翰林待诏杨大邺问。小儿大小便秘涩者为何？答曰乳食失度，使之四大不调，
滋味有贪，遂乃五脏受病，甘甜聚食，咸酸滞涎，食滞留结于胃肠，风壅渍癖于心
肺，气脉不顺，水谷不行，虽不逆于上焦，即秘结于下部，小儿不知疼痛，莫说因
由，惊啼叫以频频，但怒胀而不乳，不知孩儿痛刺连脐则面色青黄，但按脉息与治，
若不见病源，只根据外变，用药安能克效。《百问》调理婴孩伤寒体热，头目昏沉，
不思饮食，夹惊夹食寒热，大小便闭涩不通，烦躁作渴，冷汗妄流，夹积伤滞，膈
满胀急，青黄体瘦，日夜大热。及疗伤风伤暑，惊痫客忤，肾藏疳气等热，并宜脱
甲散主之（伤寒）。亦可服大连翘汤（痘便秘）加大黄、神芎。治小儿惊风积热，大小便涩滞，
其效尤速。又掩脐法，用连根葱一茎，不洗带泥土，生姜一块，淡豆豉二十一粒，盐
二匙。同研烂，捏饼烘热，掩脐中，以绵扎定，良久气透自通，不然再换一剂。
神芎丸 治风热壅滞，头目昏眩，口舌生疮，牙齿疳蚀，或遍身疮疥，切牙惊惕怔
忡，烦躁多渴，或大小便涩滞，或积热腹满，惊风潮搐，并皆治之。
大黄（生） 黄芩（各二两） 生牵牛末（一两） 滑石（四两） 黄连 薄荷叶 川芎（各半两）
上为细末，滴水丸桐子大。每服四五十丸，食后温水下。一方加蒲黄，止血证用。
钱氏郁李仁丸 治襁褓小儿、大小便不通，并惊热痰实，欲得溏动者。
郁李仁（去皮） 川大黄（去粗皮，取实者，锉，酒浸半日，控干，炒，为细末。各一两） 滑石（半两，研细）
上，先将郁李仁研成膏，和大黄滑石，丸如黍米大。量大小与之，以乳汁或薄荷汤下，食前。
犀角丸 治小儿风热，痰实面赤，大小便秘涩，三焦邪热，腑脏蕴毒，疏导极稳。
生犀（末，一分） 人参（去须，切） 枳实（去瓤，炙） 槟榔（各半两） 黄连（一两） 大黄（二两，酒浸
切片，以巴豆去皮一百个贴在大黄上，纸裹，饭上蒸三次，切，炒令黄焦，去巴豆不用）
上为细末，炼蜜和丸，如麻子大。每服一二十丸，临卧熟水下。未动加丸数。
亦治大人，孕妇无损。
《惠眼》芍药散 治大小便下药不通者。
芍药 大黄 甘草（炙） 当归 朴硝（各一分）
上为末，每服一大钱，水一盏，瓦器中煎至半盏，去滓服，即通。
〔吉氏〕治大小便不通方
甘草节（炮） 槐花（洗。各一两）
上件末。每服一钱，茶半钱，汤点下。
又方
滑石（一大钱） 灯心（一握）
上以水二碗，煎至一盏，温服。
《子母秘录》用蜂房烧末，酒服一钱，日再。
掩脐法
海蛳（四十九个） 葱根（带土七个） 黑豆（七个） 盐（少许）
握宣丸 治小儿便难燥结，或服涩药腹胀闷乱，命在须臾，可用此丸，不移时、大小便自利。
巴豆（一钱半） 硫黄 良姜 附子 槟榔 甘遂（各等分）
上为细末，粟米饭和丸，如绿豆大。用椒汤洗小儿男左女右手，握之，用绵裹
定，看行数多少，置药洗去，不用即止。
《千金》灸法 小儿大小便不通，灸两口吻各一壮。
Yang Daye, Hanlin Daizhao (Attendant Physician in the Hanlin Academy), asked: What is the cause of constipation and difficult urination in infants?
The answer is: This results from improper feeding of milk and food, leading to disharmony of the "Four Bigs" (referring to head, limbs, abdomen, and qi); due to indulgence in delicious tastes, the five Zang organs are affected. Sweet foods accumulate as undigested food, while salty and sour foods stagnate saliva. Food remains stagnant and knotted in the stomach and intestines; wind obstruction infiltrates the heart and lungs, causing the qi and blood vessels to flow irregularly, preventing the normal transport of water and grain. Although the pathogenic factor may not rebel upwards in the Upper Jiao, it inevitably becomes blocked and constipated in the lower part. Infants do not understand pain nor can they explain the cause; they only cry frequently with fright, showing anger and distension without nursing. If one does not realize that the child's piercing pain radiating to the umbilicus causes a greenish-yellow complexion, but instead diagnoses and treats based solely on external manifestations without identifying the root cause, how can medication be effective?
The *Baiwen* (Hundred Questions) states: To regulate infantile cold damage presenting with body heat, dizziness and heaviness of the head and eyes, loss of appetite, alternating chills and fever complicated by fright and food retention, complete blockage of stool and urine, irritability, thirst, spontaneous cold sweating, food accumulation and stagnation, chest fullness and urgency, greenish-yellow complexion with emaciation, and persistent high day and night heat. It also treats wind-cold, summerheat injury, fright epilepsy, sudden invasion by evil spirits (Ke Wu), and heat from kidney deficiency with malnutrition (Gan Qi). For these conditions, Tuojia San (Shedding Armor Powder) should be used as the main formula (for cold damage). Alternatively, Dalianqiao Tang (Large Dangling-pearl Decoction) for measles/rubella constipation can be taken, augmented with Dahuang (Rhubarb Root and Rhizome) and Shenxiong (Angelica and Ligusticum). It is particularly effective for treating infantile convulsions with accumulated heat causing sluggish stool and urine.
Another method is the Umbilical Covering Method: Use one stalk of scallion with roots, unwashed and retaining soil; one piece of fresh ginger; 21 grains of fermented soybean (Dan Dou Chi); and two teaspoons of salt. Grind them together into a paste, shape into a cake, warm it, and apply it to the umbilicus. Secure firmly with cotton cloth. After some time, if qi circulation restores, bowel movement will naturally occur; otherwise, replace with another dose.
Shenxiong Wan (Ligusticum and Ligusticum Pill): Treats wind-heat obstruction causing dizziness, mouth and tongue sores, dental caries (Gan erosion), or skin sores and scabies all over the body, teeth grinding, fright, palpitations, irritability, excessive thirst, sluggish stool and urine, abdominal fullness due to accumulated heat, and infantile convulsions with tidal spasms. All are treated by this pill.
Ingredients: Dahuang (Raw) (2 liang), Huangqin (Scutellaria Root) (2 liang), Sheng Qianniu Mò (Raw Prepared Morning Glory Seed Powder) (1 liang), Huashi (Talcum) (4 liang), Huanglian (Coptis Rhizome), Bohe Ye (Mint Leaf), Chuanxiong (Ligusticum Rhizome) (each 0.5 liang).
Preparation and Administration: Grind all ingredients into fine powder. Add water dropwise to form pills the size of paulownia seeds. Take 40–50 pills after meals with warm water. Another prescription adds Puhuang (Pollen Typhae) for hemostasis.
Qian Shi Yuliren Wan (Dr. Qian’s Prunus Maritima Pill): Treats infants with constipation and difficult urination, as well as fright-heat, phlegm-stagnation, and excess syndromes where softening of stools is desired.
Ingredients: Yuliren (Prunus Maritima Seed, peeled) (1 liang), Chuan Dahuang (Rhubarb Root and Rhizome, remove coarse bark, take solid part, cut, soak in wine for half a day, drain, stir-fry, grind to fine powder) (1 liang), Huashi (Talcum, finely ground) (0.5 liang).
Preparation and Administration: First grind Yuliren into a paste. Mix with Dahuang and Huashi powder. Form pills the size of millet seeds. Administer according to age/size. Give before meals with breast milk or mint decoction.
Xijiao Wan (Rhinoceros Horn Pill): Treats infantile wind-heat, phlegm-excess with red face, constipation and difficult urination, pathogenic heat in the Three Jiao, and accumulated toxicity in the fu-zang organs. Its guiding and draining action is very stable.
Ingredients: Sheng Xi (Rhino Horn, powdered, 1 fen), Renshen (Ginseng Root, remove whiskers, slice) (0.5 liang), Zhishi (Immature Bitter Orange, remove pith, roast) (0.5 liang), Binglang (Areca Seed) (0.5 liang), Huanglian (Coptis Rhizome) (1 liang), Dahuang (Rhubarb Root and Rhizome) (2 liang, soaked in wine and sliced, place 100 peeled Badou seeds against the rhubarb slices, wrap in paper, steam over rice three times, slice, stir-fry until yellow-brown, discard Badou).
Preparation and Administration: Grind all ingredients into fine powder. Mix with refined honey to form pills the size of hemp seeds. Take 10–20 pills before sleep with cooked water. Increase dosage if no bowel movement occurs. Also suitable for adults and pregnant women without harm.
*Huiyan* Shaoyao San (*Huiyan* Peony Powder): Treats cases where oral medications fail to relieve constipation and difficult urination.
Ingredients: Shaoyao (Peony Root), Dahuang (Rhubarb Root and Rhizome), Gancao (Licorice Root, roasted), Danggui (Angelica Sinensis Root), Poxiao (Mirabilite) (each 1 fen).
Preparation and Administration: Grind to powder. Take one large qian per dose. Decoct with one cup of water in a clay vessel until half remains. Strain and drink. Bowel movement will follow.
[Mr. Ji’s] Prescription for Constipation and Difficult Urination:
Ingredients: Gancao Jie (Licorice Root Node, processed), Huaihua (Sophora Flower, washed) (each 1 liang).
Preparation and Administration: Grind to powder. Take one qian per dose, mixed with half a qian of tea, taken with hot water.
Another Formula:
Ingredients: Huashi (Talcum) (one large qian), Dengxin (Juncus Medulla) (one handful).
Preparation and Administration: Decoct with two bowls of water until one bowl remains. Take warm.
*Zimu Milu* records: Burn bee comb (Fengfang) to ash, take one qian with wine, twice daily.
Umbilical Covering Method (Alternative):
Ingredients: Haisi (Sea Snail) (49 pieces), Conggen (Scallion Root, with soil) (7 pieces), Heidou (Black Soybean) (7 pieces), Yan (Salt) (a little).
Woxuan Wan (Grasping Release Pill): Treats infantile difficult and dry stool, or abdominal bloating and confusion caused by astringent medicines, when life is in imminent danger. This pill can restore normal bowel and bladder function shortly after administration.
Ingredients: Badou (Areca Nut/Areca Seed, processed) (1.5 qian), Liuhuang (Sulfur), Liangjiang (Galangal Rhizome), Fuzi (Aconite Lateral Root), Binglang (Areca Seed), Gansui (Kansui Root) (equal parts).
Preparation and Administration: Grind to fine powder. Mix with millet rice paste to form pills the size of mung beans. Wash the infant’s hand (left for males, right for females) with pepper water. Have the infant hold the pill. Wrap securely with cotton. Observe the number of steps walked. Remove the medicine and wash off when appropriate. Stop if unnecessary.
*Qianjin* Moxibustion Method: For infantile constipation and difficult urination, moxa bust at each corner of the mouth (1 cone).