治
治悬痈，此疮生谷道、外肾之间，初发甚痒，状如松子，四十日赤肿如桃，治迟则破，而大小便皆从
此出，不可治矣。
方
国老汤 治悬痈
用横纹大甘草一两，截长三寸许，取出山涧东流水一碗，不用井水、河水，以甘草蘸水，文武火慢炙，
不可急性，须用三时久，水尽为度，劈视草中润透，却以无灰酒二碗，煮至一碗，温服，一
日一服，半月消尽为度。
将军散
大黄（煨） 贝母 白芷 甘草节
上为末，酒调空心服。虚弱。加当归一半。
脉
便血则芤，数则赤黄，实脉癃闭，热在膀胱。
病
夫肠 者，大便下血也。又谓肠风、脏毒是也。皆由饱食炙爆生冷酒色，并伤坐卧当风，荣卫气虚，风
斜冷气进袭脏腑，因热乘之，血渗肠间，肠风斜气入脏。脏毒是脏中积毒，风则散之，热则
清之，寒则温之，虚则补之，停滞则疏涤之。
治
肠风下血，必在粪前，是名近血。色清而鲜，其脉必浮，宜败毒散主之。脏毒下血，必在粪后，是名
远血。色黯而浊，其脉必沉滞，香连丸主之。脏寒下血无痛，脉沉微。经云∶阳虚阴必走，宜以姜、桂之类，
温则血归经也。积热下血，纯下鲜血，甚则兼痛，脉洪数，宜三黄丸主之，或败毒散加黄连。肠风者，邪气
外入，随感随见，所以其色清也；脏毒者，蕴积毒，久而始见，所以其色浊。治肠风，以散风行湿药；治
脏毒，以清湿凉血药。又要看其虚实、新久之不同，新者、实者宜降之，泻之；虚者、久者宜
升之，补之。故治法有所异也。
方
枳壳散 治大便下血。
枳壳（二两，炒） 黄连（一两） 槐花（五钱，炒） 地榆（五钱） 白芍（一两） 甘草（二钱半）
上锉五剂，水煎，空心服。
一方加当归、生地黄、防风（各五钱）
海上方 治肠风下血，痔漏，脱肛。
丝瓜根经霜一二次，收采洗净，夜露十余宿，悬当风处阴干，
每服三五钱，锉散，水煎热，去渣，滴香油如钱大，空心温服。忌鸡、烧酒，一日一服，即放。
干柿散 治肠风、脏毒、肠 神效。
干柿不拘多少，焙干，烧存性。每服二钱，米饮调下。
槐黄丸（周后峰传） 治肠风、脏毒、便血、痔漏，神效。
黄连（四两，酒炒） 槐花（四两，炒）
上为末，入猪大肠头长一尺，内扎住，用韭菜二斤，水同煮
烂，去菜用肠药，捣烂，丸如梧子大。如湿加神曲丸，每服八十丸，空心米汤下。
解毒四物汤（京师传）〔批〕（按此方治下血虚弱之剂） 治大便下血，不问粪前、粪后，肠风、脏毒等证。
当归（酒洗，八分） 川芎（五分） 白芍（炒，六分） 生地黄（一钱） 黄连（炒，
六分） 黄芩（炒，八分） 黄柏（炒，七分） 栀子（炒黑，七分） 地榆（八分） 槐花
（炒，五分） 阿胶珠（六分） 柏叶（炒，六分）
上水煎，空心服。腹胀，加陈皮六分。气虚，加人参三分，白术三分，木香三分。肠风，加荆芥五分。
气下陷，加升麻五分。心血不足，加茯苓六分。虚寒，加炒干姜五分。
Treatment
To treat Xuan Yong (Hanging Abscess), this ulcer occurs between the anus and the external genitalia. Initially, it is extremely itchy and resembles a pine nut. After forty days, it becomes red and swollen like a peach. If treatment is delayed, it will rupture, causing both urine and feces to discharge from this opening, rendering it incurable.
Formulas
Guolao Tang (Old Man Decoction) for treating Xuan Yong
Take one liang of large Licorice Root (Gancao, 甘草) with transverse wrinkles, cut into segments approximately three cun long. Prepare one bowl of running water from the east side of a mountain stream; do not use well water or river water. Dip the Licorice Root in the water and slowly roast it over alternating mild and strong heat. Do not rush; this process must take three shichen (six hours). Stop when the water is exhausted. Split the root to check if it is thoroughly moist inside. Then, add two bowls of pure wine (Wuhui Jiu, 无灰酒) and boil until only one bowl remains. Take warm. Administer once daily. Continue until the swelling subsides completely after half a month.
Jiangjun San (General Powder)
Rhubarb Rhizome (Dahuang, 大黄, baked) Fritillaria Bulb (Beimu, 贝母) Angelica Dahurica Root (Baizhi, 白芷) Licorice Root Tips (Gancao Jie, 甘草节)
Grind all ingredients into a fine powder. Mix with wine and take on an empty stomach. For patients with deficiency and weakness, add half the amount of Angelica Sinensis Root (Danggui, 当归).
Pulse Diagnosis
If blood appears in the stool, the pulse is Kou (Couping, 芤 - hollow); if rapid, the urine is red and yellow; if excess, there is urinary retention, indicating heat in the Bladder.
Disease
Chang Pi (Intestinal Dysentery/Bloody Stool) refers to bleeding from the rectum. It is also known as Chang Feng (Wind Intestine) and Zang Du (Visceral Toxin). These conditions arise from overeating, consuming roasted, fried, raw, or cold foods, excessive alcohol consumption, and sexual indulgence, combined with sitting or lying in drafts. This leads to deficiency of Ying (Nutrient) and Wei (Defensive) Qi. Wind pathogens invade obliquely, and cold qi attacks the Zang-Fu organs. Heat then exploits this vulnerability, causing blood to渗 (seep) into the intestines. Chang Feng refers to wind pathogens entering the viscera. Zang Du refers to accumulated toxins within the viscera. Treatment principles: disperse wind, clear heat, warm cold, tonify deficiency, and purge stagnation.
Treatment
Bleeding from Chang Feng typically appears before the stool, termed "Near Blood" (Jin Xue, 近血). The blood is clear and bright red, and the pulse is floating. Treat primarily with Baidu San (Detoxification Powder). Bleeding from Zang Du typically appears after the stool, termed "Far Blood" (Yuan Xue, 远血). The blood is dark and turbid, and the pulse is deep and sluggish. Treat primarily with Xianglian Wan (Coptis and Aucklandia Pill). Bleeding due to Cold in the Viscera presents without pain and a deep, faint pulse. The Classics state: "When Yang is deficient, Yin must wander." Use Ginger (Shengjiang, 生姜) and Cinnamon Twig (Guizhi, 桂枝) to warm the channels so that blood returns to its vessels. Bleeding due to Accumulated Heat presents as pure fresh blood, sometimes with severe pain, and a surging, rapid pulse. Treat primarily with Sanhuang Wan (Three Rhubarbs Pill) or Baidu San added with Coptis Rhizome (Huanglian, 黄连). Chang Feng involves external pathogenic factors appearing immediately upon exposure, hence the clear blood color; Zang Du involves accumulated toxins manifesting later, hence the turbid blood color. Treat Chang Feng with herbs that dispel wind and dry dampness; treat Zang Du with herbs that clear heat, dry dampness, and cool the blood. One must also distinguish between deficiency/excess and new/chronic conditions. New and excess conditions should be treated by descending and purging; deficiency and chronic conditions should be treated by ascending and tonifying. Thus, treatment methods vary.
Formulas
Zhiqiao San (Immature Bitter Orange Powder) for bloody stool.
Immature Bitter Orange (Zhiqiao, 枳壳, two liang, stir-fried) Coptis Rhizome (Huanglian, 黄连, one liang) Sophora Flower (Huaihua, 槐花, five qian, stir-fried) Sanguisorba Root (Diyu, 地榆, five qian) White Peony Root (Baishao, 白芍, one liang) Licorice Root (Gancao, 甘草, two qian half)
Cut into pieces for five doses. Decoct in water and take on an empty stomach.
Alternative prescription: Add Angelica Sinensis Root (Danggui, 当归), Rehmannia Root (Shengdihuang, 生地黄), and Saposhnikovia Root (Fangfeng, 防风) (five qian each).
Haishang Fang (Formula from the Sea Region) for Chang Feng bloody stool, hemorrhoids/fistula, and rectal prolapse.
Collect Silk Gourd Roots (Sigua Gen, 丝瓜根) after one or two frosts. Wash clean. Expose to night dew for more than ten nights. Hang in a ventilated area to dry in the shade.
Take three to five qian per dose. Cut into pieces, decoct in water until hot. Strain. Add sesame oil equivalent to the size of a coin. Take warm on an empty stomach. Avoid chicken and distilled spirits. Take once daily until cured.
Ganshi San (Dried Persimmon Powder) for Chang Feng, Zang Du, and Chang Pi. Efficacious.
Dried Persimmons (Ganshi, 干柿) as needed. Bake dry. Char until the medicinal property is preserved (Cunxing, 存性).
Take two qian per dose. Mix with rice drink and swallow.
Huaihuang Wan (Sophora and Coptis Pill) (Transmitted by Zhou Housheng) for Chang Feng, Zang Du, bloody stool, hemorrhoids/fistula. Efficacious.
Coptis Rhizome (Huanglian, 黄连, four liang, wine-fried) Sophora Flower (Huaihua, 槐花, four liang, stir-fried)
Grind into powder. Insert into a one-chi long pig large intestine segment, tying both ends. Boil with two jin of Chinese Chives (Jiucai, 韭菜) in water until soft. Remove the chives. Use only the intestine and medicine. Pound into a paste. Form pills the size of sophora seeds. If dampness is heavy, combine with Medicated Leaven (Shenqu, 神曲) pills. Take eighty pills per dose with rice gruel on an empty stomach.
Jiedu Siwu Tang (Detoxifying Four Substances Decoction) (Transmitted in the Capital) [Commentary: This formula treats bloody stool associated with deficiency.] For bloody stool regardless of whether it precedes or follows defecation, including Chang Feng and Zang Du syndromes.
Angelica Sinensis Root (Danggui, 当归, eight fen, wine-washed) Ligusticum Rhizome (Chuanxiong, 川芎, five fen) White Peony Root (Baishao, 六分, stir-fried) Prepared Rehmannia Root (Shengdihuang, 生地黄, one qian) Coptis Rhizome (Huanglian, 六分, stir-fried) Scutellaria Root (Huangqin, 黄芩, eight fen, stir-fried) Phellodendron Bark (Huangbai, 黄柏, seven fen, stir-fried) Gardenia Fruit (Zhizi, 栀子, seven fen, charred black) Sanguisorba Root (Diyu, 八分) Sophora Flower (Huaihua, 五 fen, stir-fried) Donkey-Hide Gelatin Beads (Ejiaozhu, 阿胶珠, six fen) Biota Leaf (Baiye, 柏叶, six fen, stir-fried)
Decoct in water and take on an empty stomach. For abdominal distension, add Tangerine Peel (Chenpi, 陈皮) six fen. For Qi deficiency, add Ginseng Root (Renshen, 人参) three fen, Atractylodes Macrocephala Rhizome (Baizhu, 白术) three fen, and Costus Root (Muxiang, 木香) three fen. For Chang Feng, add Schizonepeta Spike (Jingjie, 荆芥) five fen. For sinking of Qi, add Cimicifuga Rhizome (Shengma, 升麻) five fen. For insufficient Heart Blood, add Poria (Fuling, 茯苓) six fen. For deficiency-cold, add Dry Ginger (Ganjiang, 干姜) five fen, stir-fried.