🌿 Folk Prescriptions

Differential Diagnosis and Treatment
One, Real Constipation
1. Accumulated Heat in Intestines and Stomach
Symptoms: Hard stool, abdominal distension and pain, flushed face, feverish body, dry mouth and bad breath, restlessness, short red urine, red tongue with yellow dry coating, slippery rapid pulse.
Treatment Method: Clear heat, guide stagnation, moisten and unblock.
Formula: Ma Zi Ren Wan. Ingredients: Rhubarb, Citrus Aurantium, Magnolia Bark clear the bowels and clear heat; Hemp seeds, Apricot kernels, honey moisten the intestines and unblock defecation; Peony nourishes yin and harmonizes blood. If body fluids are already injured, add Rehmannia, Scrophularia, Ophiopogon to nourish yin and generate fluids. If there is liver stagnation with anger and red eyes, add Gengyi Wan to clear liver and unblock bowels. If heat is not severe or defecation is not smooth after medication, use Qinglin Wan to gently clear the bowels and avoid reconstipation. If heat is intense, with fullness, hardness, dryness, and firmness, use Da Chengqi Tang urgently to preserve yin. Other formulas may be selected based on syndrome differentiation: Danggui Longhui Wan, Huanglong Tang, Liangge San.
2. Qi Stagnation
Symptoms: Hard or not very hard stool, desire to defecate but unable to pass, or incomplete evacuation, intestinal rumbling, abdominal distension and pain, chest and rib fullness, frequent belching, poor appetite, thin greasy coating, wiry pulse.
Treatment Method: Regulate Qi, guide stagnation.
Formula: Liu Mo Tang. Ingredients: Sandalwood regulates Qi, Wu Yao promotes Qi, Aquilaria descends Qi, Rhubarb, Areca Nut, Citrus Aurantium break Qi and guide stagnation. Add Magnolia Bark, Cyperus, Bupleurum to assist Qi regulation. If Qi stagnation has long persisted and transformed into fire, add Scutellaria, Gardenia, Gentiana to clear liver fire. If there is vomiting due to Qi reversal, add Pinellia, Inula, Hematite. If emotional distress leads to depression and silence, add Peony, Bupleurum, Albizia to relieve depression. If constipation occurs after injury or surgery, due to Qi stagnation and blood stasis, add Persica, Safflower, Red Peony to activate blood and resolve stasis.
3. Cold Accumulation and Stagnation
Symptoms: Difficult defecation, abdominal pain with cramping, distension and tenderness, lateral abdominal pain, cold extremities, hiccups, vomiting, white greasy coating, wiry tight pulse.
Treatment Method: Warm interior, dispel cold, unblock bowels, relieve pain.
Formula: Da Huang Fu Zi Tang. Ingredients: Aconite warms and disperses cold, Rhubarb clears accumulated stagnation, Asarum disperses cold and relieves pain. Add Citrus Aurantium, Magnolia Bark, Sandalwood to enhance purgative effect; add Dried Ginger, Fennel to enhance cold-dispelling power. If there is severe abdominal pain, clenched jaw, sudden collapse due to extreme cold accumulation, use Sanwu Beiji Wan to aggressively expel cold accumulation.
Two, Deficient Constipation
1. Qi Deficiency
Symptoms: Stool is not hard, but despite the urge, straining fails to evacuate, sweating, shortness of breath, fatigue after defecation, pale face, fatigue, listlessness, weak pulse.
Treatment Method: Tonify Qi, moisten intestines.
Formula: Huangqi Tang. Ingredients: Astragalus tonifies spleen and lung Qi, Hemp seeds, honey moisten intestines and unblock defecation, Tangerine Peel regulates Qi. If Qi deficiency is severe, add Ginseng, Atractylodes. If Qi deficiency leads to prolapse, use Bu Zhong Yi Qi Tang. If lung Qi is insufficient, add Shengmai San. If long-term deficiency leads to kidney Qi insufficiency, use Dabuyuan Jian.
2. Blood Deficiency
Symptoms: Hard stool, pale complexion, palpitations, shortness of breath, insomnia, frequent dreaming, forgetfulness, pale lips, pale tongue with white coating, fine pulse.
Treatment Method: Nourish blood, moisten dryness.
Formula: Runchang Wan. Ingredients: Angelica, Rehmannia nourish blood and yin, Hemp seeds, Peach kernels moisten and unblock, Citrus Aurantium guides Qi downward. Can add Scrophularia, Polygonum, Goji berries to nourish blood and moisten intestines. If blood deficiency leads to internal heat, add Anemarrhena, Picrorhiza to clear deficient heat. If yin-blood has recovered but stool remains dry, use Wu Ren Wan to lubricate the intestines.
3. Yin Deficiency
Symptoms: Hard stool resembling sheep droppings, emaciated body, dizziness, tinnitus, red cheeks, irritability, poor sleep, night sweats, soreness and weakness in waist and knees, red tongue with little coating, fine rapid pulse.
Treatment Method: Nourish yin, unblock bowels.
Formula: Zengye Tang. Ingredients: Scrophularia, Ophiopogon, Rehmannia nourish yin and generate fluids. Can add Peony, Polygonatum, Dendrobium to enhance nourishing yin; add Hemp seeds, Platycladus seed, Trichosanthes seed to enhance moistening intestines. If stomach yin deficiency with dry mouth and thirst, use Yiw Wei Tang. If kidney yin deficiency with soreness and weakness, use Liuwei Dihuang Wan. If yin deficiency with dryness and stagnation, severe heat depleting fluids, use Zengye Chengqi Tang to increase fluids and facilitate bowel movement.
4. Yang Deficiency
Symptoms: Hard or not hard stool, difficult to pass, clear long urination, pale complexion, cold limbs, abdominal cold pain relieved by warmth, soreness and coldness in waist and knees, pale tongue with white coating, deep slow pulse.
Treatment Method: Warm yang, unblock bowels.
Formula: Jichuan Jian. Ingredients: Cistanche, Eucommia warm and supplement kidney yang, moisten intestines, and unblock bowels; Angelica nourishes blood and moistens intestines;升Ma, Ze Xie raise clear Qi and descend turbid Qi; Citrus Aurantium widens the intestines and descends Qi. For elderly with cold deficiency constipation, use Banliu Wan. For spleen yang deficiency with cold accumulation, use Wenpi Tang. For kidney yang deficiency, use Shenqi Wan. Other formulas may be selected based on syndrome differentiation: Lǐzhōng Wán, Sìshén Wán, Yòuguī Wán.
[Prognosis and Outcome]
If constipation persists, it may lead to anal fissures, hemorrhoids, impair digestive function, and even cause turbid Qi to rise, resulting in various complications. For elderly, weak, postpartum, or convalescent patients with constipation, it is mostly due to qi and blood deficiency, cold accumulation, requiring gradual treatment—speed is not expected. In general, with active treatment combined with dietary, emotional, and exercise care, most cases recover within a short period.
[Prevention and Adjustment]
For habitual constipation, maintain a cheerful mood, increase physical activity, pay attention to dietary adjustment, and establish regular toilet habits.