洁古云∶脏腑之秘，不可一概论治。有虚秘，有实秘，有风秘，有冷秘，有气秘，有热
秘，
有老人津液干燥，妇人分产亡血，及发汗利小便，病后血气未复，皆能作闭。不可一例用硝
、黄利药，巴豆、牵牛尤在所禁。按∶仲景云，脉浮而数，能食不大便者，为实，名曰阳结
，期十七当剧。脉沉而尽，不能食，身体重，大便反硬，名曰阴结，期十四日当剧。东垣云
∶阳结者散之，阴结者热之。前所云实闭、热闭，即阳结。所云冷闭、虚闭，即阴结也。
虚闭有二，一以阴虚，一以阳虚也。凡下焦阳虚，则阳气不行，阳气不行，则不能传送
而阴
凝于下。下焦阴虚，则精血枯燥，精血枯燥，则津液不到，而肠脏干槁。治阳虚者，但益其
火，则阴凝自化。治阴虚者，但壮其水，则泾渭自通。
苁蓉润肠丸
肉苁蓉（酒浸，焙，二两） 沉香（另研，一两）
为末，用麻子仁汁打糊为丸，梧子大，每服七十丸，空心服。
益血润肠丸
熟地（六两） 杏仁（炒去皮尖） 麻仁（各三两，以上三味各杵膏） 枳壳 橘红（各二两
半） 阿胶（炒） 肉苁蓉（各一两半） 苏子 荆芥（各一两） 当归（三两）
末之，以前三味膏同杵千余下，加炼蜜为丸如梧子大，每服五六十丸，空心白汤下。
五仁丸
柏子仁（半两） 松子仁 桃仁 杏仁（各一两） 郁李仁（一钱） 陈皮（四两，另为末）
上将五仁另研如膏，入陈皮末研匀，炼蜜丸梧子大，每服五十丸，空心米饮下。
黄 汤 治老人虚闭。
绵黄 陈皮（去白，各半两）
上为末，每服三钱，用大麻仁一合研烂，以水投取浆水一盏，滤去滓，于银石器内煎，
后有乳起，即入白蜜一大匙，再煎令沸，调药末，空心食前服。闭甚者不过两服愈。
洁古说：脏腑的秘结，不能一概而论地治疗。有虚秘，有实秘，有风秘，有冷秘，有气秘，有热秘，还有老人津液干燥，妇女分娩时失血，以及发汗、利小便后，病后气血尚未恢复，这些情况都能导致便秘。不能一律使用芒硝、大黄等泻下药物，巴豆、牵牛子更是禁忌。
按语：仲景说，脉象浮而数，能进食但大便不通的，属于实证，名叫阳结（Yang Jie, yang-type constipation），预计十七天后病情会加重。脉象沉而迟，不能进食，身体沉重，大便反而干硬，名叫阴结（Yin Jie, yin-type constipation），预计十四天后病情会加重。东垣说：阳结用消散法，阴结用温热法。前面所说的实闭、热闭，就是阳结；所说的冷闭、虚闭，就是阴结。
虚秘有两种，一种是阴虚，一种是阳虚。凡是下焦阳气虚弱，则阳气运行不畅，阳气运行不畅，则不能推动传导，导致阴寒凝滞于下焦。下焦阴精亏虚，则精血干枯枯燥，精血干枯枯燥，则津液无法到达，导致肠道干枯槁涩。治疗阳虚者，只需补益其火（肾阳），则阴寒凝滞自然化解。治疗阴虚者，只需滋壮其水（肾阴），则水道自然通畅。
苁蓉润肠丸 (Congrong Runchang Wan)
肉苁蓉 (Cistanche Herba, 酒浸，焙，二两) 沉香 (Aquilariae Lignum Resinatum, 另研，一两)
研为细末，用麻子仁汁打糊制作成丸，如梧桐子大，每次服用七十丸，空腹服用。
益血润肠丸 (Yixue Runchang Wan)
熟地黄 (Rehmanniae Radix Praeparata, 六两) 杏仁 (Armeniacae Semen, 炒去皮尖) 麻子仁 (Cannabis Fructus, 各三两，以上三味分别捣膏) 枳壳 (Aurantii Fructus, 二两半) 橘红 (Citri Reticulatae Pericarpium Rubrum, 二两半) 阿胶 (Asini Corii Colla, 炒) 肉苁蓉 (Cistanche Herba, 各一两半) 苏子 (Perillae Fructus) 荆芥 (Schizonepetae Herba, 各一两) 当归 (Angelicae Sinensis Radix, 三两)
研为细末，以前三味药膏同捣千余下，加入炼蜜制成如梧桐子大的丸剂，每次服用五六十丸，空腹用白开水送服。
五仁丸 (Wuren Wan)
柏子仁 (Platycladi Semen) 松子仁 (Pini Semen) 桃仁 (Persicae Semen) 杏仁 (Armeniacae Semen, 各一两) 郁李仁 (Prunellae Semen) 陈皮 (Citri Reticulatae Pericarpium, 四两，另研为末)
先将五种果仁分别研如膏状，加入陈皮末研匀，用炼蜜制成如梧桐子大的丸剂，每次服用五十丸，空腹用米饮送服。
黄芪汤 (Huangqi Tang) 治疗老人虚秘。
绵黄芪 (Astragali Radix) 陈皮 (Citri Reticulatae Pericarpium, 去白，各半两)
研为细末，每次服用三钱，用大麻仁一合研烂，加水取浆水一盏，滤去渣滓，在银石器内煎煮，待表面泛起泡沫乳状物时，加入一大匙白蜜，再煎至沸腾，调入药末，空腹饭前服用。便秘严重者不过两服即可痊愈。
Jiegou stated: Constipation of the zang-fu organs cannot be treated uniformly. There is deficiency constipation, excess constipation, wind constipation, cold constipation, qi constipation, and heat constipation. Additionally, dryness of body fluids in the elderly, blood loss during childbirth in women, as well as conditions following sweating or diuresis, and incomplete recovery of qi and blood after illness, can all lead to constipation. One must not indiscriminately use purgative drugs such as Mirabilite (Natrii Sulfas) and Rhubarb (Rhei Radix et Rhizoma); Croton Seed (Crotonis Fructus) and Morning Glory Seed (Pharbitidis Semen) are especially contraindicated.
Commentary: Zhongjing stated that if the pulse is floating and rapid, and the patient can eat but has no bowel movement, it is an excess pattern named Yang Jie (Yang-type constipation), which is expected to worsen on the seventeenth day. If the pulse is deep and slow, the patient cannot eat, feels heavy in the body, and the stool is conversely hard, it is a deficiency pattern named Yin Jie (Yin-type constipation), which is expected to worsen on the fourteenth day. Dongyuan stated: For Yang Jie, disperse it; for Yin Jie, warm it. The previously mentioned excess constipation and heat constipation correspond to Yang Jie; the cold constipation and deficiency constipation correspond to Yin Jie.
Deficiency constipation has two types: one due to yin deficiency, and one due to yang deficiency. When yang qi of the lower jiao is deficient, the movement of yang qi is obstructed; when yang qi fails to move, it cannot transport and transform, leading to the coagulation of yin-cold in the lower jiao. When yin essence and blood of the lower jiao are deficient, the essence and blood become dry and withered; when essence and blood are dry, body fluids cannot reach the intestines, causing the intestinal organs to become dry and brittle. To treat yang deficiency, simply tonify its fire (kidney-yang), and the yin-cold coagulation will naturally resolve. To treat yin deficiency, simply strengthen its water (kidney-yin), and the waterways will naturally flow smoothly.
Congrong Runchang Wan (Cistanche Pill to Moisten the Intestines)
Cistanche Herba (Cistanche Herba, soaked in wine, dried, two liang) Aquilariae Lignum Resinatum (Aquilariae Lignum Resinatum, ground separately, one liang)
Grind into fine powder, make pills using juice of Cannabis Fructus as a binder, size of Sophora japonica seeds. Take seventy pills per dose, on an empty stomach.
Yixue Runchang Wan (Benefit Blood Pill to Moisten the Intestines)
Rehmanniae Radix Praeparata (Rehmanniae Radix Praeparata, six liang) Armeniacae Semen (Armeniacae Semen, stir-fried, skin and tip removed) Cannabis Fructus (Cannabis Fructus, each three liang; the above three ingredients are pounded into paste separately) Aurantii Fructus (Aurantii Fructus, two and a half liang) Citri Reticulatae Pericarpium Rubrum (Citri Reticulatae Pericarpium Rubrum, two and a half liang) Asini Corii Colla (Asini Corii Colla, stir-fried) Cistanche Herba (Cistanche Herba, each one and a half liang) Perillae Fructus (Perillae Fructus) Schizonepetae Herba (Schizonepetae Herba, each one liang) Angelicae Sinensis Radix (Angelicae Sinensis Radix, three liang)
Grind into fine powder. Pounded together with the paste of the first three ingredients for over a thousand times, add refined honey to make pills size of Sophora japonica seeds. Take fifty to sixty pills per dose, with plain boiled water on an empty stomach.
Wuren Wan (Five Seeds Pill)
Platycladi Semen (Platycladi Semen) Pini Semen (Pini Semen) Persicae Semen (Persicae Semen) Armeniacae Semen (Armeniacae Semen, each one liang) Prunellae Semen (Prunellae Semen) Citri Reticulatae Pericarpium (Citri Reticulatae Pericarpium, four liang, ground into powder separately)
First, grind the five seeds separately into a paste. Mix evenly with the powder of Citri Reticulatae Pericarpium. Make pills with refined honey, size of Sophora japonica seeds. Take fifty pills per dose, with rice drink on an empty stomach.
Huangqi Tang (Astragalus Decoction) Treats deficiency constipation in the elderly.
Astragali Radix (Astragali Radix) Citri Reticulatae Pericarpium (Citri Reticulatae Pericarpium, white part removed, each half liang)
Grind into fine powder. Take three qian per dose. Grind one he of Cannabis Fructus until mushy. Add water to extract one cup of liquid. Filter out the dregs. Decoct in a silver or earthenware vessel. When milky foam rises, add one large spoonful of white honey. Boil again. Mix with the medicine powder. Take before meals on an empty stomach. Severe constipation will be cured in no more than two doses.