《圣惠》坐儿稍早，为客风吹脊，风气达髓，使背高如龟，虽有药方，多成痼疾，
以灸法为要。〔钱〕儿生下客风入脊，逐于骨髓，即成龟背，治之以龟尿点节骨。
取尿之法，当安龟在莲叶上，后用镜照之，其尿自出，以物盛之。〔张〕婴儿生后
一百八十日，始 骨成，方能独坐，若强令儿坐之太早，即客风寒吹着儿背及脊至
骨，传入于髓，使背高如龟之状，以松药丹疗之。
〔张〕松药丹 治龟背病。
松花（洗，焙干） 枳壳（去瓤，麸炒） 独活 防风（去芦叉。各一两） 川大黄（炮） 前胡 麻黄（去根节）
桂心（各半两）
上为细末，炼蜜和如黍米大。每服十粒，粥饮下，量儿大小加减。《圣惠》
麻黄丸、多芍药，少前胡。一方，多槟榔、诃皮。一方，无松花，有当归，
煮面糊丸，名枳壳防风丸。
《圣惠》灸法 当灸第三椎骨节下两旁各一寸半肺俞穴，又第五椎骨节下两旁各一寸
半心俞穴，又第七椎骨节下两旁各一寸半膈俞穴，以小儿中指节为一寸，艾炷如
小麦大，三五壮即止。此法累用，十有一二得效，亦无全效之功。（《颅囟经》云∶符殿直
之孙绍熙，辛亥春，灸即效。）
〔世〕龟背在百日内不治。
〔曾〕肺与大肠为表里，肛者大肠之门，肺实热，则闭结不通，肺虚寒，则肠头
出露，有因痢久里急后重，努力肛开，为外风所吹，或伏暑作泻，肠滑不禁，或禀
赋怯弱，易于感冷，亦致大肠虚脱。凡小儿所患泻痢，皆因暑湿风热乘脾胃虚而得，
盖风属木，木胜则制土，土主脾胃，虚而受制，又湿喜伤脾，因虚受湿，不能分别
清浊，水谷交杂，则为洞泄，洞泄既久，大肠亦虚，大肠乃手阳明燥金，而土虚不
能生金，金气既虚，则传送之道亦虚，又为风冷所袭，故肛门脱而不收。法宜补脾
温胃，使金得受母之益而气实，宜藿香饮（不乳食）、匀气散（疝）、平胃散（不乳食）主之，次则
内投固肠之剂，用健脾饮（不乳食）养脏汤（痢）服饵，外以敷贴之法，用伏龙肝散敷之，及
萆麻膏贴囟门，使引气上，令其自收，如收尽，仍以水洗去其膏。及有邪热积滞
于大肠，未经疏涤，亦成此疾，其肛门色红而软，肺脉浮数，右手指纹紫见，身微
有热，时或烦躁，先投清肺饮（嗽）疏解，次用薄荷散、蟠龙散为治，间服万安饮亦
佳。〔薛〕巢氏云∶实热则大便秘结，虚寒则肛门脱出，此多因吐泻脾气虚，肺无
所养，故大肠之气虚，脱而下陷也，用补中益气、或四君子为主。若脱出绯赤，
或作痛者，血虚而有热也，用补中益气汤佐以四物、牡丹皮，微者或作痛者，气虚
而有热也，佐以四君、牡丹皮。大凡手足指热者属胃气热，手足指寒者属胃气寒。
汤氏方治脱肛大肠自粪门出，宜用葱汤熏洗令软，款款送上。此因泻利得之者，亦
可服泻利之药，然后用槐花等药。又有用一味五倍子煎汤，入朴硝熏洗而缩者。又
有用真蒲黄碾极细，以猪脂拌匀，敷肛门上而入者。
《全婴方》用涩肠散，兼有痔证肿痛者，用黄丹、滑石等分，井水调涂即消，并用
铅白霜半钱，片脑半字，好酒调敷肿处，甚佳。黄连解毒汤亦可服。用苦参汤洗亦
效。亦有密陀僧、白矾、脑子末之敷上，更用荆芥、防风等项洗之。用生栝蒌根者效。
【内服】
张涣芜荑丹 治小儿久痢频并，大肠虚冷，肛门脱出。
白芜荑（微炒） 鳖甲（涂酥炙黄，去裙 ） 蜗牛皮（炙令焦黄） 磁石（烧，醋蘸七遍，细研水飞。各一两） 蚺
蛇胆 黄连（去须，微炒。各半两）
上件捣，罗为末，用软饭和丸，如黍米大。每服十粒，粥饮下，量儿大小加减，乳食前。
妙应散
莨菪子（淘去浮者，炒令黑色） 天台乌药（各半两。以上捣罗为细末，次入） 白面（一分） 龙脑（半钱）
上件都拌匀。每服一字，蜜汤调下，乳食前。
〔曾氏〕薄荷散 治阳证脱肛。
薄荷（和梗） 骨碎补（去毛。各半两） 金罂刺根（七钱半） 甘草（二钱半）
上锉碎。每服二钱，水一盏，入无灰酒大匙，煎七分，空心温服，或无时。
《聚宝方》象豆丸 治诸痢脱肛。
HT 藤子（一名象豆，出广南山林间，如通草藤，紫黑）
上一味为末，每服二钱。血痢，热酒调下，三服必效。白痢，倾打破取仁子碎
碾，银器中慢火炒黄褐色，碾细，罗一两遍后，若带白时再炒褐色，为末，宿蒸
饼汤浸，却握干和丸豌豆大，略焙干。每服十五丸至二十丸，仓米饮温下，空心，
食前服，痢瘥即止。虫毒五痔、小儿脱肛，并可为末，酒调下，立愈。
〔茅先生〕方用破故纸一两，于瓦上焙干为末，每服一字或半钱，米饮调下。吴茱萸末亦可。
《婴孺》用黄连、黄柏，二味为末，蜜丸桐子大。饮下三丸，日三四服。
〔庄氏〕用干莲蓬焙干为末。米饮调下一二钱。
〔汤氏〕治大肠虚弱，肛门脱下方
龙骨 诃子（煨，去核。各一两） 没石子（大者，二枚） 罂粟壳（去核，醋涂炙，二钱）
上，为末，白汤点服。仍用葱汤熏洗令软，款款以手托入，用新砖瓦烧红，以
醋浇之，气上，即用脚布叠数重压定，使热气上透，不可过热，令病者以臀坐于
布上，如觉布温，逐旋减之，以常得温热为度。并常服前药。
〔洁古〕五倍子散 治小儿脱肛。
五倍子 地榆（各等分）
上，为细末。每服半钱或一钱，空心米饮调下。
【外治】
钱氏赤石脂散 治小儿因痢后努 气下，推出肛门不入。（ ，于建反，用力努腹也）
真赤石脂 伏龙肝（各等分）
上，为细末。每用五分，敷肛头上，频用按入。
〔曾氏〕蟠龙散 治阳证脱肛。
干地龙蟠（如钱样者佳，略去土，一两） 风化朴硝（二钱）
上锉、焙，研为细末，仍和匀朴硝。每以二钱至三钱，肛门湿润干涂，或干燥
用清油调涂。先以见毒消、荆芥、生葱煮水，候温浴洗，轻与拭干，然后敷药。
伏龙肝散 治阴证脱肛。
伏龙肝（一两） 鳖头骨（一具） 百药煎（二钱半）
上三味，焙研为末。每用一钱至三钱，浓煎紫苏汤候温，和清油调涂患处，并
如前法浴洗拭干，方上药。
治小儿脱肛用五倍子为末，量多少掺患处，以物衬手揉入，切忌食发风毒物。
脱肛治法，用蒲黄一两，猪脂二两，炼猪脂和蒲黄成膏，涂肠头上，即缩入。
水圣散 治小儿脱肛不收，用浮萍草不以多少，杵为细末，干贴患处。
涩肠散 治小儿久痢，大肠头脱出不收
诃子（炮） 赤石脂 龙骨（各等分）
上为末。腊茶少许，和药掺肠头上，绢帛揉入。又治痢，米汤调。又方，治脱
肛，五倍子焙为末，入茶，根据前方用。
胜雪膏 治随肠、番花、鼠奶等痔，热痛不可忍，或已成疮者，并皆治之。
片脑 风化硝
上件，各半字，用好酒少许，研成膏子涂之。随手辄愈。
治大人小儿脱肛不收方 连翘不以多少，洗净，为细末。先以盐水洗，后用药末时
时干敷脱肛上，立瘥。
蓖麻膏 治暴患脱肛。
蓖麻子（一两）
上件，烂杵为膏，捻作饼子，两指宽大，贴囟上。如阴证脱肛，加生附子末，
葱蒜同研作膏，根据前法贴之。
《朱氏家传》治小儿脱肛方
上用磁母石，以石碾为末，面糊为丸，如绿豆大。熟水下五七丸。后以磨刀水
洗脱肛处，立效。
脱肛用东北方陈壁泥土，汤泡，先洗下，后熏上。
《保生信效》治久病肠风痔漏，肠出不收，至有出数寸者，苦楚良极。小儿久泻痢，亦名此疾。
上，先用五倍子四两，以水五升，煎汤一两沸，投入朴硝四两，通手淋洗，至
水冷即止。若觉热痛，即津唾调熊胆涂之，痛即止，当渐收，甚者不过淋洗三五
次收尽。窃详此药朴硝能软，五倍子能收，二物相须以为用也，或更以干蜘蛛末
掺之，乘热以软帛 入，尤妙。（掺蜘蛛者与葛氏方同）
《九 卫生》疗小儿脱肛方
香附子 荆芥穗（各等分）
上，同为粗末。每用三匙，水一大碗，煎十数沸，淋渫。
苦参汤 治脱肛并痔。
枳壳 黄连 大黄 甘草 荆芥 苦参 赤芍药 黄芩（各等分）
上锉散。每用五钱，以车前子、茅草同煎，熏洗。
小儿脱肛泻血，秋深不痊。灸龟尾一壮，炷如小麦大，脊端穷骨也。小儿脱肛者，
灸脐中三壮。小儿脱肛久不瘥，及风痫中风，角弓反张，多哭言语不择，发无
时节，盛即吐沫者，取百会一穴，灸七壮，在鼻直入发际五寸顶中央旋毛中，可容豆，炷如小麦大。
《圣惠方》认为，让婴儿过早坐立，容易受到外界风寒侵袭脊柱，风气深入骨髓，导致背部隆起像乌龟一样。虽然也有药方，但多形成顽固难愈的疾病，因此以灸法为主要治疗手段。〔钱乙〕认为，婴儿出生后若客风侵入脊柱，逐入骨髓，就会形成龟背病，治疗可用龟尿点涂节骨处。取龟尿的方法是：将龟放在莲叶上，然后用镜子照射它，龟尿就会自然流出，用器物盛接即可。〔张涣〕指出，婴儿出生后一百八十天，骨骼才发育成形，才能独自坐立。如果强行让婴儿过早坐立，外界的风寒就会吹袭婴儿的背部和脊柱直至骨骼，传入骨髓，使背部隆起像乌龟的形状，可用松药丹来治疗。
〔张涣〕松药丹：治疗龟背病。
配方：松花（清洗后焙干）一两，枳壳（去除瓤，麸皮炒制）一两，独活一两，防风（去芦头及分叉部分）一两，川大黄（炮制）半两，前胡半两，麻黄（去根和节）半两，桂心半两。
以上药物研成细末，用炼蜜调和制成如黍米大小的丸剂。每次服用十粒，用粥饮送下，根据患儿年龄大小增减剂量。《圣惠方》中的麻黄丸，芍药用量较多，前胡用量较少。另一方的配方中，槟榔和诃子皮用量较多。还有一方没有松花，但有当归，煮面糊为丸，名为枳壳防风丸。
《圣惠方》灸法：应当灸第三椎骨节下方两旁各一寸半处的肺俞穴，第五椎骨节下方两旁各一寸半处的心俞穴，第七椎骨节下方两旁各一寸半处的膈俞穴。以小儿中指中间一节为一寸的标准，艾炷大小如小麦粒，每穴灸三至五壮即止。此法多次使用，十分之一二的病例有效，也没有完全治愈的功效。（《颅囟经》记载：符殿直的孙子绍熙，在辛亥年春天，经过灸治后即见效。）
〔世医观点〕龟背病在百日内若不治疗则难以痊愈。
〔曾氏〕肺与大肠互为表里，肛门是大肠的门户。肺有实热，会导致大便闭结不通；肺虚寒，则会导致直肠脱出露在外面。有的因为痢疾日久，里急后重，用力努挣导致肛门张开，被外风吹袭；或者因伏暑引起腹泻，肠道滑脱不能控制；或者因先天禀赋怯弱，容易感受寒冷，也会导致大肠虚脱。凡是小儿患的泻痢，都是因为暑湿风热乘脾胃虚弱而致病。风属木，木气旺盛则克制土气，土主脾胃，脾胃虚弱受制，加上湿气容易伤脾，因虚受湿，不能分别清浊，水谷混杂，就形成洞泄（严重的水样腹泻）。洞泄日久，大肠也会虚弱。大肠属手阳明燥金，土虚不能生金，金气既虚，传导功能也虚弱，再加上被风冷侵袭，所以肛门脱出而不能收回。治疗方法宜补脾温胃，使金气得母（土）的滋养而气实。宜用藿香饮（适用于不乳食）、匀气散（适用于疝气）、平胃散（适用于不乳食）为主治疗，其次内服固肠的药物，用健脾饮（适用于不乳食）、养脏汤（适用于痢疾）服用。外用敷贴法，用伏龙肝散敷贴，以及蓖麻膏贴敷囟门，以引导气机上行，使其自行收回。如果完全收回，仍需用水洗去药膏。如果有邪热积滞于大肠，未经过疏涤清理，也会形成此病，其肛门颜色红而软，肺脉浮数，右手指纹紫色显现，身体微热，时而烦躁，先投清肺饮（适用于咳嗽）疏解，次用薄荷散、蟠龙散治疗，间服万安饮也很好。
〔薛己〕巢元方说：实热则大便秘结，虚寒则肛门脱出，这多因吐泻导致脾气虚，肺无所养，故大肠之气虚，脱而下陷。治疗用补中益气汤或四君子汤为主。如果脱出的部分绯红，或者疼痛，是血虚而有热，用补中益气汤佐以四物汤、牡丹皮；症状轻微且疼痛的，是气虚而有热，佐以四君子汤、牡丹皮。大凡手足指头发热的属于胃气热，手足指头发冷的属于胃气寒。
汤氏方治疗脱肛，大肠自粪门脱出，宜用葱汤熏洗令其变软，慢慢送回。这是因泻利引起的，也可服用治泻利的药，然后用槐花等药。又有用一味五倍子煎汤，加入朴硝熏洗而使肛门缩回的。又有用真蒲黄碾成极细粉末，用猪脂拌匀，敷在肛门上使其纳入的。
《全婴方》用涩肠散，兼有痔疮证肿痛者，用黄丹、滑石等分，井水调涂即消退，并用铅白霜半钱，片脑半字，好酒调敷肿处，效果很好。黄连解毒汤也可以服用。用苦参汤清洗也有效。也有用密陀僧、白矾、脑子末敷上的，更用荆芥、防风等项清洗。用生栝蒌根者有效。
【内服】
张涣芜荑丹：治疗小儿久痢频发，大肠虚冷，肛门脱出。
配方：白芜荑（微炒）一两，鳖甲（涂酥炙黄，去裙边）一两，蜗牛皮（炙令焦黄）一两，磁石（烧后醋蘸七遍，细研水飞）一两，蚺蛇胆半两，黄连（去须，微炒）半两。
以上捣碎，过筛为末，用软饭和丸，如黍米大小。每次服用十粒，粥饮送下，根据患儿大小增减剂量，在吃奶吃饭前服用。
妙应散：
配方：莨菪子（淘去浮者，炒令黑色）半两，天台乌药半两。以上捣罗为细末，次加入白面一分，龙脑半钱。
以上都拌匀。每次服用一字，蜜汤调下，在吃奶吃饭前服用。
〔曾氏〕薄荷散：治疗阳证脱肛。
配方：薄荷（带梗）半两，骨碎补（去毛）半两，金罂刺根七钱半，甘草二钱半。
以上锉碎。每次服用二钱，水一盏，加入无灰酒一大匙，煎至七分，空腹温服，或不定时服用。
《聚宝方》象豆丸：治疗各种痢疾脱肛。
配方：HT藤子（一名象豆，产于广南山林间，像通草藤，紫黑色）。
以上一味为末，每次服用二钱。血痢，用热酒调下，服三次必效。白痢，倾出打破取仁子碎碾，在银器中慢火炒至黄褐色，碾细，过筛一两遍后，若带白色再炒至褐色，为末，用宿蒸饼汤浸泡，挤干和丸如豌豆大，略焙干。每次服用十五丸至二十丸，仓米饮温下，空腹，食前服，痢疾痊愈即停。虫毒五痔、小儿脱肛，均可研为末，酒调下，立即痊愈。
〔茅先生〕方用破故纸一两，在瓦上焙干为末，每次服用一字或半钱，米饮调下。吴茱萸末也可以。
《婴孺书》用黄连、黄柏，二味为末，蜜丸如桐子大。饮水送下三丸，每日三四次服用。
〔汤氏〕治疗大肠虚弱，肛门脱下方的配方：
龙骨一两，诃子（煨，去核）一两，没石子（大的两枚），罂粟壳（去核，醋涂炙）二钱。
以上为末，白开水冲服。仍用葱汤熏洗令其变软，慢慢用手托入，用新砖瓦烧红，浇醋，热气上升，即用脚布叠数层压定，使热气上透，不可过热，令患者臀部坐在布上，如果觉得布温，逐渐减少层数，以常得温热为度。并常服前面的药物。
〔洁古〕五倍子散：治疗小儿脱肛。
配方：五倍子等分，地榆等分。
以上为细末。每次服用半钱或一钱，空腹米饮调下。
【外治】
钱氏赤石脂散：治疗小儿因痢后努气下坠，推出肛门不入。（“努”，音同建反，意为用力努腹。）
配方：真赤石脂等分，伏龙肝等分。
以上为细末。每次用五分，敷在肛头上，频繁使用并按入。
〔曾氏〕蟠龙散：治疗阳证脱肛。
配方：干地龙蟠（如钱样者佳，略去土）一两，风化朴硝二钱。
以上锉、焙，研为细末，仍和匀朴硝。每次用二钱至三钱，肛门湿润时干涂，或干燥时用清油调涂。先用见毒消、荆芥、生葱煮水，候温浴洗，轻轻拭干，然后敷药。
伏龙肝散：治疗阴证脱肛。
配方：伏龙肝一两，鳖头骨一具，百药煎二钱半。
以上三味，焙研为末。每次用一钱至三钱，浓煎紫苏汤候温，和清油调涂患处，并如前法浴洗拭干，方才上药。
治疗小儿脱肛用五倍子为末，根据多少掺在患处，用手揉入，切忌食用发风毒物。
脱肛治法，用蒲黄一两，猪脂二两，炼猪脂和蒲黄成膏，涂在肠头上，即缩入。
水圣散：治疗小儿脱肛不收，用浮萍草不限多少，杵为细末，干贴患处。
涩肠散：治疗小儿久痢，大肠头脱出不收。
配方：诃子（炮）等分，赤石脂等分，龙骨等分。
以上为末。腊茶少许，和药掺肠头上，绢帛揉入。又治痢，米汤调服。又一方，治脱肛，五倍子焙为末，入茶，根据前方使用。
胜雪膏：治疗随肠、番花、鼠奶等痔疮，热痛不可忍，或已成疮者，皆能治疗。
配方：片脑半字，风化硝半字。
以上各半字，用好酒少许，研成膏子涂之。随手辄愈。
治大人小儿脱肛不收方：连翘不限多少，洗净，为细末。先以盐水洗，后用药末时时干敷脱肛上，立即痊愈。
蓖麻膏：治疗暴患脱肛。
配方：蓖麻子一两。
以上烂杵为膏，捻作饼子，两指宽大，贴囟门上。如果是阴证脱肛，加生附子末，葱蒜同研作膏，根据前法贴之。
《朱氏家传》治疗小儿脱肛方：
用磁母石，以石碾为末，面糊为丸，如绿豆大。熟水送下五七丸。后用磨刀水洗脱肛处，立即见效。
《保生信效》治疗久病肠风痔漏，肠出不收，甚至出数寸者，痛苦至极。小儿久泻痢，也称此疾。
以上，先用五倍子四两，以水五升，煎汤一两沸，投入朴硝四两，通手淋洗，至水冷即止。如果觉得热痛，就用津唾调熊胆涂之，痛即止，当渐渐收回，严重者不过淋洗三五次收尽。仔细详查此药，朴硝能软化，五倍子能收敛，二物相须为用。或者更以干蜘蛛末掺之，趁热以软帛推入，尤其妙。（掺蜘蛛者与葛氏方相同）
《九卫生》治疗小儿脱肛方：
配方：香附子等分，荆芥穗等分。
以上同为粗末。每次用三匙，水一大碗，煎十数沸，淋渫。
苦参汤：治疗脱肛并痔疮。
配方：枳壳等分，黄连等分，大黄等分，甘草等分，荆芥等分，苦参等分，赤芍药等分，黄芩等分。
以上锉散。每次用五钱，以车前子、茅草同煎，熏洗。
小儿脱肛泻血，秋深不痊。灸龟尾一壮，炷如小麦大，龟尾即脊端穷骨也。小儿脱肛者，灸脐中三壮。小儿脱肛久不瘥，及风痫中风，角弓反张，多哭言语不择，发无时节，盛即吐沫者，取百会一穴，灸七壮，在鼻直入发际五寸顶中央旋毛中，可容豆，炷如小麦大。
*Shenghui Fang* (Sanitary Formulas of the Holy Emperor) suggests that allowing infants to sit too early exposes them to external wind-cold invading the spine. Wind pathogenic factors reach the marrow, causing the back to protrude like a turtle shell. Although medicinal formulas exist, they often result in chronic, stubborn diseases; therefore, moxibustion is the primary treatment method. [Qian Yi] believes that if postnatal "guest wind" invades the spine and penetrates the bone marrow, it results in turtle-back deformity. Treatment involves applying turtle urine to the joint bones. To obtain turtle urine, place the turtle on a lotus leaf and shine a mirror upon it; the urine will naturally excrete, which can be collected with a vessel. [Zhang Huan] points out that an infant's bones do not fully form until 180 days after birth, at which point they can sit independently. Forcing an infant to sit too early allows external wind-cold to blow upon the back and spine, reaching the bones and penetrating the marrow, causing the back to protrude like a turtle shell. This can be treated with *Songyao Dan* (Pine Medicine Pill).
[Zhang Huan] *Songyao Dan*: Treats turtle-back disease.
Ingredients: *Pinus massoniana* flower heads (Wu Jia Pi Hua, Pine Flower) (washed and dried by baking), 1 liang; *Aurantii Fructus* (Zhi Ke, Bitter Orange) (pulp removed, stir-fried with bran), 1 liang; *Angelicae Pubescentis Radix* (Duhuo) (1 liang); *Saposhnikoviae Radix* (Fangfeng) (rhizome and forked parts removed), 1 liang; *Rhei Radix et Rhizoma* (Chuan Dahuang) (processed), 0.5 liang; *Peucedani Radix* (Qianhu) (0.5 liang); *Ephedrae Herba* (Mahuang, Ephedra) (roots and nodes removed), 0.5 liang; *Cinnamomi Cortex* (Guixin, Cinnamon Bark) (0.5 liang).
Grind all ingredients into fine powder. Mix with refined honey to form pills the size of millet seeds. Administer 10 pills per dose, taken down with gruel broth. Adjust dosage according to the child's age and size. In *Shenghui Fang*'s *Mahuang Wan*, the dosage of *Paeoniae Radix Alba* (Baishao, White Peony Root) is higher, and *Peucedani Radix* (Qianhu) is lower. Another formula increases the dosage of *Arecae Semen* (Binglang, Betel Nut) and *Terminalia Chebula Retzii Fructus* (Hepi, Chebula Fruit Peel). Yet another formula excludes pine flowers but includes *Angelicae Sinensis Radix* (Danggui, Dang Gui), using boiled wheat paste to form pills, named *Zhike Fangfeng Wan*.
*Shenghui Fang* Moxibustion Method: Moxibustion should be applied to Feishu (BL13, Lung Shu) located 1.5 cun lateral to the spinous process of the third thoracic vertebra; Xinshu (BL15, Heart Shu) located 1.5 cun lateral to the spinous process of the fifth thoracic vertebra; and Geshu (BL17, Diaphragm Shu) located 1.5 cun lateral to the spinous process of the seventh thoracic vertebra. Use the middle phalanx of the child's middle finger as the standard for 1 cun. The moxa cone should be the size of a wheat grain. Apply 3-5 cones per acupoint. This method has been used repeatedly with success in only one or two out of ten cases, and no complete cure has been achieved. (*Luxin Jing* records: Fu Dianzhi's grandson, Shaoxi, was cured after moxibustion in the spring of the Xinhai year.)
[General Medical View] Turtle-back deformity is incurable if not treated within the first hundred days.
[Zeng Zhixi] The Lung and Large Intestine are exterior-interiorly related. The anus is the gate of the Large Intestine. Lung excess-heat causes constipation and blockage; Lung deficiency-cold causes rectal prolapse. Some cases arise from prolonged dysentery with tenesmus and straining, causing the anus to open and be exposed to external wind. Others result from summer-heat retention causing diarrhea and intestinal sliding without control. Some stem from congenital weakness, making them susceptible to cold, leading to Large Intestine deficiency and collapse. All pediatric diarrhea and dysentery are caused by summer-heat, dampness, wind, and heat pathogens attacking the Spleen and Stomach during their deficiency. Wind belongs to Wood; excessive Wood controls Earth. Earth governs the Spleen and Stomach; when deficient and controlled, and combined with Dampness injuring the Spleen due to deficiency, the ability to separate clear from turbid is lost. Water and food mix, resulting in severe watery diarrhea (Dongxie). Prolonged Dongxie weakens the Large Intestine. The Large Intestine is Hand-Yangming Dryness-Metal. Earth deficiency fails to generate Metal; thus, Metal Qi becomes deficient, weakening the transmission pathway. Attack by wind-cold causes anal prolapse that cannot retract. The treatment principle is to tonify the Spleen and warm the Stomach, allowing Metal to receive benefit from its mother (Earth) and strengthen its Qi. Primary formulas include *Huoxiang Yin* (for anorexia/lack of milk intake), *Yunqi San* (for hernia), and *Pingwei San* (for anorexia). Subsequently, internal administration of intestinal-astringing agents such as *Jianpi Yin* (for anorexia) and *Yangzang Tang* (for dysentery) is used. External application methods include applying *Fulonggan San* (Dragon Bone Powder) and *Bima Gao* (Castor Oil Paste) to the Fontanelle (Baihui area) to guide Qi upward, allowing spontaneous retraction. Once fully retracted, wash off the paste with water. If pathogenic heat and stagnation accumulate in the Large Intestine without prior clearing, this condition also arises. The anus appears red and soft, the Lung pulse is floating and rapid, the fingerprint on the right hand is purple, there is slight fever, and occasional irritability. Initially administer *Qingfei Yin* (for cough) to disperse and resolve, followed by *Bohe San* and *Panlong San*. Intermittent use of *Wan'an Yin* is also beneficial.
[Xue Ji] Chao Yuanfang stated: Excess-heat causes fecal impaction; deficiency-cold causes anal prolapse. This is mostly due to vomiting and diarrhea causing Spleen Qi deficiency, leaving the Lung un-nourished, resulting in Large Intestine Qi deficiency, leading to prolapse and sinking. Treatment uses *Buzhong Yiqi Tang* (Tonify the Middle and Augment the Qi Decoction) or *Sijunzi Tang* (Four Gentlemen Decoction) as the main formula. If the prolapsed tissue is crimson or painful, it indicates Blood deficiency with heat; treat with *Buzhong Yiqi Tang* assisted by *Siwu Tang* (Four Substances Decoction) and *Mudanpi* (Tree Peony Bark). If symptoms are mild and painful, it indicates Qi deficiency with heat; assist with *Sijunzi Tang* and *Mudanpi*. Generally, hot fingers and toes indicate Stomach Qi heat; cold fingers and toes indicate Stomach Qi cold.
[Tang Shi's Formula] For anal prolapse where the Large Intestine exits the anus, fumigate and wash with Scallion Decoction to soften the tissue, then gently push it back. For cases caused by diarrhea, administer anti-diarrheal medicines, followed by *Huaihua* (Sophora Flower) etc. Another method uses a decoction of single-ingredient *Wubeizi* (Galla Chinensis) with *Xiaokuniao* (Mirabilite) for fumigation and washing to shrink the prolapse. Another method uses finely ground *Puhuang* (Pollinis Typhae) mixed with lard, applied to the anus to facilitate reduction.
*Quanying Fang* uses *Sechang San* (Intestine-Astringing Powder). For concurrent hemorrhoid swelling and pain, mix equal parts of *Hongdan* (Red Lead Oxide) and *Huashi* (Talcum) with well water and apply; it resolves immediately. Also apply *Qianbaishuang* (Basic Lead Carbonate) half a qian and *Pian Nao* (Borneol) half a zi, mixed with good wine, applied to the swollen area; this is very effective. *Huanglian Jiedu Tang* (Coptis Decoction for Resolving Toxicity) can also be taken. Washing with *Kushen Tang* (Sophora Decoction) is also effective. Applications of *Miduoseng* (Litharge), *Baifan* (Alum), and powdered *Naozi* (Camphor) are used, along with washing with *Jingjie* (Schizonepeta) and *Fangfeng* (Saposhnikovia). Using raw *Gualugen* (Trichosanthes Root) is effective.
[Internal Administration]
Zhang Huan's *Wuyi Dan* (Melia Pill): Treats pediatric chronic frequent dysentery, Large Intestine deficiency-cold, and anal prolapse.
Ingredients: *Meliae Toosendan Fructus* (Bai Wuyi) (lightly stir-fried), 1 liang; *Testudinis Carapax et Plastrum* (Biejia) (coated with butter, roasted yellow, remove skirt), 1 liang; *Viper Skin* (Wopi) (roasted until scorched yellow), 1 liang; *Magnetitum* (Cishi) (calcined, dipped in vinegar seven times, finely ground and washed with water), 1 liang; *Pythonis Gallbladder* (Ranshedan), 0.5 liang; *Coptidis Rhizoma* (Huanglian) (remove whiskers, lightly stir-fried), 0.5 liang.
Crush and sieve into powder. Mix with soft rice to form pills the size of millet seeds. Administer 10 pills per dose, taken down with gruel broth. Adjust dosage based on the child's size. Take before nursing or eating.
*Miaoying San* (Wonderful Efficacy Powder):
Ingredients: *Hyoscyami Semen* (Langdangzi) (wash away floating ones, roast until black), 0.5 liang; *Linderae Radix* (Tiantai Wuyao), 0.5 liang. Crush and sieve into fine powder. Add *Tritici Farina* (Baifan, Wheat Flour), 1 fen; *Borneolum Syntheticum* (Longnao/Borneol), 0.5 qian.
Mix thoroughly. Administer one "zi" per dose, mixed with honey water. Take before nursing or eating.
[Zeng Shi] *Bohe San* (Mint Powder): Treats Yang-type anal prolapse.
Ingredients: *Menthae Haplocalycis Herba* (Bohe, Mint) (with stem), 0.5 liang; *Drynariae Rhizoma* (Gusuibu, Bone Setter) (remove hairs), 0.5 liang; *Berberidis Radix* (Jinyingsigen, Gold Pellet Thorn Root), 7.5 qian; *Glycyrrhizae Radix et Rhizoma* (Gancao, Licorice), 2.5 qian.
Cut into pieces. Administer 2 qian per dose with one cup of water and one large spoon of non-adulterated wine. Decoct to 0.7 cup. Take warm on an empty stomach, or at any time.
*Jubao Fang* *Xiangdou Wan* (Elephant Bean Pill): Treats various dysenteries with anal prolapse.
Ingredient: *HT Tengzi* (One name: Xiangdou, produced in Guangnan mountain forests, resembles *Akebia* vine, purple-black).
Grind into powder. Administer 2 qian per dose. For bloody dysentery, take down with hot wine; three doses guarantee efficacy. For white dysentery, break open, extract kernels, crush, and slowly roast in a silver vessel until yellow-brown. Grind fine, sieve twice. If white remains, roast again until brown. Grind into powder. Soak in steamed cake soup, squeeze dry, and form pills the size of pea seeds. Lightly bake dry. Administer 15-20 pills per dose, taken down with warehouse rice broth, on an empty stomach before meals. Stop when dysentery resolves. For worm toxins, five types of hemorrhoids, and pediatric anal prolapse, grind into powder and take down with wine for immediate cure.
[Mao Xiansheng] Formula: Roast *Gubuzhi* (Psoralea Fructus) 1 liang on a tile until dry, grind into powder. Administer one "zi" or half a qian, taken down with rice broth. *Wuzhuyu* (Evodia Fruit) powder is also usable.
*Yingru Book*: Uses *Huanglian* (Coptis) and *Huangbai* (Phellodendron), grind into powder, form honey pills the size of paulownia seeds. Take down with water, 3 pills per dose, 3-4 times daily.
[Zhuang Shi]: Roast dried lotus pods until dry, grind into powder. Take down with rice broth, 1-2 qian per dose.
[Tang Shi] Formula for treating Large Intestine weakness and anal prolapse:
*Longgu* (Fossilized Bones), 1 liang; *Hezi* (Chebula Fruit) (roasted, pitted), 1 liang; *Myrobalans* (Moshizi) (large ones, 2 pieces); *Papaveris Pericarpium* (Yangsuhua) (pitted, coated with vinegar and roasted), 2 qian.
Grind into powder. Take down with plain boiling water. Continue to fumigate and wash with scallion water to soften, then gently push back with hands. Heat new brick tiles, pour vinegar on them to generate steam. Stack several layers of foot cloth, press firmly to allow heat to penetrate upwards (ensure it is not too hot). Have the patient sit on the cloth. As it cools, gradually reduce layers. Maintain a constant warm sensation. Continue taking the previous internal medicine regularly.
[Jiegu] *Wubeizi San* (Galla Chinensis Powder): Treats pediatric anal prolapse.
Ingredients: *Galla Chinensis* (Wubeizi) in equal parts; *Sanguisorbae Radix* (Diyu) in equal parts.
Grind into fine powder. Administer half a qian or one qian per dose, taken down with rice broth on an empty stomach.
[External Treatment]
Qian Shi's *Chishizhi San* (Red Halloysite Powder): Treats pediatric anal prolapse caused by straining after dysentery, where the anus pushes out and does not retract. ("Nu" means straining the abdomen with force.)
Ingredients: *Realgar*? No, *Chishizhi* (Red Halloysite) in equal parts; *Fulonggan* (Dragon's House Liver/Loess) in equal parts.
Grind into fine powder. Apply 5 fen to the anal head frequently, pressing it in each time.
[Zeng Shi] *Panlong San* (Coiling Dragon Powder): Treats Yang-type anal prolapse.
Ingredients: *Pheretima* (Di Long, Earthworm) (dried, coiled like a coin is best, remove soil slightly), 1 liang; *Natrii Sulfas Efflorescens* (Fenghua Xiaoxiao, Effloresced Mirabilite), 2 qian.
Cut, bake, and grind into fine powder. Mix evenly with Mirabilite. Apply 2-3 qian per dose. If the anus is moist, apply dry powder; if dry, mix with sesame oil. First, boil *Jian Du Xiao*?, *Jingjie* (Schizonepeta), and fresh scallion in water. Wash with warm water, gently pat dry, then apply medicine.
*Fulonggan San* (Dragon's House Liver Powder): Treats Yin-type anal prolapse.
Ingredients: *Fulonggan* (Loess), 1 liang; *Testudinis Cranium* (Bie Tou Gu, Turtle Skull Bone), 1 piece; *Bai Yao Jian* (Fermented Medicinal Cake), 2.5 qian.
Bake and grind the three ingredients into powder. Apply 1-3 qian per dose. Mix with strong decoction of *Perillae Folium* (Zisu Ye, Perilla Leaf) cooled to warm temperature, blended with sesame oil, and apply to the affected area. Wash and dry as described previously before applying medicine.
For pediatric anal prolapse, use *Wubeizi* (Galla Chinensis) powder, sprinkle appropriately on the affected area, and rub in with hand. Strictly avoid foods that trigger wind-toxicity.
Treatment for anal prolapse: Mix 1 liang of *Puhuang* (Pollinis Typhae) with 2 liang of lard. Refine lard and mix with powder to form a paste. Apply to the prolapsed intestine tip to induce retraction.
*Shuisheng San* (Water Sacred Powder): Treats pediatric anal prolapse that does not retract. Use *Fuping* (Azolla) herb, amount unspecified, pound into fine powder, and apply dry to the affected area.
*Sechang San* (Intestine-Astringing Powder): Treats pediatric chronic dysentery with Large Intestine prolapse that does not retract.
Ingredients: *Hezi* (Chebula Fruit) (roasted) in equal parts; *Chishizhi* (Red Halloysite) in equal parts; *Longgu* (Fossilized Bones) in equal parts.
Grind into powder. Add a little aged tea, mix with medicine, sprinkle on the prolapsed intestine, and roll in with silk fabric. Also treats dysentery; take down with rice soup. Another formula for anal prolapse: Roast *Wubeizi* (Galla Chinensis) into powder, add tea, use according to the previous formula.
*Xuesnow Paste* (Snow-Vanquishing Paste): Treats hemorrhoids such as Suichang, Fanhua, Shunai, etc., with unbearable heat-pain or those already ulcerated.
Ingredients: *Borneolum Syntheticum* (Pian Nao, Borneol), half a zi; *Natrii Sulfas Efflorescens* (Fenghua Xiao Xiao, Effloresced Mirabilite), half a zi.
Grind both with a small amount of good wine into a paste and apply. Cures immediately upon application.
Formula for treating adult and pediatric anal prolapse that does not retract: Use *Lianqiao* (Forsythia Fruit) in any amount, wash clean, grind into fine powder. First wash with salt water, then periodically apply dry powder to the prolapsed anus. Cures immediately.
*Bima Gao* (Castor Oil Paste): Treats acute anal prolapse.
Ingredients: *Ricini Semen* (Bimazi, Castor Seed), 1 liang.
Pound until mushy to form a paste. Shape into a cake, two fingers wide, and apply to the Fontanelle (Baihui area). For Yin-type anal prolapse, add *Fuzi* (Prepared Aconite) powder, crush with scallion and garlic to form a paste, and apply according to the previous method.
*Zhu Shi Jia Chuan* (Zhu Family Tradition) Formula for Pediatric Anal Prolapse:
Use *Ci Mu Shi* (Magnetite/Lithomargite), grind with stone mill into powder, form pills with wheat paste the size of mung beans. Take down with cooked water, 5-7 pills. Afterwards, wash the prolapsed area with whetstone water for immediate effect.
For anal prolapse, use old wall earth from Northeast China. Soak in hot water, wash the lower part first, then fumigate the upper part.
*Bao Sheng Xin Xiao* (Trustworthy Efficacy of Preserving Life) treats chronic intestinal wind, hemorrhoids, and fistulas where the intestine prolapses and does not retract, sometimes extending several inches, causing extreme suffering. Pediatric chronic diarrhea/dysentery is also called this disease.
Take 4 liang of *Wubeizi* (Galla Chinensis), boil in 5 sheng of water for one boil. Add 4 liang of *Xiaokuniao* (Mirabilite). Wash with the solution while it is comfortably warm. Stop when the water cools. If heat-pain occurs, mix bear bile with saliva and apply to stop pain. It will gradually retract. Severe cases may require 3-5 washes to fully retract. Carefully analyzing this medicine: Mirabilite softens, and Galla Chinensis astringes; the two work synergistically. Alternatively, sprinkle dry spider powder and push in with soft cloth while hot; this is especially excellent. (Adding spider powder is the same as Ge Shi's formula.)
*Jiu Wei Wei Sheng* (Nine Methods for Health Preservation) Formula for Pediatric Anal Prolapse:
Ingredients: *Cyperi Rhizoma* (Xiangfu, Cyperus) in equal parts; *Schizonepetae Spica* (Jingjie Sui, Schizonepeta Spike) in equal parts.
Grind into coarse powder. Use 3 spoons per dose with one large bowl of water. Boil for more than ten boils, then pour over/wash.
*Kushen Tang* (Sophora Decoction): Treats anal prolapse and hemorrhoids.
Ingredients: *Aurantii Fructus* (Zhi Ke) in equal parts; *Coptidis Rhizoma* (Huanglian) in equal parts; *Rhei Radix et Rhizoma* (Dahuang) in equal parts; *Glycyrrhizae Radix et Rhizoma* (Gancao) in equal parts; *Schizonepetae Herba* (Jingjie) in equal parts; *Sophorae Flavescentis Radix* (Kushen) in equal parts; *Paeoniae Radix Rubra* (Chishao, Red Peony Root) in equal parts; *Scutellariae Radix* (Huangqin) in equal parts.
Cut into pieces. Use 5 qian per dose. Decoct with *Plantaginis Semen* (Cheqianzi, Plantago Seed) and *Imperatae Rhizoma* (Ma Cao, Cogon Grass). Fumigate and wash.
For pediatric anal prolapse with bloody stool, unhealed late in autumn: Apply one moxa cone to Weizhui (GV1, Tailbone), cone size like a wheat grain. Weizhui is the end of the spine. For pediatric anal prolapse: Apply three moxa cones to Qizhong (CV8, Umbilicus). For pediatric anal prolapse unhealed for a long time, wind-stroke epilepsy, opisthotonos, excessive crying, inappropriate speech, irregular onset, and foaming at the mouth during peaks: Select Baihui (GV20) acupoint. Apply seven moxa cones. Baihui is located 5 cun directly above the hairline at the vertex center, in the whorl of hair, space enough to hold a bean. Cone size like a wheat grain.