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If a child's heart area throbs, it is definitely due to fright. If there is fever but no throbbing, it can be known as injury by wind pathogen (Feng Shang). Although the body is cold and the eyes roll back, it should be viewed as water fright (Shui Jing).

Qian stated: When physicians examine patients, they use observation, listening/smelling, inquiry, and palpation. However, observation must come first. Therefore, when performing pediatric tuina, one must also prioritize observation methods.

When a newborn is born, the five sense organs should appear red. The ears, eyes, mouth, nose, and tianting (the center of the forehead) are considered the five sense organs. At birth, qi and blood are full, and their color is purely red; hence they are called "chi zi" (red children). If white qi appears at shangen (root of the nose), yintang (between the eyebrows), or the hairline, it indicates premature death. Black qi appearing above and below kan (referring to areas around the philtrum) indicates insufficient qi and blood; if seen above and below the lips, it also indicates premature death. Only if there is a bone tendon on the nasal bridge extending straight up to tianxin (above the glabella), termed "bu gu cha tian," does it indicate longevity and nobility, predicting no fright or epilepsy throughout life.

A constant red mouth indicates no disease; white indicates deficiency; black indicates critical condition. Blackness in the philtrum indicates abdominal pain and intestinal parasites; dotted blackness indicates vomiting or dysentery. Purple at shangen indicates milk or food injury; green indicates illness. Yellow and white at yintang are auspicious; green and red indicate fright-wind. Green forehead indicates fright; red forehead indicates heat. Red eyebrows indicate night crying and irritability. Yellow sclera indicates typhoid/febrile disease; yellow iris indicates food stagnation.

First, observe both eyes. The eyes are the gathering place of the essence of the five zang organs and the seed of divine spirit throughout the body. It is most favorable for the eyeballs to be black and lustrous with clear whites, showing bright spirit, which is a sign of longevity. Even if diseased, recovery will be easy. If the whites are excessive and the blacks are dim, or if the pupils are small, this indicates weak congenital qi from parents and deficient endowment, leading to many disasters and illnesses.

Second, observe the fontanelle. This is formed from father's essence and mother's blood. If full and tight, the child will surely live long. If soft and not firm, diseases will frequently occur. If the fontanelle fails to close, it is named "jie lu" (cranial suture delay). A sunken fontanelle indicates certain death and requires no treatment.

Third, observe the physique and appearance. Generally, a small mouth, crooked nose, furrowed brow between the eyebrows, and rough skin indicate that although not necessarily premature death, the child will suffer from many illnesses. Conversely, a large mouth, straight nose, clear eyebrows, beautiful eyes, and proportional features form the foundation of fortune and longevity.

Fourth, observe the hair. Hair is nourished by mother's blood and thus called "xue yu" (blood remainder). If mother's blood is sufficient, the child's hair will be black, shiny, and moist. If mother's blood is weak, the child's hair will be yellow and dry, inevitably leading to conditions like gan syndrome (malnutrition) and skin sores.

Fifth, observe the ear gates. Ears shaped like a small 'ding' frame with double tips indicate longevity. Single tips indicate premature death. If at birth the exterior shows single tips but interior palpation reveals double bones, which subsequently grow out, longevity is still possible. In summary, double-tip frames may not indicate longevity, while single tips certainly prevent growing up. Physicians observing this can determine survival or death.