2020年10月18日星期日

what does a hemorrhoids look like,Description of the etiology and pathogenesis of anorectal diseases in ancient documents

    1. Wind, cold, heat, dampness, dryness and heat can cause this disease, but rheumatism and dryness and heat are most common. They are both pathogenic factors and new pathological factors.

    In the qi transmission of the six exogenous kinks, all of them can constrict the anus and form hemorrhoids, causing hemorrhoids bleeding. For example, Feng Luzhan's "Experiences in the Department of Ulcers" said: "The wind, cold, heat, dampness, heat, and exogenous pathogens can cause blood to fall." In the "Keys for Syndrome and Treatment", "Serial and fresh color are intestinal winds, and heat and heat will force blood to be arrogant." If the blood does not follow the meridians, it will overflow into blood in the stool.” This more clearly illustrates the clinical manifestations of blood under intestinal wind and the pathogenesis of heat evil. "Lingshu•Carbuncle" says: "If the cold air is in the veins, the blood will cry, the blood will weep, and the blood will be blocked. If it fails, the qi will return, and it must not be reverted. Therefore, the carbuncle, the cold turns into heat, and the fever does not stop. Winning results in meat rot, and meat rot in the form of pus." Another example in the "Six Books of Hejian Medicine" says: "The wind and heat will not dissipate, but the qi will remain overflowing and spread to the lower part, so the anus becomes swollen and the knots are like plum plum nuclei. It may even turn into a fistula.” It points out that perianal abscess and anal fistula are caused by the feeling of external evils, heat inside, stagnation of qi and blood, and pus and fistula from rotten flesh. "Yi Zong Jin Jian • General Theory Song of Carbuncle" "Carbuncle was originally caused by fire."

    The record in "Yi Zong Jin Jian • Essentials of Surgical Heart Techniques" "The anus ruptures around the folds, and those who have stools, the fire is dry" briefly point out the cause of the anal fissure. Traditional Chinese medicine believes that the disease is mostly caused by blood heat, dryness in the intestines or deficiency of yin and lack of body fluid, causing constipation, struggling to defecate, causing anal skin lacerations, damp toxins invading the skin muscles and collaterals, local qi and blood stasis, and inability to function Smooth, lack of qi and blood nutrition in the ulcerated place, and get sick after a long time.

    In addition, among the six kinks, anorectal diseases caused by rheumatism and heat are the most common. The "Mai Jing" says: "Floating Yang pulse, blood will be caused by intestinal hemorrhoids. Intestinal scorching blood, wind and heat predominantly"; "Yi Zong Jin Jian • Surgical Heart Methods" says: "Hemorrhoids have many different shapes and names. "External rheumatism and heat source"; and give the characteristics of the disease concisely: "If the knot is swollen and stuffy, the dampness is also high; the knot is swollen and painful like fire, and the two stools are closed, the large intestine and the small intestine are also hot; Those who are itchy, the wind is strong; the anus is surrounded, the creases are broken, and those who have stools, the fire is also dry."; The "Ten Books of the East Wall" states: "The good and the sick are all injured by the four qi of dampness, heat and wind drying, but heat "It’s the most."; and the "Neijing" says: "Yingwei detained in the meridian, the blood injection will not work, if it does not work, the defense qi will be blocked from it, and the confinement will not work, so the heat will not stop, and the heat will not stop. Meat rot, meat rot is pus." It emphasizes the central link of "heat" in the pathogenesis of anal carbuncle.

    2. The role of damp evil in pathogenesis evolution

    Moisture inside and outside. Anorectal diseases, mainly due to internal dampness, are mostly caused by improper diet, damage to the spleen and stomach, dampness from endogenous, and damp-heat accumulation. For example, "Ulcer Department Experience Collection" Juan Zhongyun: "Covering the anus is the main body of the bladder meridian of the sun. It is the body of the meridian gathered by the heat and dampness, where carbuncle arises, and the dampness does not become turbid due to alcohol, and the qi is not popular. many". It is pointed out that damp-heat accumulates to block the anus, qi and blood stagnate, and heat beats meat rot to form perianal abscess.

    Qing • Ye Gui's "Clinical Guide to Medical Cases" pointed out: "...hemorrhoids are bloody, mostly damp and hot..." [7] You Qing • Chen Shiduo's "Act in the Cave" Juan Jiuyun: "Hemorrhoids are born on the side of the anus in the valley. It is a person who is born from the poison of damp and heat in the five internal organs....Although hemorrhoids have many shapes, it is the same if they are caused by damp and heat. Both of them clearly put forward the prominent position of damp pathogens. Below, so the anal diseases are more common due to wetness.

    3. Visceral deficiency and dysfunction are the internal causes of the disease

    In the long-term medical practice, the sages found that the occurrence of anorectal disease has an important relationship with the imbalance of Yin and Yang and the deficiency of the internal organs. Just as the "Danxi Heart Method" says: "Hemorrhoids are all due to the insufficiency of the internal organs, trauma and rheumatism, internal heat toxins, drunkenness and fullness, and more desire to prostrate themselves, so that blood and blood fall, gather in the anus, stay stagnant, and conflict For hemorrhoids". It is clarified that the weakness of the viscera is the root, and a variety of pathogenic factors cause qi and blood to fall and gather in the anus as the standard for hemorrhoids.

    "Internal Classics•Five Zang Discourses" says "The husband’s stomach, large intestine, small intestine, triple burn bladder, these five are born from the weather, so the weather is so diarrhea but not hidden. It is affected by the turbidity of the five internal organs and is called the house of transmission. For those who lose diarrhea, the pomen are also the five internal organs, so that the water cannot be stored for a long time. The six-fu-organs transfer the material without hiding, so it is not full. Therefore, if the water enters the water, the stomach is solid but the intestines are weak. The intestine is solid but the stomach is weak, so it is not full but full but not full. The pomen mentioned here is the anus in modern medicine. It also points out that the large intestine and anus can accept turbidity, excrete dross, inhale water, and secrete body fluid. The function of regulating and controlling defecation. The restraining effect of the Pomen is mainly maintained by the insufficiency of Qi and blood, and the normal function of adjusting the viscera up and down.

    "The lung governs the qi and the breath", which is in line with the large intestine. The normal function of lung-qi Xuan-down is related to the normal conduction and transport function of the large intestine. If you have lung heat, it will often cause the large intestine to be unfavorable and cause sores or hemorrhoids in the anus. Or the lungs are stagnant and fail to subdue, the large intestine becomes hot and dry, constipation is difficult to resolve, or hemorrhoids in the stool can be caused.

    The spleen governs transportation, transformation and purification, and is related to the conduction of the large intestine. Spleen-qi rises and stomach-qi falls. It is the pivot of the Qi machine lifting and lowering. The Qi machine rises and falls in an orderly manner, and the anus opens and closes normally. The spleen controls the blood. If the spleen's control function is abnormal, blood in the stool may occur. Shen Yuenan said in "Golden Chamber Synopsis Notes": "The blood of the five internal organs depends on the temperament." That is the meaning. The liver controls diarrhea, regulates the Qi machine, and the normal function of the Pomen, depends on the smooth flow of the human Qi machine. Disorders of liver drainage, qi and blood discord, and dystrophy of muscles and veins will result in pomen contracture and unfavorable defecation. The important role of stomach qi for hemorrhoid bleeding is emphasized.

    The liver belongs to wood, which governs the evacuation; the spleen belongs to soil, which governs transportation and transformation. Ye Tianshiyun: "Liver disease must be insulted, and it is the victory of insults. If you suppress the spleen, you will have bloating, loose stools or uncomfortable." It can be seen that liver qi is stagnated, the liver is insufficiency, and the liver qi invades the spleen, causing the large intestine to lose its conduction. "Dropping" dysfunction is the root cause of functional bowel disease, so although the disease is located in the intestine, the actual disease is in the liver. "The nature of the wood is mainly to relieve the drainage, and the qi enters the stomach. It depends on the qi of the liver wood to relieve the qi, and the water is transformed; if the liver does not clear the sun, the water cannot be relieved, and it is a sign of fullness. It is inevitable." "Theory of Blood Syndrome•On the Pathogenesis of Visceral Organs" due to liver failure, dereliction of duty, taking advantage of the spleen to injure the stomach, dysfunction of qi, and imbalance of elevation, abdominal pain, bloating, chest tightness, lack of heating and eating, and diarrhea The qi is temporarily smooth, and the pain decreases after diarrhea. Ming Li Ping's "Introduction to Medicine" further explained: "The spleen cannot be transported if the food is covered, the large intestine will not be transported if the food accumulates, the spleen soil is weak, the lungs are not nourished, the liver tree will grow, and the wind and evil will be deficient. Blood under the wind will turn into hemorrhoids."

    4. Acquired dystrophy plays a dominant role in the occurrence and development of anorectal disease

    Doctors in the past dynasties have attributed improper diet to the main cause of the disease. First of all, the "Internal Classics" on the issue of improper diet and anorectal diseases are particularly rich. For example, "Su Wen • Bi Lun" said: The stomach and intestines hurt." "Suwen•The theory of anger to the sky" says: "Therefore you are full, your muscles and veins are loosened, and intestinal addiction is hemorrhoids"; "The change of ointment beams will give birth to daisies." "Xiang Lun" further explained the intestinal addiction, thinking that its meaning mainly refers to the accumulation of intestines and compression of the intestinal wall, affecting the collaterals. It goes without saying that dietary factors such as "hence fullness" are one of the main causes of hemorrhoids. Obviously, it is said that overeating is fatty, drinking excessively, and eating spicy and irritating foods will inevitably cause intestinal and collateral congestion and expansion, so that "the blood is crisscrossed, the meridians are interlaced, and the anus flows into this hemorrhoid." And drinking alcohol is essential. The hazards of the disease have been clearly detailed by the physicians of the past dynasties. For example, "Tai Ping Sheng Hui Fang" said: "The husband's alcoholic hemorrhoids are caused by excessive drinking and injury to the spleen and stomach. The husband's alcohol is very hot and has great poison. The alcohol stains the internal organs, causing the blood to overflow, and the heat does not accumulate. Disperse, attack the large intestine, so the blood is ordered." "Surgery Zhengzong" said: "Excessive drinking, gastrointestinal injury, and even turbid qi and blood stasis in the anus, all can cause hemorrhoids." It can be seen that abstinence is beneficial to anorectal disease. The importance of the patient.

    Bad lifestyle habits cannot be ignored as an important cause of disease. The constipation doctors of all generations believe that this is one of the important causes of hemorrhoids. For example, "Theories on the Sources of Diseases" believes that if a long time tolerate bowel movements can cause hemorrhoids. Pregnancy, childbirth and irregular menstruation: "Surgical Statutes" believes that "women are suffering from cold after menstruation, menstrual cold, remaining blood in the heart meridian, and blood flowing in the large intestine"; "there are also people who have hemorrhoids due to excessive force after delivery." Atrioventricular carelessness: For example, in the "Jin Jian of the Medical Zong · The Keys of Surgical Heart Techniques", the cause of hemorrhoids is "always nothing more than getting into the room with drunkenness, dissolving tendons and veins, venting the essence and qi, and betting on the weakness of heat and poison." Another example is the "Medicine Recipe Ju" says: "Or enter the room drunk and full, release the essence and qi, bet against the deficiency of heat, or enter the room with obscenity, causing injury to the bladder, liver, kidney, muscles and veins. Cover the bladder muscles and veins to the waist and kidneys Go through the buttocks and walk the liver ring before and after the yin, so hemorrhoids are also tendons and veins." "Dongtian Olympics" Juan Jiuyun: "Leaks, holes outside the anus.... The world's treatment methods, use knife and needle, hanging Lines increase the pain and counteract blood consumption. If you don’t go on a diet and lose your color, there will be no one who can survive."

    "Theories of various disease sources" says: "All hemorrhoids are caused by colds, atrioventricular carelessness, drunkenness and fullness of yin and yang, causing disturbance of blood qi, and tendons and veins overflow, leaking between the intestines, and flushing the lower part." "Persons with hemorrhoids are usually damp and hot, over-eating and burning, or the bloodline is not good because of sitting for a long time, and because of the seven emotions, they are also suffering from cold, and burdened, striving to travel far, qi and blood crisscross, meridians... Hemorrhoids can occur.” The above all pointed out the influence of bad living habits on this disease.

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