前人忽略推拿。（卓溪）今来一赋。寒热温平。药之四性。推拿揉掐。性与药同。用推即是用药。不明何可乱推。推
上三关。代却麻黄肉桂。退下六腑。替来滑石羚羊。水底捞月。便是黄连犀角。天河引水。还同芩柏连翘。大指脾面旋
推。味似人参白术。泻之则为灶土石膏。大肠侧推虎口。何殊诃子炮姜。反之则为大黄枳实。涌泉右转不揉。朴硝何异。
一推一揉右转。参术无差。食指泻肺。功并桑皮桔梗。旋推止嗽。效争五味冬花。精威拿紧。岂羡牛黄贝母。肺俞重揉。
漫夸半夏南星。黄蜂入洞。超出防风羌活。捧耳摇头。远过生地木香。五指节上轮揉。乃祛风之苍术。足拿大敦鞋带。
实定掣之钩藤，后溪推上。不减猪苓泽泻。小指补肾。焉差杜仲地黄。涌泉左揉。类夫砂仁藿叶。重揉手背。同乎白芍
川芎。脐风灯火十三。恩符再造。定惊元宵十五。不啻仙丹。病知表里虚实。推合重症能生。不谙推拿揉掐。乱用便添
一死。代药五十八言。自古无人道及。虽无格致之功。却亦透宗之赋。
卓溪夏禹铸曰。万物以土为母。而人身亦然。陈非宋问曰。物赖土生。有形可见。人身亦以土为母。何以知之。曰。
脾属土也。以是知脾土为一身之母也。有脾土而后生肺金。肺金生肾水。肾水生肝木。肝木生心火。心火生脾土。此五
脏相生之序也。有生亦必有克，不克则太旺无制。故肝木克脾土。脾土克肾水。肾水克心火。心火克肺金。肺金克肝木。
此五脏相克之序也。业医者。不明五脏生克之定理。则治病兼
补兼泻之法。从何而施。如脾家虚极。法虽用补。补之不足。必兼补心。苟不明相生之理。焉知补心以补脾。如脾家热
极。法虽泻脾。然泻之不克。必兼泻肺。不明相生之理。又焉知泻肺以泻脾。生我者谓之母。克我者谓之贼邪。如肝家
虚极。则肺邪乘肝。补肝
禹铸曰。望闻问切。固医家之不可少一者也。在大方脉则然。而小儿科。则惟以望为主。
问继之。闻则次。而切则无矣。经云。切而知之之谓巧。夫小儿六脉未全。切无可切。而巧亦无所用其巧。问而知
之之谓工。小儿于未言时。问之无可问。即于能言者问之。多不以真对。是问之不必问。而工亦无所用其工。闻而知之
之谓圣。小儿初病之时。声音或不失其常。至病久而气丧。气丧而声失。闻之无可闻。而圣又何所见其圣。况书有曰。
哭声不响者多死。而亦有不至于死者何。无非泥其声。而不得其肺之绝与不绝故也。吾故曰。以望为主。曰。五脏之体
隐而理微。望从何处。曰。体固隐矣。然发见于苗窍颜色之间者。用无不周。理固微矣。乃昭着于四大五官之外者。无
一不显。中庸所谓费而隐。显之微者。不可引之相发明哉。
故小儿病于内。必形于外。外者内之着也。望形审窍。自知其病。按病推拿。药石见效之速。未有不如响之应声者。内
有脏。曰心。曰脾。曰肺。曰肾。曰肝。五脏不可望。惟望五脏之苗与窍。
也。淡白。虚也。鼻准与牙床。乃脾之窍。鼻红燥。脾热也。
脾胃之窍。红紫。热也。
淡白。虚也。如漆黑
耳与齿。乃
肾之窍。耳鸣。气不和也。齿如黄豆。肾气绝也。目乃肝之窍。勇视而睛转者。风也。直
以目分
言之。又属五脏之窍。黑珠属肝。纯是黄色。凶症也。白珠
乃肺受湿热。
疸症也。瞳人属肾。无光采。又兼发黄。肾气虚也。大角属大肠。破烂。肺有风也。小角属小肠。破烂。心有热也。上
皮
属脾。肿。脾伤也。下皮属胃。青色。胃有寒也。上下皮睡合不紧。露一线缝者。脾胃虚极也
属。
额属心。离火也。左腮属肝。震木也。右腮属肺。兑金也。唇
之表。
小便短黄涩痛。心热也。清长而
伤胃
旺
也。闻声着吓。肝虚也。膀胱。肾之表。居脐下气海之右。有名无形。筋
曰红。
红病在心。面红者热。一曰青。青病在
一曰黑。
者矣。
五脏各有所司从外治内
心 乃一身之主。通身皆心司之。专主血。专司神（如惊悸不安，属心虚） 泪（无因而泪
者，心
脾 专司元气（气弱者脾虚） 气（又分司汗，气虚盗汗） 肌肉（消瘦者脾虚） 痰（实痰
动者，脾湿也，虚痰动者，脾虚也） 思虑（过则伤脾） 以上有病俱从脾治。
肺 专司声音（弱者肺虚也，有声不出者痰蔽也，声撒者肺气不敛也，无声者肺绝也）
热（出在肺） 皮毛（破痒者肺燥，不润者肺虚） 腠理（肉外皮内，不密则汗出） 以上有病，俱从肺治
肝 专司血（血弱者肝虚） 汗（又分司汗，血虚自汗） 筋（抽掣者肝风） 以上有病俱从肝治。
肾 专司骨、齿、耳 以上有病俱从肾治。
脾肺内有伤，皆从外入，如父母舐犊过爱，则饮食伤脾，护持疏失，则六淫伤肺。至于心
、肾、肝无有伤处，到成人后，纵情欲多房事伤肾，守钱虏去财谷伤心，四畏至时忍恼伤肝
，乃如之症远近便多，卓溪虽有良方，惜乎鞭长莫及。
The ancients overlooked tuina (Chinese therapeutic massage). Now, Zhuoxi presents this fu (rhapsody). Cold, heat, warmth, and neutrality are the four natures of herbs. The techniques of pushing, kneading, and pinching in tuina share the same nature as drugs. Using push techniques is equivalent to using medicinal herbs; without understanding this, how can one practice tuina recklessly?
Pushing Shang Sang Guan (Upper Three Gates, a tuina point/manipulation) substitutes for Ephedrae Herba (Mahuang, 麻黄) and Cinnamomi Ramulus (Guizhi, 桂枝) in inducing sweating and releasing the exterior. Retreating Xia Liu Fu (Lower Six Stars, a tuina point/manipulation) replaces Polyporus (Zhu Ling, 猪苓) and Gypsum Fibrosum (Shigao, 石膏) [Note: Text says Huashi/Lingyangjiao, translating as Talcum (Huashi, 滑石) and Antelope Horn (Lingyangjiao, 羚羊角)] for clearing heat and promoting urination. Dipping the Moon at the Bottom of the Water (Shuidi Laoyue, a tuina technique) is akin to Scutellariae Radix (Huangqin, 黄芩) and Rhinoceros Horn (Xijiao, 犀角) [Note: Text says Huanglian/Xijiao, translating as Coptidis Rhizoma (Huanglian, 黄连) and Rhinoceros Horn (Xijiao, 犀角)] for clearing heat and cooling blood. Guiding Water through the Heavenly River (Tianhe Yinshui, a tuina technique) is similar to Scutellariae Radix (Huangqin, 黄芩), Phellodendri Cortex (Huangbai, 黄柏), and Forsythiae Fructus (Lianqiao, 连翘) for clearing heat and purging fire. Rotating push on the Spleen surface of the thumb tastes like Astragali Radix (Huangqi, 黄芪) [Note: Text says Renshen/Baizhu, translating as Ginseng Radix (Renshen, 人参) and Atractylodis Macrocephalae Rhizome (Baizhu, 白术)] in tonifying Spleen Qi. Pushing towards the fingertip (Draining method) is like Caulis Fossae (Zaotuzhongshi, 灶心土) and Gypsum Fibrosum (Shigao, 石膏) [Note: Text says Zaotu/Shigao, translating as Caulis Fossae (Zaotu, 灶心土) and Gypsum Fibrosum (Shigao, 石膏)] for clearing heat or astringing. Pushing the Large Intestine side towards the Tiger's Mouth (Hekou, 合谷) is no different from Terminalia Chebulae Fructus (Heshuo, 诃子) and Zingiberis Rhizoma Preparatum (Paojiang, 炮姜) in astringing the intestines and warming the middle. Conversely (pushing towards the fingertip), it is like Rheum Palmatum Radix et Rhizoma (Dahuang, 大黄) and Aurantii Fructus Immaturus (Zhishi, 枳实) for purging and guiding out stagnation. Rotating right at Yongquan (KI1, 涌泉) without kneading is indistinguishable from Natrii Sulfas (Piaoxiao, 朴硝/Mangxiao, 芒硝) in softening hardness and purging. One push and one knead rotating right differs not from Ginseng Radix (Renshen, 人参) and Atractylodis Macrocephalae Rhizome (Baizhu, 白术) in benefiting Qi. Draining the Lung meridian on the index finger has efficacy comparable to Platycodonis Radix (Jiegeng, 桔梗) and Platycodonis Radix (Sangbaipi, 桑白皮) [Note: Text says Sangpi/Jiegeng, translating as Cortex Platycodonis (Sangbaipi, 桑白皮) and Platycodonis Radix (Jiegeng, 桔梗)] for diffusing Lung Qi and resolving phlegm. Rotating push to stop coughing rivals Schisandrae Fructus (Wuweizi, 五味子) and Kolkwitsiae Flos (Donghua, 冬花) [Note: Text says Wuweidonghua, translating as Schisandrae Fructus (Wuweizi, 五味子) and Adenophorae Radix (Beimu, 贝母) or Kolkwitsiae Flos (Donghua, 冬花)] in moistening the Lung and stopping cough. Jingwei Jinna (Jingwei Na Jin, a specific grip/technique) does not envy Calculus Bovis (Niuhuang, 牛黄) and Fritillariae Bulbus (Beimu, 贝母) in clearing heat, resolving phlegm, and opening orifices. Heavy kneading of Feishu (BL13, 肺俞) need not boast of Pinelliae Rhizoma (Banxia, 半夏) and Pinelliae Rhizoma Preparatum (Nanxing, 南星) in drying dampness and resolving phlegm. Yellow Bee Entering the Cave (Huangfeng Rudong, a tuina technique) surpasses Saposhnikoviae Radix (Fangfeng, 防风) and Notopterygii Rhizoma et Radix (Qianghuo, 羌活) in dispelling wind and releasing the exterior. Holding ears and shaking head (Peng'er Yaotou, a tuina technique) far exceeds Rehmanniae Radix (Shengdi, 生地) and Aucklandiae Radix (Muxiang, 木香) in nourishing Yin and moving Qi. Rolling knead on the Five Finger Nodes (Wuzhijie, 五指节) is the effect of Atractylodis Rhizome (Cangzhu, 苍术) in dispelling wind. Grasping Dadun (LR1, 大敦) with shoe laces truly settles the convulsions of Uncariae Ramulus cum Uncis (Gouteng, 钩藤). Pushing up Houxi (SI3, 后溪) is no less than Polyporus (Zhu Ling, 猪苓) and Alisma Rhizoma (Zexie, 泽泻) in promoting diuresis. Tonifying the Kidney meridian on the little finger is no inferior to Eucommiae Cortex (Duzhong, 杜仲) and Rehmanniae Radix Preparata (Dihuang, 地黄) in tonifying Kidney Essence. Left kneading at Yongquan (KI1, 涌泉) resembles Amomum Fructus (Sharen, 砂仁) and Agastaches Herba (Huoxiang, 藿香) in transforming dampness and awakening the spleen. Heavy kneading of the back of the hand is similar to Paeoniae Radix Alba (Baishao, 白芍) and Chuanxiong Rhizoma (Chuanxiong, 川芎) in nourishing blood and invigorating circulation. Thirteen applications of moxa moxibustion for Umbilical Wind (Qifeng, 脐风/Newborn Tetanus) bestows grace like re-creation; Fifteen [units/times] for calming fright on the Lantern Festival is no less than an immortal pill. Knowing the exterior-interior and deficiency-excess of diseases, tuina can save severe cases; failing to understand tuina techniques and using other methods recklessly adds to mortality. These fifty-eight words substituting for medicine have never been mentioned since ancient times. Although lacking profound investigation into things, it is indeed a rhapsody penetrating the essence of medicine.
Zhuoxi Xia Yuzhu said: All things take Earth as their mother, and the human body is the same. Chen Feisong asked: Objects rely on Earth to grow, having visible form. How do we know the human body also takes Earth as its mother? I replied: The Spleen belongs to Earth; thus we know Spleen-Earth is the mother of the whole body. After Spleen-Earth exists, Lung-Metal is generated; Lung-Metal generates Kidney-Water; Kidney-Water generates Liver-Wood; Liver-Wood generates Heart-Fire; Heart-Fire generates Spleen-Earth. This is the sequence of mutual generation among the five Zang organs. Where there is generation, there must be restriction; without restriction, excessive prosperity would be uncontrolled. Thus, Liver-Wood restricts Spleen-Earth; Spleen-Earth restricts Kidney-Water; Kidney-Water restricts Heart-Fire; Heart-Fire restricts Lung-Metal; Lung-Metal restricts Liver-Wood. This is the sequence of mutual restriction among the five Zang organs. Physicians who do not understand the fixed principles of mutual generation and restriction among the five Zang organs cannot apply methods of simultaneous tonification and draining in treating diseases. For example, if the Spleen is extremely deficient, although the method requires tonification, if tonifying the Spleen alone is insufficient, one must simultaneously tonify the Heart (because Fire generates Earth, tonifying the Heart tonifies the Mother of the Spleen). Without understanding the principle of generation, how could one know to tonify the Heart to benefit the Spleen? If the Spleen is extremely hot, although the method requires draining the Spleen, if draining the Spleen alone fails, one must simultaneously drain the Lung (based on the text's logic, likely referring to draining the Child to reduce the Mother's excess or specific interaction). Without understanding the principle of generation, how could one know to drain the Lung to drain the Spleen? That which generates me is called Mother; that which restricts me is called Thief Evil. For instance, if the Liver is extremely deficient, then Lung Evil attacks the Liver...
Xia Yuzhu said: Observation, listening/smelling, inquiry, and palpation are indispensable for physicians. This holds true for adult internal medicine (Da Fang Mai), but in pediatrics, observation is primary, inquiry follows, listening/smelling is secondary, and palpation is virtually non-existent. The Classic says: "Palpation to know is called skillful." However, children's six pulses are not fully formed, so there is nothing to palpate, and "skill" has no place to be used. The Classic says: "Inquiry to know is called competent." When children cannot speak, there is nothing to inquire about; even when they can speak, they often do not answer truthfully. Thus, inquiry is not always necessary, and "competence" has no place to be used. The Classic says: "Listening/smelling to know is called sage-like." When children first fall ill, their voice may remain normal, but after prolonged illness, Qi declines, and when Qi declines, the voice is lost. There is nothing to listen to, so where is the "sage-like" quality seen? Moreover, books state: "Those whose crying sound is weak mostly die," yet some do not die. Why? It is merely sticking to the sound without determining whether Lung Qi is exhausted or not. Therefore, I say observation is primary.
Question: The forms of the five Zang organs are hidden, and their principles are subtle. From where does one observe? Answer: Although the forms are hidden, manifestations appear in the color and features of the orifices, making application comprehensive. Although the principles are subtle, manifestations are evident outside the four limbs and five sense organs. As stated in the Doctrine of the Mean, "Great yet hidden," these manifested subtle principles should be cited to illuminate each other.
Therefore, disease inside the child must manifest outside. The outside is the manifestation of the inside. Observing form and examining orifices allows one to know the disease. Applying tuina according to the disease, medicinal effects are swift, like an echo responding to a sound. Inside are the Zang organs: Heart, Spleen, Lung, Kidney, Liver. The Zang organs themselves cannot be observed directly; only their orifices and markers can be observed.
The tip of the nose and gums are the orifices of the Spleen. Red and dry nose indicates Spleen Heat. Pale white indicates Spleen Deficiency. Red-purple lips indicate Stomach-Spleen Heat. Pale white indicates Stomach-Spleen Deficiency. Pitch black [ears/teeth] relates to the Kidney orifice. Tinnitus indicates Disharmony of Qi. Teeth resembling soybeans [developmental issues] indicate Exhaustion of Kidney Qi. The eyes are the orifice of the Liver. Bold staring and rolling eyes indicate Wind.
Speaking solely regarding the eyes, they also belong to the orifices of the five Zang organs. The black part [iris/pupil area] belongs to the Liver. Pure yellow [sclera/eyes] indicates a critical condition. The white part belongs to the Lung; affected by Damp-Heat, it indicates Jaundice. The pupil belongs to the Kidney; lackluster appearance with yellowing indicates Kidney Qi Deficiency. The inner canthus belongs to the Large Intestine; ulceration indicates Wind in the Lung. The outer canthus belongs to the Small Intestine; ulceration indicates Heat in the Heart. The upper eyelid belongs to the Spleen; swelling indicates Spleen injury. The lower eyelid belongs to the Stomach; bluish color indicates Cold in the Stomach. Upper and lower eyelids not closing tightly, leaving a slit, indicates extreme Deficiency of Stomach-Spleen.
The forehead belongs to the Heart, Fire of Li. The left cheek belongs to the Liver, Wood of Zhen. The right cheek belongs to the Lung, Metal of Dui. The lips' surface... [Text fragment]: Short, yellow, painful, and difficult urination indicates Heart Heat. Clear, long, and abundant urination... [Fragment] ...Exuberance. Hearing sounds causing fright indicates Liver Deficiency. The Bladder is the exterior of the Kidney, located to the right of Qihai below the umbilicus, named but formless. Tendons... [Fragment] ...Red indicates Disease in the Heart. Red face indicates Heat. Green indicates Disease in the Liver. Black indicates... [Fragment].
Each Zang organ has its specific functions, treating the interior from the exterior:
Heart: Master of the whole body, governing all. Specifically governs Blood and Spirit (e.g., palpitations and restlessness indicate Heart Deficiency). Tears (crying without cause indicates Heart [Deficiency]).
Spleen: Specifically governs Yuan Qi (weak Qi indicates Spleen Deficiency). Qi (also governs sweat, spontaneous night sweats indicate Qi Deficiency). Muscles (emaciation indicates Spleen Deficiency). Phlegm (excessive phlegm movement indicates Spleen Dampness; deficient phlegm movement indicates Spleen Deficiency). Overthinking injures the Spleen. Diseases above are treated via the Spleen.
Lung: Specifically governs Voice (weakness indicates Lung Deficiency; inability to produce sound indicates Phlegm obstruction; scattered voice indicates Lung Qi failure to consolidate; no voice indicates Lung exhaustion). Heat (emanates from the Lung). Skin and hair (cracking and itching indicate Lung Dryness; lack of moisture indicates Lung Deficiency). Couli (interstitial spaces between skin and muscle; if not dense, sweating occurs). Diseases above are treated via the Lung.
Liver: Specifically governs Blood (weak blood indicates Liver Deficiency). Sweat (also governs sweat, spontaneous sweating due to Blood Deficiency). Tendons (convulsions indicate Liver Wind). Diseases above are treated via the Liver.
Kidney: Specifically governs Bones, Teeth, Ears. Diseases above are treated via the Kidney.
Injuries to the Spleen and Lung enter from the exterior. Excessive parental love leads to dietary injury of the Spleen; negligent care leads to invasion of the Six Evils injuring the Lung. As for the Heart, Kidney, and Liver, they are rarely injured in childhood. In adulthood, indulgence in sexual activity injures the Kidney; greed for wealth injures the Heart; enduring anger during times of fear injures the Liver. Such conditions are common everywhere. Although Zhuoxi has good prescriptions, alas, the whip is too short to reach [the distant patient/adult conditions].