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The treatment is the same as for the syndrome described previously.

Scallion White (4 jin, cut into fine shreds) Dry Rice Vinegar (prepare ample amount for use)

Stir-fry the scallion white shreds and vinegar until extremely hot. Divide into two bags. Apply hot compresses to the umbilicus while hot. Swap them when they cool down; do not interrupt the process. For the cooled bag, add a little more vinegar and reheat by stir-frying.

However, the amount of vinegar used during stir-frying must be carefully considered. The standard is that after being packed into cloth bags, no liquid should leak out. Compress for six hours, and the intestinal obstruction will naturally resolve.

A child, aged six. Due to excessive meat consumption leading to indigestion, stagnation accumulated in the intestines. Bowel movement had been absent for six or seven days. The abdomen was distended and hard upon palpation, like stone. All purgative medicines proved ineffective. This method was applied via hot compress. After three hours, the abdomen gradually softened. After another three hours, stool passed resembling sheep dung, and the distension subsided.

A boy, aged fifteen or sixteen. Suffering from mild external contraction, he experienced abdominal distension and constipation for several days. However, this was not the excess heat and dryness accumulation of the Yangming channel. The physician administered Chengqi Tang (Gut-Draining Decoction), but bowel movements remained unobstructed, and abdominal distension worsened. The patient felt compelled by the abdominal distension, nearly unable to breathe, and occasionally experienced palpitations (heart flutter). His pulse was extremely faint and thin, disappearing upon pressure. This presented as a deficiency pulse with an excess syndrome, seemingly untreatable. The Scallion White Hot Compress method was also employed, resulting in immediate reduction of abdominal distension. After another three hours of compression, the stagnation was felt to have opened and moved downward to the lower jiao. Subsequently, the Pig Bile Suppository Method was used, allowing bowel movement to resume and recovery ensued.

A man, around forty years old, who generally feared cold and cool substances. I instructed him to take raw Realgar (Sheng Liuhuang) daily, two pieces the size of black soybeans each time. It showed significant efficacy and had been used for over a year. Accidentally, due to labor on a summer day, he developed internal heat, indulged in eating melons and fruits, and consumed a heavy meal of meat. Indigestion occurred, causing intestinal stagnation and obstruction, accompanied by pain and frequent vomiting. The physician used Dahuang Fuzi Xixin Tang (Rhubarb, Aconite, and Asarum Decoction) to purge downwards, but it was ineffective. Then, Baochi Wanyingsan (Treasure Infant Universal Powder) from Kyoto was used; three doses were combined into one and taken. Abdominal pain decreased, but bowel movement remained obstructed. Later, I examined him; his pulse was near normal, slightly wiry and powerless. Considering he had not eaten for several days and had not had a bowel movement for ten days, I treated him with the Scallion White Hot Compress method. He felt the abdomen become loose and comfortable, and sounds of opening were heard intermittently. However, nausea persisted, and he desired to vomit. Subsequently, Oolithus (Zheshi, 2 liang) and Dried Ginger (Ganjiang, 1 qian half) were decocted and taken orally to stop the nausea. The Scallion White Hot Compress method was continued to facilitate bowel movement. With external compression and internal medication, after more than five hours, bowel movement resumed, and he recovered.

Commentary: Dahuang Fuzi Xixin Tang (Rhubarb, Aconite, and Asarum Decoction) from *Jinkui Yaolue* (Essential Prescriptions of the Golden Cabinet) is indeed an excellent formula for resolving stagnation. I have used it frequently to treat intestinal obstruction and abdominal pain with great effect. Even Baochi Wanyingsan, when three doses are combined into one for adults, is a good formula for resolving stagnation. I have used it many times with success. However, it failed in treating this specific case because the syndrome included vomiting, which neither formula could address. The patient stated that previously ingested medicines felt as if they did not reach the disease site before regurgitating upwards. Only this time did the medicine feel heavy and descend directly to the site of stagnation, thus achieving purgation.

A man, aged forty-three. After sexual intercourse, he indulged in raw and cold foods, suddenly experiencing cramping pain in the lower abdomen and retraction of the scrotum. Bowel movement had been absent for four days, accompanied by irritability in the upper jiao. The physician prescribed Dahuang Fuzi Xixin Tang (Rhubarb, Aconite, and Asarum Decoction), causing pain and distension in the hypochondrium. His pulse was wiry and deep, with the deepness particularly pronounced at both Chi positions (kidney pulses). Initially, the Scallion White Hot Compress method was applied. The abdomen made rumbling sounds, indicating a strong tendency towards resolution. The scrotal retraction improved, but bowel movement remained obstructed. Then, Oolithus (Zheshi, 2 liang), Prepared Aconite Root (Fuzi, 5 qian), Angelica Sinensis Root (Danggui), and Perilla Seed (Suzi) (each 1 liang) were decocted. Upon ingestion, he immediately felt the medicinal force descending. He was instructed to decoct and drink the dregs again. Shortly after, some hardened feces were discharged, and all ailments resolved.

Commentary: Using the Scallion White Hot Compress for this syndrome did not immediately result in bowel movement, but the intestinal stagnation had already begun to open. Regarding the administered medicine, the heavy use of Oolithus (Zheshi) was necessary because this syndrome originally required hot herbs to warm the lower jiao, while the irritability in the upper jiao and the dryness of the stool were unsuitable for hot herbs alone. By heavily using Oolithus to assist, the heat was directed downwards, avoiding the risk of rebellious upward flare-up. Furthermore, its heavy and sinking nature possesses the function of resolving stagnation. The floating heat in the upper jiao returned to its root, and the coagulated cold in the lower jiao was completely transformed.

Appendix:
(1) The Pig Bile Suppository Method is a technique for treating dryness accumulation found in *Shanghan Lun* (Treatise on Cold Damage). Originally, pig bile was mixed with a little vinegar and instilled into the anus. Now, modifying this method: pour vinegar into a pig gallbladder, knead by hand to mix the vinegar and bile thoroughly. Insert one end of a long, ventilated bamboo tube into the gallbladder and tie it securely with a thin string. Insert the other end into the anus. Squeeze the pig bile into the anus through the bamboo tube by hand. If the anus is far from the stool, insert the bamboo tube deeply to the location of the dry feces. If the stagnation is severe, two or three such preparations may need to be used consecutively. If one fears the cooling nature of pig bile or if it is cold, warm the gallbladder in water. If fresh pig gallbladders are unavailable, dried ones can be soaked in vinegar until the congealed bile melts after kneading; these can also be used. If an enema syringe is available, its use is even more convenient.

(2) Ancient formulas for sudden urinary retention include the Scallion White Moxibustion Method. Take a handful of scallion whites, bundle them together, trim both ends evenly, leaving about two cun in the middle. Place one end on the umbilicus and moxa-burn the other end with charcoal fire. When heat penetrates to the umbilicus, urination will naturally resume. This likely utilizes the warming and unblocking properties of scallions, penetrating from the umbilicus, transferring to the Bladder, and opening the pathway for urination. However, burning only one end makes heat penetration difficult. If replaced by my proposed Scallion White Hot Compress method, the therapeutic effect for urinary retention caused by cold or qi stagnation would be faster.

Commentary: This compress method not only facilitates the passage of urine and stool but is also effective for early-stage hernia (Shanqi). Applying this method invariably leads to cure. However, it requires multiple applications; even after the hernia subsides, apply it two or three more times. Alternatively, adding powders of Small Fennel Fruit (Xiaohuixiang) and Pepper (Hujiao) and stir-frying together is also beneficial (when using pepper powder, do not exceed 5 qian; small fennel fruit can be used in larger amounts).