闻人氏云∶痘疮大便下血或黑粪，若睡而不醒，是为恶候，乃内热盛也，用犀角地黄汤、抱龙丸、小柴胡汤加生地
黄主之。窃谓前症若寒热作渴，小柴胡加生地黄。发热体倦，用五味异功散加当归。口干作渴，用人参白术散。大凡
作渴引饮发热者，属实热；作渴饮汤，手足不热者，属虚热；手足逆冷者，属虚寒。治者审之。
一小儿出痘便血，痘赤痛如锥，或疮内出血，余谓肝火炽盛，用小柴胡汤加生地黄一剂，随用犀角地黄汤，一剂而
痊。
一小儿痘疮下血，且不起发，先君谓气血不足，用紫草快 汤加参、 、归、术，血顿止，疮顿起，用八珍汤而愈。
一小儿痘疮下血，小便赤色，疮色如赭，发热饮冷，二便不利，先君谓心小肠实热，用八正散，后用解毒防风汤，
及饮芹菜汁而痊。
一小儿痘疹便血倦怠，作渴饮汤，余谓∶倦怠便血，脾虚下陷也；少食作渴，津液枯涸也，用五味异功散加紫草而
愈。
一小儿便血腹胀，困倦身热，口干饮汤，四肢逆冷，先君谓脾气虚寒不能摄血，用五味异功散加丁香、干姜，二剂
血止，痘贯而靥。
一小儿痘将愈而便血，面白恶寒，大便欲去而不去，余
谓此元气虚而下陷也，用益气汤，不信，服凉血之剂，致吐泻腹痛而殁。
一小儿痘将愈，患便血，面白恶寒，手足并冷，脉沉细如无，余谓阳气虚寒，欲用人参、姜、桂。不从，翌日而
死，手足青黑。惜哉！
解毒防风汤 治痘疮，毒瓦斯炽盛便血。
防风 地骨皮 黄 荆芥 白芍药（炒） 牛蒡子（各等分）
上每服四钱，水煎。或为末，白汤调下。
紫草快 汤 治痘疹下血，不能起发，出不快，色不红活等症。（即紫草汤，方见顶陷心烦）
圣济犀角地黄汤 治热毒内蕴，烦躁作渴，面色赤，大便黑屎，或神昏便血。（方见顶陷心烦）
小柴胡 治肝经有热，不能藏血而便血。（方见痘身疼）
五味异功散 治脾胃气虚，不能统血，而大便下血。（方见寒战切牙）
八珍汤 治气虚不能慑血而便血。（方见顶陷灰白）
八正散 治心小肠有热，小便赤，并大便下血。（方见痘小便不利）
七味白术散（即人参白术散，方见痘发热）
Mr. Wenren stated: In cases of smallpox where blood is passed in the stool or black feces are excreted, if the patient falls into a deep sleep and cannot be awakened, this is a malignant prognosis, indicating excessive internal heat. The treatment should employ Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction), Baolong Wan (Dragon-Embracing Pill), and Xiaochaihu Tang (Minor Bupleurum Decoction) with added Shengdihuang (Rehmanniae Radix). I hold that for the aforementioned symptoms, if accompanied by alternating chills and fever along with thirst, Xiaochaihu Tang with added Shengdihuang should be used; if there is fever accompanied by physical fatigue, Wuyi Yigong San (Five-Agent Powder for Strengthening the Spleen) with added Danggui (Angelicae Sinensis Radix) should be used; if there is dry mouth and thirst, Ren Shen Baizhu San (Ginseng and Atractylodes Macrocephala Powder) should be used. Generally speaking, thirst with a desire for cold drinks accompanied by fever indicates excess heat; thirst with a desire for hot drinks and cool extremities indicates deficiency heat; and cold extremities indicate deficiency cold. The practitioner must examine these carefully.
A child suffering from smallpox passed blood in the stool; the pustules were red and painful as if pierced by needles, or bleeding occurred within the sores. I considered this to be due to blazing liver fire. One dose of Xiaochaihu Tang with added Shengdihuang was administered, followed by Xijiao Dihuang Tang. The child recovered after one dose.
Another child with smallpox experienced bleeding and the lesions failed to erupt properly. My father attributed this to insufficiency of qi and blood. Zicao Kuiban Tang (Arnebia Rapid-Eruption Decoction) with added Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), Danggui, and Baizhu (Atractylodis Macrocephalae Rhizoma) was prescribed. The bleeding stopped immediately, and the lesions erupted promptly. The child was subsequently cured using Bazhen Tang (Eight-Treasure Decoction).
Another child with smallpox had bloody stools, dark red urine, and pustules resembling ochre in color. The child had a fever, desired cold drinks, and suffered from difficulty in urination and defecation. My father diagnosed this as excess heat in the Heart and Small Intestine. Bazheng San (Eight-Righteousness Powder) was used initially, followed by Jiedu Fangfeng Tang (Detoxifying and Saposhnikovia Decoction), and the child drank celery juice until recovery.
Another child with measles and smallpox passed blood in the stool and felt fatigued, desiring hot drinks when thirsty. I reasoned that fatigue with bloody stools indicated spleen qi deficiency with sinking; reduced food intake with thirst indicated exhaustion of body fluids. The child was cured using Wuyi Yigong San with added Zicao (Arnebiae Radix seu Rubrae).
Another child presented with bloody stools, abdominal distension, fatigue, low-grade fever, dry mouth desiring hot drinks, and cold extremities. My father diagnosed this as spleen qi deficiency and cold failing to control the blood. Wuyi Yigong San with added Dingxiang (Caryophylli Flos) and Ganjiang (Zingiberis Rhizoma) was prescribed. After two doses, the bleeding ceased, and the pustules crusted over and fell off.
Another child passed blood in the stool just as the smallpox was nearing resolution. The face was pale, the child feared cold, and there was a sensation of needing to defecate but inability to do so. I attributed this to deficiency of yuan qi (primordial qi) with sinking. Yi Qi Tang (Benefit Qi Decoction) was recommended. The family did not believe this and administered cooling-blood agents instead, resulting in vomiting, diarrhea, abdominal pain, and death.
Another child suffered from bloody stools as the smallpox was resolving. The face was pale, the child feared cold, both hands and feet were cold, and the pulse was deep, fine, and nearly imperceptible. I diagnosed this as yang qi deficiency and cold, intending to prescribe Renshen, Jiang (Ginger), and Gui (Cinnamon Twig). The family refused. The next day, the child died, with hands and feet turning blue-black. What a pity!
Jiedu Fangfeng Tang: Treats smallpox where toxic factors are blazing, causing bloody stools.
Ingredients: Fangfeng (Saposhnikoviae Radix), Digupi (Lycii Cortex), Huangqi (Astragali Radix), Jingjie (Schizonepetae Spica), Shaoyao (Paeoniae Radix Alba, stir-fried), Niubangzi (Arctii Fructus) in equal parts.
Usage: Take four qian per dose, decoct in water. Alternatively, grind into powder and take with warm water.
Zicao Kuiban Tang: Treats bloody stools in measles and smallpox, failure of lesions to erupt, slow eruption, and dull color. (This is Zicao Tang, see entry "Top Depression and Restlessness" for the formula.)
Shengji Xijiao Dihuang Tang: Treats internal accumulation of heat-toxin, restlessness and thirst, red face, black stools, or coma with bloody stools. (See entry "Top Depression and Restlessness" for the formula.)
Xiaochaihu Tang: Treats bloody stools caused by heat in the Liver channel failing to store blood. (See entry "Smallpox Body Pain" for the formula.)
Wuyi Yigong San: Treats bloody stools due to spleen and stomach qi deficiency failing to control blood. (See entry "Chills and Teeth Grinding" for the formula.)
Bazhen Tang: Treats bloody stools due to qi deficiency failing to grasp blood. (See entry "Top Depression and Ashen White" for the formula.)
Bazheng San: Treats heat in the Heart and Small Intestine, red urine, and bloody stools. (See entry "Smallpox Urinary Difficulty" for the formula.)
Qiwei Baizhu San (i.e., Ren Shen Baizhu San, see entry "Smallpox Fever" for the formula).