人禀天地。全而最灵。原无夭札。善养则存。始生为幼。三四为小。七龆八龀。九童十稚。惊痫
疳癖。伤食中寒。汤剂为难。推拿较易。以其手足。联系脏腑。内应外通。察识详备。男左女右。为
主看之。先辨形色。次观虚实。认定标本。手法祛之。寒热温凉。取效指掌。四十余穴。有阴有阳。
十三手法。至微至妙。审症欲明。认穴欲确。百治百灵。万不失一。
要得小儿安。常带饥与寒。肉多必滞气。生冷定成疳。胎前防辛热。乳后忌风参。保养常如法。灾病自无干。
小儿有变蒸热症。变蒸者。所以变化脏腑。坚强骨脉。是阴阳正气。阳气行于旦。交人物之情
性。阴气行于夜。变人物之形体。故小儿自初生至四岁八岁。三十二日一变蒸。而肾气足。八八六
十四日再变蒸。则膀胱气足。以后每增四八则一蒸。使五腑气俱足。到三百二十日。凡十蒸变。则
诸脏气足。小蒸既毕。然后大蒸。又积至二百零六日。大蒸三遍毕。然后出蒸。是一岁零七个月。
大小蒸俱毕。或一日二日发热。此不可推。痘疹亦然。推则拂乱其气。反受其伤。故下手要观五
色。辨音。细问。切脉。察病数件。庶不有误也。（上唇尖有米粒又黄泡者即是）
小儿之疾。大半胎毒。小半食伤。外感风寒之症。什一而已。儿在胎中。母饥亦饥。母饱亦饱。
辛辣适口。胎热即随。情欲动中。胎息即噪。专食煎炒。恣味辛酸。喜怒不常。皆能令子受患。母若
胎前不能谨节。产后不能调养。惟务姑息。不能防微杜渐。未满百日。遽与咸酸之味。未及周岁。
辄与肥甘之物。则百疾由是而生焉。小儿脾胃。本自娇嫩。易于损伤。乳食伤胃。则为呕吐。乳食
伤脾。则为泄泻。吐泻既久。则成慢惊。乳食停积。则生湿痰。痰则生火。痰火交作。则为急惊。或
成喉痹。痰火结滞。则成吊痫。或为喘嗽。胎热胎寒。禀受有病。脐风撮口者。胎元有毒也。鹅口。
口疮。胃有湿热也。重口木舌。脾经有实火也。走马牙疳。气虚湿热也。爱吃泥土。脾脏心生疳热
也。胎惊夜啼。邪火入心也。变蒸发热者。毒散而五脏生也。丹毒者。火行于外也。蕴热者。火积于
中而外邪乘也。睡惊者。内火动也。喉痹者。热甚也。眼痛者。火动也。脓耳者。肾气上冲也。鼻塞
者。因冒风寒也。头疮者。胎毒热攻也。脐风者。中痰中湿也。尾骨痛者。阴虚痰也。诸虫痛者。胃
气伤也。阴肿痛者。寒所郁也。盘肠气痛者。冷滞脾胃也。便血者。热传心肺也。淋 者。热郁膀胱
也。吐血生肿者。荣卫气逆也。小便不通者。无阴有阳也。大便不通者。无虚有实也。解颅鹤节者。
胎元不全也。行迟发迟者。血气不完也。鸡胸者。肺热满胸也。龟背者。风邪入脊也。语迟者。邪乘
心也。齿迟者。肾不足也。疟疾者。膈上痰结也。痢疾者。食积腹中也。咳嗽者。肺气伤也。喘气者。
痰气盛也。心痛者。虫所啮也。腹痛食所伤也。内伤发热。口苦舌干也。外感发热。鼻塞声重也。腹
胀者。脾胃虚弱也。水肿。水旺土亏也。疸黄者。脾胃虚而有湿热也。故调理脾胃。医中之王道也。
节戒饮食。却病之良方。惊疳积热。小儿之常病也。恒居时。常观其脾。微有青黑。即推数百。去
其青黑之气。再加补脾手法。可保小儿常安。此为要着。不可忽也。然推脾必要补。泄而不补。则
脾愈弱。擦龟尾亦要补。如不补。则泄不止。脾上用功。手法之要务也。痢痞痰疳。小儿之重症也。
医家慎之。（病源论得精细入手者所宜留心）
人禀受天地之气而生，最为灵秀，原本没有夭折或早亡之理，善于调养就能存活。出生不久称为“幼”，三四岁称为“小”，七岁换牙、八岁换齿称为“龆龀”，九岁称为“童”，十岁称为“稚”。惊风、癫痫、疳积、癖块，以及伤食、中寒等病证，使用汤药治疗较为困难，而推拿则相对容易。因为小儿的手足与脏腑相连，内应脏腑，外通体表，通过观察可以详尽了解病情。诊治时遵循“男左女右”的原则，主要观察左手或右手。先辨别面色和形体，再观察虚实证候，认定疾病的根本与表象，运用手法祛除病邪。无论是寒证、热证、温证还是凉证，都能在手到掌间取得疗效。四十多个穴位，分属阴经和阳经；十三种推拿手法，极其精微奥妙。审察病症要明晰，辨认穴位要准确，这样就能百治百灵，万无一失。
想要小儿平安健康，平时常让他们保持轻微的饥饿感和凉爽感。体内脂肪过多必然导致气机阻滞，生冷食物定会造成疳积。母亲在怀孕期间要防止食用辛辣燥热之物，哺乳后要避免受风和服用人参等补益药物。保养孩子要合乎法度，灾祸疾病自然就不会发生。
小儿有变蒸（一种生理性发育过程）引起的发热症状。“变蒸”是用来变化脏腑功能、坚强骨骼脉络的，这是阴阳正气的运行。阳气在白天运行，影响人的性情；阴气在夜晚运行，改变人的形体。所以小儿从初生到四岁、八岁，每三十二天经历一次变蒸，此时肾气充足；再过六十四天（即出生后约九十六天左右，原文意指累积周期）再次变蒸，膀胱气充足。此后每增加四个八天（三十二天）就有一次蒸，使五脏六腑之气都充足。到了三百二十天，总共经历十次变蒸，那么诸脏之气就充足了。小蒸结束后，然后是大蒸，又积累至二百零六天，大蒸三次结束后，才算真正完成变蒸过程，这是一岁零七个月时大小变蒸全部结束。期间可能出现一两天发热，这不可当作疾病去推论治疗，出痘疹的情况也是如此。如果强行推拿干预，会扰乱其气血，反而造成伤害。所以下手操作前必须观察五色（面部的青赤黄白黑），辨别声音，详细询问，切脉，仔细检查几项关键指标，才不会出错。（上嘴唇尖端有米粒大小的黄色水泡，就是变蒸发热的征象）。
小儿的疾病，大半是胎毒所致，小半是饮食损伤，外感风寒的病症只占十分之一。胎儿在母体中时，母亲饥饿胎儿也饥饿，母亲饱食胎儿也饱食。母亲口味偏好辛辣，胎热就会随之产生；母亲情欲波动，胎息就会躁动不安。如果母亲专吃煎炸炒制食品，放纵食用辛酸味道，喜怒无常，都会让孩子遭受病患。如果母亲在孕期不能谨慎节制，产后不能调养，只是一味姑息溺爱，不能防微杜渐，在孩子未满百日时就给予咸酸食物，不到周岁就给予肥甘厚味，那么各种疾病就会由此产生。小儿脾胃本来娇嫩，容易受损。乳食损伤胃，就会导致呕吐；乳食损伤脾，就会导致泄泻。吐泻久了，就会形成慢惊风。乳食停积，就会产生湿痰；痰郁化火，痰火交作，就会形成急惊风。或者形成喉痹（咽喉肿痛闭塞）；痰火结滞，就会形成吊痫（角弓反张的癫痫）；或者出现喘咳。胎热胎寒，禀赋有病，脐风撮口（新生儿破伤风）是胎元有毒；鹅口疮、口疮，是胃有湿热；重舌、木舌（舌头肿大僵硬），是脾经有实火；走马牙疳（坏疽性口炎），是气虚兼湿热；爱吃泥土，是脾脏心生疳热；胎惊夜啼，是邪火入心；变蒸发热，是胎毒散发而五脏生长；丹毒，是火行于体表；蕴热，是火积于体内而外邪乘虚而入；睡中惊悸，是内火扰动；喉痹，是热势严重；眼痛，是火动；脓耳（中耳炎流脓），是肾气上冲；鼻塞，是因为冒受风寒；头疮，是胎毒热邪攻冲；脐风，是中痰中湿；尾骨痛，是阴虚夹痰；诸虫痛（寄生虫腹痛），是胃气受伤；阴部肿痛，是寒邪郁结；盘肠气痛（肠痉挛），是冷滞脾胃；便血，是热传心肺；淋证（小便频数短涩），是热郁膀胱；吐血生肿，是营卫之气逆乱；小便不通，是无阴有阳（阴液枯竭，阳气独盛）；大便不通，是无虚有实（非虚证而是实证）；解颅（囟门迟闭）、鹤膝节（关节畸形），是胎元不全；行走迟缓、牙齿生长迟缓，是血气不完备；鸡胸，是肺热满胸；龟背，是风邪侵入脊柱；言语迟缓，是邪气乘袭心脏；牙齿生长迟缓，是肾气不足；疟疾，是膈上痰结；痢疾，是食积腹中；咳嗽，是肺气受伤；喘气，是痰气盛；心痛，是虫咬所致；腹痛，是饮食所伤；内伤发热，伴有口苦舌干；外感发热，伴有鼻塞声重；腹胀，是脾胃虚弱；水肿，是水旺土亏（肾水泛滥，脾土虚弱）；黄疸，是脾胃虚弱而有湿热。所以调理脾胃，是医道中的王道之法；节制饮食，是祛病的良方。惊风、疳积、积热，是小儿的常见病。日常居住时，要经常观察小儿脾经部位（如食指络脉），如果微现青黑色，就要推拿数百次，去除青黑之气，再加用补脾手法，可以保证小儿平安。这是关键要点，不可忽视。然而推脾必须要配合补法，只泄不补，脾会更弱；擦龟尾穴也要配合补法，如果不补，腹泻就不会停止。在脾经上用功，是推拿的要务。痢疾、痞块、痰证、疳积，是小儿的重症，医生们要谨慎对待。（《病源论》中精细入微的入手方法，值得留心研究）。
Humans are endowed with the Qi of Heaven and Earth, possessing the highest spirituality, originally free from premature death or calamity; proper nurturing ensures survival. The period shortly after birth is called "You" (infancy), three to four years old is called "Xiao" (toddlerhood), seven to eight years old when teeth change is called "Tiao Chen" (childhood), nine years old is "Tong", and ten years old is "Zhi". Conditions such as Wind-Convulsion (Jing Feng), Epilepsy (Xian), Infantile Malnutrition (Gan Ji), and Masses (Pi Ku), as well as Food Stagnation and Cold Invasion, are difficult to treat with herbal decoctions but relatively easier with Tuina (Chinese therapeutic massage). This is because a child's hands and feet are connected to the Zang-Fu organs, internally reflecting and externally communicating with the body surface, allowing for detailed observation. Diagnosis follows the principle of "Left for males, Right for females," primarily observing the left or right hand. First, distinguish complexion and physique; then observe Deficiency (Xu) and Excess (Shi) patterns; identify the root and branch of the disease, and apply manual techniques to eliminate pathogens. Whether Cold, Heat, Warmth, or Coolness, efficacy can be achieved at the touch of a finger. There are over forty acupoints, belonging to Yin and Yang meridians; thirteen Tuina manipulation methods are extremely subtle and profound. To examine symptoms clearly and identify acupoints accurately ensures hundred percent efficacy and no mistakes.
To keep children safe and healthy, they should often maintain a state of slight hunger and coolness. Excessive flesh leads to Qi stagnation; raw and cold foods inevitably cause Gan syndrome. During pregnancy, avoid pungent and hot foods; after breastfeeding, avoid wind exposure and Ginseng tonics. Nurturing must follow proper methods, so disasters and diseases will not interfere.
Children may experience fever due to Bian Zheng (a physiological developmental process). "Bian Zheng" transforms Zang-Fu functions and strengthens bones and vessels through the movement of Yin-Yang righteous Qi. Yang Qi moves during the day, influencing temperament; Yin Qi moves at night, altering physical form. Thus, from birth to four and eight years old, every thirty-two days constitutes one Bian Zheng cycle, filling Kidney Qi; another sixty-four days later, Bladder Qi fills. Subsequently, every four times eight days (32 days) brings one Zheng, ensuring all Zang-Fu Qi are sufficient. By 320 days, ten cycles complete, making all organ Qi sufficient. After small Zheng ends, large Zheng begins, accumulating another 206 days. Three rounds of large Zheng complete the process at one year and seven months. Fever occurring for one or two days during this time should not be treated as pathology; similar logic applies to Smallpox/Measles eruption. Forcing Tuina disrupts Qi and causes harm. Therefore, before treatment, one must observe the Five Complexions (Green, Red, Yellow, White, Black), distinguish voice, ask in detail, palpate the pulse, and examine key indicators to avoid error. (Yellow blisters like rice grains on the tip of the upper lip indicate Bian Zheng fever).
Most childhood illnesses stem from Fetal Toxin (Tai Du), less from food injury, and only one-tenth from external Wind-Cold invasion. In the womb, if the mother is hungry, the fetus is hungry; if full, the fetus is full. If the mother craves spicy food, fetal heat arises; if the mother experiences emotional desire, fetal breath becomes restless. Fried foods, excessive sour/pungent tastes, and mood swings all harm the child. If the mother fails to restrain herself prenatally or care postpartum, indulging rather than preventing minor issues, giving salty/sour foods before 100 days or rich/greasy foods before one year, myriad diseases arise. Children's Spleen and Stomach are delicate and easily damaged. Food injuring the Stomach causes vomiting; food injuring the Spleen causes diarrhea. Prolonged vomiting/diarrhea leads to Slow Convulsion. Food stagnation generates Damp-Phlegm; Phlegm generates Fire; Phlegm-Fire interaction causes Fast Convulsion. It may also lead to Throat Bi (obstruction), Hanging Epilepsy (opisthotonos), or wheezing cough. Congenital Heat/Cold defects cause Umbilical Wind (neonatal tetanus); Goose Mouth Sores/Mouth Ulcers indicate Stomach Damp-Heat; Heavy Tongue/Wooden Tongue indicates Spleen Meridian Excess Fire; Running Horse Gum Rot indicates Qi deficiency with Damp-Heat; craving dirt indicates Spleen-Heart Gan Heat; Fetal Startle/Night Crying indicates Evil Fire entering the Heart; Bian Zheng fever indicates toxin dispersal and organ growth; Erysipelas indicates Fire moving outward; Accumulated Heat indicates internal Fire accumulation with external pathogen invasion; Sleep Startle indicates internal Fire stirring; Throat Bi indicates severe Heat; Eye Pain indicates Fire movement; Otitis Media with Pus indicates Kidney Qi rushing upward; Nasal Congestion indicates Wind-Cold invasion; Head Sores indicate Fetal Toxin Heat attacking; Umbilical Wind indicates Phlegm-Damp invasion; Coccyx pain indicates Yin deficiency with Phlegm; Worm pain indicates Stomach Qi injury; Genital swelling/pain indicates Cold stagnation; Intestinal Colic indicates Cold stagnation in Spleen/Stomach; Hematochezia indicates Heat transmitting to Lung/Heart; Strangury indicates Heat stagnating in Bladder; Vomiting blood with swelling indicates Ying-Wei Qi rebellion; Urinary retention indicates "No Yin, Only Yang"; Constipation indicates "No Deficiency, Only Excess"; Craniolysis/Rickets indicates incomplete fetal origin; Delayed walking/tooth eruption indicates incomplete Blood-Qi; Pigeon Chest indicates Lung Heat filling the chest; Hunchback indicates Wind-Evil invading the spine; Delayed speech indicates Evil attacking the Heart; Delayed tooth eruption indicates Kidney insufficiency; Malaria indicates Phlegm knotting above the diaphragm; Dysentery indicates Food stagnation in the abdomen; Cough indicates Lung Qi injury; Wheezing indicates盛 Phlegm-Qi; Heart pain indicates worm biting; Abdominal pain indicates food injury; Internal Injury Fever presents with bitter taste and dry tongue; External Contraction Fever presents with nasal congestion and heavy voice; Abdominal distension indicates Spleen-Stomach weakness; Edema indicates Water excess and Earth deficiency; Jaundice indicates Spleen-Stomach deficiency with Damp-Heat. Therefore, regulating Spleen and Stomach is the King's Way of medicine; dietary restraint is the good prescription for dispelling disease. Convulsion, Gan, and Accumulated Heat are common childhood ailments. Daily observation of the Spleen meridian (e.g., finger collaterals): if slightly green/black, perform hundreds of manipulations to remove the color, then apply Spleen-tonifying techniques to ensure safety. This is crucial and cannot be ignored. However, pushing the Spleen must include tonification; purging without tonifying weakens the Spleen further. Rubbing the Guwei point must also include tonification; otherwise, diarrhea persists. Working on the Spleen is the primary task of Tuina. Dysentery,痞块 (masses), Phlegm, and Gan are severe pediatric conditions; physicians must exercise caution. (The precise diagnostic methods in *Bing Yuan Lun* deserve attention).