小儿方术。号曰哑科。口不能言。脉无所视。唯形色以为凭。竭心思而施治。故善养子
似养龙以调护。不善养子者。如舐犊之爱惜。爱之愈深。害之愈切。乍头温而足冷。忽多啼
而乱叫。差之毫厘。失之千里。此无脉之风门。以补造化之不及。肠胃脆薄兮。饮食易伤。
筋骨柔弱兮。风寒易袭。父母何知。看承太重。重绵浓褥。反助阳以耗阴。流 放饭。总败
脾而损胃。闻异声。见异物。失以提防。深其居。简其出。固于周密。未期而行立兮。喜其
长成。无事而喜笑兮。谓其聪明。一旦病生。而人心戚。不信医而信巫。不求药而求鬼。此
人事之不修。谓天命之如此。欲观气色。先分部位。左颊青龙属肝。右颊白虎属肺。天庭高
而离阳心火。地阁低而坎阴肾水。鼻在中而脾土为通气。观乎色之所见。知乎病之所起。又
况脾应乎唇。肺通于鼻。舌乃心苗。泪为肝液。胃流注于双颐。肾开窍于两耳。爪则筋之余
。而脾为之运。发则血之余。而肾为之主。脾司手足。肾运齿牙。苟五脏之或衰。即所属之
先毙。凡观乎外。必知其内。红气现而热蒸。青色露而惊悸。如煤之黑兮。中恶之因。似橘
之黄兮。脾虚之谓。白乃疳劳。紫为热极。青遮口角难医。黑掩太阳不治。年寿赤光。多生
脓血。山根青黑。频见灾危。虽察色以知乌。岂按图而索骥。朱雀贯于双瞳。火入水乡。青
龙达于四白。肝乘肺位。泻痢而带伤须防。咳嗽而拖蓝可忌。疼痛方殷。常面青而唇撮。惊
风欲发。先颜赤而目直。火光焰焰。外感风寒。金气浮浮。中藏癖积。乍黄乍白兮。疳热连
绵。又赤又青兮。风邪紧急。察之若精。治之得理。鸦声鱼口。枉费精神。肉折皮干。空劳
心力。气色改移。形容变易。气乏兮囟门成坑。血衰兮头毛作穗。眼生眵泪兮肝风 目。口
流痰涎兮。脾冷滞积。面目虚浮。定腹胀而气喘。眉毛频蹙。则肚痛以多啼。蛔出兮脾胃将
败。 疮兮肛藏先亏。苟瞑眩而弗瘳。纵神仙而何益。手如数物。肝风将发。面若涂朱。心
火以炽。坐卧欲冷兮。烦热之攻。伸缩就暖兮。风寒之畏。肚大脚细。脾欲困而成疳。眼瞪
口张。热已危而必毙。弄舌脾热。解颅肾惫。重舌木舌。虚热积于心脾。哽气喘气。实火浮
于脾肺。龈宣臭露。必是牙疳，哺露丁奚。多缘食积。唇干作渴。肠鸣自利。夜啼分为四症
。变蒸周于一年。心热欲言而不能。脾虚无时而好睡。病后失音肾怯。咳嗽失音肺病。肚痛
而清水流出者虫。腹痛而大便酸秽者积。口频欠而肝虚。舌长伸而火炽。龟背兮肾风入于骨
髓。龟胸兮肺火胀于胸膈。鼻干黑燥。火盛金衰。肚大青筋。木强土坏。丹瘤疮疥。皆胎毒
之流连。吐泻疟痢。乃食积之沾滞。不能吮乳者。热在心脾。常欲俯卧者。热蒸肠胃。喜视
灯火。烦热在心。爱吃泥土。疳热在脾。腹痛寒侵。口疮热积。脐风忌一腊。火丹畏一周。
惊自热来。痫因痰至。吐泻而精神耗散则危。疟痢而饮食减少心瘁。惊本心生。风因肝致。
搐分左右。症有顺逆。药分补泻。病有虚实。急惊者。由于积热之深。凉泻便宜。慢惊者。
得于大病之后。温补为贵。头摇目窜而气喘兮。上工莫医。口噤鼻张而足凉兮。灵丹何济。
闭目兮无魂。狂叫兮多祟。不知吞吐者死。反加闷乱者危。既明症候。须知调理。胎毒兮甘
草黄连。食积兮白术枳壳。急掠搐掣。以导赤泻青。慢惊螈 。以补中益气。集圣治疳。备
急去积。抱龙丸化痰镇惊。胃苓丸补中开胃。夜啼兮退热凉心。晡热兮养血升提。理中主泻
。香连止痢。积热不除。凉惊丸大有神功。沉寒难瘳。养脾丸最为秘密。痰火攻兮三黄丸。
谷下兮一粒金。柴芩治疟。月蝉消痞。潮热金花。咳嗽玉液。疮疥胡麻。丹瘤凉膈。吐泻而
渴兮。白术可投。烦热而渴兮。益元为最。丹疹兮消毒。腹痛兮脾积。鼻衄咳血茅花。木舌
重舌针刺。口疮不愈者洗心。腹胀不食者平胃。五拗治啼。四苓利水。退黄消肿。胃苓加减
以堪行。破积安虫。集圣从容而可治。大抵小儿易为虚实。调理但取其平。补泻无过其剂。
尤忌巴牛。勿多金石。辛热走气以耗阴。苦寒败阳而损胃。如逢食积。解之不可或迟。若过
虚羸。补之尤为至急。才少俄延。便成劳毙。
Pediatric medicine is referred to as the "Mute Department" (Ya Ke). Since infants cannot speak and pulse diagnosis is difficult, treatment relies solely on observing facial complexion and physical form, requiring great mental effort. Therefore, those who are good at nurturing children care for them like tending to a dragon, while those who are not good at it love them excessively like an old cow licking its calf; the deeper the love, the more severe the harm. Sudden warmth of the head with cold feet, or sudden excessive crying and screaming, if mishandled even slightly, can lead to disastrous consequences. This approach compensates for the lack of pulse information through observation.
Infants have fragile intestines and stomachs, making them susceptible to dietary injury; their bones and sinews are weak, making them vulnerable to wind-cold invasion. Parents often misunderstand this, overprotecting the child. Thick cotton clothes and heavy bedding may assist yang but consume yin. Overly refined foods damage the spleen and stomach. Failure to guard against strange sounds or objects, keeping the child in deep seclusion without going out, though well-intentioned, is misguided. Expecting an infant under one year old to walk or stand, or interpreting normal smiling as intelligence, leads to disappointment when illness strikes. Instead of trusting doctors and seeking medicine, parents may turn to shamans and ghosts, blaming fate rather than human negligence.
To observe complexion, one must distinguish locations: the left cheek corresponds to the Azure Dragon (Qing Long) and the Liver; the right cheek to the White Tiger (Bai Hu) and the Lungs; the high forehead (Tian Ting) to the Li Yang Heart Fire; the low chin (Di Ge) to the Kan Yin Kidney Water; and the nose in the center to the Earth of the Spleen, serving as the passage for qi. Observing colors reveals the origin of disease. The spleen manifests in the lips, the lungs in the nose, the tongue is the sprout of the heart, tears are the fluid of the liver, the Stomach meridian flows to the cheeks, and the Kidneys open into the ears. Nails are the surplus of sinews, governed by the Spleen's transformation; hair is the surplus of blood, governed by the Kidneys. The Spleen controls the hands and feet, and the Kidneys govern teeth and jaws. If any of the five Zang organs declines, its corresponding external sign will fail first. External observation reveals internal states: redness indicates steaming heat; blueness indicates fright and palpitations; black like coal indicates poisoning from evil qi; yellow like an orange indicates Spleen deficiency; white indicates consumption (Gan syndrome); purple indicates extreme heat. Blue covering the mouth corners is hard to treat; black covering the temples is untreatable. Redness at the Nasal Tip and below (Nian Shou) suggests pus and blood; blue-black at the Mountain Root (Shan Gen) suggests frequent disaster. Although color observation aids diagnosis, one must not rigidly follow charts.
Redness piercing the pupils indicates Fire entering the Water region (Kidney); blueness reaching the whites of the eyes indicates Liver attacking the Lung position, suggesting diarrhea/dysentery with potential injury. Cough with a blue tint should be avoided. Severe pain presents with a green face and puckered lips; impending convulsions present with a red face and staring eyes. Flaming redness indicates external wind-cold; floating pallor indicates internal accumulation (Pi Ji). Alternating yellow and white indicates lingering Gan-heat; mixed red and blue indicates urgent wind-pathogen. Precise observation and rational treatment are essential. "Crow voice" or "fish mouth" breathing wastes effort; broken flesh and dry skin exhaust energy. Changes in qi and color alter appearance. Qi deficiency causes a sunken fontanelle; blood deficiency causes tufted hair. Eye discharge indicates Liver wind eye disease; drooling indicates Cold-Spleen stagnation. Puffy face indicates abdominal distension and asthma; furrowed brows indicate abdominal pain and crying. Roundworms exiting the anus indicate failing Spleen-Stomach; anal sores indicate initial deficit in the lower orifices. If Mingxuan reaction (herxheimer-like reaction) does not lead to cure, even immortals cannot help. Hands counting objects indicate impending Liver wind; face painted red indicates blazing Heart fire. Desire to sit/lie cool indicates harassing heat; desire to stretch/toward warmth indicates fear of wind-cold. Large belly and thin legs indicate Spleen exhaustion leading to Gan syndrome; staring eyes and open mouth indicate critical heat leading to death. Tongue protrusion indicates Spleen heat; open fontanelle (Jie Lu) indicates Kidney exhaustion. Double tongue or wooden tongue indicates deficient heat accumulating in Heart and Spleen; choking and panting indicate excess fire floating in Spleen and Lungs. Gums receding and foul odor indicate tooth gangrene; "Pu Lu Ding Xi" (severe emaciation) stems from food stagnation. Dry lips and thirst with borborygmus and spontaneous diarrhea. Night crying has four syndromes. Bian Zheng cycles occur within a year. Heart heat causes inability to speak despite wanting to; Spleen deficiency causes drowsiness. Post-illness aphonia indicates Kidney weakness; cough with aphonia indicates Lung disease. Abdominal pain with clear water indicates worms; abdominal pain with sour/foul stool indicates accumulation. Frequent yawning indicates Liver deficiency; long tongue extension indicates blazing fire. Tortoise back indicates Kidney wind entering bone marrow; tortoise chest indicates Lung fire swelling the chest/diaphragm. Dry/black nose indicates excess fire and deficient Metal; large belly with visible veins indicates strong Wood (Liver) and ruined Earth (Spleen). Dan tumors, sores, and scabies stem from lingering fetal toxins; vomiting, diarrhea, malaria, and dysentery stem from food stagnation. Inability to suck milk indicates heat in Heart/Spleen; preference for prone position indicates heat steaming intestines/stomach; liking bright lights indicates harassing heat in Heart; eating dirt indicates Gan-heat in Spleen. Abdominal pain from cold invasion; mouth ulcers from heat accumulation. Umbilical wind is feared until age one; fire dan is feared until age one. Fright arises from heat; epilepsy arises from phlegm. Vomiting/diarrhea with spirit depletion is critical; malaria/dysentery with reduced appetite causes heart exhaustion. Fright originates in the Heart; wind originates in the Liver. Convulsions differ by side; syndromes have favorable/unfavorable courses; medicines differ by tonifying/draining; diseases differ by deficiency/excess.
Acute convulsions (Ji Jing Feng) result from deep accumulated heat, suitable for cooling and draining. Chronic convulsions (Man Jing Feng) occur after major illnesses, suitable for warming and tonifying. Head shaking, eye wandering, and panting are untreatable by experts; clenched jaw, flaring nostrils, and cold feet render spirits useless. Closed eyes without soul, wild screaming with many hauntings, inability to swallow/digest, and increased restlessness are fatal or critical. Once symptoms are understood, regulation is needed. Fetal toxin uses Gan Cao and Huang Lian; food stagnation uses Bai Zhu and Zhi Ke. For acute convulsions with jerking, use Dao Chi San and Xie Qing Wan. For chronic convulsions with twitching, use Bu Zhong Yi Qi Tang. Ji Sheng Wan treats Gan; Bei Ji Wan removes stagnation. Bao Long Wan resolves phlegm and calms fright; Wei Ling Wan tonifies middle and opens stomach. Night crying uses methods to clear heat and cool the heart; afternoon fever (Bu Re) uses methods to nourish blood and lift qi. Li Zhong Tang treats diarrhea; Xiang Lian Wan stops dysentery. If accumulated heat persists, Liang Jing Wan is effective; if deep cold resists cure, Yang Pi Wan is secret. Phlegm-fire attacking uses San Huang Wan; prolapse uses Yi Li Jin. Chai Hu and Huang Qin treat malaria; Yue Chan resolves masses. Chao Re uses Jin Hua Wan; cough uses Yu Ye Gao. Sores/scabies use Hu Ma; Dan tumors use Liang Ge San. Vomiting/diarrhea with thirst allows Bai Zhu; harassing heat with thirst favors Yi Yuan San. Dan zhen uses detoxification; abdominal pain uses Spleen-accumulation treatment. Epistaxis/hemoptysis uses Mao Hua; wooden/double tongue needs acupuncture. Persistent mouth ulcers use Xi Xin San; abdominal distension/anorexia uses Ping Wei San. Wu Ao Tang treats crying; Si Ling San promotes urination. To reduce jaundice/swelling, modified Wei Ling Wan works. To break stagnation and calm worms, Ji Sheng Wan works calmly.
Generally, infants easily shift between deficiency and excess; regulation seeks balance. Tonification and drainage must not exceed appropriate doses. Bahu (Euphorbia) and Niuhuang (Calculus Bovis) are especially taboo; metallic/mineral drugs should be used sparingly. Acrid-hot herbs move qi and consume yin; bitter-cold herbs defeat yang and damage the stomach. Food stagnation requires prompt resolution; severe deficiency requires urgent tonification. Delay leads to consumptive death.