Anal fistula

Also fistula. Long pipe-like ulcerations from the perimeter or surrounding area of the anus. They may develop from hemorrhoids, welling- and flat-abscesses yōng jū of the anus, or splitting of the anus. Fistulas discharge pus-like fluid, are sore and itchy, and heal with difficulty. Distinction is made between vacuity and repletion patterns. Hardness and swelling of the local area, discharge of thick pus, and strong body constitute repletion; softness and depression in the area of the opening, discharge of thin pus, and weakness and emaciation constitute vacuity.

Medicinal therapy: Fistulas are treated by threaded ligation and other surgical methods, combined with oral medication. For repletion, clear heat and disinhibit dampness. Use variations of Mysterious Two Pill (二妙丸 èr miào wán), or Fish Poison Yam Dampness-Percolating Decoction (萆薢渗湿汤 bì xiè shèn shī tāng). For vacuity, support right and promote internal expression. Use variations of Internal Expression Toxin-Dispersing Powder (托里消毒散 tuō lǐ xiāo dú sǎn) or Six-Ingredient Rehmannia Pill (六味地黄丸 liù wèi dì huáng wán). Compare communicating bowels.