论
经曰∶因而饱食，筋脉横解，肠 为痔。又曰∶脾胃者，仓廪之官，五味出焉。大肠者，传道之官，变化出焉。若
夫饱食太过，则脾气倦甚，不能运化精微，朝伤暮损，清浊混淆，故食积下流于大肠之间而为病也。盖脾胃一虚，肺气
亦乏，而大肠之气亦从而虚，其肝木得以乘虚下流而为肠风病，则是皆金失所养、木寡于畏之所为耳。其为变见名状种
种不同，曰牛奶，曰鼠奶，曰鸡心，曰鸡冠，曰莲花，曰翻花，曰蜂窠，曰穿肠，曰外痔，虽曰为状不一，而其因则同
焉。治法以苦寒泻火，芩、连、栀子、槐花之类。以辛温和血，川归、川芎、桃仁之类。风邪在下，以秦艽、防风、升
麻之类提之。燥热怫郁，以大黄、枳壳、麻仁之类润之。遘此疾者，自宜慎口节欲，根据法调治，无有不安者也。
脉法
脉沉小实者，易治；浮洪而软弱者，难愈。
方法
丹溪曰∶痔病，因风热燥归于大肠也，治血为主，大法用条芩凉大肠，人参、黄连、生地黄、槐角凉血生血，当归
和血，川芎、升麻、枳壳宽肠。
漏疮，先须用补药以补气血，参、 、归、术为主，大剂服之。外以附子为末，津和作饼子如钱浓，以艾多灸之，
漏大者艾炷亦大，漏小者艾炷亦小，灸令微热，不可令痛，饼干即易之，再和再灸。又以补气血药，作膏药贴之。
一方 治痔疮肿痛，用蜗牛（一名蜒蝣）阴干为末，敷之即愈。或用香油浸蜗牛月余，而以其油沫敷，亦效。
洗药，用五倍子、朴硝、桑寄生、莲房煎汤，先熏后洗。
又方 治痔疮风肿疼痛，用胡麻子煎汤洗之，其肿即消。
又方 用木鳖子、五倍子共为细末，调敷。
塞药，用炉甘石 ，以童子尿淬之，牡蛎 ，共为末敷之。
又方 用马兰草根研细敷上，片时看肉平去药，稍迟恐肉反出。
肠风，独在胃与大肠出，用黄芩、秦艽、槐角、青黛、升麻。
一方 用∶大黄（煨） 桃仁（去尖，各三钱） 皮（炙） 黄连 秦艽 槐角子（各一两） 当归 槟榔 皂
角仁 黄柏（炒） 荆芥 枳壳（各五钱）为末，面糊为丸，如梧桐子大，每服五十丸，白汤下。如下鲜血者，加棕榈
灰、莲房灰。
（以上丹溪方法凡十条）
秦艽羌活汤（东垣） 治痔漏，成块下垂，不任其痒。
羌活（一钱二分） 秦艽 黄 （各一钱） 防风（去芦，七分） 升麻 炙甘草 麻黄 柴胡（各五分） 本
（三分） 细辛 红花（各少许）
上细切，作一服，水煎服。忌寒风处大小便。
秦艽苍术汤（东垣） 治痔核已破，谓之痔漏，大便秘涩，必作大痛，此湿、热、风、燥四气合而为病。故大
肠头成块者，湿也。作大痛者，风也。大便燥结者，兼受火邪也。其西方肺金主气，其体收下，亦助病为邪，须当用破
气药兼之，其效如神。
秦艽（去芦） 桃仁（去皮尖，另研） 皂角仁（烧存性，各一钱） 苍术（米泔浸） 防风（各七分） 黄柏（酒
洗，五分） 当归梢（酒洗） 泽泻（各三分） 槟榔（二分另研） 大黄（少许，虽大便过涩，亦不可多用也）
上件除槟榔、桃仁、皂角仁三味另研外，余药细切，作一服，水三盏，煎至一盏二分，去渣，入槟榔等三味末子，
再上火煎至一盏，空心热服，待少时以美膳压之，不犯胃气也。服药日，忌生冷硬物及酒、湿面、大料、椒、姜等物，
若犯之其药无效。如有白脓，加白葵花头五朵，去萼心，青皮五分，入正药中同煎，木香三分为细末，同槟榔等三味根据
前煎服饵。古人治此疾，多以岁月待除之，惟此药一服即愈。
秦艽当归汤（东垣） 治痔漏，大便燥结疼痛。
大黄（煨，四钱） 秦艽（去芦） 枳实（各一钱） 泽泻 当归梢 皂角仁 白术（各五分） 红花（少许） 桃
仁（二十个，去尖，研细）
上细切，作一服，水三盏，煎主一盏，食前服，忌如前。
秦艽防风汤（东垣） 治痔漏，每日大便时发疼痛（如无疼痛者，非痔漏也）此药主之。
秦艽 防风 当归身 白术（各一钱五分） 炙甘草 泽泻（各六分） 黄柏（酒洗，五分） 大黄（煨） 陈皮
（各三分） 柴胡 升麻（各二分） 桃仁（三十个，去尖，另研） 红花（少许）
上细切，作一服，水三盏，煎至一盏，去渣稍热空心服之。避风寒，忌房事、酒、湿面、大辛热之物。
当归郁李仁汤（东垣） 治痔漏，大便硬，努出大肠头，下血苦痛。
郁李仁 皂角仁（各二钱，另研） 枳实（七分） 秦艽（去芦） 麻仁 当归梢 生地黄 苍术（各五分） 大
黄（煨） 泽泻（各三分）
上细切，作一服，除皂角仁为末用外，水三盏，煎至一盏，去渣，入皂角仁末和匀，空心服，忌如前。
红花桃仁汤（东垣） 治痔漏经年，因而饱食，筋脉横解，肠 为痔。治法，当补北方，泻中央。
黄柏（一钱五分） 生地黄（一钱） 泽泻（八分） 苍术（六分） 当归梢 汉防己 防风梢 猪苓（各五分） 麻
仁（二分） 红花（少许） 桃仁（十个）
上细切，作一服，水三盏，煎至一盏，去渣稍热服，忌如前。
七圣丸（东垣） 治大肠疼痛不可忍。《脉诀》云∶积气生于脾脏傍，大肠疼痛阵难当，但令稍泻三焦火，草漫
多方立纪纲。
羌活（一两） 郁李仁（汤浸，去皮尖，另研，一两五钱） 大黄（八钱，煨） 槟榔 桂心 木香 川芎（各五
钱）
上除郁李仁另研施入外，其余共为细末，炼蜜为丸，如梧桐子大，每服三、五十丸，白汤下，食前服，取微利，一
般而愈。切禁不得多利大便，其痛滋甚。
秦艽白术丸（东垣） 治痔疾并漏，有脓血，大便燥硬，疼痛不可忍。
秦艽（去芦） 桃仁（去皮尖，研） 皂角仁（烧存性，各一两） 当归梢（酒浸） 泽泻 枳实（麸炒黄色） 白
术（各五钱） 地榆（三钱）
上为细末，和桃仁泥再研匀，面糊为丸，如鸡头实大，令药光滑，焙干，每服五、七十丸，白汤空心下，待少时，
以美膳压之。忌生冷、硬物、冷水、冷菜之类，并酒、湿面及辛辣、大料、热物，犯之则药无验也。
Treatise
The *Yellow Emperor's Inner Classic* states: If one suffers from overeating, the sinews and vessels become lax and relaxed, leading to hemorrhoids in the large intestine. It also says: The spleen and stomach are the officials responsible for storage and granaries, from which the five flavors emerge. The large intestine is the official responsible for transmission, from which changes occur. If food intake is excessive, the spleen qi becomes extremely fatigued and unable to transform and transport essence and micro-nutrients. Injury in the morning leads to damage by evening; clear and turbid energies mix and confuse. Thus, food stagnation flows downward into the large intestine, causing disease. Generally, if the spleen and stomach are deficient, lung qi will also be lacking, and large intestine qi will follow suit in becoming deficient. Liver wood can then take advantage of this deficiency to flow downward, resulting in wind-intestinal diseases. These are all caused by metal (lung) losing its nourishment and wood (liver) lacking restraint. The manifestations vary greatly in name and form: there are Milk Hemorrhoids, Rat Hemorrhoids, Chicken Heart Hemorrhoids, Chicken Comb Hemorrhoids, Lotus Hemorrhoids, Turning-Flower Hemorrhoids, Beehive Hemorrhoids, Intestine-Piercing Hemorrhoids, and External Hemorrhoids. Although the shapes differ, the etiology is the same. Treatment methods involve using bitter-cold herbs to purge fire, such as Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Gardeniae Fructus (Zhizi), and Sophorae Flos (Huaihua). Use pungent-warm herbs to harmonize blood, such as Angelicae Sinensis Radix (Danggui), Chuanxiong Rhizoma (Chuanxiong), and Persicae Semen (Taoren). For wind pathogens located below, use Gentianae Macrophyllae Radix (Qinjiao), Saposhnikoviae Radix (Fangfeng), and Cimicifugae Rhizoma (Shengma) to lift and raise. For dryness-heat stagnation, use Rheum Palmatum (Dahuang), Aurantii Fructus (Zhiqiao), and Cannabis Seed (Heren) to moisten. Those contracting this disease should naturally be cautious with diet and restrain desires; following these methods for regulation and treatment ensures recovery without complication.
Pulse Diagnosis
A pulse that is deep, small, and solid is easy to treat; a pulse that is floating, flooding, yet weak and soft is difficult to cure.
Methods
Zhu Danxi said: Hemorrhoid disease arises because wind-heat and dryness return to the large intestine. Treatment focuses primarily on regulating blood. The general principle uses Scutellariae Radix (Tiaohuangqin) to cool the large intestine, Ginseng Radix (Renshen), Coptidis Rhizoma (Huanglian), Rehmanniae Radix (Shengdihuang), and Sophorae Fructus (Huaijiao) to cool blood and generate blood, Angelicae Sinensis Radix (Danggui) to harmonize blood, and Chuanxiong Rhizoma (Chuanxiong), Cimicifugae Rhizoma (Shengma), and Aurantii Fructus (Zhiqiao) to widen the intestines.
For fistulas (Lou Chuang), one must first use tonic herbs to replenish qi and blood, primarily using Ginseng Radix (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Angelicae Sinensis Radix (Danggui), and Poria (Fuling), administered in large doses. Externally, use Aconiti Lateralis Radix Preparata (Fuzi) powdered, mixed with saliva to form cakes of coin thickness. Apply moxa extensively; for larger fistulas, use larger moxa cones, and for smaller ones, smaller cones. Moxibustion should induce slight warmth but not pain. Replace the cake when it hardens, re-mix, and continue moxibustion. Additionally, apply a plaster made from qi- and blood-tonifying herbs.
One prescription for treating hemorrhoid swelling and pain uses Snail (Wo Niu, also known as Yan You) dried in the shade and powdered, applied topically for immediate cure. Alternatively, soak snails in sesame oil for over a month and apply the oil foam; this is also effective.
Washing medicine: Decoct Terminalia Chebula Retz. (Wubeizi), Mirabilite (Puxiao), Taxillus Chinensis (Sangjisheng), and Nelumbinis Speciosae Folium (Lianfang) in water. Steam first, then wash.
Another prescription for hemorrhoid wind-swelling and pain uses Sesame Seeds (Humaizi) decocted in water for washing; the swelling subsides immediately.
Another prescription uses Biota Orientalis Seed (Mubiezi) and Terminalia Chebula Retz. (Wubeizi) ground into fine powder, mixed and applied.
Suppository medicine: Use Calamina (Luganshi) quenched in urine of a healthy boy, and Oyster Shell (Muli), ground together into powder for application.
Another prescription uses fresh roots of Kalimeris Indica (Malan Gen) ground finely and applied. Check after a short while; once the flesh levels out, remove the medicine. Delaying may cause the flesh to protrude further.
Intestinal Wind bleeding originates solely from the stomach and large intestine. Use Scutellariae Radix (Huangqin), Gentianae Macrophyllae Radix (Qinjiao), Sophorae Fructus (Huaijiao), Indigo Naturalis (Qingdai), and Cimicifugae Rhizoma (Shengma).
One prescription uses: Prepared Rheum Palmatum (Dahuang, roasted), Persicae Semen (Taoren, tips removed, each 3 qian), Prepared Citri Reticulatae Pericarpium (Chenpi, roasted), Coptidis Rhizoma (Huanglian), Gentianae Macrophyllae Radix (Qinjiao), Sophorae Fructus (Huaijiaozi, each 1 liang), Angelicae Sinensis Radix (Danggui), Areca Seed (Binglang), Gleditsiae Sinensis Spina (Zaoren), Prepared Phellodendri Cortex (Huangbai, fried), Schizonepeta Spike (Jingjie), and Aurantii Fructus (Zhiqiao, each 5 qian). Grind into powder, make pills with wheat paste, size of Sophora japonica seeds. Take 50 pills per dose with warm water. If bright red blood is passed, add Ash of Palme Fruit (Zonglv Hui) and Ash of Lotus Pod (Lianfang Hui).
(Above are ten methods from Danxi.)
Qinjiao Qianghuo Decoction (Li Dongyuan) treats hemorrhoids and fistulas forming lumps that hang down, intolerable itching.
Notopterygii Rhizoma et Radix (Qianghuo, 1.2 qian), Gentianae Macrophyllae Radix (Qinjiao), Astragali Radix (Huangqi, each 1 qian), Saposhnikoviae Radix (Fangfeng, de-rhizome, 0.7 qian), Cimicifugae Rhizoma (Shengma), Prepared Glycyrrhizae Radix et Rhizoma (Zhigancao), Ephedrae Herba (Mahuang), Bupleuri Radix (Chaihu, each 0.5 qian), Ligustici Rhizoma et Radix (Gaoben, 0.3 qian), Asari Radix et Rhizoma (Xixin), Safflower (Honghua, each a little).
Finely cut, prepare as one dose. Decoct in water and take orally. Avoid defecating or urinating in windy/cold places.
Qinjiao Cangzhu Decoction (Li Dongyuan) treats ruptured hemorrhoidal nodes, termed hemorrhoid fistula, with constipation and severe pain. This results from the combination of dampness, heat, wind, and dryness. Lumps at the anal opening indicate dampness; severe pain indicates wind; dry stool indicates fire pathogen. The Metal of the West (Lung) governs qi, its nature is descending and collecting, aiding the pathogenic factors. One must combine qi-breaking herbs for divine efficacy.
Gentianae Macrophyllae Radix (Qinjiao, de-rhizome), Persicae Semen (Taoren, peel and tip removed, separately ground), Gleditsiae Sinensis Spina (Zaoren, burned to retain character, each 1 qian), Atractylodis Rhizoma (Cangzhu, soaked in rice wash water), Saposhnikoviae Radix (Fangfeng, each 0.7 qian), Phellodendri Cortex (Huangbai, wine-washed, 0.5 qian), Angelicae Sinensis Radix (Danggui shao, wine-washed), Alismatis Rhizoma (Zexie, each 0.3 qian), Areca Seed (Binglang, 0.2 qian, separately ground), Rheum Palmatum (Dahuang, a little; even if stool is very dry, do not use too much).
Except for Binglang, Taoren, and Zaoren which are separately ground, finely cut the rest. Prepare one dose with three cups of water, decoct to 1.2 cups, strain, add the powders of Binglang, etc., boil again to 1 cup. Take hot on an empty stomach. Wait a moment, then eat a good meal to settle the stomach qi. On days taking medicine, avoid raw, cold, hard foods, alcohol, wet noodles, spices, pepper, ginger, etc. Violation renders the medicine ineffective. If white pus is present, add five heads of white sunflower, remove calyx, add 0.5 qian of Qingpi, decoct with main herbs. Add 0.3 qian of Costus Root (Muxiang) powder, taken with Binglang etc. according to previous method. Ancient people treated this disease over years; this medicine cures in one dose.
Qinjiao Danggui Decoction (Li Dongyuan) treats hemorrhoid fistula with dry, painful stool.
Prepared Rheum Palmatum (Dahuang, roasted, 4 qian), Gentianae Macrophyllae Radix (Qinjiao, de-rhizome), Aurantii Fructus (Zhishi, each 1 qian), Alismatis Rhizoma (Zexie), Angelicae Sinensis Radix (Danggui shao), Gleditsiae Sinensis Spina (Zaoren), Atractylodis Macrocephalae Rhizoma (Baizhu, each 0.5 qian), Safflower (Honghua, a little), Persicae Semen (Taoren, 20 pieces, tips removed, finely ground).
Finely cut, prepare one dose with three cups of water, decoct to 1 cup. Take before meals. Avoidances as above.
Qinjiao Fangfeng Decoction (Li Dongyuan) treats hemorrhoid fistula with pain during daily bowel movements (no pain means not hemorrhoid fistula). This medicine is indicated.
Gentianae Macrophyllae Radix (Qinjiao), Saposhnikoviae Radix (Fangfeng), Angelicae Sinensis Radix (Danggui shen), Atractylodis Macrocephalae Rhizoma (Baizhu, each 1.5 qian), Prepared Glycyrrhizae Radix et Rhizoma (Zhigancao), Alismatis Rhizoma (Zexie, each 0.6 qian), Phellodendri Cortex (Huangbai, wine-washed, 0.5 qian), Prepared Rheum Palmatum (Dahuang, roasted), Citri Reticulatae Pericarpium (Chenpi, each 0.3 qian), Bupleuri Radix (Chaihu), Cimicifugae Rhizoma (Shengma, each 0.2 qian), Persicae Semen (Taoren, 30 pieces, tips removed, separately ground), Safflower (Honghua, a little).
Finely cut, prepare one dose with three cups of water, decoct to 1 cup, strain, take slightly warm on empty stomach. Avoid wind and cold. Avoid sexual intercourse, alcohol, wet noodles, and pungent-hot substances.
Danggui Yuliren Decoction (Li Dongyuan) treats hemorrhoid fistula with hard stool, prolapse of rectal tissue upon straining, painful bleeding.
Prunus humilis seed (Yuliren), Gleditsiae Sinensis Spina (Zaoren, each 2 qian, separately ground), Aurantii Fructus (Zhishi, 0.7 qian), Gentianae Macrophyllae Radix (Qinjiao, de-rhizome), Cannabis Seed (Heren), Angelicae Sinensis Radix (Danggui shao), Rehmanniae Radix (Shengdihuang), Atractylodis Rhizoma (Cangzhu, each 0.5 qian), Prepared Rheum Palmatum (Dahuang, roasted), Alismatis Rhizoma (Zexie, each 0.3 qian).
Finely cut, prepare one dose. Except for Zaoren powder, decoct remaining ingredients in three cups of water to 1 cup, strain, mix in Zaoren powder, take on empty stomach. Avoidances as above.
Honghua Taoren Decoction (Li Dongyuan) treats chronic hemorrhoid fistula caused by overeating, leading to lax sinews/vessels and hemorrhoids. Treatment principle: Tonify North (Kidney), Purge Center (Spleen/Stomach).
Phellodendri Cortex (Huangbai, 1.5 qian), Rehmanniae Radix (Shengdihuang, 1 qian), Alismatis Rhizoma (Zexie, 0.8 qian), Atractylodis Rhizoma (Cangzhu, 0.6 qian), Angelicae Sinensis Radix (Danggui shao), Stephania Tetrandra (Hanfangji), Saposhnikoviae Radix (Fangfeng shao), Polyporus (Zuling, each 0.5 qian), Cannabis Seed (Heren, 0.2 qian), Safflower (Honghua, a little), Persicae Semen (Taoren, 10 pieces).
Finely cut, prepare one dose with three cups of water, decoct to 1 cup, strain, take slightly warm. Avoidances as above.
Seven-Sages Pill (Li Dongyuan) treats unbearable large intestine pain. *Mai Jue* states: Accumulated qi arises beside the spleen organ, large intestine pain comes in waves; merely purging Sanjiao fire allows herbal formulas to establish order.
Notopterygii Rhizoma et Radix (Qianghuo, 1 liang), Prunus humilis seed (Yuliren, soaked in water, peeled, tips removed, separately ground, 1.5 liang), Prepared Rheum Palmatum (Dahuang, roasted, 8 qian), Areca Seed (Binglang), Cinnamomi Cortex (Guixin), Costus Root (Muxiang), Chuanxiong Rhizoma (Chuanxiong, each 5 qian).
Except for Yuliren separately ground and added later, grind the rest into fine powder. Make pills with refined honey, size of Sophora japonica seeds. Take 30-50 pills with warm water before meals. Aim for mild diarrhea; generally cured. Strictly forbid excessive purging, as pain will intensate.
Qinjiao Baizhu Pill (Li Dongyuan) treats hemorrhoids and fistulas with pus/blood, dry/hard stool, unbearable pain.
Gentianae Macrophyllae Radix (Qinjiao, de-rhizome), Persicae Semen (Taoren, peeled, tips removed, ground), Gleditsiae Sinensis Spina (Zaoren, burned to retain character, each 1 liang), Angelicae Sinensis Radix (Danggui shao, wine-soaked), Alismatis Rhizoma (Zexie), Aurantii Fructus (Zhishi, bran-fried yellow), Atractylodis Macrocephalae Rhizoma (Baizhu, each 5 qian), Sanguisorbae Radix (Diyu, 3 qian).
Grind into fine powder, mix with Taoren paste, grind evenly. Make pills with wheat paste, size of Euryale Seed (Jiantoushi), smooth surface, bake dry. Take 50-70 pills with warm water on empty stomach. Wait a moment, then eat a good meal. Avoid raw, cold, hard foods, cold water/vegetables, alcohol, wet noodles, spicy foods, spices, and hot substances. Violation renders medicine ineffective.