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Zhang Luyu treated the wife of a servant. Her menstruation had been closed for three months, with lower abdominal pain radiating to the heart and chest, accompanied by persistent Yin Chui (vaginal flatulence). After one dose of Shixiao San (Pain-Relieving Powder), a large amount of blood stasis was discharged, and the symptom ceased.

He also treated a noblewoman who, after a miscarriage, suffered from alternating chills and fever, abdominal pain, and Yin Chui (vaginal flatulence). Hawthorn charcoal was charred black and made into pills with brown sugar. Longgu Fulonggan (Dragon Bone and Dragon Liver Earth) was boiled in water, clarified, and used to decoct Dushen Tang (Single Ginseng Decoction) to deliver three qian of the pills. One dose resulted in the passage of large amounts of dry feces; upon further administration, blood stasis continued to discharge, leading to recovery. It was then realized that Zhigao Fa Jian (Pig Fat and Hair Decoction) was indeed established for expelling blood stasis.

[Appendix] A woman suffered from hard swelling of the external genitalia. Eight liang of Zhishi (Immature Bitter Orange) were crushed, stir-fried until hot, wrapped in old cloth, and applied as a hot compress to the affected area. The compress was replaced when it cooled.

Li Dongyuan treated a young woman with rectal prolapse. One spoonful of Nuomi (Glutinous Rice) was decocted strongly in water, strained, and drunk while warm. The anus was gently washed with the liquid. Then, a brick was heated red-hot, splashed with vinegar, and covered with a green cloth. The patient sat on the cloth with the prolapsed rectum exposed. If it felt too hot, more layers of cloth were added to thicken it. The rectum naturally retracted and healed.

[Appendix] A man suffered from a portion of the large intestine protruding over one cun. When dry, it would fall off spontaneously, only to protrude again immediately. This condition is called Jiechang Bing (Intestinal Truncation Disease). He sat in a vessel containing Sesame Oil (Zhima You) and drank several sheng of Dama Ren Juice (Cannabis Seed Juice), resulting in recovery.

Xue Lizhai treated Yu Shizheng, who had a history of hemorrhoids. Every time he exerted himself physically, he experienced rectal prolapse, swelling, pain, and oozing fluid. This was due to Sinking of Middle Qi (Spleen Qi Deficiency with sinking sensation). Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was modified with Fuling (Poria) and Shaoyao (Peony Root). After more than ten doses, he recovered.

Yu Zhen treated a man with rectal prolapse, swelling, pain, and oozing fluid. The Chi pulse (Kidney pulse) was surging and rapid. Chugen Baipi (Phellodendri Cortex), Chuanbai (Phellodendri Chinensis Cortex), Hezi Rou (Chebulae Fructus Retortae Pericarpium), Meishizi (Myrobalan Nut), and Bie Tou Hui (Ash of Turtle Head) were used, leading to recovery. The patient enjoyed alcohol and had a robust constitution, indicating Damp-Heat Pouring Downward, rather than Qi Deficiency with Sinking.

A postpartum woman developed hemorrhoids. The lesions had heads the size of a red bean, sometimes discharging fresh blood, sometimes purple blood, with pain during defecation. Heishen San (Black Divine Powder) was administered. Additionally, excessive meat consumption led to Damp-Heat accumulating in the Large Intestine. The prescription included: Yuliren (Pericarpium Pruni Armeniaci Semen Amarum, peeled), Mahuang Ren (Cannabis Seed), Huaijiao (Gleditsiae Sinensis Fructus) each 7 fen; Zhike (Aurantii Fructus Immaturus), Zaojiao Ren (Gleditsiae Sinensis Spina) each 5 qian; Cangzhu (Atractylodis Rhizoma), Guiwei (Angelicae Sinensis Radix Tail), Shengdi (Rehmanniae Radix) each 3 qian; Dahuang (Rhei Radix et Rhizoma), stir-fried, 1.6 qian. Decoct and take orally.

Yu Zhen commented: This formula, along with Jiuzhu Huanglian Wan (Wine-Boiled Coptis Pill) and Zanglian Wan (Viscera-Connected Pill), are standard methods for treating hemorrhoid pain and bleeding. Other remedies include burning dried persimmons to ash and taking them with water, which can be used in all seasons; or burning Baiye (Bamboo Leaf) to ash and taking it mixed. These are also good. Chan Hui of Daochang stated that moxibustion of seven moxa cones on the vertebra level with the umbilicus, or on both sides of the vertebral column one cun away for chronic cases, invariably cures the root cause. This method is worth trying. However, the case of the Luogu Post Station clerk, who washed hemorrhoids with strong willow branch decoction and then applied three to five moxa cones directly on the hemorrhoids, resulting in massive discharge of bloody foul matter, extreme pain, but eventual disappearance of hemorrhoids, is a method I dare not lightly attempt.

A friend of mine, surnamed Xu, first suffered from internal hemorrhoids, followed by external ones. The external ones swelled, pained, and discharged pus and blood; the internal ones caused severe distending pain. After defecation, the internal hemorrhoids would prolapse and needed to be pushed back, but were obstructed by the external ones. Waiting for them to retract caused extreme pain due to friction, making walking and sitting impossible, forcing him to lie on his side day and night. Internally, he took Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Huaihua (Flos Sophorae), etc. Externally, he applied Xiongdan (Ursi Fel), Bingpian (Borneolum Syntheticum), and Tianshui (Concha Meretrix) water, all without effect. Severe pain, profuse sweating, and exhaustion ensued. Taking even a small amount of Renshen (Ginseng Radix et Rhizoma) exacerbated the pain. Diagnosis revealed deep, large, and forceful pulses at the Right Guan (Spleen/Stomach) and Chi (Kidney) positions. Recalling a folk remedy using Qiaomai Mian (Buckwheat Flour) bound with Zhu Dan (Porcine Bile) into pills, he was instructed to take this regimen. After consuming bile from twenty pigs, both internal and external hemorrhoids disappeared.

Lu Shangshe suffered painful hemorrhoids in winter. The Right Cun pulse was floating and large; the Left Cun pulse was surging and rapid. Xue Lizhai said, "Winter presenting with Summer pulses indicates the need to strengthen the Water element to suppress Yang Fire." The patient considered this pedantic and took Huangqin and Huanglian formulas instead. Xue told his nephew, "Your uncle's Kidney Water fails to nourish Liver Wood; he will die in Spring." This proved accurate. Now, your uncle's Kidney Water fails to control Heart Fire; he will die in Summer. In the sixth month of Jiachen year, Xue examined him again. Phlegm-saliva surged upward, insomnia persisted day and night, the pulse was surging, large, and rapid but empty upon pressure, the Left Chi pulse was absent, and the feet, knees, shoulders, and arms were cold. Xue said, "The situation is critical." The patient requested only a few more days to see his heir. Treatment began with Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui (Angelicae Sinensis Radix), Paojiang (Zingiberis Rhizoma Preparatum), and Liuwei Wan material plus Rougui (Cinnamomi Cortex). He died that month. The principles of the Five Elements are indeed trustworthy.