观形察色辨因由。阴弱阳强发碍柔。若是伤寒双足冷。要知有热肚皮求。鼻冷便知是疹痘。
耳凉知是风热投。浑身皆热伤风症。下冷上热食伤仇。
儿有大小之不同。病有浅深之不一。形声色脉之殊。望闻问切之间。若能详究于斯。可谓神
圣工巧者矣。盖望者。鉴望辨其色也。假如面部。左腮属肝。右腮属肺。额属心。鼻属脾。颊属肾
脏。肝病面青。肺病面白。心病面赤。脾病面黄。肾病面黑。是乃望而知之也。闻者。听声知其症
也。假如肝病声悲。肺病声促。心病声雄。脾病声慢。肾病声沉。属于脏。大肠病声长。小肠病声
短。胃病声速。胆病声清。膀胱病声微。属于腑。是乃闻而知之也。问者。究其病源也。好食酸肝
病。好食辛肺病。好食苦心病。好食甘脾病。好食咸肾病。好食热内寒。好食凉内热。是乃问而知
之也。切者。切脉察病也。三周以下儿有病。男左女右看三关。卯是气关。寅是风关。辰是命关医
难治。虎口有筋往上接。看之须要分五色。红黄安乐五脏和。青紫定是受风吓。是乃切而知之也。
此其大略也。
观察形体和面色以辨别病因。阴气虚弱、阳气强盛会导致身体柔韧度受损(或表现为僵硬不适)。如果是伤寒病,双脚会发冷;要知道体内有热邪,需查看腹部情况。鼻子发冷便知是疹痘(天花或麻疹类疾病);耳朵发凉知道是风热之邪侵袭。全身发热是伤风症;下部寒冷上部发热则是饮食积滞所致。
儿童体型有大有小不同,病情有浅有深不一。形体、声音、神色、脉象各有差异,在望、闻、问、切四种诊法之间,如果能详细探究其中的道理,就可以称为具备“神、圣、工、巧”高超医术的医生了。所谓“望”,是通过观察来辨别面色。比如面部:左腮属肝,右腮属肺,额头属心,鼻子属脾,脸颊属肾。肝病面色青,肺病面色白,心病面色赤,脾病面色黄,肾病面色黑。这就是通过望诊而知晓病情。所谓“闻”,是通过听声音来知晓病症。比如:肝病声音悲凉,肺病声音急促,心病声音雄壮,脾病声音缓慢,肾病声音低沉。这些属于五脏病变;大肠病声音长,小肠病声音短,胃病声音快速,胆病声音清脆,膀胱病声音微弱。这些属于六腑病变。这就是通过闻诊而知晓病情。所谓“问”,是探究疾病的根源。喜欢食酸味提示肝病,喜欢食辛味提示肺病,喜欢食苦味提示心病,喜欢食甘味提示脾病,喜欢食咸味提示肾病。喜欢食热性食物提示体内有寒,喜欢食凉性食物提示体内有热。这就是通过问诊而知晓病情。所谓“切”,是通过切脉来察看病症。三周岁以下的幼儿患病,男性看左手,女性看右手的手指三关。卯位是气关,寅位是风关,辰位是命关(病情危重,医生难以治疗)。虎口处如果有筋络向上延伸,观察时必须分辨五色。红黄色表示安乐,五脏调和;青色和紫色定是受了惊吓或风邪。这就是通过切诊而知晓病情。这是大概的原则。
虎口有三关:紫色主热,红色主伤寒,青色主惊风,白色主疳积(营养不良),黑色主中恶(突发的严重中毒或邪祟),黄色主脾胃病。三关指的是风关、气关、命关这三关。
五个手指梢头发冷,说明受惊严重,不可抵挡。如果中指发热,必定是伤寒。如果只有中指独自发冷,则是疹痘病的征兆。男女患儿要分左右手来看,必须分明仔细地观察。
Observe the physical form and facial color to distinguish the etiology. Yin deficiency and Yang excess may lead to impaired flexibility (or manifest as stiffness). If it is Shanghan (Cold Damage), both feet will be cold; to know if there is internal heat, one must examine the abdomen. A cold nose indicates Zhen Dou (smallpox or measles); cool ears indicate an invasion of Wind-Heat. Generalized body heat characterizes Shang Feng (Wind-Cold injury); coldness in the lower body with heat in the upper body points to Food Stagnation.
Children vary in size, and diseases differ in depth. The physical form, voice, spirit, and pulse present distinct variations. Among the four diagnostic methods—Wang (Inspection), Wen (Auscultation and Olfaction), Wen (Inquiry), and Qie (Palpation)—if one can thoroughly investigate these principles, one can be considered a physician possessing the divine, sacred, skilled, and adept arts. "Wang" (Inspection) involves observing to distinguish colors. For instance, on the face: the left cheek corresponds to the Liver, the right cheek to the Lung, the forehead to the Heart, the nose to the Spleen, and the cheeks/jaw area to the Kidney. Liver disease manifests as a greenish complexion; Lung disease as white; Heart disease as red; Spleen disease as yellow; Kidney disease as black. This is knowing through inspection. "Wen" (Auscultation) involves listening to the voice to identify symptoms. For example: Liver disease presents with a mournful voice; Lung disease with a rapid/short breath voice; Heart disease with a robust voice; Spleen disease with a slow voice; Kidney disease with a deep voice. These belong to the Zang organs. Large Intestine disease presents with a long voice; Small Intestine disease with a short voice; Stomach disease with a quick voice; Gallbladder disease with a clear voice; Bladder disease with a faint voice. These belong to the Fu organs. This is knowing through auscultation. "Wen" (Inquiry) involves investigating the source of the disease. Preference for sour taste suggests Liver disease; pungent taste suggests Lung disease; bitter taste suggests Heart disease; sweet taste suggests Spleen disease; salty taste suggests Kidney disease. Preference for hot foods suggests internal Cold; preference for cold foods suggests internal Heat. This is knowing through inquiry. "Qie" (Palpation/Pulse-taking) involves palpating the pulse to observe the disease. In children under three years old who are ill, inspect the Three Passages on the left hand for males and the right hand for females. The Mao position is the Qi Passage; the Yin position is the Wind Passage; the Chen position is the Life Passage (where treatment is difficult for physicians). If tendons in the Tiger's Mouth extend upwards, one must distinguish among five colors. Red and yellow indicate peace and harmony of the Five Zang organs; blue/green and purple indicate fright or Wind pathogen invasion. This is knowing through palpation. This is the general outline.
The Tiger's Mouth has three passages: Purple indicates Heat; Red indicates Shanghan; Green indicates Fright/Wind; White indicates Gan accumulation (malnutrition); Black indicates Zhong E (sudden severe poisoning or evil influence); Yellow indicates Spleen/Stomach disorders. The Three Passages refer to the Wind, Qi, and Life passages.
Coldness at the tips of all five fingers indicates severe fright that is hard to withstand. If the middle finger is hot, it is definitely Shanghan. If only the middle finger is cold, it transmits the sign of Zhen Dou (measles/smallpox). One must distinguish between left and right hands for males and females, observing clearly and carefully.