治肠胃有湿，胀满下血。
苍术 浓朴 陈皮 当归 枳壳（各一两） 槐花（二两） 甘草 乌梅（各五钱） 每用五
钱水煎空心服。
治肠胃积热，或酒毒下血。
黄连（四两，酒炒一两，姜汁炒一两，灰火煨一两，生用一两） 黄芩 防风（各一两）
为末，煮面糊丸，桐子大，每服五十丸，米泔浸，枳壳水下。
治大便后下血，腹中痛，谓之热毒下血。
芍药 黄连 当归（各五钱） 淡桂（五分） 炙甘草（二钱） 大黄 每服一两，水煎
服。如痛甚者，加木香、槟榔。
治脏腑虚寒，下血不止，而色痿黄，日久赢瘦。盖失血症乃火使之然。言虚则可，
言寒则不可也。然久则火势已衰，脏腑虚寒兼备矣。丹溪云，下血久不愈者，后用温
剂。
侧柏叶（炒黄） 鹿茸（火去毛，醋煮） 附子（泡去皮、脐） 川续断（酒
浸） 阿胶（蛤粉炒） 黄 当归（去芦，酒浸，各一两） 白矾（枯，五钱） 为
末，醋煮米糊丸，如桐子大，每服七十丸，空心米饮下。
一方
治便血不论新久，神效。
用白矾细末，七八分，大人一钱五分，调入鸡子内煎熟，切作细块，空心白汤吞下。
丹溪曰∶肠风独在胃与大肠出。兼风者宜苍术、秦艽、芍药、香附之类。肠风者，
邪气外入，随感随见，所以色清，脏毒者蕴积毒久而始见，所以色浊。治肠风以散风行
湿，治脏毒以清热凉血，又要看其虚实新久，新者实者降之泻之，虚者久者升之补
之。血之在身，有阴有阳，阳者顺气而行，循流脉中，调和五脏，洒陈六腑，谓之营
血，阴者居于络脉，专守脏腑，滋养神气，濡润筋骨，若感内外之邪，而受伤，则或循
经之阳血，至其伤处，为邪气所沮，漏泄经外，或居络之阴血，因留着之邪，溃裂而
出，则皆渗入肠胃而泄矣。世俗率以肠风名之，不知风乃六淫之一耳。若肠胃受火热二
淫，与寒燥湿怫郁其气，及饮食劳力，伤其阴络之血者，亦可谓之肠风乎？《针经》曰∶
阳络伤则血外溢而吐衄，阴络伤则血内溢而便溺，是也。不可纯用寒凉药，必加辛散为
佐，久之不愈，宜理胃气，兼升举药，盖精气血气皆生于谷气，大便下血，多以胃药收
功，徒用苦寒而不理脾胃，是绝气危生之下工也。
肠胃本无血，而有下血者，大肠之病也。大肠何以病下血，邪以感之也。盖阴络
不伤，肠胃不虚，虽有外邪，亦不能患，惟醉饱房劳，坐卧风湿，恣啖生冷，以致湿热
阴络受伤，外邪得以乘之。《经》云∶阴络伤，则血内溢而便血；又云，结阴者便血一
升，再结二升，三结三升，此言阴气内结，不得外行渗入肠间，乃寒湿生灾，而阴邪之
胜也。外邪者何？风寒暑湿热是也。风喜伤肝，肝伤则不能藏血而下者，醉后饮冷，寒
饮内伤，血为寒凝，渗入大肠而下者，内外伤湿，湿伤凝胃，随气下流而致者，膏粱人
浓味酒色，藜藿人劳役过度，以致热积下焦而致者，然湿毒下血者，腹中不痛，热毒下
血者，腹中多痛，更有内伤阳气不足，下焦之阴，无元阳以维之，而下血者，书所谓病
人面无色，脉浮弱，手按之绝者，下血是也。有脾虚阳气下陷，不能统血，以致血随
气降而下者，盖阴必从阳，血必从气，脾为气血生化之源，故必赖补中升阳，以胃药收
功，有以先便后血者为远血，由足阳明随经入胃，先血后便者为近血，由手阳明大肠随
经下渗，有以心肺为远血而属阳，肝肾为近血而属阴，以论者名为肠风脏毒，实非外感
之风，肿热之毒之谓，盖阳明之气不能上越，下陷大肠，肠胃之脉随气虚陷，陷久则
湿热蕴毒，随气陷而先至，其腹不痛，血清而色鲜者名曰肠风、邪气外人，随感而见者
也。谓之挟寒下血，后人因古方多用荆防升散，而窒之为风，实非风也。脏毒者肠风日
久，气血俱虚，下陷日甚，大肠湿热蕴积，遂生窠穴，为积血之器，从便之前后而来，
其腹痛则痛，血浊而色黯者名曰脏毒，内伤蕴积，久而始发者也。谓之挟热下血，虽有
毒名，实菲毒也。肠风者风邪淫乎肠胃也。脏毒者湿邪淫乎肠胃也。若血射如线者虫痔
也。肠风脏毒之血，自肠脏而来，五痔之血，自肛门蚀孔处出也。
凡下血身凉血寒者生，身热血温者死。
一方
治积热便血。
苍术 陈皮（各一两五钱） 黄连 黄柏 条芩（各七钱五分） 连翘（五钱） 为末，生
膏六两，合丸桐子大，每服五七十丸，白汤下。
治疗肠胃有湿邪，导致腹胀满并伴有便血。
苍术、浓朴、陈皮、当归、枳壳（各一两），槐花（二两），甘草、乌梅（各五钱）。每次取五钱，加水煎煮，空腹服用。
治疗肠胃积热，或因酒毒导致的便血。
黄连（四两，其中一两用酒炒，一两用姜汁炒，一两用灰火煨，一两生用），黄芩、防风（各一两）。研为细末，用煮面糊制成丸药，如梧桐子大小，每次服用五十丸，用米泔水浸泡过的枳壳汤送服。
治疗大便后便血，腹部疼痛，这称为热毒下血。
芍药、黄连、当归（各五钱），淡桂（五分），炙甘草（二钱），大黄。每次服用一两，加水煎煮服用。如果疼痛剧烈，加入木香、槟榔。
治疗脏腑虚寒，便血不止，血色萎黄，日久身体消瘦。失血症多由火邪引起，说虚是可以的，说寒则不准确。然而病程久了，火势已经衰退，脏腑便兼具了虚和寒的特点。丹溪说，便血久治不愈的，后期应用温补药剂。
侧柏叶（炒至变黄），鹿茸（用火去毛，醋煮），附子（泡制去皮、脐），川续断（酒浸），阿胶（蛤粉炒），黄芪、当归（去芦头，酒浸，各一两），白矾（枯矾，五钱）。研为细末，用醋煮米糊制成丸药，如梧桐子大小，每次服用七十丸，空腹用米饮送服。
另一个方子：
治疗便血不论新久，神效。
用白矾细末，七分或八分，成人一钱五分，调入鸡蛋内煎熟，切成小块，空腹用白开水吞下。
丹溪说：肠风出血独见于胃与大肠。兼有风邪的，适宜用苍术、秦艽、芍药、香附之类。肠风，是邪气从外侵入，随感随发，所以血色清亮；脏毒，是蕴积毒素日久才发作，所以血色浑浊。治疗肠风要疏散风邪、祛除湿邪，治疗脏毒要清热凉血，还要辨别虚实和新久，新病实证用降法泻法，虚病久病用升法补法。血液在体内，有阴有阳，阳性的顺气而行，循行于脉管之中，调和五脏，布散六腑，称为营血；阴性的居于络脉，专守脏腑，滋养神气，濡润筋骨，若感受内外邪气而受伤，那么或是循经的阳血，到了受伤处，被邪气阻滞，漏泄出经脉之外；或是居于络脉的阴血，因留着的邪气，溃裂而出，都会渗入肠胃而排泄出来。世俗人一概称之为肠风，不知道风只是六淫之一罢了。如果肠胃受火热二淫，以及寒燥湿郁结其气，加上饮食劳力，伤了阴络之血，也可以称之为肠风吗？《针经》说：阳络受伤则血外溢而吐血衄血，阴络受伤则血内溢而便溺出血，正是这个道理。不能纯用寒凉药，必须加辛散药作为辅助，久治不愈的，应当调理胃气，兼用升举药，因为精气血气都生于谷气，大便下血，多以调理脾胃的药物收功，只用苦寒药而不调理脾胃，这是断绝生气、危及生命的下等医生。
肠胃本来没有血，而出现便血的，是大肠的病。大肠为什么会病而下血，是因为邪气侵袭所致。只要阴络不伤，肠胃不虚，虽然有外邪，也不能致病，只有醉饱房劳，坐卧风湿，恣意吃生冷，导致湿热伤了阴络，外邪得以乘虚而入。《内经》说：阴络受伤，则血内溢而便血；又说，结阴者便血一升，再结二升，三结三升，这是说阴气内结，不得外行渗入肠间，乃寒湿生灾，而阴邪胜盛所致。外邪是什么？风寒暑湿热是也。风容易伤肝，肝伤则不能藏血而下注；醉后饮冷，寒饮内伤，血为寒凝，渗入大肠而下注；内外伤湿，湿伤凝滞胃气，随气下流而导致；膏粱之人厚味酒色，藜藿之人劳役过度，以致热积下焦而导致。然而湿毒下血者，腹中不痛；热毒下血者，腹中多痛。更有内伤阳气不足，下焦之阴，无元阳以维系，而下血者，书中所说病人面无血色，脉浮弱，手按之绝者，就是下血。有脾虚阳气下陷，不能统摄血液，以致血随气降而下注的，盖阴必从阳，血必从气，脾为气血生化之源，所以必须依赖补中升阳，以调理脾胃的药收功。有先大便后出血的称为远血，由足阳明胃经随经入胃；先出血后大便的称为近血，由手阳明大肠经随经下渗。有心肺为远血而属阳，肝肾为近血而属阴的说法。论者名为肠风脏毒，其实并非外感之风，也不是肿热之毒的意思。盖阳明之气不能上越，下陷大肠，肠胃之脉随气虚陷，陷久则湿热蕴毒，随气陷而先到，其腹不痛，血清而色鲜的叫做肠风，是邪气从外人侵，随感而发的。叫做挟寒下血，后人因为古方多用荆芥、防风升散，而将其窒塞为风，其实不是风。脏毒是肠风日久，气血俱虚，下陷日甚，大肠湿热蕴积，遂生窠穴，成为积血的容器，从便前便后而来，其腹痛则痛，血浊而色黯的叫做脏毒，是内伤蕴积，久而始发的。叫做挟热下血，虽然有毒名，其实不是毒。肠风是风邪淫溢于肠胃。脏毒是湿邪淫溢于肠胃。如果血射如线的，是虫痔。肠风脏毒的血，自肠脏而来；五痔的血，自肛门蚀孔处出。
凡是便血身凉血寒的预后良好，身热血温的预后不良。
另一个方子：
治疗积热便血。
苍术、陈皮（各一两五钱），黄连、黄柏、条芩（各七钱五分），连翘（五钱）。研为细末，用生蜜六两，合丸如梧桐子大，每次服用五七十丸，白开水送下。
Treats dampness in the intestines and stomach, leading to abdominal distension and fullness accompanied by hematochezia (blood in stool).
Cangzhu Rhizoma Atractylodis Macrocephalae, Nongpo Cortex Magnoliae Officinalis, Chenpi Pericarpium Citri Reticulatae, Danggui Radix Angelicae Sinensis, Zhike Fructus Aurantii Immaturus (each 1 liang), Huaihua Flos Sophorae Flavescentis (2 liang), Gancao Radix Glycyrrhizae uralensis, Wumei Fructus Mume (each 5 qian). Take 5 qian each time, decoct in water, and take on an empty stomach.
Treats accumulation of heat in the intestines and stomach, or hematochezia caused by alcohol toxicity.
Huanglian Radix Coptidis (4 liang: 1 liang stir-fried with wine, 1 liang stir-fried with ginger juice, 1 liang roasted in ash fire, 1 liang used raw), Huangqin Radix Scutellariae, Fangfeng Radix Saposhnikoviae (each 1 liang). Grind into fine powder, make pills using wheat paste, size of Sophora seeds. Take 50 pills each time, soaked in rice wash water, taken down with Zhike Fructus Aurantii Immaturis water.
Treats hematochezia after defecation, accompanied by abdominal pain, known as heat-toxicity hematochezia.
Shaoyao Radix Paeoniae Alba, Huanglian Radix Coptidis, Danggui Radix Angelicae Sinensis (each 5 qian), Dan Gui Ramulus Cinnamomi (5 fen), Zhi Gancao Radix Glycyrrhizae uralensis preparata (2 qian), Dahuang Radix et Rhizoma Rhei. Take 1 liang each time, decoct in water and take. If pain is severe, add Muxiang Radix Aucklandiae, Binglang Semen Arecae.
Treats deficiency-cold of the zang-fu organs, persistent hematochezia, with withered yellow blood color, and emaciation over a long period. Hemorrhagic diseases are generally caused by fire; saying it is deficiency is acceptable, but saying it is cold is not accurate. However, after a long duration, the fire energy has declined, and the zang-fu organs possess both deficiency and cold characteristics. Danxi stated that for persistent hematochezia that does not heal, warm agents should be used later.
Cebaiye Folium Platycladi, Lurong Cornu Cervi Pantotrichum (fire-dehaired, boiled in vinegar), Fuzii Radix Aconiti Lateralis Preparata (soaked, skin and umbilicus removed), Chuanxuduan Radix Dipsaci, Ejiao Colla Asini (stir-fried with Gefen Powder), Huangqi Radix Astragali, Danggui Radix Angelicae Sinensis (remove root neck, soak in wine, each 1 liang), Baifan Alumen (calcined, 5 qian). Grind into fine powder, make pills using vinegar-boiled rice paste, size of Sophora seeds. Take 70 pills each time, taken on an empty stomach with rice drink.
Another prescription:
Treats hematochezia regardless of whether new or old, with miraculous effect.
Use finely powdered calcined alum (Baifan), 7-8 fen, adults 1.5 qian, mix into an egg, fry until cooked, cut into small pieces, swallow with plain warm water on an empty stomach.
Danxi said: Intestinal wind bleeding occurs exclusively in the stomach and large intestine. For cases complicated by wind, Cangzhu Rhizoma Atractylodis Macrocephalae, Qinjiao Radix Gentianae Macrophyllae, Shaoyao Radix Paeoniae Alba, Xiangfu Rhizoma Cyperi Rotundi are suitable. Intestinal wind refers to pathogenic factors entering from outside, appearing immediately upon exposure, hence the blood is clear. Zangdu (Visceral toxin) involves accumulated toxins manifesting only after a long time, hence the blood is turbid. To treat intestinal wind, disperse wind and eliminate dampness; to treat Zangdu, clear heat and cool blood. One must also assess deficiency/excess and new/old nature. New and excess conditions are treated with descending and purging methods; deficient and chronic conditions are treated with ascending and tonifying methods. Blood in the body has yin and yang aspects. Yang blood follows qi, circulates within the vessels, harmonizes the five zang organs, and distributes to the six fu organs, called Ying-blood (Nutritive blood). Yin blood resides in the collaterals, guarding the zang organs, nourishing spirit and qi, and moistening sinews and bones. If injured by internal or external pathogens, either the Yang blood following the meridians reaches the injury site, is obstructed by pathogens, and leaks out of the meridians; or the Yin blood residing in the collaterals, due to lingering pathogens, ruptures and exits. Both will seep into the intestines and stomach and be excreted. The common people generally call this intestinal wind, not knowing that wind is merely one of the Six Excessive Factors (Liu Yin). If the intestines and stomach are affected by Heat and Fire excessive factors, or constrained by Cold, Dryness, and Dampness, along with dietary and labor injuries damaging the Yin collateral blood, can this also be called intestinal wind? The *Zhen Jing* (Needle Classic) states: Injury to Yang collaterals leads to external blood overflow causing hematemesis and epistaxis; injury to Yin collaterals leads to internal blood overflow causing hematochezia and hematuria. This is correct. One cannot use purely cold-cooling medicines; pungent dispersing agents must be added as assistants. For chronic non-healing cases, regulate Stomach Qi and combine with ascending/lifting herbs. Essence, Qi, Blood, and Qi all originate from Grain Qi. Hematochezia often resolves with Stomach-regulating medicines. Using only bitter-cold medicines without regulating Spleen and Stomach is the work of inferior doctors who cut off vital energy and endanger life.
The intestines and stomach originally have no blood; hematochezia is a disease of the Large Intestine. Why does the Large Intestine bleed? It is due to pathogenic invasion. If Yin collaterals are not injured and the intestines/stomach are not deficient, even with external pathogens, disease cannot occur. Only through drunkenness, overeating, sexual indulgence, sitting/lying in wind-dampness, and indulging in raw/cold foods, leading to damp-heat injuring Yin collaterals, can external pathogens take advantage. The *Classic* says: Injury to Yin collaterals leads to internal blood overflow and hematochezia; it also says, those with Jieyin (Knotted Yin) bleed one sheng, if knotted again two sheng, if knotted thrice three sheng. This refers to internal knotting of Yin Qi, unable to circulate outward, seeping into the intestines, causing disaster from cold-dampness and dominance of Yin pathogens. What are external pathogens? Wind, Cold, Summer-heat, Dampness, Heat. Wind easily injures the Liver; Liver injury fails to store blood, leading to downward flow. Drinking cold liquids after intoxication causes internal cold injury, congealing blood, which seeps into the Large Intestine and flows down. Internal and external dampness injury congeals Stomach Qi, flowing down with Qi. People consuming rich foods, alcohol, and sensual pleasures, or laborers working excessively, cause heat accumulation in the Lower Jiao. However, damp-toxicity hematochezia presents without abdominal pain; heat-toxicity hematochezia presents with frequent abdominal pain. Furthermore, internal injury with insufficient Yang Qi, where Yin in the Lower Jiao lacks Yuan-Yang support, leads to bleeding. Books describe patients with pale faces, floating and weak pulses, feeling absent upon pressure, as having hematochezia. Spleen deficiency with sinking of Yang Qi, failing to control blood, causes blood to descend with Qi. Yin follows Yang, Blood follows Qi. The Spleen is the source of Qi and Blood production, thus requiring Bu Zhong Sheng Yang (Tonify Middle and Ascend Yang) and resolving with Stomach medicines. Bleeding before defecation is called Yuanxue (Remote Blood), associated with Foot Yangming Stomach Meridian entering the Stomach; bleeding after defecation is called Jin xue (Close Blood), associated with Hand Yangming Large Intestine Meridian seeping downward. Some consider Heart/Lung as Remote Blood (Yang) and Liver/Kidney as Close Blood (Yin). Those discussing "Intestinal Wind" and "Zangdu" actually do not mean external Wind or swelling-Heat Toxicity. When Yangming Qi fails to ascend and sinks into the Large Intestine, the intestinal meridians sink with Qi deficiency. Long-term sinking leads to damp-heat accumulating into toxicity. Arriving first with sinking Qi, with no abdominal pain, clear serum, and bright red color, it is named Intestinal Wind, meaning external pathogens enter and appear upon exposure. It is called Cold-complicated hematochezia. Later generations, because ancient formulas often used Jingjie (Schizonepeta) and Fangfeng (Saposhnikovia) for ascending/dispersing, mistakenly categorized it as Wind, but it is not actually Wind. Zangdu results from prolonged Intestinal Wind, where Qi and Blood become deficient, sinking worsens daily, damp-heat accumulates in the Large Intestine, forming nests/pockets, becoming vessels for accumulated blood, coming before or after stool. With abdominal pain, turbid blood, and dark color, it is named Zangdu, resulting from internal injury and accumulation, manifesting only after a long time. It is called Heat-complicated hematochezia. Although named toxicity, it is not actually toxic. Intestinal Wind is Wind Pathogen overflowing in intestines/stomach. Zangdu is Damp Pathogen overflowing in intestines/stomach. If blood shoots like a thread, it is Chongzhi (Worm Hemorrhoids). Blood from Intestinal Wind/Zangdu comes from intestines/viscera; blood from Five Hemorrhoids comes from anal erosion points.
Generally, hematochezia with cool body and cold blood indicates survival; hematochezia with hot body and warm blood indicates death.
Another prescription:
Treats accumulation-heat hematochezia.
Cangzhu Rhizoma Atractylodis Macrocephalae, Chenpi Pericarpium Citri Reticulatae (each 1.5 liang), Huanglian Radix Coptidis, Huangbai Cortex Phellodendri, Tiao Qin Radix Scutellariae (each 0.75 liang), Lianqiao Fructus Forsythiae (0.5 liang). Grind into powder, mix with 6 liang of raw honey, make pills size of Sophora seeds. Take 50-70 pills each time, taken down with warm water.