答曰。大肠者。传导之官。变化出焉。传者。传其不洁之物也。上与肺合。膀胱者。州都之
官。津液藏焉。气化则能出矣。化者。化其溲便之泄注也。内与肾合。或脏腑不和。营卫不
调。使阴阳二气失升降之道。致大小二肠为秘结之患。巢氏云。热则秘结。寒则鸭溏。热搏
于大肠。则大便不通。热结于小肠。则小便不通。令大小便不通者。是大小二肠受客热所结也。小肠受热化物不出。是
致膀胱不能使溲也。故便血尿血者。皆繇热
之所使也。
枳杏丸。治脏腑坚秘涩少。
杏仁(一两汤泡去皮尖别研) 枳壳(二两先研为末)
上为细末。神曲为丸。桐子大。每服四十或五十丸。食前米饮姜汤下。麻仁丸。治津液亏少
。大便结秘。
麻仁(二两去皮) 枳实(四两去白麸炒) 芍药(四两) 大黄(炮四两) 浓朴(二两) 杏仁(
二两)
上为末。蜜丸桐子大。米饮下二十丸。未通加至三十丸。
石韦饮子。治气淋。小遗涩痛。
石韦(浸刷皮一两) 瞿麦 木通(各一两) 陈皮 茯苓 芍药 桑白皮 人参 黄芩(各三
分)
上为细末。每服二钱。水一盏半。姜五片。煎七分。去滓温服。 咀亦得。
真珠丸。常观血之流行。起自于心。聚之于脾。藏之于肝。此三经者。皆心血所系之处也。
若三经守节。则血濡养而安和。苟一脏有伤。则血散溢而为咎。指迷方云。小便赤色。不痛
不涩者。非热非淋。繇经气乘心。心气散溢。血无所归。渗入下经。故治之多用心药。宜服
真珠丸。
真珠母(三分研如粉) 柏子仁(研) 当归(各一两) 人参 沉香(半两) 酸枣仁(炒去皮研)
犀角(镑) 熟地(酒浸洗蒸干一两半) 茯神(去木) 龙齿(各半两)
上为细末。蜜丸桐子大。辰砂为衣。每服四十丸加至五十丸。金银薄荷汤下。日午临卧时各
一服。
回答说：大肠，是负责传导的器官，食物的糟粕由此排出。所谓“传”，是指传递那些不洁净的物质。大肠在生理上与肺相合。膀胱，是津液汇聚的官窍，经过气化作用才能将尿液排出。所谓“化”，是指将尿液和粪便排泄出去。膀胱在生理上与肾相合。如果脏腑功能失调，营卫之气不调和，导致阴阳二气失去正常的升降规律，就会造成大小肠秘结不通的病患。巢元方曾说：热邪会导致秘结，寒邪则导致大便稀薄如水鸭之粪。热邪搏结于大肠，就会导致大便不通；热邪结聚于小肠，就会导致小便不通。现在出现大小便都不通的情况，是因为大小二肠受到外来热邪的结滞所致。小肠受热后，化物不能正常排出，这导致膀胱无法使尿液顺利排出。因此，便血和尿血的症状，都是由热邪引起的。
枳杏丸，治疗脏腑坚实秘涩、排便量少。
杏仁（一两，用热水浸泡去皮尖，单独研碎），枳壳（二两，预先研成粉末）。
以上药物制成细末，用神曲糊作为丸剂，大小如梧桐子。每次服用四十或五十丸，饭前用米汤姜汤送服。
麻仁丸，治疗津液亏损稀少，大便结秘。
麻仁（二两，去皮），枳实（四两，去白瓤，麸皮炒），芍药（四两），大黄（炮制过，四两），浓朴（二两），杏仁（二两）。
以上药物制成粉末，用蜂蜜炼制成丸，大小如梧桐子。用米汤送服二十丸，若未通便，可加至三十丸。
石韦饮子，治疗气淋，小便涩痛。
石韦（浸水刷去毛皮，一两），瞿麦，木通（各一两），陈皮，茯苓，芍药，桑白皮，人参，黄芩（各三分）。
以上药物制成细末。每次服用二钱，加水一盏半，生姜五片，煎煮至七分满，滤去药渣，温服。嚼碎服用也可以。
真珠丸，通常观察血液的运行，起始于心，聚集于脾，储藏于肝。这三条经脉，都是心血所关联的部位。如果这三经坚守其节度，那么血液就能濡养身体而安宁调和。倘若其中一脏受损，血液就会散溢而产生祸患。《指迷方》中说：小便颜色赤红，但不疼痛也不涩滞的，不是热证也不是淋证，而是由于经气侵犯心脏，心气散溢，血液无处归依，渗入下部经脉所致。所以治疗时多使用安神定志的药物，适宜服用真珠丸。
真珠母（三分，研磨如粉），柏子仁（研碎），当归（各一两），人参，沉香（半两），酸枣仁（炒后去皮研碎），犀角（镑成片），熟地黄（酒浸洗后蒸干，一两半），茯神（去除木质部分），龙齿（各半两）。
以上药物制成细末，用蜂蜜炼制成丸，大小如梧桐子，以朱砂为衣。每次服用四十丸，加至五十丸。用金银薄荷汤送服，每日中午和临睡前各服一次。
Answer: The Large Intestine is the official responsible for conduction, from which changes (excretion) emerge. "Conduction" refers to transmitting impure substances. It connects internally with the Lung. The Bladder is the official of the lower jiao where fluids are stored; only through Qi transformation can they be discharged. "Transformation" refers to the excretion of urine and feces. It connects internally with the Kidney. If the Zang-Fu organs are disharmonious and Ying-Wei (Nutritive and Defensive) Qi are unregulated, causing Yin and Yang Qi to lose their normal ascending and descending pathways, it leads to constipation in both the Large and Small Intestines. Chao Yuan-fang stated: Heat causes constipation, while Cold causes duck-like loose stools. When Heat combats the Large Intestine, bowel movements become obstructed. When Heat knots in the Small Intestine, urination becomes obstructed. The condition of simultaneous obstruction of both stool and urine indicates that the Large and Small Intestines are constrained by external Heat. When the Small Intestine is affected by Heat and cannot transform and expel waste, it results in the Bladder's inability to discharge urine. Therefore, blood in stool or blood in urine are all caused by Heat.
Zhixing Wan (Bitter Apricot Seed and Aurantium Pill), treats firmness and dryness in the Zang-Fu organs with scanty defecation.
Xingren (Apricomi Semen, 1 liang, soaked in hot water, skin and tips removed, separately ground), Zhike (Aurantii Fructus, 2 liang, pre-ground into powder).
Grind the above into fine powder, use Shenqu (Medicated Leaven) to form pills the size of Sophora seeds. Take 40 or 50 pills per dose before meals, washed down with rice water and ginger decoction.
Maren Wan (Hemp Seed Pill), treats deficiency of body fluids leading to dry and obstinate bowels.
Maren (Cannabis Fructus, 2 liang, skin removed), Zhishi (Aurantii Fructus Immaturus, 4 liang, white pith removed, bran-fried), Shaoyao (Paeoniae Radix, 4 liang), Dahuang (Rhei Radix et Rhizoma, prepared, 4 liang), Houpo (Magnoliae Officinalis Cortex, 2 liang), Xingren (Apricomi Semen, 2 liang).
Grind the above into powder, form pills with honey the size of Sophora seeds. Take 20 pills with rice water; if not relieved, increase to 30 pills.
Shiwei Yinzi (Pyrosia Decoction), treats Qi Lin (Qi-type strangury) with painful and difficult urination.
Shiwei (Pyrios Folium, soaked and brushed to remove hairs, 1 liang), Qumai (Dianthi Herba), Mutong (Akebiae Caulis, each 1 liang), Chenpi (Citri Reticulatae Pericarpium), Fuling (Poria), Shaoyao (Paeoniae Radix), Sangbaipi (Mori Cortex), Renshen (Ginseng Radix et Rhizoma), Huangqin (Scutellariae Radix, each 3 fen).
Grind the above into fine powder. Take 2 qian per dose with 1.5 sheng of water and 5 slices of ginger, decoct until reduced to 0.7 sheng, strain, and take warm. Chewing the crude herbs is also acceptable.
Zhenzhu Wan (Pearl Pill): Generally, observe the circulation of Blood, originating in the Heart, gathering in the Spleen, and storing in the Liver. These three meridians are sites connected to Heart Blood. If these three meridians maintain their discipline, Blood nourishes and remains harmonious. If one Zang organ is injured, Blood scatters and overflows, causing pathology. *Zhimi Fang* states: Urine that is red but without pain or difficulty is neither Heat nor Lin syndrome; it arises because Meridian Qi invades the Heart, Heart Qi scatters, Blood has no place to return, and seeps into the lower meridians. Therefore, treatment often employs Heart-calming medicines. It is suitable to take Zhenzhu Wan.
Zhenzhumu (Concha Margaritifera, 3 fen, ground to powder), Baiziren (Biota Semen, ground), Danggui (Angelicae Sinensis Radix, each 1 liang), Renshen (Ginseng Radix et Rhizoma), Chenxiang (Aquilariae Lignum Resinatum, 0.5 liang), Szaoren (Ziziphi Spinosae Semen, fried, skin removed, ground), Xijiao (Rhino Ceratosis, shaved), Shudi (Rehmanniae Radix Praeparata, soaked in wine, washed, steamed, and dried, 1.5 liang), Fushen (Poria cum Radix, wood removed), Longchi (Dent Draconis, each 0.5 liang).
Grind the above into fine powder, form pills with honey the size of Sophora seeds, coat with Zhusha (Cinnabar). Take 40 pills, increasing to 50, washed down with Yinjin Bohe Tang (Silver and Mint Decoction). Take one dose at noon and one before bed.