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[Formula Song] Hemorrhoids present in various shapes and names, their etiology lies not beyond Wind, Dampness, Dryness, and Heat. They can occur both inside and outside the anus; if ulcerated for a long time and forming fistulas, they are hardest to cure.

[Annotation] This condition manifests as sores growing in the anal region, some occurring inside the anus, others outside. Initially, when nodules form without breaking, it is called hemorrhoids (Zhi), which is easy to treat; if broken and discharging pus and blood, with yellow fluid oozing and dripping continuously for a long time, it is called fistula (Lou), which is difficult to cure. The name derives from the morphology. Although there are twenty-four types, the causes generally stem from indulgence in alcohol and food followed by sexual activity, leading to relaxation of tendons and vessels, depletion of essence and Qi, allowing Heat-Toxin to sink downward due to deficiency; or from excessive worry and thought, accumulating Heat-Toxin, and angry stagnation causing Wind, Dampness, Dryness, and Heat to combine. If nodules are swollen, stifling, and painful, it indicates excess Dampness; if nodules are swollen, painful like burning, with constipation and urinary retention, it indicates excess Heat in the Large Intestine and Small Intestine; if nodules are itchy, it indicates excess Wind; if the anal folds rupture and stool is dry, it indicates Fire and Dryness. Initially, all cases should take Zhitong Rushen Tang (Pain-Relieving Divine Decoction) to resolve the pathogen, and externally apply Puti Lu (Bodhi Dew) or Tianluo Shui (River Snail Water). For hard nodules, use Wubeizi San (Five-Gallnut Powder) mixed with saliva and applied topically, combined with washing using a decoction of Xiaokao (Mirabilite) and Congtou (Green Onion Bulb). For nodules with a large head and small stalk, tie a medicinal thread around the base of the hemorrhoid, tightening it daily until the hemorrhoid withers and falls off, then sprinkle Yuebai Zhenzhu San (Moon-white Pearl Powder) to heal the wound; for those with a small head and large stalk, use Kuzhi San (Hemorrhoid-Withering Powder) to cause necrosis. For internal hemorrhoids that do not prolapse, insert Huanzhi San (Hemorrhoid-Calling Powder) into the anus to induce prolapse, then wash with a decoction of Xiaokao and Congtou. For hemorrhoids caused by hard labor, carrying heavy loads, and long-distance walking, resulting in chaotic Qi and Blood, take modified Zhitong Rushen Tang. For "Blood-Arrow Hemorrhoids" occurring inside or outside the anus, causing blockage, heaviness, and swelling, where bright red blood spurts like an arrow upon defecation effort, regardless of whether it occurs before or after stool, this is due to Wind-Heat in the intestines and stomach combined with sudden anger. Initially take Shengshu Sanhuang Wan (Raw and Cooked Three-Yellow Pill); if lips are pale, complexion sallow, and limbs weak, it belongs to Dual Deficiency of Qi and Blood, suitable for Shiquan Dabu Tang (Ten Complete Tonifying Decoction) with increased Chuanxiong (Ligusticum Rhizome), Renshen (Ginseng Root), and Huangqi (Astragalus Root), washed externally with one's own urine, or hot child's urine may also be used, stopping the bleeding. For Changfeng Xiexue (Intestinal Wind Bleeding) dripping out, occurring before stool, use Fangfeng Qinjiao Tang (Saposhnikovia Decoction); for bleeding after stool, attributed to Alcohol-Toxin, take Kushen Dihuang Wan (Sophora and Rehmannia Pill). After efficacy, take Zanglian Wan (Viscera-Linked Pill) for two to three courses to eradicate the root. For hemorrhoids caused by excessive exertion postpartum, use Buzhong Yiqi Tang (Middle-Joint Qi-Supplementing Decoction) added with Taoren (Peach Kernel), Honghua (Safflower), and Sumu (Red Sandalwood). For hemorrhoids arising from chronic diarrhea or dysentery, use Buzhong Yiqi Tang added with Huaihua (Sophora Flower) and Saojiazi [Fired] Powder (Soapberry Seed). If hemorrhoids have penetrated the bowel and filth exits through the fistula opening, use Hulian Zhuidu Wan (Anisoindigo Pursuing-Toxin Pill) taken with wine; if pus and water increase after taking the medicine, it indicates the medicinal power has reached the lesion, do not fear. If the fistula has a tract, use Huanglian Guan Guan Wan (Coptis Closing-Tract Pill), which can replace the effect of needles, knives, and threads. For all hemorrhoids, whether unbroken, broken, or formed into fistulas, wash with Que Du Tang (Eliminate-Toxin Decoction) or boil Laba Hua (Morning Glory, i.e., Solanum nigrum seedlings) for washing twice daily, while abstaining from sexual intercourse, pufferfish, seafood, spicy foods, Sichuan pepper, and alcohol. Those who suffer from hemorrhoids for a long time and subsequently develop coughing are difficult to treat; those who suffer from chronic coughing and subsequently develop hemorrhoids often prove incurable.

Formula: Zhitong Rushen Tang (Pain-Relieving Divine Decoction)
Composition: Qinjiao (Gentianae Radix, removed sprouts) 3g, Taoren (Persicae Semen, peeled and tip removed, crushed) 3g, Saojiazi (Gleditsiae Sinensis Fructus Spina, burnt to retain nature, crushed) 3g, Cangzhu (Atractylodis Rhizoma, soaked in rice water, stir-fried) 2.1g, Fangfeng (Saposhnikoviae Radix) 2.1g, Huangbai (Phellodendri Cortex, wine-fried) 1.5g, Dangguiwei (Angelicae Sinensis Radix tail, wine-washed) 0.9g, Zexie (Alismatis Rhizoma) 0.9g, Binglang (Arecae Semen) 0.3g, Shuda Huanglian (Rhei Radix et Rhizoma, cooked) 3.6g.
Except for Taoren, Saojiazi, and Binglang, add two sheng (approx. 480ml) of water, decoct the remaining herbs to one sheng (approx. 240ml); then add Taoren, Saojiazi, and Binglang, decoct again to eight fen (approx. 192ml). Take hot on an empty stomach, follow with a good meal shortly after to protect the stomach. Avoid raw/cold foods, five pungents, strong liquor, hard foods, strong spices, and damp flour products.
If swelling contains pus, add Bai Kuihua (White Hibiscus Flower, removed pistil) 5 flowers, Qingpi (Citri Reticulatae Pericarpium Viride) 1.5g, Muxiang (Aucklandiae Radix) 0.9g, so pus discharges via stool. If severe constipation, double Da Huang (Rhei Radix et Rhizoma), add Huren (Cannabis Semen) and Zhishi (Aurantii Fructus Immaturus). If severe swelling, double Huangbai and Zexie, add Fangji (Stephaniae Tetrandrae Radix), Zhuling (Polyporus), and Tiao Qin (Scutellariae Radix). If severe pain, add Qianghuo (Notopterygii Rhizoma et Radix) and Yuliren (Prunus Armeniacae Semen Amarum). If severe itching, double Fangfeng, add Huangqi (Astragali Radix), Qianghuo, Mahuang (Ephedrae Herba), Gaoben (Ligustici Wallichii Rhizoma et Radix), and Gancao (Glycyrrhizae Radix et Rhizoma). If bleeding, double Huangbai, add more Diyü (Sanguisorbae Radix), Huaihua, Jingjie Sui (Schizonepetae Spica), and Baizhi (Angelicae Dahuricae Radix). If urinary difficulty and frequency, add Chifuling (Poria cum Rosa), Cheqianzi (Plantaginis Semen), Dengxin (Junci Medullia), and Bianxu (Polygoni Avicularis Herba).

[Formula Song] Zhitong Rushen treats all hemorrhoids, preventing Wind, Dampness, Dryness, and Heat; Danggui, Huangbai, Taoren, Binglang, Saojiazi, Cangzhu, Qinjiao, Fangfeng, Zexie, Da Huang.

Another Formula: Tianluo Shui (River Snail Water)
Composition: One large river snail. Use a sharp knife to lift the operculum, add 0.25g of Bingpian (Borneolum Syntheticum) powder, place flat in a porcelain dish; after a moment, clear fluid seeps from the snail's aperture. Dip a chicken feather in the fluid and apply frequently to the affected area; swelling will naturally dissipate.

[Formula Song] Tianluo Shui points hemorrhoids effectively, Bingpian inserted into snail aperture, wait briefly for water formation to point sore, pain relief and swelling reduction are miraculous.

Another Formula: Wubeizi San (Five-Gallnut Powder)
Composition: One large Chuan Wen Ge (Clam Shell). Make a small hole, stuff with dried Lizhicao (Prunella vulgaris), fill completely, seal hole with paper, wrap in wet paper, bake for a short while, remove paper, grind to fine powder. Add 0.9g Qingfen (Calomelas) and 0.25g Bingpian per qian (3g) of powder, grind extremely fine, mix with saliva and apply to affected area.

[Formula Song] Wubeizi San treats hemorrhoid pain and heaviness, instantly disperses hard swelling and pain; Qingfen and Bingpian ground fine, Lizhicao baked inside clam shell.

Another Formula: Yao Xian (Medicinal Thread)
Composition: Yuanhua (Genkwa Flos) 15g, Biqian (Oecobius Nidus) 6g.
Take 9g of white fine cotton thread, place with Yuanhua and Biqian in one bowl of water in a small porcelain jar, simmer slowly until liquid dries up, take out thread and air-dry. For hemorrhoids or goiters with large heads and small stalks, use one thread (two for larger lesions), tie tightly around the base with a double knot, leaving ends loose, tighten gradually day by day until the lesion turns purple-black and cold. Mild cases fall off in seven days, severe in fifteen days; Yuebai Zhenzhu San is very effective for healing.

[Formula Song] Medicinal thread with Yuanhua and Biqian, boiled together with white knotted thread; tie at the root of various hemorrhoids and goiters, shaped like mushrooms, use this to discard.

Another Formula: Kuzhi San (Hemorrhoid-Withering Powder)
Composition: Tianlinggai (Skull Cap of Boy, best quality; soak in green thread water briefly, remove, fire until red, quench in green thread water, repeat seven times, net weight 12g), Pishuang (Realgar) 30g, Baifan (Alumen crude) 60g, Qingfen (Calomelas) 12g, Chansu (Toad Venom) 6g.
Grind to extremely fine powder, place in a new small iron pot, cover tightly with a coarse porcelain bowl, seal with salt mud, roast over charcoal fire for two incense sticks' duration. When cool, open bowl, grind medicine again, apply to hemorrhoids. At Chen, Wu, and Shen hours daily, wash affected area with warm water, apply medicine three times. After seven to eight days, hemorrhoid becomes black, hard, cracks, and falls off naturally.

[Formula Song] Kuzhi uses Tianlinggai roasted and quenched, Realgar, Alum, Calomelas, and Toad Venom combined; sealed in pot and bowl with mud and roasted, fresh or old hemorrhoids wiped away.

Another Formula: Huanzhi San (Hemorrhoid-Calling Powder)
Composition: Kubai Fan (Calcined Alum) 1.5g, Yanpan (Salt, stir-fried) 0.9g, Caowu (Aconiti Radix, raw) 3g, Ciwei Pi (Erinacei Corium, burnt to retain nature) 3g, Shexiang (Moscus) 1.5g, Bingpian (Borneolum Syntheticum) 0.6g.
Grind to fine powder. First wash anus with warm water, then mix 9g of medicine with saliva, insert into anus; it will prolapse in a moment.

[Formula Song] Huanzhi San calls internal hemorrhoids out, Ciwei Pi, Salt, Moscus, Caowu; Bingpian and Calcined Alum ground fine, saliva-mixed insertion causes quick prolapse.

Another Formula: Shengshu Sanhuang Tang (Raw and Cooked Three-Yellow Decoction)
Composition: Shengdi Huang (Rehmanniae Radix) 4.5g, Shudi Huang (Rehmanniae Radix Preparata) 4.5g, Huanglian (Coptidis Rhizoma) 3g, Huangbai (Phellodendri Cortex) 3g, Huangqin (Scutellariae Radix) 3g, Renshen (Ginseng Radix) 3g, Cangzhu (Atractylodis Rhizoma, soaked in rice water, stir-fried) 3g, Baizhu (Atractylodis Macrocephalae Rhizoma, earth-fried) 3g, Houpo (Magnoliae Officinalis Cortex, ginger-processed) 3g, Dangguishen (Angelicae Sinensis Radix body) 3g, Chenpi (Citri Reticulatae Pericarpium) 3g, Diyü (Sanguisorbae Radix) 3g, Fangfeng (Saposhnikoviae Radix) 3g, Zexie (Alismatis Rhizoma) 3g, Gancao (Glycyrrhizae Radix et Rhizoma, raw) 1.8g, Wumei (Mume Fructus) 2 pieces.
Add two sheng (approx. 480ml) of water, decoct to eight fen (approx. 192ml), take before meals.

[Formula Song] Shengshu Sanhuang with Coptis, Phellodendron, Ginseng; Atractylodes, Scutellaria, Magnolia, Atractylodes, Angelica, Citrus; Sanguisorba, Saposhnikovia, Alisma, Mume, Licorice; specifically divine for Blood-Arrow Hemorrhoids.

Another Formula: Fangfeng Qinjiao Tang (Saposhnikovia Decoction)
Composition: Fangfeng (Saposhnikoviae Radix) 3g, Qinjiao (Gentianae Macrophyllae Radix) 3g, Danggui (Angelicae Sinensis Radix) 3g, Shengdi Huang (Rehmanniae Radix) 3g, Baishao (Paeoniae Radix Alba, wine-fried) 3g, Chuanxiong (Ligustici Rhizoma et Radix) 3g, Chifuling (Poria cum Rosa) 3g, Lianqiao (Forsythiae Fructus, removed heart) 3g, Zhizi (Gardeniae Fructus, raw, crushed) 3g, Cangzhu (Atractylodis Rhizoma, soaked in rice water, stir-fried) 3g, Huaijiao (Sophorae Flavescentis Fructus) 3g, Baizhi (Angelicae Dahuricae Radix) 3g, Diyü (Sanguisorbae Radix) 3g, Zhike (Aurantii Fructus Immaturus, bran-fried) 3g, Binglang (Arecae Semen) 1.8g, Gancao (Glycyrrhizae Radix et Rhizoma, raw) 1.8g.
Add two sheng (approx. 480ml) of water, decoct to eight fen (approx. 192ml), take warm before meals. Add Da Huang if constipated.

[Formula Song] Fangfeng and Qinjiao treat Intestinal Wind, relieving heaviness, swelling, fluids, and blood pain; Four Substances, Zhizi, Cangzhu, Huaijiao, Baizhi, Sanguisorba, Aurantium, Licorice, Forsythia, Areca, Poria.

Another Formula: Kushen Dihuang Wan (Sophora and Rehmannia Pill)
Composition: Kushen (Sophorae Flavescentis Radix, sliced, soaked in wine until moist, steamed and sun-dried nine times, stir-fried yellow, pure powder 500g), Sheng Di Huang (Rehmanniae Radix, soaked in wine overnight, steamed ripe, mashed, mixed with Kushen powder 120g).
Add refined honey to form pills, size of Sophora seeds. Take 9g per dose, swallow with plain boiling water or wine, twice daily.

[Formula Song] Kushen and Dihuang for red blood after stool, caused by Alcohol-Toxin Heat attacking; these two ingredients wine-steamed and honey-refined, pills swallowed with water are most effective.

Another Formula: Zanglian Wan (Viscera-Linked Pill)
Composition: Huanglian (Coptidis Rhizoma, finely ground powder 240g), Gong Zhu Dachang (Male Pig Large Intestine, washed clean, fatty segment 36cm long).
Place Huanglian powder inside the intestine, tie both ends tightly with thread, place in clay pot, add 1250g of cooking wine, simmer slowly until wine is dry. Remove the medicine-filled intestine, pound together into paste. If too thick, sun-dry for about an hour, then pound again into pills, size of Sophora seeds. Take 70 pills per dose, swallow with warm wine on an empty stomach; long-term use eradicates the root.

[Formula Song] Zanglian Wan uses Chuan Huanglian, ground into pig intestine, boiled in wine; pounded into pills, taken with warm wine, cures rectal bleeding and anal heaviness/swelling.

Another Formula: Hulian Zhuidu Wan (Anisoindigo Pursuing-Toxin Pill)
Composition: Hulian Huang (Coptidis Rhizoma? No, Anisoindigo Herba - Isatidis Folium/Root? Actually Hu Lian Huang is Picrorhizae Rhizoma) (sliced, stir-fried with ginger juice, ground powder) 30g, Ciwei Pi (Erinacei Corium, roasted, sliced, stir-fried yellow, ground powder) 30g, Shexiang (Moscus, finely ground) 0.6g.
Mix evenly, form pills with soft rice, size of sesame seeds. Take 3g per dose, swallow with warm wine before meals.

[Formula Song] Hulian Zhuidu Wan treats hemorrhoids, most suitable for fistulas penetrating bowel; Picrorhiza, Moscus, Erinaceus Corium rice pills expel stasis and pus, replacing with healthy tissue.

Another Formula: Huanglian Guan Guan Wan (Coptis Closing-Tract Pill)
Composition: Hulian Huang (Picrorhizae Rhizoma, pure powder) 30g, Chuanshan Jia (Manis Squama, fried in sesame oil until yellow) 15g, Shijueming (Haliotidis Concha, burnt) 15g, Huaihua (Sophorae Flavescentis Flos, lightly stir-fried) 15g.
Grind to fine powder, form pills with refined honey, size of sesame seeds. Take 3g per dose, swallow with clear rice soup on an empty stomach. Take morning and evening, twice daily; even severe cases heal within forty days.
If hard flesh protrudes around the four sides of the fistula, add 20 Jiangcan (Bombyx Batryticatus), stir-fried and ground into powder, add to medicine. This formula is effective for various fistulas throughout the body.

[Formula Song] Huanglian Guan Guan Wan with Manis, Haliotis, Sophora ground fine; removes fistula tracts sent with rice soup, honey pills size of sesame seeds.

Another Formula: Que Du Tang (Eliminate-Toxin Decoction)
Composition: Wasong (Parmeliae Thallus) 15g, Machixian (Portulacae Herba) 15g, Gancao (Glycyrrhizae Radix et Rhizoma, raw) 15g, Chuan Wen Ge (Clam Shell) 9g, Chuanjiao (Sichuan Pepper) 9g, Cangzhu (Atractylodis Rhizoma) 9g, Fangfeng (Saposhnikoviae Radix) 9g, Congbai (Allii Fistulosi Bulbus) 9g, Zhike (Aurantii Fructus Immaturus) 9g, Ce Bai Ye (Platycladi Cacumen) 9g, Yanxiao (Nitratum) 30g.
Add five bowls of water, decoct to three bowls. Steam first, then wash, use three times daily.

[Formula Song] Que Du Tang washes hemorrhoids and fistulas effectively, Parmelia, Licorice, Clam, Sichuan Pepper; Portulaca, Atractylodes, Saposhnikovia, Allium, Aurantium, Platycladus boiled together with Niter.

Another Formula: Puti Lu (See Zangdu section)
Yuebai Zhenzhu San, Shiquan Dabu Tang, Buzhong Yiqi Tang (See Ulcer Section)