五脏有外候,不离正面间,耳乃肾之窍,两眼原属肝。鼻孔
肺为主,脾唇心舌尖。
左颊属木肝生风,右颊属金肺位同。额为心火赅为肾,准头
鼻土位居中。
肝主风兮目直视,闷乱叫哭不安宁。心主热兮不得眠,惊悸
饮水口舌干。脾主困兮多好睡,吐泄(4)瘦弱病成疳。肺主气兮多
咳嗽,皮干发枯喘绵绵。肾主虚兮胎气弱,小儿肾弱养应难。
今人专看虎口纹,风关气关命关分。风关病轻气关重,命关
若过死将临。青筋红热黑势恶,直轻斜曲重看云。
小儿一指分三位,息数须将六至看,七至八至数为热。三至
四至迟虚寒。坚实平和无病断,细小沉迟有病春。
按全婴等书云:小儿三岁已(5)前,虎口第一指上寅卯关有脉
弦(6)见者,可验病状(7)。男左女右,视之脉弦。从寅关起不至卯
关者,病易治;若连于卯关者,病难治;如寅连卯,卯过辰关者,
十难救一。若脉弦小或短者,病可治。宜参视之(8)。
啼哭直视热在肝,泄清一服及时安。啼哭面斥热在心,导赤
麦冬效如神。面赤四逆腹中痛,益黄散用姜汤送。夜夜见灯多拗
哭,父母矫爱多不足。
急症惊风面赤背,目多直视不回晴。手足搐掣牙关紧,只怕
昏昏再(9)不醒。
惊来掐人中,虎口拿总筋。泄青吞导赤,调理治凉惊。口眼
若喝斜,看他左右偏,太阳颊下穴(10),一焠自然安。
面色黄白神气弱,昏睡眼闭口不合。口鼻气冷手足冷,慢惊
搐掣时时作。
慢惊不可医,调元急补脾。渐醒能食吉。常昏不乳危。
五脏的外在征象,主要体现在面部的特定区域:耳朵是肾的窍道,双眼归属于肝。鼻孔由肺所主,嘴唇属于脾,舌尖属于心。
左颊属木,对应肝脏,肝易生风;右颊属金,对应肺脏,二者位置相同(指面部左右对应脏腑)。额头属心火,下巴(地阁)属肾,鼻头(准头)属土,位居面部中央。
肝主风,表现为眼睛直视、心中烦闷混乱、叫喊哭泣、不得安宁。心主热,表现为无法入睡、惊悸、想喝水但口舌干燥。脾主困倦,表现为嗜睡、呕吐腹泻、身体消瘦虚弱,进而形成疳积病。肺主气,表现为多咳嗽、皮肤干枯、头发枯黄、喘息不止。肾主虚,表现为胎元之气薄弱,小儿肾脏虚弱则养育困难。
现在的人专门观察虎口的指纹,将其分为风关、气关、命关三个部位。风关病变轻,气关病变重,如果指纹超过命关,则预示死亡临近。指纹颜色青筋为寒或痛,红色为热,黑色为病情凶险。指纹形态直者病轻,斜曲者病重,如云片状者需仔细辨别轻重。
小儿诊脉时,一指可分三位,呼吸次数以六至(每息六次脉搏跳动)为正常标准。七至八至为数快,属于热证。三至四至为数慢,属于虚寒证。脉象坚实平和表示无病,细小沉迟则表示有病。
根据《全婴书》等典籍记载:小儿在三岁以前,虎口第一指上的寅卯关出现弦脉,可以验证病症情况。男看左手,女看右手,观察脉象是否呈弦象。如果脉象从寅关开始但未延伸到卯关,病容易治疗;如果连及卯关,病难治疗;如果寅关连到卯关,甚至越过辰关,十例中难得救活一例。如果脉象弦小或者短促,病尚可治疗。应当参考其他诊法综合判断。
啼哭且眼睛直视,说明热邪在肝,服用泄青散及时调理即可安愈。啼哭且面色红赤,说明热邪在心,使用导赤散加麦冬,效果神速。面色红赤伴有四肢逆冷和腹痛,使用益黄散并用姜汤送服。夜间见到灯光就哭闹不止,往往是父母过度娇惯、要求得不到满足所致。
急症惊风表现为面赤背热,眼睛经常直视不能转动。手足抽搐、牙关紧闭,只怕患者昏迷不醒。
惊风发作时掐按人中穴,在虎口处拿捏总筋。若伴有泄泻,吞服导赤散进行调理,采用凉惊的治疗方法。
如果出现口眼歪斜,要看偏向哪一侧,针刺太阳穴下方的穴位,用火针焠刺一次即可自然安宁。
面色黄白、神气虚弱、昏睡闭眼、口唇不开。口鼻气息寒冷、手足冰冷,这是慢惊风,抽搐时时发作。
慢惊风难以医治,急需调补元气、温补脾胃。若能逐渐苏醒并能进食,则为吉兆;若常昏睡且不吸乳,则病情危重。
The external manifestations of the five Zang organs are primarily reflected in specific areas of the face: the ears are the orifices of the Kidney (Shen), and the two eyes belong to the Liver (Gan). The nostrils are governed by the Lung (Fei), the lips by the Spleen (Pi), and the tip of the tongue by the Heart (Xin).
The left cheek corresponds to Wood and the Liver, which tends to generate Wind; the right cheek corresponds to Metal and the Lung. The forehead belongs to Fire and the Heart, while the chin (Di Ge) belongs to Water and the Kidney. The nose tip (Zhun Tou) belongs to Earth and is located centrally on the face.
The Liver governs Wind, manifesting as fixed staring of the eyes, mental restlessness, crying and shouting, and agitation. The Heart governs Heat, manifesting as insomnia, palpitations with fright, thirst, and dryness of the mouth and tongue. The Spleen governs stagnation and fatigue, manifesting as excessive sleepiness, vomiting and diarrhea, emaciation, and weakness, eventually leading to Gan syndrome (infantile malnutrition). The Lung governs Qi, manifesting as frequent coughing, dry skin, withered hair, and continuous wheezing. The Kidney governs Deficiency, manifesting as weak prenatal Qi; if a child's Kidneys are weak, nurturing them is difficult.
Currently, people specifically observe the fingerprint patterns on the tiger's mouth (the web between the thumb and index finger), dividing them into three sections: the Wind Section (Feng Guan), the Qi Section (Qi Guan), and the Life Section (Ming Guan). Disease at the Wind Section is mild, at the Qi Section is severe, and if it extends beyond the Life Section, death is imminent. Blue-green veins indicate cold or pain, red indicates heat, and black indicates a dire condition. A straight pattern suggests mild disease, while oblique or curved patterns suggest severity; cloud-like patterns require careful assessment.
In pediatric pulse diagnosis, one finger covers three positions. A normal rate is six beats per respiration. Seven to eight beats per respiration indicates rapidity and Heat. Three to four beats per respiration indicates slowness and Deficient Cold. A firm and harmonious pulse indicates health, while a fine, small, deep, and slow pulse indicates disease.
According to texts such as *Quan Ying Shu*: For children under three years old, if a Wiry Pulse (Xian Mai) appears at the Yin-Mao section on the first phalanx of the tiger's mouth, it can verify the pathological state. Observe the left hand for males and the right hand for females. If the pulse starts at the Yin section but does not reach the Mao section, the disease is easy to treat; if it connects to the Mao section, it is difficult to treat; if it connects from Yin to Mao and exceeds the Chen section, fewer than one in ten cases can be saved. If the pulse is wiry, small, or short, the disease is treatable. These findings should be cross-referenced with other diagnostic methods.
Crying with fixed staring indicates Heat in the Liver; administering Xie Qing San (Drain Liver Powder) promptly brings relief. Crying with a red face indicates Heat in the Heart; using Dao Chi San (Guide Out Red Powder) combined with Dong Gong (Ophiopogon Tuber) yields miraculous results. A red face accompanied by cold extremities and abdominal pain requires Yi Huang San (Benefit Yellow Powder) taken with ginger decoction. Nightly crying when seeing lights is often due to parental over-indulgence and unmet demands.
Acute Jing Feng (Convulsive Disorder) presents with a red face, hot back, fixed staring without eye movement, limb convulsions, and locked jaw. The patient may fall into a coma and never wake up.
Upon onset of Jing Feng, pinch the Renzhong point (GV26) and grasp the Zongjin tendon at the tiger's mouth. If accompanied by diarrhea, swallow Dao Chi San for regulation, employing cooling methods to calm Jing.
If there is facial paralysis (deviation of mouth and eyes), observe which side is affected. Apply cauterization to the acupoint below the Taiyang cheek area; one application brings natural peace.
A yellowish-white complexion with weak Shen Spirit, drowsiness, closed eyes, and an open mouth indicates Slow Jing Feng (Chronic Convulsive Disorder) with intermittent spasms. Cold breath from the nose and mouth and cold extremities confirm this diagnosis.
Slow Jing Feng is difficult to cure; urgently regulate Yuan Qi and tonify the Spleen. Gradual awakening and ability to eat are auspicious signs. Constant lethargy and refusal to nurse indicate critical danger.