“Anal swelling” is an uncomfortable symptom occurring in the rectum, anal margin, perineum, the patient is very painful after the disease, the main manifestations are: localized falling, distension, foreign body, stool, ants, burning sensation. Even to the lumbosacral, lower limbs reflex. The disease is prolonged for a long time, often combined with mental symptoms, such as nervousness, anxiety, paranoia, insomnia, lightheartedness and so on. The cause of this disease is very complex, both primary and secondary, the author believes that the most important causes of this disease are the following three aspects. First, anal neurosis mental trauma and misinformation or local pain stimulation, resulting in cerebral cortex dysfunction, vegetative nerve dysfunction, local nerve dysfunction, anorectal sensory abnormalities. In Chinese medicine, it is a “depression”, which is caused by the deficiency of heart qi and heart blood due to emotion and depression. Diagnostic points: (1) subjective bizarre anal symptoms, swelling, numbness, burning, foreign body sensation or severe pain. (2) Difficulty in distinguishing the primary and secondary conditions in each narrative, inconsistency, extreme emotional instability, and frequent visits to the doctor. There is no positive sign in specialized examination. (3) Accompanied by mental depression, depressed mood, easily agitated, lack of confidence in health. (4) Symptoms may change and aggravate with mood fluctuations. Functional anorectal pain Rome Ⅲ divided this disease into chronic anal pain and spasmodic anal pain, the two types often co-exist, but can be distinguished according to the duration, frequency and characteristics of pain. Among them, there are two subtypes of chronic anorectal pain: anorectal muscle syndrome and non-specific functional anorectal pain. 1, chronic anorectal pain Diagnostic points: (1) chronic or recurrent anorectal pain. (2) The pain lasts for at least 20min. (3) The above symptoms appear at least 6 months before diagnosis and last for at least 3 months. (4) Other causes are excluded: ischemia, inflammatory bowel disease, cryptitis, interosseous abscess, anal fissure, hemorrhoids, prostatitis, and coccygeal pain. Subtypes: (1) Fulfills the diagnostic criteria for chronic anal pain and causes tenderness when the puborectalis muscle is pulled posteriorly. (2) The pain is usually vague and dull, electric, tearing, or burning, or manifests as increased pressure sensation in the rectum, aggravated by prolonged sitting and lying down, lasting from hours to days. Non-specific functional anorectal pain: (1) Meets the diagnostic criteria for chronic anorectal pain, and does not cause tenderness when the puborectalis muscle is pulled from the back. (2) Cases are rare. 2, spasmodic anorectal pain Diagnostic points: (1) sudden severe pain in the anal area, lasting several seconds or minutes, and then disappear completely. (2) After the attack, the pain will disappear completely as normal until the next attack. The duration of the attack is uncertain and irregular; it may occur once in a few days or once in several years. (3) The pressure in the anal canal and sigmoid colon is elevated. (4) Duration of 3 months. (5) The etiology is mostly related to psychological disorders, and the mechanism may originate from abnormal smooth muscle contraction. Third, anal sinus inflammation Due to inflammation stimulation of the dentate line and pelvic floor nerves, resulting in anal and rectal swelling. Chinese medicine: damp-heat injection, heat and toxins within the knot. Diagnostic Points: Symptoms (1), anal swelling, vague pain, aggravated after defecation. (2) Sense of bowel movement, feeling of incomplete bowel movement, or urgency and heaviness. (3) Reflexes to the urogenital region through the internal pubic nerve and the second and fourth sacral nerves, or to the sacrum and coccyx through the infra-iliac abdominal and anal-coccygeal nerves, or to the lower extremities through the sciatic nerve. (4) Or with gastrointestinal symptoms, such as dyspepsia, profuse flatulence and constipation. (5) It may be accompanied by mental symptoms such as insomnia, anxiety, and paranoia. Signs and symptoms: Anal sphincter tension on palpation, hardness and tenderness of anal saphenous fossa and anal papilla. Anoscopically, the sinuses and anal valves are congested and edema is obvious. The probe can probe into the deeper parts (only 0.2-0.3cm in normal), and the pain is obvious when probing. Clinical need to carefully identify, make a clear diagnosis, and then take Chinese and Western medicine reasonable treatment methods, in order to achieve good results.