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Children over one year of age can have their pulse examined. A pulse rate of six beats per respiration is considered normal (Pinghe); seven to eight beats indicates Excess Heat (Shire); three to four beats is a Slow pulse (Chi), indicating Deficiency and Weakness.

The poem *Xijiang Yue* states:
In children, the usual pulse condition is six beats per respiration for normalcy; seven to eight beats indicate excessive heat; three or four beats signify the onset of deficiency-cold disease. If the pulse beats ninety times rapidly followed by an irregular "sparrow pecking" (Quezhuo) pattern, or if it beats only one or two times with a deep and severe quality under the fingers, these are critical signs. Whether the pulse is Fine (Wei), Deficient (Xu), Tight (Jin), or Rapid (Shu), there should be no error in differentiation; the methods of Tonification (Bu) and Purging (Xie) must be clearly distinguished when prescribing medication.

If the body is hot and the pulse is Floating (Fu), sweating therapy may be used; if the body is cold and the pulse is Fine (Xi), do not use attacking methods. If there is wheezing and coughing with a Tight and Rapid pulse, medicinal efficacy will be poor; if there is abdominal distension and swelling with a Fine and minute pulse, it is a cause for concern. Diarrhea and dysentery with a Deep (Chen) and Slow (Chi) pulse are easy to cure; exanthems appearing with a Surging (Hong) and Rapid (Shu) pulse should be treated by following the pathogen's trend. If vomiting and twisting occur with fear of a Floating and Surging pulse, or if abdominal pain presents with a Deep and Minute pulse, caution is required in handling.

If the child's shins are hot, cheeks are red, restlessness and thirst persist, the head and face prefer exposure, arms are thrown about and legs kicked, stool is constipated, urine is yellow, and high fever does not recede, this situation is suitable for Cooling and Resolving (Liangjie). Hot and tonifying medicines must not be administered.

If the child's shins are cold, complexion is pale and lusterless, vomiting and diarrhea persist, abdomen hurts, the body often leans against people, eyes show bluish veins, breath from the mouth is cold, tidal fever comes and goes irregularly, this situation is suitable for Warming and Tonifying (Wenbu). Cold and purgative medicines must not be administered.

The poem *Xijiang Yue* states:
Children should not take hot medicines. If both cheeks are flushed crimson, hands and feet feel like fire baking, the six pulses are Floating, Surging, and chaotic, urine is dark yellow and difficult to pass, stool is constipated and hard to expel, the child throws off clothes, drinks water, prefers facing the wind, suffers from restlessness and thirst, and even has nosebleeds, this indicates heat.

Children should not take cold medicines. If the facial skin is pale and spiritless, limbs are cold as ice, the six pulses are Floating, Minute, and faint, milk is not digested leading to vomiting, feces resemble duck droppings and are frequent, spirit is deficient with abdominal pain, eyes show bluish veins, and prolonged illness leads to various symptoms of Infantile Malnutrition (Gan), this indicates cold/deficiency.

Children are of a Pure Yang constitution (Chunyang zhi ti); Yin and Yang (Yinyang) must not be injured excessively. Keeping them slightly hungry and cool facilitates easier care. Generally, the Spleen (Pi) is often insufficient, while Liver Qi (Ganqi) may be excessive and needs prevention. Medicines that are neither too cold nor too hot are best; one must strictly avoid reckless and careless actions.

Why is pediatric treatment difficult? It has been called the "Mute Department" (Ya Ke) since ancient times because the pulse is hard to assess and the child cannot speak of the illness. Parents are constantly alarmed, and doctors have much experience in trial and diagnosis. By calmly prescribing formulas according to symptoms, what is truly difficult to grasp?

For children under one year old who fall ill, it is mostly due to Fetal Toxin (Taidu), and detoxification is indicated. In critical situations, careful differentiation is needed. For children over two years old who fall ill, it is mostly due to Food Stagnation (Shiji), and resolving stagnation and tonifying the Spleen are indicated. Details on the principles of treating other conditions are recorded in their respective sections, so they are not repeated here.