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[Da] The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "If wind is injured in spring, diarrhea with undigested food will occur in summer." This is because the Wood Qi (Liver) overacts on Earth Qi (Spleen). If the Spleen cannot transform and transport fluids properly, the Wood Qi becomes excessive, leading to diarrhea. Conversely, if Wind pathogen causes dryness of body fluids, constipation results. Therefore, one should not reverse this logic and attribute constipation and dryness solely to Wind. My relative, Lord Zhang Gongdu's mother, was seventy years old. She suffered from diarrhea dozens of times a day, which resisted all treatments. She also suffered from stiffness and spasms in her waist and legs. Lord Zhang Gongdu treated her spasms with Tribulus seeds (*Jili*) and Sour Jujube seeds (*Suanzaoren*), resulting in the cessation of her diarrhea. Huang Tingjian's mother, the Lady of An'kang Commandery, suffered from severe constipation. After administering Lord Zhang Gongdu's prescription, her bowels moved freely. Thus, it can be known that both constipation and diarrhea can stem from Wind pathogen. Lord Zhang Gongdu was from Luzhou. His name is not recorded here, but his family possessed virtue for generations. He inherited his father's medical skills and brought honor to his family. He cultivated himself purely and did not take wealth improperly; he is truly a virtuous gentleman, as seen here.

[Xue] Commentary: Regarding the aforementioned conditions, if they are caused by deficiency of the Three Yin meridians of the foot (Liver, Spleen, Kidney), accompanied by fever, thirst, chest and diaphragm discomfort, easy digestion, a ruddy complexion, a surging yet empty pulse, and limb fatigue, use *Buzhong Yiqi Tang* (Tonify the Middle and Augment the Qi Decoction) and *Liuwei Dihuang Wan* (Six-Ingredient Pill with Rehmannia). For Spleen and Lung Qi deficiency, use *Buzhong Yiqi Tang*. For Spleen meridian depression and stagnation, use *Jiawei Guipi Tang* (Modified Restore the Spleen Decoction). For combined Qi and Blood deficiency, use *Bazhen Tang* (Eight-Treasure Decoction) plus *Roucongrong* (Cistanche). For insufficiency of Kidney meridian fluids, use *Liuwei Dihuang Wan*. For Stomach fire consuming fluids, use *Zhuye Shigao Tang* (Bamboo Leaf and Gypsum Decoction). For Liver Wood insulting Spleen Earth, use *Xiao Chaihu Tang* (Minor Bupleurum Decoction) plus Gardenia (*Shanzhi*), Prunus seed (*Yuliren*), and Aurantium peel (*Zhiqiao*). For accumulation of heat from rich foods, use *Qingwei San* (Clear the Stomach Powder) plus Gardenia, Prunus seed, and Aurantium peel. If dry stool is in the rectum, use Pig Gallbladder enema (*Zhudan Dao*).

Treat constipation or diarrhea in patients with Wind stroke or Hongjiao (Foot Qi disease). This is especially suitable for deficient persons.

**Sapodilla Seed Pill (Zaojiao Zi Wan):** Take three hundred Sapodilla seeds (*Zaojiaozi*), break them into two pieces, stir-fry slowly until very dry. Add butter equivalent to the size of a jujube pit, stir-fry until dry again. Add more butter and stir-fry until charred black. Grind into fine powder. Mix with refined honey to form pills the size of paulownia seeds. Take thirty pills each time, washed down with decoction of Tribulus seeds and Sour Jujube seeds. Take on an empty stomach. If no bowel movement after two shichen (four hours), take another dose. Gradually increase up to one hundred pills without harm. Stop when bowels move smoothly.

**Tribulus Soup (Jili Tang):** Use an appropriate amount of Tribulus seeds (*Jili*), stir-fry until red-black. Pound in a mortar with a wooden pestle to remove spines. Winnow and clean. Take three taels of Tribulus seeds and one tael of Sour Jujube seeds (*Suanzaoren*), stir-fry until fragrant. Pound together into coarse powder. Sieve through a horsehair sieve. Take three qian per dose. Add one cup of water, decoct until seven-tenths remain. Strain and take warm. Use to wash down the above pills.

**Da Wu Rou Wan (Great Five Softening Pills):** Mainly treats disordered Zang-Qi, causing difficult defecation. It unites Ying and Wei, benefits the nine orifices, and promotes appetite.
* Rhubarb (*Dahuang*): Steamed over rice in a bucket, sliced, and dried.
* Aurantium Peel (*Zhiqiao*): Pulp removed, stir-fried with bran.
* White Peony Root (*Baishaoyao*).
* Lepidium Seed (*Tingli*): Stir-fried until fragrant, separately ground.
* Cistanche (*Roucongrong*): Soaked in wine until soft, washed in warm water, sliced, and dried (one tael each).
* Peach Kernel (*Taoren*): One hundred kernels.
* Apricot Kernel (*Xingren*): Forty kernels, skin and tip removed, stir-fried with bran until yellow, separately pounded.
* Beef Fat (*Niuzhi*): Sinews and fascia removed, rendered into oil. Mixed with Lepidium and Apricot kernels.

Grind all non-oily ingredients into powder. Add beef fat, Peach kernels, Apricot kernels, and Lepidium. Pound thousands of times. Form pills the size of paulownia seeds. Take three pills with rice drink, three times daily. Take when the abdomen is slightly empty. If ineffective, slightly increase the dose until effective.

The Lady of An'kang Commandery suffered from Wind-induced constipation. I prescribed **Zhihe Erren Wan (Aurantium and Chebula Two-Kernel Pills)**.
* Apricot Kernel (*Xingren*): Skin and tip removed, stir-fried with bran until yellow.
* Hemp Seed (*Maren*): Separately ground (two taels each).
* Aurantium Peel (*Zhiqiao*): Pulp removed, stir-fried with bran and ground.
* Chebula Fruit (*Hezi*): Slowly stir-fried, crushed to remove pits.

Take one tael each of the above two powdered items. Mix with the two kernels. Combine with refined honey and pound to form pills the size of paulownia seeds. Take twenty to thirty pills with warm water. Increase slightly if ineffective.

When Duke Lu served at Beimen, during midsummer he suffered from irregular bowel movements. His attending physician, Li Wan, originally from Quzhou market town, was tolerated and taught medicine by the Duke. When the Duke suffered from diarrhea, Li Wan undermined his confidence and sought quick effects. He presented Red Halloysite (*Chishizhi*), Dragon Bone (*Longgu*), and Dried Ginger (*Ganjiang*). The Duke took these and suffered from constipation for several days, in great distress. I arrived from Gongcheng to see him. Before sitting down, we discussed this matter. The Duke disliked taking Rhubarb (*Dahuang*). I told him, "This is dry feces in the rectum, inaccessible to oral medication. Please use Honey Suppository (*Mi Dui*)." The Duke agreed. It was mid-July, extremely hot. I sweated profusely while making the honey suppository for him. That night, after three applications, he passed forty to fifty hard stools, black like acorns. Within two to three days, his diet returned to normal. There are some deficient persons who cannot tolerate purgatives. Here is the method.

**Honey Suppository Method (Mi Dui Fa):** Take four to five taels of good honey. Simmer gently in silver or earthenware vessels. Stir constantly with a spoon until it can be molded and hardens upon exposure to air. Dust hands with Clam Powder (*Ge Fen*). Mold into a finger shape, about three cun long. Sit on the toilet and insert it. Hold in place with hand. Release when bowel movement occurs. If not satisfied, make another. (The above four formulas are from Chu Yushi.)

**Supplementary Tongqi San (Ventilation Powder):** Treats women whose lungs are injured by worry and anger. Since the Lung and Large Intestine are exterior-interior related, this leads to transmission dysfunction, causing constipation and blockage. Also applicable if constipation results from excessive intake of drying medicines.
* Tangerine Peel (*Chenpi*).
* Perilla Leaf (*Suye*).
* Aurantium Peel (*Zhiqiao*).
* Akebia Stem (*Mutong*): Remove nodes and joints.

Equal parts, cut into pieces. Take four qian per dose. Decoct in water and take warm.

**Sapodilla Pill (Zaojiao Wan)** and **Perilla and Hemp Porridge (Suma Zhou)** are also excellent. (See previous text.)