Written By Jun Heo (許浚, 1539~1615), translated by Namil Kim, Wung Seok Cha et al. Published by Ministry of Health & Welfare (Korea)
24 Blocked Flow of Feces 大便不通 대변이 나오지 않는 것
① Constipation is where the stool is dried and makes the person struggle in the toilet, while blocked flow (不通) means that feces does not come out for days and the abdomen swells.
② When the heat pathogen enters, dry feces appear in the stomach, and when the heat pathogen hides in the triple energizers, fluid and humor dry inside. This is because heat exists in the large intestine. In deficient persons, the viscera are cold so collateral vessels dry; in the aged, the viscera are cold and the pathways of qi are not smooth. This is because there is cool qi in the large intestine. Abdominal swelling, pain, discorfort, and nausea from chest stuffiness result from blockage by retained food. The intestines and stomach becoming dried and hardened from receiving wind pathogen; this is because wind-qi burns Fire up. When qi is unable to move down and the pathway of food is blocked, the person will hiccup. A Three Yellows Decoction (三黃湯) should be prescribed when heat exists, and a Pinellia and Sulphur Pill when cold exists. A spleen Accumulation Formula is used when there is retained food, Cannabis Fruit Pill for constipation due to wind and a Platycodi Radix and Ponciri Fructus Pericarpium Decoction when qi is unable to move down. The large intestine and lungs are in an exterior-interior relationship with each other. As the large intestine is the gateway of the road on which all qi flows, promoting the flow of lung qi is the key point of treatment.
③ Blocked the flow of feces from abdominal excess heat from chronic diseases should be promoted to flow with a Moisten Intestines Pill and severe diarrhea should never be induced.
④ The blocked flow of feces not responding to medicines like an Order the qi Decoction should be prescribed with a Four Substances Decoction with the addition of Arecae Semen (檳榔), Aruantii Fructus Immaturus (枳殼), Persicae Semen (桃仁), and Carthami Flos (紅花). Classic prescriptions used medicines that move qi down in treating the blocked flow of feces. This is from the point of view that lung qi should first descend for feces to be discharged. Herbs like Armeniacae Semen (杏仁), Aruantii Fructus Immaturus (枳殼), Aquillariae Lignum (沈香), and Terminaliae Fructus (訶子) are used. When the aged, deficient persons, or persons with wind disease have constipation from decreased fluid and humor, it should be moistened with medicines like Cannabis Semen (麻仁), Sesame, and Asini Corii Colla (阿膠). Strong medicine may make fluid and humor leak out and even if feces comes out for a moment, it will be constipated again or other diseases may appear.
⑤ A Miraculous Treasure Elixir, Perilla Disease Formula, Moisten Intestines Decoction, and Rhubarb Pill should be prescribed when feces are blocked. Prescriptions like Moisten Intestines Pill and Moisten Intestines Decoction should be used for the aged or deficient persons. Unblock Spirit Powder, Regulate and Guide Drink is prescribed for constipation in women.
⑥ A Diffuse Accumulation Pill and Lift Pelvic Cavity Powder are prescribed for external application.
- Spleen Accumulation Formula 脾積元 비적원: It treats abdominal swelling, acid regurgitation, and constipation from the stagnation of food. Curcumae Rhizoma (蓬朮) 1.5 nyang, Sparganii Rhizoma (三 稜) 1 nyang, Citri Unshius Pericarpium Immaturus (靑皮) 5 don, Alpiniae Officinari Phizoma (良薑) (decocted with vinegar, sliced thin and dried under fire), Aucklandiae Radix (木香), Fulvis Fumi Carbonisatus (百草霜), and Crotonis Semen Degelatinatum (巴豆霜) 2.5 don each. Powder these medicines, make into dough with flour paste, and make into pills the size of hemp seeds. Take 50~70 pills each time with water decocted with Citrus Unshius Pericarpium (橘皮).
- Miraculous Treasure Elixir 靈寶丹 영보단: It treats the blocked flow of feces by pushing accumulation out. Aucklandiae Radix (木香), Aquillariae Lignum (沈香), Olibanum (乳香) 0.5 don each, and Crotonis Semen (巴豆) (removal of skin, flesh and oil) 2 don. Powder these medicines, mix 3 Zizyphi Fructus (大棗) (steamed and removal of flesh) even, and pound it. Make into pills the size of mung beans. Take one pill at a time with cool water. To induce three times of diarrhea, first let the patient take cool water three times, and then take the medicine with cool water. For diarrhea of five to six times, drink five to six cups of water first, and then take the medicine.
- Moisten Intestines Decoction 潤腸湯 윤장탕: It treats chronic constipation. Cannabis Semen (麻仁) 1.5 glass (Ground finely and soaked in water, Sieved, skin removed, and juiced.), sesame seed half glass (Ground finely, soaked in water, sieved, and juiced), Persicae Semen (桃仁) (ground roughly) 1 nyang, and Schizonepetae Spica (荊芥穗) 1 nyang (powdered by pounding). Decoct these medicines with some salt and drink this instead of tea until feces comes out.
- Rhubarb Pill 大黃飮子 대황음자: It treats constipation from heat-dryness. Rehmanniae Radix Crudus (生地黃) 2 don, Rhei Radix et Rhizoma (大黃) (baked while buried under an ash Fire), Armeniacae Semen (杏仁), Gardeniae Fructus (梔子), Cimicifugae Rhizoma (升麻), Aruantii Fructus Immaturus (枳殼) 1 don each, Ginseng Radix (人參), Scutellariae Radix (黃芩), and Glycyrrhizae Radix (甘草) 5 pun each. Slice these medicines as 1 pack, put 5 pieces of Zingiberis Rhizoma (乾薑), 21 Sojae Semen Praeparatum (豆豉), and 1 Mume Fructus Praeparatum (烏梅), decoct these together, and take.
- Moisten Intestines Pill 潤腸丸 윤장환: It treats constipation in the aged from decreased blood and dried intestines. The stool is the color of the pig’s stool and will not come out for seven to eight days. When it does come out it is small in amount. Angelica Gigantis Radix (當歸), Rehmanniae Radix Crudus (生地黃), Aruantii Fructus Immaturus (枳 殼), Persicae Semen (桃仁), and Cannabis Semen (麻仁) all the same quantities. Powder these medicines, make into dough with honey, and make into pills the size of a seed of a foxglove tree. Take 40~50 pills each time with porridge on an empty stomach.
- Moisten Intestines Decoction 潤腸湯 윤장탕: It treats blocked feces in the aged and deficient persons. Honey 1 nyang, sesame oil 5 don, and Mirabilitum (朴硝) 1 handful. Decoct these medicines in a half doe of water until it boils up several times. Take it warm.
- Regulate and Guide Drink 調導飮 조도음: It treats constipation in women before and after labor. Angelica Gigantis Radix (當歸), Cnidii Rhizoma (芎藭), Saposhnikoviae Radix (防風), Aruantii Fructus Immaturus (枳殼) 1.25 don each, and Glycyrrhizae Radix (甘草) 3 pun. Slice these medicines as 1 pack, put 3 pieces of Zingiberis Rhizoma (乾薑), 2 Zizyphi Fructus (大棗), decoct in water, and take it on an empty stomach.
- Diffuse Accumulation Pill 宣積丸 선적환: It treats blocked feces. Crotonis Semen (巴豆) (removal of skin), Zingiberis Rhizoma (乾薑), Allium tuberosum Rottl. ex Spreng (韭子), Alpiniae Officinari Phizoma (良薑), Sulfur (硫黃), Euphorbiae Kansui Radix (甘遂), and White Arecae Semen (白檳榔) all the same quantities. Powder these medicines, make into dough with steamed rice and make into pills the size of Galli Ovum (雞子). After washing hands with water decocted with Zanthoxyli Pericarpium (川椒), apply sesame oil on the palms in the early morning, and hold one pill, then diarrhea will come out soon. To stop the diarrhea, wash hands with cold water.
- Lift Pelvic Cavity Powder 提盆散 제분산: ① It treats the blocked flow of feces. Cut the root of one Allii Fistulosi Bulbus (葱白) and get juice from the end. Powder Aconiti Ciliare Tuber (草烏) very finely. Put the juice and powder together and insert through the anus. It will be unblocked soon. ② This is also known as a Thunderbolt Arrow. It treats blocked feces and urine.
25 Blocked Feces and Urine 大小便不通 대소변이 나오지 않는 것
① In the Inner Classic (內經), blocked feces, and urine are called Samchoyak (三焦約: disease caused by the dysfunction of the triple warmer). Yak (約) means obstruction of flow. Blocked feces and urine are also yin yang obstruction and rejection, which is the equivalent to Sam Cho Yak.
② When the feces and urine do not come out well due to triple energizer constipation, a Bitter Orange Pill and Push Qi Pill should be used.
③ When feces and urine do not come out, a Three and One Raise Qi Decoction, Catharsii Corpus and Gryllotalpa Powder, Iron Feet Pill, Reversal Powder, Rotate and Exchange Powder, Dung Beetle Powder, Euphorbiae Powder, and Umbilicus Plaster should be prescribed.
④ For external application, a Return Life Spiritual Paste, Cloves Powder, navel-compressing therapy, enema, and suppositories can be used.
• Push Qi Pill 推氣丸 추기환: It treats constipation and red or yellow urine from qi not being able to ascend or descend. Pharbitidis Semen (黑丑) (first powder after sieved), Rhei Radix et Rhizoma (大黃), Arecae Semen (檳榔), Ponciri Fructus Immaturus (枳實), Citrus Unshius Pericarpium (陳皮), and Scutellariae Radix (黃芩), all the same quantity. Powder these medicines, make into paste by boiling Zingiberis Rhizoma (乾薑) juice, and make into pills the size of a seed of a foxglove tree. Take 30~50 pills at a time with water decocted with Zingiberis Rhizoma (乾薑).
- Three and One Raise Qi Decoction 三一承氣湯 삼일승기탕: ① It treats blocked feces and urine and fullness and pain in the chest and abdomen from exuberant heat in Cold Damage and miscellaneous diseases. ② By leading Natrii Sulfas (芒硝) and Rhei Radix et Rhizoma (大黃) into the large intestine, it moistens what is dried, softens what is hardened, and discharges heat. Both located in the bottom, feces and urine, belong to yin. In the division of front and back, front is qi and back is blood. It can be said that the kidneys conduct difficulties both in defecation and urination. Residential urination and constipation are both from decreased water. In the Classic (經), it is said, “When heat is excess inside, it should be treated with salty and cold medicine and assisted with a bitter taste.” Therefore, in this medicine, Natrii Sulfas (芒硝) and Rhei Radix et Rhizoma (大黃) function to reinforce each other.
- Catharsii Corpus and Gryllotalpa Powder 車狗散 거구산: ① It treats chronically blocked feces and urine causing stuffiness and fullness as if death is near. 7 tumblebug (推車客) and 7 mole cricket (土狗). For the male patient, use the heads of the tumblebugs and use the bodies of the mole crickets. For the female patient, use the heads of the mole crickets and use the bodies of the tumblebugs. Put the two medicines on a new roof tile and dry under the sun, powder, mix with thick decoction of the skin of Ailanthi Radicis Cortex (樗根白皮) (虎目樹) facing South-east and take. It works dramatically. Chu geo (推車) is a tumblebug and To gu (土狗) is a mole cricket. As some people say that Ailanthi Radicis Cortex (樗根白皮) is a tree of heaven and others say that Ailanthi Radicis Cortex (樗根白皮) is a Korean knotweed, probably a tree of heaven is right.
- Euphorbiae Powder 甘遂散 감수산: It treats blocked feces and urine. Mix 2 nyang of red-skinned Euphorbiae Kansui Radix (甘遂) and 2 hop of boiled honey even, quarter 1 nyang, and take once a day with honey-water.
- Iron Feet Pill 鐵脚丸 철각환: It treats blocked feces and urine. Make into dough large Gleditsiae Spina (皂角) (burned with property maintained and powdered) with flour paste (added with alcohol) and make into pills the size of a seed of a foxglove tree. Take 30 pills at a time with alcohol.
- Reversal Powder 顚倒散 전도산: It treats blocked feces, blocked urine, or blocked feces and urine. Rhei Radix et Rhizoma (大黃), Talcum (滑石), and Gleditsiae Spina (皂角) 3 don each. Add 3 don of Talcum (滑石) when urine does not come out, add 3 don of Rhei Radix et Rhizoma (大黃) when feces does not come out; when urine and feces both do not come out, add Rhei Radix et Rhizoma (大黃) and Talcum (滑石) 3 don each. Powder these medicines, mix 3 don each time in warm alcohol, and take on an empty stomach.
- Umbilicus Plaster 貼臍膏 첩제고: It treats blocked feces and urine. Mix powdered Euphorbiae Kansui Radix (甘遂) and flour to make into paste. Place some of the paste in the middle of the umbilicus and the other on the tender area under the umbilicus. Also, take decocted Glycyrrhizae Radix (甘草) until feces comes out.
- Rotate and Exchange Powder 倒換散 도환산: It treats blocked feces and urine. Slice Rhei Radix et Rhizoma (大黃) 1 nyang and Armeniacae Semen (杏仁) 3 don when feces does not come out, slice Rhei Radix et Rhizoma (大黃) 3 don and Armeniacae Semen (杏仁) 1 nyang when urine does not come out. Divide them into 2 packs, decoct in water, and take.
- Dung Beetle Powder 蜣蜋散 강랑산: This is also called Two Marvels Powder (二妙散). It treats blocked feces and urine. Thread a tumblebug on the stool of cow or horse in June or July and keep it in the shade until dried. Put a normal one on the clean brick and after burning with an ash Fire from every direction, cut the waist with a knife. Use the upper half when feces are blocked, use the lower half when urine is blocked, and use all when feces and urine are both blocked. Finely powder this and take with fresh water, and feces and urine will be unblocked.
- Return Life Spiritual Paste 迴生神膏 회생신고: It treats blocked feces and urine for days from yin syndrome. This is for emergency use only. Ostreae Testa牡蠣粉 (old one) and Zingiberis Rhizoma (乾薑) (baked after wrapped with damp paper) 1 nyang each. Powder these medicines finely. For a male patient, knead it with female’s saliva, put it on the palm, rub until heated, and cover both testes. Then with sweating, it will be recovered. For a female patient, knead it with male’s saliva, put it on the palm, rub until heated, and cover both breasts then it will be recovered as sweat comes out. As testes and breasts are the basis of male and female, they belong to Gam and Ri trigrams (坎离) from the Book of Changes as separated.
- Cloves Powder 丁香散 정향산: It dramatically treats blocked feces and urine. Syzygii Flos (丁香) 5 don, Aconiti Tuber (川烏) (baked after wrapped with damp paper), Aconiti Ciliare Tuber (草烏) (baked after wrapped with damp paper), Angelicae Dahuricae Radix (白芷), Gleditsiae Spina (猪牙皂角) (baked after wrapped with damp paper), Asiasari Radix et Rhizoma (細辛) 3 don each, Piperis Nigri Fructus (胡椒) 1 don, and Moschus (麝香) a little. Powder these medicines finely, put in a bamboo pipe, and blow into the anus. Then feces and urine will come out soon after.
25-1 Navel-compressing Therapy 罨臍法 엄제법
① It treats blocked feces and urine. Put 1 spoon of powdered Alumen (礬石) in the navel and drop cold water to let cold qi enter into the stomach; then feces and urine will come out.
② To treat blocked feces and urine, grind 1~2 stem of leek, one lump of Zingiberis Rhizoma (乾薑), 21 Sojae Semen Praeparatum (豆豉) and one spoon of salt together, and make into rice cake. After heating this, stick it on the navel, tie, and fix with cloth. After a while, qi will flow well and feces will come out naturally. If no feces come out, stick another rice cake on it.
③ When the patient is unable to recognize people from blocked feces, pound 1~2 alive fresh water snails with the shells with one spoon of salt together. Then put it 1.3 cun below the navel and tie it with cloth. Feces will come out soon very well.
④ Pound fresh water snail with the shell and add a little Moschus (麝香). Stick it on the navel and rub with hands. Feces will come out soon.
⑤ In the treatment of blocked feces and urine, powder Crotonis Semen (巴豆肉), Armeniacae Semen (杏仁), and Gleditsiae Spina (皂角) to make into rice cake and then cover the navel and apply moxibustion. Then feces will come out naturally.
⑥ Snail Paste (蝸牛膏) treats blocked feces and urine. Pound 3 snails with the shell and add Moschus (麝香) a little. Stick it on the navel and rub with hands. Feces and urine will come out soon. Someone tested with fresh water snails as there were no snails, and it showed dramatic effects.
25-2 Enemas and Suppositories 導便法도변법
① When medicine cannot be prescribed for blocked feces in the aged or deficient persons, put powdered Gleditsiae Spina (皂角) in boiled honey, rub, make into a pill, and then put into the anus. Then feces will come out soon.
② Mil Jun Do Bub (蜜煎導法 : Honey-stick suppository method) is boiling 7 hop of honey over a mild fire as in making yeot (Korean hard taffy), rubbing it with hands to make into jujube seed-shaped pills, and inserting into the anus, pressing it with the hands, and then picking out when feces are about to come out.
③ In treating blocked feces, mix one pig’s gall bladder without bile and a bit of vinegar and put into the anus. Then feces will come out naturally.
④ The honey-stick suppository method treats blocked feces. Boil 3 hop of honey and two pig’s bile as in making yeot (Korean hard taffy), rub with fingers when it congeals to the size of the little finger, soak in cold water, and then insert into the anus. Then feces will come out soon. It is good to make into pills with powdered Gleditsiae Spina (皂角) mixed together and it is also good to add powdered Menthae Herba (薄荷).
⑤ Fumigation also treats blocked feces. Burn Gleditsiae Spina (皂角) in a bowl, put in a tub, and fumigate the bottom. Then feces will come out soon after.
⑥ Mil Do bub (honey suppository method) is like as follows. Boil honey thick and yellow and put in cold water. Make into the size of a little finger right away and coat with powdered Gleditsiae Spina (皂角) and Moschus (麝香). Put oil around the interior anus and insert the medicine into the anus. Then feces will come out soon.
⑦ Defecation induced with pig’s bile is like this. Remove bile by tilting one pigs gall bladder, add vinegar in, connect it to a bamboo pipe, and insert the pipe into the anus. As the gall bladder is massaged into the anus, feces will soon come out.
⑧ Enema by sesame oil is as follows. Soak the bamboo pipe in the juice of leek and put deep into the anus. Put a mixture of half sesame oil and half warm water in the pig’s urinary bladder and connect to the bamboo pipe. Then make the patient stand on his/her hands. Then feces will come out in an hour.
⑨ Chronic feces otherwise treated ineffectively may be treated as follows. Let one person wait with sesame oil in the mouth. Put one small bamboo pipe into the patient’s anus and let the person blow sesame oil into the anus. Then patient will feel oil coming up as if a worm is creeping, discharge black feces, and be recovered.
⑩ Folk remedy is as follows. Mix sesame oil and soy sauce, put into the anus, and then feces will come out. Or put Platycodonis Radix (桔梗) (raw one soaked in oil or soy sauce) into the anus and feces will come out.
⑪ In the honey-stick suppository method, feces will not be discharged without Gleditsiae Spina (皂角).
