（即肛门也，又谓之下极。旧重出大便者非）属手太阴肺经（孙景思曰∶肛门者，肺之
下口也，内通于肺，故曰魄门。肺与大肠为表里，故肺实则大肠热，热则秘结；肺虚则大肠寒，寒则脱肛。《素
问》曰∶肺咳不已，则大肠受之，大肠咳状，咳而遗矢。王海藏曰∶贲门上主往来，魄门下主收闭，故肺与大
肠为通道。注∶贲门，胃门也）。又属手阳明大肠经（《素问》曰∶大肠者传道之官，变化出焉。注∶传道，谓
传不洁之道。变化，谓变化物之形。王海藏曰∶年高虚人，大肠燥结，不可过泄者，脉浮在气，杏仁、陈皮主
之；脉沉在血，桃仁、陈皮主之。所以俱用陈皮者，以手阳明与足太阴，俱为表里也。朱丹溪曰∶大肠为邪坠
下之重，其重至圊后不减；大肠虚滑不收之重，其重至圊后随减，以御米壳等涩剂，固其滑，收其气，用亦愈也
）。又属足太阳膀胱经（《灵枢》曰∶足太阳之正，别入于 中，其一道下尻五寸，别入于肛。《中藏》曰∶
下焦实热，则小便不通，大便难苦重痛；虚寒，则大小便泄下不止。李东垣曰∶防己，大苦寒纯阴，泄血中之
湿热，通血中之滞塞，补阴泻阳，助秋冬，泻春夏之药也。下焦有湿热，流入十二经，以致二阴不通，方可审
用；若上焦湿热，
则不可用。陈良甫曰∶脏腑气实，皆生于湿热，随所停之处而成病。故热结于大肠，则大便不通；热结于小肠，
则小便不通；若大小肠俱热所结，则烦满，而大小便俱不通也）。兼属足少阴肾经（《灵枢》曰∶厥气走喉而
不能言，手足清，大使不利，取足少阴。《素问》曰∶北方黑色，入通于肾，开窍于二阴，畏湿。王太仆曰∶
肾气化，则二阴通，二阴 ，则胃填满。盖肾者，胃之关也。王海藏曰∶以在下言之，则便溺俱阴；以前后言
之，则前气后血∶以肾言之，则总主大小便难。溺塞闭结，俱为水少。经言∶热淫于内，治以咸寒，佐以苦辛。
故用芒硝、大黄相须为使。戴复庵曰∶每日五更初洞泻者，此病在肾分，米饮下二神丸，或合五味子散，名为
四神丸，治之尤妙）。又属足太阴脾经、阳明胃经（《灵枢》曰∶厥而腹中 ，便溲难，取足太阴。《素
问》曰∶仓廪不藏者，门户不要也。注∶仓廪谓脾胃，门户谓魄门，要，谓禁要也。王海藏曰∶汗多，胃热，
便难，三者皆因燥热而亡津液，即所谓脾约症也。经云∶燥者润之。故张仲景用麻子仁入足太阴、手阳明，以
润二经之燥，肠结可通也。张洁古曰∶脏腑之秘，不可一概治疗。胃实而秘者，能饮食，小便赤，当以麻仁丸
主之；胃虚不能食，小便清利，浓朴汤主之。实者秘物也，虚者秘气也。戴复庵曰∶痢疾，古名滞下，以气滞
成积，积以成痢，治法当以顺气为先，须当开胃，故曰无饱死痢疾）。又属足厥阴肝经（《灵枢》曰∶足厥阴
所生病者，胸满，呕逆，飧泄。又曰∶阴络伤，则血内溢，血内溢，则后血。刘河间曰∶大便涩滞，由火盛制
金，不能平木，肝木生风，风能胜湿，热能耗液故也）。
（肛门，也称为下极。旧书中重复记载大便的内容是不正确的）归属于手太阴肺经（孙景思说：肛门是肺的下口，内部连通于肺，所以称为魄门。肺与大肠互为表里，所以肺气实则大肠热，热则导致便秘；肺气虚则大肠寒，寒则导致脱肛。《素问》说：肺咳不止，病邪会传至大肠，大肠咳的症状是咳嗽时遗屎。王海藏说：贲门主管气机的往来，魄门主管气机的收闭，所以肺与大肠构成通道。注：贲门即胃门）。又归属于手阳明大肠经（《素问》说：大肠是传导的官职，负责变化排泄物。注：传导，指传递不洁之物。变化，指改变物质的形态。王海藏说：年老体虚之人，若大肠燥结，不可过度泻下，若脉浮在气分，用杏仁、陈皮主治；若脉沉在血分，用桃仁、陈皮主治。之所以都使用陈皮，是因为手阳明大肠经与足太阴脾经互为表里。朱丹溪说：大肠湿热下坠的重感，若在排便后不减；若是大肠虚滑不收的重感，则在排便后随即减轻，可用御米壳等收敛固涩的药物，以固摄滑脱，收敛气机，也能治愈）。又归属于足太阳膀胱经（《灵枢》说：足太阳的正经，别行进入膻中部位，其中一条支脉下行至尾骨五寸处，别行进入肛门。《中藏经》说：下焦实热，则小便不通，大便困难且痛苦沉重疼痛；若为虚寒，则大小便泄下不止。李东垣说：防己味大苦大寒，属纯阴之品，能泄血中的湿热，通利血中的滞塞，具有补阴泻阳、助益秋冬、泻除春夏邪气的功效。只有当下焦有湿热，流入十二经脉，导致前后二阴不通时，方可审慎使用；若上焦有湿热，则不可用。陈良甫说：脏腑之气实，多由湿热引起，随其停留之处而发病。所以热结于大肠，则大便不通；热结于小肠，则小便不通；若大小肠俱受热结，则烦闷胀满，大小便均不通）。兼归属于足少阴肾经（《灵枢》说：厥逆之气上冲咽喉而不能言语，手足寒冷，大便不利，应取足少阴经穴。《素问》说：北方黑色，内通于肾，开窍于前后二阴，畏惧湿气。王太仆说：肾气化功能正常，则前后二阴通畅；前后二阴通畅，则胃中食物得以充实。因为肾是胃的关口。王海藏说：从位置在下来说，大小便均属阴；以前后来说，前阴主气，后阴主血；从肾的角度来说，总司大小便的困难。小便闭塞不通，都属于水液不足。经文说：热邪蕴结于内，用咸寒药物治疗，辅以苦辛药物。所以使用芒硝、大黄相须为用。戴复庵说：每天五更初出现洞泻的，此病在肾分，用米饮送服二神丸，或合五味子散，名为四神丸，治疗尤为巧妙）。又归属于足太阴脾经、足阳明胃经（《灵枢》说：厥逆且腹中胀满，大便小便困难，取足太阴经穴。《素问》说：仓廪不能储藏，是因为门户不能约束。注：仓廪指脾胃，门户指魄门，要，指约束禁固。王海藏说：汗多、胃热、大便难，这三者都因燥热而耗伤津液，这就是所谓的脾约症。经文说：燥者润之。所以张仲景使用麻子仁入足太阴、手阳明经，以滋润这两条经脉的燥邪，肠道结滞即可通畅。张洁古说：脏腑的秘结，不可一概而论进行治疗。胃实而秘结的，能进食，小便赤，应当用麻仁丸主治；胃虚不能进食，小便清利，用浓朴汤主治。实者是秘结有形之物，虚者是秘结无形之气。戴复庵说：痢疾，古名滞下，因气滞而成积，积久成痢，治法应当以顺气为先，必须开胃，所以说没有吃饱而死在痢疾上的）。又归属于足厥阴肝经（《灵枢》说：足厥阴经所生的疾病，包括胸满、呕吐逆气、完谷不化的泄泻。又说：阴络受伤，则血液内溢，血液内溢，则出现便血。刘河间说：大便涩滞，是由于火盛克制金（肺），不能平抑木（肝），肝木生风，风能胜湿，热能耗伤津液所致）。
(The anus, also referred to as the lower extremity. The old texts' redundant records regarding defecation are incorrect.) It belongs to the Hand-Taiyin Lung Meridian (Sun Jingsi stated: "The anus is the lower outlet of the lung, internally connecting to the lung, hence called the 'Gate of Po' (Hun and Po). The Lung and Large Intestine are exterior-interiorly related; thus, when Lung Qi is excess, the Large Intestine becomes hot, leading to constipation; when Lung Qi is deficient, the Large Intestine becomes cold, leading to rectal prolapse." *Suwen* states: "If lung cough persists, the pathogen transmits to the Large Intestine. The manifestation of Large Intestine cough involves involuntary defecation during coughing." Wang Haicang stated: "The cardiac orifice (Bumen) governs the movement of Qi, while the Gate of Po governs retention; therefore, the Lung and Large Intestine form a channel." Note: Bumen refers to the gastric cardia.) It also belongs to the Hand-Yangming Large Intestine Meridian (*Suwen* states: "The Large Intestine is the official of transmission, responsible for transformation and excretion." Note: Transmission refers to conveying unclean matter; Transformation refers to altering the form of substances. Wang Haicang stated: "In elderly or deficient individuals with dry stool accumulation in the Large Intestone, excessive purgation should be avoided. If the pulse is floating indicating involvement of Qi, Apricot Seed (Xingren) and Tangerine Peel (Chenpi) are indicated; if the pulse is deep indicating involvement of Blood, Peach Kernel (Taoren) and Tangerine Peel (Chenpi) are indicated. Tangerine Peel is used in both cases because the Hand-Yangming Large Intestine Meridian and Foot-Taiyin Spleen Meridian are exterior-interiorly related. Zhu Danxi stated: "The sensation of heaviness from Large Intestine damp-heat sinking downward remains unchanged after defecation; whereas the heaviness from Large Intestine deficiency and slipping does not decrease after defecation. In such cases, astringent agents like Pericarpium Oryzae Sativae (Yumiqiao) can be used to secure slipping and gather Qi, which may also lead to recovery.") It also belongs to the Foot-Taiyang Bladder Meridian (*Ling Shu* states: "The regular pathway of the Foot-Taiyang diverges into the chest cavity; one branch descends five cun below the sacrum and diverges into the anus." *Zhong Zang Jing* states: "Excess-heat in the Lower Jiao leads to urinary obstruction and difficult, painful, heavy defecation; Deficiency-cold leads to continuous incontinence of both urine and feces." Li Dongyuan stated: "Fangji (Stephania Root) is extremely bitter and cold, purely Yin in nature. It drains damp-heat from the blood and unblocks blood stasis, tonifying Yin and draining Yang, assisting Autumn/Winter energies, and draining Spring/Summer pathogens. It should only be used cautiously when damp-heat in the Lower Jiao flows into the Twelve Meridians causing obstruction of both yin openings; it is contraindicated if damp-heat is in the Upper Jiao. Chen Liangfu stated: "Excess Qi in the Zang-Fu organs often arises from damp-heat, manifesting as disease where it stagnates. Thus, heat binding in the Large Intestine causes constipation; heat binding in the Small Intestine causes urinary retention; if heat binds in both, it results in irritability, fullness, and obstruction of both urine and feces.") It is also associated with the Foot-Shaoyin Kidney Meridian (*Ling Shu* states: "When rebellious Qi rushes to the throat causing aphonia, accompanied by cold limbs and difficult defecation, points on the Foot-Shaoyin should be selected." *Suwen* states: "The color Black corresponds to the North and enters the Kidney, opening through the two yin openings, and fears dampness." Wang Tai stated: "When Kidney Qi transforms properly, the two yin openings are patent; when the two yin openings are patent, the Stomach is filled. The Kidney serves as the gatekeeper of the Stomach." Wang Haicang stated: "From the perspective of location below, both urination and defecation belong to Yin; from the perspective of anterior/posterior, the anterior governs Qi and the posterior governs Blood; from the perspective of the Kidney, it generally governs difficulties in both urination and defecation. Urinary blockage and retention are all due to insufficient fluids. The Classic states: 'For heat rampant within, treat with salty-cold herbs, assisted by bitter-pungent ones.' Therefore, Mangxiao (Natrii Sulfas) and Dahuang (Rhei Radix et Rhizoma) are used synergistically. Dai Fu'an stated: "Morning diarrhea occurring at dawn indicates pathology in the Kidney division. Administer Ershen Wan with rice water, or combine with Wuweizi San, known as Sishen Wan, which is particularly effective.") It is also associated with the Foot-Taiyin Spleen Meridian and Foot-Yangming Stomach Meridian (*Ling Shu* states: "In cases of cold extremities with abdominal distension and difficulty in defecation and urination, select points on the Foot-Taiyin." *Suwen* states: "The granaries cannot store because the gates fail to restrain." Note: Granaries refer to the Spleen and Stomach; Gates refer to the Gate of Po; Restrain means to control. Wang Haicang stated: "Profuse sweating, Stomach heat, and difficult defecation are all caused by dry-heat consuming body fluids, known as the Pi Yue Syndrome (Spleen Constraint). The Classic states: 'For dryness, moisten.' Therefore, Zhang Zhongjing used Huomaren (Cannabis Fructus) to enter the Foot-Taiyin and Hand-Yangming meridians to moisten their dryness, allowing intestinal constriction to resolve. Zhang Jiegu stated: "Constipation of the Zang-Fu organs cannot be treated uniformly. For Stomach excess constipation, characterized by ability to eat and dark urine, Maziren Wan is indicated. For Stomach deficiency constipation, characterized by inability to eat and clear urine, Houpo Tang is indicated. Excess constipation involves tangible material retention; deficiency constipation involves intangible Qi stagnation." Dai Fu'an stated: "Dysentery, anciently named 'Zhi Xia' (Stagnant Downward), arises from Qi stagnation forming accumulation, which turns into dysentery. Treatment should prioritize regulating Qi and opening the stomach; thus, one never dies of dysentery from overeating.") It is also associated with the Foot-Jueyin Liver Meridian (*Ling Shu* states: "Diseases generated by the Foot-Jueyin include chest fullness, vomiting and rebellious Qi, and undigested food diarrhea." It also states: "Injury to the Yin collaterals causes internal bleeding; internal bleeding results in hematochezia." Liu Hejian stated: "Astringent and sluggish defecation occurs because Fire excess suppresses Metal (Lung), failing to control Wood (Liver). Liver Wood generates Wind, Wind overcomes Dampness, and Heat consumes fluids.")