治同前证。
大葱白（四斤，切作细丝） 干米醋（多备待用）
将葱白丝和醋炒至极热，分作两包，乘热熨脐上。凉则互换，不可间断。其凉者，仍可加醋少许，再炒热。
然炒葱时，醋之多少，须加斟酌。以炒成布包后，不至有汤为度。熨至六点钟，其结自开。
一孺子，年六岁。因食肉过多，不能消化，郁结肠中。大便不行者六七日，腹中胀满，按之硬如石，用一
切通利药皆不效。为用此法熨之，至三点钟，其腹渐软。又熨三点钟，大便通下如羊矢，其胀遂消。
一童子，年十五六。因薄受外感，腹中胀满，大便数日不通，然非阳明之实热燥结也。医者投以承气汤，
大便仍不通，而腹转增胀。自觉为腹胀所迫，几不能息，且时觉心中怔忡。诊其脉，甚微细，按之即无。脉虚
证实，几为束手。亦用葱白熨法，腹胀顿减。又熨三点钟，觉结开，行至下焦。继用猪胆汁导法，大便得通而愈。
一人，年四十许，素畏寒凉。愚俾日服生硫黄，如黑豆粒大两块，大见功效，已年余矣。偶因暑日劳碌，
心中有火，恣食瓜果，又饱餐肉食，不能消化，肠中结而不行，且又疼痛，时作呕吐。医者用大黄附子细辛汤
降之，不效。又用京都薛氏保赤万应散，三剂并作一剂服之，腹疼减去，而仍不通行。后愚诊视，其脉近和平，
微弦无力。盖此时不食数日，不大便十日矣。遂治以葱白熨法，觉腹中松畅，且时作开通之声。而仍然恶心，
欲作呕吐。继用赭石二两，干姜钱半，俾煎服以止其恶心。仍助以葱白熨法，通其大便。外熨内攻，药逾五点
钟，大便得通而愈。
按∶《金匮》大黄附子细辛汤，诚为开结良方。愚尝用以治肠结腹疼者甚效。即薛氏保赤万应散，三剂作
一剂服之，以治大人，亦为开结良方。愚用过屡次皆效。而以治此证，二方皆不效者，以其证兼呕吐，二方皆
不能止其呕吐故也。病患自言，从前所服之药，皆觉下行未至病所，即上逆吐出。独此次服药，则沉重下达，
直抵病结之处，所以能攻下也。
一人，年四十三。房事后，恣食生冷，忽然少腹抽疼，肾囊紧缩。大便四日不通，上焦兼有烦躁之意。医
者投以大黄附子细辛汤，两胁转觉疼胀。诊其脉，弦而沉，两尺之沉尤甚。先治以葱白熨法，腹中作响，大有
开通之意。肾囊之紧缩见愈，而大便仍未通。又用赭石二两，附子五钱，当归、苏子各一两，煎汤，甫饮下，
即觉药力下坠。俾复煎渣饮之，有顷，降下结粪若干，诸病皆愈。
按∶此证用葱白熨之，虽未即通，而肠中之结已开。至所服之药，重用赭石者，因此证，原宜用热药以温
下焦，而上焦之烦躁，与大便之燥结，又皆与热药不宜。惟重用赭石以佐之，使其热力下达，自无僭上之患。
而其重坠之性，又兼有通结之功。上焦之浮热，因之归根，下焦之凝寒，因之尽化矣。
附∶
（1）猪胆汁导法，乃《伤寒论》下燥结之法也。原用猪胆汁，和醋少许，以灌谷道中。今变通其法，用
醋灌猪胆中，手捻令醋与胆汁融和，再用以通气长竹管，一端装猪胆中，用细绳扎住，一端纳谷道中。用手将
猪胆汁，由竹管挤入谷道。若谷道离大便犹远，宜将竹管深探至燥粪之处。若结之甚者，又必连用两三个。若
畏猪胆汁凉，或当冷时，可将猪胆置水中温之。若无鲜猪胆，可将干者，用醋泡开，再将醋灌猪胆中，以手捻
至胆汁之凝结者皆融化，亦可用。若有灌肠注射器，则用之更便。
（2）古方治小便忽然不通者，有葱白炙法。用葱白一握，捆作一束，将两端切齐，中留二寸。以一端安
脐上，一端用炭火炙之。待炙至脐中发热，小便自通。此盖借其温通之性，自脐透达，转入膀胱，以启小便之
路也。然仅以火炙其一端，则热力之透达颇难。若以拙拟葱白熨法代之。则小便之因寒不通，或因气滞不通者，
取效当更速也。
按∶此熨法，不但可通二便，凡疝气初得，用此法熨之，无不愈者。然须多熨几次，即熨至疝气消后，仍
宜再熨两三次。或更加以小茴香、胡椒诸末，同炒亦佳（用胡椒末时，不宜过五钱，小茴香可多用）。
治疗与前文所述证候相同。
将葱白丝和醋一起炒至极热，分成两包，趁热熨烫在肚脐上。凉了之后互换位置，不可中断。变凉的那一包，可以再加少许醋，重新炒热。
然而炒葱时，醋的用量必须斟酌适当。以炒好装入布包后，不至于有汤汁渗出为标准。熨烫六个小时，肠结自然解开。
有一个六岁的孩童。因为吃肉过多，无法消化，郁积在肠中。大便不通已有六七天，腹部胀满，按压时硬如石头，使用一切通利大便的药物都无效。于是用此法熨烫，三小时后，腹部逐渐变软。又熨烫三个小时，大便排出如羊粪状，腹胀随即消除。
有一个十五六岁的少年。因为轻微感受外邪，腹部胀满，大便数日不通，但这并非阳明经的实热燥结。医生给予承气汤服用，大便仍然不通，而腹部反而更加胀满。患者自觉被腹胀压迫，几乎无法呼吸，且时常感到心中心悸怔忡。诊察其脉象，非常微细，按之即无。这是脉虚证实的危重情况，几乎束手无策。也采用葱白熨法，腹胀顿时减轻。又熨烫三个小时，感觉结滞已开，下行至下焦。随后使用猪胆汁导法，大便得以通畅而痊愈。
有一位四十岁左右的男子，平时畏惧寒凉。我让他每天服用生硫黄，每次两块如黑豆大小，效果显著，已经持续一年多了。偶然因夏日劳碌，心中有火，肆意食用瓜果，又饱餐肉食，导致不能消化，肠中结滞不通，并且疼痛，时常呕吐。医生使用大黄附子细辛汤降逆攻下，无效。又使用京都薛氏保赤万应散，将三剂药合并为一剂服用，腹痛减轻，但大便仍不通畅。后来我诊视，脉象接近平和，微弦无力。考虑到此时患者几天未进食，十天未解大便了。于是用葱白熨法治疗，感觉腹中松畅，且不时发出开通的声音。但仍然恶心，想要呕吐。继而又用赭石二两，干姜一钱半，煎服以止住恶心。同时继续辅助以葱白熨法，通导大便。外熨内服，用药超过五个小时，大便得通而痊愈。
按语：《金匮要略》中的大黄附子细辛汤，确实是开通结滞的良好方剂。我曾用来治疗肠结腹痛，非常有效。即使是薛氏保赤万应散，将三剂合并为一剂服用，用于治疗成人，也是开通结滞的好方子。我多次使用都很有效。但用来治疗上述证候，这两个方子都无效，是因为该证候兼有呕吐，而这两个方子都不能止住呕吐的缘故。病人自己说，以前服用的药物，都觉得药力下行未到病处，就向上逆吐出来。唯独这次服药，感觉沉重下达，直抵结滞之处，所以能攻下。
有一位四十三岁的男子。房事后，恣意食用生冷食物，突然少腹抽搐疼痛，阴囊紧缩。大便四天不通，上焦兼有烦躁之意。医生投予大黄附子细辛汤，两胁转而觉得疼痛胀满。诊察其脉象，弦而沉，两尺部的沉脉尤其明显。先采用葱白熨法治疗，腹中作响，大有开通之意。阴囊的紧缩症状有所缓解，但大便仍未通。又用赭石二两，附子五钱，当归、苏子各一两，煎汤，刚喝下去，就感觉药力下坠。让患者再将药渣复煎饮用，不久，降下了若干结块粪便，各种病症都痊愈了。
按语：此证用葱白熨烫，虽然大便没有立即通畅，但肠中的结滞已经打开。至于所服用的药物，重用赭石的原因，是因为此证原本适宜用热药来温煦下焦，而上焦的烦躁，以及大便的燥结，又不适宜单纯用热药。只有重用赭石来佐助，使热力下达，自然没有僭越上行的祸患。而且赭石的重坠之性，又兼具通导结滞的功效。上焦的浮热，因此归根于下；下焦的凝寒，因此完全化解。
附录：
（1）猪胆汁导法，是《伤寒论》中治疗燥结的方法。原方是用猪胆汁，加少许醋，灌入肛门中。现在变通此法，用醋灌入猪胆中，用手捻动使醋与胆汁融合，再用通气长的竹管，一端插入猪胆中，用细绳扎紧，另一端纳入肛门中。用手将猪胆汁由竹管挤入肛门。如果肛门距离大便尚远，应将竹管深探至燥粪处。如果结滞严重的，还必须连续使用两三个。如果害怕猪胆汁太凉，或者天气冷时，可以将猪胆放在水中温热。如果没有鲜猪胆，可以用干的，用醋泡开，再将醋灌入猪胆中，用手捻至胆汁凝结的部分全部融化，也可以使用。如果有灌肠注射器，则使用它更方便。
（2）古方治疗小便忽然不通的，有葱白炙法。用一把葱白，捆成一束，将两端切齐，中间留出二寸。将一端放在肚脐上，另一端用炭火炙烤。等到炙烤到肚脐发热，小便自然通畅。这大概是借助葱白的温通之性，从脐部透达，转入膀胱，以开启小便的路径。然而仅用火炙其一端，热力的透达颇为困难。如果用我拟定的葱白熨法代替，那么对于因寒或气滞导致的小便不通，取效应当更快。
按语：这种熨法，不仅能通利二便，凡是疝气初起，用此法熨烫，无不治愈的。但是需要多熨几次，即使熨到疝气消退后，仍然应该再熨两三次。或者再加上小茴香、胡椒等粉末，一同炒制也很好（使用胡椒末时，不宜超过五钱，小茴香可以多放）。
The treatment is the same as for the syndrome described previously.
Scallion White (4 jin, cut into fine shreds) Dry Rice Vinegar (prepare ample amount for use)
Stir-fry the scallion white shreds and vinegar until extremely hot. Divide into two bags. Apply hot compresses to the umbilicus while hot. Swap them when they cool down; do not interrupt the process. For the cooled bag, add a little more vinegar and reheat by stir-frying.
However, the amount of vinegar used during stir-frying must be carefully considered. The standard is that after being packed into cloth bags, no liquid should leak out. Compress for six hours, and the intestinal obstruction will naturally resolve.
A child, aged six. Due to excessive meat consumption leading to indigestion, stagnation accumulated in the intestines. Bowel movement had been absent for six or seven days. The abdomen was distended and hard upon palpation, like stone. All purgative medicines proved ineffective. This method was applied via hot compress. After three hours, the abdomen gradually softened. After another three hours, stool passed resembling sheep dung, and the distension subsided.
A boy, aged fifteen or sixteen. Suffering from mild external contraction, he experienced abdominal distension and constipation for several days. However, this was not the excess heat and dryness accumulation of the Yangming channel. The physician administered Chengqi Tang (Gut-Draining Decoction), but bowel movements remained unobstructed, and abdominal distension worsened. The patient felt compelled by the abdominal distension, nearly unable to breathe, and occasionally experienced palpitations (heart flutter). His pulse was extremely faint and thin, disappearing upon pressure. This presented as a deficiency pulse with an excess syndrome, seemingly untreatable. The Scallion White Hot Compress method was also employed, resulting in immediate reduction of abdominal distension. After another three hours of compression, the stagnation was felt to have opened and moved downward to the lower jiao. Subsequently, the Pig Bile Suppository Method was used, allowing bowel movement to resume and recovery ensued.
A man, around forty years old, who generally feared cold and cool substances. I instructed him to take raw Realgar (Sheng Liuhuang) daily, two pieces the size of black soybeans each time. It showed significant efficacy and had been used for over a year. Accidentally, due to labor on a summer day, he developed internal heat, indulged in eating melons and fruits, and consumed a heavy meal of meat. Indigestion occurred, causing intestinal stagnation and obstruction, accompanied by pain and frequent vomiting. The physician used Dahuang Fuzi Xixin Tang (Rhubarb, Aconite, and Asarum Decoction) to purge downwards, but it was ineffective. Then, Baochi Wanyingsan (Treasure Infant Universal Powder) from Kyoto was used; three doses were combined into one and taken. Abdominal pain decreased, but bowel movement remained obstructed. Later, I examined him; his pulse was near normal, slightly wiry and powerless. Considering he had not eaten for several days and had not had a bowel movement for ten days, I treated him with the Scallion White Hot Compress method. He felt the abdomen become loose and comfortable, and sounds of opening were heard intermittently. However, nausea persisted, and he desired to vomit. Subsequently, Oolithus (Zheshi, 2 liang) and Dried Ginger (Ganjiang, 1 qian half) were decocted and taken orally to stop the nausea. The Scallion White Hot Compress method was continued to facilitate bowel movement. With external compression and internal medication, after more than five hours, bowel movement resumed, and he recovered.
Commentary: Dahuang Fuzi Xixin Tang (Rhubarb, Aconite, and Asarum Decoction) from *Jinkui Yaolue* (Essential Prescriptions of the Golden Cabinet) is indeed an excellent formula for resolving stagnation. I have used it frequently to treat intestinal obstruction and abdominal pain with great effect. Even Baochi Wanyingsan, when three doses are combined into one for adults, is a good formula for resolving stagnation. I have used it many times with success. However, it failed in treating this specific case because the syndrome included vomiting, which neither formula could address. The patient stated that previously ingested medicines felt as if they did not reach the disease site before regurgitating upwards. Only this time did the medicine feel heavy and descend directly to the site of stagnation, thus achieving purgation.
A man, aged forty-three. After sexual intercourse, he indulged in raw and cold foods, suddenly experiencing cramping pain in the lower abdomen and retraction of the scrotum. Bowel movement had been absent for four days, accompanied by irritability in the upper jiao. The physician prescribed Dahuang Fuzi Xixin Tang (Rhubarb, Aconite, and Asarum Decoction), causing pain and distension in the hypochondrium. His pulse was wiry and deep, with the deepness particularly pronounced at both Chi positions (kidney pulses). Initially, the Scallion White Hot Compress method was applied. The abdomen made rumbling sounds, indicating a strong tendency towards resolution. The scrotal retraction improved, but bowel movement remained obstructed. Then, Oolithus (Zheshi, 2 liang), Prepared Aconite Root (Fuzi, 5 qian), Angelica Sinensis Root (Danggui), and Perilla Seed (Suzi) (each 1 liang) were decocted. Upon ingestion, he immediately felt the medicinal force descending. He was instructed to decoct and drink the dregs again. Shortly after, some hardened feces were discharged, and all ailments resolved.
Commentary: Using the Scallion White Hot Compress for this syndrome did not immediately result in bowel movement, but the intestinal stagnation had already begun to open. Regarding the administered medicine, the heavy use of Oolithus (Zheshi) was necessary because this syndrome originally required hot herbs to warm the lower jiao, while the irritability in the upper jiao and the dryness of the stool were unsuitable for hot herbs alone. By heavily using Oolithus to assist, the heat was directed downwards, avoiding the risk of rebellious upward flare-up. Furthermore, its heavy and sinking nature possesses the function of resolving stagnation. The floating heat in the upper jiao returned to its root, and the coagulated cold in the lower jiao was completely transformed.
Appendix:
(1) The Pig Bile Suppository Method is a technique for treating dryness accumulation found in *Shanghan Lun* (Treatise on Cold Damage). Originally, pig bile was mixed with a little vinegar and instilled into the anus. Now, modifying this method: pour vinegar into a pig gallbladder, knead by hand to mix the vinegar and bile thoroughly. Insert one end of a long, ventilated bamboo tube into the gallbladder and tie it securely with a thin string. Insert the other end into the anus. Squeeze the pig bile into the anus through the bamboo tube by hand. If the anus is far from the stool, insert the bamboo tube deeply to the location of the dry feces. If the stagnation is severe, two or three such preparations may need to be used consecutively. If one fears the cooling nature of pig bile or if it is cold, warm the gallbladder in water. If fresh pig gallbladders are unavailable, dried ones can be soaked in vinegar until the congealed bile melts after kneading; these can also be used. If an enema syringe is available, its use is even more convenient.
(2) Ancient formulas for sudden urinary retention include the Scallion White Moxibustion Method. Take a handful of scallion whites, bundle them together, trim both ends evenly, leaving about two cun in the middle. Place one end on the umbilicus and moxa-burn the other end with charcoal fire. When heat penetrates to the umbilicus, urination will naturally resume. This likely utilizes the warming and unblocking properties of scallions, penetrating from the umbilicus, transferring to the Bladder, and opening the pathway for urination. However, burning only one end makes heat penetration difficult. If replaced by my proposed Scallion White Hot Compress method, the therapeutic effect for urinary retention caused by cold or qi stagnation would be faster.
Commentary: This compress method not only facilitates the passage of urine and stool but is also effective for early-stage hernia (Shanqi). Applying this method invariably leads to cure. However, it requires multiple applications; even after the hernia subsides, apply it two or three more times. Alternatively, adding powders of Small Fennel Fruit (Xiaohuixiang) and Pepper (Hujiao) and stir-frying together is also beneficial (when using pepper powder, do not exceed 5 qian; small fennel fruit can be used in larger amounts).