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When Shen (Spirit) is in excess, there is incessant laughter; when Shen is deficient, there is sorrow. When Qi (Vital Energy) is in excess, there is panting, coughing, and rebellious Qi moving upward; when Qi is deficient, breathing is smooth but the voice is weak and short. (*Suwen*)

When Xing (Form/Body) and Qi are harmonious, life is sustained. (*Suwen*)

Children whose cognitive abilities and acuity surpass others often have short lives; those who require less artificial refinement tend to live longer. (*Qianjin Fang*)

Inquiring about longevity depends on observing Shen. There is no case of premature death without Shen deficiency. Shen should be stored internally rather than exposed, harmonious rather than stagnant, clear rather withered, expressive rather than frivolous, and tranquil rather than restless. (*Damo*)

When Qi gathers, there is life; when Qi scatters, there is death. (Zhu Wengong)

Congenital constitution is weak and timid, Shen and Qi are insufficient, eyes lack luster, complexion is pale, and fontanelles are unclosed. These conditions indicate difficulty in nurturing, and even if nurtured, longevity is unlikely. (*Xiao'er Zhijue*)

If a child specifically loves being held by one person and avoids others, this indicates weak and timid Shen. (Wan Mizhai)

The classics state: "Qi arrives but color does not arrive" indicates survival. It also states: "Color arrives but Qi does not arrive" indicates death. This means having Qi but lacking Color, though ill, is not ominous; having Color but lacking Qi, though seemingly healthy, leads to death. (Yu Jiayan)

The five sense organs and hundred bones of the human body exist integrally because Shen resides within them. Complexion is the banner of Shen. When Shen is vigorous, complexion is vibrant; when Shen is declining, complexion is dull; when Shen is stored, complexion is reserved; when Shen is exposed, complexion is glaring. (Yu Jiayan)

The subtlety of observing complexion lies entirely in observing Shen. Blood nourishes Qi, and Qi nourishes Shen. A person who has lost sleep shows signs of hunger in their Shen; a parent who has lost a child shows signs of dullness in their Shen, as Qi has depleted and Shen loses its nourishment. (Yu Jiayan)

The collateral vessels of the Stomach connect upwards to the Heart. Any blockage immediately obstructs the orifices for the entry and exit of Shen and Qi, resulting in an inability to recognize people. (Zhao Yi-de)

Speaking alone as if seeing ghosts indicates that the Shen of the Heart Master is deficient, and the disease aligns with the Shaoyin channel. The pivot mechanism of Shaoyin Shen moves in and out intermittently; if it fails, Shen becomes confused and disoriented, leading to an inability to recognize people. (Zhang Yin'an)

In all diseases, if breathing is急促 and cannot continue, Qi has already scattered; spontaneous sweating like rain causes Qi to scatter with the sweat; severe vomiting and diarrhea cause Qi to scatter with the discharge; enuresis, hematemesis, and essence depletion cause Qi to scatter accordingly. Qi belongs to Yang. When Qi scatters, it transitions from Yang to Yin, signaling impending death. (Lin Peiqin)

When a person is near death, phlegm rattling is heard in the throat. It is mistaken to think this is caused by phlegm-saliva blocking the airways and exhausting Qi. In reality, the True Qi has already separated, and phlegm floats up with the Qi, producing sound. (Lin Peiqin)

For children with illness, if Shen is clear and bright, even severe cases can be saved; if Shen is confused and dull, even mild cases will likely undergo sudden deterioration. (Xu Xuanzhi)

The five Zang organs store Jing-Qi internally and manifest on the face. Although complexion arises from Qi, what is subtly contained within the skin is Qi, while what is prominently displayed outside the skin is Color. Color is external and Qi is internal; Color has visible traces, while Qi has none. (*Xinfa* Note)

When disease progresses to the point of losing Shen-Ming and hoarseness occurs, it indicates that the Five Zang organs have been exhausted, and treatment is futile. (*Daquan*)

Among the five body parts of children, the head is supreme, and only Shen on the face can be relied upon. Bright spirit is auspicious; confused spirit is inauspicious. (Chen Feixia)

Shen and Qi are the masters of the body. Clear and refreshing Shen, complete Spirit and sufficient Qi, indicate peace and auspiciousness. Deprived Shen and shifted Qi, fatigued Spirit and turbid Qi, indicate premature death. (Tili Zi)

Cold conditions lead to clear Shen; heat conditions lead to confused Shen. Excess conditions mean Shen is in abundance; deficiency conditions mean Shen is lacking. (Tili Zi)

Excessive Cold leads to quiet Qi; excessive Heat leads to rough Qi. Deficiency results in deficient Qi; Excess results in robust Qi. (Tili Zi)

Rough breathing at the mouth and nose, exiting and entering quickly, indicates excess of external pathogenic factors. Weak breathing at the mouth and nose, exiting and entering slowly, indicates deficiency of internal Qi. (Tili Zi)

Commentary: Syndromes are categorized as Exterior, Interior, Deficiency, Excess, Cold, and Heat. These are difficult to distinguish in adults, and even more so in children. Yu Xia cast methods for examining Miao Qiao (Orifices). Chen Feixai adopted this, believing that since internal organ diseases are hard to gauge, the manifestations reaching from inside to outside are called Miao Qiao, which are the external expressions of the Zang-Fu. Miao Qiao have visible traces for examination, whereas Shen-Qi has invisible traces, making its examination crucial. Those concerned with life should be adept at observing Shen-Qi; from this, internal injuries and external infections can be distinguished, and life and death determined, thus qualifying as excellent physicians. (Tili Zi)