汤氏牛黄丸 治小儿通睛，皆因失误筑打，触着头面额角，兼倒扑，令儿肝受惊风，
遂使两目斗睛，名曰通睛，宜服此。
牛黄 白附子（炮） 肉桂 全蝎 芎 石膏（ 。各一钱） 白芷 朱砂（各二钱，研）
藿香（半两） 麝香（一分）
上为末，炼蜜丸，如芡实大。三岁以下，每服一丸，薄荷汤下，乳食后。忌油
面猪肉。
〔薛〕小儿雀盲，眼札。服煮肝丸而目明，服四味肥儿丸而目不札。一小儿
发搐目扎。属肝胆经风热。先用柴胡清肝散治其肝，后用地黄丸补其肾而愈。一
小儿因惊眼札，或搐。先用加味小柴胡汤加芜荑、黄连以清肝热，又用六味地黄
丸以滋肾生肝而痊。一小儿两目连札，或色赤，或时拭眉。此肝经风热，欲作肝
疳也。用四味肥儿丸加龙胆草而瘥。
目睛 动
目直
目动（俱见惊搐门）
胎黄（见初生门）
〔曾〕婴儿小便不通者，有阴阳二证。阴闭者，为冷湿乘虚入里，因而不通，名
曰阴闭，以白芍药汤加南木香，及用炒盐以绢帕兜，令带热熨脐四围，并投五苓散
入灵砂末，盐汤空心调服，其效尤速。阳闭者，因暴热所逼，涩而不通，名曰阳闭。
又有癃闭，与淋不同，《内经》宣明五气篇曰∶膀胱不利为癃。盖癃者，乃五内气虚，
受热壅滞，宣化不行，非涩非痛，但闭不通，腹胀紧满，但以 咀五苓散加车前子、
灯心、之类，及投木通散、玉露饮、益元散皆可用之，或贴姜豉饼于脐上取效，
不拘阴阳二证，悉能疗之，并与万安饮尤妙。〔薛〕东垣云∶小便不利，有在气在
血之异，夫小便者，足太阳膀胱之所主，长生于申，申者金也，金能生水，肺中伏
热，水不能生，是绝小便之源也，治法，用清燥金之正化气薄之药，茯苓、猪苓、
泽泻、琥珀、灯心、通草、车前、瞿麦、 蓄之类，皆为淡渗能泄肺中之热，而滋
水之化源也。若不渴，热在下焦，是热涩其流而溺不泄也，须用气味俱浓，阴中之
阴药治之。二者之病，一居上焦，在气分而必渴，一居下焦，在血分而不渴，血中
有湿，故不渴也，二者之殊，至易分别耳。窃谓前证若津液偏渗于肠胃，大便泻利，
而小便涩少者，宜分利。若热蕴于下焦，津液燥而小便不行者，宜渗泄。若脾胃气
涩，不能通调水道者，宜顺气。若乳母肝心二经有热者，用栀子清肝散。肝经怒火
者，用柴胡栀子散。若因父母曾服燥剂而致者，用四物、麦门、甘草。数而黄者，
用四物加山茱萸、黄柏、知母、五味、麦门。肺虚而短少者，用补中益气加山药、
麦门。阴挺痿痹而频数者，用地黄丸。热结膀胱而不利者，用五淋散。脾肺燥不能
化生者，用黄芩清肺饮。膀胱阴虚，阳无以生而淋沥者，用滋肾丸。若膀胱阳虚，
阴无以化而淋沥者，用六味丸。若因乳母浓味、酒面积热者，用清胃散、五淋散。
仍参诸淋览之。一小儿十四岁，肢体倦怠，发热晡热，口干作渴，吐痰如涌，小
便淋沥，或面目赤色，躁不欲衣。此禀赋肾虚阴躁也。用补中益气汤、加减八味丸
而愈。一儿五岁，小便不利，用五苓散分利澹泄之药，益加不通，小便阴囊渐肿。
先兄谓∶前药复损真阴也。用六味丸料加牛膝、肉桂、车前子，佐以补中益气汤而
痊。一儿八岁，先小便涩滞，服五苓散益甚，加木通、车前之类，腹胀吐痰，
加枳壳、海金砂，而胸满阴肿，遍身发浮。余用六味丸煎送滋肾丸而痊。此皆禀父
气所致，其作湿热痰气治之，而殁者多矣。一儿八岁，先因小便黄赤，服五苓、
导赤、等散，后患便血。余以为禀赋虚热也，用六味丸，及补中益气汤而痊。
〔钱〕捻头散 治小便不通。
玄胡索 川苦楝（各等分）
上同为细末。每服半钱或一钱，捻头汤调下，量大小多少与之，食前服。（捻头汤即沸汤
中滴油数点是）
〔汤〕木通散 治心经伏热，小便不通，啼叫。
木通（一两） 牵牛子（炒，半两） 滑石（一两）
上为末。灯心、葱白水煎服。
冬葵子散 治小儿腹急闷。
冬葵子（一两） 木通（半两）
上为末。每服一钱，水煎。
〔张〕葵石散 治小便不通、闷乱者。
葵根（一握，锉） 滑石 木通（各一两） 牵牛子（半两，炒）
上件，捣为粗末。每服一钱，以水一大盏，入灯心、葱白各少许，煎六分，
去滓，放温服，乳食前。
车前散 治热盛，积于小肠，甚则尿血。
牡蛎（烧为粉，半两） 车前子 甘草（炙微黄，锉） 川朴硝（各一分）
上件药，捣罗为散。每服一钱，以水一小盏，煎至五分，去滓，温服，不拘时。
量儿大小加减。
芎黄散 治脏腑有热，小便涩，兼大便不通。
芎 （一两） 川大黄（锉，微炒） 郁李仁（汤浸去皮，微炒。各七钱半）
上件，捣罗为散。每服一钱，以温水调下。量儿大小加减。
朱砂丹 治证同前。
朱砂（细研水飞） 续随子（各半两） 腻粉（一钱）
上件药，都研令匀，炼蜜和，如黍米大。每服七粒，以温水下，量儿大小加减，
乳食后。
朱砂散 治心神烦躁，小便赤涩不通。
朱砂（一两，另研细） 滑石 犀角屑（各半两） 黄芩 甘草（炙微赤，锉） 车
前子（各七钱半）
上件药，捣罗为散，入朱砂同拌匀。每服半钱，煎竹叶汤调下，食前。
〔曾〕白芍药散（见疝） 五苓散（见惊） 玉露饮 益元散 万安饮（俱见积热） 木通
散（见惊）
清肺散 治渴而小便闭，或黄或涩。
五苓散加琥珀（半钱） 灯心 通草 车前子（炒。各二钱半） 瞿麦（半钱） 木通
蓄（各一两七钱半）
上为粗末。每服三钱，水煎，食前服。
〔薛〕八正散 治蕴热咽干口燥，大渴引饮，心忪面热，烦躁不宁，目赤睛疼，或咽
舌生疮，小便赤闭，或热淋血淋。
车前子 瞿麦（炒） 大黄（面裹煨） 山栀 滑石 蓄 木通 甘草（炙。各一两）
上为末。每服二三钱，入灯心水煎，食前服。
栀子仁散 治小便不通，脐腹胀闷，心神烦热。
栀子仁（五枚） 茅根 冬葵子（各半两） 甘草（炙二钱）
上为末。每服一钱，水煎，空心服。
滋肾丸 栀子清肝散 柴胡栀子散（即柴胡清肝散，三方并见发热）
[Tang Shi] Niuhuang Wan (Calf Bezoar Pill): Treats tongjing (strabismus, specifically esotropia) in children. This is usually caused by accidental blows to the head, face, or forehead, or by falling and tumbling, which causes the liver to be affected by wind-stroke due to fright, resulting in both eyes turning inward, named tongjing. It is suitable to take this pill.
Ingredients: Niu Huang (Calculus Bovis), Baifu Zi (Radix Aconiti Kusnezoffii Preparata), Rou Gui (Cortex Cinnamomi), Quan Xie (Scorpio), Xiong (Rhizoma Chuanxiong), Shigao (Gypsum Fibrosum), each 1 qian; Baizhi (Radix Angelicae Dahuricae), Zhusha (Cinnabar), each 2 qian, finely ground; Huoxiang (Herba Pogostemonis), 0.5 liang; Shexiang (Moschus), 1 fen.
Grind the above ingredients into fine powder, mix with refined honey to form pills the size of a Chinese chestnut. For children under three years old, administer one pill per dose, taken down with Bohe Tang (Mint Decoction), after milk or food intake. Avoid oily foods, wheat products, and pork.
[Xue Ji's Commentary] Children suffering from quemang (night blindness) and yan zha (eyelid twitching). Vision brightens after taking Zhu Gan Wan (Boiled Liver Pill), and eyelid twitching stops after taking Siwei Fei'er Wan (Four-Ingredient Child-Nourishing Pill). One child developed eyelid twitching due to convulsions. This belongs to wind-heat in the Liver and Gallbladder meridians. First treat the Liver with Chaihu Qinggan San (Bupleurum Liver-Clearing Powder), then tonify the Kidney with Dihuang Wan (Rehmannia Pill) for recovery. Another child suffered from eyelid twitching due to fright, sometimes accompanied by convulsions. First clear Liver heat using Jiawei Xiaochaihu Tang (Modified Minor Bupleurum Decoction) added with Wuyi (Seed of Coicis) and Huanglian (Rhizoma Coptidis), then use Liuwu Dihuang Wan (Six-Ingredient Rehmannia Pill) to nourish the Kidney and generate Liver blood for recovery. Another child had continuous eye twitching, sometimes with redness of the face or wiping of the eyebrows. This indicates wind-heat in the Liver meridian, likely developing into Gangan (Liver Calcinosis, a pediatric condition involving ocular lesions and malnutrition). Use Siwei Fei'er Wan added with Longdan Cao (Radix Gentianae) for cure.
Eye movements, Mudirect (fixed gaze), Mou dong (eye movement) (all see the Convulsions chapter).
Taihuang (Neonatal Jaundice) (see Neonates chapter).
[Zeng Shirong] Infants with inability to urinate have two syndromes: Yin and Yang. Yin Bi (Yin obstruction) occurs when cold-dampness invades the interior due to deficiency, causing obstruction, named Yin Bi. Use Baishaoyao Tang (White Peony Decoction) added with Nanmuxiang (Aucklandiae Radix), and apply hot stir-fried salt wrapped in silk cloth to warm-moxibustion around the umbilicus. Simultaneously administer Wuling San (Five-Ingredient Powder) mixed with Lingsha (Cinnabar and Gold amalgam), taken with salt water on an empty stomach; the effect is particularly rapid. Yang Bi (Yang obstruction) is caused by sudden heat forcing stagnation, resulting in涩 (astringency/stagnation) and inability to urinate, named Yang Bi. There is also Longbi (difficulty in urination without pain), which differs from Lin syndrome (dysuria). The *Neijing* states in the "Xuanming Wuqi" chapter: "Bladder dysfunction leads to Long." Long refers to deficiency of Qi in the five viscera, blocked by heat, failing to diffuse and transform, not characterized by astringency or pain, but by closure and inability to urinate, accompanied by abdominal distension and tightness. Simply chew/coarsely grind Wuling San, add Cheqianzi (Plantaginis Semen), Dengxincao (Papyrus Pith), etc., and administer Mutong San (Akebia Decoction), Yulu Yin (Jade Dew Drink), or Yi Yuan San (Benefit Origin Powder); all are applicable. Alternatively, apply Jiangchi Bing (Ginger and Fermented Soybean Cake) to the umbilicus for effect. Regardless of Yin or Yang syndromes, it can be treated, and combining with Wan'an Yin (Ten-Thousand Safety Drink) is especially excellent.
[Xue Ji's Commentary] Li Dongyuan said: Inability to urinate differs based on whether it involves Qi or Blood. Urination is governed by the Foot-Taiyang Bladder Meridian. Its Qi originates at Shen hour (3-5 PM), which corresponds to Metal. Metal generates Water. If latent heat exists in the Lungs, Water cannot be generated, thus cutting off the source of urine. The treatment method uses drugs that clear dryness from Metal and have thin aromas, such as Fuling (Poria), Zhuling (Polyporus), Zexie (Alisma), Hupo (Amber), Dengxincao (Papyrus Pith), Tongcao (Tetrapanacis Medulla), Cheqianzi (Plantaginis Semen), Qumai (Dianthi Herba), Pianchu (Polygoni Avicularis Herba), etc. These are all bland and leaching drugs that drain heat from the Lungs and nourish the source of Water transformation. If there is no thirst, the heat is in the Lower Jiao, where heat causes astringency of flow and prevents urination. One must use drugs with strong flavors and properties, belonging to Yin within Yin. These two diseases differ: one is in the Upper Jiao, involves Qi, and necessarily causes thirst; the other is in the Lower Jiao, involves Blood, and does not cause thirst because dampness exists in the Blood. The distinction between the two is very easy to identify. I suggest that if fluids leak excessively into the intestines and stomach, causing diarrhea and scanty urine, separation and promotion should be used. If heat accumulates in the Lower Jiao, drying fluids and preventing urination, infiltration and drainage should be used. If Spleen and Stomach Qi is stagnant, unable to regulate water passages, promoting Qi circulation should be used. If the nursing mother has heat in the Heart and Liver meridians, use Zhizi Qinggan San (Gardenia Liver-Clearing Powder). If Liver fire flares up, use Chaihu Zhizi San (Bupleurum Gardenia Powder). If caused by parents' previous use of drying agents, use Siwu Tang (Four-Substance Decoction), Maimendong (Ophiopogonis Radix), and Gancao (Licorice Root). If the pulse is rapid and urine yellow, use Siwu Tang added with Shanzhuyu (Corni Fructus), Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), Wuweizi (Schisandrae Fructus), and Maimendong. If Lung deficiency causes shortness of breath and scanty urine, use Buzhong Yiqi Tang (Middle-Warming and Qi-Supplementing Decoction) added with Shanyao (Dioscoreae Rhizoma) and Maimendong. If prolapse, flaccidity, numbness, and frequent urination occur, use Dihuang Wan. If heat binds the Bladder causing dysfunction, use Wulin San (Five-Lin Powder). If Spleen and Lung dryness prevents transformation, use Huangqin Qingfei Yin (Scutellaria Lung-Clearing Drink). If Bladder Yin deficiency fails to generate Yang, causing dribbling, use Zishen Wan (Kidney-Nourishing Pill). If Bladder Yang deficiency fails to transform Yin, causing dribbling, use Liuwei Wan (Six-Ingredient Pill). If caused by the nursing mother consuming rich flavors and alcohol accumulation leading to heat, use Qingwei San (Stomach-Clearing Powder) and Wulin San. Refer to various Lin syndromes for reference.
One fourteen-year-old child presented with limb fatigue, fever worsening in the afternoon, dry mouth and thirst, profuse expectoration, dribbling urine, sometimes red face and eyes, irritability, and aversion to clothing. This was congenital Kidney deficiency causing Yin restlessness. Treated with Buzhong Yiqi Tang and Jiawei Bawei Wan (Modified Eight-Ingredient Pill) for recovery.
One five-year-old child had difficulty urinating. After taking Wuling San and other diuretic drugs, the condition worsened, with swelling of the genital area and scrotum. My elder brother stated: The previous medicines damaged True Yin again. Used Liuwei Wan material added with Niuxi (Achyranthis Bidentatae Radix), Rougui (Cinnamon Twig), and Cheqianzi, assisted by Buzhong Yiqi Tang for recovery.
One eight-year-old child initially had astringent urination. Taking Wuling San made it worse. Adding Mutong and Cheqianzi led to abdominal distension and expectoration. Adding Zhike (Aurantii Fructus) and Haijinsha (Lygodii Spora) led to chest fullness, genital swelling, and generalized edema. I used Liuwei Wan decoction to swallow Zishen Wan for recovery. All these were caused by inheriting the father's constitution. Treating them as damp-heat, phlegm, and Qi stagnation resulted in many deaths.
One eight-year-old child initially had yellow-red urine. After taking Wuling San and Daochi San (Guide Out Red Powder), he later suffered from hematochezia. I considered it congenital deficient heat. Treated with Liuwei Wan and Buzhong Yiqi Tang for recovery.
[Qian Yi] Niandou San (Pinch Head Powder): Treats inability to urinate.
Yanhusuo (Corydalis Rhizome), Chuan Koushen (Meliae Toosendan Fructus), equal parts.
Grind together into fine powder. Take half a qian or one qian per dose, mixed with Niandou Tang, according to the child's age and size, before meals. (Niandou Tang is boiling water with a few drops of oil added.)
[Tang Shi] Mutong San (Akebia Decoction): Treats latent heat in the Heart meridian, inability to urinate, and crying.
Mutong (Akebiae Caulis), 1 liang; Qianniu Zi (Semen Pharbitidis), stir-fried, 0.5 liang; Huashi (Haloxyli Radix), 1 liang.
Grind into powder. Decoct with Dengxincao (Papyrus Pith) and Congbai (Allii Fistulosi Bulbus) in water for administration.
Dongkuizi San (Malvae Semen Powder): Treats abdominal urgency and stuffiness in children.
Dongkuizi (Malvae Semen), 1 liang; Mutong (Akebiae Caulis), 0.5 liang.
Grind into powder. Take one qian per dose, decoct in water.
[Zhang Huan] Kuishi San (Abutilon Stone Powder): Treats inability to urinate and mental confusion.
Kuigen (Abutili Radix), one handful, chopped; Huashi (Haloxyli Radix); Mutong (Akebiae Caulis), each 1 liang; Qianniu Zi (Semen Pharbitidis), stir-fried, 0.5 liang.
Crush into coarse powder. Take one qian per dose, with one large cup of water, adding a little Dengxincao and Congbai, decoct to six-tenths, strain, and take warm before milk or food.
Cheqian San (Plantago Powder): Treats excess heat accumulating in the Small Intestine, severe cases may present with hematuria.
Muli (Concha Ostreae), calcined to powder, 0.5 liang; Cheqianzi (Plantaginis Semen); Gancao (Glycyrrhizae Radix et Rhizoma), roasted until slightly yellow, chopped; Chuan Pu Xiao (Natrii Sulfas), each 1 fen.
Grind and sieve into powder. Take one qian per dose, with one small cup of water, decoct to five-tenths, strain, and take warm at any time. Adjust dosage according to the child's size.
Xionghuang San (Chuanxiong Rhubarb Powder): Treats heat in the Zang-Fu organs, astringent urination, and concomitant constipation.
Xiong (Rhizoma Chuanxiong), 1 liang; Chuan Dahuang (Rhei Radix et Rhizoma), chopped, lightly stir-fried; Yuliren (Pruni Semen), soaked in water, skin removed, lightly stir-fried, each 0.75 liang.
Grind and sieve into powder. Take one qian per dose, mixed with warm water. Adjust dosage according to the child's size.
Zhusha Dan (Cinnabar Pill): Same indications as above.
Zhusha (Cinnabar), finely ground and washed; Xuisui Zi (Euphorbiae Lathyridis Semen), each 0.5 liang; Nin Fen (Calomelas), 1 qian.
Grind all ingredients evenly, mix with refined honey to form pills the size of millet seeds. Take seven pills per dose, taken with warm water. Adjust dosage according to the child's size, after milk or food.
Zhusha San (Cinnabar Powder): Treats mental restlessness and irritability, red and astringent inability to urinate.
Zhusha (Cinnabar), 1 liang, separately ground fine; Huashi (Haloxyli Radix); Xijiao Xie (Cornu Rhinocerotis Segmentum), each 0.5 liang; Huangqin (Scutellariae Radix); Gancao (Glycyrrhizae Radix et Rhizoma), roasted until slightly red, chopped; Cheqianzi (Plantaginis Semen), each 0.75 liang.
Grind and sieve into powder, mix evenly with Zhusha. Take half a qian per dose, taken down with Zhuye (Bambusae Folium) decoction, before meals.
[Zeng Shirong] Baishaoyao San (White Peony Powder) (see Hernia chapter), Wuling San (Five-Ingredient Powder) (see Fright chapter), Yulu Yin (Jade Dew Drink), Yi Yuan San (Benefit Origin Powder), Wan'an Yin (Ten-Thousand Safety Drink) (all see Accumulated Heat chapter), Mutong San (Akebia Decoction) (see Fright chapter).
Qingfei San (Lung-Clearing Powder): Treats thirst with urinary closure, urine either yellow or astringent.
Wuling San (Five-Ingredient Powder) added with Hupo (Amber), 0.5 qian; Dengxincao (Papyrus Pith); Tongcao (Tetrapanacis Medulla); Cheqianzi (Plantaginis Semen), roasted, each 2.5 qian; Qumai (Dianthi Herba), 0.5 qian; Mutong (Akebiae Caulis); Pianchu (Polygoni Avicularis Herba), each 1.75 liang.
Make into coarse powder. Take three qian per dose, decoct in water, before meals.
[Xue Ji] Bazheng San (Eight-Upright Powder): Treats accumulated heat causing dry throat and mouth, extreme thirst with desire to drink, palpitations and facial heat, restlessness and irritability, red eyes and eye pain, or sores in the throat and tongue, red and closed urine, or heat-Lin and blood-Lin.
Cheqianzi (Plantaginis Semen); Qumai (Dianthi Herba), stir-fried; Dahuang (Rhei Radix et Rhizoma), wrapped in flour and baked; Shanzhi (Gardeniae Fructus); Huashi (Haloxyli Radix); Pianchu (Polygoni Avicularis Herba); Mutong (Akebiae Caulis); Gancao (Glycyrrhizae Radix et Rhizoma), roasted, each 1 liang.
Grind into powder. Take two to three qian per dose, decoct with Dengxincao in water, before meals.
Zhizi Ren San (Gardenia Kernel Powder): Treats inability to urinate, abdominal distension and stuffiness, and mental restlessness and heat.
Zhizi Ren (Gardeniae Fructus Kernel), five kernels; Maogen (Imperatae Rhizoma); Dongkuizi (Malvae Semen), each 0.5 liang; Gancao (Glycyrrhizae Radix et Rhizoma), roasted, 2 qian.
Grind into powder. Take one qian per dose, decoct in water, on an empty stomach.
Zishen Wan (Kidney-Nourishing Pill), Zhizi Qinggan San (Gardenia Liver-Clearing Powder), Chaihu Zhizi San (Bupleurum Gardenia Powder) (which is Chaihu Qinggan San, all three formulas see Fever chapter).