有痰，有湿热，有血热，察其兼证，脉理推疗。如患风寒疟邪等而足跟痛，但宜清解足太阳经邪，病痊自已。
主方 苍术 防风 枳壳 当归（各二钱） 防己（钱半） 牛膝 薏苡仁 木瓜（各一钱）水煎服。
血热，四物加黄柏、知母、牛膝；寒痰，五积散加木瓜；湿热，除湿汤加薏苡仁。
经曰∶北方黑色，通入于肾，开窍于二阴，藏精于肾。又曰∶肾主五液。故肾实则津液足而大
便润，肾虚则津液竭而大便燥。凡大便秘结，皆由房劳过度或恣饮酒，喜食辛热。饮食火起于脾胃
，淫欲火起于命门。致阴虚血耗，火盛水亏，津液少生，传道失度。有高年血少或脱血肠枯；或新
产血竭；或虚人运滞；皆成斯证。惟当养血滋阴，滑涩润燥，勿妄通利，耗伤真元，再发转甚。辨
风秘、气秘、热秘、寒秘、湿秘之异酌治。若日久幽门不通，上冲吸门不开，渐成噎膈者有矣。脉
沉伏而结，自汗，小便涩，忌攻，宜猪胆法润。
主方 （热秘）当归 生地 熟地 麻仁 桃仁 杏仁 枳壳 浓朴 条芩（各七分） 大黄
（酒蒸，五分） 水煎服（或丸。）
血虚加芍药，倍归、地、桃仁；风秘，郁李仁、羌活、皂荚；气虚，人参、麦冬；气实，槟榔
、枳实；痰多，栝蒌、竹沥；老人，天麦冬、蒌仁，倍归地；产后加人参、红花（倍归、地、玄、
苓、桃；）幽门不通加槟榔。
脾约丸 治肠胃燥热，大便不通，宜兼燥证参酌。
大黄（酒蒸） 浓朴 枳实 白芍（各二两） 杏仁 麻仁（各两半）
上末，炼蜜和丸桐子大，每服三十丸，空心白汤下，常服寸丸。
润肠丸 治脾火，肠燥秘结，少食。
琼脂膏 润燥通便（二方并见燥证。）
补中益气汤 （方见虚损）治气虚秘，加养血润肠药。血虚，四物吞脾约丸。
四物汤 （方见妇科）治血燥秘，加桃仁、大黄（等分）为末，蜜丸，三十丸汤下。
搜风顺气丸 能润肠宣水，久服诸病皆效（方见中风。）
掩脐法 大小便秘。葱（一枝）、姜（一块）、豉（二十粒）、盐（一匙），共捣掩脐，帛缚自通。
蜜导，猪胆，香油灌等法（见伤寒门。）
简便方 便秘。
朱砂（飞，研，一钱） 真芦荟（一钱四分）
细研，滴好酒和丸，作二次，好酒下。
又 黑丑（半生半熟）研末，每服二钱，热茶下。或麻子研，和米煮粥。
又 羊蹄根一两，水煎服。常食猪油及悉尼，妙。
又 苁蓉（一个，重三、四两者，酒洗，去鳞甲，）白酒三碗，煎一碗服。峻补精血，便通。
体内有痰湿，有湿热，有血热，需观察其伴随症状，通过脉象原理来推断治疗方法。如果是因风寒疟邪等导致足跟痛，只需清解足太阳经的邪气，病自然会痊愈。
主方：苍术、防风、枳壳、当归（各二钱），防己（一钱半），牛膝、薏苡仁、木瓜（各一钱），水煎服。
若是血热证，用四物汤加黄柏、知母、牛膝；若是寒痰证，用五积散加木瓜；若是湿热证，用除湿汤加薏苡仁。
《内经》说：北方对应黑色，精气通入于肾，开窍于前后二阴，精气藏于肾。又说：肾主管五种津液。所以肾气充实则津液充足而大便滋润，肾气虚弱则津液枯竭而大便干燥。凡是便秘，大多是由于房事过度或纵欲饮酒，喜欢食用辛辣热气食物所致。饮食之火起于脾胃，淫欲之火起于命门。导致阴虚血耗，火盛水亏，津液生成减少，传导功能失常。也有老年人血少或失血后肠道干枯；或新产后血液枯竭；或体虚之人运化停滞；都形成这种病症。只应当养血滋阴，滑涩润燥，不要妄用攻下通利之法，以免耗伤真元，使病情复发加重。辨别风秘、气秘、热秘、寒秘、湿秘的不同酌情治疗。如果日久幽门不通，向上冲击吸门不开，逐渐形成噎膈病的也有这种情况。脉象沉伏而结代，自汗，小便涩滞，忌用攻下法，宜用猪胆汁导法润肠通便。
主方（热秘）：当归、生地、熟地、麻仁、桃仁、杏仁、枳壳、浓朴、条芩（各七分），大黄（酒蒸，五分），水煎服（或制成丸剂）。
血虚加芍药，加倍使用当归、地黄、桃仁；风秘，加郁李仁、羌活、皂荚；气虚，加人参、麦冬；气实，加槟榔、枳实；痰多，加栝蒌、竹沥；老年人，加天冬、麦冬、栝楼仁，加倍使用当归、地黄；产后加人参、红花（加倍使用当归、地黄、玄参、茯苓、桃仁）；幽门不通加槟榔。
脾约丸：治疗肠胃燥热，大便不通，宜结合燥证情况斟酌使用。
大黄（酒蒸）、浓朴、枳实、白芍（各二两），杏仁、麻仁（各一两半）。
以上研末，炼蜜和丸如梧桐子大，每次服用三十丸，空腹用白开水送服，常服可增至寸许大小的一丸。
琼脂膏：润燥通便（这两个方子并见于燥证章节）。
补中益气汤（方见虚损章节）：治疗气虚便秘，加养血润肠药。血虚者，用四物汤吞服脾约丸。
四物汤（方见妇科章节）：治疗血燥便秘，加桃仁、大黄（等分）研末，蜜丸，每次三十丸，开水送服。
搜风顺气丸：能润肠宣水，久服对多种疾病皆有效（方见中风章节）。
掩脐法：治疗大小便便秘。葱（一根）、姜（一块）、豆豉（二十粒）、盐（一匙），共同捣碎敷在肚脐上，用布帛缚紧，自然通畅。
蜜导、猪胆、香油灌肠等方法（见伤寒门章节）。
简便方：治疗便秘。
朱砂（飞研，一钱），真芦荟（一钱四分）。
细研，滴好酒调和成丸，分为两次服用，用好酒送下。
又方：黑丑（半生半熟）研末，每次服用二钱，用热茶送下。或者将麻子研碎，和米煮粥吃。
There is phlegm, damp-heat, and blood-heat; observe the accompanying symptoms and deduce the treatment through pulse diagnosis. If heel pain is caused by wind-cold or malaria pathogens, it is only necessary to clear and resolve the pathogenic factors of the Foot-Taiyang Bladder Meridian (Zu Tai Yang Jing), and the disease will heal itself.
Main Formula: Cangzhu (Atractylodis Rhizoma), Fangfeng (Saposhnikoviae Radix), Zhike (Aurantii Fructus), Danggui (Angelicae Sinensis Radix) (each 2 qian), Fangji (Stephaniae Tetrandrae Radix) (1.5 qian), Niuxi (Achyranthis Bidentatae Radix), Yiyiren (Coicis Semen), Mugua (Chaenomelis Fructus) (each 1 qian). Decoct in water and take orally.
For blood-heat syndrome, use Siwu Tang (Four Substances Decoction) with added Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), and Niuxi; for cold-phlegm syndrome, use Wuji San (Five Accumulations Powder) with added Mugua; for damp-heat syndrome, use Chushi Tang (Dampness-Removing Decoction) with added Yiyiren.
The Classic states: The North corresponds to black, its essence connects to the Kidney, opens into the two yin orifices, and stores essence in the Kidney. It also states: The Kidney governs the five fluids. Therefore, when Kidney qi is substantial, body fluids are sufficient and stool is moist; when Kidney qi is deficient, body fluids are exhausted and stool becomes dry. All cases of constipation arise from excessive sexual activity, indulgence in alcohol, or a preference for spicy and hot foods. Fire from diet originates in the Spleen and Stomach, while fire from lust originates in the Mingmen (Gate of Life). This leads to yin deficiency and blood consumption, excess fire and water depletion, reduced production of body fluids, and dysfunction of transmission and transformation. In elderly people with blood deficiency or after hemorrhage, the intestines may become dry; similarly, after childbirth when blood is depleted, or in weak individuals with sluggish transportation, these conditions result in this syndrome. One should nourish blood and yin, lubricate dryness and unblock stiffness, and avoid reckless purgation that consumes true yuan (original qi), which would cause recurrence and worsening. Differentiate between wind constipation, qi constipation, heat constipation, cold constipation, and damp constipation, and treat accordingly. If long-standing obstruction of the pylorus prevents the opening of the shamen (cardia), leading gradually to dysphagia (yige), such cases exist. With a deep, hidden, and knotted pulse, spontaneous sweating, and astringent urination, purgation is contraindicated; instead, use the pig gallbladder method for lubrication.
Main Formula (Heat Constipation): Danggui (Angelicae Sinensis Radix), Shengdi (Rehmanniae Radix), Shudi (Rehmanniae Radix Preparata), Maren (Cannabis Semen), Taoren (Persicae Semen), Xingren (Armeniacae Semen Amarum), Zhike (Aurantii Fructus), Nongpo (Moutan Cortex/Zhi Ke variant context implies Magnolia Bark usually Houpo but text says Nongpo, likely Houpo), Tiaoqin (Scutellariae Radix) (each 7 fen), Dahuang (Rhei Radix et Rhizoma, steamed with wine) (5 fen). Decoct in water and take orally (or make into pills).
For blood deficiency, add Shaoyao (Paeoniae Radix Alba), and double the dosage of Danggui, Dihuang, and Taoren; for wind constipation, add Yuliren (Pruni Semen), Qianghuo (Notopterygii Rhizoma et Radix), and Zhaojiao (Gleditsiae Sinensis Spina); for qi deficiency, add Renshen (Ginseng Radix) and Maidong (Ophiopogonis Radix); for qi excess, add Binglang (Arecae Semen) and Zhishi (Aurantii Fructus Immaturus); for excessive phlegm, add Gualou (Trichosanthis Fructus) and Zhuli (Bambusae Caulis in Taenia); for the elderly, add Tianmendong (Asparagi Radix), Maidong, and Louren (Trichosanthis Semen), doubling Danggui and Dihuang; postpartum, add Renshen and Honghua (Carthami Flos) (doubling Danggui, Dihuang, Xuanshen, Fuling, Taoren); for pyloric obstruction, add Binglang.
Pi Yue Wan (Spleen-Restriction Pill): Treats intestinal and stomach dryness-heat with constipation; consult dryness syndromes for reference.
Dahuang (steamed with wine), Nongpo (Houpo), Zhishi, Baishao (each 2 liang), Xingren, Maren (each 1.5 liang).
Grind into powder, mix with refined honey to form pills the size of tung tree seeds. Take 30 pills each time, swallowed with plain warm water on an empty stomach. For regular use, increase to the size of an inch-long pill.
Run Chang Wan (Intestine-Lubricating Pill): Treats spleen fire, intestinal dryness constipation, and poor appetite.
Qiongzhi Gao (Agar Jelly Paste): Lubricates dryness and promotes bowel movement (both formulas appear under Dryness Syndromes).
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (see Deficiency Syndromes): Treats qi deficiency constipation; add blood-nourishing and intestine-lubricating herbs. For blood deficiency, swallow Pi Yue Wan with Siwu Tang.
Siwu Tang (Four Substances Decoction) (see Gynecology): Treats blood-dryness constipation; add Taoren and Dahuang (equal parts), grind into powder, mix with honey to form pills, take 30 pills with warm water.
Sou Feng Shun Qi Wan (Search Wind and Smooth Qi Pill): Lubricates intestines and promotes water metabolism; effective for various diseases with long-term use (see Stroke Syndromes).
Umbilical Covering Method: For fecal and urinary retention. Mix one scallion, one piece of ginger, twenty grains of fermented soybean (Chishao), and one spoonful of salt; pound together and apply to the umbilicus, binding tightly with cloth until natural passage occurs.
Methods such as honey suppository, pig gallbladder enema, and sesame oil enema (see Shanghan Men/Exogenous Febrile Disease Section).
Simple Formula for Constipation:
Zhusha (Cinnabar, washed and ground, 1 qian), Zhen Luye (Real Aloe, 1.4 qian).
Grind finely, mix with good liquor to form pills, divide into two doses, take with good liquor.
Another formula: Heiqiu (Brayerae Semen, half raw half roasted), grind into powder, take 2 qian each time with hot tea. Or crush hemp seeds and cook congee with rice.
Another formula: Yangti Gen (Radix Rheum Palmati), 1 liang, decoct in water and take. Frequently consuming lard and Sydney (Note: 'Xini' likely a typo for a specific food/herb like 'Xinyi' or local term, kept as transliteration per instruction) is excellent.
Another formula: Congrong (Cynomorii Herba, one piece weighing 3-4 liang, washed with wine, scales removed), decoct in three bowls of white wine until one bowl remains, then drink. Vigorously tonifies essence and blood, promoting bowel movement.