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When children reach three or five years of age, pulse diagnosis can be performed. However, their wrists are short and narrow, making it difficult to distinguish the three positions (Cun, Guan, Chi). Therefore, one finger is used to palpate the pulse, which is indeed not easy. In the *Huangdi Neijing* (Yellow Emperor's Inner Canon), the diagnosis of pediatric diseases is based on four pulse qualities: large (Da), small (Xiao), slow/relaxed (Huan), and rapid/tense (Ji). Presuming not to overstep my bounds, I have interpreted its intent and replaced these with floating (Fu), deep (Chen), slow (Chi), and rapid (Shu) pulses, determining deficiency and excess by the presence or absence of force (You Li / Wu Li). This seems clearer and more explicit than "large, small, slow, and rapid." Let later scholars carefully contemplate this.

The Yellow Emperor asked: If a nursing infant suffers from heat disease, and the pulse is suspended and small/thin, what does this indicate? [Commentary: When an infant has heat disease, a suspended and small pulse represents a Yang syndrome presenting with Yin pulse signs, which is fundamentally a major taboo. However, if the pulse is small yet relaxed (Huan), the pathogen is mild, and recovery is likely; if the pulse is small yet rapid/tense (Ji), the pathogen is severe, which is concerning. Hence, this question is posed.] Qibo replied: Survival is indicated if the hands and feet are warm; death ensues if they are cold. [Commentary: Infants possess a delicate Yang constitution. When afflicted with heat disease, the pulse should not be small. Although the pulse body may be small, if the hands and feet are warm, it indicates that Yang Qi remains, as the four limbs are the root of all Yang Qi. Conversely, if the four limbs are cold, it signifies that the pathogen has overcome the healthy Qi, and the Primordial Yang has departed; thus, death is predicted.]

The Emperor asked: If a nursing infant contracts wind-heat, manifesting with wheezing, stridor, and shoulder-lifting respiration, what will the pulse be like? Qibo answered: In cases of wheezing, stridor, and shoulder-lifting respiration, the pulse should be substantial and large. If the pulse is relaxed/slow (Huan), there is life; if it is rapid/tense (Ji), there is death. [Commentary: This discusses external contraction in infants. Wind-heat invading the Yang aspect leads to wheezing, stridor, and shoulder-lifting respiration, requiring a substantial and large pulse. A large yet relaxed pulse indicates that Stomach Qi is preserved and the pathogen is receding, leading to survival. A substantial yet rapid/tense pulse reveals the appearance of the True Zang pulse, indicating worsening disease, leading to death.] This is the purport of the *Neijing*. The Sages' words were concise and comprehensive, leaving nothing out. People of the world fail to comprehend this, treating it as commonplace. If one focuses on such critical points, half of the essentials of pulse diagnosis are understood. In my clinical practice, my prognoses regarding auspiciousness and inauspiciousness are often accurate, precisely because of these principles, though my mind grasps them while my tongue struggles to express them fully. Upon careful examination, the "large, small, slow, and rapid" mentioned in the classics also imply implicit meanings. Essentially, "large" corresponds to floating/hyperbolous (Fu/Hong) types; "small" corresponds to deep/fine (Chen/Xi) types; "rapid/tense" (Ji) corresponds to rapid (Shu); and "slow/relaxed" (Huan) corresponds to slow (Chi). Is it not better to simply use floating, deep, slow, and rapid? Furthermore, combining this with Jie'an’s method of distinguishing exterior-interior and deficiency-excess via "forceful vs. forceless" pulses constitutes a natural and indispensable secret for pediatric diagnosis. Mr. Jie'an was but an ordinary person, yet he could distinguish Yin-Yang, Exterior-Interior, Cold-Heat, and Deficiency-Excess through "forceful vs. forceless." Though extremely obvious and simple, it is profoundly accurate. Who says ancients cannot compare to moderns!