2021年1月28日星期四

hemorrhoids essential oils,Highlights of Academic Achievements in Anorectal Diseases in "Surgery Master"

    【Abstract】 Objective To explore and sort out the academic achievements of "Surgery Dacheng" in the subject of anorectal diseases. Methods According to the clinical manifestations of common diseases in the anorectal department of modern medicine, the academic value of the traditional Chinese medical literature "Surgery Dacheng" on the common prolapse and anal itching in the lower part and in children were combed. Results The description and treatment of anorectal diseases in "Surgery Dacheng" is objective and realistic, and the types of diseases are more comprehensive, which has great guiding significance for the diagnosis and treatment of anal diseases in modern Chinese medicine. Conclusion It is very necessary to re-study "Surgery Dacheng" and strengthen the collation and verification of treatment methods.

    [Keywords] surgery master; anorectal disease; disease name; diagnosis; treatment; prescription

    "Surgery Dacheng" [1] was written by Qi Kun (Guangsheng) in the Kangxi period of the Qing Dynasty. It summarizes the diagnosis and treatment methods of TCM surgical diseases before the Qing Dynasty, and incorporates his own clinical experience into it, and its influence on modern TCM surgery major. Only the contributions in the anorectal sciences are summarized as follows.

    1 The characteristics of anorectal disease

    In "Surgery Dacheng", the anorectal diseases discussed are mainly distributed in the "lower back" part. There are roughly 15 kinds of diseases, including stork ulcer, sitting horse carbuncle, hip carbuncle, upper horse carbuncle, dismount carbuncle, wind carbuncle, hanging carbuncle, spring gangrene, piercing hair, cross-horse carbuncle, dirty poison, valley sore, hemorrhoids (Twenty-four hemorrhoids), leakage (eight leakage), intestinal mutilation (prolapse), etc. There are also two common diseases of anal prolapse and anal itching in children. Covers almost all the common diseases of the anorectal department such as hemorrhoids (including internal hemorrhoids, external hemorrhoids, mixed hemorrhoids), anal fissures, anal fistulas, rectal polyps, anal papillary hypertrophy and their combined diseases, anorectal tumors, anorectal abscesses, Rectal prolapse, anal sinusitis, proctitis and skin diseases around the anus.

    1.1 Age characteristics of anorectal diseases "Surgery Dacheng" believes that anorectal diseases are mainly seen in adults, but also occur in children. Adult anal diseases mainly include hemorrhoids, carbuncle around the anus, gangrene, hair and so on. The common cases are children’s rectal prolapse and anal itching, which are consistent with the characteristics of adult patients with rectal prolapse seen today. The onset of the disease does not heal until adulthood. Children’s anal itching is mostly caused by intestinal parasites such as pinworms.

    1.2 Location characteristics of anorectal diseases "Surgery Dacheng" for anorectal diseases attributable to the lower part, follow the anus as the center, spread to the perianal, forming anal diseases of different nature and different parts. If the disease is close to the anus, it is generally called hemorrhoids (ie, Zhao Zhenzi's twenty-four hemorrhoids). It spreads to the outer periphery and is farther from the anus. It is usually named as infectious diseases. According to the characteristics of the front and rear, left and right parts, the names are different. The posterior position is called sitting carbuncle, the left side is called upper carbuncle, and the right side is called dismounted carbuncle. The bit is called carbuncle across horses. No matter how far away from the anus, it indicates that the disease is more serious. According to different degrees, it is divided into carbuncle, gangrene, and hair. Named according to the location. For example, the farthest place in the posterior position is called stork gangrene, and the farthest place in the front position is called crotch-piercing hair. The farthest point on both sides is called gluteal carbuncle. After carbuncle rupture, it is divided into eight leaks according to the different parts of the shape. The mild one that does not belong to the above-mentioned diseases that occurs within the anus and rectum is anal sore, and the severe one is called dirty poison. "The first red is bowel wind, and then the red is alcohol poison."

    1.3 Description of anal occlusion hemorrhoids The type of hemorrhoids described in "Surgery Dacheng" is called anal occlusion hemorrhoids, "anal occlusion hemorrhoids, the inside and outside of the anus are locked like bamboo joints, shaped like jellyfish, tenesmus, heavy, thin and flat stools. "Smelly water" vividly describes the typical clinical manifestations of anorectal cancer, which is an important milestone for later Chinese medicine to recognize anorectal tumors. It is adopted by the current Chinese medicine textbook "Chinese Medicine Surgery" [2] and is also one of the names of modern Chinese medicine. One.

    1.4 Description of Intestinal Stomach The intestinal stump described in "Surgery Dacheng" is actually a special manifestation of rectal prolapse. Just as the saying "intestinal amputation, anal prolapse" means "occasionally shedding." Sigmoid colon prolapse, which is equivalent to rectal prolapse in modern medicine, is accompanied by partial intestinal wall necrosis, and rectal prolapse is accompanied by rectal polyp polyps shedding. It can be regarded as a rare and difficult type of prolapse.

    1.5 The diagnosis of hemorrhoids should follow the "Inner Classics" of "there is fullness, muscles and veins, and intestines are hemorrhoids" due to the onset of hemorrhoids. The specific reason is to "after eating, or anger, or hard work, or sitting down," Or wine, women or childbirth, children or night crying, etc., can lead to diseases such as "qi and blood crisscrossing, meridian crisscrossing, flowing into the anus", "swelling is wet, pain is fire, and itching is windy," The closed ones are also dry."

    2 Specialist

    Zhao Zhenzi’s family biography 24 hemorrhoids "Surgery Dacheng" fully inherited the hemorrhoids specialist Zhao Zhenzi’s family biography at that time, using 24 hemorrhoids for the treatment, although it is similar to the 25 hemorrhoids in the "Experience Book of Ulcers", and it is similar to the "Yi Zong Jin Jian" 24 Hemorrhoids are slightly different [3], but the nature is the same, which fully reflects the characteristics of TCM treatment of anorectal diseases at that time, and it is still of great significance to the inheritance and development of TCM. 24 Hemorrhoids include (in the order of the original text): carbuncle hemorrhoids, anal contraction hemorrhoids, flower hemorrhoids, lotus hemorrhoids, overlapping hemorrhoids, hook intestinal hemorrhoids, biliary hemorrhoids, internal and external hemorrhoids, internal hemorrhoids, blood sword hemorrhoids, vigorous hemorrhoids, intestinal Hemorrhoids, bayberry hemorrhoids, child-mother hemorrhoids, male and female hemorrhoids, water chestnut hemorrhoids, grape hemorrhoids, walnut hemorrhoids, pomegranate hemorrhoids, cherry hemorrhoids, milk hemorrhoids, cockscomb hemorrhoids, sweet heart hemorrhoids, rat tail hemorrhoids. According to the understanding of modern medicine, the clinical manifestations and treatment characteristics of 24 hemorrhoids are compared and organized as follows.

    2.1 Knowing about hemorrhoids. Among the 24 hemorrhoids in the family hemorrhoids of the specialist Zhao Zhenzi, there are double (turned) hemorrhoids, lotus hemorrhoids, overlapping hemorrhoids, suspension hemorrhoids, internal and external hemorrhoids, internal hemorrhoids, blood sword hemorrhoids, There are 14 types of hemorrhoids, such as gas hemorrhoids, intestinal hemorrhoids, male and female hemorrhoids, milk hemorrhoids, cockscomb hemorrhoids, chicken heart hemorrhoids, and rat tail hemorrhoids, which are summarized as follows in combination with the modern classification of hemorrhoids.

    2.1.1 Internal hemorrhoids

    2.1.1.1 The first-stage hemorrhoids are called blood sword hemorrhoids in Zhao Zhenzi’s family biography. Its clinical features are mainly blood-based, "If the stool is resolved, blood will be like an arrow, regardless of the front and back of the feces", "but no pain and itching". Others are the same as "internal hemorrhoids". Conservative therapy can be used for treatment, moxibustion at Chengshan acupoint, and oral administration of Xipi Xianglong pills.

    2.1.1.2 Hemorrhoids in the second stage are called internal hemorrhoids in Zhao Zhenzi's family biography. Its clinical feature is the coexistence of hematochezia and prolapse. "In the anus, bleeding will be like an arrow in the anus, so you can press it with your hand and enter it for a long time." There are two methods of treatment. One is to take the anus powder orally, plug the hemorrhoids in the anus, turn the hemorrhoids out, wash, and apply externally such as the holy powder for 5 to 7 times. The medicine is closed; the second method is to ligate the hemorrhoids with medicine thread after turning out the hemorrhoids, and take Huaijiao Kushen pills or Liangxue Dihuang pills orally, and the effect is also good. When using it, pay attention: "Stools are difficult to understand for 7 or 8 days, and you must use less food and drink. First explain to the patient to avoid confusion."

    2.1.1.3 Hemorrhoids in the third stage are called biliary hemorrhoids in Zhao Zhenzi's family biography. The clinical feature is that the prolapsed material cannot be taken back. It is "born in the viscera, suspended outside the anus, sometimes draining pus, and painful bleeding." The treatment mainly adopts the method of dry hemorrhoids, without closing the mouth, taking the Dragon Blood Internal Elimination Pill by mouth.

    2.1.1.4 Incarcerated hemorrhoids are called Fanhua hemorrhoids in Zhao Zhenzi’s family biography. The clinical features of internal hemorrhoids are that the internal hemorrhoids can not be absorbed outside the anus, and there are ulcers and erosions on the surface of the hemorrhoids, and there are thrombosis in the anus. The four sides turned out to be as big as a bowl, the flesh was purple and black, and the water was painful and bleeding." It means that the local heat toxin is severe, it is advisable to take the medicine for cooling blood and detoxification, wash it with water for external use, and tie it with the medicine thread; if the root is not exhausted, apply Wanyi ointment externally, 3 or 4 times, remove the root; take the rhinoceros dihuang pill forever Don't post.

    2.1.2 External hemorrhoids

    2.1.2.1 Connective tissue external hemorrhoids are called milk hemorrhoids, cockscomb hemorrhoids, chicken heart hemorrhoids, and rat-tail hemorrhoids in Zhao Zhenzi's family biography. The clinical feature is that only the skin of the anal margin is raised, which is named according to its appearance. The other type is the symptoms of only anal itching, called overlapping hemorrhoids. Due to the repeated episodes of external hemorrhoids, it has the characteristics of "the middle of the seam, the layers are stacked, dry and anhydrous, only itching but not swelling and pain". Three types of hemorrhoids, namely, gas hemorrhoids, chicken heart hemorrhoids, and rat tail hemorrhoids do not need to be treated or are harmless. When these types of external hemorrhoids are large, such as milk hemorrhoids and cockscomb hemorrhoids, they can be removed by ligation of medicine thread, and a small amount of Wanyi ointment or powder cream can be applied to the wound according to the situation. The principle of treatment is the same as today. The overlapped hemorrhoids only need to be removed. Use Rusheng powder for external application 3 or 4 times. The hemorrhoids will fall on the 7th without oral medication.

    2.1.2.2 Inflammatory external hemorrhoids It is called anal hemorrhoids in Zhao Zhenzi's family biography. Its clinical feature is that when the connective tissue external hemorrhoids become inflamed, there will be pain and itching symptoms, that is, "there are all around, itching and watery". It shows that there is heat toxin in the local area. The treatment method is to first apply the Erxian Dan one or two times to the local area, then use Sophora japonicus and Puxiao decoction, combined with cooling blood antidote 3, 4 orally or Qingjinwan and a half after turning into yellow water. Oral Hu will eradicate the poison.

    2.1.2.3 Thrombotic external hemorrhoids are called child-mother hemorrhoids in Zhao Zhenzi’s family biography. Its clinical features are the appearance of lumps on the anal margin, often opposite each other, mainly swelling and pain, that is, “the two sides are opposite, large or small, sometimes swollen It hurts sometimes, the head is big and the root is small. Sometimes it needs to be distinguished from the abscess of the anal margin, that is, male and female hemorrhoids, which are characterized by "swelling and painful pus." For the treatment of hemorrhoids in sons and mothers, two celestial pills can be applied externally, and Huaijiao Diyu Pills can be taken internally to recover power.

    2.1.2.4 Varicose external hemorrhoids are called vigorous hemorrhoids in Zhao Zhenzi’s family biography. The skin of the anal margin is obviously raised when he is clinically struggling to defecate. You can see obvious varicose veins, which are usually painless and itchy, that is, "anal side" There are no hemorrhoids. If you suffer from hard work, anger, wine color, and swelling, the shape is like a peach core, hard as a stone, and if the Qi disinfectant powder is used, it will be calm as before." Generally no treatment is required.

    2.1.3 Mixed hemorrhoids Mixed hemorrhoids are called internal and external hemorrhoids in Zhao Zhenzi's family biography. They have the common characteristics of internal and external hemorrhoids, and the internal and external hemorrhoids are integrated. Described as "both inside and outside the anus, bleeding and pain in case of stool". Internal and external hemorrhoids are milder mixed hemorrhoids. Conservative treatment can be used. Bear bile borneol ointment is applied externally, 3 or 4 times a day, with local fumigation and washing medicine. Another type of mixed hemorrhoids is the ring-shaped mixed hemorrhoids dominated by external hemorrhoids. It is called lotus hemorrhoids in Zhao Zhenzi’s family biography. Its clinical characteristics are that the external hemorrhoids are ring-shaped and the radial grooves are obvious. They are divided into multiple, similar Lotus petal-shaped, due to the traction of external hemorrhoids, the internal hemorrhoids are also prolapsed. The anal recess between the internal hemorrhoids and the external hemorrhoids near the dentate line can be observed, similar to pores, and pus will come out when inflamed, that is, "like a lotus, layer Layered up, there are pores, itching and pus." It means that there are damp-heat toxins inside. The treatment is to use Rusheng powder for 7 or 8 times, until the hemorrhoids are purple and black. After 7 or 8 days, the hemorrhoids will fall off; the powder cream is applied once to remove the roots and the roots are taken internally. Corner pills to remove internal poison.

    2.1.4 Hemorrhoids of venereal diseases When they first occur, venereal diseases often show a similar appearance to hemorrhoids in the anus, that is, they are similar to hemorrhoids along the anus. They are called bayberry hemorrhoids in Zhao Zhenzi’s family biography. , Only itching but not painful, dry and no pus, this bayberry is about to appear." Bayberry hemorrhoids are a special form of hemorrhoids. For treatment, you must first take 1 dose of Rusheng Powder, 10 doses of Tuoli Jiedu Decoction, and 3 or 4 times of external application of Fecal Dan for self-healing. Of course, modern treatment should not be limited to this, and further examination is needed to confirm the diagnosis.

    2.2 Understanding of anal fissure Anal fissure has the characteristics of longitudinal skin fissure of the anal canal, constipation, pain and bleeding. Old anal fissure is also accompanied by the proliferation of external hemorrhoids and anal papilla. In Zhao Zhenzi's family biography, hemorrhoids are called hooked intestinal hemorrhoids, which are characterized by "hemorrhoids inside and outside the anus, broken creases, stool like sheep dung, bleeding behind the feces, foul smelly and painful". The treatment should be oral health-preserving pill, fumigation and lotion for external use, and intra-anal musk pill, 1 pill per night, about 1 month. TCM textbook "Chinese Medicine Surgery" [2] adopted.

    2.3 Understanding of perianal abscess and anal leakage In ancient literature, the idea of ​​"hemorrhoids leaking for a long time" was followed. Therefore, the phenomenon of hemorrhoids leaking is often seen, as is the case in Zhao Zhenzi's family biography. Among 24 hemorrhoids, there are 6 types of hemorrhoids, including male and female hemorrhoids, water chestnut hemorrhoids, grape hemorrhoids, walnut hemorrhoids, pomegranate hemorrhoids, and cherry hemorrhoids, which have obvious characteristics of perianal abscess and anal fistula.

    2.3.1 Perianal abscess and low-position simple anal leakage anal margin swelling and pain, initial mass, close to the anus, small mass, can not distinguish between inflammatory external hemorrhoids or perianal abscess, in Zhao Zhenzi’s family biography It is called cherry hemorrhoids, "remove the hemorrhoids first, perforate the second time, take amber pills to collect the work", that is to say, remove the bumps and find that there is anal leakage, which can be directly incised. Simple low anal fistula formed by ulceration. If there is no anal fistula, it is an inflammatory external hemorrhoid.

    2.3.2 Complicated anal leakage is called water chestnut hemorrhoids in Zhao Zhenzi's family biography, including low complex anal leakage and high complex anal leakage. "It looks like a water chestnut, with three or four holes on the left and right, and one hole leads to the intestine to drain pus." It is a low complex anal leak. If the "older person has an attached tube", it is a high complex anal leak. The principle of treatment is to remove the hemorrhoids and pass through the leak first. The treatment method is to remove the tube with medicine nails, and close the mouth with second penetration, combined with oral wax alum pills, and close the mouth with dry pus. For those who are deficient, take 60 tablets of Shiquan Dabu Decoction. In addition, male and female hemorrhoids are also low abscesses, which form low complex anal leakage after ulceration, also called "male and female leakage" [4], which is characterized by the ulcer on both sides of the anus, that is, "the two sides are opposite, but the larger and the smaller , Swelling and pain, pus, small roots of the head are big foreign ears." In the treatment, 6 or 7 times of external application of Rusheng San, oral Kushen pills to clear away heat and detoxification, until the hemorrhoids fall off, and then miss the treatment.

    2.3.3 Anal leakage that occurs in the anterior position of the anus is called pomegranate hemorrhoids in Zhao Zhenzi's family biography. In the treatment, hemorrhoids are removed first, the mouth is closed again, and Huaijiao Kushen pills are taken orally.

    2.3.4 High abscess and anal leak High abscess is called walnut hemorrhoids in Zhao Zhenzi's family biography. It is characterized by "the outer side of the anus, shaped like a walnut, with swelling and painful pus." The principle of treatment is the same as that of water chestnut hemorrhoids. The hemorrhoids should be pierced with medicated thread first, then piercing and leaking, and oral wax alum pill should be taken to close the mouth.

    2.3.5 Recurrent Anal Leakage Anal leakage occurs repeatedly, and there is hyperplasia of inflammatory granulation tissue around the ulcer, which is called grape hemorrhoids, which is characterized by "the left and right sides are like nipples piled up, only itching but not painful, and water is discharged in case of hard work. Or hemorrhoids have holes. Pus". If the grape hemorrhoids have no holes and no pus, they may also be external hemorrhoids. The treatment principle is the same as that of water chestnut hemorrhoids. The specific method is to take the medicine with a tube to close the mouth, and at the same time take a wax alum pill to close the work.

    2.4 Regarding anorectal malignant tumors Among the 24 hemorrhoids passed down by Zhao Zhenzi's family, there are anal hemorrhoids and carbuncle hemorrhoids. Clavicle hemorrhoids have been discussed before. When the rectal and anal tumors are combined with infection, they are called carbuncle and hemorrhoids. It is characterized by "anus swelling like steamed buns, the two sides are tightly closed, the outside is firm but the inside is ulcerated, and the pus is often flowing. This is a lifelong disease." No better treatment has been proposed. The method requires the use of modern medical methods.

    2.5 About anal papillary fibroma. Among the 24 hemorrhoids passed down by Zhao Zhenzi's family, they are called biliary hemorrhoids, which are as large as the gallbladder, with relatively smooth surface and tough texture. It is characterized by "born in the viscera, suspended outside the anus, sometimes draining pus, painful bleeding in the stool". If the shape is small, it is called "beads and hemorrhoids", which is described as "the shape hangs down like a bead" in the "Experience Book of Sores" [3]. The treatment is the same as internal hemorrhoids.

    3 Diagnosis and treatment characteristics of eight leaks

    3.1 Types of leakage In addition to hemorrhoids or combined leakage, "Surgery Dacheng" believes that "there are eight leakages. Shenshu leakage: born at Shenshu point. Melon leakage: shaped like watermelon flesh. Renal capsule leakage: leakage tube Intestinal leak: its leaky tube is coiled around the anus. Bend leak: its tube is not straight, and it is difficult to administer medicine to the bottom. The two symptoms of gluteal leak and honeycomb leak, if the skin is hard black, There must be a heavy pipe inside. Although it is troublesome to hang the thread and thread it in order, it will be troublesome. It is easy to get rid of the root of the intestinal leakage. Therefore, there are good and evil points. There are old people with deficiency of energy. Those who are exhausted and exhausted, and those who suffer from spleen deficiency and chronic diarrhea, are all dead.” It can be seen from this that only the leakage that is connected to the anus is to be threaded.

    3.2 Arsenic production method Arsenic has a unique effect in the external treatment of Chinese medicine and surgery, but its toxicity is relatively high, and it can cause poisoning to the human body. Therefore, special production is required during use to minimize its toxicity while exerting its corrosion and pain relief effects. The method of "Surgery Dacheng" is to use Scutellaria baicalensis, Coptis, Phellodendron amurense, half and half of licorice and mung beans, add 5 bowls of water, decoct the soup, add 1 tael of arsenic to the soup and decoct, with the dry soup as the degree. Then use the method of making Shengdan to make clinically usable arsenic. The prepared arsenic is mixed with Shan Cigu powder into a paste, ready to be made into medicinal strips. When making medicinal strips, pig bristles are used as cores and rolled into medicinal strips of appropriate size. After drying for a while, the bristles are drawn out to make hollow medicinal strips for later use. It has the advantage of "ventilation" when inserting the fistula, and can fully drain.

    3.3 The characteristics of the leakage medicine preparation method Cicada slough: Put it into a bamboo tube, wrap it in mud, simmer in ash for use. Snake slough: Put it in a walnut shell, tie it with iron wire, and wrap it with mud for storage. Dung beetle: Put it in a porcelain bottle, burn it with fire, remove its head and feet and set aside. Earth Dragon: After removing the soil in the abdomen, wash it with yellow wine, then bake it with a slow fire, and place it on a new tile for roasting. Snail: Remove the shell to get the meat, some can be soaked in water overnight to get the meat. Pig hoof and horn gills: Repeated roasting 12 times to become crispy yellow for use. Beef glue, fish maw: stir fry with clam noodles. Hedgehog skin: Soaked in wine, vinegar, and boy urine, and then roasted. Clam powder: Choose the one with purple mouth and simmer with chaff. Dew honeycomb: It is soaked in milk and turned black. Ivory: Sunburn with ghee.

    3.4 Collection of retreating medicine line (1) Use 1 coin of white arsenic and 5 cents of realgar to make powder, put it in a crock for sealing, spray three incense, wipe the lid of the can frequently with water, and add frankincense and myrrh after taking it out 5 coins each, make a thread with white and powder, and wrap it with cork powder. (2) Use 5 coins of white arsenic, 5 coins of realgar, 5 coins of cinnabar, 5 coins of mercury, and 1 tael of alum to make the powder. The preparation method is the same as before. Take out the drug thread, fry the deer ribs into the yellow powder and wrap the drug. The thread has the effect of "no pain when entering the sore". (3) Use 1 tael each of borax and realgar, as the end, put it into the jar, cover with 1 tael of alum powder on the top, use the ascending method as before, blend into a thread with the batter. (5) Put 5 cents of white arsenic powder into an iron pan, cover with 1.5 cents of alum, burn the alum with fire, spray 1 saliva on the alum, cover with tissue paper, and spray 3~5 saliva on the paper. , Cover with a pot lid to see the white frost on the paper. After removing the paper, add oil frankincense and myrrh powder for about 1 cent. After cooling, take the powder and mix it with Feilo noodles to form a paste. Medicine strips.

    3.5 Moxibustion Leaking Method The method of moxibustion leaking in "Surgery Dacheng" mostly uses moxibustion. The types of medicinal cakes are different. They can be pounded with sulfur, wheat flour and garlic, mole crickets can be used for making cakes, and aconites can be used for cakes.

    4 Differential treatment of ulcers around the anus

    4.1 Differential treatment of stork gangrene (sitting horse carbuncle) Stork gangrene is born at the high bones of the Shiri tail (tail point), while sitting horse carbuncle is born slightly above the Shiri tail. The clinical manifestations are as follows: It is strong and big, like a stork's mouth for a long time, the morning is cold and dusk is hot, the night is heavy and the day is light, and it will produce thin pus or blood after the collapse. Its pathogenesis is the formation of wet phlegm in the Du Channel Meridian (turbid qi). The prognosis is "the young and the strong are especially good, the old and the weak are difficult to treat." The specific treatment method is, from the beginning, using the He method, the representative prescription Ziyin Chushi Decoction (Chuanxiong, Angelica, White Peony, Rehmannia, Bupleurum, Scutellaria, Tangerine Peel, Anemarrhena, Fritillaria, Alisma, Digu Bark, Licorice, 3 pieces of ginger are used for decocting; the pus is formed, using the Tuo method, which represents the prescription and Qi Yangrong Decoction (ginseng, tuckahoe, atractylodes, licorice, astragalus, tangerine peel, danpi, agarwood, angelica, rehmanniae) decoction; After more qi and blood weakness, use tonic, representative prescriptions for nourishing kidney and protecting yuan soup (ginseng, poria, atractylodes, licorice, astragalus, angelica, rehmannia, paeonol, eucommia, cornus, cinnamon, aconite, 3 slices of ginger, lotus 7 pieces of meat are decocted in water. If the leakage has formed, take Xiantian Dazao pills and amber wax alum pills orally. Marabou gangrene (sitting horse carbuncle) is similar to today's presacral cyst ulceration or unhealed postoperatively, and sacrococcygeal sinus ulceration is similar, please refer to the application.

    4.2 Differential treatment of buttock carbuncle (upper horse carbuncle, lower horse carbuncle) The place where the buttock carbuncle (upper horse carbuncle, lower horse carbuncle) occurs is the yin in the yin, which belongs to the full sun bladder meridian. Its etiology is characterized by nine out of ten people from the inside to the outside, and one or two in a hundred people who have sex outside. Its pathogenesis is coagulation of wet phlegm, which eventually leads to loss of Sanyin Meridian. The prognostic feature is the most difficult to converge. The principles of treatment are summarized as external attack, avoid internal attack, cultivate tonic, avoid cold. Specific treatments are initially divided into two categories. If there is a head, redness and heat, fever, or dry mouth, use Lifa, you can take Guijin pills orally with cyanotic ointment; if there is no head, swelling, and skin color is not For those who have changed, take care of the method, take orally cyanose, plus garlic moxibustion.If the general trend has subsided and the remaining swelling has not disappeared, use the representative prescription to dehumidify Erchen Decoction (Tangerine peel, Pinellia, Poria, Gentiana, Coix, Licorice, 1 piece of ginger, 2 roots of rush for decocting), plus boiled hot spring onions Iron the affected area frequently. It has been completed and will be used as pus. Use the representative Fangtuoli Qianghuo Decoction (namely, the internal support Qianghuo Decoction, the hard swelling and pain of buttock carbuncle, astragalus, cork, Qianghuo, angelica, ligustrum, forsythia, atractylodes, licorice, cinnamon, yellow wine are Cited) Decoction in water. If the pain is severe, add Shenshou Sanitation Powder; if the general trend has subsided, take Tuoli Sanshu San; if the swelling does not disappear, it is spleen deficiency, it is appropriate to take Liujunzi Decoction plus Chuanxiong, Angelica, and Astragalus; if spleen deficiency, bet, Baizhu Blindly decoct with water; if the lumps remain unresolved, and those who are thirsty and drenched, it is yin deficiency, take Liuwei Dihuang Pills and schisandra. After the ulcer, if the wound is not constricted, wash with ginger decoction and moxibustion with tempeh cake. Similar to today's high abscess and high anal leakage, it can be used as a reference for treatment.

    4.3 Differential treatment of wind chancre Wind chancre usually occurs in the hips and legs, and its clinical characteristics are the shape of scabies, broken yellow water, itching first and then pain or itching pain in the valley. The pathogenesis is responsible for the wind and cold in the valley. The treatment is fragrant. White powder and other topical application. Generally, the poisonous water is exhausted, and the scab is healed. Wind chancre is similar to today's hidradenitis suppurativa, please refer to the application.

    4.4 Differential treatment of Suspended Carbuncle (Yongquan Gangrene, Crotch-piercing Hair, Cross-horse Carbuncle) The four diseases of Suspended Carbuncle, Yongquan Gangrene, Crotch-piercing Hair, and Cross-horse Carbuncle are all located in "after the front yin, before the back yin", Among them, hanging carbuncle "born in the perineum point, after the scrotum, before the valley road", the clinical manifestations are "the first birth is like a pine nut, the second is like a lotus seed, it starts in a few days, it is red and swollen and painful, and it is as big as a peach and plum." "Before jiri"; "Born in the Qionggu point, which is the bottom of the vulva" by wearing the crotch, the clinical manifestations are "color red swelling, pain with the vulva and the back and anus"; cross-horse carbuncle "born in the cross crotch, Near the product line".

    The pathogenesis of the four diseases: Suspended carbuncle, Yongquan gangrene, cross-horse carbuncle, and cross-horse carbuncle are all "belonging to the collaterals of any vein, clamping the governor channel, and the meeting of the chong maiden," "Caused by", among them, "yin essence is weak in all likelihood, yang qi is hyperactive, one or two in a hundred". The prognosis is often "leakage from light to leakage, and more meteorites from severe", symptoms of "numbness, black sinking, diarrhea, vomiting, and fatigue" appear, which can spread to the "valley path" over time and rupture in the internal organs, resulting in a poor prognosis . Specifically, Yongquan gangrene is said to be "white pus smooth, blue pus risk, red and black reversal, no point death". For the treatment of four diseases: Suspended carbuncle, Yongquan gangrene, Crotch-piercing hair, and cross-horse carbuncle, it is advisable to take one or two doses of oral roasted licorice and garlic moxibustion. Xiegan soup. If pus develops, use Tuoli Duli San plus pangolin and saponins thorn water to decoct orally. Cooperate with incision and drainage or self-collapse of tenure. After the rupture, take Liuwei Dihuang Wan in the court and take Shiquan Dabu Decoction plus Danpi, Alisma or Aconite in the afternoon. For those who rupture for a long time and become leaky, use Guolao Gaohuatang orally with wax alum pill, combined with moxibustion with tempeh cake, and moxibustion with aconite cake for a long time. If hot polydipsia, fatigue, lack of food, loose stools, and urination are due to spleen deficiency, it is advisable to supplement Zhongyiqi Decoction plus Poria and Pinellia pinellia. When the symptoms are relieved, add Ophiopogon and Schisandra. Be careful not to use the bitter cold agents such as Anemarrhena and Phellodendron. According to the syndrome differentiation of Yin and Yang, the patients with hyperactive yang should use Kanli pills, and those with weak yang should use Liuwei Dihuang pills. Suspended carbuncle, spring gangrene, crotch hair, and straddling horse carbuncle are similar to today’s perineal abscess and necrotizing fasciitis, which can be referred to and applied.

    4.5 Diagnosis and treatment of visceral toxins In "Surgery Dacheng", visceral toxins are mainly manifested as "anal swelling and pain". The internal and external deficiency is generally distinguished. The pathogenesis and treatment are different. The details are as follows. Generally, from the beginning, you can use a decoction powder (Angelica sinensis tail, saponins thorn, peach kernel, pangolin, licorice, coptis, citrus aurantium, betel nut, black medicine, angelica, trichosanthes, red peony root, safflower, xuanming powder, rhubarb) decoction in water Oral, for patients with swelling and pain in the anus, take five ash powder (centipede, pangolin, raw antlers, vascular goose feathers, blood surplus, equal parts burned ash, 9g water). Regarding "dirt poison", modern Chinese medicine generally considers 4 types according to the literature. In addition to the above, there are blood in the stool in "Introduction to Medicine", anal carbuncle in "Surgery Zheng Zong" and modern dysentery [4].

    4.6 Treatment of ulcers caused by ulcers ulcers caused by ulcers is a mild disease of the anus. You can take licorice orally for the last 3 dollars, and externally use gallium (calcined) for external application.

    5 Treatment of anal disease in children

    5.1 Syndrome differentiation and treatment of anal prolapse in children It is generally believed that constipation may occur due to excessive heat in the lungs, and prolapse may occur due to deficiency and coldness of the lungs. The main prescription of treatment is Buzhong Yiqi Decoction plus Qianghuo, white peony root, simmered dried ginger orally, combined with external use of clam powder or lychee seed, or aged sauce radish slices, or kangong nails. Syndrome Differentiation: If the intestinal segment is red for pain, it is caused by blood deficiency and heat, use Jia Siwu Tang paeonol; if the intestine is slightly red for pain, it is due to Qi deficiency and heat, use Jiadan Pi, Sijunzi Tang; if the hands and feet are hot, it belongs to the stomach Heat, if the hands, feet and fingers are cold, it is a cold in the stomach. If the heat accumulates, add cohosh and strips.

    5.2 The diagnosis and treatment of children’s anal itching is caused by worm-eaten the anus. The clinical manifestations are small white spots in the lower lip or small nodules before and after the ears. Jiuwei Aloe Pills can be taken orally, and the external realgar and patina are divided into the end External application. Although in the Department of Pediatrics, as a disease, "Surgery Dacheng" should be the first record.

    6 Analysis of characteristics of syndrome differentiation and treatment of twenty-four hemorrhoids

    6.1 Syndrome Differentiation and Treatment of Anal Diseases by Oral Administration "Surgery Dacheng" believes that all hemorrhoids, "swelling is wet, pain is fire, itching is windy, and closed is dry", should be treated according to the syndrome.

    6.1.1 Anal diseases with bleeding as the main syndrome The diseases with bleeding as the main symptoms mainly include internal hemorrhoids, hemorrhoids, intestinal wind, and visceral poison.

    6.1.1.1 Kushen Rehmannia Pills The medicine consists of two flavors of Kushen and Rehmannia, and honey is a pill, orally, twice a day. Indications of hemorrhoid bleeding, intestinal wind blood, and alcohol poisoning blood.

    6.1.1.2 Cypress Pills The medicine consists of five flavors: raw arborvitae leaves, Qingzhou persimmons, old palm, charcoal from blood, sophora japonica, and honey as pills, 3 times a day. Take hemostasis as the degree. Indications of hemorrhoids, intestinal wind, visceral toxins and other blood, vomiting blood, blood collapse and so on.

    6.1.1.3 Ermiao Pill The medicine consists of 2 flavors of cottonseed and pau nitrate. After soaking in wine, it is dried to the end and taken orally. Indications of internal hemorrhoids, visceral toxin bleeding. Not the second wonderful pill of "Danxi Heart Law".

    6.1.1.4 Zanglian Pills The medicine consists of two flavors of Coptis and Sophora japonicus. It is packed into the large intestine of male pigs, wrapped with leeks for external use, steamed until the intestines are completely fat, removed from the intestines and dried in the sun. It has more flavors of Sophora japonica than "Zhengsheng for Syndrome and Treatment", and its preparation method is different.

    6.1.1.5 Baicao Pills The medicine is composed of Baicao Cream, Scutellaria baicalensis Georgi, Gardenia, Coptis chinensis, Sophora japonicus, Sanyu 6 flavors. It is a paste pill that is taken orally.

    6.1.2 Anal disease with swelling, pain and bleeding as the main symptom

    6.1.3 Anal disease mainly caused by swelling, pain and constipation

    6.1.3.1 Qingjin Yangrong Decoction The medicine composition is Angelica sinensis, Radix Paeoniae Rubra, Rehmannia glutinosa, Coptis, Radix Scutellariae, Forsythia, Rhubarb, Fructus Aurantii, Maren, Poria, Trichosanthes, Licorice 12 flavors, decoction. Indications of hemorrhoids, swelling and pain, dry stool, tenesmus.

    6.1.3.2 The medicine composition of Tongsheng Powder is Fangfeng, Nepeta, Red Peony Root, Guiwei, Gardenia, Forsythia, Scutellaria, Atractylodes, Mint, Ligusticum Chuanxiong, Liquorice, Platycodon, Gypsum, Talc, Rhubarb, Chrysanths Ginger, red dates, rushes and other 20 flavors, decoction in water. After taking 1 dose, diarrhea 2 or 3 times, change to Qingjin San. Indications of hemorrhoids, swelling and pain, closed stools.

    6.1.3.3 Qingjin Powder The medicine consists of five flavors of Coptis, Citrus aurantium, Tangerine Peel, Frankincense, and Myrrh. First use Tongsheng Powder, then use this medicine and decoct in water. Indications of hemorrhoids, swelling and pain, closed stools. With the fumigation and washing method, the effect of pandan external application is better.

    6.1.3.4 Niuhuang Dingtong Pills The medicine is composed of 5 flavors of Niuhuang, Phu Huanglian, Gardenia, Sophora japonica, and bitter food. It is a paste pill that is taken orally.

    6.1.4 So Fengshunqi Pills for anal diseases with the main symptoms of Secret Blood Emergencies: Rhubarb, Maren, Yuliren, Duhuo, Plantago Seed, Dodder, Citrus aurantium, Betel Nut, Yam, Achyranthes, Dogwood, Add 12 flavors of Qianghuo, refine honey into pills, orally once a day. Indications of internal heat, tenesmus, severe intestinal wind and blood poisoning.

    6.1.5 Anal disease with ulcers that do not heal for a long time

    6.1.5.1 Shiquan Dabu Decoction The medicine consists of astragalus, angelica, rehmannia, chuanxiong, white peony, ginseng, atractylodes, poria, cinnamon, licorice, red dates, and those with weak spleen and stomach, add tangerine peel and amomum 13 flavors, decoct in water. Indications of anal disease with insufficient qi and blood and unable to grow flesh to close the mouth.

    6.1.5.2 Liuwei Dihuang Wan Indications for long-term leakage, clear and thin pus, can not be closed. It has the functions of nourishing the kidney and yin, nourishing qi and nourishing blood.

    6.1.5.3 Bawei Dihuang Pills Liuwei Dihuang Pills add aconite and cinnamon to cure sore toxins. It has the functions of replenishing yin and assisting yang, smoothing the spleen and stomach, making muscles grow easily and pus should be dry.

    The method of treating hemorrhoids in "Surgery Dacheng" is summarized as the following process. First take 3 or 4 doses of cooling blood detoxification prescriptions, such as Liangxue Dihuang Decoction, Tongsheng Powder, etc., and then take Huaijiao Diyu Pills and Zanglian Pill Banhu , Eliminate internal poison, cut the root. If there is too much urgency, or cause prolapse, use the recuperate to disperse it; if the cold is too severe, nocturnal emission occurs, make up for it. Blood under intestinal hemorrhoids, caused by wind-heat, it is advisable to use Tiaoqin, Coptidis, Shengdi, Sophora japonicus, or Xiaoji, Danshen to clear heat, Angelica, Chuanxiong, and safflower to regulate blood; Ginseng, Citrus aurantium, Cohosh Smoothly. For those who are cold, add Poria and Woody; for those who are drinking, add Pueraria lobata, ebony, and black beans. It is especially mentioned that cohosh is a necessary medicine for the treatment of hemorrhoids. After the above treatment, the effect of hemorrhoids is not good, it is better to warm up, and use Sijunzi Decoction plus astragalus, lentils, or Shenlingbaizhu powder. Finally, when the blood under the large intestine collects power with the stomach qi, the blood returns to the meridian.

    6.2 Characteristics of comprehensive treatment of hemorrhoids

    6.2.1 Ligation of internal and external hemorrhoids The first step: the first step of using dry hemorrhoids. Step 2: When the hemorrhoids are turned out, ligate with medicine thread. The composition of the medicinal thread includes four medicinal decoctions of fresh daphne, lei pill, toad venom, and grass black. The raw silk is soaked in the medicinal juice and dried, repeated several times. If there is no leaky tube, use different methods to close the mouth according to the characteristics of hemorrhoids. For milk hemorrhoids, just order Wanyi ointment 1 or 2 times, Wanyi ointment is five ash juice; for cockscomb hemorrhoids, apply external powder cream once. The specific method of ligation is not explained, and the method of tying is sufficient for now. The third step: Oral Kushen pills. It is mentioned in "Surgery Dacheng" that the head is big and the root is small, use this method. If the head is small and the root is big, use withered medicine. After the hemorrhoids fall off, in the treatment of leakage, if there is a fistula, nail medicine can be used, and the intestine can be used to hang the thread. If there is no hemorrhoids and leaks, the anus will be swollen first Hard, half a year or a year, painful pus, first pass the intestine and then ulcerate, there must be an attached tube. The effect can be guaranteed by taking the tube out of the treatment and hanging the thread afterwards.

    6.2.2 The specific steps of internal hemorrhoids

    6.2.2.1 Method 1 (Zhao Zhenzi’s family biography) The first step: Oral Fanzhi powder plus Huanzhi powder and anal method. For internal hemorrhoids that cannot be prolapsed, you can take 1 dose of Turning Hemorrhoid Powder orally, and use Huanzhi Powder for external application to turn out the internal hemorrhoids. The medicine composition of Fanzhi Powder is 3 yuan of raw citrus aurantium, 1 gold of tangerine peel, 2 flavors in total. The medicine composition of Huanzhi Powder is raw grass black tip, hedgehog skin, dried alum, white salt, musk, borneol and green onion juice. After mixing the prodrug finely with green onion juice, send it into the anus to make internal hemorrhoids. Flip out. The second step: such as Shengsan external coating method. Wash the turned out internal hemorrhoids, use saliva to make a holy powder, and apply it on the hemorrhoids 5 or 6 times a day until the color of the hemorrhoids turns purple-black. For example, Shengsan can treat all hemorrhoids inside and outside, and fall spontaneously within seven days. Its medicine composition is chicken manure (dried), orpiment, realgar, alum, dermatophyte, bile alum, frankincense, myrrh, and borneol. The first 6 flavors are Put the powder in a silver container, cover it, fire to burn out the blue smoke, take it out, add the last 3 flavors, a total of fine powder, put it in a porcelain jar, seal it, take it out when used, and apply it with saliva On the hemorrhoid body. The third step: washing the trotters soup outside. Decoction with trotters, wash 3 or 4 times a day until the wound heals. The fourth step: Shengjisan closing method. On the 7th, hemorrhoids fell off spontaneously. Slightly use Shengji San, and it can be closed in 2 or 3 days. After the wound is collected, take 1 dose of recuperating powder orally and earn it by yourself. For details of Shengji San, see thread-hanging therapy.

    6.2.2.2 Method 2 "Surgery Dacheng" mentioned in the method of withered hemorrhoids, first enclose the good meat around the medicine. Coptis, turmeric, and gypsum are divided into equal parts, Bletilla striata is halved, honey is diluted, painted, and covered with tissue paper. Apply withered medicine, or add borneol and musk. Before replacing the medicine for hemorrhoids, it is advisable to wash it with Qianghuo and Duhuo decoction. If the hemorrhoids have dried up and do not fall off, use the spiritual magnet, the stiff silkworm, and the five points each of the five points, and adjust it with cold water. After the hemorrhoids fall off, first use licorice decoction to wash outside, and then use nepeta and clam decoction to wash outside, there will be no pus. For those who are itchy after taking off, wash outside with decoction powder and licorice thick sauce.

    6.2.3 External hemorrhoids and hemorrhoids The medicine used for external hemorrhoids is different from that of internal hemorrhoids, but Erxiandan or Yuhong powder is used.

    6.2.3.1 Erxian Pill, also known as Saijin San. The preparation method of the two medicines of golden foot arsenic and alum is the same as Sheng San, plus roasted scorpion tail and raw grass black, and the usage is the same as Sheng San.

    6.2.3.2 Yuhong San The medicine is composed of 6 flavors: elixir, realgar, white clove, toad venom, frankincense, and myrrh. The total is fine powder, and the usage is the same as that of holy powder. The similarities and differences between the two are that both can treat external hemorrhoids, and the latter can also be used to remove the rotten flesh of the fistula.

    6.2.3.3 Application of hemorrhoid powder The medicine consists of 6 flavors of coptis coptis, dragon's blood, catechu, bear gall, borneol, and musk, or add borax or lead white cream, and adjust the application with bitter food and water.

    6.2.4 Anal leakage drug nail withdrawal method When it is found that the leaky tube is not related to the anorectum, it is called external leakage. At this time, a tube withdrawal spindle can be used. The first step: make the tube withdrawal spindle and the muscle-producing medicine nail. The medicine composition of the retreating tablet is 9 medicines such as elixir, white clove, realgar, light powder, toad venom, frankincense, myrrh, musk, and dung beetle. The first 9 medicines are combined into fine powder. After the rice is mixed, it is made into a green grass. The strips are about 2 inches long and dry in the shade to become medicine nails. All sores and fistulas are used. The medicine composition of Shengjiyao Nail is pearl, ivory, keel, catechu, stamen, dragon's blood, light powder, angelica, baiji, cinnabar, and borneol. The second step: When using, insert the pipe withdrawal spindle into the leaking pipe. Generally, it takes two or three times to corrode the hard leaking pipe. Be careful not to penetrate the rectum, otherwise you will need thread-hanging therapy. Step 3: After the leakage sore is gone, insert the muscle-producing medicine nail into the wound and gradually close the mouth. The precautions for the drug inserting nail mentioned in "Surgery Dacheng" are that when inserting the drug nail, do not insert it into the bottom of the leaky tube, that is, "if the hole is one inch deep, insert the drug in seven to eight degrees"; insert the drug twice in the morning and evening , 3 or 4 consecutive days. "Kong Dajia is inserted in several places"; after 7 days, large seams will be cracked on all sides of the affected area, that is, Yuhong ointment will be applied; after 7 days, it will fall by itself. When there is no black rot on the sides, replace it with Shengji powder; when the pus is thick, close the mouth with the pearl powder, do not put on the plaster, fear that it will breathe pus, and the mouth will be slow; take waxy yellow pills orally to dry the pus .

    6.2.5 Thread-hanging therapy for anal leakage The thread-hanging therapy is currently a characteristic therapy of TCM for the treatment of anal leakage. It is widely used, but nowadays, rubber bands are often used to replace medical thread or nails. Whether it is a development or a loss of advantage is worth further research. The medicine thread used is the same as the hemorrhoid ligation method. After the leaking tube is hung up by the medication line, proceed as follows. Shengji Powder for external use, its medicinal composition is calamine, woody, odorifera, frankincense, myrrh, dragon's blood, catechu, cork, coptis, angelica, daikon, keel, borneol, musk, red stone fat, yellow almond , Sea cuttlefish 17 flavored medicine, altogether is the end, external use, has the effect of growing flesh and closing the mouth. Pearl powder also has the same effect as Shengji powder. Its medicinal composition is 8 flavors: pearl, gypsum, red stone fat, light powder, white keel, borneol, baby bone and ivory. In general, oral wax alum pill or amber pill is sufficient. The drug composition of wax alum pill is yellow wax and alum. It has the function of closing the dry pus after the leak hole is pierced; the drug composition of amber pill is alum, ivory, 7 flavors of dragon's blood, frankincense, myrrh, musk, honeycomb, and yellow wax. If the pus is incessant, you can take Astragalus Liuyi Powder orally. Its composition is 2 flavors of Astragalus and Licorice. After more than 10 doses, the pus can dry by itself. It is mentioned in "Surgery Dacheng" that for porous patients, only one hole will be treated first, and then another hole will be treated every few days. If the thread falls and the mouth opens, apply the muscles to loosen.

    6.2.6 Drug therapy of anal leakage It is generally believed that after the formation of anal leakage, it is difficult to cure with oral drugs and must be treated surgically. However, "Surgery Dacheng" records more prescriptions for oral treatment of anal leakage. Whether it is prejudice or lack of research methods is worth pondering.

    6.2.6.1 Method One: Oral internal elimination tube pills. (1) Oral internal disappearance tube pill: internal disappearance tube pill, also known as Jie Xue internal Xiao pill, can withdraw the tube and close the mouth without external treatment. The medicine composition is 10 kinds of medicines including hive, hedgehog skin, dragon's blood, ivory, rigid silkworm, cicada slough, wood incense, fire nitrate, frankincense, and myrrh. The preparation method is yellow wax boiled in black, and after warming, it will total the top 10 Add the flavored medicine and stir well to make a pill the size of Wutong seeds. Each serving is 3 yuan, 3 times a day, and delivered with wine for 7 consecutive days. At this time, the pus will increase. Reduce the amount to 1 serving a day, about 15 days later , The poison will be exhausted. (2) Cooperate with external use of Shengji San: The clinical sign of the end of the poison is "the fleshy tube comes out". Gradually cut off with scissors every day, and blow Shengji San into the fistula, which has the effect of closing the mouth. The medicinal composition of Shengji San consists of four medicines: Pan Pheasant, Dragon's Blood, Catechu, and Borneol, all of which are finely divided and reserved. (3) Auxiliary external washing: when the poison is found to be exhausted, wash externally with ham broth, 2 or 3 times a day, it has the effect of closing dry pus.

    6.2.6.2 Method 2 Oral health-preserving pills. The medicinal composition of Yangshengdan is sow large intestine, puerperium, ivory, hedgehog skin, musk, porcine hoof, pangolin, frankincense, myrrh, realgar, sanguis, rhubarb, green salt, angelica, alum, small live tortoise, hive 22 herbs, yellow ox horn gills, puxiao, sophora japonicus, yellow wax, natural copper, the preparation method is that the medicine is used for the end, the honey is made into pills, 3 yuan per serving, 2 times a day, old wine is delivered. After 15 consecutive days, the tube can be seen, and it can be cured in about 30 days without myogenic drugs.

    6.2.6.3 Method 3 Oral Hedgehog Pixianglong Pills. The medicine composition of Hedgehog Pixianglong Pills is mercury, orpiment, realgar, ore, Yu surplus grain, alum, and 7 medicines including hedgehog skin, benjamin, ivory, dragon's blood, frankincense, myrrh, and pig's hoof. The method is to put the first 6 herbs at the end, put them in the Yangcheng jar, seal, simmer until the time for three sticks of incense, wipe the bottom of the jar with water until the temperature drops to normal, the purpose is to remove the fire poison in it, and take it out the next day The latter and the latter 7 medicines are fine powder, melted with yellow wax, and made into mung bean-sized pills, 50 pills each time, 3 times a day, and taken with Sophora japonica soup. It has the function of "withdrawing the pipe and eliminating the need to hang the line". After the above 3 kinds of oral drugs are cured, they must take Shougongwangen Pills to remove the roots of hemorrhoids. Shougongjingen pill is composed of five medicines: dried alum, realgar, clam, ebony meat, and borneol. A total of refined honey is made into pill, 1 minute a day, and taken with water.

    6.2.7 Fumigation and washing method Fumigation and washing method is used for the treatment of hemorrhoid swelling, pain, bleeding and leakage of toxin.

    6.2.7.1 The medicine composition of the fumigation and washing prescription consists of seven medicines including Digu Bark, Sophora japonica, Chive Root, Piaoxiao, Alum, Sago Leaf, and Onion. Try not to reveal the medicinal gas, smoke it first and then wash it. It is best to wait until the hemorrhoids are yellow.

    6.2.7.2 Fumigation and Washing Hemorrhoids Recipe The medicine consists of 7 flavors: Wasong, Aristolochia, Pitan, Clams, Lotus House, Bee House, and Peach Tree Root, and the usage is the same as above.

    6.2.8 Suppository anal plug method The anal plug method is used to treat internal hemorrhoids swelling and pain and visceral income, which has pain inside and has analgesic function. Its medicine is Neishan, also known as Long She Wan. The medicine is composed of 7 herbs of bezoar, tianzhu yellow, light powder, frankincense, myrrh, mint leaf, and borneol. The total is fine powder, and dilong is smashed into pills, made into the size of jujube nucleus, and wrapped with borneol. When lying supine, insert 1 pill into the anus, 7 times. Can make hemorrhoids get rid of the roots.

    7 Summary of the academic achievements of "Surgery Dacheng"

    The main contributions of "Surgery Dacheng" are as follows: First, it fully records the secret recipe of Zhao Zhenzi, a specialist in hemorrhoids in the Ming Dynasty; second, the clinical manifestations and prognosis of anal clevisoid hemorrhoids are proposed for the first time; Enterostomy; fourth, the creation of classic prescriptions for the treatment of anorectal diseases, such as Liangxue Dihuang Decoction, etc.; fifth, the scope of traditional Chinese medicine for anorectal diseases has been determined.

    【references】

    1 Qi Kun. Master of Surgery. Shanghai: Commercial Press, 1963, 138-162.

    2 Li Yueqing. Traditional Chinese Medicine Surgery. Beijing: China Press of Traditional Chinese Medicine, 2002, 276-378.

    3 Tian Zhenguo. Collection of ancient Chinese medical literature on anorectal diseases. Shenyang: Liaoning Science and Technology Press, 2007, 414-416.

    4 Hou Yufen, Chen Bonan. Interpretation of TCM Surgical Disease Names. Jinan: Shandong University Press, 1997, 189.

    5 Li Kaitai. Hemorrhoids. Beijing: People's Medical Publishing House, 1959, 148.

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