古人云，宁治十男子，莫治一妇人，宁治十妇人，莫治一小儿。此言小儿号曰哑科，治
之甚难。景岳先生又谓其甚易，何以见之。盖小儿之病无脉可诊，血气未充故也。病之痛痒
又不能以言传，惟有望闻切而已，难乎不言。而独言其易者，抑亦以小儿之病不过外感风寒
、内伤饮食、惊风吐泻之类，并无七情六郁色欲忧思之患。故予治小儿，表病不过香苏散、
惺惺散之类；治小儿里病，不过平胃散、藿香散之类；治小儿虚痰诸症，不过二陈汤、六君
子汤之类；治小儿实热诸症，不过小儿牛黄丸、泻青丸之类。凡此表里虚实之病，解表攻里
，只宜轻剂，毋容大表大下以伤元气。至于惊风吐泻各种杂症，则分入门别例而治之矣。
（内附望闻问切）
小儿有病令人怜，全仗医生仔细观。令人抱出光明处，先将面部用心看。额属心兮鼻属
脾，左肝右肺两腮前。颏乃肾经为主宰，五经辨色要心虔。白有气虚黄有积，赤者为热青主
寒。鼻塞声重伤风重，眼下青色主饮痰。口唇赤白辨阴阳，赤者胃热白者寒。虫积唇内生白
点，疳气鼻燥体态干。有痛啼哭总不止，有积襁褓不耐烦。抱出探凉欲赴冷，此是内热使之
然。若是当风急畏缩，必是伤风与阴寒。鼻冷疮疹耳冷热，遍身发热是风寒。手足心热口发
渴，纹沉食积是真诠。若是下午手心热，阴虚盗汗夜生烦。倘若手指梢头冷，便是惊风一例
看。只有中间一指热，小儿亦定是伤寒。中指微微独自冷，定然麻痘恐相缠。复看指纹记歌
诀，浮沉色气审的端。要看指纹风气命，三关内推细心研。三关部位寅卯辰，病之吉凶在此
间。初起风关病无碍，气关纹现恐缠绵。乍临命位诚危急，射中通关命难全。指纹何故浮然
样，邪在皮肤病易蠲。腠理不通名表证，急行疏解汗之先。忽尔关纹沉沉状，已知入里病盘
旋。莫将风药轻相试，须向阳明里证宣。身安定见红黄色，红艳本来是伤寒。淡红隐隐虚伤
寒，定将深红作热看。关纹见紫热之兆，青色为风是的端。伤食紫青痰气送，三关青黑恐难
安。指纹淡淡不必悦，气质薄弱禀先天。脾胃本虚中气微，切防攻伐损婴元。关纹滞涩本因
积，邪遏阴营卫气连。食郁中焦风热炽，不行推荡病何迁。腹痛纹入掌中里，弯内自然是风
寒。纹向外弯痰食热，水形脾胃两伤焉。复诊掌后关中脉，浮沉迟数审的端。七至八至为数
热，四至五至为迟寒。浮脉主表病在外，沉脉至里病内潜。数脉六至腑有热，迟脉三至主脏
寒。浮而有力风与热，无力中虚宜培元。沉而有力痰积食，沉而无力气滞间。迟而有力乃为
痛，迟而无力是虚寒。数而有力本实热，无力疮疡恐熬煎。此是切脉真口诀，静心审的要心
专。再看舌苔分表里，红黄有火清即安。白滑里寒温中急，白涩里热黄滑寒。若是舌黑辨阴
阳，气息冷热用手探。口中气热小便赤，舌黑必燥下为先。气微便清手足冷，参 桂附妙如
仙。小儿阴亏舌亦黑，滋阴润燥无不痊。又看胸腹坚与软，虚实此中可细参。望切之理谅如
是，闻声问证岂可偏。言厉声粗知病实，气衰体虚必微言，肝病怒声心病笑，脾病发声如歌
然。肺病出声有若哭，肾主呻吟恐共间。阳证身轻言响亮，阴证昏逆闭眼眠。阳症发狂喜饮
水，阴证郑声话懒言。一问寒热二问汗，三问头身与胸前，四问饮食病新久，五问二便与渴
烦，六问前服药寒热，七问痘麻与后先。用药细心谅虚实，有积体虚兼培元。热清温湿风疏
散，久泻当涩固先天。如斯延医细斟酌，药到病除福无边。少者怀之遵圣意，惟愿赤子寿百
年。若问是编何人辑，亚拙山人在鱼泉。
古人说：“宁可治疗十个男子，也不愿治疗一个妇人；宁可治疗十个妇人，也不愿治疗一个小儿。”这是说小儿科被称为“哑科”，因为治疗起来非常困难。张景岳先生又说小儿病很容易治，凭什么这么说呢？大概是因为小儿生病没有脉象可以诊察，这是因为他们的血气尚未充盈的缘故。小儿患病时的疼痛和瘙痒又不能通过言语表达，只能依靠望、闻、切三种诊法，所以说不难是困难的。而唯独说它容易，也是认为小儿的疾病不过是外感风寒、内伤饮食、惊风吐泻这一类病症，并没有七情（喜、怒、忧、思、悲、恐、惊）、六郁（气、血、痰、火、湿、食之郁结）、色欲、忧思等祸患。所以我治疗小儿疾病，表证不过使用香苏散、惺惺散之类方剂；治疗小儿里证，不过使用平胃散、藿香散之类方剂；治疗小儿虚痰等各种症状，不过使用二陈汤、六君子汤之类方剂；治疗小儿实热等各种症状，不过使用小儿牛黄丸、泻青丸之类方剂。凡是这些表、里、虚、实的病症，解表或攻里，只宜用轻剂，不容许使用大发汗或大泻下的猛药以损伤元气。至于惊风、吐泻等各种杂症，则分别按照门类例子来治疗。
（内附望、闻、问、切四诊歌诀）
小儿有病令人怜爱，全仗医生仔细观察。让人将孩子抱到光线明亮的地方，先将面部用心查看。额头属于心经，鼻子属于脾经，左腮属肝，右腮属肺，两颊前方亦分属脏腑。下巴乃肾经所主，辨别五脏经络的气色要心存虔诚。面色白表示气虚，黄表示有积滞，红赤表示有热，青色主寒。鼻塞声音重浊表示伤风较重，眼下青色主饮停生痰。口唇红白可辨别阴阳，红色者胃热，白色者胃寒。虫积表现为唇内生白点，疳气表现为鼻燥、体态干枯。有痛楚则啼哭不止，有积滞则婴儿不耐烦躁动。想要被抱到阴凉处甚至想赴冷，这是内热所致。如果对着风就急忙畏缩，必定是伤风与阴寒。鼻冷、疮疹、耳热、遍身发热，这是风寒。手足心热、口发渴，指纹沉伏是食积的真确指征。如果是下午手心发热，则是阴虚盗汗，夜间烦躁。倘若手指梢头冷，便是惊风一类病症来看待。只有中间一指热，小儿也定是伤寒。中指微微独自发冷，定然麻痘（天花、麻疹）恐怕纠缠。再看指纹并记住歌诀，浮沉、颜色、气势要审察得确切。要看指纹的风、气、命三关，向内推寻细心研究。三关的部位对应寅、卯、辰三个时辰，病的吉凶就在这里。初起在风关，病无妨碍；气关出现纹现，恐怕缠绵难愈；刚临命位确实危急，若射中通关，性命难保。指纹为何呈现浮起的样态？邪气在皮肤，病容易消除。腠理不通称为表证，急行疏解，先发汗为先。忽然关纹呈现沉伏状，已知病邪入里盘旋。不要将风药轻易尝试，须向阳明里证宣通。身体安定见红黄色，红艳本来是伤寒。淡红隐隐为虚伤寒，定将深红当作热证看待。关纹见紫是热之征兆，青色为风的确切指征。伤食呈紫青色，痰气送致，三关青黑恐怕难以安宁。指纹淡淡不必喜悦，这是气质薄弱禀赋先天不足。脾胃本虚中气微弱，切防攻伐损伤婴儿元气。关纹滞涩本来因于积滞，邪气遏制营卫之气相连。食郁中焦风热炽盛，不行推荡之法病如何迁延。腹痛且纹入掌中里侧，弯曲向内自然是风寒。纹向外弯为痰、食、热，水形（肾/膀胱相关）脾胃两伤。再诊掌后关部脉象，浮沉迟数要审察得确切。七至八至为数脉主热，四至五至为迟脉主寒。浮脉主表，病在外；沉脉主里，病在内潜藏。数脉六至腑有热，迟脉三至主脏寒。浮而有力为风与热，无力为中虚宜培补元气。沉而有力为痰积食滞，沉而无力为气滞之间。迟而有力乃为痛证，迟而无力是虚寒。数而有力本是实热，无力则恐疮疡煎熬。这是切脉的真口诀，静心审察要专心。再看舌苔分辨表里，红黄有火清热即安。白滑为里寒需急温中，白涩为里热，黄滑为寒。若是舌黑辨别阴阳，气息冷热用手探试。口中气热小便赤，舌黑必燥，先下法为宜。气微便清手足冷，人参、肉桂、附子妙如神仙。小儿阴亏舌亦黑，滋阴润燥无不痊愈。又看胸腹坚硬与柔软，虚实在此中可细细参详。望、切之理大致如此，闻声、问证岂可偏废。言语严厉声粗知病属实，气衰体虚必定声音细微，肝病怒声，心病笑，脾病发声如歌然。肺病出声有若哭，肾主呻吟恐怕夹杂其间。阳证身轻言响亮，阴证昏逆闭眼眠。阳症发狂喜饮水，阴证郑声话懒言。一问寒热，二问汗，三问头身与胸前，四问饮食病新久，五问二便与渴烦，六问前服药寒热，七问痘麻与先后顺序。用药细心斟酌虚实，有积体虚兼培补元气。热清、温湿、风疏散，久泻当涩固先天。如斯延医细斟酌，药到病除福无边。少者怀之遵圣意，惟愿赤子寿百年。若问是编何人辑录，亚拙山人在鱼泉。
Ancient texts state: "It is better to treat ten men than one woman; it is better to treat ten women than one infant." This indicates that pediatrics is referred to as the "Mute Department" (Ya Ke), as treatment is extremely difficult. Mr. Zhang Jingyue, however, stated that pediatric diseases are very easy to treat. How can this be seen? It is because infants and young children have no pulse to diagnose, due to their blood and qi not yet being fully developed. The pain or itching of their illnesses cannot be conveyed through speech, so diagnosis relies solely on observation (Wang), listening/smelling (Wen), and palpation (Qie); thus, saying it is not difficult is indeed difficult. The reason for saying it is easy lies in the fact that pediatric illnesses are merely external contraction of wind-cold, internal injury from diet, convulsions with vomiting and diarrhea, etc., without the afflictions of the seven emotions (Qi Qing), six depressions (Liu Yu), lust, or excessive worry. Therefore, when I treat pediatric diseases, for exterior syndromes, I use only formulas such as Xiangsu San (Fragrant and Perilla Powder) or Xingxing San (Awakening Powder); for interior syndromes, I use only Pingwei San (Calm the Stomach Powder) or Huoxiang San (Agastache Powder); for deficiency-phlegm and other symptoms, I use only Erchen Tang (Two-Cured Decoction) or Liujunzi Tang (Six-Gentlemen Decoction); for excess-heat symptoms, I use only Xiao'er Niuhuang Wan (Infant's Buffalo Horn Pill) or Xieqing Wan (Drain Green Pill). For all these exterior, interior, deficiency, and excess conditions, resolving the exterior or purging the interior should only employ mild agents; one must not use heavy sweating or drastic purging methods to damage the primordial qi. As for various miscellaneous conditions like convulsions, vomiting, and diarrhea, they are treated according to their specific categories and examples.
(Attached are the rhymes for Observation, Listening/Smelling, Inquiry, and Palpation)
Pediatric illness evokes pity, relying entirely on the doctor's careful observation. Have the child carried out to a bright place, and first carefully examine the face. The forehead belongs to the Heart channel, the nose to the Spleen channel; the left cheek belongs to the Liver, the right cheek to the Lung, and the front of both cheeks correspond to the organs. The chin is governed by the Kidney channel; distinguishing the colors of the five zang-organs requires devout attention. White color indicates Qi deficiency, yellow indicates accumulation, red indicates heat, and green/blue indicates cold. Nasal congestion with heavy voice indicates severe Wind-Cold invasion; blueness under the eyes indicates fluid retention and phlegm. Red or white lips distinguish Yin and Yang; red indicates Stomach heat, white indicates cold. White spots inside the lips indicate worm accumulation; dry nose and emaciated body indicate Gan syndrome (nutritional disorder). Unceasing crying indicates pain; restlessness in swaddling clothes indicates food stagnation. Seeking coolness or desiring cold indicates internal heat. Shrinking away from wind indicates Wind-Cold and Yin cold. Cold nose, herpes, hot ears, and generalized fever indicate Wind-Cold. Heat in palms and soles with thirst indicates true food stagnation shown by deep fingerprint lines. Afternoon palm heat indicates Yin deficiency with night sweats and nighttime irritability. Cold finger tips indicate Convulsion (Jing Feng) type conditions. Heat only in the middle finger indicates Shanghan (Cold Damage). Slight coldness alone in the middle finger suggests possible Meidan (Smallpox/Measles) entanglement. Observe the fingerprint and remember the rhyme; examine floating/sinking, color, and qi accurately. To view the Wind, Qi, and Life gates of the fingerprint, push inward and study carefully. The three gates correspond to Yin, Mao, and Chen hours; the prognosis lies here. If at the initial Wind gate, the disease is harmless; if appearing at the Qi gate, it may linger; if reaching the Life gate, it is critical; if piercing through to the Pass Gate, life is hard to save. Why does the fingerprint appear floating? Pathogen in the skin makes the disease easy to eliminate. Blockage of cou-li (interstices) is called Exterior Syndrome; urgently apply dispersing methods to induce sweating first. If the gate line suddenly appears sinking, the pathogen has entered the interior and lingers. Do not lightly try wind-dispersing drugs; you must clear the Yangming Interior Syndrome. Stable body with red-yellow color indicates Shanghan; pale red hidden indicates deficient Shanghan; deep red is viewed as heat. Purple at the gate indicates heat omen; green indicates wind as the definite sign. Food injury shows purple-green; phlegm-qis send it; green-black across three gates is hard to settle. Pale fingerprint need not please; constitution is weak due to innate endowment. Spleen and Stomach are originally deficient with faint Middle Qi; beware of attacking and damaging the infant's Yuan Qi. Stagnant and rough gate lines are due to accumulation; pathogen obstructs Ying and Wei Qi connection. Food stagnation in Middle Jiao with fierce Wind-Heat; without pushing and purging, how will the disease move? Abdominal pain with line entering palm interior, bending inward naturally indicates Wind-Cold. Line bending outward indicates Phlegm, Food, Heat; Water shape (Kidney/Bladder) and Spleen-Stomach are both injured. Re-examine the pulse at the Guan position behind the palm; examine floating/sinking, slow/rapid accurately. Seven to eight beats per breath is Rapid (Shu) indicating heat; four to five beats is Slow (Chi) indicating cold. Floating pulse governs Exterior, disease outside; Sinking pulse governs Interior, disease hidden inside. Rapid pulse six beats indicates Fu-organ heat; Slow pulse three beats indicates Zang-organ cold. Floating and forceful indicates Wind and Heat; forceless indicates Middle deficiency, suitable for tonifying Yuan Qi. Sinking and forceful indicates Phlegm, Accumulation, Food; sinking and forceless indicates Qi stagnation. Slow and forceful is Pain; slow and forceless is Deficient Cold. Rapid and forceful is Excess Heat; forceless fears ulceration torment. This is the true rhyme of pulse diagnosis; calm mind and focus attentively. Again, look at tongue coating to distinguish exterior/interior; red/yellow with fire, clear it to achieve peace. White and slippery indicates Interior Cold, urgently warm the Middle; white and rough indicates Interior Heat; yellow and slippery indicates Cold. If tongue is black, distinguish Yin/Yang; test breath temperature with hand. Hot mouth breath and red urine, black tongue must be dry, purgative method first. Faint breath, clear stool, cold limbs, Ginseng, Cinnamon Twig, Aconite Root are miraculous as immortals. Infant Yin deficiency also causes black tongue, nourishing Yin and moistening dryness cures all. Also examine chest and abdomen for hardness or softness; deficiency/excess can be studied herein. The principles of Observation and Palpation are thus; how can Listening and Inquiry be biased? Harsh voice and coarse speech know disease is Excess; failing Qi and weak body must speak softly. Liver disease angry voice, Heart disease laughter, Spleen disease sound like singing. Lung disease sound like crying, Kidney governs groaning possibly mixed. Yang syndrome light body and loud speech, Yin syndrome coma/reversal sleeping with closed eyes. Yang syndrome mania likes drinking water, Yin syndrome Zheng Sheng (faint murmuring) speaks lazily. First ask about chills and fever, second ask about sweating, third ask about head/body and chest, fourth ask about diet and disease duration, fifth ask about urination/defecation and thirst/irritability, sixth ask about previous medication effects, seventh ask about smallpox/measles sequence. Medication carefully considers deficiency/excess; if accumulation and deficiency, simultaneously tonify Yuan Qi. Clear heat, warm dampness, disperse wind; chronic diarrhea should be astringent to secure the Primordial. Such medical consultation, medicine arrives and disease removes, boundless fortune. Cherish the young following sage intent, wishing infants live a hundred years. If asked who compiled this book, Yazhuo Shanren at Yuquan.