（东垣）
治幽门不通，上冲吸门，噎塞不开，气不得下，大便艰难，名曰下脘不通，治在幽门（下
脘即幽门，胃之下口也。人身上下有七门，皆下冲上也。幽门上冲吸门，吸门即会厌，气喉
上掩
而大
润
也
当归身 升麻 桃仁（研） 红花 甘草（炙，一钱） 生地黄 熟地黄（五分。）或
加槟榔
此手足阳明药也。当归、二地滋阴以养血；桃仁、红花润燥而行血；槟榔下坠而破气滞
；加升麻者，天地之道，能升而后能降，清阳不升，则浊阴不降，经所谓地气上为云，天气
下为雨也（李东垣曰∶肾开窍于二阴，经曰∶大便难者，取足少阴。夫肾主五液，津液足则
大便如常；若饥饱劳役，损伤胃气，反食辛热味浓之物，而助火邪，火伏血中，耗损真阴，
津液亏少，故大便燥结。少阴不得大便，以辛润之；太阴不得大便，以苦泄之；阳结者，散
之；阴结者，温之；伤食者，以苦泄之；血燥者，以桃仁、酒制大黄通之；风燥者，以麻仁
加大黄利之；气涩者，郁李仁、枳实、皂角仁润之。不可概用牵牛、巴豆之类下之，损其津
液，燥
（丹溪）
治胃脘有死血，干燥枯槁，食下作痛，翻胃便秘（胃脘有死血者，嗜酒食辛，躁暴多怒，
积久而成
出也；瘀
可下而食
口也，此
阑门，小
宜随病
韭菜汁 牛乳，等分。时时呷之。有痰阻者，加姜汁。本方去牛乳，加陈酒，治血膈韭
汁专消瘀血。
此足阳明药也。韭汁辛温，益胃消瘀；牛乳甘温，润燥养血；瘀去则胃无阻，血润则大
肠通而食得下矣（朱丹溪曰；反胃膈噎，大便燥结，宜牛羊乳时时咽之，兼服四物汤为上策；
不可
燥血
所言
姜
消
（李东垣）
治疗幽门不通，气机上冲至吸门，导致噎塞不开，气机不能下行，大便艰难，名为下脘不通。治疗应针对幽门（下脘即幽门，是胃的下口）。人身上下共有七门，气机皆由下向上冲逆。幽门上冲至吸门，吸门即会厌，气喉被掩而大润。
当归身、升麻、桃仁（研碎）、红花、甘草（炙，一钱）、生地黄、熟地黄（五分）。或者加入槟榔。
这是手足阳明经的药物。当归、二地（生地黄、熟地黄）滋阴以养血；桃仁、红花润燥而行血；槟榔下坠以破气滞。加入升麻的原因在于，天地运行的规律，能够上升而后才能下降，清阳不升，则浊阴不降，正如经典所说“地气上为云，天气下为雨”。
李东垣说：肾开窍于二阴，经典记载：“大便难者，取足少阴。”肾主五液，津液充足则大便如常；如果因饥饱劳役损伤胃气，又反食辛热味浓之物，从而助长火邪，火伏于血中，耗损真阴，津液亏少，所以大便燥结。少阴经不得大便，用辛润之法；太阴经不得大便，用苦泄之法；阳结者，散之；阴结者，温之；伤食者，用苦泄之法；血燥者，用桃仁、酒制大黄通下；风燥者，用麻子仁加大黄利导；气涩者，用郁李仁、枳实、皂角仁润下。不可一概使用牵牛、巴豆之类的药物攻下，以免损伤津液，使燥结更甚。
（朱丹溪）
治疗胃脘有死血（瘀血），干燥枯槁，进食后作痛，翻胃便秘。（胃脘有死血的原因，多因嗜酒食辛，性情躁暴易怒，积久而成。）
韭菜汁、牛乳，等分。时时呷饮。有痰阻者，加姜汁。本方去掉牛乳，加入陈酒，治疗血膈。韭汁专消瘀血。
这是足阳明经的药物。韭汁辛温，益胃消瘀；牛乳甘温，润燥养血；瘀血去除则胃无阻滞，血液滋润则大肠通畅而食物得以咽下。
朱丹溪说：反胃膈噎，大便燥结，宜用牛羊乳时时咽下，兼服四物汤为上策；不可...（原文此处残缺）燥血...所言...姜...消...
(Li Dongyuan)
Treating obstruction of the幽门 (Houmen, lower orifice of the stomach), where qi rebels upward to the 吸门 (Ximen, gate of inhalation, i.e., epiglottis), causing dysphagia and inability of qi to descend, with difficult defecation. This is named "obstruction of the lower wan" (xia wan). Treatment should focus on the Houmen (the lower wan is the Houmen, the lower outlet of the stomach). In the human body, there are seven gates from top to bottom, through which qi all rebels upward. The Houmen rebels upward to the Ximen; the Ximen is the epiglottis, where the airway is covered and moistened.
Danggui Shen (Radix Angelicae Sinensis), Shengma (Rhizoma Cimicifugae), Taoren (Semen Persicae, pounded), Honghua (Flos Carthami), Gancao (Radix Glycyrrhizae, honey-fried, 1 qian), Shengdihuang (Radix Rehmanniae Preparata), Shudihuang (Radix Rehmanniae Praeparata, 5 fen). Alternatively, add Binglang (Arecae Semen).
These are herbs for the Foot and Hand Yangming meridians. Danggui and the two Dihuangs nourish yin to generate blood; Taoren and Honghua moisten dryness and invigorate blood; Binglang descends to break qi stagnation. The reason for adding Shengma is that the way of heaven and earth is that only after ascending can one descend. If clear yang does not ascend, then turbid yin cannot descend, as stated in the classics: "Earthly qi ascends to become clouds, heavenly qi descends to become rain."
Li Dongyuan said: The Kidney opens into the two yin orifices. The classics state: "For difficult defecation, treat the Foot Shaoyin." The Kidney governs the five fluids; when fluids are sufficient, defecation is normal. However, if damage to Stomach qi occurs due to irregular diet or overwork, and one consumes pungent, hot, and rich foods, thereby assisting fire pathogenic factors, fire hides in the blood, consuming true yin. With deficient fluids, stool becomes dry and constipated. For Shaoyin constipation, use pungent-moistening methods; for Taiyin constipation, use bitter-draining methods; for Yang knotting, disperse it; for Yin knotting, warm it; for food injury, drain with bitterness; for blood dryness, unblock with Taoren and wine-processed Dahuang; for wind dryness, promote movement with Mahuangren and Dahuang; for qi涩 (stagnation), moisten with Yuliren, Zhishi, and Zaojiaoren. One must not generally use purgatives like Qianniu or Badou, as this damages fluids and worsens dryness.
(Zhu Danxi)
Treating dead blood (blood stasis) in the Weiwan (epigastric region), causing dryness and withering, pain upon eating, regurgitation, and constipation. (The cause of dead blood in the Weiwan is often excessive alcohol consumption, pungent foods, irritability, and anger, accumulating over time.)
Jiucaizhi (Fresh Juice of Allium tuberosum) and Niurou (Bovine Milk), in equal parts. Sip frequently. If phlegm obstruction exists, add Jiangzhi (Ginger Juice). To treat blood ge (dysphagia due to blood stasis), remove Niurou from this formula and add Chenjiu (Aged Wine). Jiucaizhi specializes in eliminating blood stasis.
This is a formula for the Foot Yangming meridian. Jiucaizhi is pungent and warm, benefiting the Stomach and eliminating stasis; Niurou is sweet and warm, moistening dryness and nourishing blood. When stasis is removed, the Stomach has no obstruction; when blood is moistened, the Large Intestine becomes unblocked, allowing food to be swallowed.
Zhu Danxi said: For regurgitation, ge syndrome, and dry constipation, it is best to sip cow or sheep milk frequently and concurrently administer Siwu Tang. One must not... [text incomplete] ...dry blood... what was said... Ginger... eliminate...