大要当先解散胃中风邪热毒。败毒散合芎归汤为必用之剂。初以黄连丸、槐花散；久则须
以调和胃气，正气散、理中汤亦所宜施。至谓寒冷骤用乌附，则亦妄也。
丹溪云∶风邪下陷者，盖风伤肝。肝主血故也，宜升提之。
凡下血之人，用凉药多而不愈者，必须加辛味。用辛味而不愈，可用温剂兼升提药，酒
浸酒炒。始然要去湿热为主；久而虚者，当行温散，如四物加升麻、炮干姜之属是也。
右尺脉洪数而疾为下血。
经曰∶阴结，便血一升，再结二升，三结三升；又结在五脏，则阴脉不和，阴脉不和则血
留之。结阴之病，阴气内结，不得外行，无所禀，渗入肠间，故便血也。
脉虚涩，非肠风脏毒也。为中虚，宜灸中脘，气海。
败毒散 治初下血。（方见瘟疫门。）
芎归汤总治诸血。
川芎 当归 上等分，水煎服。
地榆散 治肠风热证下血。
地榆 黄芩 茜根 栀子仁 茯苓 黄连（各等分）
上为粗未，每服三钱。韭白五寸，同煎，食远温服。
加灭四物汤 治肠风下血不止。
侧柏叶 生地黄 当归 川芎（各一钱） 枳壳 荆芥穗 槐花（炒） 甘草（各五分）
上水二盏，姜三片，乌梅（二枚），煎七分，空心服。
滑石散 治肠风下血。
滑石 当归 生地黄 黄芩 苍术 甘草（等分）
上水煎服。
（子和）黄连贯众散 治肠风下血，肠中疼痛。
黄连 贯众 大黄 鸡冠花 乌梅肉 枳壳 荆芥（各一两） 甘草（炙，七钱）
上为末，每服二钱，食前温米饮调下。
芍药黄连汤 治大便后下瘀血。腹痛为热毒。
芍药 黄连 当归（各四钱） 大黄（一钱） 官桂（一钱） 甘草（五分）
上作二服，每服水盏半，煎七分，空心温服。
槐角散 治肠胃不调，下血不止。
苍术 浓朴 陈皮 当归 枳壳（各一钱） 槐角（一钱） 乌梅（三个） 甘草（五分）
上水盏半，煎七分，食前服。
槐花散 治同前。
黄连 枳壳（各三分） 槐花（一两）
上以槐花炒二味药，去花不用。只将二味，水一盏半，煎七分，温心服。
香连丸 治一切肠风下血，酒热脏毒。（方见痢门。）
脏连丸 治远年近日肠风脏毒下血。
大鹰爪黄连（半斤） 槐花米（二两） 枳壳（一两） 防风 粉草 槐角 香附子
猪牙皂角 木香（各五钱）
上用陈熟仓米三合，同香附一处为末。以上药共为细末，用猪大肠约二尺长，水洗净，装入
香附、仓米，缚定口。量用水二大碗，沙锅炭火煮干，即添水，慢慢煮烂猪肠如泥。取起和药捣
如糊，再入黄连等末，同捣为丸，梧桐子大。每服空心米饮下八十丸。忌面、蒜、生冷煎炙
之物。一料病痊。
蒜连丸
独蒜（十枚） 黄连末（二两）
上先将蒜煨香熟，和连末杵捣烂匀为丸，梧桐子大。空心米汤下四十丸。
香槐散 治肠风。
香附子（炒） 槐花（炒。各一两） 枳壳 当归 川芎（五分） 甘草（三分）
上水一盏半，姜三片、枣一枚煎服。
槐角丸 治肠风泻血脱肛。
槐角（一两） 防风 地榆 当归 枳壳 木贼 茯神（各半两）
上为末，酒糊丸，梧桐子大。每服四十丸，米汤下。
黑圣散 治肠风、脏毒下血，痔漏等疾。
当归 川芎 茯苓 地榆 槐花 败棕（炮） 艾叶（烧，存性） 百草霜
上等分为末，每服二钱，食前米汤调下。
Generally, treatment should first focus on dispersing wind pathogens and heat toxins in the stomach. Baidu San (Dissolve Toxicity Powder) combined with Xionggui Tang (Ligusticum and Angelica Decoction) is an essential prescription. In the initial stage, Huanglian Wan (Coptis Pill) and Huaihua San (Sophora Flower Powder) are used; for chronic cases, it is necessary to harmonize Stomach Qi, so Zhengqi San (Regular Qi Powder) and Lizhong Tang (Regulate the Middle Decoction) are also appropriate. It is absurd to suddenly use Wutou (Aconite Root) and Fuzi (Prepared Aconite Root) for cold conditions.
Danxi stated: "Wind pathogens sinking downward" occur because wind damages the Liver. Since the Liver governs Blood, lifting and raising methods should be employed.
For patients with hematochezia who do not improve after prolonged use of cooling medicines, pungent-flavor herbs must be added. If adding pungent herbs does not work, warm agents combined with lifting herbs can be used, processed by wine soaking or wine frying. Initially, the primary approach should be to eliminate damp-heat; for chronic deficiency, warming and dispersing methods should be applied, such as Siwu Tang (Four Substances Decoction) plus Shengma (Cimicifugae Rhizoma) and Paoganjiang (Prepared Ginger).
A surging, rapid, and frequent pulse at the Right Chi position indicates hematochezia.
The Classics state: "Yin Knot" syndrome involves bleeding one sheng initially, two sheng upon recurrence, and three sheng upon further recurrence; if the knot affects the Five Zang organs, the Yin pulses become disharmonious. Disharmony of Yin pulses leads to blood stasis. The disease of Yin Knot involves internal accumulation of Yin Qi, which cannot circulate outward, lacks nourishment, and seeps into the intestines, causing hematochezia.
A deficient and choppy pulse indicates that this is neither Changfeng (Intestinal Wind) nor Zangdu (Visceral Toxin), but rather Spleen/Stomach deficiency. Moxibustion on Zhongwan (CV12) and Qihai (CV6) is indicated.
Baidu San (Dissolve Toxicity Powder): Treats initial hematochezia. (Formula see Plague Section.)
Xionggui Tang (Ligusticum and Angelica Decoction): Generally treats various hemorrhagic conditions.
Chuanxiong Rhizoma (Chuanxiong) and Danggui Radix (Angelicae Sinensis) in equal parts, decocted in water and taken orally.
Diyu San (Sanguisorba Powder): Treats hematochezia caused by Intestinal Wind Heat syndrome.
Sanguisorbae Radix (Diyu), Scutellariae Radix (Huangqin), Rubiae Radix et Rhizoma (Qiancao), Gardeniae Semen (Zhizi Ren), Poria (Fuling), Coptidis Rhizoma (Huanglian) in equal parts.
Grind into coarse powder. Take 3 qian per dose. Add 5 cun of Chinese Leek White (Jiu Bai), decoct together, and take warm shortly after meals.
Siwu Tang Plus (Modified Four Substances Decoction): Treats persistent hematochezia from Intestinal Wind.
Platycladi Cacumen (Cebaiye), Rehmanniae Radix Recens (Shengdihuang), Angelicae Sinensis Radix (Danggui), Chuanxiong Rhizoma (Chuanxiong) (each 1 qian), Aurantii Fructus Immaturus (Zhiqiao), Schizonepetae Spica (Jingjie Sui), Sophorae Flos (Huaihua, stir-fried), Glycyrrhizae Radix et Rhizoma (Gancao) (each 0.5 qian).
Add 2 liang of water, 3 slices of Zingiberis Rhizoma Recens (Shengjiang), and 2 Fructus Mume (Wumei). Decoct until 0.7 portion remains. Take on an empty stomach.
Huashi San (Talcum Powder): Treats Intestinal Wind hematochezia.
Talcum (Huashi), Angelicae Sinensis Radix (Danggui), Rehmanniae Radix Recens (Shengdihuang), Scutellariae Radix (Huangqin), Atractylodis Rhizoma (Cangzhu), Glycyrrhizae Radix et Rhizoma (Gancao) in equal parts.
Decoct in water and take orally.
(Hanzi's) Huanglian Guanzhong San (Coptis and Cyathula Powder): Treats Intestinal Wind hematochezia and abdominal pain.
Coptidis Rhizoma (Huanglian), Cyathulae Radix (Guanzhong), Rhei Radix et Rhizoma (Dahuang), Coronillae Flos (Jiguanhua), Fructus Mume Carnis (Wumei Rou), Aurantii Fructus Immaturus (Zhiqiao), Schizonepetae Spica (Jingjie) (each 1 liang), Glycyrrhizae Radix et Rhizoma (Zhi Gancao, honey-fried) (7 qian).
Grind into powder. Take 2 qian per dose before meals, mixed with warm rice drink.
Shaoyao Huanglian Tang (Peony and Coptis Decoction): Treats passage of dark blood after defecation. Abdominal pain due to heat toxin.
Paeoniae Radix Alba (Shaoyao), Coptidis Rhizoma (Huanglian), Angelicae Sinensis Radix (Danggui) (each 4 qian), Rhei Radix et Rhizoma (Dahuang) (1 qian), Cinnamomi Cortex (Guangui) (1 qian), Glycyrrhizae Radix et Rhizoma (Gancao) (0.5 qian).
Divide into two doses. For each dose, add 1.5 liang of water, decoct until 0.7 portion remains. Take warm on an empty stomach.
Huaijiao San (Sophora Pod Powder): Treats gastrointestinal disharmony and persistent hematochezia.
Atractylodis Rhizoma (Cangzhu), Magnoliae Officinalis Cortex (N Houpo), Citri Reticulatae Pericarpium (Chenpi), Angelicae Sinensis Radix (Danggui), Aurantii Fructus Immaturus (Zhiqiao) (each 1 qian), Sophorae Fructus (Huaijiao) (1 qian), Fructus Mume (Wumei) (3 pieces), Glycyrrhizae Radix et Rhizoma (Gancao) (0.5 qian).
Add 1.5 liang of water, decoct until 0.7 portion remains. Take before meals.
Huaihua San (Sophora Flower Powder): Treats the same condition as above.
Coptidis Rhizoma (Huanglian), Aurantii Fructus Immaturus (Zhiqiao) (each 0.3 fen), Sophorae Flos (Huaihua) (1 liang).
Stir-fry the Sophora Flower with the other two herbs, then discard the flowers. Use only the remaining two herbs, add 1.5 liang of water, decoct until 0.7 portion remains. Take warm.
Xianglian Wan (Costus and Coptis Pill): Treats all types of Intestinal Wind hematochezia and Damp-Heat Visceral Toxin from alcohol. (Formula see Dysentery Section.)
Zanglian Wan (Intestine-Connected Pill): Treats long-standing and recent Intestinal Wind and Visceral Toxin hematochezia.
Da Yingzhao Huanglian (Large Hawk-claw Coptis) (0.5 jin), Huaihua Mi (Sophora Seed) (2 liang), Aurantii Fructus Immaturus (Zhiqiao) (1 liang), Saposhnikoviae Radix (Fangfeng), Fencao (Powdered Licorice), Sophorae Fructus (Huaijiao), Cyperi Rhizoma (Xiangfu), Gleditsiae Sinensis Spina (Zhuya Zaojiao), Costi Radix (Muxiang) (each 5 qian).
Take 3 he of aged cooked millet rice, grind together with Cyperi Rhizoma into powder. Grind all other herbs into fine powder. Wash a pig large intestine about 2 chi long with water. Stuff the Cyperi Rhizoma and millet rice inside, tie the ends securely. Add 2 large bowls of water to a clay pot over charcoal fire. Boil until water evaporates, then add more water slowly until the intestine is cooked to a mushy consistency. Remove and mix with the herb powder, pounding into a paste. Add Coptis powder and pound again into pills the size of a paulownia seed. Take 80 pills on an empty stomach with rice drink. Avoid noodles, garlic, raw/cold foods, and fried/grilled items. One course of treatment cures the disease.
Suanlian Wan (Garlic and Coptis Pill)
Single Garlic Bulb (10 pieces), Coptidis Rhizoma Powder (Huanglian Mo) (2 liang).
Roast the garlic until fragrant and cooked. Mix with Coptis powder and pound into uniform pills, size of a paulownia seed. Take 40 pills on an empty stomach with rice soup.
Xianghuai San (Cyperi and Sophora Powder): Treats Intestinal Wind.
Cyperi Rhizoma (Xiangfu, stir-fried), Sophorae Flos (Huaihua, stir-fried) (each 1 liang), Aurantii Fructus Immaturus (Zhiqiao), Angelicae Sinensis Radix (Danggui), Chuanxiong Rhizoma (Chuanxiong) (0.5 qian), Glycyrrhizae Radix et Rhizoma (Gancao) (0.3 fen).
Add 1.5 liang of water, 3 slices of Zingiberis Rhizoma Recens (Shengjiang), and 1 Jujube (Zao). Decoct and take.
Huaijiao Wan (Sophora Pod Pill): Treats Intestinal Wind hemorrhage and rectal prolapse.
Sophorae Fructus (Huaijiao) (1 liang), Saposhnikoviae Radix (Fangfeng), Sanguisorbae Radix (Diyu), Angelicae Sinensis Radix (Danggui), Aurantii Fructus Immaturus (Zhiqiao), Equiseti Herba (Muzei), Poria (Fushen) (each 0.5 liang).
Grind into powder, bind with wine paste into pills the size of a paulownia seed. Take 40 pills with rice soup.
Heisheng San (Black Holy Powder): Treats Intestinal Wind and Visceral Toxin hematochezia, hemorrhoids, and fistulas.
Angelicae Sinensis Radix (Danggui), Chuanxiong Rhizoma (Chuanxiong), Poria (Fuling), Sanguisorbae Radix (Diyu), Sophorae Flos (Huaihua), Palmus Martini Folium Usturn (Baizhong, processed), Artemisiae Argyi Folium (Aiye, burned to retain properties), Cacospongia Nigra (Baicaoshuang) in equal parts.
Grind into powder. Take 2 qian per dose before meals, mixed with rice soup.