全幼心鉴云凡小儿囟肿囟陷汗出不流如珠如油舒舌退场门舌肿发惊泻黑黯血发直如麻皮肤
无血色此心绝也并壬癸日死
病重啼哭无泪及病不哭下泪爪甲青黑眼深如陷舌卷。囊缩发搐目科连唇口动手如抱头之
状或脚面直素问云其华在爪其充在筋肝绝也并庚辛日死
人中满人中黑唇缩HT 张唇焦枯燥唇干紫黑唇不盖齿血肿尿血舌缩或卷鼻孔开张齿禁冷涎
如油嘬口如囊面如土色四肢逆冷如湿石之状吃乳不收泻粪赤黑脾绝也并甲乙日死
有热咽汤水并药食喉中鸣是胃脆直不能阴肺此证医书少有盖累曾试之有验并死不治目直
青鲜
气喘不回吃食噎嗽痰涎塞口喉中鸣响鼻塞不通鼻干黑燥肺胀胃膈头汗四肢冷此肺绝也并丙丁
日死
面黑神昏眼黑眼肿目无光彩耳叶青黄焦枯疳牙齿落发疏黄燥皮肤黑燥惊风咬乳戛齿泄屁
黑色绕口此肾绝也并戊巳日死
辰关(上节) 卯关(中节) 寅关(下节)
汤氏曰小儿初生变蒸未足血气未定呼吸至数太过必辨虎口色脉方可察其病之的要者正谓
此也
男以左手观之女以右手观之凡脉纹从寅关起不至卯关者易治若连于卯关者有病难治如寅关连
卯关卯关侵过辰关者十难救一若脉纹小或短者有病不妨
仁斋曰虎口者叉手处也三关者第二指之三节是也除拇指第一指近虎口第一节为初关一名
风关
第二节为中关亦名气关第三节为末关亦名命关男以左手女以右手侧看之惊风初得纹出虎口或
在初关多是红色传至中关色赤而紫又传过其色紫青病势深重其色青黑青而纹乱者病沉重若见
纯黑危恶不治大抵红者风热重紫者惊热青者惊积青赤相半惊积风热俱有主急惊风青而淡紫伸
缩来去主慢惊风紫丝青丝或黑丝隐隐相杂似出不出主慢脾风凡指纹在初关者易治过中关者难
治透末关者不治三关直透大抵不治然脉势湾入里者顺病虽重而证顺犹可用力若纹势湾反出外
靠于指甲者断不可回其有三关纹如流珠流米三五点相连或形于面或形于身危恶尤甚
《全幼心鉴》记载:凡是小儿囟门肿胀或凹陷,汗出不流,汗珠如油,伸舌退阴,舌体肿胀,惊风发作,泻下黑黯色血,头发直立如乱麻,皮肤无血色,这是心气绝的表现,多在壬日、癸日死亡。
病情危重时啼哭无泪,或者病重不哭,流泪时指甲青黑,眼睛深陷,舌体卷缩,阴囊收缩,发生抽搐,两眼上视连及唇口,双手动作像抱头状,或者脚面僵硬挺直。《素问》说:“肝的荣华表现在爪甲,肝充养筋脉。”这是肝气绝的表现,多在庚日、辛日死亡。
人中部位饱满或发黑,嘴唇收缩,张口呼吸,嘴唇焦枯干燥,嘴唇干紫黑色,嘴唇不能覆盖牙齿,血液肿胀,尿血,舌体缩短或卷缩,鼻孔开张,牙关紧闭,冷涎如油,撮口如囊,面色如土色,四肢逆冷像湿石头一样,吃奶无法吞咽,泻下赤黑色粪便,这是脾气绝的表现,多在甲日、乙日死亡。
如果有发热,喝汤水或服药时喉中鸣响,这是胃气脆弱直而不能受纳阴液。此证在医书中很少记载,大概是因为以前尝试过都有验证,且多属死证不可治疗。眼睛直视,青色鲜明。
气喘不止,进食噎塞咳嗽,痰涎堵塞口腔,喉中鸣响,鼻塞不通,鼻干黑燥,肺胀,胃膈部不适,头部出汗,四肢寒冷,这是肺气绝的表现,多在丙日、丁日死亡。
面色黑,神志昏迷,眼黑,眼睑肿胀,目光无光彩,耳叶青黄焦枯,疳积,牙齿脱落,头发稀疏黄燥,皮肤黑燥,惊风咬乳,磨牙,泄屁黑色绕口,这是肾气绝的表现,多在戊日、己日死亡。
辰关(上节)、卯关(中节)、寅关(下节)。
汤氏说:小儿初生,变蒸之气未足,血气未定,呼吸至数太过,必须辨别虎口色脉,才可以察知疾病的要害,正是说的这个意思。
男孩看左手,女孩看右手。凡是脉纹从寅关起,不到卯关的,容易治疗;如果连到卯关的,有病难治;如果寅关连卯关,卯关侵过辰关的,十难救一。如果脉纹细小或短小的,有病不妨碍。
仁斋说:虎口是叉手的地方。三关是指第二指的三节。除了拇指第一指近虎口的第一节为初关,又名风关;第二节为中关,又名气关;第三节为末关,又名命关。男孩看左手,女孩看右手,侧着看。惊风初得,纹出虎口或在初关,多是红色;传至中关,色赤而紫;又传过其色紫青,病势深重;其色青黑,青而纹乱的,病沉重;若见纯黑,危恶不治。大抵红色者风热重,紫色者惊热,青色者惊积,青赤相半者惊积风热俱有,主急惊风;青而淡紫,伸缩来去,主慢惊风;紫丝、青丝或黑丝隐隐相杂,似出不出,主慢脾风。凡指纹在初关者易治,过中关者难治,透末关者不治,三关直透的大抵不治。然而脉势弯曲向里的为顺,病虽重但证候顺,犹可用力治疗;如果纹势弯曲反出外,靠于指甲的,断不可回。那有三关纹如流珠、流米,三五点相连,或者形见于面或形见于身的,危恶尤其严重。
*Quan You Xin Jian* records: Whenever an infant's fontanelle is swollen or sunken, sweat does not flow freely but appears as beads like oil, the tongue protrudes and the genitals retract, the tongue is swollen, convulsions occur, diarrhea presents with dark black blood, the hair stands upright like a mess, and the skin lacks luster, this indicates the exhaustion of Heart Qi (Heart Qi Exhaustion). Death usually occurs on Ren (壬) or Gui (癸) days.
When the illness is severe, crying without tears, or not crying at all when critically ill, tearing up with cyanotic black fingernails, eyes sunken deep, tongue curled, scrotum retracted, convulsions occurring, eyes staring upward connecting to the lips and mouth, hands moving as if holding the head, or feet stiffly straight. *Su Wen* states: "The Liver's brilliance manifests in the nails, and the Liver nourishes the sinews." This indicates the exhaustion of Liver Qi (Liver Qi Exhaustion). Death usually occurs on Geng (庚) or Xin (辛) days.
The area between the nose and upper lip (Ren Zhong) is full or black, lips are contracted, breathing through an open mouth, lips are scorched, dry, and cracked, lips are dry purple-black, lips cannot cover the teeth, blood swelling, hematuria, tongue shortened or curled, nostrils dilated, jaw locked, cold saliva like oil, puckered mouth like a bag, complexion like earth, limbs cold and reversed like wet stones, inability to suck milk, passing red-black feces, this indicates the exhaustion of Spleen Qi (Spleen Qi Exhaustion). Death usually occurs on Jia (甲) or Yi (乙) days.
If there is fever, and wheezing sounds from the throat when drinking soup or taking medicine, this indicates the stomach is fragile and unable to receive Yin fluids. This syndrome is rarely recorded in medical books, likely because previous attempts have proven effective in confirming its fatality and incurability. Eyes staring straight, bright green color.
Panting without relief, choking and coughing while eating, phlegm and saliva blocking the mouth, wheezing sounds in the throat, nasal congestion, dry and black nose, lung distension, discomfort in the epigastrium, sweating on the head, cold limbs, this indicates the exhaustion of Lung Qi (Lung Qi Exhaustion). Death usually occurs on Bing (丙) or Ding (丁) days.
Black complexion, unconsciousness, black eyes, swollen eyelids, lackluster gaze, yellow-green scorched earlobes, rickets (Gan Syndrome), tooth loss, sparse yellow-dry hair, black-dry skin, convulsions biting the breast, grinding teeth, passing black gas around the mouth, this indicates the exhaustion of Kidney Qi (Kidney Qi Exhaustion). Death usually occurs on Wu (戊) or Ji (己) days.
Chen Guan (Upper Segment), Mao Guan (Middle Segment), Yin Guan (Lower Segment).
Shi says: When infants are first born, their transformation and evaporation energies are insufficient, blood and Qi are unstable, and respiration is excessive. One must distinguish the colors and pulses of the Tiger's Mouth (Hu Kou) to observe the essentials of the disease. This is precisely what is meant here.
For boys, observe the left hand; for girls, observe the right hand. If the pulse vein starts from the Yin Guan and does not reach the Mao Guan, it is easy to treat. If it connects to the Mao Guan, the illness is difficult to treat. If the Yin Guan connects to the Mao Guan, and the Mao Guan invades past the Chen Guan, ten cases will hardly save one. If the pulse vein is small or short, having an illness is not detrimental.
Ren Zhai says: The Tiger's Mouth is the place where hands cross. The Three Guan (Passes) refer to the three segments of the second finger. Excluding the first segment of the thumb near the Tiger's Mouth, which is the Initial Guan (Feng Guan/Wind Pass); the second segment is the Middle Guan (Qi Guan/Air Pass); the third segment is the Terminal Guan (Ming Guan/Life Pass). Observe boys' left hands and girls' right hands from the side. In early stages of convulsions, if the vein emerges from the Tiger's Mouth or is in the Initial Guan, it is mostly red. If it transmits to the Middle Guan, the color is red and purple. If it transmits further, the color becomes purple-green, indicating a deep and severe condition. If the color is blue-black, or blue with chaotic veins, the illness is heavy. If pure black is seen, it is critical and incurable. Generally, red indicates severe Wind-Heat; purple indicates Convulsion-Heat; blue indicates Convulsion-Stagnation; half blue and half red indicates both Convulsion-Stagnation and Wind-Heat, primarily associated with Acute Convulsion (Ji Jing Feng); blue with pale purple, extending and contracting, indicates Chronic Convulsion (Man Jing Feng); hidden intermingled purple, blue, or black threads appearing faintly indicate Chronic Spleen Wind (Man Pi Feng). Veins in the Initial Guan are easy to treat; those passing the Middle Guan are difficult to treat; those penetrating the Terminal Guan are incurable; those penetrating all three Guan directly are generally incurable. However, if the vein trend curves inward, it is favorable; although the illness is severe, the syndrome is compliant, and treatment efforts can still be made. If the vein trend curves outward toward the nail, recovery is impossible. If the veins in the three Guan resemble flowing pearls or rice grains, connected in three to five dots, or manifesting on the face or body, the critical nature is even more severe.