大意
肺与大肠。相为表里。故肺热则肛藏。肺虚则肛脱。（心法）
内因
肠风痔漏。久服寒凉。坐努下脱。久痢久泄。里急后重。窘迫下脱。男子房欲过度。产妇用力太早。小儿叫号
伤气。俱有此症。（医鉴）
外候
因气血空虚。不能内守。肛门无力收摄。以致或大或小。块物外坠。有似去白之卵黄。故曰脱肛。（绳墨）
治法
病之虚实。入者为实。出者为虚。（难经）肛门脱出。非虚而何。治须温肺脏。补肠胃。耐心久服。渐见收缩也。
（汇补）
死症
如元气大脱。饮食不进。气逆肿喘者。不治。（类案）
用药
主以补中益气汤。挟热。加黄芩、槐花。挟寒。加木香、炮姜。止涩。加赤石脂、禹余粮。兜住。加诃子、椿皮。
外用香荆散浴之即收。或五倍为末。托而上之。或用葱头汤熏洗。又有肛门燥涩。大便努责而下脱者。此属内热。
用收肛散治之。（汇补）
脱肛选方
补中益气汤 统治脱肛。
人参 白术 当归 黄 升麻 柴胡 广皮 炙草 姜 枣
快捷方式方
蓖麻子捣烂。酒调敷病患头顶正心。少顷即收。收即洗去。又方。用熊胆三分、儿茶三分、冰片一分。共
为末。入人乳调涂肛上。热汁下而自愈。
[General Principle]
The Lung and Large Intestine are exteriorly-interiorly related. Therefore, Lung Heat (Fei Re) causes the anus to retract inward, while Lung Deficiency (Fei Xu) causes the anus to prolapse. (*Yizong Xinfa*)
[Etiology (Internal Factors)]
Suffering from Changfeng (Intestinal Wind) or hemorrhoids/fistulas, long-term use of cold-natured drugs, prolonged sitting with straining during defecation leading to downward prolapse; chronic dysentery or diarrhea accompanied by tenesmus (Li Ji Hou Zhong), straining in urgency leading to downward prolapse; excessive sexual activity in men, premature exertion by postpartum women, and qi injury due to crying/shouting in infants—all these conditions can result in this symptom. (*Yijian*)
[External Manifestations]
Due to emptiness of Qi and Blood, inability to maintain internal retention, and lack of strength in the anal sphincter to contract, masses of varying sizes protrude outward, resembling an egg white removed from its shell; hence it is called Tuogang (Rectal Prolapse). (*Shengmo*)
[Therapeutic Principles]
Regarding the deficiency and excess of disease: invasion of pathogenic factors inward indicates Excess (Shi), while organ protrusion outward indicates Deficiency (Xu). (*Nanjing*) Rectal prolapse is undoubtedly a Deficiency syndrome. Treatment requires warming the Lung Zang and tonifying the Stomach and Intestines. Patience and long-term administration are necessary to gradually observe contraction. (*Zhengzhi Huibu*)
[Prognosis (Fatal Signs)]
If Yuan Qi (Original Qi) is severely depleted, food intake is impossible, and there is rebellious Qi with swelling and panting, the condition is incurable. (*Lei'an*)
[Medication]
The primary formula is Buzhong Yiqi Tang (Tonifying the Middle and Augmenting Qi Decoction). If complicated by Heat, add Huangqin (Scutellariae Radix) and Huaihua (Sophorae Flos); if complicated by Cold, add Muxiang (Aucklandiae Radix) and Paojiang (Prepared Ginger); for astringency, add Chishizhi (Halloysit Rubra) and Yuyuliang (Magnetitum) to secure and hold; for astringent action, add Hezi (Terminalia Chebulae Fructus) and Chunpi (Toonae Cortex).
Externally, bathing with Xiangjing San (Fragrant and Perilla Powder) will cause retraction. Alternatively, powder Wubeizi (Galla Chinensis) and manually reduce the prolapse. Or fumigate and wash with Congtou Tang (Scallion Head Decoction). In cases where the anus is dry and astringent, and prolapse occurs due to straining during defecation, this belongs to Internal Heat, treated with Shougang San (Anus Retraction Powder). (*Zhengzhi Huibu*)
[Selected Formulas for Rectal Prolapse]
Buzhong Yiqi Tang (Tonifying the Middle and Augmenting Qi Decoction): Universally treats rectal prolapse.
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui (Angelicae Sinensis Radix), Huangqi (Astragali Radix), Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), Guangpi (Citri Reticulatae Pericarpium), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma), Jiang (Zingiberis Rhizoma), Zao (Jujubae Fructus).
[Quick Method Formula]
Grind Sesamum indicum seeds (Bimazi) into a paste, mix with wine, and apply to the center of the patient's vertex (Baihui area). It will retract shortly after application; wash off immediately upon retraction. Another method: Use Xiongdan (Ursi Fel) 3 fen, Ercha (Catechu) 3 fen, Bingpian (Borneolum Syntheticum) 1 fen. Grind together into powder, mix with human milk, and apply to the anus. If caused by hot discharge, it will heal spontaneously.