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Qian Zhongyang stated: When a child's pulse qi is disharmonious, it presents as wiry and tense (Xianji); food injury presents as deep and slow (Chenhuān); deficiency fright presents as rapid and hurried (Cuji); wind presents as floating (Fu); cold presents as deep and fine (Chenxi); and a chaotic pulse indicates an untreatable condition.

The *Shuijing Jue* states: Yin and Yang interact to form the body; once the nine orifices and four limbs are distinguished, the five zang and six fu organs arise. Since their locations are distinct, determining favorable and unfavorable prognoses is difficult. Relying solely on the floating or sinking of the cunkou pulse will inevitably lead to the sudden death of the child. One must clearly observe the Tiger’s Mouth (the radial side of the infant's index finger) and examine the Three Passes (Fengguan, Qiguan, Mingguan). Only by carefully evaluating and prescribing medication can errors be avoided. For children under three years old, observe the Tiger’s Mouth fingerprint. The first segment of the index finger is named Fengguan (Wind Pass); if the fingerprint appears here, the disease is in its early stage and easy to treat. The second segment is named Qiguan (Qi Pass); if the fingerprint appears here, the disease is deep and difficult to treat. The third segment is named Mingguan (Life Pass); if the fingerprint appears here, the condition is fatal and untreatable. A greenish color across the three passes indicates fright from four-legged animals; red indicates fright from water; black indicates fright from humans; purple indicates diarrhea and dysentery; yellow indicates fright from thunder. If the fingerprint spans all three passes, it signifies extreme fright and is fatal. If the fingerprint is either green or red with a straight line extending from the tip, it indicates spleen injury from milk and food, which will likely develop into fright-heat. If identical on both sides, it indicates concurrent fright and accumulation. If there are three lines or they are scattered, it indicates wind-phlegm generated by the lungs. Abnormal sounds may accompany this. Redness indicates wind-cold and cough; fire-red indicates diarrhea; a mix of red and black indicates dysentery; black and green indicate white or bloody dysentery; a mix of red and purple with thirst indicates stomach qi disharmony. Green indicates fright and accumulation; green-black indicates slow fright; if the pulse enters the palm, it indicates internal hooking (Neidiao, a condition of abdominal pain and constriction); if the fingerprint curves inward, wind is excessive; if it curves outward, food accumulation is present. This describes the method for children over three years old. For children under three, use one finger to press the high bone (radial styloid process) to distinguish the three passes and count breaths. Seven to eight beats per breath is a normal pulse; nine beats indicates discomfort; ten beats indicates critical condition. Floating indicates wind; deep and slow indicates deficiency-cold; full indicates heat; tight indicates epilepsy; surging indicates excessive heat; deep and slow indicates deficiency-diarrhea; faint and slow indicates accumulation and parasites; slow and choppy indicates stomach epigastric disharmony; deep indicates difficulty digesting milk; deep and fine indicates milk stagnation; tight and wiry indicates abdominal heat and pain; firm and solid indicates constipation. Deep and rapid indicates heat in the bones; wiry and long indicates wind in the liver and lungs; tight and rapid indicates fright-wind pathology with twitching of the four limbs; floating and surging indicates heat in the stomach; deep and tight indicates abdominal pain due to cold; deficient and choppy indicates qi stagnation and also slow fright; hollow indicates profuse bowel movements with blood. For children under four, roll one finger to locate the three positions, using the Guan position as the standard. For seven- or eight-year-olds, shift the finger slightly. For nine-year-olds, sequentially follow the Three Passes positions. Eleven- and twelve-year-olds are similar. Fourteen- and fifteen-year-olds are examined according to adult pulse diagnosis methods. Generally, determine floating/sinking, slow/rapid, yin/yang, and cold/heat first. Deep (Interior) and Slow (Cold) are Yin; Floating (Exterior) and Rapid (Heat) are Yang. Also consider the location. Green indicates fright-wind; white indicates deficiency-diarrhea; red indicates phlegm-heat; black indicates deep disease; yellow indicates spleen malnutrition (Gan). By comparing these, treatment can proceed without error. (Commentary: Do not rigidly adhere to the following fingerprint shapes for prescription, but one must know them, so they are attached below. Below involves differentiating pulse forms for treatment.)

Liuzhu Shape (Commentary: Liuzhu shape is a single red dot on the side of the Wind Pass of the index finger): Indicates food injury, internal heat with desire to vomit, or borborygmus with spontaneous diarrhea, irritability, and crying. Use Zhuwei Gao (Stomach-Assisting Paste) to resolve food and differentiate yin and yang. If digestion resolves but the illness persists, use Xiangsha Zhuwei Gao (Aucklandia and Amomum Stomach-Assisting Paste) to tonify the spleen and stomach.

Huanzhu Shape (Commentary: Huanzhu shape is larger than Liuzhu): Indicates spleen deficiency with food retention, chest and diaphragm distension, irritability, thirst, and fever. Use Wuwei Yigong San (Five-Ingredient Extraordinary Efficacy Powder) plus Hawthorn Fruit (Shanzha) and Immature Bitter Orange (Zhishi) to strengthen the spleen and resolve food. Subsequently, use Liujunzi Tang (Six-Gentlemen Decoction) to regulate middle qi.

Changzhu Shape (Commentary: Changzhu shape is round and long; above does not mean circles, generally red vessels penetrate qi like this): Indicates spleen injury, food stagnation, abdominal pain, alternating chills and fever, and anorexia. First use Da'an Wan (Great Peace Pill) to resolve stagnation, then use Yigong San (Extraordinary Efficacy Powder) to strengthen spleen qi.

Laishe Shape (Commentary: Laishe shape is a dispersed Changzhu shape, large at one end and pointed at the other): Indicates spleen-stomach issues, spleen damp-heat causing epigastric obstruction, dry retching, and anorexia. This is internal Gan pathogen activity. First use Siwei Fei'er Wan (Four-Ingredient Child-Nourishing Pill) to treat Gan, then use Sijunzi Tang (Four-Gentlemen Decoction) to tonify the spleen.

Qushe Shape (Commentary: Qushe is similar, divided into upper and lower directions, hence called Laishe and Qushe): Indicates spleen deficiency with food accumulation leading to vomiting and diarrhea, irritability, thirst, shortness of breath, rapid breathing, anorexia, and fatigue. First use Liujunzi Tang plus Zhishi to strengthen the spleen and resolve accumulation, then use Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder) to regulate and tonify stomach qi.

Gongfanli Shape (Commentary: Opisthotonos curving inward is favorable, outward is unfavorable): Indicates contraction of cold evil, gasping, fright palpitations, fatigue, cold extremities, dark urine, cough, and salivation. First use Xingxing San (Wonderful Powder) to assist stomach qi and dispel external evil, then use Wuwei Yigong San plus Poria (Fushen) and Angelica Sinensis (Danggui) to nourish heart blood and assist stomach qi. If external evil is resolved but fright palpitations and cold fingers persist, spleen qi is damaged; use Qiwei Baizhu San to tonify. If there is confusion, rough breathing, and rapid gasping, it is difficult to treat due to severe spleen deficiency.

Gongfanwai Shape: Indicates phlegm-heat, mental confusion, concurrent fright and food, wind-epilepsy with abundant phlegm. First use Tianma Fangfeng Wan (Gastrodia and Saposhnikovia Pill) to dispel external evil, then use Wuwei Yigong San to regulate middle qi.

Zhen Shape (Commentary: Zhen shape goes straight up): Indicates wind-heat generating phlegm and convulsions. First use Baolong Wan (Dragon-Holding Pill); if ineffective, use Niuhuang Qingxin Wan (Calculus Bovis Heart-Clearing Pill). If transmitted to spleen and lungs, or due to overuse of wind-phlegm resolving drugs resulting in various symptoms, specifically regulate and tonify spleen and stomach.

Yugu Shape (Commentary: Yugu shape is separated like fish bones): Indicates fright-phlegm and fever. First treat with Baolong Wan; if ineffective, it belongs to excess heat of liver fire, use little Yiqing Wan (Suppressing Cyan Pill) to clear the liver, followed by Liuwei Wan (Six-Ingredient Pill) to tonify the liver. Or if fever with poor appetite or abundant phlegm with convulsions occurs, it is liver wood overcoming spleen earth; use Liujunzi Tang plus Bupleurum (Chaihu) to tonify spleen earth to control liver wood.

Shuizi Shape (Commentary: Shuizi shape shows three pulses simultaneously): Indicates wind-fright and food accumulation, chest irritation, sudden stuffiness, poor appetite, night crying with abundant phlegm, locked jaw, and convulsions. This is spleen-stomach weakness, food stagnation, and wood overcoming earth. First use Da'an Wan to guide out food, then use Liujun Gouteng (Six-Gentlemen and Uncaria) to tonify middle and clear liver. If already taken resolving and phlegm-resolving agents but the illness persists, use Sijunzi, Cimicifuga (Shengma), Bupleurum (Chaihu), and Uncaria (Gouteng) to ascend and tonify spleen qi and level liver wood.

Zhen Shape (Commentary: Zhen shape crosses the pass by one or two rice grains): Indicates extreme heat in heart and liver generating wind, fright palpitations, oppression, fatigue, anorexia, abundant phlegm, and convulsions. First use Baolong Wan to dispel wind and resolve phlegm, then use Liujunzi Tang and Gouteng to calm liver and strengthen spleen.

Touguanshezhi Shape (Commentary: Touzhi Mingmai curves inward): Indicates fright-wind and phlegm-heat gathering in chest and diaphragm, due to spleen-lung deficiency and phlegm pathogen accumulation. First use Niuhuang Qingxin Wan to clear spleen-lung and resolve phlegm-saliva, then use Liujunzi Tang plus Platycodon (Jiegeng) and Chinese Yam (Shanyao) to tonify spleen earth and benefit lung metal.

Touguanshejia Shape (Commentary: Shejia Mingguan extends outward): Indicates a deteriorating condition of fright-wind where liver wood overcomes spleen earth. Urgently use Liujunzi, Costus Root (Muxiang), Gouteng, and Cinnamon Twig (Guangui) to warm and tonify spleen earth. If ineffective, add Aconite (Fuzi) to restore yang qi; many recover. I have heard ancients say that children are like sprouts, like grass shoots or water bubbles, because their zang-fu are fragile and tender, they cannot speak, and prescribing is most difficult. One should first observe facial color to determine the category, then verify the Tiger’s Mouth to identify the cause, which is truly a concise treatment method.

(Tiger’s Mouth Fingerprint Song:)
(Differentiate three passes for infant food accumulation, looking left for boys and right for girls similarly. To know initial wind conditions, ending at Mingmen is easy yet difficult. To know Tiger’s Mouth qi and fingerprint pulse, look at the finger shape and divide five colors. Yellow and red indicate harmonious five zang; red and purple indicate slight gain or loss. Purple-green indicates food injury and qi deficiency; green-black indicates extreme seasonal symptoms. Suddenly pure black in between makes even skilled doctors fearful. Deep green fingerprint indicates fright palpitations; half green indicates acute fright. Green and deep purple with shriveled spirit and irregular movement indicates slow fright. Purple-black-green patterns or hidden, appearing and disappearing, indicate slow spleen. Light green indicates abdominal pain; green-black indicates internal hooking and convulsions. Pale red indicates dysentery or vomiting/diarrhea; abdominal pain and anorexia make the illness particularly difficult. Deep purple indicates fright crying; red indicates fright-heat; half red-half purple indicates wind-cold. Light purple indicates irritability/thirst or vomiting/dysentery. Curved fingerprint relates to milk injury illness. Curved inward is smooth and acceptable; outward crossing the nail indicates dying pulse. Wind Pass fish-bone indicates fright-green treatment; Qi Pass indicates Gan-labor heat easily cured. Mingguan green indicates deficiency wind treatment; wind entering spleen and lung indicates difficulty. Wind seeing hanging needle indicates water fright; Qi Pass Gan also generates lung annoyance. Mingguan appearance is untreatable; slight purple-red is light. Wind Pass water indicates fright entering lung, cough generating phlegm and tidal fever. Qi Pass saliva-phlegm accumulation not transforming; Mingguan fright-Gan accumulation crying also collapses. Yi character at Wind Pass indicates liver fright; Qi Pass also indicates fright invasion. Mingguan if slow spleen disease, even spiritual pills cannot save life. Wind seeing roundworm Gan accumulation, urinary blockage and abdominal distension. Qi Pass thirst indicates diarrhea-dysentery; Mingguan meeting it definitely leads to collapse. Ring shape at Wind Pass indicates liver Gan accumulation; Qi Pass knows vomiting invasion. Long illness definitely due to Gan entering stomach; Mingguan appearance means death without life. Once seeing Liuzhu, diaphragm heat is much; three jiao not slow, frequent diarrhea. Irritability crying wanting to vomit, borborygmus and self-diarrhea can be harmonized. Laishe epigastric disharmony, accumulated qi attacking dry retching much. If seeing Qushe time diarrhea-dysentery, spleen deficiency food not digested. Gongfanli shape head-eye heavy, cold evil fright inside urine yellow. Four limbs fatigue and cold, dispelling cold and dispersing wind brings health. Gongfanwai shape phlegm-heat illness, concurrent fright-food and wind-epilepsy. Mental fright palpitations spirit tired, using medicine to calm heart brings cure.)

(Purple heat, red wind-cold, green fright, white Gan, black time due to evil intrusion, yellow traps spleen.)

For infants under half a year, place three fingers of the ring finger between the forehead, eyebrow ends, and hairline. If the child's head is to the left, raise the right hand; if to the right, raise the left hand. Index finger is upper, middle finger is middle, ring finger is lower. Heat in all three fingers indicates external wind contraction, nasal congestion, and cough; cold in all three indicates external cold contraction, internal food injury, fever, vomiting, and diarrhea. Heat in the middle finger indicates upper heat and lower cold; heat in the middle finger indicates concurrent fright; heat in the index finger indicates food stagnation.

[Attached Formulas]
Zhuwei Gao (Stomach-Assisting Paste): Aucklandia (Muxiang), Dried Ginger (Ganjiang), Prepared Licorice (Zhigancao), Chinese Yam (Shanyao), Lotus Seed (Lianrou), Atractylodes Macrocephala (Baizhu), Poria (Fuling), Myristica Seed (Rouguo), Chebula Fruit (Hezi), Medicated Leaven (Shenqu), Malt (Maiya), Ginseng (Renshen), Amomum (Sharen), Tangerine Peel (Dingpi), White Cardamom (Baiko). Grind into powder, honey-pill, size of Corn Coturnix seed (Qianshi).
Wuwei Yigong San (Five-Ingredient Extraordinary Efficacy Powder): See Fright-Wind Syndrome.
Liujunzi Tang (Six-Gentlemen Decoction): See Malaria Syndrome.
Da'an Wan (Great Peace Pill): See Drooling Syndrome.
Siwei Wan (Four-Ingredient Pill): See Five-Softness Syndrome.
Sijunzi Tang (Four-Gentlemen Decoction): See Fright-Wind Syndrome.
Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder): See [Missing] Syndrome.
Xingxing San (Wonderful Powder): See Various Vomiting Syndromes.
Tianma Fangfeng Wan (Gastrodia and Saposhnikovia Pill): Gastrodia (Tianma), Saposhnikovia (Fangfeng), Pinellia (Banxia), Ligusticum Chuanxiong (Chuanxiong), Aloe (Lvhui), Indigo Naturalis (Qingdai), Coptis (Huanglian), Trogopterus Dung (Wuling), Cicada Slough (Chantui), Whole Scorpion (Quanxie), Moschus (Shexiang), Owl Droppings (Yemingcha).
Baolong Wan (Dragon-Holding Pill): See Fright-Wind Syndrome.
Niuhuang Qingxin Wan (Calculus Bovis Heart-Clearing Pill): See Drooling Syndrome Internal.
Yiqing Wan (Suppressing Cyan Pill): Coptis (Huanglian), Evodia (Wuzhuyu). Soak in decoction overnight, grind into powder, water-pill. Greatly drains liver fire, treats left hypochondriac pain.