小儿大便下血，皆因恣食肥甘，致生内热，伤阴络也。若血色黯而浊，肛门肿痛，先血后粪者为近血，名曰
脏毒。若血鲜而清，腹中不痛，先粪后血者为远血，名曰肠风。故便血属脏毒者，肛门每多肿痛，初起古方主皂
刺大黄汤消之（如皂刺、生大黄、各等分）。量儿年岁大小虚实，酌其多少。水酒煎服。大下血后，热盛微痛者，
古法主槐花散和之（如炒槐花、侧柏叶、炒枳壳、川黄连、炒荆芥穗等味）。
脏毒加苍术、苦楝；肠风加秦艽、防风。湿盛不痛者，古法主平胃地榆汤和之（如炒苍术、陈皮、姜炒浓朴、
甘草、地榆，引用生姜）。
便血日久，脉微气血弱者，古法主升阳和血汤和之（如炙黄 、酒炒当归、炒白芍、牡丹皮、陈皮、肉桂、秦
艽、生地、熟地、生甘草、炙甘草、炒苍术、绿升麻等味）。
继以人参养荣汤补之（如人参、黄 、炒白术、茯苓、炒白芍、肉桂、熟地、酒洗当归、炒甘草、陈皮，引
用姜、枣）。
〔真按〕小儿粪前见血，此血自大肠来也。方用正雅连五分，川黄柏一钱，小条芩一钱，生甘草五分，引用
灯芯十茎。
粪后见血，此血从胃脘小肠来也。方用黑栀仁五分，大生地钱半，粉丹皮一钱，大归身五分，雅川连五分，
太子参八分，生于术六分。
久不止者，本方加西党参钱半，升麻三分。
Hematochezia in children is generally caused by indulging in rich and sweet foods, leading to the generation of internal heat and damage to the Yin collaterals (collaterals distributed deep within the zang organs). If the blood is dark and turbid, accompanied by anal swelling and pain, with bleeding occurring before defecation, it is called "proximal blood" and named Zangdu (Visceral Toxin). If the blood is bright red and clear, without abdominal pain, with bleeding occurring after defecation, it is called "distal wind" and named Changfeng (Intestinal Wind). Therefore, for hematochezia attributed to Zangdu, the anus often presents with swelling and pain. In the initial stage, ancient formulas advocate using Zaoci Dahuang Tang (Stinging Twig and Rhubarb Decoction) to dissipate it (e.g., Gleditsiae Spina [Zaocis Spina], Raw Rheum Rhizome [Rhei Radix et Rhizoma], equal parts). The dosage should be adjusted according to the child's age and the deficiency or excess of their constitution. It is decocted with water and wine and taken orally. After severe hemorrhage, if the heat is prominent but pain is slight, ancient methods advocate using Huaihua San (Sophora Flower Powder) to harmonize it (e.g., Fried Sophora Flower [Flos Sophorae], Fried Biota Top Leaf [Cacumen Biotae], Fried Aurantium Fructus Immaturus [Aurantii Fructus Immaturus], Coptis Rhizome [Coptidis Rhizoma], Fried Schizonepeta Spike [Schizonepetae Spica], etc.).
For Zangdu, add Atractylodes Rhizome [Atractylodis Rhizoma] and Melia Toosendan Fruit [Toosendan Fructus]; for Changfeng, add Gentian Macrophylla Root [Gentianae Macrophyllae Radix] and Saposhnikovia Root [Saposhnikoviae Radix]. If dampness is predominant and there is no pain, ancient methods advocate using Pingwei Diyue Tang (Pingwei and Sanguisorba Decoction) to harmonize it (e.g., Fried Atractylodes Rhizome [Atractylodis Rhizoma], Tangerine Peel [Citri Reticulatae Pericarpium], Ginger-processed Magnolia Bark [Magnoliae Officinalis Cortex], Licorice Root [Glycyrrhizae Radix et Rhizoma], Sanguisorba Root [Sanguisorbae Radix], with Fresh Ginger [Zingiberis Rhizoma Recens] as a guide).
For prolonged hematochezia with a faint pulse and deficiency of qi and blood, ancient methods advocate using Shengyang Hexue Tang (Ascending Yang and Harmonizing Blood Decoction) to harmonize it (e.g., Honey-fried Astragalus Root [Astragali Radix], Wine-processed Angelica Sinensis Root [Angelicae Sinensis Radix], Fried White Peony Root [Paeoniae Radix Alba], Moutan Bark [Moutan Cortex], Tangerine Peel [Citri Reticulatae Pericarpium], Cinnamon Twig [Cinnamomi Ramulus], Gentian Macrophylla Root [Gentianae Macrophyllae Radix], Rehmannia Root [Rehmanniae Radix], Prepared Rehmannia Root [Rehmanniae Radix Preparata], Raw Licorice Root [Glycyrrhizae Radix et Rhizoma], Honey-fried Licorice Root [Glycyrrhizae Radix et Rhizoma Praeparata], Fried Atractylodes Rhizome [Atractylodis Rhizoma], Green Cimicifuga Rhizome [Cimicifugae Rhizoma], etc.).
Subsequently, Renshen Yangrong Tang (Ginseng Nourishing Harmony Decoction) is used for tonification (e.g., Ginseng Root [Panacis Ginseng Radix], Astragalus Root [Astragali Radix], Fried Atractylodes Macrocephala Rhizome [Atractylodis Macrocephalae Rhizoma], Poria [Poria], Fried White Peony Root [Paeoniae Radix Alba], Cinnamon Twig [Cinnamomi Ramulus], Prepared Rehmannia Root [Rehmanniae Radix Preparata], Wine-washed Angelica Sinensis Root [Angelicae Sinensis Radix], Fried Licorice Root [Glycyrrhizae Radix et Rhizoma Praeparata], Tangerine Peel [Citri Reticulatae Pericarpium], with Fresh Ginger [Zingiberis Rhizoma Recens] and Jujube [Ziziphi Jujubae Fructus] as guides).
[True's Commentary]: When blood appears before stool in children, this blood originates from the Large Intestine. The formula uses Zheng Yalian (Coptis Rhizome [Coptidis Rhizoma]) 5 fen, Chuan Huangbai (Phellodendron Bark [Phellodendri Chinensis Cortex]) 1 qian, Xiao Tiaoqin (Scutellaria Baicalensis Root [Scutellariae Radix]) 1 qian, Raw Licorice Root [Glycyrrhizae Radix et Rhizoma] 5 fen, with 10 stalks of Centella Herb [Centellae Herba] as a guide.
When blood appears after stool, this blood comes from the Stomach Epigastrium and Small Intestine. The formula uses Black Gardenia Seed [Gardeniae Semen], Raw Rehmannia Root [Rehmanniae Radix] 1.5 liang, Powdered Moutan Bark [Moutan Cortex], Large Angelica Sinensis Root [Angelicae Sinensis Radix] 5 fen, Ya Chuanlian (Coptis Rhizome [Coptidis Rhizoma]) 5 fen, Pseudoginseng Root [Notoginseng Radix et Rhizoma] 8 fen, Sheng Baizhu (Atractylodes Macrocephala Rhizome [Atractylodis Macrocephalae Rhizoma]) 6 fen.
If it persists for a long time, add Xi Dangshen (Codonopsis Root [Codonopsis Radix]) 1.5 qian and Cimicifuga Rhizome [Cimicifugae Rhizoma] 3 fen to the original formula.