附大便
论曰∶小肠为受盛之腑，传导水液，若始觉小便微涩赤黄，渐渐不通，小腹膨 ，由
心经蕴热，传于小肠，小肠热，则渗于脬中，脬辟而系转，诊心脉大而牢，用 叶散，或
石苇汤主之。
叶散
裹茶 叶（一两，烧灰） 滑石（半两，研）
上为细末，沸汤浸服。或小便暴不通，点好茶一杯，入生油三两，点饮之。
石苇汤
石苇（去毛，锉） 车前子（锉，车前叶亦可，等分）
上浓煮汁饮之。若腹胀，溺溲不得，好卧屈膝，阴缩肿，此厥阴之厥，加赤茯苓、黄芩
分两如前。
若卒暴小便不通，脐腹膨急，气上冲心，闷绝欲死，由忍尿劳役，或从惊恐，气无所伸
乘并膀胱，气冲脬系不正。诊其脉，右手急大，葱白汤
葱白汤
橘皮（洗，三两，切） 葵子（一两） 葱白（三茎，切）
上以水五升，煮取二升，分三服。
固脬丸
茴香（炒，一两） 桑螵蛸（炒，半两） 菟丝子（拣净，酒浸一宿，乘润捣烂，焙干，
二
两） 戎盐（炒一分） 附子（炮，去皮脐，半两）
上为细末，煮糊为丸，如梧桐子大。饮下三十粒，空心服。
若小便纯血，血下则凝，亦无痛处， 短气，由阳气不固，阴无所守，五液注下
脉散涩欲绝而身冷者死，苁蓉丸主之。
苁蓉丸 史载之《指南方》∶治虚劳溺血，加桑螵蛸半两，炙焦，酒糊为丸，盐汤下。
菟丝子（拣净，酒浸一宿，乘润捣烂，再焙） 肉苁蓉（洗，切，焙） 鹿茸（去毛，
截片
酥炙） 干地黄（等分）
上为细末，煮糊为丸，如梧桐子大。饮下三十粒，空心服。
若大肠为传导之官，变化出焉。如大便不通者，津液燥也。慎无以烈药，宜紫苏丸主之
紫苏丸
紫苏子（去皮，研） 橘皮（洗，各二两） 知母（一两）
上为末，用生姜汁调成稀膏，于重汤上煮，不住手搅，候可，丸如梧桐子大。蜜汤下三
十粒。
[Discussion on Defecation]
The discussion states: The Small Intestine is the fu-organ responsible for receiving and storing, and it conducts fluids. If initially one feels slight astringency in urination with reddish-yellow urine, gradually progressing to complete obstruction and abdominal distension, this is due to heat accumulating in the Heart Meridian and transmitting to the Small Intestine. Heat in the Small Intestine penetrates into the Bladder (Pao), causing the bladder wall to relax and its ligamentous attachment to twist. Upon diagnosis, if the Heart pulse is large and firm, Ye San (Leaf Powder) should be used, or Shiwei Tang (Sheepweed Decoction) as the primary formula.
Ye San (Leaf Powder)
Ingredients: Cha Ye (Tea Leaf, 1 liang, burnt to ash); Hua Shi (Talcum, 0.5 liang, ground).
Preparation and Administration: Grind the above ingredients into a fine powder. Soak in boiling water and drink. In cases of sudden complete urinary retention, take a cup of good tea, add 3 liang of raw oil, mix well, and drink.
Shiwei Tang (Sheepweed Decoction)
Ingredients: Shi Wei (Pyrosia Leaf, de-haired and chopped); Che Qian Zi (Plantago Seed, chopped; Che Qian Ye/Plantago Leaf may also be used, equal parts).
Preparation and Administration: Decoct strongly to obtain the juice and drink. If accompanied by abdominal distension, difficulty in urination, a preference for lying with knees flexed, and retraction and swelling of the genitals, this indicates Jue Yin Jue (Cold Reversal of the Jueyin Meridian). Add Chi Fu Ling (Red Poria) and Huang Qin (Scutellaria Root) in the aforementioned proportions.
In cases of sudden acute urinary retention with urgent distension of the umbilical and abdominal regions, qi rushing up to strike the heart, suffocation and near-death sensation, this is caused by holding urine, overexertion, or fright, leading to stagnant qi failing to extend freely and invading the Bladder. The qi rush causes misalignment of the bladder ligament. Diagnosis reveals an urgent and large pulse on the right hand. Use Cong Bai Tang (Scallion White Decoction).
Cong Bai Tang (Scallion White Decoction)
Ingredients: Ju Pi (Citrus Peel, washed, 3 liang, sliced); Kui Zi (Abelmoschus Seed, 1 liang); Cong Bai (Scallion White, 3 stems, sliced).
Preparation and Administration: Add 5 sheng of water, decoct to obtain 2 sheng of liquid. Divide into three doses.
Gu Pao Wan (Bladder-Stabilizing Pill)
Ingredients: Hui Xiang (Fennel Fruit, stir-fried, 1 liang); Sang Piao Xiao (Mantis Egg Case, stir-fried, 0.5 liang); Tu Si Zi (Cuscuta Seed, selected clean, soaked in wine overnight, pounded while moist, dried, 2 liang); Rong Yan (Rock Salt, stir-fried, 1 fen); Fu Zi (Aconite Root, processed, skin and navel removed, 0.5 liang).
Preparation and Administration: Grind into a fine powder. Make pills using cooked paste, sized like paulownia seeds. Take 30 pills with water on an empty stomach.
If the urine contains pure blood, which coagulates upon exiting, without pain, and accompanied by shortness of breath, this is due to insecure Yang qi and unguarded Yin essence. If five fluids pour down, the pulse is scattered and choppy nearly to extinction, and the body is cold, the prognosis is fatal. Treat with Cong Rong Wan (Cistanche Pill).
Cong Rong Wan (Cistanche Pill) from Shi Zaizhi's *Zhi Nan Fang*: Treats hematuria due to deficiency exhaustion. Add Sang Piao Xiao (Mantis Egg Case) 0.5 liang, roasted until scorched, make pills with wine paste, administer with salt water.
Ingredients: Tu Si Zi (Cuscuta Seed, selected clean, soaked in wine overnight, pounded while moist, re-dried); Rou Cong Rong (Cistanche Stem, washed, sliced, dried); Lu Rong (Deer Antler Velvet, de-haired, sliced, roasted with butter); Di Huang (Rehmannia Root, dried, all equal parts).
Preparation and Administration: Grind into a fine powder. Make pills using cooked paste, sized like paulownia seeds. Take 30 pills with water on an empty stomach.
[Discussion on the Large Intestine]
The Large Intestine is the official of conduction, responsible for transformation and excretion. Constipation occurs due to dryness of body fluids. One must strictly avoid harsh purgatives; instead, Zi Su Wan (Perilla Fruit Pill) is appropriate.
Zi Su Wan (Perilla Fruit Pill)
Ingredients: Zi Su Zi (Perilla Fruit, peeled and ground); Ju Pi (Citrus Peel, washed, both 2 liang); Zhi Mu (Anemarrhena Rhizome, 1 liang).
Preparation and Administration: Grind into powder. Mix with ginger juice to form a thin paste. Cook in a double boiler, stirring constantly. When ready, form pills sized like paulownia seeds. Take 30 pills with honey water.