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Shi Wan stated: Although the syndrome of Jiaochang (Intestinal Cross-Connection) is recorded in medical texts, it is rarely seen in the world. The wife of a stone mason surnamed Zhan from Lushi Mountain, five or six days postpartum, had retained lochia. Her abdomen was distended and full, accompanied by wheezing and chest oppression. Upon inquiry into the cause, it was found that she had a strong preference for smoking and drinking alcohol in her daily life. The child she delivered was soft-bodied and lacked bones, which caused her great shock, leading to this syndrome. I prescribed Xiong Gui Tang (Cnidium and Angelica Decoction) added with Ezhu (Curcuma Zedoaria Rhizome), Rougui (Cinnamon Bark), and charred Shan Zha (Crataegus Fruit). After one dose, the lochia flowed freely, and urination and defecation returned to normal.

Another case involved the daughter of Lu Shengxiang, who was only four years old. In early autumn, she suffered from bloody dysentery, with loose stool discharging from the anterior yin (vulva/urethra). This was treated as a disorder of cold and heat imbalance combined with food stagnation. Wuling San (Five-Ingredient Poria Pill) was administered, along with Xianglian Wan (Coptis and Aucklandia Pill). She recovered after two doses.

Furthermore, the daughter of Qian Jifu, aged thirteen, was obese with abundant phlegm-dampness. Due to the shock of a burglary at her neighbor's house, she developed fever, headache, vomiting, and a bluish complexion. Her six pulses were wiry and rapid, and her urination and defecation were displaced. This was caused by chaotic qi due to fright and phlegm invading the orifices. Sizi Tang (Four-Gentleman Decoction variant for Qi Stagnation) was given to administer Mengshi Guntan Wan (Fluorite Rolling Phlegm Pill). By opening up the phlegm and qi, the condition stabilized.

Yu Jiayan stated: Jiang Yiren presented with a bizarre syndrome where both urine and feces discharged from the anterior yin. It was tentatively diagnosed as Jiaochang (Intestinal Cross-Connection). However, there are cases that appear similar but are fundamentally different. Jiaochang is an acute disease where qi becomes chaotic in the middle jiao suddenly. This case, however, is a chronic disease where blood gradually withers internally; they are completely distinct. Tracing the origin of the illness, it began with worry and thought damaging the Spleen. The Spleen failed to control the blood, causing it to descend like metrorrhagia or metrostaxis. At an age when menstruation had long ceased, this was actually a syndrome of Tuo Ying (Depletion of Essence/Blood). Tuo Ying requires vigorous tonification and urgent consolidation. Instead, it was treated using methods for metrorrhagia/metrostaxis, employing cooling blood and clearing fire, which resulted in even more blood loss. The blood of the Bao Men (Uterine Gate) and Zi Hu (Child Chamber) gradually perished. Eventually, blood from the Large Intestine circulated and seeped into the uterine sac. Over time, the blood in the Large Intestine was exhausted, and the qi of the Large Intestine, which usually accompanies blood, became isolated and leaderless, scattering chaotically. The Youmen (Pylorus) failed to separate clear from turbid, forcing its way into the path of bleeding, creating a channel resembling the anal passage. How could one use the formulas listed for Jiaochang, such as reusing Wuling San (Five-Ingredient Poria Pill) to open the water passages? Only when the old pathway of the Large Intestine is restored can order be re-established from chaos. Currently, the patient cries frequently, which is known as Zang Zao (Visceral Agitation), characterized by excessive weeping. The Large Intestine has become useless. When the jujube leaves sprout next spring, the Large Intestine qi will perish, and death will occur. This prediction proved accurate.

When I first studied medicine, there was a tailor in my village surnamed Jin, over twenty years old. On a rainy day, the road was slippery, and he fell on his buttocks. Initially, he felt no pain. The next day, his abdomen felt the urge to defecate, but gas passed from the penis. He felt the stool moving forward rather than backward, and the penis suffered unbearable pain. The stool was forced out thin as rice straw cores. My teacher, Mr. Jin Shangtao, used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). One dose cured him. Four or five days later, the illness recurred, and this decoction was ineffective. Urination did not mix with stool, nor did stool mix with urine. The urethral meatus gradually expanded due to dry, hard stool, causing indescribable pain. The Large Intestine had essentially ceased to function. At that time, renowned physicians in Wu Prefecture, such as Wang, Ye, and Xue, were present. We sought their help everywhere, but none could cure him. My teacher predicted he would die in March of the following year. When the time came, the patient was emaciated beyond belief, yet still able to eat and drink. The alternating discharge of urine and stool from the penis had become customary, and the pain had decreased, suggesting he might survive. Suddenly, one day, urination stopped completely, while defecation continued. After three days of urinary retention, urine gushed from the nostrils, black in color, and he died immediately. This seemed similar to the pathogenesis described in Yu's case. Recently, I treated a boatman whose roundworms exited from the penis. The worms were alive, with one emerging folded. The pain was unbearable. Five worms were expelled over three days. Subsequently, vaginal flatulence (Yin Chui) became very loud. I administered Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), and he recovered.