重实声 重实雄声体热为，三焦气壅在心脾，伤风咳嗽喉咽痛，结涩肠中粪
出迟。
悲焦声 声悲焦有燥，恐怖欲生风，重浊声沉静，疳攻必耳聋。
啼哭声 但哭无啼只是惊，多啼不哭痛分明，声轻颤嗄风痫病，速缓声频吐泻成。
HT 煎声 HT 煎烦躁病难安，燥促声音为感寒，语短气微尿主涩，长迟声细痢多般。
迟缓声 语短声迟缓，肠鸣泄泻频，嗄声多不响，风热肺家因。
候儿脉，当以大指按三部，一息六七至为平和，八九至为发热，五至为内寒。
脉弦为风痫，沉缓为伤食，促急为虚惊，弦急为气不和，沉细为冷，浮为风，大小
不匀为恶候、为鬼祟，浮大数为风、为热，伏结为物聚，单细为疳劳。凡腹痛，多
喘呕而脉洪者为有虫，沉而迟、潮热者胃寒也，温之则愈。诀曰∶小儿脉紧风痫候，
沉缓食伤多呕吐，弦急因知气不和，急促急惊神不守，冷则沉细风则浮，牢实大便
应秘久，腹痛之候紧而弦，脉乱不治安可救，变蒸之时脉必乱，不治自然无过缪，
单细疳劳洪有虫，大小不匀为恶候，脉沉而迟有潮热，此必胃寒来内冠，泻利脉大
不可医，仔细酌量宜审究。（云岐子云∶未及五岁、不可视听者，未可别脉，五岁以上，
方可以脉别浮沉迟数。按∶钱氏论，又不拘五岁上下也。）
脉应杂病∶
诸数脉 为热，属腑。
诸迟脉 为冷，属脏。
阳数脉 主吐逆，不吐必发热。
阴微脉 主泄泻，不泻必盗汗。
沉数脉 寒热，寒多热少，亦主骨蒸热。
紧数脉 寒热，热多寒少，又主骨热，急则惊痫。
沉紧脉 心腹痛，短数同，亦主咳嗽。
沉细脉 乳食不化，亦主腹痛下痢。
沉伏脉 为积聚，亦主霍乱。
微缓脉 乳不化，泄泻，沉缓亦同。
微涩脉 螈 筋挛。
微急脉 寒热唾血。
浮滑脉 宿食不消，亦主咳嗽。
浮紧脉 疳气耳聋。
浮弦脉 头疼身热。
紧滑脉 吐血恶。
心脉急数 惊痫。不惊者疳淋。
肝脉急甚 颠痫风痫，痰涎流液。
肺脉浮实 鼻塞，并大小便不通。
关脉紧滑 主蛔虫，尺脉沉，亦主蛔。
尺脉微细 溏泄冷痢，乳食不化。
尺脉微涩 便血，无血者必盗汗。
脉过寸口入鱼际 主遗尿。
审脉逆顺∶
惊搐脉 浮数顺，沉细逆，身温顺，肢冷逆。
夜啼脉 微小顺，洪大逆，身冷逆。
心腹痛 沉细顺，浮大逆，身温顺，肢冷逆。
伤寒脉 洪弦顺，沉细逆，浮大顺，微伏逆。
汗后脉 沉细顺，洪紧逆，困睡顺，狂躁逆。
温病脉 洪大顺，沉细逆，身热顺，腹痛逆。
咳嗽脉 滑浮顺，沉细逆，身温顺，肢冷逆。
霍乱脉 浮洪顺，迟微逆，身温顺，肢冷逆。
吐 脉 浮大顺，沉细逆，身温顺，肢冷逆。
泄泻脉 缓小顺，浮大逆，身温顺，肢冷逆。
诸痢脉 沉细顺，浮大逆，身温顺，肢冷逆。
诸渴脉 洪数顺，微细逆，身温顺，肢冷逆。
诸肿脉 浮大顺，沉细逆，脏实顺，肠泄逆。
腹胀脉 浮大顺，虚小逆，脏实顺，泄泻逆。
痰喘脉 滑大顺，沉细逆，身温顺，肢冷逆。
寒热脉 紧数顺，沉细逆，倦怠顺，强直逆。
疳劳脉 紧数顺，沉细逆，脏实顺，脾泄逆。
虫痛脉 紧滑顺，浮大逆，身温顺，唇青逆。
诸失血 沉细顺，浮数逆，身温顺，发热逆。
中恶腹胀 紧细顺，浮大逆，身热顺，身冷逆。
黄胆脉 浮大顺，沉细逆，腹宽顺，泄泻逆。
火瘅脉 浮洪顺，沉细逆，身热顺，身冷逆。
钱仲阳云∶小儿之脉，气不和则弦急，伤食则沉缓，虚惊则促急，风则浮，冷
则沉细，脉乱者不治。《水镜诀》云∶阴阳运合，男女成形，已分九窍四肢，乃生
五脏六腑，部分既别，逆顺难明，若凭寸口之浮沉，必乃横亡于孩子，须明虎口，
辨别三关，消详用药，始无差误。未至三岁，看虎口食指第一节名风关，脉初见易
治，第二节名气关，脉见病深难治，第三节名命关，脉见死不治。三关青是四足惊，
赤是水惊，黑是人惊，紫色泻利，黄色雷惊。三关通度，是极惊之症，必死。或青
或红、有纹如线一直者，是乳食伤脾，必发惊热。左右一样者，是惊与积齐发。有
三条、或散，是肺生风痰，或似 声。有赤，是伤寒及嗽。如红火，是泻。红黑
相兼，主下痢，青多白痢，红多赤痢，紫色相兼、加渴。虎口脉纹乱，主胃气不和。
青是惊与积。青黑发慢惊。脉入掌，乃内钓。指纹曲里、风盛，弯外、食积。此论
三岁以上之法。若三岁以下，更用一指按高骨，乃分三关，定其息数，呼吸八至为
平脉，九至不安，十至危困。浮主风。沉迟主虚冷。实主有热。紧主癫痫。洪主热
盛。沉缓主虚泻。微迟有积有虫。迟涩主胃脘不和。沉主乳食难化。沉细主乳食停
滞。紧弦主腹中热痛。牢实主大便秘。沉而数者，骨中有热。弦长是肝膈有风。紧
数乃惊风为患，四肢掣颤。浮洪乃胃口有热。沉紧主腹痛有寒。虚濡者有气，又主
慢惊。芤主大便利血。四岁以下用一指衮转寻三部，以关为准，七八岁移指少许，
九岁次第根据三关部位寻取，十一十二岁亦同，十四十五岁根据大方脉部位诊视。
凡看脉，先定浮沉迟数，阴阳冷热，沉迟为阴，浮数为阳。更兼看部位，青主惊风，
白主虚泻，赤主痰热，黑色病甚，黄主脾疳。以此相参，察病治疗，庶无误矣。《全
幼心鉴》云∶小儿半岁之际有病，当于额前、眉端、发际之间，以名中食三指曲
按之，儿头在左举右手，在右举左手，食指为上，中指为中，名指为下，三指俱热
主感风邪，鼻塞气粗，发热咳嗽。若三指俱冷，主外感风寒，内伤饮食，发热吐泻。
若食中二指热，主上热下冷。名中二指热，主夹惊之疾。食指热，主胸满食滞。又
当参辨脉形主之。流珠形，主饮食所伤，内热欲吐，或肠鸣自利，烦躁啼哭，用助
胃膏消饮食，分阴阳，若食消而病仍作，用香砂助胃膏以补脾胃。环珠形，主脾虚
停食，胸膈胀满，烦渴发热，用五味异功散加山楂、枳实健脾消食，后用六君子
汤调养中气。长珠形，主脾伤饮食积滞，肚腹作痛，寒热不食，先用大安丸消其积
滞，次以异功散健其脾气。来蛇形，主脾胃湿热，中脘不利，干呕不食，此疳邪内
作，先用四味肥儿丸治疳，后用四君子汤补脾。去蛇形，主脾虚食积，吐泻烦渴，
气短喘急，不食困睡，先用六君子汤加枳实健脾消积，次以七味白术散调补胃气。
弓反里形，主感冒寒邪，哽气出气，惊悸倦怠，四肢稍冷，小便赤色，咳嗽吐涎，
先用惺惺散助胃气，祛外邪，后以五味异功散加茯苓、当归养心血、助胃气，若外
邪既解，而惊悸指冷，脾气受伤也，宜用七味白术散补之，若闷乱气粗，喘促哽气
者难治，脾虚甚故也。弓反外形，主痰热心神恍惚，夹惊夹食，风痫痰盛，先以天
麻防风丸祛外邪，又用五味异功散调中气。枪形，主风热生痰发搐，先用抱龙丸，
如未应，用牛黄清心丸，若传于脾肺，或过用风痰之药而见一切诸症者，专调补脾
胃。鱼骨形，主惊痰发热，先用抱龙丸治之，如未应，属肝火实热，少用抑青丸以
清肝，随用六味丸以补肝，或发热少食，或痰盛发搐，乃肝木克脾土，用六君子汤
加柴胡补脾土以制肝木。水字形，主惊风食积，胸膈烦躁，顿闷少食，或夜啼痰
盛，口噤搐搦，此脾胃虚弱，饮食积滞而木克土也，先用大安丸消导饮食，次以六
君、钓藤钩、补中清肝，若已服消食化痰等剂而病不愈者，用四君、升麻、柴胡、
钓藤钩升补脾气、平制肝木。针形，主心肝热极生风，惊悸顿闷，困倦不食，痰盛
搐搦，先用抱龙丸祛风化痰，次用六君子加钓藤钩平肝实脾。透关射指形，主惊风
痰热，聚于胸膈，乃脾肺亏损，痰邪乘聚，先用牛黄清心丸清脾肺、化痰涎，次用
六君子汤加桔梗、山药补脾土、益肺金。透关射甲形，主惊风肝木克制脾土之败
症，急用六君、木香、钓藤钩、官桂温补脾土，未应，即加附子以回阳气，多得
生者。尝闻古人云∶小儿为芽儿，如草之芽，水之沤，盖因脏腑脆嫩，口不能言，
最难投剂，当首察面色而知其所属，次验虎口以辨其所因，实为治法之简要也。
\r虎口三关脉纹\p03-b44a1.bmp\r
\r十三指形\p03-b44a2.bmp\r
流珠只一点红色。环珠差大。长珠圆长。以上非谓圈子，总皆红脉贯气之如此。
来蛇即是长珠，散一头大，一头尖。去蛇亦如此，分上下朝，故曰来去。角弓反张，
向里为顺，向外为逆。枪形，直上。鱼骨，分开。水字，即三脉并行。针形，即过
关一二粒米许。射甲，命脉向外。透指，命脉曲里。虽然，余常治之亦有不专执其
形脉而投剂者，盖但有是症，即服是药，而亦多验。
【听声】
重实声：声音沉重、坚实且雄壮，伴有身体发热，这是三焦气机壅滞在心脾所致。若是伤风引起的咳嗽和咽喉疼痛，大便干结涩滞，排出迟缓。
悲焦声：声音悲哀焦躁，体内有燥热，产生恐惧感并欲生惊风；若声音重浊而沉静，则是疳积攻冲导致的耳聋。
啼哭声：只哭不啼（无泪或无声调变化）只是受惊的表现；多啼而不哭则疼痛明显；声音轻细颤抖且嘶哑，是风痫病；声音急促频繁呕吐腹泻，则是吐泻症形成。
煎声：烦躁不安，病情难以安宁，声音干燥急促为感受寒邪所致；言语短促、气息微弱、小便涩痛，声音长而迟细多为痢疾等多种病症。
迟缓声：言语短促，声音迟缓，肠鸣音多且泄泻频繁；声音嘶哑大多不响亮，病因在于风热侵袭肺脏。
【脉法】
诊察小儿脉象时，应用大拇指按诊寸、关、尺三部。一呼一吸间脉搏跳动六七次为平和之脉，八九次为发热，五次为内寒。
脉象弦紧主风痫，沉缓主伤食，促急主虚惊，弦急主气机不和，沉细主冷证，浮脉主风邪，脉象大小不匀主恶候或鬼祟作怪，浮大数主风热，伏结主有形之物积聚，单细主疳劳。凡是腹痛，若多伴有喘息呕吐且脉象洪大的，是有虫积；若脉沉迟且潮热的，是胃寒，温补即可痊愈。诀曰：小儿脉紧主风痫候，沉缓主伤食多呕吐，弦急知气机不和，急促主急惊神志不守，冷证则脉沉细，风邪则脉浮，牢实脉主大便久秘，腹痛之候脉紧而弦，脉乱无序者难治，变蒸之时脉必紊乱，不治亦自然无过错，单细脉主疳劳，洪脉主有虫，大小不匀为恶候，脉沉迟有潮热，此必胃寒内盛，泻利见大脉不可医，仔细斟酌审究。（云岐子说：未满五岁，无法视听辨脉的，不可单独凭脉诊断，五岁以上，方可凭脉辨别浮沉迟数。按：钱乙的论述，又不拘泥于五岁上下。）
脉象对应杂病：
诸数脉：主热，属腑病。
诸迟脉：主冷，属脏病。
阳数脉：主吐逆，若不吐必发热。
阴微脉：主泄泻，若不泻必盗汗。
沉数脉：主寒热，寒多热少，也主骨蒸热。
紧数脉：主寒热，热多寒少，又主骨热，急则惊痫。
沉紧脉：主心腹痛，短数脉同此，也主咳嗽。
沉细脉：主乳食不化，也主腹痛下痢。
沉伏脉：主积聚，也主霍乱。
微缓脉：主乳食不化，泄泻，沉缓脉亦同此。
微涩脉：主抽搐筋挛。
微急脉：主寒热唾血。
浮滑脉：主宿食不消，也主咳嗽。
浮紧脉：主疳气耳聋。
浮弦脉：主头疼身热。
紧滑脉：主吐血恶候。
心脉急数：主惊痫。不惊者主疳淋。
肝脉急甚：主颠痫风痫，痰涎流液。
肺脉浮实：主鼻塞，并大小便不通。
关脉紧滑：主蛔虫，尺脉沉，也主蛔虫。
尺脉微细：主溏泄冷痢，乳食不化。
尺脉微涩：主便血，无血者必盗汗。
脉过寸口入鱼际：主遗尿。
审察脉象逆顺：
惊搐脉：浮数为顺，沉细为逆；身温为顺，肢冷为逆。
夜啼脉：微小为顺，洪大为逆；身冷为逆。
心腹痛：沉细为顺，浮大为逆；身温为顺，肢冷为逆。
伤寒脉：洪弦为顺，沉细为逆；浮大为顺，微伏为逆。
汗后脉：沉细为顺，洪紧为逆；困睡为顺，狂躁为逆。
温病脉：洪大为顺，沉细为逆；身热为顺，腹痛为逆。
咳嗽脉：滑浮为顺，沉细为逆；身温为顺，肢冷为逆。
霍乱脉：浮洪为顺，迟微为逆；身温为顺，肢冷为逆。
吐脉：浮大为顺，沉细为逆；身温为顺，肢冷为逆。
泄泻脉：缓小为顺，浮大为逆；身温为顺，肢冷为逆。
诸痢脉：沉细为顺，浮大为逆；身温为顺，肢冷为逆。
诸渴脉：洪数为顺，微细为逆；身温为顺，肢冷为逆。
诸肿脉：浮大为顺，沉细为逆；脏实为顺，肠泄为逆。
腹胀脉：浮大为顺，虚小为逆；脏实为顺，泄泻为逆。
痰喘脉：滑大为顺，沉细为逆；身温为顺，肢冷为逆。
寒热脉：紧数为顺，沉细为逆；倦怠为顺，强直为逆。
疳劳脉：紧数为顺，沉细为逆；脏实为顺，脾泄为逆。
虫痛脉：紧滑为顺，浮大为逆；身温为顺，唇青为逆。
诸失血：沉细为顺，浮数为逆；身温为顺，发热为逆。
中恶腹胀：紧细为顺，浮大为逆；身热为顺，身冷为逆。
黄胆脉：浮大为顺，沉细为逆；腹宽为顺，泄泻为逆。
火瘅脉：浮洪为顺，沉细为逆；身热为顺，身冷为逆。
钱仲阳说：小儿脉象，气不和则弦急，伤食则沉缓，虚惊则促急，风邪则浮，冷证则沉细，脉乱者不治。《水镜诀》说：阴阳运合，男女成形，已分九窍四肢，乃生五脏六腑，部分既别，逆顺难明，若仅凭寸口之浮沉，必致横亡于孩子，须明虎口，辨别三关，详查用药，始无差误。未满三岁，看虎口食指第一节名风关，脉初见易治，第二节名气关，脉见病深难治，第三节名命关，脉见死不治。三关青色是四足惊风，赤色是水惊风，黑色是人惊风，紫色主泻利，黄色主雷惊风。三关通度，是极惊之症，必死。或青或红、有纹如线一直者，是乳食伤脾，必发惊热。左右一样者，是惊与积齐发。有三条、或散，是肺生风痰，或似慢惊声。有赤色，是伤寒及嗽。如红火，是泻。红黑相兼，主下痢，青多白痢，红多赤痢，紫色相兼加渴。虎口脉纹乱，主胃气不和。青色是惊与积。青黑发慢惊。脉入掌，乃内钓。指纹曲里、风盛，弯外、食积。此论三岁以上之法。若三岁以下，更用一指按高骨，乃分三关，定其息数，呼吸八至为平脉，九至不安，十至危困。浮主风。沉迟主虚冷。实主有热。紧主癫痫。洪主热盛。沉缓主虚泻。微迟有积有虫。迟涩主胃脘不和。沉主乳食难化。沉细主乳食停滞。紧弦主腹中热痛。牢实主大便秘。沉而数者，骨中有热。弦长是肝膈有风。紧数乃惊风为患，四肢掣颤。浮洪乃胃口有热。沉紧主腹痛有寒。虚濡者有气，又主慢惊。芤主大便利血。四岁以下用一指衮转寻三部，以关为准，七八岁移指少许，九岁次第根据三关部位寻取，十一十二岁亦同，十四十五岁根据大方脉部位诊视。凡看脉，先定浮沉迟数，阴阳冷热，沉迟为阴，浮数为阳。更兼看部位，青主惊风，白主虚泻，赤主痰热，黑色病甚，黄主脾疳。以此相参，察病治疗，庶无误矣。《全幼心鉴》说：小儿半岁之际有病，当于额前、眉端、发际之间，以名中食三指曲按之，儿头在左举右手，在右举左手，食指为上，中指为中，名指为下，三指俱热主感风邪，鼻塞气粗，发热咳嗽。若三指俱冷，主外感风寒，内伤饮食，发热吐泻。若食中二指热，主上热下冷。名中二指热，主夹惊之疾。食指热，主胸满食滞。又当参辨脉形主之。流珠形，主饮食所伤，内热欲吐，或肠鸣自利，烦躁啼哭，用助胃膏消饮食，分阴阳，若食消而病仍作，用香砂助胃膏以补脾胃。环珠形，主脾虚停食，胸膈胀满，烦渴发热，用五味异功散加山楂、枳实健脾消食，后用六君子汤调养中气。长珠形，主脾伤饮食积滞，肚腹作痛，寒热不食，先用大安丸消其积滞，次以异功散健其脾气。来蛇形，主脾胃湿热，中脘不利，干呕不食，此疳邪内作，先用四味肥儿丸治疳，后用四君子汤补脾。去蛇形，主脾虚食积，吐泻烦渴，气短喘急，不食困睡，先用六君子汤加枳实健脾消积，次以七味白术散调补胃气。弓反里形，主感冒寒邪，哽气出气，惊悸倦怠，四肢稍冷，小便赤色，咳嗽吐涎，先用惺惺散助胃气，祛外邪，后以五味异功散加茯苓、当归养心血、助胃气，若外邪既解，而惊悸指冷，脾气受伤也，宜用七味白术散补之，若闷乱气粗，喘促哽气者难治，脾虚甚故也。弓反外形，主痰热心神恍惚，夹惊夹食，风痫痰盛，先以天麻防风丸祛外邪，又用五味异功散调中气。枪形，主风热生痰发搐，先用抱龙丸，如未应，用牛黄清心丸，若传于脾肺，或过用风痰之药而见一切诸症者，专调补脾胃。鱼骨形，主惊痰发热，先用抱龙丸治之，如未应，属肝火实热，少用抑青丸以清肝，随用六味丸以补肝，或发热少食，或痰盛发搐，乃肝木克脾土，用六君子汤加柴胡补脾土以制肝木。水字形，主惊风食积，胸膈烦躁，顿闷少食，或夜啼痰盛，口噤搐搦，此脾胃虚弱，饮食积滞而木克土也，先用大安丸消导饮食，次以六君、钓藤钩、补中清肝，若已服消食化痰等剂而病不愈者，用四君、升麻、柴胡、钓藤钩升补脾气、平制肝木。针形，主心肝热极生风，惊悸顿闷，困倦不食，痰盛搐搦，先用抱龙丸祛风化痰，次用六君子加钓藤钩平肝实脾。透关射指形，主惊风痰热，聚于胸膈，乃脾肺亏损，痰邪乘聚，先用牛黄清心丸清脾肺、化痰涎，次用六君子汤加桔梗、山药补脾土、益肺金。透关射甲形，主惊风肝木克制脾土之败症，急用六君、木香、钓藤钩、官桂温补脾土，未应，即加附子以回阳气，多得生者。尝闻古人云：小儿为芽儿，如草之芽，水之沤，盖因脏腑脆嫩，口不能言，最难投剂，当首察面色而知其所属，次验虎口以辨其所因，实为治法之简要也。
虎口三关脉纹图
十三指形图
流珠只有一点红色。环珠稍大。长珠圆长。以上并非圆圈之意，总皆红脉贯气之如此形态。来蛇即是长珠，散一头大一头尖。去蛇亦如此，分上下朝向，故曰来去。角弓反张，向里为顺，向外为逆。枪形，直上。鱼骨，分开。水字，即三脉并行。针形，即过关一二粒米许。射甲，命脉向外。透指，命脉曲里。虽然，我常治之亦有不专执其形脉而投剂者，盖但有是症，即服是药，而亦多验。
[Listening to Voice]
Heavy and Solid Voice: The voice is heavy, solid, and robust, accompanied by body heat. This indicates Qi stagnation in the Sanjiao (Triple Burner) affecting the Heart and Spleen. If caused by Wind-Cold injury leading to cough and sore throat, with dry and difficult stool passage that is delayed.
Sad and Scorched Voice: The voice is sad and anxious, indicating internal dryness-heat, fear, and a tendency to generate Wind-convulsions. If the voice is heavy, turbid, and quiet, it indicates deafness caused by Gan syndrome (malnutrition/parasitic accumulation) attacking the ears.
Crying and Wailing Voice: Crying without wailing (no tearful or tonal variation) indicates fright. Frequent wailing without crying indicates clear pain. A light, trembling, and hoarse voice indicates Wind-epilepsy. A frequent, urgent voice with vomiting and diarrhea indicates the formation of vomiting and diarrhea syndromes.
"Jian" (Boiling/Agitated) Voice: Restlessness and inability to find comfort indicate severe illness. Dry and urgent voice indicates Cold pathogen invasion. Short speech, faint Qi, and astringent urination indicate various types of dysentery with long, slow, and thin voices.
Slow and Delayed Voice: Short speech and slow voice, with frequent borborygmus and diarrhea. Hoarse and mostly inaudible voice indicates Lung pathology due to Wind-Heat.
When examining pediatric pulses, use the thumb to palpate the Cun, Guan, and Chi positions on both wrists. Six to seven beats per respiratory cycle indicate a harmonious pulse; eight to nine beats indicate fever; five beats indicate internal Cold.
Xian (Wiry) pulse indicates Wind-epilepsy; Chen-Huan (Deep-Slow) pulse indicates food injury; Cu-Ji (Rapid-Irregular) pulse indicates deficiency fright; Xian-Ji (Wiry-Urgent) pulse indicates Qi disharmony; Chen-Xi (Deep-Fine) pulse indicates Cold; Fu (Floating) pulse indicates Wind; irregular pulse size indicates ominous signs or malevolent influences; Fu-Da-Shu (Floating-Big-Rapid) pulse indicates Wind-Heat; Fu-Jie (Hidden-Knotted) pulse indicates mass accumulation; Dan-Xi (Single-Fine) pulse indicates Gan-Lao (chronic wasting). For abdominal pain, if accompanied by wheezing, vomiting, and a Hong (Surging) pulse, it indicates intestinal parasites. If the pulse is Chen-Chi (Deep-Slow) with tidal fever, it indicates Stomach Cold, which heals with warming treatment. The maxim states: Tight pulse in children indicates Wind-epilepsy; Deep-Slow indicates food injury with much vomiting; Wiry-Urgent indicates Qi disharmony; Urgent-Quick indicates acute fright with loss of spirit possession; Cold presents as Deep-Fine; Wind presents as Floating; Firm-Solid indicates prolonged constipation; Abdominal pain presents as Tight-Wiry; Chaotic pulse is incurable; During Bian-Zheng (metabolic transformation periods), the pulse must be chaotic; no treatment is needed as it will resolve naturally; Single-Fine indicates Gan-Lao; Surging indicates worms; Irregular size is an ominous sign; Deep-Slow with tidal fever indicates internal Stomach Cold; Large pulse with diarrhea/dysentery is hard to treat; careful deliberation is required. (Yun Qizi said: For children under five who cannot communicate well, pulse diagnosis alone is insufficient; only after age five can floating/sinking and slow/rapid be distinguished. Note: Qian Yi's discussion does not strictly adhere to the age of five.)
Pulse Correspondence with Miscellaneous Diseases:
All Shu (Rapid) pulses: Indicate Heat, belonging to the Fu organs.
All Chi (Slow) pulses: Indicate Cold, belonging to the Zang organs.
Yang Shu pulse: Indicates vomiting and regurgitation; if no vomiting, fever ensues.
Yin Wei (Micro) pulse: Indicates diarrhea; if no diarrhea, night sweats ensue.
Chen-Shu (Deep-Rapid) pulse: Indicates alternating cold and heat, more cold than heat, also indicates bone-steaming heat.
Jin-Shu (Tight-Rapid) pulse: Indicates alternating cold and heat, more heat than cold, also indicates bone heat; if urgent, convulsions and epilepsy occur.
Chen-Jin (Deep-Tight) pulse: Indicates heart and abdominal pain; Duan-Shu (Short-Rapid) is similar, also indicates cough.
Chen-Xi (Deep-Fine) pulse: Indicates undigested milk/food, also indicates abdominal pain and dysentery.
Chen-Fu (Deep-Hidden) pulse: Indicates accumulations and masses, also indicates cholera-like disorder.
Wei-Huan (Micro-Slow) pulse: Indicates undigested milk/food and diarrhea; Chen-Huan (Deep-Slow) is similar.
Wei-Se (Micro-Astringent) pulse: Indicates convulsions and muscle cramps.
Wei-Ji (Micro-Tight) pulse: Indicates alternating cold and heat with blood in saliva.
Fu-Hua (Floating-Slippery) pulse: Indicates retained food not digesting, also indicates cough.
Fu-Jin (Floating-Tight) pulse: Indicates Gan-Qi (Gan syndrome Qi) and deafness.
Fu-Xian (Floating-Wiry) pulse: Indicates headache and body heat.
Jin-Hua (Tight-Slippery) pulse: Indicates hematemesis and ominous signs.
Heart pulse Ji-Shu (Urgent-Rapid): Indicates fright-epilepsy. If no fright, indicates Gan-lin (Gan syndrome with strangury).
Liver pulse Ji-Shen (Very Urgent): Indicates Dian-Xian (Epilepsy) and Feng-Xian (Wind-Epilepsy), with flowing phlegm-saliva.
Lung pulse Fu-Shi (Floating-Solid): Indicates nasal congestion and obstruction of both large and small bowels.
Guan pulse Jin-Hua (Tight-Slippery): Indicates roundworms; Chi pulse Chen (Deep) also indicates roundworms.
Chi pulse Wei-Xi (Micro-Fine): Indicates loose stools and cold dysentery, undigested milk/food.
Chi pulse Wei-Se (Micro-Astringent): Indicates blood in stool; if no blood, night sweats ensue.
Pulse extending past Cun into Yuji (LU10): Indicates enuresis.
Examining Pulse Reversal and Compliance:
Fright-Convulsion pulse: Fu-Shu (Floating-Rapid) is compliant; Chen-Xi (Deep-Fine) is reversed; Warm body is compliant; Cold limbs are reversed.
Night-crying pulse: Wei-Xiao (Micro-Small) is compliant; Hong-Da (Surging-Big) is reversed; Cold body is reversed.
Heart-Abdominal Pain: Chen-Xi (Deep-Fine) is compliant; Fu-Da (Floating-Big) is reversed; Warm body is compliant; Cold limbs are reversed.
Shang-Han (Cold Damage) pulse: Hong-Xian (Surging-Wiry) is compliant; Chen-Xi (Deep-Fine) is reversed; Fu-Da (Floating-Big) is compliant; Wei-Fu (Micro-Hidden) is reversed.
Post-Sweating pulse: Chen-Xi (Deep-Fine) is compliant; Hong-Jin (Surging-Tight) is reversed; Sleepiness is compliant; Mania/restlessness is reversed.
Wen-Bing (Warm Disease) pulse: Hong-Da (Surging-Big) is compliant; Chen-Xi (Deep-Fine) is reversed; Body heat is compliant; Abdominal pain is reversed.
Cough pulse: Hua-Fu (Slippery-Floating) is compliant; Chen-Xi (Deep-Fine) is reversed; Warm body is compliant; Cold limbs are reversed.
Huo-Luan (Cholera-like) pulse: Fu-Hong (Floating-Surging) is compliant; Chi-Wei (Slow-Micro) is reversed; Warm body is compliant; Cold limbs are reversed.
Vomiting pulse: Fu-Da (Floating-Big) is compliant; Chen-Xi (Deep-Fine) is reversed; Warm body is compliant; Cold limbs are reversed.
Diarrhea pulse: Huan-Xiao (Slow-Small) is compliant; Fu-Da (Floating-Big) is reversed; Warm body is compliant; Cold limbs are reversed.
All Dysentery pulses: Chen-Xi (Deep-Fine) is compliant; Fu-Da (Floating-Big) is reversed; Warm body is compliant; Cold limbs are reversed.
All Thirst pulses: Hong-Shu (Surging-Rapid) is compliant; Wei-Xi (Micro-Fine) is reversed; Warm body is compliant; Cold limbs are reversed.
All Edema pulses: Fu-Da (Floating-Big) is compliant; Chen-Xi (Deep-Fine) is reversed; Organ excess is compliant; Intestinal leakage is reversed.
Abdominal Distension pulse: Fu-Da (Floating-Big) is compliant; Xu-Xiao (Deficient-Small) is reversed; Organ excess is compliant; Diarrhea is reversed.
Phlegm-Asthma pulse: Hua-Da (Slippery-Big) is compliant; Chen-Xi (Deep-Fine) is reversed; Warm body is compliant; Cold limbs are reversed.
Alternating Cold-Heat pulse: Jin-Shu (Tight-Rapid) is compliant; Chen-Xi (Deep-Fine) is reversed; Lassitude is compliant; Rigidity is reversed.
Gan-Lao pulse: Jin-Shu (Tight-Rapid) is compliant; Chen-Xi (Deep-Fine) is reversed; Organ excess is compliant; Spleen diarrhea is reversed.
Worm-Pain pulse: Jin-Hua (Tight-Slippery) is compliant; Fu-Da (Floating-Big) is reversed; Warm body is compliant; Blue lips are reversed.
All Blood Loss: Chen-Xi (Deep-Fine) is compliant; Fu-Shu (Floating-Rapid) is reversed; Warm body is compliant; Fever is reversed.
Zhong-E (Evil Strike) Abdominal Distension: Jin-Xi (Tight-Fine) is compliant; Fu-Da (Floating-Big) is reversed; Body heat is compliant; Body cold is reversed.
Jaundice pulse: Fu-Da (Floating-Big) is compliant; Chen-Xi (Deep-Fine) is reversed; Wide abdomen is compliant; Diarrhea is reversed.
Fire Jaundice pulse: Fu-Hong (Floating-Surging) is compliant; Chen-Xi (Deep-Fine) is reversed; Body heat is compliant; Body cold is reversed.
Qian Zhongyang said: In children, Qi disharmony presents as Wiry-Urgent; Food injury as Deep-Slow; Deficiency Fright as Rapid-Irregular; Wind as Floating; Cold as Deep-Fine; Chaotic pulse is incurable. *Shui Jing Jue* says: Yin and Yang combine, male and female form, nine orifices and four limbs are divided, then Five Zang and Six Fu organs arise. Once parts are distinct, reversal and compliance are hard to discern. Relying solely on Cun/Guan floating/sinking will surely lead to the child's sudden death. One must understand the Tiger Mouth (thenar eminence) and distinguish the Three Passages (Guan) to prescribe medication without error. Under three years old, observe the Tiger Mouth index finger: The first segment is the Wind Passage (Feng Guan); appearance of pulse here is easy to treat. The second segment is the Qi Passage (Qi Guan); appearance here indicates deep disease, hard to treat. The third segment is the Life Passage (Ming Guan); appearance here indicates death, incurable. Green in all three passages indicates Four-Footed Fright (animal-related fright); Red indicates Water Fright; Black indicates Human Fright; Purple indicates diarrhea/dysentery; Yellow indicates Thunder Fright. All three passages penetrated indicates extreme fright, fatal. Green or red with a straight line like a thread indicates milk/food injuring Spleen, leading to fright-heat. Identical on left and right indicates simultaneous Fright and Accumulation. Three lines or scattered indicates Lung generating Wind-Phlegm, resembling slow-fright sounds. Red indicates Shang-Han and cough. Like bright fire indicates diarrhea. Red and black mixed indicates dysentery; more green means white dysentery; more red means bloody dysentery; purple mixed with thirst. Chaotic Tiger Mouth pulse texture indicates Stomach Qi disharmony. Green indicates Fright and Accumulation. Green-black indicates Slow Fright. Pulse entering palm indicates Internal Hooking. Texture curving inward indicates Excess Wind; curving outward indicates Food Accumulation. This applies to children over three. For under three, use one finger to press the high bone to divide the three passages and count breaths: Eight beats per breath is normal; nine is uneasy; ten is critical. Floating indicates Wind. Deep-Slow indicates Deficiency-Cold. Solid indicates Heat. Tight indicates Epilepsy. Surging indicates Excess Heat. Deep-Slow indicates Deficiency Diarrhea. Micro-Slow indicates Accumulation and Worms. Slow-Astringent indicates Stomach Disharmony. Deep indicates Hard-to-digest milk/food. Deep-Fine indicates Milk/Food Stagnation. Tight-Wiry indicates Abdominal Heat-Pain. Firm-Solid indicates Constipation. Deep-Rapid indicates Heat in bones. Wiry-Long indicates Wind in Liver/Diaphragm. Tight-Rapid indicates Fright-Wind causing limb twitching. Floating-Surging indicates Heat in Stomach opening. Deep-Tight indicates Abdominal Pain with Cold. Deficient-Soft indicates Qi presence and Slow Fright. Kou (Hollow) indicates profuse loose stools with blood. Under four years, use one finger rolling to find the three positions, using Guan as standard. Seven-eight years, shift fingers slightly. Nine years, follow the three passages sequentially. Eleven-twelve years same. Fourteen-fifteen years, diagnose according to adult methods. Generally, first determine Floating/Sinking, Slow/Rapid, Yin/Cold, Yang/Heat. Deep-Slow is Yin; Floating-Rapid is Yang. Also observe color: Green indicates Fright-Wind; White indicates Deficiency Diarrhea; Red indicates Phlegm-Heat; Black indicates severe disease; Yellow indicates Spleen Gan. By combining these, observe disease and treat, avoiding errors. *Quan You Xin Jian* says: For infants half-year-old with illness, press the forehead, between eyebrows, and hairline with ring, middle, and index fingers bent. If head is left, raise right hand; if right, raise left. Index is Upper, Middle is Middle, Ring is Lower. Heat in all three indicates Wind-Evil invasion, nasal congestion, rough breathing, fever, cough. Cold in all three indicates External Wind-Cold and Internal Food Injury, fever, vomiting, diarrhea. Heat in Middle and Ring fingers indicates Upper Heat/Lower Cold. Heat in Ring and Middle fingers indicates夹杂 Fright disease. Heat in Index finger indicates Chest fullness and Food Stagnation. Further analyze pulse shape. Bead Shape (Liu Zhu): Indicates food injury, internal heat with desire to vomit, borborygmus, spontaneous diarrhea, restlessness, crying. Use Zhu Wei Gao to digest food and separate Yin/Yang. If food digests but illness persists, use Xiang Sha Zhu Wei Gao to tonify Spleen/Stomach. Ring Bead Shape (Huan Zhu): Indicates Spleen Deficiency with retained food, chest/diaphragm distension, irritability, thirst, fever. Use Wu Wei Yi Gong San plus Shan Zha and Zhi Shi to strengthen Spleen and digest food, followed by Liu Jun Zi Tang to regulate Middle Qi. Long Bead Shape (Chang Zhu): Indicates Spleen injury with food accumulation, abdominal pain, alternating cold/heat, anorexia. First use Da An Wan to eliminate accumulation, then Yi Gong San to strengthen Spleen Qi. Coming Snake Shape (Lai She): Indicates Spleen/Stomach Damp-Heat, epigastric discomfort, dry heaving, anorexia. This is Gan Evil acting internally. First use Si Wei Fei Er Wan to treat Gan, then Si Jun Zi Tang to tonify Spleen. Going Snake Shape (Qu She): Indicates Spleen Deficiency with food accumulation, vomiting/diarrhea, irritability/thirst, shortness of breath, rapid breathing, anorexia, sleepiness. First use Liu Jun Zi Tang plus Zhi Shi to strengthen Spleen and eliminate accumulation, then Qi Wei Bai Zhu San to regulate/tonify Stomach Qi. Bow Reversing Inside Shape (Gong Fan Li): Indicates Cold-Evil invasion, choking gas/exhalation, fright palpitations, lassitude, slight cold limbs, red urine, cough with salivation. First use Xing Xing San to assist Stomach Qi and dispel external evil, then Wu Wei Yi Gong San plus Fu Ling and Dang Gui to nourish Heart Blood and assist Stomach Qi. If external evil resolves but fright/cold fingers persist, Spleen Qi is injured; use Qi Wei Bai Zhu San to tonify. If confused, rough breathing, panting, and choking persist, it is hard to treat due to severe Spleen Deficiency. Bow Reversing Outside Shape (Gong Fan Wai): Indicates Phlegm-Heat with mental confusion,夹杂 Fright and Food, Wind-Epilepsy with abundant phlegm. First use Tian Ma Fang Feng Wan to dispel external evil, then Wu Wei Yi Gong San to regulate Middle Qi. Spear Shape (Qiang): Indicates Wind-Heat generating Phlegm and convulsions. First use Bao Long Wan. If ineffective, use Niu Huang Qing Xin Wan. If transmitting to Spleen/Lung or due to overuse of Wind-Phlegm drugs causing various symptoms, focus on tonifying Spleen/Stomach. Fish Bone Shape (Yu Gu): Indicates Fright-Phlegm fever. First use Bao Long Wan. If ineffective, indicates Liver Fire Excess-Heat; use little Yi Qing Wan to clear Liver, then Liu Wei Wan to tonify Liver. Or fever/anorexia, or abundant phlegm/convulsions, indicating Liver Wood overcoming Spleen Earth; use Liu Jun Zi Tang plus Chai Hu to tonify Spleen Earth to control Liver Wood. Water Character Shape (Shui Zi): Indicates Fright-Wind and Food Accumulation, chest/diaphragm irritability, sudden stuffiness, anorexia, or night crying with abundant phlegm, locked jaw, convulsions. This is Spleen/Stomach weakness, food accumulation, and Wood overcoming Earth. First use Da An Wan to guide out food, then Liu Jun Zi, Gou Teng Gou, and Bu Zhong to clear Liver. If food-clearing/phlegm-resolving agents fail, use Si Jun Zi, Sheng Ma, Chai Hu, Gou Teng Gou to raise/tonify Spleen Qi and level/control Liver Wood. Needle Shape (Zhen): Indicates Extreme Heat in Heart/Liver generating Wind, fright palpitations, sudden stuffiness, lassitude, anorexia, abundant phlegm/convulsions. First use Bao Long Wan to dispel Wind and resolve Phlegm, then Liu Jun Zi plus Gou Teng Gou to level Liver and solidify Spleen. Penetrating Passage Shooting Finger Shape (Tou Guan She Zhi): Indicates Fright-Wind Phlegm-Heat gathering in chest/diaphragm, Spleen/Lung deficiency, Phlegm Evil accumulating. First use Niu Huang Qing Xin Wan to clear Spleen/Lung and resolve phlegm, then Liu Jun Zi Tang plus Jie Geng and Shan Yao to tonify Spleen Earth and benefit Lung Metal. Penetrating Passage Shooting Nail Shape (Tou Guan She Jia): Indicates敗症 (Intractable Syndrome) of Fright-Wind where Liver Wood overcomes Spleen Earth. Urgently use Liu Jun Zi, Mu Xiang, Gou Teng Gou, Guan Gui to warm/tonify Spleen Earth. If ineffective, add Fu Zi to restore Yang Qi; many survive. I have heard ancients say: Children are like sprouts, like grass shoots, like water foam, because their Zang-Fu are fragile and tender, they cannot speak, making prescription difficult. One must first observe complexion to know the organ involved, then examine the Tiger Mouth to identify the cause. This is truly a concise method of treatment.
[Images: Tiger Mouth Three Passages Pulse Texture; Thirteen Finger Shapes]
Bead Shape: Only a dot of red. Ring Bead: Slightly larger. Long Bead: Round and long. These do not mean circles, but rather red pulses penetrating Qi in these shapes. Coming Snake is like Long Bead, scattered, one end big, one end sharp. Going Snake is similar, dividing upper/lower directions, hence "Coming/Going". Archaic Back Extension (Gong Fan Zhang), inward is compliant, outward is reversed. Spear Shape: Straight up. Fish Bone: Split apart. Water Character: Three pulses running parallel. Needle Shape: Passing the passage by 1-2 rice grains. Shooting Nail: Life pulse outward. Penetrating Finger: Life pulse curving inward. Although, I often treat without strictly adhering to these shapes/pulses for prescription. Basically, if there is this symptom, take this medicine, and it is often effective.