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-Fu organs is injured, Wind pathogen enters spontaneously; there may be accumulated Heat or retained Cold, Damp-Toxin affecting the Spleen and Stomach, or malnutrition (Gan syndrome) damaging the Zang-Fu due to dietary excess. Consequently, Cold and Heat strike each other, and Gan-Dampness interacts, causing Blood-qi to move and remain internally, stagnating without returning to its vessels, seeping into the intestines, thus resulting in hematochezia. Some cases present with abdominal distension; cold Qi attacking from within can also cause hematochezia. Additionally, Wind-Cold invading the Spleen and Stomach due to deficiency, or blood stasis remaining in the stomach and intestines, may result in damp-toxin discharging like bean juice. Furthermore, Gan injury to the Zang-Fu can also lead to blood in stool. If Heat accumulates in the Upper Jiao (Heart and Lungs) and pours downward into the Large Intestine, it too causes hematochezia. Loss of Blood leads to weak Spleen Qi and inevitable thirst; over time, Blood deficiency results in sallow complexion and black hair loss.
Hematuria (blood in urine) occurs because the Heart governs Blood and connects with the Small Intestine. Blood circulates through the meridians and Zang-Fu organs. If Heat gathers in the Bladder, Blood seeps into the bladder (Pao), causing blood to exit with urine. Xue Ji stated: "The Lung directs the Qi of all vessels; the Liver controls the Blood of all meridians." It is also said: "Qi provides warmth; Blood provides nourishment." Ying-Blood (Nutritive Blood) is the essence of food and drink, irrigating the Zang-Fu organs and limbs. If the Spleen and Stomach are damaged, Ying and Wei (Defensive) Qi become weak, and their movement deviates from normal pathways, leading to epistaxis or hematemesis above, and hematuria or hematochezia below. If affected by external Wind pathogen, the blood is bright red, known as Changfeng (Intestinal Wind); if affected internally, the blood is turbid, known as Zangdu (Visceral Toxin). Heat entering the Large Intestine causes hematochezia; Heat entering the Small Intestine causes hematuria. However, children often suffer from heat received in the womb, or from the nursing mother's exposure to Six Excesses or Seven Emotions, consumption of rich flavors causing heat accumulation, or the child's own consumption of sweet and fatty foods causing heat, or invasion by Six Excesses externally. If caused by the mother's consumption of rich flavors, use Jia Wei Qing Wei San (Modified Clearing Stomach Powder). If caused by anger stirring Liver Fire, use Jia Wei Xiao Chai Hu Tang (Modified Minor Bupleurum Decoction). If caused by worry, thought, depression, and anger, use Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction). If due to inheriting Kidney Dryness from the father, use Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill). For children with accumulated Heat and hematuria: if it is Excess Heat, use Qing Xin Lian Zi Yin (Clear Heart Lotus Seed Drink); if Deficient Heat, use Liu Wei Di Huang Wan. For hematochezia, use Xi Jiao Di Huang Tang (Rhinoceros Horn Rehmannia Decoction). For external Wind invasion, use Cang Lin San (Granary Powder). For post-illness sinking of Yuan Qi (Primal Qi), use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). If blood appears before stool, use Si Jun Zi Tang (Four Gentlemen Decoction) added with Coptis Rhizome processed with Evodia Fruit. If blood appears after stool, use Si Jun Zi Tang added with Evodia Fruit processed with Coptis Rhizome. For infants, treatment should primarily focus on the mother; for others, adjust according to clinical presentation.
Qing Wei San (for gingival bleeding) Xiao Chai Hu Tang (for tidal fever) Gui Pi Tang (for irritability) Di Huang Wan (for Kidney deficiency) Qing Xin Lian Zi Yin (for white turbid urine) Wubei Wan: Treats pediatric hematochezia resembling Changfeng or Zangdu.
Take Wu Bei Zi (Galla Chinensis), dry and powder it, mix with refined honey to make pills the size of small beans. For three-year-olds, administer thirty pills per dose, washed down with rice soup.
He Hui San: Treats pediatric hematochezia due to Gan syndrome.
Take He Zi (Terminalia Chebula Retusa Fruit), burn to ash while preserving its nature, take half as powder, mix with rice soup for administration before meals. For three-year-olds, administer one qian per dose.
Tao Jiao Wan: Treats pediatric hematuria with pain in the penis.
Take a piece of Tao Jiao (Prunus Mume Gum) the size of a jujube, decoct in one and a half cups of water until reduced to one-third. Administer three times daily. When stone-like particles the size of beans are passed and stones are exhausted, stop medication.
Huo Fu San: Treats pediatric hematuria.
Tong Cao (Tetrapanax Papyrifer Stem) Sheng Di Huang (Rehmannia Glutinous Root) Gan Cao (Licorice Root) Huang Qin (Scutellaria Baicalensis Root)
Powder these ingredients. Decoct one cup of water until reduced to six-tenths, warm and administer at any time.
Che Qian San: Treats excessive Heat accumulating in the Small Intestine, severe cases presenting with hematuria.
Mu Li (Oyster Shell, half liang, calcined to powder) Che Qian Zi (Plantago Seed) Gan Cao (Licorice Root, honey-fried, slightly yellow, sliced) Chuan Po Xiao (Mirabilite, one fen each)
Grind and sieve into a powder. Take one qian per dose, decoct in one small cup of water until reduced to five-tenths, strain and warm for administration. Adjust dosage based on the child's age and size; no specific timing required.