Library

[Da] Women suffering from hemorrhoids are often caused by emotional depression and anger, invasion of wind-heat, and excessive consumption of rich and greasy foods. There are five types: those with protrusions like nipples at the anal verge accompanied by pus discharge are called Pin Zhì (Female Hemorrhoid); those with swelling and bleeding are called Mu Zhì (Male Hemorrhoid); those with itching and pain are called Mai Zhì (Pulse Hemorrhoid); those with nodules are called Chang Zhì (Intestinal Hemorrhoid); and those with bleeding during defecation are called Xue Zhì (Blood Hemorrhoid). Treatment requires careful differentiation.

[Xue] The aforementioned conditions in women are often caused by pregnancy and childbirth, menstruation, improper diet and lifestyle, and imbalance of the Six Evils (Wind, Cold, Summer-heat, Dampness, Dryness, Fire) and Seven Emotions (Joy, Anger, Worry, Pensiveness, Sorrow, Fear, Fright). In men, they are often caused by sexual intercourse after drunkenness or overeating, leading to flaccidity of tendons and vessels, depletion of essence and qi, and invasion of heat-toxin due to deficiency. Or, forcing retention of essence during intercourse causes Liver Wood to overcome Lung Metal due to fire; or consuming roasted, fried, and strong-flavored foods leads to Yin deficiency with damp-heat. Treatment should employ cooling blood, moistening dryness, and dispersing wind. After ulceration, one must nourish Yuan Qi (Primal Qi) and tonify Yin essence. If not cured, it may become a fistula, spreading to the buttocks, genitals, or penetrating the intestine. Nodules at the anus indicate damp-heat; pain indicates wind; dry stool indicates fire; ulceration with pus indicates heat overwhelming blood. Pain during defecation requires moistening dryness and draining dampness. Heaviness and pain in the anus require purging fire and guiding out dampness. Astringent and stagnant urination requires clearing the Liver and guiding out dampness. The Classics state: "Due to overeating, tendons and vessels become flaccid, and the intestines transform into hemorrhoids." This syndrome belongs to insufficiency of the Liver and Kidney, so Jia Wei Di Huang Wan (Modified Rehmannia Pill) and Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) are effective. Do not apply toxic medicines or take cold-cooling agents.

Bie Jia San (Turtle Shell Powder) treats the five types of hemorrhoidal fistulas with dripping pus and blood, or hard swelling and pain with a bearing-down sensation.
Bie Jia (Testudo Skin), Lu Feng Fang (Honeycomb), She Tui (Snake Slough), Zhu Hou Xuan Ti Pi (Skin of Pig's Hind Hoof) (these five ingredients calcined until the original nature remains, each 2 qian), She Xiang (Musk) (0.1 fen).
Grind into powder. Take 1 qian per dose, mixed with decoction of Sheng Di Huang (Raw Rehmannia Root) taken on an empty stomach, combined with external application.

Another prescription: For heat and pain, use Han Shui Shi (Halloysitum Rubrum) and Po Xiao (Mirabilite) ground into powder, applied with saliva.

Treatment methods and prescriptions are detailed in the "Miscellaneous Diseases" section under Hemorrhoids; they are not repeated here.

[Da] Rectal prolapse is a manifestation of Large Intestine pathology. Deficient-cold of the Large Intestine causes Qi to sink, resulting in eversion of the anus; or straining during childbirth can also cause rectal prolapse.

[Xue] For the aforementioned condition, if it is damp-heat of the Large Intestine, use Sheng Yang Chu Shi Tang (Yang-Raising Damp-Draining Decoction). If it is blood-heat, use Si Wu Tang (Four-Substance Decoction) with Tiao Qin (Scutellariae Radix prepared strips) and Huai Hua (Sophorae Flos). If it is blood deficiency, use Si Wu Tang with Bai Zhu (Atractylodis Macrocephalae Rhizoma) and Fu Ling (Poria). If accompanied by hemorrhoidal pain, use Si Wu Tang with Huai Hua, Huang Lian (Coptidis Rhizoma), and Sheng Ma (Cimicifugae Rhizoma). For weakness due to wind-stroke, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with Shao Yao (Paeoniae Radix Alba) and Bai Zhu. For deficiency-cold of the Middle Qi, add Ban Xia (Pinelliae Rhizoma), Pao Jiang (Prepared Zingiberis Rhizoma), and Wu Wei Zi (Schisandrae Fructus). For Kidney deficiency, use Liu Wei Di Huang Wan. For deficiency-cold, use Ba Wei Di Huang Wan (Eight-Ingredient Rehmannia Pill). The Lung and Large Intestine are exterior-interior partners; the anus is the gate of the Large Intestine. Lung excess-heat causes constipation; Lung deficiency-cold causes prolapse. The Kidneys govern defecation; thus, this condition is common in cases of Lung and Kidney deficiency. A woman with rectal prolapse was cured after taking Bu Zhong Yi Qi Tang and Jia Wei Gui Pi Tang (Modified Spleen-Tonifying Decoction) for over a hundred doses each. Later, she suffered recurrence after delivery and was cured again after taking each prescription for over two hundred doses.

Sheng Yang Chu Shi Tang (Yang-Raising Damp-Draining Decoction) For symptoms manifesting downward, guide them upward.
Sheng Ma (Cimicifugae Rhizoma), Chai Hu (Bupleuri Radix), Fang Feng (Saposhnikoviae Radix), Shen Qu (Massa Medicata Fermentata) (stir-fried), Ze Xie (Alismatis Rhizoma), Zhu Ling (Polyporus), Cang Zhu (Atractylodis Rhizoma) (1 liang), Chen Pi (Citri Reticulatae Pericarpium), Gan Cao (Licorice Root) (honey-fried), Da Mai (Hordei Fructus) (each 3 qian; Sheng Ma, Chai Hu, Fang Feng, Shen Qu, Ze Xie, Zhu Ling each 0.5 liang).
Take 5 qian per dose, decocted in water, taken on an empty stomach. If there is Stomach cold with borborygmus, add Yi Zhi Ren (Alpiniae Oxyphyllae Fructus) and Ban Xia (0.5 qian each), decocted with Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus).

Yao Hezhong recommended applying Iron Powder (Tie Fen) externally for good results. (Sheng Hui Fang also treats vaginal prolapse and vulvar swelling.)
Ji Yan Fang uses three jin of raw iron boiled in ten dou of water down to five sheng; wash the area with the liquid twice daily.
Sun Simiao used Toad skin burned in a bottle to generate smoke for fumigation, which has profound efficacy.

Another prescription: Wash with decoction of Wu Bei Zi (Galla Chinensis), sprinkle Chi Shi Zhi (Kaolinite) powder on the area, and push it back in. If the prolapse is long, place two beds side by side leaving a gap of about one chi, fill a porcelain bottle with soup, and have the patient lie supine immersing the area in the bottle. Change daily until fully retracted.