夫关格者。是大小便不通也。大便不通谓之内关。小便不通谓之外格。二便不通。故为
关格
得营
故
日
治风冷气入小肠。忽痛坚急。如状大小便不通。或小肠有气结如升大。胀起。名为
关格
川大黄（一两锉碎微炒） 苦参（一两锉） 贝齿（一两烧为灰） 滑石（一两）
上件药。捣细罗为散。不计时候。煮葵根汤调下二钱。
治大小便。气壅不利。胀满。关格不通。吴茱萸丸方。
吴茱萸（一分汤浸七遍焙干微炒） 桂心（半两） 干姜（一分炮裂锉） 川大黄（一
两锉碎
微炒） 当归（半两锉微炒） 赤芍药（半两） 甘草（半两炙微赤锉） 芎 （半两） 人
参（三分
去芦
上件药。捣罗为末。炼蜜和捣三二百杵。丸如梧桐子大。每服。以生姜橘皮汤下三十丸。
日三服。以通利为度。
又方。
木通（一两锉） 川朴硝（一两） 郁李仁（一两汤浸去皮微炒） 黄芩（半两） 车
前子（一
两） 蘧麦花（半两）
上件药。捣粗罗为散。每服四钱。以水一中盏。煎至六分。去滓。温服。日三四服。
治大小便关格不通。腹胀喘急。立效方。
水银（一分） 腻粉（一分） 滑石（一分）
上件药。一处研令水银星尽。每服。以葱白汤调下一钱。
又方。
甘遂（半钱煨令黄） 贝齿（二枚烧为灰）
上件药。捣细罗为散。都为三服。用暖浆水一小盏。调服立效。
又方。
胡椒（二十颗捣碎） 川朴硝（半两）
上件药。先以水一大盏。煎胡椒至六分。去滓。入硝更煎一两沸。放温。顿服神效。
又方。
腻粉（一钱） 生麻油（一合）
上件药相和。空腹服之。
治大小便。关格闭塞方。
上用蔓荆子油一合。空腹服之即通。通后汗出勿怪。
治大小便关格不通。肚胀气筑心闷绝方。
上用乌臼树东面白皮。阴干。捣罗为末。如五七日不通。以熟水调下二钱。如急用。火
上焙干为妙。
又方。
蜀葵花（一两烂捣） 麝香（半钱细研）
上相和。以水一大盏。煎至五分。去滓。服之。如无花。即取根拍破用之。
治大小便关格不通。经三五日方。\x
上用无 皂荚烧灰。细研。以粥饮调下三钱。立通。
Guan-Ge disease refers to the condition where both defecation and urination are obstructed. Obstruction of defecation is termed "Nei-Guan" (Internal Closure), while obstruction of urination is termed "Wai-Ge" (External Grid). When both bowel movements and urination are blocked, it is therefore called Guan-Ge.
This section treats the formula for Guan-Ge, a condition caused by wind-cold qi invading the small intestine, suddenly causing pain, hardness, and urgency, leading to obstruction of defecation and urination, or where qi stagnates in the small intestine forming a swelling as large as a sheng (a unit of volume), resulting in distension.
Cassiae Semen (Cassiae Fructus) [Note: Text says Chuan Da Huang, which is Rhizoma Rhei / 大黄], one liang, crushed and lightly stir-fried; Sophorae Flavescentis Radix (Kushen), one liang, crushed; Concha Tridacnae (Beichi), one liang, calcined to ash; Talcum (Huashi), one liang.
The above medicines are finely ground and passed through a fine sieve to make a powder. Take two qian at any time, mixed with decoction of Malvae Verticillatae Caulis (Kuigen Tang).
Formula for Wuzhuyu Pills treating Qi stagnation and dysfunction in defecation and urination, abdominal distension and fullness, and obstruction of Guan-Ge.
Evodiae Fructus (Wuzhuyu), one fen, soaked in hot water seven times, dried and lightly stir-fried; Cinnamomi Cortex (Guixin), half liang; Zingiberis Rhizoma (Ganjiang), one fen, processed until cracked and crushed; Cassiae Semen (Chuan Dahuang - Note: Text specifies Chuan Da Huang/Rhizoma Rhei), one liang, crushed and lightly stir-fried; Angelicae Sinensis Radix (Danggui), half liang, crushed and lightly stir-fried; Paeoniae Radix Rubra (Chishao), half liang; Glycyrrhizae Radix et Rhizoma (Gancao), half liang, honey-fried until slightly red and crushed; Ligustici Chuanxiong Rhizoma (Xiong), half liang; Ginseng Radix (Renshen), three qian, rhizome removed.
The above medicines are ground into powder, mixed with refined honey, and pounded three to two hundred times until uniform. Form pills the size of paulownia seeds. Each dose consists of thirty pills, taken with decoction of Zingiberis Recens Rhizoma (Shengjiang) and Citri Reticulatae Pericarpium (Jupi), three times a day. Stop when free passage is achieved.
Another formula.
Akebiae Caulis (Mutong), one liang, crushed; Natrii Sulfas (Chuan Pu Xiao), one liang; Pruni Semen (Yuliren), one liang, soaked in hot water, skin removed, and lightly stir-fried; Scutellariae Radix (Huangqin), half liang; Plantaginis Semen (Cheqianzi), one liang; Fagopyri Dibotryis Flos (Qu Maihua), half liang.
The above medicines are coarsely ground into a powder. Each dose is four qian, boiled with one zhong of water until reduced to six parts, strained, and taken warm, three to four times a day.
Immediate Effect Formula for treating obstruction of Guan-Ge in defecation and urination, accompanied by abdominal distension and panting.
Hydrargyrum (Shuiyin), one fen; Calomelas (Nifen); Talcum (Huashi), one fen.
The above medicines are ground together until the mercury stars disappear. Each dose is one qian, taken with decoction of Allii Fistulosi Bulbus (Congbai Tang).
Another formula.
Kansui Radix (Gansui), half qian, roasted until yellow; Concha Tridacnae (Beichi), two shells, calcined to ash.
The above medicines are finely ground into a powder and divided into three doses. Mix with a small zhong of warm rice water and take for immediate effect.
Another formula.
Piperis Longi Fructus (Hujiao), twenty grains, crushed; Natrii Sulfas (Chuan Pu Xiao), half liang.
First, boil the pepper in one zhong of water until reduced to six parts, strain, add the salt, boil for one or two boils, let cool to warm temperature, and take all at once for miraculous effect.
Another formula.
Calomelas (Nifen), one qian; Sesami Oleum (Sheng Mayou), one he.
Mix the above medicines and take on an empty stomach.
Formula for treating closure of Guan-Ge in defecation and urination.
Take one he of Viticis Trifolii Fructus Oil (Manjingzi You) and take on an empty stomach; passage will be achieved immediately. Do not be surprised if sweating occurs after passage.
Formula for treating obstruction of Guan-Ge in defecation and urination, with abdominal distension, qi rushing to the heart causing suffocation and despair.
Use the white inner bark from the east side of the Cornus Albissima tree (Wujiu Shu), dry in shade, and grind into powder. If there is no passage for five to seven days, take two qian mixed with warm water. For urgent use, it is better to dry it over fire.
Another formula.
Malvae Abutilonidis Flos (Shuhuihua), one liang, mashed thoroughly; Moschus (Shexiang), half qian, finely ground.
Mix the above, boil with one zhong of water until reduced to five parts, strain, and take. If flowers are unavailable, use the root, smashed.
Formula for treating obstruction of Guan-Ge in defecation and urination lasting three to five days.
Use Gleditsiae Sinensis Fructus (Wuzao Jia) without thorns, calcined to ash, finely ground. Take three qian mixed with rice drink for immediate passage.