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Xia Yuzhu said: The substitution of herbs in decoctions has its appropriateness and inappropriateness, just as the substitution of words in texts has its propriety and impropriety. In the same way that there is a difference between insightful views and shallow opinions when changing words, there is also a distinction between shallow and insightful approaches when substituting herbs. For instance, Fan Zhongyan wrote the "Record of Yan Ziling's Shrine," containing the verse: "The virtue (De) of the Master." At that time, Li Taibo was present and changed the character "De" (virtue) to "Feng" (wind/style), which was indeed an insightful modification. Li Bai's poem reads: "Human smoke chills the kumquats and pomelos," while Huang Tingjian replaced "Yan Han" (smoke chills) with "Jia Yuan" (homeland), which was a shallow alteration. As for physicians using Siwu Tang (Four Substances Decoction) to nourish blood, which contains Shudi Huang (Prepared Rehmanniae Radix), if the patient has heart fire and hot blood, replacing Shudi Huang with Shengdi Huang (Raw Rehmanniae Radix) is an insightful approach; however, if there is no heart fire and the blood is not hot, yet one still replaces Shudi Huang with Shengdi Huang, this is a shallow approach. Such knowledge can only be discussed with those who understand; it is difficult to explain to those who do not. Practitioners of medicine should pay attention to this.

Xia Yuzhu said: Pediatric diseases are numerous, but they cannot escape the scope of the five zang organs, six fu organs, qi, and blood. Although symptoms may appear bizarre, they ultimately stem from deficiency, excess, cold, heat, wind, or phlegm. Even if the disease is hard to discern, it cannot hide from the complexion and miao qiao (external signs such as facial color, eyes, ears, nose, mouth, and fingernail beds). Although symptoms are difficult to differentiate, one must not ignore the colors green, white, red, and yellow on the face. The facial complexion and miao qiao reflect the state of the zang-fu organs and the qi-blood. The colors red, yellow, green, and white manifest the conditions of cold, heat, deficiency, and excess. If a physician can exert effort in observing these aspects, they will have acquired our family's secret method.
[Image: Diagram of Facial Acupoints]
Pushing technique: Use a decoction of scallion and ginger to moisten the doctor's thumb. First, push from the center of the eyebrows upward to the forehead, repeating twenty-four times.
Next, push outward from the center of the eyebrows toward the Taiyang (Temple) and Taiyin points, nine times each side.
Then, pinch once at each point from Tian Ting (Forehead Center) down to Cheng Jiang (Chin Groove), acting as a substitute for acupuncture.
Subsequently, at the Dayang and Taiyin areas, induce sweating or stop sweating as indicated.
Then, pinch and rub the tips of both earlobes.
Hold the child's head and face with both hands and shake gently to observe their breath/qi.
Observe cold and heat patterns; push San Guan (Three Gates) and Tui Liu Fu (Retreat Six Bowels) on the hand, and perform Yun Ba Gua (Rotate Eight Trigrams).
Then, fen tui (divide-push) the chest area, rub the umbilicus, finish pushing Wei Zhong, and then rub Jian Jing. For other acupoints, additional rubbing methods are applied based on the specific symptoms.
[Image: Diagram of Palm Pushing San Guan, Retreating Liu Fu, and Rotating Ba Gua]
San Guan, Liu Fu, and Ba Gua manipulations are performed on the left hand for both boys and girls. People often assume the boy's right hand corresponds to the girl's left hand, failing to realize that the right palm lacks the Ba Gua diagram. If the right palm also had Ba Gua, Zhen would be in the west, Dui in the east, Gen in the northwest, and Kun in the southwest. Would this alter the fixed principles of Later Heaven Ba Gua for female pediatric massage? Moreover, the pulse positions for the heart, liver, and kidneys are on the left hand for both genders. If the girl's right hand were treated as the left, would the heart and liver pulses then be on the right hand?
[Image: Diagram of Water Bottom Moon Retrieval and Drawing Water Up to Heavenly River on Palm]
Pushing technique: Grasp the child's hand with both hands. Place both thumbs on Zong Jin (Total Sinew) and push outward to the sides.
If the child's eyes roll upward, press the nail of the thumb at Xiao Tian Xin (Little Heavenly Heart) downward toward the palm center until it settles.
If the child's eyes roll downward, press the nail of the thumb at Xiao Tian Xin upward toward Zong Jin until it settles.
Xia Yuzhu said: The palmar surface of the thumb belongs to the Spleen. Traditional painters did not depict the thumb facing forward, adhering to orthodox painting conventions. Consequently, predecessors wrote "Spleen Earth" on the side. Later generations misunderstood this, spreading the error, and came to regard the lateral side of the thumb as the Spleen meridian. Therefore, in my anterior palm diagram, I positioned the thumb facing frontally. This was a pragmatic adjustment for drawing the Spleen Earth. Additionally, the mnemonic states: "Spleen Earth curved supplementation, straight pushing." Seeing the word "curved," people bent the child's finger so the side faced forward, further cementing the misconception that the side is the Spleen. They failed to realize that "curved" refers to rotation; rotating on the frontal surface constitutes supplementation, while straight pushing toward the nail constitutes purging. This single-character error by predecessors led to incurable deviations. Current ineffectiveness in massage stems from inaccurate acupoint identification. Since predecessors transmitted errors, later practitioners must avoid repeating them.
[Image: Diagram of Back of Hand Pushing Upper San Guan and Rubbing Five Finger Joints]
Shao Shang Acupoint: Located on the dorsal aspect of both thumbs near the nails. Moxibustion with one cone treats Omphalospasm (Umbilical Tetanus).
Wai Lao Gong Acupoint: Bend the little finger and firmly rub Wai Lao Gong to dispel cold wind from the zang-fu organs.
Hou Xi Acupoint: Pushing downward tonifies the Kidney; pushing upward clears the Kidney and promotes urination.
Xia Yuzhu said: The tips of all five fingers belong to the lower part; predecessors claiming they belong to the upper part were mistaken. Just as roots are the base and tips are the extremities, the extremities are lower, which is self-evident. Predecessors also frequently confused the left foot with the right foot. Did they not consider that when a person sits centrally in a hall facing north, the west is on their left? This is a clear and simple principle; why the error? For females, the right foot corresponds to the left, following the principle that earth/yin favors the right.
For males, the dorsal aspect of the straight bone on the left hand is San Guan, belonging to the Qi level. Pushing upward moves Qi into Yang, generating heat, thus constituting a supplementation method.
For males, the volar aspect of the straight bone on the left hand is Liu Fu, belonging to the Blood level. Pushing downward moves Blood into Yin, generating cold, thus constituting a purging method. The lateral sides represent the junction of Yang Qi and Yin Blood. Using this area for San Guan/Liu Fu creates ambiguity regarding Qi and Blood, making it inappropriate to combine supplementation and purging techniques here.
The Five Zang organs are Yang. Why is pushing upward considered cold/cool for females? This follows the principle that extreme Yang generates Yin. Females belong to Yin, so manipulation proceeds from where Yin arises.
The Six Fu organs are Yin. Why is pushing downward considered hot/warming for females? This follows the principle that extreme Yin generates Yang. Thus, females are manipulated from where Yang arises.
Mnemonic: Regarding the Kidney Water line and Hou Xi, pushing upward clears, while pushing downward tonifies. For urinary retention with dark urine, upward pushing clears effectively; for Kidney deficiency with scanty urine, downward pushing is suitable for tonification.
Xia Yuzhu said: The other four Zang organs are supplemented by pushing upward and purged by pushing downward. Why is the Kidney opposite? Because the four Zang reside in the upper body, while the Kidney resides below. In cases of Kidney deficiency, pushing the Qi of the four Zang downward nourishes the Kidney; hence, downward pushing is termed "tonifying." When Kidney water is turbid, causing urinary retention and dark urine, pushing downward exacerbates the blockage. Pushing upward unblocks the water passages, clearing the urine; hence, upward pushing is termed "clearing." The differences in upper/lower clearing and tonifying must be elucidated. Without clarifying this logic, people might suspect errors in the terms "up" and "down" for Kidney manipulation, causing significant harm. Therefore, this is recorded.
[Image: Diagram of Hegu Acupoint]
Hegu Acupoint: Located in the depression between the two bones. Apply one cone of moxibustion on the元宵节 lantern fire to each hand.
Observing the lateral bones clearly shows the frontal view, yet later generations often misinterpret it. How lamentable!
Lao Long Acupoint: In cases of convulsive death, if the child does not revive after pinching Jing Wei, pinch Lao Long. If pain is felt, the child lives; if not, the child dies. One may rub Fei Shu to test responsiveness.
Xia Yuzhu said: Predecessors drew the Hegu acupoint on a side-view hand diagram because they could only depict one side, not three. Thus, they placed San Guan and Liu Fu on the sides. Although depicted on the sides in the diagram, logically, both sides represent the frontal view. Later generations failed to grasp this intent, mistakenly taking the side of the side-view diagram as the lateral side of the child's actual frontal hand to define San Guan and Liu Fu. Is this not strange? Ancient diagrams of acupoints were likely accurate; errors arose from careless individuals who failed to reason through the context, leading to widespread transmission of mistakes. I vigorously critique these past errors not to show off, but from extensive practical experience. Future scholars should not dismiss me as absurd.
[Image: Diagram of Foot Acupoints]
Yongquan Acupoint: For males, rotating left stops vomiting; rotating right stops diarrhea. Left rotation without rubbing indicates vomiting; right rotation without rubbing indicates diarrhea. For females, reverse these directions.
In acute fright, pinch Da Dun. Alternatively, pinch Xie Dai bilaterally. If the infant is extremely weak and no pulse is felt at Da Dun, and none at Jie Xi, the condition is critical (twelfth degree of weakness); medical intervention is futile. If pulses are present at both sites, administer 1-2 fen of Renshen (Ginseng). Do not overdose, as excessive dosage may overwhelm the weak constitution and cause death. Physicians must know this.
During fright, if the body thrusts forward, pinch Weizhong downward to straighten the body. If the body arches backward, pinch Gui Yan above the knee downward to correct the posture.
[Image: Diagram of Body/Face Moxibustion Points]
Calming Fright Moxibustion: Xuan Men, Mei Xin, Qi Xin, Qi Lun, Hegu, Xie Dai, etc., totaling fifteen cones.
Omphalospasm Moxibustion: Xuan Men, Mei Xin, Ren Zhong, Cheng Jiang, Shao Shang on both thumbs, Qi Xin, Qi Lun, totaling thirteen cones.
[Image: Diagram of Back Fei Shu Acupoints]