Internal bleeding from a point far from the anus, i.e., in the stomach or small intestine, characterized by the passage of stool followed by blood and by dark blackish stool. Distal bleeding is attributable to a) spleen-stomach vacuity cold, b) liver depression transforming into fire causing frenetic movement of the blood, c) accumulated heat toxin, or d) spleen vacuity and lung dryness stemming from yīn vacuity with effulgent fire.
Medicinal therapy: Spleen-stomach vacuity cold is treated by warming the center and fortifying the spleen, using Yellow Earth Decoction (黄土汤huáng tǔ tāng). Liver depression transforming into fire is treated by clearing the liver and resolving depression with variations of Moutan and Gardenia Free Wanderer Powder (丹栀逍遥散dān zhī xiāo yáo sǎn). Accumulated heat toxin, often referred to as visceral toxin, is treated by clearing heat and resolving toxin with formulas such as Pig’s Intestines and Coptis Pill (脏连丸zàng lián wán). Spleen vacuity and lung dryness is treated by nourishing yīn and clearing the stomach, using Ginseng Lung-Clearing Decoction (人参清肺汤rén shēn qīng fèi tāng). For severe bloody stool and reversal cold of extremities, and a faint weak vacuous floating pulse, the method of treatment is to greatly supplement qì and blood and fortify the spleen and boost the kidney, using formulas such as Ginseng Provisioning-Nourishing Decoction (人参养荣汤rén shēn yǎng róng tāng) or Redness-Severing Pill (断红丸duàn hóng wán).