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
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、浓朴也。硫半丸，即硫黄、半夏
也。握药，即巴豆仁、干姜、韭子、良姜、硫黄、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。
大便燥结总括 / 结燥治法
热性燥结（阳结）表现为能进食、脉象数；寒性燥结（阴结）表现为不能进食、排便迟缓。实性燥结是因食积停滞、热邪结聚于胃；虚性燥结（脾虚）表现为先干硬后稀溏，属脾气虚弱。气机燥结因气机阻隔、下降不利所致；血虚燥结因血液干枯、多见于久病体虚者；风邪燥结多见于素有风疾的患者；若直肠内粪便结硬，则适宜采用导法治疗。
【注】热性燥结即阳结，特点是能进食且脉象浮数有力，常与三阳经的热证同时出现。寒性燥结即阴结，特点是不能进食且脉象沉迟有力，常与三阴经的寒证同时出现。实性燥结即胃中实热导致的大便干硬，常与腹部胀满疼痛同时出现。虚性燥结即脾虚引起的干燥，表现为大便先干硬后稀溏，常与气短、腹部收缩不适同时出现。气机燥结即气道受阻引起的干燥，常与噎膈（吞咽困难）、反胃（食物吐出）同时出现。血虚燥结即血液干枯引起的干燥，常与久病年老体虚同时出现。风邪燥结即长期患有风病所致的干燥，应从治疗风病的角度入手。直肠结硬，即燥屎极其坚硬，结在肛门难以排出，应采用导法治之。
热实证适用三承气汤类方剂，寒实证适用备急丸或温脾汤。温脾汤由大黄、干姜、附子、肉桂、甘草、浓朴组成。寒虚证可用硫黄半夏丸通过握药法治疗；虚燥证可在益气基础上加入硝石和大黄；血燥证宜用润肠丸或更衣丸；气燥证宜用四磨汤或人参利膈丸以行气利膈；风燥证宜用搜风顺气丸。
【注】温脾汤，即由大黄、干姜、附子、肉桂、甘草、浓朴组成的方剂。硫半丸，即由硫黄、半夏组成的方剂。握药法所用的药物包括：巴豆仁、干姜、韭子、高良姜、硫黄、甘遂、白槟榔各五分，研成细末混合均匀，用水调和制成两粒药丸。先用花椒水洗手，再用麻油涂抹手心握住药丸，过一段时间后大便即可泻下，若想停止药效，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、生地黄、枳壳、桃仁、火麻仁各等分研末，蜂蜜为丸，米汤送服，早晨服用。更衣丸，即由生芦荟、朱砂末等分制成饭粒大小的丸药，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。
**General Overview of Dry Stool in Constipation / Treatment Methods for Dryness-Induced Obstruction**
Heat-induced dryness, also known as Yang obstruction (Yang Jie, a type of constipation caused by excess heat), is characterized by the ability to eat and a rapid pulse. Cold-induced dryness, also known as Yin obstruction (Yin Jie, a type of constipation caused by cold deficiency), is characterized by an inability to eat and delayed defecation. Excess dryness results from food stagnation and heat accumulation in the stomach (Wei). Deficiency dryness, related to Spleen deficiency (Pi Xu), presents with stools that are initially hard and later loose. Qi-related dryness arises from blocked Qi mechanism and failure of descent. Blood-deficiency dryness stems from dried-up blood fluids and is common in chronic or elderly patients with deficiency. Wind-related dryness is a pattern seen in patients with long-standing wind disorders. If feces are hardened in the rectum, the guiding method (Dao Fa) is appropriate.
[Note] Heat-induced dryness is synonymous with Yang obstruction; it features the ability to eat and a floating, rapid, and forceful pulse, often appearing concurrently with heat syndromes of the Three Yang meridians. Cold-induced dryness is synonymous with Yin obstruction; it features an inability to eat and a deep, slow, and forceful pulse, often appearing concurrently with cold syndromes of the Three Yin meridians. Excess dryness refers to hardness and dryness due to stomach excess, often appearing concurrently with abdominal fullness and pain. Deficiency dryness refers to dryness due to Spleen deficiency, characterized by stools that are first hard and then loose, often appearing concurrently with shortness of breath and abdominal contraction/discomfort. Qi-related dryness refers to dryness caused by obstruction of the Qi pathway, often appearing concurrently with dysphagia (Ye Ge) and regurgitation (Fan Wei). Blood-deficiency dryness refers to dryness caused by dried-up blood fluids, often appearing concurrently with chronic illness and elderly deficiency. Wind-related dryness refers to dryness resulting from long-standing wind diseases, which should be treated according to wind-disease protocols. Rectal obstruction refers to extremely hard dry stool stuck in the anus, difficult to expel, which should be treated using the guiding method.
**Wen Pi Tang (Warm the Spleen Decoction) and Palm-Holding Medication Method**
For heat-excess patterns, the three Cheng Qi Decoctions (San Cheng Qi Tang) are used. For cold-excess patterns, Bei Ji Wan (Emergency Rescue Pill) or Wen Pi Tang (Warm the Spleen Decoction) are used. Wen Pi Tang consists of Da Huang (Rhubarb Root and Rhizome), Gan Jiang (Dried Ginger), Fu Zi (Prepared Aconite Root), Rou Gui (Cinnamon Bark), Gan Cao (Licorice Root), and Hou Po (Magnolia Bark). For cold-deficiency patterns, Liu Ban Wan (Sulfur and Pinellia Pill) administered via the palm-holding method is used. For deficiency-dryness, Xiao Yao San (Free and Easy Wanderer Powder) modified with adding Mang Xiao (Mirabilite) and Da Huang (Rhubarb Root and Rhizome) is indicated. For blood-deficiency dryness, Run Chang Wan (Moisten the Intestines Pill) or Geng Yi Wan (Changing Clothes Pill) are suitable. For Qi-related dryness, Si Mo Tang (Four Steaming Decoction) or Ren Shen Li Ge Wan (Ginseng Throat-Opening Pill) are used to promote Qi movement and open the diaphragm. For wind-related dryness, Sou Feng Shun Qi Wan (Search Wind and Smooth Qi Pill) is appropriate.
[Note] Wen Pi Tang (Warm the Spleen Decoction) consists of Da Huang (Rhubarb Root and Rhizome), Gan Jiang (Dried Ginger), Fu Zi (Prepared Aconite Root), Rou Gui (Cinnamon Bark), Gan Cao (Licorice Root), and Hou Po (Magnolia Bark). Liu Ban Wan (Sulfur and Pinellia Pill) consists of Liu Huang (Sulfur) and Ban Xia (Pinellia Tuber). The ingredients for the palm-holding medication include Ba Dou Ren (Croton Seed), Gan Jiang (Dried Ginger), Jiu Zi (Allium Tuberosum Seed), Liang Jiang (Galangal Rhizome), Liu Huang (Sulfur), Gan Sui (Kansui Root), and Bai Bing Lang (Areca Seed), each at five fen, ground into powder and mixed evenly. Mix with water to form two pills. Wash hands with Sichuan pepper water first, apply sesame oil to the palms, hold the pills, and after some time, diarrhea will occur. To stop the effect, wash hands with cold water. "Yi Qi" refers to Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with Da Huang (Rhubarb Root and Rhizome) and Pu Xiao (Mirabilite). Run Chang Wan (Moisten the Intestines Pill) consists of Dang Gui (Angelica Sinensis Root), Sheng Di Huang (Rehmannia Root), Zhi Qiao (Aurantium Fruit), Tao Ren (Peach Seed), and Huo Ma Ren (Hemp Seed), all in equal parts, ground into powder, formed into honey pills, taken in the morning with rice drink. Geng Yi Wan (Changing Clothes Pill) consists of Sheng Lu Hui (Aloe) and Zhu Sha (Cinnabar) in equal parts, formed into rice-grain-sized pills, taken with wine. Si Mo Tang (Four Steaming Decoction) consists of Ren Shen (Ginseng Root), Wu Yao (Lindera Root), Chen Xiang (Aquilaria Wood), and Bing Lang (Areca Seed). "Shen Li Ge" refers to Ren Shen Li Ge Wan (Ginseng Throat-Opening Pill). "Sou Feng Shun Qi" refers to Sou Feng Shun Qi Wan (Search Wind and Smooth Qi Pill).