男子妇人之病。可以问而知。可以切而得。断死生。辨难易。审差剧。犹有所根据。而
不至于大误。若小儿者。怀抱之时。虽有所苦。而不能言。及能学语。又不能指其苦之处。欲诊
其脉。则骸骨短小。气血未足。寸关尺将何以分。浮中沉将何以定。虽有一指滚取二部之说
。而终未得其部位。况至数急促。岂能以悉审之。大约八九至为平。五六至为迟。十一二至
为数。依稀仿佛之间而已。故哑科治疗之难。每十倍于大人。而尤不可以不慎者也。惟虎口
之脉稍为可验。其脉在食指外侧。每一部一关。三节为三关。男视在左。女视在右。有筋脉
如系。 于肉内。仔细观之。紫则为风。红则伤寒青则为惊。白则为疳。黄则为脾困。青黑
则
为慢惊。入掌则为内吊。若三关通度为沉 之候。惟此可以少知之耳。虽然幼科之治病。当
多方求之。岂可执虎口之脉法。而尽小儿之诸病哉。必于病之未形。而用意察之。庶可以为
预消之地。如小儿呵欠连绵。乃小儿脏腑受邪。病之渐也。若面赤则知其风热。而泻肝之剂可
以先服。面青则知其惊风。而治惊之剂可以先服。面黄则知其为脾虚。而补脾之剂可以先服
。多睡则知其为内热。而清热之剂可以先服。口中气热则知其为伤风。而疏风之剂可以先服
。皆当随症形而先治之。勿俟其发而后用药也。其有不治之症者。尤不可以不知。小儿眼上
有赤脉。囟肿及陷者。一不治也。鱼口气粗。啮齿咬人者。二不治也。冷汗如雨。痰热不退
者。三不治也。脐风撮口。锁肚吊肠者。四不治也。风攻颐颔。唇项肿硬者。五不治也。鼻
有黑色者。六不治也。咳喘心痛者。七不治也。四肢浮肿者。八不治也。胸高而突起者。九
不治也。五软五硬者。十不治也。凡见此等之症。即当去矣苟不如几。而复药之。则病者之
死。虽不由于我。我亦何辞于彼哉。大凡小儿之病有常。多者不得所欲则易怒而啼。故肝病
常多。饮食不知节。虽饱而犹求食。故脾病常多。心神未定。闻响易动。故惊病常多。性喜
吮乳。甘食停积。而易感风热。故痰病常多。治儿之病。审其所常多者。酌而施之。以己之
意。参病之情。亦庶乎用药之无误也。然此数种。虽或常有。而肝脾之病尤多。神而明之。
存乎其人。得心应手。不可以言求也。
男子和女子的疾病，可以通过问诊得知，通过切脉获得。判断生死，辨别难易，审查病情的轻重，尚且有依据，不至于出现大的误诊。至于小儿，在怀抱之中时，虽然感到痛苦，却无法言语；等到学会说话后，又不能指出痛苦的具体部位。想要诊察其脉象，由于骨骼短小，气血尚未充足，寸、关、尺三部脉位如何区分？浮、中、沉三候如何确定？虽然有一指滚法兼取两部脉的说法，但终究未能准确掌握脉的部位。况且小儿脉搏至数急促，怎么能完全审察清楚呢？大约八九至为平脉，五六至为迟脉，十一二至为数脉，只是在依稀仿佛之间罢了。所以儿科治疗的困难，往往比成人高出十倍，尤其不可不谨慎。只有虎口之脉稍微可以验证。其脉位于食指外侧，每一部为一关，三节即为三关。男性看左手，女性看右手。有筋脉像绳索一样系于肉内，仔细观察：紫色则为风证，红色则为伤寒，青色则为惊证，白色则为疳积，黄色则为脾困，青黑色则为慢惊风，脉纹入掌则为内吊。如果三关贯通直达指甲，则是沉寒的征候。只有这一点可以稍微了解罢了。虽然如此，治疗儿科疾病，应当多方面探求，岂可只拘执虎口脉法来诊断小儿的所有疾病呢？必须在病症未显现之前，用心观察，或许可以在病情发生前进行预防消除。例如小儿连连呵欠，这是小儿脏腑受邪，是疾病的萌芽。如果面色赤红，则知道是风热，可以先服用泻肝的药物；面色青，则知道是惊风，可以先服用治惊的药物；面色黄，则知道是脾虚，可以先服用补脾的药物；嗜睡，则知道是内热，可以先服用清热的药物；口中气息热，则知道是伤风，可以先服用疏风的药物。都应当根据症状形态提前治疗，不要等到发病后再用药。那些无法治愈的病症，尤其不可以不知道。小儿眼上有赤色脉络，囟门肿胀或凹陷的，是一不治；鱼口气粗，咬人磨牙的，是二不治；冷汗如雨，痰热不退的，是三不治；脐风撮口，锁肚吊肠的，是四不治；风邪侵袭颐颔，嘴唇颈部肿胀坚硬的，是五不治；鼻头有黑色的，是六不治；咳嗽气喘伴心痛的，是七不治；四肢浮肿的，是八不治；胸部高耸突起的，是九不治；五软五硬的，是十不治。凡是见到这些病症，就应当放弃治疗。如果不及时放弃，反而继续用药，那么病人的死亡，虽然不归咎于我，我又有什么理由向家属推脱呢？大凡小儿的疾病是有规律的，大多是因为不能满足欲望就容易发怒啼哭，所以肝病常见；饮食不知节制，虽然吃饱了还要求食，所以脾病常见；心神未定，听到响声容易受惊，所以惊病常见；天性喜欢吮乳，甘甜食物停积体内，容易感受风热，所以痰病常见。治疗小儿疾病，审察那些常见的病症，斟酌施治，结合自己的意图，参酌病情的实际情况，也差不多可以避免用药的错误了。然而这几类病症，虽然常有，但肝脾的疾病尤其多见。神妙地领悟它，关键在于个人，得心应手的境界，不是言语所能完全表达的。
The diseases of men and women can be known through inquiry and obtained through pulse diagnosis. One can determine life and death, distinguish between difficult and easy cases, and assess the severity of the illness, all with a basis, thus avoiding major errors. However, for infants and children, although they suffer while being held in their parents' arms, they cannot speak; and when they learn to talk, they still cannot point out where it hurts. To diagnose their pulse, since their bones are short and small, and their qi and blood are not yet sufficient, how can the Cun (inch), Guan (bar), and Chi (cubit) positions be distinguished? How can the Floating (Fu), Middle (Zhong), and Deep (Chen) depths be determined? Although there is a theory of using one finger to roll and take two positions, one ultimately fails to grasp the correct pulse position. Moreover, since the pulse rate is rapid, how can it be fully examined? Generally, 8-9 beats per breath cycle is a normal pulse, 5-6 beats is a slow pulse, and 11-12 beats is a rapid pulse; these distinctions are merely vague and approximate. Therefore, the difficulty of treating pediatric diseases is often ten times that of adults, and extreme caution is required. Only the pulse at the Tiger's Mouth (Hu Kou) is somewhat verifiable. This pulse is located on the lateral side of the index finger. Each segment corresponds to a Guan (pass), and three segments constitute three Guans. For males, the left hand is observed; for females, the right hand. There is a vein resembling a thread tied within the flesh, which must be observed carefully: purple indicates Wind syndrome, red indicates Cold Damage (Shang Han), green/cyan indicates Fright syndrome, white indicates Gan accumulation (parasitic disease or malnutrition), yellow indicates Spleen distress, and cyan-black indicates Slow Convulsion syndrome. If the pulse pattern extends into the palm, it indicates Internal Torsion (Nei Diao). If the three Guans are connected and extend to the nail tip, it is a sign of Deep Cold. Only this aspect can be slightly understood. Nevertheless, when treating pediatric diseases, one should seek information from multiple sources. How can one rely solely on the Tiger's Mouth pulse method to diagnose all pediatric diseases? One must observe attentively before symptoms manifest, so as to prevent the disease in its early stages. For instance, continuous yawning in children indicates that the zang-fu organs are affected by pathogenic factors, marking the onset of illness. If the face is red, it indicates Wind-Heat, and Liver-draining formulas can be administered first. If the face is cyan, it indicates Fright-Wind, and formulas for calming fright can be used first. If the face is yellow, it indicates Spleen deficiency, and Spleen-tonifying formulas can be used first. Excessive sleepiness indicates internal heat, and heat-clearing formulas can be used first. Hot breath from the mouth indicates Wind-Cold attack, and wind-dispersing formulas can be used first. Treatment should always precede the full manifestation of symptoms based on the clinical presentation, rather than waiting for the disease to develop before administering medication. One must also know those incurable conditions. The following are ten incurable signs: 1. Red vessels on the eyelids, or bulging/sunken fontanelle. 2. Fish-mouth odor with coarse breathing, teeth grinding, or biting people. 3. Cold sweat like rain with persistent phlegm-heat. 4. Umbilical wind with mouth puckering, locked abdomen, or intestinal torsion. 5. Pathogenic wind attacking the jaw and chin, with swollen and hard lips and neck. 6. Black coloration on the nose. 7. Coughing, wheezing, accompanied by heart pain. 8. Edema of the four limbs. 9. High and protruding chest. 10. Five Softnesses (Wu Ruan) and Five Stiffnesses (Wu Ying). Upon seeing such signs, one should cease treatment. If one fails to do so promptly and continues to administer medicine, although the patient's death may not be directly attributed to me, I would have no excuse to offer to the family. Generally, pediatric diseases follow certain patterns. Most frequently, inability to get what one wants leads to anger and crying, hence Liver diseases are common. Lack of dietary moderation, craving food even after being full, leads to frequent Spleen diseases. Unsettled mind and spirit, easily startled by noise, lead to frequent Fright diseases. A nature fond of sucking milk, with stagnation of sweet foods leading to susceptibility to Wind-Heat, results in frequent Phlegm diseases. When treating pediatric illnesses, one should examine these common patterns, apply judgment, combine one's own understanding with the specific condition of the disease, and thereby minimize medication errors. Although these types are common, Liver and Spleen diseases are particularly prevalent. Profound understanding depends on the individual practitioner; the state of mental acuity and manual dexterity cannot be fully conveyed through words.