毛 十二岁 癸亥十二月初二日 粪后便红，责之小肠寒湿，不与粪前为大肠热湿同科
，举世业医者，不知有此，无怪乎十数年不愈也，用古法黄土汤。
灶中黄土（二两） 生地黄（三钱） 制苍术（三钱） 熟附子（三钱） 阿胶（三钱） 黄芩（
二钱，炒） 炙甘草（三钱）
加酒炒白芍 全归（钱半）
水八碗，煮成三碗，分三次服。
初七日 小儿脉当数而反缓，粪后便血，前用黄土汤，业已见效，仍照前法加刚药，即
于前方内去白芍、全当归，加∶
附子（一钱） 苍术（二钱）
孙 男 三十八岁 戊寅七月初一日 湖州孝廉其人，素有便红之症，自十八岁起至今
不绝，现面色萎黄，失血太多，急宜用古法，有病则病受，虽暑月无碍也。
方法分两同前，服一帖即止，次日停后服，半月复发，再服一帖痊愈。
福 二十九岁 初因恣饮冰振黄酒，冰浸水果，又受外风，致成风水。头面与身，肿大
难状
，肿起自头，先与越婢汤发其汗，头面肿消，继与利小便，下截三消胀减，后与调理脾胃，
自上年十月间服药，至次年三月方止，共计汤一百四十三帖，其病始安，嘱其戒酒肉生冷。
不意夏月暑热甚时，仍恣吃冰冷水果，自八月后粪后大下狂血，每次有升数之多。余用黄土
汤去柔药，加刚药，每剂黄土用一斤，附子用六钱，或止复来。伊芳本人见其血之不止也，加
附子至八钱，或一两，他药接是，服至九十余帖，始大愈。
胡 三十岁 乙酉年九月十七日 本系酒客，湿中生热，久而发黄，颜色暗滞，六脉俱
弦，其来也渐，此非阳黄，况粪后见红，非又为小肠寒湿乎。
灶中黄土（八两，代水先煎） 熟附子（三钱） 茵陈（五钱） 苍术炭（三钱） 黄柏（三钱
，炒） 猪苓（三钱） 泽泻（三钱） 云茯苓（三钱）
煮三杯，分三次服，五帖全愈。
陈 三十五岁 乙酉四月二十一日 粪后便红，寒湿为病，误补误凉，胃口伤残，气从
溺管
而出，若女子阴吹之属瘕气者然。左胁肝部，卧不着席，得油腻则寒战发杂无伦，几于无处
下手。议治病必求其本，仍从寒湿论治，令能安食再商。与黄土汤中去柔药，加刚药。
川椒炭（三钱） 广陈皮（三钱） 生姜（二钱） 灶中黄土（四两） 云茯苓（五钱） 生茅术
（三钱） 香附（三钱） 熟附子（三钱） 益智仁（三钱）
煮三杯，分三次服，服三帖。
五月初二日，又服二帖。
初三日 心悸短气，加小枳实四钱，干姜二钱，已服四帖。
十一日 去川椒三钱，已服三帖。
二十一日 诸症皆效，大势未退，左脉紧甚，加熟附子一钱，降香末三钱，干姜一钱，
已服三帖。
二十七日 诸症向安，惟粪后便血又发，与黄土汤法，粪后便血，乃小肠寒湿，不与粪
前为大肠热湿同科。
灶中黄土（八两） 广皮炭（三钱） 熟附子（四钱） 益智仁（二钱） 黄芩炭（四钱） 云茯
苓（五钱） 苍术（四钱，炒）
煮三杯，分三次服，以血不来为度。
七月十四日 面色青黄滞暗，六脉弦细无阳，胃口不振，暂与和胃，其黄土汤，俟便红
发时再服。
姜半夏（六钱） 云苓块（五钱） 广陈皮（三钱） 生苡仁（五钱） 益智仁（三钱） 川椒炭
（一钱） 白蔻仁（一钱）
煮三杯，分三次服。
十七日 加桂枝（五钱）。
十一月十五日 肝郁挟痰饮，寒湿为病，前与黄土汤，治粪后便血之寒湿，兹便红已止
，继
与通补胃阳，现下饮食大进，诸症渐安，惟六脉细弦，右手有胃气，左手弦紧，痰多畏寒，
胁下仍有伏饮，与通补胃阳，兼逐痰饮。
桂枝（六钱） 小枳实（三钱） 川椒炭（三钱） 旋复花（三钱） 香附（四钱） 广皮（五钱）
炒白芍（三钱） 干姜（三钱） 云苓（五钱） 姜半夏（八钱）
煮三杯，分三次服。
十二月初十日 脉弦紧痰多畏寒，冲气上动，与桂枝茯苓甘草汤，合桂枝加桂汤法。
桂枝（一两） 茯苓块（二两，连皮） 炙甘草（五钱） 全当归（三钱） 川芎（二钱） 桂
（五钱，去粗皮）
服一帖，冲气已止，当服药后，吐顽痰二口。
十一日 冲气已止，六脉紧退，而弦未除，可将初十日方，再服半帖，以后再服二十九
日改定方，以不畏寒为度。
十三日 服十一月十五日疏肝药二帖。
十四初 背畏寒，脉仍弦紧，再服十二月初十日桂枝加桂汤二帖，以峻补冲阳，服药后
吐顽痰二口。
十七日 脉仍弦紧，背犹畏寒，阳未全复，照原方再服二帖，分四日服。
十九日 前之畏寒，至今虽减，而未痊愈，脉之弦紧，亦未冲和，冲气微有上动之象，
可取初十日桂枝加桂汤法，再服二帖，分四日，立春以后故也。
丙戌正月初五日 六脉俱弦，左脉更紧，粪后便红，小肠寒湿，黄土汤为主方，议黄土
汤去柔药，加淡渗通阳，虽自觉胸中热，背心如热水浇，所云热非热也，况又恶寒乎。
灶中黄土（八两） 生苡米（五钱） 云苓块（六钱） 熟附子（四钱） 苍术炭（四钱） 桂枝
（五钱） 黄芩炭（四钱） 广皮炭（四钱）
煮四碗，分四次服，血多则多服，万一血来甚涌，附子加至八钱，以血止为度，再发再
服，切勿听浅学人妄转一方也。
丸方
阳虚脉弦，素有寒湿痰饮，与蠲饮丸方，通阳渗湿而补脾阳。
桂枝（八两） 苍术炭（四两） 生苡仁（八两） 云苓块（八两） 干姜炭（四两） 炙甘草（
三两） 益智仁（四两） 半夏（八两） 广皮（六两）
神曲糊丸，小梧子大，每服三钱，日三服，忌生冷猪肉介属。
初十日 粪后便红虽止，寒湿未尽，脉之紧者亦减，当退刚药，背恶寒未罢，行湿之中
，兼与调和营卫。
苍术炭（三钱） 黄芩炭（钱半） 灶中黄土（一两） 焦白芍（四钱） 生苡仁（三钱）
煮三杯，分三次服，以背不恶寒为度，戒生冷介属猪肉。
Mao, aged 12. On the second day of the twelfth lunar month in the Guihai year. Hematochezia (blood in stool after defecation), attributed to Cold-Dampness of the Small Intestine, which is different from Damp-Heat of the Large Intestine seen in hematochezia before defecation. Physicians throughout the world are unaware of this distinction, no wonder the condition has persisted for over ten years. Treat with the ancient method of Huangtu Tang (Yellow Earth Decoction).
Prescription: Zaozhong Huangtu (Fired Hearth Soil, 2 liang), Sheng Dihuang (Fresh Rehmanniae Radix, 3 qian), Zhi Cangzhu (Prepared Atractylodis Rhizoma, 3 qian), Shu Fuzi (Prepared Aconiti Lateralis Radix, 3 qian), Ejiao (Donkey-hide Gelatin, 3 qian), Huangqin (Scutellariae Radix, 2 qian, stir-fried), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma, 3 qian).
Add Jiuchao Baishao (Wine-stir-fried Paeoniae Radix Alba) and Quan Danggui (Total Angelicae Sinensis Radix, 1.5 qian).
Use eight bowls of water, decoct into three bowls, divide into three doses.
On the seventh day: Children's pulse should be rapid but instead appears slow. Hematochezia after defecation; the previous use of Huangtu Tang has shown efficacy. Continue with the previous method, adding "Gang" (acrid-warm/drying) herbs. Remove Baishao and Danggui from the previous formula, add:
Fuzi (Aconiti Lateralis Radix Praeparata, 1 qian), Cangzhu (Atractylodis Rhizoma, 2 qian).
Sun, Male, aged 38. On the first day of the seventh lunar month in the Wuyin year. A Juren (Licentiate) from Huzhou, he has had a chronic history of hematochezia since age 18 without cessation. His complexion is sallow, and he has lost too much blood. It is urgent to use the ancient method. "When there is disease, the disease receives the treatment"; even if taken during the hot summer months, it will not cause harm.
The composition and dosage of the method are the same as before. One dose stops the bleeding immediately; stop subsequent doses the next day. After half a month, it recurs; take one more dose to recover.
Fu, aged 29. Initially, due to excessive consumption of iced yellow wine, iced fruits, and exposure to external Wind, he developed Fengshui syndrome (Wind-Water edema). The head, face, and body became severely swollen. The swelling started from the head. First, give Yebip Tang (Yarrow Diuretic Decoction) to induce sweating; the head and facial swelling subsided. Then, promote urination to reduce lower body swelling. Later, regulate the Spleen and Stomach. From October of the previous year to March of the next year, he took a total of 143 doses of decoction before the illness was resolved. He was advised to abstain from alcohol, meat, and raw/cold foods.
Unexpectedly, during the peak of summer heat, he continued to consume iced fruits excessively. After August, he experienced massive hematochezia after defecation, with each episode amounting to several sheng (a unit of volume). I used Huangtu Tang, removing "Rou" (soft/moistening) herbs and adding "Gang" (acrid-warm/drying) herbs. Each dose used one jin (approx. 500g) of Zaozhong Huangtu and 6 qian of Fuzi. Sometimes bleeding stopped but recurred. Seeing the persistent bleeding, the patient himself increased Fuzi to 8 qian or 1 liang, adjusting other herbs accordingly. After taking over 90 doses, he greatly recovered.
Hu, aged 30. On the seventeenth day of the ninth lunar month in the Yiyu year. He is a habitual drinker; Dampness generated Heat over time, leading to Jaundice. The color is dark and dull, all six pulses are wiry, and the onset was gradual. This is not Yang Jaundice. Moreover, seeing red after defecation indicates Small Intestine Cold-Dampness, does it not?
Prescription: Zaozhong Huangtu (Fired Hearth Soil, 8 liang, decocted first in water), Shu Fuzi (Prepared Aconiti Lateralis Radix, 3 qian), Yinchen (Artemisiae Scopariae Herba, 5 qian), Cangzhu Tan (Charred Atractylodis Rhizoma, 3 qian), Huangbai (Phellodendri Cortex, 3 qian, stir-fried), Zhuling (Polyporus, 3 qian), Zexie (Alismatis Rhizoma, 3 qian), Yun Fuling (Poria, 3 qian).
Decoct into three cups, divide into three doses. Cured in five doses.
Chen, aged 35. On the twenty-first day of the fourth lunar month in the Yiyu year. Hematochezia after defecation, caused by Cold-Dampness. Mistakenly treated with tonics and cooling herbs, damaging the Stomach appetite. Qi exits through the urethra, similar to Yin Chui (vaginal flatulence) associated with Jia Qi (mass qi) in women. Pain in the left hypochondrium Liver region prevents lying down; eating greasy food causes chaotic chills. It seems difficult to treat. We propose treating the root cause, continuing to treat based on Cold-Dampness, allowing him to eat comfortably before further discussion. Use Huangtu Tang, removing "Rou" herbs and adding "Gang" herbs.
Prescription: Chuanjiao Tan (Charred Zanthoxyli Pericarpium, 3 qian), Guang Chenpi (Charred Citri Reticulatae Pericarpium, 3 qian), Shengjiang (Fresh Zingiberis Rhizoma, 2 qian), Zaozhong Huangtu (Fired Hearth Soil, 4 liang), Yun Fuling (Poria, 5 qian), Sheng Maoshu (Raw Atractylodis Rhizoma, 3 qian), Xiangfu (Cyperii Rhizoma, 3 qian), Shu Fuzi (Prepared Aconiti Lateralis Radix, 3 qian), Yizhiren (Alpiniae Oxyphyllae Fructus, 3 qian).
Decoct into three cups, divide into three doses. Take three doses.
On the second day of the fifth lunar month, take two more doses.
On the third day: Palpitations and shortness of breath, add Xiao Zhishi (Immature Bitter Orange, 4 qian), Ganjiang (Dried Zingiberis Rhizoma, 2 qian). Total four doses taken.
On the eleventh day: Remove Chuanjiao (3 qian). Total three doses taken.
On the twenty-first day: All symptoms improved, but the major pattern persists. Left pulse is very tight. Add Shu Fuzi (1 qian), Jiangxiang Mo (Sappan Wood Powder, 3 qian), Ganjiang (1 qian). Total three doses taken.
On the twenty-seventh day: Symptoms tend towards stability, but hematochezia after defecation has recurred. Use Huangtu Tang method. Hematochezia after defecation is Small Intestine Cold-Dampness, distinct from Large Intestine Damp-Heat seen before defecation.
Prescription: Zaozhong Huangtu (Fired Hearth Soil, 8 liang), Guang Pi Tan (Charred Citri Reticulatae Pericarpium, 3 qian), Shu Fuzi (Prepared Aconiti Lateralis Radix, 4 qian), Yizhiren (Alpiniae Oxyphyllae Fructus, 2 qian), Huangqin Tan (Charred Scutellariae Radix, 4 qian), Yun Fuling (Poria, 5 qian), Cangzhu (Atractylodis Rhizoma, 4 qian, stir-fried).
Decoct into three cups, divide into three doses. Stop when bleeding ceases.
On the fourteenth day of the seventh lunar month: Complexion is cyan-yellow, dull and dark. Six pulses are wiry-thin without Yang. Appetite is poor. Temporarily harmonize the Stomach. Defer Huangtu Tang until hematochezia recurs.
Prescription: Jiang Banxia (Pinelliae Rhizoma Preparatum, 6 qian), Yun Lingkuai (Poria, 5 qian), Guang Chenpi (Citri Reticulatae Pericarpium, 3 qian), Sheng Yiren (Coicis Semen, 5 qian), Yizhiren (Alpiniae Oxyphyllae Fructus, 3 qian), Chuanjiao Tan (Charred Zanthoxyli Pericarpium, 1 qian), Baokou Ren (Amomi Fructus Rotundus, 1 qian).
Decoct into three cups, divide into three doses.
On the seventeenth day: Add Guizhi (Cinnamomi Ramulus, 5 qian).
On the fifteenth day of the eleventh lunar month: Liver Qi Stagnation with Phlegm-Fluid retention, Cold-Dampness pathogenesis. Previously used Huangtu Tang to treat Cold-Dampness causing hematochezia. Now that bleeding has stopped, continue to unblock and tonify Stomach Yang. Currently, dietary intake has increased significantly, symptoms are gradually stabilizing. However, six pulses are fine-wiry. Right hand shows Stomach Qi, left hand is wiry-tight. There is much phlegm, aversion to cold, and latent Fluids under the hypochondrium. Unblock and tonify Stomach Yang, while simultaneously expelling Phlegm-Fluids.
Prescription: Guizhi (Cinnamomi Ramulus, 6 qian), Xiao Zhishi (Immature Bitter Orange, 3 qian), Chuanjiao Tan (Charred Zanthoxyli Pericarpium, 3 qian), Xuanfuhua (Inulae Flos, 3 qian), Xiangfu (Cyperii Rhizoma, 4 qian), Guang Pi (Citri Reticulatae Pericarpium, 5 qian), Chao Baishao (Stir-fried Paeoniae Radix Alba, 3 qian), Ganjiang (Dried Zingiberis Rhizoma, 3 qian), Yun Ling (Poria, 5 qian), Jiang Banxia (Pinelliae Rhizoma Preparatum, 8 qian).
Decoct into three cups, divide into three doses.
On the tenth day of the twelfth lunar month: Pulse wiry-tight, much phlegm, aversion to cold. Chong Qi (Penetrating Vessel Qi) moving upward. Use Guizhi Fuling Gancao Tang (Cinnamon Twig, Poria, and Licorice Decoction), combined with the method of Guizhi Jia Gui Tang (Cinnamon Twig Decoction plus Cinnamon Twig).
Prescription: Guizhi (Cinnamomi Ramulus, 1 liang), Fuling Kuai (Poria Block, 2 liang, with skin), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma, 5 qian), Quan Danggui (Total Angelicae Sinensis Radix, 3 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma, 2 qian), Gui (Cinnamomi Ramulus, 5 qian, remove rough bark).
After one dose, Chong Qi movement ceased. After taking the medicine, expectorated two mouthfuls of stubborn phlegm.
On the eleventh day: Chong Qi movement has ceased. The tightness of the six pulses has retreated, but wiriness remains. Take half a dose of the prescription from the tenth day again. Subsequently, take the revised prescription from the twenty-ninth day, stopping when aversion to cold disappears.
On the thirteenth day: Took two doses of the Liver-soothing prescription from the fifteenth day of the eleventh lunar month.
On the fourteenth day: Aversion to cold in the back, pulse still wiry-tight. Take two more doses of Guizhi Jia Gui Tang from the tenth day of the twelfth lunar month to vigorously tonify Chong Yang. Expectorated two mouthfuls of stubborn phlegm after taking the medicine.
On the seventeenth day: Pulse still wiry-tight, back still feels cold. Yang has not fully recovered. Continue with the original prescription for two more doses, divided over four days.
On the nineteenth day: Although the previous aversion to cold has decreased, it is not fully cured. The wiry-tight pulse has not yet become harmonious. Chong Qi shows slight upward movement. Use the method of Guizhi Jia Gui Tang from the tenth day, take two more doses, divided over four days, due to being after Li Chun (Start of Spring).
On the fifth day of the first lunar month in the Bingxu year: All six pulses are wiry, left pulse is tighter. Hematochezia after defecation, Small Intestine Cold-Dampness. Huangtu Tang is the main formula. Propose Huangtu Tang removing "Rou" (moistening) herbs, adding mild diuretic and Yang-unblocking herbs. Although he feels heat in the chest and his back feels like being poured with hot water, this claimed heat is not true heat, especially given the aversion to cold.
Prescription: Zaozhong Huangtu (Fired Hearth Soil, 8 liang), Sheng Yimi (Coicis Semen, 5 qian), Yun Lingkuai (Poria, 6 qian), Shu Fuzi (Prepared Aconiti Lateralis Radix, 4 qian), Cangzhu Tan (Charred Atractylodis Rhizoma, 4 qian), Guizhi (Cinnamomi Ramulus, 5 qian), Huangqin Tan (Charred Scutellariae Radix, 4 qian), Guang Pi Tan (Charred Citri Reticulatae Pericarpium, 4 qian).
Decoct into four bowls, divide into four doses. If bleeding is heavy, take more. If bleeding is extremely profuse, increase Fuzi to 8 qian. Stop when bleeding ceases. If it recurs, take again. Do not listen to superficial scholars who might arbitrarily change the formula.
Pill Formula:
Yang Deficiency with wiry pulse, chronic Cold-Dampness and Phlegm-Fluid retention. Use Juan Yin Wan (Eliminate Fluid Pill Formula) to unblock Yang, leach out Dampness, and tonify Spleen Yang.
Prescription: Guizhi (Cinnamomi Ramulus, 8 liang), Cangzhu Tan (Charred Atractylodis Rhizoma, 4 liang), Sheng Yiren (Coicis Semen, 8 liang), Yun Lingkuai (Poria, 8 liang), Ganjiang Tan (Charred Dried Zingiberis Rhizoma, 4 liang), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma, 3 liang), Yizhiren (Alpiniae Oxyphyllae Fructus, 4 liang), Banxia (Pinelliae Rhizoma, 8 liang), Guang Pi (Citri Reticulatae Pericarpium, 6 liang).
Make pills with Shenqu paste (Medicated Leaven Paste), size of small wu zi (Chinese bayberry seeds). Take 3 qian per dose, three times daily. Avoid raw/cold foods, pork, and shellfish.
On the tenth day: Hematochezia after defecation has stopped, but Cold-Dampness is not fully resolved. The tightness of the pulse has also decreased. Retract "Gang" (acrid-warm) herbs. Aversion to cold in the back has not ceased. While resolving Dampness, also harmonize Ying and Wei (Nutritive and Defensive levels).
Prescription: Cangzhu Tan (Charred Atractylodis Rhizoma, 3 qian), Huangqin Tan (Charred Scutellariae Radix, 1.5 qian), Zaozhong Huangtu (Fired Hearth Soil, 1 liang), Jiao Baishao (Charred Paeoniae Radix Alba, 4 qian), Sheng Yiren (Coicis Semen, 3 qian).
Decoct into three cups, divide into three doses. Stop when back is no longer cold. Avoid raw/cold foods, shellfish, and pork.