论曰，脉痔者，脏腑蕴积风热不得宣通也，风热之气，乘虚流注下部，故肛边生疮，痒
痛血出也，盖实为痛，虚为痒。今实热乘虚下攻肛肠，故痒且痛，又脉者血之腑，得热则妄
行，故血乃出也。
治脉痔生疮，下血痒痛。槐荚煎丸方 槐荚（一斤净洗并子烂研入水半升同研捩取
汁） 白蜜（二两与槐荚汁同熬成膏）
枳壳（去瓤麸炒一两） 黄 （锉） 防风（去叉各半两） 杏仁（汤去皮尖双仁麸炒
研入）
上七味，除前膏并杏仁外，捣罗为末，与杏仁和匀，以槐荚膏再和，杵二三百下，丸如
梧桐子大，每服二十丸，清米饮下，早晚食前服。
治脉痔下血，大肠肿痒。大圣散方
枳壳（十四枚） 胡桃（十枚） 荆芥穗 木贼（炒各一两） 延胡索（半两）
上五味，将枳壳胡桃同入藏瓶内，用泥固济，烧存性，捣后三味为细末，再同研匀，每
服二钱匕，米饮调下。
治脉痔有虫，时或痒痛，血不止。姜附汤方
生姜 艾叶（各半两） 附子（炮裂去皮脐） 枳壳（去瓤麸炒各三分） 生地黄（一
两半）
上五味，锉如麻豆大，每服五钱匕，水一盏半，煎至一盏，去滓早晚食前温服。
治脉痔下部痒痛生疮、血出。阿胶汤方
阿胶（炒） 艾叶 当归（切焙） 青葙子（各一两）
上四味，粗捣筛，每服五钱匕，水一盏半，煎至一盏，去滓早晚食前温服。
治脉痔痒痛，下血不止。樗根散方
樗根皮（洗切） 枳壳（去瓤麸炒各三两） 皂荚子（取仁炒二两）
上三味，捣罗为散，每服二钱匕，温米饮调下，早晚食前服。
治脉痔肛边生疮痒痛。杀虫散方
獭皮
上一味，烧灰细研，空心米饮调下二钱匕，日晚再服。
治脉痔，下部痒痛成疮，涂痔。槐白皮膏方
槐白皮（五两） 赤小豆（五合） 楝实 槐实（各五十枚） 当归（切焙三两） 白
芷甘草
上八味，锉细七味，先煎脂令沸，下诸药同煎，候白芷黄赤色，绵绞去滓，瓷合盛，
每用涂摩疮上，日三五次。
治脉痔，生疮痒痛，下部如虫啮。熏痔汤方
苦桃皮 李根皮 蓄 苦参（各一两）
上四味锉碎，以水六升，煎至四升，去滓乘热熏洗，日三五次。
治脉痔，下部痒痛，四沿肿起出血。拓痔大豆帛方
大豆（三升） 甘草（一两） 槐白皮（三两）
上三味，除豆外，细锉，先以水一斗，入豆煎汁，至二升，去豆，次下甘草槐皮，同煎
至一升，去滓，浸故帛三四重，拓下部，冷即再暖，日三五次。
治脉痔，下部如虫啮，纳下部。露蜂房散方
露蜂房 生螺靥（各一两）
上二味，烧灰细研为末，以绵裹二钱匕，纳下部中，日晚再易。
治脉痔有虫，或下脓血，熏痔。槐白皮汤方
槐白皮（二斤）
上一味细锉，以水一斗五升，煎至一斗，去滓倾盆中坐熏，冷即再暖，虫当随便利自出
，更捣槐白皮末，绵裹一钱，纳下部中。
治脉痔，下部如虫啮，出虫方
桃叶（一秤捣研）
上一味，蒸令热，纳小口器中，布复熏之，虫即出。
治脉痔，下部如虫啮，痒痛出血。涤痔散方
白矾（末半两）
上一味，取小便三升，入矾末，乘热洗之。
治脉痔，下部如虫啮，敷痔。 皮散方
皮
上一味，烧灰研为末，每用少许，生油调敷之。
论述说，脉痔（一种以肛门周围血脉异常、出血、瘙痒疼痛为特征的痔疮），是由于脏腑内蕴积风热之邪，导致气机不得宣通所致。风热之气乘人体正气虚弱之时，流注于下部，因此肛门边缘生疮，出现瘙痒、疼痛和出血的症状。一般来说，实证多表现为疼痛，虚证多表现为瘙痒。如今实热之邪乘虚下攻肛肠，所以既痒又痛。另外，“脉”是血液汇聚的府库，血液受热则妄行溢出脉外，因此血液流出。
治疗脉痔生疮、下部出血且伴有瘙痒疼痛的方剂：槐荚煎丸方
药材：槐荚（一斤，洗净并连同种子一起捣烂，加入半升水共同研磨后拧取汁液）、白蜜（二两，与槐荚汁一同熬制成膏状）。
枳壳（去除瓤部，麸炒，一两）、黄芩（锉碎）、防风（去除叉枝，各半两）、杏仁（用热水去皮尖，保留双仁，麸炒后研入）。
以上七味药，除了前面的膏剂和杏仁外，将其他药物捣碎过筛成细末，与杏仁混合均匀，再用槐荚膏调和，杵捣二三百下，制成如梧桐子大小的丸药。每次服用二十丸，用清米饮送服，早晚饭前服用。
治疗脉痔下部出血、大肠肿胀瘙痒的方剂：大圣散方
药材：枳壳（十四枚）、胡桃（十枚）、荆芥穗、木贼（炒，各一两）、延胡索（半两）。
以上五味药，将枳壳和胡桃一同放入瓷瓶中，用泥密封瓶口，烧至存性（即内部炭化而外部保持原形），将剩下的三种药捣成细末，再与前两者共同研磨均匀。每次服用二钱匕，用米饮调服。
治疗脉痔有虫，时而瘙痒疼痛，出血不止的方剂：姜附汤方
药材：生姜、艾叶（各半两）、附子（炮裂，去皮脐）、枳壳（去瓤麸炒，各三分）、生地黄（一两半）。
以上五味药，锉碎如麻豆大小。每次服用五钱匕，加水一盏半，煎煮至一盏，去渣，早晚饭前温服。
治疗脉痔下部瘙痒疼痛生疮、出血的方剂：阿胶汤方
药材：阿胶（炒）、艾叶、当归（切后焙干）、青葙子（各一两）。
以上四味药，粗捣筛过。每次服用五钱匕，加水一盏半，煎煮至一盏，去渣，早晚饭前温服。
治疗脉痔瘙痒疼痛，下部出血不止的方剂：樗根散方
药材：樗根皮（洗净切制）、枳壳（去瓤麸炒，各三两）、皂荚子（取仁炒，二两）。
以上三味药，捣碎过筛成散剂。每次服用二钱匕，用温米饮调服，早晚饭前服用。
治疗脉痔肛门边缘生疮瘙痒疼痛的方剂：杀虫散方
药材：獭皮。
以上一味药，烧成灰后细细研磨，空腹时用米饮调服二钱匕，晚上再服一次。
治疗脉痔，下部瘙痒疼痛成疮，外用涂抹的方剂：槐白皮膏方
药材：槐白皮（五两）、赤小豆（五合）、楝实、槐实（各五十枚）、当归（切后焙干，三两）、白芷、甘草。
以上八味药，将除甘草外的七味药锉细，先煎油脂令其沸腾，放入诸药同煎，等到白芷呈现黄赤色时，用绵布绞去药渣，盛在瓷器中。每次取适量涂抹按摩在疮面上，每天三到五次。
治疗脉痔，生疮瘙痒疼痛，下部感觉像被虫子咬一样的方剂：熏痔汤方
药材：苦桃皮、李根皮、蓄草、苦参（各一两）。
以上四味药锉碎，用水六升，煎煮至四升，去渣，趁热气熏洗患处，每天三到五次。
治疗脉痔，下部瘙痒疼痛，四周肿胀隆起出血的方剂：拓痔大豆帛方
药材：大豆（三升）、甘草（一两）、槐白皮（三两）。
以上三味药，除大豆外，其余细锉。先用水一斗，放入大豆煎汁，至二升时去掉大豆，接着放入甘草和槐皮，同煎至一升，去渣。将旧帛布浸透药汁，折叠三四层，敷贴在下部患处，冷了再加热，每天三到五次。
治疗脉痔，下部感觉像被虫子咬，塞入下部的方剂：露蜂房散方
药材：露蜂房、生螺靥（各一两）。
以上两味药，烧成灰后细细研磨成末。用绵布包裹二钱匕的药末，塞入下部中，早晚更换一次。
治疗脉痔有虫，有时排出脓血，用于熏痔的方剂：槐白皮汤方
药材：槐白皮（二斤）。
以上一味药细锉，用水一斗五升，煎煮至一斗，去渣，倒入盆中坐浴熏蒸，凉了再加热。虫子应当会随着大便自然排出。之后再将槐白皮研成末，用绵布包裹一钱，塞入下部中。
治疗脉痔，下部感觉像被虫子咬，排出虫子的方剂：出虫方
药材：桃叶（一秤，捣烂研磨）。
以上一味药，蒸热后，放入小口容器中，用布覆盖熏蒸，虫子就会出来。
治疗脉痔，下部感觉像被虫子咬，瘙痒疼痛出血的方剂：涤痔散方
药材：白矾（研末，半两）。
以上一味药，取小便三升，加入白矾末，趁热清洗患处。
治疗脉痔，下部感觉像被虫子咬，敷贴痔疮的方剂：皮散方
药材：皮（原文此处似有缺字，通常指某种动物皮或特定树皮，依原文仅录“皮”）。
以上一味药，烧成灰研为末，每次取少许，用生油调和后敷贴。
Discussion states that Mai Hemorrhoids (hemorrhoids characterized by abnormal blood vessels in the anal region, bleeding, itching, and pain) are caused by the accumulation of wind-heat pathogens within the Zang-Fu organs, leading to a failure of Qi mechanism to circulate freely. The pathogenic factors of wind-heat flow into the lower body when the healthy Qi is deficient, resulting in sores around the anus, accompanied by itching, pain, and bleeding. Generally, excess patterns manifest as pain, while deficiency patterns manifest as itching. Currently, excess heat pathogens attack the intestines and rectum from below due to deficiency, causing both itching and pain. Furthermore, "Mai" (Blood Vessels) is the residence where blood gathers; when affected by heat, blood flows recklessly and overflows from the vessels, hence the bleeding occurs.
Formula for treating Mai Hemorrhoids with sores, lower bleeding, itching, and pain: Huai Jia Jian Wan (Locust Pod Decoction Pills)
Ingredients: Locust Pods (one jin, thoroughly washed and mashed together with seeds, mixed with half sheng of water, ground, and squeezed to extract juice); White Honey (two liang, boiled together with locust pod juice until it becomes a paste).
Zhi Qiao (Bitter Orange Peel, pith removed, bran-fried, one liang); Huang Qin (Scutellaria Root, crushed); Fang Feng (Saposhnikovia Root, forked parts removed, each half liang); Xing Ren (Apricot Seed, skin and tip removed using hot water, retaining double kernels, bran-fried and ground).
The above seven ingredients: Except for the aforementioned paste and apricot seeds, grind the remaining herbs into fine powder, mix evenly with the apricot seeds, then blend with the locust pod paste. Pound 200-300 times to form pills the size of sophora tree seeds. Take twenty pills per dose, administered with clear rice drink, morning and evening before meals.
Formula for treating Mai Hemorrhoids with lower bleeding, intestinal swelling, and itching: Da Sheng San (Great Sage Powder)
Ingredients: Zhi Qiao (Bitter Orange Peel, fourteen pieces); Hu Tao (Walnut, ten pieces); Jing Jie Sui (Schizonepeta Flower Spike); Mu Zei (Equisetum Hiemale, fried, each one liang); Yan Hu Suo (Corydalis Rhizome, half liang).
The above five ingredients: Place Zhi Qiao and walnuts in a porcelain bottle, seal tightly with mud, and burn until carbonized internally but preserved externally (cun xing). Grind the remaining three herbs into fine powder, then mix uniformly with the carbonized mixture. Take two qian bi per dose, mixed with rice drink.
Formula for treating Mai Hemorrhoids with parasites, intermittent itching and pain, and continuous bleeding: Jiang Fu Tang (Ginger and Aconite Decoction)
Ingredients: Sheng Jiang (Fresh Ginger); Ai Ye (Mugwort Leaf, each half liang); Fu Zi (Prepared Aconite Root, cracked by frying, skin and navel removed); Zhi Qiao (Bitter Orange Peel, pith removed, bran-fried, each three fen); Sheng Di Huang (Rehmannia Root, one and a half liang).
The above five ingredients: Crush to the size of hemp seeds. Take five qian bi per dose, add one and a half sheng of water, boil down to one sheng, remove dregs, and take warm before meals morning and evening.
Formula for treating Mai Hemorrhoids with lower itching, pain, sores, and bleeding: E Jiao Tang (Donkey-Hide Gelatin Decoction)
Ingredients: E Jiao (Donkey-Hide Gelatin, fried); Ai Ye (Mugwort Leaf); Dang Gui (Angelica Sinensis Root, sliced and dried); Qing Xiang Zi (Celosia Seed, each one liang).
The above four ingredients: Coarsely crush and sieve. Take five qian bi per dose, add one and a half sheng of water, boil down to one sheng, remove dregs, and take warm before meals morning and evening.
Formula for treating Mai Hemorrhoids with itching, pain, and continuous lower bleeding: Chu Gen San (Ailanthus Root Bark Powder)
Ingredients: Chu Gen Pi (Ailanthus Root Bark, washed and sliced); Zhi Qiao (Bitter Orange Peel, pith removed, bran-fried, each three liang); Zao Jia Zi (Gleditsia Sinensis Fruit Seed, kernel extracted, fried, two liang).
The above three ingredients: Grind into powder. Take two qian bi per dose, mixed with warm rice drink, morning and evening before meals.
Formula for treating Mai Hemorrhoids with sores, itching, and pain around the anus: Sha Chong San (Parasite-Killing Powder)
Ingredients: Ta Pi (Rabbit Skin).
The above single ingredient: Burn to ash, grind finely. Take two qian bi, mixed with rice drink on an empty stomach, and take again in the evening.
Formula for treating Mai Hemorrhoids with lower itching, pain, and sores, for external application: Huai Bai Pi Gao (Locust White Bark Ointment)
Ingredients: Huai Bai Pi (Locust Tree White Bark, five liang); Chi Xiao Dou (Adzuki Bean, five he); Lian Shi (Chinaberry Fruit); Huai Shi (Locust Fruit, each fifty pieces); Dang Gui (Angelica Sinensis Root, sliced and dried, three liang); Bai Zhi (Angelica Dahurica Root); Gan Cao (Licorice Root).
The above eight ingredients: Finely chop the first seven ingredients. First boil animal fat until boiling, add all herbs, and simmer until Bai Zhi turns yellowish-red. Strain through cotton cloth, store in porcelain. Apply and massage onto sores three to five times daily.
Formula for treating Mai Hemorrhoids with sores, itching, pain, and sensation of insect bites in the lower body: Xun Zhi Tang (Fumigation Hemorrhoid Decoction)
Ingredients: Ku Tao Pi (Bitter Peach Bark); Li Gen Pi (Plum Root Bark); Xu Shu (Polygonum Aviculare); Ku Shen (Sophora Flavescens Root, each one liang).
The above four ingredients: Crush finely. Add six sheng of water, boil down to four sheng, remove dregs. Fumigate and wash the area while hot, three to five times daily.
Formula for treating Mai Hemorrhoids with lower itching, pain, swelling around the anus, and bleeding: Tuo Zhi Da Dou Bo Fang (Hemorrhoid-Pressing Soybean Cloth Formula)
Ingredients: Da Dou (Soybeans, three sheng); Gan Cao (Licorice Root, one liang); Huai Bai Pi (Locust Tree White Bark, three liang).
The above three ingredients: Finely chop except for soybeans. First, boil soybeans in ten dou of water until reduced to two sheng, then remove soybeans. Add Gan Cao and Huai Bai Pi, boil down to one sheng, and remove dregs. Soak old cloth in the decoction, fold three to four layers, and apply to the lower area. Re-warm if cooled, three to five times daily.
Formula for treating Mai Hemorrhoids with sensation of insect bites in the lower body, for insertion: Lu Feng Fang San (Wasp Nest Powder)
Ingredients: Lu Feng Fang (Wasp Nest); Sheng Luo Ye (Raw Snail Shell, each one liang).
The above two ingredients: Burn to ash, grind finely. Wrap two qian bi of powder in cotton cloth, insert into the lower orifice, and replace morning and evening.
Formula for treating Mai Hemorrhoids with parasites, occasional pus and blood discharge, for fumigation: Huai Bai Pi Tang (Locust White Bark Decoction)
Ingredients: Huai Bai Pi (Locust Tree White Bark, two jin).
The above single ingredient: Finely chop. Add one and a half dou of water, boil down to one dou, remove dregs. Pour into a basin for sitz bath/fumigation. Re-warm if cooled. Parasites should pass naturally with stool. Subsequently, grind Locust White Bark into powder, wrap one qian in cotton cloth, and insert into the lower orifice.
Formula for treating Mai Hemorrhoids with sensation of insect bites in the lower body, to expel parasites: Chu Chong Fang (Expel Parasites Formula)
Ingredients: Tao Ye (Peach Leaves, one cheng, mashed and ground).
The above single ingredient: Steam until hot. Place in a narrow-mouthed vessel, cover with cloth for fumigation. Parasites will emerge.
Formula for treating Mai Hemorrhoids with sensation of insect bites, itching, pain, and bleeding in the lower body: Di Zhi San (Hemorrhoid-Cleansing Powder)
Ingredients: Bai Fan (Alum, powdered, half liang).
The above single ingredient: Take three sheng of urine, add alum powder, and wash the area while hot.
Formula for treating Mai Hemorrhoids with sensation of insect bites in the lower body, for topical application: Pi San (Skin Powder)
Ingredients: Pi (Skin - *Note: Original text appears incomplete here, likely referring to a specific animal skin*).
The above single ingredient: Burn to ash, grind into powder. Take a small amount, mix with raw oil, and apply topically.