小儿过岁当切脉，位小一指定三关，浮脉轻取皮肤得，沉脉重取筋骨间，
一息六至平和脉，过则为数减迟传，滑脉如珠多流利，涩脉滞涩往来艰，
三部无力为虚脉，三部有力作实言，中取无力为孔脉，微脉微细有无间，
洪脉来盛去无力，数缓时止促结占，紧脉左右如转索，弦则端直张弓弦，
浮为在表外感病，沉为在里内伤端，数为在府属阳热，迟为在藏乃阴寒，
滑痰洪火微怯弱，弦饮结聚促惊痫，孔主失血涩血少，沉紧腹痛浮感寒，
虚主诸虚不足病，实主诸实有余看，疸疹欲发脉洪紧，大小不匀中恶勘，
一息三至虚寒极，九至十至热极炎，一二十一十二死，浮散无根沉伏难，
表里阴阳虚实诊，惟在儿科随证参。
[注]
过岁者一岁也，有疾则当切脉，但部位甚小，不能以三指诊之，
须用一指以定三关，三关者寸关尺也，
浮脉者，轻取皮肤之上即得，故曰浮也，
沉脉者，重按筋骨之问则见，故曰沉也，
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，则曰无疾，
至数若过者，七至八至也，谓之数脉，
至数若减者，四至五至也，谓之迟脉，
滑脉如珠，往来流利，
涩脉滞洪，往来艰难，
三部者脉之浮沉中也，
浮中沉三部无力为虚，浮中沉三部有力为实，
芤脉者，中取无力，微脉者，按之微细，若有若无，
洪脉者，来时虽盛，去时无力，
促脉者，数而时止，结脉者，缓而时止，
紧脉者，左右如转索之象，
弦脉者，端直如张弓弦，此皆言脉之形象至数也，
浮脉病在表，外感风寒也，
沉脉病在里，内伤饮食也，
数脉病在六府，属阳也，
迟脉病在五藏，属阴也，
滑主痰盛，
洪主火热，
微主怯弱之证，
弦主停饮，
结主积聚，
促主惊痫，
芤主失血，
涩主血少，
沉紧主腹痛，
浮紧主感寒，
虚为不足，主诸虚，
实为有余，主诸实，
洪紧者，疽疹欲发也，
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，此诸脉所主之病也，
若一息只一至二至，或十一十二至者，皆死脉也，
浮散无根又沉浮，取之不应指者，皆难治之脉也，
凡病之阴阳表里虚实，虽可以诊脉而得，
惟临证时合望闻问三者，细为参考焉。
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Pediatric patients over one year of age should undergo pulse diagnosis (pulse palpation). Due to the small size of their pulse position, a single finger is used to assess the three positions: Cun (Inch), Guan (Bar), and Chi (Cubit) simultaneously. The Floating Pulse (Fu Mai) is obtained by light pressure on the skin surface; the Deep Pulse (Chen Mai) is obtained by heavy pressure between the muscles and bones.
Six beats per respiratory cycle constitute a Harmonious Pulse (Ping He Mai); more than six indicates a Rapid Pulse (Shu Mai), while fewer indicates a Slow Pulse (Chi Mai). The Slippery Pulse (Hua Mai) flows smoothly like rolling pearls; the Choppy Pulse (Se Mai) is stagnant and difficult to flow.
Weakness in all three positions (Cun, Guan, Chi) indicates a Deficient Pulse (Xu Mai); strength in all three positions indicates an Excess Pulse (Shi Mai). Weakness upon moderate pressure indicates a Scallion-Stalk Pulse (Kou Mai); the Fine Pulse (Wei Mai) is extremely thin and faint, seeming to exist or not exist. The Surging Pulse (Hong Mai) arrives with force but departs weakly; the Hasty Pulse (Cu Mai) is rapid with intermittent pauses, and the Knotted Pulse (Jie Mai) is slow with intermittent pauses. The Tight Pulse (Jin Mai) feels like a twisting rope from side to side; the Wiry Pulse (Xian Mai) is straight and long, like a drawn bowstring.
The Floating Pulse indicates Exterior syndrome (Biao Zheng), typically due to External Contraction (Wai Gan); the Deep Pulse indicates Interior syndrome (Li Zheng), typically due to Internal Injury (Nei Shang). The Rapid Pulse indicates involvement of the Six Fu Organs (Liu Fu) and belongs to Yang-Heat (Yang Re); the Slow Pulse indicates involvement of the Five Zang Organs (Wu Zang) and belongs to Yin-Cold (Yin Han). The Slippery Pulse indicates Phlegm-Dampness (Tan Yin); the Surging Pulse indicates Fire-Heat (Huo Re); the Fine Pulse indicates Qi Deficiency and weakness (Qie Ruo); the Wiry Pulse indicates Fluid Retention (Ting Yin); the Knotted Pulse indicates Accumulation and Stagnation (Ji Ju); the Hasty Pulse indicates Fright and Epilepsy (Jing Xian). The Scallion-Stalk Pulse indicates Blood Loss (Shi Xue); the Choppy Pulse indicates Blood Deficiency (Xue Shao); the Deep-Tight Pulse indicates Abdominal Pain (Fu Tong); the Floating-Tight Pulse indicates Cold Invasion (Gan Han). The Deficient Pulse indicates various deficiency syndromes (Zhu Xu); the Excess Pulse indicates various excess syndromes (Zhu Shi). A Surging-Tight Pulse suggests impending eruption of carbuncles or rashes (Ju Zhen); irregular pulse sizes suggest Zhong E (Sudden Evil Attack).
Three beats per respiratory cycle indicate extreme Deficiency-Cold (Xu Han); nine to ten beats indicate extreme Heat (Re Ji). One or two beats, or eleven to twelve beats per cycle, are Death Pulses (Si Mai). Floating and scattered pulses without root, or Deep and hidden pulses that do not respond to palpation, are difficult to treat.
Diagnosis of Exterior/Interior, Yin/Yang, and Deficiency/Excess in pediatrics must be integrated with clinical symptoms for comprehensive assessment.
[Note]
"Guo Sui" refers to being over one year old. When pediatric patients are ill, pulse diagnosis is necessary, but because the pulse position is very small, it cannot be assessed with three fingers separately. Instead, one finger must be used to determine the three positions: Cun, Guan, and Chi. These three positions refer to the Cun, Guan, and Chi locations.
The Floating Pulse is obtained by light pressure on the skin surface, hence named "Floating."
The Deep Pulse is revealed by heavy pressure down to the bone level, hence named "Deep."
"One Xi" refers to one exhalation and one inhalation.
"Zhi" refers to the number of pulse beats.
Six beats per respiratory cycle represent a Harmonious Pulse, indicating health.
If the beat count exceeds this (e.g., seven or eight beats), it is called a Rapid Pulse.
If the beat count decreases (e.g., four or five beats), it is called a Slow Pulse.
The Slippery Pulse resembles pearls, flowing smoothly.
The Choppy Pulse is stagnant, with difficult flow.
"The Three Positions" refer to the levels of light, moderate, and deep pressure.
Weakness at all three levels indicates a Deficient Pulse; strength at all three levels indicates an Excess Pulse.
The Scallion-Stalk Pulse is weak at moderate pressure; the Fine Pulse is extremely thin upon pressing, seeming to exist or not exist.
The Surging Pulse arrives strongly but departs weakly.
The Hasty Pulse is rapid with occasional stops; the Knotted Pulse is slow with occasional stops.
The Tight Pulse feels like a twisting rope.
The Wiry Pulse is straight and long, like a taut bowstring. These descriptions refer to the shape and rhythm of the pulse.
The Floating Pulse indicates Exterior disease, such as External Wind-Cold invasion.
The Deep Pulse indicates Interior disease, such as Internal Dietary Injury.
The Rapid Pulse indicates disease in the Six Fu Organs, belonging to Yang.
The Slow Pulse indicates disease in the Five Zang Organs, belonging to Yin.
Slipperiness indicates abundant Phlegm.
Surging indicates Fire-Heat.
Fineness indicates weakness syndromes.
Wiryness indicates retained fluids.
Knottedness indicates accumulations.
Hastiness indicates fright and epilepsy.
Scallion-stalkness indicates blood loss.
Choppiness indicates blood deficiency.
Deep-tightness indicates abdominal pain.
Floating-tightness indicates cold invasion.
Deficiency indicates insufficiency, governing various deficiency syndromes.
Excess indicates surplus, governing various excess syndromes.
Surging-tightness indicates the impending eruption of sores or rashes.
Irregular pulse size indicates Zhong E syndrome.
Three beats per cycle indicate extreme Deficiency-Cold.
Nine to ten beats indicate excessive Fire-Heat. These are the diseases associated with these pulses.
One or two beats, or eleven to twelve beats per cycle, are Death Pulses.
Pulses that are floating and scattered without root, or those that do not respond to deep or shallow palpation, are difficult to treat.
Although Yin/Yang, Exterior/Interior, and Deficiency/Excess can be diagnosed via pulse taking, clinicians must carefully correlate these findings with observation, listening/smelling, and inquiry during practice.