脉沉小实者。易治。浮洪而软弱者。难愈。
夫痔漏之原。由乎酒色过度。湿而生热。充乎脏腑。溢于经络。坠于谷道之左右。冲突
为痔。久而成漏者也。痔轻而漏重。痔实而漏虚。治痔之法。不过凉血清热而已。
至于治漏。初则宜凉血清热燥湿。久则宜涩窍杀虫。而兼乎温散也。或曰。痔漏火是根
原。
何故而用温涩。殊不知痔止出血。始终是热。漏流脓水。始是湿热。终是湿寒。不用温药。
何以去湿而化寒乎。非止痔漏。百病中多有始热百终寒者。如泻痢。如呕吐。初作则肠胃气
实而热。久则肠胃气虚而为寒矣。一论痔疮肿痛初起。立效。
祛风解毒汤
黄连（一钱） 黄芩（一钱） 连翘（一钱五分） 赤芍（一钱） 枳壳（麸炒一钱） 大黄（酒蒸
一钱五分） 苦参（一钱五分） 黄柏（一钱） 槐花（一钱）
上锉。水煎。空心服。为末。水泛为丸。用温水下。亦可。
一论内经曰。二阴皆属肾。虽见症于大肠。实阴虚而火盛也。
祛毒养荣汤
当归（一钱） 芍药（二钱） 生地黄（酒洗一钱） 黄连（酒炒一钱五分） 黄芩（一钱） 黄
柏（酒炒五分） 知
母（一钱） 连翘（一钱） 升麻（五分） 荆芥（一钱） 槐角（二钱） 皂角子（二钱） 皂
角刺（二钱） 天花粉（二钱） 黄 （一钱） 人参（一钱） 甘草节（一钱）
上锉一剂。水煎。空心热服。远酒色。则全愈。
一论千金不换刀圭散。治痔漏百发百中。（方见中风）
一论专治通肠痔漏。
济生莲蕊散
莲蕊（焙一两） 当归（五钱） 五倍子（五钱） 黄连（五钱） 乳香（五钱） 没药（五钱）
矾红（四两） 黑丑头末（炒一两） 锦纹大黄（半生半熟一两）
上共九味。为细末。欲服药。前一日勿食晚饭。次日空心。用淡猪肉汁一钟。好酒一钟
半。
和猪肉汁煎。称药一钱二分调服。午后。于干净黄土上。大便见紫血为验。或如烂杏。五色
相杂。亦为验矣。如散药难服。用酒糊丸。如绿豆大。每服一钱五分。淡猪肉汤下。此方神
效。不可轻忽。切忌烧酒色欲。发物鱼羊犬肉。
一论治痔漏累验。
皮丸 长葛张明山传。
刺 皮（一个连刺酒浸炙干） 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（十个内取膈三十六片）
上为细末。醋糊为丸。如梧桐子大。每服二十五丸。白汤或酒。早晚二服。一月后平复
神效。
一论凡人衣食丰饶。患痔必由于饮食色欲所致。及有乘酒醉犯房。欲要除根。必须服此
滋阴补内之药。大戒醇酒浓味。寡欲可也。
脏连固本丸
怀生地黄（六两） 山药（四两） 山茱萸肉（四两） 白茯苓（去皮三两） 牡丹皮（三两）
泽泻
（一两） 黄连（四两） 黄柏（去皮四两） 槐角（三两） 知母（去毛三两） 人参（三两）
当归（二两） 皂角（二两） 天花粉（二两）
上各为细末。用雄猪大肠一段。去脂油。灌药末于内。两头丝线
缚住。用糯米二升煮饭。将半熟时。捞起。去汤。将药肠盘藏于饭中。如蒸饭已熟。待
取出。去两头无药线缚之肠。将药肠入净石臼内杵烂。拣出肠渣筋。如不粘。加些饭杵之好
丸如梧桐子大。晒干。每服百丸。白滚水送下。
一论痔漏多年不瘥之神方也。
收功补漏丸 临川徐学韦验。
白茯苓（去皮） 赤茯苓（去皮） 没药（各二两） 破故纸（四两）
上药。俱不犯铁器。于石臼捣成块。春秋酒浸三日。夏二日。冬五日。取出。木笼蒸熟
晒
干为末。酒糊为丸。如梧桐子大。每服二十丸。缓缓加至五十丸。空心。温酒送下。予尝以
此方。加入全料六味地黄丸。同作一处。同丸服。治年久漏不愈者。一料全愈。
一论漏疮。先须用补药。以补气血。参、 、归、术为主要。大剂服之。外以附子为细
末
津调作饼子。如铜钱浓。以艾火灸之。漏大者艾炷亦大。漏小者艾炷亦小。灸令微热。不
可令痛。饼干即易之。再和再灸。又以补气血药。作膏贴之。
一论痔疮。脓血淋漓。口干作渴。晡热便血。自汗盗汗。以益气汤加茯苓、半夏、炮干
姜。脾胃渐醒。后以六味丸兼进而愈。一治莲花痔疮。余绍坪得效。
黄连（三钱） 乌梅（三十个） 大黄（三钱） 穿山甲（炒三钱）
上锉。水煎。空心服。
If the pulse is deep, small, and solid, it is easy to treat. If the pulse is floating, surging, yet weak and soft upon pressure, it is difficult to cure.
The origin of hemorrhoids (hemorrhoids) and fistulas (anal fistula) lies in excessive indulgence in alcohol and sexual activity, leading to dampness generating heat. The pathogenic factors fill the Zang-Fu organs and overflow into the meridians, descending to both sides of the anus (Gu Dao). Conflict and stagnation of Qi and blood form hemorrhoids, which, if left untreated for a long time, develop into fistulas. Hemorrhoids are generally mild while fistulas are severe; hemorrhoids tend to be excess patterns whereas fistulas tend to be deficiency patterns. The treatment for hemorrhoids mainly involves cooling the blood and clearing heat. As for treating fistulas, initially, one should use herbs that cool the blood, clear heat, and dry dampness. For chronic cases, one should use astringents to close the orifice and eliminate parasites, combined with warming and dispersing methods. One might ask: Since fire (heat) is the root cause of hemorrhoids and fistulas, why use warming and astringent drugs? It is unknown that hemorrhoids merely involve bleeding and are always heat patterns; fistulas discharge pus and water, starting as damp-heat but eventually turning into damp-cold. Without using warming medicines, how can one remove dampness and transform cold? This applies not only to hemorrhoids and fistulas but also to many other diseases where the initial stage is heat and the final stage is cold. For example, diarrhea and dysentery, or vomiting: initially, there is excess Qi and heat in the stomach and intestines, but over time, Qi deficiency leads to cold.
First discussion: For the initial onset of swelling and pain in hemorrhoids, there is an instantly effective prescription called Qufeng Jiedu Tang (Wind-Dispersing and Toxin-Resolving Decoction).
Ingredients: Coptidis Rhizoma (Huanglian, 1 qian), Scutellariae Radix (Huangqin, 1 qian), Forsythiae Fructus (Lianqiao, 1.5 qian), Paeoniae Radix Rubra (Chishao, 1 qian), Aurantii Fructus (Zhike, bran-fried 1 qian), Rhei Radix et Rhizoma (Dahuang, wine-steamed 1.5 qian), Sophorae Flavescentis Radix (Kushen, 1.5 qian), Phellodendri Cortex (Huangbai, 1 qian), Sophorae Flos (Huaihua, 1 qian).
Preparation and Administration: Coarsely crush the ingredients, decoct in water, and take on an empty stomach. Alternatively, grind into powder, make pills with water, and swallow with warm water. This method is also acceptable.
Second discussion: The *Neijing* states, "Both Yin openings belong to the Kidney." Although symptoms manifest in the Large Intestine, the root is actually Yin deficiency with flourishing Fire. Prescription name: Qudu Yangrong Tang (Toxin-Clearing and Nutritive-Qi-Nourishing Decoction).
Ingredients: Angelicae Sinensis Radix (Danggui, 1 qian), Paeoniae Radix (Shaoyao, 2 qian), Rehmanniae Radix Recens (Shengdihuang, wine-washed 1 qian), Coptidis Rhizoma (Huanglian, wine-fried 1.5 qian), Scutellariae Radix (Huangqin, 1 qian), Phellodendri Cortex (Huangbai, wine-fried 0.5 qian), Anemarrhenae Rhizoma (Zhimu, 1 qian), Forsythiae Fructus (Lianqiao, 1 qian), Cimicifugae Rhizoma (Shengma, 0.5 qian), Schizonepetae Spica (Jingjie, 1 qian), Sophorae Fructus (Huaijiao, 2 qian), Gleditsiae Sinensis Fructus (Zaocaozi, 2 qian), Spina Gleditsiae Sinensis (Zaocaoci, 2 qian), Trichosanthis Radix (Tianhuafen, 2 qian), Astragali Radix (Huangqi, 1 qian), Ginseng Radix et Rhizoma (Renshen, 1 qian), Glycyrrhizae Radix et Rhizoma cum Sarcina (Gancao jie, 1 qian).
Preparation and Administration: Take one dose, coarsely crush, decoct in water, and take hot on an empty stomach. Abstain from alcohol and sexual activity for complete recovery.
Third discussion: Qianjin Buhuan Dao Guisan (Thousand-Gold Unexchangeable Dao Gui Powder) treats hemorrhoids and fistulas with 100% efficacy. (See the Stroke chapter for the formula.)
Fourth discussion: A prescription specifically for trans-intestinal hemorrhoids and fistulas, named Jisheng Lianrui San (Jisheng Lotus Stamen Powder).
Ingredients: Nelumbinis Plumula (Lianrui, roasted/dried 1 liang), Angelicae Sinensis Radix (Danggui, 5 qian), Terminalia Chebulae Fructus (Wubeizi, 5 qian), Coptidis Rhizoma (Huanglian, 5 qian), Boswelliae Resina (Ruxiang, 5 qian), Myrrha (Moyao, 5 qian), Alum Red (Fan Hong, 4 liang), Morning Glory Seed (Heiqiu tou mo, fried 1 liang), Rheum Palmatum (Jinwen Dahuang, half raw half cooked 1 liang).
Preparation and Administration: Grind the nine ingredients into fine powder. On the day before taking the medicine, do not eat dinner. On the next morning, on an empty stomach, mix light pork broth (one cup) and good liquor (one and a half cups). Boil this mixture, then add 1.2 qian of the powder and take it. In the afternoon, if passing purple blood on clean yellow earth, or discharging foul matter resembling rotten apricots with mixed colors, these are signs of efficacy. If the powder is hard to take, make pills with wine paste, size of mung beans, take 1.5 qian per dose with light pork soup. This formula is miraculous; do not neglect it. Strictly avoid distilled spirits, sexual indulgence, and triggering foods such as fish, mutton, and dog meat.
Fifth discussion: A repeatedly effective prescription for hemorrhoids and fistulas, named Pi Wan (Bark Pills), transmitted by Zhang Mingshan of Changge.
Ingredients: Fatsia Japonici Cortex (Ci Pi, one piece with spines, soaked in wine and roasted dry), Angelicae Sinensis Radix (Danggui, wine-washed 2 liang), Sophorae Fructus (Huaijiao, wine-soaked and fried 2 liang), Coptidis Rhizoma (Huanglian, wine-fried 2 liang), Lycii Cortex (Digupi, wine-fried and dried 2 liang), Glycyrrhizae Radix et Rhizoma (Gancao, honey-roasted 2 liang), Boswelliae Resina (Ruxiang, 2 qian), Juglans Regia Semen (Hetao, ten nuts, taking 36 pieces of the internal septum).
Preparation and Administration: Grind into fine powder, make pills with vinegar paste, size of sophora seeds. Take 25 pills per dose with plain water or wine, morning and evening. After one month, the condition resolves with miraculous effect.
Sixth discussion: People with abundant food and clothing who suffer from hemorrhoids usually do so due to rich diet and sexual excess. If one engages in intercourse after getting drunk, to eradicate the root, one must take Yin-nourishing and interior-tonifying medicines. Strictly abstain from strong wine and rich flavors, and practice moderation in desire. Prescription name: Zanglian Guben Wan (Intestine-Connected Root-Solidifying Pills).
Ingredients: Rehmanniae Radix Preparata (Huai Sheng Dihuang, 6 liang), Dioscoreae Rhizoma (Shanyao, 4 liang), Corni Fructus (Shanzhuyu rou, 4 liang), Poria (Baifuling, peeled 3 liang), Moutan Cortex (Mudanpi, 3 liang), Alisma Rhizoma (Zexie, 1 liang), Coptidis Rhizoma (Huanglian, 4 liang), Phellodendri Cortex (Huangbai, peeled 4 liang), Sophorae Fructus (Huaijiao, 3 liang), Anemarrhenae Rhizoma (Zhimu, de-haired 3 liang), Ginseng Radix et Rhizoma (Renshen, 3 liang), Angelicae Sinensis Radix (Danggui, 2 liang), Gleditsiae Sinensis Fructus (Zaocao, 2 liang), Trichosanthis Radix (Tianhuafen, 2 liang).
Preparation and Administration: Grind each ingredient into fine powder. Take a segment of male pig large intestine, remove the fat, and stuff the powder inside. Tie both ends with silk thread. Cook two sheng of glutinous rice. When the rice is half-cooked, remove it, drain the water, and place the stuffed intestine in the middle of the rice to steam together until fully cooked. Remove, discard the untied ends, and pound the stuffed intestine in a clean mortar until smooth. Pick out intestinal fibers. If not sticky enough, add some cooked rice and pound again. Make pills size of sophora seeds, dry in the sun. Take 100 pills per dose with boiling water.
Seventh discussion: A divine formula for hemorrhoids and fistulas that have persisted for years without healing, named Shougong Bulou Wan (Merit-Accumulating Fistula-Repairing Pills), verified by Xu Xuewei of Linchuan.
Ingredients: Poria (Baifuling, peeled), Poria (Chifuling, peeled), Myrrha (Moyao, 2 liang each), Psoraleae Fructus (Poguzhi, 4 liang).
Preparation and Administration: Do not let these herbs touch iron vessels. Pound into chunks in a stone mortar. Soak in wine for three days in spring/autumn, two days in summer, five days in winter. Remove, steam in a bamboo steamer until cooked, dry, and grind into powder. Make pills with wine paste, size of sophora seeds. Take 20 pills per dose, gradually increasing to 50 pills, on an empty stomach with warm wine. I once added this formula to the complete Six-Ingredient Rehmannia Pill (Liujun Diwan), made them together, and took them. For chronic non-healing fistulas, one course of treatment resulted in complete cure.
Eighth discussion: For fistula sores, one must first use tonifying medicines to replenish Qi and Blood, primarily using Ginseng Radix et Rhizoma (Renshen), Astragali Radix (Huangqi), Angelicae Sinensis Radix (Danggui), and Atractylodis Macrocephalae Rhizoma (Baizhu). Take large doses. Externally, grind Aconiti Lateralis Radix Preparata (Fuzi) into fine powder, moisten with saliva to make cakes, thickness like a copper coin. Moxibustion with moxa cones. Larger fistulas require larger moxa cones; smaller ones require smaller cones. Moxa until slightly warm, not painful. Replace the cake when dry, re-moisten, and moxa again. Also apply a plaster made of Qi and Blood tonifying medicines.
Ninth discussion: For hemorrhoids with dripping pus and blood, dry mouth and thirst, afternoon fever, hematochezia, spontaneous sweating, and night sweats, use Yiqi Tang (Qi-Benefiting Decoction) plus Poria (Fuling), Pinelliae Tuber (Banxia), and Prepared Zingiberis Rhizoma (Pao Ganjiang). Once the Spleen and Stomach function gradually recovers, follow up with Liujun Diwan (Six-Ingredient Rehmannia Pill) combined for recovery.
Tenth discussion: Treating Lotus-shaped hemorrhoids, achieved effectiveness by Yu Shaoping.
Ingredients: Coptidis Rhizoma (Huanglian, 3 qian), Pruni Mume Fructus (Wumei, 30 pieces), Rhei Radix et Rhizoma (Dahuang, 3 qian), Manis Squama (Chuanshanjia, fried 3 qian).
Preparation and Administration: Coarsely crush, decoct in water, and take on an empty stomach.