《婴童百问》云∶小儿大便不通，乃胃与大肠有热，以致秘结不通，用清凉饮之类。若饮食
夹惊，及积滞而不通者，用大连翘饮之类。惊风积热而不通者，用掩脐法。此皆治实热之例
也，余尝治之。因乳母或儿膏粱积热，及六淫七情、郁火，传儿为患者，用清邪解郁之剂。
禀赋怯弱，早近色欲，大便难而小便牵痛者，用滋补肺肾之剂。《褚氏遗书》云∶男子精未
满而御女，以通其精，则四体有不满之处，异日有难状之疾。老人阴已痿而思色，以降其精
，则精不出而内败，精已耗而复竭之，则大小便牵痛如淋。今童子即有此患，益见今人所禀
，与古人大径庭矣。人之血气浓薄既殊，而医之用药疗法，又岂可泥执古方，而无加减之变
乎？
治验
一小儿食膏粱之味，大便不通，饮冷发热，用清凉饮加大黄而通。后饮食停滞，腹痛大便不
通，用保和丸而痛止，再煎槟榔汤送保和丸，一服而便通。
一小儿食粽停滞，大便不通，痛不可忍，手足发搐，用大柴胡汤，调酒曲末一钱，下滞秽甚
多，作呕不食，用五味异功散加柴胡、升麻而愈。
一小儿大便不通，审乳母饮食浓味所致，用清胃饮以治母热，儿间饮以一二匙而愈。后乳母
感寒腹痛，食姜酒之物，儿大便秘结，兼便血，仍用清胃散，每日数匙而愈。
一小儿因乳母暴怒，大便不通，儿亦患之，兼用加味小柴胡汤，儿先用保和丸二服，后用五
味异功散加升麻、柴胡，儿日饮数匙并愈。
大柴胡汤（方见痉症）
神芎丸（方见惊风）
六味丸（方见肾脏）
清胃散（方见内钓）
According to *Yingtong Baiwen* (Hundred Questions for Infants and Children): Constipation in infants and children is caused by heat in the Stomach and Large Intestine, leading to dryness and obstruction. Treatments such as Qingliang Yin (Cooling Drink Decoction) are used. If constipation results from food stagnation complicated by fright, or from retained food causing obstruction, Dalianqiao Yin (Great Lonicera Decoction) is indicated. For constipation due to convulsions and accumulated heat, the Umbilical Covering Method (applying medicine to the navel) is employed. These are all examples of treating excess-heat patterns, which I have personally treated. In cases where heat accumulates from the wet nurse or infant consuming rich and greasy foods, or where transmission occurs due to the Six Exogenous Pathogens (Wind, Cold, Summerheat, Dampness, Dryness, Fire), Seven Emotions (Joy, Anger, Worry, Pensiveness, Sorrow, Fear, Fright), or constrained fire affecting the child, decoctions that clear pathogenic factors and resolve constraint are used. For children with congenital weakness, or those suffering from premature depletion of essence (metaphorically referring to early sexual activity or excessive strain on kidney essence), presenting with difficult defecation and pulling pain in urination, decoctions that tonify the Lung and Kidney are prescribed.
*Chu Shi Yi Shu* (Remnant Book of Master Chu) states: If a man engages in intercourse before his essence is full, draining it prematurely, his body will not fully develop, and he may suffer from inexplicable ailments later in life. If an elderly man, whose yin energy has already declined, indulges in lust and forces ejaculation, the essence exits but internal vitality decays; if essence is already depleted yet further exhausted, it leads to pulling pain in both bowel movements and urination resembling strangury (Lin syndrome). Today, even young boys suffer from this condition, further demonstrating that the innate constitution of people today differs significantly from that of the ancients. Since the thickness and thinness of blood and qi vary among individuals, how can physicians rigidly adhere to ancient prescriptions without making modifications?
Clinical Cases:
Case 1: An infant developed constipation after consuming rich and greasy foods, followed by fever after drinking cold water. Treatment with Qingliang Yin plus Rhubarb (Dahuang) resulted in the passage of stool. Later, due to food stagnation, abdominal pain, and constipation, Baohe Wan (Harmonize the Stomach Pill) was administered, stopping the pain. Subsequently, Bilelang Tang (Areca Seed Decoction) was decocted to administer with Baohe Wan; after one dose, bowel movement was restored.
Case 2: An infant suffered from constipation and unbearable pain due to sticky rice dumpling (Zongzi) stagnation, accompanied by twitching of hands and feet. Dachaihu Tang (Major Bupleurum Decoction) was used, mixed with one qian of fermented yeast powder. This expelled a large amount of stagnant waste. When vomiting and loss of appetite occurred afterwards, Wuwei Yigong San (Five-Ingredient Decoction for Supporting Vitality) added with Bupleurum (Chaihu) and Cimicifuga (Shengma) led to recovery.
Case 3: An infant had constipation, diagnosed as caused by the wet nurse's consumption of strong-flavored foods. Qingwei Yin (Stomach-Clearing Decoction) was used to treat the mother's heat, while the infant drank small amounts (one or two spoonfuls) intermittently, resulting in recovery. Later, when the wet nurse caught a cold with abdominal pain and consumed ginger and wine, the infant suffered from severe constipation combined with bloody stools. Qingwei San (Stomach-Clearing Powder) was still used, administered in small doses daily, leading to recovery.
Case 4: An infant had constipation because the wet nurse experienced sudden rage, affecting the infant similarly. Jiawei Xiaochaihu Tang (Modified Minor Bupleurum Decoction) was used concurrently. The infant first took two doses of Baohe Wan, followed by Wuwei Yigong San added with Cimicifuga (Shengma) and Bupleurum (Chaihu). Drinking several spoonfuls daily led to complete recovery.
Dachaihu Tang (See formula under Convulsion Syndrome)
Shenxiong Wan (See formula under Fright Convulsion)
Liuwei Wan (See formula under Kidney Disease)
Qingwei San (See formula under Internal Hooking/Abdominal Pain)