夫痔者滞也。盖男女皆有之。富贵者因于酒色。贫贱者劳碌饥饱。僧道者食饱而久坐。经云因而
饱食筋脉横解肠癖为痔。痔曰肠癖是也。妇女因产难久座。或经行时因气怒伤冷受湿。余血渗入肛边
而生。有小儿因过食浓味。或痢而久 。 或母腹中受毒。大抵痔疮不必缘于酒色也。宜详其原受之因而治之。自应验
矣。古书虽有五痔之分。而未尝离于风湿燥热四气郁滞。弗能通泄。气逼大肠所作也。然二十四痔。
言其形状也。五痔者牡痔牝痔脉痔肠痔血痔。乃病之源也。然未破名曰痔。已破者名曰 。 有八般
气风阴冷痔血 HT 痿腮等八症。各有治法于下。凡观者切之秘之。
止痛如神汤 即秦艽苍术汤加减。
凡痔所作必由风热乘食饱不通。气逼大肠而生。受病者燥气也。为病者胃湿也。四气相合。故大
肠头结而成块肿者。湿也。痛者火也。痒者风也。大便秘者燥也。
秦艽（去苗） 桃仁（去尖皮另研） 皂角子（烧存性各一钱研） 苍术（泔浸炒） 防风（各
七分） 黄柏（酒洗五分） 当归尾（酒洗） 泽泻（三分） 尖槟榔（一分另研） 熟大黄（一钱）
上咀除三味另研。药用水二钟。煎至一钟。二分。
入此三味。再煎至八分空心热服。切忌生冷五辛烧酒肝肠湿面等。
如肿有脓加白葵花五朵去蕊心。青皮五分。木香三分。随后入煎则脓从大便中出也如神。
如大便秘甚加大黄麻仁枳实。
如肿甚加黄柏防己泽泻猪苓条黄芩。
如痛甚加羌活郁李仁。
如痒甚加黄 羌活防风甘草麻黄 本。
如血下多加地榆黄柏槐花荆芥穗白芷。
如小便涩数不通者。加赤茯车前灯心 蓄。
痔疮，其义为“滞”，即气血津液运行不畅、阻滞之意。男女均可患有此病。富贵之人多因饮酒纵欲所致；贫贱之人多因劳累过度、饥饱不均引起；僧侣道士则常因饮食过饱而久坐不动。《黄帝内经》云：“因而饱食，筋脉横解，肠澼为痔。”这里的“肠澼”指的就是痔疮。妇女则多因分娩困难、久蹲久坐，或在月经期间因愤怒伤肝、感受寒湿，导致余血渗入肛门周围而生痔。小儿多因过量食用肥甘厚味，或因痢疾日久不愈，或母体在孕期受毒气影响所致。大抵来说，痔疮并非一定源于酒色之害，应当详细审察其具体的致病原因，然后针对性治疗，自然能够见效。
古代医书虽有“五痔”的分类，但并未脱离风、湿、燥、热四种邪气郁结阻滞，导致腑气不能通泄，逼迫大肠而形成的病理机制。所谓的“二十四痔”，是描述其形态特征的；而“五痔”（牡痔、牝痔、脉痔、肠痔、血痔）则是疾病的本源。尚未溃破的称为“痔”，已经溃破流脓血的称为“漏”。此外还有气痔、风痔、阴冷痔、血痔、脱肛、腮肿等八种病症，各自的治法如下。凡阅读此书的医者，务必将此秘法珍藏保密。
止痛如神汤：即在秦艽苍术汤基础上进行加减化裁而成。
凡是痔疮发作，必定是由于风热之邪侵袭，加之饮食过饱导致气机不通，气机逼迫大肠而生。其中，感受病邪的是燥气，产生病变的是胃中湿气。风、湿、燥、热四气相合，故大肠头部凝结成块状肿胀，这是湿邪的表现；疼痛是火邪所致；瘙痒是风邪所致；大便秘结是燥邪所致。
药材及剂量：秦艽（去苗）、桃仁（去尖皮，另研）、皂角子（烧至存性，各一钱，研细）、苍术（用淘米水浸泡后炒制）、防风（各七分）、黄柏（酒洗，五分）、当归尾（酒洗）、泽泻（三分）、尖槟榔（一分，另研）、熟大黄（一钱）。
以上药物除前三味需另研外，其余切碎。用水二钟（约400毫升），煎煮至一钟（约200毫升），滤出药汁二分（约100毫升）。
将另外三味研好的药粉加入药液中，再煎煮至八分（约160毫升），空腹时温热服用。切忌食用生冷、五辛（葱蒜韭等）、烧酒、动物肝脏、香肠、湿面等食物。
若肿胀且有脓液，加白葵花五朵（去蕊心）、青皮五分、木香三分，随后放入同煎，则脓液可随大便排出，效果神奇。
若大便秘结严重，加大黄、麻仁、枳实。
若肿胀严重，加黄柏、防己、泽泻、猪苓、条芩（黄芩）。
若疼痛剧烈，加羌活、郁李仁。
若瘙痒剧烈，加黄柏、羌活、防风、甘草、麻黄、藁本。
若便血过多，加地榆、黄柏、槐花、荆芥穗、白芷。
若小便涩痛、频数且不通畅，加赤茯苓、车前子、灯心草、萹蓄。
Hemorrhoids, the term implies "stagnation," referring to the obstruction of Qi, blood, and body fluids. Both men and women can suffer from this condition. Those in wealth and status often contract it due to excessive alcohol consumption and sexual indulgence; those of humble status often due to overwork and irregular eating habits; monks and Taoist priests often due to overeating followed by prolonged sitting. The *Yellow Emperor's Inner Classic* states: "Due to overeating, tendons and vessels become slack, leading to intestinal dysentery which manifests as hemorrhoids." Here, "intestinal dysentery" refers to hemorrhoids. Women often develop them due to difficult childbirth, prolonged squatting or sitting, or during menstruation when anger injures the Liver and cold-dampness invades, causing residual blood to seep into the perianal region. Children may suffer from excessive intake of rich and greasy foods, chronic dysentery, or exposure to toxic factors in the womb. Generally, hemorrhoids are not necessarily caused by wine and lust; one must carefully investigate the specific etiology to treat accordingly, ensuring efficacy.
Although ancient texts classify hemorrhoids into five types, they all stem from the stagnation of Wind, Dampness, Dryness, and Heat pathogens, preventing the free flow and discharge of Qi, thereby forcing the Large Intestine. The "twenty-four types of hemorrhoids" describe their morphological variations, while the "five types" (Mao, Pin, Mai, Chang, Xue) represent the pathological origin. Those that have not ulcerated are called "hemorrhoids"; those that have ulcerated are called "fistulas." Additionally, there are eight other conditions: Qi-type, Wind-type, Cold-type, Blood-type, Rectal prolapse, and Mumps, each with its own treatment method detailed below. Readers are advised to keep this secret prescription confidential.
Zhitong Rushen Decoction (Pain-Relieving Divine Speed Decoction): This is a modified version of Qinjiao Cangzhu Tang.
Hemorrhoids invariably arise from Wind-Heat invading alongside food stagnation, causing Qi obstruction and forcing the Large Intestine. The pathogenic factor involved is Dryness, while the pathological basis involves Stomach Dampness. The combination of these four pathogens causes nodules and swelling at the head of the Large Intestine (Dampness); pain is caused by Fire; itching by Wind; and constipation by Dryness.
Ingredients: Qinjiao (*Gentianae Radix*, remove sprouts), Taoren (*Persicae Semen*, remove tips and skins, grind separately), Zaojiazi (*Gleditsiae Sinensis Fructus Spina*, calcined until carbonized but retaining properties, 1 qian each, ground), Cangzhu (*Atractylodis Rhizoma*, soaked in rice water and stir-fried), Fangfeng (*Saposhnikoviae Radix*, 7 fen each), Huangbai (*Phellodendri Cortex*, washed with wine, 5 fen), Dangguiwei (*Angelicae Sinensis Radix*, wine-washed), Zexie (*Alismatis Rhizoma*, 3 fen), Jianbinglang (*Arecae Semen*, 1 fen, ground separately), Shudahuang (*Rhei Radix et Rhizoma praeparated with wine, 1 qian*).
Prepare the herbs by cutting them, except for the first three ingredients which should be ground separately. Add two zhong (approx. 400 ml) of water, decoct to one zhong (approx. 200 ml), and filter out half (approx. 100 ml).
Add the three pre-ground powders to the liquid, decoct again to eight fen (approx. 160 ml), and take warm on an empty stomach. Strictly avoid raw/cold foods, Five Pungents (garlic, onion, chives, etc.), distilled spirits, animal liver, sausages, and damp wheat products.
If swelling is present with pus, add five white sunflower heads (*Helianthi Annuus Flos*, remove pistils), Qingpi (*Citri Reticulatae Pericarpium Viride*, 5 fen), and Muxiang (*Vladimiriae Radix*, 3 fen). Add these later during decoction; the pus will be expelled via stool with divine efficacy.
If severe constipation occurs, increase Dahuang (*Rhei Radix et Rhizoma*), Haren (*Cannabis Semen*), and Zhishi (*Aurantii Fructus Immaturus*).
If severe swelling occurs, add Huangbai (*Phellodendri Cortex*), Fangji (*Stephaniae Tetrandrae Radix*), Zexie (*Alismatis Rhizoma*), Zhuling (*Polyporus*), and Tiaohuangqin (*Scutellariae Radix*).
If severe pain occurs, add Qianghuo (*Notopterygii Rhizoma et Radix*) and Yuziren (*Prunella Fructus*).
If severe itching occurs, add Huangbai (*Phellodendri Cortex*), Qianghuo (*Notopterygii Rhizoma et Radix*), Fangfeng (*Saposhnikoviae Radix*), Gancao (*Glycyrrhizae Radix et Rhizoma*), Mahuang (*Ephedrae Herba*), and Gaoben (*Ligustici Chuanxiong Rhizoma*).
If heavy bleeding occurs, add Diyü (*Sanguisorbae Radix*), Huangbai (*Phellodendri Cortex*), Huaihua (*Sophorae Flos*), Jingjie Sui (*Schizonepetae Spica*), and Baizhi (*Angelicae Dahuricae Radix*).
If urinary difficulty, frequency, and obstruction occur, add Chifuling (*Poria cum Rhizomo Polypori*), Cheqianzi (*Plantaginis Semen*), Dengxincao (*Junci Medulla*), and Bianxu (*Polygoni Avicularis Herba*).