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。
翰林待诏杨大邺问道：小儿出现大小便秘涩不通的情况，原因是什么？我回答说：这是由于乳食喂养不当，导致小儿“四大”（指地、水、火、风，中医借用以形容身体平衡状态）不调；因贪恋美味滋味，致使五脏受病。甘甜之物易聚积食物，咸酸之物易停滞涎液，饮食滞留结聚于胃肠；风邪壅滞浸渍于心肺，导致气脉运行不顺，水谷精微无法正常输布。虽然病邪不一定逆冲于上焦，但必然秘结阻滞于下部。小儿不懂得表达疼痛，无法说明病因，只是频繁惊啼叫喊，因愤怒胀满而不愿吃奶。若不知晓孩子疼痛牵连至肚脐时面色会呈现青黄色，仅凭脉象和表象进行治疗，如果不探求病源，只根据外在变化用药，怎么能取得疗效呢？
《百问》中提到：调理婴儿伤寒引起的体热、头目昏沉、不思饮食，以及夹惊、夹食导致的寒热往来，大小便闭涩不通，烦躁口渴，冷汗妄流，夹积伤滞，膈部满胀急迫，面色青黄、身体消瘦，日夜持续高热。以及治疗伤风、伤暑、惊痫、客忤（外邪侵袭所致的神志异常），肾藏疳气等热证，均宜使用脱甲散为主方（针对伤寒）。也可以服用大连翘汤（适用于痘疹便秘者），加大黄、神芎丸。治疗小儿惊风积热导致的大小便涩滞，效果尤其迅速。
另外有掩脐法：用带根的葱一根，不洗，保留泥土；生姜一块；淡豆豉二十一粒；盐两匙。一同研烂，捏成饼状，烘热后敷在脐中，用棉布扎紧固定，过一段时间气机通畅，大便自然排出；如果不行，再更换一剂。
神芎丸：治疗风热壅滞，头目昏眩，口舌生疮，牙齿疳蚀，或遍身疮疥，咬牙惊惕怔忡，烦躁多渴，或大小便涩滞，或积热腹满，惊风潮搐，皆能治疗。
处方组成：大黄（生用）、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）。
制法用法：以上药物研为细末，滴水泛丸，如梧桐子大。每次服用四五十丸，饭后用温水送服。另一配方加蒲黄，用于止血证。
钱氏郁李仁丸：治疗襁褓中的小儿大小便不通，以及惊热痰实，想要使大便溏动者。
处方组成：郁李仁（去皮）、川大黄（去粗皮，取实心部分，锉碎，酒浸半天，控干，炒，研为细末，各一两）、滑石（半两，研细）。
制法用法：先将郁李仁研成膏，加入大黄、滑石，丸如黍米大。根据小儿年龄大小给药，饭前用乳汁或薄荷汤送服。
犀角丸：治疗小儿风热，痰实面赤，大小便秘涩，三焦邪热，腑脏蕴毒，疏导作用极为稳妥。
处方组成：生犀角（研末，一分）、人参（去须，切片）、枳实（去瓤，炙）、槟榔（各半两）、黄连（一两）、大黄（二两，酒浸切片，将去皮的一百个巴豆贴在大黄片上，用纸包裹，在饭上蒸三次，取出切片，炒至黄焦，去掉巴豆不用）。
制法用法：以上药物研为细末，炼蜜和丸，如麻子大。每次服用一二十丸，临睡前用熟水送服。若未通便，可增加丸数。此方也治成人，孕妇服用无损。
《惠眼》芍药散：治疗大小便服药后仍不通者。
处方组成：芍药、大黄、甘草（炙）、当归、朴硝（各一分）。
制法用法：以上药物研为末，每次服用一大钱，用水一盏，在瓦器中煎至半盏，去渣服用，大便即通。
〔吉氏〕治疗大小便不通的方子：
处方组成：甘草节（炮制）、槐花（洗净，各一两）。
制法用法：以上药物研为末。每次服用一钱，茶半钱，用汤水点服。
又一方：
处方组成：滑石（一大钱）、灯心草（一握）。
制法用法：以上药物用水二碗，煎至一盏，温服。
《子母秘录》记载：用蜂房烧成末，酒送服一钱，每日两次。
掩脐法（另一版本）：
处方组成：海蛳（四十九个）、葱根（带土七个）、黑豆（七个）、盐（少许）。
握宣丸：治疗小儿大便难燥结，或者服用涩药后腹胀闷乱，生命垂危，可用此丸，不久时间，大小便自然通利。
处方组成：巴豆（一钱半）、硫黄、良姜、附子、槟榔、甘遂（各等分）。
制法用法：以上药物研为细末，用粟米饭和丸，如绿豆大。用椒汤清洗小儿，男左女右手，握住药丸，用棉布裹紧固定，观察行走多少步数，放置药丸处洗去药物，不再需要时就停止。
《千金》灸法：小儿大小便不通，灸两口角旁各一壮。
Yang Daye, Hanlin Daizhao (Attendant Physician in the Hanlin Academy), asked: What is the cause of constipation and difficult urination in infants? I replied: This is due to improper feeding of milk and food, leading to an imbalance of the "Four Elements" (a TCM concept referring to the body's physiological balance, metaphorically derived from earth, water, fire, and wind); greed for rich flavors causes disease in the five Zang organs. Sweet foods tend to accumulate undigested food, while salty and sour foods tend to stagnate saliva. Food remains stagnant and knotted in the stomach and intestines; wind pathogen stagnation infiltrates the heart and lungs, causing the Qi and blood vessels to flow irregularly, and water and grain essences cannot be transported normally. Although the pathogenic factor may not reverse upward to the Upper Jiao, it must be blocked and knotted in the lower part of the body. Infants do not understand pain nor can they explain the cause; they only cry frequently with fright, refuse to nurse due to anger and distension. If one does not know that when a child is in piercing pain radiating to the umbilicus, their complexion turns greenish-yellow, and treats solely based on pulse diagnosis and external manifestations without seeking the root cause, how can medication be effective?
The *Baiwen* (Hundred Questions) states: To regulate infantile typhoid fever presenting with body heat, dizziness and heaviness of the head and eyes, loss of appetite, combined with fright and food stagnation causing alternating cold and heat, complete obstruction of stool and urine, irritability, thirst, spontaneous profuse cold sweat, food retention and stagnation, chest fullness and urgency, greenish-yellow emaciated complexion, and persistent high fever day and night. It also treats wind-cold, summerheat injury, fright epilepsy, Ke Wu (sudden illness caused by external evil invasion affecting the spirit), and heat from Kidney Gan Qi (wasting-thirst syndrome related to the Kidney). All these conditions should primarily be treated with Tuojia San (Shedding Armor Powder) (for Typhoid). Alternatively, Dalianqiao Tang (Greater Forsythia Decoction) (for constipation during smallpox/variolae) can be taken with added Dahuang (Rhei Radix et Rhizoma) and Shenxiong Wan (Shenxiong Pill). For treating infantile convulsions due to accumulated heat causing sluggish stool and urine, its effect is particularly rapid.
Another method is the Umbilical Covering Method: Use one stalk of scallion with roots, unwashed and retaining soil; one piece of fresh ginger; twenty-one grains of Dan Dou Chi (Fermented Soybean); 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 a while, if Qi circulation is restored, defecation will occur naturally. If not, apply another dose.
Shenxiong Wan (Shenxiong Pill): Treats wind-heat stagnation, dizziness and vertigo, sores in the mouth and tongue, dental gan erosion, or 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 convulsive seizures.
Composition: Dahuang (Raw Rhei Radix et Rhizoma), Huangqin (Scutellariae Radix) (2 liang each), Sheng Qianniu Mo (Ground Raw Pharbitidis Semen) (1 liang), Huashi (Talcum) (4 liang), Huanglian (Coptidis Rhizoma), Bohe Ye (Menthae Haplocalycis Folium), Chuanxiong (Ligustici Chuanxiong Rhizoma) (0.5 liang each).
Preparation and Administration: Grind the above ingredients into fine powder, add water dropwise to make pills the size of wutong seeds. Take 40-50 pills after meals with warm water. Another formula adds Puhuang (Typhae Pollen) for hemostasis.
Qian's Yuliren Wan (Yuliren Pill by Dr. Qian): Treats infants with obstruction of stool and urine, as well as fright-heat, phlegm-stagnation, and excess syndromes where loose stools are desired.
Composition: Yuliren (Prunus japonica Seed, peeled), Chuan Dahuang (Rhei Radix et Rhizoma, coarse skin removed, solid core taken, cut, soaked in wine for half a day, drained, stir-fried, ground into fine powder) (1 liang each), Huashi (Talcum, 0.5 liang, finely ground).
Preparation and Administration: First grind Yuliren into a paste, mix with Dahuang and Huashi, make pills the size of millet seeds. Administer according to age/size, before meals, with breast milk or Bohe Tang (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, toxicity accumulation in fu-zang organs. Its guiding and draining action is very stable.
Composition: Sheng Xi Jiao Mo (Ground Raw Cornu Rhinocerotis - *Note: Modern substitution often uses Sheng Shui Niu Jiao/Cornu Bubali*, 1 fen), Ren Shen (Ginseng Radix et Rhizoma, whiskers removed, sliced), Zhishi (Aurantii Fructus Immaturus, pith removed, stir-fried), Binglang (Arecae Semen) (0.5 liang each), Huanglian (Coptidis Rhizoma) (1 liang), Dahuang (Rhei Radix et Rhizoma) (2 liang, sliced after wine soaking, place 100 peeled Badou seeds against the Dahuang slices, wrap in paper, steam over rice three times, slice, stir-fry until yellow-brown, discard Badou).
Preparation and Administration: Grind into fine powder, mix with refined honey to make pills the size of hemp seeds. Take 10-20 pills before sleep with cooked water. Increase dosage if bowel movement does not occur. Also treats adults; safe for pregnant women.
*Huiyan* Shaoyao San (Shaoyao Powder from *Huiyan*): Treats cases where stool and urine remain obstructed even after taking purgatives.
Composition: Shaoyao (Paeoniae Radix), Dahuang (Rhei Radix et Rhizoma), Gancao (Licorice Root, stir-fried), Danggui (Angelicae Sinensis Radix), Puxiao (Natrii Sulfas) (1 fen each).
Preparation and Administration: Grind into powder. Take one large qian per dose, decoct in one cup of water in a clay vessel until half remains, strain, and drink. Stool and urine will pass immediately.
[Dr. Ji's] Formula for Obstruction of Stool and Urine:
Composition: Gancao Jie (Licorice Root Nodes, processed), Huaihua (Sophorae Flos, washed) (1 liang each).
Preparation and Administration: Grind into powder. Take one qian per dose, mixed with half a qian of tea, taken with hot water.
Another Formula:
Composition: Huashi (Talcum) (one large qian), Dengxin (Junci Medulla) (one handful).
Preparation and Administration: Decoct in two bowls of water until one bowl remains, take warm.
*Zimu Milu* records: Burn Fengfang (Vespa Nidus) to ash, take one qian with wine, twice daily.
Umbilical Covering Method (Alternative):
Composition: Haisi (Siliqua/Volva shells) (49 pieces), Conggen (Allii Fistulosi Rhizoma, with soil) (7 pieces), Heidou (Sojae Semen Nigrum) (7 pieces), Yan (Salt) (a little).
Woxuan Wan (Woxuan Pill): Treats infantile dry fecal impaction, or abdominal bloating and confusion caused by astringent medicines, where life is at stake. This pill can be used; within a short time, stool and urine will pass naturally.
Composition: Badou (Crotonis Fructus) (1.5 qian), Liuhuang (Sulfur), Liangjiang (Alpiniae Officinarum Rhizoma), Fuzi (Aconiti Lateralis Radix Praeparata), Binglang (Arecae Semen), Gansui (Kansui Radix) (equal parts).
Preparation and Administration: Grind into fine powder, mix with millet rice paste to make pills the size of mung beans. Wash the infant's hand (left for males, right for females) with pepper water, have them hold the pill, wrap securely with cotton. Observe how many steps they walk, then wash off the medicine. Stop when no longer needed.
*Qianjin* Moxibustion Method: For infantile obstruction of stool and urine, moxa moxibustion one Zhuang at each corner of the mouth.