脱肛属气热、气虚、血虚、血热。热虚者，补气，参、 、芎、归、升麻。血虚，四
物汤；血热
者，凉血，四物汤加炒柏；气热者，条芩六两，升麻一两，曲糊丸，外用五倍子为末，托
而上之。一次未收，至五七次，待收乃止。又东北方壁土泡汤，先熏后洗。
〔附录〕肺与大肠为表里，故肺藏蕴热，则肛门闭结；肺藏虚寒，则肛门脱出。又有妇人
产育用力，小儿久痢，皆致此。治之必须温肺藏，补阳胃，久则自然收矣。
附方
香荆散 治肛门脱出，大人小儿皆主之。
香附子 荆芥（等分） 砂仁
上为末。每服三钱，水一碗，煎热，淋洗；每服三钱，煎服亦可。
又方
五倍子为末，每用三钱，煎洗。
又方
木贼不以多少，烧灰为末。掺肛门上按入，即愈。
凡有声有物，谓之呕吐；有声无物，谓之哕。胃中有热膈上有痰者，二陈汤加炒
山栀、黄连、生姜；有久病呕者，胃虚不纳谷也，用人参、生姜、黄 、白术、香附之类
。呕吐，朱奉议以半夏、橘皮、生姜为主。刘河间谓呕者，火气炎上，此特一端耳。有痰
膈中焦，食不得下者；有气逆者；有寒气郁于胃口者；有食滞心肺之分，而新食不得下而反
出者；有胃中有火与痰而呕者。呕吐药，忌栝蒌、杏仁、桃仁、萝卜子、山栀，
皆要作吐，丸药带香药行散，不妨。注船大吐，渴饮水者即死，童便饮之，最妙。
附方
理中加丁香汤 治中脘停寒，喜辛物，入口即吐。
人参 白术 甘草（炙） 干姜（炮，各一钱） 丁香（十粒）
上 咀。生姜十片，水煎服。或加枳实半钱亦可。不
效，或以二陈汤加丁香十粒，并须冷服
，盖冷遇冷则相入，庶不吐出。又或《活人》生姜橘皮汤。
《活人》生姜橘皮汤
橘皮（四两） 生姜（半斤）
上 咀。水七盏，煮至三盏，去滓，逐旋温服。
热呕《济生》竹茹汤、小柴胡加竹茹汤，见疟类。
上并用生姜多煎服。
《济生》竹茹汤
葛根（三两） 半夏（炮七次，二两） 甘草（炙，一两）
上 咀。每四钱，水一盏，入竹茹一小块，姜五片。
加味二陈汤 治停痰结气而呕。
半夏 橘皮（各五两） 白茯苓（三两） 甘草（炙，一两半） 砂仁（一两） 丁香（五钱） 生姜（三两
上水煎服。
吐虫而呕方
黑铅炒成灰 槟榔末
米饮调下。
脱肛（直肠脱垂）属于气热、气虚、血虚、血热几种证型。对于气热和气虚者，采用补气法，使用人参、[缺字，通常为黄芪或白术]、川芎、当归、升麻。对于血虚者，使用四物汤；对于血热者，采用凉血法，在四物汤中加入炒黄柏；对于气热者，使用条芩六两、升麻一两，用神曲糊制成丸剂，外用五倍子研末，托举肛门使其复位。如果一次未能收回，可进行五到七次，待其完全收回后停止。另外，东北地区的壁土泡制汤剂，先熏蒸后清洗。
〔附录〕肺与大肠互为表里，因此肺脏蕴藏热邪，会导致肛门闭结不通；肺脏虚寒，则会导致肛门脱出。又有妇女分娩用力过度，小儿久患痢疾，都会导致此病。治疗时必须温补肺脏，补益脾胃阳气，时间久了自然就会收敛复原。
附方
香荆散：治疗肛门脱出，大人小孩都适用。
香附子、荆芥（等量），砂仁。
以上药物研为细末。每次服用三钱，用水一碗，煎热后淋洗患处；每次服用三钱，煎汤内服也可以。
又一方：
五倍子研为细末，每次用三钱，煎水清洗。
又一方：
木贼不拘多少，烧成灰研为细末。撒在肛门上并按入，即可痊愈。
凡是有声音且有呕吐物的，称为呕吐；只有声音而没有呕吐物的，称为哕（干呕）。胃中有热、膈上有痰者，使用二陈汤加入炒山栀、黄连、生姜；有久病呕吐者，是胃虚不能受纳食物，用人参、生姜、黄芪、白术、香附之类药物。关于呕吐，朱奉议以半夏、橘皮、生姜为主药。刘河间认为呕吐是火气炎上所致，这只是其中一种情况。还有痰阻膈中焦，食物无法下咽的；有气机逆乱的；有寒气郁结于胃口的；有食滞在心肺之间，新吃下的食物不能下行反而反出的；有胃中有火和痰而呕吐的。治疗呕吐的药物，忌用栝蒌、杏仁、桃仁、萝卜子、山栀，因为这些药容易引起呕吐。丸药中带有香药以行气散结是可以的。注船（一种急救或特殊疗法，此处指剧烈呕吐导致脱水危象）大吐且口渴想喝水的会死亡，饮用童便（童子尿），效果最好。
附方
理中加丁香汤：治疗中脘部停聚寒邪，喜欢辛辣食物，入口即吐。
人参、白术、甘草（炙）、干姜（炮，各一钱）、丁香（十粒）。
以上药物切碎。加入生姜十片，水煎服。或者加枳实半钱也可以。如果无效，可以用二陈汤加丁香十粒，并且必须冷服，因为冷遇冷则相互渗透，这样才不至于吐出。或者使用《活人书》中的生姜橘皮汤。
《活人》生姜橘皮汤
橘皮（四两）、生姜（半斤）。
以上药物切碎。用水七盏，煮至三盏，去渣，慢慢温服。
热呕：《济生方》竹茹汤、小柴胡加竹茹汤，见疟疾类。
以上均用生姜多量煎服。
《济生》竹茹汤
葛根（三两）、半夏（炮七次，二两）、甘草（炙，一两）。
以上药物切碎。每次取四钱，用水一盏，加入竹茹一小块，生姜五片。
加味二陈汤：治疗停痰结气而呕吐。
半夏、橘皮（各五两）、白茯苓（三两）、甘草（炙，一两半）、砂仁（一两）、丁香（五钱）、生姜（三两）。
以上用水煎服。
吐虫而呕方：
黑铅炒成灰、槟榔末。
用米饮调服。
Rectal prolapse (Tuogang) is categorized into patterns of Qi heat, Qi deficiency, Blood deficiency, and Blood heat. For cases of Qi heat and Qi deficiency, the method of tonifying Qi is employed, using Ren Shen (Ginseng Radix et Rhizoma), [missing character, likely Huang Qi or Bai Zhu], Chuan Xiong (Szechwan Lovage Rhizome), Dang Gui (Angelica Sinensis), and Sheng Ma (Cimicifugae Rhizome). For Blood deficiency, Si Wu Tang (Four Substances Decoction) is used; for Blood heat, the method of cooling Blood is applied by adding Chao Bai Bo (Fried Phellodendri Cortex) to Si Wu Tang. For Qi heat, Tiao Qin (Scutellariae Radix) six taels and Sheng Ma one tael are processed with Qu paste into pills. Externally, Wu Bei Zi (Galla Chinensis) powder is used to support and reduce the prolapse. If reduction is not achieved in one attempt, it may be repeated five to seven times until fully reduced. Additionally, soil from walls in the northeast region can be soaked in water to make a decoction for fumigation followed by washing.
[Appendix] The Lung and Large Intestine are exterior-interiorly related. Therefore, if the Lung contains accumulated heat, it leads to anal constipation; if the Lung is deficient and cold, it results in rectal prolapse. Furthermore, excessive effort during childbirth in women and chronic dysentery in children can also cause this condition. Treatment must focus on warming the Lung and tonifying the Yang of the Stomach and Spleen; over time, natural retraction will occur.
Attached Formulas
Xiang Jing San: Treats rectal prolapse, applicable to both adults and children.
Xiang Fu (Cyperi Rhizoma) and Jing Jie (Schizonepetae Herba) in equal parts, Sha Ren (Amomi Fructus).
Grind the above into powder. Take three qian per dose, boil in one bowl of water, heat, and wash externally; alternatively, take three qian as an oral decoction.
Another Formula:
Wu Bei Zi (Galla Chinensis) ground into powder, use three qian per dose, decoct for washing.
Another Formula:
Mu Zei (Equiseti Herba) in any amount, burnt to ash and ground into powder. Sprinkle onto the anus and manually reduce it; recovery follows immediately.
Vomiting with sound and matter is called "Ou" (Vomiting); vomiting with sound but no matter is called "Yue" (Hiccups/Dry Heaving). When there is heat in the Stomach and phlegm in the diaphragm, Er Chen Tang (Two-Cured Decoction) is added with Chao Shan Zhi (Fried Gardenia Fruit), Huang Lian (Coptidis Rhizoma), and Sheng Jiang (Zingiberis Rhizoma). For chronic vomiting due to prolonged illness, which indicates Stomach deficiency failing to receive food, Ren Shen (Ginseng Radix et Rhizoma), Sheng Jiang (Zingiberis Rhizoma), Huang Qi (Astragali Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), and Xiang Fu (Cyperi Rhizoma) are used. Regarding vomiting, Zhu Fengyi emphasized Ban Xia (Pinelliae Rhizoma), Ju Pi (Citri Reticulatae Pericarpium), and Sheng Jiang (Zingiberis Rhizoma) as primary herbs. Liu Hejian stated that vomiting is caused by Fire Qi flaring upward, which is merely one aspect. Other causes include phlegm obstructing the middle jiao preventing food descent, rebellious Qi, Cold Qi stagnating at the stomach opening, food stagnation between the Heart and Lung preventing new food from descending causing regurgitation, and Stomach Fire combined with Phlegm causing vomiting. Medications for vomiting should avoid Gua Lou (Trichosanthis Fructus), Xing Ren (Armeniacae Semen Amarum), Tao Ren (Persicae Semen), Luo Bo Zi (Raphani Semen), and Shan Zhi (Gardeniae Fructus), as these tend to induce vomiting. Pills containing aromatic herbs to promote circulation and dispersion are acceptable. In cases of severe vomiting leading to dehydration and thirst where drinking water causes death, drinking Tong Bian (Child's Urine) is most effective.
Attached Formulas
Li Zhong Jia Ding Xiang Tang: Treats Cold stagnation in the Zhong Wan (Middle Jiao), craving spicy foods, and immediate vomiting upon ingestion.
Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Gan Cao (Licorice Root, honey-fried), Gan Jiang (Zingiberis Rhizoma, roasted, each 1 qian), Ding Xiang (Caryophylli Flos, 10 buds).
Chop the above ingredients. Add ten slices of Sheng Jiang (Zingiberis Rhizoma), decoct in water, and take orally. Alternatively, add Zhi Shi (Aurantii Fructus Immaturus) half a qian. If ineffective, use Er Chen Tang (Two-Cured Decoction) with ten Ding Xiang (Caryophylli Flos), and it must be taken cold. The principle is that cold meets cold to penetrate, thereby preventing expulsion. Alternatively, use Sheng Jiang Ju Pi Tang (Fresh Ginger and Tangerine Peel Decoction) from *The Living Book* (*Huo Ren Shu*).
*Huo Ren* Sheng Jiang Ju Pi Tang
Ju Pi (Citri Reticulatae Pericarpium, 4 liang), Sheng Jiang (Zingiberis Rhizoma, 0.5 jin).
Chop the above. Use seven bowls of water, boil down to three bowls, remove dregs, and take warm gradually.
Heat Vomiting: Zhu Ru Tang (Bamboo Shavings Decoction) from *Ji Sheng Fang* and Xiao Chai Hu Tang (Minor Bupleurum Decoction) plus Zhu Ru (Bambusae Caulis in Taenia), see Malaria category.
All the above should be decocted with a large amount of Sheng Jiang (Zingiberis Rhizoma) and taken warm.
*Ji Sheng* Zhu Ru Tang
Ge Gen (Puerariae Lobatae Radix, 3 liang), Ban Xia (Pinelliae Rhizoma, roasted seven times, 2 liang), Gan Cao (Licorice Root, honey-fried, 1 liang).
Chop the above. Take four qian per dose, use one bowl of water, add a small piece of Zhu Ru (Bambusae Caulis in Taenia) and five slices of Sheng Jiang (Zingiberis Rhizoma).
Jia Wei Er Chen Tang: Treats vomiting due to retained Phlegm and stagnant Qi.
Ban Xia (Pinelliae Rhizoma), Ju Pi (Citri Reticulatae Pericarpium, each 5 liang), Bai Fu Ling (Poria, 3 liang), Gan Cao (Licorice Root, honey-fried, 1.5 liang), Sha Ren (Amomi Fructus, 1 liang), Ding Xiang (Caryophylli Flos, 0.5 qian), Sheng Jiang (Zingiberis Rhizoma, 3 liang).
Decoct in water and take orally.
Formula for Vomiting Parasites:
Hei Qian (Lead, stir-fried to ash), Bing Lang (Arecae Semen) powder.
Mix with Mi Yin (Rice Decoction) and take orally.