凡孩子三岁以下，呼为纯阳，元气未散，若有脉候，即须于一寸取之，不得同大人分寸
。其脉候未来，呼之脉来三至，吸之脉来三至，呼吸定息一至，此为无患矣。所言定息，呼
气未出，吸气未入，定息之中又至，此是和平也。若以大人脉五至取之，即差矣。如此七至以上
，即为有气，或脉浮如弓之张弦，此为有风，并可根据后方合药治之。或七至以下，此为冷候
，亦宜根据后方合药疗之。或诊候取平，或忽而不见，沉浮不定，伏益根平者，此为神鬼之病，
且合求祟，续宜使药或桃柳枝汤浴，煎饮子为使，一两颗桃心。
孩子脉呼吸十五至以上，三至以下，皆死矣。
初生小儿，鹅口撮噤，并是出胎，客风着颅脐致有此，可以小艾灸三壮及烙之愈。
初生小儿，至夜啼者，是有瘀血腹痛，夜乘阴而痛则啼。
初生小儿，一月内乳利如胶，是母寒气伤胃所致也。
初生小儿，一月内乳利如血，是母胸有滞热所作也。
初生小儿，一月内两眼赤者，是在胎之时，母吃炙 热面，壅滞气入胎中，熏儿脑所致也。
小儿温热，皆因从气热而搏胃气使然，下之气平即愈。气虚则生惊而变痫。
小儿惊痫，一从虚邪客气相搏而生其候，当用补养安和即愈。加以性冷及太过即死。
小儿哕逆吐，皆胃气虚，逆气客于脏气而作，当和胃养气。如至下冷极，即小儿霍乱吐
逆，皆胃气与阴阳气上下交争而作，当用安和补药，调养即愈。
小儿客忤、无辜，皆因客入所触，及暴露星月，小儿嫩弱，所以此候多恶。
小儿一 眼青揉痒是肝疳。二 齿焦是骨疳。三 肉色鼻中干是肺疳。四 皮干肉裂
是筋疳。五 发焦黄是血疳。六 舌上生疮是心疳。七 爱吃泥土是脾疳。孩子肌骨肥实，
皮肤白，无故烦渴，此自小奶猛冲损肺，但根据后方内用甘草人参合饮子。若气急甚，胸胀起
，鼻连眼下睑青色，呻吟之声者，此必死之兆，不得与药。
孩子痢如疳靛者，难效。痢如鹅鸭血者，脾已烂损，不宜与药。
孩子凡有诸色疾苦，但睑下垂牵，必定死矣。
孩子疟皆难效，或发无时，即口噤切牙作声，此必死矣。呼为历瘠疳疟，亦名为锁肠疳。
孩子无故摇头，此为脑顶风。
孩子渴吃乳食，夜啼作声，此即是腹肚痛。
孩子吃乳皆出，此是脾冷。
孩子无故肚大项细，四肢消瘦，筋脉骨节弛缓，是小来少乳，嚼食与吃，早成骨热疳劳
，先宜与保童丸吃，续与柴胡鳖甲饮子。（保童丸方见一切疳门中，柴胡饮子方见行迟门中。）
孩子头面胸膊肌浓，臂胫细瘦，行走迟者，是小时抱损。
孩子鼻流清涕，或鼻下赤痒，此是脑中鼻中疳极，宜用后方，青黛散吹鼻，兼敷下赤烂
处。（方见疳疾吹鼻门中。）
已前并诊候孩子疾状，孩子气脉未调，脏腑脆薄，腠理开疏，看脉以时，根据方用药。
孩子或夏中热时，因乳母沐浴多使冷水，奶得冷气，血脉皆伏，见孩子气未定便与奶，
使孩子胃毒，及赤白两般恶痢，此乃是奶母之过。凡浴后可令定息良久，候气定揉与之，即全无患。
师巫烧钱，乳母须预祝之，勿令着水喷儿，皆令惊热入心，转成患害，切宜慎之。
凡孩子自生，但任阴阳推移。即每六十日一度变蒸，此骨节长来四肢发热，或不下食乳
，遇如此之时，上唇有珠之如粟粒大，此呼为变蒸珠子，以后方退热饮子疗之，不宜别与方
药。《幼幼新书》注云∶《颅囟经》以六十日为一变，巢氏《病源》以三十二日为一变，说
有不同，故兼存之。
凡是三岁以下的小孩，被称为“纯阳”，元气尚未消散。如果有脉象可诊，应当在寸口部位取脉，不能像成人那样运用分寸法来定位。
如果脉象尚未显现（指脉搏频率极慢），称为“脉来三至”（一呼一吸间脉搏跳动三次），吸气时脉搏也跳动三次，呼吸平稳间歇时再跳动一次，这表示没有病患。所谓“定息”，是指呼气未出、吸气未入的停顿瞬间，此时脉搏又跳动一次，这是平和健康的脉象。如果用成人脉象“五至”的标准来衡量，那就错了。
如果脉搏达到七次以上，说明体内有热气；或者脉象浮起，像弓弦张开一样紧绷，这是受了风邪，可以根据后方的方剂配合药物进行治疗。如果脉搏在七次以下，这是寒证，也应当根据后方的方剂配合药物治疗。如果脉象平和不偏不倚，或者突然摸不到，沉浮不定，伏于深处且根基平缓的，这是鬼神作祟引起的疾病，暂时需要祈求驱除邪祟，随后适宜使用药物或桃柳枝汤洗浴，煎煮饮子作为辅助治疗，其中包含一两颗桃仁心。
小孩脉搏在一呼一吸间跳动十五次以上，或者三次以下，都是死症。
刚出生的婴儿，出现鹅口疮（口腔黏膜白色斑块）、撮口（口唇紧缩）、噤风（牙关紧闭），都是因为出生时受到客风侵袭头部和脐部所致，可以用小艾炷灸三壮并烙烫患处即可痊愈。
刚出生的婴儿，到了夜晚啼哭不止，是因为有瘀血导致腹痛，夜间阴气盛而疼痛加剧所以啼哭。
刚出生的婴儿，一个月内吃奶后大便像胶一样黏稠，是母亲寒气损伤了婴儿胃部所致。
刚出生的婴儿，一个月内吃奶后大便带血，是母亲胸部有郁热传导给婴儿所致。
刚出生的婴儿，一个月内双眼发红，是因为在母体胎儿时期，母亲吃了炙烤过的燥热面食，壅滞之气进入胎中，熏蒸婴儿脑部所致。
小儿温热病，都是因为感受热气并与胃气相搏结造成的，下部气机平复就会痊愈。如果气虚则会产生惊悸并转变为痫证。
小儿惊痫，一种情况是由于虚邪与客气相互搏结而产生症状，应当使用补养安和的方法治疗即可痊愈。如果加上体质偏冷或者治疗过度，就会导致死亡。
小儿呃逆呕吐，都是因为胃气虚弱，逆气客居于脏气之中而产生，应当调和胃气、养护正气。如果发展到下焦寒冷至极，就会变成小儿霍乱吐逆，这都是胃气与阴阳之气上下交争所致，应当使用安和补益的药物，调养后即可痊愈。
小儿客忤（因惊吓或外邪入侵导致的病症）、无辜疳（一种慢性消耗性疾病），都是因为外来邪气侵入所触碰到的地方，以及暴露在星月之下，小儿身体嫩弱，所以这些症状大多凶险。
小儿眼部症状：一眼发青且揉搓瘙痒的是肝疳；牙齿焦黑的是骨疳；肌肉颜色异常且鼻中干燥的是肺疳；皮肤干燥肌肉开裂的是筋疳；头发焦黄的是血疳；舌头上生疮的是心疳；爱吃泥土的是脾疳。如果孩子肌肉骨骼肥实，皮肤白皙，却无故烦躁口渴，这是因为从小喝奶太猛冲损了肺气，只可根据后方内服甘草人参合煎的饮子。如果气急严重，胸腹胀满隆起，鼻子及眼下眼睑发青，发出呻吟声的，这是必死的征兆，不得给药。
孩子痢疾如果像靛蓝染料的颜色，难以见效。痢疾如果像鹅鸭血的颜色，说明脾脏已经腐烂损坏，不宜给药。
孩子凡是有各种颜色的疾苦，只要眼睑下垂牵引，必定死亡。
孩子患疟疾都难治愈，如果发作没有定时，并且口噤切牙发出声音，这必定死亡。这种病称为历瘠疳疟，也称为锁肠疳。
孩子渴欲吃乳食，夜间啼哭有声，这就是腹部疼痛。
孩子无故肚子大脖子细，四肢消瘦，筋脉骨节松弛无力，是因为小时候母乳不足，过早咀嚼喂食固体食物，早成骨热疳劳，先适宜服用保童丸，随后服用柴胡鳖甲饮子。（保童丸方见一切疳门中，柴胡饮子方见行迟门中。）
孩子头面胸背肌肉丰厚，手臂小腿细瘦，行走迟缓的，是因为小时候被抱持不当造成损伤。
孩子流清鼻涕，或者鼻下赤痒，这是脑中及鼻中疳疾极重，适宜用后方，将青黛散吹入鼻腔，兼敷在下部赤烂处。（方见疳疾吹鼻门中。）
以上都是诊断孩子的疾病状况。孩子的气脉尚未调顺，脏腑脆薄，腠理开疏，看脉要按时令，根据方剂用药。
孩子在夏季中暑热时，因为乳母多次用冷水沐浴，乳汁沾染了冷气，血脉皆潜伏，看到孩子气息未定就喂奶，使孩子胃中毒，以及赤白两种恶痢，这乃是乳母的过错。凡是沐浴后可让孩子安静休息很久，等气息平稳后再揉捏乳房喂奶，就完全没有祸患。
师巫烧钱祭祀时，乳母必须预先祈祷，不要让水喷到孩子身上，都会让惊热入心，转而成为祸害，务必谨慎。
凡是孩子自出生起，任由阴阳推移变化。每六十天会有一次“变蒸”（婴幼儿生长发育过程中的生理现象），这时骨节生长，四肢发热，或者不吃奶，遇到这样的时刻，上唇会有如粟粒大小的珠子，这称为变蒸珠子，以后方的退热饮子治疗，不宜另外给予方药。《幼幼新书》注释说：《颅囟经》以六十天为一变，巢元方《诸病源候论》以三十二天为一变，说法不同，所以兼存这两种说法。
For children under three years old, they are referred to as "Pure Yang" (Chunyang), meaning their primordial Qi (Yuanqi) has not yet dissipated. If a pulse can be palpated, it should be taken at the Cun position (the distal end of the radial artery), and one must not use the proportional measurement method used for adults.
If the pulse is not yet manifest (referring to an extremely slow rate), it is called "three beats per cycle" (San Zhi), where the pulse beats three times during one respiration cycle. Specifically, it beats three times during exhalation and three times during inhalation, and beats once more during the pause between breaths (Dingxi). This indicates a state without disease. The term "Dingxi" refers to the moment when exhalation has ended and inhalation has not yet begun; if the pulse beats once during this pause, it signifies a harmonious and healthy state. Using the adult standard of "five beats per cycle" would be incorrect here.
If the pulse reaches seven beats or more per cycle, it indicates internal heat. Or, if the pulse is floating and taut like a drawn bowstring, this indicates Wind pathogen invasion. Treatment should follow the formulas provided later. If the pulse is fewer than seven beats per cycle, this indicates a Cold syndrome, which should also be treated according to the subsequent formulas. If the pulse is balanced and neither floating nor sinking, or if it suddenly becomes imperceptible, fluctuating between deep and superficial levels, or hidden deeply with a flat root, this is considered a disease caused by spirits or evil influences. One should temporarily seek to dispel the malevolent influence, and subsequently, it is appropriate to use herbal medicine or a bath of Peach and Willow branch decoction, along with a decoction drink containing two peach kernel hearts.
If a child's pulse beats fifteen times or more per respiration cycle, or fewer than three times, both are signs of death.
Newborn infants presenting with Goose-mouth sore (Ekou, white patches in the mouth), Grasping-jaw (Cuo Jing, tight lips), and Lockjaw (Jin Feng, trismus) are caused by external Wind pathogens attacking the head and umbilicus at birth. These can be cured by moxibustion with small cones (three burns) and cauterization.
Newborn infants who cry incessantly at night do so due to abdominal pain caused by blood stasis; the pain intensifies at night when Yin energy is dominant.
Newborn infants whose stool resembles glue within the first month after birth have suffered stomach injury from maternal Cold.
Newborn infants whose stool contains blood within the first month are affected by stagnant Heat in the mother's chest transmitted to the infant.
Newborn infants with red eyes within the first month were exposed in utero to stagnating Qi from the mother consuming roasted, hot wheat noodles, which steamed and affected the infant's brain.
Pediatric febrile diseases result from the interaction of Heat Qi with Stomach Qi; recovery occurs when the Qi in the lower body calms down. If Qi is deficient, it leads to fright and transforms into Epilepsy (Xian).
Pediatric fright and epilepsy arise from the conflict between deficient pathogens and external guest pathogens. Recovery is achieved through tonification, nourishment, and harmonizing methods. However, if combined with a cold constitution or excessive treatment, it leads to death.
Infant hiccups and vomiting stem from Stomach Qi deficiency, where rebellious Qi invades the Zang organs. Treatment requires harmonizing the Stomach and nurturing Qi. If it progresses to extreme cold in the lower body, it becomes Infant Huoluan (cholera-like vomiting and diarrhea), caused by the struggle between Stomach Qi and Yin-Yang Qi. Anharmonizing and tonifying medicines should be used for recovery.
Infant Ke Wu (fright from external intrusion) and Wugu Gan (a chronic wasting disease) occur due to exposure to external pathogens and exposure to starlight/moonlight. Because infants are tender and weak, these conditions are often severe.
Symptoms of pediatric Gan (malnutrition/wasting syndrome): Greenish eyes with itching/rubbing indicate Liver Gan; scorched teeth indicate Bone Gan; abnormal muscle color with dry nose indicates Lung Gan; dry skin with cracked flesh indicates Sinew Gan; scorched yellow hair indicates Blood Gan; ulcers on the tongue indicate Heart Gan; craving dirt indicates Spleen Gan. If a child has solid muscles and bones, white skin, but suffers from unexplained irritability and thirst, it is due to lung damage from forceful breastfeeding in infancy. Treat with Gancao (Licorice) and Renshen (Ginseng) decoction. If there is severe shortness of breath, chest distension, blueness around the nose and lower eyelids, and groaning, it is a sign of inevitable death, and no medicine should be given.
Dysentery resembling indigo dye is difficult to treat. Dysentery resembling goose or duck blood indicates rotting of the Spleen, and medicine is contraindicated.
Any pediatric disease accompanied by drooping and pulling of the eyelids indicates certain death.
Malaria in children is difficult to cure. If attacks are irregular and accompanied by lockjaw, teeth grinding, and sounds, it is fatal. This is called Liji Gan Malaria or Suochang Gan.
Unexplained head shaking in children indicates Wind attacking the top of the brain.
Thirst, desire for milk/food, and nocturnal crying indicate abdominal pain.
Vomiting all milk indicates Cold Spleen.
Enlarged abdomen with a thin neck, emaciated limbs, and lax sinews/bones/joints indicate insufficient breastfeeding in early life and premature introduction of solid foods, leading to early onset of Bone Heat Gan Lao (consumption). Initially, give Baotong Wan, followed by Chaihu Biejia Yinzi. (See Baotong Wan formula in the General Gan section, and Chaihu Yinzi formula in the Delayed Walking section.)
Thick flesh on the head, face, chest, and back, with thin arms and legs and delayed walking indicates improper holding during infancy.
Clear nasal discharge or redness/itching below the nose indicates severe Gan in the brain and nasal cavity. Use Qingdai San (Indigo Powder) insufflated into the nose and applied to the red/ulcerated areas below. (See formula in the Gan Disease Nasal Insufflation section.)
The above describes diagnosing pediatric conditions. Children's Qi and pulses are unregulated, their Zang-Fu organs are fragile, and their Couli (pores) are open. Pulse diagnosis must consider seasonal timing, and treatment follows specific formulas.
During summer heat, if the lactating mother frequently bathes in cold water, her milk absorbs Cold Qi, causing blood vessels to contract. Feeding the infant before their Qi stabilizes poisons the Stomach, leading to dysentery (red and white types). This is the mother's fault. After bathing, allow the infant to rest until Qi stabilizes, then massage the breast before feeding to prevent harm.
When shamans burn money for rituals, the lactating mother must pray beforehand and ensure no water is sprayed on the infant, as this allows Fright-Heat to enter the Heart and cause harm. Caution is essential.
From birth, children undergo natural Yin-Yang transformations. Every sixty days, they experience "Bian Zheng" (growth spurts involving bone development and limb fever), during which they may refuse milk. At such times, pearl-like bumps appear on the upper lip, called Bian Zheng Zhu Zi. Treat with the subsequent Releasing Heat Decoction; do not use other medicines. *Youyou Xinshu* notes: *Luxin Jing* states 60 days per cycle, while Chao Yuanfang's *Zhubing Yuanhou Lun* states 32 days per cycle. Both views are preserved due to discrepancy.