This disease is a malignant tumor occurring in the rectum of the anal canal, the disease to the late stage, tumor obstruction, anal narrowing, defecation difficulties. It is like locking the anus, so it is called locking anus hemorrhoid. Equivalent to Western medicine’s anorectal cancer. Surgery Dacheng” said: “lock anal hemorrhoids, inside and outside the anus, such as bamboo knot locking, shaped like a jellyfish, in a hurry and then heavy, fecal matter is thin and flat, when the flow of stinking water ……”. The symptoms and prognosis of this disease are described in detail. The age of onset of this disease is more than 40 years old, occasionally seen in young people, its early features are blood in the stool, stool habit change. Etiology and pathogenesis: melancholy and depression, spleen and stomach disharmony, damp-heat accumulation, day-long transformation of toxicity, multiplying the downstream injection, immersion in the intestinal tract, stagnation of qi and blood stasis, dampness and toxicity stagnation and condensation of tumors; or dietary impurity, prolonged dysentery and diarrhea, polyps and insects, damage to the spleen and stomach, transport and transformation of the disorder, damp-heat endogenous heat and toxin condensation, the flow of injection into the large intestine, the condensation of toxicity, and the knot into a swelling. In short, damp-heat downward injection, fire and poison internalization, and swelling is the symptom of the disease; deficiency of positive qi and deficiency of spleen and kidney is the root of the disease. Rectal cancer is mostly adenocarcinoma, which occurs in the upper part of rectum and the junction with sigmoid colon. Anal canal cancer originates from anal canal skin, mostly squamous cell carcinoma. Anal scar tissue, warts, anal fistula and other lesions can also induce cancer. Diagnosis] 1. Clinical manifestations: Initial manifestation is a small hard nodule protruding from the mucous membrane of rectum or anal skin without obvious symptoms, and a series of changes may appear when the condition further develops. (1) Blood in stool: it is the most common early symptom of rectal cancer. The blood in stool is bright red or dark red, not much, often accompanied by mucus and persistent, which is often mistaken as “hemorrhoids”. The further development of the disease, there may be an increase in the number of stools, there is a sense of urgency, defecation, there is blood, pus, mucus in the stool, and a special odor. (2) Change of bowel habit: It is also a common early symptom of rectal cancer. It manifests as increased frequency of defecation, frequent urge to defecate, feeling of incomplete defecation, etc. Sometimes it is constipation. Sometimes it is constipation, and at the same time, there is discomfort or falling sensation in anus. (3) Stool deformation: due to narrowing of intestinal lumen in the late stage of the disease, there is less feces, the shape of stool becomes thin and flat, and there are signs of intestinal obstruction, such as abdominal distension, abdominal pain and hyperactive bowel sounds. (4) Metastatic signs: first of all, it spreads directly, and in the later stage, it passes through the intestinal wall and invades the bladder, vaginal wall, prostate and other adjacent tissues; if it invades the bladder and urethra, there is dysuria, painful urination and frequent urination. If it invades the presacral plexus, there may be severe persistent pain in the rectum or sacral region, and radiates to the lower abdomen, waist or lower limbs. In addition, there may be upward lymphatic metastasis to lymph nodes that follow the course of the superior rectal vein. About 10-15% of patients have hematogenous metastasis of the cancer to the liver via the portal vein at the time of diagnosis, resulting in hepatomegaly, ascites and jaundice. In advanced stage, patients may have malignant manifestations such as loss of appetite, general weakness, anemia, extreme emaciation and so on. (5) Physical examination: anal canal cancer is rare, early lumps are small, movable and wart-like. With further development, protruding mass or ulcer can be seen in the anus, with uneven base and hard texture, and there may be satellite metastatic nodules and inguinal lymph node metastasis. (6) Rectal finger test: it is the most important method to diagnose rectal cancer, 80% of rectal cancer is located in the palpable part of finger, when the tumor is large, the finger test can clearly find hard lumps on the intestinal wall, huge ulcers and narrowing of the lumen. Blood, pus and mucus can be seen on the finger after withdrawing the finger. The size, scope, location and degree of fixation should be clearly detected when the cancer is detected by finger-examination in order to decide the treatment method. (1) Proctoscopy or sigmoidoscopy: all fingerprints of suspicious or undoubted rectal cancer should be subjected to proctoscopy or sigmoidoscopy, which can not only see the scope of lesions in rectum, but also take or tissue for pathological examination to determine the diagnosis. (2) Barium enema examination: it can find the narrowing of intestinal lumen or barium shadow residue, etc.. In order to exclude multiple primary cancers in colon, arctic observation or gas-barium double contrast should be performed routinely. (3) Other examinations: when the cancer of lower rectum is large, female patients should undergo vaginal and bimanual examination, and male patients should undergo cystoscopy if necessary. If liver metastasis is suspected, B-mode ultrasonography, CT or isotope scan should be performed. If rectal cancer invades into anal canal and inguinal lymph nodes are enlarged, lymph nodes should be removed and biopsied. Differential Diagnosis] Early increased frequency of defecation or blood in stool should be differentiated from dysentery, enteritis and bleeding hemorrhoids; palpation of mass should be differentiated from polyps and anal papillae hypertrophy; cancerous ulceration of anal canal should be differentiated from anal leakage and warts. Treatment: Once diagnosed, the disease should be treated with radical surgery as early as possible, and according to the situation, preoperative and postoperative application of traditional Chinese medicine therapy, radiotherapy or chemotherapy can improve the therapeutic effect. (1) Internal treatment ① Damp-heat syndrome Symptoms: anal swelling, increased stool, blood in stool, dark red color, or mucus, or dysentery, red and white, acute and then heavy; tongue red, moss yellow and greasy, pulse slippery. Treatment: clearing heat and dampness Prescription: Sophora Jiao Diyu Pill plus subtraction ② Qi stagnation and blood stasis Certificate Symptoms: perianal swelling bulging, hard to the touch, pain and refused to press, or stool with blood, purple color, dark, heavy, difficult to defecate; purple tongue, astringent pulse. Treatment: Promoting Qi and activating Blood. Prescription: Tao Hong Si Wu Tang combined with Lost Smile San plus subtractions. Symptoms: colorless face, emaciation, weakness, loose stool or difficult defecation, blood in stool, purple color, anal swelling; or accompanied by heartburn, dry mouth, night sweating; red or reddish tongue, scanty moss, weak or fine pulse. Treatment: benefiting Qi and nourishing Yin, clearing heat and removing toxins. Prescription: Sijunzi Tang and Zengyi Tang with additions and subtractions. (2) External treatment: apply Jiuhua ointment or Huanglian ointment externally if the anal canal cancer is ulcerated. (1) Surgery: Radical resection should be performed as early as possible for resectable anorectal cancer. It is suitable for patients whose cancer is confined to the rectal wall or anal canal and only has local lymph node metastasis. For those who have invaded the uterus, the vaginal wall can also be resected at the same time. When advanced anorectal cancer has been widely metastasized and radical surgery cannot be performed, sigmoidostomy is feasible to relieve obstruction and alleviate patients’ pain. (2) Radiotherapy and chemotherapy have certain efficacy as auxiliary treatment. Preoperative radiotherapy for advanced rectal cancer can improve local symptoms, and some patients can have radical resection. Local recurrence of rectal cancer after surgery is mostly seen in perineum, radiotherapy can inhibit its growth, but cannot cure it. Chemotherapy with radical resection can improve 5-year survival rate. (3) Enema: 30g of sepsis herb, 30g of white-flower snakeweed, 80ml of water decoction, retained enema, twice a day, 40ml each time. 【Prevention and Conditioning】 Those who are over 40 years old and have change in bowel habit and blood in stool should consult doctor at early stage, and be alert to the occurrence of rectal cancer.