有风秘。冷秘。气秘热秘。又有老人津液干燥。是名虚证。妇人分产亡血。及发汗利小
便。
病后血气未复。皆能作秘。俱宜麻仁丸。风秘之病。由风搏肺脏。传于大肠。故传化难。或
其人素有风病
者。亦多有秘。宜小续命汤。去附子倍芍药。入竹沥两蚬壳许。实者。吞脾约麻仁丸。虚者
吞养正丹。冷秘由冷气横于肠胃。凝阴固结。津液不通。胃道秘塞。其人肠内气攻。喜热
恶寒。宜藿香正气散。加官桂枳壳各半钱。吞半硫丸。热药多秘。惟硫黄暖而通。冷药多泄
惟黄连肥肠而止泄。气秘而气不升降。谷气不行。其人多噫。宜苏子降气汤。加枳壳。吞
养正丹。或半硫丸来复丹未效。佐以木香槟榔丸。欲其速通。则枳壳生用。
热秘面赤身热。肠胃胀闷。时欲得冷。或口舌生疮。此由大肠热矣。宜四顺清凉饮。吞
顺肠
丸。或木香槟榔丸。有气作疼。大便秘结。用通剂而便愈不通。便有秘气。强饮通之。虽通
复闭。或迫之使通。因时下血者。此惟当顺气。气顺便自通。顺气之法。又当求温暖之剂。
曾有
下巴豆等药不通。进丹附却通。不可不知。老人虚秘。及出汗利小便过多。一切病后血气未
复而秘者。宜苏子降气汤。倍加当归。吞威灵仙丸。或肉黄饮苁蓉顺肠丸尤宜。
如妇人下血而秘者。见妇人门。
伤寒阳明经热实而闭。见诸伤门伤寒证。
宿食留滞。结而不通。腹胀气急。胸中痞满。宜感应丸加巴豆。
凡诸秘服药不通。或兼他证不受药者。用蜜皂角兑。冷秘生姜兑亦佳。
存在风秘、冷秘、气秘和热秘。此外，老年人因津液干燥所致者，属于虚证；妇女分娩时失血，以及发汗过多或利小便过度，还有病后气血尚未恢复，这些情况都能导致便秘。以上各类便秘均适宜服用麻仁丸。
风秘的病因是风邪搏结于肺脏，传变至大肠，导致传导功能困难。如果患者素来有风病，也常伴有便秘，适宜服用小续命汤，去掉附子，加倍使用芍药，并加入约两蚬壳量的竹沥。实证患者，可吞服脾约麻仁丸；虚证患者，可吞服养正丹。
冷秘是由于冷气横亘在肠胃之间，阴寒凝结固结，导致津液不通，胃道闭塞。患者感觉肠内气体攻冲，喜欢温热而厌恶寒冷，适宜服用藿香正气散，加入官桂和枳壳各半钱，并吞服半硫丸。热性药物多导致便秘，只有硫黄既能温暖又能通便；寒性药物多导致泄泻，只有黄连能使肠道充实并止住泄泻。
气秘表现为气机升降失常，谷气运行不畅，患者多打嗝，适宜服用苏子降气汤，加入枳壳，并吞服养正丹。如果服用苏子降气汤、养正丹或半硫丸、来复丹无效，可辅助服用木香槟榔丸以求速效。若要追求快速通便，则枳壳应生用。
热秘的症状包括面红身热，肠胃胀闷，时常想要冷饮，或者口舌生疮。这是由大肠有热引起的，适宜服用四顺清凉饮，吞服顺肠丸，或者木香槟榔丸。如果有气滞疼痛，大便秘结，使用通下剂后大便仍然不通，说明形成了“秘气”。强行饮用通下药物，虽然暂时通畅但随即又闭塞；或者逼迫其排便，导致时下出血。这种情况只应当顺气，气顺了大便自然通畅。顺气的方法，又应当寻求温热的方剂。曾经有用巴豆等药物治疗无效的病例，服用含有丹砂和附子的药物后却通了，这一点不可不知道。
老年人虚秘，以及出汗、利小便过多，一切病后气血未恢复而导致的便秘，适宜服用苏子降气汤，加倍加入当归，吞服威灵仙丸，或者肉苁蓉顺肠丸更为适宜。如果是妇女因下血而导致便秘，参见妇人门的相关记载。
There are constipation due to wind (Feng Mi), cold (Leng Mi), qi stagnation (Qi Mi), and heat (Re Mi). Additionally, dryness of body fluids in the elderly constitutes a deficiency syndrome. Blood loss during childbirth for women, excessive sweating or diuresis, and incomplete recovery of qi and blood after illness can all cause constipation. All such cases are suitable for treating with Mahuang Wan (Hemp Seed Pill).
The pathology of constipation due to wind arises from wind pathogens combing with the Lung organs and transmitting to the Large Intestine, thereby hindering transportation and transformation. Individuals who have a history of wind diseases often suffer from constipation as well; they are suitable for Xiaoxuming Tang (Minor Continuation of Life Decoction), with Fuzi (Aconite Root) removed, Shaoyao (Peony Root) doubled, and approximately two shellfuls of Zhuli (Bamboo Sap) added. For excess patterns, Pipaoshu Mahuang Wan (Spleen-Restricting Hemp Seed Pill) may be swallowed; for deficiency patterns, Yangzheng Dan (Nourishing Righteousness Pellet) may be swallowed.
Constipation due to cold is caused by cold qi horizontal in the stomach and intestines, condensing yin and binding firmly, leading to unavailability of body fluids and blockage of the gastric pathway. The patient feels qi attacking within the intestines, prefers warmth, and dislikes cold. Huoxiang Zhengqi San (Patchouli Powder to Rectify the Qi) is suitable, with Guigui (Cinnamon Twig) and Zhike (Aurantium Fruit) added, each half a qian, along with Banshu Wan (Half-Sulfur Pill). Warm-natured herbs often cause constipation, whereas only Sulfur (Liuhuang) is warming yet unblocking; cold-natured herbs often cause diarrhea, whereas only Huanglian (Coptis Rhizome) firms the intestines and stops diarrhea.
In constipation due to qi stagnation, the ascending and descending of qi fails, and grain qi does not move; the individual often belches. Suzi Jiangqi Tang (Perilla Seed Decoction to Descend Qi) with added Zhike is suitable, along with swallowing Yangzheng Dan. If Suzi Jiangqi Tang, Yangzheng Dan, Banshu Wan, or Laifu Dan (Reviving Origin Pellet) prove ineffective, Muxiang Binglang Wan (Costus and Areca Nut Pill) may be assisted to achieve rapid unblocking. To seek rapid passage, Shengyong (raw use) of Zhike is recommended.
Heat constipation presents with a red face, body heat, abdominal distension and fullness in the stomach and intestines, frequent desire for cold drinks, or sores on the mouth and tongue. This results from heat in the Large Intestine. Sishun Qingliang Yin (Four-Obedience Cooling Drink) is suitable, with Shunchuan Wan (Intestine-Obeying Pill) swallowed, or Muxiang Binglang Wan. If there is pain due to qi stagnation and severe constipation, using purgatives fails to relieve it, indicating the formation of "constipating qi." Forcing purgatives may yield temporary relief followed by re-obstruction, or forcing bowel movements may result in bleeding. In such cases, one should only regulate qi; once qi flows smoothly, stool will pass naturally. The method of regulating qi should seek warm formulas. There are cases where Baidu (Radix Euphorbiae Hussonis) failed to work, but Danfu (Pellets containing Cinnabar and Aconite) succeeded; this must be known.
For elderly deficiency constipation, and constipation resulting from excessive sweating or diuresis, or incomplete recovery of qi and blood after any illness, Suzi Jiangqi Tang with doubled Danggui (Angelica Sinensis) is suitable, swallowing Weilingxian Wan (Swallowwort Pill), or Roucong Rong Shunchuan Wan (Cistanche and Intestine-Obeying Pill) is even more appropriate. For women with constipation due to uterine bleeding, see the Women's Section.
Closure due to heat and excess in the Yangming Meridian of Cold Damage (Shanghan) is described in the Cold Damage Section.
Retention of undigested food causing stagnation and blockage, leading to abdominal distension, urgent breathing, and chest fullness, is suitable for Yinggan Wan (Miraculous Response Pill) with added Baidu.
For all types of constipation where medication fails to induce movement, or when other symptoms prevent taking oral medicine, Honey and Zaorjiao (Gleditsia Sinensis Fruit) mixed together may be used; for cold constipation, Ginger mixed with medicine is also excellent.