夫小儿者。幼科也。初生曰婴儿。三岁曰小儿。十岁曰童子。儿有大小之不同。病有浅
各异。观形察色之殊。望闻问切之间。若能详究于斯。可竭神圣工巧者矣。盖望者鉴貌辨其
色也。假如面部左腮属肝。右腮属肺。额属心。鼻属脾。颧属肾。肝病则面青。肺病则面白
。心病则面赤。脾病则面黄。肾病则面黑。是乃望而知之也。闻者听声知其证也。假如肝病
则声悲。肺病则声促。心病则声雄。脾病则声缓。肾病则声沉。此属于脏。又大肠病则声长
。小肠病则声短。胃病则声速。胆病则声清。膀胱病则声微。此属于腑。是乃闻而知之也。
问者问病究其原也。假如好食酸则肝病。好食辛则肺病。好食苦则心病。好食甘则脾病。好
食咸则肾病。好食热则内寒。好食冷则内热。是乃问而知之也。切者切脉察其病也。假如小
儿三岁以下。有病。须看男左女右手虎口三关。从第二指侧。第一节名风关。二节名气关。
三节名命关。辨其纹色。紫者属热。红者属寒。青者属风。白者疳病。黑者中恶。黄者脾之
困也。色见红者可治。色黑则危矣。若见于风关为轻。气关为重。过于命关。则难治矣。至
三岁以上。乃以一指按寸关尺三部。常以沉实七至为率。添则为热，减则为寒。浮洪风盛。
数则多惊。沉迟为虚。沉实为积。是乃切而知之也。大抵小儿之病。大半胎毒。而小半于伤
食也。其外感风寒之疾十一而已。盖小儿之在胎也。母饥亦饥。母饱亦饱。辛辣适口。胎气
随热。情欲无节。或喜怒不常。皆能令其子受患。其为母者，胎前既不能谨节。产后尤不能
调护。是以唯务姑息。不能防微杜渐。或未满百 。而遂与酸咸之味。或未及周岁。而辄与
肥甘之物。百病由是而生焉。且小儿脾胃。本自娇嫩。易于伤积。乳食伤胃。则为呕吐。乳
食伤脾。则为泄泻。吐泻既久。则变缓惊。或为肝病。食乳停积。则生湿痰。痰则生火。痰
火变作。则为急惊。或成喉痹。痰火结滞。或成痛吊。或为喘嗽。又如胎寒者，禀受有病也
。脐风撮口者。胎元有病也。鹅口口疮者。胃中有湿热也。重舌木舌者。脾经有实火也。走
马牙疳者。气虚实热也。爱吃泥土者。脾脏生疳也。胎惊夜啼者。邪热乘心也。变蒸发热者
。胎毒将散也。丹毒者。火行于外也。蕴热者。火积于中也。中恶者。外邪乘也。睡惊者。
内火动也。喉痹者。热毒也。眼痛者。火盛也。脓耳者。肾气上冲也。鼻寒者。风邪在胃也
。头痛者。热毒攻也。脐痛者。风湿中也。尾骨痛者。阴虚痰也。诸虫痛者。胃气腐也。阴
肿疝气者。寒所郁也。盘肠气者。冷所搏也。脱肛者。大肠虚滑也。遗溺者。膀胱冷弱也。
尿浊者。湿滞脾胃也。便血者。热传心肺也。下淋者。膀胱郁热也。吐血者。荣卫气逆也。
小便不通者。有阴有阳也。大便闭结者。有虚有实也。解颅鹤膝者。胎元不全也。行迟发逆
者。气血不充也。龟胸者。肺热胀满也。龟背者。邪风入脊也。语迟者。邪乘心也。齿迟者
。肾不足也。疟者。膈上痰结也。痢者。腹中食积也。咳嗽者。肺伤风也。喘急者。痰气盛
也。心痛者。虫所啮也。腹痛者。食所伤也。内伤发热。则口苦舌干也。外感发热。则鼻塞
声重也。腹胀者。脾胃虚弱也。水肿者。土虚火旺也。黄胆者。脾胃湿热也。斑疹者。阴阳
毒瓦斯也。自汗者。气虚也。积者有常所。有形之血也。聚者无定位。无形之气也。胃者主纳
受。脾者主运化。脾胃壮实。四肢安宁。脾胃虚弱。百病蜂起。故调理脾胃者。医中之王道
也。节戒饮食者。却病之良方也。惊疳积热者。小儿之常病也。望闻问切。医家之大法也。
若夫疗病用药。如箭中鹄心。则又可以心悟。而不可以言传也。孟子曰。梓匠轮舆。能与人
规矩。不能使人巧。斯言得之矣。
Pediatrics is the medical discipline dedicated to children. Those just born are called infants, those aged three are called young children, and those aged ten are called boys/children. Children vary in age, diseases differ in depth and severity, and the methods for observing form and complexion also vary. Among the four diagnostic methods of inspection (Wang), auscultation and olfaction (Wen), inquiry (Wen), and palpation (Qie), if one can thoroughly investigate these principles, one can attain the high level of skill described as "Divine, Sage, Artisan, and Skillful."
Inspection involves observing the face to distinguish complexions. For instance, the left cheek belongs to the Liver, the right cheek to the Lung, the forehead to the Heart, the nose to the Spleen, and the zygomatic arch to the Kidney. In Liver disease, the complexion is green; in Lung disease, it is white; in Heart disease, it is red; in Spleen disease, it is yellow; and in Kidney disease, it is black. This is how diagnosis is made through inspection.
Auscultation and olfaction involve listening to the voice to know the syndrome. For example, in Liver disease, the voice is mournful; in Lung disease, it is rapid; in Heart disease, it is loud and vigorous; in Spleen disease, it is slow; and in Kidney disease, it is deep. These pertain to the Zang organs. Additionally, in Large Intestine disease, the voice is long; in Small Intestine disease, it is short; in Stomach disease, it is fast; in Gallbladder disease, it is clear; and in Bladder disease, it is faint. These pertain to the Fu organs. This is how diagnosis is made through auscultation.
Inquiry involves asking about the illness to investigate its origin. For example, a preference for sour foods suggests Liver disease; for pungent foods, Lung disease; for bitter foods, Heart disease; for sweet foods, Spleen disease; and for salty foods, Kidney disease. A preference for hot foods indicates internal cold, while a preference for cold foods indicates internal heat. This is how diagnosis is made through inquiry.
Palpation involves feeling the pulse to observe the disease. For children under three years old who are ill, one must examine the three sections on the tiger's mouth area of the left hand for boys and the right hand for girls. From the side of the second finger, the first segment is named the Wind Section, the second the Qi Section, and the third the Life Section. One distinguishes the color of the veins: purple indicates Heat, red indicates Cold, green indicates Wind, white indicates Gan disease (nutritional deficiency disorder), black indicates Zhong'e (sudden severe pathogenic invasion), and yellow indicates Spleen-Stomach distress. If the color is red, it is treatable; if black, it is critical. If seen in the Wind Section, the condition is mild; in the Qi Section, it is severe; if extending beyond the Life Section, it is difficult to treat. For children over three years old, one presses the Cun, Guan, and Chi positions with one finger. The normal rate is typically seven beats per breath cycle. An increased rate indicates Heat, a decreased rate indicates Cold. Floating and surging pulses indicate excess Wind; rapid pulses indicate frequent fright; deep and slow pulses indicate Deficiency; deep and solid pulses indicate Accumulation. This is how diagnosis is made through palpation.
Generally, most childhood illnesses stem from fetal toxins, and a smaller portion from food injury. Diseases caused by external contraction of Wind-Cold account for only one-tenth. While in the womb, when the mother is hungry, the fetus is hungry; when the mother is full, the fetus is full. If the mother consumes spicy and pungent foods, the fetal qi becomes heated due to the spice; if the mother has unregulated desires or irregular emotions like anger and joy, these can cause harm to the fetus. Mothers who fail to be cautious during pregnancy and cannot provide proper care postpartum, instead indulging the child and failing to prevent problems at an early stage, may give sour and salty foods before the child is 100 days old, or rich and sweet foods before the child is one year old. Various diseases arise from this. Moreover, a child's Spleen and Stomach are naturally delicate and prone to accumulation from dietary injury. If milk and food injure the Stomach, vomiting occurs; if they injure the Spleen, diarrhea occurs. Prolonged vomiting and diarrhea can transform into Huan Jing (slow convulsion) or trigger Liver disease. Stagnant milk and food generate damp-phlegm; phlegm stagnates and transforms into fire. Phlegm-fire interaction leads to Ji Jing (acute convulsion); it may form Hou Bi (throat obstruction); phlegm-fire stagnation may form Tong Diao (a spasmodic disorder); or it may cause wheezing and coughing. For example, Tai Han (fetal cold) is a pathological state inherited from the mother; Qi Feng Cuo Kou (umbilical wind with mouth closing) is a defect in the fetal origin; E Kou Kou Chuang (goose-mouth sore tongue and oral ulcers) is damp-heat in the Stomach; Chong She Mu She (double tongue and wooden tongue) is excess fire in the Spleen meridian; Zou Ma Ya Gan (running-horse dental caries) is deficiency of qi combined with excess heat; craving dirt indicates Gan disease arising in the Spleen organ; Tai Jing Ye Ti (fetal fright and night crying) is evil heat attacking the Heart; Bian Fa Re Re (transformation fever) is fetal toxin dispersing; Dan Du (erysipelas/toxic heat) is fire moving externally; Yun Re (accumulated heat) is fire accumulating internally; Zhong'e is external pathogens taking advantage of weakness; Shui Jing (sleep fright) is internal fire stirring; Hou Bi is toxic heat; Yan Tong is excess fire; Nong Er is Kidney qi rushing upward; Bi Han is Wind pathogen in the Stomach; Tou Tong is toxic heat attacking; Qi Tong is Wind-Dampness striking; Wei Gu Tong is Yin deficiency with phlegm; Zhu Chong Tong is rotting Stomach qi; Yin Zhong Shan Qi (scrotal swelling and hernia) is depression by Cold; Pan Chang Qi (coiled-intestine qi) is clashing by cold; Tuo Gang (rectal prolapse) is deficiency and slipping of the Large Intestine; Yi Niao (enuresis) is cold weakness of the Bladder; Niao Zhuo (cloudy urine) is dampness stagnating in the Spleen and Stomach; Bian Xue (blood in stool) is heat transmitting to the Heart and Lungs; Xia Lin (dysuria) is depressed heat in the Bladder; Tu Xue (vomiting blood) is rebellion of Ying and Wei qi; Xiao Bian Bu Tong (inability to urinate) has Yin and Yang distinctions; Da Bian Bi Jie (constipation) has Deficiency and Excess distinctions; Jie Lu He Xi (open fontanelle and crane knee) is incomplete fetal origin; Xing Chi Fa Ni (delayed walking and inverted hair) is insufficient qi and blood; Gui Xiong (turtle chest) is Lung heat causing distension; Gui Bei (turtle back) is evil wind entering the spine; Yu Chi (delayed speech) is evil attacking the Heart; Chi Chi (delayed teething) is insufficiency of the Kidney; Nue (malaria) is phlegm knotting above the diaphragm; Li (dysentery) is food accumulation in the abdomen; Ke Sou (cough) is Lung injured by Wind; Chan Ji (wheezing urgency) is excess phlegm and qi; Xin Tong (heart pain) is caused by worms biting; Fu Tong (abdominal pain) is caused by food injury; Internal injury fever presents with bitter taste and dry tongue; External contraction fever presents with nasal congestion and heavy voice; Zhang Fu (abdominal distension) is Spleen-Stomach weakness; Shui Zhong (edema) is Earth deficiency with Fire hyperactivity; Huang Dan (jaundice) is damp-heat in the Spleen and Stomach; Ban Zhen (macules and papules) is Yin-Yang toxic vapor; Zi Han (spontaneous sweating) is qi deficiency; Ji (accumulation) has fixed locations and consists of有形 (formative) blood; Ju (mass) has no fixed position and consists of无形 (formless) qi. The Stomach governs reception and acceptance; the Spleen governs transportation and transformation. When Spleen and Stomach are strong, the four limbs are peaceful; when weak, myriad diseases arise. Therefore, regulating the Spleen and Stomach is the royal way among physicians; restraining diet is the good prescription for dispelling disease. Jing (fright), Gan (malnutrition), Ji (accumulation), and Re (heat) are common childhood diseases. Wang, Wen, Wen, Qie are the great methods of physicians. As for treating diseases with medicine, hitting the target like an arrow requires mental comprehension and cannot be fully conveyed by words. Mencius said: "Carpenters and wheelwrights can teach others the rules, but cannot make them skillful." This statement is apt.