I would like to talk about my clinical experience in treating habitual constipation in the elderly. Habitual constipation in the elderly, clinical extremely common, when patients visit, often said to a long course of disease, more than a few years, less than a few months, every few days a stool, like goat shit, dry and hard as a stone, throwing the ground, extremely painful to relieve stool. The doctor often has no good strategy, mostly to laxative treatment, or cast to clear the heat and fire, such as the ox huang on the clearing pill, noon tea, or senna leaf, rhubarb bubble water, or to the western medicine phenol peptide long-term oral, or to open the enema. Patients can mostly relieve the stool after using it. As a result, patients feel its effectiveness, long-term repeated use of the. The result is constipation for a long time, the more pass more constipation! Must be engaged in clinical people have more of the same feeling. The brilliant treatment, or people who have some understanding of Chinese medicine, more to hemp pill treatment. Ma Ren Wan, from the “Golden Horoscope”: “tarsus Yang pulse floating and astringent, floating is strong gas, astringent is the number of urine, floating astringent phase, the stool is firm, its spleen is about, Ma Ren Wan main.” The pathogenesis is dryness and heat in the intestines and stomach, deficiency of fluid, and loss of moistening of the intestines. The formula uses fire hemp seed, almonds, white peony and honey to lax the bowels and Xiao Cheng Qi Tang (Rhubarb, Citrus aurantium and Hou Pu) to move the Qi, pass the stool and relieve heat. The pathogenesis of constipation treated by this formula is different from that of habitual constipation in the elderly, therefore, the treatment of habitual constipation in the elderly can only be effective for a while, but cannot solve the problem at the root! So, what are the characteristics of the pathogenesis of habitual constipation in the elderly? This will be analyzed from the physiopathological characteristics of the elderly. The Nei Jing? Shanggu Tianzhen said: men “five or eight kidney qi failure, hair fall teeth haggard”, women “five or seven Yangming pulse failure, the face began to anxiety, hair began to fall. Sixth and seventh, three Yang pulse decay in the upper, face are scorched, hair begins to white. Seventy-seven Ren pulse deficiency, Tai Chong pulse decay less, the day sebum exhaustion, the earth does not pass, so the form is bad and childless.” In other words, people who are over half a century old mostly have the pathological changes of essence and blood deficiency and kidney yang deficiency. Combined with the condition of elderly patients with habitual constipation, they often have other conditions such as dizziness, tinnitus, and lumbago. Therefore, I believe that the key to the pathogenesis of habitual constipation in the elderly lies in the deficiency of kidney essence and deficiency of yuan yang. For the treatment of constipation caused by deficiency, Zhang Jinyue points out that “where the disease involves deficiency and constipation, then agents such as nitrous oxide attack must not be used.” Therefore, in the selection of the formula, it is necessary to consider three characteristics, one is the formula of the drug should have the effect of tonifying the kidney and benefit the essence, the second is the drug should also have the effectiveness of warming the kidney Yang, the third is to be able to laxative and laxative. Only drugs that have all three can really be applied to the treatment of habitual constipation in the elderly. In clinical practice, I used to use Jichuan Decoction from Jing Yue Quan Shu as the base formula for treatment. The recipe is as follows: Cistanches 20g, Lock-Yang 20g, Angelica Sinensis 20g, Huai Niu Knee 20g, Sheng Ma 3g, Citrus aurantium 10g. 6g of Rhubarb and 15g of Fire Ma Ren are added in the first 7 doses. This formula is actually Ji Chuan Decoction minus Ze Di, plus Lock-Yang. The “Ben Jing Feng Yuan” said: “Cistanches and lock Yang, always one of a kind, taste thick sexual descending, the life of the phase fire is appropriate for those who are inadequate, the severe replenishment of essence and blood, sudden use of reaction stool slippery diarrhea …… lock Yang treatment waist and knee weakness, because it can warm the essence and blood. The total are nourishing benefit of the fire experience, the elderly dry knot, it is appropriate to cook porridge to eat.” The “Materia Medica Seeking Truth” says: “Lock-Yang specializes in the kidneys, and also into the large intestine.” In the recipe, Cistanches and Lock-Yang are the rulers, accompanied by Angelica sinensis and Huai Niu Knee to moisten the intestines, but both have the function of tonifying the kidney and benefiting the essence and blood. With Shengma and Citrus aurantium, clearing and lowering turbidity, clearing and lowering turbidity, then the internal qi will be released. Why did you remove Zelig from Ji Chuan Decoction? It is not suitable for people who are deficient in essence, blood and fluid, so it is removed. This formula in the clinical treatment of hundreds of such patients, most patients can solve the problem at the root, the use of the following skills: ① Cistanches, lock Yang, Angelica, Huai Niugini dose must be large; ② treatment course should be long enough, generally less than 1 month, more than 2 to 3 months, that is, the stool is still applied for a period of time after normal; ③ to go to the toilet regularly, to develop the conditioned reflex of defecation.