阳明病，自汗出，若发汗，小便自利者，此为津液内竭，虽□不可攻之，当须自欲大
便，宜蜜煎导而通之。若土瓜根及大猪胆汁，皆可为导。
【注】
此承上条详其义、以明其治也。阳明病，自汗出，或发汗、小便自利者，此为津液内
竭，虽大便□而无满痛之苦，不可攻之，当待津液还胃，自欲大便，燥屎已至直肠，
难出肛门之时，则用蜜煎润窍滋燥，导而利之。或土瓜根宣气通燥；或猪胆汁清热润
燥，皆可为引导法，择而用之可也。
【集注】
成无己曰：津液内竭，肠胃干燥，大便因□，此非结热，故不可攻，宜以润药外治而
导引之。
张璐曰：凡系多汗伤津，及屡经汗下不解，或尺中脉迟弱，元气素虚之人，当攻而不
可攻者，并宜导法。
程应旄曰：小便自利者，津液未还入胃中，津液内竭而□，故自欲大便，但苦不能出
耳。须有此光景时，方可从外导法，渍润其肠，肠润则水流就湿，津液自归还于胃，
故不但大便通，而小便亦从内转矣。
蜜七合，一味纳铜器中，微火煎之，稍凝似饴状，搅之勿令焦者，欲可丸，并手捻作
挺子，令头锐大如指，长二寸许。当热时急作，冷则硬，以内谷道中，以手急抱，欲
大便时乃去之。
『内台方』用蜜五合，煎凝时，加皂角末五钱，蘸捻作挺，以猪胆汁、或油润谷道内
之。
阳明病，出现自汗出，如果又用了发汗法，加上小便通畅自利，这是体内津液枯竭的表现。虽然大便干结，但不可使用攻下法，应当等待患者有便意时，适宜用蜜煎栓剂来引导通便。也可以使用土瓜根或大猪胆汁，都可以作为引导通便的方法。
【注】
这一段承接上一条条文详细阐述其含义，以明确治疗方法。阳明病，如果有自汗出，或者经过发汗、小便通利的情况，这是因为体内津液枯竭。虽然大便干结但没有腹部胀满疼痛的痛苦，所以不可使用攻下法。应当等待津液回归胃中，大便自然产生便意，燥屎已经到达直肠，难以从肛门排出之时，这时使用蜜煎润窍滋燥，引导大便排出。或者使用土瓜根宣通气机、通导燥结；或者使用猪胆汁清热润燥，都可以作为引导法，根据情况选择使用即可。
【集注】
成无己说：津液在体内枯竭，肠胃干燥，大便因此干结，这并非实热结聚，所以不可攻下，适宜用润药进行外治并引导排便。
张璐说：凡是因多汗损伤津液，以及多次经过发汗、攻下治疗仍未痊愈，或者尺脉迟弱、元气素来虚弱的人，属于应当攻下却不可直接攻下的情况，都适宜采用导法。
程应旄说：小便自利，说明津液尚未回归胃中，津液在体内枯竭导致大便干结，所以患者虽有便意，只是痛苦于无法排出罢了。必须等到这种情形出现时，才可以从外部采用导法，浸泡滋润肠道，肠道湿润后水流就湿（比喻顺势而为），津液自然会归还于胃，所以不仅大便能通，小便也会从内部转化恢复。
取蜂蜜七合，单味药放入铜器中，用微火煎煮，稍微凝固呈现像饴糖一样的状态，搅拌时不要让它烧焦。待温度适宜可以捏丸时，用手捻制成条状栓剂，头部尖锐粗大如手指，长约二寸左右。要在热的时候赶紧制作，冷了就会变硬。将其纳入肛门中，用手紧抱臀部，想要大便时才取出。
《内台方》中使用蜂蜜五合，煎至凝固时，加入皂角末五钱，蘸取后捻制成条状栓剂，用猪胆汁或油润滑肛门后纳入。
Yangming disease, with spontaneous sweating; if diaphoresis is applied, and urination is free and abundant, this indicates exhaustion of body fluids internally. Although the stool is dry, purgatives should not be used. One should wait for the patient's natural urge to defecate, and then use Honey Suppository (Mijian Dao) to guide the passage of stool. Radix Trichosanthis Kirilowii (Tugua Gen) or bile of a large pig may also be used as guiding agents.
[Annotation]
This passage elaborates on the meaning of the preceding clause to clarify the treatment method. In Yangming disease, with spontaneous sweating, or after diaphoresis and free urination, this signifies exhaustion of internal body fluids. Although the stool is dry, there is no suffering from abdominal fullness and pain, so purgation is contraindicated. One must wait until body fluids return to the Stomach, the natural urge to defecate arises, and the dry feces have reached the rectum but are difficult to pass through the anus. At this time, Honey Suppository (Mijian Dao) is used to moisten the orifice and nourish dryness, guiding the stool out. Alternatively, Radix Trichosanthis Kirilowii (Tugua Gen) can circulate Qi and unblock dryness; or Pig Bile (Zhudan Zhi) can clear heat and moisten dryness. Both can serve as guiding methods, chosen according to the situation.
[Collected Annotations]
Cheng Wuji stated: Exhaustion of internal body fluids leads to dryness of the intestines and stomach, causing the stool to become dry. This is not due to accumulated heat, so purgation is inappropriate. It is suitable to use moistening medicines for external treatment to guide defecation.
Zhang Lu stated: For cases involving excessive sweating damaging body fluids, or those unresolved after repeated diaphoresis and purgation, or in patients with a slow and weak Chi pulse and constitutionally deficient Yuan Qi, where purgation is indicated but cannot be directly applied, guiding methods are appropriate.
Cheng Yingmao stated: Free urination indicates that body fluids have not yet returned to the Stomach. With internal exhaustion of body fluids leading to dryness, the patient has an urge to defecate but suffers from the inability to expel it. Only when this condition presents can external guiding methods be employed to soak and moisten the intestines. Once the intestines are moistened, water flows towards dampness (following the path of least resistance), and body fluids naturally return to the Stomach. Thus, not only will the stool pass, but urination will also transform and recover internally.
Take seven he of honey, place it alone in a copper vessel, and simmer over a low fire until it slightly thickens to a consistency resembling maltose syrup. Stir constantly to prevent burning. When it cools enough to be molded, shape it by hand into suppositories, with one end pointed and thick like a finger, approximately two cun long. Shape them while hot, as they harden when cold. Insert into the anus, hold the buttocks tightly with hands, and remove only when the urge to defecate arises.
The Neitai Fang uses five he of honey, adding five qian of powdered Gleditsia Sinensis Fruit (Zaojiao) when it thickens. Dip and mold into suppositories, lubricating the anus with Pig Bile (Zhudan Zhi) or oil before insertion.