夫肠风痔病者,所发手太阴、阳明经以应。经脉谓∶肺与大肠为表里,主为传道,
以行糟粕。肠风痔病有五种,其证亦异。盖因肠气虚而玄府疏,风邪乘而热自生。风温邪热,
攻于肠中,致使大便涩而燥热郁,血热散而流溢冲,浸浚肠里,故以先血后便。热在下,先便
后血,热在上,先血后便。久而不愈,乃作痔。
《素问》云∶因而饱食,筋脉横解,房室劳伤,肠癖为痔。风热不散,谷气流溢,传
于下部,故令肛门肿满,结如梅李核。甚者而变成 也。
五脏切宜保养,勿令受邪。
香壳丸 治湿热内甚,因而饱食,肠癖成痔,久而成 者,服之悉愈。
木香 黄柏(各三钱) 枳壳(去穣,炒) 浓朴(各半两) 黄连(一两) 皮(一个,
烧) 当归(四钱) 荆芥穗(三钱)
上为末,面糊为丸,如桐子大,每服二三十丸,温水,食前,日三服。
藤子丸 治肠风泻血,湿热内甚,因为诸痔,久而不治,乃变成 。
黄 枳实 槐花 荆芥穗 凤眼草(以上各一两) 藤子(一对,炙) 皂子(三百个,炙)
上为细末,面糊为丸,如桐子大,每服二三十丸,空心,酒下,米饮亦得。忌油腻、
冷、猪、鱼、臭血物等。
乌荆丸 治肠风痔疾,大肠 涩。
川乌头(二两,炮) 荆芥穗(四两)
上为末,醋面糊为丸,如桐子大,每服二三十丸,温水下,日三服。
黄 葛花丸 治肠中久积热,痔 下血疼痛。
黄 葛花 黄赤小豆花(各一两) 大黄 赤芍药 黄芩 当归(各三分) 皮(一个)
槟榔 白蒺藜 皂角子仁(炒。各半两) 生地黄(焙,一两)
上为末,炼蜜和丸,如桐子大,每服二十丸至三十丸,煎桑白皮汤下,食前,槐子煎汤
下亦得。
黄连散 治肠风下血,疼痛不止。
鸡冠花 黄连 贯众 川大黄 乌梅(各一两) 甘草(三分,炙)
上为末,每服二钱,用温米饮调下,日三服,不计时候。
乳香没药散 治五种肠风痔 ,无问久新。
宣黄连 白矾(各一两) 谷精草(半两) 酸石榴(一个,用刀子割下盖子,里
面取子三停一停,次将黄连、白矾碎纳入石榴内,用原盖子合用。)
上以湿纸一张裹石榴,裹了后用胶泥拍作饼子,以炭火烧通赤为度,取出,去泥纸,
后将谷精草于铫子内炒焦黄为度,与石榴研细后,抄药末一钱、乳香一钱、没药一钱,研细,
拌匀,每服一钱,酒小半盏调下,日三服。
木香浓朴汤 治痔 脱肛,肠胃间冷,腹胁虚胀,不思饮食。
木香 桂心 桃仁 陈皮 浓朴(各一两) 肉豆蔻 赤石脂(各半两) 皂角子(三两,
去皮,于醋炙黄) 大附子(三分,炮)
上为末,每服二钱,温粥饮调下,食前。
关于肠风痔病的论述,其发病与手太阴肺经、手阳明大肠经相应。经脉理论指出:肺与大肠互为表里,主要功能是传导和排泄糟粕。
肠风痔病分为五种,其症状表现各不相同。大概是因为肠道之气虚弱,导致玄府(汗孔及毛孔等体表孔隙)疏松,风邪趁机侵入而内生热邪。风温邪热侵袭肠道内部,致使大便干涩、燥热郁结;血分受热则血液散乱流溢冲撞,浸渍于肠内,因此出现先便后血的症状。若热邪在下部,则先排便后出血;若热邪在上部,则先出血后排便。若病情迁延不愈,就会形成痔疮。
《素问》中说:因为饱食过度,导致筋脉松弛弛缓,加上房事劳伤,导致肠癖(痢疾或泄泻伴脓血)进而发展为痔疮。风热之邪不能消散,谷气(饮食精微)流溢扩散,传至身体下部,从而导致肛门肿胀满闷,结块如同梅子或李子核一般坚硬。严重的甚至会转变为瘘管。
香壳丸:治疗湿热内盛严重,因饱食过度,导致肠癖形成痔疮,日久转化为瘘管的病症,服用此药均可痊愈。
药材组成:木香、黄柏(各三钱)、枳壳(去除瓤,炒制)、浓朴(各半两)、黄连(一两)、陈皮(一个,烧存性)、当归(四钱)、荆芥穗(三钱)。
制法用法:将上述药物研为细末,用面糊制作成丸剂,大小如梧桐子大。每次服用二三十丸,饭前用温水送服,每日三次。
藤子丸:治疗肠风泻血,湿热内盛严重,因而引发各种痔疮,日久不治疗,最终转变为瘘管的病症。
药材组成:黄芪、枳实、槐花、荆芥穗、凤眼草(以上各一两)、榧子(一对,炙烤)、皂角子(三百个,炙烤)。
制法用法:将上述药物研为细末,用面糊制作成丸剂,大小如梧桐子大。每次服用二三十丸,空腹时酒送服,米饮送服也可以。忌食油腻、生冷、猪肉、鱼类、腥臭血液类食物等。
乌荆丸:治疗肠风痔疾,大肠涩滞不通。
药材组成:川乌头(二两,炮制)、荆芥穗(四两)。
制法用法:将上述药物研为细末,用醋和面糊制作成丸剂,大小如梧桐子大。每次服用二三十丸,温水送服,每日三次。
黄芪葛花丸:治疗肠中久积热邪,痔疮下血疼痛。
药材组成:黄芪、葛花、黄赤小豆花(各一两)、大黄、赤芍药、黄芩、当归(各三分)、陈皮(一个)、槟榔、白蒺藜、皂角子仁(炒制,各半两)、生地黄(焙干,一两)。
制法用法:将上述药物研为细末,用炼蜜调和制作成丸剂,大小如梧桐子大。每次服用二十丸至三十丸,煎桑白皮汤送服,饭前服用;用槐子煎汤送服也可以。
黄连散:治疗肠风下血,疼痛不止。
药材组成:鸡冠花、黄连、贯众、川大黄、乌梅(各一两)、甘草(三分,炙烤)。
制法用法:将上述药物研为细末,每次服用二钱,用温米饮调服,每日三次,不限时候。
乳香没药散:治疗五种肠风痔漏,无论病程新久。
药材组成:宣黄连、白矾(各一两)、谷精草(半两)、酸石榴(一个,用刀割下盖子,取出里面三分之一的种子,然后将黄连、白矾碎末纳入石榴内,用原盖子合上)。
制法用法:用一张湿纸包裹石榴,裹好后用胶泥拍成饼状,用炭火烧至通红为度,取出,去掉泥和纸,然后将谷精草在铫子内炒至焦黄为度,与处理过的石榴一起研细。之后取药末一钱、乳香一钱、没药一钱,研细拌匀。每次服用一钱,用不到半盏酒调服,每日三次。
木香浓朴汤:治疗痔疮脱肛,肠胃间寒冷,腹胁虚胀,不思饮食。
药材组成:木香、桂心、桃仁、陈皮、浓朴(各一两)、肉豆蔻、赤石脂(各半两)、皂角子(三两,去皮,在醋中炙烤至黄)、大附子(三分,炮制)。
制法用法:将上述药物研为细末,每次服用二钱,用温粥饮调服,饭前服用。
Regarding the pathology of Changfeng (Wind in Intestines) and hemorrhoids, its onset corresponds to the Hand-Taiyin Lung Meridian and the Hand-Yangming Large Intestine Meridian. The meridian theory states that the Lung and Large Intestine are interior-exteriorly related, primarily governing the transmission and excretion of waste matter.
Changfeng hemorrhoids are classified into five types, with varying clinical manifestations. Generally, this condition arises from deficiency of Qi in the intestines, leading to the laxity of Xuanfu (pores and body orifices), allowing Wind pathogenic factors to invade and generate internal Heat. Wind-Warmth and pathogenic Heat attack the interior of the intestines, causing dryness and obstruction of stool with stagnant heat; Heat in the Blood level causes blood to scatter and overflow, soaking the intestinal lining, thus resulting in bleeding after defecation. If Heat is located in the lower part, defecation precedes bleeding; if Heat is in the upper part, bleeding precedes defecation. If the condition persists without healing, it develops into hemorrhoids.
The *Suwen* states: "Due to overeating, tendons and vessels become relaxed and flaccid; due to sexual exhaustion, Changpi (dysentery or diarrhea with pus and blood) transforms into hemorrhoids. When Wind-Heat does not dissipate, grain Qi overflows and transmits to the lower part of the body, causing swelling and fullness of the anus, with nodules forming like plum or apricot kernels. In severe cases, it may transform into fistulas."
The Five Zang organs must be carefully preserved and protected from pathogenic invasion.
Xiangke Wan (Fragrant Shell Pill): Treats severe internal Damp-Heat, caused by overeating, leading to Changpi transforming into hemorrhoids, which persist for a long time and transform into fistulas. Administration of this formula leads to complete recovery.
Ingredients: Muxiang (Costi Rhizoma), Huangbai (Phellodendri Cortex) (each 3 qian); Zhike (Aurantii Fructus Immaturus) (deprived of pith, stir-fried); Houpo (Magnoliae Officinalis Cortex) (each 0.5 liang); Huanglian (Coptidis Rhizoma) (1 liang); Chenpi (Citri Reticulatae Pericarpium) (one piece, charred); Danggui (Angelicae Sinensis Radix) (4 qian); Jingjie Sui (Schizonepetae Spica) (3 qian).
Preparation and Administration: Grind the above ingredients into fine powder, bind with wheat paste to form pills the size of paulownia seeds. Take 20–30 pills per dose, before meals, with warm water, three times daily.
Feizi Wan (Torreya Seed Pill): Treats Changfeng bloody diarrhea, severe internal Damp-Heat, leading to various hemorrhoids, which, if untreated for a long time, transform into fistulas.
Ingredients: Huangqi (Astragali Radix), Zhishi (Aurantii Fructus), Huaihua (Sophorae Flos), Jingjie Sui (Schizonepetae Spica), Fengyancao (Euphorbiae Humifusae Herba) (each 1 liang); Feizi (Torreyaegrandis Semen) (a pair, roasted); Zaoren (Gleditsiae Sinensis Spina) (300 pieces, roasted).
Preparation and Administration: Grind into fine powder, bind with wheat paste to form pills the size of paulownia seeds. Take 20–30 pills per dose, on an empty stomach, with wine; rice drink is also acceptable. Avoid greasy, cold, pork, fish, and foul-smelling blood products.
Wujing Wan (Black Aconite and Schizonepeta Pill): Treats Changfeng hemorrhoidal diseases and large intestine stagnation/obstruction.
Ingredients: Chuan Wutou (Aconiti Radix Lateralis Preparata) (2 liang, processed); Jingjie Sui (Schizonepetae Spica) (4 liang).
Preparation and Administration: Grind into fine powder, bind with vinegar-wheat paste to form pills the size of paulownia seeds. Take 20–30 pills per dose, with warm water, three times daily.
Huangqi Gehua Wan (Astragalus and Flos Sophorae Bud Pill): Treats long-standing accumulation of Heat in the intestines, causing hemorrhoidal bleeding and pain.
Ingredients: Huangqi (Astragali Radix), Gehua (Flos Sophorae Bud), Huangchi Xiaodouhua (Yellow Red Adzuki Bean Flower) (each 1 liang); Dahuang (Rhei Radix et Rhizoma), Chi Shaoyao (Paeoniae Radix Rubra), Huangqin (Scutellariae Radix), Danggui (Angelicae Sinensis Radix) (each 3 fen); Chenpi (Citri Reticulatae Pericarpium) (one piece); Binglang (Arecae Semen), Bajieli (Tribuli Fructus), Zaoren Ren (Gleditsiae Sinensis Spina Kernel, stir-fried) (each 0.5 liang); Sheng Dihuang (Rehmanniae Radix, baked) (1 liang).
Preparation and Administration: Grind into fine powder, mix with refined honey to form pills the size of paulownia seeds. Take 20–30 pills per dose, decocted with Sangbaipi (Mori Cortex) and taken before meals; decoction of Huaizi (Sophorae Japonicae Fructus) is also acceptable.
Huanglian San (Coptis Powder): Treats Changfeng rectal bleeding with unceasing pain.
Ingredients: Jiguanhua (Celosiae Cristatae Flos), Huanglian (Coptidis Rhizoma), Guanzhong (Cyathulae Radix), Chuan Dahuang (Rhei Radix et Rhizoma), Wumei (Mume Fructus) (each 1 liang); Gancao (Glycyrrhizae Radix et Rhizoma) (3 fen, roasted).
Preparation and Administration: Grind into fine powder. Take 2 qian per dose, mixed with warm rice drink, three times daily, at any time.
Ruxiang Moyao San (Frankincense and Myrrh Powder): Treats the five types of Changfeng hemorrhoidal fistulas, regardless of whether the condition is new or chronic.
Ingredients: Xuan Huanglian (Coptidis Rhizoma), Baifan (Alumen) (each 1 liang); Gujingcao (Gymnosporiae Flos) (0.5 liang); Suan Shiliu (Punica Granati Pericarpium) (one fruit, cut off the lid, remove one-third of the seeds inside, then insert crushed Huanglian and Baifan into the fruit, and replace the lid).
Preparation and Administration: Wrap the pomegranate in one sheet of wet paper, then encase in clay paste shaped into a cake. Bake over charcoal until thoroughly red-hot. Remove, discard clay and paper. Stir-fry Gujingcao in a ding pot until scorched yellow. Mix with the processed pomegranate and grind finely. Then take 1 qian of this powder, plus 1 qian Ruxiang (Boswelliae Resina) and 1 qian Moyao (Myrrhae Resina), grind together finely, and blend well. Take 1 qian per dose, mixed with less than half a cup of wine, three times daily.
Muxiang Houpo Tang (Costus and Magnolia Decoction): Treats prolapsed hemorrhoids and rectum, cold in the gastrointestinal tract, deficiency distension of the abdomen and hypochondrium, and loss of appetite.
Ingredients: Muxiang (Aucklandiae Radix), Guixin (Cinnamomi Ramulus), Taoren (Persicae Semen), Chenpi (Citri Reticulatae Pericarpium), Houpo (Magnoliae Officinalis Cortex) (each 1 liang); Roudoukou (Myristicae Semen), Chishizhi (Halloysit Rubrum) (each 0.5 liang); Zaoren (Gleditsiae Sinensis Spina) (3 liang, peeled, roasted in vinegar until yellow); Da Fuzi (Aconiti Lateralis Radix Preparata) (3 fen, processed).
Preparation and Administration: Grind into fine powder. Take 2 qian per dose, mixed with warm porridge drink, before meals.