总括 小儿便结哭声高，津液不润为火熬；急投煎剂并导法，免使儿遭日夜号。
脉法 阳结脉沉实而数，阴结脉浮而迟。
《内经》∶北方黑色，入通于肾，开窍于二阴，藏精于肾。又曰∶肾主大便，大便难者，取足少阴。夫肾主五液，
津液润则大便如常，若饥饱失节，劳役过度，损伤胃气及食辛热味浓之物而助火邪，伏于血中，耗散真阴，津液亏少，
故大便燥结。杨氏曰，邪热入里，则内有燥粪，三焦伏暑则津液中干，此大肠之夹热也。宿食留滞则腹胀痛闷，胸痞欲
呕，热气燔灼，则内受风热，坚燥闭塞，热宜疏利三黄丸，积宜消积丸，惟胸中活法治之。
小儿初生，腹胀欲绝，大小便不通，急令妇人漱口，吸咂儿胸前背心手足腹脐下，共七处，以红赤色为度，须臾自
通。
〔附方〕
消积丸 见伤积症内。
三黄丸 黄连 黄芩 大黄（酒蒸晒九次）等分为末，蜜丸。
（宜与疝症参看）
总括 厥阴少阴寒激搏，致令肿缩宜温药；光浮不痛作虚医，赤肿须凭凉剂却。
《内经》曰∶ 癃疝肤胀者，阴气盛而脉胀不通也。今小儿阴茎全缩不见，有阴囊光肿不痛，此因肝肾气虚，用橘
仁煎汤，调金铃散，或匀气散。观《内经》之言，乃阴气盛而致，此吊缩者，筋急也。筋遇寒则引缩，遇热则弛张，故
三因所用方法，以宽小肠气，疏风为治。然此乃坐阴润之地，感风湿而得，用当归散加槟榔苍术服，或服钩藤膏，并以
立消散敷之。
阴囊肿痛而引缩者，盖诸筋会于阴器，邪客于厥阴、少阴之经，与冷气相搏而成。治之不早则成固疾，如腰曲腹痛
冷汗自出，阴囊内二子吊缩入腹，痛止方出，名曰内吊，用乌梅散、匀气散、金铃散为治。
有外肾无故而肤囊肿大，不燥不痛，光亮如灯，此名气虚所致，亦用匀气散调治。
一症外肾皮囊赤肿通明，及女儿阴户肿胀，乃心热所传，皆以木通散、导赤散为治，以朴硝散敷之。（批∶小儿七
日肾缩，乃初生受寒气所致，用硫磺、茱萸各五钱，研末，大蒜调涂腹，仍以蛇床子微烟熏之。）
〔附方〕
金铃散 三棱 莪术 青皮 陈皮 赤茯 茴香 木香 槟榔 枳壳 钩藤 金铃子 甘草
匀气散 桔梗 陈皮 砂仁 茴香 僵蚕 甘草
当归散 见吐泻症内。
钩藤膏 钩藤 玄胡索 当归 乳香 薄桂 麝香 甘草
立消散 赤小豆 赤芍 风化硝 枳壳 商陆 各为末，敷之，乃以五苓散加车前子及米仁煎服。
乌梅散 见腹痛症内。
木通散 木通 蓄 大黄 甘草 山栀 赤茯 瞿麦 滑石 车前仁 黄芩
导赤散 见五淋症内。
朴消散 大黄 牡砺 朴硝 为末，水调敷。
总括：小儿大便干结时哭声高亢，这是因为津液不足无法滋润，被火热煎熬所致；应当紧急使用煎剂配合导法治疗，以免让孩子日夜哀号。
《黄帝内经》说：北方对应黑色，气机通于肾，开窍于前后二阴，精气藏于肾。又说：肾主管大便，大便困难的，应取足少阴肾经的穴位。肾主管五液，津液滋润则大便正常。如果饥饱失常，劳役过度，损伤了胃气，以及食用辛辣、气味浓烈且性热的食物助长火邪，火邪潜伏在血中，耗散真阴，导致津液亏少，所以大便燥结。杨氏说，邪热入里，体内就有燥屎；三焦伏留暑热则津液中干，这是大肠夹有热邪。宿食停滞则腹胀痛闷，胸膈痞塞想呕吐；热气炽盛，则内受风热，导致坚硬干燥闭塞。热证适宜用疏利法的三黄丸（Sanhuang Wan, Three-Yellow Pill），积滞适宜用消积丸（Xiaoji Wan, Accumulation-Dispersing Pill），只有运用灵活的方法在胸中调理才能治愈。
小儿刚出生时，腹部胀满几乎要破裂，大小便不通，应立即让妇女漱口，吸吮婴儿胸前、背心、手足、腹部和脐下，共七处，以皮肤出现红赤色为度，不久自然通畅。
〔附方〕
消积丸 见伤积症篇内。
三黄丸 黄连、黄芩、大黄（用酒蒸晒九次）等分为末，蜂蜜制丸。
（宜与疝症参看）
总括：厥阴经和少阴经受寒邪激搏，导致肿胀收缩，适宜用温药；如果光亮浮肿但不疼痛，属于虚证，按虚证医治；如果红肿，必须凭凉剂来消除。
《黄帝内经》说：癃疝肤胀，是因为阴气盛而脉道胀满不通。现在小儿阴茎完全缩回看不见，有的阴囊光亮肿胀但不疼痛，这是因为肝肾气虚，用橘仁煎汤，调服金铃散（Jinling San, Golden Bell Powder）或匀气散（Yunqi San, Qi-Balancing Powder）。观察《黄帝内经》的话，说是阴气盛导致的，这种吊缩的情况，是筋脉拘急。筋遇寒则牵引收缩，遇热则松弛伸展，所以三因制宜所用的方法，以宽理小肠气、疏风为治法。然而这往往是坐在阴湿之地，感受风湿而得病，用当归散（Danggui San, Angelica Decoction）加槟榔、苍术服用，或者服用钩藤膏（Gouteng Gao, Uncaria Paste），并用立消散（Lixiao San, Immediate-Resolution Powder）外敷。
阴囊肿痛并引起睾丸上缩的，因为诸筋汇聚于阴器，邪气客居在厥阴、少阴经脉，与冷气相搏结而成。治疗不及时就会变成顽固疾病，如腰部弯曲腹痛，冷汗自出，阴囊内的两个睾丸吊缩入腹，疼痛停止后才出来，名叫“内吊”，用乌梅散（Wumei San, Sour Plum Powder）、匀气散、金铃散来治疗。
有一种外肾（睾丸）无故皮肤囊肿大，不干燥也不疼痛，光亮如灯，这叫气虚所致，也用匀气散调治。
一种症状是外肾皮囊赤肿透明，以及女儿阴户肿胀，这是心热传变所致，都用木通散（Mutong San, Akebia Decoction）、导赤散（Daochi San, Guide-Out Red Powder）治疗，并用朴硝散（Puxiao San, Niter Powder）外敷。（批注：小儿出生后七天出现肾缩，是初生时受寒气所致，用硫磺、吴茱萸各五钱，研成末，用大蒜调和涂抹腹部，仍用蛇床子微烟熏之。）
〔附方〕
金铃散 三棱、莪术、青皮、陈皮、赤茯苓、茴香、木香、槟榔、枳壳、钩藤、金铃子、甘草
匀气散 桔梗、陈皮、砂仁、茴香、僵蚕、甘草
当归散 见吐泻症篇内。
钩藤膏 钩藤、玄胡索、当归、乳香、薄桂、麝香、甘草
立消散 赤小豆、赤芍、风化硝、枳壳、商陆，各为末，外敷，然后用五苓散加车前子及薏苡仁煎服。
乌梅散 见腹痛症篇内。
木通散 木通、蓄、大黄、甘草、山栀、赤茯苓、瞿麦、滑石、车前仁、黄芩
导赤散 见五淋症篇内。
朴消散 大黄、牡蛎、朴硝，为末，水调敷。
General Summary: When infants suffer from constipation, their crying is loud and high-pitched. This is due to a lack of body fluids failing to moisten the intestines, which are being scorched by fire-heat. One should urgently administer decoctions combined with guiding methods (such as enemas or suppositories) to prevent the child from wailing day and night.
Pulse Diagnosis: The pulse for Yang Constipation is deep, solid, and rapid; the pulse for Yin Constipation is floating and slow.
The *Neijing* (Yellow Emperor's Inner Canon) states: The North corresponds to black, its qi communicates with the Kidney, it opens into the two yin orifices (anus and urethra), and stores essence in the Kidney. It also says: The Kidney governs defecation; for difficult defecation, one should select points on the Foot-Shaoyin Kidney Meridian. The Kidney governs the five fluids. When body fluids are moistening, defecation is normal. If diet is irregular (feasting or fasting without rhythm), or if overexertion damages Stomach Qi, or if one consumes pungent, strong-flavored, and hot-natured foods that assist pathogenic fire, this fire may lurk within the blood, consuming true Yin. Consequently, body fluids become deficient, leading to dry and hard stools. Mr. Yang stated: When pathogenic heat enters the interior, dry feces accumulate inside; when summer-heat lingers in the Triple Burner, middle-body fluids dry up; this constitutes Heat clashing with the Large Intestine. If retained food stagnates, there will be abdominal distension, pain, fullness, chest oppression, and nausea. If heat blazes fiercely, internal wind-heat is affected, resulting in hardness, dryness, and blockage. For Heat patterns, the Sanhuang Wan (Three-Yellow Pill) is suitable for purging and draining; for accumulation patterns, Xiaoji Wan (Accumulation-Dispersing Pill) is suitable. Only through flexible treatment focusing on the chest/middle jiao can this be cured.
For newborns presenting with extreme abdominal distension and inability to pass stool or urine, immediately have a woman rinse her mouth and suckle seven areas of the infant: the chest front, back, hands, feet, abdomen, and below the umbilicus. Continue until the skin turns red. The obstruction will naturally resolve shortly.
[Attached Formulas]
Xiaoji Wan (Accumulation-Dispersing Pill): See the section on Food Injury Syndrome.
Sanhuang Wan (Three-Yellow Pill): Equal parts of Coptidis Rhizoma (Huanglian), Scutellariae Radix (Huangqin), and Rheum Palmatum Rhizoma et Radix (Dahuang, steamed with wine and dried nine times). Grind into powder and make into honey pills.
(Should be read in conjunction with Hernia Syndromes)
General Summary: Cold stimulation clashing between the Jueyin and Shaoyin meridians causes swelling and retraction, requiring warm herbs. If the scrotum is shiny and swollen but painless, it is a deficiency pattern treated as such. If red and swollen, cool formulas must be used to dispel it.
The *Neijing* states: In cases of strangury, hernia, and cutaneous distension, it is because Yin Qi is excessive, causing vessel distension and obstruction. Currently, some infants have a penis completely retracted and invisible, while others have a shiny, swollen scrotum that is painless. This is due to deficiency of Liver and Kidney Qi. Use decoction of Citri Reticulatae Pericarpium (Juren) to take Jinling San (Golden Bell Powder) or Yunqi San (Qi-Balancing Powder). Observing the words of the *Neijing*, this retraction is caused by excess Yin Qi; this "hanging retraction" is due to tendon spasm. Tendons contract when exposed to cold and relax when exposed to heat. Therefore, according to the Three Causes theory, the treatment method involves relaxing the Small Intestine Qi and dispersing Wind. However, this condition often arises from sitting in damp, shady places and contracting Wind-Dampness. Use Danggui San (Angelica Decoction) added with Arecae Semen (Binglang) and Atractylodis Macrocephalae Rhizoma (Cangzhu), or take Gouteng Gao (Uncaria Paste), and apply Lixiao San (Immediate-Resolution Powder) externally.
If the scrotum is swollen, painful, and accompanied by testicular retraction, it is because all tendons converge at the genitalia. Pathogens lodge in the Jueyin and Shaoyin meridians and clash with Cold Qi. If not treated early, it becomes a chronic disease. Symptoms include curved waist, abdominal pain, spontaneous cold sweat, and the two testes retracting into the abdomen, emerging only when pain ceases. This is called "Internal Retraction." Treat with Wumei San (Sour Plum Powder), Yunqi San, and Jinling San.
In some cases, the external genitalia swell inexplicably, becoming large, non-dry, painless, and shiny like a lamp. This is caused by Qi deficiency and is also treated with Yunqi San.
In another syndrome, the skin of the external genitalia is red, swollen, and transparent, or the vulva of female infants is swollen. This is transmitted from Heart Heat. Treat with Mutong San (Akebia Decoction) and Daochi San (Guide-Out Red Powder), and apply Puxiao San (Niter Powder) externally. [Commentary: Infantile renal retraction occurring seven days after birth is caused by cold invasion at birth. Use 5 qian each of Sulfur and Evodiae Fructus (Zhuyu), grind into powder, mix with garlic juice to apply to the abdomen, and fumigate with mild smoke from Cnidii Fructus (Shechuangzi).]
[Attached Formulas]
Jinling San (Golden Bell Powder): Sparganii Rhizoma (Sanleng), Curcumae Rhizoma (Ezhu), Tangerine Peel (Qingpi), Aged Tangerine Peel (Chenpi), Red Poria (Chifu), Fennel Seed (Huixiang), Aucklandiae Radix (Muxiang), Arecae Semen (Binglang), Aurantii Fructus (Zhiqiao), Uncariae Ramulus cum Uncis (Gouteng), Meliae Semen (Jinlingzi), Licorice Root (Gancao).
Yunqi San (Qi-Balancing Powder): Platycodon Root (Jiegeng), Aged Tangerine Peel (Chenpi), Amomi Fructus (Sharen), Fennel Seed (Huixiang), Bombyx Batryticatus (Jiangcan), Licorice Root (Gancao).
Danggui San (Angelica Decoction): See the section on Vomiting and Diarrhea Syndrome.
Gouteng Gao (Uncaria Paste): Uncariae Ramulus cum Uncis (Gouteng), Corydalis Rhizoma (Yanyhusuo), Angelicae Sinensis Radix (Danggui), Boswelliae Resina (Ruxiang), Cinnamomi Ramulus (Boogui), Moschus (Shexiang), Licorice Root (Gancao).
Lixiao San (Immediate-Resolution Powder): Adzuki Bean (Chixiaodou), Red Peony Root (Chishao), Effloresced Natrii Sulfas (Fenghuaxiao), Aurantii Fructus (Zhiqiao), Phytolaccae Radix (Shanglu). Grind each into powder for external application. Internally, take Wuling San (Five-Ingredient Powder with Poria) added with Plantaginis Semen (Cheqianzi) and Coicis Semen (Yiren) as a decoction.
Wumei San (Sour Plum Powder): See the section on Abdominal Pain Syndrome.
Mutong San (Akebia Decoction): Akebiae Caulis (Mutong), Polygoni Avicularis Herba (Bianxu), Rheum Palmatum Rhizoma et Radix (Dahuang), Licorice Root (Gancao), Gardenia Fruit (Shanzhi), Red Poria (Chifu), Diantherae Herba (Qumai), Talcum (Huashi), Plantaginis Semen (Cheqianren), Scutellariae Radix (Huangqin).
Daochi San (Guide-Out Red Powder): See the section on Five Types of Strangury Syndrome.
Puxiao San (Niter Powder): Rheum Palmatum Rhizoma et Radix (Dahuang), Ostrea Concha (Muli), Natrii Sulfas (Puxiao). Grind into powder, mix with water, and apply externally.