阜城杜××，年四十五岁，得大便下血证。
病因 因劳心过度，每大便时下血，服药治愈。因有事还籍，值夏季暑热过甚，又复劳心过度，
旧证复发，屡治不愈。遂来津入西医院治疗，西医为其血在便后，谓系内痔，服药血仍
不止，因转而求治于愚。
证候 血随便下，且所下甚多，然不觉疼坠，心中发热懒食，其脉左部弦长，右部洪滑。
诊断 此因劳心生内热而牵动肝经所寄相火，致肝不藏血而兼与溽暑之热相并，所以血妄行也。
宜治以清心凉肝兼消暑热之剂，而少以培补脾胃之药佐之。
处方 生怀地黄（一两） 白头翁（五钱） 龙眼肉（五钱） 生怀山药（五钱）
知母（四钱） 秦皮（三钱） 黄柏（二钱） 龙胆草（二钱） 甘草（二钱）
共煎汤一大盅，温服。
复诊 上方煎服一剂，血已不见，服至两剂，少腹觉微凉。再诊其脉，弦长与洪滑之象皆减退，
遂为开半清半补之方以善其后。
处方 生怀山药（一两） 熟怀地黄（八钱） 净萸肉（五钱） 龙眼肉（五钱）
白头翁（五钱） 秦皮（三钱） 生杭芍（三钱） 地骨皮（三钱）
甘草（二钱）
共煎汤一大盅，温服。
效果 将药煎服一剂后，食欲顿开，腹已不疼，俾即原方多服数剂，下血病当可除根。
阜城人杜某某，四十五岁，患大便下血证。
病因 因用脑过度，每次大便时便血，服药后治愈。后因事回乡，正值夏季暑热极盛，又再次用脑过度，旧病复发，多次治疗无效。于是来到天津进入西医院治疗，西医认为其血液在排便后流出，诊断为内痔，服药后出血仍不止，因此转而寻求我的诊治。
证候 血液随大便排出，且出血量很大，但不觉疼痛或肛门坠胀感，心中发热，食欲不振，脉象左部弦长，右部洪滑。
诊断 这是由于劳心导致内生内热，进而牵动肝经所寄居的相火（指肝肾中维持生命活动的动力之火），致使肝脏不能正常藏血，同时与潮湿酷热的暑气相结合，所以血液妄行溢出。应当使用清心、凉肝并兼消暑热的方剂进行治疗，并少量辅以培补脾胃的药物作为佐助。
处方 生怀地黄（一两） 白头翁（五钱） 龙眼肉（五钱） 生怀山药（五钱）
知母（四钱） 秦皮（三钱） 黄柏（二钱） 龙胆草（二钱） 甘草（二钱）
共同煎煮成一大盅汤药，温服。
复诊 上方煎服一剂后，出血已停止，服用两剂后，小腹部感觉微微凉爽。再次诊察其脉象，弦长和洪滑的脉象都已减退，于是为他开具半清泄半补益的方剂以巩固疗效。
处方 生怀山药（一两） 熟怀地黄（八钱） 净萸肉（五钱） 龙眼肉（五钱）
白头翁（五钱） 秦皮（三钱） 生杭芍（三钱） 地骨皮（三钱）
甘草（二钱）
共同煎煮成一大盅汤药，温服。
效果 将药物煎服一剂后，食欲立刻大开，腹部不再疼痛，让他继续按原方多服几剂，下血的病症应当可以除根。
Fucheng resident Du XX, aged forty-five, suffered from hematochezia (blood in stool).
Etiology Due to excessive mental exertion, he experienced bleeding during defecation, which was cured by medication. Later, due to matters requiring his return to his hometown, coinciding with extreme summer heat and dampness, and again suffering from excessive mental exertion, the old condition relapsed. Despite multiple treatments, it remained uncured. He then came to Tianjin for treatment at a Western hospital. The Western physicians noted that the blood appeared after defecation and diagnosed internal hemorrhoids. However, medication failed to stop the bleeding, so he turned to seek my treatment.
Symptoms Blood passed with the stool, and the volume of bleeding was substantial; however, there was no sensation of pain or tenesmus (painful straining). He felt heat in the heart region and had a poor appetite. His pulse was wiry and long on the left side, and large and slippery on the right side.
Diagnosis This condition arises because mental overexertion generates internal heat, which agitates the Ministerial Fire (Xiang Huo, the fire associated with the Liver and Kidney meridians) residing within the Liver meridian. Consequently, the Liver fails to store blood properly, and this pathological state combines with the humid and hot pathogenic factor of summer-heat, leading to reckless bleeding. Treatment should employ a formula that clears the Heart, cools the Liver, and dissipates summer-heat, supplemented with a small amount of herbs to tonify the Spleen and Stomach.
Prescription Raw Shenghuai Rehmanniae Radix (1 liang), Pulsatillae Radix (5 qian), Longan Arillus (5 qian), Raw Shenghuai Dioscoreae Rhizoma (5 qian), Anemarrhenae Rhizoma (4 qian), Phellodendri Cortex (3 qian), Phellodendri Amurensis Cortex (2 qian), Gentianae Radix (2 qian), Glycyrrhizae Radix et Rhizoma (2 qian).
Decoct together in one large cup of water, take warm.
Second Visit After taking one dose of the above prescription, the bleeding ceased. After two doses, he felt a slight coolness in the lower abdomen. Upon re-examination, both the wiry-long and large-slippery pulse qualities had subsided. Therefore, I prescribed a formula that is half-clearing and half-tonifying to consolidate the recovery.
Prescription Raw Shenghuai Dioscoreae Rhizoma (1 liang), Cooked Shenghuai Rehmanniae Radix (8 qian), Clean Corni Fructus (5 qian), Longan Arillus (5 qian), Pulsatillae Radix (5 qian), Phellodendri Cortex (3 qian), Raw Hangbai Paeoniae Radix (3 qian), Lycii Cortex (3 qian), Glycyrrhizae Radix et Rhizoma (2 qian).
Decoct together in one large cup of water, take warm.
Outcome After taking one dose, his appetite immediately improved, and abdominal pain disappeared. Advised him to continue taking several more doses of the original prescription, and the hematochezia should be eradicated.