TCM and Hemorrhoidal Diseases
By Dr. Hong-Yen Hsu
In Chinese medical theory, hemorrhoidal diseases result from blood stagnation and sinking qi and present with symptoms of swelling, hemorrhage and inflammation. If accompanied by qi deficiency and more severe blood stagnation and sinking qi, there can be subsequent developments of internal hemorrhoids projecting from the interior to the exterior in a prolapsed anal condition. This condition is usually treated by dispersing stagnant blood with hemostatics to raise the sinking qi and heat cleansing formulas. The most commonly used formula is Cimicifuga Combination which has been verified as a very effective hemorrhoidal treatment according to reports in Japanese medical circles, and Lithospermum Ointment for external protrusions.
This formula was first developed empirically by Nanyo Gen, who was a well celebrated physician in the Tokugawa era in Japan. Later (1878) it was modified by Sohaku Asada, at which time it was used for common hemorrhoidal aching, bleeding and anal fissures. In contemporary times it has been further modified by the renowned Japanese herbal physician Keisetsu Otsuka, who has made it more effective with the addition of persica, moutan and houttuynia.
Formulas for Specific Symptoms
1. Hemorrhoids with obvious bleeding: When presented with this complication, combine Cimicifuga Combination with Tang-kuei and Gelatin Combination or with Coptis and Scute Combination. If the amount of blood lost results in the patient developing a rapid pulse or dry mouth, combine granular ginseng (3gm), or Ginseng and Astragalus Combination (3gm), with Cimicifuga Combination and administer three times daily.
After the obvious bleeding has been stopped, the patient may feel dizzy, asthenic and anemic; at this point use Astragalus Combination or ginseng until the symptoms subside.
2. External blood stagnant hemorrhoids with pain and tenderness, and internal hemorrhoids with carceration: Treatment is based on Cimicifuga Combination, which is combined with Peony and Licorice Combination for oral administration, and .with Lithospermum Ointment for (external application). If the patient has a strong physique with constipation or hard stools, and the hemorrhoids are dark red in color, use either Persica and Rhubarb Combination or Rhubarb and Moutan Combination.
3. Hemorrhoids in asthenic physique, presenting with symptoms of fatigue, poor GI function or diarrhea: Ginseng and Astragalus Combination plus coptis and kaolin.
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