初诊2015.2.22，某，男，36岁。182cm，214斤。

病史：肛门内上5公分左右有囊肿,下坠感重。5年前手术过，8天前饮酒复发在青医附院，奥硝唑治疗无效。22号转山东大学齐鲁医院，头孢曲松钠和氯化钠治疗，效差。建议手术。预计初七手术。患者畏惧手术后会再次复发，且担心出现肛瘘。

恰逢春节，诊所休假。只能通过网诊了解病况。

患者电文：1、便前后无任何岀血，大便正常；2、确诊肛周囊肿，无出溃破，但是确诊化脓；3、无肺部症状，短气等；4、有烟酒吃辣习惯；5、胃部前列脉等无任何不适；6、不发病时大小便等均正常，但发病大便痛甚； 7、年龄36，高182，体重214斤；8、近两年未服用任何中西药；9、十天前复发，原因烟酒过渡， 症状与5年前完全相同，但部位似乎不同，应属于新发部灶； 10、无肛交史。有舌象照片。

因为此类病病因比较单一，相对比较容易治疗，脉象也较为单一，症状大同小异，所以，凭证可直接出方。

病机：肺热转大肠，久则瘀血

治则：宣肺解毒、清热凉血

至2.28日，服药5付，来电告，坐、立、行已不痛，大便稍稀。无其他不适。称病灶还有2公分左右。坚持服药加外洗、栓药，二周后临床治愈。一个月后，病灶结痂脱落。

此病大便时疼痛难忍，甚则不能坐姿。西医一般采取手术治疗，但容易复发，更可能造成肛瘘，一但发生将成为终身遗憾

Male 36 years old, Clinic visit on Feb 22, 2015, Weight 107kgs (236lbs), H: 182cm

Cyst 5cm upper part on Perianal, a sensation of Anal prolapse. five years ago, had a surgery for same problem and eight days ago came back after drinking too much. 22nd transferred to Qilu Hospital, no improvement after Ceftriaxone sodium and sodium chloride treatment. A second-time surgery was refused by patient; in fear it will recur again. 

Severe burning pain when pooing and could not take sit stance.

It was an emergency call on Chinese New Year's holiday. I was out of town.  It was a single symptom disease, comparatively easier to cure. After checking for all the symptoms, I gave therapy.

Diagnosis: pulmonary heat passed to anus, long enough to transform to remove bl0od stasis.

Principle: clear the heat and blood stasis

herbal therapy for intake and external washing and filling

On Feb 28, patient called and said no pain when pooing and sitting. About 2cm -size cyst remains. In about a month, the focus dried and fell off.

The danger of repeated surgery? archosyrinx, an anal fistula, a life-long hassle that one will be accompanied with in the rest of own's life. Cost for CM treatment? Only about 1/5 of the surgery cost.