妇人小便中出大粪名交肠，服五苓散如未尽愈，可用旧 头烧灰服之。（《得效》）（按∶先君子曰∶肠
痈有大便从小便中出，云母膏为丸，煎黄 汤下。见王明清《余话》。）
夏子益《奇疾方》云∶妇人因生产，阴阳易位，前阴出粪，名曰交肠病，取旧 头烧灰酒服，仍向服五苓散
分利之。如无 头，凡旧漆纱帽皆可代之（按《医碥》曰∶以受头气日久，取阳气上冲之义），此皆取漆能行
败血之义耳。（《本草纲目》）
加减四物汤，治妇人冷热不调，阴阳不分，大小便相反。
上用四物汤五钱，加益原散二钱半，水酒各一盏，煎至八分，去渣空心服。（《宝鉴》）
交肠之病，大小便易位而出，盖因气不循故道，清浊混淆。宜五苓散、调气散各一钱，加阿胶末半钱，汤
调服。或研黄连阿胶丸为末，加木香少许，再以煎药送下。（《要诀》）（按∶《医碥》举此文曰∶此皆除湿
热之剂，盖气乱由于郁，郁则为湿热也。）
一人嗜酒，痛饮不醉，忽糟粕出前窍，尿溺出后窍，脉沉涩。与四物汤，加海金沙、木香、槟榔、木通、
桃仁，八帖而安。（《丹溪》）
俞子本曰∶大小便易位而出，是名交肠。或因醉饱，或因大怒，遂使脏气乖乱，不循常道。法当宣吐，以开
提其气（按∶《医通》此下曰∶宜五苓加木香以探之。肥盛多痰者，二陈汤加枳实、木香以探之。《医碥》曰∶
如走错路者，仍令回至原处，则不再误也。盖诸家之说多是臆测，未必亲验，姑存之耳），使阑门清利，得复
泌别之职，则愈矣。（《六要》）
忌破气、燥热，宜升清降浊、兼补气、淡渗。（《本草经疏》）
一产妇小便出粪，名大小肠交，乃气血俱虚，失行常道。先用六君子汤二剂，又用五苓散一剂而痊。寻常肠
交，亦可效治。（《赤水》）
交肠病，妇人有此病者，粪从小便出，尿从大便出，混浊不分，必是夏月伏暑而致。须用五苓散，加牛膝、
海金砂、木通、通草，但令大小便各归本脏即安。西园公治临颖徐少用母，服此药而愈，加车前子。（《济世
全书》）
活人理物汤，即四物汤合理中汤，治交肠。（《和剂》）
交肠作泻 答曰∶此症百无一生，必腑脏溃烂，便溺不循故道。（《一万社草》）（按∶问辞偶有脱页，
仍不录。）
如人粪从小便出，小便从大便出者，此夏天暑热之症，人以五苓散治之亦妙，而予更有奇方，止用车前子三
两，煎汤三碗，一气服完即愈。（《石室》）
交肠证，虽见于方书，而世罕见。绿石山詹石匠之妇，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，休肥痰盛，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。（《医通》）
交肠一证，乃屎出前阴、溺出后孔之候。溺出后孔者，水气并入大肠，自阑门不能泌别清浊，可以阑门不
清为论。若屎出前阴者，乃肠膀并破之候，非肠穿则屎从何窦而出，膀胱不破则屎从何窦而入，要必肠穿膀破，
而后屎溺得以易位而出也。亦必其肠膀破损之处，其窦贴连，而后得出入之不爽也。若非贴连，则肠虽破穿而
屎出，亦不过流于肠外募原夹层之内，纵使膀胱亦损，而其窦不相接连，亦不得出于前阴也。则阑门不清之论，
实模糊影响之说，理解不得者也。（《医级》）
余治交肠症四五人皆妇病，多得于横生险产之后，则其内损脬肠，更不待言矣。（同上）
复有老人阴血干枯，大肠结燥，便溺俱自前出，此非交肠，乃血液枯涸之征，气血衰败之候也。多服大剂
八珍汤，或可稍延岁月耳。（《心悟》）（按∶《寓意草》姜宜人奇证，宜参。）
妇女在小便中排出大便，称为“交肠”，服用五苓散如果未能完全治愈，可以使用旧棉絮头烧成灰后服用。（《得效方》）（按语：先父说：肠痈也有大便从小便中排出的情况，可用云母膏制成丸药，用黄芩汤送服。详见王明清的《余话》。）
夏子益在《奇疾方》中说：妇女因生产，导致阴阳位置颠倒，前阴排出粪便，名为交肠病，取旧棉絮头烧成灰后用酒送服，同时继续服用五苓散以分利水道。如果没有棉絮头，任何旧的漆纱帽都可以代替（按语：《医碥》说：因为受头气日久，取阳气上冲的含义），这都是取漆能行散败血的意义罢了。（《本草纲目》）
加减四物汤，治疗妇女冷热不调，阴阳不分，大小便排泄相反。
以上述四物汤五钱，加入益原散二钱半，用水和酒各一盏，煎至八分，去渣后空腹服用。（《宝鉴》）
交肠之病，大小便位置互换而排出，这是因为气不循常规路径，清浊之气混淆。适宜使用五苓散、调气散各一钱，加入阿胶末半钱，用汤剂调服。或者将黄连阿胶丸研为粉末，加入少许木香，再用煎好的药汤送下。（《要诀》）（按语：《医碥》引用此文说：这些都是除湿热的方剂，因为气乱是由于郁结，郁结则产生湿热。）
有一人嗜好饮酒，痛饮而不醉，忽然糟粕从前窍（尿道）排出，尿液从后窍（肛门）排出，脉象沉涩。给予四物汤，加入海金沙、木香、槟榔、木通、桃仁，服用八帖后痊愈。（《丹溪心法》）
俞子本说：大小便位置互换而排出，这名叫交肠。或因醉酒饱食，或因大怒，致使脏腑之气乖乱，不循常道。治法应当宣吐，以升提其气（按语：《医宗金鉴》在此之下说：适宜用五苓散加木香来探吐。形体肥胖多痰者，用二陈汤加枳实、木香来探吐。《医碥》说：如同走错路的人，仍让他回到原处，就不会再误了。大概各家说法多是臆测，未必亲自验证，姑且保存于此），使阑门清利，恢复其泌别清浊的功能，病就好了。（《六要》）
禁忌破气、燥热药物，适宜升清降浊、兼补气、淡渗利湿。（《本草经疏》）
一位产妇小便中排出粪便，名为大小肠交，这是气血俱虚，失去常道运行。先用六君子汤两剂，又用五苓散一剂而痊愈。寻常的肠交病，也可以效仿此法治愈。（《赤水玄珠》）
交肠病，妇女有此病者，粪便从小便排出，尿液从大便排出，混浊不分，必定是夏季伏暑所致。必须使用五苓散，加入牛膝、海金砂、木通、通草，只要让大小便各自回归本脏即可安宁。西园公治疗临颖徐少用的母亲，服用此药而痊愈，后来加入了车前子。（《济世全书》）
交肠作泻 回答说：此症百无一救，必定是脏腑溃烂，便溺不循常规路径。（《一万社草》）（按语：问辞偶有脱页，故不收录。）
如果有人粪便从小便排出，小便从大便排出，这是夏天暑热之症，人们用五苓散治疗也很巧妙，而我还有更奇的方子，只用车前子三两，煎汤三碗，一口气服完即愈。（《石室秘录》）
交肠证，虽然在方书中可见，但世间罕见。绿石山詹石匠的妻子，产后五六天，恶露不行，腹胀喘满，大便从前阴排出。询问其原因，是因为平素酷嗜烟酒，所生之子身体软而无骨，因而惊骇，遂患此证。我用芎归汤加入莪术、肉桂、炒黑山楂，一服后恶露通畅，二便恢复正常。又有陆圣祥的女儿四岁，初秋患血痢，稀粪从前阴排出。当作冷热不调、食积治疗，给予五苓散配合香连丸，两剂而愈。又有钱吉甫的女儿十三岁，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，这是因惊气扰乱，痰邪侵袭窍端所致。给予四七汤送服礞石滚痰丸，开通痰气而安宁。（《医宗金鉴》）
交肠一证，乃是屎出前阴、溺出后孔的症状。溺出后孔者，是水气并入大肠，自阑门不能泌别清浊，可以阑门不清来论述。若屎出前阴者，乃是肠道与膀胱并破的症状，不是肠穿破则屎从何窦而出，膀胱不破则屎从何窦而入，一定要肠穿膀破，而后屎溺才得以易位而出。也必须是肠膀破损之处，其窦贴连，而后才能出入无误。如果不是贴连，则肠虽破穿而屎出，也不过流于肠外募原夹层之内，纵使膀胱也受损，而其窦不相接连，也不能出于前阴。则阑门不清的说法，实在是模糊影响之说，无法理解。（《医级》）
我治疗交肠症四五人都是妇女患病，大多得于横生险产之后，那么其内损脬肠，更是不言而喻了。（同上）
另有老人阴血干枯，大肠结燥，便溺俱自前阴排出，这不是交肠，而是血液枯涸的征象，气血衰败的候象。多服大剂量的八珍汤，或许可以稍延寿命。（《寓意草》）（按语：《寓意草》中姜宜人的奇证，宜参考。）
In women, the discharge of feces through the urethra is called "Jiao Chang" (Crossed Intestines). If Wu Ling San (Five-Ingredient Poria Decoction) fails to fully cure the condition, one may administer the ash obtained by burning old cotton wadding. (*De Xiao Fang*) [Note: My late father stated that in cases of intestinal abscess, feces may also be discharged through the urethra; this can be treated with Yunmu Gao Pills taken with Huang Qin Tang (Scutellaria Decoction). See Wang Mingqing's *Yu Hua*.]
Xia Ziyi, in *Qi Ji Fang* (Formulas for Strange Diseases), states: In women, due to childbirth, the positions of Yin and Yang are reversed, resulting in feces being discharged from the anterior orifice (urethra), a condition named Jiao Chang disease. One should take the ash of old cotton wadding administered with wine, while continuing to take Wu Ling San (Five-Ingredient Poria Decoction) to promote diuresis and separate fluids. If cotton wadding is unavailable, any old lacquered gauze cap can serve as a substitute. [Note: *Yi Que* states: Because it has absorbed head Qi for a long time, this takes the meaning of Yang Qi rushing upward. This all derives from the principle that lacquer can move stagnant blood.] (*Ben Cao Gang Mu*)
Jia Jian Si Wu Tang (Modified Four Substances Decoction) treats women with disharmony of cold and heat, and indistinct Yin and Yang, resulting in reversed excretion of urine and feces.
Take Si Wu Tang (Four Substances Decoction) 5 qian, add Yi Yuan San 2.5 qian, decoct with one cup of water and one cup of wine until reduced to 0.8 cup, strain, and take on an empty stomach. (*Bao Jian*)
The disease of Jiao Chang involves the reversal of positions in the excretion of urine and feces, caused by Qi not following its normal pathway, leading to confusion between clear and turbid substances. It is suitable to use Wu Ling San (Five-Ingredient Poria Decoction) and Tiao Qi San (Regulate Qi Powder), each 1 qian, mixed with 0.5 qian of Ejiao powder (Donkey-hide Gelatin), and taken with decoction. Alternatively, grind Huang Lian E Jiao Wan (Coptis and Donkey-hide Gelatin Pill) into powder, add a small amount of Mu Xiang (Aucklandiae Radix), and swallow with the decoction. (*Yao Jue*) [Note: *Yi Que* cites this text saying: These are all formulas for removing damp-heat, as Qi disorder stems from stagnation, and stagnation generates damp-heat.]
A person addicted to alcohol, who drank heavily without getting drunk, suddenly had feces discharged from the anterior orifice (urethra) and urine from the posterior orifice (anus). The pulse was deep and choppy. He was given Si Wu Tang (Four Substances Decoction) added with Hai Jin Sha (Lygodii Spora), Mu Xiang (Aucklandiae Radix), Bing Lang (Arecae Semen), Mu Tong (Akebiae Caulis), and Tao Ren (Persicae Semen). After eight doses, he recovered. (*Dan Xi Xin Fa*)
Yu Ziben said: Reversal in the excretion of urine and feces is named Jiao Chang. It may be caused by drunkenness and overeating, or by severe anger, causing the Qi of the Zang-Fu organs to become chaotic and deviate from the normal path. The treatment method should involve inducing vomiting to lift and raise the Qi. [Note: *Yi Zong Jin Jian* adds below this: It is suitable to use Wu Ling San (Five-Ingredient Poria Decoction) with Mu Xiang (Aucklandiae Radix) to induce vomiting. For those who are obese and have much phlegm, use Er Chen Tang (Two-Aged Decoction) added with Zhi Shi (Aurantii Fructus) and Mu Xiang (Aucklandiae Radix) to induce vomiting. *Yi Que* says: Like someone who has taken a wrong turn, make them return to the original place so they will not err again. Generally, the theories of various schools are mostly speculative and not necessarily verified by personal experience; they are preserved here tentatively.] This allows the Lan Men (Gate of the Large Intestine) to become clear and restores its function of separating clear from turbid, leading to recovery. (*Liu Yao*)
Contraindicate Qi-breaking and drying-hot herbs. It is suitable to raise the clear and descend the turbid, supplement Qi, and use bland-leaching methods. (*Ben Cao Jing Jiu Shu*)
A postpartum woman had feces discharged in her urine, named Da Xiao Chang Jiao (Large and Small Intestine Cross-over). This is due to deficiency of both Qi and Blood, causing deviation from the normal path. First, administer Liu Jun Zi Tang (Six-Gentlemen Decoction) for two doses, followed by Wu Ling San (Five-Ingredient Poria Decoction) for one dose, resulting in recovery. Ordinary cases of intestinal cross-over can also be treated effectively by this method. (*Chi Shui Xuan Zhu*)
In cases of Jiao Chang disease in women, where feces are discharged via urine and urine via feces, with turbidity undifferentiated, it must be caused by latent summer-heat from the summer season. One must use Wu Ling San (Five-Ingredient Poria Decoction) added with Niu Xi (Achyranthis Bidentatae Radix), Hai Jin Sha (Lygodii Spora), Mu Tong (Akebiae Caulis), and Tong Cao (Tetrapanacis Medulla). As long as urine and feces return to their respective organs, peace will be restored. Master Xi Yuan cured the mother of Xu Shaoyong of Linying with this prescription, later adding Che Qian Zi (Plantaginis Semen). (*Ji Shi Quan Shu*)
Huo Ren Li Wu Tang (Living Person Regulating Matter Decoction), which is Si Wu Tang (Four Substances Decoction) combined with Li Zhong Tang (Regulate the Middle Decoction), treats Jiao Chang. (*He Ji Ju Fang*)
Regarding Jiao Chang presenting as diarrhea: The answer is that this condition is almost invariably fatal, implying ulceration of the Fu-Zang organs, with excreta not following the normal paths. (*Yi Wan She Cao*) [Note: The question text has missing pages, so it is not recorded.]
If feces are discharged from the urethra and urine from the anus, this is a summer-heat syndrome in summer. People treat it with Wu Ling San (Five-Ingredient Poria Decoction), which is effective. However, I have an even more miraculous formula: use only 3 liang of Che Qian Zi (Plantaginis Semen), decoct in three bowls of water, and drink all at once for immediate recovery. (*Shi Shi Mi Lu*)
The syndrome of Jiao Chang appears in medical texts but is rarely seen in practice. The wife of stone mason Zhan from Lvshi Mountain, five or six days after childbirth, had no lochia discharge, abdominal distension, and fullness of the chest with panting, and feces were discharged from the anterior orifice. Investigating the cause, she had previously been extremely fond of tobacco and alcohol, and the child she delivered was soft-boned. Due to fright, she developed this syndrome. I used Xiong Gui Tang (Angelica and Ligusticum Decoction) added with E Zhu (Curcumae Rhizoma), Rou Gui (Cinnamomi Cortex), and charred Shan Zha (Crataegi Fructus). After one dose, lochia flowed freely, and bowel and bladder functions returned to normal. Another case: Lu Shengxiang’s four-year-old daughter suffered from bloody dysentery in early autumn, with loose stool discharging from the anterior orifice. Treated as disharmony of cold and heat with food stagnation, she was given Wu Ling San (Five-Ingredient Poria Decoction) combined with Xiang Lian Wan (Costus and Coptis Pill), recovering after two doses. Another case: Qian Jifu’s thirteen-year-old daughter, who was obese with abundant phlegm, developed fever, headache, vomiting, and cyanosis of the face due to fear from a neighbor's robbery. Her six pulses were wiry and rapid, and excretion of urine and feces was reversed. This was caused by fright disturbing the Qi and phlegm invading the orifices. She was given Si Qi Tang (Four-Substance Decoction) to deliver Meng Shi Gun Tan Wan (Fluorite Rolling Phlegm Pill), opening the phlegm-Qi obstruction, leading to calmness. (*Yi Zong Jin Jian*)
The syndrome of Jiao Chang is characterized by feces exiting the anterior orifice and urine exiting the posterior orifice. When urine exits the posterior orifice, it is because water Qi merges into the Large Intestine and cannot separate clear from turbid at the Lan Men (Gate of the Large Intestine); thus, it can be discussed in terms of unclear Lan Men. However, when feces exit the anterior orifice, it indicates rupture of both the intestines and the bladder. If the intestine does not perforate, from what orifice would feces emerge? If the bladder does not rupture, from what orifice would feces enter? It must be that both intestine and bladder are perforated for feces and urine to reverse their paths. Furthermore, the ruptured sites of the intestine and bladder must be adherent for such exchange to occur without error. If they are not adherent, even if the intestine perforates and feces exit, they would merely flow into the space between the muscle layers outside the intestine. Even if the bladder is damaged, if the orifices are not connected, feces cannot exit from the anterior orifice. Therefore, the theory of "unclear Lan Men" is indeed a vague and unsubstantiated explanation that cannot be logically understood. (*Yi Ji*)
I treated four or five cases of Jiao Chang, all in women, most occurring after difficult or breech deliveries. Thus, internal damage to the bladder and intestines goes without saying. (Same source)
There is also an elderly person with dry Yin Blood and constipation of the Large Intestine, where both stool and urine discharge from the anterior orifice. This is not Jiao Chang, but a sign of dried-up blood and a symptom of declining Qi and Blood. Taking large doses of Ba Zhen Tang (Eight-Treasure Decoction) might slightly prolong life. (*Yi Yu Cao*) [Note: Refer to the strange case of Jiang Yiren in *Yi Yu Cao*.]