小儿一岁。变蒸已足。方有脉自寸口而生。予见小儿初生未盈月。手掌高骨之际。亦有
脉
息。吸吸而动。脉者气血之波澜。既生乃成人。必有气血。焉得无脉。但不见有大人察其端
的之至意也。
小儿有病须凭脉。一指三关定息数。迟冷数热古今传。浮风沉积当先识。左手人迎主外
症。
右手气口主内疾。外候风寒暑湿侵。内候乳食痰积致。洪紧无汗是伤寒。浮缓伤风有自汗。
浮洪多是风热盛。沉细原因乳食积。沉紧腹中痛不休。弦紧喉间作气急。紧促之时痘疹生。
紧数之际惊风至。虚软慢惊作螈 。紧实风痫发搐搦。软而细者为疳虫。牢而实者因便闭。
脉芤大小便中血。虚濡有气兼惊悸。滑主露湿冷所伤。弦急客忤君须记。大小不匀为恶候。
二至为脱三至卒。五至为虚四至损。六至和平曰无疾。七至八至病犹轻。九至十至病势急。
十一二至死无疑。此诀万中无一失。
心脉 心脉浮数惊与热。伤暑焦啼明白诀。吊肠疝气及盘肠。壅结口疮小腑涩。心脉沉
迟脏腑寒。诸气有冷痛难当。小便频数肠中冷。下指端详仔细看。
肝脉 肝脉浮数定主风。目赤翳膜又主筋。流泪出血眼生眵。或痒或痛怕羞明。肝脉沉
迟主有寒。面青唇白眼喜张。诸病传入慢风候。良医仔细要参详。
脾脉 脾脉浮数热痰涎。能食胃恶脾脏坚。滞颐口疮停壅结。唇红脸赤胃中热。脾脉沉
迟主风吹。更加吐泻慢脾传。气虚胃弱不能食。滞颐呕恶醒脾丸。
肺脉 肺脉浮数主便血。伤寒咳嗽遍身热。气急痰甚或疮疹。泻痢潮热大腑涩。肺脉沉
迟主虚寒。脏腑滑肠或洞泄。仍有咳嗽与痰涎。下根不定即无根。
肾脉 肾脉浮数实有热。偏坠膀胱痛又赤。口臭切牙是肾惊。火热齿内出鲜血。肾脉沉
迟定有寒。脏腑停留入肾囊。偏坠膀胱尤不痛。浮而虚大最难当。
小儿满一岁，变蒸（婴幼儿生长发育过程中出现的生理性发热现象）已经完成。此时脉象才从寸口部位产生。我见到刚出生未满月的小儿，在手掌高骨（桡骨茎突）附近，也有脉息。呼吸间微微跳动。脉是气血运行的波澜。既然已经出生成为人，必然有气血，怎么会有没有脉的情况呢？只是大人没有仔细探究其端倪的极致用心罢了。
小儿有病必须依靠脉诊。用一根手指在三关（寸、关、尺）上确定脉搏次数。迟脉主寒证，数脉主热证，这是古今相传的经验。浮脉主风邪，沉脉主积滞，应当首先识别。左手人迎穴处（此处指左手寸口脉，代指表/外）主要判断外症。右手气口穴处（此处指右手寸口脉，代指里/内）主要判断内疾。外候观察风寒暑湿的侵袭。内候观察乳食痰积导致的病变。洪大紧实且无汗的是伤寒。浮缓且有自汗的是伤风。浮洪多是风热盛。沉细原因是乳食积滞。沉紧是腹中疼痛不止。弦紧是喉间气急。紧促之时痘疹生出。紧数之际惊风发作。虚软慢惊出现抽搐。紧实是风痫发作抽搐。软而细的是疳虫（寄生虫病或营养不良）。牢而实的是因为便秘。脉芤（中空如葱管）是大便或小便出血。虚濡是有气虚兼惊悸。滑脉主露湿冷所伤。弦急是客忤（突发惊吓或邪气入侵），你必须记住。脉象大小不匀是恶候。两至一搏为脱脉，三至一搏为卒死之兆。五至一搏为虚脉，四至一搏为损脉。六至一搏和平，称为无病。七至八至病势尚轻。九至十至病势危急。十一二至必死无疑。此诀万无一失。
心脉 心脉浮数主惊悸与热证。伤暑焦躁啼哭，明白这一诀断。吊肠疝气及盘肠（肠痉挛）。壅结口疮小便涩痛。心脉沉迟主脏腑寒证。诸气伴有寒冷，疼痛难忍。小便频数肠中寒冷。下指端详仔细看。
肝脉 肝脉浮数定主风邪。目赤翳膜又主筋病。流泪出血眼生眵（眼屎）。或痒或痛怕羞明（畏光）。肝脉沉迟主有寒。面青唇白眼喜张。诸病传入慢风候（慢性惊风）。良医仔细要参详。
脾脉 脾脉浮数主热痰涎。能食但胃恶脾脏坚实。滞颐（流口水）、口疮停壅结。唇红脸赤胃中热。脾脉沉迟主风吹（受风）。更加吐泻转为慢脾风（慢性脾胃虚衰）。气虚胃弱不能食。滞颐呕恶用醒脾丸治疗。
肺脉 肺脉浮数主便血。伤寒咳嗽遍身热。气急痰甚或疮疹。泻痢潮热大腑（大肠）涩。肺脉沉迟主虚寒。脏腑滑肠或洞泄（严重腹泻）。仍有咳嗽与痰涎。下根不定即无根（脉无根基）。
肾脉 肾脉浮数实有热。偏坠（睾丸肿大下垂）膀胱痛又赤。口臭切牙是肾惊。火热齿内出鲜血。肾脉沉迟定有寒。脏腑停留入肾囊（阴囊）。偏坠膀胱尤不痛。浮而虚大最难当（难以救治）。
When a child reaches one year of age, the *bianzheng* (physiological febrile phenomena associated with infant growth and development) is complete. At this point, the pulse begins to manifest at the *Cunkou* (radial artery at the wrist). I have observed that in infants less than one month old, there is also a pulse sensation near the high bone of the palm (styloid process of the radius), moving slightly with each breath. The pulse is the ripple of Qi and Blood. Since they are born as humans, they must possess Qi and Blood; how could they lack a pulse? It is merely that adults do not exert the utmost effort to investigate its origins meticulously.
For pediatric diseases, diagnosis must rely on the pulse. Using one finger across the three positions (Cun, Guan, Chi) determines the pulse rate. A slow (*Chi*) pulse indicates cold, and a rapid (*Shu*) pulse indicates heat, a principle passed down through ancient and modern times. A floating (*Fu*) pulse indicates wind, and a deep (*Chen*) pulse indicates accumulation; these should be recognized first. The left hand's *Renying* position (referring to the left radial pulse, representing exterior/exterior syndromes) primarily governs external conditions. The right hand's *Qikou* position (referring to the right radial pulse, representing interior/interior syndromes) primarily governs internal diseases. External observations monitor invasions by wind, cold, summer-heat, and dampness. Internal observations monitor lesions caused by milk/food retention and phlegm accumulation. A full, large, and tight pulse without sweating indicates *Shanghan* (Cold Damage). A floating and relaxed pulse with spontaneous sweating indicates *Shangfeng* (Wind Strike). A floating and full pulse often indicates excess wind-heat. A deep and thin pulse is due to food stagnation. A deep and tight pulse indicates unceasing abdominal pain. A wiry and tight pulse indicates airway urgency. During periods of tightness and urgency, smallpox/rash emerges. During periods of tightness and rapidity, *Jingfeng* (pediatric convulsions) arrives. A deficient and soft pulse indicates slow *Jingfeng* with twitching. A tight and solid pulse indicates wind-*Xian* (epilepsy) with convulsions. A soft and thin pulse indicates *Ganchong* (worm infestation or malnutrition). A firm and solid pulse is due to constipation. A hollow (*Kou*) pulse indicates blood in stool or urine. A deficient and soggy pulse indicates Qi deficiency combined with palpitations and fright. A slippery (*Hua*) pulse indicates injury from exposure to dew, cold, and dampness. A wiry and urgent pulse indicates *Kewu* (sudden fright or pathogenic invasion); you must remember this. Irregular pulse size is an ominous sign. Two beats per respiration indicates collapse (*Tuo*); three beats indicates sudden death. Five beats indicates deficiency (*Xu*); four beats indicates damage (*Sun*). Six beats per respiration is harmonious, indicating no disease. Seven to eight beats indicate mild illness. Nine to ten beats indicate critical illness. Eleven to twelve beats indicate certain death. This formula is infallible.
Heart Pulse: A floating and rapid heart pulse indicates fright and heat. Heatstroke causing irritability and crying is clearly diagnosed by this rule. It also relates to intestinal hernia, coiled intestine (intestinal colic), congestion, mouth ulcers, and scanty/difficult urination. A deep and slow heart pulse indicates cold in the Zang-Fu organs. Various Qi disorders accompanied by cold cause unbearable pain. Frequent urination and cold intestines require careful examination under the fingers.
Liver Pulse: A floating and rapid liver pulse definitively indicates wind. Red eyes with nebulae also indicate tendon issues. Tearing, bleeding, and eye discharge indicate either itching or pain with photophobia. A deep and slow liver pulse indicates cold. A blueish complexion, white lips, and a preference for opening the mouth suggest that various diseases have progressed to slow wind syndrome (chronic convulsions). Physicians must analyze this carefully.
Spleen Pulse: A floating and rapid spleen pulse indicates hot phlegm and saliva. The patient may eat well but reject stomach functions while the spleen is firm. Drooling (*Zhiyi*), mouth ulcers, and stagnation/congestion occur. Red lips and face indicate stomach heat. A deep and slow spleen pulse indicates wind invasion. With vomiting and diarrhea, it progresses to slow spleen wind (chronic spleen deficiency). Qi deficiency and weak stomach prevent eating. For drooling and vomiting, use *Xingpi Wan* (Spleen-Awakening Pill).
Lung Pulse: A floating and rapid lung pulse indicates hematochezia. Cold damage with cough and generalized fever, airway urgency, severe phlegm, or rashes. Diarrhea, dysentery, tidal fever, and large bowel obstruction. A deep and slow lung pulse indicates deficiency-cold. Spleen and stomach slipping/intestine or profuse diarrhea. Cough and phlegm persist. If the root is unstable, the pulse lacks foundation.
Kidney Pulse: A floating and rapid kidney pulse indicates real heat. Hernia (testicular swelling/drooping), bladder pain, and redness. Bad breath and teeth grinding indicate kidney fright. Fire-heat causes fresh blood from inside the gums. A deep and slow kidney pulse definitively indicates cold. Pathogens lingering in Zang-Fu enter the scrotum. Hernia and bladder pain may be absent. A floating and deficient-large pulse is the most difficult to treat.