《孫真人備急千金要方》Vol. 48

Emptiness and Fullness of the Flesh

The Treatise says: When the flesh is deficient, a person cannot sit steadily and the body tends to sway. When the flesh is replete, a person sits steadily and does not like to move, but breathes rapidly. Changes in the deficiency and repletion of the flesh are mainly associated with the Spleen. If an illness in the organs and bowels causes the flesh to become hot, this corresponds to an organ; if the flesh becomes cold, it corresponds to a bowel.

Five-Plus Wine: This treats deficient flesh, unsteady sitting, and restlessness, a condition attributed to the Spleen being injured by cold Qi. Take two sheng each of Wujia bark and goji bark; eight liang each of dried Rehmannia and salvia root; one jin each of gypsum (another version reads “stone bed”) and Eucommia bark; four liang of dried ginger; and three liang of aconite. Cut up all eight ingredients and steep them in two dou of clear wine for three nights. Take seven ge per dose, twice a day.

Pinellia Decoction: This treats replete flesh, when a person sits steadily but cannot move, accompanied by panting. The formula is used when the Spleen is affected by Heat pathogens and there is obstruction of Qi flow with panting. Take eight liang each of Pinellia and aged fresh ginger; five liang of apricot kernels; four liang each of asarum and tangerine peel; one liang of ephedra; seven liang of gypsum; and two liang of blackberry lily. Cut up all eight ingredients, add nine sheng of water, and boil down to three sheng. Divide into three doses. To promote bowel movements, add three liang of mirabilite.

Constipation

The Treatise says: Some people recover from an epidemic illness, then develop constipation and eventually die from it. This must never be taken lightly. The author sets out these formulas in particular so that people can be prepared when an emergency arises. Even if this is not considered a serious, life-threatening illness, it is lamentable when people who do not know how to use medicines can only wait helplessly as the condition worsens. Constipation is generally treated with oily or slippery substances, sometimes combined with cold water. When assessing the condition, a yellowish complexion may indicate that the bowels are unlikely to move freely.

The Hemp Seed Pill is indicated by this pulse pattern: the Fuyang pulse (the Stomach meridian pulse on the top of the foot) is floating and rough. A floating pulse indicates that Stomach Qi is relatively strong; a rough pulse indicates frequent urination. When the floating and rough qualities occur together, the stool becomes dry and hard. This means that the Spleen’s transformation and distribution functions are constrained, a condition known as “Spleen constraint”: the patient has dry, hard stools and free urination, but is not thirsty.

Use two sheng of hemp seed, eight liang each of immature bitter orange and peony root, one sheng of apricot kernels, and one jin each of rhubarb and magnolia bark. These six ingredients are ground into a fine powder and mixed with honey to make pills the size of parasol tree seeds. Take five pills at a time, three times a day, then gradually increase the dose to ten pills. The prescriptions recorded in the Zhouhou Fang and the Waitai Miyao do not include apricot kernels.

A prescription for treating blockage and obstruction, with no bowel movement

Use five liang each of mirabilite, smoked plum, and mulberry root bark; four liang each of peony root and apricot kernels; three liang of hemp seed; and eight liang of rhubarb. Cut the seven ingredients into pieces and boil them in seven sheng of water. Reduce the liquid to three sheng and take it in three doses.

Another recorded prescription omits the smoked plum and instead adds two liang each of immature bitter orange and dried rehmannia root.

A prescription called the “Divine Remedy” for severe constipation

If pig or sheep bile is unavailable, use an enema syringe to draw up about three ge of bile, insert it well into the anus, and inject the bile. A bowel movement will usually follow quickly. If the bowels have not emptied fully, another injection may be given after a short while. Another prescription mixes winter mallow seed juice into the bile; this also works well.

Alternatively, mix five sheng of pepper and fermented soybean decoction with three ge of pork fat and administer it as an enema. Or boil honey until thick, shape it into a finger-sized stick, and insert it well into the anus. Another option is to prepare half a sheng of strong wine that has not been clarified with ash, add three qian of salt, and process it; then use it as described above. These prescriptions use readily available ingredients and may be chosen according to what is on hand.

Three-Yellow Decoction: a prescription for heat accumulation in the lower burner that prevents bowel movements

Use three liang of rhubarb, two liang of scutellaria root, twenty gardenia fruits, and one liang of licorice root. Cut the four ingredients into pieces and boil them in five sheng of water. Reduce the liquid to one sheng and eight ge, and take it in three doses. If the constipation is severe, add two liang of mirabilite.

Five-Softening Pills: a prescription for difficult, blocked bowel movements, physical weakness and depletion, inability to nourish the muscles through food, and disharmony of the Three Burners and the nutritive and defensive Qi

Steam one sheng of rhubarb over three dou of rice. Add two liang of hog-fennel root, and one liang each of pinellia, cistanche, peony root, poria, Chinese angelica, field pennycress seed, and asarum. Grind all nine ingredients into a fine powder, mix with honey, and pound repeatedly ten thousand times to make pills the size of parasol tree seeds. Take fifteen pills after meals, gradually increasing the dose. Take them twice a day. Cui says this prescription improves the appetite and makes food easier to digest.

(The opening is a fragment from the preceding prescription; the wording is incomplete.) To strengthen its nourishing and Qi-boosting effects, add half a liang of pine nuts and half a liang of anlü and take them with it. To soothe the middle burner, one may also take the medicine referred to as “buru yin” (the original text here may contain a transcription error). One may also add one liang of Scutellaria root.

Great Five-Softening Pill: Treats disordered movement of Qi through the organs and bowels and difficulty passing stool. It also harmonizes the nutritive and defensive Qi and promotes free flow.

Formula to Unblock the Nine Orifices, Aid Digestion, and Boost Qi

Ingredients: rhubarb, peony, immature bitter orange, cistanche (written as “xirong” in the original), water lily seed, licorice, Scutellaria root, and Achyranthes root (two liang each); 100 peach kernels and 40 apricot kernels.

Grind all ten ingredients into a fine powder, mix with honey, and form pills the size of parasol tree seeds. Take three pills three times a day, gradually increasing the dose to twenty pills, with wine.

Moistening the Bowels Decoction: Treats constipation lasting six or seven days, with dry, hard stool in the abdomen, chills and fever, restlessness and urgency, shortness of breath, sweating, abdominal distension, and other symptoms.

Ingredients: fresh kudzu root and lard, two sheng each; rhubarb, one liang.

Cut the three ingredients into pieces, add seven dou of water, and boil until five dou of liquid remain. Strain out the dregs, then add the lard and simmer until three dou remain. Let the liquid settle and take it. A robust person should take the full amount at once; a frail person should divide it into two doses. This formula is also used for difficulty urinating and defecating.

Formula for Treating Constipation

Ingredients: kansui, one jin; soybeans, five sheng; pokeweed root and Achyranthes root, three jin each.

Cut the four ingredients into pieces, add five sheng of water, and boil until two sheng of liquid remain. Use this liquid to cook five sheng of soybeans until it has boiled away and the beans are dry. Take three beans at first, adjusting the dose until the bowels move freely.

Another formula: Mix honey with swallow droppings and insert the mixture into the anus; this will relieve constipation.

Another formula: Mix four sheng of water with one sheng of honey and boil. Let it cool, then inject it into the anus. The bowels should move after about the time it takes to eat a meal.

Another formula: Combine half a ge of salt with three ge of honey and simmer until thick and sticky like malt syrup. Remove it from the heat and place it in cold water. Roll it into a finger-thick pill shaped like a betel nut and insert it deep into the anus; this should quickly relieve constipation.

Formula for Treating Difficult Defecation

One may use fermented soybean liquid, soy sauce, sheep’s milk cheese, or snake gourd root juice alone as an enema; this should quickly relieve constipation.

Another formula: Soak smoked plums in soy sauce, then inject the liquid into the anus.

Another formula: A handful each of white mulberry root bark and white elm root bark.

Cut the two ingredients into pieces, add three sheng of water, and boil until one and a half sheng remain. Divide into three doses.

Another formula: Add three sheng of peach tree bark to five sheng of water and boil until one sheng remains. Take the whole amount at once.

Another prescription: Boil a handful of sheep sorrel root in one sheng of water. When the liquid has reduced to half a sheng, drink it all at once.

Another prescription: Boil hemp seeds regularly and drink the liquid.

Another prescription: Take five he of honey decoction regularly.

Another prescription: Mix lard with powdered old mallow seeds (mallow seeds that have been stored for several years) and form pills the size of parasol tree seeds. Take ten pills at a time and stop once bowel movements become easy.

Another prescription: Take one fangcunbi of peach blossoms (about a small spoonful of medicinal powder) with water. If peach blossoms are unavailable, peach tree bark may be used instead.

Another prescription: Taking plantain seeds and leaves regularly is also effective.

Another prescription: Pound the roots of winter mallow to extract their juice, and drink it fresh.

Another prescription: Take three cun of good-quality glue and a handful of scallion whites. Boil these two ingredients in four sheng of water until the liquid is reduced to one and a half sheng, then drink it all at once. This should bring on a bowel movement.

Another prescription: Take one sheng each of winter mallow seeds and ox butter (butter made from cow’s milk); lard may be used instead of ox butter. First boil the winter mallow seeds in four sheng of water until the liquid is reduced to one sheng, then add the butter and bring it to a boil once more. Let it cool and drink it in two portions.

Another prescription: Mix equal amounts of winter mallow seed juice and milk, and drink. This should bring on a bowel movement quickly.

Another prescription: Take three sheng of clear soy sauce, two sheng of sesame oil, and three cun of scallion whites. Boil them together until the mixture turns black, then strain out the dregs. Let it cool and drink it all at once. Another version omits the clear soy sauce.

Mirabilite Pills: For abdominal distention and difficulty passing stool

Take one and a half liang each of mirabilite and peony, two liang each of apricot kernels and rhubarb, and one liang plus six zhu of baical skullcap. Grind the five ingredients into powder and use honey to form pills the size of parasol tree seeds. Take fifteen pills with water, gradually increasing to twenty, until bowel movements become easy. Take three times a day.

Another prescription: Take four liang each of tetrapanax pith and mirabilite, and three liang each of Chinese plums, baical skullcap, and larkspur. Chop the six ingredients, add eight sheng of water, and boil until reduced to two and a half sheng. Divide into three portions and take them separately. Another method is to put the ingredients in a silk bag and boil them; once cooked, drink two sheng all at once.

Another prescription: Roast a single-clove garlic bulb, peel it, wrap it in cotton cloth, and insert it into the anus; this should quickly restore the flow of Qi. Alternatively, slice off a piece of ginger, wrap it in salt, and insert it into the anus; or pound dried ginger, salt, and apricot kernels together into pills and insert them into the anus. These methods are also effective.

Prescriptions for abdominal distention and obstruction

Take one sheng of evodia, dried ginger, rhubarb...

Chinese angelica root, cinnamon heartwood, peony root, licorice root, chuanxiong (also called Sichuan lovage root), ginseng, asarum, white peach bark (the white inner bark of the peach tree), pearl, and realgar. Licorice root, chuanxiong, and some other ingredients are specified as “two liang each”; ginseng, asarum, and others as “one liang each.” Use one handful of white peach bark, half a liang of pearl, and eighteen zhu of realgar.

Chop the thirteen ingredients. Boil them in one dou of water until three sheng of liquid remain, then strain out the herbs. Add the finely ground realgar and pearl, along with one sheng of wine, and bring the mixture to a boil three times over a low flame. Take one sheng per dose. Stop taking it once the medicine has been consumed.

Zouma Decoction treats various sudden attacks of demonic affliction, heart pain, abdominal distension, and inability to pass stool. (The formula appears in “Treating Heart and Abdominal Pain.”)

Croton Pill treats cold accumulations, retained food, and food that remains undigested and blocks the abdomen after prolonged drinking or overeating.

Formula: one sheng of croton kernels and five sheng of clear wine. Put the croton kernels in the wine and boil for three days and three nights, then pound them. Once thoroughly cooked, simmer the mixture with the wine over a low flame and form it into pills the size of fava beans. To induce vomiting or bowel movements, take two pills.

Lianzhong Pill treats retained food that will not digest and difficulty passing stool. (In the Handbook of Prescriptions for Emergencies, it is called “Chengqi Pill.”)

Eight liang of rhubarb, and four liang each of Chinese laticed seeds, apricot kernels, and mirabilite. Grind the four ingredients into a fine powder and form pills with honey, each the size of a paulownia seed. Take seven pills after meals, three times a day, gradually increasing the dose.

Moxibustion

For difficulty passing stool, apply seven moxa cones on each side of the seventh vertebra, one cun from the spine; then apply three cones at each of the two Chengjin points. The Chengjin points are in the hollows at the center of the calf muscles.

For inability to pass stool, apply moxibustion at the points called “Intestinal Seepage,” two cun to either side of Yuquan. The number of moxa cones should equal the person’s age. (Another account places the points two and a half cun apart.) One may also apply four cones at Dadun. Dadun is near the base of the big toenail, where the hairs at the end of the toe gather.

For blocked stool, qi stagnation, and hard, distended fullness below the heart, apply one hundred moxa cones at Shimen.

For constipation and inability to pass stool, apply moxibustion at Dadu on the foot, using a number of cones equal to the person’s age.

To treat incontinence in the elderly and children, apply three moxa cones on each big toe, one cun from the toenail; then apply three cones at the cleft between each big toe and second toe.

Formulas for Treating Inability to Urinate or Defecate

Grind one sheng of sunflower seeds (winter-mallow seeds) into powder and take one handful of green bamboo leaves. Boil the two ingredients in two sheng of water, bringing it to a boil five times, then take the entire amount at once.

Another formula: one sheng of sunflower seeds and one sheng of chopped elm bark. Boil the two ingredients in five sheng of water until two sheng of liquid remain, then divide into three doses.

Another prescription: Take one sheng of sunflower seeds (the seeds of winter mallow) and boil them in three sheng of water. When the liquid has reduced to one sheng, strain out the residue and add one sheng of pork fat. Take on an empty stomach in two doses.

Another prescription: Boil the binding strap used to secure a rice steamer and mix the resulting liquid with one square-inch spoonful of cattail pollen. Take in seven doses.

Another prescription: Take one jin of pork fat and boil it three times with two sheng of water. Drink the resulting liquid; it is said to relieve constipation quickly.

Prescriptions for Difficulty Urinating and Defecating

Take two sheng of sunflower seeds and two liang of sodium nitrate. Boil them in five sheng of water until the liquid has reduced to two sheng, then take in two doses.

Prescriptions for Children Unable to Urinate or Defecate

Grind white-flowered mallow seeds into powder, boil them in water, and drink the liquid.

Another prescription: Grind the white part of chicken droppings into powder and take one qian-spoonful.

Moxibustion Methods

When urination and defecation are obstructed and abdominal pain is about to begin, apply one hundred moxibustion cones to the “Four Rongwei Points.” These points lie on either side of the spine, one cun from it.

For heat in the abdomen, difficulty urinating and defecating, and lower back pain extending to the chest, apply one hundred cones to “Tuangang.” The points lie two cun below Xiaochangshu, the back-shu point associated with the small intestine. There are three points in a horizontal row, each one cun apart.

For difficulty urinating and defecating, apply three cones one cun below the navel. Another hundred cones may also be applied along the abdominal crease.

For difficulty urinating and defecating, apply one hundred cones to the “Eight Jiao” points (jiao is pronounced “liao”). They lie three cun below the hollows of the lower back, on either side of the spine, with four cun between the left and right sides. There are four points on each side, eight in all, hence the name “Eight Jiao.”

For children unable to urinate or defecate, apply one cone at each corner of the mouth.

For difficulty urinating and frequent diarrhea, apply fifty cones to “Qu Gu Duan.”

For difficulty urinating and diarrhea, apply one hundred cones to “Tianshu.” Tianshu lies on either side of the navel, about three cun from it. The source says this is the “abode of the hun and po” and must not be needled. Its general locating instruction is one cun beside the navel, with the distance across the navel bringing the total to about three cun.

Sun Simiao, Essential Prescriptions Worth a Thousand in Emergencies, juan 48.