《巢氏病源》小儿伤寒大小便不通候∶伤寒是寒气客于皮肤，搏于血气，使腠理闭密，气不宣泄，蕴积生热，
故头痛体疼而壮热，其大小便不通，是寒搏于气而生热，热流入大小肠，故涩结不通。凡大小便不通，则内热
不歇；或干呕，或言语而气还逆上，则心腹胀满也。
《圣惠》治小儿伤寒，壮热心躁，头痛口干，小便大便赤难。大黄散方
川大黄（半两，锉碎，微炒） 栀子仁 赤芍药 甘草（炙微赤，锉） 黄芩（各一钱）
上件药捣，粗罗为散。每服一钱，以水一中盏，煎至五分，去滓，量儿大小分减，温服，以利为效。
《圣惠》治小儿伤寒五六日，壮热心躁，口干烦渴，大小便难。三黄散方
川大黄（锉碎，微炒） 麦门冬（去心，焙。各半两） 石膏（一两，细研） 甘草（炙微赤，锉） 川芒硝 黄
芩黄连（去须。各一分）
上件药捣，粗罗为散。每服一钱，以水一小盏，煎至五分，去滓。量儿大小分减，频服，以利为效。
张涣犀角散方 治小儿伤寒六七日，大便不通热甚者。
犀角（末） 川大黄（炮） 柴胡（去苗。各一两） 人参（半两，去芦头） 朴硝 甘草（炙。各一分）
上件为细末。每服一钱，以水八分一盏，入生姜二片，枣子一枚，煎至五分，去滓温服。量儿大小加减。
《活人书》洗心散 治遍身壮热，头目碎痛，背膊拘急，大热冲上，口苦唇焦，夜卧舌干，咽喉肿痛，涕唾稠
粘、痰壅，吃食不进，心神躁热，眼涩睛疼；伤寒鼻塞，四肢沉重，语声不出，百节痛，大小便不利；麸豆疮，
时行温疫，狂语多渴及小儿天 风，夜惊，并宜服也。
大黄（以米泔水浸一炊间，漉出令干，慢炒取熟） 当归（炒） 芍药（生用） 甘草（炙） 荆芥（各四两） 白
术（一两，炒）
上捣罗为细末。每服抄二钱，以水一盏，入生姜一片，薄荷二叶，同煎至八分，放温，和滓服了，略卧
仍去枕少时。如五脏壅实，煎四、五钱匕，若要溏转，则热服。
According to *Chao Shi Bing Yuan* (Source and Characteristics of Diseases by Chao Yuanfang), regarding the condition of infants and children with cold damage (Shanghan) resulting in obstruction of urination and defecation: Cold damage occurs when cold qi invades the skin, contending with blood and qi, causing the couli (skin pores and interstices) to become closed and dense. As a result, qi cannot be vented, leading to accumulation and generation of heat. Consequently, there is headache, body pain, and high fever. The obstruction of urination and defecation arises because cold contends with qi to generate heat; this heat flows into the Large Intestine and Small Intestine, causing dryness and binding that prevents passage. Whenever urination and defecation are obstructed, internal heat does not cease; alternatively, one may experience dry retching or speech accompanied by counterflow of qi, leading to distension and fullness in the heart and abdomen.
*Tai Ping Sheng Hui Fang* (Imperial Grace Formulary of the Taiping Era) prescribes the Da Huang San (Rhubarb Powder) for treating infantile cold damage characterized by high fever, mental restlessness, headache, dry mouth, and difficult passage of dark red urine and stool.
Ingredients: Chuan Da Huang (Radix et Rhizoma Rhei, half liang, crushed, slightly stir-fried); Zhi Zi Ren (Semen Gardeniae, one qian); Chi Shao Yao (Radix Paeoniae Rubra, one qian); Zhi Gan Cao (Radix Glycyrrhizae Preparata, stir-fried until slightly red, crushed, one qian); Huang Qin (Radix Scutellariae, one qian).
Preparation: Crush the above ingredients and sift them coarsely to make a powder. For each dose, take one qian, add one zhong zhan (approx. 200ml) of water, decoct until five fen (approx. 100ml) remains, strain, and administer warm. Adjust the dosage according to the child's age and size. Efficacy is indicated by the relief of bowel obstruction.
*Tai Ping Sheng Hui Fang* also prescribes the San Huang San (Three Yellows Powder) for infantile cold damage persisting for five to six days, presenting with high fever, mental restlessness, dry mouth, vexatious thirst, and difficulty in urination and defecation.
Ingredients: Chuan Da Huang (Radix et Rhizoma Rhei, crushed, slightly stir-fried, half liang); Mai Men Dong (Tuber Ophiopogonis, core removed, baked, half liang); Shi Gao (Gypsum Fibrosum, one liang, finely ground); Zhi Gan Cao (Radix Glycyrrhizae Preparata, stir-fried until slightly red, crushed, one qian); Chuan Mang Xiao (Natrii Sulfas, one qian); Huang Qin (Radix Scutellariae, one qian); Huang Lian (Rhizoma Coptidis, roots removed, one qian).
Preparation: Crush the above ingredients and sift them coarsely to make a powder. For each dose, take one qian, add one xiao zhan (approx. 100ml) of water, decoct until five fen remains, and strain. Administer frequently, adjusting the dosage according to the child's age and size. Efficacy is indicated by the relief of bowel obstruction.
Zhang Huan's Xi Jiao San (Rhinoceros Horn Powder) treats infantile cold damage lasting six to seven days, where the large intestine is obstructed and heat is severe.
Ingredients: Xi Jiao (Cornu Rhinocerotis, powdered, one liang); Chuan Da Huang (Radix et Rhizoma Rhei, processed, one liang); Chai Hu (Radix Bupleuri, stems removed, one liang); Ren Shen (Radix Ginseng, rootlets removed, half liang); Pu Xiao (Natrii Sulfas, one qian); Zhi Gan Cao (Radix Glycyrrhizae Preparata, stir-fried, one qian).
Preparation: Grind the above ingredients into a fine powder. For each dose, take one qian, add eight fen zhan (approx. 160ml) of water, include two slices of fresh ginger and one jujube, decoct until five fen remains, strain, and administer warm. Adjust the dosage according to the child's age and size.
The Xi Xin San (Heart-Washing Powder) from *Huo Ren Shu* (Book of Saving Lives) treats generalized high fever, fine pain in the head and eyes, stiffness and tension in the back and shoulders, surging high heat, bitter taste in the mouth, scorched lips, dry tongue during sleep, swelling and pain in the throat, thick and sticky nasal discharge and saliva, phlegm obstruction, loss of appetite, mental restlessness and heat, dry and sore eyes, nasal congestion due to cold damage, heaviness in the four limbs, inability to speak, pain in all joints, and unfavorable urination and defecation. It is also suitable for fu dou chuang (smallpox-like eruptions), epidemic febrile diseases, delirium with excessive thirst, infantile tian diao feng (convulsive disorder), and night frights.
Ingredients: Da Huang (Radix et Rhizoma Rhei, soaked in rice washing water for the time it takes to cook a meal, drained and dried, slowly stir-fried until cooked, four liang); Dang Gui (Radix Angelicae Sinensis, stir-fried, four liang); Shao Yao (Radix Paeoniae Alba/Lactiflora, used raw, four liang); Zhi Gan Cao (Radix Glycyrrhizae Preparata, stir-fried, four liang); Jing Jie (Herba Schizonepetae, four liang); Bai Zhu (Rhizoma Atractylodis Macrocephalae, stir-fried, one liang).
Preparation: Crush and sift the above ingredients into a fine powder. For each dose, scoop out two qian, add one zhan of water, one slice of fresh ginger, and two leaves of bo he (Herba Menthae), decoct together until eight fen remains, allow to cool to warm temperature, and consume the liquid along with the dregs. After ingestion, lie down briefly but keep the head elevated on a pillow for a short while. If the five zang organs are severely congested and solid, decoct four to five qian bi (spoonfuls). If loose stools are desired, administer hot.