Internal hemorrhoids are soft masses above the dentate line in the anus, and the clinical symptoms are mainly bleeding and prolapse. The size of hemorrhoids varies, from large ones like prune fruit to small ones like cherries, some 1-2 isolated and some several connected together. According to the different degrees of development of internal hemorrhoids, they are divided into 4 stages: Stage I, mainly bleeding during defecation, no pain; Stage II, there is blood in the stool, hemorrhoids prolapse with defecation, but after defecation hemorrhoids can be returned by themselves; Stage III, each time defecation prolapse outside the anal opening, can not be returned by themselves, must be held back by hand; Stage IV, internal hemorrhoids prolapse outside the anus can not be returned to the inside of the anus, or immediately after the reply, this is the most serious stage of internal hemorrhoids. This is the most serious stage of internal hemorrhoids, which is mostly seen in elderly patients. There are many treatment methods for internal hemorrhoids, including drug injection, PPH (TST), ligation, and so on. The first choice among them is hemorrhoid injection treatment, which is less painful, has shorter healing time, less complications and is easier to perform. The hemorrhoid elimination spirit is successfully developed by Professor Shi Zhaoqi of the Department of Anorectal Medicine, Guang’anmen Hospital, Chinese Academy of Traditional Chinese Medicine. The main ingredients are tannic acid extracted from Wu Bei Zi and medical alum (potassium aluminum sulfate). After the injection of anti-hemorrhoid spirit, it causes a sterile inflammatory reaction, which is divided into acute inflammatory period and chronic inflammatory period. The acute inflammatory edema period after the injection of anti-hemorrhoid spirit is only 5 hours, which produces tissue fibrosis on the basis of chronic inflammation, and the adhesion of mucosa and submucosa is fixed, so that the hemorrhoids atrophy and disappear. The method of injection of anti-hemorrhoid spirit: the procedure requires a flared anoscope (clear field of view, easy to operate), a No. 5 syringe, a No. 5 needle (the needle is 5 cm long, with a fine tip and a sense of hand conduction during injection), and a 1:1 concentration of anti-hemorrhoid spirit solution (1 part of original anti-hemorrhoid spirit solution plus 1 part of 1% lidocaine). The purpose of local anesthesia is to relax the anal sphincter and expose the field of view clearly, so that the anal swelling caused by anal sphincter spasm can be avoided after treatment. The procedure can be started after rectal disinfection. The first step is to enter the needle from the superior rectal artery area above the hemorrhoid nucleus: that is, 3, 7 and 11 points above the three main hemorrhoid nuclei, to be biased towards the submucosal layer of 1-2cm diagonally above, and inject 2-3ml of medicine at each place. The second three steps, that is, injection into the submucosal and intramucosal layers of hemorrhoids: enter the needle into the middle of the hemorrhoid nucleus under the anoscope, the direction of the needle is slightly diagonally above, and after there is muscular resistance, slightly lift the tip of the needle to detach it from the muscular layer before injecting medicine. The amount of medicine injected is slightly larger than the volume of the internal hemorrhoid nucleus. The injection volume is 1/2-1/3 of the second step, and the sign of the appropriate injection volume is the slightly raised surface of the hemorrhoid mucosa and the clear mucosal vascular texture, which indicates that the injection has been appropriate, if the mucosa becomes pale and the vascular texture disappears, it shows that the injection volume is too much or too concentrated. The amount of drug injection in the third step should not be too much to prevent superficial necrosis. After the second and third step of injection, paraplegia injection is performed. The amount of drug injection is decided according to the size and pathological typing of the paraplegia. Generally, the amount of drug injected into each paraplegic nucleus should be slightly larger than the volume of the nucleus. If the paramyloid nucleus is vasomatous, only the submucosal layer of the hemorrhoid should be injected; if it is varicose veins or fibrosis, the submucosal and intramucosal layers should be injected. The fourth step of injection is 0.1-0.2 cm above the tooth line: after entering the submucosa, inject 1-2 ml of medicine into each sinusoidal vein of the main hemorrhoid nucleus. if you also have to do external stripping and internal ligation, the fourth step of injection can be simplified. It is important to emphasize the four-part injection method of eliminating hemorrhoids, using the lowest position of the first needle through the mucosa → mucosal lamina propria → mucosal muscle layer → submucosal layer, after there is muscular resistance, slightly lift the needle tip to detach from the muscle layer and then inject the drug. The purpose of injecting drugs while retreating from the needle is to make the drug evenly distributed, but also to make the mucosa at the needle not appear back to blood (never use the needle injection). Sometimes during the operation, the nucleus of the injected hemorrhoid swells and affects the exposure of the nucleus of the uninjected hemorrhoid. A dry cotton ball can be placed under the anoscope to compress the nucleus of the injected hemorrhoid so that the nucleus of the uninjected hemorrhoid is clearly exposed and then injected. After the injection is completed, the forefinger repeatedly gently touches the injected hemorrhoid nucleus to evenly disperse the medication. Finally, incorporate a tylenol suppository. It should be noted that the internal hemorrhoids should not be clamped or pulled out of the anus for injection; the first step of injection should not be performed or the amount of injection should be too large; the drug should be injected into the superficial part of the internal hemorrhoids; the drug should not be injected after the first injection, but while the needle is in. 12-point injection must pay attention to protect the prostate gland. After the injection the patient can go home and rest on his own after 1-2 hours of observation in the hospital, take oral or sedative antibiotics for three days, and control bowel movements for one day. Put one TENA hemorrhoid suppository in the anus every morning and evening. Regular follow-up visits are sufficient. There are no significant adverse reactions yet after the injection and it does not affect general activities. There is no other uncomfortable reaction other than the possible anal swelling within a few hours after the injection, and no hemorrhoid nucleus prolapse and bleeding in the first bowel movement after the injection, and the hemorrhoid nucleus atrophy disappears in 5-7 days. In a word, the treatment of internal hemorrhoids with the injection of elimination hemorrhoids has the advantages of reliable efficacy, no pain, quick recovery and low recurrence rate, which is suitable for patients of any age group.