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Regarding hematochezia (blood in stool) from the Large Intestine, there are two types: one is called Changfeng (Intestinal Wind), and the other is called Zangdu (Visceral Toxin). Changfeng refers to external pathogenic factors invading the body, manifesting immediately upon infection; therefore, the blood color is clear and bright red. Zangdu refers to toxins accumulating internally for a long time before manifesting; therefore, the blood color is turbid and dark purple. The Classics state: "When Yin collaterals are damaged, blood overflows internally, resulting in hematochezia." People often suffer from this due to drunkenness and overeating, excessive sexual activity, sitting or lying in damp-wind environments, retention of cold from raw and cold foods, or accumulation of heat from excessive alcohol consumption. These factors injure the Yin collaterals and damage the Spleen and Stomach, allowing external pathogens to take advantage. This causes Ying Blood (Nutritive Blood) to lose its proper course, seeping into the Large Intestine and flowing downward. Over time, Yuan Qi (Original Qi) sinks further, and damp-heat deepens, transforming into Zangdu. If defecation precedes bleeding, the source is distant; if bleeding precedes defecation, the source is proximate. The general principle of treatment is first to dissipate wind pathogens in the Spleen and Stomach. For heat patterns, use Baidu San (Toxin-Dissipating Powder); for cold patterns, use Bu Huan Jin Zhengqi San (Golden Replacement Upright Qi Decoction) added with Chuanxiong Rhizome (Chuanxiong) and Angelicae Sinensis Radix (Danggui). Subsequently, treat according to cold or heat. If internal injury leads to insufficient Yang Qi, and Yin in the Lower Jiao lacks the support of Yuan Yang, causing bleeding, it is appropriate to use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), Liujunzi Tang (Six Gentlemen Decoction), or Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder), added with Chuanxiong, Danggui, Aurantii Fructus (Zhike), Sanguisorbae Radix (Diyu), and Sophorae Flavescentis Flos (Huaihua). Since Qi and Blood originate from Gu Qi (Grain Qi), they must rely on tonifying the Middle and raising Yang, concluding with stomach-regulating herbs. Once Stomach Qi returns, blood will naturally circulate within the meridians.

Supplement: Lin Shi stated that the essence of Changfeng is that the Clear Qi of Foot-Yangming Stomach Meridian cannot ascend and penetrate to the limbs and interstices, but instead sinks into the Large Intestine. The blood vessels of the Large Intestine also become deficient and sink with this Qi. After prolonged sinking, Qi and Blood stagnate and transform into damp-heat. Consequently, blood follows the stagnant Qi. During defecation, when Qi sinks and Fire forces it, blood appears before the feces, flowing out clearly and in small amounts. Initially called Changfeng, this name likely arises because formulas often use wind-dispelling herbs like Schizonepetae Spica (Jingjie), Saposhnikoviae Radix (Fangfeng), and Cimicifugae Rhizoma (Shengma) to raise Clear Yang, leading to the misconception of external Wind. Even if it is Wind, it is Wind transformed from Blood Heat; how could external Wind enter the Large Intestine? As for Zangdu, it occurs because Changfeng persists for a long time, leading to deficiency of both Qi and Blood. The sinking Qi becomes increasingly severe, and damp-heat in the Large Intestine accumulates deeply. Hand-Yangming Large Intestine Meridian is the site of accumulated blood; its momentum inevitably sinks with the Qi, emerging before or after the feces. Although painless, the blood is often dark black and clotted, hence the name "Toxin," though it lacks the toxicity of hemorrhoids, fistulas, intestinal abscesses, pus, blood, or pain. If the disease lingers, Qi and Blood become more deficient, and Spleen-Stomach Yuan Qi is undoubtedly depleted first. It can no longer control and transport the blood vessels of the whole body, preventing smooth flow, and thus sinks into the Large Intestine, forming the syndrome of Jieyin Hematochezia. In the lower part, it manifests as failure to raise Clear Qi, with hematochezia accompanied by undigested food diarrhea (Xunxie); in the upper part, it manifests as congealed Turbid Qi, with chest fullness accompanied by wheezing and coughing; eventually leading to limb edema, chest and abdominal distension, and death. This condition should be divided into three categories: mild is Changfeng, severe is Zangdu, and critical is Jieyin. (Jieyin means Yin Qi knots internally and cannot move outward, seeping into the intestines; this is disaster caused by cold-dampness and the predominance of Yin pathogens.)

Supplement: Feng Luzhan said: External pathogens such as Wind, Cold, Summer-heat, Dampness, and Heat can all cause bleeding. Wind tends to injure the Liver; when the Liver is injured, it cannot store Blood, leading to bleeding. Drinking cold liquids after drunkenness injures the interior with Cold, coagulating Blood, which seeps into the Large Intestine, causing bleeding. Internal and external Dampness condenses and injures the Stomach Qi, flowing downward with Qi, causing bleeding. Those who consume rich foods, strong flavors, alcohol, and engage in excessive sex, or those who labor excessively, lead to heat accumulation in the Lower Jiao, causing bleeding. Furthermore, internal injury with insufficient Yang Qi leaves Yin without support; Spleen deficiency with sinking Yang Qi fails to control Blood, often causing bleeding. At the onset, the pulse may be deep and rapid with force, or wiry and uncountable. Later, it may be hollow and rapid without force, or deep, choppy, and weak. In cases of Jieyin and Spleen deficiency, the pulse is either hollow and choppy or deficient and thready. Treatment methods: Initially, it is suitable to raise Yang and clear heat; subsequently, clear and tonify simultaneously, harmonize Blood, and detoxify. For Jieyin, one should raise Clear Qi and drain Turbid Qi, combined with warming and tonifying the Blood.