Hemorrhoids

General

Clinical Manifestations
Treatment Principle
Herb Formulas	For bleeding without pain, constipation or distention: Huai Hua San For bleeding, constipation and distention without pain: Huai Jiao Wan For bleeding, constipation, distention and pain: Di Yu San Post-hemorrhoidectomy: Xue Fu Zhu Yu Tang Gui Zhi Fu Ling Wan Tao Hong Si Wu Tang Topical: Zi Yun Gao Topical Chinese Patent Medicine: She Xiang Zhi Chuang Gao
Points	Bleed every Ahshi point on the back. Bleed every dark spot on the back that does not lose color under pressure Bleed every papule located on the frenulum of the upper lip. Bleed every dark spot on the coccygeal area. Bleed DU-28. Bleed the hemorrhoid directly. Moxa the hemorrhoid directly. For hemorrhoids: DU-1, Erbai, LU-6, PC-4 For pain: UB-35, UB-52, UB-57, Yaoqi

Wind-Heat Attacks The Lungs

Clinical Manifestations	Cough with thick, sticky, yellow sputum Sore, red, swollen throat Thirst with a desire to drink cold liquids Runny or blocked nose with thick, yellow discharge Fever with perspiration Slight chills Aversion to Wind Headache Maybe dyspnea with flared nostrils Maybe chest pain T: Red tip C: Thin and yellow P: Superficial and rapid
Treatment Principle	Expel Wind Clear Heat Ventilate the Lungs
Herb Formulas	Ma Xing Shi Gan Tang
Points	DU-14, DU-16, GB-20, LI-4 + LU-7 or LI-4 + SJ-5, LU-5, LU-10, LU-11, UB-12, UB-13

Tai Yang - Yang Ming - Shao Yang Heat

Clinical Manifestations	Dizziness Red, sore eyes Difficulty swallowing Nasal congestion and infection Thick, sticky nasal discharge and saliva Bitter taste in the mouth Dry mouth Focal distention in the chest and diaphragm Stifling sensation in the chest and diaphragm Manic behavior Carbuncles Heat rash Headache Acne Chills High fever Restlessness Urticaria Sore throat Swelling of the throat Coughing Reddish urine Dyspnea Vertigo Severe aversion to Cold Skin rashes Skin ruptures or ulcers Tense abdomen Shoulder stiffness Numb extremities Fatigue Constipation Dysuria with reddish urine Dark, rough urination Obesity Fullness of the abdomen Fullness of the epigastrium Heaviness in the head T: Red C: White or Yellow and greasy P: Flooding and rapid or Wiry and slippery or Floating, smooth and rapid or Floating, slippery, rapid and wiry or Floating, slippery, rapid and overflowing
Treatment Principle	Disperse Wind Release the Exterior Drain Heat Unblock the bowels
Herb Formulas	Fang Feng Tong Sheng San
Points

Shao Yang Fu

Clinical Manifestations	Hemorrhoids Alternating chills and fever (not so likely) Restlessness Irritability Continuous vomiting Headache (side of head) Hypochondriac pain Epigastric pain Bitter taste in mouth Digestive disruption Anorexia Nausea Acid regurgitation Burning diarrhea or Constipation Menstrual problems Dry throat Heart pain with vomiting Throat pain Hip pain T: Red C: Thin yellow P: Wiry, forceful
Treatment Principle	Harmonize the Liver and Gall Bladder Purge Internal Heat
Herb Formulas	Da Chai Hu Tang
Points	To harmonize the Liver and Gall Bladder: GB-34, LIV-3, LIV-14, SJ-5 For nausea and vomiting: PC-6, SP-4, ST-36 For headache: GB-1, GB-8, GB-14, Taiyang For constipation: SJ-6, ST-25 For fever: DU-13, DU-14 For Stomach Heat: LI-4, LI-11, ST-44 To support the San Jiao and Regulate Yin: PC-5, PC-6 To support Yin: KI-7 To support the Ying: GB-41, SJ-5 , SP-10 To regulate menstruation: SP-6 For Shao Yang Fu with Tai Yang: For the Shao Yang: GB-34, LIV-3, LIV-14, SJ-6 For the Tai Yang: GB-20, UB-12 For Shao Yang Fu with underlying Liver Qi Stagnation: To harmonize the Shao Yang: GB-34, LIV-3, SJ-6 To clear Heat: LI-11, ST-44 To calm the Shen: HT-7, PC-6 Ear: Shenmen, Liver, Gall Bladder, bleed Heat points

Toxic Heat Affecting The Lungs And Skin

Clinical Manifestations	Swelling Slight suppuration Muscle tension Sore throat
Treatment Principle	Resolve Phlegm Detoxify Clear Heat
Herb Formulas	Bai Nung Tang
Points

Large Intestine Heat

Clinical Manifestations	Dry stools Knotted constipation Mouth parched Sensation of burning heat, swelling and pain of anus Urine short and dark T: Pink C: Yellow and dry P: Slippery and rapid
Treatment Principle	Clear Heat Purge constipation
Herb Formulas	Liang Ge San Mild cases: Ma Zi Ren Wan
Points	LI-4, LI-11, SJ-6, ST-25, ST-37, ST-44, UB-25

Large Intestine Excess Heat

Clinical Manifestations	Knotted constipation or Watery, thin diarrhea Burning hot sensation in the anus Abdominal distention and pain (dislikes pressure) High fever or infantile tidal fever Hands and feet dripping with perspiration Vomiting Irritating thirst Delirium T: Pink, maybe prickles or Red C: Thick, yellow and dry P: Deep and Excess
Treatment Principle	Clear Excess Heat with bitter, cold, strong purgative herbs
Herb Formulas	Tiao Wei Cheng Qi Tang Xiao Cheng Qi Tang Da Cheng Qi Tang With Qi and Blood Deficiency: Huang Long Tang
Points	LI-11, SJ-6, ST-25, ST-37, ST-44

Large Intestine Fluid Deficiency

Clinical Manifestations	Hemorrhoids with bleeding of fresh red Blood that may precede or follow defecation If bleeding precedes defecation, it may be copious and forcefully ejected from the anus The hemorrhoids may protrude, but are easily reduced There may be pain, distention and/or fullness with defecation Dry stools Knotted constipation or bowel movements once a day Difficulty passing stools Dizziness Bad breath Mouth and throat dry Thirst Dry skin T: Red C: Little or Dry and yellow P: Thready and rapid
Treatment Principle	Lubricate the Intestines Relieve constipation
Herb Formulas	Qin Jiao Bai Zhu Wan Zeng Ye Tang Ma Zi Ren Wan Wu Ren Wan Run Chang Wan Ze Ye Cheng Qi Tang Liu Mo Tang For robust, yang Excess Patients: Liang Xue Di Huang Tang Topical: Mix 3g Alumen Ming Fan in a little water, dissolve 30g petroleum jelly and mix in the Ming Fan. Place on sterile gauze and insert into the anal canal. Chinese Patent Medicines: For Heat-type constipation: Run Chang Wan For constipation with Qi Stagnation: Chen Xiang Hua Qi Wan To nourish Yin and moisten Dryness: Gu Ben Wan Topical: Jing Wan Hong
Points	KI-6, SJ-6, SP-15, ST-25, ST-37, UB-25, UB-57 With Heat: + LI-4, LI-11 With Heat in the Liver: + LIV-2 With severe bleeding: + Erbai, PC-4 With severe pain: + DU-1, SI-5 Magnets: DU-2 KI-1, KI-3, KI-6, SJ-6, SP-15, ST-25, ST-37, UB-25 Ear: Constipation area, Hemorrhoids, Large Intestine, Distal Segment Rectum, Shenmen, Sanjiao

Intestinal Wind (Wind-Heat In The Stomach And Intestines)

Clinical Manifestations	Bleeding of fresh Blood from the bowel which often precedes the bowel movement The bleeding may follow the passage of stool The bleeding may be alarmingly copious Abdominal pain or Absence of pain, itching, swelling or distention or A burning sensation in the rectum and anus Dry mouth Tendency toward constipation Dry or difficult stools T: Red C: Yellow P: Slippery and rapid or Thready and rapid
Treatment Principle	Clear Heat from the Intestines Cool the Blood Stop bleeding
Herb Formulas	Huai Jiao Wan modified Huai Hua San modified Topical: Mix 3g Alumen Ming Fan in a little water, dissolve 30g petroleum jelly and mix in the Ming Fan. Place on sterile gauze and insert into the anal canal. Chinese Patent Medicines: Yi Zi Tang Zheng Gan Zhi Gen Duan To stop bleeding: Yun Nan Bai Yao Shen Tian Qi Pian For Intestinal bleeding with Heat: Zhong Gan Zhi Gen Dan For Damp-Heat: Huang Lian Jie Du Wan With Spleen and Stomach Deficiency: Xiang Sha Yang Wei Wan
Points	Ahshi points, DU-1, Erbai, SP-1, ST-25, ST-37, UB-30, UB-32, UB-57 With pain in the rectum or lower Intestine: + UB-2, UB-52 With severe bleeding: + PC-4, SP-10 Ear: 1. Large Intestine, Small Intestine, Distal Segment Rectum, Subcortex, Shenmen 2. Hemorrhoids, Large Intestine, Distal Segment Rectum, Shenmen

Spleen Not Governing The Blood

Clinical Manifestations	Hemorrhoids with bleeding of pale or fresh red Blood The volume of Blood is usually relatively scant, but may be copious on occasion There may be little protrusion and little distention or discomfort Sallow or pale complexion Anorexia Fatigue Lethargy Four limbs feel tired and heavy Physical and mental exhaustion Abdominal and epigastric distention after eating Easily satiated Maybe acid regurgitation or vomiting Loose or unformed stools Shortness of breath Dizziness Light-headedness Blurred vision Poor memory Poor concentration Insomnia Palpitations Anxiety Panic attacks Palpitations Functional Uterine Bleeding Purpura Epistaxis Hemafecia Hematuria Menorrhagia Metrorrhagia T: Pale and flabby - may have teethmarks C: White P: Thready and weak or Hollow
Treatment Principle	Benefit Qi Conserve Blood
Herb Formulas	Gui Pi Tang modified Bu Zhong Yi Qi Tang modified Gui Pi Tang + Jiao Ai Tang For persistent bleeding: Gu Chong Tang modified Chinese Patent Medicines: Gui Pi Wan With Cold: Shi Quan Da Bu Wan With constipation: Cong Rong Bu Shen Wan
Points	REN-12, SP-1, SP-3, SP-6, ST-25, ST-36, UB-20, UB-25 With prolapse or a falling sensation: + DU-20 With anxiety or insomnia: + HT-7, PC-6 SP-1, SP-3, ST-36, UB-20 For Deficiency type uterine bleeding: DU-20, LI-11, REN-4, SP-4, SP-10, SP-14, UB-17 Ear: Spleen, Stomach, hemorrhoids, Large Intestine, Distal Segment Rectum, Shenmen

Central Qi Sinking

Clinical Manifestations	Protruding hemorrhoids when defecating or when walking, coughing, sneezing or standing for a long time Non-returning hemorrhoids unless assisted manually or by lying down Discharge of pale-colored Blood Forceless defecation Frequent defecation or Enduring diarrhea Fatigue Lassitude Prolapse of one or more organs Sallow complexion Anorexia Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools Shortness of breath T: Pale and flabby - may have teethmarks C: White P: Even or Soft and thready
Treatment Principle	Strengthen the Spleen Benefit Qi Reinforce the Center Invigorate Yang
Herb Formulas	Bu Zhong Yi Qi Tang For profuse bleeding without protrusion, pain or distention: Gui Pi Tang modified    With enduring diarrhea: Hemorrhoids #1 With Qi and Blood deficiency: Ti Gang Tang Topical: Apply a cool decoction three time a day of 6g Galla Rhois Chinensis Wu Bei Zi, 9g Fr. Rosae Laevigatae Jin Ying Zi, 9g Fr. Chebulae Mu Gua and 9g Alumen Ming Fan.
Points	DU-1, DU-20, Erbai, REN-6, ST-36, UB-57 For severe bleeding: + SP-6 For Heart palpitations: + UB-15 For dizziness: + UB-15, UB-20 For a poor appetite: + REN-21 For uterine leaking and spotting: + SP-6 DU-1, DU-20, UB-46, moxa REN-8 For swelling and pain: + UB-58 For burning pain: + PC-8 DU-20, other points are selected according to the type of prolapse

Spleen Yang Deficiency

Clinical Manifestations	Chronic loose stools or diarrhea which may contain undigested food The stools may be urgent Early morning diarrhea Dark, purplish or pale Blood preceding, following or Black, tarry or Blood-streaked loose stools (the bleeding may also be occult) Dull, persistent abdominal or epigastric cold-pain which improves with warmth and pressure Sallow complexion Anorexia (maybe with vomiting) Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Intolerance to Cold Shortness of breath Cold abdomen Cold limbs Feeling chilled Frequent, clear urination Mental fatigue Weakness Exhaustion Maybe scanty urine with edema Maybe clear, watery vaginal discharge T: Pale, wet and swollen with toothmarks C: Thin and white P: Deep and weak or Deep, weak and slow
Treatment Principle	Warm the Center Dispel Cold Nourish the Blood Stop bleeding
Herb Formulas	Huang Qi Jian Zhong Tang With Toxic swelling: Qian Nei Tuo San With relatively severe bleeding: Huang Tu Tang modified With relatively mild bleeding: Fu Zi Li Zhong Wan modified When the bleeding has stopped: Bu Zhong Yi Qi Tang Si Jun Zi Tang Chinese Patent Medicines: For Spleen Yang Deficiency with severe Cold: Fu Zi Li Zhong Wan For Spleen Yang Deficiency: Li Zhong Wan For bleeding: Yun Nan Bai Yao Sheng Tian Qi Pian
Points	Moxa or moxa needle DU-20, REN-6, REN-12, SP-1, SP-6, ST-25, ST-36, UB-20, UB-25, needle SP-4 With Kidney Yang Deficiency: + moxa or moxa needle REN-4, UB-23 Moxa box REN-8 Moxa LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20 Ear: Spleen, Stomach, Large Intestine, Small Intestine, Adrenal, Subcortex, Shenmen

Spleen And Stomach Deficiency Cold

Clinical Manifestations	Mild constant epigastric pain; relieved by warmth and pressure Anorexia Abdominal pain and fullness after meals Nausea Vomiting Loose, unformed stools Excessive salivation Cold limbs Lassitude Weakness Sallow or pale, dull complexion Maybe edema Maybe scanty urination Maybe clear, watery, copious vaginal discharge T: Pale C: White and greasy P: Deep, thready and forceless
Treatment Principle	Strengthen the Spleen Warm Yang Warm the Center Dispel Cold
Herb Formulas	Fu Zi Li Zhong Wan Tao Hua Tang
Points	Moxa or moxa needle LIV-13, REN-12, SP-3, SP-6, ST-36, UB-20, UB-21

Spleen And Kidney Yang Deficiency

Clinical Manifestations	Frequent pale, red Blood in the urine Body cold Limbs icy Fatigue Lassitude Lack of strength White and shiny or sallow, yellow facial complexion Low back, knees and abdomen feel cold and painful Lower abdomen feels cold and painful Abdominal distention Dizziness Tinnitus Anorexia Loose stools containing undigested food or “Cock-crow” diarrhea (occurs at about 5 am) Edema of face and limbs Dysuria Bruises easily Bleeding hemorrhoids Melaena Uterine bleeding Severe: Abdominal ascites T: Pale, moist and swollen C: Thin and white or White and greasy P: Deep, thready, weak and maybe slow or Soft and moderate
Treatment Principle	Warm and Reinforce the Spleen and Kidneys Stop bleeding
Herb Formulas	Dang Gui Shao Yao San Once the bleeding has stopped: For Kidney Yang or Qi Deficiency: Jin Gui Shen Qi Wan For Spleen Yang Deficiency: Fu Zi Li Zhong Wan Chinese Patent Medicines: Jin Kui Shen Qi Wan Bu Zhong Yi Qi Wan Yun Nan Bai Yao
Points	Moxa or moxa needle SP-10 For abdominal cramping and aversion to Cold and a long, deep pulse: + moxa DU-4, KI-3, REN-4, REN-6, SP-9, For enduring diarrhea: + moxa REN-8 For abdominal distention: + ST-36 Moxa or moxa needle REN-4, REN-12, SP-6, SP-9, ST-36, UB-20, UB-23 Moxa or moxa needle SP-10 For abdominal cramping and aversion to Cold and a long, deep pulse: + moxa DU-4, REN-4, SP-1, SP-6, SP-10, ST-36, UB-17, UB-20, UB-23

Heart And Stomach Fire

Clinical Manifestations	Fever Irritability Restlessness Anxiety Flushed face Constipation Abdominal distention Delirious speech Epigastric distention Jaundice Gastric distention Dysenteric disorders Hematemesis Epistaxis Red, swollen, painful eyes Chest oppression Red, swollen ears Restlessness Insomnia Thirst Dark, concentrated urine Tinnitus Hemoptysis Vomiting Shoulder stiffness Suppurative skin infection Tongue and mouth ulcerations T: Red tip C: Yellow and greasy P: Rapid
Treatment Principle	Drain Fire Relieve toxicity Drain Dampness Dispel noxious Heat and toxins from the Heart and Stomach
Herb Formulas	San Huang Xie Xin Tang
Points	HT-7, HT-8, LI-4, LI-11, PC-6, PC-7, PC-8, ST-6, ST-34, ST-36, ST-43, ST-44, ST-45, UB-15, UB-21

Heart Blood And Spleen Qi Deficiency

Clinical Manifestations	Palpitations Insomnia Much dreaming Easily startled Poor memory Four limbs tired and lethargic Loss of appetite Distention and fullness of the epigastrium and abdomen Loose stools Sallow complexion Copious, pale menses Uterine bleeding or Light menstrual flow or Amenorrhea T: Pale P: Thready and weak
Treatment Principle	Reinforce and Benefit the Heart and Spleen
Herb Formulas	Gui Pi Tang modified Chinese Patent Medicines: Gui Pi Wan With Cold or Spleen Yang Deficiency: Li Zhong Wan
Points	HT-7, REN-4, SP-1, SP-6, ST-36, UB-15, UB-20

Liver Qi Stagnation Invading The Spleen

Clinical Manifestations	Abdominal distention and pain Gas Borborygmus Diarrhea Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Women: Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Pink C: White and greasy P: Slippery and wiry
Treatment Principle	Soothe the Liver Invigorate the Spleen
Herb Formulas	Xiao Yao San Tong Xie Yao Fang Hei Xiao Yao San Shao Yao Gan Cao Tang
Points	LIV-3, LIV-13, SP-6, ST-25, ST-36, ST-37

Liver Fire

Clinical Manifestations	Hemorrhoids Severe, splitting headaches with dizziness Sudden tinnitus or Sudden deafness Flushed face Red, swollen, painful eyes Irascibility with violent angry outbursts Dry mouth Bitter taste in mouth Thirst Vomiting sour or bitter liquid Insomnia Restlessness Constipation or dry stools Maybe rib pain In severe cases: Mania Hemoptysis Hematemesis Epistaxis Liver Fire Attacks the Lungs: Hemoptysis Rib pain which is severe when coughing Liver Fire Attacks the Stomach: Hematemesis T: Red tip and edges C: Thick, yellow, dry and rough P: Wiry, Excess and rapid
Treatment Principle	Clear the Liver Purge Fire
Herb Formulas	Dang Gui Long Hui Wan
Points	GB-12, GB-34, GB-37, LIV-2, UB-18, UB-19

Yin And Blood Deficiency

Clinical Manifestations	Chronic hemorrhoidal bleeding Maybe hemorrhoidal pain Dizziness Tinnitus or deafness Poor memory Dry mouth Thirst Night sweats Five Sole Heat Malar flush Low grade fever in the afternoon Dry throat, maybe recurrent sore throat Dry stools and/or Constipation Urine short and red Heightened libido Palpitations Insomnia Dry skin Dry hair Paleness Fatigue Scanty periods T: Red or Pink and dry C: Little or None or Thin, white and dry P: Thready and rapid or Weak
Treatment Principle	Nourish Yin Nourish Blood Ease defecation Stop bleeding Stop pain
Herb Formulas	Zhi Lou Wan With pain: Dang Gui Jian Zhong Tang
Points	KI-1, KI-2, KI-3, KI-6, KI-9, KI-10, REN-4, SP-6, UB-23

Qi And Blood Stagnation

Clinical Manifestations	Protruding hemorrhoids when defecating Discharge of Blood Sagging, distended and painful anus Difficult defecation Dark, swollen hemorrhoids which are comparatively large with severe pain Abdominal distention and fullness T: Dark purple C: White P: Choppy and wiry
Treatment Principle	Regulate Qi Activate the Blood Disperse swelling Transform Stasis
Herb Formulas	Tao He Cheng Qi Tang modified Xue Fu Zhu Yu Tang modified Chinese Patent Medicine: Xue Fu Zhu Yu Wan For bleeding: + Sheng Tian Ji Pian Topical: Chinese Patent Medicine: Chin Wang Hung She Xiang Zhi Chuang Gao
Points	DU-1, Erbai, SJ-6, SP-6, UB-57 For severe pain: + LI-4 For Heat: + LI-11, ST-44

Qi , Blood And Yang Deficiency With Cold

Clinical Manifestations	Anemia Uterine bleeding Cold extremities Pale or sallow face Dizziness General fatigue Coarse skin Nocturnal emissions Weak knees Fatigue Dyspnea Night sweats Irregular menstruation Insomnia Intolerance of Cold Decreased eyesight after a prolonged illness Anxiety Intermittent fever Jaundice Deficient cough Shortness of breath Palpitations Anorexia Listlessness Lassitude Spontaneous sweating Spermatorrhea Continuous spotting Leukorrhea Weak legs and knees T: Pale C: Thin and white P: Thready and weak
Treatment Principle	Replenish Yang Warm and tonify Qi and Blood
Herb Formulas	Shi Quan Da Bu Tang
Points

Blood Stagnation

Clinical Manifestations	Hemorrhoids with relatively severe or continuous anal pain, protrusion, distention and swelling The pain is aggravated during defecation The hemorrhoids a purple and quite large Bleeding may be fresh red or plum colored Dark or purplish spider naevi or broken vessels around the inner ankles and knee Pain in the iliac fossa on palpation, especially around left ST-27 Hypochondriac pain, tension or discomfort Dry mouth and throat with no desire to drink Dry, scaly skin A dull, sallow or darkish complexion Dark or purplish lips and conjunctiva Dark rings under the eyes T: Purplish or with purple or brown petechiae with distended sublingual veins C: Little or None P: Thready and choppy
Treatment Principle	Activate the Blood Break up Stagnation Regulate Qi Stop pain
Herb Formulas	Huo Xue San Yu Tang #2 For severe Blood Stagnation with constipation and pain: Tao He Cheng Qi Tang  modified With Phlegm: Gui Zhi Fu Ling Wan With Blood Deficiency: Tao Hong Si Wu Tang Chinese Patent Medicines: For severe Blood Stagnation with pain: Tong Jing Wan
Points	DU-1, Erbai, LI-4, SP-8, SP-10, ST-37, UB-25, UB-30, UB-32, UB-57 Ear: Hemorrhoids, Large Intestine, Distal Segment Rectum, Shenmen

Dry-Heat

Clinical Manifestations	Hemorrhoids which may protrude beyond the anus Dry stools Difficult defecation May an explosive discharge of fresh Blood from the anus Constipation Abdominal distention or fullness A dry mouth Thirst Dark colored urine T: Red and dry C: Dry and yellow P: Rapid
Treatment Principle	Clear Heat Moisten Dryness Cool the Blood Stop bleeding
Herb Formulas	Liang Xue Di Huang Tang Jia Jian For severe constipation with dry stools: Zeng Ye Cheng Qi Tang (temporarily) Topical Chinese Patent Medicine: She Xiang Zhi Chuang Gao
Points	DU-1, Erbai, KI-6, SJ-6, UB-57 (DU-1 can be alternated with DU-2 using moxa and UB-31, UB-32, UB-33, UB-34 with electroacupuncture or five-star needle For severe Dryness: + LI-11, SP-6, ST-44

Damp-Heat

Clinical Manifestations	Swollen, severely painful hemorrhoids Possible protrusion following defecation which looks dull red in color and ulcerated The protrusion may reduce after defecation or may be manually reduced Discharge of fresh, red or turbid, plum-colored colored Blood which may precede or follow defecation or may coat the stool The hemorrhoids are small, soft and bright red or bluish-purple The bleeding is often copious Difficult defecation A hot, itching or burning distended feeling in the anus, which is worse during defecation Itchy anus Tenesmus Abdominal distention Poor appetite A heavy body Fatigue Thirst Concentrated urine A tendency toward constipation or sluggish, loose stools T: Normal or Red or Red edges C: Slimy and yellow P: Slippery and rapid or Wiry and rapid
Treatment Principle	Clear Heat Disinhibit Dampness Dispel Stasis Scatter nodulations
Herb Formulas	Zhi Tong Ru Shen Tan Jia Wei Huai Hua San  modified Yi Zi Tang Qing Chang Tang San Huang Xie Xin Tang Wu Hua Tang Topical: 1. Boil 30g Rx. Sophorae Ku Shen, Fr. Cnidii She Chuang Zi, Cx. Phellodendri Huang Bai and Rx. et Rz. Rhei Da Huang in 2-3 liters of water for 30 minutes. Discard the dregs and use the remaining water to soak the affected area once or twice daily in a sitz bath. 2. Wash the affected area 3 times a day with a cool decoction of 9g Rz. Coptidis Huang Lian, 9g Rx. Picrorhizae Hu Huang Lian and 9g Rx. Sophorae Ku Shen. Or apply Chinese Patent Medicines: Huang Lian Jie Du Wan With bleeding: Zhong Gan Zhi Gen Duan With constipation: Yi Zi Tang With severe Heat: + Chuan Xin Lian Kang Yan Pian Topical: She Xiang Zhi Chuang Gao Ching Wang Hung
Points	DU-1, Erbai, SP-9, ST-37, UB-57 For severe Heat: + LI-11, ST-44 DU-1, Erbai, LI-11, ST-37, UB-30, UB-32, UB-57 With swelling and pain: + UB-54, UB-58 With Heat in the Liver: + LIV-2 DU-1, UB-32, UB-35, UB-57 With swelling and pain: + UB-2, UB-54 For hemorrhage: + SP-10, UB-24 For constipation: + ST-37, UB-25 Magnets can be applied to DU-2 Ear: Hemorrhoids, Large Intestine, Distal Segment Rectum, Shenmen

Heat And Blood Stagnation (Toxic Heat)

Clinical Manifestations	Lower abdominal distention and pain (usually on right) Pain increases on pressure with rebound tenderness Guarding of the abdominal musculature Groin pain resembling urinary dysfunction without urinary difficulty Groin pain relieved by flexing hip and knee Groin pain intensified by extending hip Perspiration Irregular or intermittent fever followed by chills and perspiration May be mass in lower right quadrant of abdomen Aversion to Cold Hard lumps T: Pink C: Thin, white or yellow and greasy P: Slippery and rapid or Tight or Wiry and tight or Tight and rapid
Treatment Principle	Drain Heat Break up Blood Stasis Activate the Blood Disperse nodules Reduce swelling
Herb Formulas	Da Huang Mu Dan Tang Pai Nong San
Points