脱肛者，肺脏蕴热，肛门闭结；肺脏虚寒，肛门脱出。用参 汤加减。凡泻痢久虚，或
老人气血虚惫，或产妇用力过度，俱有脱肛也。小儿亦有脱肛症者。
脱肛症者，肛门翻出，虚寒脱出。
参 汤
人参 黄 （蜜水炒） 当归 生地黄 白术（去芦） 芍药（炒） 茯苓（去皮，各一钱） 升
麻桔梗 陈皮（各五分） 甘草（炙，五分）
肺脏虚寒，加干姜（炒）五分。上锉一剂。姜、枣煎，食前服。
大凡脱出肛门不收，用热尿洗后，用烘热鞋底揉进，恐迟则冷燥难进；或用冰片点上，
亦收。
浮萍散 于秋暮取霜露打过浮萍，不拘多少，以净瓦摊开阴干。其瓦一日一易，不可见
日，务要阴干，用纸包起。凡有前疾者，临时研为细末。先取井中新汲水洗净脱出肛，次
以药末掺上，其肛徐徐即进，一时即愈。不拘男妇大小儿并治。
脱肛方 五倍子炒黄为末，放热鞋底上抵之，即收。
一春元素有痔，每劳役便脱肛，肿痛出水，中气下陷。用补中益气汤加茯苓、芍药十余
剂，中气复而愈。后复脱作痛，误用大黄丸，腹鸣恶食几危。余用前汤加炮姜、芍药，诸症
渐愈。后去姜，加熟地、五味，三十余剂而愈。
脉∶脉沉实者生，虚大者死。夫脉沉而滑者，为寸白虫。慝蚀阴痛，脉虚小者生，劲急
者死。《外台》云∶虫脉当沉弱而弦，今反洪大，即知蛔虫甚也。
古云∶湿热生虫，正如今人俗验禾苗，雨洒日照，禾节生虫，此帮助矣。人患虫积，或
饥饿调摄失宜，或过腥 白酒，或炙食牛羊，或啖鳖苋，中脘气虚，湿气少运，故生寸白、
蛔厥诸虫。形如蚯蚓，相似团鱼曰血鳖。小儿最多，大人间有为患。嘈杂腹痛，呕吐涎沫，
面色痿黄，眼眶鼻下青黑，以致饮食少进，肌肉不生，沉黑寒热。虫不早治，相生不已。古
云∶虫长一尺，则能杀人；虫若贯心，杀人甚急。治宜选方而用。
诸虫者，肠胃中湿热所生也。
追虫丸
木香 槟榔 芜荑 锡灰（各一钱） 史君子（肉，二钱） 大黄（二钱） 牵牛（末，一两）
先将皂角与楝树根皮二味浓煎二大碗，煎熬成膏，和前药末为丸，如梧桐子大，将沉香
末为衣，后又将雷丸末为衣子。每服五十丸，空心，砂糖汤送下。追取虫积，即愈。
追虫取积散
槟榔（末，二钱） 黑丑（头未，二钱） 陈皮（末，八分） 木香（末，五分）
上为末，共研匀。每服五钱，小者三钱，砂糖汤送下。五更服三、四次，以米汤补之。
忌鱼腥、油腻之物三、五日。
五仙方 治诸虫如神。
大黄（四两） 皂角 雷丸 苦楝根（各一两） 木香
上为末，酒糊丸。每服三、四十丸，茶下。
治蛔虫方 用苦楝根刮去外粗皮，取内白二两，以水三碗，煮取一碗半，去渣。用晚粳
米三合煮粥，空心，先以炒肉一、二片吃，引虫向上，然后进药粥一、二口；少顷，又吃一
、二口；渐渐加一碗或二碗，其虫尽下而愈。
治腹中有寸白虫 榧子一斤，陆续去壳用。不拘男妇、大人、小儿，如有此疾者，用此
果去壳，陆续吃。用尽一斤，其虫从大便中出。用净桶接着，是雄者，自一条；是雌者，大
小不等，或三、五条，或六、七条不止。只是还要吃一斤，此虫方绝出尽。若虫出后，其人
宜好酒饮食调理，不半月，精神颜色身胖如初也。
治虫方 使君子（火煨）十个，去热。水送下。其虫尽出。
脱肛，是指肺脏蕴积热邪，导致肛门闭塞；或是肺脏虚寒，导致肛门脱出。治疗可用参汤进行加减。凡是因长期腹泻痢疾导致身体极度虚弱，或者是老年人气血亏虚疲惫，亦或是产妇分娩时用力过度，都可能出现脱肛的情况。小儿也会出现脱肛的症状。
参汤方：
人参、黄芪（用蜜水炒）、当归、生地黄、白术（去芦头）、芍药（炒制）、茯苓（去皮），以上各一钱；升麻、桔梗、陈皮，以上各五分；甘草（炙制），五分。
若属肺脏虚寒，加干姜（炒制）五分。将上述药材锉碎为一剂，加入生姜、大枣煎煮，饭前服用。
大凡肛门脱出无法收回的，先用热尿液清洗，然后用烘热的鞋底揉按推入，恐怕拖延久了会导致局部冷燥难以推入；或者在患处点上冰片，也能使其收回。
浮萍散：在秋末霜露降临时采集浮萍，数量不限，铺在干净的瓦片上阴干。瓦片每天更换一次，不可见阳光，务必阴干，用纸包好。凡是有上述病症的人，临时将其研为细末。先取井中刚打上来的新水洗净脱出的肛门，然后将药末撒在上面，肛门就会慢慢缩回，一时即可痊愈。不论男女老少均可治疗。
脱肛方：五倍子炒黄后研为细末，放在热鞋底上抵住患处，即可收回。
某年春季，元素患有痔疮，每次劳累排便时都会脱肛，伴有肿痛流水，这是中气下陷所致。使用补中益气汤加入茯苓、芍药，服用十余剂后，中气恢复而痊愈。后来再次脱出并疼痛，误用了大黄丸，导致腹鸣、厌恶饮食，几乎危及生命。我使用前面的汤剂加入炮姜、芍药，各种症状逐渐好转。后来去掉姜，加入熟地黄、五味子，服用三十余剂后痊愈。
脉象方面：脉象沉实的预后良好，脉象虚大的预后不良。脉象沉而滑的，说明有寸白虫（绦虫）。若虫蚀阴部致痛，脉象虚小的预后良好，脉象劲急的预后不良。《外台秘要》说：虫证的脉象应当沉弱而弦，如果反而洪大，就知道是蛔虫严重了。
古语说：湿热生虫，就像现在人们俗信禾苗被雨淋日晒，禾节处生虫一样，这是辅助验证的说法。人患虫积，或因饥饿调养不当，或过食腥膻白酒，或食用烤制的牛羊，或吃鳖苋菜，导致中脘气虚，湿气运化无力，因此生出寸白虫、蛔厥等诸虫。虫形如蚯蚓，相似团鱼的称为血鳖。小儿最多见，大人偶尔也会受害。表现为嘈杂腹痛，呕吐涎沫，面色萎黄，眼眶鼻下青黑，以致饮食减少，肌肉不生，出现沉黑寒热等症状。虫子不早治，会相生不已。古语说：虫长一尺，就能杀人；若虫贯穿心脏，杀人非常迅速。治疗宜选择方剂使用。
追虫丸：
木香、槟榔、芜荑、锡灰（各一钱）；使君子仁（二钱）；大黄（二钱）；牵牛子末（一两）。
先将皂角与楝树根皮两味药浓煎成两大碗，熬制成膏，与前药末混合制成丸药，大小如梧桐子，用沉香末做外衣，之后再用雷丸末做内层衣。每次服用五十丸，空腹，用砂糖汤送服。可追取虫积，随即痊愈。
追虫取积散：
槟榔末（二钱）、黑丑（头未，二钱）、陈皮末（八分）、木香末（五分）。
以上研为细末，混合均匀。每次服用五钱，小儿三钱，用砂糖汤送服。五更天服用三到四次，服药后用米汤补养。忌食鱼腥、油腻之物三到五天。
五仙方：治疗诸虫如神效。
大黄（四两）、皂角、雷丸、苦楝根（各一两）、木香。
以上研为细末，用酒糊制成丸药。每次服用三四十丸，茶送下。
治蛔虫方：用苦楝根刮去外层粗皮，取内部白色部分二两，用水三碗，煮取一碗半，去渣。用晚粳米三合煮粥，空腹时，先吃一两片炒肉以引虫向上，然后喝一两口药粥；过了一会儿，再吃一两口；逐渐增加到一碗或两碗，虫子全部排出即愈。
治腹中有寸白虫：榧子一斤，陆续去壳使用。不论男女、大人、小儿，如有此病者，用此果去壳，陆续食用。吃完一斤，虫子会从大便中排出。用干净的桶接着，如果是雄虫，自是一条；如果是雌虫，大小不等，或三五条，或六七条不止。只是还要继续吃一斤，这些虫子才能绝迹排尽。若虫子排出后，患者宜用美酒饮食调理，不到半个月，精神气色和体型就会恢复如初。
Hemorrhoids (prolapse of the rectum) refers to the condition where heat accumulates in the Lung organ, causing anal constriction; or where the Lung organ is deficient and cold, leading to prolapse of the anus. Treatment can be adjusted using Shen Tang (Ginseng Decoction). Whenever prolonged diarrhea and dysentery lead to extreme deficiency, or when elderly people suffer from Qi and Blood exhaustion, or when parturient women exert excessive force during delivery, all may result in hemorrhoids (prolapse of the rectum). Children may also present with symptoms of hemorrhoids (prolapse of the rectum).
The symptom of hemorrhoids (prolapse of the rectum) manifests as the anus turning outwards, typically due to deficiency-cold causing the prolapse.
Shen Tang (Ginseng Decoction):
Ren Shen (Ginseng Root), Huang Qi (Astragalus Root, stir-fried with honey), Dang Gui (Angelica Sinensis Root), Sheng Di Huang (Rehmannia Root), Bai Zhu (Atractylodes Macrocephala Rhizome, rhizome removed), Shao Yao (Peony Root, stir-fried), Fu Ling (Poria, peel removed), each 1 qian; Sheng Ma (Cimicifugae Rhizoma), Jie Geng (Platycodon Root), Chen Pi (Citrus Reticulatae Pericarpium), each 0.5 qian; Gan Cao (Licorice Root, roasted), 0.5 qian.
If caused by Lung deficiency-cold, add Gan Jiang (Dried Ginger, stir-fried), 0.5 qian. The above herbs should be coarsely crushed for one dose, decocted with Sheng Jiang (Fresh Ginger) and Da Zao (Jujube), and taken before meals.
For cases where the anus protrudes and cannot be retracted, wash it first with hot urine, then rub and push it back in using a shoe sole that has been heated. Delaying this may cause the area to become cold and dry, making reduction difficult; alternatively, applying Bing Pian (Borneol) on the site can also facilitate retraction.
Fu Ping San (Lemna Minor Powder): Collect Lemna Minor (Floating Duckweed) at the end of autumn after frost and dew have fallen, in any quantity. Spread it thinly on clean tiles to dry in the shade. Replace the tiles daily, ensuring no exposure to sunlight, and strictly dry in the shade. Wrap in paper. For those suffering from the aforementioned conditions, grind into fine powder just before use. First, wash the protruding anus with fresh well water, then sprinkle the powder onto the area. The anus will slowly retract, and recovery will occur quickly. This treatment applies to both men and women, adults and children alike.
Formula for Hemorrhoids (Prolapse of the Rectum): Stir-fry Wu Bei Zi (Galla Chinensis) until yellow, grind into powder, place on a hot shoe sole, and press against the affected area to achieve retraction.
In the spring of a certain year, Yuan Su suffered from hemorrhoids (anal hemorrhoids). Every time he exerted himself during defecation, his anus would prolapse, accompanied by swelling, pain, and discharge of fluid. This was due to sinking of Middle Qi (Spleen Qi). He used Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with Fu Ling (Poria) and Shao Yao (Peony Root) for more than ten doses. His Middle Qi (Spleen Qi) recovered, and he was cured. Later, the prolapse recurred with pain. Mistakenly using Da Huang Wan (Rhubarb Pill), he experienced abdominal borborygmus and anorexia, nearly reaching a critical state. I used the previous decoction added with Pao Jiang (Prepared Ginger) and Shao Yao (Peony Root), and his symptoms gradually improved. Later, I removed the ginger and added Shu Di Huang (Prepared Rehmannia Root) and Wu Wei Zi (Schisandra Berry). After more than thirty doses, he was cured.
Regarding pulse diagnosis: A deep and solid pulse indicates a favorable prognosis, while a deficient and large pulse indicates an unfavorable prognosis. A deep and slippery pulse suggests the presence of Shi Bai Chong (Taenia Solium/Beef Tapeworm). If there is itching and pain in the yin region due to worm erosion, a deficient and small pulse indicates a favorable prognosis, while a tense and rapid pulse indicates an unfavorable prognosis. *Waitai Mi Yao* states: The pulse for worm conditions should be deep, weak, and wiry. If it is instead surging and large, it indicates severe Ascaris lumbricoides (Roundworm) infestation.
Ancient texts say: Damp-heat generates worms, similar to the folk belief that rice seedlings exposed to rain and sun develop worms at the nodes; this serves as corroborative evidence. Humans suffer from worm accumulation due to improper dietary regulation during hunger, excessive consumption of fishy or alcoholic beverages, eating roasted beef or mutton, or consuming turtle and amaranth. This leads to deficiency of Qi in the Middle Jiao (Epigastrium), poor transformation of dampness, thereby generating Shi Bai Chong (Taenia Solium/Beef Tapeworm), Hui Jue (Ascaris-related disorders), and other worms. Worms resemble earthworms; those resembling soft-shelled turtles are called Xue Bie (Blood Turtle). These are most common in children, though adults occasionally suffer from them. Symptoms include epigastric discomfort and abdominal pain, vomiting of saliva, sallow complexion, bluish-black discoloration under the eyes and nose, reduced food intake, lack of muscle growth, and alternating chills and fever. If worms are not treated early, they will reproduce endlessly. Ancient texts state: A worm growing to one chi (approx. 33 cm) can kill a person; if a worm penetrates the heart, death occurs very rapidly. Treatment should involve selecting appropriate formulas.
Various worms are generated by damp-heat in the intestines and stomach.
Zhui Chong Wan (Worm-Chasing Pill):
Mu Xiang (Aucklandiae Radix), Bing Lang (Areca Seed), Wu Ti (Chuan Lian Zi, fruit of Toosendan), Xi Hui (Tin Ash), each 1 qian; Shi Jun Zi (Quisqualis Fruit, flesh), 2 qian; Da Huang (Rhei Radix et Rhizoma), 2 qian; Qian Niu (Pharbitidis Semen, powder), 1 liang.
First, decoct Zao Jiao (Gleditsia Sinensis Spine) and Lian Shu Gen Pi (Meliae Cortex) strongly in two large bowls, boil down to a paste, mix with the powdered herbs, and form pills the size of Sophora seeds. Coat with Chen Xiang (Aquilaria Wood) powder, then coat again with Lei Wan (Olax Seed) powder. Take 50 pills per dose, on an empty stomach, washed down with sugar water. This chase and eliminates worm accumulation, leading to immediate cure.
Zhui Chong Qu Ji San (Worm-Chasing and Accumulation-Expelling Powder):
Bing Lang (Areca Seed, powder), 2 qian; Hei Chou (Pharbitidis Semen, head portion), 2 qian; Chen Pi (Citrus Reticulatae Pericarpium, powder), 0.8 qian; Mu Xiang (Aucklandiae Radix, powder), 0.5 qian.
Grind all into a uniform powder. Take 5 qian per dose, 3 qian for children, washed down with sugar water. Take three to four times at dawn (Wu Geng), followed by rice gruel to nourish the body. Avoid fishy and greasy foods for three to five days.
Wu Xian Fang (Five Immortals Formula): Treats various worms with miraculous efficacy.
Da Huang (Rhei Radix et Rhizoma), 4 liang; Zao Jiao (Gleditsia Sinensis Spine), Lei Wan (Olax Seed), Ku Lian Gen (Meliae Cortex), each 1 liang; Mu Xiang (Aucklandiae Radix).
Grind into powder, bind with wine paste into pills. Take 30–40 pills per dose, washed down with tea.
Formula for Treating Ascaris lumbricoides (Roundworm): Scrape off the outer rough bark of Ku Lian Gen (Meliae Cortex), take 2 liang of the inner white part. Decoct in three bowls of water until one and a half bowls remain, then strain. Cook congee with San He of Wan Jing Mi (Late Japonica Rice). On an empty stomach, eat one or two slices of fried meat first to draw the worms upward, then consume one or two mouthfuls of the medicinal congee. After a short while, eat another one or two mouthfuls. Gradually increase to one or two bowls. The worms will be completely expelled, and the patient will recover.
Formula for Treating Taenia Solium (Beef Tapeworm) in the Abdomen: Fei Zi (Torreya Grandis Seed), one jin (approx. 600g), shell and use progressively. Regardless of gender, adult or child, if suffering from this disease, consume the shelled nuts progressively. Upon finishing one jin, the worms will pass through the stool. Catch them in a clean bucket. Male worms appear singly; female worms vary in size, appearing in groups of three to five, or six to seven or more. One must continue eating one jin for these worms to be completely eradicated. After the worms are expelled, the patient should regulate diet with good wine and food. Within half a month, their spirit, complexion, and physique will return to normal.
Formula for Treating Worms: Shi Jun Zi (Quisqualis Fruit, fire-roasted), ten pieces, remove heat property. Wash down with water. The worms will be completely expelled.