《百问》小儿大便秘，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（热）加柴胡。热甚者，加山栀、黄芩、流利之。其表里俱热者，
面黄颊赤，唇燥口干，小便赤涩，大便焦黄，无汗者先解表，以柴胡散（伤寒）汗之，解后
大便秘，或肚疼者，以清凉饮、大柴胡汤、承气汤（并热）皆可下之。积热者，神芎丸尤
妙。〔薛〕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。人之气血浓薄既殊，而医之用药疗法，又
岂可泥执古方，而无加减之变乎。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，用五味异功散加升麻、柴
胡、而愈。一小儿大便不通。审乳母饮食浓味所致。用清胃散以治母热，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，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。
《圣惠》芎黄散 治小儿大便不通，腹胁妨闷。
芎 （半两） 川大黄（锉，微炒） 郁李仁（汤浸，去皮，微炒。各三分）
上件药捣，细罗为散。每服一钱，以温水半盏调服，量儿大小，以意分减，以
利为度。张涣兼治大小便不通。
张锐《鸡峰方》用麻子以水研汁饮之。
《百问》指出，小儿大便秘结，是由于肺家有热邪在里，传入大肠，导致秘结不通，这属于实热证，应当使用四顺清凉饮（清热剂）加入柴胡。如果热势严重，可加入山栀、黄芩以增强清热之力。若表里俱热，表现为面色黄而两颊红赤，嘴唇干燥，口干，小便短赤涩痛，大便焦黄，若无汗，应先解表，用柴胡散（伤寒方）发汗；表解之后，若仍大便秘结或伴有腹痛，可用清凉饮、大柴胡汤、承气汤（均为清热泻下剂）进行攻下治疗。若是积热所致，神芎丸尤为适宜。〔薛己〕认为，因乳母或患儿食用膏粱厚味导致积热，以及六淫七情郁火传变给患儿致病者，应使用清解邪气、疏解郁火的药剂。若禀赋怯弱，或因早近色欲导致肾精亏虚，出现大便困难且小便牵引疼痛者，应使用滋补肺肾的药剂。《褚氏遗书》说：男子精气未充时便御女泄精，会导致身体各处都有不足之处，日后会有难以名状的疾病；老人阴气已痿废却思慕色欲以泄精，则精液不出而在体内败坏。精气已耗损却又进一步枯竭，就会导致大小便牵引疼痛如同淋证。如今童子也有此患，更可见今人的禀赋与古人相差甚远。人的气血浓薄既然不同，医生用药疗法，又怎能拘泥于古方，而不加以加减变化呢？有一个小儿吃了粽子停滞不化，大便不通，疼痛难忍，手足抽搐。用大柴胡汤调服酒曲末一钱，排出大量积滞秽物后，出现呕吐不食，改用五味异功散加升麻、柴胡，得以痊愈。另一个小儿大便不通，经查是乳母饮食浓味所致。用清胃散治疗乳母之热，让小儿间断饮用一二匙而愈。后来乳母受寒腹痛，食用姜酒之物，导致小儿大便秘结兼有便血，仍用清胃散每日数匙服用而愈。还有一个小儿因乳母暴怒，导致大便不通，患儿也患病，兼用加味小柴胡汤，先用保和丸二服，后用五味异功散加升麻、柴胡，让小儿每日饮用数匙，一并痊愈。
《圣惠方》中的芎黄散，治疗小儿大便不通，腹胁部胀闷不适。
川芎（半两），川大黄（锉碎，微炒），郁李仁（温水浸泡，去皮，微炒。各三分）。
以上药物捣碎，过细筛制成散剂。每次服用一钱，用温水半盏调服，根据小儿年龄大小，酌情减量，以利通为度。张涣还用它兼治大小便不通。
张锐《鸡峰普济方》主张用水研磨麻子取汁饮用。
The text "Baiwen" states that constipation in children is caused by heat in the Lung organ remaining internally, flowing into the Large Intestine, resulting in blockage and inability to pass stool; this is a case of excess-heat (Excess Heat), and should be treated with Sishun Qingliang Yin (Four-Obedience Cooling Drink) added with Chai Hu (Bupleurum Root). If the heat is severe, add Shan Zhi (Gardenia Fruit) and Huang Qin (Scutellaria Root) to promote smoothness. In cases where both exterior and interior are hot, presenting with a sallow complexion but red cheeks, dry lips and mouth, dark and scanty urine, and scorched yellow stool: if there is no sweating, first resolve the exterior using Chai Hu San (Bupleurum Powder) to induce sweating; after the exterior is resolved, if constipation persists or abdominal pain occurs, Qingliang Yin, Da Chai Hu Tang (Major Bupleurum Decoction), or Cheng Qi Tang (Purgative Decoctions) can all be used for purgation. For accumulated heat, Shen Xiong Wan (Divine Xion Pill) is particularly excellent. [Xue Ji] posits that when pathogenic factors arise from the wet nurse or child consuming rich and greasy foods leading to accumulated heat, or from the transmission of depression-fire due to the six exogenous pathogens and seven emotions to the child, agents that clear pathogenic factors and resolve depression should be used. In cases of innate weakness or early indulgence in sexual activity leading to difficulty in defecation accompanied by pulling pain in urination, agents tonifying the Lung and Kidney should be used. The "Chu Shi Yi Shu" states: "If a man engages in intercourse before his essence is full, leaking his essence, his body will have deficiencies, and later he will suffer from inexplicable diseases; if an elderly person, whose yin energy is already atrophied, desires sexual activity to release essence, the essence will not exit but rot internally. If essence has been depleted and then further exhausted, it causes pulling pain in both large and small bowel movements resembling strangury." That young boys now suffer from this condition further reveals that the constitution of people today differs greatly from that of the ancients. Since the density and thinness of people's qi and blood vary, how can physicians rigidly adhere to ancient prescriptions without making modifications? One child suffered from food stagnation after eating zongzi (sticky rice dumplings), resulting in constipation, unbearable pain, and convulsions of the hands and feet. He was treated with Da Chai Hu Tang mixed with one qian of fermented grain powder, which expelled much stagnant waste. Subsequently, vomiting and loss of appetite occurred, so Wuwei Yigong San (Five-Ingredient Efficacious Labor Powder) added with Sheng Ma (Cimicifuga Rhizome) and Chai Hu was used, leading to recovery. Another child had constipation, determined to be caused by the wet nurse's consumption of rich flavors. The mother was treated with Qing Wei San (Stomach-Clearing Powder), and the child recovered after intermittently drinking one or two spoons. Later, the wet nurse caught a cold and had abdominal pain after consuming ginger and wine, causing the child to develop severe constipation with bloody stools; still, Qing Wei San was administered in several spoons daily, resulting in recovery. A third child suffered from constipation due to the wet nurse's sudden anger, affecting the child as well. Jiami Xiao Chai Hu Tang (Modified Minor Bupleurum Decoction) was used concurrently; initially, Baohe Wan (Harmonize and Preserve Pill) was given twice, followed by Wuwei Yigong San added with Sheng Ma and Chai Hu, with the child drinking several spoons daily, leading to complete recovery.
The Xiong Huang San (Szechwan Lovage and Scutellaria Powder) from "Shenghui Fang" treats pediatric constipation accompanied by abdominal and hypochondriac fullness and oppression.
Xiong (Ligusticum Chuanxiong Rhizome) (half liang), Chuan Da Huang (Rhubarb Radix et Rhizoma) (crushed, slightly stir-fried), Yu Li Ren (Prunus Humilis Seed) (soaked in water, skin removed, slightly stir-fried. Each three qian).
Grind the above ingredients into a fine powder. Take one qian per dose, mixed with half zhan of warm water, adjusting the dosage according to the child's age and size, stopping when bowel movement is facilitated. Zhang Huan also uses it to treat both constipation and urinary retention.
Zhang Rui's "Jifeng Fang" recommends grinding hemp seeds (Cannabis Fructus) in water, extracting the juice, and drinking it.