燥结血少，不能润泽，理宜养阴。
入方
治大肠虚秘而热。
白芍（一两半）陈皮 生地黄 归身（一两） 条芩 甘草（二钱）
上为末，粥丸。白汤下七八十丸。
〔附录〕凡人五味之秀者养脏腑，诸阳之浊者归大肠，大肠所以司出而不纳也。今停蓄蕴
结，独不得疏导何哉？抑有由矣！邪入里，则胃有燥粪，三焦伏热，则津液中干，此大肠挟热然
也。虚入脏冷而血脉枯，老人脏寒而气道涩，此大肠之挟冷然也。亦有肠胃受风，涸燥
秘涩，此证以风气蓄而得之。若夫气不下降而谷道难，噫逆泛满，必有其证矣。
东坦诸论，原附于此，今节不录，观者宜于东垣书中求之。
附方
理宜节去，姑存以便阅者。
导滞通幽汤 治大便难，幽门不通，上冲，吸门不开，噎塞不便，燥秘，气不得下。治
在幽门，以辛润之。
归身 升麻 桃仁泥（各一钱） 生地黄 熟地黄（各半钱） 甘草（炙） 红花（各三分）
上作一服，水煎。食前调槟榔末半钱，或加麻仁泥一钱。加大黄，名当归润燥汤。
润燥汤
升麻 生地黄（各二钱） 归梢 生甘草 大黄（煨） 熟地黄 桃仁泥 麻仁（各一钱） 红花
上除桃仁、麻仁另研，作一服，水煎，次下桃仁、麻仁煎。空心热服。
活血润燥丸 治大便风秘血秘，常常燥结。
归梢（一钱） 防风（三钱） 大黄（纸裹煨） 羌活（各一两） 桃仁（二两，研如泥） 麻仁（二两五钱
研） 皂角仁（烧存性，一两五钱，其性得温则滑，温滑则燥结自通）
上除二仁另研外，余为末后和匀，蜜丸梧子大。空心服五十丸，白汤送下。三两服后，
以苏子麻子粥，每日早晚食之，大便不致结燥。以瓷器盛之，纸封无令见风。
半硫丸 治冷秘，风秘结，老人秘。
透明硫黄（研） 半夏（洗七次，等分）
上为末，生姜糊丸梧子大。服二十丸，姜汤下；或用一葱白一条，姜三片煎，入阿胶二片
溶开，食前空心送下。
麻仁丸 治大便秘，风秘，脾约。
郁李仁 麻子仁（各六两，各研） 大黄（二两半，以一半炒） 山药 防风 枳壳（炒，七钱半
槟榔（五钱） 羌活 木香（各五钱半）
上为末，蜜丸梧子大。服七十丸，白汤下。
脾约丸
麻仁（一两一钱半，研） 枳实 浓朴 芍药（各二两） 大黄（四两，蒸） 杏仁（去皮麸炒，一两
二钱，研）
上为末，炼蜜丸，梧子大。服三五十丸，温水下。
凡诸秘，服药不通，或兼他证，又或老弱虚极不可用药者，用蜜熬入皂角末少许作□以
导之。冷秘生姜□亦佳。
Dryness accumulation due to blood deficiency fails to moisten the intestines; the appropriate treatment principle is to nourish Yin.
Prescription
For constipation caused by deficiency and heat in the Large Intestine (Da Chang).
Bai Shao (Radix Paeoniae Alba, 1.5 liang), Chen Pi (Pericarpium Citri Reticulatae), Sheng Di Huang (Radix Rehmanniae Preparata, 1 liang), Gui Shen (Radix Angelicae Sinensis, 1 liang), Tiao Qin (Scutellariae Radix), Gan Cao (Radix Glycyrrhizae, 2 qian).
Grind the above into powder, make pills with congee paste. Take 70-80 pills with warm water.
[Appendix] Generally, the essence of the five flavors nourishes the Zang-Fu organs, while the turbid part of Yang Qi returns to the Large Intestine. The Large Intestine is responsible for excretion but not reception. Why do feces now stagnate and accumulate without being guided out? There must be reasons! When pathogenic factors enter the interior, dry stool accumulates in the Stomach; when latent heat lingers in the San Jiao (Triple Burner), body fluids become dry internally. This is constipation accompanied by Heat in the Large Intestine. When deficiency-cold enters the Zang organs, causing coldness and withered blood vessels, or when elderly people have cold internal organs and sluggish Qi mechanism, this is constipation accompanied by Cold in the Large Intestine. There are also cases where Wind affects the stomach and intestines, leading to dryness and constipation due to fluid depletion; this condition arises from the accumulation of Wind Qi. If Qi fails to descend, making defecation difficult, accompanied by belching, regurgitation, and fullness, there must be corresponding symptoms.
The discussions by Dong Yuan (Li Gao) were originally attached here but are excerpted and not fully recorded now; readers should seek them in Dong Yuan's medical books.
Attached Prescriptions
Ideally, these should be removed, but they are retained for the reader's convenience.
Dao Zhi Tong You Tang (Guiding Stasis and Opening the Hidden Pass Decoction)
Treats difficulty in defecation, obstruction at the幽门 (Yumen/Hyomen - anatomical term for pylorus/anal sphincter contextually implying lower passage blockage), upward rushing Qi, inability of the 吸门 (Ximen) to open, dysphagia and inconvenience, dry constipation, and Qi failing to descend. Treatment focuses on the Yumen, using acrid and moistening methods.
Gui Shen (Radix Angelicae Sinensis), Sheng Ma (Cimicifugae Rhizoma), Tao Ren Ni (Persicae Semen Paste, each 1 qian), Sheng Di Huang (Radix Rehmanniae Preparata), Shu Di Huang (Radix Rehmanniae Recens Preparata, each 0.5 qian), Zhi Gan Cao (Prepared Radix Glycyrrhizae), Hong Hua (Carthami Flos, each 3 fen).
Take as one dose, decoct in water. Before meals, mix with 0.5 qian of Bing Lang (Arecae Semen) powder, or add 1 qian of Ma Ren (Semen Cannabis) paste. If Da Huang (Rhei Radix et Rhizoma) is added, it is named Dang Gui Run Zao Tang.
Run Zao Tang (Moistening Dryness Decoction)
Sheng Ma (Cimicifugae Rhizoma), Sheng Di Huang (Radix Rehmanniae Preparata, each 2 qian), Gui Shao (Ramulus Angelicae Sinensis Terminalis), Sheng Gan Cao (Raw Radix Glycyrrhizae), Wei Da Huang (Baked Rhei Radix et Rhizoma), Shu Di Huang (Radix Rehmanniae Recens Preparata), Tao Ren Ni (Persicae Semen Paste), Ma Ren (Semen Cannabis, each 1 qian), Hong Hua (Carthami Flos).
Except for Tao Ren and Ma Ren which are ground separately, take the rest as one dose, decoct in water, then add Tao Ren and Ma Ren and continue decocting. Take hot on an empty stomach.
Huo Xue Run Zao Wan (Invigorate Blood and Moisten Dryness Pill)
Treats wind-constipation and blood-deficiency constipation, frequently occurring dry accumulation.
Gui Shao (Ramulus Angelicae Sinensis Terminalis, 1 qian), Fang Feng (Saposhnikoviae Radix, 3 qian), Zhi Bao Wei Da Huang (Paper-wrapped baked Rhei Radix et Rhizoma), Qiang Huo (Notopterygii Rhizoma et Radix, each 1 liang), Tao Ren (Persicae Semen, 2 liang, ground to paste), Ma Ren (Semen Cannabis, 2.5 liang, ground), Zao Jiao Ren (Gleditsiae Sinensis Fructus Seed, charred to retain properties, 1.5 liang; its nature becomes slippery when warm, and warmth-slipperiness naturally unblocks dryness).
Except for the two seeds which are ground separately, grind the rest into powder, mix evenly, and make pills with honey the size of wu zi (loquat seeds). Take 50 pills on an empty stomach with warm water. After taking three doses, consume Su Zi Ma Zi Zhou (Perilla Seed and Hemp Seed Porridge) morning and evening daily to prevent dryness. Store in porcelain vessels, sealed with paper to avoid exposure to air.
Ban Liu Wan (Half Sulfur Pill)
Treats cold-constipation, wind-accumulation constipation, and elderly constipation.
Tou Ming Liu Huang (Transparent Sulfur, ground), Ban Xia (Pinelliae Rhizoma, washed seven times, equal parts to sulfur).
Grind into powder, make pills with ginger paste the size of wu zi. Take 20 pills with ginger soup; or decoct one scallion white and three slices of ginger, dissolve two pieces of E Jiao (Colla Corii Asini) in it, and take on an empty stomach before meals.
Ma Ren Wan (Hemp Seed Pill)
Treats severe constipation, wind-constipation, and Pi Yue (Spleen Restriction) syndrome.
Yu Li Ren (Prunus japonica seed), Ma Ren (Semen Cannabis, each 6 liang, ground separately), Da Huang (Rhei Radix et Rhizoma, 2.5 liang, half stir-fried), Shan Yao (Dioscoreae Rhizoma), Fang Feng (Saposhnikoviae Radix), Chao Zhi Ke (Stir-fried Aurantii Fructus, 7.5 qian), Bing Lang (Arecae Semen, 5 qian), Qiang Huo (Notopterygii Rhizoma et Radix), Mu Xiang (Aucklandiae Radix, each 5.5 qian).
Grind into powder, make pills with honey the size of wu zi. Take 70 pills with warm water.
Pi Yue Wan (Spleen Restriction Pill)
Ma Ren (Semen Cannabis, 1.15 liang, ground), Zhi Shi (Immature Bitter Orange Fruit), Nong Po (Magnoliae Officinalis Cortex), Shao Yao (Paeoniae Radix, each 2 liang), Da Huang (Rhei Radix et Rhizoma, 4 liang, steamed), Xing Ren (Pruni Armeniaci Semen, peeled and stir-fried with bran, 1.2 liang, ground).
Grind into powder, make pills with refined honey the size of wu zi. Take 30-50 pills with warm water.
For all types of constipation, if medication does not result in bowel movement, or if there are concurrent conditions, or if the patient is extremely weak and elderly and cannot tolerate medication, use boiled honey mixed with a small amount of Zao Jiao (Gleditsiae Sinensis Fructus) powder to make a suppository for guidance. For cold-constipation, suppositories made with ginger are also effective.