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The *Nan Jing* (Classic of Difficult Issues) states: In cold damage, both the Yin and Yang pulses are vigorous and tight and choppy. ○ The *Shanghan Lun* (Treatise on Cold Damage) states: When the pulse is tight in both Yin and Yang aspects, it is named cold damage. ○ At the Cun Kou (Inch Port) position, if the pulse is floating and tight, floating indicates wind, and tight indicates cold. ○ A pulse that is floating, choppy, and tight indicates cold damage.

Pediatric cold damage is no different from that in adults; the only difference lies in the concurrent presence of fright and food retention. The seventy-two syndromes and their corresponding formulas do not exceed the principles established by Zhang Zhongjing and Zhu Gong, differing only in dosage being slightly smaller. Treatment should cease once the medicine reaches the disease site. According to Zhang Zhongjing's *Shanghan Lun*: Spring climate is mild, summer climate is hot and humid, autumn climate is cool, and winter climate is severe and biting. This is the normal sequence of the four seasons' righteous Qi. Only in winter, when it is severely cold, do people seek warmth to avoid injury; accidental exposure to wind and cold is termed "injury." If cold pathogen is contracted in winter, lying latent in the skin and muscles without immediate onset, and manifesting in spring, it is called warm disease (Wen Bing); if it manifests in summer, it is called heat disease (Re Bing). By this time, the latent cold has transformed into other diseases following the Qi of spring and summer, and after a long duration, it can no longer be referred to as cold. Thus, it is said that "warm disease does not involve aversion to cold," which reveals the underlying principle. If spring should be warm but is instead cold, summer should be hot but is instead cool, autumn should be cool but is instead hot, and winter should be cold but is instead warm, this phenomenon of having the Qi of one season at the wrong time is called the aberrant Qi of the four seasons. Accidental contraction of such pathogens is called seasonal Qi (Shi Qi), which differs from cold damage.

As for infants in swaddling clothes or older children with weak congenital constitution, the cause is often due to wet nurses exposing themselves to wind and cold by loosening clothing. For adults, one can identify the syndromes of the Six Channels (Liu Jing): some transmit through the Three Yang channels before entering the Three Yin channels; some remain in a single channel throughout; some skip channels (Yue Jing); some transmit across channels (Jian Jing); some stop after transmitting to one or two channels; and some bypass the Yang channels to directly strike the Yin channels. These can all be differentiated and treated based on pulse and syndrome. However, pediatric patients cannot verbalize the cause of illness, and the pulse may not fully reveal the inevitable pathology, presenting mainly as irritability, crying, and fever. Therefore, physicians must exert utmost diligence. Upon initial onset, infants are examined via the redness of the fingerprint at the Tiger's Mouth (Hu Kou), while older children are assessed by pressing the three segments (San Guan) of the index finger with one digit. Judgment is made based on the tightness and fullness of the Ren Ying pulse (here referring to a specific palpation site or aspect of the radial pulse) on the left hand. Qian Yi (Qian Shi) stated: Boys presenting with heavy body and sallow complexion, girls with reddish face, panting, rapid breathing, and aversion to cold, along with yawning, irritability, restlessness, and neck stiffness, indicate Heat in Heart Qi. Those who fear cold and wind, clinging to others, hiding their bodies, and tightly wrapping themselves exhibit exterior syndromes. Those who fear heat and have interior excess, protruding their heads and faces, flinging arms and legs, experiencing irritability, thirst, dry stools, pushing away covers, and coarse breathing, exhibit interior syndromes. Conversely, cold sweat on the forehead and temples, cold hands and feet, cold breath, dark and dull facial complexion, and green loose stools indicate Yin syndromes. Observing urine, whether red or white, reveals the presence or absence of interior heat; whether clear or turbid indicates the severity of interior heat. From these observations, methods such as diaphoresis (sweating), purgation, and warming can be inferred.