交肠之病。大小便易位而出。或因醉饱。或因大怒。遂致遂脏气乖乱。不循故道。法当宣吐以
开提其气。宜五苓散加木香以探之。肥盛多痰者。二陈汤加枳实、木香以探之。使阑门清利。得
司泌别之职则愈矣。
石顽曰。交肠证。虽见于方书。而世罕见。缘石山詹石匠之妇。产后五六日。恶露不行。腹
胀喘满。大便从前阴而出。省其故。缘平昔酷嗜烟酒。所产之儿。身软无骨。因而惊骇。遂患此
证。余以芎归汤。加莪术、肉桂、炒黑山楂一服。恶露通而二便如常。又陆圣祥之女。方四岁。
新秋患血痢。而稀粪出于前阴。作冷热不调食积治。与五苓散服香连丸。二剂而愈。又钱吉甫女。
年十三。体肥痰盛。因邻居被盗。发热头痛。呕逆面青。六脉弦促。而便溺易位。此因惊气乱。
痰袭窍端所致也。与四七汤下礞石滚痰丸。开通痰气而安。
内经肠鸣有五。一曰脾虚。经云。脾虚则腹满肠鸣。飧泄食不化。枳实理中汤加木香。二曰
中气不足。肠为之苦鸣。六君子汤加木香。三曰邪在大肠。经云。肠中雷鸣。气上冲胸。邪在大
肠。半夏泻心汤。四曰土郁。经云。土郁之发。肠鸣而为数后是也。平胃散加半夏、木香、茯苓。
五曰热胜。经云。少阴在泉。热淫所胜。病腹中肠鸣。气上冲胸。葶苈木香散。金匮云。腹中寒
气。雷鸣切痛。胸腹逆满呕吐。附子粳米汤。东垣云。如胃寒泄泻肠鸣。于升阳除湿汤中加益智、半
夏各五分。生姜、大枣和煎。丹溪云。腹中鸣者。病本于胃。乃火激动其水也。二陈加芩、连、
山栀。不应。用胃苓汤加减。肺移寒于肾。为涌水。涌水者。按腹不坚。水气客于大肠。疾行则
鸣濯濯。如囊裹浆。水之病也。葶苈丸加木香。
交肠病，表现为大小便的排泄部位互换。其病因可能是由于醉酒饱食，或者因大怒，导致脏腑之气紊乱，不再循行于正常的通道。治疗法则应当采用宣发涌吐的方法来升提气机。适宜使用五苓散加入木香来探吐。对于形体肥胖且多痰湿的患者，宜用二陈汤加入枳实、木香来探吐。使得阑门（小肠与大肠连接处）清利，恢复其分别清浊的功能，疾病即可痊愈。
石顽说：交肠证，虽然记载在医方书籍中，但世间很少见到。例如石山詹石匠的妻子，产后五六天，恶露不行，腹胀喘满，大便从前阴排出。询问其病史，原来她平时酷嗜烟酒，所生的孩子身体柔软无骨，因此受到惊吓，于是患上了此证。我用芎归汤，加入莪术、肉桂、炒黑山楂，服用一剂后，恶露通畅，大小便恢复正常。又有陆圣祥的女儿，才四岁，初秋患血痢，稀粪从前阴排出。按冷热不调兼食积治疗，给予五苓散配合服香连丸，两剂后痊愈。还有钱吉甫的女儿，十三岁，身体肥胖痰盛，因为邻居被盗受惊，出现发热头痛，呕吐逆气，面色青紫，六脉弦而急促，大小便排泄部位互换。这是因惊恐之气扰乱，痰邪侵袭窍道末端所致。给予四七汤送服礞石滚痰丸，开通痰气后病情安定。
《内经》记载肠鸣有五种情况。第一种是脾虚。经文说：脾虚则腹部胀满，肠鸣，完谷不化的泄泻，食物不消化。用枳实理中汤加木香。第二种是中气不足。经文说：中气不足，肠道为之痛苦地鸣响。用六君子汤加木香。第三种是邪气在大肠。经文说：肠中雷鸣般作响，气向上冲至胸部，这是邪气在大肠。用半夏泻心汤。第四种是土郁。经文说：土郁发作时，肠鸣并伴有频繁的后重感。用平胃散加半夏、木香、茯苓。第五种是热胜。经文说：少阴在泉，热气淫胜，病见腹中肠鸣，气上冲胸。用葶苈木香散。《金匮要略》说：腹中寒气，雷鸣样腹痛，胸腹逆满呕吐。用附子粳米汤。李东垣说：如胃寒导致的泄泻肠鸣，在升阳除湿汤中加入益智仁、半夏各五分，生姜、大枣和煎。朱丹溪说：腹中鸣响，病本在于胃，是火扰动水液所致。用二陈汤加黄芩、黄连、山栀。如果无效，用胃苓汤加减。肺将寒气移于肾，称为涌水。涌水这种病，按压腹部不坚硬，水气客居在大肠，快步行走时发出濯濯声，像囊袋裹着浆液，这是水的病变。用葶苈丸加木香。
Jiao Chang (Intestinal Exchange) disease is characterized by the exchange of excretion sites for urine and feces. Its etiology may stem from drunkenness and overeating, or from severe anger, leading to chaotic Qi of the Zang-Fu organs that no longer follows its normal pathway. The treatment principle should employ inducing vomiting to raise and lift the Qi. Wuling San (Five-Ingredient Poria Decoction) with added Muxiang (Aucklandiae Radix) is suitable for this purpose. For patients who are obese and have abundant phlegm, Erchen Tang (Two-Aged Decoction) with Zhishi (Aurantii Fructus Immaturus) and Muxiang (Aucklandiae Radix) should be used to induce vomiting. This clears and benefits the Lanmen (Gate between Small and Large Intestine), restoring its function of separating the clear from the turbid, thereby curing the disease.
Shi Wan stated: Although Jiao Chang syndrome is recorded in medical texts, it is rarely seen in the world. For instance, the wife of a stone mason named Zhan from Shishan, five or six days postpartum, had retained lochia, abdominal distension, and wheezing fullness, with feces discharging from the anterior yin. Upon investigating the cause, it was found that she had previously had a strong craving for tobacco and alcohol, and her newborn child was soft-bodied without bones, causing great fright, which led to this syndrome. I prescribed Xiong Gui Tang (Angelica and Ligusticum Decoction) with Ezhu (Curcumae Rhizoma), Rougui (Cinnamomi Cortex), and charred Shan Zha (Crataegi Fructus). After one dose, the lochia flowed freely, and urination and defecation returned to normal. Another case involved the daughter of Lu Shengxiang, aged four, who suffered from bloody dysentery in early autumn, with loose stools discharging from the anterior yin. Treated as cold-heat imbalance with food stagnation, she was given Wuling San (Five-Ingredient Poria Decoction) combined with Xianglian Wan (Costus and Coptis Pill). She recovered after two doses. Additionally, the daughter of Qian Jifu, aged thirteen, was obese with excessive phlegm. Due to a robbery at a neighbor's house, she experienced fright, fever, headache, vomiting, cyanotic face, and wiry-rapid pulses throughout all six positions, along with exchanged excretion sites. This was caused by chaotic Qi from fright and phlegm invading the ends of the orifices. Siqi Tang (Four-Seven Decoction) was administered with Mengshi Guntan Wan (Calamine Rolling Phlegm Pill) to open the phlegm-Qi obstruction, resulting in stabilization.
The Nei Jing (Inner Canon) describes five types of intestinal borborygmus. First, Spleen deficiency: The classic states, "Spleen deficiency leads to abdominal fullness, intestinal borborygmus, undigested stool diarrhea, and failure to digest food." Use Zhishi Lizhong Tang (Immature Bitter Orange and Atractylodes Macrocephala Decoction) with added Muxiang (Aucklandiae Radix). Second, insufficiency of Middle Qi: The classic states, "Insufficiency of Middle Qi causes painful borborygmus in the intestines." Use Liujunzi Tang (Six-Gentlemen Decoction) with added Muxiang (Aucklandiae Radix). Third, pathogenic factors in the Large Intestine: The classic states, "Borborygmus like thunder in the intestines, with Qi rushing up to the chest; this indicates pathogenic factors in the Large Intestine." Use Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium). Fourth, Earth depression: The classic states, "When Earth depression occurs, there is borborygmus accompanied by frequent tenesmus." Use Pingwei San (Powder to Level the Stomach) with added Banxia (Pinelliae Rhizoma), Muxiang (Aucklandiae Radix), and Fuling (Poria). Fifth, excess Heat: The classic states, "When Shaoyin rules the interior and Heat dominates excessively, symptoms include abdominal borborygmus and Qi rushing up to the chest." use Tingli Muxiang San (Descurainia and Aucklandia Powder). The Jin Gui Yao Lue (Essential Prescriptions from the Golden Cabinet) states: "Cold Qi in the abdomen causes borborygmus-like cutting pain, reverse fullness of the chest and abdomen, and vomiting." Use Fuzi Jiangmi Tang (Aconite and Rice Decoction). Li Dongyuan stated: "For diarrhea and borborygmus due to Stomach cold, add Yizhi (Alpiniae Oxyphyllae Fructus) and Banxia (Pinelliae Rhizoma), each 0.5 fen, to Shengyang Chushi Tang (Raise Yang and Expel Dampness Decoction), decocted with Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus)." Zhu Danxi stated: "Borborygmus in the abdomen originates from the Stomach; it is Fire agitating Water." Use Erchen Tang (Two-Aged Decoction) with Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), and Shanzhi (Gardeniae Fructus). If ineffective, use Weiling Tang (Stomach and Five-Ingredient Poria Decoction) with modifications. When Lung transfers Cold to the Kidney, it is called Yong Shui (Surging Water). In Yong Shui, pressing the abdomen reveals no hardness; Water Qi resides in the Large Intestine, producing a sloshing sound when walking quickly, resembling a bag containing liquid. This is a water pathology. Use Tingli Wan (Descurainia Pill) with added Muxiang (Aucklandiae Radix).