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[Section on Hemorrhoids and Fistulas, Case 1]
In some individuals, red nodules suddenly appear around the inside and outside of the anus. Initially, there is itching followed by pain, eventually developing into hemorrhoids. If these persist for a long time without healing, this condition is caused by Damp-Heat (Shi Re). The etiology often involves excessive indulgence in alcohol. People in the Jiangnan region frequently suffer from this due to the local humid and hot climate combined with the toxic heat generated by drinking alcohol, causing accumulation at the anal margin that cannot be quickly resolved. The anus connects to the Large Intestine (Da Chang); normally, Damp-Heat should be expelled with stool. Why does it accumulate to form hemorrhoids? Because Damp-Heat cannot remain long in the Large Intestine and inevitably trends toward the anus. The anus serves as the lock and key of the Large Intestine, possessing a closing and defensive function that prevents Damp-Heat from directly exiting outward. Consequently, accumulated Damp-Heat toxin is borne solely by the anus. Toxins must manifest externally; thus, hemorrhoids do not form inside the anus but outside. Although internal and external presentations differ slightly, the suffering is identical. However, how can treatment abandon clearing Damp-Heat to seek other methods? Since the anus is distant from the Spleen and Stomach, resolving Damp-Heat toxins necessarily passes through the Spleen and Stomach. This may harm the Spleen and Stomach before benefiting the anus, leading to failure. Therefore, medication must benefit the anus without damaging the Spleen and Stomach to achieve efficacy. Use Yi Hou Tang: Poria (Fu Ling, 1 liang), White Peony Root (Bai Shao, 1 liang), Sanguisorba Root (Di Yu, 3 qian), Pangolin Scales (Chuan Shan Jia, 1 slice, stir-fried with earth and powdered), Chinese Yam (Shan Yao, 1 liang), Coix Seed (Yi Ren, 1 liang). Decoct in water.
After taking four doses, the anus feels relaxed and comfortable. After another four doses, internal and external hemorrhoids completely disappear. Then, increase each ingredient of the previous formula tenfold, process into pills or powders, and bind with honey. Take 5 qian with boiling water before drinking alcohol. One course will naturally result in complete cure and no recurrence.
This formula promotes urination to remove Damp-Heat, harming neither the Spleen and Stomach nor failing to benefit the anus, achieving both goals.

[Section on Hemorrhoids and Fistulas, Case 2]
Some individuals first develop small boils near the anus. Due to lack of restraint regarding alcohol and sexual activity, these rot and transform into hemorrhoidal fistulas that fail to close. Meat tubes (fistulous tracts) subsequently grow, one per year, discharging pus and blood, causing great suffering. Common treatments use knives, needles, or ligature threads, subjecting patients to pain while internal toxins remain unremoved and external wounds fail to heal, yielding little result over years. Are fistulas truly incurable? Or is it due to laxity in abstaining from alcohol and sex, and improper treatment? The flesh and skin of the anus differ from other body parts. Other skin and muscle tissues grow either horizontally or vertically. Anal tissue has both orientations, making healing difficult. Moreover, frequent passage of stool combined with knife/needle/ligature trauma makes such invasive methods inadvisable. Eliminating Damp-Heat toxin via internal regulation is superior. However, long-standing fistulas damage Qi and Blood, hindering recovery. Thus, tonifying Middle-Jiao Qi while dissipating toxicity is effective. Use Qing Gui Wan: Turtle Shell and Flesh (Qing Gui, 1 whole), Poria (Fu Ling, 5 liang), Coix Seed (Yi Ren, 6 qian), Sheep Hind Hooves (Yang Ti Hou Zhua, 4 pairs), Pangolin Scales (Chuan Shan Jia, 5 qian, all stir-fried with earth), Ginseng (Ren Shen, 2 liang), Green Moss (Qing Tai, dried, 1 liang), Astragalus Root (Huang Qi, 8 liang), Angelica Sinensis (Dang Gui, 3 liang), Wall Pine (Wa Song, 2 strips, air-dried, not roasted), Angelica Dahurica (Bai Zhi, 1 liang), Sophora Flower Bud (Huai Mi, 1 liang). Powder all ingredients. Crush the turtle in a stone mortar, mix with powder, steam in a rice cooker until cooked. Dry the turtle meat and shell by fire, powder them, and mix with the other powders. Bind with honey into pills. Take 3 qian daily. After one month, the fistula dries; after two months, it fills and heals; completing the course ensures cure and no recurrence. During medication, live separately and abstain from alcohol and sex for three months. Failure to abstain renders treatment ineffective; caution is required.
This formula is uniquely effective for fistulas, unlike common prescriptions. It removes dampness without dispersing Qi, defeats toxins without damaging Blood, repairs invisibly, and fills gaps visibly. I urge people to respect and take this formula, observing the three-month abstinence to cure decade-long diseases.

[Section on Hemorrhoids and Fistulas, Case 3]
Some individuals spray a small amount of blood before defecation. Laypeople assume this is hematochezia, but it is actually hidden blood hemorrhoids in the anus. Long-standing hemorrhoids typically transform into fistulas discharging pus and blood. However, differing etiologies yield different symptoms. This condition often results from excessive consumption of distilled spirits. Heat travels to the rectum but cannot be quickly excreted, forming small, unresolving hemorrhoids. Over time, the mucosa breaks, causing bleeding. This blood exits from outside the rectum, not inside, originating from the Bladder (Pang Guang). The Bladder governs Qi transformation, not Blood generation. Alcohol toxin penetrates the Bladder; while alcohol-Qi transforms into water and exits via the urethra, alcohol-toxin scorches Blood, preventing its exit via the urethra. Consequently, the toxin trends toward the Large Intestine and anus. With distinct pathways and secure gates, the toxin accumulates outside the rectum, attacking inward and generating rectal hemorrhoids. Hemorrhoids rupture, allowing Bladder blood to enter through the gap. Over time, blood attracts blood, drawing all Bladder blood here. When the anal sphincter opens during defecation, blood bursts out first, appearing as pre-defecation spraying, indicating urgency. Treatment should ideally fill the gap to block blood exit. However, once the leak opens, stopping only the lower outlet is insufficient; one must clear the upper source. Use Qing Yuan San: Coptis Rhizome (Huang Lian, 3 qian), Poria (Fu Ling, 5 qian), White Peony Root (Bai Shao, 5 qian), Kudzu Root (Ge Gen, 2 qian), Angelica Dahurica (Bai Zhi, 3 fen), Sophora Flower (Huai Hua, 3 qian), Sanguisorba Root (Di Yu, 3 qian), Ginseng (Ren Shen, 3 qian), Pangolin Scales (Chuan Shan Jia, stir-fried with earth and powdered, 1 qian), Atractylodes Macrocephala (Bai Zhu, 5 qian), Plantago Seed (Che Qian Zi, 2 qian), Notoginseng Root Powder (San Qi Gen Mo, 3 qian). Decoct in water, mix with powders. Take three doses; bleeding may initially increase. After three doses, remove Huang Lian, continue for three more doses until bleeding stops and hemorrhoids heal. Post-cure, strictly abstain from alcohol for life. Abstinence from sexual activity for three months suffices to prevent recurrence. If abstinence is impossible, treatment is futile; warn the patient beforehand.
The brilliance of this formula lies in the high dose of Huang Lian to resolve alcohol-heat toxin, clearing the source first. With the upper source clear, the lower flow remains calm. The herbs are well-balanced, focusing on removing dampness and transforming heat. No better blocking formula exists.

[Section on Hemorrhoids and Fistulas, Case 4]
Some individuals develop sores on the chest. Due to unrestrained alcohol and sexual activity, fistulous openings form, leaking blood continuously. Over time, spirit and form become exhausted, lower back pain prevents extension, and gait resembles kyphosis. Laypeople diagnose this as Heart Fistula (Xin Lou), but it is actually caused by Kidney Deficiency (Shen Xu). The Heart and Kidney are interconnected; Heart-Qi relies on Kidney-Qi for mutual generation, and Kidney-Qi relies on Heart-Qi for closure. Heart Fistula arises from Kidney-Qi leakage. To cure it, one must urgently treat Kidney-Qi deficiency. However, treating the Kidneys without closing Heart-Qi is like not tonifying at all, as there is egress without ingress. Some argue that since most fistulas stem from Damp-Heat, tonifying Kidneys without closing the Heart or removing Damp-Heat is ineffective. Yet, fistulas vary. Those elsewhere can be treated by draining Damp-Heat, but chest fistulas cannot. Chest Fistula stems from Kidney Deficiency, which causes Cold, not Heat. Kidney Deficiency implies deficient Kidney-Yin (Water), not excess pathogenic Water. Treatment should tonify True Yin to eliminate pathogenic water and warm Kidney-Cold to resolve apparent Damp-Heat. Use Wen Shen Dan: Deer Antler Velvet (Lu Rong, 2 pieces), Prepared Aconite Root (Fu Zi, 2 pieces), Blue Salt (Qing Yan, 2 liang), Ginseng (Ren Shen, 2 liang), Wall Leek (Wa Cong, 2 branches), Red Dates (Hong Zao, 4 liang). Powder all ingredients. Cook red dates until soft, mash, and bind into pills. Take 30 pills on an empty stomach with wine. Lower back pain reduces after half a month; Heart Fistula heals after over a month.
The miracle of this formula lies in Lu Rong, which benefits both Kidney Water and Fire and replenishes Heart deficiencies. Fu Zi’s pungent heat penetrates all meridians, guiding Lu Rong directly to the Heart and Kidneys to fill voids. Qing Yan’s salty nature consolidates and stops bleeding, crucial for fistulas with multiple holes. Wa Cong eliminates latent Damp-Heat invisibly, preventing pore obstruction despite the non-Damp-Heat nature of Heart Fistula. Ren Shen generates Qi between Heart and Kidney, assisting Lu Rong and Fu Zi in circulating throughout the body, ensuring success.