《颅囟经》∶凡孩子三岁以下呼为纯阳，元气未散，若有脉候即须于一寸取之，不得同大人分寸。其脉候未
来，呼之脉来三至；吸之脉亦三至；呼吸定息六至，此为无患矣。所言定息，呼气也出，吸气未入，定息之
中又至，此是平和也。得以大人脉五至取之即瘥矣。如此七至以上即为有气，或脉浮如弓之张弦，此为有风，
并可根据后方合药治之。或七至以下，此为冷候，亦宜根据后方合药疗之。或诊候取平和，或而不见，深浮不定，
伏益根平者，此为神鬼之病，且合求祟，续宜使药，或桃、柳枝汤法煎饮子。为使一两颗桃心。
《颅囟经》又云∶孩子脉呼吸十五至以上，三至以下皆死矣。
《千金翼》∶凡妇人脉，常欲濡弱于丈夫也。小儿四、五岁者，脉自疾 ，呼吸八至也。
尺寸俱浮直下，此为督脉腰背强痛不得俯仰，大人癫病，小儿风痫。小儿脉沉者，乳不消也。小儿脉弦急
者，客忤气也。
王叔和小儿生死候歌∶
小儿乳后辄呕逆，更兼脉乱无忧虑。（《病源》小儿啼未定，气息未调，乳母忽遽以乳饮之，其气逆上，
乳不得下，停滞胸膈，则胸满气急令
儿呕逆。又乳母将息取冷，冷气入乳，乳变坏，不捻除之，仍以饮之，冷乳入腹与胃相逆，则腹胀满痛，
气息喘急，亦令呕逆。又解脱换易衣裳及洗浴露儿身体，不
避风冷，风冷客于皮肤腠理，传于血气，入于胃则腹胀而吐逆也。凡如此变坏之乳，非有冷吐逆，肠虚入
胃则为痢矣。）弦急之时被气缠，脉缓即是不消
乳。（小儿脉弦主风邪气，脉缓即气不消。）紧数细快亦少苦，虚濡邪气惊风助。（小儿脉紧与形相称也，虚
濡亦生虚邪惊风也。）痢下宣肠急痛时，浮大之脉归泉路。（下痢脉浮大者，死形与脉相反也。）
《圣惠》辨小儿脉法∶夫小儿脉，三岁以上五岁以下可看候，然与大人有异，呼吸八至是其常也，九至者
病，十至者困。小儿脉紧者必风痫也。脉沉者乳不消，脉弦急者为客忤。脉沉数者骨间有冷。脉浮而数乳痫风
热。脉紧而弦腹痛，脉弦而数乳热五脏壅。脉牢而实大肠秘涩。脉乍短、乍长、乍大、乍小不等者有祟。小儿
变蒸之时，身热而脉乱，汗出，不欲食乳，食乳即吐逆，不可用药，必自瘥矣。小儿病困，汗出如珠，着身不
流者，不可治。小儿久下病痢，脉浮而腹痛者，不可治。小儿有病，胸陷，口唇干，目直，口中气冷，头低，
卧不举身，手足垂软，身体强直，掌中冷，皆不可治。
茅先生辨小儿五脏本脉∶肝弦，心洪，脾缓，肺浮，肾沉。
又辨小儿四季受脉∶小儿脉数，热病脉洪，泻痢沉细，风疾弦紧，气疾脉洪。头痛，寸急数；水藏急数，
小便频滴冷痛；脾浮洪，胃中有气块，不思饮食。
上前件脉法，各有声出看，各受本候浅深。其小儿合阴阳二部脉，将竞骨为中关，前为阳关，后为阴关。
阳得阴脉死，阴得阳脉亦如之。六岁以前，第一看太冲脉及看形色，并看虎口及三关脉。六岁以后方可看阴阳
二部脉，即根据前法。小儿无脉至数，如看前来迟及不动即死候。虎口及三关脉若迭起来黑色，死候不治。太冲
脉不动，亦死。
汉东王先生《家宝》小儿一见生死诀∶
幼童脉气辩何形，（《水鉴》先生曰∶小儿虽受阴阳二气成其形状，气尚未周，何言有脉。直至变蒸候
尽，阴阳气足方可看脉。其髫 之年，方生阴阳
二气。圣人云∶男七岁曰髫，生其元阳之气。女八岁曰 ，其阴阳方成。故未满髫 之年呼为淳阳，若
髫满后呼为童儿，始可看脉。如身体俱盛，脉至一息六至为常
人之脉，一息八至为热，九至风、五至虚、四至损、三至脱、二至死、十至必是疳痨、虚损，形容瘦劣。
若或身肥，血色青白，一息十一、二至者，谓之虚，是风病死，
是为脉乱。若一息十至六者，为脉不来，其人当令必死。迟若一息十一、二至者必死速，不满二日。何名
为一息？一呼、一吸名为一息。呼吸者，即是出一气，入一
气，谓之一息。其脉若指下未硬，隐指急大者是有积。若来微细即是冷，若虚轻紧即是热，时复一大即是
惊，若大小不匀即是死候也。先生所论浮数为热，伏结为寒，
沉细为冷，大小不匀为恶候。数者紧也，浮者轻也，伏者贴也，重手方见。结者乱也，沉者重没谓之沉。
细者微也，大小不匀则是。或大或小而不匀是为气不生，其
人必死也。）二十五种甚分明。（有二十五候，定其生死。）抱着遍身不温暖，（是血绝不 也。）四肢垂 哭鸦声，
（四肢垂 者为胃绝也，胃主四
肢，即绝不能管也，鸦声已解在形候门中。）啼哭无泪泻涎清，（是肝绝也。） 眉摘眼爪甲黑，（即是筋绝、筋痒，
故摘其眉眼也。）泥坛肿起或
为炕，（其囟门或肿或陷也。）将口咬人鱼口急，（即是两口角垂如鲫鱼吸水之状。）脚直肚大有青筋，（是
筋绝不能收，脚肚胀即是气绝也。）上视以
觑于高物，（目直故上视也。）长嘘出气黑文行，（气欲绝出而不回，黑文即血不 脉。）吃乳不收舌退场门，（吃乳
不收则胃绝，舌退场门即是心绝。）唇
不盖齿眼坑倾；（则是脾绝，脾主肌肉，外应于唇，脾绝则唇缩眼坑，倾亦属脾。）泻痢多变异 血，（则
是心绝，心主血，心若绝则下血黑色臭。）偏搐
似笑没心情。（一边搐也，虚笑不止，颜没其心情，此恶候也。）不论贵贱及男女，救疗十人无一生。（诸候并是难医者。）
钱乙论小儿脉法∶脉乱（不治），气不和（弦急），伤食（沉缓），虚惊（促急），风（浮），冷（沉细）。
《婴童宝鉴》论脉候（指脉内候附∶）夫小儿三岁以上，七岁以下，其脉驶。一息七八至为平，八至
以上至于十至者
曰大过（其病为阳盛也，）下不及五至六至曰不足。（其病为阴盛也。）
浮为风。（浮者阳，按之不足，轻手乃得，如葱管者，曰浮也。）沉为冷。（沉者阴，重手乃得，举指即无，
行于骨下，曰沉也。）洪为热。（洪者，按之
散大满部，状如浮者，曰洪。）微为寒。（微脉指下往来细如乱丝，重手即无，轻手乃得也。）紧为实。（亦曰痛。
紧者如丝而急，按之有力曰紧也。）沉细为乳
结。（亦为冷。言其脉细小而沉也。）弦数为疟。（脉弦如筝，通度带快。）弦急为客忤。（弦急，如新上之
弦。）大小不匀为中恶。（言其脉或大或小，不
根据其部也。）脉虚病亦虚。（虚脉轻手得之，重手即无也。曰虚，只因频下，脏腑即虚，亦因久泻也。）变蒸之
脉寸口乱。（乱为大小不匀。）伏为气。（伏
行筋中曰伏也。）
左手寸无脉，心下痛，胸中热，时时呕，口中生疮，犹乳母食冷所兼，咳嗽，头有汗，寒热作，喉中哽塞
作声。
右手寸无脉者，短气、气逆，喉中咳噫，犹乳母出冲风露所为也。
心脉满大，肝脉小急，并为痫、螈 之疾。凡寸脉但浮，直上直下，督脉连腰脊强不得俯仰。三部脉紧急，
其痫可治。吐 ，浮者可治。弦急者气痛，中恶微者可治。弦紧牢强为症癖病，脉随其左右上见。三部脉沉为
食乳不消化，缓亦同上。少阴脉数为疳淋，虚濡者，惊风邪气。脉如雀啄，若紧者风痫。伤寒脉洪者易理，微
者难理。脉来浮大者，宜发汗。一投一止病，假令六投一止，六曰病也。春脉弦，夏脉洪，秋脉浮，冬脉
沉。四季脉缓，各推其王相表里。若浮而见病，在表，属皮肤，在腑而为顺；阳脉沉，见病在里，属脏、骨髓，
逆行阴之理也。脉在上，病在上，死生见焉。
又论死脉∶伤寒身大热，体黄，脉沉细者死。中恶、脉紧细者死。黄胆、脉沉细，腹满者死。
《惠眼观证》诊候诀∶凡疾患既重，次看脉息如何，当以一指在鱼际或太冲看。若是伤寒、急惊、疹痘之
候，此为腑病，得浮洪即易安，沉细即难安。且与回阳两日至第三日再诊之，如得阳脉方许调理。然阳脉取之
在轻手如捻葱管乃有，满部重按即无是也。若中慢惊、吐泻、疟痢之候，此为脏病，得沉细即易安，浮洪即难
安。盖阴病脉行于内，不可行于外。凡一切病觉脉来三点大又三点细，此亦难治。大都小儿脉只看阳脉大，阴
脉细，余不可验也。学人宜审详之。
《保生论》∶小儿三岁以后或五百七十六日外，皆可诊两手脉，一指定三关。
歌曰∶小儿有病须凭脉，一指三关定其息，浮洪风盛数因惊，虚冷沉迟实有积。
浮为风。（秋得浮曰平和。）浮者，轻手来大，重手来细弱如按葱叶之状故曰浮。主小儿中风，伤风咳嗽，嚏喷，烦
躁壮热，鼻流清涕，一身头面虚浮，下泄多，小便如粉，可与解表，甚者与出汗即愈。
洪为热。（夏得洪曰平和。）洪者，轻手脉来大，重手脉来亦大，故曰洪。主小儿痫，发热，身生痈疖及瘰 ，喉
闭囟肿，风热面赤，气喘，心脏有热，小便淋沥，频患赤痢。
数因惊。（春得数曰平和。）数者，脉来小急，过数速疾故曰数。主小儿梦中咬齿惊掷，见人恐怖，夜多盗汗，白
日多困，气粗不语，忽泻青粪。若得数脉乃生惊候，此乃惊气传膀胱，主小儿有疝偏坠。
沉迟为虚冷。沉迟者，轻手按全不见，重手按至骨，脉来沉弱细小，故曰沉迟。主小儿脾胃虚冷，泄泻无
时，呕逆不食。
实有积。（冬得实曰平和。）实者，轻手脉不见，重手脉来大，故曰实。主小儿脏腑有积腹胀，面黄发立，小便如
油，面仆地卧，频频吐食，腹内鸣响。又积不治，即成疳痨、丁奚、哺露候。若孩儿肥实者，宜与稍凉药取积，
后补。若孩儿羸瘦，脏腑虚薄，可与性温药取积后补。
凡小儿脉春数、夏洪、秋浮、冬实、脉来八至止者，皆平和之脉也。若脉来急如弓弦，脉来两动而止不见
者，皆必死之脉也。
《孔氏家传》王叔和经∶小儿脉呼吸八至者平，九至者伤，十至者困。诊小儿脉多雀斗，要以三部脉为主。
若紧为风痫，沉者乳不消，弦急者客忤，沉而数者骨间有热。
《宝童方》中指脉法∶（孩儿五、七岁方诊中指脉。）孩儿五、七岁，五脏脉方现，中指两畔内，于中仔细看。
左男右女专心记，左主脾肝心肾肺，右主热生惊气疳，女子背看各从类，欲察病源谁得知，脉洪大急来归
内，此是伤寒病因热，洪大却慢伤脾气，迟细脾虚因取极，脉小急来肾虚致，疾在小肠凭药力，到此医人须用
意。诊脉若来三两通，此为死候命须终，吸人指面如弓急，慢脾死候命将毕。
翰林待诏杨大邺中指脉看死候法∶中指中间为动脉，医家莫便怀疑恻，此时风满四肢头，万卷千书医不得。
别一本五指歌曰∶五指指节冷，惊来不可安。忽然中指热，决定是伤寒。中指独自冷，疹痘有多般。女右
男逢左，八片锦中看。
《庄氏集》脉法歌∶小儿脉数多风热，沉伏原因乳食结，弦长必动肝肠风，弦数惊蛔四肢掣，洪浮胸中，似火
烧，若兼肠痛好添愁，息数和平八九至，此个分明不必忧。
《颅囟经》说：凡是三岁以下的小孩称为“纯阳”，元气尚未耗散。如果有脉象表现，必须在寸口一寸的范围内诊察，不能像成人那样划分分寸。其脉象频率为：呼气时脉搏跳动三次，吸气时脉搏也跳动三次；一呼一吸定息之间共跳动六次，这是没有病患的表现。所谓“定息”，是指呼气结束、吸气尚未开始的那一瞬间，此时脉搏又跳动一次，这属于平和之脉。如果能按照成人脉象五至的标准来取脉，病情就会痊愈。如果脉搏七至以上，说明体内有邪气；或者脉象浮起如同弓弦紧绷，这是受风邪所致，都可以依据后方的方剂配合药物治疗。如果脉搏七至以下，这是寒证候，也应当依据后方的方剂配合药物疗治。或者诊察到脉象平和，或者脉象隐伏不见，或者深浮不定，或者伏在深处且根部平塌的，这是鬼神作祟的病，暂且需要祈求驱除邪祟，随后宜使用药物，或者用桃枝、柳枝汤的方法煎煮饮用。为了使药力生效，需取一两颗桃心（桃仁）。
《颅囟经》又说：小孩脉搏呼吸十五次以上，或三至以下的，都是死证。
《千金翼方》说：凡是妇女的脉象，通常比男子柔和微弱。四、五岁的小孩，脉象自然疾速，呼吸间脉搏跳动八次。
寸部和尺部脉象都浮直而下，这是督脉病变，表现为腰背强痛，不能俯仰，成人患癫病，小儿患风痫。小儿脉象沉，是乳食不消化。小儿脉象弦急，是客忤气所致。
王叔和的小儿生死候歌诀：
小儿吃奶后就呕吐逆气，再加上脉象紊乱也不必忧虑。（《诸病源候论》指出：小儿啼哭未停，气息未调，乳母匆忙喂奶，导致气逆上冲，乳汁不下，停滞在胸膈，就会胸闷气急使小儿呕吐逆气。另外，乳母调养时贪凉，冷气进入乳汁，乳汁变质，若不剔除清除，仍然喂给小儿，冷乳入腹与胃气相逆，就会腹胀满痛，气息喘急，也导致呕吐逆气。还有，给小儿脱换衣裳及洗浴露出身体，不避风冷，风冷侵袭皮肤腠理，传入血气，进入胃部则腹胀而吐逆。凡这种变坏的乳汁，如果不是冷吐逆，肠虚入胃就会变成痢疾。）脉象弦急之时被气缠身，脉象缓和不紧就是乳食不消。（小儿脉弦主风邪气，脉缓即气不消。）脉象紧数细快也少有痛苦，脉象虚濡则是邪气惊风辅助。（小儿脉紧与形体相称，脉象虚濡也会产生虚邪惊风。）下痢宣发肠急痛时，脉象浮大者归向泉路（死亡）。（下痢脉浮大者，是死证，形与脉相反。）
《太平圣惠方》辨析小儿脉法：小儿脉象，三岁以上五岁以下可以诊察，然而与成人不同，呼吸间脉搏跳动八次是其常态，九次为有病，十次为困顿。小儿脉象紧者必定是风痫。脉象沉者是乳食不消，脉象弦急者是客忤。脉象沉数者骨间有冷。脉象浮而数者，是乳痫风热。脉象紧而弦者腹痛，脉象弦而数者乳热五脏壅滞。脉象牢而实者大肠秘涩。脉象乍短、乍长、乍大、乍小不等者，是有邪祟。小儿处于变蒸时期，身体发热而脉象紊乱，出汗，不想吃奶，吃奶就呕吐逆气，不可用药，必然自愈。小儿病重，汗出如珠，附着在身上不流动，不可治愈。小儿久患痢疾，脉象浮而腹痛者，不可治愈。小儿有病，胸部凹陷，口唇干燥，眼睛直视，口中气冷，头低垂，躺着不能翻身，手足垂软，身体强直，手掌冰冷，都不可治愈。
茅先生辨析小儿五脏本脉：肝脉弦，心脉洪，脾脉缓，肺脉浮，肾脉沉。
又辨析小儿四季受脉：小儿脉数，热病脉洪，泻痢脉沉细，风疾脉弦紧，气疾脉洪。头痛，寸脉急数；水脏（肾）急数，小便频滴冷痛；脾脉浮洪，胃中有气块，不思饮食。
前述脉法，各有声音发出以观察，各自承受本候的浅深。小儿合阴阳二部脉，将掌后高骨作为中关，前为阳关，后为阴关。阳脉得阴脉者死，阴脉得阳脉也是如此。六岁以前，首先看太冲脉以及观察形色，并看虎口及三关脉。六岁以后才可以看阴阳二部脉，即根据前面的方法。小儿如果没有脉至数，如看前面迟滞及不动，就是死候。虎口及三关脉若迭起来呈黑色，是死候不治。太冲脉不动，也是死证。
汉东王先生《家宝》小儿一见生死诀：
幼童脉气辨别什么形态？（《水鉴》先生说：小儿虽然受阴阳二气形成形状，但气尚未周全，何言有脉。直到变蒸候尽，阴阳气足才可以看脉。其髫龀之年，才生阴阳二气。圣人云：男七岁曰髫，生其元阳之气。女八岁曰龀，其阴阳方成。所以未满髫龀之年称为淳阳，若髫龀满后称为童儿，始可看脉。如果身体俱盛，脉至一息六次为常人之脉，一息八次为热，九次为风、五次为虚、四次为损、三次为脱、两次为死、十次必是疳痨、虚损，形容瘦劣。如果身体肥胖，血色青白，一息十一、十二次的，谓之虚，是风病死，是为脉乱。如果一息十至六次，为脉不来，其人当令必死。迟若一息十一、十二次者必死速，不满二日。何名为一息？一呼、一吸名为一息。呼吸者，即是出一气，入一气，谓之一息。其脉若指下未硬，隐指急大者是有积。若来微细即是冷，若虚轻紧即是热，时复一大即是惊，若大小不匀即是死候也。先生所论浮数为热，伏结为寒，沉细为冷，大小不匀为恶候。数者紧也，浮者轻也，伏者贴也，重手方见。结者乱也，沉者重没谓之沉。细者微也，大小不匀则是。或大或小而不匀是为气不生，其人必死也。）二十五种甚分明。（有二十五候，定其生死。）抱着遍身不温暖，（是血绝不通也。）四肢垂弱哭鸦声，（四肢垂弱者为胃绝也，胃主四肢，即绝不能管也，鸦声已解在形候门中。）啼哭无泪泻涎清，（是肝绝也。）皱眉摘眼爪甲黑，（即是筋绝、筋痒，故摘其眉眼也。）泥坛肿起或为炕，（其囟门或肿或陷也。）将口咬人鱼口急，（即是两口角垂如鲫鱼吸水之状。）脚直肚大有青筋，（是筋绝不能收，脚肚胀即是气绝也。）上视以觑于高物，（目直故上视也。）长嘘出气黑文行，（气欲绝出而不回，黑文即血不注脉。）吃乳不收舌退场门，（吃乳不收则胃绝，舌退场门即是心绝。）唇不盖齿眼坑倾；（则是脾绝，脾主肌肉，外应于唇，脾绝则唇缩眼坑，倾亦属脾。）泻痢多变异 血，（则是心绝，心主血，心若绝则下血黑色臭。）偏搐似笑没心情。（一边搐也，虚笑不止，颜没其心情，此恶候也。）不论贵贱及男女，救疗十人无一生。（诸候并是难医者。）
钱乙论小儿脉法：脉乱（不治），气不和（弦急），伤食（沉缓），虚惊（促急），风（浮），冷（沉细）。
《婴童宝鉴》论脉候（指脉内候附∶）夫小儿三岁以上，七岁以下，其脉驶。一息七八至为平，八至以上至于十至者曰大过（其病为阳盛也，）下不及五至六至曰不足。（其病为阴盛也。）
浮为风。（浮者阳，按之不足，轻手乃得，如葱管者，曰浮也。）沉为冷。（沉者阴，重手乃得，举指即无，行于骨下，曰沉也。）洪为热。（洪者，按之散大满部，状如浮者，曰洪。）微为寒。（微脉指下往来细如乱丝，重手即无，轻手乃得也。）紧为实。（亦曰痛。紧者如丝而急，按之有力曰紧也。）沉细为乳结。（亦为冷。言其脉细小而沉也。）弦数为疟。（脉弦如筝，通度带快。）弦急为客忤。（弦急，如新上之弦。）大小不匀为中恶。（言其脉或大或小，不根据其部也。）脉虚病亦虚。（虚脉轻手得之，重手即无也。曰虚，只因频下，脏腑即虚，亦因久泻也。）变蒸之脉寸口乱。（乱为大小不匀。）伏为气。（伏行筋中曰伏也。）
左手寸无脉，心下痛，胸中热，时时呕，口中生疮，犹乳母食冷所兼，咳嗽，头有汗，寒热作，喉中哽塞作声。
右手寸无脉者，短气、气逆，喉中咳噫，犹乳母出冲风露所为也。
心脉满大，肝脉小急，并为痫、抽搐之疾。凡寸脉但浮，直上直下，督脉连腰脊强不得俯仰。三部脉紧急，其痫可治。吐 ，浮者可治。弦急者气痛，中恶微者可治。弦紧牢强为症癖病，脉随其左右上见。三部脉沉为食乳不消化，缓亦同上。少阴脉数为疳淋，虚濡者，惊风邪气。脉如雀啄，若紧者风痫。伤寒脉洪者易理，微者难理。脉来浮大者，宜发汗。一投一止病，假令六投一止，六曰病也。春脉弦，夏脉洪，秋脉浮，冬脉沉。四季脉缓，各推其王相表里。若浮而见病，在表，属皮肤，在腑而为顺；阳脉沉，见病在里，属脏、骨髓，逆行阴之理也。脉在上，病在上，死生见焉。
又论死脉：伤寒身大热，体黄，脉沉细者死。中恶、脉紧细者死。黄疸、脉沉细，腹满者死。
《惠眼观证》诊候诀：凡疾患既重，次看脉息如何，当以一指在鱼际或太冲看。若是伤寒、急惊、疹痘之候，此为腑病，得浮洪即易安，沉细即难安。且与回阳两日至第三日再诊之，如得阳脉方许调理。然阳脉取之在轻手如捻葱管乃有，满部重按即无是也。若中慢惊、吐泻、疟痢之候，此为脏病，得沉细即易安，浮洪即难安。盖阴病脉行于内，不可行于外。凡一切病觉脉来三点大又三点细，此亦难治。大都小儿脉只看阳脉大，阴脉细，余不可验也。学人宜审详之。
《保生论》：小儿三岁以后或五百七十六日外，皆可诊两手脉，一指定三关。
歌曰：小儿有病须凭脉，一指三关定其息，浮洪风盛数因惊，虚冷沉迟实有积。
浮为风。（秋得浮曰平和。）浮者，轻手来大，重手来细弱如按葱叶之状故曰浮。主小儿中风，伤风咳嗽，嚏喷，烦躁壮热，鼻流清涕，一身头面虚浮，下泄多，小便如粉，可与解表，甚者与出汗即愈。
洪为热。（夏得洪曰平和。）洪者，轻手脉来大，重手脉来亦大，故曰洪。主小儿痫，发热，身生痈疖及瘰疬，喉闭囟肿，风热面赤，气喘，心脏有热，小便淋沥，频患赤痢。
数因惊。（春得数曰平和。）数者，脉来小急，过数速疾故曰数。主小儿梦中咬齿惊掷，见人恐怖，夜多盗汗，白日多困，气粗不语，忽泻青粪。若得数脉乃生惊候，此乃惊气传膀胱，主小儿有疝偏坠。
沉迟为虚冷。沉迟者，轻手按全不见，重手按至骨，脉来沉弱细小，故曰沉迟。主小儿脾胃虚冷，泄泻无时，呕逆不食。
实有积。（冬得实曰平和。）实者，轻手脉不见，重手脉来大，故曰实。主小儿脏腑有积腹胀，面黄发立，小便如油，面仆地卧，频频吐食，腹内鸣响。又积不治，即成疳痨、丁奚、哺露候。若孩儿肥实者，宜与稍凉药取积，后补。若孩儿羸瘦，脏腑虚薄，可与性温药取积后补。
凡小儿脉春数、夏洪、秋浮、冬实、脉来八至止者，皆平和之脉也。若脉来急如弓弦，脉来两动而止不见者，皆必死之脉也。
《孔氏家传》王叔和经：小儿脉呼吸八至者平，九至者伤，十至者困。诊小儿脉多雀斗，要以三部脉为主。若紧为风痫，沉者乳不消，弦急者客忤，沉而数者骨间有热。
《宝童方》中指脉法：（孩儿五、七岁方诊中指脉。）孩儿五、七岁，五脏脉方现，中指两畔内，于中仔细看。左男右女专心记，左主脾肝心肾肺，右主热生惊气疳，女子背看各从类，欲察病源谁得知，脉洪大急来归内，此是伤寒病因热，洪大却慢伤脾气，迟细脾虚因取极，脉小急来肾虚致，疾在小肠凭药力，到此医人须用意。诊脉若来三两通，此为死候命须终，吸人指面如弓急，慢脾死候命将毕。
翰林待诏杨大邺中指脉看死候法：中指中间为动脉，医家莫便怀疑恻，此时风满四肢头，万卷千书医不得。
别一本五指歌曰：五指指节冷，惊来不可安。忽然中指热，决定是伤寒。中指独自冷，疹痘有多般。女右男逢左，八片锦中看。
《庄氏集》脉法歌：小儿脉数多风热，沉伏原因乳食结，弦长必动肝肠风，弦数惊蛔四肢掣，洪浮胸中，似火烧，若兼肠痛好添愁，息数和平八九至，此个分明不必忧。
*The Cranium and Fontanelle Classic (Luxin Jing)* states: Children under three years of age are referred to as "Pure Yang" (Chunyang), where the primordial Qi (Yuanqi) has not yet dispersed. If a pulse is present, it must be taken within one cun at the Cun Kou (Radial Artery Pulse Point), and cannot be measured in fen (tenths of a cun) like adults. The pulse rate is described as follows: during exhalation, the pulse beats three times; during inhalation, the pulse also beats three times. In a complete respiratory cycle (Dingxi), totaling six beats, this indicates no illness. "Dingxi" refers to the moment when exhalation ends and inhalation has not yet begun, during which the pulse beats once more; this represents a harmonious pulse. If the pulse can be assessed according to the adult standard of five beats per cycle, the condition will resolve. If the pulse exceeds seven beats per cycle, there is pathogenic Qi; or if the pulse is floating and taut like a bowstring, this indicates Wind invasion. These conditions can be treated with herbal formulas as detailed later. If the pulse is below seven beats per cycle, this is a Cold pattern, which should also be treated with appropriate herbal formulas. Alternatively, if the pulse is found to be harmonious, or if it is imperceptible, or fluctuates between deep and superficial levels, or is hidden (Fu) with a flat root, this is attributed to demonic influence. Initially, one should seek to dispel the malevolent spirit, followed by herbal treatment, such as decocting and drinking a soup made from Peach Twig (Taolizhi) and Willow Twig (Liuzhizhi). To enhance efficacy, one should use one or two peach kernels (Taoxin).
*The Cranium and Fontanelle Classic* further states: If a child's pulse exceeds fifteen beats per cycle, or is fewer than three beats per cycle, it is a sign of death.
*Qianjin Yi Fang* states: Generally, women's pulses are typically softer and weaker than men's. For children aged four or five, the pulse is naturally rapid, beating eight times per respiratory cycle.
If both the Cun (Distal) and Chi (Proximal) positions are floating and straight downward, this indicates a disorder of the Du Mai (Governing Vessel), manifesting as stiffness and pain in the waist and back, inability to bend or extend. In adults, this corresponds to Dian disease (Epilepsy/Psychosis); in children, it corresponds to Feng Xian (Wind Epilepsy). A sinking pulse in children indicates undigested milk. A wiry and tense pulse in children indicates Ke Wu Qi (Sudden Shock/Qi disturbance).
Wang Shuhe's Song on Life and Death Signs in Children:
Vomiting and regurgitation immediately after breastfeeding, accompanied by a chaotic pulse, need not cause worry. (*Zhubing Yuanhou Lun*: When a child is still crying and breathing is unregulated, if the mother hastily breastfeeds, the Qi rebels upward, causing milk to stagnate in the chest and diaphragm, leading to chest fullness, shortness of breath, and vomiting. Additionally, if the mother consumes cold foods, cold Qi enters the milk, spoiling it. If not removed and fed to the child, the cold milk clashes with Stomach Qi, causing abdominal distension, pain, panting, and vomiting. Furthermore, exposing the child to wind and cold during dressing or bathing allows pathogens to enter the skin and pores, transmitting into the blood and Qi, entering the Stomach to cause distension and vomiting. Such spoiled milk, if not causing cold vomiting, may lead to dysentery due to intestinal deficiency.) When the pulse is wiry and tense, Qi is constrained; a slow pulse indicates undigested milk. (A wiry pulse in children indicates Wind pathogen; a slow pulse indicates Qi stagnation.) A tight, rapid, fine, and fast pulse suggests little suffering; a deficient and soggy pulse indicates Evil Qi assisting in Wind-Convulsion. (A tight pulse matching the body shape is normal; a deficient/soggy pulse generates Empty Evil and Wind-Convulsion.) Dysentery with urgent intestinal pain and a floating-large pulse leads to the underworld. (Floating-large pulse in dysentery indicates death, as the form contradicts the pulse.)
*Taiping Shenghui Fang* analyzes pediatric pulse methods: For children aged three to five, pulses can be examined, differing from adults. Eight beats per cycle is normal; nine beats indicates illness; ten beats indicates exhaustion. A tight pulse in children indicates Wind Epilepsy. A sinking pulse indicates undigested milk. A wiry-tense pulse indicates Ke Wu. A sinking-rapid pulse indicates Cold in the bones. A floating-rapid pulse indicates Milk Epilepsy, Wind-Heat. A tight-wiry pulse indicates abdominal pain. A wiry-rapid pulse indicates Heat in the Five Zang organs due to milk. A firm-solid pulse indicates constipation. Pulses varying suddenly in length or size indicate demonic influence. During Bian Zheng (metabolic growth periods), children may have fever, chaotic pulse, sweating, anorexia, and vomiting upon feeding; medication is unnecessary as they will recover spontaneously. Profuse bead-like sweat that does not flow indicates incurability. Chronic dysentery with floating pulse and abdominal pain is incurable. Symptoms including sunken chest, dry lips, fixed gaze, cold breath, head drooping, inability to turn over, flaccid limbs, rigidity, and cold palms indicate incurability.
Master Mao analyzes the intrinsic pulses of the Five Zang in children: Liver is Wiry (Xian), Heart is Surging (Hong), Spleen is Slow/Relaxed (Huan), Lung is Floating (Fu), Kidney is Sinking (Chen).
He further analyzes seasonal pulse variations: Rapid pulse indicates heat; Surging pulse indicates heat syndrome; Sinking-fine pulse indicates diarrhea/dysentery; Wiry-tight pulse indicates Wind disease; Surging pulse indicates Qi disease. Headache with urgent-rapid Cun pulse; Kidney (Water Organ) urgent-rapid pulse with frequent, cold, painful urination; Spleen floating-surging pulse with gastric Qi mass and anorexia.
Regarding the aforementioned pulse methods, each has specific auditory characteristics indicating depth. For children, Yin and Yang pulse positions are defined with the radial styloid process as the Middle Guan, anterior as Yang Guan, and posterior as Yin Guan. Yang position yielding Yin pulse indicates death; Yin position yielding Yang pulse similarly indicates death. Under six years old, primarily observe the Tai Chong pulse, physical appearance, and the Tiger Mouth and Three Guan pulses. Over six years old, observe Yin and Yang positions according to previous methods. Absence of pulse beat count, or delayed/non-existent pulse, indicates death. Black color rising in Tiger Mouth and Three Guan pulses indicates death. Non-existent Tai Chong pulse indicates death.
Mr. Wang Haidong's *Jiabao* Decree on Life and Death for Children:
How to distinguish the form of young children's Qi? (Mr. *Shuijian* states: Although children are formed by Yin and Yang Qi, their Qi is not yet complete, so pulse diagnosis is premature. Only after Bian Zheng concludes and Yin-Yang Qi is sufficient can pulses be read. At the age of Tiao (boys 7) and Chi (girls 8), Yin-Yang Qi forms. Thus, before this age, they are called Chunyang; after, Tong'er, and only then can pulses be read. If the body is robust, six beats per cycle is normal; eight beats is Heat; nine beats is Wind; five beats is Deficiency; four beats is Damage; three beats is Exhaustion; two beats is Death; ten beats indicates Gan Lao (Malnutrition/Tuberculosis) and Deficiency. If fat but with blue-white complexion, eleven-twelve beats indicates Deficiency, Wind-death, and chaotic pulse. Ten-to-six beats indicates absent pulse and imminent death. One Xi (breath cycle) equals one exhalation and one inhalation. If the pulse feels hard under fingers, urgent and large, it indicates accumulation. Micro-fine indicates Cold. Deficient-light-tight indicates Heat. Occasional large beat indicates Shock. Uneven size indicates death. Master discusses: Floating-Rapid is Heat; Hidden-Knotted is Cold; Sinking-Fine is Cold; Uneven size is bad omen. Rapid is Tight; Floating is Light; Hidden is贴着 (close to bone), visible only with heavy pressure. Knotted is Chaotic; Sinking is Heavy/Submerged. Fine is Micro. Uneven size means Qi fails to generate, indicating death. There are twenty-five distinct signs determining life and death. Whole body cold when held indicates Blood exhaustion. Limbs limp, crying like a crow indicates Stomach exhaustion (Stomach governs limbs). Crying without tears, clear saliva indicates Liver exhaustion. Frowning, picking eyes, black nails indicates Sinew exhaustion. Sunken or swollen fontanelle. Biting mouth corners like a crucian carp sucking water. Straight legs, distended belly with blue veins indicates Sinew/Stomach exhaustion. Upward gaze indicates eye fixation. Long sighing with black lines indicates Qi/Blood exhaustion. Refusing milk, tongue receding indicates Stomach/Heart exhaustion. Lips not covering teeth, sunken eye sockets indicate Spleen exhaustion. Dysentery with black foul blood indicates Heart exhaustion. Unilateral convulsions with empty laughter indicate evil omen. Regardless of status or gender, ten treated yield no survivors. All these signs are difficult to treat.
Qian Yi on Pediatric Pulse Methods: Chaotic pulse (incurable); Disharmonious Qi (Wiry-Tense); Food Injury (Sinking-Slow); Empty Shock (Rapid-Urgent); Wind (Floating); Cold (Sinking-Fine).
*Yingtong Baojian* on Pulse Signs: For children aged three to seven, pulses are rapid. Seven-eight beats per cycle is normal. Eight to ten beats is Excess (Yang Excess). Below five-six beats is Insufficiency (Yin Excess).
Floating indicates Wind. (Yang, insufficient on pressure, light touch yields like scallion tube.)
Sinking indicates Cold. (Yin, heavy pressure yields, disappears on lift, runs under bone.)
Surging indicates Heat. (Expands fully, similar to floating but fuller.)
Micro indicates Cold/Frailty. (Fine like tangled silk, disappears on heavy pressure.)
Tight indicates Solidity/Pain. (Like thread, urgent, forceful on pressure.)
Sinking-Fine indicates Milk Knot/Cold.
Wiry-Rapid indicates Malaria.
Wiry-Tense indicates Ke Wu.
Uneven size indicates Zhong E (Acute Poisoning/Evil Qi).
Deficient pulse indicates Deficient disease. (Light touch yields, heavy disappears; caused by frequent purging or chronic diarrhea.)
Bian Zheng pulse at Cun Kou is chaotic.
Hidden indicates Qi stagnation. (Runs within sinews.)
Left Cun absent pulse: Pain below heart, heat in chest, occasional vomiting, mouth ulcers (possibly due to mother eating cold foods), cough, sweating on head, alternating chills/fever, throat obstruction sounds.
Right Cun absent pulse: Shortness of breath, rebellious Qi, throat coughing/belching (possibly due to mother exposed to wind/cold).
Full-Large Heart pulse, Small-Urgent Liver pulse: Both indicate Epilepsy and Convulsions. Floating Cun pulse, straight up and down, connects to Du Mai causing stiff waist/spine. Urgent pulses in all three positions: Epilepsy is treatable. Vomiting with floating pulse: treatable. Wiry-Tense pulse with Qi pain, mild Zhong E: treatable. Wiry-Tight-Firm-Strong pulse indicates Zheng Pi (Masses). Sinking pulses in three positions indicate undigested milk; Slow also applies. Shao Yin rapid pulse indicates Gan Lin; Deficient-Soggy indicates Shock-Wind Evil. Bird-pecking pulse, if tight, indicates Wind Epilepsy. Typhoid with Surging pulse is easy to manage; Micro pulse is difficult. Floating-Large pulse requires sweating method. One beat stops every six beats indicates illness. Spring pulse Wiry, Summer Surging, Autumn Floating, Winter Sinking. Four Seasons pulse Slow, deducing Wang/Xiang relationships. Floating disease is exterior/skin/fu organs (favorable); Sinking Yang pulse indicates interior/Zang/marrow disease (unfavorable/Yin reversal). Pulse location indicates disease location and prognosis.
Dead Pulses discussed: Typhoid with high fever, yellow body, Sinking-Fine pulse: Death. Zhong E with Tight-Fine pulse: Death. Jaundice with Sinking-Fine pulse and abdominal fullness: Death.
*Huiyan Guanzheng* Diagnostic Decree: For severe diseases, check pulse at Yu Ji or Tai Chong. For Typhoid, Acute Shock, Rash/Smallpox (Fu organ diseases), Floating-Surging pulse indicates ease of recovery; Sinking-Fine indicates difficulty. Wait two days for Yang pulse to appear before regulating. Yang pulse is felt lightly like scallion tube, disappears on heavy pressure. For Slow Shock, Vomiting/Diarrhea, Malaria/Dysentery (Zang organ diseases), Sinking-Fine indicates ease; Floating-Surging indicates difficulty. Yin disease pulses should not be external. Pulsations alternating three large and three small beats are difficult to treat. Generally, pediatric pulses show Large Yang and Fine Yin; other signs are unreliable. Scholars should examine carefully.
*Bao Sheng Lun*: Children over three years or 576 days can have both hands pulsed, one finger spanning three Guan.
Song: Pediatric illness relies on pulse; one finger spans three Guan to determine rhythm. Floating-Surging indicates excess Wind; Rapid indicates Shock; Sinking-Slow indicates Empty-Cold; Solid indicates Accumulation.
Floating indicates Wind. (Autumn floating is normal. Light touch large, heavy touch fine like scallion leaf. Indicates Wind stroke, cold cough, sneezing, irritability, high fever, runny nose, facial edema, diarrhea, powdery urine. Treat with exterior-releasing herbs; sweating cures severe cases.)
Surging indicates Heat. (Summer surging is normal. Large on both light and heavy touch. Indicates Epilepsy, fever, abscesses, scrofula, throat closure, fontanelle swelling, Wind-Heat red face, asthma, Heart Heat, dribbling urine, frequent bloody dysentery.)
Rapid indicates Shock. (Spring rapid is normal. Small, urgent, faster than normal. Indicates night grinding teeth, fear of people, night sweats, daytime fatigue, coarse breathing, sudden green stool. Rapid pulse indicates Shock Qi transmitting to Bladder, hernia.)
Sinking-Slow indicates Empty-Cold. (Invisible on light touch, felt to bone on heavy touch. Weak and fine. Indicates Spleen-Stomach Empty-Cold, constant diarrhea, vomiting/anorexia.)
Solid indicates Accumulation. (Winter solid is normal. Invisible on light touch, large on heavy touch. Indicates abdominal distension from internal accumulation, yellow face, erect hair, oily urine, prone posture, frequent vomiting, borborygmus. Untreated accumulation becomes Gan Lao, Ding Xi, Bu Lu syndromes. For robust children, use slightly cool herbs to remove accumulation then tonify. For emaciated children with weak viscera, use warm herbs to remove accumulation then tonify.)
Pediatric pulses: Spring Rapid, Summer Surging, Autumn Floating, Winter Solid, up to eight beats per cycle are normal. Pulse urgent like bowstring, or stopping after two beats, indicates death.
*Kong Shi Jia Chuan* Wang Shuhe Classic: Eight beats per cycle is normal, nine is injury, ten is exhaustion. Pediatric pulses often resemble bird pecking; focus on three positions. Tight indicates Wind Epilepsy; Sinking indicates undigested milk; Wiry-Tense indicates Ke Wu; Sinking-Rapid indicates Heat in bones.
*Bao Tong Fang* Middle Finger Pulse Method: (For children aged five-seven.) Five-seven years old, Five Zang pulses appear. Carefully examine inside both sides of the middle finger. Left for males, Right for females. Left governs Spleen/Liver/Heart/Kidney/Lung; Right governs Heat/Shock/Qi/Gan. Women view oppositely. Surge-Large-Urgent inward indicates Typhoid due to Heat. Surge-Large but slow damages Spleen Qi. Slow-Fine indicates Spleen Deficiency. Small-Urgent indicates Kidney Deficiency. Disease in Small Intestine relies on medicine. Physicians must pay attention. Pulse coming three-two intervals indicates death. Inhalation feeling urgent like bowstring indicates Slow Spleen death approaching.
Yang Daye's Middle Finger Dead Pulse Method: Middle of middle finger is Dynamic Pulse. Do not doubt. Wind fills limbs and head; thousands of books cannot cure.
Another Five Finger Song: Cold finger joints indicate untreatable Shock. Sudden middle finger heat indicates Typhoid. Isolated cold middle finger indicates various rashes/smallpox. Female right, Male left, viewed within eight pieces of brocade.
*Zhuang Shi Ji* Pulse Song: Rapid pulse indicates Wind-Heat; Sinking-Hidden indicates Milk/Food knot; Wiry-Long indicates Liver/Intestinal Wind; Wiry-Rapid indicates Shock/Ascaris with limb jerking. Surging-Floating in chest like fire burning; if combined with intestinal pain, adds sorrow. Normal rhythm 8-9 beats causes no worry.