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Triangle for Piles

Also called: the bed-wetting point, बवासीर

Prone; one heel near the tail bone, then both heels above the hip at S5, then outward near S3, then S1

How it is given
Face Down
What it is used for
Each Point in Use
Take care
not to those passing little urine

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Given by a therapist

From Face Down

TRIANGLE FOR PILES — ट्रायंगल फॉर पाईल्स

This is given for piles (बवासीर). That is why it has been given this name.

Method:

As per the figure, stand with the feet on the ground between the waist and the thigh. First place the heel of one foot on their hip near the tail bone — that is, the last end of the spinal column.

Then, taking the full weight of the body on the hands with the support of the chairs, place both heels above the hip, near the S5 bead (at the place marked 1 in the figure).

Simultaneously pressing with the heels in the direction of the head, with one jerk push the muscles below upward.

Then change the position of your heels, placing them slightly outward, near the S3 bead, and give an upward jerk.

Finally, do the same near the S1 bead.

Repeat as many times as needed.

In the symbol above, the numbers '1', '2', '3' on the sides of the triangle show where to start and where to finish; but the number '3' written in the middle of the upper line shows how many times to repeat.

For an ordinary person three times is enough, but for very severe piles one may give 5–6 times for a day or two at first — then the middle number will change to 5 or 6.

Besides piles, it also gives benefit in anal fissure, fistula and prolapse of the rectum. It is also beneficial for control of urine in children and in the elderly, and in women for prolapse of the uterus and for controlling excessive bleeding in menstruation.

Patient's positionProne, 1½ pillows; the therapist standing with the feet on the ground between the waist and the thigh, the full weight of the body on the hands with the support of the chairs Prone
Where the feet are placedFirst the heel of one foot near the tail bone — the last end of the spine. Then both heels above the hip, near the S5 bead (place 1); slightly outward, near S3 (place 2); near S1 (place 3)
Duration and repetitionsAt each place, pressing with the heels in the direction of the head, with one jerk push the muscles below upward. Three times is enough for an ordinary person; for very severe piles, 5–6 times for a day or two — the middle number then changes to 5 or 6. Repeat as many times as needed
DirectionPlace the chairs so that the pressure is in the direction of the head, and not in the direction of the ground ▲ Take care
What it is forPiles (बवासीर); anal fissure, fistula, prolapse of the rectum; control of urine in children and the elderly; in women, prolapse of the uterus and excessive bleeding in menstruation

The three stations trace the shape of the bone — a triangle standing on its point: place 1 low and close to the midline at S5, place 2 further out at S3, place 3 highest and widest at S1. The first placement, one heel near the tail bone, is a settling, not a treatment. Then every station is one jerk, upward — a single quick lift of the tissue toward the head, both heels together, after which the heels are moved. You do not jerk twice from the same place. (Figure 21.6)

Key teaching

Reading the triangle symbol — numbers on the sides, and the number in the middle

The glyph is an inverted triangle with numbers on it, and they mean two different things depending on where they sit.

'1', '2', '3' on the sides show where to start and where to finish — the three heel stations, in order.

'3' in the middle of the upper line shows how many times to repeat.

So the middle number is a dose, and it changes: three times is enough for an ordinary person, but in very severe piles one may give 5–6 times for a day or two — and then the middle number will change to 5 or 6 on the card. The side numbers never change, because there are always three stations. The raised dose is written for a day or two, not for a course.

What lies beneath. The heel sits on the back plate of the sacrum, over the origin of the great buttock muscle and the flat tendon of the long back muscles; the small holes through which the sacral nerves reach the buttock lie in rows under the stations. The nerves running to bladder and back passage come off the same levels but turn forward, where no heel follows. The upward vector is coherent — but coherent is not demonstrated, and both words should be used. And one fact, because patients ask: the cushions inside the back passage are normal anatomy, and piles are what happens when the tissue anchoring them gives way.

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