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Hemorrhoids, the term implies "stagnation," referring to the obstruction of Qi, blood, and body fluids. Both men and women can suffer from this condition. Those in wealth and status often contract it due to excessive alcohol consumption and sexual indulgence; those of humble status often due to overwork and irregular eating habits; monks and Taoist priests often due to overeating followed by prolonged sitting. The *Yellow Emperor's Inner Classic* states: "Due to overeating, tendons and vessels become slack, leading to intestinal dysentery which manifests as hemorrhoids." Here, "intestinal dysentery" refers to hemorrhoids. Women often develop them due to difficult childbirth, prolonged squatting or sitting, or during menstruation when anger injures the Liver and cold-dampness invades, causing residual blood to seep into the perianal region. Children may suffer from excessive intake of rich and greasy foods, chronic dysentery, or exposure to toxic factors in the womb. Generally, hemorrhoids are not necessarily caused by wine and lust; one must carefully investigate the specific etiology to treat accordingly, ensuring efficacy.

Although ancient texts classify hemorrhoids into five types, they all stem from the stagnation of Wind, Dampness, Dryness, and Heat pathogens, preventing the free flow and discharge of Qi, thereby forcing the Large Intestine. The "twenty-four types of hemorrhoids" describe their morphological variations, while the "five types" (Mao, Pin, Mai, Chang, Xue) represent the pathological origin. Those that have not ulcerated are called "hemorrhoids"; those that have ulcerated are called "fistulas." Additionally, there are eight other conditions: Qi-type, Wind-type, Cold-type, Blood-type, Rectal prolapse, and Mumps, each with its own treatment method detailed below. Readers are advised to keep this secret prescription confidential.

Zhitong Rushen Decoction (Pain-Relieving Divine Speed Decoction): This is a modified version of Qinjiao Cangzhu Tang.
Hemorrhoids invariably arise from Wind-Heat invading alongside food stagnation, causing Qi obstruction and forcing the Large Intestine. The pathogenic factor involved is Dryness, while the pathological basis involves Stomach Dampness. The combination of these four pathogens causes nodules and swelling at the head of the Large Intestine (Dampness); pain is caused by Fire; itching by Wind; and constipation by Dryness.

Ingredients: Qinjiao (*Gentianae Radix*, remove sprouts), Taoren (*Persicae Semen*, remove tips and skins, grind separately), Zaojiazi (*Gleditsiae Sinensis Fructus Spina*, calcined until carbonized but retaining properties, 1 qian each, ground), Cangzhu (*Atractylodis Rhizoma*, soaked in rice water and stir-fried), Fangfeng (*Saposhnikoviae Radix*, 7 fen each), Huangbai (*Phellodendri Cortex*, washed with wine, 5 fen), Dangguiwei (*Angelicae Sinensis Radix*, wine-washed), Zexie (*Alismatis Rhizoma*, 3 fen), Jianbinglang (*Arecae Semen*, 1 fen, ground separately), Shudahuang (*Rhei Radix et Rhizoma praeparated with wine, 1 qian*).
Prepare the herbs by cutting them, except for the first three ingredients which should be ground separately. Add two zhong (approx. 400 ml) of water, decoct to one zhong (approx. 200 ml), and filter out half (approx. 100 ml).
Add the three pre-ground powders to the liquid, decoct again to eight fen (approx. 160 ml), and take warm on an empty stomach. Strictly avoid raw/cold foods, Five Pungents (garlic, onion, chives, etc.), distilled spirits, animal liver, sausages, and damp wheat products.

If swelling is present with pus, add five white sunflower heads (*Helianthi Annuus Flos*, remove pistils), Qingpi (*Citri Reticulatae Pericarpium Viride*, 5 fen), and Muxiang (*Vladimiriae Radix*, 3 fen). Add these later during decoction; the pus will be expelled via stool with divine efficacy.
If severe constipation occurs, increase Dahuang (*Rhei Radix et Rhizoma*), Haren (*Cannabis Semen*), and Zhishi (*Aurantii Fructus Immaturus*).
If severe swelling occurs, add Huangbai (*Phellodendri Cortex*), Fangji (*Stephaniae Tetrandrae Radix*), Zexie (*Alismatis Rhizoma*), Zhuling (*Polyporus*), and Tiaohuangqin (*Scutellariae Radix*).
If severe pain occurs, add Qianghuo (*Notopterygii Rhizoma et Radix*) and Yuziren (*Prunella Fructus*).
If severe itching occurs, add Huangbai (*Phellodendri Cortex*), Qianghuo (*Notopterygii Rhizoma et Radix*), Fangfeng (*Saposhnikoviae Radix*), Gancao (*Glycyrrhizae Radix et Rhizoma*), Mahuang (*Ephedrae Herba*), and Gaoben (*Ligustici Chuanxiong Rhizoma*).
If heavy bleeding occurs, add Diyü (*Sanguisorbae Radix*), Huangbai (*Phellodendri Cortex*), Huaihua (*Sophorae Flos*), Jingjie Sui (*Schizonepetae Spica*), and Baizhi (*Angelicae Dahuricae Radix*).
If urinary difficulty, frequency, and obstruction occur, add Chifuling (*Poria cum Rhizomo Polypori*), Cheqianzi (*Plantaginis Semen*), Dengxincao (*Junci Medulla*), and Bianxu (*Polygoni Avicularis Herba*).