论大便不痛，小便不痛 疟症不已 产妇感中风邪
天师曰∶末治者，乃六腑之治也。人如病大小便不通，或疟症不已，产后风寒，皆作末治也。凡
久病之后，或大便一月不通，不必性急，止补其真阴，使精足以生血，血足以润肠，大便自出，不可视为
根本之病，而速求其愈。亦有人小便点滴不出，亦不必十分大急，乃肾气不能行于膀胱也，补其肾气，则
小便自出，不必视为根本之病，而急欲出之也。大便不通方∶用熟地一两，元参一两，当归一两，川芎五钱，
火麻仁一钱，蜜半瓯，大黄一钱，桃仁十个，红花三分，水煎服。此方妙在用熟地、元参、当归以生阴
血，少加麻仁，大黄以润肠下行。此正末治其闭结，而不亟亟以通之也。小便不通方∶用肉桂一钱，熟地
一两，山茱萸四钱，茯苓二钱，车前子一钱，泽泻一钱，丹皮一钱，山药一钱，水煎服。此方即七味
地黄汤。妙在不去通小便，而专治肾水肾火。盖肾中有火，而膀胱之气化自行，不通小便而小便自通矣。
此末治之一法也。
疟症不已，终岁连朝，经年累月，或已止而又发，或未止而难痊。人皆谓有邪未散也，急宜逐邪，
不可末视之。殊不知邪之久踞，乃正虚之甚也，自当重补其正，而末治其邪。方用熟地五钱，何首乌五
钱，鳖甲五钱，白术五钱，当归五钱，人参二钱，甘草一钱，柴胡一钱，半夏一钱，肉桂五分，山茱萸
四钱，水煎服。此方妙在熟地、山茱萸、当归之品以补阴血，加人参、白术以健脾，加鳖甲以入阴分，加
何首乌以补阴气，加半夏、柴胡，少少去其痰与邪，则正气有余，邪自退舍。此又末治之一法也。
产妇感中风邪，皆作末治者。产妇旧血尽去，新血未生。
大虚躯壳，原易中邪。风寒袭之，一散邪，必有厥逆寒症之变，死亡顷刻矣。方用当归一两，川芎五钱，
人参一两，荆芥一钱，肉桂一钱，益母草一钱治之。此方妙在用参、归各一两，参以固气，归以生血，气
血既生，而风邪易去。大虚之人，略带去邪之药，则邪原易出，乃腠理实疏，关门不锁故耳。方中荆芥一
品最妙，不特易于祛邪，而且引旧血以归经，佐新血以复正，故两用之而成功也。益母草更是产科最利之
品，安有他虞哉。此又固气血为先，散邪为末又一法也。
张公曰∶俱讲得入神出化，予又何佐高深哉。尚有一言相商，产妇临月之前一月，如有风邪感冒等
症，皆作风寒感冒治之。其临月之期，如有感中风邪，不可作风邪治之。方用人参一两，当归一两，川芎
五钱，柴胡二钱，甘草一钱，白芥子三钱，水煎服。毋论其头疼身痛，咳嗽太阳痛，六经传经伤寒，俱宜
以此方治之，切不可轻用桂枝、麻黄。盖孕妇实与平常人治法大不相同耳。
孙真君曰∶大便不通，亦多实症，天师传者，治虚症之
方耳。我传此方，治实症者，实有奇效。方用大黄五钱，当归尾一两，升麻五分，蜜半瓯，水煎服。（〔
批〕天师云∶此方尚加熟地一两。）大黄泄利，用当归润之，仍以为君，虽泄而不十分过猛，不至有亡阴
之弊∶况有升麻以提之，则泄中有留，又何必过虑哉。
天师说：所谓“末治”，是指对六腑疾病的治疗。如果人患大小便不通，或者疟疾久治不愈，以及产后感受风寒，都采用“末治”的方法。凡是久病之后，或者大便一个月不通畅，不必性急，只需补益真阴，使精液充足以生血，血液充足以滋润肠道，大便自然排出。不可将其视为根本性的重病而急于求成。也有人小便点滴不出，也不必过分焦急，这是因为肾气不能运行到膀胱所致，补益肾气，则小便自然排出，同样不可将其视为根本性的重病而急于通利小便。
治疗大便不通的方剂：使用熟地黄一两，玄参一两，当归一两，川芎五钱，火麻仁一钱，蜂蜜半碗，大黄一钱，桃仁十个，红花三分，水煎服。这个方剂的妙处在于使用熟地黄、玄参、当归来生成阴血，少量加入麻仁、大黄以润肠通便下行。这正是通过“末治”来处理闭结，而不是急切地强行通下。
治疗小便不通的方剂：使用肉桂一钱，熟地黄一两，山茱萸四钱，茯苓二钱，车前子一钱，泽泻一钱，牡丹皮一钱，山药一钱，水煎服。这个方剂就是七味地黄汤（此处指六味地黄丸加肉桂，即金匮肾气丸之意，原文称七味）。其妙处不在于直接通利小便，而是专门调理肾水和肾火。因为肾中有火，膀胱的气化功能自然运行，不通利小便而小便自然通畅了。这是“末治”的一种方法。
疟疾久治不愈，整年连日发作，经年累月，或者已经停止却又复发，或者尚未停止却难以痊愈。人们都认为是有邪气未散，应当急切地驱逐邪气，不可轻视其为“末治”。殊不知邪气长久盘踞，是因为正气极度虚弱，自然应当着重补益正气，而将祛邪作为次要手段（末治）。方剂使用熟地黄五钱，何首乌五钱，鳖甲五钱，白术五钱，当归五钱，人参二钱，甘草一钱，柴胡一钱，半夏一钱，肉桂五分，山茱萸四钱，水煎服。这个方剂的妙处在于使用熟地黄、山茱萸、当归等药物来补益阴血，加入人参、白术来健脾，加入鳖甲以深入阴分，加入何首乌来补益阴气，加入半夏、柴胡，少量去除痰浊和邪气，那么正气充足，邪气自然退避。这又是“末治”的一种方法。
产妇感受风邪，也都采用“末治”的方法。产妇旧有的瘀血已尽去，新的血液尚未生成。身体极度虚弱，原本就容易中邪。风寒侵袭，如果单纯发散邪气，必然会导致厥逆寒症的变化，顷刻间就会死亡。方剂使用当归一两，川芎五钱，人参一两，荆芥一钱，肉桂一钱，益母草一钱来治疗。这个方剂的妙处在于使用人参、当归各一两，人参以固护气，当归以生成血，气血既已生成，风邪就容易去除。对于极度虚弱的人，稍微带一点祛邪的药物，邪气原本就容易排出，这是因为腠理实疏，门户不锁的缘故。方中的荆芥这一味药最为奇妙，不仅易于祛除邪气，而且能引导旧血回归经脉，辅助新血恢复正气，所以重用这两味药而取得成功。益母草更是产科最有利的药物，还有什么可担忧的呢？这又是以固护气血为先，疏散邪气为后的另一种方法。
张公说：都说得神出鬼没，变化无穷，我又怎么能附和这种高深的见解呢？还有一句话想商量一下：产妇在临产前一个月，如果有风邪感冒等症状，都按风寒感冒治疗。到了临产期间，如果感受风邪，不可按普通风邪治疗。方剂使用人参一两，当归一两，川芎五钱，柴胡二钱，甘草一钱，白芥子三钱，水煎服。无论患者是头疼身痛，咳嗽太阳经疼痛，还是六经传变的伤寒，都适宜用此方治疗，切不可轻易使用桂枝、麻黄。因为孕妇与平常人的治疗方法大不相同。
孙真人说：大便不通，也有很多实证，天师所传的，是治疗虚证的方子罢了。我传授的这个方子，治疗实证者，确有奇效。方剂使用大黄五钱，当归尾一两，升麻五分，蜂蜜半碗，水煎服。（批注：天师说：此方还应加上熟地黄一两。）大黄具有泄利作用，用当归来润燥制约它，仍以当归为君药，虽然泄下但不过分猛烈，不至于造成亡阴的弊端；况且有升麻来提举阳气，那么在泄下中留有留存之力，又何必过度忧虑呢？
Tian Shi (Heavenly Master) stated: The so-called "Mo Zhi" (End Treatment/Secondary Treatment) refers to the treatment of diseases in the Six Fu Organs. If a person suffers from obstruction of urination and defecation, or persistent malaria, or postpartum wind-cold invasion, all are treated using the method of "Mo Zi". Following prolonged illness, or if there is no bowel movement for a month, one need not be impatient; simply tonify the True Yin (True Yin), so that essence is sufficient to generate blood, and blood is sufficient to moisten the intestines, allowing stool to pass naturally. One must not regard this as a fundamental disease requiring hasty cure. Similarly, if urine flows out drop by drop, there is no need for extreme anxiety, as this is due to Kidney Qi failing to circulate to the Bladder. Tonifying Kidney Qi will allow urine to flow naturally; again, it should not be viewed as a fundamental disease requiring urgent diuresis.
Formula for Obstruction of Defecation: Use Shu Di Huang (Prepared Rehmannia Root) 1 liang, Yuan Shen (Scrophularia Root) 1 liang, Dang Gui (Angelica Sinensis) 1 liang, Chuan Xiong (Ligusticum Chuanxiong Rhizome) 5 qian, Huo Ma Ren (Hemp Seed) 1 qian, Honey half a bowl, Da Huang (Rhubarb Root and Rhizome) 1 qian, Tao Ren (Peach Kernel) 10 pieces, Hong Hua (Safflower) 3 fen. Decoct in water and take orally. The brilliance of this formula lies in using Shu Di Huang, Yuan Shen, and Dang Gui to generate Yin Blood, with small additions of Hemp Seed and Rhubarb to moisten the intestines and promote downward movement. This precisely treats the constipation via "Mo Zhi" (addressing the root/end rather than the branch), rather than urgently forcing purgation.
Formula for Obstruction of Urination: Use Rou Gui (Cinnamon Bark) 1 qian, Shu Di Huang 1 liang, Shan Zhu Yu (Cornus Officinalis Fruit) 4 qian, Fu Ling (Poria) 2 qian, Che Qian Zi (Plantago Seed) 1 qian, Ze Xie (Alisma Rhizome) 1 qian, Dan Pi (Moutan Cortex) 1 qian, Shan Yao (Dioscorea Rhizome) 1 qian. Decoct in water and take orally. This formula is essentially Qi Wei Di Huang Tang (Seven-Ingredient Rehmannia Decoction). Its brilliance lies not in directly promoting urination, but in specifically treating Kidney Water and Kidney Fire. Since there is fire in the Kidney, the Qi transformation of the Bladder functions automatically; thus, without forcibly promoting urination, urination becomes unobstructed naturally. This is one method of "Mo Zhi".
When malaria persists, occurring day after day throughout the year, lasting months or years, or stopping only to recur, or remaining unresolved and difficult to cure, people often claim that pathogenic factors have not dispersed and urge immediate expulsion of pathogens, dismissing it as unworthy of "Mo Zhi". Little do they know that the long-standing presence of pathogens indicates severe deficiency of Zheng Qi (Upright Qi). Therefore, one should heavily tonify Zheng Qi and treat the pathogen secondarily ("Mo Zhi"). The formula uses Shu Di Huang 5 qian, He Shou Wu (Polygonum Multiflorum Root) 5 qian, Bie Jia (Turtle Shell) 5 qian, Bai Zhu (Atractylodes Macrocephala Rhizome) 5 qian, Dang Gui 5 qian, Ren Shen (Ginseng Root) 2 qian, Gan Cao (Licorice Root) 1 qian, Chai Hu (Bupleurum Root) 1 qian, Ban Xia (Pinellia Tuber) 1 qian, Rou Gui 5 fen, Shan Zhu Yu 4 qian. Decoct in water and take orally. The brilliance of this formula lies in using Shu Di Huang, Shan Zhu Yu, and Dang Gui to tonify Yin Blood, adding Ren Shen and Bai Zhu to strengthen the Spleen, adding Bie Jia to enter the Yin level, adding He Shou Wu to tonify Yin Qi, and adding Ban Xia and Chai Hu to slightly eliminate phlegm and pathogens. When Zheng Qi is abundant, pathogens retreat spontaneously. This is another method of "Mo Zhi".
Postpartum wind-pathogen invasion is also treated via "Mo Zhi". After childbirth, old blood is exhausted, and new blood has not yet formed. The body is extremely deficient and prone to pathogen invasion. If wind-cold invades and one merely disperses the pathogen, it will inevitably lead to Jue Ni (Reversal Cold Syndrome) and death within moments. The formula uses Dang Gui 1 liang, Chuan Xiong 5 qian, Ren Shen 1 liang, Jing Jie (Schizonepeta Spike) 1 qian, Rou Gui 1 qian, Yi Mu Cao (Motherwort Herb) 1 qian. The brilliance lies in using Ren Shen and Dang Gui, each 1 liang; Ren Shen consolidates Qi, and Dang Gui generates Blood. Once Qi and Blood are generated, the wind-pathogen is easily expelled. For extremely deficient individuals, adding slight pathogen-dispersing herbs allows pathogens to exit easily because the Cou Li (interstices/skin pores) are loose and the gates are unlocked. Jing Jie in the formula is particularly exquisite; not only does it easily dispel pathogens, but it also guides old blood back to its vessels and assists new blood in restoring normalcy, hence achieving success through their dual use. Yi Mu Cao is even more beneficial for obstetrics; what else could there be to worry about? This is yet another method: prioritizing the consolidation of Qi and Blood, with dispersing pathogens as secondary.
Master Zhang said: These explanations are profound and transformative; how can I add to such depth? However, I have one point for discussion: In the month prior to delivery, if symptoms like wind-pathogen colds occur, treat them as Wind-Cold Common Cold. During the time of delivery, if wind-pathogen invasion occurs, do not treat it as a common wind-pathogen case. Use the formula: Ren Shen 1 liang, Dang Gui 1 liang, Chuan Xiong 5 qian, Chai Hu 2 qian, Gan Cao 1 qian, Bai Jie Zi (White Mustard Seed) 3 qian. Decoct in water and take orally. Regardless of whether the patient has headache and body pain, cough, Taiyang meridian pain, or Shaoyang/Yangming/etc. transmitted cold damage, this formula is suitable. Do not lightly use Gui Zhi (Cinnamon Twig) or Ma Huang (Ephedra). The treatment for pregnant women differs significantly from that for ordinary people.
Sun Zhen Jun (True Lord Sun, i.e., Sun Simiao) said: Obstruction of defecation often involves Excess syndromes; the formula passed down by Tian Shi is for Deficiency syndromes. My formula, used for Excess syndromes, yields miraculous effects. The formula uses Da Huang 5 qian, Dang Gui Wei (Tail of Angelica Sinensis) 1 liang, Sheng Ma (Cimicifuga Rhizome) 5 fen, Honey half a bowl. Decoct in water and take orally. [Commentary: Tian Shi noted: Add Shu Di Huang 1 liang to this formula.] Da Huang promotes purgation, restrained by Dang Gui's moistening properties; Dang Gui remains the Sovereign herb. Although purgative, it is not overly fierce, avoiding the detriment of losing Yin. Moreover, with Sheng Ma lifting Qi, there is retention within purgation; why worry excessively?