孙文垣治潘大司马，常有肠风之症，八月丁祭学博馈鹿血，食之血暴下，用槐角子五钱，黄连、
枳壳、地
榆、贯众各三钱，一服而止。潘善其方，书之粘壁间，遇有便血者，根据方服之，无不立效。
陈鹿塘原有肠风脏毒之症，大便燥结，数日不能一行，痛苦殊甚，此胃寒肠热也。其脉两寸皆数，
两关弦而无力，两尺洪滑，而左尤甚。久治不效，因忆东垣有云∶大肠喜清而恶热，脾胃喜温而恶寒，
以胃属土，肠属金也。乃制一方，专以肠风脏毒药为主，外以养血之药裹之，使不伤胃气。盖药先入
胃，后入大肠，入胃时裹药未化，及入大肠，则裹药化而君药始见，庶几两不相妨。因以九制大黄二
两，槐花三两，木耳二两，郁李仁、皂角子、象牙屑、条芩各一两，血余、升麻、荆芥穗各五钱，共
为末，炼蜜为丸，赤豆大，外以四物加蒲黄各一两为衣。米饮送下，空心及下午各二钱，血果止，大
便不燥，饮食日加而愈。
王祖泉大便里急后重，腹痛，日夜下紫稠粘三四十度，作痢治，三月不效。肌瘦懒食，眼合懒开，
悉以为不治。脉之，六部濡弱，所下之色甚晦，状如芋苗汁，曰∶此非痢，乃脏毒下血也。《医说》
中人参樗皮散，正与此对。即制与之，其夜果减半，终剂全愈。方以人参、樗根白皮各二两，为末，
空心米饮调二钱。忌肉汁、生菜、鱼腥。
汤封君简庵，血分热甚，以善饮致肠风，且心肾不交，以四物汤加枣仁、侧柏叶、槐花、连翘，
蜜为丸，服之即愈。
吴孚先治张东铭，素患痔疾，兼后重之症，似痢非痢，登圊窘迫，行步如跨马状，坐亦作楚，六
脉偏盛，稍觉无神，知为气血虚而挟湿热。用芎、归、芩、连、生地、槐角、楂肉、升麻，加人参二
两，为丸。彼去参服之，不效，复入参，服半料已全愈。
张子和曰∶一男子脏毒下血，当六月热不可堪，自分必死，忽思蜜水，猛舍性命饮一大盏，痛止
血住。
汝南节度副使完颜君宝病脏毒，下 血发渴，寒热往来，延及六载，日渐瘦弱无力，面黄如染。
张诊其两手脉沉而身凉。《内经》寒以为荣气在故生，可治。先以七宣丸下五七行，次以黄连解毒汤
加当归、赤芍、地榆散，同煎服之，一月而愈。
方勺《泊宅编》云∶外兄刘掾病脏毒下血，凡半月，自分必死。得一方，只以干柿烧灰，饭服二
钱，遂愈。又王 《百一方》云∶曾通判子病下血十年，亦用此方，一服而愈。为丸为散皆可。（《本
草纲目》）
薛立斋治一男子脏毒下血，服凉血败毒药，不惟血不能止，且饮食少思，肢体愈倦，脉数，按之
则涩，先以补中益气汤，数剂少止。更以六君子汤加升麻、炮姜，四剂而止。乃去炮姜，加芎、归，
月余脾胃亦愈。常治积热，或风热下血者，先以败毒散散之；胃寒气弱者，用四君子汤，或参苓白术
散补之，并效。
一男子脏毒下血，脾气素弱，用六君子汤加芎、归、枳壳、地榆、槐花，治之而愈。后因谋事，
血复下，诸药不应。意思虑伤脾所致，投归脾汤四剂而痊。大抵此症，所致之由不一，当究其因而治
之。丹溪云∶芎归汤一剂，又调血之上品，热加茯苓、槐花，冷加茯苓、木香，此则自根自本之论也。
虽然精气血出于谷气，惟大肠下血，以胃药收功。以四君子汤、参 白术散，以枳壳散，小乌沉汤和
之，胃气一回，血自循经络矣。肠风者，邪气外入，随感随见；脏毒者，蕴积毒久而始见。又云∶人
惟坐卧风温，醉饱房劳，生冷停寒，酒面积热，以致荣血失道，渗入大肠，此肠风脏毒之所作也。挟
热下血，清而色鲜，腹中有痛。挟冷下血，浊而色黯，腹内略痛。清则为肠风，浊则为脏毒。有先便
而后血者，其来也远；有先血而后便者，其来也近。世俗屎前屎后之说，非也。治法大要，先当解散
肠胃风邪，热则败毒散，冷则换金正气散加芎、归，后随其冷热治之。刘河间云∶起居不节，用力过
度，则络脉伤。阳络伤则血外溢，血外溢则衄血；阴络伤则血内溢，血内溢则便血。肠胃之络伤则溢
血，肠外有寒汁沫，与血相搏，则并合凝聚不得散而成积矣。又《内经》云∶肠癖下脓血，脉弦绝者
死，滑大者生，血溢身热者死，身凉者生。诸方皆谓风热侵于大肠而然。若饮食有节，起居有时，肠
胃不虚，邪气从何而入？
王执中云∶何教授汤簿有肠风疾，积年不愈，取脊端穷骨，名龟尾，当中一灸除根，汤簿因传此
方。后观《灸经》，此穴疗小儿脱肛泻血，盖岐伯灸小儿法也，后人因之以灸大人肠风泻血耳。盖大
人、小儿之病，初不异故也。五痔便血失屎 气，灸百壮，在脊穷骨上赤下白处。
孙文垣治疗潘大司马，他常有肠风（便血的一种，多由风邪引起）的症状。八月丁祭时，学博赠送鹿血，食用后血液突然大量下泄。孙文垣使用槐角子五钱，黄连、枳壳、地榆、贯众各三钱，服用一次后出血即止。潘大司马称赞这个方子好，将其写在纸上贴在墙壁间，遇到有便血的人，依照此方服用，没有不立刻见效的。
陈鹿塘原本就有肠风和脏毒（一种严重的肠道湿热毒邪引起的便血或痢疾）的症状，大便干燥结硬，几天不能排便一次，痛苦非常严重，这是胃寒而肠热的表现。他的脉象两寸部都数（快），两关部弦（如按琴弦）且无力，两尺部洪大滑利，左侧尤其明显。长期治疗无效，于是想起李东垣说过：“大肠喜欢清凉而厌恶热邪，脾胃喜欢温暖而厌恶寒冷”，因为胃属土，肠属金。于是制定一个方子，专门以治疗肠风脏毒的药物为主药，外面用养血药物包裹，以免损伤胃气。因为药物先进入胃，后进入大肠，进入胃时包裹的药还未化开，等到进入大肠，包裹的药才化开，主药才开始发挥作用，这样两者互不干扰。因此用经过九次蒸晒的大黄二两，槐花三两，木耳二两，郁李仁、皂角子、象牙屑、黄芩各一两，血余炭、升麻、荆芥穗各五钱，共同研成细末，用炼蜜制成丸子，大小如赤豆，外面用四物汤加蒲黄各一两作为包衣。用米汤送服，空腹和下午各服二钱，血果停止，大便不再干燥，饮食逐渐增加而痊愈。
王祖泉大便里急后重（想排便但排不出或排不尽的感觉），腹痛，日夜排出紫红色稠粘粪便三四十次，被当作痢疾治疗，三个月没有效果。身体消瘦，懒得进食，眼睛闭合懒得睁开，大家都认为无法治愈。诊脉发现六部脉象都濡弱（软而浮细），排出的血色很晦暗，形状像芋头苗的汁液，说：“这不是痢疾，而是脏毒下血。”《医说》中记载的人参樗皮散，正好对应这种病症。于是制作该方给他服用，当晚出血量果然减半，服药结束后完全痊愈。方剂用人参、樗根白皮各二两，研成细末，空腹时用米汤调服二钱。忌食肉汁、生菜、鱼腥食物。
汤封君简庵，血分热邪很重，因为喜欢饮酒导致肠风，并且心肾不交（心火与肾水不能相互协调），用四物汤加酸枣仁、侧柏叶、槐花、连翘，蜂蜜制丸，服用后即愈。
吴孚先治疗张东铭，素来患有痔疮疾病，兼有里急后重的症状，似痢非痢，上厕所时窘迫难受，走路像跨马的样子，坐着也感到疼痛，六部脉象偏盛，稍微觉得无神，知道是气血虚弱而夹杂湿热。用川芎、当归、黄芩、黄连、生地、槐角、山楂肉、升麻，加入人参二两，制成丸剂。患者去掉人参服用，没有效果，重新加入人参，服用半料后完全痊愈。
张子和说：有一个男子患脏毒下血，正值六月天气炎热难耐，自己断定必死无疑，忽然想到喝蜜水，拼命舍命喝了一大碗，疼痛停止，出血也止住了。
汝南节度副使完颜君宝患脏毒，下血并口渴，寒热往来（忽冷忽热），延续六年，日渐瘦弱无力，面色黄得像染过一样。张子和诊察他两手脉象沉而身体发凉。《内经》说“寒以为荣气在故生”，说明还有生机，可以治疗。先用七宣丸泻下五六次，接着用黄连解毒汤加当归、赤芍、地榆散，同煎服用，一个月后痊愈。
方勺在《泊宅编》中说：外兄刘掾患脏毒下血，凡是半个月，自己断定必死。得到一个方子，只用干柿子烧成灰，饭后服用二钱，于是痊愈。又王《百一方》说：曾通判的儿子患下血十年，也用这个方子，服用一次就痊愈了。做成丸剂或散剂都可以。（出自《本草纲目》）
薛立斋治疗一个男子患脏毒下血，服用凉血败毒药物，不仅血不能止住，而且饮食减少思虑，肢体更加疲倦，脉数，按压则涩，先用补中益气汤，几剂后稍有好转。再用六君子汤加升麻、炮姜，四剂后止血。然后去掉炮姜，加入川芎、当归，一个多月后脾胃也痊愈了。常治疗积热，或风热下血者，先用败毒散发散；胃寒气弱者，用四君子汤，或参苓白术散补益，都有效。
一个男子患脏毒下血，脾气素来虚弱，用六君子汤加川芎、当归、枳壳、地榆、槐花，治疗而痊愈。后来因为谋划事情，心思忧虑损伤脾脏，血再次下泄，各种药物都不应验。认为是思虑伤脾所致，投用归脾汤四剂而痊愈。大抵这个病症，产生的原因不一，应当探究其原因而治疗。丹溪说：芎归汤一剂，又是调理血液的上品，热证加茯苓、槐花，冷证加茯苓、木香，这是从根本出发的理论。虽然精气血来源于谷气，唯独大肠下血，以调理胃药收功。用四君子汤、参苓白术散，配合枳壳散，小乌沉汤调和它，胃气一旦恢复，血自然循行于经络之中。肠风，是邪气从外部侵入，随感随见；脏毒，是蕴积毒邪久了才显现。又说：人只有坐卧受风温侵袭，醉饱房劳过度，生冷停寒，酒面积热，导致营血失去正道，渗入大肠，这是肠风脏毒产生的原因。挟热下血，清亮而色鲜红，腹中有痛感。挟冷下血，浑浊而色黯黑，腹内略微疼痛。清亮的是肠风，浑浊的是脏毒。有先大便而后出血的，病位较远；有先出血而后大便的，病位较近。世俗关于屎前屎后的说法，是不正确的。治法的大要，首先应当解散肠胃风邪，热证用败毒散，冷证用换金正气散加川芎、当归，随后根据冷热情况治疗。刘河间说：起居不节制，用力过度，则络脉受伤。阳络受伤则血外溢，血外溢则鼻衄血；阴络受伤则血内溢，血内溢则便血。肠胃之络受伤则溢血，肠外有寒汁沫，与血相搏，则合并凝聚不得消散而成积聚了。又《内经》说：肠癖下脓血，脉弦绝者死，滑大者生，血溢身热者死，身凉者生。各方都认为这是风热侵于大肠所致。如果饮食有节制，起居有规律，肠胃不虚，邪气从何而入？
王执中说：何教授汤簿有肠风疾病，多年不愈，取脊端穷骨，名为龟尾穴，正中灸一次除根，汤簿因此传授此方。后来观看《灸经》，此穴治疗小儿脱肛泻血，大概是岐伯灸小儿的方法，后人因此用它来灸大人肠风泻血罢了。大概大人、小儿的疾病，起初并没有不同。五种痔疮便血失禁，灸一百壮，位于脊穷骨上红下白交界处。
Sun Wenyuan treated Pan Dasima, who frequently suffered from Changfeng (intestinal wind, a type of rectal bleeding often caused by wind pathogen). During the Ding sacrifice in August, the Xuebo presented him with deer blood. After consuming it, he experienced sudden and massive lower gastrointestinal bleeding. Sun prescribed Huaijiao Zi (Fructus Acanthopanacis Senticosi) 5 qian, along with Huanglian (Rhizoma Coptidis), Zhike (Pericarpium Citri Reticulatae), Diyü (Radix Sanguisorbae), and Guanzhong (Rhizoma Cyperi Rotundi), each 3 qian. One dose stopped the bleeding. Pan praised the prescription and posted it on his wall. Whenever someone else suffered from hematochezia, they followed this prescription and achieved immediate efficacy.
Chen Lutang originally suffered from Changfeng and Zangdu (intestinal toxin, a severe form of intestinal damp-heat toxicity causing bleeding or dysentery). His stools were dry and hard, unable to pass for several days, causing extreme pain. This indicated cold in the stomach and heat in the intestines. His pulse was rapid at both Cun positions, wiry and weak at both Guan positions, and surging and slippery at both Chi positions, especially on the left side. After long-term ineffective treatment, he recalled Li Dongyuan’s saying: “The large intestine prefers coolness and dislikes heat; the spleen and stomach prefer warmth and dislike cold,” because the stomach belongs to Earth and the intestines to Metal. Thus, he formulated a prescription primarily using herbs for treating Changfeng and Zangdu, wrapped externally with blood-nourishing herbs to prevent damage to stomach Qi. Since the medicine enters the stomach first and then the large intestine, the wrapping remains intact in the stomach and dissolves only upon reaching the large intestine, allowing the main ingredients to act there without interfering with the stomach. He used Jiuzhi Dahuang (Nine-processed Rhizoma et Radix Rhei) 2 liang, Huaihua (Flos Sophorae) 3 liang, Mu'er (Sporophorus Auriculariae Judae) 2 liang, Yuliren (Semen Pruni) 1 liang, Zhaojiao Zi (Fructus Gleditsiae Sinensis) 1 liang, Xiangyasui (Dens Elephantis) 1 liang, and Tiaoxin (Radix Scutellariae) 1 liang, plus Xuerou (Cortex Cornus) 5 qian, Shengma (Rhizoma Cimicifugae) 5 qian, and Jingjisui (Flos Chrysanthemi Indici) 5 qian. These were ground into powder, mixed with refined honey to make pills the size of Adzuki beans, coated with Siwu Tang (Four Substances Decoction) plus Puhuang (Pollen Typhae) 1 liang each. Taken with rice water, 2 qian on an empty stomach and in the afternoon. The bleeding stopped, stools softened, appetite improved, and he recovered.
Wang Zuquan suffered from tenesmus and abdominal pain, passing purple, thick, sticky stool 30–40 times day and night. Treated as dysentery for three months with no effect. He became emaciated, lost appetite, and kept his eyes closed due to fatigue. Everyone deemed it incurable. Pulse diagnosis revealed weak and soggy pulses in all six positions. The discharged blood was dark and resembled taro juice. He stated: “This is not dysentery, but Zangdu bleeding.” The Ren Shen Chu Pi San (Ginseng and Chinese Toona Powder) recorded in *Yi Shuo* precisely matches this condition. He prepared and administered it. That night, bleeding halved, and after completing the course, he fully recovered. The formula consisted of Ren Shen (Radix Ginseng) and Chu Gen Bai Pi (Cortex Toosendan Fructus), each 2 liang, powdered and taken with rice water, 2 qian on an empty stomach. Avoid meat broth, raw vegetables, and fishy foods.
Tang Fengjun Jian’an had excessive heat in the blood level, leading to Changfeng due to heavy drinking, accompanied by Heart-Kidney non-interaction. He took Siwu Tang (Four Substances Decoction) supplemented with Zaoren (Semen Ziziphi Spinosae), Cebei Ye (Folium Platycladi), Huaihua (Flos Sophorae), and Lianqiao (Fructus Forsythiae), made into honeyed pills, which cured him immediately.
Wu Fuxian treated Zhang Dongming, who had chronic hemorrhoids with tenesmus, resembling dysentery but not quite. He felt urgent discomfort during defecation, walked like riding a horse, and sat painfully. All six pulses were slightly excessive but lacked spirit, indicating Qi and Blood deficiency with damp-heat. He used Xiong (Radix Chuanxiong), Gui (Radix Angelicae Sinensis), Qin (Radix Scutellariae), Lian (Rhizoma Coptidis), Shengdi (Radix Rehmanniae Preparata), Huaijiao (Fructus Acanthopanacis Senticosi), Zhari Rou (Sarcocarp Crataegi), and Shengma (Rhizoma Cimicifugae), adding 2 liang of Ren Shen (Radix Ginseng), made into pills. When the patient omitted Ren Shen, it failed. Upon re-including Ren Shen, half a dose cured him completely.
Zhang Hezi said: A man suffered from Zangdu bleeding in the sweltering heat of June, believing death was inevitable. Suddenly craving honey water, he drank a large bowl desperately. Pain ceased, and bleeding stopped.
Wanyan Junbao, Vice Commissioner of Runan Jiedu, suffered from Zangdu, with bleeding, thirst, alternating chills and fever, lasting six years. He became increasingly weak and yellow-faced. Zhang diagnosed deep pulses in both hands and a cool body. *Neijing* states that if cold indicates Ying Qi is present, life can be sustained. First, seven Xuan Wan (Seven Promoting Pills) were given to induce bowel movements five to seven times. Then, Huanglian Jiedu Tang (Coptis Decoction for Detoxification) plus Danggui (Radix Angelicae Sinensis), Chishao (Radix Paeoniae Rubra), and Diyü San (Sanguisorba Powder) were decocted together and taken. He recovered in one month.
Fang Shuo in *Bozhai Bian* wrote: His cousin Liu Yuan suffered from Zangdu bleeding for half a month, expecting death. He obtained a prescription using dried persimmon ash, taken with rice, 2 qian, which cured him. Wang’s *Baiyi Fang* also records a case of a son of Zeng Tongpan suffering from bleeding for ten years, cured by one dose of this prescription. It can be made into pills or powder. (From *Bencao Gangmu*)
Xue Lizhai treated a man with Zangdu bleeding. Cooling and detoxifying herbs failed to stop the bleeding and worsened his appetite and fatigue. Pulses were rapid but choppy on pressure. He first used Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting Qi) for several doses, slightly stopping the bleeding. Then, Liujunzi Tang (Six Gentlemen Decoction) plus Shengma (Rhizoma Cimicifugae) and Paojiang (Prepared Rhizoma Zingiberis) stopped it in four doses. Paojiang was removed, and Xiong (Radix Chuanxiong) and Gui (Radix Angelicae Sinensis) added. After over a month, his spleen and stomach recovered. For cases of accumulated heat or wind-heat bleeding, Baidu San (Detoxification Powder) is used first. For cold-stomach weakness, Sijunzi Tang (Four Gentlemen Decoction) or Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) tonifies effectively.
A man with weak spleen Qi suffered from Zangdu bleeding. Liujunzi Tang plus Xiong, Gui, Zhike, Diyü, and Huaihua cured him. Later, mental stress caused recurrence, unresponsive to other drugs. Recognizing it as spleen injury from worry, Guipi Tang (Restore the Spleen Decoction) for four doses healed him. Generally, causes vary, so treatment must address the root. Danxi said: Xionggui Tang (Chuanxiong and Angelica Decoction) is a premier blood regulator. Add Fuling (Poria) and Huaihua for heat; add Fuling and Muxiang (Radix Aucklandiae) for cold. This is a fundamental theory. Although essence, Qi, and blood derive from grain Qi, lower GI bleeding is ultimately resolved by treating the stomach. Using Sijunzi Tang, Shenling Baizhu San, Zhike San (Citrus Peel Powder), and Xiao Wuchen Tang (Minor Black Stagnation Decoction) harmonizes the system. Once Stomach Qi returns, blood flows normally in the collaterals. Changfeng arises from external pathogens appearing immediately; Zangdu results from accumulated toxins manifesting later. Sitting in wind/warmth, overindulgence in sex/diet, cold/raw food retention, and alcohol-induced heat cause Ying blood to deviate and seep into the large intestine. Heat-associated bleeding is clear and bright red with abdominal pain; cold-associated bleeding is turbid and dark with slight pain. Clear indicates Changfeng; turbid indicates Zangdu. Bleeding after stool implies distant origin; bleeding before stool implies near origin. Folk theories about pre/post-stool bleeding are incorrect. General treatment involves resolving intestinal wind first: Baidu San for heat, Huanjin Zhengqi San (Golden Change Upright Qi Decoction) plus Xiong and Gui for cold, followed by heat/cold differentiation. Liu Hejian said: Irregular lifestyle and excessive strain injure collaterals. Yang collateral injury causes external bleeding (epistaxis); Yin collateral injury causes internal bleeding (hematochezia). Intestinal collateral injury leads to blood overflow. Cold fluids outside the intestine mix with blood, forming stagnation. *Neijing* states: Dysentery with pus/blood, wiry/absent pulse means death; slippery/large pulse means survival. Hemorrhage with fever means death; cool body means survival. Most formulas attribute this to wind-heat invading the large intestine. If diet and lifestyle are regulated, and the interior is strong, how can pathogens enter?
Wang Zhizhong said: Professor Tang Bo suffered from Changfeng for years without cure. Moxibustion on Qionggu (Tailbone), specifically the Guwei point (GV1), once eliminated the root. Tang Bo transmitted this method. Later, *Jiu Jing* noted this point treats pediatric prolapse and bloody diarrhea, originating from Qibo’s pediatric moxibustion methods, later applied to adults. Adult and pediatric diseases share similar origins. For five types of hemorrhoids with bleeding/incontinence, moxa 100 zhuang at the junction above the tailbone where red meets white.