When a child is ill, one must rely on pulse diagnosis. Using the index and middle fingers to press the Cun, Guan, and Chi positions, the physician determines the pulse rate by counting breaths. A slow (Chi) pulse indicates cold syndromes, while a rapid (Shu) pulse indicates heat syndromes; this has been passed down through generations. A floating (Fu) pulse indicates wind pathogens, and a deep (Chen) pulse indicates accumulation; these should be identified first. The Renying pulse (Hegu point area on the radial artery) on the left hand primarily reflects exterior syndromes, while the Qikou pulse (Cun position on the radial artery) on the right hand primarily reflects interior diseases. Exterior conditions involve invasion by wind, cold, summerheat, and dampness; interior conditions involve milk food retention, phlegm, and accumulation. A surging (Hong) and tight (Jin) pulse without sweating indicates Cold Damage (Shanghan); a floating and relaxed (Huan) pulse with sweating indicates Wind Injury (Shangfeng). A floating and surging pulse often indicates excess wind-heat; a deep and thin pulse is due to milk food accumulation. A deep and tight pulse indicates unceasing abdominal pain; a wiry (Xian) and tight pulse indicates急促 breathing in the throat. When the pulse is tight and hurried (Cu), rashes and smallpox appear; when tight and rapid, convulsive disorders (Jingfeng) occur. A deficient and soft, slow pulse indicates slow convulsions (Man Jing) causing twitching; a tight and solid pulse indicates wind epilepsy causing spasms. A soft and thin pulse indicates gut worms (Ganchong); a firm and solid pulse is due to constipation. A knotted (Kou) pulse indicates blood in stool or urine; a deficient and soggy (Ru) pulse indicates Qi deficiency combined with palpitations and fright. A slippery (Hua) pulse indicates injury from exposure to cold dew; a wiry and urgent pulse indicates Ke Wu (sudden fright or alien qi invasion); this must be remembered. An irregular pulse of varying sizes is an ominous sign. Two beats per breath indicate collapse (Tuo); three beats indicate sudden death; five beats indicate deficiency (Xu); four beats indicate damage (Sun); six beats indicate harmony and absence of disease; seven to eight beats indicate mild illness; nine to ten beats indicate extreme severity; eleven to twelve beats indicate certain death. This formula is infallible.

Observing the finger veins on the little finger distinguishes the three gates. For boys, observe the left hand; for girls, the right hand; the method is the same. Everyone knows the initial gate is the Wind Gate (Feng Guan), and the terminal gate is the Life Gate (Ming Guan), which is easy yet difficult to judge. To understand the Qi vein at the tiger's mouth and the pulse, look at the finger veins with fingers inverted, distinguishing five colors: yellow and red indicate peace and harmony of the five Zang organs; faint red and purple indicate changes (benefit or harm); purple and green indicate food retention with much deficiency and vexation; cyan and black patterns indicate adverse conditions. If pure black suddenly appears in between, even skilled physicians will feel fear. If the vein extends straight to the Wind Gate, divide it into two ends based on grain-of-rice length. If it shoots like a spear, convulsive disorders arrive; if it branches like fingers, there are several types. Curving inward like a bow is favorable (Shun); outward is unfavorable (Ni). When favorable and unfavorable intertwine, the illness is difficult; the length of the branching head indicates potential for rescue; thus, physicians must examine carefully. Boys aged two are still called infants; three and four years old are called young children; five and six grow older in sequence; seven and eight begin to show understanding; nine are called children; ten are called tender youths. When ill, distinguish the causes of Guan Ge (obstruction). At eleven, epilepsy is called Dian Feng; Gan disease attacks similarly to consumption (Lao Bing). Pi Pi (abdominal masses) are definitely heavy conditions; resolving tidal fever differs. Initially, if the palm is hot, body heat follows. A hot belly with cold hands and feet confirms food accumulation; hot feet and forehead indicate wind sensation; a cold forehead and hot feet result from fright; rashes appear with redness behind the ears. For children with accumulation, appropriate digestive formulas should be given; for the three types of Shanghan, resolution via sweating is suitable. For food-induced diarrhea, accumulation must be present; for cold diarrhea, Spleen-warming methods are required; for watery diarrhea, astringent methods for the Zang organs are suitable, starting with Zhijie San. If a healthy child suddenly screams loudly, it is not convulsive disorder but Tiandiao (a type of convulsion). Loud screaming with急促 breathing and coarse long sounds indicates ingestion of hot toxins blocking the heart orifices; urgent vomiting and purging to harmonize the spleen are needed; administering convulsion medicines is truly laughable.