燥结血少，不能润泽，理宜养阴。
入方
治大肠虚秘而热。
白芍（一两半）陈皮 生地黄 归身（一两） 条芩 甘草（二钱）
上为末，粥丸。白汤下七八十丸。
〔附录〕凡人五味之秀者养脏腑，诸阳之浊者归大肠，大肠所以司出而不纳也。今停蓄蕴
结，独不得疏导何哉？抑有由矣！邪入里，则胃有燥粪，三焦伏热，则津液中干，此大肠挟热然
也。虚入脏冷而血脉枯，老人脏寒而气道涩，此大肠之挟冷然也。亦有肠胃受风，涸燥
秘涩，此证以风气蓄而得之。若夫气不下降而谷道难，噫逆泛满，必有其证矣。
东坦诸论，原附于此，今节不录，观者宜于东垣书中求之。
附方
理宜节去，姑存以便阅者。
导滞通幽汤 治大便难，幽门不通，上冲，吸门不开，噎塞不便，燥秘，气不得下。治
在幽门，以辛润之。
归身 升麻 桃仁泥（各一钱） 生地黄 熟地黄（各半钱） 甘草（炙） 红花（各三分）
上作一服，水煎。食前调槟榔末半钱，或加麻仁泥一钱。加大黄，名当归润燥汤。
润燥汤
升麻 生地黄（各二钱） 归梢 生甘草 大黄（煨） 熟地黄 桃仁泥 麻仁（各一钱） 红花
上除桃仁、麻仁另研，作一服，水煎，次下桃仁、麻仁煎。空心热服。
活血润燥丸 治大便风秘血秘，常常燥结。
归梢（一钱） 防风（三钱） 大黄（纸裹煨） 羌活（各一两） 桃仁（二两，研如泥） 麻仁（二两五钱
研） 皂角仁（烧存性，一两五钱，其性得温则滑，温滑则燥结自通）
上除二仁另研外，余为末后和匀，蜜丸梧子大。空心服五十丸，白汤送下。三两服后，
以苏子麻子粥，每日早晚食之，大便不致结燥。以瓷器盛之，纸封无令见风。
半硫丸 治冷秘，风秘结，老人秘。
透明硫黄（研） 半夏（洗七次，等分）
上为末，生姜糊丸梧子大。服二十丸，姜汤下；或用一葱白一条，姜三片煎，入阿胶二片
溶开，食前空心送下。
麻仁丸 治大便秘，风秘，脾约。
郁李仁 麻子仁（各六两，各研） 大黄（二两半，以一半炒） 山药 防风 枳壳（炒，七钱半
槟榔（五钱） 羌活 木香（各五钱半）
上为末，蜜丸梧子大。服七十丸，白汤下。
脾约丸
麻仁（一两一钱半，研） 枳实 浓朴 芍药（各二两） 大黄（四两，蒸） 杏仁（去皮麸炒，一两
二钱，研）
上为末，炼蜜丸，梧子大。服三五十丸，温水下。
凡诸秘，服药不通，或兼他证，又或老弱虚极不可用药者，用蜜熬入皂角末少许作□以
导之。冷秘生姜□亦佳。
入方（处方）
治疗大肠虚弱且伴有热象导致的便秘。
白芍（一两半）、陈皮、生地黄、当归身（一两）、黄芩、甘草（二钱）。
以上药物研为细末，用米粥煮糊制作成丸剂。用温开水送服七八十丸。
〔附录〕大凡五味中精华的部分滋养脏腑，诸阳之气中浑浊的部分归于大肠，大肠的功能是主管排泄而不收纳。如今粪便停滞积聚蕴结，唯独不能疏导，这是为什么呢？大概是有原因的！邪气侵入体内，则胃中有干燥的粪块；三焦潜伏热邪，则津液中间干枯，这是大肠挟带热邪所致。虚寒之邪侵入脏腑导致寒冷而血脉枯槁，老人脏腑虚寒而气机运行涩滞，这是大肠挟带冷邪所致。也有肠胃受风邪侵袭，导致津液枯竭干燥、大便秘涩，此证是由于风气蓄积而得病。如果是气机不下降而导致肛门排便困难，嗳气逆乱、胸脘胀满，必然有相应的证候表现。
东垣（李杲）的相关论述，原本附在此处，现在节选不再收录，读者宜在东垣的医书中寻求。
附方
理当删减去除，姑且保留以便读者阅读。
导滞通幽汤 治疗大便困难，幽门不通畅，气机上冲，吸门不开，噎塞不便，燥结便秘，气机不得下行。治疗关键在于幽门，采用辛味润下的方法。
当归身、升麻、桃仁泥（各一钱）、生地黄、熟地黄（各半钱）、炙甘草、红花（各三分）。
以上为一剂药量，加水煎煮。饭前调入槟榔末半钱，或者加入麻仁泥一钱。若加大黄，则名为当归润燥汤。
润燥汤
升麻、生地黄（各二钱）、当归梢、生甘草、煨大黄、熟地黄、桃仁泥、火麻仁（各一钱）、红花。
以上除桃仁、火麻仁另行研磨外，其余药物作为一剂，加水煎煮，随后加入桃仁、火麻仁继续煎煮。空腹时热服。
活血润燥丸 治疗大便因风邪或血虚导致的秘结，经常发生燥结。
当归梢（一钱）、防风（三钱）、纸裹煨大黄、羌活（各一两）、桃仁（二两，研磨如泥）、火麻仁（二两五钱，研磨）、皂角仁（烧至存性，一两五钱，其性质遇温则滑利，温滑则燥结自然通畅）。
以上除桃仁、火麻仁另行研磨外，其余药物研为细末后混合均匀，用蜂蜜制成梧桐子大小的丸剂。空腹服用五十丸，用温开水送下。服用三两剂后，每日早晚食用苏子麻子粥，大便就不会导致结燥。药丸需用瓷器盛装，用纸密封以防见风。
半硫丸 治疗冷秘、风邪秘结、老人便秘。
透明硫黄（研磨）、半夏（清洗七次，与硫黄等分）。
以上研为细末，用生姜汁糊制作成梧桐子大小的丸剂。服用二十丸，用姜汤送下；或者用一根葱白、三片生姜煎煮，加入两片阿胶溶化，空腹饭前送服。
麻仁丸 治疗大便秘结、风秘、脾约证。
郁李仁、火麻仁（各六两，分别研磨）、大黄（二两半，其中一半炒制）、山药、防风、炒枳壳（七钱半）、槟榔（五钱）、羌活、木香（各五钱半）。
以上研为细末，用蜂蜜制成梧桐子大小的丸剂。服用七十丸，用温开水送下。
脾约丸
火麻仁（一两一钱半，研磨）、枳实、厚朴、芍药（各二两）、大黄（四两，蒸制）、杏仁（去皮麸炒，一两二钱，研磨）。
以上研为细末，用炼蜜制成梧桐子大小的丸剂。服用三五十丸，用温水送下。
凡是各种便秘，服药后仍不通畅，或者兼有其他病症，又或者年老体弱极度虚损不宜用药者，可用熬制的蜂蜜加入少许皂角末做成栓剂以引导通便。冷秘证使用生姜制成的栓剂效果也很好。
Dryness accumulation due to blood deficiency fails to moisten the intestines; the appropriate treatment principle is to nourish Yin.
Prescription
For constipation caused by deficiency and heat in the Large Intestine (Da Chang).
Bai Shao (Radix Paeoniae Alba, 1.5 liang), Chen Pi (Pericarpium Citri Reticulatae), Sheng Di Huang (Radix Rehmanniae Preparata, 1 liang), Gui Shen (Radix Angelicae Sinensis, 1 liang), Tiao Qin (Scutellariae Radix), Gan Cao (Radix Glycyrrhizae, 2 qian).
Grind the above into powder, make pills with congee paste. Take 70-80 pills with warm water.
[Appendix] Generally, the essence of the five flavors nourishes the Zang-Fu organs, while the turbid part of Yang Qi returns to the Large Intestine. The Large Intestine is responsible for excretion but not reception. Why do feces now stagnate and accumulate without being guided out? There must be reasons! When pathogenic factors enter the interior, dry stool accumulates in the Stomach; when latent heat lingers in the San Jiao (Triple Burner), body fluids become dry internally. This is constipation accompanied by Heat in the Large Intestine. When deficiency-cold enters the Zang organs, causing coldness and withered blood vessels, or when elderly people have cold internal organs and sluggish Qi mechanism, this is constipation accompanied by Cold in the Large Intestine. There are also cases where Wind affects the stomach and intestines, leading to dryness and constipation due to fluid depletion; this condition arises from the accumulation of Wind Qi. If Qi fails to descend, making defecation difficult, accompanied by belching, regurgitation, and fullness, there must be corresponding symptoms.
The discussions by Dong Yuan (Li Gao) were originally attached here but are excerpted and not fully recorded now; readers should seek them in Dong Yuan's medical books.
Attached Prescriptions
Ideally, these should be removed, but they are retained for the reader's convenience.
Dao Zhi Tong You Tang (Guiding Stasis and Opening the Hidden Pass Decoction)
Treats difficulty in defecation, obstruction at the幽门 (Yumen/Hyomen - anatomical term for pylorus/anal sphincter contextually implying lower passage blockage), upward rushing Qi, inability of the 吸门 (Ximen) to open, dysphagia and inconvenience, dry constipation, and Qi failing to descend. Treatment focuses on the Yumen, using acrid and moistening methods.
Gui Shen (Radix Angelicae Sinensis), Sheng Ma (Cimicifugae Rhizoma), Tao Ren Ni (Persicae Semen Paste, each 1 qian), Sheng Di Huang (Radix Rehmanniae Preparata), Shu Di Huang (Radix Rehmanniae Recens Preparata, each 0.5 qian), Zhi Gan Cao (Prepared Radix Glycyrrhizae), Hong Hua (Carthami Flos, each 3 fen).
Take as one dose, decoct in water. Before meals, mix with 0.5 qian of Bing Lang (Arecae Semen) powder, or add 1 qian of Ma Ren (Semen Cannabis) paste. If Da Huang (Rhei Radix et Rhizoma) is added, it is named Dang Gui Run Zao Tang.
Run Zao Tang (Moistening Dryness Decoction)
Sheng Ma (Cimicifugae Rhizoma), Sheng Di Huang (Radix Rehmanniae Preparata, each 2 qian), Gui Shao (Ramulus Angelicae Sinensis Terminalis), Sheng Gan Cao (Raw Radix Glycyrrhizae), Wei Da Huang (Baked Rhei Radix et Rhizoma), Shu Di Huang (Radix Rehmanniae Recens Preparata), Tao Ren Ni (Persicae Semen Paste), Ma Ren (Semen Cannabis, each 1 qian), Hong Hua (Carthami Flos).
Except for Tao Ren and Ma Ren which are ground separately, take the rest as one dose, decoct in water, then add Tao Ren and Ma Ren and continue decocting. Take hot on an empty stomach.
Huo Xue Run Zao Wan (Invigorate Blood and Moisten Dryness Pill)
Treats wind-constipation and blood-deficiency constipation, frequently occurring dry accumulation.
Gui Shao (Ramulus Angelicae Sinensis Terminalis, 1 qian), Fang Feng (Saposhnikoviae Radix, 3 qian), Zhi Bao Wei Da Huang (Paper-wrapped baked Rhei Radix et Rhizoma), Qiang Huo (Notopterygii Rhizoma et Radix, each 1 liang), Tao Ren (Persicae Semen, 2 liang, ground to paste), Ma Ren (Semen Cannabis, 2.5 liang, ground), Zao Jiao Ren (Gleditsiae Sinensis Fructus Seed, charred to retain properties, 1.5 liang; its nature becomes slippery when warm, and warmth-slipperiness naturally unblocks dryness).
Except for the two seeds which are ground separately, grind the rest into powder, mix evenly, and make pills with honey the size of wu zi (loquat seeds). Take 50 pills on an empty stomach with warm water. After taking three doses, consume Su Zi Ma Zi Zhou (Perilla Seed and Hemp Seed Porridge) morning and evening daily to prevent dryness. Store in porcelain vessels, sealed with paper to avoid exposure to air.
Ban Liu Wan (Half Sulfur Pill)
Treats cold-constipation, wind-accumulation constipation, and elderly constipation.
Tou Ming Liu Huang (Transparent Sulfur, ground), Ban Xia (Pinelliae Rhizoma, washed seven times, equal parts to sulfur).
Grind into powder, make pills with ginger paste the size of wu zi. Take 20 pills with ginger soup; or decoct one scallion white and three slices of ginger, dissolve two pieces of E Jiao (Colla Corii Asini) in it, and take on an empty stomach before meals.
Ma Ren Wan (Hemp Seed Pill)
Treats severe constipation, wind-constipation, and Pi Yue (Spleen Restriction) syndrome.
Yu Li Ren (Prunus japonica seed), Ma Ren (Semen Cannabis, each 6 liang, ground separately), Da Huang (Rhei Radix et Rhizoma, 2.5 liang, half stir-fried), Shan Yao (Dioscoreae Rhizoma), Fang Feng (Saposhnikoviae Radix), Chao Zhi Ke (Stir-fried Aurantii Fructus, 7.5 qian), Bing Lang (Arecae Semen, 5 qian), Qiang Huo (Notopterygii Rhizoma et Radix), Mu Xiang (Aucklandiae Radix, each 5.5 qian).
Grind into powder, make pills with honey the size of wu zi. Take 70 pills with warm water.
Pi Yue Wan (Spleen Restriction Pill)
Ma Ren (Semen Cannabis, 1.15 liang, ground), Zhi Shi (Immature Bitter Orange Fruit), Nong Po (Magnoliae Officinalis Cortex), Shao Yao (Paeoniae Radix, each 2 liang), Da Huang (Rhei Radix et Rhizoma, 4 liang, steamed), Xing Ren (Pruni Armeniaci Semen, peeled and stir-fried with bran, 1.2 liang, ground).
Grind into powder, make pills with refined honey the size of wu zi. Take 30-50 pills with warm water.
For all types of constipation, if medication does not result in bowel movement, or if there are concurrent conditions, or if the patient is extremely weak and elderly and cannot tolerate medication, use boiled honey mixed with a small amount of Zao Jiao (Gleditsiae Sinensis Fructus) powder to make a suppository for guidance. For cold-constipation, suppositories made with ginger are also effective.