（第二十二）
小儿大便不通者，乃是肺家有热在里，流入大肠，以致秘结不通，乃实热也。当以四顺清
凉饮加柴胡，或神芎丸、大柴胡汤以流利之。小便不通者，皆因心经不顺，或伏热、或惊起。
心火上炎，不能降济，肾水不上升，故使心经愈热，而小肠与心合，所以小便不通也。宜木通
散主之，甚者，八正散服之。小便不通，脐腹妨闷，心神烦热，宜栀子散主之。又有伤寒体热
，头目昏沉，不思饮食，夹惊夹食，寒热，大小便皆闭涩不通，烦躁作渴，冷汗妄流，变积伤
滞，膈满胀急，青黄体瘦，日夜大热，及伤风、伤暑、惊痫、客忤、筋骨肾脏疳气等热，大小
便不通者，并宜脱甲散、大连翘饮加大黄、神芎丸皆可服之。小儿惊风、积热、大小便闭涩，用
掩脐法，以连须葱不洗带土、生姜块、淡豉二十一粒，盐二匙同研烂作饼HT 子，烘热掩脐中，
以绵条札定，良久气通自利。不然再换一剂，如不通，服药。
木通汤 治小儿小便不通。
木通 滑石（各一两） 黑豆（炒，半两）
上咀，灯芯、葱白煎服，量大小，以意加减。
栀子仁散 治小儿小便不通，脐腹妨闷，心神烦躁。
栀子（五枚） 茅根 冬葵子（各半两） 甘草
上咀，每服二钱，不拘时煎服。
掩脐法
海狮（四十九个） 黑豆（七粒） 葱根（七个） 盐（少许）
上烂捣细作饼，烘热着于脐上。
八正散（方见淋门。）
（第二十二条）
小儿大便不通，是由于肺中有热邪蕴结于内，下传至大肠，导致肠道秘结、排便不畅，这属于实热证。应当使用四顺清凉饮加入柴胡，或者使用神芎丸、大柴胡汤来通利大便。小便不通，都是因为心经气机不顺，或是体内潜伏热邪，或是因受惊而起。心火向上炎升，不能下行以温煦肾水，肾水也不能上济于心，从而导致心经更加燥热；因为小肠与心相表里，所以出现小便不通的症状。适宜用木通散主治，病情严重的，服用八正散。若小便不通，伴有脐腹部胀闷不适，心神烦乱发热，适宜用栀子散主治。又有患伤寒身体发热，头目昏沉，不想进食，兼夹惊风或食积，寒热往来，大小便都闭塞涩滞不通，烦躁口渴，冷汗淋漓妄出，变成积滞损伤，胸膈满胀急迫，面色青黄，身体消瘦，日夜持续高热，以及伤风、伤暑、惊痫、客忤、筋骨肾脏疳气等各种热证，导致大小便不通的，都适宜使用脱甲散、大连翘饮加大黄、神芎丸等方剂服用。对于小儿惊风、积热导致的大小便闭涩不通，可以使用掩脐法，取带须且未清洗、带有泥土的葱、生姜块、淡豆豉二十一粒、盐两匙，一同研烂制成饼状，加热后敷在肚脐中，用棉条扎紧固定，过一段时间后气机通畅自然通便。如果不行，再更换一剂药饼，如果仍然不通，则改为服药。
木通汤：治疗小儿小便不通。
药材及用量：木通、滑石（各一两），黑豆（炒制，半两）。
用法：将药物切碎，用灯芯草、葱白煎煮后服用，根据患儿年龄大小，酌情加减剂量。
栀子仁散：治疗小儿小便不通，脐腹部胀闷，心神烦躁。
药材及用量：栀子（五枚），茅根、冬葵子（各半两），甘草。
用法：将药物切碎，每次服用二钱，不拘泥时间，煎煮后服用。
掩脐法
药材及用量：海狮（四十九个），黑豆（七粒），葱根（七个），盐（少许）。
用法：将上述药物捣烂成细末，制成饼状，加热后敷在肚脐上。
八正散（方剂见淋证门。）
(No. 22)
Infantile constipation is caused by heat in the Lung (Lung organ) accumulating internally and flowing into the Large Intestine (Large Intestine organ), resulting in dryness, accumulation, and inability to pass stool; this is a Excess Heat (Excess pathogenic heat) pattern. One should use Sishun Qingliang Yin (Four-Obedience Cooling Decoction) with added Chaihu (Bupleuri Radix), or Shenyong Wan (Shenyong Pill) or Dachaihu Tang (Major Bupleurum Decoction) to promote bowel movement. Infantile urinary retention is due to disharmony of the Heart Meridian (Heart channel), either from latent heat or arising from fright. The Heart Fire (Pathogenic fire originating from the Heart) flares upward and cannot descend to nourish the Kidney Water (Kidney yin/fluids), while Kidney Water fails to ascend to moisten the Heart, causing the Heart Meridian to become increasingly hot. Since the Small Intestine (Small Intestine organ) is interiorly-exteriorly related to the Heart, urinary retention occurs. Mutong San (Akebia Decoction) is indicated as the primary treatment; for severe cases, Bazheng San (Eight-Orthodoxies Decoction) may be administered. If urinary retention is accompanied by distension and oppression around the umbilicus and abdomen, and mental restlessness with fever, Zhizi San (Gardenia Decoction) is indicated. Furthermore, in cases of Shanghan (Cold Damage disease) with body heat, dizziness and heaviness of the head and eyes, loss of appetite, complicated by fright or food stagnation, alternating chills and fever, complete obstruction of both large and small bowel movements, irritability, thirst, profuse cold sweating, transformation into stagnation and injury, chest fullness and abdominal tightness, cyanotic-yellow complexion, emaciation, persistent high fever day and night, as well as various heat patterns such as Shangfeng (Wind-Cold attack), Shangshu (Summerheat injury), Jingxian (Convulsions), Kewu (Alien influence), and Ganshi (Childhood malnutrition syndrome affecting bones, muscles, and kidneys), all leading to urinary and fecal retention, Tuojia San (Shell-Shedding Decoction), Dalianqiao Yin (Major Forsythia Decoction) with added Dahuang (Rhei Radix et Rhizoma), and Shenyong Wan are all suitable. For infantile convulsions and accumulated heat causing urinary and fecal retention, the Navel-Smearing Method (Navel application therapy) can be used: take green onions with roots intact, unwashed and with soil attached, pieces of fresh ginger, 21 grains of Danchi (Fermented Soybean), and two teaspoons of salt; grind them together into a paste, form into a cake, warm it, and apply it to the umbilicus, securing it firmly with a cotton strip. After a while, qi will flow freely and defecation will occur naturally. If this fails, apply another dose; if still ineffective, administer oral medication.
Mutong Tang (Akebia Decoction): Treats infantile urinary retention.
Ingredients: Mutong (Akebiae Caulis), Huashi (Talcum), each 1 liang; Heidou (Sojae Semen Nigrum), stir-fried, 0.5 liang.
Preparation: Coarsely crush the herbs, decoct with Dengxincao (Junci Medulla) and Congbai (Allii Fistulosi Bulbus), and administer orally. Adjust dosage according to the child's age and condition.
Zhizi Ren San (Gardenia Kernel Decoction): Treats infantile urinary retention with abdominal distension and mental restlessness.
Ingredients: Zhizi (Gardeniae Fructus), 5 fruits; Maogen (Imperatae Rhizoma), Dongkuizi (Malvae Semen), each 0.5 liang; Gancao (Glycyrrhizae Radix et Rhizoma).
Preparation: Coarsely crush the herbs, take 2 qian per dose, decoct and drink at any time.
Navel-Smearing Method
Ingredients: Haishi (Hydrophilus), 49 specimens; Heidou (Sojae Semen Nigrum), 7 grains; Conggen (Allii Fistulosi Radix), 7 roots; Yan (Sal), a small amount.
Preparation: Pound finely into a paste, form into cakes, warm, and apply to the umbilicus.
Bazheng San (Eight-Orthodoxies Decoction) (See formula in Lin Syndrome section.)