《病源论》云∶大便难者，由五脏不调，阴阳偏有虚实，三焦不和，则冷热并结故也。
又云∶渴利之家，大便亦难，为津液枯竭，致令肠胃干燥。
《葛氏方》云∶脾胃不和，常患大便坚强难者∶
大黄（三两） 夕药（三两） 浓朴（三两） 枳实（六斤） 麻子仁（五合）
捣筛，蜜丸如梧子，服十丸，日三，稍增，以通利为度，可恒将之。
《千金方》治大便难方∶
单用豉、清酱、清羊酪、土瓜根汁，并单灌之，立出。
又方∶酱清渍乌梅，灌下部中。
又方∶麻油二升，纳葱白三寸，煮令黑，去滓，待冷顿服。
又方∶灸承筋三壮。
又方∶夹玉泉相去各二寸灸之。
《新录方》大便干骨立者方∶
灸胃脘穴千炷。
又方∶生地黄切三升，韭切三升，以水一斗，煮取二升五合，分三服，相去十里。
又方∶单服马苋汁一升，瘥止。
又方∶捣蒜为泥，酒服如枣，日三。
又方∶烧鱼为灰，酒服方寸匕，日二三。
又方∶服甑带汁五六合，日二。
《承祖方》治大便 难腹热连日欲死方∶
甘遂 芫花 黄芩
凡三物，分等，捣，蜜丸如小豆，服五丸，不通，更服三丸。
《华佗方》治大便坚，数清不能得出方∶
皂荚末，下筛，以猪脂和合，苇管长一寸，以指排纳谷道中齐指一节，须臾则去。
又云∶二车丸主临饭腹痛不能食，复又大便难方∶
大黄（十三两） 柴胡（四两） 细辛（二两） 茯苓（一分） 半夏（一两）
凡五物，冶筛，丸以蜜，饮服如梧子五丸，日再。
《集验方》治大便 难，腹热连日欲死方∶
白蜜三升，于微火上煎之，使如强 以投冷水中，须臾当凝出丸，丸如手指大，长六寸
七寸
又云∶不得大便十日或一月烦满欲死方∶葵子二升，水以四升，煮取一升，去滓，顿服
之。
The *Zhubing Yuanhou Lun* (Treatise on the Pathogenesis and Manifestations of All Diseases) states: Difficulty in defecation arises from the disharmony of the Zang-Fu organs, with Yin and Yang being biased towards excess or deficiency, and the San Jiao (Triple Burner) failing to function harmoniously, resulting in the binding of cold and heat pathogens.
It further states: Individuals suffering from Xiao Ke (Wasting-Thirst Syndrome, characterized by polydipsia and polyuria) also experience difficulty in defecation, as the depletion of Jin-Ye (Body Fluids) leads to dryness of the intestines and stomach.
The *Ge Shi Fang* records a prescription for those with Spleen-Stomach disharmony who frequently suffer from hard and difficult stools:
Da Huang (Rhei Radix et Rhizoma, 3 liang), Shaoyao (Paeoniae Radix Alba, 3 liang), Houpo (Magnoliae Officinalis Cortex, 3 liang), Zhishi (Aurantii Fructus Immaturus, 6 jin), Huozhiren (Cannabis Semen, 5 he).
Crush and sieve the ingredients, mix with honey to form pills the size of wu zi (seed of Cerasus pseudocerasus). Take 10 pills per dose, three times daily. Gradually increase the dosage until bowel movement is unobstructed. This medicine may be kept for regular use.
The *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) offers prescriptions for difficulty in defecation:
Use Dou Chi (Sojae Semens Praeparatum), Qing Jiang (Fermented Soybean Paste), Qing Yang Luo (Fresh Sheep Cheese), or Tu Gua Gen Ji (Benincasae Caulis Juice) separately for enema administration; stool will be expelled immediately.
Another prescription: Soak Wu Mei (Mume Fructus) in Jiang Qing (Soy Sauce Liquid) and administer as an enema into the anus.
Another prescription: Use Ma You (Perillae Oleum, 2 sheng), add Cong Bai (Allii Fistulosi Bulbus, 3 cun), boil until black, filter out the dregs, let cool, and take all at once.
Another prescription: Moxibustion on Chengjin (BL-57) for three moxa cones.
Another prescription: Moxibustion on points located two cun lateral to the Jiaji (EX-B2) points along the spine.
The *Xin Lu Fang* provides a prescription for severe constipation where the body appears emaciated like dry bones:
Moxibustion on Weiwang (ST-12) for one thousand cones.
Another prescription: Cut Sheng Di Huang (Rehmanniae Radix Recens, 3 sheng) and Jiu Cai (Allii Tuberosi Herba, 3 sheng). Boil in 1 dou of water until reduced to 2.5 sheng. Divide into three doses, taken at intervals equivalent to traveling ten li.
Another prescription: Take Ma Xian Ji (Portulacae Herba Juice, 1 sheng) alone; stop when cured.
Another prescription: Crush Suan (Allii Sativi Bulbus) into a paste, take with wine in a size similar to a jujube, three times daily.
Another prescription: Burn fish to ash, take with wine using a fang cun bi (square-inch measure), two to three times daily.
Another prescription: Take juice from the strap of a steamer (Zeng Dai), 0.5-0.6 sheng, twice daily.
The *Cheng Zu Fang* treats difficulty in defecation accompanied by abdominal heat persisting for days, causing extreme distress:
Gan Sui (Kansui Radix), Yuan Hua (Genkwa Flos), Huang Qin (Scutellariae Radix).
Take these three herbs in equal parts, crush them, and mix with honey to form pills the size of a small bean. Take five pills. If defecation does not occur, take three more pills.
The *Hua Tuo Fang* treats hard stools and frequent attempts to defecate without success:
Zao Jiao Mo (Gleditsiae Sinensis Fructus Powder), sifted finely, mixed with Zhu Zhi (Porcine Adipose Tissue). Form into a reed tube one cun long. Insert into the anus up to the first joint of the finger using a finger, and remove after a short while.
It also states that Er Che Wan (Two-Carriage Pill) treats abdominal pain before meals preventing eating, as well as difficulty in defecation:
Da Huang (Rhei Radix et Rhizoma, 13 liang), Chai Hu (Bupleuri Radix, 4 liang), Xi Xin (Asari Radix et Rhizoma, 2 liang), Fu Ling (Poria, 1 fen), Ban Xia (Pinelliae Rhizoma, 1 liang).
Process the five herbs, grind and sieve, mix with honey to form pills. Take five pills the size of wu zi with warm water, twice daily.
The *Ji Yan Fang* treats difficulty in defecation with abdominal heat persisting for days, causing extreme distress:
Bai Mi (Apis Mellifera, 3 sheng). Simmer over low heat until it becomes thick and viscous. Drop into cold water; it will solidify into pills. Shape into cylinders the size of a finger, six to seven cun long.
It also states that for cases of inability to defecate for ten days or a month, accompanied by irritability and fullness causing extreme distress:
Kui Zi (Malvae Semen, 2 sheng). Boil in 4 sheng of water until reduced to 1 sheng. Filter out the dregs and take in one dose.