Library

There are cases of rectal prolapse where, upon defecation, the rectum protrudes and refuses to retract. Over time, this leads to a sensation of obstruction and pain. People attribute this to intestinal deficiency causing sinking, but who knows that it is actually due to the decline of Yang Qi (vital energy), which fails to lift and support?

The condition of rectal prolapse often originates from Spleen Deficiency Diarrhea (chronic diarrhea due to spleen weakness). Frequent diarrhea consumes Yin fluids (body fluids and essence). When Yin is depleted, it inevitably leads to a sensation of bearing down, and Qi also sinks. Consequently, the damp-heat filth within the intestines cannot be expelled quickly, causing discomfort. The patient then strains with weak effort; if the straining is excessive, the rectum follows the strain and prolapses.

Once the damp-heat pathogenic factors have been exhausted and the rectal prolapse is established, it is necessary to lift and raise Yang Qi, assisted by agents that remove dampness and clear heat. However, lifting Qi requires Qi-tonifying herbs for effective elevation; tonifying Qi without lubricating the intestines leaves the anus prone to prolapse. The key lies in combining these approaches. The prescription Ti Chang Tang (Intestine-Lifting Decoction) is used: Ren Shen (Ginseng Radix, 3 qian), Huang Qi (Astragali Radix, 5 qian), Dang Gui (Angelicae Sinensis Radix, 3 qian), Bai Shao (Paeoniae Radix Alba, 1 liang), Sheng Ma (Cimicifugae Rhizoma, 1 qian), Fu Ling (Poria, 3 qian), Huai Mi (Sophorae Flos, 1 qian), Yi Ren (Coicis Semen, 5 qian). Decoct in water and take orally. After four doses, the anal canal gradually rises and retracts. After another four doses, prolapse ceases.

This formula tonifies Qi to lift it, raising Qi to the Upper Jiao (Upper Burner), thereby dispersing stagnation throughout the body. Lubricating the intestines makes them smooth, allowing damp-heat to dissipate naturally.

This condition can also be treated with Jia Wei Bu Xue Tang (Modified Blood-Nourishing Decoction): Huang Qi (Astragali Radix, 5 qian), Dang Gui (Angelicae Sinensis Radix, 5 qian), Sheng Ma (Cimicifugae Rhizoma, 1 qian), Bei Wu Wei Zi (Schisandrae Chinensis Fructus, 10 grains). Take continuously for ten doses for complete recovery.

In some cases, rectal prolapse occurs even without defecation, accompanied by severe pain. People attribute this to Qi deficiency and sinking, but who knows that it is caused by the rushing and forcing action of Fire in the Large Intestine?

The Large Intestine belongs to Metal and is originally associated with the Lung. The Lung and Large Intestine are exterior-interior pairs, closely related. Unable to withstand the burning of Fire, the Large Intestine seeks relief from the Lung. However, the Lung resides above the diaphragm, too distant to provide immediate aid. Thus, the Fire descends to the anus as a temporary refuge. Since the anus is governed by the Lung, and the Large Intestine fears Fire, does the anus not fear Fire as well? Moreover, the Po Men (Anal Orifice) and the Large Intestine share similar Qi and help each other in distress. How could they bear to abandon each other? Therefore, the anus willingly yields its space, moving out of bounds to avoid the Fire, which explains why the anus and rectum protrude outside the anal opening. The pain arises because the Fire burns and damages the tissue, lacking fluid nourishment, leading to dryness and increased pain.

For such diseases, using lifting methods is completely ineffective and only increases suffering. Lifting herbs are mostly Yang-natured substances; increasing Yang exacerbates Yin deficiency, and Yin deficiency intensifies Fire. How could there be any hope of efficacy? The treatment should urgently purge the Fire in the intestines. Once the Fire subsides, the Metal element (Lung/Large Intestine Qi) will naturally return. However, the Fire in the Large Intestine does not originate solely within it. Stomach Fire excess leads to Large Intestine Fire excess; Kidney Water dryness leads to Large Intestine Water dryness. If one treats only the Large Intestine Fire without purging Stomach Fire, or treats only Large Intestine Water without nourishing Kidney Water, the Large Intestine Water will not generate, and the Fire will not cease. How can Large Intestine Qi return to the abdomen and the rectal tube return inside? The prescription Gui Chang Tang (Intestine-Returning Decoction) is used: Xuan Shen (Scrophulariae Radix, 1 liang), Shi Gao (Gypsum Fibrosum, 3 qian), Shu Di Huang (Rehmanniae Radix Preparata, 1 liang), Dan Pi (Moutan Cortex, 3 qian), Dang Gui (Angelicae Sinensis Radix, 3 qian), Di Yu (Sanguisorbae Radix, 3 qian), Huai Hua (Sophorae Flos, 2 qian), Jing Jie (Schizonepetae Spica, stir-fried black, 3 qian). Decoct in water and take orally. Pain stabilizes after one dose, the intestine rises after two doses, and full recovery occurs after three doses.

This formula treats both the Stomach and Kidney simultaneously, clearing Fire from the Large Intestine. As long as the source of water is uninterrupted, Fire will naturally dissipate. Is it not inevitable that the guest (Fire) departs and the host (Qi) returns? This is a necessary principle.

Yu Di Xuan Gui Tang (Diyu-Xuanshen-Danggui Decoction) is also effective for this condition: Di Yu (Sanguisorbae Radix, 3 qian), Dang Gui (Angelicae Sinensis Radix, 1 liang), Xuan Shen (Scrophulariae Radix, 1 liang), Sheng Di Huang (Rehmanniae Radix Recens, 1 liang). Decoct in water and take orally. Continuous use for ten doses results in complete recovery.