治内损，吐血下血，或饮酒太过，劳伤于内，其血妄行，出如涌泉，口鼻皆流，须臾不
救即死。
侧柏叶（一两半，蒸焙） 荆芥穗（烧灰） 人参（各一两）
上为细末，入飞罗面一钱，新汲水调如稀糊，不拘时啜服。
治诸吐血下血，溺血衄血。
生地黄 熟地黄 枸杞子 地骨皮 天门冬 黄 芍药 黄芩 甘草（各等分）
上锉碎，每服一两，水二盏，煎七分，食后温服。如脉微身凉，恶风，加桂半钱，吐血
者多有此证。
治吐呕血。
大蓟汁 地黄汁 生姜汁 麦门冬汁 刺蓟汁（各三合）
上用白蜜半匙相和匀，冷服。
治鼻衄不止。
麝香（半字，另研） 明矾（枯，另研） 龙骨（另研，各五钱）
上和匀，每用一字，先以冰水洗净鼻内血涕，然后吹入鼻中，或以湿纸蘸药塞鼻中亦可。
凡九窍出血皆可用方
墙头苔藓可以塞，车前草汁可以滴；
火烧莲房用水调，锅底墨煤可以吃；
石榴花片可以塞，生萝卜汁可以滴；
火 龙骨可以吹，水煎茅花可以吃。
经曰∶风客淫气，其精乃亡，邪伤肝也，因而饱食，筋脉横解，肠 为痔。盖缘风气
通于肝，肝生风，风生热，风客则淫气伤精，精亡则邪热伤肝，因饱食行房，则筋脉横解，
而肠 痔漏生焉。夫痔者，而《巢氏病源论》有五∶曰牡痔、牝痔、脉痔、肠痔、血痔也、
及古诸方又有酒痔、气痔、虫痔、番花、蝼蛄等痔之名不一，且痔于肛门生 ，或在外而或
在内，有似鼠乳者，有似樱桃者，其形不一。其病有痛有痒，有硬有软，有脓溃者，有不溃
者，有肿痛便难者，有随大便下清血不止者，有穿窍血出如线者。至于失治而成漏者，成漏
而穿臀者，及有穿肠成孔、粪从孔中出者，或肛门四围，生 数枚，脓血浸淫，若莲花者。
详此诸证，大凡肛边生乳鼠，时出脓血者为牡痔；肛边生疮，肿痛出血者为牝痔；肛边生疮，
且疼且痒者为脉痔；肛内结核，寒热出血者为肠痔；肛门肿痛，大便难，强力则肛出不收者
为气痔；肛门疮肿流血，饮酒即发者为酒痔；肛边有窍，血出如射线者为血痔；肛门浸淫湿
烂，内有蛲虫，蚀肠穿穴，遂成漏者为虫痔也。然此诸证，皆本之于大肠也。大肠者，庚金
也，本性燥清，肃杀之气，本位主收，所司主行津液，以从足阳明中州土之所化，若旺则能
生化万物，而衰则损伤万物，故云万物生于土而归于土，此之谓也。然手足之阳明，同司其
化焉。若人醉饱行房，精气脱泄，其脉空虚，酒热之毒，流着于脉；或因醉饱，淫极而强忍
泄；或用药固其精，弗能泄越，停积于脉，归注大肠，以致木乘火势，而侮燥金，以火就燥，
则大便闭而痔漏作矣。治宜苦寒泻火，辛温和血润燥，疏风止痛之剂也。《灵枢经》云∶足
太阳膀胱之脉及筋，皆抵腰中，入络肾，其支者贯臀足，故主筋为病，则生此疾。由是推之，
足厥阴之脉，环绕前后一阴，故亦能为痔矣。每见人患痔，其发则色青痛甚，盖谓肝苦急而
然也。且夫痔与漏，初致之由虽同，所患之病实异。初生肛边，成 不破者曰痔；破溃而出
脓血，黄水浸淫，淋沥久不止者曰漏也。原此受病者，燥气也，为病者，湿热也，胃行大肠
则化燥，火以乘湿，热之实也。若夫肠头成块者，湿也，作痛者，风也，脓血溃出者，热胜
血腐也，溃成黄水者，湿热风燥也，大便闭，作大痛者，风热郁滞，弗能通泄，气逼大肠而
作也。大肠结燥者，主病兼受，火邪也。凡此疾者，皆由湿热风燥，四气相合而致也。而肠
者，为大便下血也。盖因人之不避风毒，恣饮醇酒炙爆之物，纵欲，喜怒无常，脏腑郁抑，
饮食自倍，肠胃乃伤，阴阳不和，关格壅滞，热毒下注，血渗大肠，其肠 痔漏，不可得而
无矣。经云筋脉横解，肠 为痔者此也。至于脏毒肠风痔漏，而名虽殊，其源实一。大抵肠
之病，有可治不可治者。若便血身寒则可治，身热则不可治。肠 下白沫，脉沉者生，脉
浮者死；如下脓血，脉滑大者生，脉悬绝则死。肠 脾脉外鼓，沉久自已，而肝脉小缓则易
治，肾脉搏沉，身热是死也。医疗之法，惟宜祛风消毒，解热凉脏，和血润燥，随宜施治，
无不瘥矣。
治疗内伤引起的吐血、便血，或因饮酒过量、体内劳损导致血液妄行，出血如涌泉般，口鼻同时流血，若不及时抢救就会死亡。
侧柏叶（一两半，蒸后焙干） 荆芥穗（烧成炭灰） 人参（各一两）
以上药物研成细末，加入飞罗面一钱，用刚打来的冷水调成稀糊状，不限时间服用。
治疗各种吐血、便血、尿血、鼻出血。
生地黄 熟地黄 枸杞子 地骨皮 天门冬 黄芪 芍药 黄芩 甘草（各等分）
以上药物切碎，每次服用一两，加水两盏，煎至七分，饭后温服。如果脉象微弱、身体发凉、怕风，加桂枝半钱，吐血患者多有这种证候。
治疗呕吐血液。
大蓟汁 地黄汁 生姜汁 麦门冬汁 刺蓟汁（各三合）
以上用白蜜半匙调和均匀，冷服。
治疗鼻出血不止。
麝香（半字，单独研磨） 明矾（枯矾，单独研磨） 龙骨（单独研磨，各五钱）
以上药物混合均匀，每次取一字量，先用冰水洗净鼻腔内的血涕，然后吹入鼻中，或者用湿纸蘸药塞入鼻中也可以。
凡是九窍出血都可以使用的方剂：
墙头苔藓可以塞入，车前草汁可以滴入；
烧焦的莲房用水调服，锅底黑灰可以吃下；
石榴花瓣可以塞入，生萝卜汁可以滴入；
煅龙骨可以吹入，茅花水煎可以喝下。
经书说：风邪客居体内扰乱正气，人的精气就会耗亡，邪气伤害肝脏，如果因此饱食，筋脉松弛横解，肠道就会发生痔疮。大概因为风气通于肝，肝生风，风生热，风邪客居则淫乱之气损伤精气，精气耗亡则邪热伤害肝脏，加上饱食和行房事，导致筋脉松弛横解，从而产生肠痔和痔漏。所谓痔，《巢氏病源论》中有五种：叫牡痔、牝痔、脉痔、肠痔、血痔；以及古代各方又有酒痔、气痔、虫痔、番花痔、蝼蛄痔等名称不一。而且痔生在肛门处，有的在外，有的在內，形状像鼠乳的，像樱桃的，形态各不相同。病症有痛有痒，有硬有软，有化脓溃烂的，有不溃烂的，有肿痛排便困难的，有大便时流出清血不止的，有穿孔出血如线状的。至于失治而成漏的，成漏后穿透臀部的，以及穿透肠道形成孔洞、粪便从孔中流出的，或者肛门四周生出数枚疮疡，脓血浸淫，像莲花一样的。详细考察这些症状，大凡肛边生出像鼠乳一样的，时常流出脓血的是牡痔；肛边生疮，肿痛出血的是牝痔；肛边生疮，又疼又痒的是脉痔；肛内有结核，伴有寒热出血的是肠痔；肛门肿痛，大便困难，用力时肛门脱出不能收回的是气痔；肛门疮肿流血，饮酒就发作的是酒痔；肛边有孔窍，出血如射线状的是血痔；肛门浸淫湿烂，里面有蛲虫，侵蚀肠道穿透孔穴，最终成漏的是虫痔。然而这些病症，根源都在大肠。大肠属庚金，本性燥而清肃，具有肃杀之气，本位主收敛，所主管的是运行津液，以顺从足阳明中州土所化生的性质，如果旺盛就能生化万物，如果衰弱就会损伤万物，所以说万物生于土而归于土，就是这个道理。然而手阳明和足阳明，共同主管这种化生作用。如果人醉酒后行房事，精气脱泄，脉象空虚，酒热的毒邪，流注于脉管；或者因为醉饱，纵欲过度而强行忍耐不泄；或者用药固摄精气，不能发泄，停积在脉管中，归注于大肠，导致木乘火势，而侮慢燥金，以火就燥，从而导致大便闭塞而痔漏发作。治疗应当用苦寒泻火、辛温和血润燥、疏风止痛的药剂。《灵枢经》说：足太阳膀胱的经脉及筋，都抵达到腰部，进入联络肾脏，其分支贯穿臀部，所以主治筋的病，就会产生这种疾病。由此推断，足厥阴肝经的经脉，环绕前后二阴，所以也能导致痔疮。经常看到患痔的人，发作时脸色青紫疼痛剧烈，这是因为肝苦急的缘故。况且痔与漏，最初致病的原因虽然相同，但所患的疾病实际上不同。初生在肛边，成块而不破溃的叫痔；破溃而出脓血，黄水浸淫，淋漓长久不止的叫漏。推究这种受病的根源，是燥气；致病的原因是湿热。胃气行于大肠则化为燥，火邪乘袭湿气，这是热实的表现。至于肠头成块的，是湿邪；作痛的，是风邪；脓血溃出的，是热盛血腐；溃烂成黄水的，是湿热风燥；大便闭塞，产生剧痛的，是风热郁滞，不能通泄，气逼迫大肠而产生的。大肠结燥的，是主病兼受火邪。凡是这种疾病，都是由湿热风燥四种邪气相合而导致的。而“肠”是指大便下血。大概因为人们不避风毒，恣意饮用醇酒和吃烤爆的食物，纵欲，喜怒无常，脏腑郁抑，饮食过量，肠胃受伤，阴阳不和，关格壅滞，热毒下注，血液渗入大肠，那么肠痔漏就不可能没有。经书说筋脉松弛横解，肠道发生痔疮，就是说的这种情况。至于脏毒、肠风、痔漏，虽然名称不同，但源头其实是一样的。大抵肠痔这类病，有可治和不可治的区别。如果便血且身体发冷的就可以治，身体发热的就不能治。肠痔下白沫，脉象沉的能生，脉象浮的死；如果下脓血，脉象滑大的能生，脉象悬绝的死。肠痔脾脉外鼓，沉久自会痊愈，而肝脉小缓则容易治，肾脉搏沉，身体发热是死证。医疗的方法，只宜祛风消毒，解热凉脏，和血润燥，根据情况施治，没有不好的。
Treatment for internal injury causing hematemesis (vomiting blood) and hematochezia (blood in stool), or excessive alcohol consumption and internal fatigue leading to reckless bleeding, where blood flows like a gushing spring from both mouth and nose; without immediate rescue, death will ensue.
*Ce Bai Ye* (Platycladi Cacumen, 1.5 liang, steamed and dried), *Jing Jie Sui* (Schizonepetae Spica, charred to ash), *Ren Shen* (Ginseng Radix et Rhizoma, each 1 liang).
Grind the above into fine powder, add 1 qian of refined flour, mix with fresh cold water to form a thin paste, drink at any time.
Treatment for various types of hematemesis, hematochezia, hematuria (blood in urine), and epistaxis (nosebleed).
*Sheng Di Huang* (Rehmanniae Radix Recens), *Shu Di Huang* (Rehmanniae Radix Preparata), *Gou Qi Zi* (Lycii Fructus), *Di Gu Pi* (Lycii Cortex), *Tian Men Dong* (Asparagi Radix), *Huang Qi* (Astragali Radix), *Bai Shao* (Paeoniae Radix Alba), *Huang Qin* (Scutellariae Radix), *Gan Cao* (Glycyrrhizae Radix et Rhizoma) (equal parts).
Crush the above ingredients, take 1 liang per dose, add two zhan of water, decoct until seven-tenths remain, take warm after meals. If the pulse is faint, body temperature is low, and there is aversion to wind, add 0.5 qian of *Gui Zhi* (Cinnamomi Ramulus); this syndrome is common in patients with hematemesis.
Treatment for vomiting blood.
*Da Ji Zhi* (Cirsii Japonici Juice), *Di Huang Zhi* (Rehmanniae Juice), *Sheng Jiang Zhi* (Zingiberis Recens Juice), *Mai Men Dong Zhi* (Ophiopogonis Juice), *Ci Ji Zhi* (Cirsii Japonici Thorns Juice) (each 3 he).
Mix evenly with half a spoonful of white honey, take cold.
Treatment for persistent epistaxis.
*She Xiang* (Moschus, half zi, ground separately), *Ming Fan* (Alumen, calcined, ground separately), *Long Gu* (Fossilia Ossis Mastodi, ground separately, each 5 qian).
Mix evenly, use one zi per application. First clean the nasal cavity of bloody discharge with ice water, then insufflate the powder into the nose, or alternatively, dip wet paper in the medicine and plug the nose.
Formulas applicable to bleeding from all nine orifices:
Moss on wall tops can be plugged; juice of *Che Qian Cao* (Plantaginis Herba) can be dripped;
Charred lotus pods mixed with water can be ingested; soot from pot bottoms can be eaten;
Pomegranate flower petals can be plugged; juice of raw radish can be dripped;
Calcined *Long Gu* (Fossilia Ossis Mastodi) can be insufflated; decoction of *Mao Hua* (Setariae Germen) can be drunk.
The Classics state: "When wind pathogens lodge and disrupt vital qi, essence is lost, and evil damages the Liver." Consequently, overeating leads to flaccidity of sinews and vessels, resulting in hemorrhoids. This is because wind qi connects with the Liver; the Liver generates wind, wind generates heat, and lodging wind causes disruptive qi to damage essence. Loss of essence allows pathogenic heat to damage the Liver. Combined with overeating and sexual activity, sinews and vessels become flaccid, leading to intestinal hemorrhoids and fistulas. The *Chao Yuan Fang Lue* (Source Book of Diseases) describes five types of hemorrhoids: Mu Hemorrhoids (protruding), Pin Hemorrhoids (sunken), Mai Hemorrhoids (vascular), Chang Hemorrhoids (intestinal), and Xue Hemorrhoids (bloody). Ancient formulas also mention Jiu Hemorrhoids (alcohol-induced), Qi Hemorrhoids (qi-stagnation-induced), Chong Hemorrhoids (parasite-induced), Fanhua Hemorrhoids, and Lougu Hemorrhoids, among others. Hemorrhoids occur at the anus, either external or internal, resembling mouse teats or cherries, with varying shapes. Symptoms include pain, itching, hardness, softness, suppuration, non-suppuration, swelling with difficulty in defecation, continuous clear blood loss during defecation, and linear bleeding from perforations. Untreated cases may develop into fistulas, penetrating the buttocks, or even perforating the intestine, allowing feces to exit through holes. Some present with multiple lesions around the anus, oozing pus and blood like a lotus flower. Detailed examination reveals: protrusions at the anal verge with intermittent pus and blood are Mu Hemorrhoids; sores at the anal verge with swelling, pain, and bleeding are Pin Hemorrhoids; sores that are painful and itchy are Mai Hemorrhoids; nodules inside the anus with chills, fever, and bleeding are Chang Hemorrhoids; anal swelling, pain, difficult defecation, and prolapse upon exertion are Qi Hemorrhoids; anal sores bleeding triggered by alcohol are Jiu Hemorrhoids; orifices at the anal verge with ray-like bleeding are Xue Hemorrhoids; anal maceration with pinworms eroding the intestine into fistulas are Chong Hemorrhoids. All these originate from the Large Intestine. The Large Intestine corresponds to Geng Metal, possessing dry and clear nature, with a肃杀 (astringent and killing) quality, governing contraction and fluid metabolism, transforming according to the Earth of the Foot Yangming Stomach. When prosperous, it generates all things; when deficient, it damages them—hence "all things are born of Earth and return to Earth." Both Hand and Foot Yangming meridians share this transformation. If one engages in sexual activity while intoxicated, essence leaks, pulses become empty, and alcohol-heat toxins flow into the vessels. Or, due to overeating and excessive desire held back, or using drugs to retain essence preventing release, stagnation accumulates in vessels and directs to the Large Intestine. Wood overacts on Fire, insulting Dry Metal; Fire follows Dryness, causing constipation and hemorrhoid-fistula formation. Treatment requires bitter-cold purgatives to drain fire, acrid-warm agents to harmonize blood and moisten dryness, and wind-dispersing analgesics. The *Ling Shu Jing* states: The Foot Taiyang Bladder meridian and its sinews reach the waist, connect to the Kidney, and branch through the buttocks; thus, sinew diseases produce this ailment. By inference, the Foot Jueyin Liver meridian surrounds the anterior and posterior yin openings, thus also causing hemorrhoids. Patients often show cyanosis and severe pain upon onset, attributed to the Liver's aversion to constraint. Although hemorrhoids and fistulas share initial causes, they differ clinically. Initial lumps at the anal verge without rupture are hemorrhoids; ruptured lesions discharging pus, blood, and yellow fluid continuously are fistulas. The root cause is Dryness Qi; the pathological factor is Damp-Heat. Stomach Qi transforming in the Large Intestine creates Dryness; Fire attacking Dampness creates Heat Excess. Lumps indicate Dampness; pain indicates Wind; pus and blood indicate Heat overwhelming and rotting blood; yellow fluid indicates Damp-Heat-Wind-Dryness. Constipation with severe pain indicates Wind-Heat stagnation blocking expulsion, pressuring the Large Intestine. Large Intestine dryness involves concurrent Fire Evil. These diseases result from the combination of Damp-Heat, Wind, and Dryness. "Chang" refers to lower gastrointestinal bleeding. Caused by exposure to wind-toxins, indulgence in rich foods and alcohol, lust, emotional instability, organ stagnation, overeating damaging intestines and stomach, yin-yang disharmony, blockage, downward injection of heat-toxin, and blood seeping into the Large Intestine. The Classics state: flaccid sinews and vessels lead to intestinal hemorrhoids. Zang Du, Chang Feng, and hemorrhoid-fistulas have different names but identical origins. Treatability varies: hematochezia with cold body is treatable; with fever, untreatable. White mucus with deep pulse indicates survival; floating pulse indicates death. Pus and blood with slippery-large pulse indicates survival; suspended-extreme pulse indicates death. Spleen pulse bulging externally with deep-long pulse resolves spontaneously; small-slow Liver pulse is easy to treat; deep-knocking Kidney pulse with fever indicates death. Therapeutic methods should focus on dispelling wind, detoxifying, clearing heat, cooling organs, harmonizing blood, and moistening dryness, tailored to the case, ensuring recovery.