【歌】燥甚津衰血不充，大肠干涩故难通。若然皴揭并干劲，盖是阳明燥气钟。
【论】经云∶诸涩枯涸，干劲皴揭，皆属于燥。河间云∶风、热、火，同阳也；燥、湿、寒，同阴也。
又，燥、湿，小异也。然燥金虽属秋阴，而异于寒、湿，反同其风、热。故火胜金而风生，则风能胜湿，热能
耗液而反寒，阳实阴虚，则风热胜于水湿而为燥也。热燥在里，耗其津液，故大便秘结，消渴生焉。夫风劲清
肃，燥气在表，钟于皮肤，则皮毛燥涩，皴揭干疥，爪枯之病生焉。东垣云∶饥饱劳役，损伤胃气。及食辛辣
浓味之物，而助火邪，伏于血中，耗散真阴，津液亏少，故大便结燥。然燥结亦有风燥、热燥、阴结、阳结之
类。治法∶以辛润之，以苦泻之，则结散燥除也。
风燥
血弱不能养筋，筋燥，手足不能动，指爪枯槁，大秦艽汤。大肠风闭燥结者，搜风顺气丸。
大秦艽汤（方见真中风条。）
搜风顺气丸
治腰、脚疼痛，四肢无力，恶疮下注，风气、香港脚。常服润三焦，和五脏，润肠，除风湿。
大黄（五两，半生半熟用） 麻仁（微炒，去壳另研） 山茱萸（去核） 山药（各三两） 槟榔 郁李仁
（另研） 菟丝子（酒蒸） 牛膝（酒浸，二两） 车前子（一两） 枳壳（麸炒） 川独活（各两） 防风（一两半）
上为末，蜜丸如梧子大，每服三十丸，茶、酒任下。
火燥
脾胃伏火，大便秘结，润肠丸、脾约麻仁丸。五内火炽盛，烧灼津液，烦渴燥甚，白虎汤。燥热结者，清
凉饮子。
润肠丸
桃仁（去皮尖，另研） 麻仁（炒去壳，各一两） 大黄（煨） 羌活 当归梢（各五钱）
如风湿，加皂角、秦艽。如脉涩气滞，加郁李仁。
上为末，炼蜜丸如梧子，白汤下。
脾约麻仁丸
治肠胃热燥，大便秘结。
浓朴（姜制） 枳实（麸炒） 芍药（各八分） 大黄（一两六钱，酒蒸，焙干） 杏仁（去皮尖，
炒） 麻仁（炒，去壳另研，各五钱）
上为末，蜜丸如梧子大，每服二十丸，临卧温水下。
润麻丸
能润血燥，大便不通。
麻仁 当归 桃仁 生地 枳壳（各一两）
上为末，蜜丸如梧子大，每服五十丸，空心白汤下。
白虎汤（方见火证。）
清凉饮子
大黄 当归 赤芍 甘草
上各等分，水煎服。
虚燥
阴虚火盛，下焦燥热，小便涩数者，六味地黄丸、大补阴丸。虚秘者，蜜导法、胆导法。血虚干涸脏结者，
元戎四物汤、通幽汤或蜜导法。
六味地黄丸
大补阴丸（二方见虚损。）
元戎四物汤
治脏结闭涩。
四物加煨大黄、桃仁，等分煎服。
通幽汤
治幽门不通，上冲吸门，吸门不开，则为噎塞。治在幽门，以辛润之。
生地 熟地（各五分） 甘草（炙） 红花（各三分） 升麻（五分） 当归身 桃仁泥（各一钱）
上锉，水煎，调槟榔末五分，稍热服。
蜜导法
以蜜炼如饴，捻成指大，长二寸许，纳谷道中。
【歌诀】燥邪严重导致津液衰少、血液不充盈，大肠干涩所以难以通畅。如果出现皮肤皱裂并伴有干燥紧绷感，这是因为阳明经的燥气聚集所致。
【论述】《内经》说：各种涩滞、枯涸、干燥紧绷、皮肤皴裂的症状，都归属于燥证。刘河间（刘完素）说：风、热、火，同属于阳；燥、湿、寒，同属于阴。另外，燥与湿，虽有细微差别。然而燥金虽然属于秋季的阴气，却不同于寒和湿，反而与风和热相同。所以火胜则金被克而风生，风能胜湿，热能耗伤津液从而反显寒象（注：此处原文逻辑为阳实阴虚，风热胜于水湿而为燥），阳气实而阴气虚，风热胜过水湿从而形成燥证。热燥在体内，耗伤津液，所以大便秘结，消渴症由此产生。风气劲急清肃，燥气在体表，聚集于皮肤，则皮毛干燥涩滞，出现皮肤皴裂、干燥疥癣、指甲枯槁等疾病。李东垣说：饥饱失常、劳累过度，损伤胃气。以及食用辛辣浓味之物，助长火邪，潜伏在血中，耗散真阴，津液亏少，所以大便结燥。然而燥结也有风燥、热燥、阴结、阳结等类型。治疗方法：用辛味药润之，用苦味药泻之，则结散燥除。
风燥
血弱不能滋养筋脉，筋脉燥涩，手足不能活动，手指指甲枯槁，用大秦艽汤（Qin Jiao Tang）。大肠因风闭阻导致的燥结，用搜风顺气丸（Soufeng Shunqi Wan）。
大秦艽汤（方剂见“真中风”条。）
搜风顺气丸
治疗腰、脚疼痛，四肢无力，恶疮下注，风气、香港脚（足癣/痛风类病症）。常服可润三焦，和五脏，润肠，除风湿。
大黄（五两，半生半熟使用） 麻仁（微炒，去壳另研） 山茱萸（去核） 山药（各三两） 槟榔 郁李仁（另研） 菟丝子（酒蒸） 牛膝（酒浸，二两） 车前子（一两） 枳壳（麸炒） 川独活（各一两） 防风（一两半）
以上药物研为细末，蜂蜜炼蜜为丸，如梧桐子大小，每次服用三十丸，茶或酒送服均可。
火燥
脾胃有伏火，大便秘结，用润肠丸（Run Chang Wan）、脾约麻仁丸（Pi Yue Ma Ren Wan）。五脏内火炽盛，烧灼津液，烦渴燥甚，用白虎汤（Bai Hu Tang）。燥热互结者，用清凉饮子（Qing Liang Yin Zi）。
润肠丸
桃仁（去皮尖，另研） 麻仁（炒去壳，各一两） 大黄（煨） 羌活 当归梢（各五钱）
如有风湿，加皂角、秦艽。如果脉涩气滞，加郁李仁。
以上药物研为细末，炼蜜为丸如梧桐子大小，白开水送服。
脾约麻仁丸
治疗肠胃热燥，大便秘结。
浓朴（姜制） 枳实（麸炒） 芍药（各八分） 大黄（一两六钱，酒蒸，焙干） 杏仁（去皮尖，炒） 麻仁（炒，去壳另研，各五钱）
以上药物研为细末，蜂蜜为丸如梧桐子大小，每次服用二十丸，临睡前温水送服。
润麻丸
能润血燥，大便不通。
麻仁 当归 桃仁 生地 枳壳（各一两）
以上药物研为细末，蜂蜜为丸如梧桐子大小，每次服用五十丸，空腹白开水送服。
白虎汤（方剂见“火证”条。）
清凉饮子
大黄 当归 赤芍 甘草
以上各等分，水煎服。
虚燥
阴虚火盛，下焦燥热，小便涩痛频数者，用六味地黄丸（Liu Wei Di Huang Wan）、大补阴丸（Da Bu Yin Wan）。虚秘者，用蜜导法、胆导法。血虚干涸脏结者，用元戎四物汤（Yuan Rong Si Wu Tang）、通幽汤（Tong You Tang）或蜜导法。
六味地黄丸
大补阴丸（两个方剂见“虚损”条。）
元戎四物汤
治疗脏结闭涩。
四物汤加煨大黄、桃仁，等分煎服。
通幽汤
治疗幽门不通，气上冲吸门，吸门不开，则为噎塞。治疗重点在幽门，用辛味药润之。
生地 熟地（各五分） 甘草（炙） 红花（各三分） 升麻（五分） 当归身 桃仁泥（各一钱）
以上切碎，水煎，调入槟榔末五分，稍热时服用。
蜜导法
将蜂蜜炼得像饴糖一样，捏成手指粗细，长约二寸，纳入肛门中。
[Verse] When dryness is severe, body fluids decline and blood fails to fill the vessels; the large intestine becomes dry and astringent, making bowel movements difficult. If skin wrinkles and cracks appear along with dryness and tightness, it is because Yangming dryness qi has gathered there.
[Discussion] The Classics state: "All cases of astringency, withering, drying up, stiffness, and skin cracking belong to dryness." Liu Hejian (Liu Wansu) stated: Wind, heat, and fire are all Yang; dryness, dampness, and cold are all Yin. Furthermore, dryness and dampness differ slightly. Although dryness-metal belongs to autumn Yin, it differs from cold and dampness, resembling wind and heat instead. Thus, when fire prevails over metal, wind arises; wind can overcome dampness, and heat consumes fluids, potentially leading to a relative cold state due to fluid loss. When Yang is excess and Yin is deficiency, wind and heat prevail over water and dampness, resulting in dryness. Internal heat-dryness consumes body fluids, causing constipation and generating Xiao Ke (wasting-thirst syndrome). Wind is vigorous and clear/desiccating; when dryness qi is at the exterior, gathering in the skin, it causes the skin and hair follicles to become dry and astringent, leading to diseases such as skin cracking, dry scabies, and brittle nails. Li Dongyuan stated: Irregular eating and drinking, or overwork, damage Stomach Qi. Consuming spicy and rich flavors aids fire pathogens, which lie latent in the blood, consuming True Yin and causing a deficiency of body fluids, thus leading to dry constipation. However, dry constipation also includes types such as Wind-Dryness, Heat-Dryness, Yin-Constipation, and Yang-Constipation. Treatment methods: Use acrid herbs to moisten them, and bitter herbs to purge them, so that the accumulation disperses and dryness is eliminated.
Wind-Dryness
When blood is weak and cannot nourish the sinews, the sinews become dry, causing immobility of the hands and feet, and brittle nails. Use Qin Jiao Tang (Qin Jiao Decoction). For large intestine dryness constipation caused by wind obstruction, use Soufeng Shunqi Wan (Search for Wind and Promote Qi Pill).
Qin Jiao Tang (See formula under "True Stroke" section.)
Soufeng Shunqi Wan
Treats pain in the waist and legs, weakness in the four limbs, downward flow of malignant sores, wind-dampness, and Hong Kong Foot (podagra/tinea pedis-like conditions). Regular use moistens the San Jiao (Triple Burner), harmonizes the Five Zang organs, moistens the intestines, and eliminates wind-dampness.
Rhubarb Root (Wu Liang, half raw and half cooked) Hemp Seed (lightly stir-fried, shell removed and ground separately) Cornus Fruit (core removed) Chinese Yam (each San Liang) Areca Seed (ground separately) Apricot Seed (ground separately) Dodder Seed (steamed with wine) Achyranthes Root (soaked in wine, Er Liang) Plantago Seed (Yi Liang) Aurantium Fruit (bran-fried) Angelica Dahurica (Ge Liang) Saposhnikovia Root (Yi Liang Ban)
Grind the above into powder, mix with honey to form pills the size of a wu zi (cibotium seed). Take thirty pills per dose, washed down with tea or wine as preferred.
Fire-Dryness
Latent fire in the Spleen and Stomach causing constipation: use Run Chang Wan (Moisten Intestines Pill) or Pi Yue Ma Ren Wan (Splee-Restriction Hemp Seed Pill). Excessive fire within the five internal organs burning body fluids, causing irritability, thirst, and severe dryness: use Bai Hu Tang (White Tiger Decoction). Dryness-heat binding together: use Qing Liang Yin Zi (Cooling Drink).
Run Chang Wan
Peach Kernel (skin and tip removed, ground separately) Hemp Seed (stir-fried, shell removed, each Yi Liang) Rhubarb Root (roasted) Notopterygium Root Angelica Caudata Tip (each Wu Qian)
If wind-dampness is present, add Gleditsia Sinensis Fruit and Qin Jiao. If pulse is astringent and Qi is stagnant, add Apricot Seed.
Grind the above into powder, mix with refined honey to form pills the size of a wu zi. Take with plain boiled water.
Pi Yue Ma Ren Wan
Treats intestinal and stomach heat-dryness and severe constipation.
Magnolia Bark (processed with ginger) Aurantium Fruit (bran-fried) Paeonia Lactiflora Root (each Ba Fen) Rhubarb Root (Yi Liang Liu Qian, steamed with wine, dried) Apricot Seed (skin and tip removed, stir-fried) Hemp Seed (stir-fried, shell removed and ground separately, each Wu Qian)
Grind the above into powder, mix with honey to form pills the size of a wu zi. Take twenty pills per dose, washed down with warm water before bedtime.
Run Ma Wan
Moistens blood-dryness and treats inability to pass stool.
Hemp Seed Angelica Sinensis Peach Kernel Rehmannia Root Aurantium Fruit (each Yi Liang)
Grind the above into powder, mix with honey to form pills the size of a wu zi. Take fifty pills per dose on an empty stomach with plain boiled water.
Bai Hu Tang (See formula under "Fire Syndrome" section.)
Qing Liang Yin Zi
Rhubarb Root Angelica Sinensis Red Peony Root Licorice Root
Take equal parts of each, decoct in water, and take orally.
Deficiency-Dryness
Yin deficiency with hyperactive fire, lower Jiao dryness-heat, and astringent/frequent urination: use Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) or Da Bu Yin Wan (Great Supplement Yin Pill). For deficiency-type constipation, use Mi Dao Fa (Honey Suppository Method) or Dan Dao Fa (Gallbladder Bile Suppository Method). For blood deficiency leading to dryness and organ binding: use Yuan Rong Si Wu Tang (Yuan Rong Four Substances Decoction), Tong You Tang (Open the Dark Passage Decoction), or Mi Dao Fa.
Liu Wei Di Huang Wan
Da Bu Yin Wan (Both formulas see "Deficiency Damage" section.)
Yuan Rong Si Wu Tang
Treats organ binding and astringency.
Si Wu Tang (Four Substances Decoction) plus roasted Rhubarb Root and Peach Kernel, equal parts, decoct and take orally.
Tong You Tang
Treats obstruction of the pylorus, with Qi rushing upward to the Xi Men (inhaling gate); if the Xi Men does not open, it results in dysphagia/choking. Treatment focuses on the pylorus, using acrid herbs to moisten.
Rehmannia Root (Sheng Di) Prepared Rehmannia Root (Shu Di) (each Wu Fen) Licorice Root (roasted) Safflower (each San Fen) Cimicifuga Rhizome (Wu Fen) Angelica Sinensis Body Peach Kernel Paste (each Yi Qian)
Cut into pieces, decoct in water, mix with five Fen of Areca Seed powder, and take while slightly warm.
Mi Dao Fa (Honey Suppository Method)
Refine honey until it resembles malt syrup, shape it into a finger-sized suppository about two Cun long, and insert it into the anal canal.