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Use a large *Pachyma* (snail), pound it until mushy, and apply it to the area below the umbilicus; this can open up and clear constrained heat.

Method of Hot Compress on the Umbilicus
Take one green onion with roots (do not wash off the soil), one slice of fresh ginger, twenty-one fermented soybeans (*Douchi*), and two spoonfuls of salt. Grind and pound them together into a cake. Place the cake on a small pot to heat it up. Cover the umbilicus with the hot cake and secure it tightly with thick cotton wadding. After a while, when the qi flows freely, defecation will occur naturally; if not, replace with a new cake.

Take one large pig gallbladder. Cut both ends off a goose quill tube. Insert one end into the gallbladder and tie it securely with thread to prevent movement. Blow air into the opening of the gallbladder through the other end of the tube, then tie the opening with a slipknot to trap the air. Insert the other end of the goose quill tube inward into the anus. Remove the slipknot, allowing the bile to enter the intestines. Shortly thereafter, when the qi flows freely, defecation will occur naturally.

*Xi Jiang Yue*:
The syndrome of constipation differs in deficiency and excess. Deficiency is due to insufficient body fluids and poor circulation, causing dry intestines unable to transport stool. Internally administer *Tongyou Tang* (Unblocking the Abyss Decoction); externally use application or enema methods to unblock. If it is a heat syndrome with abdominal pain, *Sanhuang* (Three Yellows) formulas may be used.
If it is a food stagnation syndrome, there must be abdominal pain, yellowish complexion, and severe constipation difficult to endure. Use *Jiuzhuan Lingying Wan* (Nine-Turn Efficacious Pill).
If blood appears in the stool, the cause is accumulated heat in the Large Intestine. Use *Lianqiao* (Forsythiae Fructus), *Huaike* (Stemonae Radix - note: context implies bark/seed related herbs like Sophora), *Baipi* (Phellodendri Cortex), *Yupi* (Ulmus Bark), *Binglang* (Arecae Semen), and *Jingjie* (Schizonepetae Herba). If prolapse of the rectum occurs, add *Weipi* (Erinaceus Spina).
For frequent bleeding after defecation, *Diyu Wan* (Sanguisorbae Pill) is highly effective. Combine with *Fangfeng* (Saposhnikoviae Radix), *Zhike* (Aurantii Fructus), and *Sheng Huangqi* (Raw Astragali Radix); *Diyu* (Sanguisorbae Radix) and *Danggui* (Angelicae Sinensis Radix) are superior. Combine *Wumei* (Mume Fructus), *Gancao* (Glycyrrhizae Radix et Rhizoma), and *Hezi* (Chebulae Fructus) with *Huanglian* (Coptidis Rhizoma) and *Jingjie* (Schizonepetae Herba). Use *Fulonggan* (Dragon's Liver - calcined earth), *Huaihua* (Sophorae Flos), and *Baizhu* (Atractylodis Macrocephalae Rhizoma); form pills with rice vinegar and swallow.
Regarding the treatment of urinary retention, one must distinguish between Yin obstruction and Yang obstruction. Yin obstruction is caused by wind-cold invading due to deficiency. Add *Muxiang* (Aucklandiae Radix) to *Wuling San* (Five-Ingredient Powder with Poria), and add *Lingsha* (Cinnabaris et Realgar mixture) ground into powder. Swallow on an empty stomach with salt water. Externally, fry salt and hot-compress the umbilicus to promote qi flow without stagnation.
Yang obstruction is forced by sudden heat. Symptoms include red lips and face, and urine flowing like drops of bright blood. Add *Cheqianzi* (Plantaginis Semen) to *Wuling San*. Alternatively, use *Jianhong San* (Cut Red Powder). For severe cases, use *Bazheng San* (Eight-Ingredient Powder) with *Mutong* (Akebiae Caulis). Externally applying the hot compress method on the umbilicus will achieve patency. This is the meritorious achievement of pediatric therapy, worthy of praise.
There is also the condition of damp-phlegm sinking. The child is fat and robust, has phlegm in the throat, a slightly red face, and urine that stagnates upon landing. The shape is turbid like rice wash water. This syndrome must not be treated recklessly. Add *Cangzhu* (Atractylodis Rhizoma) to *Erchen Tang* (Two-Aged Decoction), and add *Mutong* (Akebiae Caulis) and *Shengma* (Cimicifugae Rhizoma).
Initially slightly red, it clarifies and turns white like rice wash water after a while. This is due to milk and food damaging the Spleen's primal qi, presenting as a syndrome of unclear separation of pure and turbid. Treat with *Fenqing Yin* (Separating Clear Decoction), or use *Weiling Tang/Wan* (Stomach-Ling Decoction/Pill). Prioritize tonifying the Spleen and resolving stagnation; only when the Spleen is solid can this illness be eliminated.
In all cases of treating urinary retention, cold-natured medicines should not be overused. If *Tianluo* (Snail) is applied to the umbilicus, cold pathogen is forced into the abdomen and becomes difficult to expel. It is advisable to use *Renshen* (Ginseng Radix), *Baizhu* (Atractylodis Macrocephalae Rhizoma), accompanied by *Fuling* (Poria) and *Gancao* (Glycyrrhizae Radix et Rhizoma). Additionally add *Cheqianzi* (Plantaginis Semen) and *Huashi* (Talcum), along with *Shengma* (Cimicifugae Rhizoma), *Huangqin* (Scutellariae Radix), and *Mutong* (Akebiae Caulis).
When both large and small bowels are blocked, the syndrome is indeed ominous and critical. It is most appropriate to first unblock the large bowel; the small bowel will naturally become patent. Use *Jiuzhuan Lingying Wan* (Nine-Turn Efficacious Pill), mixed with water decocted from *Cheqianzi* (Plantaginis Semen). Such treatment methods are truly miraculous; physicians should engrave them in their hearts and remember them firmly.
When blood appears in both large and small bowels, it is due to accumulated heat in the Heart and Lung attacking each other. *Sanhuang Jiedu* (Three Yellows Detoxification) possesses divine efficacy, with *Huanglian* (Coptidis Rhizoma) and *Huangqin* (Scutellariae Radix) working together. Also use *Huangbai* (Phellodendri Cortex), *Honghua* (Carthami Flos), and *Shengdi* (Rehmanniae Radix). *Dahuang* (Rhei Radix et Rhizoma), *Gancao* (Glycyrrhizae Radix et Rhizoma), and *Mutong* (Akebiae Caulis) are included. Only the root of *Danggui* (Angelicae Sinensis Radix) should be used, taken with plain water decoction.