1.热燥阳结能食数, 寒燥阴结不食迟, 实燥食积热结胃, 食少先硬
后溏脾; 气燥阻隔不降下, 血燥干枯老病虚, 风燥久患风家候, 直肠
结硬导之宜.
【注】热燥即阳结也, 能食而脉浮数有力, 与三阳热证同见者也. 寒
燥即阴结也, 不能食而脉沉迟有力, 与三阴寒证同见者也. 实燥即胃
实硬燥也, 与腹满痛同见者也. 虚燥即脾虚, 先硬后溏之燥也, 与少
气腹缩同见者也. 气燥即气道阻隔之燥也, 与噎膈, 反胃同见者也.
血燥即血液干枯之燥也, 与久病老虚同见者也. 风燥即久患风病之燥
也,从风家治. 直肠结, 即燥屎巨硬, 结在肛门难出之燥也, 从导法
治之.
温脾汤 握药法
2.热实脾约三承气, 寒实备急共温脾, 大黄姜附桂草朴, 寒虚硫半
握药医, 虚燥益气硝黄入, 血燥润肠与更衣, 气燥四磨参利膈, 风燥
搜风顺气宜.
【注】温脾汤, 即大黄, 干姜, 附子, 肉桂, 甘草, 厚朴也. 硫半丸
,即硫黄, 半夏也. 握药, 即巴豆仁, 干姜, 韭子, 良姜, 甘遂, 白
槟榔, 各五分, 为末合均, 饮和分二粒, 先以花椒汤洗手, 麻油涂手
心握药, 移时便泻, 欲止则以冷水洗手. 益气, 即补中益气汤, 加大
黄,朴硝. 润肠丸, 即当归, 生地, 枳壳, 桃仁, 火麻仁, 各等分为
末,蜜丸, 米饮早服. 更衣丸, 即生芦荟, 朱砂末等分, 饭丸, 酒服
.四磨汤, 即人参, 乌药, 沉香, 槟榔也. 参利膈, 即人参利膈丸也
.搜风顺气, 即搜风顺气丸也.
1. 热燥（阳结）表现为能进食、脉象数；寒燥（阴结）表现为不能进食、脉象迟。实燥由食积和热邪结于胃所致，症状为先大便干硬后稀溏，属脾虚；气燥因气机阻隔、不下降所致；血燥表现为干枯，多见于久病体虚者；风燥多见于素有风疾的患者；直肠结硬者适宜采用导法治疗。
【注】热燥即阳结，表现为能进食且脉浮数有力，常与三阳经的热证同时出现。寒燥即阴结，表现为不能进食且脉沉迟有力，常与三阴经的寒证同时出现。实燥即胃中实热导致的大便干硬，常与腹部胀满疼痛同时出现。虚燥即脾虚引起的大便先干后稀，常与少气、腹部收缩感同时出现。气燥即气道阻隔引起的大便干燥，常与噎膈、反胃同时出现。血燥即血液干枯引起的大便干燥，常与久病、年老体虚同时出现。风燥即长期患有风病引起的大便干燥，应从风病治疗。直肠结，即燥屎极其坚硬，结在肛门难以排出的情况，应采用导法治疗。
温脾汤、握药法
2. 热实及脾约证使用三承气汤；寒实证使用备急丸或温脾汤。方剂组成包括大黄、干姜、附子、肉桂、甘草、厚朴。寒虚证使用硫黄半夏丸治疗；虚燥证在使用益气药的基础上加入硝石和大黄；血燥证使用润肠丸或更衣丸；气燥证使用四磨汤或人参利膈丸；风燥证适宜使用搜风顺气丸。
【注】温脾汤，即由大黄、干姜、附子、肉桂、甘草、厚朴组成。硫半丸，即由硫黄、半夏组成。握药，即由巴豆仁、干姜、韭子、良姜、甘遂、白槟榔各五分，研为细末混合均匀，每次用饮调和分为两粒。先用花椒汤洗手，用麻油涂抹手心握住药丸，过一段时间后就会腹泻，若想停止则用冷水洗手。益气，即补中益气汤加大黄、朴硝。润肠丸，即由当归、生地、枳壳、桃仁、火麻仁各等分研为细末，蜜炼为丸，米汤送服，早晨服用。更衣丸，即由生芦荟、朱砂末等分制成饭丸，酒送服。四磨汤，即由人参、乌药、沉香、槟榔组成。参利膈，即人参利膈丸。搜风顺气，即搜风顺气丸。
1. Heat-induced dryness (Yang constipation) is characterized by the ability to eat and a rapid pulse; cold-induced dryness (Yin constipation) is characterized by the inability to eat and a slow pulse. Excess dryness results from food accumulation and heat binding in the Stomach, presenting with hard stool first followed by loose stool, which relates to Spleen deficiency; Qi dryness results from obstruction of Qi mechanism preventing descent; Blood dryness presents as dryness and withering, often seen in chronic illness and deficiency; Wind dryness is commonly seen in patients with a history of wind disorders; for rectal impaction with hardness, the guiding method (suppository/enema therapy) is appropriate.
[Note] Heat dryness is Yang constipation, characterized by the ability to eat and a floating, rapid, and forceful pulse, often occurring concurrently with heat syndromes of the Three Yang meridians. Cold dryness is Yin constipation, characterized by the inability to eat and a deep, slow, and forceful pulse, often occurring concurrently with cold syndromes of the Three Yin meridians. Excess dryness refers to excess heat and hardness in the Stomach, often occurring concurrently with abdominal fullness and pain. Deficiency dryness refers to Spleen deficiency causing dryness with hard stool first followed by loose stool, often occurring concurrently with shortness of breath and abdominal contraction sensation. Qi dryness refers to dryness caused by obstruction of the Qi pathway, often occurring concurrently with dysphagia (Yi Ge) and regurgitation (Fan Wei). Blood dryness refers to dryness caused by depletion of blood essence, often occurring concurrently with chronic illness and elderly deficiency. Wind dryness refers to dryness resulting from long-standing wind diseases, treated according to wind disorder protocols. Rectal impaction refers to extremely hard dry feces impacted in the anus, difficult to expel, treated with the guiding method.
Wenpi Tang (Warm the Spleen Decoction), Grasping Medicine Method
2. For heat-excess and Pi Yue (Spleen Confinement) syndromes, use the Three Chengqi Decoctions; for cold-excess syndromes, use Beijiji Wan (Emergency Preparedness Pill) or Wenpi Tang. The formula ingredients include Dahuang (Rhei Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma), Fuzi (Aconiti Lateralis Radix Praeparata), Rougui (Cinnamomi Cortex), Gancao (Glycyrrhizae Radix et Rhizoma), and Houpo (Magnoliae Officinalis Cortex). For cold-deficiency syndromes, treat with Liuhalf Ban Wan (Sulfur and Pinellia Pill); for deficiency dryness, add Xiaoshi (Natrii Sulfas) and Dahuang to Qi-tonifying formulas; for blood dryness, use Runchang Wan (Moisten Intestines Pill) or Gengyi Wan (Change Clothes Pill); for Qi dryness, use Simo Tang (Four-Steaming Decoction) or Renshen Lige Wan (Ginseng Diaphragm-Relieving Pill); for wind dryness, use Soushun Fengqi Wan (Search for Wind and Promote Qi Pill).
[Note] Wenpi Tang consists of Dahuang, Ganjiang, Fuzi, Rougui, Gancao, and Houpo. Liuhalf Ban Wan consists of Liuhuang (Sulfur) and Banxia (Pinelliae Rhizoma). Grasping medicine consists of Badou Ren (Crotonis Fructus Semen), Ganjiang, Jiu Zi (Allii Tuberosi Semen), Liangjiang (Alpiniae Katsumadai Rhizoma), Gansui (Kansui Radix), and Baibinglang (Arecae Semen), each 5 fen, ground into fine powder and mixed evenly. Take two pills mixed with drink. First wash hands with Zhaohua (Zanthoxyli Pericarpium) decoction, apply Sesame Oil (Mayou) to the palm, grasp the medicine pill, wait until defecation occurs; to stop, wash hands with cold water. "Yiqi" refers to Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Dahuang and Poxiao (Natrii Sulfas). Runchang Wan consists of Danggui (Angelicae Sinensis Radix), Shengdi (Rehmanniae Radix), Zhike (Aurantii Fructus), Taoren (Persicae Semen), and Huomaren (Cannabis Semen), equal parts ground into powder, honey-pilled, taken in the morning with rice drink. Gengyi Wan consists of Sheng Lushen (Aloe) and Zhusha Mo (Cinnabaris Pulvis), equal parts, rice-pilled, taken with wine. Simo Tang consists of Renshen (Ginseng Radix et Rhizoma), Wuyao (Tsaoko Fructus), Chenxiang (Aquilariae Lignum Resinatum), and Binglang (Arecae Semen). "Shen Lige" refers to Renshen Lige Wan. "Soushun Fengqi" refers to Soushun Fengqi Wan.