（男妇同治）
脱肛属大肠气血虚而兼湿热。有久痢气血俱虚而脱者，有因肾虚而脱者，有中气虚而脱
者，有
、茯苓。兼痔而痛者，四物加槐花、黄连、升麻。久痢者，补中益气汤加酒炒芍药。中气虚
陷者，前汤加半夏、炮姜、茯苓、五味。肾虚者，六味丸。虚寒者，八味丸。肺与大肠为表
里，肛者大肠之门，肺实热则秘结，肺虚寒则脱出，肾主大便，故肾虚者多患此症。
治验
举人于时正，素有痔。每劳役便脱肛，肿痛出水，中气下陷也。用补中益气汤加茯苓、
芍药十余剂，中气复而即愈。后复脱作痛，误服大黄丸，腹鸣恶食几危。余用前汤，加炮姜、芍
药，诸症渐愈，后去姜，加熟地、五味，三十余剂而愈。
一男子脾胃素弱，或因劳倦，或因入房，肛门即下，肿闷痛甚。用补中益气汤加麦门、
五味，兼六味丸而愈。后因过饮，下坠肿痛，误用降火消毒，虚症蜂起。余用前汤加炮姜、木香
，一剂，再用前汤，并加减八味丸，两月而安。
一儒者面白神劳，素畏风寒，饮食喜热，稍多必吞酸作泻，吸气觉冷，便血盗汗。余以
为脾肾虚寒，用补中益气加炮姜、肉桂，五十余剂，八味丸斤许，诸症悉愈。
（男妇同治）
肾脏风属肾虚，风邪乘于 胫，以致皮肤如癣，或渐延上腿，久则延及遍身。外症则搔
痒成疮，脓水淋漓，眼目昏花；内症则口燥舌干，腰腿倦怠，吐痰发热，盗汗体疲。治法用六味
丸为主，佐以四生散。若脾胃虚弱者，用补中益气为主，佐以六味丸、四生散为善。
治验
钦天薛循斋，六十有一，两 患之，脓水淋漓，发热吐痰四年矣。此肾脏风症也，与六
味丸、四生散而瘥。年余复作，延及遍身，日晡益甚，痰渴盗汗，唇舌生疮，两目昏赤，皆肾经
虚
内败也。用前丸，及补中益气汤加麦门、五味而愈。
(To be treated for both men and women)
Prolapse of the rectum belongs to deficiency of Qi and Blood in the Large Intestine combined with Damp-Heat. There are cases where prolonged dysentery leads to deficiency of both Qi and Blood causing prolapse; cases caused by Kidney deficiency; cases caused by sinking of Middle Qi (Spleen Qi); and [text missing]... (based on context: cases caused by downward flow of Damp-Heat). When accompanied by hemorrhoids and pain, use Siwu Tang (Four Substances Decoction) plus Huaihua (Stamen Sophorae Flavescentis), Huanglian (Rhizoma Coptidis), and Shengma (Rhizoma Cimicifugae). For prolonged dysentery, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Shaoyao (Radix Paeoniae Alba) stir-fried with wine. For sinking of Middle Qi, add Banxia (Rhizoma Pinelliae), Paojiang (Prepared Ginger), Fuling (Poria), and Wuweizi (Fructus Schisandrae Chinensis) to the previous formula. For Kidney deficiency, use Liuwei Wan (Six-Ingredient Pill with Rehmannia). For deficiency-cold, use Bawei Wan (Eight-Ingredient Pill with Rehmannia). The Lung and Large Intestine are exterior-interior partners; the anus is the gate of the Large Intestine. Lung Excess-Heat causes constipation, while Lung Deficiency-Cold causes prolapse. The Kidneys govern defecation; therefore, those with Kidney deficiency often suffer from this condition.
Case Records
Yu Shizheng, a Juren (degree holder), had suffered from hemorrhoids for some time. Every time he exerted himself physically, his rectum would prolapse during defecation, accompanied by swelling, pain, and discharge of fluid. This was due to sinking of Middle Qi. I used Buzhong Yiqi Tang plus Fuling (Poria) and Shaoyao (Radix Paeoniae Alba). After more than ten doses, his Middle Qi recovered, and he was cured. Later, it prolapsed again with pain. He mistakenly took Dahuang Wan (Rhubarb Pill), leading to borborygmus (abdominal rumbling) and anorexia, nearly reaching a critical state. I used the previous formula again, adding Paojiang (Prepared Ginger) and Shaoyao (Radix Paeoniae Alba). His symptoms gradually improved. Later, I removed the ginger and added Shudi (Prepared Radix Rehmanniae) and Wuweizi (Fructus Schisandrae Chinensis). After more than thirty doses, he was cured.
A man whose Spleen and Stomach were inherently weak experienced anal prolapse, with severe swelling, distension, and pain, either after physical fatigue or sexual intercourse. He was cured using Buzhong Yiqi Tang plus Maimendong (Radix Ophiopogonis Japonici) and Wuweizi (Fructus Schisandrae Chinensis), along with Liuwei Wan (Six-Ingredient Pill with Rehmannia). Later, due to excessive drinking, he experienced downward dragging, swelling, and pain. Mistakenly treated with herbs that clear heat and detoxify, various deficiency symptoms arose. I used the previous formula plus Paojiang (Prepared Ginger) and Muxiang (Radix Aucklandiae). After one dose, followed by the previous formula and Jiajian Bawei Wan (Modified Eight-Ingredient Pill with Rehmannia), he stabilized over two months.
A scholar with a pale complexion and fatigued spirit, who feared wind and cold, preferred hot food, and suffered from acid regurgitation and diarrhea if he ate slightly too much. Inhaling air felt cold to him; he also had blood in the stool and night sweats. I diagnosed this as Spleen and Kidney Deficiency-Cold. I used Buzhong Yiqi Tang plus Paojiang (Prepared Ginger) and Rougui (Cortex Cinnamomi). After more than fifty doses, and taking approximately one jin (approx. 500g) of Bawei Wan (Eight-Ingredient Pill with Rehmannia), all symptoms disappeared.
(To be treated for both men and women)
Kidney Wind belongs to Kidney deficiency, where Wind pathogen invades the lower legs (shins), causing the skin to resemble tinea (ringworm), which may gradually spread up the thighs, and eventually cover the whole body. External symptoms include itching leading to sores, dripping pus and fluid, and blurred vision; internal symptoms include dry mouth and tongue, lassitude of the waist and legs, expectoration of phlegm, fever, night sweats, and physical fatigue. The treatment method uses Liuwei Wan (Six-Ingredient Pill with Rehmannia) as the main formula, assisted by Sisheng San (Four Generations Powder). If the Spleen and Stomach are weak, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) as the main formula, assisted by Liuwei Wan (Six-Ingredient Pill with Rehmannia) and Sisheng San (Four Generations Powder).
Case Records
Xue Xunzhai, an official at the Imperial Astronomical Bureau, aged sixty-one, suffered from this condition in both shins for four years, with dripping pus and fluid, fever, and expectoration of phlegm. This was a Kidney Wind syndrome. It was cured with Liuwei Wan (Six-Ingredient Pill with Rehmannia) and Sisheng San (Four Generations Powder). More than a year later, it recurred and spread to the whole body, worsening in the late afternoon. He had excessive phlegm, thirst, night sweats, sores on the lips and tongue, and red, blurred eyes. These were signs of deficiency and internal collapse of the Kidney Meridian. He was cured using the aforementioned pills, along with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Maimendong (Radix Ophiopogonis Japonici) and Wuweizi (Fructus Schisandrae Chinensis).