一论先恶心。而后呕出成升成碗者。由怒气逆甚所致。治方用
当归（三钱） 川芎（一钱五分） 芍药（三钱） 生地黄（四钱） 炒山栀（三钱）
上锉。水煎。临服。入童便一盏。姜汁少许同服。
一论呕血。脉大发热。喉中痛者。此是气虚。用
黄 （二钱） 人参（二钱） 黄柏（一钱五分） 生地黄（三钱） 荆芥（一钱） 当归（二钱）
上锉一剂。水煎服。
一论怒气逆甚而呕血。宜
栝蒌仁（三钱） 当归（二钱） 生地黄（四钱） 桔梗（八分） 通草（一钱五分） 牡丹皮（
三钱）
上锉一剂。水煎服。
一论唾血者。出于肾。鲜血随唾而出也。
麦门冬 天门冬 知母 贝母 黄柏 桔梗 熟地黄 玄参 远志（各等分） 干姜（炒
减半）
上锉。水煎服。
一论下血者。大便出血也。乃脏腑蕴积湿热之毒而成。或因气郁。酒色过度。及多食炙
爆热
毒之物。或风邪之冒。或七情六淫所伤。使气血逆乱。荣卫失度。皆能令人下血。此方治大
便下血。不问粪前粪后。并肠风下血皆治。
解毒四物汤
当归（酒洗五分） 川芎（五分） 白芍（炒六分） 生地黄（一钱） 黄连（炒一钱）
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（炒六分） 侧柏
叶（六分）
上锉一剂。水煎服。腹胀。加陈皮六分。气虚。加人参三分。白术三分。木香三分。肠
风下
血。加荆芥五分。气下陷。加升麻五分。心血不足。加茯苓六分。虚寒。加炒黑干姜五分。
一方。去阿胶。加苦参七分。
一论大便下血。去多心虚。四肢无力。面色痿黄。宜
滋阴脏连丸
怀生地黄 怀熟地黄（各用四两） 山茱萸（酒蒸去核） 牡丹皮 白茯苓（去皮各二两）
川黄连（酒炒） 泽泻（三两） 山药（四两） 槐花（拌蒸） 大黄（酒蒸九次极黑各用三两）
上为细末。装入雄猪大肠头内。两头扎住。糯米三升。水浸透米。去水。将药肠藏糯米
甑内。蒸一炷香时为度。捣药肠为丸。如梧桐子大。每服八十丸。空心。盐汤下。
一虚人大便下血。用补中益气汤。（方见内伤）加炒阿胶、酒炒椿根皮、地榆、槐花。
一下血。服脏连丸等药。其血愈多。形体消瘦。发热少食。里急后重。此脾气下陷。以
补中益气汤。加炒黑干姜。立止。
一论肠风下血者。必在粪前。是名近血。色清而鲜。其脉又浮。宜人参败毒散。（方
见感冒）根据本方加黄连。
柏叶汤 治肠风下血。
侧柏叶 当归 生地黄 黄连 枳壳（麸炒） 槐花 地榆 荆芥 川芎（各等分）
甘草（减半）
上锉一剂。乌梅一个。生姜切片。水煎。空心服。
槐角丸 治肠风下血。不问粪前粪后。远年近日。皆效。
槐角子（一两） 枳壳（麸炒） 黄芩（酒炒） 地榆 荆芥 黄连 侧柏叶（酒浸各五钱）
黄柏（酒浸） 防风 归尾（酒洗各四钱）
上为细末。酒糊为丸。如梧桐子大。每服五七十丸。空心米汤送下。忌生冷烧酒蒜毒等
物。戒房事。
一论脏毒下血。必在粪后。是名远血。宜
八宝汤
黄连 黄芩 黄柏 栀子 连翘 槐花（各一钱五分） 细辛 甘草（各四分）
上锉一剂。水煎。空心服。
一论大便下血。大肠痛不可忍。肛门肿起。此下焦热毒盛也。宜
加味解毒汤
大黄 黄连 黄芩 黄柏 栀子 赤芍 连翘 枳壳（麸炒） 防风 甘草
上锉。水煎。空心服。
一治肠胃闭闷。下血。积热脏毒。
黄连（四两炒） 枳壳（去穣炒四两）
上为细末。水糊为丸。如梧桐子大。每服七十丸。清茶下。
一论肠风脏毒便血。痔痛下血。宜
槐黄丸
槐花（四两） 黄连（酒炒四两）
上为细末。入猪大肠内。两头扎住。入韭菜二斤。水同煮烂。去菜。用药肠捣烂。为丸
如栀子大。如湿加些面。每服八十丸。空心米汤送下。
一论大便下血。久不止者。此脏腑虚寒故也。面色痿黄。身体瘦弱。宜
断红丸
鹿茸（去毛醋煮） 大附子（炮去皮脐） 当归（酒洗） 续断（酒浸） 黄 （炒） 阿胶（蛤
粉炒） 侧柏叶（炒各一两） 白矾（枯五钱）
上为细末。醋煮米糊为丸。如梧桐子大。每服七十丸。空心。米汤下。
丹溪云。下血久不愈者。后用温剂。先用四物汤加炮姜、附子、升麻。后服断红丸收效
一论肠风下血。热者其血鲜。寒者其血青黑或成块。
一儒者素勤苦。因饮食失节。大便下血。或赤或黯。半载之后。非便血则盗汗。非恶
寒则
发热。血汗二药。用之无效。六脉浮大。心脾则涩。此思伤心脾。不能摄血归源。然而即汗
汗即血。其色赤黯。便血盗汗。由火之升降微甚。恶寒发热。气血俱虚也。在午前。用补
中益气汤。以补肺脾之源。举下陷之气。午后。用归脾加麦冬、五味。以补心脾之血。收耗
散之液。不两月。诸症悉愈。
一人素善饮酒。不时便血。或在粪前。或在粪后。食少体倦。面色痿黄。此脾气虚而不
能统血。以益气汤加茱萸、黄连。
一男子便血。精滑发热。一男子便血发热。一男子发热遗精。或小便不禁。俱是脾肾亏
损。用六味地黄丸、益气汤。以滋化源。并皆全愈。
一论下血。服犀角地黄汤等药。其血愈多。形体消瘦。发热少食。里急后重。此脾气下
陷。以益气汤加炮姜。立收效。
一治大便下血。用石莲肉四两。去壳捶碎。入公猪肚内。水煮烂。去莲肉。将肚并汤食
之立止。
一治大便下血秘方。
观音救苦方 马伏所传。
木香（四两） 黄连（二两）
上将黄连切片煎汁。浸木香。慢火焙干。为末。乌梅肉捣为丸。如梧桐子大。每服六十
丸。空心。滚汤送下。
一患肠风下血者。何也。人肠皆有脂裹之。浓则肠胃以安。肠中本无血。血缘有风或有
热以
消其脂。肠遂薄。渗入身中血。初患时。必服凉药而愈。服之过者。则肠寒而脂愈不生。其
血必再作。凡热者。其血鲜。冷者。其血青黑察其冷热用药可也。冷者。用断红丸。热者。
用四物汤合黄连解毒汤。加苦参、槐角、地榆、侧柏叶。
一肠胃流热。则粪门暴肿。用蜗牛细研。涂之则消。
一治脏毒下血。用黄连解毒汤合四物汤。和调为末。滴水为丸。每服八九十丸。空心。
陈米饮下。
补中益气汤（方见内伤） 归脾汤（方见健忘） 六味丸（方见补益）
First discussion: Feeling nausea first, followed by vomiting blood in amounts of a sheng or a bowl. This is caused by severe reversal of anger qi. The treatment formula uses Danggui (Angelicae Sinensis Radix) (3 qian), Chuanxiong (Chuanxiong Rhizoma) (1.5 qian), Shaoyao (Paeoniae Radix) (3 qian), Shengdihuang (Rehmanniae Radix) (4 qian), and Chao Shanzhi (Gardeniae Fructus, stir-fried) (3 qian). The above herbs are cut into pieces, decocted in water. Before taking the medicine, add one zhan of Tongbian (Child's Urine) and a small amount of Jiangzhi (Ginger Juice) to take together.
Second discussion: Vomiting blood with a large pulse, fever, and throat pain. This indicates Qi deficiency. Use Huangqi (Astragali Radix) (2 qian), Renshen (Ginseng Radix et Rhizoma) (2 qian), Huangbai (Phellodendri Cortex) (1.5 qian), Shengdihuang (Rehmanniae Radix) (3 qian), Jingjie (Schizonepetae Spica) (1 qian), and Danggui (Angelicae Sinensis Radix) (2 qian). Cut the above herbs into one dose, decoct in water, and take orally.
Third discussion: For vomiting blood caused by severe reversal of anger qi, it is suitable to use Gualouren (Trichosanthis Semen) (3 qian), Danggui (Angelicae Sinensis Radix) (2 qian), Shengdihuang (Rehmanniae Radix) (4 qian), Jiegeng (Platycodonis Radix) (0.8 fen), Tongcao (Tetrapanacis Medulla) (1.5 fen), and Mudanpi (Moutan Cortex) (3 qian). Cut the above herbs into one dose, decoct in water, and take orally.
Fourth discussion: Spitting blood originates from the Kidney, where fresh blood comes out with saliva. Use Maimendong (Ophiopogonis Radix), Tianmendong (Asparagi Radix), Zhimu (Anemarrhenae Rhizoma), Beimu (Fritillariae Bulbus), Huangbai (Phellodendri Cortex), Jiegeng (Platycodonis Radix), Shudihuang (Prepared Rehmanniae Radix), Xuanshen (Scrophulariae Radix), Yuanzhi (Polygalae Radix) (all in equal parts), and Ganjiang (Zingiberis Rhizoma, stir-fried, halved). Cut the above herbs, decoct in water, and take orally.
Fifth discussion: Lower bleeding refers to hematochezia (blood in stool). It is formed by the accumulation of damp-heat toxin in the Zang-Fu organs. It may be due to Qi stagnation, excessive drinking and sexual activity, frequent consumption of roasted, fried, and heat-toxic foods, invasion by wind pathogens, or injury by the Seven Emotions and Six Exogenous Pathogens, causing chaotic Qi and Blood, and imbalanced Ying and Wei. All can cause lower bleeding. This formula treats hematochezia, regardless of whether the blood appears before or after stool, and also treats Changfeng Xiaxue (Wind-intestinal bleeding).
Jiedu Siwu Tang (Detoxifying Four Substances Decoction)
Danggui (Angelicae Sinensis Radix, wine-washed) (0.5 fen), Chuanxiong (Chuanxiong Rhizoma) (0.5 fen), Baishao (Paeoniae Radix Alba, stir-fried) (0.6 fen), Shengdihuang (Rehmanniae Radix) (1 qian), Huanglian (Coptidis Rhizoma, stir-fried) (1 qian), Huangqin (Scutellariae Radix, stir-fried) (0.8 fen), Huangbai (Phellodendri Cortex, stir-fried) (0.7 fen), Zhizi (Gardeniae Fructus, stir-fried until black) (0.7 fen), Diyü (Sanguisorbae Radix) (0.8 fen), Huaihua (Sophorae Flos, stir-fried) (0.5 fen), Ejiao (Colla Corii Asini, stir-fried) (0.6 fen), Cebeiyè (Platycladi Cacumen) (0.6 fen). Cut the above herbs into one dose, decoct in water, and take orally. If there is abdominal distension, add Chenpi (Citri Reticulatae Pericarpium) 0.6 fen; if Qi deficient, add Renshen (Ginseng Radix et Rhizoma) 0.3 fen, Baizhu (Atractylodis Macrocephalae Rhizoma) 0.3 fen, and Muxiang (Aucklandiae Radix) 0.3 fen; if Changfeng Xiaxue (Wind-intestinal bleeding), add Jingjie (Schizonepetae Spica) 0.5 fen; if Qi sinking, add Shengma (Cimicifugae Rhizoma) 0.5 fen; if Heart Blood insufficient, add Fuling (Poria) 0.6 fen; if deficiency-cold, add Chao Hei Ganjiang (Zingiberis Rhizoma, stir-fried until black) 0.5 fen. Another prescription removes Ejiao and adds Kushen (Sophorae Flavescentis Radix) 0.7 fen.
Sixth discussion: For hematochezia accompanied by palpitations, restlessness, weakness in the four limbs, and sallow complexion, Ziyang Zanglian Wan (Nourishing Yin Intestine-Lining Pill) is suitable. Huaishengdihuang (Rehmanniae Radix, from Huaiqing) and Huaishudihuang (Prepared Rehmanniae Radix, from Huaiqing) (each 4 liang), Shanzhuyu (Corni Fructus, steamed in wine, pitted), Mudanpi (Moutan Cortex), Bai Fuling (Poria, peeled) (each 2 liang), Chuan Huanglian (Coptidis Rhizoma, stir-fried in wine), Zexie (Alismatis Rhizoma) (3 liang), Shanyao (Dioscoreae Rhizoma) (4 liang), Huaihua (Sophorae Flos, mixed and steamed), Dahuang (Rhei Radix et Rhizoma, steamed in wine nine times until very black) (each 3 liang). Grind into fine powder, pack into the head of a male pig's large intestine, tie both ends tightly. Take 3 sheng of glutinous rice, soak thoroughly in water, drain the water, place the herb-filled intestine in a steamer with the glutinous rice, steam for the time it takes to burn one incense stick. Mash the intestine and herbs into pills, size of Sophora seeds. Take 80 pills per dose, on an empty stomach, with salt water.
Seventh: For deficiency-type hematochezia, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). (Formula see Internal Injury chapter) Add Chao Ejiao (Stir-fried Colla Corii Asini), Jiuchao Chun Genpi (Wine-stir-fried Toosendan Cortex), Diyü (Sanguisorbae Radix), and Huaihua (Sophorae Flos).
Eighth: For lower bleeding, after taking Zanglian Wan and other medicines, the bleeding increases, body emaciates, fever occurs, appetite decreases, and tenesmus is present. This is Spleen Qi sinking. Use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Chao Hei Ganjiang (Stir-fried Black Ginger Rhizome) for immediate effect.
Ninth discussion: Changfeng Xiaxue (Wind-intestinal bleeding) must occur before stool, named Jin Xue (Near Bleeding). The color is clear and bright red, and the pulse is floating. Ren Shen Bai Du San (Ginseng Detoxifying Powder) is suitable. (Formula see Cold Damage chapter) Add Huanglian (Coptidis Rhizoma) to this formula.
Baiye Tang (Platycladus Leaf Decoction) Treats Changfeng Xiaxue (Wind-intestinal bleeding).
Cebeiyè (Platycladi Cacumen), Danggui (Angelicae Sinensis Radix), Shengdihuang (Rehmanniae Radix), Huanglian (Coptidis Rhizoma), Zhike (Aurantii Fructus Immaturus, bran-fried), Huaihua (Sophorae Flos), Diyü (Sanguisorbae Radix), Jingjie (Schizonepetae Spica), Chuanxiong (Chuanxiong Rhizoma) (all equal parts), Gancao (Licorice Root, halved). Cut the above herbs into one dose, add one Wumei (Mume Fructus), slice fresh ginger, decoct in water, take on an empty stomach.
Tenth: Huaijiao Wan (Sophora Fruit Pill) Treats Changfeng Xiaxue (Wind-intestinal bleeding), effective regardless of whether blood appears before or after stool, for long-standing or recent cases.
Huaijiao Zi (Sophorae Fructus) (1 liang), Zhike (Aurantii Fructus Immaturus, bran-fried), Huangqin (Scutellariae Radix, wine-stir-fried), Diyü (Sanguisorbae Radix), Jingjie (Schizonepetae Spica), Huanglian (Coptidis Rhizoma), Cebeiyè (Platycladi Cacumen, wine-soaked) (each 5 qian), Huangbai (Phellodendri Cortex, wine-soaked), Fangfeng (Saposhnikoviae Radix), Guiwei (Angelicae Sinensis Radix Tail, wine-washed) (each 4 qian). Grind into fine powder, make pills with wine paste, size of Sophora seeds. Take 50-70 pills per dose, on an empty stomach, with rice water. Avoid raw/cold foods, distilled liquor, garlic, and toxic substances. Abstain from sexual intercourse.
Eleventh discussion: Zangdu Xiaxue (Visceral Toxic Lower Bleeding) must occur after stool, named Yuan Xue (Far Bleeding). Babao Tang (Eight Treasures Decoction) is suitable.
Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex), Zhizi (Gardeniae Fructus), Lianqiao (Forsythiae Fructus), Huaihua (Sophorae Flos) (each 1.5 qian), Xixin (Asari Radix et Rhizoma), Gancao (Licorice Root) (each 0.4 fen). Cut the above herbs into one dose, decoct in water, take on an empty stomach.
Twelfth discussion: Hematochezia with unbearable large intestine pain and anal swelling indicates excess heat-toxin in the Lower Jiao. Jiawei Jiedu Tang (Modified Detoxifying Decoction) is suitable.
Dahuang (Rhei Radix et Rhizoma), Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex), Zhizi (Gardeniae Fructus), Chishao (Paeoniae Radix Rubra), Lianqiao (Forsythiae Fructus), Zhike (Aurantii Fructus Immaturus, bran-fried), Fangfeng (Saposhnikoviae Radix), Gancao (Licorice Root). Cut the above herbs, decoct in water, take on an empty stomach.
Thirteenth: Treats intestinal and gastric obstruction/stuffiness, lower bleeding, accumulated heat, and Zangdu.
Huanglian (Coptidis Rhizoma, stir-fried 4 liang), Zhike (Aurantii Fructus Immaturus, pulp removed, stir-fried 4 liang). Grind into fine powder, make pills with water paste, size of Sophora seeds. Take 70 pills per dose, with clear tea.
Fourteenth discussion: For Changfeng Zangdu Bianxue (Wind and Visceral Toxic Hematochezia) and hemorrhoidal pain with bleeding, Huaihuang Wan (Sophora and Coptis Pill) is suitable.
Huaihua (Sophorae Flos) (4 liang), Huanglian (Coptidis Rhizoma, wine-stir-fried 4 liang). Grind into fine powder, put into pig intestine, tie both ends. Add 2 jin of Chinese chives, boil with water until soft, remove chives, mash the herb-filled intestine into pills, size of Gardenia fruits. If too wet, add some flour. Take 80 pills per dose, on an empty stomach, with rice water.
Fifteenth discussion: For chronic hematochezia that does not stop, this is due to Zang-Fu deficiency-cold. Sallow complexion and emaciation indicate suitability for Duanhong Wan (Stop Red Pill).
Lurong (Deer Antler, hair removed, boiled in vinegar), Dafuzi (Aconiti Lateralis Radix Praeparata, processed, skin and navel removed), Danggui (Angelicae Sinensis Radix, wine-washed), Xuduan (Dianbei Radix, wine-soaked), Huangqi (Astragali Radix, stir-fried), Ejiao (Colla Corii Asini, stir-fried with蛤粉 Ge Fen), Cebeiyè (Platycladi Cacumen, stir-fried) (each 1 liang), Baifan (Alumen, calcined) (5 qian). Grind into fine powder, make pills with vinegar-boiled rice paste, size of Sophora seeds. Take 70 pills per dose, on an empty stomach, with rice water.
Zhu Danxi said: For lower bleeding that persists for a long time, use warm agents later. First use Siwu Tang (Four Substances Decoction) added with Paojiang (Processed Ginger) and Fuzi (Processed Aconite Root), then take Duanhong Wan (Stop Red Pill) for efficacy.
Sixteenth discussion: For Changfeng Xiaxue (Wind-intestinal bleeding), heat type presents with bright red blood, cold type presents with dark blue/black blood or clots.
Seventeenth: A scholar, usually diligent and hardworking, suffered from hematochezia due to irregular diet, with blood sometimes red, sometimes dark. After half a year, he experienced either hematochezia or night sweats, either aversion to cold or fever. Medicines for stopping sweating and bleeding were ineffective. The six pulses were floating and large, while the Heart and Spleen pulses were choppy. This was due to overthinking injuring the Heart and Spleen, failing to control blood return to its source. However, sweating turned into blood, color red-dark. Hematochezia and night sweats were caused by the fluctuation of Fire's ascending and descending. Aversion to cold and fever indicated joint deficiency of Qi and Blood. In the morning, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to tonify Lung and Spleen sources and lift sinking Qi. In the afternoon, use Guipi Tang (Restore the Spleen Decoction) added with Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus) to tonify Heart and Spleen Blood and consolidate dissipating fluids. Within two months, all symptoms resolved.
Eighteenth: A person who loved drinking alcohol suffered from intermittent hematochezia, either before or after stool, with poor appetite, fatigue, and sallow complexion. This was Spleen Qi deficiency failing to control blood. Use Yiqi Tang (Augment Qi Decoction) added with Zhuyu (Corni Fructus) and Huanglian (Coptidis Rhizoma).
Nineteenth: A man had hematochezia with seminal emission and fever; another man had hematochezia and fever; another man had fever with nocturnal emission or involuntary urination. All were due to Spleen and Kidney deficiency. Use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) and Yiqi Tang to nourish the source of transformation and assimilation, resulting in complete recovery.
Twentieth discussion: For lower bleeding, after taking Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) and other medicines, bleeding increases, body emaciates, fever occurs, appetite decreases, and tenesmus is present. This is Spleen Qi sinking. Use Yiqi Tang (Augment Qi Decoction) added with Paojiang (Processed Ginger) for immediate effect.
Twenty-first: To treat hematochezia, use 4 liang of Shilian Rou (Stone Lotus Seed Flesh), shell removed and crushed, put into a male pig's stomach, boil in water until soft, remove lotus seeds, eat the stomach and drink the broth to stop bleeding immediately.
Twenty-second: Secret recipe for treating hematochezia.
Guanyin Jiuku Fang (Guanyin Saving from Suffering Formula) Passed down by Ma Fu.
Muxiang (Aucklandiae Radix) (4 liang), Huanglian (Coptidis Rhizoma) (2 liang). Slice Huanglian, decoct in water to make juice, soak Muxiang, dry slowly over low fire, grind into powder. Mash Wumei Rou (Mume Fructus Flesh) into pills, size of Sophora seeds. Take 60 pills per dose, on an empty stomach, with boiling water.
Twenty-third: What causes Changfeng Xiaxue (Wind-intestinal bleeding)? Human intestines are wrapped in fat; thick fat ensures intestinal health. There is originally no blood in the intestines; blood enters because wind or heat dissolves the fat, thinning the intestines, allowing blood from the body to seep in. At the onset, cooling medicines must be taken to cure. Overuse leads to intestinal cold and failure of fat regeneration, causing recurrence. Heat type presents with bright red blood; cold type presents with dark blue/black blood. Observe cold and heat to prescribe medication. Cold type: use Duanhong Wan (Stop Red Pill); Heat type: use Siwu Tang (Four Substances Decoction) combined with Huanglian Jiedu Tang (Coptis Detoxifying Decoction), added with Kushen (Sophorae Flavescentis Radix), Huaijiao (Sophorae Fructus), Diyü (Sanguisorbae Radix), and Cebeiyè (Platycladi Cacumen).
Twenty-fourth: Intestinal and gastric flowing heat causes sudden anal swelling. Grind snails finely and apply topically to reduce swelling.
Twenty-fifth: To treat Zangdu Xiaxue (Visceral Toxic Lower Bleeding), combine Huanglian Jiedu Tang (Coptis Detoxifying Decoction) and Siwu Tang (Four Substances Decoction), mix into powder, make pills with drops of water. Take 80-90 pills per dose, on an empty stomach, with aged rice drink.
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (Formula see Internal Injury chapter) Guipi Tang (Restore the Spleen Decoction) (Formula see Forgetfulness chapter) Liuwei Wan (Six-Ingredient Pill) (Formula see Tonification chapter)