大便不通者，由三焦五脏不和，冷热之气不调，热气偏入肠胃，津液竭燥，故令糟粕痞
结，壅塞不通也。其汤熨针石，别有正方，补养宣导，今附于后。
《养生方·导引法》云∶龟行气，伏衣被中，覆口鼻头面，正卧，不息九通，微鼻出气
大便失禁者，由大肠与肛门虚弱冷滑故也。肛门，大肠之候也，俱主行糟粕，既虚弱冷
滑，气不能温制，故使大便失禁。
关格者，大小便不通也。大便不通，谓之内关；小便不通，谓之外格；二便俱不通，为
关格也。由阴阳气不和，荣卫不通故也。阴气大盛，阳气不得荣之，曰内关。阳气大盛，阴
气不得荣之，曰外格。阴阳俱盛，不得相荣，曰关格。关格则阴阳气痞结，腹内胀满，气不
行于大小肠，故关格而大小便不通也。
又风邪在三焦，三焦约者，则小肠痛内闭，大小便不通。日不得前后，而手足寒者，为
三阴俱逆，三日死也。
诊其脉来浮牢且滑直者，不得大小便也。
大小便难者，由冷热不调，大小肠有游气，游气在于肠间，搏于糟粕，溲便不通流，故
诊其尺脉滑而浮大，此为阳干于阴，其人苦小腹痛满，不能尿，尿即阴中痛，大便亦然
。其汤熨针石，别有正方，补养宣导，今附于后。
《养生方·导引法》云∶正坐，以两手交背后，名曰带便。愈不能大便，利腹，愈虚羸
。反叉两手着背上，推上使当心许， 坐，反到九通。愈不能大小便，利腹，愈虚羸也
Impediment in defecation (Da Bian Bu Tong) arises from disharmony among the Triple Burner (San Jiao, 三焦: the three upper abdominal cavities responsible for fluid metabolism and transportation) and the five Zang organs, with an imbalance of cold and heat qi. When excessive heat qi invades the stomach and intestines, body fluids are depleted and dried up, causing fecal matter to become obstructed and congested, resulting in blockage. Regarding treatments involving decoctions, hot compresses, acupuncture, and stone therapy, there are separate specific prescriptions; methods for nourishing supplementation and guiding-exercise (Dao Yin, 导引: traditional Chinese therapeutic exercises) are attached hereafter.
The *Preservation Formulas · Guiding-Exercise Methods* states: For "Turtle Qi Movement," lie prone under clothing and blankets, covering the mouth, nose, head, and face. Lie straight and still, hold the breath nine times, then exhale slightly through the nose.
Incontinence of stool is caused by weakness, coldness, and laxity of the Large Intestine (Da Chang, 大肠: organ responsible for absorbing water and forming feces) and the anal sphincter. The anus serves as the external manifestation of the Large Intestine, jointly governing the passage of waste. Due to weakness, coldness, and laxity, the qi fails to provide warmth and control, leading to incontinence of stool.
Guan Ge disease refers to the obstruction of both urination and defecation. Obstruction of defecation is termed "Nei Guan" (Internal Blockade); obstruction of urination is termed "Wai Ge" (External Rejection); when both are obstructed, it is called "Guan Ge." This results from disharmony of Yin and Yang qi and the blockage of Ying (Nutritive) and Wei (Defensive) qi. When Yin qi is excessively abundant and Yang qi cannot nourish it, it is called "Nei Guan." When Yang qi is excessively abundant and Yin qi cannot nourish it, it is called "Wai Ge." When both Yin and Yang are excessively abundant and cannot mutually nourish each other, it is called "Guan Ge." In Guan Ge, Yin and Yang qi become stagnant and knotted, causing abdominal distension and fullness, and preventing qi circulation in the Small and Large Intestines, thus resulting in Guan Ge and the obstruction of both urination and defecation.
Furthermore, if wind-pathogen invades the Triple Burner and the Triple Burner becomes constrained, it leads to pain in the Small Intestine (Xiao Chang, 小肠: organ responsible for separating clear from turbid) and internal closure, causing obstruction of both urination and defecation. If one cannot pass urine or stool anteriorly and posteriorly, accompanied by cold hands and feet, this indicates reversal of Qi in all three Yin meridians, which is fatal within three days.
Palpating the pulse, if it comes floating, firm, slippery, and straight, it indicates obstruction of both urination and defecation.
Difficulty in passing both urine and stool arises from an imbalance of cold and heat, with wandering qi present in the Small and Large Intestines. This wandering qi resides between the intestinal walls, combats the fecal matter, and prevents the smooth flow of urine and stool. Therefore, upon palpating the Chi position (Cun Kou pulse location corresponding to the lower abdomen/kidneys) as slippery, floating, and large, this indicates Yang pathogen interfering with Yin. The patient suffers from lower abdominal pain and fullness, inability to urinate, and pain in the genitalia during urination; the condition of defecation is similar. Regarding treatments involving decoctions, hot compresses, acupuncture, and stone therapy, there are separate specific prescriptions; methods for nourishing supplementation and guiding-exercise are attached hereafter.
The *Preservation Formulas · Guiding-Exercise Methods* states: Sit upright, cross both hands behind the back, a movement named "Dai Bian." It cures constipation, unblocks the abdomen, but may increase emaciation. Cross hands backward on the back, push upward toward the heart region, sit upright, and twist backward nine times. It cures difficulty in both urination and defecation, unblocks the abdomen, but may increase emaciation.