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Bazhen Tang (Eight Treasure Decoction), Shiquan Dabuj Tang (Ten Complete Tonifying Decoction), Bawei Wan (Eight-Ingredient Pill) (all see the Ulcer Section).

The disease known as Zangdu (Visceral Toxin) arises from prolonged consumption of strong wine and rich, greasy foods, combined with excessive physical labor and hardship. This leads to accumulated toxins flowing into the anus, forming a mass. The disease is distinguished by internal versus external onset, and by deficiency versus excess patterns. External onset is mostly excess and heat; the pulse is rapid and forceful; the anus swells suddenly; stool is constipated; the abdomen feels distended and uncomfortable; urination is difficult. In severe cases, the flesh around the anus swells like a hoop, and the anal orifice is tightly closed. This is external onset, belonging to Yang patterns, which are easy to treat. It is appropriate to use Sishun Qingliang Yin (Four-Obedience Cooling Clearing Decoction) or Neixiao Woxue Tang (Internal Resolution Snow-Washing Decoction) to unblock both large and small bowels. For severe pain, Zhensan San (Pearl Powder) or Renzhongbai San (Human Tooth Ash Powder) should be applied externally. If pus has formed causing swelling and pain, needle drainage is indicated. Internal onset belongs to Yin deficiency with damp-heat seeping into the anus, causing masses in the five zang organs. Pain is stabbing and severe, like being struck by a bell; urination is dribbling; stool is constipated but due to deficiency; cough produces phlegm; the pulse is rapid, deficient, and thin; there is alternating chills and fever, worsening at night. This is internal onset, belonging to Yin patterns, which are difficult to treat. It is appropriate to use Siwu Tang (Four Substance Decoction) added with Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), Tianhuafen (Trichosanthis Radix), and Gancao (Licorice Root), combined with Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) for regulation. Condition will stabilize once pus from the five zang organs is discharged.

There are also those whose temperament is irritable and hasty, who indulge in rich foods, or who take tonics such as Baizhu (Atractylodis Macrocephalae Rhizoma). Accumulated toxins knot within the viscera, and fire-heat flows into the anus, forming a swelling. The pain radiates to the lower abdomen; the anus feels heavy and dragging; bowel and bladder functions are abnormal, presenting as either diarrhea or constipation; the interior of the anus erodes, damaging meridians and collaterals; foul fluid drains from the large opening. The patient is unable to eat and suffers extreme thirst. Those contracting this condition have no hope of survival.

Furthermore, chronic deficiency consumption with long-term coughing may cause phlegm-fire to knot in the anus like a chestnut. Once ruptured, it inevitably becomes a fistula; when qi and blood are exhausted, death ensues. These two conditions result from internal injury and cannot be cured by medicine; they must not be treated forcibly.

In the early stage, if swelling and pain present with bright red skin, intermittent pain, no sensation of anal heaviness, and normal bowel movements, the prognosis is good. If pus has formed, presenting with red swelling, fever without thirst, infrequent urination, and the ability to move freely with normal defecation, this is a favorable course. After ulceration, if pus is thick, fresh-colored, and odorless, swelling gradually subsides, pain decreases, and appetite returns, this is a favorable course. After ulceration, if discharge gradually stops, new tissue grows easily, pain is absent with predominant itching, and the wound dries quickly, this is a favorable course.

If in the early stage the swelling is hard and diffuse, accompanied by internal obstruction and pain, frequent urination, and constipation, the prognosis is dangerous. If pus has formed, with increasing pain daily, swelling extending to the lower abdomen, tight closure of the anus, and inability to pass gas, the condition is severe. If after ulceration foul fluid drips continuously, pain persists, swelling does not subside, and the body is hot with dry lips, this is an unfavorable course.