夏 便红，遇劳辄甚，初服苦参子（俗名鸦胆子），以龙眼肉裹，开
水送下十粒效。后屡试不验，予按东垣论脾为生化之源，心统诸经之血，思虑烦劳，致心脾不司统摄。宜用
归脾丸或暂服加味归脾汤，其血自止，如言而瘥。（汤丸内俱去焦白术。）
幼侄 鼻衄便红，寒热无汗，食减神疲，脉大而数。此脾肺气虚，阴火乘络，致血从清浊道横溢而出。
用补中益气汤去升麻，加山栀、白芍。一服，五更大热，比晓微汗身凉。次日寒热除，脉顿敛，三服而病已。
服侄 壮岁，便后沥血色鲜，乃肠胃远血，症属肠风。用升降法，荆芥、当归（俱醋炒）、白芍、
槐米（俱酒炒）、黑山栀、生地、甘草（炙黑）、侧柏叶。三服愈。
张 辛苦佣作，日夜便血数次，由冬入夏未止。阴络已伤，渐至食减无味，神色惨悴，脉来沉细而数，
势必寒热，延成损怯。勉用摄血，佐以益脾，以脾统血也。仿驻车丸，（去黄连。）阿胶（水化）、炮姜、
当归（土炒）、白芍、熟地、甘草（俱炒黑）、莲子（炒）、红枣、南烛子、茯神。三服红痢减，寒热亦止，
口中和。据述，腹不痛，但里急，必连便二次，此属气虚不摄。专用潞参、炙 、茯苓、山药、地榆（酒炒）、
赤石脂，便血遂止。
何 童年便血，面黄瘦，能食。此脾气郁而生火也，用清理湿热。山栀、赤苓、生白芍、生薏仁、石斛、
当归、柿饼（炭）、陈皮、地榆，数服效。
朱 春正痢血，一载未痊。阴络大伤，秋间三疟历冬，曾用常山劫剂未效。面浮足肿，食减神疲，
懔寒宵热，脉虚近数。阴伤及阳，延成损怯矣。今痢纯红，日夜十数次。即培阳摄阴，尚恐不及。乃阅所服方，
仍用制军辈，屡次通里，是欲竭其漏卮乎？毋怪愈治愈剧也。用潞参、茯苓、山药、白术（炒）、白芍、
甘草（炙黑）、荆芥（醋炒黑）、乌梅、阿胶（煨）。一服血减，明日不甚怯寒矣。又加减十数剂，疟痢渐瘳。
夏季，大便下血，劳累后症状加重。起初服用苦参子（俗名鸦胆子），用龙眼肉包裹，开水送服十粒，见效。后来多次尝试无效，我根据李东垣的理论分析：脾是气血生化之源，心统摄各经之血。因思虑过度、烦劳损伤，导致心脾无法行使统摄血液的功能。适宜使用归脾丸，或暂时服用加味归脾汤，出血自然停止，患者照此治疗而痊愈。（汤剂和丸剂中均去掉焦白术。）
幼侄，鼻出血兼有大便下血，恶寒发热且无汗，食欲减退、精神疲乏，脉象大而数。这是脾肺气虚，阴火侵扰脉络，导致血液从清道和浊道横溢而出。使用补中益气汤去掉升麻，加入山栀、白芍。服用一剂后，五更时分高热，到清晨微微出汗身体转凉。第二天寒热症状消除，脉象顿时收敛，服用三剂病愈。
堂侄，壮年时期，排便后滴出鲜红色血液，属于肠胃远血，病症归属于肠风。采用升降治法，处方为：荆芥、当归（均醋炒）、白芍、槐米（均酒炒）、黑山栀、生地、甘草（炙至黑色）、侧柏叶。服用三剂痊愈。
张姓患者，从事辛苦劳作，日夜大便出血数次，从冬季持续到夏季未止。阴络已受损，逐渐出现食欲减退、无味，神色憔悴，脉象沉细而数，势必会出现寒热症状，拖延下去会发展成虚损劳怯之症。勉强采用摄血之法，辅以益脾之法，因为脾能统血。仿照驻车丸方意（去掉黄连）：阿胶（水化开）、炮姜、当归（土炒）、白芍、熟地、甘草（均炒黑）、莲子（炒）、红枣、南烛子、茯神。服用三剂后，血色痢疾减轻，寒热也停止，口中调和。据患者叙述，腹部不痛，只是有里急后重感，必定要连续排便两次，这属于气虚不能固摄。专门使用潞参、炙黄芪、茯苓、山药、地榆（酒炒）、赤石脂，大便出血遂止。
何姓患者，童年时便血，面色黄瘦，但能进食。这是脾气郁结而生火所致，采用清理湿热的方法。处方为：山栀、赤苓、生白芍、生薏仁、石斛、当归、柿饼（炭）、陈皮、地榆，服用数剂见效。
朱姓患者，春节正月起痢疾下血，一年未痊愈。阴络大伤，秋季患三日疟延续整个冬天，曾用常山等截疟猛药但未见效。面部浮肿、足部肿胀，食欲减退、精神疲乏，夜间畏寒、白天发热，脉象虚弱近于数。阴伤及阳，拖延下去会形成虚损劳怯之症。如今痢疾纯下鲜血，日夜十几次。此时即使培补阳气以固摄阴液，还担心来不及。查看其所服用的方剂，仍使用大黄之类药物，屡次通利攻下，这是想要竭尽他那如漏斗般的正气吗？难怪越治越严重。使用潞参、茯苓、山药、白术（炒）、白芍、甘草（炙黑）、荆芥（醋炒黑）、乌梅、阿胶（煨）。服用一剂后血量减少，第二天不再那么畏寒。又加减服用十几剂，疟疾和痢疾逐渐好转。
Summer, blood in stool (hematochezia), worsening with exertion. Initially, taking *Quanshenzi* (Baccaurea ramiflora fruit, commonly known as Ya Duanzi) wrapped in Longan aril (Longan flesh), taken with boiled water, ten grains per dose, was effective. Later trials were ineffective. I analyzed based on Li Dongyuan's theory: the Spleen is the source of transformation and production (of Qi and Blood), and the Heart commands the blood of all meridians. Excessive thinking and fatigue caused the Heart and Spleen to fail in their function of controlling and retaining blood. It is suitable to use Guipi Wan (Restore the Spleen Pill) or temporarily take Jiawei Guipi Tang (Modified Restore the Spleen Decoction); the bleeding will stop naturally, and he recovered following this advice. (Both the decoction and pill formulas exclude Jiaobaizhu [Charred Atractylodis Rhizoma].)
Young nephew, epistaxis (nosebleed) combined with hematochezia, aversion to cold and fever without sweat, reduced appetite and mental fatigue, pulse large and rapid. This is deficiency of Qi in the Spleen and Lung, with Yin Fire invading the collaterals, causing blood to overflow from the clear and turbid pathways. Used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) excluding Shengma (Cimicifugae Rhizoma), adding Zhizi (Gardeniae Fructus) and Baishao (Paeoniae Radix Alba). After one dose, high fever at the fifth watch (3-5 AM), slight sweating by dawn with body cooling. The next day, aversion to cold and fever disappeared, the pulse immediately became restrained, and after three doses, the illness was cured.
Cousin, in his prime, dripping bright red blood after defecation, belonging to distant blood from the intestines and stomach, the syndrome belongs to Changfeng (Intestinal Wind). Employed the method of ascending and descending: Jingjie (Schizonepetae Herba), Danggui (Angelicae Sinensis Radix, both vinegar-fried), Baishao (Paeoniae Radix Alba), Huaimi (Sophorae Flos), Hei Zhizi (Gardeniae Fructus charred), Shengdi (Rehmanniae Radix), Gancao (Licorice Root, roasted black), Cebaiye (Platycladi Cacumen). Three doses resulted in cure.
Zhang, engaged in hard labor, had bloody stools several times day and night, continuing from winter into summer without cessation. The Yin collaterals are already injured, gradually leading to reduced appetite and lack of taste, pale and emaciated appearance, pulse deep, fine and rapid. It is inevitable that aversion to cold and fever will occur, prolonging it will develop into consumptive weakness. Reluctantly employed methods to retain blood, assisted by tonifying the Spleen, because the Spleen controls blood. Modeled after Chuche Wan (Stop Dysentery Pill) (excluding Huanglian [Coptidis Rhizoma]): Ejiao (Donkey-hide Gelatin, dissolved in water), Paojiang (Prepared Zingiberis Rhizoma), Danggui (Angelicae Sinensis Radix, earth-fried), Baishao (Paeoniae Radix Alba), Shudi (Rehmanniae Radix Preparata), Gancao (Licorice Root, all stir-fried until black), Lianzi (Nelumbinis Semen, fried), Hongzao (Jujubae Fructus), Nanzhuzi (Myricae Fructus), Fushen (Poria with Hostwood). After three doses, bloody dysentery decreased, aversion to cold and fever also stopped, and the mouth felt harmonious. According to his account, the abdomen did not hurt, but there was only a sensation of urgency (tenesmus), necessarily requiring two bowel movements consecutively; this belongs to Qi deficiency failing to retain. Specifically used Luzhen (Codonopsis Radix), Zhi Huangqi (Astragali Radix prepared), Fuling (Poria), Shanyao (Dioscoreae Rhizoma), Diyu (Sanguisorbae Radix, wine-fried), Chishizhi (Halloysit Rubrum). Bloody stool then stopped.
He, childhood hematochezia, yellow and thin face, able to eat. This is Spleen Qi stagnation generating fire, using methods to clear and resolve damp-heat. Zhizi (Gardeniae Fructus), Chiling (Poria with Red Coir), Sheng Baishao (Raw Paeoniae Radix Alba), Sheng Yiren (Coicis Semen raw), Shihu (Dendrobii Caulis), Danggui (Angelicae Sinensis Radix), Shibing Tan (Persimmon cake carbonized), Chenpi (Citri Reticulatae Pericarpium), Diyu (Sanguisorbae Radix). Several doses were effective.
Zhu, dysentery with blood starting in the first month of spring, unresolved for one year. The Yin collaterals are severely injured. In autumn, Sanlü (Triennial Malaria) lasted through winter; previously used Changshan ( Dichroae Radix) strong agents to劫 (seize/stop) malaria without effect. Facial edema and foot swelling, reduced appetite and mental fatigue, severe chills at night and heat during the day, pulse deficient and approaching rapid. Yin injury affecting Yang, prolonging it will form consumptive weakness. Now the dysentery is pure bright red blood, more than ten times day and night. Even if tonifying Yang to secure Yin, it is still feared to be too late. Reviewing the prescribed formulas, they still used Zhijun (Rhei Radix et Rhizoma processed) and similar agents, repeatedly purging the interior; is this attempting to exhaust his leaking vessel? No wonder the condition worsens with each treatment. Used Luzhen (Codonopsis Radix), Fuling (Poria), Shanyao (Dioscoreae Rhizoma), Baizhu (Atractylodis Rhizoma, stir-fried), Baishao (Paeoniae Radix Alba), Gancao (Licorice Root, roasted black), Jingjie (Schizonepetae Herba, vinegar-fried and charred), Wumei (Mume Fructus), Ejiao (Donkey-hide Gelatin, baked). After one dose, blood decreased; the next day, chills were less severe. After another dozen modified doses, malaria and dysentery gradually improved.