🌿 Folk Prescriptions

Syndrome Differentiation and Treatment
I. Real Constipation
1. Accumulated Heat in the Intestines and Stomach
Symptoms: Hard stools, 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.
Therapeutic Principle: Clear heat, guide stagnation, moisten intestines, promote defecation.
Formula: Ma Zi Ren Wan. Ingredients: Rhubarb, Citrus Aurantium, Magnolia Bark purge the bowels and clear heat; Hemp seeds, Apricot kernels, honey moisten the intestines and promote defecation; Paeoniae Alba nourishes yin and harmonizes the blood. If body fluids are already damaged, add Rehmannia, Scrophularia, Ophiopogon to nourish yin and generate fluids. If liver fire is aggravated with anger and red eyes, take Geng Yi Wan to clear liver and promote defecation. If heat is mild or defecation is unsatisfactory after medication, use Qing Lin Wan to gently purge and avoid reconstipation. If heat is severe with fullness, dryness, hardness, and firmness, use Da Cheng Qi Tang urgently to preserve yin. Other options include Danggui Longhui Wan, Huanglong Tang, Liang Ge San.
2. Qi Stagnation
Symptoms: Hard or not very hard stools, desire to defecate but unable to pass, or incomplete defecation, intestinal rumbling, abdominal distension and pain, chest and rib fullness, frequent belching, poor appetite, thin greasy coating, wiry pulse.
Therapeutic Principle: Smooth qi, guide stagnation.
Formula: Liu Mo Tang. Ingredients: Aquilaria regulates qi, Wu Yao smooths qi, Agallochus descends qi, Rhubarb, Areca, Citrus Aurantium break qi and guide stagnation. Add Magnolia Bark, Cyperus, Bupleurum to assist qi regulation. If qi stagnation persists and transforms into fire, add Scutellaria, Gardenia, Gentiana to clear liver fire. If qi reverses and causes vomiting, add Pinellia, Inula, Hematite. If emotional distress leads to depression and silence, add Paeoniae Alba, Bupleurum, Albizia bark to relieve depression. If constipation results from trauma or postoperative abdominal 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 cramping and urgency, distension and resistance to pressure, lateral abdominal pain, cold extremities, hiccups, vomiting, white greasy coating, tight wiry pulse.
Therapeutic Principle: Warm interior, dispel cold, promote defecation, 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, Aquilaria to enhance purgative effect; add Dried Ginger, Fennel to increase cold-dispelling power. If severe abdominal pain with clenched jaw and sudden collapse due to extreme cold accumulation, use San Wu Bei Ji Wan to aggressively expel cold accumulation.
II. Deficient Constipation
1. Qi Deficiency
Symptoms: Stool not hard, but despite urge to defecate, straining fails to pass stool, weak defecation, sweating, shortness of breath, fatigue after defecation, pale face, lethargy, limb fatigue, weak pulse, pale tongue with white coating.
Therapeutic Principle: Tonify qi, moisten intestines.
Formula: Huang Qi Tang. Ingredients: Astragalus tonifies spleen and lung qi; Hemp seeds, honey moisten intestines; 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 deficiency, use Sheng Mai San. If long-term kidney qi deficiency, use Da Bu Yuan Jian.
2. Blood Deficiency
Symptoms: Hard stools, pale complexion, palpitations, shortness of breath, insomnia, vivid dreams, forgetfulness, pale lips, pale tongue with white coating, fine pulse.
Therapeutic Principle: Nourish blood, moisten dryness.
Formula: Run Chang Wan. Ingredients: Angelica, Rehmannia nourish blood and yin; Hemp seeds, Peach kernels moisten and promote defecation; Citrus Aurantium guides qi downward. Add Scrophularia, Fo-ti, Goji berries to nourish blood and moisten intestines. If blood deficiency generates internal heat, add Anemarrhena, Picrorhiza to clear deficiency heat. If yin-blood has recovered but stools remain dry, use Wu Ren Wan to lubricate the intestines.
3. Yin Deficiency
Symptoms: Hard stools resembling sheep droppings, emaciated body, dizziness, tinnitus, flushed cheeks, restlessness, poor sleep, night sweats, soreness and weakness in waist and knees, red tongue with little coating, fine rapid pulse.
Therapeutic Principle: Nourish yin, promote defecation.
Formula: Zeng Ye Tang. Ingredients: Scrophularia, Ophiopogon, Rehmannia nourish yin and generate fluids. Add Paeoniae Alba, Solomon’s Seal, Dendrobium to enhance nourishing yin. Add Hemp seeds, Platycladi Seeds, Trichosanthes seeds to enhance moistening effect. If stomach yin deficiency with dry mouth and thirst, use Yi Wei Tang. If kidney yin deficiency with soreness and weakness in waist and knees, use Liu Wei Di Huang Wan. If yin deficiency with dryness and heat damaging fluids, use Zeng Ye Cheng Qi Tang to increase fluid and facilitate defecation.
4. Yang Deficiency
Symptoms: Hard or not hard stools, difficult to pass, clear long urination, pale complexion, cold limbs, cold abdominal pain relieved by warmth, soreness and coldness in waist and knees, pale tongue with white coating, deep slow pulse.
Therapeutic Principle: Warm yang, promote defecation.
Formula: Ji Chuan Jian. Ingredients: Cistanche, Eucommia warm and tonify kidney yang, moisten intestines, promote defecation; Angelica nourishes blood and moistens intestines; Bupleurum, Alisma elevate clear and descend turbid; Citrus Aurantium widens the intestines and promotes downward movement. For elderly cold-deficient constipation, use Ban Liu Wan. For spleen yang deficiency with cold accumulation, use Wen Pi Tang. For kidney yang deficiency, use Shen Qi Wan. Other options include Li Zhong Wan, Si Shen Wan, You Gui Wan.
[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. Elderly or weak individuals, postpartum or post-illness patients with constipation often suffer from qi and blood deficiency, cold coagulation—treatment should proceed gradually, not expecting quick results. In general, if constipation is actively treated and combined with dietary, emotional, and exercise adjustments, most recover within a short time.
[Prevention and Adjustment]
For habitual constipation, maintain a cheerful mood, increase physical activity, pay attention to dietary adjustment, and establish regular toilet habits.