冷热不调，大小肠有游气，壅在大小肠，不得宣散，蓄积结生热，故大小便涩，不流利
腑脏不和，荣卫不调，阴阳不相通，大小肠痞结，名曰关格。关格，故大小便不通。自
有热结于大肠，则大便不通；热结于小肠，则小便不通。今大小便不通者，是大小二肠受客
热结聚，则大小便不通。此止客热暴结，非阴阳不通流，故不称关格，而直云大小便不通。
肾与膀胱为表里，而俱主水，肾气通于阴；而小便，水液之下行者也。肾虚冷，冷气入
胞，胞虚冷，不能制小便，故遗尿。
肾与膀胱为表里，俱主于水，肾气通于阴。此二经虚，而有热乘之，热则小便涩，虚则
小便数，热涩数也。
肠胃虚弱，为风邪冷热之气所乘。肠虚则泄，故变为利也。此下利是水谷利也，热色黄
滞利，由冷热不调，大肠虚，冷热气客于肠间。热气乘之则变赤，冷气乘之则变白，冷
热相交，则赤白相杂而连滞不止，名为滞利也。其状∶白脓如涕，而有血杂；亦有少血者。
如白脓涕而有赤脉如鱼脑，又名鱼脑利。
热乘血，入于大肠，为血利也。血之随气，外行经络，内通脏腑，皆无滞积。若冒触劳
动，生于热，热乘血散，渗入大肠，肠虚相化，故血利也。
Cold and heat are not in harmony, with wandering Qi (free-flowing qi) obstructing the Large Intestine and Small Intestine, unable to disperse. Accumulation generates heat, causing difficulty and lack of smoothness in urination and defecation.
The Fu and Zang organs are out of harmony, Ying and Wei (Nutritive and Defensive Qi) are unregulated, and Yin and Yang fail to communicate, resulting in obstruction and knotting of the Large Intestine and Small Intestine, termed Guan Ge (Obstruction and Repletion). In cases of Guan Ge, urination and defecation are blocked. If heat knots in the Large Intestine, defecation is blocked; if heat knots in the Small Intestine, urination is blocked. Currently, when both urination and defecation are blocked, it is due to the accumulation of Ke Re (Exogenous Heat) in the two intestines. This is merely a sudden blockage by exogenous heat, not a complete failure of Yin and Yang flow, thus it is not called Guan Ge but directly referred to as difficulty in urination and defecation.
The Kidney and Bladder are exterior-interior pairs, jointly governing water metabolism, with Kidney Qi connecting to the external genitalia. Urine is the fluid that descends from the body. When the Kidney is deficient and cold, cold Qi enters the Bao Palace (uterus/lower jiao), making the Bao Palace deficient and cold, unable to control urine retention, leading to enuresis.
The Kidney and Bladder are exterior-interior pairs, jointly governing water metabolism, with Kidney Qi connecting to the external genitalia. When these two meridians are deficient, heat may exploit this weakness. Heat causes urinary涩 (astringency/difficulty), while deficiency causes frequent urination, presenting as a combination of heat-induced astringency and deficiency-induced frequency.
The Stomach and Intestines are weak, attacked by Wind pathogenic factors and cold/heat Qi. Deficiency of the Intestines leads to diarrhea, transforming into Li (dysentery/diarrhea). This type of Li involves undigested food and water, with yellow stool color.
Zhi Li (Stagnant Dysentery) arises from disharmony of cold and heat, intestinal deficiency, and the presence of mixed cold and heat Qi in the intestines. Attack by heat Qi turns stool red; attack by cold Qi turns stool white. Interaction between cold and heat results in mixed red and white discharge that persists continuously, named Zhi Li. Symptoms include white pus resembling mucus mixed with blood; sometimes only a small amount of blood. If white pus contains red streaks resembling fish brains, it is also called Yu Nao Li (Fish Brain Dysentery).
Heat attacking the blood and entering the Large Intestine causes Xue Li (Bloody Dysentery). Blood travels with Qi, circulating externally through meridians and internally connecting to Zang-Fu organs, normally without stagnation. If one exposes oneself to pathogens or overexerts, generating heat, the heat scatters the blood, allowing it to seep into the Large Intestine. Combined with intestinal deficiency, this results in bloody dysentery.
Vulvar pruritus in women is caused by parasites feeding on tissues. The Three Worms and Nine Worms reside between the intestines and stomach. Due to visceral deficiency, the worms become active and feed on the genital area. The activity of these worms causes mild itching; in severe cases, it causes pain.