The primary impression of the various surgical procedures reported for the treatment of mixed hemorrhoids in clinical practice is that they are similar. In any case, it is easy to reach a consensus on the identification criteria to measure the scientific rationality of the mixed hemorrhoid surgery, namely: (1) less invasive; (2) satisfactory treatment results; (3) fewer complications; and (4) lower recurrence rate. How to achieve these objectives? A variety of reports have emphasized their desirability from one or several aspects. It is like the blind man feeling the elephant. The only way to find a solution to the problem without any bias, instead of a public opinion, is to look to the theoretical axioms of natural science. More than a decade ago, the author that the initial exploration on this issue, and achieved a little understanding. More than ten years have passed, with the gradual increase of clinical observation and the clinical application of modern technology (such as anal manometry, etc.), the rationality of the etiology and formation mechanism of anal disease based on the derivation of the elastodynamic formula was further proved. The derivation process is complicated and will not be listed here. However, the conclusions are briefly described as follows. In the current clinical practice, the procedures for internal and mixed hemorrhoids are accompanied by partial severance of the internal sphincter and subcutaneous severance of the external sphincter in addition to excision and ligation, and it is clear from the derivation that the method of impairing the sphincter function is wrong in many cases. Recent studies have confirmed that 85% of the resting pressure of the anal canal is produced by the internal sphincter and 15% by the external sphincter; clinical “hemorrhoids” should not be seen that cut, asymptomatic people can be completely untreated, if you pay attention to the preservation of the skin bridge and mucosal bridge during surgery, in most cases should avoid cutting expansion, otherwise both delay the healing time after surgery, but also affect the The long-term outcome is affected. Especially in older patients, the incidence and severity of hemorrhoids are clinically higher than in younger people, and anal canal pressure measurements confirm that the resting pressure and maximum systolic pressure of the anal canal gradually decrease with age, so if the theory of anal canal stenosis and anal canal force hyperactivity is used as a guide to cut and expand at will, the consequences can be imagined.