叙曰∶秘结，燥证也。然有火燥，有风燥，有水竭之燥，有血虚之燥。从容养血清燥为
上手，急遽攻下通肠为下手。今考方药六条，古人之医法见矣。
（即脾约丸）
麻仁（十两，入百沸汤内泡浸一宿，次日曝干，砻之，粒粒皆完） 大黄（四两，酒蒸）
杏仁（一两二钱，去皮尖，炒） 芍药（酒炒） 枳实（麸炒） 浓朴（姜汁炒，各三两）
胃强脾弱，不能四布津液濡润大肠，后便燥结者，此方主之。
润可以去燥，麻仁、杏仁、芍药是也；苦可以胜燥、枳实、浓朴、大黄是也。
熟地黄 当归梢 大黄（酒浸，煨） 桃仁（去皮尖） 生甘草 麻仁（各一钱） 红
花（五
分） 生地黄 升麻（各二分）
大肠燥结，便出坚黑者，此方主之。
大肠得血则润，亡血则燥，故用熟地、当归以养血；初燥动血，久燥血瘀，故用桃仁、
红花以去瘀。麻仁所以润肠，大黄所以通燥，血热则凉以生地黄，气热则凉以生甘草，微入
升麻，消风热也。
生地黄 熟地黄 当归梢 大黄（酒浸，煨） 桃仁泥 红花 升麻
结燥腹痛者，此方主之。
此即前方润燥汤去生甘草、麻仁也。胃之下口，名曰幽门。此方服之，可以通其留滞，
故曰通幽。大便燥结，升降不通，故令腹痛。燥者濡之，生地、熟地，皆濡物也；逸者行之，
大黄、归梢，皆行物也；留者攻之，桃仁、红花，皆攻物也；抑者散之，升麻之用，散抑郁
也。
Preface states: Secretion obstruction (Bijie), also known as constipation, is a dryness syndrome. However, there is dryness caused by fire, dryness caused by wind, dryness due to fluid depletion, and dryness due to blood deficiency. The superior approach is to nourish blood and moisten dryness with a calm and steady method; the inferior approach is to purge downward and unblock the intestines with an urgent and drastic method. Now, examining these six prescriptions, the medical methods of the ancients are revealed.
(That is, Pi Yue Wan / Splee-Restriction Pill)
Hemp Seed (Shiren, Fructus Cannabis) [10 liang, soaked in boiling water overnight, dried the next day, dehusked, ensuring each grain remains intact] Rhubarb Root and Rhizome (Dahuang, Radix et Rhizoma Rhei) [4 liang, steamed with wine]
Apricot Kernel (Xingren, Semen Armeniacae Amarum) [1 liang 2 qian, dehusked and deseeded, stir-fried] Peony Root (Shaoyao, Radix Paeoniae Alba/Lactiflorae) [stir-fried with wine] Immature Bitter Orange (Zhishi, Fructus Aurantii Immaturus) [stir-fried with bran] Magnolia Bark (Nongpu, Cortex Magnoliae Officinalis) [stir-fried with ginger juice, each 3 liang]
When stomach heat is strong but spleen qi is weak, failing to distribute body fluids to moisten the large intestine, resulting in dry and hardened stool, this prescription is indicated.
Moistening agents can eliminate dryness, such as Hemp Seed, Apricot Kernel, and Peony Root; bitter agents can overcome dryness, such as Immature Bitter Orange, Magnolia Bark, and Rhubarb.
Prepared Rehmannia Root (Shudihuang, Radix Rehmanniae Preparata) Terminal Branch of Chinese Angelica Root (Dangguishaohao, Radix Angelicae Sinensis caulis) Rhubarb Root and Rhizome (Dahuang, Radix et Rhizoma Rhei) [soaked in wine, baked] Peach Kernel (Taoren, Semen Persicae) [dehusked and deseeded] Raw Licorice Root (Shenggancao, Radix Glycyrrhizae uralensis) Hemp Seed (Shiren, Fructus Cannabis) [each 1 qian] Safflower (Honghua, Flos Carthami Tinctorius) [5 fen] Raw Rehmannia Root (Shengdihuang, Radix Rehmanniae Recens) Cimicifuga Rhizome (Shengma, Rhizoma Cimicifugae) [each 2 fen]
For dryness obstruction in the large intestine with hard, black stools passed, this prescription is indicated.
The large intestine becomes moist when nourished by blood, and dry when blood is lost; therefore, Prepared Rehmannia and Chinese Angelica are used to nourish blood. Initial dryness may disturb blood, while prolonged dryness leads to blood stasis; thus, Peach Kernel and Safflower are used to remove stasis. Hemp Seed moistens the intestines, Rhubarb unblocks dryness, Raw Rehmannia cools blood heat, Raw Licorice clears qi heat, and a small amount of Cimicifuga is added to dissipate wind-heat.
Raw Rehmannia Root (Shengdihuang, Radix Rehmanniae Recens) Prepared Rehmannia Root (Shudihuang, Radix Rehmanniae Preparata) Terminal Branch of Chinese Angelica Root (Dangguishaohao, Radix Angelicae Sinensis caulis) Rhubarb Root and Rhizome (Dahuang, Radix et Rhizoma Rhei) [soaked in wine, baked] Peach Kernel Paste (Taoren ni, Semen Persicae paste) Safflower (Honghua, Flos Carthami Tinctorius) Cimicifuga Rhizome (Shengma, Rhizoma Cimicifugae)
For constipation accompanied by abdominal pain, this prescription is indicated.
This is essentially the previous Moisten Dryness Decoction without Raw Licorice and Hemp Seed. The lower opening of the stomach is called the幽门 (Yumen / Pylorus). Taking this prescription can unblock stagnation, hence it is named Tongyou (Unblocking the Secluded). Hardened stool obstructs the ascending and descending mechanisms, causing abdominal pain. For dryness, use moistening agents: Raw and Prepared Rehmannia are moistening substances; for stagnation, use moving agents: Rhubarb and Terminal Branch of Chinese Angelica are moving substances; for retention, use attacking agents: Peach Kernel and Safflower are attacking substances; for depression, use dispersing agents: Cimicifuga serves to disperse depression.