（论一首 方二首）
论曰∶夫肉虚者，坐不安席，身危变动。肉实者，坐安不动，喘气。肉虚实之应主于脾
。若其脏腑有病从肉生，热则应脏，寒则应腑。
治肉虚坐不安席好动，主脾病寒气所伤方。
五加皮 枸杞皮（各二升） 干地黄 丹参（各八两） 石膏（一作石床） 杜仲（各
一斤）
干姜（四两） 附子（二两）
上八味 咀，以清酒三斗渍三宿，一服七合，日再。
治肉实坐安席，不能动作喘气，主脾病热气所加关格除喘方。
半夏 宿姜（各八两） 杏仁（五两） 细辛 橘皮（各四两） 麻黄（一两） 石膏
（七两）
射干（二两）
上八味 咀，以水九升煮取三升，分三服，须利下加芒硝三两。
（论一首 方四十四首 灸法十五首）
论曰∶有人因时疾，瘥后得闭涩不通，遂致夭命，大不可轻之，所以备述，虽非死病，
凡人不明药饵者，拱手待毙，深可痛哉，单复诸方以虞仓猝耳。凡大便不通，皆用滑腻之物
及冷水以通之也。凡候面黄者，即知大便难。
趺阳脉浮而涩，浮则胃气强，涩则小便数，浮涩相搏，大便则坚，其脾为约，脾约者，
其人大便坚，小便利而不渴也。
麻子仁（二升） 枳实 芍药（各八两） 杏仁（一升） 大黄（一斤） 浓朴（一尺）
上六味为末，蜜丸如梧子大，饮服五丸，日三，渐加至十丸，（《肘后》、《外台》无杏
仁）。
治关格大便不通方∶
芒硝 乌梅 桑白皮（各五两） 芍药 杏仁（各四两） 麻仁（三两） 大黄（八两）
上七味 咀，以水七升煮取三升，分三服。（一本无乌梅加枳实，干地黄各二两。
治大便闭涩不通神方∶
猪羊胆不拘，以筒灌三合许，令深入即出矣。不尽须臾更灌。
一方加冬葵子汁和之亦妙。
又方 椒豉汤五升，加猪膏三合灌之佳。临时不下即用之。
又方 白蜜煎成如人指大，深纳谷道佳。又无灰浓酒半升，盐三钱匕，炼如上法。
（论述一篇，方剂两首）
论述说：所谓肉虚证，表现为坐立不安，身体摇晃变动。所谓肉实证，表现为坐卧安稳不动，但呼吸急促气喘。肉虚与肉实的病机主要归属于脾脏。如果脏腑患病由肌肉症状衍生而来，热邪则对应内脏病变，寒邪则对应六腑病变。
治疗肉虚证、坐立不安且好动，主治因脾气受寒气损伤的方剂：
五加皮、枸杞皮（各二升）、干地黄、丹参（各八两）、石膏（一作石床）、杜仲（各一斤）、干姜（四两）、附子（二两）。
以上八味药，切碎，用清酒三斗浸泡三个夜晚，每次服用七合，每日两次。
治疗肉实证、坐卧安稳但不能动作且气喘，主治因脾气受热邪加重导致的关格（上下不通之证）并消除气喘的方剂：
半夏、宿姜（陈年生姜，各八两）、杏仁（五两）、细辛、橘皮（各四两）、麻黄（一两）、石膏（七两）、射干（二两）。
以上八味药，切碎，用水九升煮取三升药液，分三次服用，如果大便不通畅需加入芒硝三两。
（论述一篇，方剂四十四首，灸法十五首）
论述说：有人因为时令疾病，痊愈后出现大便闭塞涩滞不通，从而导致死亡，这绝不可轻视，所以详细叙述。虽然这不是必死之症，但普通人如果不明白药物使用，只能拱手等待死亡，实在令人痛心，这里列举单复等人的方剂是为了防备仓促之急。凡是导致大便不通的，都应用滑腻之物及冷水来通便。凡是观察到面色发黄的人，就知道其大便困难。
趺阳脉（足背动脉，候脾胃之气）浮而涩，浮表示胃气强盛，涩表示小便频数，浮脉与涩脉相互搏结，导致大便坚硬，这是脾约证（脾阴不足，约束大肠，致便秘）。脾约证的患者，大便坚硬，小便通利且不口渴。
麻子仁（二升）、枳实、芍药（各八两）、杏仁（一升）、大黄（一斤）、浓朴（厚朴，一尺）。
以上六味药研为末，用蜂蜜制成梧桐子大小的丸剂，温水送服五丸，每日三次，逐渐增加至十丸。（《肘后备急方》、《外台秘要》中无杏仁）。
治疗关格导致大便不通的方剂：
芒硝、乌梅、桑白皮（各五两）、芍药、杏仁（各四两）、麻仁（三两）、大黄（八两）。
以上七味药，切碎，用水七升煮取三升药液，分三次服用。（另一版本无乌梅，加枳实、干地黄各二两）。
治疗大便闭塞涩滞不通的神效方剂：
猪胆或羊胆不拘多少，用竹筒灌入约三合许胆汁，深入肛门即可排出。若未排尽，须臾之间再次灌入。
另一方：加入冬葵子汁混合使用也很好。
又一方：椒豉汤五升，加入猪脂膏三合灌入效果更佳。临时不便排便时立即使用。
又一方：将白蜜煎炼成如人手指粗细的形状，深入肛门效果佳。另外可用无灰浓酒半升，盐三钱匕，按上述方法炼制使用。
(One Treatise, Two Formulas)
The treatise states: In cases of Muscle Deficiency (Rou Xu), the patient is unable to sit still and exhibits bodily instability. In cases of Muscle Excess (Rou Shi), the patient sits or lies still but suffers from panting and shortness of breath. The manifestation of Muscle Excess and Deficiency is primarily governed by the Spleen (Pi). If internal organ pathology arises from muscle symptoms, Heat (Re) corresponds to Zang organs (Viscera), while Cold (Han) corresponds to Fu organs (Bowels).
Formula for treating Muscle Deficiency characterized by restlessness and hyperactivity, indicating Spleen pathology caused by Cold pathogen injury:
Wujiapi (Cortex Acanthopanacis), Gouqipi (Cortex Lycii) (each 2 sheng); Ganyedi Huang (Radix Rehmanniae Preparata), Danshen (Radix Salviae Miltiorrhizae) (each 8 liang); Shigao (Gypsum Fibrosum) [alternative text: Shichuang]; Duzhong (Cortex Eucommiae) (each 1 jin); Ganjiang (Rhizoma Zingiberis Preparatum) (4 liang); Fuzi (Radix Aconiti Lateralis Preparata) (2 liang).
The above eight ingredients are crushed and soaked in 3 dou of clear wine for three nights. Take 7 ge per dose, twice daily.
Formula for treating Muscle Excess characterized by immobility and panting, indicating Guan Ge syndrome (obstruction of upper and lower jiao) exacerbated by Heat pathogen affecting the Spleen, aimed at relieving panting:
Banxia (Fructus Pinelliae Preparatus), Su Jiang (Old Ginger) (each 8 liang); Xingren (Semen Armeniacae Amarum) (5 liang); Xixin (Herba Asari); Ju Pi (Pericarpium Citri Reticulatae) (each 4 liang); Mahuang (Herba Ephedrae) (1 liang); Shigao (Gypsum Fibrosum) (7 liang); Shegan (Rhizoma Belamcandae) (2 liang).
The above eight ingredients are crushed and decocted in 9 sheng of water until 3 sheng remains. Divide into three doses. If constipation persists, add Mangxiao (Natrii Sulfas) 3 liang.
(One Treatise, Forty-four Formulas, Fifteen Moxibustion Methods)
The treatise states: Some individuals, after recovering from seasonal epidemics, develop severe constipation leading to death. This must not be taken lightly; hence, it is described in detail. Although not invariably fatal, laypersons ignorant of herbal medicine may simply wait for death, which is deeply regrettable. The formulas from Shan Fu et al. are provided for emergency use. Generally, for constipation, slippery substances and cold water should be used to promote bowel movement. Yellow complexion indicates difficulty in defecation.
If the Duyang pulse (pulse at the dorsalis pedis artery, reflecting Stomach/Spleen qi) is floating and choppy: Floating indicates strong Stomach qi; Choppy indicates frequent urination. The combination of floating and choppy pulses leads to hard stools. This is known as Pi Yue (Spleen Constraint). Patients with Pi Yue present with hard stools, free urination, and no thirst.
Maziren (Semen Cannabisae) (2 sheng); Zhishi (Fructus Aurantii Immaturus), Shaoyao (Radix Paeoniae Alba) (each 8 liang); Xingren (Semen Armeniacae Amarum) (1 sheng); Dahuang (Radix et Rhizoma Rhei) (1 jin); Nongpo (Cortex Magnoliae Officinalis) (1 chi).
Grind the above six ingredients into powder, mix with honey to form pills the size of wu zi (wu berry seeds). Take 5 pills with warm water, three times daily, gradually increasing to 10 pills. (Note: *Zhou Hou* and *Waitai* do not include Xingren).
Formula for Guan Ge causing constipation:
Mangxiao (Natrii Sulfas), Wumei (Fructus Mume), Sangbaipi (Cortex Mori Radicis) (each 5 liang); Shaoyao (Radix Paeoniae Alba), Xingren (Semen Armeniacae Amarum) (each 4 liang); Maren (Semen Cannabisae) (3 liang); Dahuang (Radix et Rhizoma Rhei) (8 liang).
Crush the above seven ingredients and decoct in 7 sheng of water until 3 sheng remains. Divide into three doses. (Alternative version: omit Wumei, add Zhishi and Dihuang each 2 liang).
Miraculous formula for severe constipation:
Use pig or sheep bile as needed. Insert approximately 3 ge of bile via a bamboo tube deep into the anus to induce evacuation. If incomplete, repeat after a short while.
Alternative: Mix with Dongkuizi juice for good effect.
Another method: Use Jiaochi Tang (Pepper and Fermented Soybean Decoction) 5 sheng, mixed with Sanhe of pork fat, administered enema-style. Use immediately when needed.
Another method: Boil Baimi (White Honey) until it forms a cylinder the size of a human finger, and insert deeply into the anus. Alternatively, use Ban sheng of non-ashy strong wine with three qianbi of salt, prepared similarly.