood, and the pulse is absent, it is a death sign; if the blood is warm, body heat is present, and the pulse is restless, it is a death sign.
Huoluan (Colic with Vomiting and Diarrhea): A slippery pulse indicates Huoluan; a wiry-slippery pulse indicates retained food. A洪 (Hong) pulse indicates Heat; a fine pulse indicates death; a minute and slow pulse indicates death; an extremely wiry pulse indicates death.
The pathogenic factors are three: Fire, Wind, and Dampness. Inheriting the deficiency of the Stomach, vomiting is due to Heat; diarrhea is due to Dampness; when Wind prevails, movement occurs, hence muscle cramps (Zhuan Jin). If severe, cramps entering the abdomen indicate death.
Dry Huoluan: Presents as abdominal distension and fullness with colicky pain, desire to vomit but unable to, desire to defecate but unable to, leading to death within moments. Urgently induce vomiting with salt water decoction.
For Heat, use Wu Ling San (Five-Ingredient Powder with Poria); for Cold, use Li Zhong Tang (Regulate the Middle Decoction); for Huoluan with muscle cramps, use Er Chen Tang (Two-Cured Decoction) plus Bai Zhu (Atractylodis Macrocephalae Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), and Gui Zhi (Cinnamomi Ramulus).
Dry Huoluan is due to internal accumulation and external pathogenic qi; treat with He Jie San (Harmonizing Powder). This refers to Er Chen Tang combined with He Jie San, plus Chuan Xiong (Ligustici Chuanxiong Rhizoma), Fang Feng (Saposhnikoviae Radix), Bai Zhi (Angelicae Dahuricae Radix), and Cang Zhu (Atractylodis Rhizoma).
Xiali (Diarrhea/Dysentery): A slippery pulse, which feels empty and weak upon pressure, indicates inevitable diarrhea.
If the Cun (inch) pulse is floating and rapid, and the Chi (cubit) pulse is naturally choppy, there will be passage of clear pus and blood. A deep-wiry pulse indicates tenesmus. A weak-rapid pulse indicates the condition will stop spontaneously. A slow-slippery pulse indicates excess; purgation may be used. A rapid-slippery pulse indicates retained food; purgation may be used. If there is delirious speech, or abdominal hardness and pain, and the pulse is deep-tight, purgation may be used.
A slow pulse or borborygmus, with urgency and pain in the epigastrium and anus, may be treated with warming methods. Caused by Wind-Damp-Heat; mild cases result in Sun Xie (undigested food in stool), severe cases result in dysentery with pus and blood.
If the pathogen is in the exterior, use diaphoresis. Exterior syndrome refers to body heat. Treat primarily with Chai Hu Qu Shen Tang (Bupleurum Decoction without Ginseng).
If the pathogen is in the interior, use purgation, either for tenesmus or for accumulation. If in the upper jiao, use emesis, often due to phlegm-Qi obstruction. If in the lower jiao, use draining methods; send off what should go, harmonize what is excessive, and stop what is too much.
Tenesmus is suitable for purgation, as it is a gathering place of Heat, indicated by a洪 (Hong) pulse. Also, if Qi circulation is blocked, add Bing Lang (Arecae Semen) and Mu Xiang (Aucklandiae Radix).
Abdominal pain is suitable for harmonizing Stomach Qi, using Chuan Gui Dang (Angelicae Sinensis Radix), Hou Po (Magnoliae Officinalis Cortex), Gui Zhi (Cinnamomi Ramulus), Shao Yao (Paeoniae Radix Alba), and Fu Ling (Poria) to harmonize.
Heavy body is suitable for removing Dampness; wiry pulse is suitable for dispelling Wind. Treat primarily with Da Chai Hu Tang (Major Bupleurum Decoction). Thick and sticky pus and blood require heavy medicines to drain, indicating severe Heat.
Cold body with spontaneous sweating requires toxic medicines to warm. Cold body with spontaneous sweating, silent diarrhea, clear urination, involuntary defecation, difficult breathing, deep-micro pulse, and vomiting: although there is tenesmus, this is Cold pathogen inside causing Qi dispersion; treat with Jiang Shui San (Fermented Rice Water Powder) warmed.
Loose stools constitute diarrhea, suitable for warming (if constipated, it is different); Wind pathogen contracting inward is suitable for diaphoresis. For Jue Yin dynamic diarrhea that does not stop, with deep-fine pulse, cold limbs, and pus/blood in sputum/nasal discharge, this is difficult to treat; use Ma Huang Tang (Ephedra Decoction) or Xiao Xu Ming Tang (Minor Sustaining Life Decoction) for diaphoresis.
Huang Qin Shao Yao Tang: Treats diarrhea/dysentery with abdominal pain and tenesmus, body heat, and洪疾 (rapid-large) pulse.
Huang Qin (one liang), Shao Yao (one liang), Gan Cao (five qian).
Severe pain: add a little Gui Zhi (Cinnamomi Ramulus). Dysentery with pus/blood: add Dang Gui (Angelicae Sinensis Radix) and Huang Lian (Coptidis Rhizoma), five qian each. Tenesmus: add Bing Lang (Arecae Semen) and Mu Xiang (Aucklandiae Radix). For severe preceding symptoms, Da Huang (Rhei Radix et Rhizoma) one liang, soaked in wine for half a day, decocted and taken until evacuation occurs.
Huang Lian Dang Gui Tang: Treats hematochezia without abdominal pain, called Damp-Toxin; if painful and hot, it is Heat-Toxin.
Lian Gui (half liang each). Heat-toxin: add Da Huang (one liang), Shao Yao (two qian half). Abdominal pain: add Gui Zhi (Cinnamomi Ramulus).
Bai Zhu Shao Yao Tang: Treats Spleen affected by Dampness, watery diarrhea; slight fullness, fatigue, weakness, sudden profuse diarrhea, indicating a strong trend, suitable for harmonization.
Bai Zhu (Atractylodis Macrocephalae Rhizoma), Shao Yao (Paeoniae Radix Alba), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Severe abdominal pain: add Huang Qin (Scutellariae Radix) and Gui Zhi (Cinnamomi Ramulus). Wiry pulse, headache: add Cang Zhu (Atractylodis Rhizoma) and Fang Feng (Saposhnikoviae Radix). Itching and bleeding: add Cang Zhu (Atractylodis Rhizoma) and Di Yu (Sanguisorbae Radix). Epigastric stuffiness: add Zhi Shi (Aurantii Fructus).
For all dysentery with abdominal pain: slightly increase Da Huang (Rhei Radix et Rhizoma) for food retention; increase Hou Po (Magnoliae Officinalis Cortex) for abdominal distension; increase Fu Ling (Poria) for thirst. In winter, reduce Shao Yao (Paeoniae Radix Alba) by half; in summer, add Huang Qin (Scutellariae Radix). If pus/blood appears before stool, use Huang Bo (Phellodendri Cortex) as sovereign, Di Yu (Sanguisorbae Radix) as assistant, plus Dang Gui Wei (Angelicae Sinensis Radix tail); if after stool, use Zhi Huang Qin (Prepared Scutellariae Radix) and Dang Gui (Angelicae Sinensis Radix) slightly; if mixed, use Zhi Da Huang (Prepared Rhei Radix et Rhizoma). If no abdominal pain, use half dose of Bai Shao Yao (White Peony Root).
Fatigue, eyes unwilling to open, mouth unwilling to speak: Si Jun Zi Tang (Four Gentlemen Decoction). Heaviness: use Zhi Cang Zhu (Prepared Atractylodis Rhizoma). Loss of appetite: Mu Xiang (Aucklandiae Radix), Huo Xiang (Agastaches Herba).
He Zi San: Treats deficiency-type slippery chronic diarrhea that does not cease.
Mu Xiang (Aucklandiae Radix), Huang Lian (Coptidis Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), He Zi Pi (Terminalia Chebula Pericarpium), taken as pills with Shu Shao Tang (Atractylodes-Paeonia Decoction).
Tao Hua Tang: Treats cold diarrhea with abdominal pain, passing fish-brain-like white mucus.
Chi Shi Zhi (Halloysit Rubrum), Gan Jiang (Zingiberis Rhizoma [roasted]), made into pill cakes and taken with water.
Jiang Shui San: Treats acute watery diarrhea, cold body, micro pulse, spontaneous sweating.
Ban Xia (Pinelliae Tuber [one liang]), Fu Zi (Aconiti Lateralis Radix Praeparata [roasted]), Gan Jiang (Zingiberis Rhizoma [five qian]), Liang Jiang (Alpiniae Officinarum Rhizoma [three qian]), Gui (Cinnamomi Ramulus [three qian]), Gan Cao (Glycyrrhizae Radix et Rhizoma), powdered, decocted in fermented rice water, taken with dregs.
Xiao Xu Ming Tang: Treats Wind pathogen contracting inward. Formula seen previously.
Chun Pi Wan: Treats alcohol-induced diarrhea and chronic dampness dysentery.
Huang Lian Zhu Yu Su Ke Wan: Stops diarrhea.
Xiao Chai Hu Qu Shen Tang: Treats body heat with external contraction.
Bao He Wan: Treats food-stagnation diarrhea.
Ru Xiang Mo Yao Tao Ren Hua Shi Wan: Treats blood-stasis diarrhea, taken with Mu Xiang Bing Lang Tang (Aucklandia-Areca Decoction).
Fu Ling Tang: Treats white diarrhea caused by consuming frozen drinks/water, with reduced abdominal pain and appetite.
Fu Ling (Poria), Zhu Ling (Polyporus), Ze Xie (Alismatis Rhizoma [one qian]), Chuan Gui Dang (Angelicae Sinensis Radix), Gui (Cinnamomi Ramulus [five fen]), Cang Zhu (Atractylodis Rhizoma [five fen]), Gan Cao (Glycyrrhizae Radix et Rhizoma), Shao Yao (Paeoniae Radix Alba [two qian]), Sheng Ma (Cimicifugae Rhizoma), Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix [five fen]).
Li Shi He Xue Tang: Treats intestinal bleeding, a separate category, with severe abdominal pain, due to Yangming Heat-Toxin.
Sheng Di (Rehmanniae Radix), Shu Di (Rehmanniae Radix Praeparata [five fen each]), Gan Cao (Glycyrrhizae Radix et Rhizoma [raw five fen, roasted five fen]), Shao Yao (Paeoniae Radix Alba [one qian half]), Huang Qi (Astragali Radix [one qian]), Sheng Ma (Cimicifugae Rhizoma [one qian]), Mu Dan Pi (Moutan Cortex [five fen]), Cang Zhu (Atractylodis Rhizoma), Qin Jiao (Gentianae Macrophyllae Radix), Gui (Cinnamomi Ramulus), Dang Gui (Angelicae Sinensis Radix), Chen Pi (Citri Reticulatae Pericarpium [three qian]), taken as one dose.
If no abdominal pain but heavy waist, called Damp-Toxin bleeding, add Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Fang Feng (Saposhnikoviae Radix), Ge Gen (Puerariae Lobatae Radix), Huai Hua (Sophorae Flos [three qian each]).
Yi Zhi He Zhong Tang: Treats preceding symptoms of abdominal pain, aversion to cold, wiry pulses, weak upon pressure, especially tight-wiry at Guan position, indicating obvious internal Cold.
Sheng Ma (Cimicifugae Rhizoma), Shao Yao (Paeoniae Radix Alba [one qian half]), Chuan Gui Dang (Angelicae Sinensis Radix), Huang Qi (Astragali Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma [one qian]), Ge Gen (Puerariae Lobatae Radix), Chai Hu (Bupleuri Radix), Mu Dan Pi (Moutan Cortex), Rou Gui (Cinnamomi Cortex), Ban Xia (Pinelliae Tuber), Gan Jiang (Zingiberis Rhizoma), Yi Zhi (Alpiniae Oxyphyllae Fructus [one qian half]).
Jin Kou Li (Anorexic Dysentery): Refers to diarrhea accompanied by vomiting and inability to eat, called Jin Kou. After dysentery stops, still unable to eat; eating leads to further diarrhea.
Ren Shen (Ginseng Radix et Rhizoma) boiled in Jiang Zhi (Zingiberis Juice), dried, Ban Xia (Pinelliae Tuber) half amount, mixed with Xiang Fu (Cyperi Rhizoma) powder to make pills.
Another method: Apply Su Sha Mi (Amomi Fructus Rotundus honey) on the lips; vomiting and inability to eat is called Jin Kou.
Another method: Ren Shen (Ginseng Radix et Rhizoma) and Huang Lian (Coptidis Rhizoma) decocted strongly, taken slowly sip by sip.
All diarrhea types externally include Zhi Xia (dysentery), Gan Li (parasitic diarrhea), Lao Zhai Li (consumptive diarrhea), Shi Shi Chuang Li (damp-food ulcer diarrhea).
Blood diarrhea includes blood stasis, blood exhaustion, Lung萎 (Lung Atrophy), and Wind.