闻人氏云∶痘疮大便下血或黑粪，若睡而不醒，是为恶候，乃内热盛也，用犀角地黄汤、抱龙丸、小柴胡汤加生地
黄主之。窃谓前症若寒热作渴，小柴胡加生地黄。发热体倦，用五味异功散加当归。口干作渴，用人参白术散。大凡
作渴引饮发热者，属实热；作渴饮汤，手足不热者，属虚热；手足逆冷者，属虚寒。治者审之。
一小儿出痘便血，痘赤痛如锥，或疮内出血，余谓肝火炽盛，用小柴胡汤加生地黄一剂，随用犀角地黄汤，一剂而
痊。
一小儿痘疮下血，且不起发，先君谓气血不足，用紫草快 汤加参、 、归、术，血顿止，疮顿起，用八珍汤而愈。
一小儿痘疮下血，小便赤色，疮色如赭，发热饮冷，二便不利，先君谓心小肠实热，用八正散，后用解毒防风汤，
及饮芹菜汁而痊。
一小儿痘疹便血倦怠，作渴饮汤，余谓∶倦怠便血，脾虚下陷也；少食作渴，津液枯涸也，用五味异功散加紫草而
愈。
一小儿便血腹胀，困倦身热，口干饮汤，四肢逆冷，先君谓脾气虚寒不能摄血，用五味异功散加丁香、干姜，二剂
血止，痘贯而靥。
一小儿痘将愈而便血，面白恶寒，大便欲去而不去，余
谓此元气虚而下陷也，用益气汤，不信，服凉血之剂，致吐泻腹痛而殁。
一小儿痘将愈，患便血，面白恶寒，手足并冷，脉沉细如无，余谓阳气虚寒，欲用人参、姜、桂。不从，翌日而
死，手足青黑。惜哉！
解毒防风汤 治痘疮，毒瓦斯炽盛便血。
防风 地骨皮 黄 荆芥 白芍药（炒） 牛蒡子（各等分）
上每服四钱，水煎。或为末，白汤调下。
紫草快 汤 治痘疹下血，不能起发，出不快，色不红活等症。（即紫草汤，方见顶陷心烦）
圣济犀角地黄汤 治热毒内蕴，烦躁作渴，面色赤，大便黑屎，或神昏便血。（方见顶陷心烦）
小柴胡 治肝经有热，不能藏血而便血。（方见痘身疼）
五味异功散 治脾胃气虚，不能统血，而大便下血。（方见寒战切牙）
八珍汤 治气虚不能慑血而便血。（方见顶陷灰白）
八正散 治心小肠有热，小便赤，并大便下血。（方见痘小便不利）
七味白术散（即人参白术散，方见痘发热）
闻人氏说：痘疮患者大便下血或排出黑色粪便，如果昏睡不醒，这是凶险的征候，属于内热炽盛所致，治疗应用犀角地黄汤、抱龙丸、小柴胡汤加生地黄来主治。我认为前述症状若伴有寒热往来和口渴，用小柴胡汤加生地黄；发热且身体疲倦，用五味异功散加当归；口干且口渴，用人参白术散。大凡口渴喜冷饮并伴有发热者，属实热证；口渴但想喝热水、手足不热的，属虚热证；手足逆冷的，属虚寒证。治疗者需仔细审察。
有一个小儿出痘疮时便血，痘疹红痛如针刺，或者疮口内出血，我认为这是肝火炽盛，先用小柴胡汤加生地黄一剂，随后用犀角地黄汤，服用一剂后痊愈。
有一个小儿痘疮下血，且痘疹不能起发隆起，我的父亲认为这是气血不足，用紫草快斑汤加人参、茯苓、当归、白术，血立刻停止，痘疹立刻隆起，再用八珍汤而痊愈。
有一个小儿痘疮下血，小便颜色赤红，痘色像红土一样暗红，发热且想喝冷水，大小便不通利，我的父亲认为是心与小肠实热，用八正散治疗，后来用解毒防风汤，并饮用芹菜汁而痊愈。
有一个小儿痘疹便血且倦怠，口渴想喝热水，我认为：倦怠伴便血是脾虚气陷所致；进食少且口渴是津液枯竭所致，用五味异功散加紫草而痊愈。
有一个小儿便血且腹胀，困倦身热，口干想喝热水，四肢逆冷，我的父亲认为是脾气虚寒不能统摄血液，用五味异功散加丁香、干姜，服用两剂后血止，痘疮结痂脱落。
有一个小儿痘疮即将痊愈时出现便血，面色苍白怕冷，大便有便意却排不出，我认为这是元气虚弱而下陷，用益气汤治疗，家属不信，给患儿服用了凉血药物，导致呕吐腹泻腹痛而死。
有一个小儿痘疮将愈时患便血，面色苍白怕冷，手足均冷，脉象沉细几乎摸不到，我认为这是阳气虚寒，打算用人参、干姜、肉桂治疗。家属不从，第二天患儿死亡，手足青黑。可惜啊！
解毒防风汤：治疗痘疮，毒瓦斯炽盛导致便血。
药材：防风、地骨皮、黄芪、荆芥、白芍药（炒）、牛蒡子（各等分）。
用法：每次服用四钱，水煎服。或者研为粉末，用开水调服。
紫草快斑汤：治疗痘疹下血，不能起发，出痘不快，颜色不红活等症状。（即紫草汤，方剂见“顶陷心烦”条）
圣济犀角地黄汤：治疗热毒内蕴，烦躁口渴，面色红赤，大便黑粪，或者神志昏迷便血。（方剂见“顶陷心烦”条）
小柴胡汤：治疗肝经有热，不能藏血而导致便血。（方剂见“痘身疼”条）
五味异功散：治疗脾胃气虚，不能统摄血液，而大便下血。（方剂见“寒战切牙”条）
八珍汤：治疗气虚不能摄血而导致便血。（方剂见“顶陷灰白”条）
Mr. Wenren stated: In cases of smallpox where blood is passed in the stool or black feces are excreted, if the patient falls into a deep sleep and cannot be awakened, this is a malignant prognosis, indicating excessive internal heat. The treatment should employ Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction), Baolong Wan (Dragon-Embracing Pill), and Xiaochaihu Tang (Minor Bupleurum Decoction) with added Shengdihuang (Rehmanniae Radix). I hold that for the aforementioned symptoms, if accompanied by alternating chills and fever along with thirst, Xiaochaihu Tang with added Shengdihuang should be used; if there is fever accompanied by physical fatigue, Wuyi Yigong San (Five-Agent Powder for Strengthening the Spleen) with added Danggui (Angelicae Sinensis Radix) should be used; if there is dry mouth and thirst, Ren Shen Baizhu San (Ginseng and Atractylodes Macrocephala Powder) should be used. Generally speaking, thirst with a desire for cold drinks accompanied by fever indicates excess heat; thirst with a desire for hot drinks and cool extremities indicates deficiency heat; and cold extremities indicate deficiency cold. The practitioner must examine these carefully.
A child suffering from smallpox passed blood in the stool; the pustules were red and painful as if pierced by needles, or bleeding occurred within the sores. I considered this to be due to blazing liver fire. One dose of Xiaochaihu Tang with added Shengdihuang was administered, followed by Xijiao Dihuang Tang. The child recovered after one dose.
Another child with smallpox experienced bleeding and the lesions failed to erupt properly. My father attributed this to insufficiency of qi and blood. Zicao Kuiban Tang (Arnebia Rapid-Eruption Decoction) with added Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), Danggui, and Baizhu (Atractylodis Macrocephalae Rhizoma) was prescribed. The bleeding stopped immediately, and the lesions erupted promptly. The child was subsequently cured using Bazhen Tang (Eight-Treasure Decoction).
Another child with smallpox had bloody stools, dark red urine, and pustules resembling ochre in color. The child had a fever, desired cold drinks, and suffered from difficulty in urination and defecation. My father diagnosed this as excess heat in the Heart and Small Intestine. Bazheng San (Eight-Righteousness Powder) was used initially, followed by Jiedu Fangfeng Tang (Detoxifying and Saposhnikovia Decoction), and the child drank celery juice until recovery.
Another child with measles and smallpox passed blood in the stool and felt fatigued, desiring hot drinks when thirsty. I reasoned that fatigue with bloody stools indicated spleen qi deficiency with sinking; reduced food intake with thirst indicated exhaustion of body fluids. The child was cured using Wuyi Yigong San with added Zicao (Arnebiae Radix seu Rubrae).
Another child presented with bloody stools, abdominal distension, fatigue, low-grade fever, dry mouth desiring hot drinks, and cold extremities. My father diagnosed this as spleen qi deficiency and cold failing to control the blood. Wuyi Yigong San with added Dingxiang (Caryophylli Flos) and Ganjiang (Zingiberis Rhizoma) was prescribed. After two doses, the bleeding ceased, and the pustules crusted over and fell off.
Another child passed blood in the stool just as the smallpox was nearing resolution. The face was pale, the child feared cold, and there was a sensation of needing to defecate but inability to do so. I attributed this to deficiency of yuan qi (primordial qi) with sinking. Yi Qi Tang (Benefit Qi Decoction) was recommended. The family did not believe this and administered cooling-blood agents instead, resulting in vomiting, diarrhea, abdominal pain, and death.
Another child suffered from bloody stools as the smallpox was resolving. The face was pale, the child feared cold, both hands and feet were cold, and the pulse was deep, fine, and nearly imperceptible. I diagnosed this as yang qi deficiency and cold, intending to prescribe Renshen, Jiang (Ginger), and Gui (Cinnamon Twig). The family refused. The next day, the child died, with hands and feet turning blue-black. What a pity!
Jiedu Fangfeng Tang: Treats smallpox where toxic factors are blazing, causing bloody stools.
Ingredients: Fangfeng (Saposhnikoviae Radix), Digupi (Lycii Cortex), Huangqi (Astragali Radix), Jingjie (Schizonepetae Spica), Shaoyao (Paeoniae Radix Alba, stir-fried), Niubangzi (Arctii Fructus) in equal parts.
Usage: Take four qian per dose, decoct in water. Alternatively, grind into powder and take with warm water.
Zicao Kuiban Tang: Treats bloody stools in measles and smallpox, failure of lesions to erupt, slow eruption, and dull color. (This is Zicao Tang, see entry "Top Depression and Restlessness" for the formula.)
Shengji Xijiao Dihuang Tang: Treats internal accumulation of heat-toxin, restlessness and thirst, red face, black stools, or coma with bloody stools. (See entry "Top Depression and Restlessness" for the formula.)
Xiaochaihu Tang: Treats bloody stools caused by heat in the Liver channel failing to store blood. (See entry "Smallpox Body Pain" for the formula.)
Wuyi Yigong San: Treats bloody stools due to spleen and stomach qi deficiency failing to control blood. (See entry "Chills and Teeth Grinding" for the formula.)
Bazhen Tang: Treats bloody stools due to qi deficiency failing to grasp blood. (See entry "Top Depression and Ashen White" for the formula.)
Bazheng San: Treats heat in the Heart and Small Intestine, red urine, and bloody stools. (See entry "Smallpox Urinary Difficulty" for the formula.)
Qiwei Baizhu San (i.e., Ren Shen Baizhu San, see entry "Smallpox Fever" for the formula).