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General Judgment on the Spirit and Complexion of Children:
Whenever a child is ill, one should first observe their physical form, symptoms, and spirit/complexion, and then palpate the pulse. For instance, when the Liver is diseased, the face appears green; when the Heart is diseased, the face appears red; when the Spleen is diseased, the face appears yellow; when the Lung is diseased, the face appears white; when the Kidney is diseased, the face appears black. One must first distinguish the physical signs and symptoms of the Five Zang Organs, and then examine the constitution's abundance or deficiency, and the excess or deficiency of fetal Qi. Once the root and branch of the disease are understood, treatment can be applied without failure.

Song for Initial Examination:
Observe the form and color to discern the cause; Yin deficiency or Yang excess leads to stiffness or flaccidity.
If it is Shanghan (Cold Damage), both feet will be cold; know that internal heat is found by examining the abdomen.
A cold nose indicates Chuangzhen (exanthematous diseases like smallpox or measles); cold ears indicate Wind-Heat syndrome.
Whole-body heat indicates Shanghan; upper body heat with lower body cold indicates Food Injury.
Coldness at the tips of the five fingers indicates severe Jingfeng (Convulsive Disorder) that is hard to withstand.
If the middle finger is hot, it is definitely Shanghan.
If only the middle finger is cold, it indicates Ma Dou (Measles and Smallpox).
For females, check the right hand; for males, the left hand; observe clearly and carefully.

Observing the Five Colors of the Face:
Red face indicates Wind-Heat; green face details Jingfeng.
The forms of Heart and Liver pathologies appear here; differentiate Warmth and Cold via pulse and symptoms.
Spleen deficiency, Huang Ganji (Yellow Malnutrition Accumulation), and deficiency-cold result in a pale complexion.
If black Qi emerges, Kidney essence fails and life is lost.

Observing Form and Color of the Face:
The chin belongs to Kidney Water, corresponding to the North; the left cheek belongs to Liver Wood, corresponding to the East; the forehead belongs to Heart Fire, corresponding to the South; the tip of the nose belongs to Spleen Earth, corresponding to the Center; the right cheek belongs to Lung Metal, corresponding to the West.
For children under three years old with illness, one must examine the Three Passages (San Guan) of the pulse pattern on the Tiger's Mouth (web between thumb and index finger), depending on gender (left for boys, right for girls). Viewing from the side of the second finger, the first segment is named Feng Guan (Wind Passage), the second segment Qi Guan (Qi Passage), and the third segment Ming Guan (Life Passage). Differentiate the color of the vein pattern: purple indicates Heat, red indicates Cold, green indicates Jingfeng, white indicates Ganbing (Malnutrition Disease), black indicates Zhong'e (sudden evil invasion), and yellow indicates Spleen distress. If the pattern appears in the Feng Guan, it is mild; in the Qi Guan, it is severe; if it extends beyond the Ming Guan, it is difficult to treat.

Song Governing Diseases by the Three Passages' Vein Patterns:
Purple, black, and red indicate Shanghan; green indicates Jingfeng; white indicates Ganbing.
Black indicates Zhong'e; yellow indicates Spleen distress.
Furthermore:
Green patterns, large or curved, indicate human-caused fright and four-limb convulsions.
Red patterns, large or curved, indicate fright from water, fire, flying birds, or beasts.
Purple patterns, large or curved, indicate injury from rice, flour, fish, or meat.
Black patterns, large or curved, indicate Spleen-Wind with slight convulsions.

Eight Sections of Brocade for Finger Vein Patterns:
Fish-spine shape indicates Jingfeng and Phlegm-Heat.
Hanging needle shape indicates Wind-Injury, diarrhea, and accumulated Heat.
Water character shape indicates Jing-Gan, Food Accumulation, and cough.
Yi character shape indicates Liver-Wind Jingfeng.
Worm shape indicates Liver parasites and intestinal filth accumulation.
Ring shape indicates Ganji vomiting and regurgitation.
Chaotic lines indicate parasites.
Pearl shape indicates death.

Diagram of the Three Passages' Vein Patterns on the Tiger's Mouth:
The first segment of the Feng Guan corresponds to the Yin position; the second segment of the Qi Guan corresponds to the Mao position; the third segment of the Ming Guan corresponds to the Chen position; this is located at the web of the Tiger's Mouth.
For children over three years old, use one finger to palpate the Cun, Guan, and Chi positions on all three pulses. The normal rate is typically six to seven beats per breath cycle. An increased rate indicates Heat; a decreased rate indicates Cold. Floating and surging pulses indicate abundant Wind; rapid pulses indicate frequent Jingfeng. Deep and slow pulses indicate Deficiency; deep and solid pulses indicate Accumulation.

General Song on Pediatric Pulse Diagnosis:
Pediatric illness requires pulse diagnosis; determine the breath count across the Three Passages with one finger.
Slow pulses indicate Cold, rapid pulses indicate Heat, as passed down through ages; floating pulses indicate Wind, deep pulses indicate Accumulation—these must be recognized first.
The Renying pulse on the left hand governs external syndromes; the Qikou pulse on the right hand governs internal diseases.
External signs stem from Wind, Cold, Summer-Heat, and Dampness invasion; internal signs stem from milk/food retention and Phlegm-Accumulation.
Surging and tight pulses without sweat indicate Shanghan; floating and relaxed pulses with sweat indicate Wind-Injury.
Floating and surging pulses often indicate abundant Wind-Heat; deep and fine pulses originate from milk/food accumulation.
Deep and tight pulses indicate unceasing abdominal pain; wiry and tight pulses indicate throat congestion and shortness of breath.
Tight and hurried pulses indicate the emergence of rashes/measles; tight and rapid pulses indicate the arrival of Jingfeng.
Deficient and soft pulses indicate Slow Jingfeng with convulsions; tight and solid pulses indicate Wind-Epilepsy with spasms.
Soft and fine pulses indicate Gan parasites; firm and solid pulses indicate constipation.
Kou pulse indicates blood in stool or urine; deficient and soggy pulses indicate Qi deficiency combined with fright and palpitations.
Slippery pulses indicate injury from dew, dampness, and cold; wiry and urgent pulses indicate Ke Wu (sudden fright or alien qi)—remember this well.
Unequal pulse sizes indicate ominous prognoses; two beats indicate critical condition, three beats indicate sudden death.
Five beats indicate Deficiency, four beats indicate damage, six beats indicate peace and health.
Seven to eight beats indicate mild illness; nine to ten beats indicate extreme Heat.
Eleven to twelve beats indicate certain death; this secret formula never fails.

Song on Death Signs in Children:
Red veins crossing the pupil in the eyes, fontanelle swelling yet sinking into a pit.
Black nails, dry nose, sudden crow-like voice, and blue veins on the belly.
Flaccid tongue receding, anus tightening, teeth grinding, eyes staring straight without moving.
Fish-mouth breath, urgency, inability to cry, expulsion of roundworms confirms true death form.
Throwing limbs and shaking beyond normal limits of fright; even divine pills save none out of ten.
Fish-eye fixed gaze leads to death at night; green face and black lips lead to death during the day.
Crying without wailing indicates pain; wailing without crying indicates fright.
Restless tossing indicates vexation; restless agitation indicates dryness.