脏痈痔 肛门肿如馒头。两边合紧。外坚而内溃。脓水常流。此终身之疾。治之无益。
锁肛痔 肛门内外如竹节锁紧。形如海蜇。里急后重。便粪细而带匾。时流臭水。此无治法。
番花痔 肛门四边番出如碗大。肉紫黑。痛流血水。服凉血解毒之药。药水洗之。药线扎之。根未尽者。
万忆膏敷三四次。除根。内服犀角地黄丸一料。永不再发。
莲花痔 状如莲花。层层叠起。有细孔。痒痛出脓水。数如圣散七八次。至痔紫黑色住药。待七八日。其
痔自落。敷粉霜一次。去根。服槐角地榆丸。以去内毒。
重叠痔 生骑缝中间。层层叠起。干燥无水。只痒而不肿痛。搽如圣散日三四次。七日痔落。不须服药。
钩肠痔 肛门内外有痔。折缝破烂。便如羊粪。粪后出血秽臭大痛者。服养生丹。外用熏洗。每夜塞龙
麝丸一丸于谷道内。一月收功。
悬胆痔 生于脏内。悬于肛外。时流脓水。便痛出血。先枯去痔。不须收口。服血竭内消丸。
内外痔 肛门内外皆有。遇大便即出血疼痛。用熊胆冰片膏日搽三四次。用后方熏洗。
内痔 在肛门之里。大解则出血如箭。便毕用手按。良久方入。服番肛散。塞换痔散。即番出洗净。敷如
圣散五七次。其痔紫黑色自落。换收口药收口。服收肛散即入。或番出时用药线扎之亦佳。服槐角
苦参丸。或凉血地黄丸。前法治之。其大便有七八日难解。须少用饮食。先与患者帮助。免惑。
血箭痔 与内痔同。但无痛痒为异耳。若大解则鲜血如箭。不问粪前粪后。宜灸承山穴。内服 皮象
龙丸。
气壮痔 肛门侧边有形无痔。遇劳苦气怒酒色则发。发则肿胀。形若核桃。坚硬如石。俟气消毒散。则
平复如初。惟戒气怒。不须医治。
沿肛痔 周遭皆有。痛痒出水。搽二仙丹一二次。化为黄水。用槐花、朴硝。煎汤洗之。服凉血解毒丸三
四帖。或清金丸半斤。则毒尽根除。
杨梅痔 亦周遭皆有。形似杨梅。只痒不痛。干燥无脓。此梅毒将发之候也。先服如圣散一剂。次服托
里解毒汤十余剂。外搽射粪丹三四次。自愈。
子母痔 两边相对。或大或小。时肿时疼。头大根小。敷二仙丹。内服槐角地榆丸收功。
雌雄痔 亦两边相对。但一大一小。肿痛出脓。头小根大为异耳。敷如圣散六七次。俟痔落而再医漏。
如无漏孔。就可收口。宜服苦参丸。消热解毒。
菱角痔 状如菱角。左右皆有三四孔。一孔通肠流脓水。先宜去痔。次穿漏孔。年久者内有附管。用药
丁去管。次穿漏收口。宜服蜡矾丸干脓收口。虚者服十全大补汤六十帖。
葡萄痔 左右如乳头堆起。只痒不痛。遇辛苦出水。或痔有孔出脓。宜先去痔。次穿漏孔。如不通肠。用
丁取管收口。服蜡矾丸收功。
核桃痔 肛外一边。形如核桃。有孔肿痛流脓。先用药线扎去痔。次穿漏。服蜡矾丸收口。
石榴痔 生谷道前。形如石榴。破塌疼痛。有孔出脓。宜先去痔。次收口。宜服槐角苦参丸。
樱桃痔 宜先去痔。次穿孔。服琥珀丸收功。
牛奶痔 先用药线扎去。次点万忆膏一二次除根。
鸡冠痔 亦先扎去。敷粉霜一次。痔平即可收口。
鸡心痔 鼠尾痔 俱无痛痒。遇辛苦则发。不治无害。
上痔二十四肿。形色虽殊。而治法则一。开载已悉。学人宜根据次调理。不得妄为加减。致取不验。至嘱。
脏痈痔：肛门肿胀如同馒头，两侧紧缩闭合。外部坚硬而内部溃烂，脓水常流出。这是终身的疾病，治疗无益。
锁肛痔：肛门内外像竹节一样锁紧，形状像海蜇。有里急后重感，大便细且扁平，时常流出臭水。此病无法治疗。
番花痔：肛门四周翻出如碗口大小，肉质紫黑，疼痛并流出血水。服用凉血解毒的药物，用药水洗患处，用药线结扎。若病根未尽，敷用万忆膏三四次，可除根。内服犀角地黄丸一料，永不复发。
莲花痔：形状像莲花，层层叠起，有细小的孔洞，瘙痒疼痛并流出脓水。使用如圣散七八次，直到痔疮变为紫黑色时停止用药。等待七八天，痔疮自行脱落。敷用粉霜一次，以除根。服用槐角地榆丸，以清除体内毒素。
重叠痔：生长在肛门骑缝中间，层层叠起，干燥无水，只痒而不肿痛。每天涂抹如圣散三到四次，七天后痔疮脱落，不需要服药。
钩肠痔：肛门内外都有痔疮，折缝处破烂，大便像羊粪球一样，排便后出血、污秽、气味恶臭且剧烈疼痛。服用养生丹，外用熏洗法。每晚在肛门内塞入龙麝丸一丸，一个月见效。
悬胆痔：生于直肠内部，悬挂于肛门外，时常流出脓水，排便疼痛出血。先枯死去除痔疮，不需要收敛伤口。服用血竭内消丸。
内外痔：肛门内外都有，遇到大便时即出血疼痛。用熊胆冰片膏每天涂抹三到四次，用后方进行熏洗。
内痔：位于肛门里面，解大便时出血如箭射一般，便后用手指按压，很久才能回纳。服用番肛散，塞入换痔散，使痔疮翻出洗净。敷用如圣散五到七次，痔疮变为紫黑色后自行脱落。更换收敛伤口的药物来收口。服用收肛散即可回纳。或者在痔疮翻出时用药物线结扎也可以。服用槐角苦参丸，或凉血地黄丸，按前法治之。如果大便秘结难解，需减少饮食，先帮助患者调理，以免困惑。
血箭痔：与内痔相同，只是没有痛痒为区别。如果解大便时鲜血喷射如箭，不论在粪便之前还是之后，适宜灸承山穴，内服皮象龙丸。
气壮痔：肛门侧边有形但没有痔疮，遇到劳累、愤怒、饮酒、色欲则发作。发作时肿胀，形状像核桃，坚硬如石。等待气消毒散发挥作用，则平复如初。只需戒除愤怒，不需要医治。
沿肛痔：环绕肛门周围都有，疼痛瘙痒出水。涂抹二仙丹一到两次，化为黄水。用槐花、朴硝煎汤清洗。服用凉血解毒丸三四帖，或清金丸半斤，则毒尽根除。
杨梅痔：也环绕肛门周围都有，形状像杨梅，只痒不痛，干燥无脓。这是梅毒即将发作的征兆。先服用如圣散一剂，接着服用托里解毒汤十余剂，外涂射粪丹三四次，自愈。
子母痔：两边相对，或大或小，时而肿胀时而疼痛，头大根小。敷用二仙丹，内服槐角地榆丸收功。
雌雄痔：也是两边相对，但一大一小，肿痛流脓，头小根大为区别。敷用如圣散六七次，等到痔疮脱落后再治疗漏症。如果没有漏孔，就可以收口。宜服用苦参丸，清热毒。
菱角痔：形状像菱角，左右各有三四孔，一孔通向肠道流出脓水。先宜去除痔疮，其次穿通漏孔。年代久远的内部有附管，用药丁去除管道，其次穿通漏孔并收口。宜服用蜡矾丸干脓收口，体虚者服用十全大补汤六十帖。
葡萄痔：左右像乳头堆起，只痒不痛，遇到辛苦出水，或者痔疮有孔流出脓液。宜先去痔疮，其次穿通漏孔。如果不通肠道，用药丁取出管道并收口。服用蜡矾丸收功。
核桃痔：肛门外面一边，形状像核桃，有孔洞肿痛流脓。先用药物线结扎去除痔疮，其次穿通漏孔。服用蜡矾丸收口。
石榴痔：生在肛门前面，形状像石榴，破塌疼痛，有孔流出脓液。宜先去痔疮，其次收口。宜服用槐角苦参丸。
以上二十四种痔疮，虽然形色不同，但治疗法则一致。已详细记载，学者应当根据次序调理，不得随意加减，导致疗效不佳。特此嘱咐。
Zang Yong Hemorrhoid (Visceral Abscess Hemorrhoid): The anus swells like a steamed bun, with both sides tightly closed. The exterior is hard while the interior is ulcerated, and pus often flows out. This is a lifelong disease; treatment is of no benefit.
Suo Gang Hemorrhoid (Locking-Anus Hemorrhoid): The inside and outside of the anus are locked tight like bamboo joints, resembling a jellyfish. There is a sensation of tenesmus (straining to defecate), stools are thin and flat, and foul-smelling fluid flows intermittently. There is no cure for this condition.
Fan Hua Hemorrhoid (Turned-Flower Hemorrhoid): The four sides of the anus evert like a bowl, with purple-black flesh, pain, and bleeding fluid. Take blood-cooling and detoxifying herbs, wash the area with medicinal water, and ligate with medicinal threads. If the root is not fully removed, apply Wan Yi Ointment three or four times to eradicate it. Take one dose of Xijiao Dihuang Wan (Rhinoceros Horn and Rehmannia Pill) internally to prevent recurrence permanently.
Lian Hua Hemorrhoid (Lotus Hemorrhoid): Resembles a lotus flower, layered and stacked, with fine pores. It itches and hurts, discharging pus and fluid. Apply Rusheng San (Miraculous Holy Powder) seven or eight times until the hemorrhoid turns purple-black, then stop medication. Wait seven or eight days for the hemorrhoid to fall off naturally. Apply Fen Shuang (Powder Frost) once to eradicate it. Take Huaijiao Duyu Wan (Sophora and Sanguisorba Pill) internally to clear internal toxins.
Chong Die Hemorrhoid (Overlapping Hemorrhoid): Grows in the middle of the anal cleft, layered and stacked, dry without moisture, itching only without swelling or pain. Apply Rusheng San three to four times daily. The hemorrhoid falls off after seven days; no internal medication is needed.
Gou Chang Hemorrhoid (Hook-Intestine Hemorrhoid): Hemorrhoids exist both inside and outside the anus, with broken folds at the creases. Stools resemble sheep dung, followed by bleeding, foul odor, and severe pain. Take Yangsheng Dan (Nourishing Life Pill). Use external fumigation and washing. Insert one Longshe Wan (Dragon Musk Pill) into the anus every night; efficacy is achieved within one month.
Xuan Dan Hemorrhoid (Hanging-Gallbladder Hemorrhoid): Originates inside the rectum, hanging outside the anus, discharging pus intermittently, with painful bleeding during defecation. First, necrose and remove the hemorrhoid; wound contraction is not required. Take Xuexie Neixiao Wan (Draconis Sanguis Internal Resolution Pill).
Nei Wai Hemorrhoid (Internal and External Hemorrhoid): Present both inside and outside the anus, causing bleeding and pain upon defecation. Apply Xiongdan Bingpian Gao (Bear Bile and Borneol Ointment) three to four times daily. Use the subsequent formula for external fumigation and washing.
Nei Hemorrhoid (Internal Hemorrhoid): Located inside the anus, bleeding profusely like an arrow during defecation. After defecation, manual pressure is required for a long time before reduction. Take Fangan San (Reverse Anus Powder), insert Huanzhi San (Change Hemorrhoid Powder) to evert and clean the hemorrhoid. Apply Rusheng San five to seven times; when the hemorrhoid turns purple-black, it falls off naturally. Change to astringent medications to close the wound. Take Shougang San for reduction. Alternatively, ligate with medicinal thread when everted. Take Huaijiao Kushen Wan (Sophora and Sophora Root Pill) or Liangxue Dihuang Wan (Blood-Cooling Rehmannia Pill), treating according to previous methods. If constipation persists for seven to eight days, reduce dietary intake and assist the patient first to avoid confusion.
Xue Jian Hemorrhoid (Blood-Arrow Hemorrhoid): Same as Internal Hemorrhoid, but distinguished by the absence of pain and itching. Upon defecation, fresh blood sprays like an arrow, regardless of whether it occurs before or after stool. Moxibustion on Chengshan (BL57) is suitable. Internally take Pixianglong Wan (Skin-Elephant Dragon Pill).
Qi Zhuang Hemorrhoid (Qi-Strengthening Hemorrhoid): A mass exists on the side of the anus without a distinct hemorrhoid structure. It appears upon labor, anger, alcohol consumption, or sexual indulgence. When it appears, it swells, resembling a walnut, hard as stone. Wait for Qixiao San (Qi-Dissipating Powder) to take effect, and it will return to normal. Only anger must be avoided; medical treatment is unnecessary.
Yan Gang Hemorrhoid (Along-Anus Hemorrhoid): Surrounds the entire anus, with pain, itching, and discharge. Apply Erxian Dan (Two Immortals Pill) one or two times, transforming into yellow fluid. Wash with a decoction of Huaihua (Buckthorn Flower) and Puxiao (Mirabilite). Take Liangxue Jiedu Wan (Blood-Cooling Detoxification Pill) three or four doses, or Qingjin Wan (Clear Metal Pill) half a jin, to completely eradicate the toxin.
Yangmei Hemorrhoid (Bayberry Hemorrhoid): Also surrounds the anus, resembling a bayberry, itching only without pain, dry without pus. This is a sign of impending syphilis. First take Rusheng San one dose, then take Tuoli Jiedu Tang (Support Interior and Detoxify Decoction) for more than ten doses. Externally apply Shefen Dan (Shoot-Feces Pill) three or four times; it will heal spontaneously.
Zimu Hemorrhoid (Mother-Child Hemorrhoid): Opposite each other on both sides, varying in size, swelling and hurting intermittently, with a large head and small root. Apply Erxian Dan. Internally take Huaijiao Duyu Wan to conclude treatment.
Cixiong Hemorrhoid (Female-Male Hemorrhoid): Also opposite each other on both sides, but differing in size, with swelling, pain, and pus discharge, distinguished by a small head and large root. Apply Rusheng San six or seven times. After the hemorrhoid falls off, treat any fistula. If there is no fistula, proceed to close the wound. Take Kushen Wan (Sophora Root Pill) to clear heat and detoxify.
Lingjiao Hemorrhoid (Water Caltrop Hemorrhoid): Resembles a water caltrop, with three or four holes on each side. One hole connects to the intestine, discharging pus. First remove the hemorrhoid, then penetrate the fistula. In chronic cases, there may be accessory tubes inside; use Yaoding (Medicine Nail) to remove the tube, then penetrate the fistula and close the wound. Take Lafan Wan (Beeswax and Alum Pill) to dry pus and close the wound. For deficiency patterns, take Shiquan Dabu Tang (Complete Great Tonifying Decoction) for sixty doses.
Putao Hemorrhoid (Grape Hemorrhoid): Raised on both sides like nipples, itching only without pain, discharging fluid upon exertion, or discharging pus from holes in the hemorrhoid. First remove the hemorrhoid, then penetrate the fistula. If it does not connect to the intestine, use Ding (Nail) to extract the tube and close the wound. Take Lafan Wan to conclude treatment.
Hetao Hemorrhoid (Walnut Hemorrhoid): On one side outside the anus, resembling a walnut, with a hole causing swelling, pain, and pus discharge. First ligate and remove the hemorrhoid with medicinal thread, then penetrate the fistula. Take Lafan Wan to close the wound.
Shiliu Hemorrhoid (Pomegranate Hemorrhoid): Grows in front of the anus, resembling a pomegranate, ruptured and painful, with a hole discharging pus. First remove the hemorrhoid, then close the wound. Take Huaijiao Kushen Wan.
Yingtao Hemorrhoid (Cherry Hemorrhoid): First remove the hemorrhoid, then perforate. Take Hupo Wan (Amber Pill) to conclude treatment.
Nainai Hemorrhoid (Milk Hemorrhoid): First ligate and remove with medicinal thread, then apply Wan Yi Ointment one or two times to eradicate the root.
Jiguan Hemorrhoid (Rooster Comb Hemorrhoid): Also ligate and remove first. Apply Fen Shuang once; once the hemorrhoid flattens, close the wound.
Jixin Hemorrhoid (Chicken Heart Hemorrhoid) & Shuwei Hemorrhoid (Mouse Tail Hemorrhoid): Neither itches nor hurts. They appear upon exertion but cause no harm if untreated.
The above twenty-four types of hemorrhoids, although differing in shape and color, share the same treatment principles. They have been detailed herein. Practitioners should follow these instructions for regulation and must not arbitrarily add or subtract treatments, lest they fail to achieve results. This is earnestly advised.