交肠之病。大小便易位而出。盖因气不循故道。清浊混淆。宜五苓散调气散各一钱。加
阿胶末半钱。汤调服。或研黄连阿胶丸为末。加木香末少许。再以煎汤送下。
泻血。当辨其色。色鲜为热。色瘀为寒。热血连蒲饮。寒血理物汤。血色鲜红者。多因
内蕴
热毒。毒瓦斯入肠胃。或因饮酒过多。及啖糟藏炙爆。引血入大肠。故泻鲜血。宜连蒲散。吞
黄连阿胶丸及香连丸。或一味黄连煎饮。大泻不止者。四物汤加黄连槐花。仍取血见愁草少
许。生姜捣取汁。和米饮服。于血见愁草中加入侧柏叶。与生姜同捣汁尤好。有毒暑入肠胃
下血者。一味黄连煎汤饮。
有肠风下血。以香附末加百草霜。米饮调服。加入麝香少许。其应尤捷。
泻血色瘀者。为寒血。逐气走。冷气入客肠胃。故下瘀血。理中汤不效。宜黑神散。米
饮调下。中用附子者佳。或用胶艾汤。加米煎。吞震灵丹。
扑内损。恶血入肠胃。下出浊如瘀血者。宜黑神散。加老黄茄为末。酒调下。
有风入肠胃。纯下清血。或风湿入肠胃。下如豆汁。或下瘀血。并宜胃风汤胶艾汤。
泻血或淡或浊。或鲜或瘀。亦宜胃风汤。吞驻车丸。或独泻血。或与粪俱出。当辨其色
与所感施治。
有腹痛者。乃是血不循理。故尔作痛。却无里急后重及缠坠等患。不可因痛认为血痢
妇人因月事不通。血不循故道。从后分出者。当调其经。见妇人门。
泻血过多。手足厥冷而眩晕者。当审其寒热施治。不可因眩晕而便用附子热药。寒血犹
可。热血为害不少。
Jiao Chang (Intestinal Reversal) disease is characterized by the exchange of positions in the excretion of urine and feces. This occurs because Qi fails to follow its normal pathway, leading to a confusion of clear and turbid substances. It is advisable to use Wu Ling San (Five-Ingredient Powder with Poria) and Tiao Qi San (Qi-Regulating Powder), one qian each, mixed with half a qian of powdered Ejiao (Donkey-Hide Gelatin), taken with decocted water. Alternatively, grind Huanglian Ejiao Wan (Coptis and Donkey-Hide Gelatin Pill) into powder, add a small amount of Muxiang (Aucklandiae Radix) powder, and swallow it down with the decoction.
Xie Xue (Passing Blood from the Anus) should be differentiated by color. Fresh red blood indicates Heat, while dark, clotted blood indicates Cold. For Hot Blood, use Lian Pu Yin (Coptis and Euryale Seed Decoction); for Cold Blood, use Li Wu Tang (Regulate Things Decoction). Fresh red blood is often due to internal accumulation of Heat-Toxin, which invades the intestines and stomach; or it may result from excessive alcohol consumption, or eating fermented foods, preserved meats, roasted, and fried items, which draws blood into the large intestine, causing fresh blood to pass. It is suitable to use Lian Pu San (Coptis and Euryale Seed Powder), swallow Huanglian Ejiao Wan (Coptis and Donkey-Hide Gelatin Pill) and Xiang Lian Wan (Costus and Coptis Pill), or simply decoct Huanglian (Coptidis Rhizoma) alone to drink. If diarrhea persists without stopping, use Si Wu Tang (Four Substances Decoction) added with Huanglian (Coptidis Rhizoma) and Huaihua (Sophorae Flos). Also, take a small amount of Xu Jian Chou Cao (Herba Siegesbeckiae), crush fresh Shengjiang (Zingiberis Rhizoma Recens) to extract juice, and mix with rice water to take. Adding Ce Bai Ye (Biota Top Leaf) to Xu Jian Chou Cao, crushing them together with fresh ginger to extract juice, yields an even better effect. In cases where Summerheat-Toxin invades the intestines and stomach causing bloody stool, decoct Huanglian (Coptidis Rhizoma) alone to drink.
For Chang Feng (Intestinal Wind) causing bloody stool, use Xiang Fu (Cyperi Rhizoma) powder mixed with Bai Cao Shuang (Soot of Hundred Herbs), adjusted with rice water. Adding a small amount of She Xiang (Moschus) makes the response particularly rapid.
If the passed blood is dark and clotted, it is Cold Blood, moving with Qi, where Cold-Qi lodges in the intestines and stomach, resulting in the passage of clotted blood. If Li Zhong Tang (Regulate the Middle Decoction) is ineffective, Hei Shen San (Black Divine Powder) is suitable, taken with rice water. Using formulas containing Fu Zi (Aconiti Lateralis Radix Praeparata) is preferred. Alternatively, use Jiao Ai Tang (Donkey-Hide Gelatin and Mugwort Decoction) cooked with rice, swallowing Zhen Ling Dan (Shaking Spirit Pellet).
For blunt trauma causing internal injury, where evil blood enters the intestines and stomach and exits as turbid material resembling clotted blood, use Hei Shen San (Black Divine Powder) added with Lao Huang Qie (Old Yellow Eggplant) powder, taken with wine.
When Wind pathogen invades the intestines and stomach, causing pure clear blood to pass; or when Wind-Dampness invades, causing discharge resembling bean curd dregs; or passage of clotted blood, Wei Feng Tang (Stomach Wind Decoction) or Jiao Ai Tang (Donkey-Hide Gelatin and Mugwort Decoction) are appropriate for all such cases.
For bloody stool that is either pale or turbid, fresh or clotted, Wei Feng Tang (Stomach Wind Decoction) is also suitable, swallowing Zhu Che Wan (Stopping Cartilage Pill). Whether passing blood alone or mixed with feces, treatment should be administered based on differentiating the color and the pathogenic factor involved.
Abdominal pain accompanying this condition indicates that blood is not following its proper course, thus causing pain, but there is no tenesmus or anal bearing-down sensation. One must not mistake this pain for Xue Li (Bloody Dysentery).
In women, if menstruation is obstructed and blood does not follow its normal pathway, exiting from the posterior orifice, the menses should be regulated; see the Women's Section.
Excessive loss of blood leading to cold extremities and dizziness requires careful differentiation of Cold and Heat before treatment. Do not readily use hot medicines like Fu Zi (Aconiti Lateralis Radix Praeparata) merely because of dizziness. While Cold Blood might be tolerable, Hot Blood causes significant harm.