大便下血，血清者，谓之肠风；血浊者，谓之脏毒。盖此风非外来之风，乃肠中热极则生风
也。毒非痈疽之毒，因大肠积热，猝难开解，下血不止，故有脏毒之名也。按经言∶结阴者，便血。盖
气为阳，血为阴，邪热结于阴分，故当便血。初起宜清热凉血为主，久远不愈，阴分大伤，当滋阴
〔二地、龟甲。〕养血〔枣仁、白芍。〕清热〔银花、麦冬。〕佐以酸敛收涩〔萸、味、首乌。〕引
导〔或肚入莲肉，或脏入槐花，煮烂为丸。〕之品。丹溪云∶凡治下血，不可纯用寒凉，必加辛味升举
药为佐。虞氏云∶人身精血，皆生于谷气，脾胃统血，久病虚弱，必资归脾、补中等汤，脾胃气旺，则
能摄血而不下行矣。虽方书论血，从下流为顺，易治，若大下数升，形肉枯槁，面浮肢肿，喘息脾泄诸
症悉至，正所谓轻则易治，甚则难痊。
槐榆生地汤〔自制。〕治肠风脏毒下血。〔仲淳云∶属湿热。〕
槐花 地榆 黄芩 银花〔清热除湿。〕生地 白芍 生鸡子〔补阴凉血。〕甘
草〔调和诸药。〕荆芥〔能入血分。性升上行。炒焦。〕荷叶蒂〔补助脾胃，升发阳气。〕
热甚，加犀角、黄连，或用猪脏丸服。〔另用槐花填入脏中煮烂。去槐花，捣和丸药。取其引入大肠。〕
此方清热除湿凉血。佐以升举，便血初起者甚效。《广笔记》载一方，治便血，或因酒毒发
者。先用黄连酒炒为末，空心白酒调服三钱，忌荤腥，一日服后必腹痛，去血愈多；复用白芍一
两，白术五钱，甘草三钱，同炒拣开、先以白芍煎服，腹痛自止；后用术草煎服必愈。补胃气则阳明
调，而便血自止。
广笔记方 治肠风甚效。
人参〔一、二、三钱。〕黄 〔蜜炙，三钱。〕甘草〔补气以摄之。炙一钱。〕生
地〔四钱。〕麦冬〔五钱。〕地榆〔凉血。以止之。酒洗。〕白芍〔酒炒。各三
钱。〕当归〔血去多，则补益之。〕萸肉〔各二钱。〕北五味〔血滑脱则酸敛之。八
分。〕荆芥〔炒黑一钱。〕柴胡 白芷〔血下渗则升举之。各五分。〕
此方补气养血，滋阴清热，酸敛升举，诸法尽备，以治便血，自神效也。
八仙长寿丸〔见虚劳。〕
宜加首乌〔益血而涩。〕白芍〔凉血而敛。〕莲肉〔补脾止血〕女贞子 龟甲
胶〔益阴除热。〕可用槐花煮猪脏，〔法同上方。〕加黄蜡〔涩能止血。〕丸服。
此方滋阴养血清热，佐以酸涩，便血久远者宜之。或左归丸饮，人参固本丸等方，俱可参酌上药
用之。一方、只用北五味、熟地等分为丸，服久必效，如虚人初起，胃弱难胜苦寒药者，用以上等方，须
去酸涩之品。
归脾丸〔见虚劳。〕
补中益气汤〔见泄泻。〕便血过多，脾胃虚弱者，选而加减用之。
宜加莲肉、糯米、白芍、麦冬、五味、龟甲之属。
此二方皆补脾以统血之治法也。均宜加滋阴凉血酸敛之药以治之。要之去血过多，阴分大伤，
若但用补气健脾温热等药，则阳愈旺而阴愈消矣。
大便下血，血色清稀的，称为肠风；血色浑浊的，称为脏毒。这其中的“风”并非外感之风，而是肠道内热极盛而生风。“毒”也非痈疽之毒，而是因为大肠积热，突然难以疏通化解，导致下血不止，所以有“脏毒”这个名称。按照经典记载：结阴证，会出现便血。气属阳，血属阴，邪热结聚在阴分，所以应当出现便血。初起时宜以清热凉血为主；病程长久不愈，阴分大伤，应当滋阴（用地黄、龟甲），养血（用酸枣仁、白芍），清热（用金银花、麦冬），佐以酸敛收涩的药物（用山茱萸、五味子、何首乌），并配合引经报使的药物（或者用猪肚入莲子肉，或者用动物内脏入槐花，煮烂后制成丸药）引导药力到达病所。朱丹溪说：凡是治疗下血，不可单纯使用寒凉药物，必须加入辛味升举药作为辅助。虞氏说：人身精血，都化生于谷气，脾胃统摄血液，久病体虚，必须依靠归脾汤、补中益气汤等方剂，脾胃之气旺盛，就能统摄血液而不向下流失了。虽然医书论述出血，认为从下部流出为顺症，容易治疗，但如果大量失血数升，形体肌肉枯槁，面部浮肿四肢肿胀，喘息、脾泄等症状全部出现，这正是所谓轻症易治，重症难愈。
槐榆生地汤（自制）。治疗肠风和脏毒引起的下血。（张景岳说：属于湿热证。）
组成：槐花、地榆、黄芩、金银花（清热除湿）、生地黄、白芍、生鸡蛋（补阴凉血）、甘草（调和诸药）、荆芥（能入血分，性升上行，炒焦用）、荷叶蒂（补助脾胃，升发阳气）。
若热势甚重，加犀角、黄连，或者服用猪脏丸。（另取槐花填入猪大肠中煮烂，去掉槐花，捣碎混合成丸药。取其引入大肠之意。）
此方具有清热除湿凉血的功效，佐以升举药，对于便血初起者非常有效。《广笔记》记载一方，治疗便血，有的因酒毒引发者。先用黄连酒炒研末，空腹时用白酒调服三钱，忌食荤腥，一日服药后必然腹痛，排出的血会更多；然后复用白芍一两、白术五钱、甘草三钱，同炒后拣开，先煎白芍服用，腹痛自然停止；后用白术和甘草煎服，必定痊愈。补益胃气则阳明经气调和，便血自然停止。
广笔记方。治疗肠风非常有效。
组成：人参（一、二、三钱）、黄芪（蜜炙，三钱）、甘草（补气以摄血，炙一钱）、生地黄（四钱）、麦冬（五钱）、地榆（凉血以止血，酒洗）、白芍（酒炒，各三钱）、当归（失血多，则补益它）、山茱萸（各二钱）、北五味子（血滑脱则酸敛之，八分）、荆芥（炒黑一钱）、柴胡、白芷（血下渗则升举之，各五分）。
此方补气养血，滋阴清热，酸敛升举，各种治法齐全，用来治疗便血，自然神效。
八仙长寿丸（见虚劳章节）。
适宜加入何首乌（益血而涩）、白芍（凉血而敛）、莲子肉（补脾止血）、女贞子、龟甲胶（益阴除热）。可以用槐花煮猪大肠（方法同上方），加入黄蜡（涩能止血），制成丸药服用。
此方滋阴养血清热，佐以酸涩，适合便血日久者。或者左归丸、人参固本丸等方剂，都可以参考上述药物加减使用。有一方，只用北五味子和熟地黄等分为丸，长期服用必然见效。如果是虚人初起，胃弱难以承受苦寒药物者，使用以上上等方剂，须去掉酸涩之品。
归脾丸（见虚劳章节）。
补中益气汤（见泄泻章节）。便血过多，脾胃虚弱者，选择这些方剂加减使用。
适宜加入莲子肉、糯米、白芍、麦冬、五味子、龟甲等类药物。
这两个方子都是补脾以统血的治法。都适宜加入滋阴凉血酸敛的药物来治疗。总之，去血过多，阴分大伤，如果只使用补气健脾温热等药物，那么阳气越旺，阴液就越消亡了。
Blood passing from the anus with clear blood is called Changfeng (Intestinal Wind); blood with turbid appearance is called Zangdu (Visceral Toxin). The "wind" here does not refer to external wind, but rather wind generated by extreme heat in the intestines. The "toxin" does not refer to the toxin of carbuncles and sores, but arises because accumulated heat in the large intestine is suddenly difficult to resolve, leading to continuous bleeding, hence the name Zangdu. According to the classics: Jieyin syndrome (Binding of Yin) presents with bloody stool. Qi belongs to Yang, Blood belongs to Yin; when pathogenic heat binds in the Yin aspect, bloody stool should occur. In the initial stage, treatment should primarily focus on clearing heat and cooling blood. If the condition persists for a long time without healing, causing severe injury to the Yin aspect, nourishment of Yin (using Shengdi Huang [Rehmanniae Radix], Guijia [Testudinis et Chelydrae Carapax et Plastrum]), nourishment of Blood (using Zaoren [Ziziphi Spinosae Semen], Baishao [Paeoniae Radix Alba]), clearing heat (using Yinhua [Flos Lonicerae Japonicae], Maidong [Ophiopogonis Radix]), combined with sour astringents (using Yurou [Corni Fructus], Wuwei Zi [Schisandrae Chinensis Fructus], Shouwu [Polygoni Multiflori Radix)], and guided by directing herbs (such as using pig stomach with Lotus Seeds, or viscera with Huaihua [Flos Sophorae], boiled until soft and made into pills) to guide the medicinal action to the disease site. Zhu Danxi stated: When treating lower bleeding, one must not use purely cold and cool medicines; it is necessary to add acrid herbs that lift and raise as assistants. Yu Shi stated: The essence and blood of the human body are all generated from grain qi; the Spleen and Stomach govern the holding of blood. In chronic illness with weakness, one must rely on Guipi Tang (Spleen-Restoring Decoction) and Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi); when the Qi of the Spleen and Stomach is vigorous, it can hold the blood and prevent it from flowing downward. Although medical texts discuss bleeding, considering flow from below as favorable and easy to treat, if several sheng (approx. 500ml units) of blood are lost heavily, resulting withered flesh and emaciation, facial edema, limb swelling, panting, and Pi-xie (Spleen diarrhea) appearing together, this is precisely what is meant by mild cases being easy to treat, while severe cases are difficult to cure.
Huaiyu Shengdi Tang (Self-made formula). Treats Changfeng and Zangdu causing bloody stool. (Zhang Jingyue states: It belongs to Damp-Heat.)
Ingredients: Huaihua [Flos Sophorae], Diyü [Sanguisorbae Radix], Huangqin [Scutellariae Radix], Yinhua [Flos Lonicerae Japonicae] (clears heat and removes dampness), Shengdi Huang [Rehmanniae Radix], Baishao [Paeoniae Radix Alba], raw chicken egg (nourishes Yin and cools blood), Gancao [Glycyrrhizae Radix et Rhizoma] (harmonizes the various herbs), Jingjie [Schizonepetae Herba] (enters the Blood aspect, has an ascending nature, stir-fried until charred), Heyetidi [Nelumbinis Petiolus] (supplements Spleen and Stomach, raises Yang Qi).
If heat is severe, add Xijiao [Rhinocerotis Cornu] and Huanglian [Coptidis Rhizoma], or take Zhuzang Wan (Pig Viscera Pill). (Separately, fill Huaihua [Flos Sophorae] into pig intestines, boil until soft, remove Huaihua, mash and mix into pill form. This utilizes its property to guide medicine into the Large Intestine.)
This formula clears heat, removes dampness, and cools blood, assisted by lifting herbs, and is very effective for early-stage bloody stool. *Guangbiji* records another prescription for treating bloody stool, possibly caused by alcohol toxin. First, stir-fry Huanglian [Coptidis Rhizoma] with wine, grind into powder, take three qian (approx. 10g) mixed with white liquor on an empty stomach, avoiding meat and fish. After taking it for one day, abdominal pain will inevitably occur, and more blood will be expelled. Then, use Baishao [Paeoniae Radix Alba] one liang (approx. 30g), Baizhu [Atractylodis Macrocephalae Rhizoma] five qian (approx. 15g), Gancao [Glycyrrhizae Radix et Rhizoma] three qian (approx. 10g), stir-fry them together, separate them, first decoct and take Baishao [Paeoniae Radix Alba]; the abdominal pain will stop naturally. Subsequently, decoct and take Baizhu [Atractylodis Macrocephalae Rhizoma] and Gancao [Glycyrrhizae Radix et Rhizoma]; recovery will surely follow. By supplementing Stomach Qi, the Yangming channel harmonizes, and bloody stool stops spontaneously.
Guangbiji Formula. Very effective for treating Changfeng (Intestinal Wind).
Ingredients: Renshen [Ginseng Radix et Rhizoma] (1, 2, or 3 qian), Huangqi [Astragali Radix] (honey-fried, 3 qian), Gancao [Glycyrrhizae Radix et Rhizoma] (tonifies Qi to hold blood, honey-fried, 1 qian), Shengdi Huang [Rehmanniae Radix] (4 qian), Maidong [Ophiopogonis Radix] (5 qian), Diyü [Sanguisorbae Radix] (cools blood to stop bleeding, washed with wine, 3 qian), Baishao [Paeoniae Radix Alba] (wine-fried, 3 qian), Danggui [Angelicae Sinensis Radix] (if blood loss is heavy, tonify it), Yurou [Corni Fructus] (2 qian), Bei Wuweizi [Schisandrae Chinensis Fructus] (for slippery leakage, use sour astringency, 8 fen), Jingjie [Schizonepetae Herba] (charred, 1 qian), Chaihu [Bupleuri Radix], Baizhi [Angelicae Dahuricae Radix] (for seeping blood downwards, use lifting herbs, each 5 fen).
This formula tonifies Qi and nourishes Blood, nourishes Yin and clears Heat, uses sour astringents and lifting methods; all therapeutic methods are complete. Used to treat bloody stool, it yields miraculous results.
Baxian Changshou Wan (See Xu Lao chapter).
It is suitable to add Shouwu [Polygoni Multiflori Radix] (benefits Blood and is astringent), Baishao [Paeoniae Radix Alba] (cools Blood and astringes), Lianrou [Nelumbinis Semen] (tonifies Spleen and stops bleeding), Nvzhenzi [Ligustri Lucidi Fructus], Guijiaojiao [Colla Testudinis et Colla Plastrum Testudinis] (benefits Yin and eliminates heat). One may use Huaihua [Flos Sophorae] to cook pig intestines (method same as above), add Huangla (Beeswax) (astringent to stop bleeding), and make into pills.
This formula nourishes Yin, tonifies Blood, clears Heat, assisted by sour and astringent herbs, suitable for long-standing bloody stool. Alternatively, Zuogui Wan (Left Restoring Pill), Renshen Guben Wan (Ginseng Root-Securing Pill), etc., can be consulted and used with reference to the above herbs. Another prescription uses only Bei Wuweizi [Schisandrae Chinensis Fructus] and Shudi Huang [Rehmanniae Praeparata Radix] in equal parts made into pills; long-term use will surely be effective. For deficient patients in the initial stage, or those with weak Stomachs unable to bear bitter-cold medicines, use the superior formulas mentioned above, but remove the sour and astringent ingredients.
Guipi Wan (See Xu Lao chapter).
Buzhong Yiqi Tang (See Xie Xie chapter). For excessive bloody stool due to Spleen and Stomach weakness, select these formulas and modify accordingly.
It is suitable to add Lianrou [Nelumbinis Semen], Nuomi [Oryzae Sativae Glumen], Baishao [Paeoniae Radix Alba], Maidong [Ophiopogonis Radix], Wuwei Zi [Schisandrae Chinensis Fructus], Guijia [Testudinis et Chelydrae Carapax et Plastrum], etc.
These two formulas both employ the method of tonifying the Spleen to control Blood. Both are suitable for adding herbs that nourish Yin, cool Blood, and astringe to treat the condition. Essentially, excessive blood loss severely injures the Yin aspect; if one only uses Qi-tonifying, Spleen-strengthening, and warm-hot medicines, Yang will become more vigorous while Yin will diminish further.