[A study of the Arśapraśamanisūtra: analysis]

The present paper focuses primarily on a philological and historical study of the Arśapraśamanisūtra ("The Sūtra of the Tranquilization of Hemorrhoids"). This Sūtra is one of the Buddhist scriptures that is characterized by the magico-religious treatment of various diseases, especially by means of "healing spells" (skt. dhāranī or mantra), as shown by the preliminary survey in our penultimate paper "The Tradition of Healing with Magical Spells as Seen in Buddhist Texts," Journal of the Japan Society of Medical History 55/1 (2009), 77-96. In our last paper "The Tradition of Healing with Magical Spells as Seen in Buddhist Texts (2): A Study of the Arśapraśamanisūtra: Edition and Japanese translation" we provided critically edited texts of the Tibetan and Chinese translations accompanied by their Japanese translations with critical notes and annotations. In this paper we analyze the descriptions of hemorrhoids as found in the Sūtra in comparison with those illustrated in classical Ayurveda literature, besides a detailed philological examination of the relevant passages available only in the Chinese translation of the Mūlasarvāstivāda-Vinaya. We also offer further observations about the methods and principles for the treatment and healing of hemorrhoids that are attested in Buddhist scriptures, as well as make an overview of the transmission and historical reception of the Arśapraśamanisūtra in Japan between the Nara and the Taishō periods.

[Study of "The Sūitra of the tranquilization of hemorrhoids" and other relevant material]

The present paper focuses primarily on a philological and historical study of the Arśapraśamanisūtra ("The Sütra of the tranquilization of hemorrhoids"). This Sūtra is one of the Buddhist scriptures that are characterized by the magico-religious treatment of various diseases, especially by means of "healing spells" (skt. dhāranī or mantra), as shown by the preliminary survey in our previous paper "The Tradition of healing with magical spells as seen in Buddhist texts", Journal of the Japan Society of Medical History 55/1 (2009), 77-96. The original text of the Arśapraśamanisūtra, most probably written in Sanskrit, is lost whereas its Chinese and Tibetan translations have survived. After an introductory summary, we provide critically edited texts of the Tibetan and Chinese translations accompanied by their Japanese translations with critical notes and annotations. In particular, the Tibetan translation presented here has been critically edited for the first time on the basis of collation of the five editions of the Tibetan Buddhist Canon. In our next paper we will analyze the descriptions of hemorrhoids as found in the Sūtra in comparison with those illustrated in classical Ayurveda literature. And we will also offer further observations about the methods and principles for the treatment and healing of hemorrhoid that are attested in Buddhist scriptures.

Maimonides: an early but accurate view on the treatment of haemorrhoids

Moses Maimonides was not only one of the most influential religious figures of the middle ages, but also a pioneer in a wide variety of medical practices. A brief history of his life, and what is known about his medical education, is given here. His paper on haemorrhoids is summarised, as well as a review of the current understanding of the pathogenesis, prevention and treatment of this common condition. The comparison of Maimonides' writings to modern understanding of not only the prevention and treatment of haemorrhoids, but also his approach to the patient as a whole in terms of pre- and postoperative care, demonstrate how ahead of his time this great philosopher was.

[A look at the Hippocratic treatise On Hemorrhoids in the Byzantine Era]

In two manuscripts of Galen's De compositione medicamentorum secundum locos, the Marcianus gr. V 7 and the Vaticanus Reginensis gr. 172, Galen's text is interrupted by a brief anthology about aetiology and therapy of prolapses, haemorrhoids and anal inflammations. Both manuscripts present a chapter, titled (see text), which consists of chapters 1-2 (p. 146, 2-12 July) of the Hippocratic On Haemorrhoids. My contribution presents this new document about the knowledge of this Hippocratic work, neglected by modern scholars, but well known by Byzantine medical writers.

[Historical aspects of a frequent anal disease: haemorrhoids]

In this report the authors outline the main historical aspects of haemorrhoids after a thorough review of the literature. The first texts concerning haemorrhoids are the ancient Egyptian papyruses. The twenty centuries of the history of haemorrhoids are marked by multiple pathogenetic theories, and of these the vascular and the sliding of the anal mucosa are still valid. From an analysis of the historical texts and the most recent publications, we deduce that the principles of therapy are substantially unchanged since the days of Hippocrates. In conclusion, we can say that, as in ancient times, the therapy of haemorrhoids is based on three fundamental approaches: surgical treatment, ambulatorial non-surgical treatment and medical treatment.

A literary review of Arśas (haemorrhoids)

The disease Arśas (hemorrhoids), an ano-rectal disorder is as old as mankind. Suśrta farther of surgery described the Arśas under heading of 'Mahagadas' (eight major diseases). Due to inconsistency of human diet and social obligations, a large proportion of the population is suffering from hemorrhoids. As per Ayurveda, the etiological factors are broadly classified as Sămănya (Non-specific) and Viśĕsa (Specific). Viśĕsa again sub divided in to Sahaja and Janmottara. Suśrta classified this disease on the basis of clinical manifestations in to six types, where as Caraka and Văgbhata classified in to two according to discharging nature and causative factors respectively.

[A 15th century manuscript concerning hemorroid and its treatment]

This study is about a 15th century Turkish text, a general survey of hemorroid. A copy of the text is available in the Diyarbakir Public Library. The 48 page treatise was composed upon the request of a statesman of the time. Hemorroid is described in terms of diagnosis, classification and treatment. This study contains important information on the methods of the treatment of hemorroids. A glossary is inserted at the end of the study in order to be used for deciphering the text, which is a rare example of old Turkish medical literature.

Who's afraid of the dentate line? The Whitehead hemorrhoidectomy

Between January 1, 1970 and January 1, 1980, 1,002 hemorrhoidectomies, of which 356 were modified Whitehead procedures, were performed at a University of Illinois-affiliated hospital. Follow-up data were obtained from 295 of these patients, with times ranging from 5 to 12 years. Five patients experienced postoperative contractures. Of these, three required a second procedure and one required a third. There were no cases of fecal incontinence or rectal seepage. After review of the literature, I concluded that (1) the poor record of the Whitehead hemorrhoidectomy is due to the confusing and oftentimes misleading terminology of the anorectal anatomy found in early texts, and (2) this technique, or one of its modifications, is a viable treatment option for patients with circumferential, prolapsing, mixed hemorrhoids.

The Whitehead hemorrhoidectomy. An unjustly maligned procedure

The Whitehead technique of hemorrhoidectomy has developed a reputation as an undesirable procedure since its description in 1882. The chief criticisms have been considerable blood loss, disturbance of continence, formation of an ectropion, and poor healing of the mucocutaneous junction followed by stricture formation. Five hundred fifty-six patients underwent a modified Whitehead hemorrhoidectomy, performed by one author (C.E.C.), between 1963 and 1983. Seventy-two of these patients had unclaimed follow-up letters, leaving 484 patients available for review. Four hundred forty of these patients were followed for over three years. Postoperative complications included fistula or abscess in 1.1 percent, flap loss in 6.9 percent, and a nonhealing wound in one patient. There were no recurrences and there was no ectropion formation, or "Whitehead deformity." Mortality was zero and total morbidity, including 7.2 percent flap detachment, was 12.2%. A modified Whitehead technique has become the authors' procedure of choice for circumferential prolapsing and bleeding hemorrhoids and mucosa.

Of heliotropes and hemorrhoids. St. Fiacre, patron saint of gardeners and hemorrhoid sufferers

During the Middle Ages, an integral part of the therapy for certain ailments included supplication to "patron" saints for possible divine intervention. Through legends surrounding his life, St. Fiacre, a 7th century Irish monk, has become the patron saint for hemorrhoid sufferers.