〔钱〕凡病先虚或已经下，有合下者，必先实其母，后泻其子也，假令肺虚而痰
实，此可下之证，先当益脾，后方泻肺也。泻青丸又名泻肝丸。钱氏谓肝无补法，
故无补肝药，王海藏以四物汤内加防风、羌活等分，为细末，炼蜜丸，名补肝丸。
又以泻青丸去栀子大黄，名镇肝丸，治肝虚。导赤散泻丙小肠。泻心汤泻丁心。
安神丸治心虚疳热、神思恍惚。海藏八物定志丸，补心正药。益黄散又名补脾散，
海藏云∶此剂补脾以燥湿。东垣云∶治胃中寒湿呕吐，腹痛泻利清白之圣药也。泻
黄散又名泻脾散，海藏云∶泻脾热。阿胶散又名补肺散，海藏云∶杏仁本泻肺，非
若人参、天门冬、麦门冬之类也。泻白散又名泻肺散，海藏云∶治肺热骨蒸自汗，
用此直泻之。栀子、黄芩亦泻肺，当以气血分之。地黄丸即金匮八味丸去桂附，海
藏云∶治肾虚解颅，即魃病也，治脉毛而虚。钱氏谓肾无泻法，故无泻肾药。
海藏泻肾丸治脉洪而实，即前地黄丸熟地改生地、去山茱萸是也，此治左手本部脉，
若右尺洪实，以凤随丹泻之。（详见五脏各门总论）
古称望而知之谓之神，而小儿医号为哑科，脉来驶疾，难于指下分明，尤以察
色为要，故首叙之。夫婴儿、惟察其面部必有五色，以知病源，人身五体，以头为
首，首中有面，面中有睛，睛中有神，神者目中光彩是也，隐显横冲，应位而见，
以应五脏。五色者青黄赤白黑，五脏之色，心赤、肝青、脾黄、肺白、肾黑，五脏
所主病证蕴于内，必形色见于外，故小儿有病先观其本部形色，以论其五行生克吉
凶，形色若不相应，然后听声切脉。
〔钱〕面上证∶左腮为肝。（合左手关位肝胆之分，应于风木，为初之气。）右腮为肺。（合右手寸脉肺
与大肠之分，应于燥金，为五之气。）额上为心。（合左手寸口心与小肠之分，应于君火，为二之气。）鼻为脾。
（合右手关脉脾胃之分，应于湿土，为四之气。）颏为肾。（合左手尺下肾与膀胱之分，应于寒水，为终之气。）赤者热
也，黄者积也，白者寒也，青黑者痛也，随证治之。《永类钤方》云∶青色者为惊
积不散，欲发风候。红赤色者为热，为痰积壅盛，惊悸烦躁增进。黄色者亦为热，
为食积症伤，欲作疳候，或作痞癖。若神思昏沉，其候潮热气粗困倦，或呕哕，或
泻痢。白色为寒，为肺气不利，大肠滑泄，欲作吐利。黑色者为痛，所传不烦，
变证即为逆候，荣卫失序，为疾危恶。《全婴方》云∶左颊属肝，东方之位，春见
微青者平，深青者病，白色者绝，赤色主身热拘急，肝热生风，青黑色主惊悸腹痛，
浅赤色主潮热夜间发、日中歇，唇红焦燥，脉必紧数。右颊属肺，西方之位居右，
秋见微白者平，深白者病，赤色者绝，浅色主潮热，或大便坚而气粗壅嗽，青白色
主咳嗽恶心，青色主风入肺，时时咳嗽，青黑色主惊风欲发，或肚疼盘肠内吊。额
上属心，南方之位，火性炎上故居上，夏见微赤者平，深赤者病，黑色者绝，赤色
主心经有风热，心躁惊悸，睡卧不安，青黑色主心中有邪，惊风腹疼，手足螈 而
啼叫，青黑甚主心腹疼，黄色主惊疳骨热渴，皮毛干燥，夜多盗汗，头发焦黄。
鼻上属脾，中央之位故居中，而四季见微黄者平，深黄者病，青色者绝，赤色主身
热不思乳食，深黄色主小便不通，鼻孔干燥，气粗鼻衄，夜间多哭，淡白色主泄泻
食不化，青色主吐乳，口鼻干燥，大小便不利。下颏属肾，北方之位，水性润下故
居下，冬见微黑者平，深黑者病，黄色者绝，赤色主膀胱与肾，为表里有热，则水
道不利，故小便癃闭。《永类钤方》肝部所主，睛中瞳人，内藏其神，外究五轮。
眶HT 属脾，热即生眵，两 总心，热痛如针；白属肺家，热赤生砂，黄属肝脏，昏
瞀翳障，中心瞳人，肾热不明，眼忽眨窜，发风发惊。心部所主，颧面脸颊，皆属
心位，黑即沉困，青即惊悸，赤心发风，白即疳气，虚黄卫积，浮肿气逆，心绝何
因，大叫数声，过关不叫，必作鸦声，加热惊 ，散热清心。脾部所主，唇口见
病，人中承浆，四围上下，合口脾乡，开口属心，心脾有热，唇裂舌疮，三焦积热，
唇红如血，深红重渴，鹅口慕口，木舌重舌，脾肺热就，口内喷臭，脾肾气寒，色
如死肝，大惊一吓，口干唇白，常时积惊，渐必传心，心气不足，令儿烦哭，何知
脾绝，指甲皆黑，目无神光，定难用药，五种撮口惊风，更恶不治证。肺部所
主，鼻准两孔，并连山根，大小二 ，肺部所存，鼻孔黑煤，即肺经焦，黑煤如墨，
肺经即绝，鼻中赤痒，疳盛蛔长，或泻白涕，脑寒困寐，或流清涕，伤风喜睡，肺
热鼻塞，因息吹得，或感风寒，亦闭关隔，鼻烂即疳，鼻臭积热。肾部所主，耳穴
之前，名曰耳花，耳孩名轮，轮里名廓，轮廓焦黑，肾家虚热，其黑如炭，肾绝死
旦，耳门生疮，卫积非常，耳中脓出，肾热疳极，臭名 耳，脓汁不止，疮痒如烈，
其候虚热，忽听不聪，心肾气壅，常作哄哄，热气上攻，或如虫刮，荣虚卫热，耳
轮如冰（更看耳后有红丝。）麻痘相侵，耳叶红热，伤寒是则，热极内痛，肿气相攻，清心
凉膈，关窍通塞，儿孩两肾，常虚无病，切莫攻击，补更无益。〔洁〕肝病面白。肺
病面赤。脾病面青。肾病面黄。心病面黑。若肝病惊搐，而又加面白痰涎喘急
之类，此皆难治，余仿此推之。假令春分前，风寒也，宜用地黄、羌活、防风，或
地黄丸及泻青丸相间服之。春分后，风热也，宜用羌活、防风、黄芩，或泻青丸、
导赤散下之。立夏后，热也，宜用三黄丸、导赤散。夏至后，湿热也，宜用导赤散、
泻黄散、合而服之，或黄芩、人参、木香之类。秋分后用泻白散。立冬后用地黄丸
主之，谓肾不受泻也。〔薛〕青主惊积不散欲发风候，红主痰积惊悸，黄者食积症
伤欲作疳癖，白主泄泻水谷更欲作吐，黑主脏腑欲绝。印堂，青主初患惊泻，红主
大惊夜啼，黑主客忤。山根，青主二次惊泻后发躁，黑黄甚者死。年寿，平陷
主夭，青主发热生惊，黑主利死，红主躁死，微黄曰平，黄甚曰霍乱。承浆，青
主食时被惊，黄主吐逆，亦主血利，黑主惊风。面眼黑睛黄主有热，白睛黄
主食积疳，白睛青主惊风，黑睛黄主伤寒。眉上，青吉，忽红主烦躁夜啼，
黄主霍乱，久病红者死。风气二池，青主风候，紫主吐逆或发热，黄主吐逆，赤
主烦躁夜啼。两颧，赤主肺有客热。两太阳，青主二次受惊，青自太阳入耳者
死，红主血淋。两脸，青主客忤，黄主痰溢，赤主风热。两颊，赤主伤寒。两
颐，青主吐虫。两金匮，青主第三次惊风。黑绕口二日死。青连目入耳七日死。
两风门，红主风热，黑主疝，青主水惊。黑从眉入耳即日死，唇黑不食者死。面
青眼青肝病。面赤心病。面白肺病。面黄脾病。面黑肾病。额间，赤色主心经有热，
烦躁惊悸，若饮水或叫哭，属本经实热，用泻心散以清心火。微赤困卧惊悸，热
渴饮汤属虚热，用秘旨安神丸以生心血。青黑主惊风腹痛，或螈 啼叫，用五味
异功散加木香、柴胡、钓藤钩，补脾肝。青黑主心腹作痛，此寒水乘心，用益黄
散。微黄主惊疳，用安神丸。左脸，青或兼赤，主肝经风热，项强顿闷，目札螈
，用柴胡清肝散。色微赤，倏热切牙属虚热，用地黄丸。青黑主肝克脾而惊搐腹
痛，用六君子加姜桂。微赤主潮热血虚心躁，先用秘旨安神丸，次用地黄丸。右
脸，赤主风邪，气粗咳嗽，发热饮水为实热，用泻白散，若哽气出气，唇白气短属
虚热，用五味异功散，若脾热所传，用清胃散，心火所刑，用人参平肺散。淡赤主
潮热心躁或大便坚秘，用《宣明》柴胡饮子以疏导，如潮热未止，更用钓藤饮以清
肝。色青白主咳嗽恶心，先用惺惺散解表邪，健脾土，更以六君子汤调补中气。
色青黑主惊风腹痛，盘肠内钓，用六君、钓藤钩平肝补脾。鼻，微黄为平。
赤主脾胃实热，身热饮水、乳食如常，用泻黄散清热理脾。微赤主脾经虚热，身
凉饮汤，乳食少思，用五味异功散补中健脾。色深黄主小便不通，鼻中干燥，气
粗衄血，乃脾热传于肺肾，先用《济生》犀角地黄汤，后用地黄丸。色淡白乃脾虚
泄泻，乳食不化，用六君子汤调补中气。青色主脾土虚寒，肝木所胜，用五味异功
散加木香、炮姜温中平肝。黑为死候。颏间，色赤主肾与膀胱气滞热结，而小便
不通，用五苓散以分利。鼻准微黄，兼右腮微赤，乃脾肺燥热不能化生肾水，用黄
芩清肺饮。膀胱阴虚阳无所生，用滋肾丸。若颏间微赤，乃膀胱阳虚阴无所化，用
六味地黄丸。若小腹胀满，或阴囊肿胀，属阴虚湿热壅滞，用六味丸加车前、牛膝。
脾肺气虚，不能通调水道者亦用前药。其小便赤色，久而尿血，亦属肝肾气虚有热，
用六味地黄丸，如不应，则用补中益气汤益脾肺、生肝肾。若小便后出白津，或茎
中作痛，属肝经湿热，先用龙胆泻肝汤，后用六味地黄丸。印堂，青黑主腹痛夜
啼，此脾气虚寒也，脾为至阴，故夜间腹痛而啼，用钓藤饮。色淡白主泄泻乳食不
化，属脾气虚弱，用五味异功散加木香。人中，黄主伤乳胃逆。青主下利乳食不
化，嗳气酸腐，此脾虚停滞，先用大安丸消食，后用异功散健脾。黑主蛔虫咬痛。
唇，色白主吐涎呕逆，或吐血便血，乃脾气虚弱，不能摄涎统血归源，急用六君子
汤。色赤干燥而皱者，主脾经热渴，大便不通，烦热不寐，先以清胃散治其热，次
以四君、黄连、山栀调其脾。黄主食积泄泻，乳食不化，以六君子汤健脾。色赤
兼白主衄血，乃脾肺虚热，不能摄血归源，用《圣济》犀角地黄汤清热补血，用四
君子汤以补脾气，如久不应，用麦门冬散或人参安胃散。口畔，色黄主脾经积热，
用清胃散，久病用四味肥儿丸以治疳热。唇口抽动主惊热不安，用异功散加山栀、
钓藤钩、补脾平肝。若口流涎唇色紫，乃脾气虚寒，用异功散加炮姜、木香。若腹
中痛口吐涎，乃虫作痛，先用芜荑散，后用调中丸。不吐涎是积痛也，用异功散。
手足厥冷用理中汤加乌梅温补中气，而痛自止。或吐后或大便去后而痛止者，先用
下积丸，后用异功散。白，主失血死。青，主惊风死。黑色绕口者，不治。耳后
微赤，此少阳经风热，用柴胡饮子清肝生血。微黄，主睡中惊悸切牙，用四君子加
芎、归、升麻、以调理脾气。耳干燥，主骨疳蒸热，作渴盗汗，用地黄丸。若小便
后出白津，或玉茎痒痛，属肝经湿热，先用龙胆泻肝汤，后用地黄丸。若禀赋肾气
不足，或早近女色，致小便涩滞，或作痛如淋者，急用地黄丸、补中益气汤滋其
化源。或大小便去后、谷道牵痛者，其虚尤甚，用前丸加牛膝、车前、肉桂。如手
足逆冷，或畏寒少食，阳气虚寒也，急加附子，多可得生。大抵多因禀赋脏气不平，
或乳食寒暑失节，或妊娠、乳母、饮食起居六淫七情所致，若初病元气无亏，乳食
如常，发热壮热，二便秘结，作渴饮水，睡不露睛者，悉属形病俱实，当治邪
气。若病久元气已亏，食少发热，口干饮汤，呕吐泄泻，肢体畏寒而露睛者，悉属
形病俱虚，当补正气。更宜审胎气之虚实，脏腑之相胜而治之，庶无误矣。
〔钱〕目内证∶赤者，心热，导赤散主之。淡红者，心虚热，生犀散主之。青
者，肝热，泻青丸主之。浅淡者补之。黄者，脾热，泻黄散主之。无精光者，肾
虚，地黄丸主之。如见面目浮肿，主久咳嗽，乃脾受疳积也。
凡小儿唇白，主吐涎呕逆，吐血便血。唇红，渴饮烦躁，如久渴泻唇红者，是
虚证也，不可用凉药。唇黄，主脾受积后发肿。唇口紫及吐涎者，主虫痛。不吐涎
者是积痛。唇口四畔黄如橘，主口臭，乃脾之积热也。唇青，主血虚脾寒，为冷所
乘，盖唇主脾土，木来克土，知脾弱不能食也。
凡小儿舌干、舌白、舌燥、舌胎、舌黄、舌赤肿，皆主大便不通，或通利，必
色焦黄。如舌裂、舌上芒刺、舌上出血，皆热极阳毒也。舌上生疮，心脾有热。舌
卷，主惊。久患泻利，舌黑必润，不可认为热，盖久病上焦虚热故也。久泻痢舌黑
者，必死。
【钱乙】凡是病证先见虚象，或者已经使用过泻下法，即使有应当使用泻下法的指征，也必须先补益其母脏，然后再泻其子脏。例如肺虚而痰实，这是可以使用泻下法的证候，但应当先补益脾脏，然后才能泻除肺邪。泻青丸又名泻肝丸。钱乙认为肝脏没有补法，所以方中没有专门补肝的药物。王海藏在四物汤中加入等量的防风、羌活，研成细末，用炼蜜制成丸剂，名为补肝丸。他又将泻青丸去掉栀子和大黄，命名为镇肝丸，用于治疗肝虚。导赤散用于清泻丙火小肠。泻心汤用于清泻丁火心脏。安神丸用于治疗心虚引起的疳热、神思恍惚。王海藏的八物定志丸，是补心的正药。益黄散又名补脾散，王海藏说：此方通过燥湿来补脾。李东垣说：这是治疗胃中寒湿呕吐、腹痛且大便清白稀溏的神圣药物。泻黄散又名泻脾散，王海藏说：用于清泻脾热。阿胶散又名补肺散，王海藏说：杏仁本是用来泻肺的，不同于人参、天门冬、麦门冬这类补益药。泻白散又名泻肺散，王海藏说：用于治疗肺热引起的骨蒸潮热和自汗，用此方直接清泻。栀子和黄芩也能泻肺，但应当从气和血的角度来区分。地黄丸即《金匮要略》中的八味丸去掉肉桂和附子，王海藏说：用于治疗肾虚导致的解颅（囟门迟闭），也就是魃病，针对脉象浮大无力的情况。钱乙认为肾脏没有泻法，所以方中没有专门泻肾的药物。王海藏的泻肾丸用于治疗脉象洪大而实的证候，就是将前面的地黄丸中的熟地黄改为生地黄，并去掉山茱萸而成，此方主要治疗左手尺部脉象，如果右尺脉象洪实，则用凤随丹来泻之。（详见五脏各门总论）
古人称“望而知之谓之神”，而儿科医生被称为“哑科”（因为小儿不能言语），小儿脉象急促，难以在指下分辨清楚，尤其以观察面色为关键，所以首先叙述这一内容。婴儿的面部必然呈现五色，通过观察可以了解病源。人身五体，头部为首，头中有面，面中有眼睛，眼睛中有神气，神气就是眼中的光彩，隐现横冲，对应部位显现，以应合五脏。五色是指青、黄、赤、白、黑，对应五脏的颜色：心赤、肝青、脾黄、肺白、肾黑。五脏所主的病证蕴藏在体内，必然会通过形色反映在外，所以小儿有病时先观察其本部的形色，以此论述五行生克的吉凶，如果形色不相应，然后再听声音、切脉。
【钱乙】面部的证候：左腮属肝。（对应左手关部肝胆之分，应于风木，为初之气。）右腮属肺。（对应右手寸部肺与大肠之分，应于燥金，为五之气。）额上属心。（对应左手寸口心与小肠之分，应于君火，为二之气。）鼻属脾。（对应右手关部脾胃之分，应于湿土，为四之气。）颏属肾。（对应左手尺部下肾与膀胱之分，应于寒水，为终之气。）色赤主热，色黄主积滞，色白主寒，色青黑主痛，根据证候进行治疗。《永类钤方》说：青色者多为惊积不散，欲发风证。红赤色者为热，为痰积壅盛，惊悸烦躁加重。黄色者也为热，为食积伤损，欲作疳证，或形成痞癖。若神思昏沉，表现为潮热、气粗、困倦，或呕吐呃逆，或腹泻痢疾。白色为寒，为肺气不利，大肠滑泄，欲作吐利。黑色者为痛，传变不烦扰，变证即为逆证，营卫失序，病情危重恶险。《全婴方》说：左颊属肝，东方之位，春季见微青色为平人，深青色为病，白色为绝症，赤色主身热拘急，肝热生风，青黑色主惊悸腹痛，浅赤色主潮热夜间发作、白天缓解，唇红焦燥，脉必紧数。右颊属肺，西方之位居右，秋季见微白色为平人，深白色为病，赤色为绝症，浅色主潮热，或大便干结而气粗咳嗽，青白色主咳嗽恶心，青色主风入肺，时时咳嗽，青黑色主惊风欲发，或肚疼盘肠内吊。额上属心，南方之位，火性炎上故居上，夏季见微赤色为平人，深赤色为病，黑色为绝症，赤色主心经有风热，心躁惊悸，睡卧不安，青黑色主心中有邪，惊风腹疼，手足抽搐啼叫，青黑甚主心腹疼，黄色主惊疳骨热渴，皮毛干燥，夜多盗汗，头发焦黄。鼻上属脾，中央之位故居中，四季见微黄色为平人，深黄色为病，青色为绝症，赤色主身热不思乳食，深黄色主小便不通，鼻孔干燥，气粗鼻衄，夜间多哭，淡白色主泄泻食不化，青色主吐乳，口鼻干燥，大小便不利。下颏属肾，北方之位，水性润下故居下，冬季见微黑色为平人，深黑色为病，黄色为绝症，赤色主膀胱与肾表里有热，则水道不利，故小便癃闭。《永类钤方》肝部所主，睛中瞳人，内藏其神，外究五轮。眶周属脾，热即生眵，两目总归于心，热痛如针；白珠属肺家，热赤生砂，黄珠属肝脏，昏瞀翳障，中心瞳人，肾热不明，眼忽眨窜，发风发惊。心部所主，颧面脸颊，皆属心位，黑即沉困，青即惊悸，赤心发风，白即疳气，虚黄卫积，浮肿气逆，心绝何因，大叫数声，过关不叫，必作鸦声，加热惊厥，散热清心。脾部所主，唇口见病，人中承浆，四围上下，合口脾乡，开口属心，心脾有热，唇裂舌疮，三焦积热，唇红如血，深红重渴，鹅口慕口，木舌重舌，脾肺热就，口内喷臭，脾肾气寒，色如死肝，大惊一吓，口干唇白，常时积惊，渐必传心，心气不足，令儿烦哭，何知脾绝，指甲皆黑，目无神光，定难用药，五种撮口惊风，更恶不治证。肺部所主，鼻准两孔，并连山根，大小二眦，肺部所存，鼻孔黑煤，即肺经焦，黑煤如墨，肺经即绝，鼻中赤痒，疳盛蛔长，或泻白涕，脑寒困寐，或流清涕，伤风喜睡，肺热鼻塞，因息吹得，或感风寒，亦闭关隔，鼻烂即疳，鼻臭积热。肾部所主，耳穴之前，名曰耳花，耳孩名轮，轮里名廓，轮廓焦黑，肾家虚热，其黑如炭，肾绝死旦，耳门生疮，卫积非常，耳中脓出，肾热疳极，臭名耳，脓汁不止，疮痒如烈，其候虚热，忽听不聪，心肾气壅，常作哄哄，热气上攻，或如虫刮，荣虚卫热，耳轮如冰（更看耳后有红丝。）麻痘相侵，耳叶红热，伤寒是则，热极内痛，肿气相攻，清心凉膈，关窍通塞，儿孩两肾，常虚无病，切莫攻击，补更无益。【张元素】肝病面白。肺病面赤。脾病面青。肾病面黄。心病面黑。若肝病惊搐，而又加面白痰涎喘急之类，此皆难治，其余仿此推演。假令春分前，为风寒也，宜用地黄、羌活、防风，或地黄丸及泻青丸相间服用。春分后，为风热也，宜用羌活、防风、黄芩，或泻青丸、导赤散下之。立夏后，为热也，宜用三黄丸、导赤散。夏至后，为湿热也，宜用导赤散、泻黄散，合而服用，或黄芩、人参、木香之类。秋分后用泻白散。立冬后用地黄丸主治，谓肾不受泻也。【薛己】青色主惊积不散欲发风候，红色主痰积惊悸，黄色者食积症伤欲作疳癖，白色主泄泻水谷更欲作吐，黑色主脏腑欲绝。印堂，青色主初患惊泻，红色主大惊夜啼，黑色主客忤。山根，青色主二次惊泻后发躁，黑黄甚者死。年寿，平陷主夭折，青色主发热生惊，黑色主利死，红色主躁死，微黄曰平，黄甚曰霍乱。承浆，青色主食时被惊，黄色主吐逆，亦主血利，黑色主惊风。面眼黑睛黄主有热，白睛黄主食积疳，白睛青主惊风，黑睛黄主伤寒。眉上，青色吉，忽红主烦躁夜啼，黄色主霍乱，久病红者死。风气二池，青色主风候，紫色主吐逆或发热，黄色主吐逆，赤色主烦躁夜啼。两颧，赤色主肺有客热。两太阳，青色主二次受惊，青自太阳入耳者死，红色主血淋。两脸，青色主客忤，黄色主痰溢，赤色主风热。两颊，赤色主伤寒。两颐，青色主吐虫。两金匮，青色主第三次惊风。黑绕口二日死。青连目入耳七日死。两风门，红色主风热，黑色主疝，青色主水惊。黑从眉入耳即日死，唇黑不食者死。面青眼青肝病。面赤心病。面白肺病。面黄脾病。面黑肾病。额间，赤色主心经有热，烦躁惊悸，若饮水或叫哭，属本经实热，用泻心散以清心火。微赤困卧惊悸，热渴饮汤属虚热，用秘旨安神丸以生心血。青黑主惊风腹痛，或抽搐啼叫，用五味异功散加木香、柴胡、钓藤钩，补脾肝。青黑主心腹作痛，此寒水乘心，用益黄散。微黄主惊疳，用安神丸。左脸，青或兼赤，主肝经风热，项强顿闷，目札抽搐，用柴胡清肝散。色微赤，倏热切牙属虚热，用地黄丸。青黑主肝克脾而惊搐腹痛，用六君子加姜桂。微赤主潮热血虚心躁，先用秘旨安神丸，次用地黄丸。右脸，赤主风邪，气粗咳嗽，发热饮水为实热，用泻白散，若哽气出气，唇白气短属虚热，用五味异功散，若脾热所传，用清胃散，心火所刑，用人参平肺散。淡赤主潮热心躁或大便坚秘，用《宣明》柴胡饮子以疏导，如潮热未止，更用钓藤饮以清肝。色青白主咳嗽恶心，先用惺惺散解表邪，健脾土，更以六君子汤调补中气。色青黑主惊风腹痛，盘肠内钓，用六君、钓藤钩平肝补脾。鼻，微黄为平。赤主脾胃实热，身热饮水、乳食如常，用泻黄散清热理脾。微赤主脾经虚热，身凉饮汤，乳食少思，用五味异功散补中健脾。色深黄主小便不通，鼻中干燥，气粗衄血，乃脾热传于肺肾，先用《济生》犀角地黄汤，后用地黄丸。色淡白乃脾虚泄泻，乳食不化，用六君子汤调补中气。青色主脾土虚寒，肝木所胜，用五味异功散加木香、炮姜温中平肝。黑为死候。颏间，色赤主肾与膀胱气滞热结，而小便不通，用五苓散以分利。鼻准微黄，兼右腮微赤，乃脾肺燥热不能化生肾水，用黄芩清肺饮。膀胱阴虚阳无所生，用滋肾丸。若颏间微赤，乃膀胱阳虚阴无所化，用六味地黄丸。若小腹胀满，或阴囊肿胀，属阴虚湿热壅滞，用六味丸加车前、牛膝。脾肺气虚，不能通调水道者亦用前药。其小便赤色，久而尿血，亦属肝肾气虚有热，用六味地黄丸，如不应，则用补中益气汤益脾肺、生肝肾。若小便后出白津，或茎中作痛，属肝经湿热，先用龙胆泻肝汤，后用六味地黄丸。印堂，青黑主腹痛夜啼，此脾气虚寒也，脾为至阴，故夜间腹痛而啼，用钓藤饮。色淡白主泄泻乳食不化，属脾气虚弱，用五味异功散加木香。人中，黄色主伤乳胃逆。青色主下利乳食不化，嗳气酸腐，此脾虚停滞，先用大安丸消食，后用异功散健脾。黑色主蛔虫咬痛。唇，色白主吐涎呕逆，或吐血便血，乃脾气虚弱，不能摄涎统血归源，急用六君子汤。色赤干燥而皱者，主脾经热渴，大便不通，烦热不寐，先以清胃散治其热，次以四君、黄连、山栀调其脾。黄色主食积泄泻，乳食不化，以六君子汤健脾。色赤兼白主衄血，乃脾肺虚热，不能摄血归源，用《圣济》犀角地黄汤清热补血，用四君子汤以补脾气，如久不应，用麦门冬散或人参安胃散。口畔，色黄主脾经积热，用清胃散，久病用四味肥儿丸以治疳热。唇口抽动主惊热不安，用异功散加山栀、钓藤钩、补脾平肝。若口流涎唇色紫，乃脾气虚寒，用异功散加炮姜、木香。若腹中痛口吐涎，乃虫作痛，先用芜荑散，后用调中丸。不吐涎是积痛也，用异功散。手足厥冷用理中汤加乌梅温补中气，而痛自止。或吐后或大便去后而痛止者，先用下积丸，后用异功散。白色，主失血死。青色，主惊风死。黑色绕口者，不治。耳后微赤，此少阳经风热，用柴胡饮子清肝生血。微黄，主睡中惊悸切牙，用四君子加芎、归、升麻、以调理脾气。耳干燥，主骨疳蒸热，作渴盗汗，用地黄丸。若小便后出白津，或玉茎痒痛，属肝经湿热，先用龙胆泻肝汤，后用地黄丸。若禀赋肾气不足，或早近女色，致小便涩滞，或作痛如淋者，急用地黄丸、补中益气汤滋其化源。或大小便去后、谷道牵痛者，其虚尤甚，用前丸加牛膝、车前、肉桂。如手足逆冷，或畏寒少食，阳气虚寒也，急加附子，多可得生。大抵多因禀赋脏气不平，或乳食寒暑失节，或妊娠、乳母、饮食起居六淫七情所致，若初病元气无亏，乳食如常，发热壮热，二便秘结，作渴饮水，睡不露睛者，悉属形病俱实，当治邪气。若病久元气已亏，食少发热，口干饮汤，呕吐泄泻，肢体畏寒而露睛者，悉属形病俱虚，当补正气。更宜审胎气之虚实，脏腑之相胜而治之，庶无误矣。
【钱乙】目内证候：色赤者，为心热，用导赤散主治。淡红者，为心虚热，用生犀散主治。青色者，为肝热，用泻青丸主治。浅淡者予以补益。黄色者，为脾热，用泻黄散主治。无精光者，为肾虚，用地黄丸主治。如见面目浮肿，主久咳嗽，乃脾受疳积也。
凡小儿唇白，主吐涎呕逆，吐血便血。唇红，渴饮烦躁，如久渴泻唇红者，是虚证也，不可用凉药。唇黄，主脾受积后发肿。唇口紫及吐涎者，主虫痛。不吐涎者是积痛。唇口四畔黄如橘，主口臭，乃脾之积热也。唇青，主血虚脾寒，为冷所乘，盖唇主脾土，木来克土，知脾弱不能食也。
凡小儿舌干、舌白、舌燥、舌胎、舌黄、舌赤肿，皆主大便不通，或通利，必色焦黄。如舌裂、舌上芒刺、舌上出血，皆热极阳毒也。舌上生疮，心脾有热。舌卷，主惊。久患泻利，舌黑必润，不可认为热，盖久病上焦虚热故也。久泻痢舌黑者，必死。
[Qian Yi] In cases where the disease initially presents with deficiency or has already undergone purgation, even if there are indications for purgation, one must first tonify the mother organ and then purge the child organ. For example, in lung deficiency with phlegm excess, which is a condition suitable for purgation, one should first benefit the spleen before purging the lung. Xie Qing Wan (Drain the Liver Pill), also known as Xie Gan Wan (Purge the Liver Pill). Qian Yi stated that the liver has no method of tonification, hence there are no herbs specifically for tonifying the liver in his formulas. Wang Haizang added equal parts of Fangfeng (Saposhnikoviae Radix) and Qianghuo (Notopterygii Rhizoma et Radix) to Siwu Tang (Four Substances Decoction), ground them into fine powder, and formed pills with refined honey, naming it Bu Gan Wan (Tonify the Liver Pill). He further removed Zhizi (Gardeniae Fructus) and Dahuang (Rhei Radix et Rhizoma) from Xie Qing Wan, naming it Zhen Gan Wan (Calm the Liver Pill), used to treat liver deficiency. Dao Chi San (Direct the Red Powder) drains Bing Fire (Small Intestine Fire). Xie Xin Tang (Drain the Heart Decoction) drains Ding Fire (Heart Fire). An Shen Wan (Calming Spirit Pill) treats heart deficiency causing childhood malnutrition heat (Gan Re) and mental confusion. Wang Haizang's Ba Wu Ding Zhi Wan (Eight-Ingredient Calming Will Pill) is the correct medicine for tonifying the heart. Yi Huang San (Benefit Yellow Powder), also known as Bu Pi San (Tonify Spleen Powder), according to Wang Haizang: this formula tonifies the spleen by drying dampness. Li Dongyuan stated: it is the sacred medicine for treating stomach cold-dampness vomiting, abdominal pain, and clear watery diarrhea. Xie Huang San (Drain Yellow Powder), also known as Xie Pi San (Drain Spleen Powder), according to Wang Haizang: drains spleen heat. E'jiao San (Donkey-Hide Gelatin Powder), also known as Bu Fei San (Tonify Lung Powder), according to Wang Haizang: Xingren (Prunus Armeniacae Semen) is originally for draining the lung, unlike Renshen (Ginseng Radix), Tianmendong (Asparagi Radix), and Maimendong (Ophiopogonis Radix) which are tonifying. Xie Bai San (Drain White Powder), also known as Xie Fei San (Drain Lung Powder), according to Wang Haizang: treats lung heat causing bone-steaming tidal fever and spontaneous sweating, using this formula to directly drain it. Zhizi (Gardeniae Fructus) and Huangqin (Scutellariae Radix) can also drain the lung, but differentiation should be made based on Qi and Blood. Dihuang Wan (Rehmannia Pill) is the Bajun Wan (Eight-Ingredient Pill) from *Jinkui Yaolue* minus Rougui (Cinnamomi Cortex) and Fuzi (Aconiti Lateralis Radix Praeparata). According to Wang Haizang: it treats kidney deficiency causing jie lu (delayed closure of fontanelles), also known as ba disease, addressing pulse hairiness and deficiency. Qian Yi stated that the kidney has no method of purgation, hence there are no herbs specifically for purging the kidney. Wang Haizang's Xie Shen Wan (Drain Kidney Pill) treats a洪 (surging) and solid pulse, which is the previous Dihuang Wan with Shudihuang (Rehmanniae Radix Praeparata) changed to Shengdihuang (Rehmanniae Radix), and Shanzhuyu (Corni Fructus) removed; this treats the left hand root pulse. If the right chi pulse is surging and solid, use Fengsui Dan (Phoenix Following Pill) to drain it. (See General Discussion in Each Organ Section).
Ancient texts state "to know through observation is called divine," and pediatricians are called practitioners of the "mute department" because infants cannot speak. The infant's pulse is rapid and difficult to distinguish clearly under the fingers, making observation of facial color essential; thus, it is narrated first. Infants' faces necessarily display five colors, allowing one to know the source of disease. Among the five body parts, the head is primary; within the head is the face, within the face are the eyes, and within the eyes is Shen (Spirit), which refers to the luster of the eyes. It appears or hides, moves horizontally or vertically, manifests in corresponding positions, and corresponds to the five zang organs. The five colors are green, yellow, red, white, and black, representing the colors of the five zang organs: heart red, liver green, spleen yellow, lung white, kidney black. Diseases governed by the five zang organs accumulate internally and must manifest externally in form and color. Therefore, when an infant is ill, one first observes the form and color of the corresponding region to discuss the auspiciousness or inauspiciousness of the generation and restriction of the Five Elements. If the form and color do not correspond, then one listens to the voice and palpates the pulse.
[Qian Yi] Facial signs: The left cheek belongs to the liver. (Corresponds to the guan position of the left hand, liver and gallbladder division, associated with Wind-Wood, the first qi.) The right cheek belongs to the lung. (Corresponds to the cun position of the right hand, lung and large intestine division, associated with Dryness-Metal, the fifth qi.) The forehead belongs to the heart. (Corresponds to the cunkou position of the left hand, heart and small intestine division, associated with Ministerial Fire, the second qi.) The nose belongs to the spleen. (Corresponds to the guan position of the right hand, spleen and stomach division, associated with Damp-Earth, the fourth qi.) The chin belongs to the kidney. (Corresponds to the chi position below the left hand, kidney and bladder division, associated with Cold-Water, the final qi.) Red indicates heat, yellow indicates accumulation, white indicates cold, green/black indicates pain. Treat according to the syndrome. *Yong Lei Qian Fang* states: Green indicates unsettled fright accumulation, predisposing to wind syndromes. Red/Cherry red indicates heat, excessive phlegm accumulation, worsening fright palpitations and irritability. Yellow also indicates heat, food accumulation injury, predisposing to gan syndromes or pi pi (masses). If mental spirit is dull, symptoms include tidal fever, coarse breathing, fatigue, vomiting, or diarrhea/dysentery. White indicates cold, lung qi obstruction, intestinal slippage, predisposing to vomiting and diarrhea. Black indicates pain; if transmission is not烦 (agitated), changes become adverse syndromes, Ying and Wei lose order, indicating critical danger. *Quan Ying Fang* states: Left cheek belongs to the liver, Eastern position. Slight green in spring is normal, deep green is disease, white is terminal. Red indicates body heat and stiffness, liver heat generating wind, green-black indicates fright palpitations and abdominal pain, light red indicates tidal fever occurring at night and resolving during the day, red dry lips, pulse tight and rapid. Right cheek belongs to the lung, Western position on the right. Slight white in autumn is normal, deep white is disease, red is terminal. Light color indicates tidal fever, or hard stool with coarse breathing and cough, green-white indicates cough and nausea, green indicates wind entering the lung with frequent coughing, green-black indicates impending convulsive wind or abdominal pain with intestines curling inward. Forehead belongs to the heart, Southern position. Fire nature flares upward, so it resides above. Slight red in summer is normal, deep red is disease, black is terminal. Red indicates wind-heat in the heart channel, heart irritability and fright palpitations, restless sleep, green-black indicates evil in the heart, convulsive wind abdominal pain, limb twitching and crying, severe green-black indicates heart/abdominal pain, yellow indicates fright gan bone heat and thirst, dry skin/hair, night sweats, scorched yellow hair. Nose belongs to the spleen, Central position residing in the middle. Slight yellow in all seasons is normal, deep yellow is disease, green is terminal. Red indicates body heat, loss of appetite for milk/food, deep yellow indicates urinary retention, dry nostrils, coarse breathing, epistaxis, frequent crying at night, pale white indicates diarrhea and undigested food, green indicates vomiting milk, dry mouth/nose, difficulty urinating/defecating. Chin belongs to the kidney, Northern position. Water nature moistens downward, so it resides below. Slight black in winter is normal, deep black is disease, yellow is terminal. Red indicates heat in the interior and exterior of the bladder and kidney, leading to urinary obstruction. *Yong Lei Qian Fang*: The liver section governs the pupils, which hide the spirit and investigate the five wheels externally. The eye socket belongs to the spleen; heat produces eye discharge. Both eyes belong to the heart; heat causes pain like needles. The sclera belongs to the lungs; heat/redness produces sand-like irritation. The iris/yellowish tint belongs to the liver; dimness and nebula. The center pupil belongs to the kidney; kidney heat causes unclear vision, blinking, darting eyes, wind and fright. The heart section governs the cheekbones and cheeks. Black indicates sinking/depression, green indicates fright palpitations, red indicates heart wind, white indicates gan qi, deficiency yellow with wei accumulation, edema and qi rebellion. Why does heart failure occur? Crying several times, if it stops after passing the pulse point without crying, it will make a crow-like sound; add heat for convulsions, dissipate heat to clear the heart. The spleen section governs the lips and mouth. Renzhong and Chengjiang, surrounding areas, closed mouth is spleen territory, open mouth is heart. Heart-spleen heat causes lip cracking and tongue ulcers. Sanjiao heat accumulation causes lips red as blood, deep red with severe thirst, goose-mouth, wooden tongue, double tongue. Spleen-lung heat causes foul breath. Spleen-kidney qi cold makes color like dead liver. Great fright causes dry mouth and white lips. Chronic fright accumulation gradually transmits to the heart. Heart qi deficiency causes irritable crying. How to know spleen failure? Nails turn black, eyes lack spiritual luster, definitely difficult to treat. Five types of mouth-twisting convulsive wind are even worse and incurable. The lung section governs the tip of the nose and nostrils, connected to Shan Gen (root of nose). The inner and outer canthi store lung qi. Nostrils black like coal indicate lung meridian scorching; if black like ink, lung meridian fails. Nostrils red and itchy indicate severe gan with long roundworms, or white nasal discharge. Brain cold causes drowsiness or clear runny nose. Wind-cold causes preference for sleep. Lung heat causes nasal congestion due to inhalation or wind-cold invasion, blocking passages. Rotting nose indicates gan, foul smell indicates heat accumulation. The kidney section governs the area before the ear hole, named Er Hua (Ear Flower). The ear child is named Lun (Wheel), inside is Kuo (Mouth). Scorched black contours indicate kidney deficiency heat; if black as charcoal, kidney fails and death comes at dawn. Sores on the ear gate indicate abnormal wei accumulation. Pus in the ear indicates extreme kidney heat gan, smelly ear, continuous pus, intense itching. Symptoms include deficiency heat, sudden deafness, heart-kidney qi stagnation, constant humming, heat attacking upward, or feeling like insects scraping. Ying deficiency and wei heat make the ear wheel cold (also check for red threads behind the ear). Chickenpox/measles invasion makes ear lobes red and hot, characteristic of typhoid, extreme heat causing internal pain, swelling and qi attacking. Clear heart and cool diaphragm, open/close orifices. Children's two kidneys are often empty without disease; do not attack vigorously, tonification is also of no benefit. [Zhang Yuansu] Liver disease shows white face. Lung disease shows red face. Spleen disease shows green face. Kidney disease shows yellow face. Heart disease shows black face. If liver disease involves convulsions and adds white face, phlegm saliva, and wheezing, these are all difficult to treat; deduce the rest similarly. Suppose before Spring Equinox, it is wind-cold; use Dihuang, Qianghuo, Fangfeng, or alternate Dihuang Wan and Xie Qing Wan. After Spring Equinox, it is wind-heat; use Qianghuo, Fangfeng, Huangqin, or drain with Xie Qing Wan and Dao Chi San. After Start of Summer, it is heat; use Sanhuang Wan and Dao Chi San. After Summer Solstice, it is damp-heat; use Dao Chi San and Xie Huang San together, or Huangqin, Renshen, Muxiang. After Autumn Equinox use Xie Bai San. After Start of Winter use Dihuang Wan, stating the kidney does not accept purgation. [Xue Ji] Green indicates unsettled fright accumulation predisposing to wind; red indicates phlegm accumulation and fright palpitations; yellow indicates food accumulation injury predisposing to gan/pi; white indicates diarrhea of water/grains predisposing to vomiting; black indicates visceral failure. Yintang (between eyebrows): Green indicates initial fright diarrhea; red indicates great fright and night crying; black indicates external malevolent qi. Shan Gen (nose root): Green indicates irritability after second fright diarrhea; severe black/yellow indicates death. Nian Shou (bridge of nose): Flat/sunken indicates premature death; green indicates fever generating fright; black indicates death from diarrhea; red indicates death from irritability; slight yellow is normal, severe yellow indicates cholera. Chengjiang (below lower lip): Green indicates fright during eating; yellow indicates vomiting/reversal, also bloody diarrhea; black indicates convulsive wind. Face/eye black sclera yellow indicates heat; white sclera yellow indicates food accumulation gan; white sclera green indicates convulsive wind; black sclera yellow indicates typhoid. Above eyebrows: Green is auspicious; sudden red indicates irritability and night crying; yellow indicates cholera; chronic red indicates death. Fengqi Two Pools: Green indicates wind syndrome; purple indicates vomiting/reversal or fever; yellow indicates vomiting/reversal; red indicates irritability and night crying. Both cheekbones: Red indicates guest heat in the lung. Both temples: Green indicates second fright; green entering ear from temple indicates death; red indicates bloody strangury. Both cheeks (upper): Green indicates external malevolent qi; yellow indicates phlegm overflow; red indicates wind-heat. Both cheeks (lower): Red indicates typhoid. Both jaw angles: Green indicates vomiting worms. Two Jing Kui: Green indicates third convulsive wind. Black around mouth for two days indicates death. Green connecting eye to ear for seven days indicates death. Two Fengmen: Red indicates wind-heat; black indicates hernia; green indicates water fright. Black from eyebrow to ear indicates death on the same day; black lips unable to eat indicates death. Green face and green eyes indicate liver disease. Red face indicates heart disease. White face indicates lung disease. Yellow face indicates spleen disease. Black face indicates kidney disease. Forehead: Red indicates heart channel heat, irritability, and fright palpitations. If drinking water or crying, it belongs to excess heat of the original channel; use Xie Xin San to clear heart fire. Slight red with drowsiness and fright palpitations, thirst for hot drinks indicates deficiency heat; use Mizhi Anshen Wan to generate heart blood. Green-black indicates convulsive wind abdominal pain or twitching/crying; use Wuyi Yigong San plus Muxiang, Chaihu, Gouteng Hook to tonify spleen and liver. Green-black indicates heart/abdominal pain caused by cold water invading the heart; use Yi Huang San. Slight yellow indicates fright gan; use Anshen Wan. Left cheek: Green or mixed red indicates liver channel wind-heat, stiff neck, dizziness, eye twitching; use Chaihu Qinggan San. Slight red with sudden fever and grinding teeth indicates deficiency heat; use Dihuang Wan. Green-black indicates liver restricting spleen causing convulsions and abdominal pain; use Liu Junzi plus Jiang (Ginger) and Gui (Cinnamon). Slight red indicates tidal fever, blood deficiency, heart irritability; first use Mizhi Anshen Wan, then Dihuang Wan. Right cheek: Red indicates wind pathogen, coarse breathing, cough, fever with drinking water indicating excess heat; use Xie Bai San. If gas choking, shortness of breath, white lips indicate deficiency heat; use Wuyi Yigong San. If transmitted from spleen heat, use Qingwei San. If punished by heart fire, use Renshen Pingfei San. Pale red indicates tidal fever, heart irritability, or hard constipation; use *Xuanming* Chaihu Yinzi to guide out; if tidal fever persists, use Gouteng Yin to clear liver. Green-white indicates cough and nausea; first use Xingxing San to release exterior pathogen and strengthen spleen earth, then Liujunzi Tang to regulate middle qi. Green-black indicates convulsive wind abdominal pain, intestines curling inward; use Liujunzi and Gouteng Hook to calm liver and tonify spleen. Nose: Slight yellow is normal. Red indicates spleen/stomach excess heat, body heat, drinking water, normal milk/food intake; use Xie Huang San to clear heat and regulate spleen. Slight red indicates spleen channel deficiency heat, cool body, desire for hot drinks, poor appetite; use Wuyi Yigong San to tonify middle and strengthen spleen. Deep yellow indicates urinary retention, dry nose, coarse breathing, epistaxis, spleen heat transmitting to lung/kidney; first use *Jisheng* Xijiao Dihuang Tang, then Dihuang Wan. Pale white indicates spleen deficiency diarrhea, undigested food; use Liujunzi Tang to regulate middle qi. Green indicates spleen earth deficiency cold, overcome by liver wood; use Wuyi Yigong San plus Muxiang, Paojiang (Baked Ginger) to warm middle and calm liver. Black is a death sign. Chin: Red indicates qi stagnation and heat binding in kidney/bladder, urinary retention; use Wuling San to separate and drain. Tip of nose slight yellow combined with slight red on right cheek indicates spleen/lung dry-heat unable to generate kidney water; use Huangqin Qingfei Yin. Bladder yin deficiency with no yang to generate; use Zishen Wan. If chin slight red indicates bladder yang deficiency with no yin to transform; use Liuwei Dihuang Wan. If lower abdomen fullness or scrotal swelling indicates yin deficiency with damp-heat stagnation; use Liuwei Wan plus Cheqian, Niuxi. Spleen/lung qi deficiency unable to regulate water passages also uses the previous medicines. Red urine persisting to hematuria also indicates liver/kidney qi deficiency with heat; use Liuwei Dihuang Wan. If ineffective, use Buzhong Yiqi Tang to benefit spleen/lung and generate liver/kidney. If white fluid exits after urination or pain in the penis indicates liver channel damp-heat; first use Longdan Xiegan Tang, then Liuwei Dihuang Wan. Yintang: Green-black indicates abdominal pain and night crying due to spleen qi deficiency cold. Spleen is supreme yin, hence abdominal pain and crying at night; use Gouteng Yin. Pale white indicates diarrhea and undigested milk/food due to spleen qi weakness; use Wuyi Yigong San plus Muxiang. Renzhong: Yellow indicates milk injury and stomach reversal. Green indicates diarrhea of undigested milk/food, sour belching, spleen deficiency stagnation; first use Da'an Wan to digest food, then Yigong San to strengthen spleen. Black indicates roundworm biting pain. Lips: White indicates spitting saliva, vomiting/reversal, or hematemesis/melena due to spleen qi deficiency unable to control saliva and blood; urgently use Liujunzi Tang. Red, dry, wrinkled indicates spleen channel heat/thirst, constipation, irritability, insomnia; first use Qingwei San to treat heat, then Sijunzi, Huanglian, Zhizi to regulate spleen. Yellow indicates food accumulation diarrhea, undigested food; use Liujunzi Tang to strengthen spleen. Red mixed with white indicates epistaxis due to spleen/lung deficiency heat unable to control blood; use *Shengji* Xijiao Dihuang Tang to clear heat and nourish blood, use Sijunzi Tang to tonify spleen qi. If ineffective long-term, use Maimendong San or Renshen Anwei San. Corner of mouth: Yellow indicates spleen channel heat accumulation; use Qingwei San. Chronic disease use Siwei Fei'er Wan to treat gan heat. Lip/mouth twitching indicates fright heat unrest; use Yigong San plus Zhizi, Gouteng Hook to tonify spleen and calm liver. Saliva flow with purple lips indicates spleen qi deficiency cold; use Yigong San plus Paojiang, Muxiang. Abdominal pain with saliva spitting indicates worm pain; first use Wuyi San, then Tiaozhong Wan. No saliva spitting indicates accumulation pain; use Yigong San. Cold limbs use Lizhong Tang plus Wumei to warm and tonify middle qi, pain stops spontaneously. Pain stopping after vomiting or defecation: first use Xiaji Wan, then Yigong San. White indicates death from blood loss. Green indicates death from convulsive wind. Black around mouth is incurable. Behind ear slight red indicates Shaoyang channel wind-heat; use Chaihu Yinzi to clear liver and generate blood. Slight yellow indicates fright palpitations and teeth grinding during sleep; use Sijunzi plus Xiong (Chuanxiong), Gui (Danggui), Shengma to regulate spleen qi. Dry ears indicate bone gan steaming heat, thirst, night sweats; use Dihuang Wan. If white fluid exits after urination or glans itching/pain indicates liver channel damp-heat; first use Longdan Xiegan Tang, then Liuwei Dihuang Wan. If innate kidney qi is insufficient, or early sexual activity causes dysuria or painful urination like strangury, urgently use Dihuang Wan and Buzhong Yiqi Tang to nourish the source of transformation. If pain pulls after urination/defecation, deficiency is even greater; use previous pill plus Niuxi, Cheqian, Rougui. If cold limbs or aversion to cold/poor appetite indicates yang qi deficiency cold; urgently add Fuzi, likely to survive. Generally, this is mostly due to innate uneven viscera qi, or irregular milk/food in cold/heat, or pregnancy, nursing mother, diet, daily life, six excesses, and seven emotions. If initial disease yuan qi is not depleted, milk/food normal, fever/high fever, constipation of both bowels, thirst for drinking water, sleeping with eyes not fully exposed, all belong to form and disease both excess; treat the pathogenic qi. If disease is long-term and yuan qi is depleted, poor appetite, fever, dry mouth desiring hot drinks, vomiting/diarrhea, limb aversion to cold with eyes exposed, all belong to form and disease both deficiency; tonify the righteous qi. Furthermore, examine the excess/deficiency of fetal qi and the overcoming relationship of viscera to treat accordingly, thus avoiding errors.
[Qian Yi] Signs within the eyes: Red indicates heart heat; treat with Dao Chi San. Pale red indicates heart deficiency heat; treat with Shengxi San. Green indicates liver heat; treat with Xie Qing Wan. Pale/light indicates deficiency; tonify it. Yellow indicates spleen heat; treat with Xie Huang San. Lack of luster indicates kidney deficiency; treat with Dihuang Wan. If face and eyes are swollen, it indicates chronic cough due to spleen affected by gan accumulation.
If an infant's lips are white, it indicates spitting saliva, vomiting/reversal, hematemesis, or melena. Red lips indicate thirst, drinking, irritability; if lips are red after prolonged thirst and diarrhea, it is a deficiency syndrome; do not use cooling medicines. Yellow lips indicate spleen swelling after accumulation. Purple lips/mouth with spitting saliva indicate worm pain. No spitting saliva indicates accumulation pain. Lips yellow like orange around the edges indicate bad breath due to spleen heat accumulation. Green lips indicate blood deficiency and spleen cold, attacked by cold. Since lips govern spleen earth, wood overcoming earth indicates spleen weakness and inability to eat.
Dry tongue, white tongue, rough tongue, coated tongue, yellow tongue, red/swollen tongue in infants all indicate constipation, or if loose, the color must be scorched yellow. Tongue cracks, prickles on tongue, bleeding from tongue all indicate extreme heat and yang toxin. Sores on the tongue indicate heart-spleen heat. Rolled tongue indicates fright. Chronic diarrhea with black tongue must be moist; do not consider it heat, as chronic disease causes upper jiao deficiency heat. Chronic dysentery with black tongue indicates death.