小儿三五岁，可以诊视，第手腕短促，三部莫分，惟以一指候之，诚非易易。《内经》诊视小儿，以大小缓
急四脉为准。予不避僭越，体其意，竟易为浮沉迟数，而以有力无力定其虚实，似比大小缓急，更为明悉。后
贤其体认之。
黄帝曰∶乳子而病热，脉悬小者何如？（夫乳子病热，脉见悬小者，阳证见阴脉，本为大忌，但小而缓者，
邪之微，其愈易；小而急者，邪之甚，为可虑。故以为问。）岐伯曰∶手足温则生，寒则死。（夫小儿以稚阳之体
而加病热，脉不当小。若脉体虽小，手足温者，以四肢为诸阳之本，阳犹在也；若四肢寒冷者，则邪胜其正，
元阳去矣，故曰死也）
帝曰∶乳子中风热，喘鸣肩息者，脉何如？岐伯曰∶喘鸣肩息者，脉实大也，缓则生，急则死。（此言小儿
之外感也。风热中于阳分，而喘鸣肩息者，脉当实大。但大而缓，则胃气存，邪渐退，故生；实而急，则真脏
见，病日进，故死也。）此《内经》之旨。圣人立言简切，而总括无余。世人不悟，视为泛常，能于此等处着眼，
则诊视之要，思过半矣。予之临证诊视，每论吉凶而多中者，亦不外此，第意之所至，口莫能宣。窃详经所
谓大小缓急者，亦发而不露之意。盖大即浮洪类也，小即沉细类也，急即数也，缓即迟也，何若竟易以浮沉迟
数之为得乎？再以节庵之有力无力，辨其表里虚实，诚诊视小儿天然不易之妙诀。夫节庵亦一常人，而能以
有力无力，辨其阴阳表里、寒热虚实，虽至显浅、至平易，却至确当，孰谓古今人不相及耶！
小儿到了三五岁，就可以进行脉诊，只是手腕短小，寸、关、尺三部难以区分，只能用一根手指来候脉，这确实不容易。《黄帝内经》在诊断小儿疾病时，以“大、小、缓、急”四种脉象作为标准。我不避讳僭越之嫌，体会其意旨，将其改为“浮、沉、迟、数”，并以脉搏有力或无力来判断虚实，这似乎比“大、小、缓、急”更加明确清晰。后世的贤者请仔细体认这一点。
黄帝问道：婴儿患热病，脉象悬小而细弱，是怎样的情况？（按语：婴儿患热病，脉象出现悬小，属于阳证见到阴脉，本是大忌，但如果脉小而缓，说明邪气轻微，容易痊愈；如果脉小而急，说明邪气严重，值得忧虑。所以提出这个问题。）岐伯回答说：如果手足温暖就能存活，手足寒冷就会死亡。（按语：小儿是稚阳之体，又加上患热病，脉象不应当细小。如果脉体虽然细小，但手足温暖，因为四肢是诸阳之本，说明阳气尚存；如果四肢寒冷，则是邪气胜过正气，元阳已去，所以说会死亡。）
黄帝问：婴儿感受风热，出现喘息有声、耸肩呼吸的症状，脉象如何？岐伯回答：出现喘息有声、耸肩呼吸的症状，脉象应当是实大的，如果脉缓则生，脉急则死。（按语：这是论述小儿的外感病。风热侵袭阳分，出现喘息有声、耸肩呼吸，脉象应当实大。但是脉大而缓，说明胃气尚存，邪气逐渐消退，所以能生；如果脉实而急，说明真脏脉现，病情日益加重，所以会死。）这是《黄帝内经》的宗旨。圣人立言简洁确切，总括无遗。世人不能领悟，视为平常，如果能在此类关键处着眼，那么诊断的要领就掌握了一半以上。我临证诊断时，每次论断吉凶大多准确，也不外乎这些道理，只是心意所至，口中难以完全表达出来。仔细推敲经文中所说的“大小缓急”，也是含蓄不露的意思。大概“大”就是浮洪之类的脉象，“小”就是沉细之类的脉象，“急”就是数脉，“缓”就是迟脉，何不干脆改为“浮沉迟数”更为妥当呢？再结合节庵先生提出的以“有力、无力”来辨别表里虚实，这确实是诊断小儿天然不易的妙诀。节庵先生也是一介常人，却能以“有力、无力”来辨别阴阳、表里、寒热、虚实，虽然极其显浅、平易，却极其确当，谁说古人和今人不能相比呢！
When children reach three or five years of age, pulse diagnosis can be performed. However, their wrists are short and narrow, making it difficult to distinguish the three positions (Cun, Guan, Chi). Therefore, one finger is used to palpate the pulse, which is indeed not easy. In the *Huangdi Neijing* (Yellow Emperor's Inner Canon), the diagnosis of pediatric diseases is based on four pulse qualities: large (Da), small (Xiao), slow/relaxed (Huan), and rapid/tense (Ji). Presuming not to overstep my bounds, I have interpreted its intent and replaced these with floating (Fu), deep (Chen), slow (Chi), and rapid (Shu) pulses, determining deficiency and excess by the presence or absence of force (You Li / Wu Li). This seems clearer and more explicit than "large, small, slow, and rapid." Let later scholars carefully contemplate this.
The Yellow Emperor asked: If a nursing infant suffers from heat disease, and the pulse is suspended and small/thin, what does this indicate? [Commentary: When an infant has heat disease, a suspended and small pulse represents a Yang syndrome presenting with Yin pulse signs, which is fundamentally a major taboo. However, if the pulse is small yet relaxed (Huan), the pathogen is mild, and recovery is likely; if the pulse is small yet rapid/tense (Ji), the pathogen is severe, which is concerning. Hence, this question is posed.] Qibo replied: Survival is indicated if the hands and feet are warm; death ensues if they are cold. [Commentary: Infants possess a delicate Yang constitution. When afflicted with heat disease, the pulse should not be small. Although the pulse body may be small, if the hands and feet are warm, it indicates that Yang Qi remains, as the four limbs are the root of all Yang Qi. Conversely, if the four limbs are cold, it signifies that the pathogen has overcome the healthy Qi, and the Primordial Yang has departed; thus, death is predicted.]
The Emperor asked: If a nursing infant contracts wind-heat, manifesting with wheezing, stridor, and shoulder-lifting respiration, what will the pulse be like? Qibo answered: In cases of wheezing, stridor, and shoulder-lifting respiration, the pulse should be substantial and large. If the pulse is relaxed/slow (Huan), there is life; if it is rapid/tense (Ji), there is death. [Commentary: This discusses external contraction in infants. Wind-heat invading the Yang aspect leads to wheezing, stridor, and shoulder-lifting respiration, requiring a substantial and large pulse. A large yet relaxed pulse indicates that Stomach Qi is preserved and the pathogen is receding, leading to survival. A substantial yet rapid/tense pulse reveals the appearance of the True Zang pulse, indicating worsening disease, leading to death.] This is the purport of the *Neijing*. The Sages' words were concise and comprehensive, leaving nothing out. People of the world fail to comprehend this, treating it as commonplace. If one focuses on such critical points, half of the essentials of pulse diagnosis are understood. In my clinical practice, my prognoses regarding auspiciousness and inauspiciousness are often accurate, precisely because of these principles, though my mind grasps them while my tongue struggles to express them fully. Upon careful examination, the "large, small, slow, and rapid" mentioned in the classics also imply implicit meanings. Essentially, "large" corresponds to floating/hyperbolous (Fu/Hong) types; "small" corresponds to deep/fine (Chen/Xi) types; "rapid/tense" (Ji) corresponds to rapid (Shu); and "slow/relaxed" (Huan) corresponds to slow (Chi). Is it not better to simply use floating, deep, slow, and rapid? Furthermore, combining this with Jie'an’s method of distinguishing exterior-interior and deficiency-excess via "forceful vs. forceless" pulses constitutes a natural and indispensable secret for pediatric diagnosis. Mr. Jie'an was but an ordinary person, yet he could distinguish Yin-Yang, Exterior-Interior, Cold-Heat, and Deficiency-Excess through "forceful vs. forceless." Though extremely obvious and simple, it is profoundly accurate. Who says ancients cannot compare to moderns!