Chapter 584: Chapter 555: Manual Reduction Technique

He understood the basic steps, the usual method was—

First, the preparation: using a sitz bath with warm water or potassium permanganate solution to reduce the swelling and pain of hemorrhoids, while relaxing the anal sphincter.

The specific operational steps: First, apply some lubricating essential oil to the anal area to increase smoothness. The patient should lie on their side or squat. The doctor wears a disposable glove or finger cot with lubricant, finds the prolapsed hemorrhoid, gently pinches it with fingers, and while rubbing, presses it back about 2-3 cm deep.

The patient should also cooperate by tightening their sphincter and doing several anal contraction exercises to check if the hemorrhoid prolapses again. If it does, repeat the above steps.

Subsequent treatment: Clean the anal lubricating liquid, apply hemorrhoid cream. It’s best to remain lying down at this time to prevent the hemorrhoid from prolapsing again due to gravity, and after resting in bed for a while, normal activity can resume.

Theory is just theory, specific situations require specific analysis, and while everyone knows the steps, the skill of technique varies, which tests the doctor’s operating skills.

Jin Yonghao’s prolapsed hemorrhoid was too large, and it was a mixed internal and external one, making the case quite complex.

Wang Kangzhu had seen many patients with hemorrhoids in the past, but it was the first time encountering one as severe as Jin Yonghao’s.

Wang Kangzhu reluctantly attempted the reduction for Jin Yonghao, but as soon as his finger touched the hemorrhoid, Jin Yonghao began wailing in pain, seeing him so agonized, Wang Kangzhu didn’t dare to force it into the rear, for fear of causing more trouble if it went wrong.

Just when they were at a loss, Xu Chunliang came over to console them.

Jin Yonghao had previously sought medical help from Liu Shanmin, where Xu Chunliang had seen his bare backside, and this was the second time. Jin Yonghao wished he could find a hole to disappear into, thinking, "Xu Chunliang, what’s wrong with you? Is there something so interesting to see here? Your curiosity is way too strong!"

Xu Chunliang observed for a moment and clicked his tongue in exclamation: "So big, it’s the first time I’ve seen one this large."

Wang Kangzhu said: "It’s also my first time seeing one this big. The hemorrhoid is too large to push back in, and if left too long, it might become strangulated and necrotic. Dean Jin doesn’t want surgery."

Xu Chunliang said: "Why undergo surgery? It’s not incurable—hemorrhoids are minor issues; no need for surgery. At Huichun Hall, we have a secret prescription—just a few doses, and we guarantee the medicine will cure you, giving you a beautiful little daisy back."

Everyone around laughed, Dean Xu really knows how to play with words, but the choice of words wasn’t appropriate; Jin Yonghao couldn’t be described as a little daisy at all—it was more like a rotten peach.

Jin Yonghao couldn’t join in the laughter, with a tearful face, he said: "Mayor Xu, don’t tease me with this—it’s a matter of life and death... it hurts so much..."

Wang Kangzhu suggested: "Should we proceed with surgery quickly?"

A strangulated hemorrhoid is caused by various reasons leading to the anorectal mucosa moving downwards, which cannot recover on its own in a short time. The protruding hemorrhoid stimulates the anal area, causing anal sphincter spasms, which leads to hemorrhoidal vein obstruction and lymphatic reflux. It is one of the most common emergencies in anorectal surgery and also one of the most common and severe complications of hemorrhoids.

If a strangulated hemorrhoid cannot be successfully reduced manually, it needs to be treated with excision under anesthesia.

Even though Jin Yonghao was an administrative manager, he knew his condition could not be delayed; otherwise, the consequences could be seriously dire, while he was hesitating about whether to choose surgery.

Xu Chunliang said: "No rush, let me give it a try."

Wang Kangzhu said: "You?" Is this guy here to cause trouble?

Xu Chunliang went over to Jin Yonghao, grabbed his arm, and chose the Er Bai acupoint to apply acupressure.

The term ’Er Bai acupoint’ derives from ’Er’ meaning two and ’Bai’ meaning white. This acupoint is an extraordinary point, so named because of the tenderness and paleness of the area; there are two points on one side. Stimulating the Er Bai acupoint can regulate qi and blood—the cause of hemorrhoids includes local qi and blood stasis—and massaging the Er Bai acupoint can promote qi and blood circulation, making it an essential acupoint for treating hemorrhoids.

The Er Bai acupoint is located on the palm side of the forearm, 4 inches above the wrist crease, on both sides of the tendon of the flexor carpi radialis muscle. When finding the point, make a fist and the raised tendon next to the thumb, located above the wrist crease on three horizontal finger-widths’ distance, is the intersection on both sides of the tendon.

Xu Chunliang massaged the Er Bai acupoint for Jin Yonghao, pressing on both sides simultaneously.

About three minutes later, Xu Chunliang put on gloves and applied lubricating liquid all over a hemorrhoid as large as an egg, without showing much exertion, he massaged and pressed, effortlessly pushing the hemorrhoid back into Jin Yonghao’s rear.

Oddly enough, Jin Yonghao didn’t feel pain; instead, he felt a sense of relief and comfort, as if a burden had been lifted, and he involuntarily murmured: "Oh..." It wasn’t pain, but a sense of liberation.

A group of professional medical workers, seeing the scene before them, all breathed a sigh of relief, their eyes filled with incredulous expressions. It was the same repositioning, yet he did it so naturally and smoothly. Who would have thought that Xu Chunliang had such a brilliant technique?

Only Wang Kangzhu didn’t think so. He believed his technique was fine, the key issue was that when inserting into Jin Yonghao’s rectum, this guy didn’t cooperate.

In the eyes of others, Xu Chunliang seemed to be more familiar with the structure of Jin Yonghao’s posterior than Wang Kangzhu.

Xu Chunliang said, "I told you, it’s just a minor issue."

Jin Yonghao said, "Thank you, thank you." He felt reborn after the disaster, and his gratitude toward Xu Chunliang was heartfelt.

Xu Chunliang said, "Everyone, please give us a moment. I have a few words to discuss privately with Dean Jin."

Seeing that the manual reduction was successful and Jin Yonghao was no longer in danger, the condition alleviated, and there was no immediate need for surgery, everyone left one after another.

Jin Yonghao reached out and touched his posterior, confirming the hemorrhoidal mass had indeed been successfully repositioned, he then carefully moved a bit, lying on his side, not daring to immediately get up for fear the hemorrhoid might prolapse again.

Xu Chunliang said, "Old Jin, your situation is quite serious."

Jin Yonghao said, "Last time I went to see Doctor Liu, and it was almost better, but with the holiday, too many gatherings, I didn’t watch my diet, and it relapsed again."

Xu Chunliang said, "Doctor Liu learned his methods for treating hemorrhoids from my grandfather. In fact, our family has an exclusive secret remedy that’s never been shared outside. Your condition can still be completely cured through Chinese medicine, but I don’t have a medical license."

Jin Yonghao looked hopefully at Xu Chunliang and said, "Mayor Xu, could you please treat me?" Having just personally experienced Xu Chunliang’s technique, Jin Yonghao had already concluded that in terms of skills, Xu Chunliang was far superior to Wang Kangzhu. What medical license? That’s not important; curing his condition is what’s important.

Xu Chunliang said, "Even if you undergo surgery, the prognosis might not be great. If you trust me, I can help you with acupuncture, but it can’t be here, it has to be at your office, and you can’t tell anyone else."

Jin Yonghao had suffered from hemorrhoids for several years, its worsening related to his lack of self-discipline, and partly due to his fear of surgical treatment. Now hearing it could be completely cured, of course, he wanted to try it. As for confidentiality, he could definitely manage that; it’s not something to boast about anyway, it’s already embarrassing enough for him.

Jin Yonghao lay a while longer, and after the symptoms eased, he and Xu Chunliang went to his office together.

Xu Chunliang wasn’t just being helpful; he wanted to test some secret remedies he had collected in the past before starting a proctology hospital, and Jin Yonghao was undoubtedly a suitable candidate.

Er Bai acupoint is one of the main points for treating hemorrhoids, and during Jin Yonghao’s acute strangulation phase, massaging Er Bai acupoint helped him smoothly reposition his hemorrhoidal mass.

Hemorrhoids are one of the most common anal diseases clinically. There are also extensive records in traditional Chinese medicine.

As early as the Xia and Shang dynasties, hemorrhoids were documented in oracle bone script. Over two thousand years ago, the "Inner Canon of Huangdi" first expounded on the main causes of hemorrhoids. For instance, in "Su Wen: Theory of Heavenly Qi Communication," it says: Overeating causes the sinews and veins to become loose, the intestines spill causing hemorrhoids.

During the Qin and Han periods, in "Fifty-two Disease Formulas," hemorrhoids were classified into four types, initially describing the symptoms of hemorrhoids and ligation surgery. The "Shen Nong Ben Cao Jing" lists five hemorrhoid diseases and first records 21 hemorrhoid-treating drugs. The Jin dynasty’s "Zhen Jiu Jia Yi Jing" systematically expounds on acupuncture treatments for hemorrhoids.

In the Sui and Tang dynasties, understanding of hemorrhoids deepened, as "Various Discussions on the Sources of Diseases" details the names and symptoms of five hemorrhoids (namely male hemorrhoid, female hemorrhoid, vein hemorrhoid, blood hemorrhoid, and bowel hemorrhoid) and adds air hemorrhoid and alcohol hemorrhoid.

The "Urgent Golden Prescriptions" and "Supplementary Recipes Worth a Thousand Gold" based on seven hemorrhoids, added dry-wet hemorrhoid and external hemorrhoid, dividing them into nine hemorrhoids and detailing their treatment methods. The "External Essentials" not only classifies hemorrhoids into nine types but also distinguishes between internal and external hemorrhoids, predating similar discussions in Western medicine by over a thousand years.

For acupuncture treatment of hemorrhoids, the first choice is the sacral foramina below the Liao acupoint, opposite the Yangliao acupoint above. Liao, meaning fissure. This acupoint belongs to the bladder meridian of the foot Taiyang, indicating that the earth-level meridian water of the bladder channel flows from the body’s surface to the body’s interior. The material of this acupoint is the earth-level meridian water descending from the upper bladder channel, which, after reaching the acupoint, flows from the earth fissures of this point from the earth’s heaven part into the earth’s earth part.

Located between the posterior superior iliac spine and the posterior midline, it matches the second sacral foramen, with direct puncture with a needle of 1-1.5 inches. The purpose of acupuncture is to reduce the pressure of the earth-level meridian water descending from the upper part of the bladder channel, aligning coincidentally with Western medical pathology.

Next, select the Chengshan acupoint: The Chengshan acupoint is located in the middle of the back of the lower leg, between the Weizhong and Kunlun acupoints. When the lower leg is straightened or the heel is raised, the triangular dimple that appears under the gastrocnemius muscle is this point. It is an effective point commonly used for leg cramps and anal diseases, paired with the large intestine Shu acupoint in ancient times to treat hemorrhoids.

The spleen earth particles following the bladder channel water here solidify. The qi and blood substance are the earth-level spleen earth and the wind qi ascending from the heaven part.

The wind qi ascends along the bladder channel, while the spleen earth accumulates around the acupoint. This point functions to transport and transform moisture and solidify the spleen earth, similar to the method of sclerotherapy used in Western medicine for treating hemorrhoids, which still requires medication, aligning with the acupuncture method at the Chengshan acupoint.

Similarly, in sclerotherapy, Chinese medicine achieves this without external forces, relying on the body’s own spleen earth material to solidify the hemorrhoidal mass, much superior to Western medicine in this aspect.