用田螺大者,捶烂贴脐下,能开结热。
熨脐法
用连根葱一根,不洗去泥土,生姜一片,淡豆豉二
十一粒,盐二匙,同研捶作饼,放铫子上烘热,饼掩脐
中,以厚绵絮系定,良久气通自利,不然再换。
用猪胆大者一个,将鹅毛简截去两头,一头插入胆
中,用线扎定,不令移动,着口吹气入胆内,又以线作
活套子扎定其气,将鹅毛简向内纳入谷道中,取出活套,
埋胆汁入腹中,须臾气通自利。
西 江 月
大便不通症候,有虚有实不同,虚为津液少流通,肠涩不能
传送。内服通幽汤剂,外法贴导疏通,若是热症腹中疼,屎燥三黄
可用。
若是伤食症侯,腹中必作痛疼,面黄便秘实难禁,药用九转
灵应。大便若是下血,大肠积热之因,连槐壳柏榆榔荆,脱肛猬
皮加增。
粪后时常出血,地榆丸子高强,防风枳壳与生黄,地榆当归
为上。乌梅甘草诃子,黄连荆芥同行,伏龙槐花白术当,米醋为
丸吞放。
小便不通症治,阴闭阳闭须知,阴为风冷入乘虚。五苓木香
加入,又加灵砂为末。空心盐汤吞之,外用盐炒熨其脐,热气流通
罔滞。
阳闭暴热所逼,其症唇赤面红,便如点滴血鲜流,五苓车前
加用。或用剪红[33]散子,重者八正木通,外用熨脐法即通,活幼
之功可颂。
又有湿痰下坠,其儿体胖身肥,喉中有痰面微红,小便落地
停注。其形浑如米泔,此症不可胡为,二陈汤内增苍术,木通升麻
加入。
初出有微红色,良久澄白如泔,此由乳食损脾元,清浊不分
症现。治用分清饮子,或用胃苓汤丸,补脾化滞法为先,脾实方除
此患。
凡治小便不通,凉药不可多施,若用田螺贴其脐,逼寒入腹
难出。宜用人参白术,茯苓甘草相随,再加车前与滑石,升麻芩通
并入。
大小二便俱闭,此症果是凶危。先通大便最为宜,小便自然
通利。药用九转灵应,车前煎水调之,此般治法实为奇,医者铭心
牢记。
大小二便下血,心肺积热相攻,三黄解毒有神功,黄连黄芩
相共。黄柏红花生地,大黄甘草木通,当归只可用其身,白水煎
汤相送。
熨脐法
取一根带根的葱(不去除泥土),一片生姜,二十一颗淡豆豉,两匙盐,一同研磨并捶打制成饼状。将其放在小锅上加热,用热饼覆盖在肚脐中,用厚棉絮固定住。过一段时间后,气机通畅自然就会排便;如果不行,再更换一个新的。
取一个较大的猪胆,将鹅毛管截去两头,一头插入胆中,用线扎紧固定,防止移动。对着开口向胆内吹气,再用线做一个活结扎紧以固定气体。将鹅毛管的另一端向内插入肛门中,取出活结,让胆汁流入肠道内。不久之后,气机通畅自然就会排便。
西江月词:
大便不通的症状,有虚证和实证的不同。虚证是因为津液少、流通不畅,肠道干涩无法传送粪便。内服通幽汤剂,外用贴敷或导引的方法疏通。如果是热证且腹部疼痛,可以使用三黄药方。
如果是伤食引起的症状,腹部必然疼痛,面色发黄,便秘严重难以忍受,药物选用九转灵应丸。
如果大便下血,原因是大肠积热,可用连翘、槐壳、黄柏、榆皮、槟榔、荆芥等药;若伴有脱肛,再加猬皮。
便后经常出血,用地榆丸子效果显著,配合防风、枳壳和生黄芪,地榆与当归为上品。乌梅、甘草、诃子,配合黄连和荆芥同用,伏龙肝、槐花、白术应当使用,用米醋制丸吞服。
小便不通的症治,需要分清阴闭和阳闭。阴闭是由于风冷侵入乘虚而入。在五苓散中加入木香,再加入灵砂研成末。空腹时用盐汤送服。外用炒热的盐熨烫肚脐,使热气流通而不阻滞。
阳闭是由暴热逼迫所致,症状是嘴唇红赤、面色发红,小便像点滴鲜血一样流出,可在五苓散中加入车前子。或者使用剪红散,重症者用八正散加木通。外用熨脐法即可通畅,这是活幼科的神奇功效,值得称颂。
又有湿痰下坠的情况,患儿身体肥胖,喉中有痰,面色微红,小便落地后停滞不流。尿液浑浊如米泔水,此症不可胡乱治疗,在二陈汤中加入苍术,再加入木通和升麻。
初出时有微红色,久置后澄清变白如米泔水,这是由于乳食损伤了脾元,导致清浊不分出现此症。治疗使用分清饮,或者使用胃苓汤丸,以补脾化滞为优先方法,脾气充实才能消除这种病患。
凡是治疗小便不通,凉药不可多用。如果使用田螺贴敷肚脐,会导致寒气逼入腹中难以排出。宜用人参、白术,茯苓、甘草相随,再加上车前子和滑石,升麻、黄芩、木通一并加入。
大小便都闭塞,这个病症确实凶险危急。先通大便最为适宜,小便自然会通利。药物选用九转灵应丸,用车前子煎水调服。这样的治法实在奇妙,医者应铭记在心牢记不忘。
大小便同时下血,是心肺积热相互攻冲的结果,三黄解毒汤有神效,黄连和黄芩共同作用。还有黄柏、红花、生地,大黄、甘草、木通,当归只可用其根部,用白水煎汤送服。
Use a large *Pachyma* (snail), pound it until mushy, and apply it to the area below the umbilicus; this can open up and clear constrained heat.
Method of Hot Compress on the Umbilicus
Take one green onion with roots (do not wash off the soil), one slice of fresh ginger, twenty-one fermented soybeans (*Douchi*), and two spoonfuls of salt. Grind and pound them together into a cake. Place the cake on a small pot to heat it up. Cover the umbilicus with the hot cake and secure it tightly with thick cotton wadding. After a while, when the qi flows freely, defecation will occur naturally; if not, replace with a new cake.
Take one large pig gallbladder. Cut both ends off a goose quill tube. Insert one end into the gallbladder and tie it securely with thread to prevent movement. Blow air into the opening of the gallbladder through the other end of the tube, then tie the opening with a slipknot to trap the air. Insert the other end of the goose quill tube inward into the anus. Remove the slipknot, allowing the bile to enter the intestines. Shortly thereafter, when the qi flows freely, defecation will occur naturally.
*Xi Jiang Yue*:
The syndrome of constipation differs in deficiency and excess. Deficiency is due to insufficient body fluids and poor circulation, causing dry intestines unable to transport stool. Internally administer *Tongyou Tang* (Unblocking the Abyss Decoction); externally use application or enema methods to unblock. If it is a heat syndrome with abdominal pain, *Sanhuang* (Three Yellows) formulas may be used.
If it is a food stagnation syndrome, there must be abdominal pain, yellowish complexion, and severe constipation difficult to endure. Use *Jiuzhuan Lingying Wan* (Nine-Turn Efficacious Pill).
If blood appears in the stool, the cause is accumulated heat in the Large Intestine. Use *Lianqiao* (Forsythiae Fructus), *Huaike* (Stemonae Radix - note: context implies bark/seed related herbs like Sophora), *Baipi* (Phellodendri Cortex), *Yupi* (Ulmus Bark), *Binglang* (Arecae Semen), and *Jingjie* (Schizonepetae Herba). If prolapse of the rectum occurs, add *Weipi* (Erinaceus Spina).
For frequent bleeding after defecation, *Diyu Wan* (Sanguisorbae Pill) is highly effective. Combine with *Fangfeng* (Saposhnikoviae Radix), *Zhike* (Aurantii Fructus), and *Sheng Huangqi* (Raw Astragali Radix); *Diyu* (Sanguisorbae Radix) and *Danggui* (Angelicae Sinensis Radix) are superior. Combine *Wumei* (Mume Fructus), *Gancao* (Glycyrrhizae Radix et Rhizoma), and *Hezi* (Chebulae Fructus) with *Huanglian* (Coptidis Rhizoma) and *Jingjie* (Schizonepetae Herba). Use *Fulonggan* (Dragon's Liver - calcined earth), *Huaihua* (Sophorae Flos), and *Baizhu* (Atractylodis Macrocephalae Rhizoma); form pills with rice vinegar and swallow.
Regarding the treatment of urinary retention, one must distinguish between Yin obstruction and Yang obstruction. Yin obstruction is caused by wind-cold invading due to deficiency. Add *Muxiang* (Aucklandiae Radix) to *Wuling San* (Five-Ingredient Powder with Poria), and add *Lingsha* (Cinnabaris et Realgar mixture) ground into powder. Swallow on an empty stomach with salt water. Externally, fry salt and hot-compress the umbilicus to promote qi flow without stagnation.
Yang obstruction is forced by sudden heat. Symptoms include red lips and face, and urine flowing like drops of bright blood. Add *Cheqianzi* (Plantaginis Semen) to *Wuling San*. Alternatively, use *Jianhong San* (Cut Red Powder). For severe cases, use *Bazheng San* (Eight-Ingredient Powder) with *Mutong* (Akebiae Caulis). Externally applying the hot compress method on the umbilicus will achieve patency. This is the meritorious achievement of pediatric therapy, worthy of praise.
There is also the condition of damp-phlegm sinking. The child is fat and robust, has phlegm in the throat, a slightly red face, and urine that stagnates upon landing. The shape is turbid like rice wash water. This syndrome must not be treated recklessly. Add *Cangzhu* (Atractylodis Rhizoma) to *Erchen Tang* (Two-Aged Decoction), and add *Mutong* (Akebiae Caulis) and *Shengma* (Cimicifugae Rhizoma).
Initially slightly red, it clarifies and turns white like rice wash water after a while. This is due to milk and food damaging the Spleen's primal qi, presenting as a syndrome of unclear separation of pure and turbid. Treat with *Fenqing Yin* (Separating Clear Decoction), or use *Weiling Tang/Wan* (Stomach-Ling Decoction/Pill). Prioritize tonifying the Spleen and resolving stagnation; only when the Spleen is solid can this illness be eliminated.
In all cases of treating urinary retention, cold-natured medicines should not be overused. If *Tianluo* (Snail) is applied to the umbilicus, cold pathogen is forced into the abdomen and becomes difficult to expel. It is advisable to use *Renshen* (Ginseng Radix), *Baizhu* (Atractylodis Macrocephalae Rhizoma), accompanied by *Fuling* (Poria) and *Gancao* (Glycyrrhizae Radix et Rhizoma). Additionally add *Cheqianzi* (Plantaginis Semen) and *Huashi* (Talcum), along with *Shengma* (Cimicifugae Rhizoma), *Huangqin* (Scutellariae Radix), and *Mutong* (Akebiae Caulis).
When both large and small bowels are blocked, the syndrome is indeed ominous and critical. It is most appropriate to first unblock the large bowel; the small bowel will naturally become patent. Use *Jiuzhuan Lingying Wan* (Nine-Turn Efficacious Pill), mixed with water decocted from *Cheqianzi* (Plantaginis Semen). Such treatment methods are truly miraculous; physicians should engrave them in their hearts and remember them firmly.
When blood appears in both large and small bowels, it is due to accumulated heat in the Heart and Lung attacking each other. *Sanhuang Jiedu* (Three Yellows Detoxification) possesses divine efficacy, with *Huanglian* (Coptidis Rhizoma) and *Huangqin* (Scutellariae Radix) working together. Also use *Huangbai* (Phellodendri Cortex), *Honghua* (Carthami Flos), and *Shengdi* (Rehmanniae Radix). *Dahuang* (Rhei Radix et Rhizoma), *Gancao* (Glycyrrhizae Radix et Rhizoma), and *Mutong* (Akebiae Caulis) are included. Only the root of *Danggui* (Angelicae Sinensis Radix) should be used, taken with plain water decoction.