《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）
《婴童百问》记载：小儿大便不通，是由于胃与大肠有热，导致便秘不通，使用清凉饮之类的方剂。如果是饮食停滞夹杂惊恐，以及食积阻滞而导致的大便不通，使用大连翘饮之类的方剂。因惊风、积热而导致的大便不通，使用敷脐法（掩脐法）。这些都是治疗实热证的方法，我曾亲自诊治过。如果是由于乳母或小儿食用肥甘厚味导致积热，以及感受六淫邪气、七情内伤、郁火等传变给小儿而发病的，使用清解邪气、疏解郁结的方剂。如果小儿先天禀赋怯弱，或者过早接触色欲（此处指早婚或房事过度导致的肾精亏虚概念，引申为肾气不足），出现大便困难且小便牵引疼痛的情况，使用滋补肺肾的方剂。
《褚氏遗书》记载：男子精气未充盈时就与女子交合以泄精，会导致身体各处发育不全，日后会有难以名状的疾病。老人阴痿（性功能衰退）却思慕女色，强行泄精，则精液虽出但体内精气败坏；精气已耗损却又进一步竭尽，就会导致大小便牵引疼痛如同淋证。如今童子（未成年男性）也出现这种病患，更加显示出今人的先天禀赋与古人截然不同。人的气血浓薄既然不同，那么医生用药疗法，又怎能拘泥于古方，而不进行加减变化呢？
治验记录：
一个小孩食用肥甘厚味后，大便不通，喝冷饮后发热，使用清凉饮加大黄治疗后大便通畅。后来因饮食停滞，腹痛且大便不通，使用保和丸治疗后腹痛停止，再煎服槟榔汤送服保和丸，服用一次后大便即通。
一个小孩食用粽子导致食积停滞，大便不通，疼痛难忍，手足抽搐，使用大柴胡汤，调入酒曲末一钱，排出大量积滞秽物，随后出现呕吐、不进食的症状，使用五味异功散加柴胡、升麻治疗后痊愈。
一个小孩大便不通，经诊察是乳母饮食过于浓味所致，使用清胃饮治疗乳母的火热之邪，让小儿间断饮用一二匙药汁而痊愈。后来乳母受寒腹痛，食用姜酒类食物，导致小儿大便秘结，兼有便血，仍然使用清胃散，每日让小儿饮用数匙药汁而痊愈。
一个小孩因乳母突然暴怒，导致大便不通，小儿也患此病，同时使用加味小柴胡汤治疗，小儿先服用两服保和丸，后服用五味异功散加升麻、柴胡，小儿每日饮用数匙药汁并痊愈。
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)