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Ancient texts state: "It is better to treat ten men than one woman; it is better to treat ten women than one infant." This indicates that pediatrics is referred to as the "Mute Department" (Ya Ke), as treatment is extremely difficult. Mr. Zhang Jingyue, however, stated that pediatric diseases are very easy to treat. How can this be seen? It is because infants and young children have no pulse to diagnose, due to their blood and qi not yet being fully developed. The pain or itching of their illnesses cannot be conveyed through speech, so diagnosis relies solely on observation (Wang), listening/smelling (Wen), and palpation (Qie); thus, saying it is not difficult is indeed difficult. The reason for saying it is easy lies in the fact that pediatric illnesses are merely external contraction of wind-cold, internal injury from diet, convulsions with vomiting and diarrhea, etc., without the afflictions of the seven emotions (Qi Qing), six depressions (Liu Yu), lust, or excessive worry. Therefore, when I treat pediatric diseases, for exterior syndromes, I use only formulas such as Xiangsu San (Fragrant and Perilla Powder) or Xingxing San (Awakening Powder); for interior syndromes, I use only Pingwei San (Calm the Stomach Powder) or Huoxiang San (Agastache Powder); for deficiency-phlegm and other symptoms, I use only Erchen Tang (Two-Cured Decoction) or Liujunzi Tang (Six-Gentlemen Decoction); for excess-heat symptoms, I use only Xiao'er Niuhuang Wan (Infant's Buffalo Horn Pill) or Xieqing Wan (Drain Green Pill). For all these exterior, interior, deficiency, and excess conditions, resolving the exterior or purging the interior should only employ mild agents; one must not use heavy sweating or drastic purging methods to damage the primordial qi. As for various miscellaneous conditions like convulsions, vomiting, and diarrhea, they are treated according to their specific categories and examples.

(Attached are the rhymes for Observation, Listening/Smelling, Inquiry, and Palpation)
Pediatric illness evokes pity, relying entirely on the doctor's careful observation. Have the child carried out to a bright place, and first carefully examine the face. The forehead belongs to the Heart channel, the nose to the Spleen channel; the left cheek belongs to the Liver, the right cheek to the Lung, and the front of both cheeks correspond to the organs. The chin is governed by the Kidney channel; distinguishing the colors of the five zang-organs requires devout attention. White color indicates Qi deficiency, yellow indicates accumulation, red indicates heat, and green/blue indicates cold. Nasal congestion with heavy voice indicates severe Wind-Cold invasion; blueness under the eyes indicates fluid retention and phlegm. Red or white lips distinguish Yin and Yang; red indicates Stomach heat, white indicates cold. White spots inside the lips indicate worm accumulation; dry nose and emaciated body indicate Gan syndrome (nutritional disorder). Unceasing crying indicates pain; restlessness in swaddling clothes indicates food stagnation. Seeking coolness or desiring cold indicates internal heat. Shrinking away from wind indicates Wind-Cold and Yin cold. Cold nose, herpes, hot ears, and generalized fever indicate Wind-Cold. Heat in palms and soles with thirst indicates true food stagnation shown by deep fingerprint lines. Afternoon palm heat indicates Yin deficiency with night sweats and nighttime irritability. Cold finger tips indicate Convulsion (Jing Feng) type conditions. Heat only in the middle finger indicates Shanghan (Cold Damage). Slight coldness alone in the middle finger suggests possible Meidan (Smallpox/Measles) entanglement. Observe the fingerprint and remember the rhyme; examine floating/sinking, color, and qi accurately. To view the Wind, Qi, and Life gates of the fingerprint, push inward and study carefully. The three gates correspond to Yin, Mao, and Chen hours; the prognosis lies here. If at the initial Wind gate, the disease is harmless; if appearing at the Qi gate, it may linger; if reaching the Life gate, it is critical; if piercing through to the Pass Gate, life is hard to save. Why does the fingerprint appear floating? Pathogen in the skin makes the disease easy to eliminate. Blockage of cou-li (interstices) is called Exterior Syndrome; urgently apply dispersing methods to induce sweating first. If the gate line suddenly appears sinking, the pathogen has entered the interior and lingers. Do not lightly try wind-dispersing drugs; you must clear the Yangming Interior Syndrome. Stable body with red-yellow color indicates Shanghan; pale red hidden indicates deficient Shanghan; deep red is viewed as heat. Purple at the gate indicates heat omen; green indicates wind as the definite sign. Food injury shows purple-green; phlegm-qis send it; green-black across three gates is hard to settle. Pale fingerprint need not please; constitution is weak due to innate endowment. Spleen and Stomach are originally deficient with faint Middle Qi; beware of attacking and damaging the infant's Yuan Qi. Stagnant and rough gate lines are due to accumulation; pathogen obstructs Ying and Wei Qi connection. Food stagnation in Middle Jiao with fierce Wind-Heat; without pushing and purging, how will the disease move? Abdominal pain with line entering palm interior, bending inward naturally indicates Wind-Cold. Line bending outward indicates Phlegm, Food, Heat; Water shape (Kidney/Bladder) and Spleen-Stomach are both injured. Re-examine the pulse at the Guan position behind the palm; examine floating/sinking, slow/rapid accurately. Seven to eight beats per breath is Rapid (Shu) indicating heat; four to five beats is Slow (Chi) indicating cold. Floating pulse governs Exterior, disease outside; Sinking pulse governs Interior, disease hidden inside. Rapid pulse six beats indicates Fu-organ heat; Slow pulse three beats indicates Zang-organ cold. Floating and forceful indicates Wind and Heat; forceless indicates Middle deficiency, suitable for tonifying Yuan Qi. Sinking and forceful indicates Phlegm, Accumulation, Food; sinking and forceless indicates Qi stagnation. Slow and forceful is Pain; slow and forceless is Deficient Cold. Rapid and forceful is Excess Heat; forceless fears ulceration torment. This is the true rhyme of pulse diagnosis; calm mind and focus attentively. Again, look at tongue coating to distinguish exterior/interior; red/yellow with fire, clear it to achieve peace. White and slippery indicates Interior Cold, urgently warm the Middle; white and rough indicates Interior Heat; yellow and slippery indicates Cold. If tongue is black, distinguish Yin/Yang; test breath temperature with hand. Hot mouth breath and red urine, black tongue must be dry, purgative method first. Faint breath, clear stool, cold limbs, Ginseng, Cinnamon Twig, Aconite Root are miraculous as immortals. Infant Yin deficiency also causes black tongue, nourishing Yin and moistening dryness cures all. Also examine chest and abdomen for hardness or softness; deficiency/excess can be studied herein. The principles of Observation and Palpation are thus; how can Listening and Inquiry be biased? Harsh voice and coarse speech know disease is Excess; failing Qi and weak body must speak softly. Liver disease angry voice, Heart disease laughter, Spleen disease sound like singing. Lung disease sound like crying, Kidney governs groaning possibly mixed. Yang syndrome light body and loud speech, Yin syndrome coma/reversal sleeping with closed eyes. Yang syndrome mania likes drinking water, Yin syndrome Zheng Sheng (faint murmuring) speaks lazily. First ask about chills and fever, second ask about sweating, third ask about head/body and chest, fourth ask about diet and disease duration, fifth ask about urination/defecation and thirst/irritability, sixth ask about previous medication effects, seventh ask about smallpox/measles sequence. Medication carefully considers deficiency/excess; if accumulation and deficiency, simultaneously tonify Yuan Qi. Clear heat, warm dampness, disperse wind; chronic diarrhea should be astringent to secure the Primordial. Such medical consultation, medicine arrives and disease removes, boundless fortune. Cherish the young following sage intent, wishing infants live a hundred years. If asked who compiled this book, Yazhuo Shanren at Yuquan.