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Observe the physical form and facial color to distinguish the etiology. Yin deficiency and Yang excess may lead to impaired flexibility (or manifest as stiffness). If it is Shanghan (Cold Damage), both feet will be cold; to know if there is internal heat, one must examine the abdomen. A cold nose indicates Zhen Dou (smallpox or measles); cool ears indicate an invasion of Wind-Heat. Generalized body heat characterizes Shang Feng (Wind-Cold injury); coldness in the lower body with heat in the upper body points to Food Stagnation.

Children vary in size, and diseases differ in depth. The physical form, voice, spirit, and pulse present distinct variations. Among the four diagnostic methods—Wang (Inspection), Wen (Auscultation and Olfaction), Wen (Inquiry), and Qie (Palpation)—if one can thoroughly investigate these principles, one can be considered a physician possessing the divine, sacred, skilled, and adept arts. "Wang" (Inspection) involves observing to distinguish colors. For instance, on the face: the left cheek corresponds to the Liver, the right cheek to the Lung, the forehead to the Heart, the nose to the Spleen, and the cheeks/jaw area to the Kidney. Liver disease manifests as a greenish complexion; Lung disease as white; Heart disease as red; Spleen disease as yellow; Kidney disease as black. This is knowing through inspection. "Wen" (Auscultation) involves listening to the voice to identify symptoms. For example: Liver disease presents with a mournful voice; Lung disease with a rapid/short breath voice; Heart disease with a robust voice; Spleen disease with a slow voice; Kidney disease with a deep voice. These belong to the Zang organs. Large Intestine disease presents with a long voice; Small Intestine disease with a short voice; Stomach disease with a quick voice; Gallbladder disease with a clear voice; Bladder disease with a faint voice. These belong to the Fu organs. This is knowing through auscultation. "Wen" (Inquiry) involves investigating the source of the disease. Preference for sour taste suggests Liver disease; pungent taste suggests Lung disease; bitter taste suggests Heart disease; sweet taste suggests Spleen disease; salty taste suggests Kidney disease. Preference for hot foods suggests internal Cold; preference for cold foods suggests internal Heat. This is knowing through inquiry. "Qie" (Palpation/Pulse-taking) involves palpating the pulse to observe the disease. In children under three years old who are ill, inspect the Three Passages on the left hand for males and the right hand for females. The Mao position is the Qi Passage; the Yin position is the Wind Passage; the Chen position is the Life Passage (where treatment is difficult for physicians). If tendons in the Tiger's Mouth extend upwards, one must distinguish among five colors. Red and yellow indicate peace and harmony of the Five Zang organs; blue/green and purple indicate fright or Wind pathogen invasion. This is knowing through palpation. This is the general outline.

The Tiger's Mouth has three passages: Purple indicates Heat; Red indicates Shanghan; Green indicates Fright/Wind; White indicates Gan accumulation (malnutrition); Black indicates Zhong E (sudden severe poisoning or evil influence); Yellow indicates Spleen/Stomach disorders. The Three Passages refer to the Wind, Qi, and Life passages.

Coldness at the tips of all five fingers indicates severe fright that is hard to withstand. If the middle finger is hot, it is definitely Shanghan. If only the middle finger is cold, it transmits the sign of Zhen Dou (measles/smallpox). One must distinguish between left and right hands for males and females, observing clearly and carefully.