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From one month to three years of age, infants and young children cannot yet be diagnosed by pulse taking. It is not that there is no pulse to diagnose, but rather that diagnosis is difficult, and it is hard to determine deficiency and excess. Children are often afraid of strangers; upon first meeting, they inevitably cry out, their breathing becomes disordered first, their spirit and consciousness become panicked, and the characteristics of slow/fast and large/small have already lost their original appearance. What is the benefit of diagnosing then? It is better to observe the fingerprint (Dingzhi), which can be seen, and verify it with the symptoms of the face and eyes. This also embodies the physician's combination of inspection (Wang) and palpation (Qie).

Have someone hold the child standing in a well-lit place. Use the left hand to grasp the child's index finger, and use the right thumb to push along the Three Passes (San Guan: Wind, Qi, Life) of the child's finger. Observe its color and shape, carefully discerning and recognizing them. It suffices to distinguish between exterior/interior, cold/heat, and deficiency/excess. People nowadays like novelty and do not put effort into practical work, regarding this as shallow talk and disdainful of attention. They do not know that in clinical practice, being able to distinguish these six aspects constitutes the highest level of skill. Because if the exterior/interior is clear, whether the disease is in the meridians or fu organs, sweating or purging methods will not be mistaken; if cold/heat is clear, one knows to avoid heat when using cold herbs, and avoid cold when using hot herbs, or to use cold for cold patterns and heat for heat patterns, adapting to the time, so that medication is never inappropriate; if deficiency/excess is distinguished, one knows that severe deficiency may present with excess-like signs, and severe excess may present with deficiency-like signs, avoiding confusion by false manifestations. True deficiency and false excess are easy to know, while true/false distinctions are hard to differentiate. If true and false are confused, there will be the danger of "making deficient what is already deficient and making excess what is already excess." At this critical juncture, if one does not comprehend it, but instead uses unverified words to deceive the world, claiming certain things are caused by human fright and others by animal fright, this not only deceives others but also oneself, not only failing to aid treatment but also causing death. Whose fault is this?

Song on the Locations of the Three Passes:
When the pattern first appears at the Wind Pass, the condition is not yet deep;
When the pattern reaches the Qi Pass, urgent prevention is needed;
Suddenly appearing at the Life Pass is indeed critical;
Penetrating the nail joint and crossing the pass indicates prominent disease severity.

Pattern appearing at the Wind Pass indicates the initial entry of pathogenic factors; the condition is mild, and the constitution is not yet exhausted, making treatment relatively easy. Pattern appearing at the Qi Pass indicates flourishing pathogenic factors and heavy illness, requiring rapid treatment. If the pattern spans all three passes and emerges at the Life Pass, pathogenic factors are spreading freely, filling the meridians, representing a very severe condition. If it penetrates the pass and shoots toward the nail joint, pathogenic factors have nowhere to reside, soaring high without descending, indicating an image of hyperactive Yang floating upward. Physicians must pay attention and never underestimate this.

Song on Floating/Sinking Distinguishing Exterior/Interior:
Why does the fingerprint suddenly float? Pathogens are in the skin; do not worry.
Obstruction of interstices is named an exterior syndrome; urgently administer diaphoretic herbs for dispersal and resolution.

This pattern connects with the Taoyuan pulse (Taiyuan C-7). Whenever there are external pathogens, the Taiyuan pulse floats, and thus this pattern also floats. Since pathogens are between the skin and interstices, the fingerprint also reveals itself externally, termed an exterior syndrome. Rapid dispersal and venting are needed to open the skin and interstices, allowing pathogens to resolve with slight sweating. One dose achieves success; why hesitate to administer it?

Suddenly, the pattern at the pass gradually sinks; knowing pathogens have entered the interior, the disease is deep.
Do not lightly try wind-dispelling herbs; seek the Yangming interior syndrome.

Fingerprint appearing sunk indicates pathogens entering the interior, though with differences in depth. If there are alternating chills and fever, and the fingerprint is half-sunk, it remains in the Stomach meridian of Yangming, and treatment should focus on releasing the muscle layer. If external symptoms show persistent fever, and the fingerprint is extremely sunk, it has entered the Stomach fu organ of Yangming; purging is urgently needed. Ignorant physicians, seeing fever, still use wind-dispersing treatments. Treating the exterior when the disease is internal is incorrect treatment. Not only will pathogens not resolve, but it will dry yin blood and worsen the condition.

Song on Red/Purple Distinguishing Cold/Heat:
When the body is calm, red and yellow are seen; dark red often arises from interior cold.
Pale red faintly visible is originally deficiency-cold; until deep red transforms into heat.

With tranquil spirit and quiet Ying and Wei, peace prevails. Yellow represents harmonious qi, red represents bright color. Faint yellow and red, with vibrant scenery, how could there be unrest? When cold pathogens initially enter the skin and hair, meridians suddenly stagnate, so the pattern appears dark red due to blood stasis. Whether internal or external cold, early or late stage, seeing this pattern always indicates a cold syndrome. People with weak middle qi and insufficient Ying and Wei have patterns that are pale and translucent with redness, indicating deficiency-cold. As for saying deep red transforms into heat, what is the logic? Red is originally due to cold; how can it transform into heat? Because cold closes the skin and interstices, obstruction occurs. The internal qi of the body constantly communicates with the qi of the skin and hair, without a moment's pause. Now, cold closes the sweat pores, and internal outgoing qi has no outlet, stagnating between hair follicles, accumulating and thickening, thus transforming into heat. This heat comes from internal outgoing qi, not from external cold changing into heat.

Purple at the pass is a sign of heat; green indicates wind, as stated in ancient texts.
Food injury shows purple/green, phlegm/qi rebellion; black/green across three passes brings disaster.

Ying circulates within the vessels, Wei circulates outside. Heat obstructs meridians, blocking the Yin-Ying pathway, so purple pattern indicates blazing heat, a verdict confirmed through ages. Shaoyang Jia Wood naturally has a green color; when Liver and Gallbladder receive pathogens, the pattern appears green, indicating wind-cold. It can be called wind-heat, but should not be called fright-wind to mislead the world. Green is the color of the Liver meridian; *Neijing* states "Wind in Heaven, Wood in Earth," so Wind and Wood share the same qi. When Liver receives wind pathogens, the pattern must show green. The logic is clear and obvious, yet pediatric specialists insist on calling green "fright" rather than "wind." According to pediatric theory, fright originates from the Heart. However, green is not the color of the Heart; how can green represent fright? Such forced explanations are most erroneous. I have written "Refuting Fright-Wind Misconceptions," detailed in Volume 2. Purple mixed with green indicates food injury. Solid food items obstruct Middle Jiao Clear Yang, preventing Spleen Qi from distributing, so wind pathogens take advantage to attack, causing wind to rise rebelliously. Unblocking stagnation to restore flow is sufficient. If depression persists long, Spleen Qi fails to transform further, Ying and Wei become more stagnant, then wind-phlegm-food-heat solidify in Middle Jiao, hence green mixed with black, representing extreme depression. Urgent purging is needed to preserve life; mistaking this for fright-wind leaves less than one in a hundred chances of survival.

Pale fingerprints are also alarming, generally due to light congenital endowment.
Spleen and Stomach are originally deficient, middle qi is weak; beware of attacking harming the nursing infant.

Children with yang deficiency endowment have dark white skin, pale lips and tongue; their fingerprints are pale in all seasons. Even when sick, they show only pale red, pale green, or pale purple. Pale red indicates deficiency-cold, pale green deficiency-wind, pale purple deficiency-heat. These children lack root strength and have timid middle qi. Regardless of new or old diseases, it always returns to deficiency. Do not lightly use attacking methods. If mistakenly administered draining medicines, it is like spilt water impossible to recover; regretting it will be too late.

What causes the pass pattern to be rough and stagnant? Pathogens suppress Yin-Ying and Wei qi retention.
Food stagnation in Middle Jiao, blazing wind-heat; if not pushed away, what else is sought?

Pathogens obstruct and depress Ying and Wei, circulation slows, digestion lacks power. Thus, pushing the fingerprint yields unclear results, lacking lively flowing imagery. Caused by struggle between food/drink and wind-cold, this is an excess syndrome. Urgent pushing and purging are needed to remove stale matter; recovery is easy. If the three passes are purely black and immovable upon pushing, it is a death syndrome, untreatable.

Song on Pattern Shapes Indicating Disease:
Abdominal pain: pattern enters palm center; bending inward, wind-cold invades sequentially.
Bending outward: phlegm, food, heat; Water shape: Spleen/Lung yin injured.

The palm center governs the Pericardium. Pattern entering the palm indicates pathogens invading five zang organs due to middle qi cold, hence abdominal pain. If the pattern bends like a bow, interior/exterior differ. Bending both ends toward the middle finger is interior, favorable syndrome, external wind-cold invasion, easier to treat; bending toward the thumb is exterior, unfavorable syndrome, internal food injury, slightly harder to treat. Shape like the character 'Water' indicates Spleen/Lung insufficiency, food blocking Taiyin, weak middle qi, Spleen failing to transform. Or perhaps the pattern is merely a single line; how can it form a 'Water' shape? One might say, observing the Taiyuan pulse, it is also a single line; yet Yang Linking and Yin Linking, Yang Heel and Yin Heel sometimes appear linked left and right, forming a 'Water' shape? Pulses have left/right; how can patterns not have left/right? But if one can draw analogies, everything makes sense. Is it only fingerprints that are like this?

Whenever examining fingerprints, use the side of your thumb to push the child's index finger three passes. Never push with the fingertip covering down. Nail ridges contain fire, which controls Lung Metal, causing pattern color changes. Also, only push from Life Pass up to Wind Pass; never push from Wind Pass out to Life Pass, as this forces the pattern further out. If the pattern originally did not penetrate the Life Pass, mistakenly pushing it out severely damages Lung Qi and prevents accurate color differentiation. Be cautious and vigilant.

Above, exterior/interior, cold/heat, deficiency/excess are well-founded. If recognized clearly during clinical practice, one has inner mastery; even if not perfectly accurate, one is close. If one merely blames fright-wind to shirk responsibility, asking oneself, one feels ashamed. Fellow practitioners, let us encourage each other.