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It is said that trees have roots, and water has a source. When the root is vigorous, branches and leaves flourish; when the source is deep, the flow must be long. Children are born and grow from the primordial Qi (vital energy) inherited from their parents. When primordial Qi is abundant, muscles and skin are full, and conditions such as convulsion (spasms), malnutrition (Gan syndrome), accumulation (food stagnation), and heat cannot arise. Even if affected by wind, cold, summer-heat, or dampness, they recover quickly after slight illness. If primordial Qi is deficient, the constitution is weak, various syndromes easily arise, mild ailments can be treated with medicine, but severe ones are rarely curable. Therefore, after examination, if a child cannot speak, cannot walk, holds fists tightly without extending them, or does not grow hair, these cases are still treatable. Severe cases include umbilical tetanus (umbilical wind with mouth contraction), intestinal torsion, locked abdomen, double tongue with loss of voice, scorched tongue, and whole-body cyanosis/blackening. Such symptoms require urgent treatment, otherwise almost none will survive. For other diverse diseases, the method of treatment should involve observing form, inspecting complexion, listening to sounds, and palpating the pulse. Observing form begins with the eyes: if both eyes lack luster, the black pupils do not move, and eyelashes lack sharpness, resembling fish eyes, cat eyes, or rat-like vision, this indicates pathogenic shock entering the Liver. Red face and red eyes with nocturnal fright crying indicate shock entering the Heart. Cyanotic face, aversion to crying, biting milk, and grinding teeth indicate shock entering the Kidney. Pale white face, panting, and shortness of breath indicate shock entering the Lung. Yellow face, vomiting, anorexia, profuse spontaneous sweating, and excessive sleepiness indicate shock entering the Spleen. Treatment should follow each manifestation. Regarding listening to sound, fright cries during sleep that are floating/light are easy to treat; those that are deep and dull are difficult to cure; those sounding like a crow struck by an arrow are incurable. Regarding pulse palpation, deficiency presents as fine and slow, while excess presents as large and rapid. Next, examine the fingerprint: distinguish left for males and right for females. From the tiger's mouth inward, the first segment is the Wind Gate, the second is the Qi Gate, and the third is the Life Gate. At the Wind Gate, a red line indicates fright from birds or humans; a faint red line indicates fire fright; black indicates water fright combined with trauma; green indicates thunder fright from four-legged animals; hidden green lines slightly curved indicate acute wind; curved lines indicate food stagnation. At the Qi Gate, purple lines indicate fright-Gan; green lines indicate Gan transmitting to the Liver meridian; white indicates Gan transmitting to the Lung meridian; yellow indicates transmission to the Spleen meridian; black indicates difficulty in stabilization. At the Life Gate, if green-black lines appear across all three gates and slant toward the nail bed, it is incurable. Regarding the four syndromes of fright, Gan, accumulation, and heat: Fright manifests as vacuity, timidity, palpitations, qi deficiency, scattered spirit, and moving phlegm-saliva; diarrhea is necessarily green; accumulation gradually generates wind, presenting with cold, heat, deficiency, and excess patterns. Cold requires drying methods, deficiency requires warming, excess requires purging, and heat requires cooling; this is flexible treatment. For acute fright convulsions, open the passages and cut off wind, settle spasms and remove phlegm. If heat persists, purge downwards. After one purgation, immediately harmonize the Stomach and calm the Heart; do not overuse cold-cooling formulas. If there is oral bleeding, jumping feet, abdominal twitching, groping at clothes, coma, shortness of breath, inability to swallow medicine, failure to induce sneezing via nasal stimulation, heart pain, or sudden loud screaming, it is difficult to cure. For chronic fright convulsions, use herbs to generate Stomach Qi, combined with wind-cutting and spasm-settling agents; avoid being too drying. If limbs are cold, vomiting and diarrhea worsen with cough, complexion is dark and lips pale, stomach pain produces crow-like sounds, white sores appear in the mouth, hair stands erect with head shaking, panting with rattling phlegm, or deviation of mouth, eyes, hands, and feet on one side, it is difficult to cure. Chronic spleen fright saves one or two out of ten; focus on generating Stomach Qi and restoring Yang. If the Taichong pulse is present, moxa heavily at Baihui (GV20). If the body is cold with sticky sweat, lying straight like a corpse, panting/coughing with soft head, incontinence of urine and stool, ascending vacuous phlegm, coarse breathing, and floating-rapid pulse, this is Yin excess overpowering Yang. Mistaking this for restored Yang and using harsh phlegm-purging drugs causes phlegm to descend with Qi, leading to death due to medical error. This is a condition akin to a lamp about to go out; even without medication, there is no hope. If there is sawing-like phlegm sound in the throat, eyes closed for one to two days, this is vacuous phlegm; nourish Qi, but hasty phlegm removal is unsafe; Suhe Xiang Wan (Styrax Pill) or Bai Wan Zi (White Pills) may be given temporarily. (Men and women with this condition should also adhere to these two formulas. See later sections for original fright convulsion syndromes.) Epilepsy and Tian Diao (heavenly hook) are types of wind. General stiffness and falling with sweating but no aversion to cold, cold limbs, locked jaw, is called Soft Rigidity. No sweating, aversion to cold, opisthotonos, and teeth grinding is called Hard Rigidity. These are difficult to treat. There are eight types of epilepsy: Horse epilepsy involves opening mouth, shaking head, horse neighing, and body arching; Sheep epilepsy involves raising head and sticking out tongue; Dog epilepsy involves flexed hands and curled feet; Chicken epilepsy involves shaking head and body arching; (all belong to Yang). Pig epilepsy involves foaming at the mouth and staring with vibrating eyes; Ox epilepsy involves staring and abdominal distension; Crow epilepsy involves puckered lips/mouth and shaking limbs; Snake epilepsy involves soft body, raised head, sticking out tongue, and staring; (all belong to Yin). Treatment requires distinguishing cold/heat, smoothing Qi, regulating blood, resolving phlegm, and dispelling wind. Signs of incurability include immobile eyes, locked jaw, cyanotic/black lips and face, abdominal distension with refusal to nurse, fever with bloody stools, reversal with vomiting/diarrhea, unceasing high fever with sweating, limpness with insomnia, and white opacity in eyes. Tian Diao involves high fever, everted eyes, and limb spasms resembling a hooked fish, caused by the lactating mother having excessive heat-toxin, nursing promptly, and contracting wind-pathogens. Resolve wind-heat, and recovery will be swift. Some fright convulsion syndromes are incurable. Generally, powerless neck tendons, coarse fish-like breath, teeth grinding/biting, bloody stool, continuous limb spasms, half-open eyes, limpness with locked jaw, anorexia, wooden tongue with dryness, opisthotonos, fixed sunken fontanelle, silent crying, and profuse cold sweat are signs of poor prognosis. Chronic spleen fright unresponsive to moxibustion, fixed gaze, and red vessels in eyes are also incurable. Even if Lu Dan and Bian Que were reborn, they could do nothing. Regarding Gan syndrome: children under twenty are diagnosed with Gan; over twenty with Lao (consumption). Both involve Qi and blood exhaustion and organ damage. There are five Gan syndromes corresponding to Liver, Heart, Spleen, Lung, and Kidney; externally, there are Roundworm Gan, Spinal Gan, Brain Gan, Dry Gan, Gan Thirst, Gan Diarrhea, Gan Dysentery, Swelling, Gan Consumption, Innocent Gan, Ding Xi, and Bu Lu, each with specific formulas. Etiology often involves improper feeding, gastrointestinal stagnation, or abuse of emetic/purgative drugs leading to fluid depletion. Symptoms include tight shiny scalp, sparse scorched hair, retracted cheeks, dry nose, pale mouth/lips, dim/rotten eyes, nose rubbing/frowning, protruding spine, yellowish body, fighting nails/grinding teeth, scorched exhaustion with spontaneous sweating, white sour diarrhea, abdominal distension with borborygmus, masses with tidal fever. Skin sores, craving fruits/sour foods/charcoal/rice/clay, and polydipsia are also signs. Kidney Gan is most lethal because Kidney deficiency allows pathogenic heat to rush to the Upper Jiao, likened to a running horse. Initial halitosis progresses to black teeth, then rotting gums with bleeding, eventually tooth loss; urgent treatment is needed, though teeth may not regrow even if life is saved. Other Gan syndromes with incessant drinking, unceasing slippery diarrhea, black tongue, blue veins in eyes, black aura at eye corners, milky urine, black teeth, withered bones, rectal prolapse, cough with shortness of breath, millet-like black spots on body, white lips with high abdomen, flat philtrum, holding limbs loosely, soles touching ground without pain sensation, and cold body constitute the "Five Extremities," which are incurable. Accumulation presents with sallow puffy face, tight painful abdomen, prone sleeping with drowsiness, intense crying/anorexia, constipation, oily urine, or uncontrolled loose stools with white sour feces. Black face/stool, abdominal distension, unceasing diarrhea, coarse breath, hand palm sores, and weakness are incurable. Heat disease has excess and deficiency types. Excess: deep red cheeks, red-purple lips, dry thirst, irritability, difficult urination/defecation, constant crying, paroxysmal high fever. Deficiency: pale-green vague complexion, slight fever, cold mouth, diarrhea, spontaneous sweating, alternating cold/warmth, upper congestion with lower diarrhea, indistinguishable food/fluid, indicating cold-heat imbalance. Ten external signs: Tidal fever like malaria; wind-heat with unchanged diet; accumulation-heat with frequent vomiting; cold injury with cold limbs; cold ears/nose/toes/fingertips indicates measles; lip sweat and pearl-like drool indicates physiological transformation (Bian Zheng); frequent diarrhea/thirst indicates Gan-heat; cyanotic face with large pulse indicates fright-heat; spleen pain with ceaseless crying; toxic heat with closed eyes and ruddy face. Congenital heat absence with vomiting undigested milk, black face, immediate postprandial vomiting, and whole-body coldness is incurable. Chronic diarrhea should not be abruptly stopped with astringents; first regulate Qi and harmonize middle. Unceasing watery diarrhea with anorexia has no cure. Profuse sweating with tongue protrusion, red lips, closed eyes, head shaking, coarse breath, rib movement, oral blood sores resulting from vomiting/diarrhea is named "Stomach Rot," leading to sudden death. Eight types of dysentery include Fish Mouth, Locked Mouth, Five Colors, Rectal Prolapse, Visceral Toxin, Spleen Toxin, Cold Accumulation, and Gan Dysentery, all featuring pus/blood in stool, tenesmus, heavy sensation outside, urgent abdominal pain, day and night frequency. Treatment requires investigating cause, using formulas to remove accumulation, widen intestines, and promote Qi circulation, followed by stopping diarrhea; most recover. Downward discharge like fish intestine blood/water, high fever, irritability/thirst, anorexia, spontaneous sweating, and oliguria indicate poor prognosis. Rash syndromes are exterior deficiency and interior excess, rooted in organs, serious. Measles are exterior excess and interior deficiency, rooted in skin, mild, self-limiting. Smallpox results from irregular seasons, climate contagion, external wind-cold, and internal heat accumulation, similar to Cold Damage. Fever, irritability, red face/lips, body/head pain, cold ears/nose/toes/middle finger, sneezing/yawning, panting/phlegm, alternating chills/fever. Suspect true eruption by checking for red veins behind ears and millet-like papules on chest/heart. Do not use diaphoresis or purgation at start/end; use warm-cooling formulas to resolve toxin, harmonize middle, and stabilize exterior. Analogy: cooking like building a stove, ensure looseness. If extreme heat generates wind or fright spasms, clear Heart and disperse wind; never use cold-fright drugs or moxibustion, as moxa adds fire to heat, and cold drugs trap toxins internally. Avoid foul odors, frying smoke, sexual activity, and combing hair. Contact before eruption sends toxin to Heart causing death; contact after eruption causes cutting pain, blackening, and rotting. Burn incense, heat vinegar charcoal, spray coriander wine to purify air. Do not assume rural children's immunity is the norm. Patients often refuse medicine, failing to realize pre/post-eruption requires dispersal, and active eruption requires activating Qi/blood. Following this ensures smooth eruption and drying, avoiding sequelae. Ignoring this leads to dense eruptions and difficult resolution. Residual toxins cause abscesses, scabies, consumption, red eyes, sore throat, and oral ulcers. Good and bad prognoses must be carefully distinguished. Good prognosis: normal feeding, regular bowel movements (once daily or every two days); use neutral, non-hot/non-cold herbs for safety. Bad prognosis: Spring/Summer (Yang) is favorable, Autumn/Winter is unfavorable. Winter cold favors Kidney Water; if preceded by malaria-like symptoms then thirst, with dark blood-colored lesions, it is a Kidney syndrome, incurable. Spring pus indicates Metal overcoming Wood; Summer black depression indicates Water overcoming Fire; Autumn macules indicate Fire overcoming Metal; Winter rash indicates Earth overcoming Water; all are unfavorable. Black aura at nose or black tongue, delirium/thirst after eruption, difficult urination, diarrhea, anorexia; lesions like cakes, dark/unerupted, hoarse voice, closed eyes with exposed black pupils, swollen face/depressed nose, frequent teeth grinding, swollen head/face; scratched lesions, offensive odor, cold legs to knees; small black scorched lesions, wind attacking chin/jaw, swollen hard lips/neck, protruding chest. All above are incurable. External wind-cold-summer-heat-dampness treatments are same as adults, just smaller doses. Miscellaneous diseases treated according to formulas. Alas, adult medicine is difficult; pediatrics is harder. Organs are tender, skin/bone weak, Qi/blood not full, meridians like silk, pulses like hairs, prone to vacuity/excess and cold/heat changes. Plus, inability to speak or point, unawareness of pain. Without observing form, inspecting color, listening to sound, palpating pulse, investigating source, and detailing Yin/Yang, exterior/interior, vacuity/excess, few can cure. Wrongful medication causes other syndromes; beware!