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Chen Feixia stated: There are seven manifestations of heat syndromes in children: redness of the cheeks and malar region, constipation, yellow urine, unquenchable thirst, rapid breathing with qi rebellion, heat in the soles of the feet, and red eyes. These all belong to excess-heat syndromes (Excess-Heat Syndrome), and warm-tonifying agents should be contraindicated.

There are also seven manifestations of cold syndromes in children: pale complexion, greenish-white stool, abdominal distension due to deficiency, bluish eyeballs, vomiting and diarrhea without fever, cold lower legs, and sleeping with eyes partially open (Sleeping with Eyes Open). These all belong to deficiency-cold syndromes (Deficiency-Cold Syndrome), and cold-cooling agents should be contraindicated.

Tu Weisheng stated: Although this section by Feixia is a method for distinguishing between cold and heat syndromes, two or more accompanying symptoms must be present simultaneously before one can diagnose either cold or heat. For instance, if there is only redness of the cheeks and malar region, without seeing symptoms such as yellow urine and constipation, it may be a sign of fever from Cold Damage (Shanghan) where the root is cold but the branch is heat. If there is only bluish eyeballs, without seeing symptoms such as greenish-white stool and sleeping with eyes open, it may be a sign that Liver Heat (Liver Fire) is about to blaze, where the root is heat but the branch is cold. Such subtleties must not be ignored.

Tu Weisheng further stated: Although the tongue is considered the sprout of the Heart, the qi of cold and heat from all zang-fu organs gathers upon the tongue. Therefore, by observing whether the tongue is yellow, white, black, or red, one can determine whether the condition is cold, heat, deficiency, or excess. The root of the tongue belongs to the Kidney, the tip to the Heart, the sides to the Liver and Gallbladder, and the center to the Spleen and Stomach. When pathogenic factors are at the exterior, there is no coating on the tongue; when they enter the interior, a coating forms. A yellow coating indicates interior heat; a yellow coating that is dry and lacks fluids indicates severe heat; a black coating with a dry, cracked tongue lacking fluids indicates extreme heat. However, if the coating is black yet oily and moist with fluids, this indicates extreme cold mimicking heat, and cold-cooling agents are contraindicated. If the tongue tip is red and赤 (red) with small papillae (prickles), this indicates Heart Heat, and cooling agents can be used. If the tongue body is yellow-red while the tip is grayish-white, this indicates heat below and cold above; conversely, it indicates cold below and heat above. If the entire tongue is white, greasy, and has fluids, this indicates deficiency-cold with yin condensation, and warm-tonifying agents can be used. Nevertheless, if the coating is white accompanied by alternating chills and fever, bitter taste in the mouth, and dry throat, this belongs to Shaoyang Heat Knot (Shaoyang Syndrome), and clearing and resolving methods can be used. If physicians are unclear in their symptom differentiation, they may use this method to diagnose cold and heat. As for children who do not understand and find it difficult to open their mouths, one can pinch the Chengjiang acupoint (Chengjiang, CV24) below the lip to induce crying and thus open the mouth.