千金疗大便秘涩不通神方。
猪羊胆
上一味，以筒灌三合许，令深入即出矣，不尽，须臾更灌。一方加冬葵子汁和之，又有
椒
豉汤五合，猪膏三合，灌之佳。（经心录同）
又三黄汤，疗下焦热结，不得大便方。
大黄（三两） 黄芩（二两） 甘草（炙一两） 栀子（二七枚）
上四味切，以水五升，煮取一升八合，分三服，若秘，加芒硝二两。（并出第十五卷中）
备急疗猝大便闭涩不通方。
葛氏云，削瓜菹如指大，导下部中，即效。
又方
烧乱发灰，三指捻投水半升，一服。
又方
绵裹盐作三丸如指大，纳下部中。
又方
煎蜜令强，加干姜末，和丸如指，导下部中，姚云，欲死者，蜜三升，微火煎如饴，投
冷水中，令凝丸如大指，长三四寸，导之良。
又方
猪胆一枚，纳下部中，姚云，疗七八日奔气伤心欲死者，须臾便通良。（范汪同）
病源大便失禁者，大肠与肛门虚冷滑故也，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。
又关格大便不通，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，
格，阴
关格而
而手足
四卷中）
范汪疗下部闭不通方。
取乌梅五颗，着汤渍，须臾出核，取熟捣之如弹丸，纳下部中，即通也。（肘后同）
又方
取蒴 根一把捣末，水和绞去滓，强人服一升，数用有效，兼疗香港脚。
又疗大小便不通，三阳实，大便不通方。
榆白皮（三两） 桂心（二两） 滑石（六两） 甘草（三两炙）
上四味，以水一斗，煮取三升，分三服。（集验同并出第十六卷中）
集验疗关格之病，肠中转痛，不得大小便，一日一夜，不瘥欲死方。
芒硝三两，纸三重裹，于炭火内烧令沸，安一升水中尽服之，当先饮温汤一二升以来，
吐出，乃饮芒硝汁也。（肘后同）
千金疗老人小儿大便失禁方。
灸两脚大KT 趾去爪甲一寸，三壮。
又方
灸足大趾奇间各三壮。
又疗大小便不通方。
灸脐下一寸三壮。
又方
灸横纹一百壮。
又方
葵子（一升） 竹叶（一把）
上二味，以水一升，煮一沸，顿服之。
又方
葵子（一升） 榆白皮（切一升）
上二味，以水五升，煮取二升，分二服。
又方
水三升，煮葵子一升，去滓，取一升，纳猪膏一升，空肚一服。
又方
盐半升，合蜜三合，同煎如饴，出之，着冷水中，丸如指大，深纳下部中，立通。（并
出第十五卷中）
千金翼濡脏汤，主大小便不通，六七日腹中有燥粪，寒热烦迫，短气汗出腹满方。
生葛根（二斤切） 猪膏（二斤） 大黄（一两切）
上三味，以水七升，煮取五升，去滓，纳膏，煎取三升，澄清，强人顿服之，羸人分再
服。（出第七卷中）
备急葛氏疗猝关格，大小便不通，支满欲死，二三日则杀人方。
盐以苦酒和，涂脐中，干又易之。（必效同）
陶氏猝大小便不通方。
纸裹盐烧，投水中服之。
姚氏风寒冷气入肠，忽痛坚急如吹状，大小便不通，或小肠有气结，如升大胀起，名为
关格病。
又疗大小便不利方。
苦参 滑石 贝齿（各等分）
上三味捣筛为散，每服饮下一匕，或煮葵根汁服之，弥佳。（文仲同出第六卷中）
古今录验疗关格大小便不通方。
以水三升，煮盐三合使沸，适寒温，以竹筒灌下部，立通也。
又疗大小便不通方。
通草（四两） 郁李仁（三两去皮） 车前子（五合一方一升） 黄芩（三两） 朴硝
（
四两） 瞿麦（三两）
上六味切，以水八升，煮取二升，去滓，分三服。（经心录同）
又方
取生土瓜根捣取汁，以水解之，于筒中吹纳下部，即通。（并出第二十六卷中）
经心录疗关格大小便不通方。
芒硝 乌梅 榆白皮（各五两） 芍药 杏仁（去皮尖各四两） 麻子仁（三两）
大黄（八两）
上七味切，以水七升，煮取三升，分为三服，一方无乌梅，加枳实干地黄各二两。
又疗大小便不通方。
滑石（二两） 葵子 榆白皮（各一两）
上三味下筛为散，煮麻子汁一升半，取二匕和服，两服即通。（并出第二卷中）
近效疗大小便不通方。
含硝石（吐去水）
《千金方》治疗大便秘结不通的神效方。
猪胆或羊胆：取上一味药，用竹筒灌入约三合（容量单位），深入肛门后取出；若未排尽，片刻后再灌一次。另一方法加入冬葵子汁混合使用；还有用五合豆豉汤和三合猪油灌肠的方法，效果更佳。（《经心录》记载相同）
又有三黄汤，治疗下焦热结导致的大便不通方。
大黄（三两） 黄芩（二两） 甘草（炙制一两） 栀子（十四枚）
以上四味药切碎，用水五升，煎煮至一升八合，分三次服用；如果便秘严重，加芒硝二两。（均出自第十五卷）
备急方治疗突然大便闭涩不通方。
葛氏说，将瓜菹（腌制的瓜）削成手指粗细，插入下部（肛门）中，立即见效。
又一方：
烧乱发成灰，用三个手指捏取投入半升水中，一次性服下。
又一方：
用绵纸包裹盐做成三颗如手指粗细的丸药，纳入下部（肛门）中。
又一方：
煎蜂蜜使其浓稠，加入干姜末，调和制成如手指粗细的丸药，插入下部（肛门）中。姚氏说，对于病情危重欲死者，用蜜三升，用微火煎至像饴糖一样浓稠，投入冷水中，使其凝结成如大拇指粗细、长三四寸的条状物，插入下部，效果良好。
又一方：
取猪胆一枚，纳入下部（肛门）中。姚氏说，治疗七八天奔气上冲伤心欲死者，片刻之后即可通畅良效。（范汪记载相同）
《病源论》指出，大便失禁的原因，是大肠与肛门虚寒滑利所致。肛门是大肠的外候，两者共同主管排泄糟粕。既然虚弱且寒冷滑利，气机不能温煦固摄，所以导致大便失禁。
又有关格证导致的大便不通，称为内关；小便不通，称为外格；大小便都不通，称为关格。这是由于阴阳之气不和……（原文此处有残缺/错简，涉及“格”、“阴”、“关格而”、“手足”等字，推测原意关于阴阳格拒及四肢厥冷等症状，但根据规则不推测，仅翻译可见部分逻辑关系）。此段文字在第四卷中。
范汪治疗下部闭塞不通方。
取乌梅五颗，放入热水中浸泡，片刻后去核，捣烂如弹丸大小，纳入下部（肛门）中，即可通畅。（《肘后备急方》记载相同）
又一方：
取蒴藋根一把捣碎成末，用水调和绞汁去渣，体质强壮的人服用一升，多次使用有效，兼治脚气病。
又治疗大小便不通，三阳实证，大便不通方。
榆白皮（三两） 桂心（二两） 滑石（六两） 甘草（炙制三两）
以上四味药，用水一斗，煎煮至三升，分三次服用。（《集验方》记载相同，均出自第十六卷）
《集验方》治疗关格病，肠道转动疼痛，大小便不得排出，一日一夜不好转，痛苦欲死方。
芒硝三两，用三层纸包裹，在炭火中烧至沸腾，放入一升水中完全溶解后服用。应当先喝一二升温开水，待吐出胃中宿食后，再饮用芒硝水。（《肘后备急方》记载相同）
《千金方》治疗老人小儿大便失禁方。
灸双脚大趾，距离爪甲一寸处，各灸三壮。
又一方：
葵子（一升） 竹叶（一把）
以上两味药，用水一升，煮开一次，一次性服下。
又一方：
葵子（一升） 榆白皮（切碎一升）
以上两味药，用水五升，煎煮至二升，分两次服用。
又一方：
用水三升，煮葵子一升，去渣，取一升药液，加入猪油一升，空腹一次性服下。
又一方：
盐半升，配合蜜三合，一同煎煮至像饴糖一样浓稠，取出，放入冷水中，制成如手指粗细的丸药，深深纳入下部（肛门）中，立即通畅。（均出自第十五卷）
《千金翼方》濡脏汤，主治大小便不通，六七天腹中有燥屎，伴有寒热烦躁迫促，短气汗出，腹部胀满方。
生葛根（二斤切碎） 猪膏（二斤） 大黄（一两切碎）
以上三味药，用水七升，煎煮至五升，去渣，加入猪膏，再煎煮至三升，澄清后，体质强壮的人一次性服下，体弱的人分两次服用。（出自第七卷）
《备急方》葛氏治疗突然关格，大小便不通，胸腹胀满痛苦欲死，二三天则致人死亡方。
用盐与苦酒（醋）调和，涂抹在脐中，干了就更换。（《必效方》记载相同）
姚氏认为风寒冷气侵入肠道，忽然疼痛坚硬紧急如同吹胀状，大小便不通，或者小肠有气结聚，如升般大胀起，这叫做关格病。
又治疗大小便不利方。
苦参 滑石 贝齿（各等分）
以上三味药捣碎过筛成散剂，每次服药饮送下一匕（量器名），或者煮葵根汁送服更好。（文仲记载相同，均出自第六卷）
《古今录验》治疗关格大小便不通方。
用水三升，煮盐三合至沸腾，待温度适宜时，用竹筒灌入下部（肛门），立即通畅。
又治疗大小便不通方。
通草（四两） 郁李仁（三两去皮） 车前子（五合，另一方用一升） 黄芩（三两） 朴硝（四两） 瞿麦（三两）
以上六味药切碎，用水八升，煎煮至二升，去渣，分三次服用。（《经心录》记载相同）
又一方：
取生土瓜根捣取汁，用水化解药汁，用竹筒吹入下部（肛门），即通畅。（均出自第二十六卷）
《经心录》治疗关格大小便不通方。
芒硝 乌梅 榆白皮（各五两） 芍药 杏仁（去皮尖各四两） 麻子仁（三两） 大黄（八两）
以上七味药切碎，用水七升，煎煮至三升，分为三次服用。另一方没有乌梅，加枳实、干地黄各二两。
又治疗大小便不通方。
滑石（二两） 葵子 榆白皮（各一两）
以上三味药下筛成散剂，煮麻子汁一升半，取两匕药粉调和服用，服两次即通畅。（均出自第二卷）
The *Qianjin Fang* (Thousand Gold Formulas) provides a divine prescription for treating severe constipation and inability to defecate.
**Pig or Sheep Gallbladder:** Take one of these, pour approximately three *ge* (a traditional unit of volume) into a bamboo tube, insert it deeply into the anus, and then remove it. If defecation is not complete, repeat the insertion after a short while. Another method involves mixing in juice from *Malva verticillata* seeds (*Dongkuizi*). Alternatively, five *ge* of Fermented Soybean Decoction (*Douchi Tang*) and three *ge* of lard may be used for enema, which yields good results. (Recorded identically in *Jingxin Lu*).
**Sanhuang Tang (Three-Yellow Decoction):** Treats lower jiao heat accumulation causing constipation.
*Rhubarb Root (Dahuang)* (3 liang), *Scutellaria Root (Huangqin)* (2 liang), *Licorice Root (Gancao)* (roasted, 1 liang), *Gardenia Fruit (Zhizi)* (14 fruits).
Chop the above four ingredients, boil in five sheng of water until reduced to one sheng eight he, and divide into three doses. If constipation is severe, add two liang of Mirabilite (*Mangxiao*). (All from Volume 15).
**Beiji Fang (Emergency Preparation Formula):** Treats sudden onset of fecal impaction.
Ge Shi states: Slice pickled melon (*Guazu*) into strips the size of a finger, insert into the lower orifice (anus), and efficacy will be immediate.
Another formula:
Burn human hair to ash, take a pinch with three fingers, dissolve in half a sheng of water, and take as a single dose.
Another formula:
Wrap salt in cotton wool to form three pills the size of a finger, and insert into the lower orifice.
Another formula:
Boil honey until thick, mix with powdered dried ginger, and shape into pills the size of a finger for insertion into the lower orifice. Yao Shi notes that for critical cases nearing death, use three sheng of honey, boil gently over low fire until it resembles malt syrup, then plunge into cold water to solidify into rods the size of a thumb, three to four cun long, and insert them; this is effective.
Another formula:
Insert one pig gallbladder into the lower orifice. Yao Shi notes this treats cases where "rushing qi" attacks the heart over seven to eight days, leading to near-death states; relief occurs quickly. (Identical to Fan Wang's record).
According to *Bingyuan Lun* (Source of Diseases), fecal incontinence is caused by deficiency-cold and slipperiness of the large intestine and anus. The anus is the external manifestation of the large intestine, both governing the passage of waste. Due to weakness, coldness, and slipperiness, the qi fails to warm and control the sphincter, resulting in incontinence.
Regarding Guan-Ge syndrome (Obstruction-Rebellion) causing constipation: inability to pass stool is called Internal Obstruction (Nei Guan); inability to urinate is called External Rebellion (Wai Ge); when both are blocked, it is termed Guan-Ge. This arises from disharmony between Yin and Yang Qi... [Text fragmentary]. (From Volume 4).
Fan Wang’s formula for lower orifice obstruction:
Take five dark plums (*Wumei*), soak in hot water, remove pits after a moment, mash into balls the size of a bullet, and insert into the lower orifice for immediate relief. (Identical to *Zhouhou Beiji Fang*).
Another formula:
Take a handful of *Akebia Caulis* root (*Shuodi Gen*), crush into powder, mix with water, strain, and drink one sheng for robust individuals. Repeated use is effective; also treats beriberi.
Formula for San Yang Excess pattern causing constipation:
*Bark of Ulmus Macrocarpa (Yubai Pi)* (3 liang), *Cinnamon Twig (Guixin)* (2 liang), *Talcum (Huashi)* (6 liang), *Licorice Root (Gancao)* (roasted, 3 liang).
Boil the above four ingredients in one dou of water until reduced to three sheng, divide into three doses. (Identical to *Jiyan Fang*, from Volume 16).
*Jiyan Fang* for Guan-Ge disease with intestinal colic, inability to pass stool or urine for one day and night, suffering unto death:
Roast three liang of Mirabilite (*Mangxiao*) wrapped in triple-layered paper over charcoal fire until boiling, then dissolve in one sheng of water and drink entirely. First, drink one to two sheng of warm water to induce vomiting of retained food, then consume the Mirabilite solution. (Identical to *Zhouhou Beiji Fang*).
*Qianjin Fang* for fecal incontinence in elderly and children:
Moxibustion on the big toes of both feet, one cun distal to the nail bed, three moxa cones per point.
Another formula:
Moxibustion on the extra point "Jian" on the big toe, three moxa cones per side.
Another formula for urinary and fecal retention:
Moxibustion one cun below the umbilicus, three moxa cones.
Another formula:
Moxibustion on the transverse skin fold, one hundred moxa cones.
Another formula:
*Malva Seeds (Kuizi)* (one sheng), *Bamboo Leaves (Zhuye)* (one bundle).
Boil in one sheng of water until it boils once, take in one dose.
Another formula:
*Malva Seeds (Kuizi)* (one sheng), *Bark of Ulmus Macrocarpa (Yubai Pi)* (chopped, one sheng).
Boil in five sheng of water until reduced to two sheng, divide into two doses.
Another formula:
Boil one sheng of *Malva Seeds (Kuizi)* in three sheng of water, strain, take one sheng of liquid, add one sheng of lard, and take on an empty stomach in one dose.
Another formula:
Half a sheng of salt combined with three *ge* of honey, boiled until resembling malt syrup. Remove from heat, place in cold water to form pills the size of a finger, insert deeply into the lower orifice for immediate relief. (All from Volume 15).
*Qianjin Yifang*’s Ruzang Tang treats urinary and fecal retention, dry feces in the abdomen for six to seven days, alternating chills and fever, irritability, shortness of breath, sweating, and abdominal fullness.
*Fresh Kudzu Root (Sheng Gegen)* (two jin, chopped), *Lard (Zhigao)* (two jin), *Rhubarb Root (Dahuang)* (one liang, chopped).
Boil in seven sheng of water until reduced to five sheng, strain, add lard, and simmer until reduced to three sheng. Clarify the liquid. Robust individuals take in one dose; frail individuals take in two divided doses. (From Volume 7).
Ge Shi’s *Beiji Fang* for sudden Guan-Ge, urinary and fecal retention, chest/abdominal fullness causing near-death state, fatal within two to three days:
Mix salt with vinegar (*Kujiu*), apply to the umbilicus, replace when dry. (Identical to *Bixiao Fang*).
Tao Shi’s formula for sudden urinary and fecal retention:
Wrap salt in paper, burn red hot, dissolve in water, and drink.
Yao Shi describes Wind-Cold invading the intestines, causing sudden sharp pain and rigidity like inflation, with urinary/fecal retention or qi stagnation in the small intestine causing distension the size of a measuring cup, termed Guan-Ge disease.
Another formula for difficult urination and defecation:
*Sophora Root (Kushen)*, *Talcum (Huashi)*, *Concha Arcae (Beichi)* (equal parts).
Crush and sieve into powder. Take one bi (spoonful) with water, or better, decocted *Malva Root* juice. (Identical to Wen Zhong, from Volume 6).
*Gujin Luyan* for Guan-Ge with urinary and fecal retention:
Boil three *ge* of salt in three sheng of water until boiling. When temperature is suitable, use a bamboo tube to irrigate the lower orifice for immediate relief.
Another formula for urinary and fecal retention:
*Herba Tetrapanacis (Tongcao)* (4 liang), *Pericarpium Pruni Armeniacae Amarum (Yuliren)* (pitted, 3 liang), *Semen Plantaginis (Cheqianzi)* (0.5 sheng, alternative uses 1 sheng), *Scutellaria Root (Huangqin)* (3 liang), *Mirabilite (Puxiao)* (4 liang), *Herba Dianthi (Qumai)* (3 liang).
Chop the above six ingredients, boil in eight sheng of water until reduced to two sheng, strain, and divide into three doses. (Identical to *Jingxin Lu*).
Another formula:
Crush fresh *Trichosanthes Radix (Tugua Gen)* to extract juice, dilute with water, and blow into the lower orifice using a tube for immediate relief. (All from Volume 26).
*Jingxin Lu* for Guan-Ge with urinary and fecal retention:
*Mirabilite (Mangxiao)*, *Dark Plum (Wumei)*, *Bark of Ulmus Macrocarpa (Yubai Pi)* (each 5 liang), *White Peony Root (Shaoyao)*, *Apricot Seed (Xingren)* (pitted, each 4 liang), *Cannabis Seed (Maziren)* (3 liang), *Rhubarb Root (Dahuang)* (8 liang).
Chop the above seven ingredients, boil in seven sheng of water until reduced to three sheng, divide into three doses. An alternative version omits Wumei and adds two liang each of Immature Bitter Orange (*Zhishi*) and Prepared Rehmannia Root (*Shengdihuang*).
Another formula for urinary and fecal retention:
*Talcum (Huashi)* (2 liang), *Malva Seeds (Kuizi)*, *Bark of Ulmus Macrocarpa (Yubai Pi)* (each 1 liang).
Sieve into powder. Boil hemp seed juice (1.5 sheng), mix with two bi of powder, and take. Two doses yield relief. (All from Volume 2).
*Jinxiao Fang* for urinary and fecal retention:
Hold Niter (*Xiaoshi*) in mouth (spit out water after dissolving).