秘者气之闭也。结者粪之结也。气闭则攻击于肠胃。而瘀塞于魄门。欲下不下。虽努力
以伸
肛门燥结而沥血者。秘而不结。虽不通利而不甚艰难。结而不秘。虽不滋润而不甚费力。惟
秘结兼至。难中之难也。少壮之人多患秘。以其气有余而不及转运也。衰老之人多患结。以
其血不足而大肠干燥也。又有所谓风秘者。常欲转失气。而气终不泄。肛门壅塞。努力伸之
。则有声如裂帛。而粪又不下者。其根始于伤风咳嗽。咳嗽将愈。而此病即发以肺大肠相为
表里风入于肺而传病于大肠故也。脉经曰。尺脉见浮风入肺。大肠干
涩秘难通非此之谓乎。大法秘者调其气。结者润其血。而秘之得于风者。即于调气润血药中
。加去风之剂则得之矣。
调气饮 治气闭结滞。大便不通肚腹急胀。
广木香 槟榔 枳实 苏梗 青皮 陈皮（各二钱） 玄明粉（四钱） 水煎临服。加蜜一
润肠汤 治血枯粪结。
当归（三钱） 知母 麦门冬 桃仁 麻仁 苏子 生地（各一钱五分） 水煎食前服。
通畅饮 治一切闭结。枯燥之极。
麻仁（研为泥） 桃仁（去皮尖） 杏仁（去皮尖） 当归 滑石（各一钱五分） 栝蒌仁（去
壳） 郁李仁（去壳） 玄明粉 陈皮 枳壳（各一钱） 水煎临服入蜜一两热服。
祛热汤 治火结。
大黄（三钱） 黄连 浓朴 桃仁 朴梢（各二钱） 水煎不拘时服。
牛黄丸 治一切闭结。并痢疾后重。
黄连（酒炒五两） 广木香 槟榔（各三两） 大黄（一两） 当归 黑牵牛（一斤。炒熟。
取头末。各四两） 上为末。生蜜为丸。每服三钱。白滚汤下。
如意汤 治风闭结。
防风 苏紫 当归 枳壳 桃仁（各一钱五分） 广木香 荆芥 玄明粉 山楂（各一钱）
葱白五根。煎服。
立通饮 治内有积热闭结不通。
黄芩（三钱） 石膏（ 五钱） 黄柏 山栀仁 麦冬（各一钱） 玄明粉 桃仁（各二钱）
水煎不拘时服。
搜风顺气丸 治老年血枯。大肠干燥。结硬难解。并治肢节顽麻。手足瘫痪。气血不和
积热不散。
大黄（十两酒浸九蒸九晒） 火麻仁（去壳） 山药（炒） 车前子 牛膝（酒洗） 槟榔 郁
李仁（去皮壳） 枳壳（麸炒各四两） 独活 菟丝子（酒煮捣各三两）
上为末蜜丸。每服三钱。清茶送下。
秘，是指气的闭塞。结，是指粪便的结聚。气机闭塞则会冲击肠胃，并在魄门（肛门）处瘀滞阻塞，导致想排便却排不出来。即使用力伸展肛门，若只是燥结而滴沥出血的，属于“秘”而不“结”，虽然不通畅但并不十分艰难；如果是“结”而不“秘”，虽然不滋润但并不十分费力。只有“秘”和“结”同时存在，才是最难治疗的病症。
年轻力壮的人多患“秘”，因为他们的正气有余但缺乏转运的能力。年老体衰的人多患“结”，因为他们的血液不足导致大肠干燥。又有所谓的“风秘”，常常想要排气，但气始终无法排出，肛门壅塞，用力伸展时，发出像撕裂丝绸一样的声音，而粪便仍然下不来。这种病的根源始于伤风咳嗽，当咳嗽即将痊愈时，此病随即发作，这是因为肺与大肠互为表里，风邪侵入肺部并传变至大肠所致。《脉经》说：“尺脉见浮象，是风邪入肺。”大肠干涩、便秘难通，难道不是这种情况吗？
治疗的大法：对于“秘”，要调理其气机；对于“结”，要滋润其血液。而对于因风邪导致的“秘”，就在调气润血的药物中，加入祛风的药剂即可奏效。
燥结的脉象，无论沉浮都不必怀疑（需结合其他症状判断）。热结的脉象沉而数，虚结的脉象沉而迟。如果是风结，右尺脉浮洪。
调气饮：治疗气机闭塞结滞，大便不通，肚腹急胀。
广木香、槟榔、枳实、苏梗、青皮、陈皮（各二钱），玄明粉（四钱）。水煎，临服时加蜂蜜一匙。
润肠汤：治疗血枯粪结。
当归（三钱），知母、麦门冬、桃仁、麻仁、苏子、生地（各一钱五分）。水煎，饭前服用。
通畅饮：治疗一切闭结，极度枯燥。
麻仁（研成泥状），桃仁（去皮尖），杏仁（去皮尖），当归，滑石（各一钱五分），栝蒌仁（去壳），郁李仁（去壳），玄明粉，陈皮，枳壳（各一钱）。水煎，临服时加入一两蜂蜜，热服。
祛热汤：治疗火结。
大黄（三钱），黄连、浓朴、桃仁、朴梢（各二钱）。水煎，不拘时候服用。
牛黄丸：治疗一切闭结，以及痢疾后的里急后重。
黄连（酒炒五两），广木香、槟榔（各三两），大黄（一两），当归、黑牵牛（一斤，炒熟取头末，各四两）。以上药物研为细末，用生蜜制成丸药。每次服用三钱，白开水送服。
如意汤：治疗风闭结。
防风、苏紫、当归、枳壳、桃仁（各一钱五分），广木香、荆芥、玄明粉、山楂（各一钱），葱白五根。煎服。
立通饮：治疗内有积热导致闭结不通。
黄芩（三钱），石膏（五钱），黄柏、山栀仁、麦冬（各一钱），玄明粉、桃仁（各二钱）。水煎，不拘时候服用。
搜风顺气丸：治疗老年血枯，大肠干燥，粪便结硬难解。并治疗肢节顽麻，手足瘫痪，气血不和，积热不散。
大黄（十两，酒浸九蒸九晒），火麻仁（去壳），山药（炒），车前子，牛膝（酒洗），槟榔，郁李仁（去皮壳），枳壳（麸炒，各四两），独活，菟丝子（酒煮捣碎，各三两）。
以上药物研为细末，用蜜制成丸药。每次服用三钱，清茶送服。
Bi (constipation) refers to the obstruction of Qi. Jie (impaction) refers to the concretion of feces. When Qi is obstructed, it attacks the intestines and stomach, causing stasis and blockage in the anus (Pomen). One desires to defecate but cannot; even with effort to extend the anus, if there is dryness and impaction accompanied by dripping blood, it is classified as "Bi" without "Jie". Although there is no smooth passage, it is not extremely difficult, which is "Jie" without "Bi". Although there is lack of moisture, it is not extremely laborious. Only when both Bi and Jie occur simultaneously is it the most difficult condition to treat. Young and strong people often suffer from Bi because their Qi is abundant but its transportation function is insufficient. Elderly people often suffer from Jie because their Blood is deficient, leading to dryness of the large intestine. There is also a condition called Feng Bi (Wind Constipation), characterized by a frequent desire to pass gas, yet the gas never exits, with the anus feeling blocked and congested. Effort to extend the anus produces a sound like tearing silk, yet feces do not come down. Its root cause lies in wind-cold coughing; as the cough is about to heal, this disease emerges because the Lung and Large Intestine are exterior-interior partners. Wind pathogen enters the Lung and transmits the disease to the Large Intestine. The *Mai Jing* (Classic of Pulse Diagnosis) states: "A floating pulse at the Chi position indicates wind entering the Lung." Dryness and slipperiness of the Large Intestine making constipation difficult to pass—does this not refer to this condition? The general principle of treatment: for Bi, regulate the Qi; for Jie, moisten the Blood. For Bi caused by wind, add wind-dispelling agents to the Qi-regulating and Blood-moistening formulas, and the result will be achieved.
The pulse for dryness-impaction can be either deep or floating, without doubt. The pulse for heat-impaction is deep and rapid; the pulse for deficiency-impaction is deep and slow. If it is wind-impaction, the Right Chi pulse appears floating and surging.
Tiaoqi Yin (Regulate Qi Decoction): Treats Qi obstruction and stagnation, unpassable stool, and urgent abdominal distension.
Guangmuxiang (Costus Root), Binglang (Areca Seed), Zhishi (Immature Bitter Orange), Sugeng (Perilla Stem), Qingpi (Green Tangerine Peel), Chenpi (Aged Tangerine Peel) (each 2 qian), Xuanmingfen (Mirabilite) (4 qian). Decoct in water, add one spoonful of honey before taking.
Runchang Tang (Moisten Intestines Decoction): Treats blood depletion and fecal impaction.
Danggui (Angelica Sinensis Root) (3 qian), Zhimu (Anemarrhena Rhizome), Maimendong (Ophiopogon Tuber), Taoren (Peach Kernel), Mahren (Hemp Seed), Suzi (Perilla Fruit), Shengdi (Rehmannia Root Prepared with Wine) (each 1.5 qian). Decoct in water, take before meals.
Changtong Yin (Unobstructed Flow Decoction): Treats all types of closure and impaction, extreme dryness.
Maren (Hemp Seed) (pounded into paste), Taoren (Peach Kernel) (skin and tip removed), Xingren (Apricot Kernel) (skin and tip removed), Danggui (Angelica Sinensis Root), Huashi (Talcum) (each 1.5 qian), Gualouren (Trichosanthes Seed) (shell removed), Yuliren (Bush Cherry Kernel) (shell removed), Xuanmingfen (Mirabilite), Chenpi (Aged Tangerine Peel), Zhike (Amarut Bitter Orange) (each 1 qian). Decoct in water, add one liang of honey before taking, drink hot.
Qure Tang (Dispel Heat Decoction): Treats fire-impaction.
Dahuang (Rhubarb Root and Rhizome) (3 qian), Huanglian (Coptis Rhizome), Nongpo (Magnolia Bark), Taoren (Peach Kernel), Puxiao (Terminalia Chebula Tip) (each 2 qian). Decoct in water, take at any time.
Niuhuang Wan (Calculus Bovis Pill): Treats all types of closure and impaction, and tenesmus after dysentery.
Huanglian (Coptis Rhizome) (wine-fried, 5 liang), Guangmuxiang (Costus Root), Binglang (Areca Seed) (each 3 liang), Dahuang (Rhubarb Root and Rhizome) (1 liang), Danggui (Angelica Sinensis Root), Heiqianniu (Black Morning Glory Seed) (1 jin, fried ripe, take the finest powder, each 4 liang). Grind all into fine powder, form pills with raw honey. Take 3 qian per dose, wash down with plain boiling water.
Ruyi Tang (As-You-Wish Decoction): Treats wind-closure impaction.
Fangfeng (Saposhnikovia Root), Zisu (Perilla Leaf), Danggui (Angelica Sinensis Root), Zhike (Amarut Bitter Orange), Taoren (Peach Kernel) (each 1.5 qian), Guangmuxiang (Costus Root), Jingjie (Schizonepeta Spike), Xuanmingfen (Mirabilite), Shanzha (Hawthorn Fruit) (each 1 qian), Congbai (Scallion White) (five stalks). Decoct and take.
Litong Yin (Immediate Unblocking Decoction): Treats internal accumulated heat causing closure and unpassable stool.
Huangqin (Scutellaria Root) (3 qian), Shigao (Gypsum Fibrosum) (5 qian), Huangbai (Phellodendron Bark), Shanzhiren (Gardenia Seed), Maidong (Ophiopogon Tuber) (each 1 qian), Xuanmingfen (Mirabilite), Taoren (Peach Kernel) (each 2 qian). Decoct in water, take at any time.
Soufeng Shunqi Wan (Search Wind and Smooth Qi Pill): Treats elderly blood depletion, dryness of the large intestine, hard impaction difficult to resolve. Also treats stubborn numbness in limbs and joints, paralysis of hands and feet, disharmony of Qi and Blood, and unresolved accumulated heat.
Dahuang (Rhubarb Root and Rhizome) (10 liang, soaked in wine, steamed and dried nine times), Huomaren (Hemp Seed) (shelled), Shanyao (Chinese Yam) (fried), Cheqianzi (Plantago Seed), Niuxi (Achyranthes Root) (wine-washed), Binglang (Areca Seed), Yuliren (Bush Cherry Kernel) (skin and shell removed), Zhike (Amarut Bitter Orange) (bran-fried, each 4 liang), Duhuo (Angelica Pubescens Root), Tusizi (Cuscuta Seed) (wine-boiled and pounded, each 3 liang). Grind all into fine powder, form pills with honey. Take 3 qian per dose, wash down with clear tea.