Constipation, fluid dryness

For fluid dryness constipation, add Semen Cannabis Sativae Huo Ma Ren), Herba Cistanchis (Ron Cong Rong), Radix Achyranthis Bidentatae (Niu Xi), Radix Polygoni Multiflori He Shou Wu), and Fructus Immaturus Citri Seu Ponciri (Zhi Shi). 

In adults, the signs and symptoms of hypothyroidism include somnolence, slow mentation, dryness and loss of hair, increased fluid in body cavities (e.g., the pericardial sac), low metabolic rate, tendency to gain weight, hyperlipidemia, subnormal temperature, cold intolerance, bradycardia, reduced systolic and increased diastolic pulse pressure, hoarseness, muscle weakness, slow return of muscle to the neutral position after a tendon jerk, constipation, menstrual abnormalities, infertility, and sometimes myxedema (hard edema of subcutaneous tissue with increased content of proteoglycans in the fluid). A goiter (i.e., enlargement of the thyroid gland) may be present. 

Da Huang and Mang Xiao can be selected if constipation occurs due to dryness and heat in the Large Intestine. Da Huang can stimulate the Large Intestine and purge the feces Mang Xiao can increase the fluid in the intestines and soften the feces. As both are cold in nature, they can also reduce heat in the intestines. 

The dryness arising in the Stomach and Large Intestine can be very severe and because they are Yang Ming organs, they are filled up with heat, the Yin and fluid are easily injured and acid regurgitation and constipation may occur. 

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