难经云。出者为虚。肛门之脱。非虚而何。况大肠与肺为表里。肺脏蕴热则闭。虚则脱。须
升举而补之。慎不可用坠气之药。产育及久痢用力过多。小儿气血未壮。老人气血已衰。故多患
此疾。是气虚不能约束禁固也。大剂补中益气汤为主。升麻须用醋煮。泻痢后大肠气虚。肛门脱
出。不肿不痛。属气血虚。补中益气加伏龙肝。赤肿有痛。宜兼凉血祛风。加羌、防、芍药。里
急下重有脓血。加木香、乌梅。大肠热甚而脱。升麻汤加羌、防、芩、连。肠风下血而脱。人参
胃风汤。老人虚人。用力过度而脱者。十全大补汤。肠胃燥涩。大便秘结。努挣太过。因而脱肛
者。人参固本丸加槐角凉补以润之。有肠头作痒。即腹中有虫。丈夫因酒色过度所致。大肠者传
道之官。肾者作强之官。盖肾虚则泄母气。肺热则大肠不收。故成脱肛。治法。内服黄连犀角散。
外用朴硝煎汤洗之。大肠虚而挟热。肛门红肿。槐花、槐角等分。羊血拌。炙熟为末。以酒送下。
大肠受热则赤肿。受寒则白滑。皆能脱出。当审其因证。寒者。以香附、荆芥、胡葱煎汤洗之。
热者。以五倍子、朴硝、白矾煎汤洗之。风热。以荆芥、薄荷、朴硝煎汤洗之。绯赤肿痛。不可
用热汤熏洗。尤忌五倍子等酸涩收敛。汤气蒸发。则愈肿愈痛。宜熊胆磨水点之。或田螺去靥。
入冰片少许。埋地一宿。化水点之。病劳人脱肛。骨肉相失。声散呕血。阳事不禁。梦寐交侵。
呼吸不相从。昼凉夜热者死。唾脓血者亦死。其脉不数而有根蒂。及颊不赤者生。小儿脱肛。鳖
头烧灰涂之。
谷道痒痛。多因湿热生虫。欲成痔 。宜以雄黄入艾绵烧烟熏之。治谷道虫赤肿。或痒或痛。
用杏仁捣作膏敷之。
或炒令黄。以绵蘸。涂谷道中。外台治下部虫啮。杵桃叶一斛蒸之。令极热。内小口器中。坐定
熏之。虫立死。治肛门肿痛。用木鳖子肉四五枚。研极细。沸汤泡洗。另用少许涂患处。
《难经》说：脏器脱出体外属于虚证。肛门脱出，难道不是虚证吗？况且大肠与肺互为表里，肺脏蕴积热邪则导致便秘，肺气虚弱则导致脱肛。治疗必须采用升提举陷和补益的方法，千万不可使用具有沉降气机作用的药物。妇女分娩及长期痢疾用力过度，小儿气血尚未强壮，老人气血已经衰退，所以容易患此病。这是因为气虚不能固摄约束所致。治疗以大剂量补中益气汤为主方。其中的升麻必须用醋煮制。如果在泻痢之后，因大肠气虚导致肛门脱出，且不肿不痛，这属于气血两虚，应在补中益气汤中加入伏龙肝（灶心土）。如果红肿且疼痛，应当兼用凉血祛风之法，加入羌活、防风、芍药。如果有里急后重感且大便带脓血，加入木香、乌梅。如果是大肠热盛导致的脱肛，使用升麻汤加入羌活、防风、黄芩、黄连。如果是肠风下血导致的脱肛，使用人参胃风汤。对于老人或体虚之人，因用力过度导致脱肛的，使用十全大补汤。如果是肠胃干燥涩滞，大便秘结，因努挣太过而导致脱肛的，使用人参固本丸加槐角，以凉补润燥的方式治疗。如果肛门头有瘙痒感，说明腹中有虫。男子多因酒色过度所致。大肠是传导之官，肾是作强之官。大概是因为肾虚则耗泄母脏（肺）之气，肺热则大肠收摄无力，从而形成脱肛。治疗方法：内服黄连犀角散，外用朴硝煎汤清洗。如果是大肠虚而夹杂热邪，导致肛门红肿，可用槐花、槐角等份，拌入羊血，炙烤熟后研为细末，用酒送服。大肠受热则表现为赤红肿胀，受寒则表现为白滑，这两种情况都能导致脱出。应当审察其病因和证候。属寒证的，用香附、荆芥、胡葱煎汤清洗；属热证的，用五倍子、朴硝、白矾煎汤清洗；属风热的，用荆芥、薄荷、朴硝煎汤清洗。如果局部绯红赤紫、肿胀疼痛，不可用热汤熏洗，尤其忌讳使用五倍子等酸涩收敛的药物，因为热气蒸发会使肿胀和疼痛加剧。适宜用熊胆磨水点涂患处。或者取田螺去掉壳顶，放入少许冰片，埋在地下一夜，使其化成水后点涂患处。患有劳损病的病人出现脱肛，伴有骨肉消瘦、声音嘶哑、呕血、阳事不固、梦境交侵、呼吸不调、白天发冷夜间发热的，预后不良，主死。咳吐脓血的也主死。如果脉象不急数且有根底，以及面颊不发红的，预后良好，主生。小儿脱肛，可将鳖头烧成灰涂抹患处。
肛门瘙痒疼痛，多因湿热生虫引起，想要发展成痔疮。适宜用雄黄放入艾绒中燃烧产生的烟来熏蒸患处。治疗肛门因虫引起的赤肿，或痒或痛，可用杏仁捣碎成膏敷贴患处。或者将杏仁炒至黄色，用棉絮蘸取，涂抹于肛门内部。《外台秘要》治疗下部被虫咬蚀，将一斛桃叶捣碎蒸煮，使其极热，放入小口容器中，患者坐定熏蒸，虫子立刻死亡。治疗肛门肿痛，用木鳖子肉四五枚，研磨至极细，用沸水泡洗，另取少量涂抹在患处。
The *Nan Jing* (Classic of Difficult Issues) states: "Protrusion outward indicates deficiency." Rectal prolapse is, if not a deficiency, then what? Moreover, the Large Intestine and Lung are exterior-interiorly related. If the Lung organ harbors heat, it leads to constipation; if deficient, it leads to prolapse. Treatment must involve lifting and tonifying. One must absolutely avoid using herbs that descend Qi. Due to excessive effort during childbirth or chronic dysentery, because children's Qi and Blood are not yet robust, and the elderly's Qi and Blood have declined, this disease occurs frequently. This is due to Qi deficiency failing to constrain and secure. The primary treatment is a large dose of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). The Shengma (Cimicifugae Rhizoma) must be processed with vinegar. After diarrhea or dysentery, if rectal prolapse occurs due to Large Intestine Qi deficiency, presenting without swelling or pain, it belongs to Qi and Blood deficiency; add Fulonggan (Furnacis Cinereus) to Buzhong Yiqi Tang. If there is redness, swelling, and pain, one should simultaneously cool the Blood and dispel Wind, adding Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), and Shaoyao (Paeoniae Radix). If there is tenesmus with pus and blood in the stool, add Muxiang (Aucklandiae Radix) and Wumei (Mume Fructus). If prolapse is caused by excessive heat in the Large Intestine, use Shengma Tang (Cimicifuga Decoction) added with Qianghuo, Fangfeng, Huangqin (Scutellariae Radix), and Lianzi (Coptidis Rhizoma). If prolapse is caused by wind-intestinal bleeding, use Renshen Weifeng Tang (Ginseng Wind-Protecting Decoction). For the elderly or debilitated individuals whose prolapse results from excessive effort, use Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction). If dryness and astringency in the Stomach and Intestines lead to constipation, and prolapse occurs due to excessive straining, use Rengu Guben Wan (Ginseng Solidify the Root Pill) added with Huaijiao (Gleditsiae Sinensis Fructus Immaturus) to cool-tonify and moisten. If the protruding tissue itches, it indicates intestinal parasites. In men, this is often caused by excess alcohol and sexual indulgence. The Large Intestine is the official of transmission and transformation; the Kidney is the official of strength and vigor. Generally, Kidney deficiency depletes the Qi of its mother organ (Lung), and Lung heat causes the Large Intestine to fail in its receiving function, resulting in rectal prolapse. Treatment methods: Internally administer Huanglian Xijiao San (Coptis and Rhinoceros Horn Powder); externally wash with a decoction of Xiaofanshi (Mirabilite). If the Large Intestine is deficient and accompanied by heat, causing redness and swelling of the anus, mix equal parts of Huaihua (Sophorae Flos) and Huaijiao with sheep blood, roast until cooked, grind into powder, and take with wine. When the Large Intestine receives heat, it becomes red and swollen; when it receives cold, it becomes white and slippery; both can cause prolapse. One must examine the cause and syndrome. For cold syndromes, wash with a decoction of Xiangfu (Cyperi Rhizoma), Jingjie (Schizonepetae Herba), and Hucong (Allium fistulosum bulb). For heat syndromes, wash with a decoction of Wubeizi (Galla Chinensis), Xiaofanshi, and Baifan (Alumen). For wind-heat, wash with a decoction of Jingjie, Bohe (Menthae Haplocalycis Herba), and Xiaofanshi. If the area is crimson, swollen, and painful, do not use hot water for fumigation and washing. Especially avoid astringent收敛 herbs like Wubeizi, as evaporating heat will worsen swelling and pain. It is suitable to apply bear gallbladder dissolved in water. Alternatively, remove the operculum of a snail, add a small amount of Bingpian (Borneolum Syntheticum), bury it in the ground overnight until it liquefies, and apply the liquid. For patients with consumption disease suffering from rectal prolapse, accompanied by emaciation, hoarseness, hematemesis, seminal emission, vivid dreams, irregular respiration, chills during the day and fever at night, the prognosis is fatal. Hemoptysis of pus and blood is also fatal. However, if the pulse is not rapid but has a root, and the cheeks are not red, the patient will survive. For pediatric rectal prolapse, burn turtle head to ash and apply topically.
Anal itching and pain are mostly caused by damp-heat generating parasites, potentially developing into hemorrhoids. It is suitable to fumigate the area with smoke generated by burning Xionghuang (Realgar) mixed with Aiye (Artemisiae Argyi Folium). To treat anal redness, swelling, itching, or pain caused by parasites, apply a paste made from crushed Xingren (Prunus Armeniacae Semen). Alternatively, stir-fry until yellow, dip cotton wool in it, and apply inside the anus. The *Waitai Mi Yao* (Essential Prescriptions Worth a Thousand Gold for Emergencies) treats lower body parasitic biting by pounding one hu (a unit of volume) of peach leaves, steaming them until extremely hot, placing them in a small-mouthed vessel, having the patient sit over it to fumigate, which kills the parasites immediately. To treat anal swelling and pain, use four or five Muiezi (Momordicae Semen), grind them to an extremely fine powder, soak/wash with boiling water, and apply a small amount separately to the affected area.