2. Jichuan Jian from "Jing Yue Quan Shu"

2. Jichuan Jian from "Jing Yue Quan Shu"

[Composition] Dang Gui 12 grams, Niu Xi 6 grams, Cistanche deserticola (washed with alcohol to remove salt) 6 grams, Alisma orientalis 4.5 grams, Cimicifuga foetida 2 grams, Citrus aurantium 3 grams.

[Administration] Decocted in water and taken orally.

[Indications] Kidney deficiency leading to constipation.

[Symptoms] Lower back and shoulder pain, dizziness and tinnitus, clear and long urine, and difficulty in defecating.

[Explanation] When kidney qi is deficient, lower back and shoulder pain, dizziness, and tinnitus occur. According to "Su Wen · Water Heat Evil Theory," "The kidneys are the gate of the stomach." When kidney qi is deficient, the large intestine (which, like the stomach, belongs to the Yangming meridian) loses its ability to transport, resulting in constipation. In this formula, Cistanche deserticola warms and tonifies kidney yang, while also lubricating the intestines and promoting bowel movements as the primary function; Niu Xi strengthens the kidneys and lowers the waist, guiding qi downward as a supplementary function; Alisma orientalis has a downward trend and can reduce turbidity, Cimicifuga foetida lightly disperses and clarifies, Citrus aurantium regulates qi and expands the intestines, and Dang Gui activates blood circulation and nourishes blood—all serving as additional measures.

[Clinical Modifications] For those with qi deficiency, add ginseng; for those with excessive fire, add Scutellaria baicalensis; for those with kidney deficiency, add Shu Di Huang; for those with severe deficiency, remove Citrus aurantium.

[Reference Materials] Whenever a condition involves deficiency and constipation, agents that aggressively attack the problem should never be used. If there is no choice but to address the issue, this formula should be preferred, as it combines both purging and tonifying. ("Jing Yue Quan Shu")

[Commentary] This formula can be used for constipation caused by chronic wasting diseases, such as tuberculosis and tumors; it can also be used for constipation in the elderly due to physical weakness.

4. Tonifying Purgation

Tonifying purgative formulas have the effect of both reinforcing vital energy and purging, suitable for constipation caused by deficiency of vital energy and excess of pathogenic factors. Patients present with weak constitutions and abdominal distension with constipation. In such cases, purely purging would further weaken vital energy, while purely tonifying would exacerbate the accumulation of pathogenic factors; if no action is taken, pathogenic factors cannot be eliminated, and if no tonification is done, vital energy cannot be restored. Therefore, combining purging with tonifying is the best solution, balancing both aspects.