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*Quan You Xin Jian* records: Whenever an infant's fontanelle is swollen or sunken, sweat does not flow freely but appears as beads like oil, the tongue protrudes and the genitals retract, the tongue is swollen, convulsions occur, diarrhea presents with dark black blood, the hair stands upright like a mess, and the skin lacks luster, this indicates the exhaustion of Heart Qi (Heart Qi Exhaustion). Death usually occurs on Ren (壬) or Gui (癸) days.

When the illness is severe, crying without tears, or not crying at all when critically ill, tearing up with cyanotic black fingernails, eyes sunken deep, tongue curled, scrotum retracted, convulsions occurring, eyes staring upward connecting to the lips and mouth, hands moving as if holding the head, or feet stiffly straight. *Su Wen* states: "The Liver's brilliance manifests in the nails, and the Liver nourishes the sinews." This indicates the exhaustion of Liver Qi (Liver Qi Exhaustion). Death usually occurs on Geng (庚) or Xin (辛) days.

The area between the nose and upper lip (Ren Zhong) is full or black, lips are contracted, breathing through an open mouth, lips are scorched, dry, and cracked, lips are dry purple-black, lips cannot cover the teeth, blood swelling, hematuria, tongue shortened or curled, nostrils dilated, jaw locked, cold saliva like oil, puckered mouth like a bag, complexion like earth, limbs cold and reversed like wet stones, inability to suck milk, passing red-black feces, this indicates the exhaustion of Spleen Qi (Spleen Qi Exhaustion). Death usually occurs on Jia (甲) or Yi (乙) days.

If there is fever, and wheezing sounds from the throat when drinking soup or taking medicine, this indicates the stomach is fragile and unable to receive Yin fluids. This syndrome is rarely recorded in medical books, likely because previous attempts have proven effective in confirming its fatality and incurability. Eyes staring straight, bright green color.

Panting without relief, choking and coughing while eating, phlegm and saliva blocking the mouth, wheezing sounds in the throat, nasal congestion, dry and black nose, lung distension, discomfort in the epigastrium, sweating on the head, cold limbs, this indicates the exhaustion of Lung Qi (Lung Qi Exhaustion). Death usually occurs on Bing (丙) or Ding (丁) days.

Black complexion, unconsciousness, black eyes, swollen eyelids, lackluster gaze, yellow-green scorched earlobes, rickets (Gan Syndrome), tooth loss, sparse yellow-dry hair, black-dry skin, convulsions biting the breast, grinding teeth, passing black gas around the mouth, this indicates the exhaustion of Kidney Qi (Kidney Qi Exhaustion). Death usually occurs on Wu (戊) or Ji (己) days.

Chen Guan (Upper Segment), Mao Guan (Middle Segment), Yin Guan (Lower Segment).

Shi says: When infants are first born, their transformation and evaporation energies are insufficient, blood and Qi are unstable, and respiration is excessive. One must distinguish the colors and pulses of the Tiger's Mouth (Hu Kou) to observe the essentials of the disease. This is precisely what is meant here.

For boys, observe the left hand; for girls, observe the right hand. If the pulse vein starts from the Yin Guan and does not reach the Mao Guan, it is easy to treat. If it connects to the Mao Guan, the illness is difficult to treat. If the Yin Guan connects to the Mao Guan, and the Mao Guan invades past the Chen Guan, ten cases will hardly save one. If the pulse vein is small or short, having an illness is not detrimental.

Ren Zhai says: The Tiger's Mouth is the place where hands cross. The Three Guan (Passes) refer to the three segments of the second finger. Excluding the first segment of the thumb near the Tiger's Mouth, which is the Initial Guan (Feng Guan/Wind Pass); the second segment is the Middle Guan (Qi Guan/Air Pass); the third segment is the Terminal Guan (Ming Guan/Life Pass). Observe boys' left hands and girls' right hands from the side. In early stages of convulsions, if the vein emerges from the Tiger's Mouth or is in the Initial Guan, it is mostly red. If it transmits to the Middle Guan, the color is red and purple. If it transmits further, the color becomes purple-green, indicating a deep and severe condition. If the color is blue-black, or blue with chaotic veins, the illness is heavy. If pure black is seen, it is critical and incurable. Generally, red indicates severe Wind-Heat; purple indicates Convulsion-Heat; blue indicates Convulsion-Stagnation; half blue and half red indicates both Convulsion-Stagnation and Wind-Heat, primarily associated with Acute Convulsion (Ji Jing Feng); blue with pale purple, extending and contracting, indicates Chronic Convulsion (Man Jing Feng); hidden intermingled purple, blue, or black threads appearing faintly indicate Chronic Spleen Wind (Man Pi Feng). Veins in the Initial Guan are easy to treat; those passing the Middle Guan are difficult to treat; those penetrating the Terminal Guan are incurable; those penetrating all three Guan directly are generally incurable. However, if the vein trend curves inward, it is favorable; although the illness is severe, the syndrome is compliant, and treatment efforts can still be made. If the vein trend curves outward toward the nail, recovery is impossible. If the veins in the three Guan resemble flowing pearls or rice grains, connected in three to five dots, or manifesting on the face or body, the critical nature is even more severe.