大便下血者，是大肠热结损伤所为也，脏气既伤，风邪自入，或蓄热，或积冷，
或湿毒于脾胃，或疳食伤于脏腑，因兹冷热交击，疳湿互作，致动血气，停留于内，
凝滞无归，渗入肠中，故大便下血也。或有腹胀，冷气在内攻冲，亦令大便下血。
又因风冷乘虚客入脾胃，或瘀血在于肠胃，湿毒下如豆汁。又疳伤于脏，亦能便血，
若上焦心肺积热，施注大肠，亦令大便下血也。亡血脾弱必渴，久则血虚，其人必
肌体萎黄，头发不黑矣。溺血者，盖心主血，与小肠相合，血之流行，周遍经络，
循环脏腑，若热聚膀胱，血渗入脬，故小便血出也。〔薛〕经云∶肺朝百脉之气，
肝统诸经之血。又云∶气主 之，血主濡之。盖荣血为水谷之精气，灌溉五脏六腑，
四肢百骸，若脾胃有伤，荣卫虚弱，行失常道，故上为衄血吐血，下为尿血便血矣。
若外感风邪，则血鲜为肠风，内伤则血浊为脏毒。又热入大肠，则大便下血，热入
小肠，则小便出血。然小儿多因胎中受热，或乳母六淫七情，浓味积热，或儿自食
甘肥积热，或六淫外侵而成，若因母食浓味者，加味清胃散。怒动肝火者，加味小
柴胡汤。忧思郁怒者，加味归脾汤。禀父肾燥者，六味地黄丸。儿有积热，小便出
血者，实热，用清心莲子饮，虚热，用六味地黄丸。大便出血者，犀角地黄汤。风
邪外侵者，仓廪散。病后元气下陷者，补中益气汤。粪前见血者，四君加黄连制吴
茱萸，粪后见血者，四君加吴茱萸制黄连。若婴儿，以治母为主，余当临证制宜。
清胃散（齿） 小柴胡汤（潮热） 归脾汤（烦躁） 地黄丸（肾） 清心莲子饮（尿白）
五倍丸 治小儿大便下血如肠风脏毒。
上以五倍子，干为末，炼蜜丸，如小豆大。三岁三十丸，米汤下。
诃灰散 治小儿因疳，大便有血。
上，以诃子烧灰存性，一半为末，米汤调下，食前，三岁一钱。
桃胶丸 治小儿小便出血，阴茎中痛。
上，以桃胶一块如枣大，水一盏半，煎三分，日进三服。下石子如豆，石尽，
止药。
火府散 治小儿小便出血。
木通 生地黄 甘草 黄芩
上为末。水一盏，煎六分，不时温服。
车前散 治热盛积于小肠，甚则尿血。
牡蛎（半两，烧为粉） 车前子 甘草（炙微黄，锉） 川朴硝（各一分）
上捣罗为散。每服一钱，以水一小盏，煎至五分，去滓，温服。量儿大小加减，
不拘时候。
Hematochezia (blood in stool) is caused by heat accumulation and damage in the Large Intestine. Once the Qi of the Zang organs is injured, Wind pathogens enter spontaneously; or there may be accumulated heat, accumulated cold, damp-toxin stagnating in the Spleen and Stomach, or malnutrition-disease (Gan disease) from food damaging the Zang-Fu organs. Consequently, cold and heat strike each other, and Gan-dampness interacts, causing Blood Qi to move recklessly, stagnate internally, coagulate without returning to its vessels, and seep into the intestines, thus resulting in hematochezia. Some cases present with abdominal distension; if cold Qi attacks and rushes within, it also causes hematochezia. Furthermore, if Wind-Cold invades the Spleen and Stomach due to deficiency, or if stasis-blood remains in the intestines and stomach, damp-toxin flows downward resembling bean juice. Additionally, Gan-damage to the Zang organs can also cause blood in stool. If heat accumulates in the Upper Jiao (Heart and Lungs) and transmits to the Large Intestine, it too causes hematochezia. Loss of Blood leads to weak Spleen Qi and must result in thirst; over time, Blood deficiency causes the body to become sallow and yellow, and the hair to lose its black color.
Hematuria (blood in urine) occurs because the Heart governs Blood and corresponds with the Small Intestine. Blood circulates through the meridians and cycles through the Zang-Fu organs. If heat gathers in the Bladder, blood seeps into the bladder (Pao), thus blood exits via urination. [Xue Ji] stated: The Lung directs the Qi of all vessels, and the Liver controls the Blood of all meridians. It is also said: Qi primarily moves [the blood], and Blood primarily moistens [the body]. Ying-Blood (Nutritive Blood) is the essence of water and grain, irrigating the five Zang and six Fu organs, limbs, and bones. If the Spleen and Stomach are damaged, and Ying-Wei (Defensive-Nutritive) Qi becomes weak, moving out of its normal path, then above it manifests as epistaxis (nosebleed) or hematemesis (vomiting blood), and below as hematuria or hematochezia. If external Wind pathogens invade, the blood is bright red, known as Changfeng (Intestinal Wind); internal injury results in turbid blood, known as Zangdu (Visceral Toxin). Heat entering the Large Intestine causes hematochezia; heat entering the Small Intestine causes hematuria. However, infants often suffer from heat received in the womb, or from the nursing mother’s exposure to the Six Evils (Six Pathogenic Factors) and Seven Emotions, or from consuming rich flavors leading to accumulated heat, or from the child’s own consumption of sweet and fatty foods causing accumulated heat, or from invasion by the Six Evils externally. If caused by the mother consuming rich flavors, use Jiawei Qingwei San (Modified Stomach-Clearing Powder). If caused by anger stirring Liver Fire, use Jiawei Xiaochaihu Tang (Modified Minor Bupleurum Decoction). If caused by worry, thought, depression, and anger, use Jiawei Guipi Tang (Modified Spleen-Restoring Decoction). If inheriting Kidney dryness from the father, use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). For infants with accumulated heat and blood in urine, if it is excess heat, use Qingxin Lianzi Yin (Heart-Clearing Lotus Seed Drink); if deficient heat, use Liuwei Dihuang Wan. For blood in stool, use Xijiao Dihuang Tang (Rhinoceros Horn Rehmannia Decoction). For external Wind invasion, use Canglin San (Granary Powder). For post-illness sinking of Yuan Qi (Primal Qi), use Buzhong Yiqi Tang (Middle-Warming Qi-Supplementing Decoction). If blood appears before defecation, use Sijun Zi Tang (Four Gentlemen Decoction) added with Huanglian (Coptis Rhizome) processed with Wuzhuyu (Evodia Fruit). If blood appears after defecation, use Sijun Zi Tang added with Wuzhuyu processed with Huanglian. For infants, treatment should focus on the mother; for others, clinical judgment should be applied flexibly.
Qingwei San (Stomach-Clearing Powder) [indicated for gingival bleeding]; Xiaochaihu Tang (Minor Bupleurum Decoction) [indicated for tidal fever]; Guipi Tang (Spleen-Restoring Decoction) [indicated for irritability]; Dihuang Wan (Rehmannia Pill) [indicated for Kidney deficiency]; Qingxin Lianzi Yin (Heart-Clearing Lotus Seed Drink) [indicated for white turbid urine]; Wu Bei Wan (Myrobalan Pill) treats hematochezia resembling Changfeng or Zangdu in children.
Take Myrobalan (Terminalia chebula Retz.), dry it, grind into powder, and make pills with refined honey, sized like small beans. For three-year-olds, administer thirty pills at a time, washed down with rice soup.
He Hui San (Persimmon Ash Powder) treats blood in stool due to Gan disease in children.
Take Chebula Myrobalan (Terminalia chebula Retz.), burn it to ash while preserving its nature, take half as powder, mix with rice soup and administer. Take before meals; for three-year-olds, one qian.
Tao Jiao Wan (Peach Gum Pill) treats hematuria and penile pain in children.
Take a piece of Peach Gum (Tragacanthae Gum / Pruni Persicae Gum) the size of a jujube, boil in one and a half cups of water until reduced to one-third. Administer in three doses daily. When stones the size of beans are passed and stones cease, stop medication.
Huofu San (Fire Mansion Powder) treats hematuria in children.
Akebiae Caulis (Mutong, 木通); Rehmanniae Radix Preparata (Shengdihuang, 生地黄); Glycyrrhizae Radix et Rhizoma (Gancao, 甘草); Scutellariae Radix (Huangqin, 黄芩).
Grind into powder. Boil one cup of water to reduce to six-tenths, and take warm at any time.
Cheqian San (Plantago Powder) treats heat excess accumulating in the Small Intestine, severe cases presenting with hematuria.
Ostreae Concha (Muli, 牡蛎) (half liang, calcined to powder); Plantaginis Semen (Cheqianzi, 车前子); Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) (roasted until slightly yellow, chopped); Natrii Sulfas (Chuan Puxiao, 川朴硝) (each one fen).
Pulverize and sieve into a powder. Take one qian per dose, boil in a small cup of water until reduced to five-tenths, strain, and take warm. Adjust dosage according to the child's age and size, no specific timing required.