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General Summary: When infants suffer from constipation, their crying is loud and high-pitched. This is due to a lack of body fluids failing to moisten the intestines, which are being scorched by fire-heat. One should urgently administer decoctions combined with guiding methods (such as enemas or suppositories) to prevent the child from wailing day and night.

Pulse Diagnosis: The pulse for Yang Constipation is deep, solid, and rapid; the pulse for Yin Constipation is floating and slow.

The *Neijing* (Yellow Emperor's Inner Canon) states: The North corresponds to black, its qi communicates with the Kidney, it opens into the two yin orifices (anus and urethra), and stores essence in the Kidney. It also says: The Kidney governs defecation; for difficult defecation, one should select points on the Foot-Shaoyin Kidney Meridian. The Kidney governs the five fluids. When body fluids are moistening, defecation is normal. If diet is irregular (feasting or fasting without rhythm), or if overexertion damages Stomach Qi, or if one consumes pungent, strong-flavored, and hot-natured foods that assist pathogenic fire, this fire may lurk within the blood, consuming true Yin. Consequently, body fluids become deficient, leading to dry and hard stools. Mr. Yang stated: When pathogenic heat enters the interior, dry feces accumulate inside; when summer-heat lingers in the Triple Burner, middle-body fluids dry up; this constitutes Heat clashing with the Large Intestine. If retained food stagnates, there will be abdominal distension, pain, fullness, chest oppression, and nausea. If heat blazes fiercely, internal wind-heat is affected, resulting in hardness, dryness, and blockage. For Heat patterns, the Sanhuang Wan (Three-Yellow Pill) is suitable for purging and draining; for accumulation patterns, Xiaoji Wan (Accumulation-Dispersing Pill) is suitable. Only through flexible treatment focusing on the chest/middle jiao can this be cured.

For newborns presenting with extreme abdominal distension and inability to pass stool or urine, immediately have a woman rinse her mouth and suckle seven areas of the infant: the chest front, back, hands, feet, abdomen, and below the umbilicus. Continue until the skin turns red. The obstruction will naturally resolve shortly.

[Attached Formulas]
Xiaoji Wan (Accumulation-Dispersing Pill): See the section on Food Injury Syndrome.
Sanhuang Wan (Three-Yellow Pill): Equal parts of Coptidis Rhizoma (Huanglian), Scutellariae Radix (Huangqin), and Rheum Palmatum Rhizoma et Radix (Dahuang, steamed with wine and dried nine times). Grind into powder and make into honey pills.

(Should be read in conjunction with Hernia Syndromes)

General Summary: Cold stimulation clashing between the Jueyin and Shaoyin meridians causes swelling and retraction, requiring warm herbs. If the scrotum is shiny and swollen but painless, it is a deficiency pattern treated as such. If red and swollen, cool formulas must be used to dispel it.

The *Neijing* states: In cases of strangury, hernia, and cutaneous distension, it is because Yin Qi is excessive, causing vessel distension and obstruction. Currently, some infants have a penis completely retracted and invisible, while others have a shiny, swollen scrotum that is painless. This is due to deficiency of Liver and Kidney Qi. Use decoction of Citri Reticulatae Pericarpium (Juren) to take Jinling San (Golden Bell Powder) or Yunqi San (Qi-Balancing Powder). Observing the words of the *Neijing*, this retraction is caused by excess Yin Qi; this "hanging retraction" is due to tendon spasm. Tendons contract when exposed to cold and relax when exposed to heat. Therefore, according to the Three Causes theory, the treatment method involves relaxing the Small Intestine Qi and dispersing Wind. However, this condition often arises from sitting in damp, shady places and contracting Wind-Dampness. Use Danggui San (Angelica Decoction) added with Arecae Semen (Binglang) and Atractylodis Macrocephalae Rhizoma (Cangzhu), or take Gouteng Gao (Uncaria Paste), and apply Lixiao San (Immediate-Resolution Powder) externally.

If the scrotum is swollen, painful, and accompanied by testicular retraction, it is because all tendons converge at the genitalia. Pathogens lodge in the Jueyin and Shaoyin meridians and clash with Cold Qi. If not treated early, it becomes a chronic disease. Symptoms include curved waist, abdominal pain, spontaneous cold sweat, and the two testes retracting into the abdomen, emerging only when pain ceases. This is called "Internal Retraction." Treat with Wumei San (Sour Plum Powder), Yunqi San, and Jinling San.

In some cases, the external genitalia swell inexplicably, becoming large, non-dry, painless, and shiny like a lamp. This is caused by Qi deficiency and is also treated with Yunqi San.

In another syndrome, the skin of the external genitalia is red, swollen, and transparent, or the vulva of female infants is swollen. This is transmitted from Heart Heat. Treat with Mutong San (Akebia Decoction) and Daochi San (Guide-Out Red Powder), and apply Puxiao San (Niter Powder) externally. [Commentary: Infantile renal retraction occurring seven days after birth is caused by cold invasion at birth. Use 5 qian each of Sulfur and Evodiae Fructus (Zhuyu), grind into powder, mix with garlic juice to apply to the abdomen, and fumigate with mild smoke from Cnidii Fructus (Shechuangzi).]

[Attached Formulas]
Jinling San (Golden Bell Powder): Sparganii Rhizoma (Sanleng), Curcumae Rhizoma (Ezhu), Tangerine Peel (Qingpi), Aged Tangerine Peel (Chenpi), Red Poria (Chifu), Fennel Seed (Huixiang), Aucklandiae Radix (Muxiang), Arecae Semen (Binglang), Aurantii Fructus (Zhiqiao), Uncariae Ramulus cum Uncis (Gouteng), Meliae Semen (Jinlingzi), Licorice Root (Gancao).
Yunqi San (Qi-Balancing Powder): Platycodon Root (Jiegeng), Aged Tangerine Peel (Chenpi), Amomi Fructus (Sharen), Fennel Seed (Huixiang), Bombyx Batryticatus (Jiangcan), Licorice Root (Gancao).
Danggui San (Angelica Decoction): See the section on Vomiting and Diarrhea Syndrome.
Gouteng Gao (Uncaria Paste): Uncariae Ramulus cum Uncis (Gouteng), Corydalis Rhizoma (Yanyhusuo), Angelicae Sinensis Radix (Danggui), Boswelliae Resina (Ruxiang), Cinnamomi Ramulus (Boogui), Moschus (Shexiang), Licorice Root (Gancao).
Lixiao San (Immediate-Resolution Powder): Adzuki Bean (Chixiaodou), Red Peony Root (Chishao), Effloresced Natrii Sulfas (Fenghuaxiao), Aurantii Fructus (Zhiqiao), Phytolaccae Radix (Shanglu). Grind each into powder for external application. Internally, take Wuling San (Five-Ingredient Powder with Poria) added with Plantaginis Semen (Cheqianzi) and Coicis Semen (Yiren) as a decoction.
Wumei San (Sour Plum Powder): See the section on Abdominal Pain Syndrome.
Mutong San (Akebia Decoction): Akebiae Caulis (Mutong), Polygoni Avicularis Herba (Bianxu), Rheum Palmatum Rhizoma et Radix (Dahuang), Licorice Root (Gancao), Gardenia Fruit (Shanzhi), Red Poria (Chifu), Diantherae Herba (Qumai), Talcum (Huashi), Plantaginis Semen (Cheqianren), Scutellariae Radix (Huangqin).
Daochi San (Guide-Out Red Powder): See the section on Five Types of Strangury Syndrome.
Puxiao San (Niter Powder): Rheum Palmatum Rhizoma et Radix (Dahuang), Ostrea Concha (Muli), Natrii Sulfas (Puxiao). Grind into powder, mix with water, and apply externally.