Library

Rectal prolapse refers to a condition where the rectal mucosa, anal canal, full thickness of the rectum, or even part of the sigmoid colon shifts downward and protrudes outside the anus. If there is excess heat in the Lung channel, it leads to constipation; if there is deficiency cold in the Lung channel, it leads to prolapse. The treatment should utilize Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), with Qianghuo (Notopterygii Rhizoma et Radix), Baishao (Paeoniae Radix Alba), and Wei Jiang (Prepared Ginger) added as the primary formula. If the prolapsed tissue is crimson red and painful, this indicates blood deficiency with internal heat; auxiliary treatment with Mudanpi (Moutan Cortex) and Siwu Tang (Four Substances Decoction) is appropriate. If the color is slightly red and painful, this indicates qi deficiency with internal heat; auxiliary treatment with Mudanpi and Sijunzi Tang (Four Gentlemen Decoction) is appropriate. Further carefully examine the hands and feet: warmth of the fingers belongs to Stomach heat, while coldness of the fingers belongs to Stomach cold; one should exercise discretion in handling these cases. If caused by accumulated heat, use Shengma (Cimicifugae Rhizoma) 1 liang and Huangqin (Scutellariae Radix) 6 qian, decocted in water for oral administration.

Gexiao San (Clam and Niter Powder): Used to wash the prolapsed anus. Take Wen Ge (Venerable Clam Shell) 4 liang, add 5 bowls of water, decoct into a soup, then add Puxiao (Mirabilite) 4 liang. Wash the area with the solution while it is warm enough to tolerate with the hand, stopping only when the liquid becomes cold. If heat and pain are felt, apply Xiongdan (Ursus Bile) mixed with Bingpian (Borneolum Syntheticum) dissolved in water. Alternatively, use Shou Gang San (Anus Retention Powder) (see Hemorrhoids and Fistula section). Another method is to use Lychee Seed powder to support the prolapse; another method is to use aged pickled radish slices to support it; yet another method is to apply Kangong Dingzi (Kangong Plaster).

Anal pruritus is caused by parasitic pathogens. Inspect the inner aspect of the lower lip; small sores will definitely be present there. Alternatively, small nodules may appear anterior and posterior to the ears, resembling beads on a string; this is the manifestation of parasitic erosion. Ancient texts state: "Sores on the lower lip indicate parasites eroding the anus." It is suitable to administer Jiwei Lujian Wan (Nine-Ingredient Aloe Pill). Externally, apply Xionghuang (Realgar) and Tonglv (Chrysocolla) ground into equal parts as powder. Lucang Wan (see Scrofula section).

Yidu (Congenital Venereal Poison/Hereditary Toxin) initially presents as dot-like lesions, which subsequently develop into ulcerated patches. In severe cases, the corners of the mouth, eye sockets, face, nose, and anus are all affected. Transmission from the wet nurse results in mild disease, whereas inheritance from parents' congenital toxin results in severe disease. At birth, mix Bai Fan (Alumen) well water, have the mother hold the mixture in her mouth to suckle the affected area of the infant, changing after each suction, to concentrate the toxin in one place, then apply Zijin Ding (Purple Gold Plaster) rubbed from water. If the skin is broken, apply Huangbai (Phellodendri Cortex) that has been honey-fried and powdered; if dry, mix with sesame oil for application. Internally, administer Renzhong Huang (Human Urine Sediment) powder, a small amount each time, five to seven times daily, taken with Tu Fuling (Smilacis Glabrae Rhizoma) decoction. Alternatively, administer Erhuang San (Two-Yellow Powder). For further reference, consult the chapter on Measles with Complicated Sores.

Erhuang San (Two-Yellow Powder): Treats pediatric Yidu. Niuhuang (Bovis Calculus) (7 fen), Huhuanglian (Picrorhizae Rhizoma), Shancigu (Swertiae Herba) (each 2 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (1.5 qian). Grind the above ingredients into a fine powder. Each dose is 2–3 qian, taken with honey water. Zijin Ding (Purple Gold Plaster).