小儿初生至半岁看额脉,周岁以上看虎口三关;男子五岁,女人六岁,以大指上下滚转分取三部,诊寸
口三部脉。
额脉三指热感寒,
额前眉上发际下,以无名指、中指、食指三指按之,如俱热,感寒邪,鼻塞声粗。
俱冷(三指)吐泻脏不安;食指若热胸中满,无名热者乳消难;上热下冷食中热,
食指为上,名指为下。若食、中指热,则上热下冷。
夹惊名中指详看。
若无名、中指热,便是夹惊之候。
食指风气命三关,
男左女右,以左阳右阴故也。然阴阳男女,均有两手,亦当参验。左应心肝,右应肺脾,于此变通消息
可也。故有以左手红纹似线者,发热兼惊;右手红纹似线者,脾积兼惊;三叉者,肺热、风痰、夜啼。风关
无脉则无病,有脉病轻;气关病重;命关脉纹短小面色红黄,外证又轻则无妨。若直射三关青黑,外证又重
者。死。
五色惟有红黄安;
五色∶红,黄、紫、青、黑。由其病盛色能加变,如红黄之色,红盛作紫;红紫之色,紫盛作青;紫青之
色,青盛作黑;青黑之色,至于纯黑者不治。又白色主疳,黄而不光者主脾困。
淡红寒热(在表)青惊积,
深青色,或大小曲者,四足惊;赤色大小曲者,水火飞禽惊;红色大小曲者,人惊;青带黄者,雷惊。
或红或青,如线一直者,是母伤食所致。紫丝、青丝或黑丝,隐隐相杂,似出不出,主慢脾风。
深红疹痘是伤寒。
赤红伤寒痘疹,空红泄泻。钱氏歌∶紫风红伤寒,青惊白色疳,黑时因中恶,黄即困脾端。
\r图\ps92a8.bmp\r 纹弯停食(纹)细腹痛,
多啼乳食不消。纹多则主气不和,纹乱者病久,纹曲者风热盛。
\r图\ps92a9.bmp\r纹粗黑射惊风顽;
纹粗直射指甲,必主惊风恶候,纹黑如墨困重难治。
\r图\ps92a10.bmp\r悬针青黑(风关)水(惊,气关)疳热,
命关人惊,多传慢脾风,不治。余仿此。
\r图\ps92a11.bmp\r鱼刺(又有此样刺) 青(色风关) 惊(气关) 虚劳艰。
\r图\ps92a12.bmp\r水字(风关) 肺(咳嗽) 惊(风或疳疾) 膈痰积,\r图\ps92a13.bmp\r
乙字(风气二关)惊风尽属肝∶\r图\ps92a14.bmp\r曲虫(风关肝病)疳积(气关)大肠秽,\r图\ps92a15.bmp\r肝(风关)
胃(气关多吐)疳积总如环。
\r图\ps92a16.bmp\r流珠(红点)膈热三焦(霍)乱,吐泻肠鸣,自利烦躁,啼哭。
\r图\ps92a17.bmp\r长珠寒热(腹)痛(夹)积团∶\r图\ps92a18.bmp\r来蛇干呕脏腑滞,左手则为
肝病。
\r图\ps92a19.bmp\r去蛇昏睡泻潺潺。\r图\ps92a20.bmp\r弓风里形感寒热。
头目昏重,心神惊悸,倦怠,四肢稍冷,小便赤色。
\r图\ps92a21.bmp\r反外心神恍惚间∶
夹惊夹食风痫证候,纹势弯曲入里者,病虽重而证顺,犹可用力;若纹势弓反出外, 靠于指甲者,断
不可回。其有三关纹如流珠、流米,三五点相连,或形于面,或形于身,危证尤甚。
\r图\ps92a22.bmp\r气疳向里风(疳)向外,\r图\ps92a23.bmp\r斜左伤风斜右寒。\r图\ps92a24.bmp\r
双钩三曲伤冷硬,\r图\ps92a25.bmp\r脉乱如虫疳蛔攒;\r图\ps92a26.bmp\r枪形痰热惊风搐,\r图\ps92a27.bmp\r双字
食毒惊积难。
孩儿三岁至五岁,一指三关定其息。浮洪(浮缓伤风,洪紧伤寒。人迎紧盛伤寒,气口紧盛伤食)风盛数多
惊(急促虚惊),虚冷沉迟(细)实有积;脉紧如索(弦)是风痫,沉缓须知乳化难。腹疼紧弦牢实(大便)秘,
沉而数者骨中寒;弦长多是膈干风(弦紧者,气不和,)紧数惊风四肢掣。浮洪胃口似火烧,单细疳劳洪虫啮;
虚濡有气(不和)更兼惊(神不守舍),脉芤多痢大便血。变蒸脉亦随时移,伏迟寒呕无潮热(伏结为物聚);
前大后小童脉顺,前小后大必气咽(大小不均者鬼祟)。四至洪来苦烦满,沉细腹中痛切切∶滑主露湿冷所伤,
弦长客忤分明说。五至夜甚浮大昼,六至夜细浮昼别;纯阳六至号
平和,
五至虚四至病,三至脱,七至八至病轻,九至十至剧,十一、十二至死。此是圣人传妙诀。
脉过寸口入鱼际,主遗尿、惊搐。脉浮数身温,顺;沉细肢冷,逆。夜啼脉微小,顺;洪大身冷,逆。
吐乳,脉浮大身温,顺;沉细身冷,逆。疳劳,脉紧数脏实,顺;沉细脾泄,逆。虫痛,脉紧滑身温,顺;
浮大唇青,逆。余病顺逆同大人。
小儿从出生到半岁,观察额脉;周岁以后,观察虎口三关(食指桡侧的指纹);男子五岁、女子六岁后,用医生大拇指在寸口部位上下滚转,分别取寸、关、尺三部脉象进行诊察。
额脉三指按之可辨寒热:
额头前部、眉毛上方、发际下方的区域,用无名指、中指、食指三指同时按压。如果三指感觉都热,说明感受了寒邪,会出现鼻塞、呼吸声粗重的症状。
如果三指感觉都冷,说明有呕吐、腹泻,脏腑功能不安稳;如果仅食指感觉热,说明胸中胀满;如果仅无名指感觉热,说明乳汁消化困难。
如果上部热而下部冷,说明食物积滞在中焦产生内热。这里“上”指食指,“下”指无名指。如果是食中指热,则表现为上热下冷。
如果无名指和中指感觉热,便是夹惊(兼受惊吓)的表现,需详细查看中指。
食指主风,中指主气,无名指主命,合称三关:
男左女右,是因为左侧属阳、右侧属阴的缘故。然而阴阳男女两手皆有,也应当参考验证。左手脉纹对应心、肝,右手脉纹对应肺、脾,在此处可以灵活变通斟酌。所以,左手红纹如线状者,是发热兼受惊;右手红纹如线状者,是脾积兼受惊;纹呈三叉状者,是肺热、风痰或夜间啼哭。风关(第一节)无脉纹则无病,有脉纹则病轻;气关(第二节)病重;命关(第三节)若脉纹短小且面色红黄,外部症状又轻,则无妨。如果脉纹直射三关且呈青黑色,外部症状又重,则预后不良,可能死亡。
五色之中,唯有红色和黄色为平安之色:
五色指:红、黄、紫、青、黑。颜色会随着病情加重而变化,例如红色盛极转为紫色;红紫色中紫色盛极转为青色;紫青色中青色盛极转为黑色;青黑色直至纯黑者,无法治疗。另外,白色主疳积(营养不良),黄色而不光亮者主脾困(脾胃虚弱)。
淡红色主表证寒热,青色主惊风积滞:
深青色,或纹路大小弯曲者,主四足动物惊吓所致;赤色,或纹路大小弯曲者,主水火飞禽惊吓所致;红色,或纹路大小弯曲者,主人惊吓所致;青色带黄色,主雷声惊吓所致。
或红或青,如线条一般直直的,是母亲饮食损伤所致。紫色丝、青色丝或黑色丝,隐隐混杂,似出非出,主慢脾风(慢性脾虚风动)。
深红色主疹痘,这是伤寒的表现。
赤红色主伤寒痘疹,空红色主泄泻。钱乙的歌诀说:紫色主风,红色主伤寒,青色主惊,白色主疳,黑色主中恶,黄色主脾困。
纹路弯曲停滞主停食,纹路细主腹痛:
多啼哭,乳食不消化。纹路多则主气机不和,纹路乱则病程久,纹路弯曲则风热盛。
纹路粗黑直射指甲主惊风顽疾:
纹路粗直射向指甲,必定主惊风的恶候;纹路黑如墨汁,病情沉重难治。
悬针形,风关见青黑主水饮与惊,气关主疳热,命关主人惊:
命关出现此纹主被人惊吓,多传变为慢脾风,难以治愈。其余情况仿此类推。
鱼刺形(又有这种形状的刺),风关见青色主惊,气关主虚劳艰难。
流珠形(红点),主膈热及三焦霍乱,症状包括吐泻、肠鸣、自利、烦躁、啼哭。
弓形,主风邪入里,感受寒热。症状包括头目昏重、心神惊悸、倦怠、四肢稍冷、小便赤色。
反弓形向外,主心神恍惚。
夹惊夹食的癫痫证候,纹路势态弯曲入里的,病虽重但证候顺,还可以用力治疗;如果纹路势态弓反出外,靠于指甲的,断不可救。如果有三关纹路如流珠、流米,三五点相连,或者显现于面部、身体,危重证候尤其严重。
气疳向里,风疳向外;斜向左主伤风,斜向右主伤寒。
双钩形、三曲形,主伤冷硬物;脉乱如虫形,主疳积蛔虫聚集。
枪形,主痰热惊风抽搐;双字形,主食毒、惊积难治。
孩子三岁至五岁,用一指在三关定其脉搏至数。
浮脉缓主伤风,洪紧脉主伤寒。人迎脉紧盛主伤寒,气口脉紧盛主伤食。
风盛则脉数多,急促主虚惊;虚冷则脉沉迟(细);实则有积滞。
脉紧如绳索(弦)是风痫;沉缓须知哺乳困难。
腹疼,脉紧弦牢实,大便秘结;沉而数的,骨中有寒。
弦长多是膈干风(弦紧者,气机不和);紧数主惊风,四肢抽搐。
浮洪,胃口似火烧;单细主疳劳,洪大主虫啮。
虚濡而有气机不和,更兼神不守舍之惊;脉芤多痢疾,大便出血。
变蒸(婴幼儿生长发育过程中的生理现象)的脉象也随时间变化,伏迟脉主寒呕,无潮热(伏结为物聚);
前大后小,童脉为顺;前小后大,必气咽(大小不均者,鬼祟作怪)。
四至洪大,苦于烦满;沉细,腹中痛切切。
滑脉主露湿冷所伤;弦长,客忤(外邪侵袭)分明可说。
五至,夜甚浮大昼;六至,夜细浮昼别;纯阳之体,六至号为平和。
五至为虚,四至为病,三至为脱;七至八至病轻,九至十至病剧,十一、十二至死。这是圣人传授的妙诀。
脉超过寸口进入鱼际,主遗尿、惊搐。
脉浮数身温,为顺;沉细肢冷,为逆。
夜啼,脉微小为顺;洪大身冷,为逆。
吐乳,脉浮大身温为顺;沉细身冷为逆。
疳劳,脉紧数脏实为顺;沉细脾泄为逆。
虫痛,脉紧滑身温为顺;浮大唇青为逆。
其余疾病的顺逆判断同大人一样。
From birth to six months of age, observe the forehead pulse; after one year of age, observe the three sections (Fengguan, Qiguan, Mingguan) of the Tiger's Mouth (lateral aspect of the index finger). For boys at five years and girls at six years, use the doctor's thumb to roll up and down to separately obtain the Cun, Guan, and Chi pulses at the Cun Kou (radial artery) position.
Forehead Pulse: Three-Finger Assessment for Heat and Cold
In the area of the forehead, above the eyebrows and below the hairline, press with the ring, middle, and index fingers. If all three fingers feel hot, it indicates invasion by cold pathogen, accompanied by nasal congestion and coarse breathing sounds.
If all three fingers feel cold, it indicates vomiting, diarrhea, and disharmony of the Zang organs. If only the index finger feels hot, it indicates chest fullness. If only the ring finger feels hot, it indicates difficulty in digesting milk.
If the upper part is hot and the lower part is cold, it indicates food stagnation generating heat in the middle Jiao. Here, "upper" refers to the index finger, and "lower" refers to the ring finger. If the index and middle fingers are hot, it manifests as upper heat and lower cold.
If the ring and middle fingers feel hot, it is a sign of being startled (Jia Jing), requiring detailed observation of the middle finger.
Index Finger Governs Wind, Middle Finger Governs Qi, Ring Finger Governs Life: The Three Sections
For boys on the left and girls on the right, due to the Left being Yang and Right being Yin. However, both hands possess Yin and Yang for both genders, so verification should be made by consulting both. The left hand corresponds to the Heart and Liver, and the right hand corresponds to the Lung and Spleen; flexibility and discretion are applied here. Thus, red lines resembling threads on the left hand indicate fever combined with fright; red lines resembling threads on the right hand indicate Spleen accumulation combined with fright; a trifurcated pattern indicates Lung heat, wind-phlegm, or night crying. Absence of a vein pattern at the Fengguan (Wind Section, first phalanx) means no disease; presence indicates mild disease; involvement of the Qiguan (Qi Section, second phalanx) indicates severe disease; if the Mingguan (Life Section, third phalanx) shows a short and small pattern with a reddish-yellow complexion and mild external symptoms, there is no cause for concern. If the pattern extends straight through all three sections and is cyan-black, accompanied by severe external symptoms, death ensues.
Among the Five Colors, Only Red and Yellow Indicate Safety
The five colors are: Red, Yellow, Purple, Cyan, and Black. The color changes as the disease intensifies: e.g., excessive red turns purple; excessive purple turns cyan; excessive cyan turns black; pure black is incurable. White governs Gan syndrome (malnutrition); yellow but dull indicates Spleen distress.
Pale Red indicates Exterior Cold-Heat; Cyan indicates Fright and Accumulation
Deep cyan, whether large or curved patterns, indicates fright caused by four-legged animals. Red, whether large or curved, indicates fright caused by water/fire birds. Red, whether large or curved, indicates fright caused by humans. Cyan with yellow indicates fright caused by thunder.
Red or cyan, straight like a line, indicates maternal dietary injury. Purple, cyan, or black threads, faintly mixed and seemingly emerging but not fully, indicate Slow Pi Wind (chronic Spleen deficiency with wind stirring).
Deep red indicates rash and pox, which are manifestations of Shang Han (Cold Damage).
Bright red indicates Shang Han and pox; hollow red indicates diarrhea. The song by Qian Yi states: Purple for Wind, Red for Shang Han, Cyan for Fright, White for Gan, Black for Zhong E (evil strike), Yellow for Spleen distress.
Curved Patterns Indicate Food Stagnation; Fine Patterns Indicate Abdominal Pain
Excessive crying and indigestion of milk/food. Numerous patterns indicate Qi disharmony; chaotic patterns indicate prolonged illness; curved patterns indicate excess Wind-Heat.
Thick, Black Patterns Extending Straight Indicate Stubborn Fright-Wind
Patterns thick and straight extending to the nail bed indicate ominous signs of Fright-Wind; patterns black as ink indicate heavy, difficult-to-treat conditions.
Needle-Hanging Shape: Cyan-Black at Fengguan indicates Water and Fright; Qiguan indicates Gan Heat; Mingguan indicates Human Fright
Mingguan involvement often transmits to Slow Pi Wind, which is incurable. Others follow this analogy.
Fish-Bone Shape: Cyan at Fengguan indicates Fright; Qiguan indicates Deficiency Labor (Xu Lao) and Difficulty.
Water Character Shape: Fengguan indicates Lung (Cough); Qiguan indicates Fright or Gan Disease; Phlegm Accumulation in the Diaphragm.
Yi Character Shape: Both Feng and Qi sections involved; all Fright-Wind belongs to the Liver.
Curved Worm Shape: Fengguan indicates Liver Disease; Qiguan indicates Gan Accumulation and Intestinal Filth.
Liver Character Shape (Fengguan), Stomach Character Shape (Qiguan, frequent vomiting); Gan Accumulation generally resembles a ring.
Flowing Pearl Shape (red dots): Indicates Diaphragm Heat and San Jiao Huo Luan (Cholera-like disorder), with symptoms of vomiting/diarrhea, borborygmus, spontaneous purging, irritability, and crying.
Long Pearl Shape: Indicates Cold-Heat, Abdominal Pain, and Clumped Accumulation.
Incoming Snake Shape: Indicates Dry Heaving and Visceral Stagnation; appearing on the Left Hand indicates Liver Disease.
Outgoing Snake Shape: Indicates Drowsiness and Watery Diarrhea.
Bow Shape: Indicates Wind entering the interior, contracting Cold-Heat. Symptoms include heavy dizziness, mental fright/palpitations, fatigue, slightly cold limbs, and dark urine.
Reverse Bow Shape Outward: Indicates Mental Fluctuation/Hallucination.
For Fright/Food-induced Epilepsy, patterns curving inward indicate severe but favorable prognosis, allowing for treatment; patterns bowing outward toward the nail bed indicate irreversible condition. If patterns across the three sections resemble flowing pearls or rice grains, connected in groups of three to five, or appearing on the face/body, the critical condition is even more severe.
Qi-Gan curves inward, Wind-Gan curves outward; Slanting Left indicates Wind Injury, Slanting Right indicates Cold Injury.
Double Hook and Triple Curve shapes indicate injury from cold/hard substances; Chaotic patterns resembling worms indicate Gan Syndrome with Ascaris aggregation.
Spear Shape indicates Phlegm-Heat Fright-Wind convulsions; Double Character shape indicates Food Toxicity and stubborn Fright-Accumulation.
For children aged three to five, determine the pulse rate using one finger over the three sections.
Floating and slow indicate Wind Injury; Floating and rapid indicate Fright (rapid and hurried indicates Empty Fright). Deep and slow/thin indicate Cold-Deficiency; Solid indicates Accumulation.
Tight like a rope (Wiry) indicates Wind-Epilepsy; Deep and slow indicates difficulty in nursing.
Abdominal pain with Tight, Wiry, Firm, and Solid pulse indicates constipation; Deep and Rapid indicates Cold in the bones.
Wiry and Long mostly indicate Diaphragmatic Dryness-Wind (Wiry-Tight indicates Qi disharmony); Tight and Rapid indicate Fright-Wind with limb twitching.
Floating and Rapid indicate burning stomach heat; Single Thin indicates Gan-Lao; Full/Rapid indicates worm infestation.
Empty and Soft with Qi disharmony plus Spirit insecurity (Fright); Hollow pulse indicates Dysentery with bloody stool.
Bian Zheng (physiological growth pulses) change with time; Hidden and Slow indicate Cold-Vomit without tidal fever (Hidden implies mass accumulation);
Anterior Large and Posterior Small is favorable for children; Anterior Small and Posterior Large indicates Qi obstruction (unequal sizes suggest demonic influence).
Four beats per respiration with Fullness causes vexation/fullness; Deep and Thin causes cutting abdominal pain.
Slippery indicates injury from dew/cold dampness; Wiry and Long clearly indicates Ke Wu (alien pathogenic invasion).
Five beats: Night sees Floating/Large, Day sees... Six beats: Night sees Thin, Day sees Floating. Pure Yang constitution with six beats is considered peaceful.
Five beats indicate Deficiency; Four beats indicate Disease; Three beats indicate Collapse. Seven to eight beats indicate mild disease; Nine to ten beats indicate severe disease; Eleven to twelve beats indicate death. This is the secret passed down by the Sages.
Pulse extending past Cun Kou into Yu Ji (Thenar eminence) indicates Enuresis and Fright Convulsions.
Floating-Rapid with warm body is Favorable; Deep-Thin with cold limbs is Unfavorable.
Night crying with Tiny-Small pulse is Favorable; Full-Large with cold body is Unfavorable.
Vomiting milk with Floating-Large and warm body is Favorable; Deep-Thin and cold body is Unfavorable.
Gan-Lao with Tight-Rapid and Excess Zang is Favorable; Deep-Thin with Spleen diarrhea is Unfavorable.
Worm pain with Tight-Slippery and warm body is Favorable; Floating-Large with blue lips is Unfavorable.
The favorable/unfavorable judgments for other diseases are the same as for adults.