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Chen Zishan stated: For males, examine the left hand; for females, the right hand. When observing the finger vein at the Guan position (middle segment), pinch the third joint of the middle finger. If the tongue protrudes and cannot be retracted, the prognosis is fatal; if there is pain upon inspiration, the prognosis is favorable. If the child remains unconscious for a long time, pinch the middle finger and bite/acupuncture the Kunlun point (BL60). Awakening indicates a good omen; failure to awaken indicates an ominous sign.

Tu Weisheng stated: The above excerpts capture the essence of syndrome differentiation, serving as fundamental treatment principles for pediatric diseases, which are generally comprehensive. However, medicine pursues precision, and medical theories must seek subtlety; symptoms require detailed analysis, and medication must be thorough. Therefore, I specifically cite several items from Mr. Tang Rongchuan's "Neijing Bing Ji Shu Ze" (Extreme Cases of Diseases in the Inner Canon) as supplements, so that the theory becomes clearer and the application more effective and ingenious.

Tang Rongchuan stated: A person must first have deficiencies in the Zang-Fu organs and Qi-Blood before falling ill. Thus, when discussing pathogenesis, one must first address the injury to the Zang-Fu organs.
The Classic states: Worry and overthinking damage the Heart.

Tang Rongchuan stated: The Heart belongs to the Fire element. When Fire Qi is open and bright, it can generate Blood and ensure the smooth flow of tendons and vessels. When blood vessels circulate freely, the spirit manifests as joy. Conversely, if one experiences worry and overthinking, Heart Qi becomes suppressed and Heart Fire stagnates, thereby injuring the Heart. Treatment should focus on unblocking Heart Yang and promoting blood circulation, often using joy to overcome worry, leading to recovery.

Tu Weisheng stated: Mr. Tang Rongchuan was a renowned modern physician. Although his works follow the *Inner Canon* and Zhang Zhongjing’s texts, he has many unique insights into profound theories. There are also shortcomings, not necessarily due to lack of insight, but rather "a thousand wise men will occasionally make a mistake." Regarding the statement "worry and overthinking suppress Heart Qi, causing Fire stagnation and Blood stasis, thus injuring the Heart," this explanation is somewhat rigid and imprecise. The Heart, as a Fire organ, generates Blood and governs the whole body. When facing difficult situations or environmental hardships, it is natural to feel sorrowful and thoughtful, hoping to find solutions. Even if no solution is found, persistent thinking continues. This is human nature. However, constant thinking keeps Heart Fire active; continuous Heart Fire continuously boils down Kidney Water. With limited Kidney Water supplying infinite Fire consumption, depletion is inevitable. Once Kidney Water stops replenishing, the Yin fluids of the Heart are self-burned. When burning reaches its peak, only a mass of Heat remains, inevitably causing injury. Therefore, herbs treating excessive thinking are mostly Yin-nourishing and Fire-descending, such as Sheng Di Huang (Rehmanniae Radix), Yuan Zhi (Polygalae Radix), Zhi Mu (Anemarrhenae Rhizoma), Huang Bo (Phellodendri Cortex), Huang Qin (Scutellariae Radix), Lian Zi (Nelumbinis Semen), Tian Dong (Asparagi Radix), and Mai Dong (Ophiopogonis Radix). Using joy to counteract worry is emotional therapy, not herbal therapy. Reducing worry by even a moment preserves Kidney Water and Heart Blood. Children may not have worries, but unresolved external Heat or internal Fire is similar to worry. However, this type of Heat cannot be regulated by joy; treatment requires flexibility.

The Classic states: External cold exposure and cold drinks injure the Lung.

Tang Rongchuan stated: Metal fears Fire and naturally dislikes heat. Why does it fear cold? The Lung's substance is Yin Metal, but its function governs Yang Qi. Qi distributed externally becomes Wei Qi (Defensive Qi), nourishing the skin and hair. Improper clothing leads to external cold invasion, causing chills, penetration into interstices, fever, fluid retention, cough, and asthma. Treatment requires warming and dispersing. Qi distributed internally becomes Zong Qi (Gathering Qi), governing respiration and distributing fluids to the Spleen and Bladder. Consuming too much cold food/drink prevents Yang Qi distribution, causing fluid accumulation, leading to cough, asthma, masses, and pain. Treatment requires warming and descending.

Tu Weisheng stated: "Xing Han" (body cold) is external cold injuring the Lung; "Yin Leng" (cold drink) is internal cold injuring the Lung. How does external cold injure the Lung? The Lung is the "Canopy," governing the skin and hair. Yang Qi from internal organs gathers in the Lung to disperse through the skin to resist external cold. If clothing is insufficient and cold is severe, internal Yuan Qi cannot resist. External cold penetrates from skin to interstices to interior, converting internal heat into cold, causing cough. Cough causes upward rushing of Qi to the Lung, damaging it. This is the surface aspect. The deeper aspect is external cold trapping Qi in skin/interstices, preventing outward release, transforming into heat, scorching Lung Yin, causing chronic cough, eventually injuring Lung Metal. "Yin Leng" injures the Lung by cold water congealing in the Spleen/Stomach, where Stomach Yang fails to digest, sending cold up to the Lung, causing cough. Tang Rongchuan’s explanation of "Yang Qi failing to distribute" is insufficient.

The Classic states: Grief and anger causing Qi rebellion injure the Liver.

Tang Rongchuan stated: Grief is governed by the Lung; excessive grief causes Metal to over-control Wood, preventing Wood from extending. Anger is governed by the Liver; excessive anger causes Liver Wood to surge uncontrollably, preventing Blood from settling. Both involve Qi rebellion. The Liver stores Blood; Blood flows smoothly and rests quietly due to peaceful Qi nourishing it. Qi rebellion leads to Liver rebellion, with Liver Wood stagnating below and Liver Fire attacking above, injuring the Liver. Grief causes Wood stagnation below, treated with acrid herbs to ascend and disperse. Anger causes Fire attack above, treated with bitter herbs to descend. Ultimately, nurturing the spirit and maintaining balance is best.

Tu Weisheng stated: Blood is generated above and moves below; Qi is generated below and moves above. Blood movement depends on Qi movement. If Qi surges, Blood surges; if Qi stops, Blood stops. The Liver is a Yin organ, rich in Blood and poor in Qi. When Qi rebels upward due to anger, the abundant Blood follows, moving chaotically. Even if Qi calms and anger subsides, chaotic Blood cannot simply disappear. Blood loss implies Liver consumption/injury. Treatment should calm Qi and nourish Blood. Ignorant people think "calming the Liver" means attacking, which is incorrect. Tang Rongchuan’s view that "Qi rebellion causes Liver rebellion, Wood stagnates below, Fire attacks above" is too vague. Stagnation and anger differ slightly; combined, they affect the Liver's substance without distinct upper/lower separation. Some argue upper/lower refers to functional comparison. But how does lower stagnation and upper fire injure the Liver? This seems vague. Children rarely experience grief/anger, but discipline or neglect induces anger. Grief is explained previously.

The Classic states: Diet irregularity and fatigue injure the Spleen.

Tang Rongchuan stated: Drinking moistens the Spleen; excess drinking causes fluid retention and dampness, leading to distension, diarrhea, phlegm, and cough. Earth controls Water but is trapped by it; treatment requires leaching and draining. Food nourishes the Spleen; excess food causes retention, leading to diarrhea and fullness. The Spleen transforms food but is trapped by it; treatment requires digestion and guidance. The Spleen governs muscles; moderate exercise benefits them. However, exhaustion leads to emaciation and fever because movement generates Yang, damaging Spleen Yin, affecting muscles. Treatment requires tonification and rest.

Tu Weisheng stated: Hard grains require Spleen Yin to soften them; soft liquids require Stomach Yang to transform them. Tang mentioned this. Digestive capacity is limited. Overeating/drinking beyond limits damages the Spleen/Stomach. After damage, food/fluid stagnate, causing dampness/distension/diarrhea/phlegm/cough or food retention/fullness. These occur after Spleen injury. Fatigue injures the Spleen because it exhausts its function. Doing work requires Qi/Blood from digested food. Input is constant, but digestion never rests. Supply to limbs never rests. Without input/transformation, limbs lack support, causing mental fatigue. Even if work stops, digestion may continue, emptying reserves, causing friction/injury. Leisurely people are often obese; laborers are often thin. After heavy labor, appetite returns only after energy recovers. Children suffer dietary Spleen injury often, but fatigue injury rarely, as they know when to rest.

The Classic states: Sitting long on damp ground and excessive sexual activity injure the Kidney.

Tang Rongchuan stated: Kidney Yang transforms dampness, allowing water to reach the Bladder and Qi to move limbs/spine. Sitting on damp ground increases dampness, injuring Kidney Yang, causing limb/joint swelling and pain. Treatment requires drying. Sufficient Kidney Yin allows normal sexual activity. If strength is exhausted but intercourse continues, Yin essence depletes. Treatment requires tonification.

Tu Weisheng stated: Dampness congealing below injures Kidney Yang. However, long-term dampness turns to heat, causing red urine and turbid discharge. Children easily sit on damp ground, causing these symptoms. Ignorant people think children don’t have hidden Kidney depletion, so why red urine/turbidity? They ignore the principle of dampness turning to heat.