脉
沉小实者易治，浮洪而软弱者难治。
病
夫痔漏者，肛门边内外有疮也。若成 不破者，曰痔；破溃而出脓血、黄水，浸淫淋沥久不止者，曰漏
也。由乎风、热、湿、燥合而致之。其状有五∶曰牡，曰牝，曰脉，曰血，曰肠痔是也。又
有酒痔、气痔、虫痔、翻花痔、蝼蛄痔。古方分为二十四种，名状
不同，究其所因，亦不过久嗜辛热炙爆新酒，及房欲忧思，蕴积热毒，愤郁之气所成也。或藏于肛门之内，
或突出肛门之外。蕴积深者，其状大；蕴毒浅者，其状小。大如鸡冠、莲花、核桃之状，小
如牛奶、鸡心、樱桃之形。或流脓水，或出鲜血，有妨行坐，痛苦无任，久而不愈，则成漏矣。
治
治宜祛风除湿，清热解毒，斯得痔漏之要者也。
二十四症痔歌 痔症分三八，凭君仔细看。莫交年月久，见者胆心寒。菱角看形怪，莲花不可观，穿肠
并鼠奶，酒色两相干。莫HT 翻花怨，蜂窠亦不宽。雌雄同气血，子母及肠盘。玄珠尤可怪，勾肠痛苦钻。核
桃与流气，见者便心酸。栗子于中大，鸡心在外安，珊瑚形可恶，那更脱肛难。内痔红不出，搭肠里内盘。
垂珠更难治，日久有鸡冠。切莫轻刀火，令君性命残，用功无半月，去病更除根。
方
秦艽苍术汤 治痔病若破，为之漏疾，大便闭涩，必作大痛，皆由风热所乘，食饱不通，气逼大肠
而作也。受病者、燥气也；为病者，胃湿也。胃刑大肠则化，燥火以乘燥热之，实胜风附热而来，是湿、热、
风、燥四气而合。故大肠头成块者，湿也；大痛者，风也。若大便燥结者，主病兼受火斜，热结不通也。
秦艽（去芦，一钱） 桃仁（去皮，研，一钱） 苍术（米泔浸，七分） 皂角仁（烧存
性，一钱） 防风（七分） 黄柏（酒浸，五分） 当归梢（五分） 泽泻（五分） 槟榔（二分）
大黄（二分，不可多用）
上锉一剂，水煎空心服。若久漏加鹿茸一钱，海藻一钱，甘草五分。服药日忌生冷硬物及酒湿面，大
料物干姜之类，犯之，则药不效矣。
秘方 治痔疮坐卧不得，诸药不效，惟此药妙，发时一点即好。
用大田螺八、九个，针破顶盖，入白矾末少许，置地上，尖底埋
土中，其顶盖仰天，经一宿，次日取盖上水，水汁以鸡翎搽疮上，五七次止痛即消。
治痔疮（秘方）
用半新马桶一个，入新砖一个，放桶底上，再用新砖一个烧
红，于砖上，上用全蝎两三枚，烧烟，患人坐桶上熏之，不二三次即愈。
治痔疮（刘夷门传）
用大雄鸡一只，置地板上，却不与食吃，伺饥甚却，移于净地
上，用猪胰子四两，锉碎，旋喂鸡令其撒粪，旋收之，如此两三日，候鸡粪积至四两，晒干入后药。
明矾（四两） 胆矾（五钱） 叶子雌黄（六钱） 雄黄（一钱） 朴硝（一两）
上各为细末，或砂锅，或银锅，虽完大者，先将鸡粪一两铺在锅底，次以胆矾，次以雌黄，然后尽下白
矾在内，再以鸡粪盖在上面，用新碗盖锅顶，簇炭火 青，烟尽为度，放冷取出，细研，入
乳香、没药各五钱，同研极细，入盒内收之。每用时，令患人缩一脚，用药少许，以津唾吐在手心中调匀，
以新笔蘸药敷之，一日三五次，一夜两三次，先用温汤洗净，软绵挹干，方可敷药，敷后有
黄水，淋沥不止最妙，三二日痔干枯剥落，倘硬，煎汤频洗，忌毒物、酒色，效。
神茧散（古方） 治诸痔有神效。
蚕茧内，入男子指甲，以满为度，外面用童子发缚裹，烧存
性，蜜调敷之，仍于腊月八日，取黑牛胆，入槐角子，以满为度，百日开用，空心酒吞十余粒，极妙。
五九散（徽王方） 治痔漏如神。
白牵牛（头末，一两） 大黄（一两） 五倍子（一两） 干莲蕊（一两） 矾红（五
钱，以皂角炼红） 黄连（三钱） 当归（五钱） 没药（一钱） 乳香（一钱，竹叶焙干）
上共为末。初服五分，二服六分，三服七分，四服八分，五服
九分为止，每日清晨，用牙猪肉汤半碗，加无灰酒一小钟调下，忌猪肠、肚，驴肉，烧酒。
三八全应丸（张明山方） 疮漏效验。
刺 皮（一个，连刺，酒浸晒干） 当归（酒洗，二两） 槐角（酒浸，炒，二两）
黄连（酒炒，二两） 地骨皮（酒炒干，二两） 甘草（蜜炙，二两） 乳香（二钱） 核桃
（十八个，内取隔三十六片）
上为末，醋糊为丸，如梧子大。每服三十五丸，白汤或酒，早晚二服，一月后平复。
地干丸（古方） 治痔漏通用。
槐角（二两，凉血） 当归身（一两） 黄 （一两） 生地黄（二两，生血） 川芎
（五钱） 阿脐（五钱，以上皆补虚） 黄连（一两，泻火） 连翘（一两，泻经脉中火） 黄
芩（一两，泻大肠火） 枳壳（一两，宽肠） 秦艽（一两，去大肠风） 防风（一两） 地榆
（一两，凉血） 升麻（一两，散火） 白芷（五钱，引诸药入大肠）
上为末，酒糊丸，如梧子大。每服五六十丸，加至七八十丸，空心米汤下，或酒任下。
秘方 治痔漏。
用蜜半盏，炼成丝，用雄胆一分，入蜜内再炼，入水成珠不散，将猪综绵裹拈，成拈，将蜜搽在拈上，
乃用真冰片、熊胆各半分，研细搽在拈上，插入漏眼内底，至尽头则止。如眼多，医好一个，不可一起上拈。如
外皮肉溃烂，用黄蜡、黄丹、麻油煎膏，贴疮上，缚紧一七见效。如外肉效迟，恐疮久受风湿，用五倍子，花
椒煎水洗，每一眼用拈三根，至夜换。
治痔疮方（周双桥传）
用鳖鱼一个，放在坛内，入麝香一二分于内，烧滚水倾入坛内，泡鳖，令患人将大便坐于坛口上，
热气熏蒸良久，将水洗痔，
不记遍数，却将鳖头烧灰掺上，再将鳖肉作羹食之，神效。
治痔疮方
刺 皮 雄黄 北艾
上为末，每作核桃大炷子，用竹筒如小酒杯一杯大，长尺余，
一头留节，钻一窍装入于内，烧烟令窍透疮口熏之，久则痒不可当，稍歇再熏。
洗痔漏（陈教谕传）
花椒 艾叶 葱头 五倍子 皮硝 马齿菜 茄根
上为散，水煎，先熏后洗，当时痛止，指日可愈。
追风补肾十漏十金丹 治漏，庚申甲子成除日合。
当归（二两） 人参（一两） 生地（一两） 熟地（二两） 麦门冬（二两） 破故纸
（二两） 小茴（一两） 大茴（三两） 肉苁蓉（二两） 山药（二两） 白茯苓（二两） 鹿茸
（一两） 大附子（一个） 川乌（一两） 丁香（五钱） 木香（一两） 青木香（一两） 砂
仁（一两） 浓朴（一两） 青皮（一两） 陈皮（一两） 枳壳（二两） 枳实（三两） 香附
（四两） 乌药（一两） 白芷（二两） 肉豆蔻（一两） 天麻（一两） 杏仁（二两） 松节
（四两） 砂（五钱） 乳香（一两） 没药（一两）
上为末，炼蜜丸，如弹子大，金箔为衣。每服一丸，空心酒化下。
按∶治痔之法，不过凉血清热而已，至于治漏，初则宜凉血燥湿，久则宜涩窍杀虫，而兼乎温散也。或曰
痔漏属火，何故而用温涩之药？殊不知痔止出血，始终是热；漏流脓水，始是湿热，终是
湿寒。此方虽温散，又兼补养。故丹溪云∶漏当大补气血为主，有所自矣。
Pulse:
A pulse that is deep, small, and solid indicates an easy-to-treat condition; a pulse that is floating, flooding, yet weak and soft indicates a difficult-to-treat condition.
Disease:
The term "hemorrhoids and fistula" (Zhi Lou) refers to sores occurring inside or outside the anus. If a sore forms but does not rupture, it is called "hemorrhoid" (Zhi); if it ruptures and discharges pus, blood, or yellow fluid, oozing and dripping continuously for a long time without stopping, it is called "fistula" (Lou). These conditions are caused by the combination of Wind, Heat, Dampness, and Dryness. There are five main presentations: Mu Zhi (Male Hemorrhoid), Pin Zhi (Female Hemorrhoid), Mai Zhi (Vascular Hemorrhoid), Xue Zhi (Blood Hemorrhoid), and Chang Zhi (Intestinal Hemorrhoid). Additionally, there are Jiu Zhi (Alcohol Hemorrhoid), Qi Zhi (Qi Stagnation Hemorrhoid), Chong Zhi (Parasitic Hemorrhoid), Fan Hua Zhi (Flower-Reversal Hemorrhoid), and Lou Gu Zhi (Mole Cricket Hemorrhoid). Ancient formulas classify them into twenty-four types with various names and shapes. However, investigating their etiology, they result mainly from long-term indulgence in spicy, hot, fried foods, and newly brewed wine, combined with excessive sexual activity, worry, and overthinking. This leads to the accumulation of heat toxins and the stagnation of resentful Qi. The pathogen may reside within the anus or protrude outside. Deep accumulation results in larger lesions; shallow toxin accumulation results in smaller lesions. Large lesions resemble the shape of a rooster's comb, lotus flower, or walnut; small lesions resemble a cow's teat, chicken heart, or cherry. They may discharge pus or fresh blood, hindering walking and sitting, causing unbearable pain. If left untreated for a long time, they develop into fistulas.
Treatment:
Treatment should focus on dispelling Wind and removing Dampness, clearing Heat and resolving toxicity. This is the key to treating hemorrhoids and fistulas.
Song of Twenty-Four Types of Hemorrhoids:
Hemorrhoids are divided into twenty-four types; please examine them carefully. Do not let the disease persist for years, or observers will be terrified. Look for the strange shape of the Water Chestnut type; do not observe the Lotus type. Penetrating Intestine and Mouse Milk types are related to alcohol and lust. Do not complain about the Flower-Reversal type; the Beehive type is also unyielding. Male and Female types involve Qi and Blood; Mother and Son types involve intestinal coiling. The Pearl type is particularly strange; the Bowel-Strangulating type causes drilling pain. Walnut and Flowing Qi types make observers feel sorrowful. The Chestnut type is large inside; the Chicken Heart type is safe outside. The Coral type has an ugly shape, and prolapse is even harder to treat. Internal hemorrhoids are red but do not protrude; Dacha intestine hemorrhoids coil internally. Drooping Beads are harder to treat and become rooster combs after many days. Do not lightly use knives or fire, or you will ruin lives. With diligent treatment for half a month, the disease can be eradicated at the root.
Formulas:
Qin Jiao Cang Zhu Tang (Gentian and Atractylodes Decoction): Treats hemorrhoids that have ruptured and become fistulas, with constipation and severe pain. This is caused by Wind-Heat invading, food stagnation preventing Qi flow, and Qi forcing the Large Intestine. The underlying pathology involves Dryness, while the manifesting pathology involves Stomach Dampness. Stomach evil penalizes the Large Intestine, transforming into Heat; Dryness-Fire attacks Dryness-Heat, and Excess wins, with Wind attaching to Heat. Thus, Wetness, Heat, Wind, and Dryness combine. Therefore, masses at the head of the Large Intestine are due to Dampness; severe pain is due to Wind. If stool is dry and bound, it indicates the primary disease is complicated by Fire invasion, with Heat binding and obstructing.
Ingredients: Qin Jiao (Gentianae Radix, remove rhizome, 1 qian), Tao Ren (Persicae Semen, remove skin, crush, 1 qian), Cang Zhu (Atractylodis Rhizoma, soak in rice wash water, 0.7 qian), Zao Jiao Ren (Gleditsiae Sinensis Fructus seed, burn until carbonized, 1 qian), Fang Feng (Saposhnikoviae Radix, 0.7 qian), Huang Bo (Phellodendri Cortex, soak in wine, 0.5 qian), Dang Gui Shao (Angelicae Sinensis Radix tip, 0.5 qian), Ze Xie (Alismatis Rhizoma, 0.5 qian), Bing Lang (Arecae Semen, 0.2 qian), Da Huang (Rhei Radix et Rhizoma, 0.2 qian, do not use excessively).
Usage: Coarsely crush one dose, decoct in water, and take on an empty stomach. For chronic fistulas, add Lu Rong (Cervi Cornu Pantotrichum, 1 qian), Hai Zao (Sargassum, 1 qian), and Gan Cao (Glycyrrhizae Radix et Rhizoma, 0.5 qian). During medication, avoid raw, cold, hard foods, alcoholic damp foods, noodles, and strong spices like Gan Jiang (Zingiberis Rhizoma). Violating these will render the medicine ineffective.
Secret Recipe: For hemorrhoids causing inability to sit or lie down, when other medicines fail, this remedy is miraculous; applying it once during an outbreak brings immediate relief.
Usage: Take 8-9 large river snails, puncture the top cover, insert a little Bai Fan (Alumen, white alum powder), place on the ground with the pointed bottom buried in soil and the top cover facing the sky. After one night, collect the water on the next day. Apply the juice to the sore with a chicken feather. After 5-7 applications, pain stops and swelling subsides.
Treating Hemorrhoids (Secret Recipe):
Usage: Use a semi-new toilet bucket, place a new brick at the bottom. Heat another new brick red-hot, place it on the first brick. Put 2-3 Quan Xie (Scorpio) on the hot brick. Smoke the scorpion. Have the patient sit on the bucket to fumigate the area. It heals after 2-3 sessions.
Treating Hemorrhoids (Transmitted by Liu Yimen):
Usage: Take one large rooster, place it on the floor, and withhold food. When very hungry, move it to a clean place. Chop 4 liang of Zhu Yi (Porcine Pancreas), feed it to the chicken to defecate, and collect the feces immediately. Repeat for 2-3 days until 4 liang of chicken manure is accumulated. Sun-dry the manure and add the following herbs: Ming Fan (Alumen, white alum, 4 liang), Dan Fan (Chalkosulfas, 5 qian), Ye Zi Ci Huang (Realgar mixed with orpiment, 6 qian), Xiong Huang (Realgar, 1 qian), Po Xiao (Natrii Sulfas, 1 liang).
Preparation: Grind all ingredients into fine powder. Use a clay pot or silver pot. Place 1 liang of chicken manure at the bottom, then Dan Fan, then Ci Huang, then add all the Ming Fan. Cover with more chicken manure. Cover the pot with a new bowl. Roast around charcoal fire until smoke ceases. Cool, remove, and grind finely. Add Ru Xiang (Olibanum, 5 qian) and Mo Yao (Myrrha, 5 qian), grind extremely fine, and store in a box.
Usage: Ask the patient to retract one foot. Take a small amount of medicine, mix with saliva in the palm, apply with a new brush. Apply 3-5 times daily, 2-3 times nightly. First wash with warm water and dry with soft cotton. Discharge of yellow fluid is ideal. The hemorrhoid will dry and fall off in 2-3 days. If hard, wash frequently with decoction. Avoid toxic substances, alcohol, and sex. Effective.
Shen Jian San (Silkworm Cocoon Powder) (Ancient Formula): Miraculous effect for all hemorrhoids.
Usage: Insert male fingernails into a silkworm cocoon until full. Wrap externally with hair from a young boy. Burn until carbonized. Mix with honey and apply. On the 8th day of the 12th lunar month, take the gallbladder of a black ox, fill with Huai Jiao (Sophorae Tonkinensis Fructus) until full. Open after 100 days. Swallow 10+ pills with wine on an empty stomach. Very effective.
Wu Jiu San (Five-Nine Powder) (Marquis Hui's Formula): Divine effect for hemorrhoids and fistulas.
Ingredients: Bai Qian Niu ( Pharbitidis Semen, first powder, 1 liang), Da Huang (Rhei Radix et Rhizoma, 1 liang), Wu Bei Zi (Gallae Chinensis, 1 liang), Gan Lian Rui (Nelumbinis Plumula, 1 liang), Fan Hong (Calx Aluminii et Potassii processed with Gleditsiae, 5 qian), Huang Lian (Coptidis Rhizoma, 3 qian), Dang Gui (Angelicae Sinensis Radix, 5 qian), Mo Yao (Myrrha, 1 qian), Ru Xiang (Olibanum, 1 qian, dried with bamboo leaves).
Preparation: Grind all into powder. Initial dose: 0.5 qian; 2nd dose: 0.6 qian; 3rd dose: 0.7 qian; 4th dose: 0.8 qian; 5th dose: 0.9 qian. Take daily in the morning with half a bowl of pork bone soup and a small cup of pure wine. Avoid pig intestines, tripe, donkey meat, and distilled liquor.
San Ba Quan Ying Wan (Thirty-Eight Complete Response Pill) (Zhang Mingshan's Formula): Effective for sores and fistulas.
Ingredients: Ci Pi (Tribuli Fructus pericarpium, one with spines, soaked in wine and sun-dried), Dang Gui (Angelicae Sinensis Radix, washed in wine, 2 liang), Huai Jiao (Sophorae Tonkinensis Fructus, soaked in wine and stir-fried, 2 liang), Huang Lian (Coptidis Rhizoma, stir-fried in wine, 2 liang), Di Gu Pi (Lycii Cortex, stir-fried in wine until dry, 2 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-roasted, 2 liang), Ru Xiang (Olibanum, 2 qian), He Tao (Juglandis Semen, 18 nuts, extract 36 internal partitions).
Preparation: Grind into powder, make pills with vinegar paste, size of Sophora seeds. Take 35 pills each time with plain water or wine, morning and evening. Recovery after one month.
Di Gan Wan (Earth-Drying Pill) (Ancient Formula): General formula for hemorrhoids and fistulas.
Ingredients: Huai Jiao (Sophorae Tonkinensis Fructus, 2 liang, cools blood), Dang Gui Shen (Angelicae Sinensis Radix root end, 1 liang), Huang Qi (Astragali Radix, 1 liang), Sheng Di Huang (Rehmanniae Radix, 2 liang, generates blood), Chuan Xiong (Ligustici Chuanxiong Rhizoma, 5 qian), E Ejiao (Asini Corii Colla, 5 qian; above four tonify deficiency), Huang Lian (Coptidis Rhizoma, 1 liang, drains fire), Lian Qiao (Forsythiae Fructus, 1 liang, drains fire from meridians), Huang Qin (Scutellariae Radix, 1 liang, drains Large Intestine fire), Zhi Ke (Aurantii Fructus, 1 liang, expands intestines), Qin Jiao (Gentianae Radix, 1 liang, removes Large Intestine wind), Fang Feng (Saposhnikoviae Radix, 1 liang), Di Yu (Sanguisorbae Radix, 1 liang, cools blood), Sheng Ma ( Cimicifugae Rhizoma, 1 liang, disperses fire), Bai Zhi (Angelicae Dahuricae Radix, 5 qian, guides herbs to Large Intestine).
Preparation: Grind into powder, make pills with wine paste, size of Sophora seeds. Take 50-60 pills, increasing to 70-80, with rice gruel on an empty stomach, or with wine.
Secret Recipe: Treating hemorrhoids and fistulas.
Usage: Take half a cup of honey, refine until it forms threads. Add one part Xiong Dan (Bovis Calculus, gallstone from bull) to the honey and refine again until it forms beads in water that do not disperse. Wrap the mixture in pig wool to form a wick. Apply honey to the wick. Then apply fine powder of Zhen Bing Pian (Borneolum Syntheticum) and Xiong Dan (Bovis Calculus, 0.5 fen each) to the wick. Insert the wick into the bottom of the fistula tract until the end. If there are multiple openings, treat one at a time. If external skin ulcerates, use a plaster made from Huang La (Cera Flava, yellow beeswax), Huang Dan (Minium), and Ma You (Sesami Oleum). Apply tightly; improvement seen in 7 days. If external healing is slow, suspect chronic Wind-Dampness. Wash with Wu Bei Zi (Gallae Chinensis) and Hua Jiao (Zanthoxyli Pericarpium) decoction. Use three wicks per opening, change at night.
Treating Hemorrhoids (Transmitted by Zhou Shuangqiao):
Usage: Place one turtle in a jar. Add 1-2 fen of She Xiang (Moschus). Pour boiling water into the jar to steep the turtle. Have the patient sit on the mouth of the jar to fumigate the anal area with the heat for a long time. Wash the hemorrhoids with water repeatedly. Then burn the turtle head to ash and sprinkle it on the area. Finally, cook the turtle meat as soup and eat it. Divine effect.
Treating Hemorrhoids Formula:
Ingredients: Ci Pi (Tribuli Fructus pericarpium), Xiong Huang (Realgar), Bei Ai (Artemisiae Argyi Folium).
Preparation: Grind into powder. Form moxa cones the size of walnuts. Use a bamboo tube, one cup in diameter, over a chi long, leaving one joint intact. Drill a hole and insert the cone. Burn the smoke to fumigate the sore through the hole. Itching may become unbearable; pause and resume later.
Washing Hemorrhoids and Fistulas (Transmitted by Chen Jiaoyu):
Ingredients: Hua Jiao (Zanthoxyli Pericarpium), Ai Ye (Artemisiae Argyi Folium), Cong Tou (Allii Cepae Bulbus), Wu Bei Zi (Gallae Chinensis), Pi Xiao (Natrii Sulfas), Ma Chi Cai (Portulacae Herba), Qie Gen (Solanis Melonganae Radix).
Preparation: Make into powder. Decoct in water. Fumigate first, then wash. Pain stops immediately; cure is imminent.
Zhui Feng Bu Shen Shi Lou Shi Jin Dan (Wind-Chasing Kidney-Tonifying Ten-Leak Ten-Gold Pill): Treats fistulas. Prepared on the Removal Day of Geng-Shen or Jia-Zi years.
Ingredients: Dang Gui (Angelicae Sinensis Radix, 2 liang), Ren Shen (Ginseng Radix, 1 liang), Sheng Di (Rehmanniae Radix, 1 liang), Shu Di (Rehmanniae Radix preparata, 2 liang), Mai Men Dong (Ophiopogonis Tuber, 2 liang), Po Gu Zhi (Psoraleae Fructus, 2 liang), Xiao Hui (Foeniculi Fructus, 1 liang), Da Hui (Illicii Fructus, 3 liang), Rou Cong Rong (Cynomorii Herba, 2 liang), Shan Yao (Dioscoreae Rhizoma, 2 liang), Bai Fu Ling (Poria, 2 liang), Lu Rong (Cervi Cornu Pantotrichum, 1 liang), Da Fu Zi (Aconiti Lateralis Radix Preparata, one piece), Chuan Wu (Aconiti Radix, 1 liang), Ding Xiang (Caryophylli Flos, 5 qian), Mu Xiang (Aucklandiae Radix, 1 liang), Qing Mu Xiang (Costi Radix, 1 liang), Sha Ren (Amomi Fructus, 1 liang), Hou Po (Magnoliae Officinalis Cortex, 1 liang), Qing Pi (Citri Reticulatae Pericarpium Viride, 1 liang), Chen Pi (Citri Reticulatae Pericarpium, 1 liang), Zhi Ke (Aurantii Fructus, 2 liang), Zhi Shi (Aurantii Fructus Immaturus, 3 liang), Xiang Fu (Cyperi Rhizoma, 4 liang), Wu Yao (Linderae Radix, 1 liang), Bai Zhi (Angelicae Dahuricae Radix, 2 liang), Rou Dou Kou (Myristicae Semen, 1 liang), Tian Ma (Gastrodiae Rhizoma, 1 liang), Xing Ren (Pruni Semen, 2 liang), Song Jie (Pinus Massoniana Node, 4 liang), Pi (Arsenicum, 5 qian), Ru Xiang (Olibanum, 1 liang), Mo Yao (Myrrha, 1 liang).
Preparation: Grind into powder, make pills with refined honey, size of bullet. Coat with gold foil. Take one pill, dissolve in wine on an empty stomach.
Commentary: Methods for treating hemorrhoids mainly involve cooling blood and clearing heat. For treating fistulas, early stages require cooling blood and drying dampness; late stages require astringing orifices and killing parasites, combined with warming and dispersing methods. Some ask: If hemorrhoids and fistulas belong to Fire, why use warming and astringent drugs? In fact, hemorrhoids involving bleeding are always Heat; fistulas discharging pus start as Damp-Heat but end as Cold-Dampness. Although this formula is warming and dispersing, it also tonifies. Thus, Zhu Danxi said: Fistulas should primarily be treated with major tonification of Qi and Blood, which is well-founded.