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(See the section on "Xiaoke" [Wasting and Thirsting Syndrome].)

Li Dongyuan stated: The *Jinkui Zhenyan Lun* (Treatise on the True Sayings of the Golden Cabinet) records: "The North corresponds to black, internally connecting to the Kidney, opening into the two yin orifices [anterior and posterior], and storing essence in the Kidney." It also states: "The Kidney governs defecation; for difficult defecation, one should seek treatment from the Foot-Shaoyin [Kidney] channel."

The Kidney governs the five body fluids. When body fluids are moistening, defecation is normal. If the Stomach Qi is damaged by irregular eating and drinking, overwork, or rest, and if one consumes pungent, hot, and strongly flavored foods that assist Fire pathogenic factors, these Fire pathogens lurk within the blood, consuming True Yin. This leads to a deficiency of body fluids, resulting in dry and constipated stool. However, the pathology of constipation is not uniform; there are Heat-Dryness, Wind-Dryness, Yang-Constipation, and Yin-Constipation. Additionally, there are cases caused by advanced age, Qi deficiency, and insufficient body fluids. The treatment methods are as stated in the classics: "The Kidney dislikes dryness; urgently consume pungent substances to moisten it; for consolidation, scatter it." For example, for Shaoyin disease causing inability to pass stool, use pungent substances to moisten; for Taiyin disease causing inability to pass stool, use bitter substances to purge; for Yang-Constipation, use dispersing methods; for Yin-Constipation, use warming methods. Zhang Zhongjing said: "When urination is frequent and stool is hard, do not use purgatives; instead, use Pi Yue Wan [Spleen-Restriction Pill] to moisten." If dietary injury affects the Taiyin Spleen, leading to abdominal fullness, indigestion, borborygmus, and inability to pass stool, use bitter substances to purge. Generally speaking, for dryness due to consumption of body fluids, use pungent substances to moisten; for constipation due to tangible accumulation, one should purge. If one fails to investigate the root cause and indiscriminately uses harsh purgatives such as Crotonis Fructus [Badou] and Lapsanae Fructus [Qianniu], it will damage body fluids, making the dryness and constipation worse. In extreme cases, repeated purging may lead to a state where even guided downward-draining agents cannot promote bowel movement, resulting in an incurable condition. Can one not be cautious?

Note: The above merely discusses constipation as an interior syndrome. Liu Hejian’s discussions encompass both exterior and interior aspects; therefore, it is advisable to read them in conjunction with chapters such as "Dryness-Heat Overcoming Yin and Ministerial Fire."

Ji Da Da Qin Jiao Tang [Major Decoction of Smilax Glabra]: Treats conditions where Blood deficiency and Yin deficiency fail to nourish the sinews, causing sinew dryness, immobility of the hands and feet, and dry nails, belonging to severe Wind-Heat patterns.
For the formula, see the "Zhongfeng" [Wind-Stroke] section.

Note: This is a formula for dispersing Wind-Heat and nourishing Blood, categorized under the Taiyang pattern examples.

Maren Wan [Hemp Seed Pill]
Ingredients: Pruni Semen [Yuliren] and Cannabis Fructus [Maziren] (each 1 liang, ground separately); Rheum Radix et Rhizoma [Dahuang] (2.5 liang, half stir-fried); Dioscoreae Rhizoma [Shanyao]; Saposhnikoviae Radix [Fangfeng]; Aurantii Fructus [Zhiqiao] (stir-fried, each 7 qian 5 fen); Arecae Semen [Binglang] (0.5 liang); Notopterygii Rhizoma et Radix [Qianghuo]; Costi Radix [Muxiang] (each 5 qian 5 fen).
Preparation and Administration: Grind all ingredients except those specified for separate grinding into fine powder. Mix with refined honey to form pills the size of mulberry seeds. Take 30–20 pills per dose with warm water.

Note: This formula acts on the Hand-Yangming, Foot-Yangming, and Foot-Taiyang channels; it is a formula addressing both exterior and interior, targeting the Qi level.

Li Dongyuan Run Chang Wan [Moistening Intestine Pill]: Treats latent Fire in the Spleen and Stomach causing constipation, dryness, or complete obstruction, accompanied by total loss of appetite. Whether due to Wind-Constipation or Blood-Constipation, these conditions lead to obstruction. By moistening dryness, harmonizing Blood, and dispersing Wind, patency will naturally be restored.
Ingredients: Cannabis Fructus [Maziren] and Persicae Semen [Taoren] (each 1 liang, skin and tips removed, ground separately); Notopterygii Rhizoma et Radix [Qianghuo]; Angelicae Sinensis Radix [Dangguiwei]; Rheum Radix et Rhizoma [Dahuang] (stir-baked, each 0.5 liang); Gleditsiae Sinensis Spina [Zaoren]; Gentianae Macrophyllae Radix [Qinjiao] (each 5 qian).
Preparation and Administration: Except for those specified for separate grinding, grind the remaining ingredients into fine powder. Add 5 qian of refined honey heated until boiling, and form pills the size of paulownia seeds. Take 30–50 pills per dose before meals with plain boiled water. There is another formula called Run Zao Wan [Moistening Dryness Pill], which consists of adding Pruni Semen [Yuliren] and Saposhnikoviae Radix [Fangfeng] to this base formula.

Note: This formula acts on the Foot-Taiyin and Hand/Yangming channels; it is a formula treating both exterior and interior simultaneously.