小儿一岁有病,则当切脉,但部位甚小,只以一指诊之,而寸、关、尺三部。胥在其中。切脉法分别详列于下。
一息者,人之一呼一吸也。至者,脉之至数也。一息六至,为和平之脉,则曰无病。
浮脉者,轻取皮肤之上,故曰浮。其病在表,主外感风寒。
沉脉者,重按筋骨之间,故曰沉。其病在里,主内伤饮食。
数脉七至或八至,主病在六腑,属阳也。
迟脉四至或五至,主病在五脏,属阴也。
滑脉如珠,往来流利,病主痰盛。
涩脉滞涩,往来艰难,病主血少。
芤脉者中取无力,病主失血。
微脉者,按之微细,若有若无,病主怯弱之证。
洪脉者,来时虽盛,去时无力,病主火热。
促脉者,数而时止,病主惊痫。
结脉者,缓而时止,病主积聚。
紧脉者,左右如转索之象,沉紧病主腹痛。浮紧病主感寒。
弦脉者,端直如张弓弦,病主停饮。
浮中沉三部无力,为虚,虚为不足。
浮中沉三部有力,为实,实为有余。
洪紧者,痘疹欲发也。
大小不匀者,中恶之证也。
一息三至,是虚寒之极。九至十至,乃火热太甚。若一息只一至二至,或十一至十二至者,皆不治之症。
浮散无根又沉,及浮取之不应指,皆难治之脉。
小儿诊脉,不过如此。凡病之阴、阳、表、里、虚、实。仍当合望闻问三者。参考而得病情矣。
If a child falls ill at one year of age, pulse diagnosis should be performed. However, due to the small size of the wrist area, only one finger is used for palpation, encompassing the Cun (Inch), Guan (Bar), and Chi (Cubit) positions. The specific methods for pulse diagnosis are detailed below.
"Xi" refers to one complete cycle of inhalation and exhalation. "Zhi" refers to the frequency of the pulse beats. Six beats per breath cycle indicate a harmonious and healthy pulse, signifying no disease.
The Floating Pulse (Fu Mai, Superficial Pulse) is felt lightly on the surface of the skin, hence named "Floating." It indicates pathology in the exterior (Biao, 表), primarily caused by external contraction of wind-cold.
The Deep Pulse (Chen Mai, Deep Pulse) is felt only with heavy pressure between the muscles and bones, hence named "Deep." It indicates pathology in the interior (Li, 里), primarily caused by internal injury from diet.
The Rapid Pulse (Shu Mai, Rapid Pulse) features seven or eight beats per breath cycle, indicating pathology in the Fu organs (Six Bowels), belonging to Yang.
The Slow Pulse (Chi Mai, Slow Pulse) features four or five beats per breath cycle, indicating pathology in the Zang organs (Five Viscera), belonging to Yin.
The Slippery Pulse (Hua Mai, Slippery Pulse) feels like rolling pearls, flowing smoothly back and forth, indicating an excess of phlegm-dampness.
The Choppy Pulse (Se Mai, Choppy Pulse) feels stagnant and difficult to flow, indicating blood deficiency.
The Kou Pulse (Kou Mai, Hollow Pulse) feels weak upon moderate pressure, being empty in the center, indicating blood loss.
The Micro Pulse (Wei Mai, Fine/Weak Pulse) feels extremely thin and faint upon palpation, appearing as if present or absent, indicating a condition of frailty and weakness.
The Surging Pulse (Hong Mai, Flood Pulse) arrives with great force but departs weakly, indicating excessive heat-fire.
The Hasty Pulse (Cu Mai, Hasty Pulse) is rapid with occasional irregular pauses, indicating fright-convulsion or epilepsy.
the Knotted Pulse (Jie Mai, Knotted Pulse) is slow with occasional irregular pauses, indicating accumulation masses.
The Tight Pulse (Jin Mai, Tight Pulse) feels like a twisting rope moving left and right; a deep-tight pulse indicates abdominal pain, while a floating-tight pulse indicates cold contraction.
The Wiry Pulse (Xian Mai, Wiry Pulse) is straight and long like a drawn bowstring, indicating fluid retention (stagnant fluids).
If the pulse feels weak in all three positions (floating, moderate, and deep), it is a Deficiency (Xu, 虚) pulse, representing insufficiency.
If the pulse feels strong in all three positions (floating, moderate, and deep), it is an Excess (Shi, 实) pulse, representing surplus pathogenic factors.
A pulse that is both surging and tight indicates the impending eruption of variola (smallpox/rash).
An irregular pulse with uneven magnitude indicates Zhong-E (sudden attack by foul turbid pathogens).
Three beats per breath cycle indicate extreme deficiency-cold. Nine to ten beats per cycle indicate excessive heat-fire. If there are only one or two beats per cycle, or eleven to twelve beats per cycle, these are considered untreatable critical conditions.
A pulse that is floating, scattered, rootless, and also deep, or one that does not respond to light pressure, are all difficult-to-treat pulses.
These are the basic methods for pediatric pulse diagnosis. For determining the Yin/Yang, Exterior/Interior, Deficiency/Excess nature of any disease, one must still integrate observation (Wang, 望), listening/smelling (Wen, 闻), and inquiry (Wen, 问) to comprehensively assess the condition.