In the prescientific era, disease was rarely understood through anatomical or physiological principles; instead, illness was interpreted through spiritual, cosmic, and supernatural frameworks. Among the many conditions that elicited fear, discomfort, and social stigma, hemorrhoids occupied a unique place. Painful, recurrent, and intimately associated with bodily modesty, hemorrhoids were not merely regarded as a physical affliction but often as a moral, divine, or karmic consequence. In this context, religion emerged as one of the most influential therapeutic systems in ancient and medieval societies, shaping not only the understanding of disease causation but also its treatment. Long before the development of effective surgical techniques, pharmacotherapy, and evidence-based medicine, religious institutions functioned as centers of healing. Temples, shrines, churches, and monasteries served simultaneously as places of worship and healing sanctuaries, where physical ailments were treated through prayers, rituals, offerings, pilgrimages, sacred waters, amulets, and divine intercession. Hemorrhoids, due to their chronicity and associated suffering, were frequently entrusted to divine healing, and specific deities, saints, and sacred sites became closely associated with their cure. Across civilizations – from ancient India, China, and Greece to medieval Europe and Japan – spiritual healing was often the only accessible, affordable, and socially acceptable form of therapy. A few of the famous shrines/temples of hemorrhoid treatment are: HONSHŌ-JI TEMPLE, TOKYO, JAPAN Honshō-ji is a Nichiren sect Buddhist temple near the Sumida River in Tokyo, known for its historical connection to the treatment of hemorrhoids and “illnesses below the waist.”1 The story begins with a man named Okada Magōemon, who was a clerk at a sake store in Edo. History would have condemned him to obscurity were it not for the last 7 years of his life, which he spent in debilitating agony from hemorrhoids. For years prior to his death in 1744, Okada often visited Honsho-ji, a temple near the Sumida River, to pray for relief from his symptoms. His piles never went away, and before he died, he solemnly vowed to become a guardian for those suffering from similar ailments. Posthumously deified as Shūzan Jiun Reijin, he was enshrined at the temple as the protector of “illnesses below the waist” Figure 1.Figure 1: Honshō-ji Temple, TokyoKUNIGAMI SHRINE, TOCHIGI PREFECTURE, JAPAN Located in the town of Motegi, Tochigi Prefecture, Kunigami Shrine is a bit of a mystery. There is not much information on its history, origins, traditions, or rituals. However, the most interesting aspect of this shrine is its curious festival (“kisai”) – the Jikatamajinai Festival, which was revived in 2012 by a local preservation society after it had been discontinued in 1988. The festival is held every year in mid-July and revolves around the sacred egg-shaped “butt-washing stone” on the shrine grounds. It begins with speeches, followed by an egg art award ceremony, but the real highlight of the Jikatamajinai is the butt-washing ritual. In this ritual – which the shrine priest will first demonstrate for all – worshippers pray for the prevention and healing of hemorrhoids by squatting and pointing their butt out toward the stone, chanting “ketsupitashi” three times. “Jikata” is a local term used to refer to people with hemorrhoids, while “ketsupitashi” derives from “ketsu wo hitasu” or to “soak the buttocks.” Naturally, one must pay to pray. Participating costs ¥1,000 or ¥2,000, which also nets you a boiled egg, a raw egg, and a drink; the more expensive entry fee includes a lucky amulet. The original ritual consisted of getting naked and cleaning one’s rectum in the holy Naka river nearby before pointing their arse toward the egg while praying. One source claims that the festival was originally held on 1 June, as many farmers suffered from hemorrhoids due to over-exertion and exposure to the cold during the rice planting season. This day was for them to take a break from the fields – and hope they will not develop hemorrhoids Figure 2.Figure 2: Kunigami Shrine in Tochigi Prefecture, JapanNAGATA SHRINE, KOBE, JAPAN According to local lore, after a typhoon caused a nearby river to overflow, a red stingray (known for having sharp spines on its tail) was washed into the grounds of the shrine. The spirit of this stingray is now believed to reside in the large, sacred 800-year-old camphor tree behind the Kusunomiya Inari Shrine, located within the Nagata Shrine complex. The folk belief in the stingray’s ability to cure swelling ailments, particularly hemorrhoids, is linked to a pun. By abstaining from eating the stingray (metaphorically “cutting off the tail”), one could eradicate ailments that resembled the pain caused by being pricked by the creature’s sharp spines. Historically, the area was a coastal fishing village, and local fishermen were prone to suffering from haemorrhoids due to their work, which likely gave rise to this specific folk belief as they sought a cure Figure 3.Figure 3: Nagata Shrine, Kobe, JapanSAINT FIACRE, FRANCE Saint Fiacre, a 7th-century Irish monk known for gardening and healing, became the patron saint for people with haemorrhoids (also called “figs of Saint Fiacre”) because legends say he miraculously cured them using herbs from his garden.2 People would pray to him, and even historically significant figures like Cardinal Richelieu in the 17th century sought cures from his relics. His association with hemorrhoids stems from his reputation for using medicinal plants and his own purported healing skills, making him invoked for various infirmities, especially rectal issues. During medieval times, hemorrhoids were known as “St. Fiacre’s curse.” St. Fiacre lived in Breuil until his death in 670, and his relics are installed in Meaux cathedral Figure 4.Figure 4: Saint Fiacre, Notre-Dame, Bar-le-Duc, France, 19th centuryXOCHIPILLI FLOWER GOD, MEXICO Xochipilli or the “Prince of Flowers” was the Mesoamerican god of summer, flowers, pleasure, love, dancing, painting, feasting, creativity, and souls. In Aztec mythology, Xochipilli, the “Flower Prince,” governed pleasure, art, and fertility but could inflict punishments such as hemorrhoids, boils, and venereal diseases on those who broke fasts or violated ritual purity, especially through sexual excess during forbidden times. He was linked to ecstasy from psychoactive plants and could also grant healing for these very ailments, showing his dual role as bringer of both pleasure/sickness and cure Figure 5.Figure 5: Xochipilli flower god stone sculpture Aztec culture 1428-1521 a. C. prehispanic Mexico Anthropologic National Museum Mexico CityGOD OF ISREAL AND HAEMORRHOIDS The connection between the God of Israel (Yahweh/LORD) and hemorrhoids comes from the biblical book of 1 Samuel, where the Philistines, after capturing the Ark of the Covenant, suffered from painful “tumors” or hemorrhoids, attributing these afflictions to God’s judgment, leading them to return the Ark with golden offerings of hemorrhoids and mice.3 This episode highlights the Philistines’ fear and respect (albeit forced) for the power of Israel’s God, even as they tried to rid themselves of the Ark. The Philistines realized these afflictions were linked to the Ark, showing their god Dagon was powerless against Israel’s God. To appease God, the Philistines put the Ark on a new cart pulled by cows, along with five golden tumors and five golden mice, sending it back to Israel Figure 6.Figure 6: Ark of the CovenantThus, the historical reliance on religion for the treatment of hemorrhoids reflects not merely therapeutic limitations but a broader worldview in which disease was inseparable from divinity, morality, and fate. Understanding this religious dimension is essential not only for appreciating the evolution of proctology but also for recognizing how deeply faith shaped patients’ health-seeking behavior long before the modern biomedical paradigm emerged. Author contributions Conception and design of the study - KB. Acquisition of data- KB. Drafting of the article – KB. Critical revising content – KB. Final approval- KB. Data availability statement Data sharing is not applicable to this article as no new data were created or analyzed in this study.
Kaushik Bhattacharya (Thu,) studied this question.