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At two or three years of age, observing the fingerprint on the tiger's mouth (the radial aspect of the thumb) is even more important. Pressing the high bone area with the middle finger: if the fingerprint floats, it indicates wind pathogen generation; if the pulse is rapid (Shu), it signifies fright syndrome, which relates to epilepsy; if it is surging (Hong), it indicates heat; if it is deep and thin (Chen Xi), it indicates abdominal pain; if it is slow, deep, and deficient (Huan Chen Xu), it indicates diarrhea and dysentery.

From this, we deduce:
If the pulse initially appears slightly delayed (Chi), it implies accumulation accompanied by abundant parasites; a delayed pulse at the "Qiang Yuan" (likely referring to the epigastric region) suggests original stomach obstruction. For four-year-old children, the pulse is not at the fingertip; one should press the high bone with one finger to distinguish deficiency and excess. At five or six years old, repeatedly search the three positions (San Bu), taking the level Guan position as the standard. At seven or eight years old, shift the fingers slightly; at ninety months, take the pulse by sequential positioning. The same method applies to eleven and twelve-year-olds. At fourteen and fifteen years old, use three fingers for observation. Pediatric pathological pulses are not numerous; first determine floating (Fu), deep (Chen), slow (Chi), and rapid (Shuo/Suo) characteristics. Deep and slow belong to Yin; floating and rapid belong to Yang. Further observe the facial color corresponding to the Five Elements: bluish-green indicates wind-fright; white indicates deficiency and diarrhea; red indicates phlegm-heat; black is difficult to treat; yellow indicates spleen-related malnutrition (Gan Ji). Physicians must carefully assess and decide on the treatment formula.

Generally, for diagnosis from infancy up to half a year of age, if there is illness, examine the area below the hairline between the forehead and eyebrows. Use the ring, index, and middle fingers to gently press with curved hands. If the child's head is to the left, raise the right hand; if to the right, raise the left hand. The index finger represents the upper position, and the ring finger represents the lower position. If all three fingers feel hot, it indicates cold pathogen invasion, manifesting as nasal congestion and coarse breathing; if all three are cold, it indicates internal cold, manifesting as vomiting and diarrhea; if the middle finger is hot, it indicates upper heat and lower cold; if the ring and middle fingers are hot, it is a sign of combined fright; if the index finger is hot, the chest feels tight; if the ring finger is hot...

Zeng Shirong commented: Only above half a year of age can the tiger's mouth fingerprint be examined. Above one year of age, examine both the tiger's mouth fingerprint and the single-finger pulse. If the child has completed the 574-day developmental cycles (Bian Zheng), only the single-finger pulse needs examination, using the index finger to roll and divide into three positions. When referring to "three positions," it does not mean Cun, Guan, Chi, but rather three pediatric diagnostic aspects: observing facial complexion is one part; the tiger's mouth fingerprint is the second part; the Cun position single-finger pulse is the third part. The "five pulses" refer to pressing the forehead above, diagnosing the Da Chong point below, plus the aforementioned three parts. For sick children, if the condition is not malignant, do not diagnose the Da Chong pulse, as its pulse is critical for determining life and death. Because the symptoms are critical and malignant, it must be diagnosed; one should not refuse due to fear of offending or causing harm.

[Image] Not reaching the Life Gate (Wei Guan): Middle section indicates Wind Syndrome, Initial section indicates Climate/Pathogen status.

[Image] Bead-like shape (Liu Zhu Xing): Indicates diaphragmatic heat, disharmony of the Triple Burner, qi stagnation, desire to vomit or have diarrhea after eating, fever, intestinal rumbling and spontaneous diarrhea, irritability, and crying.

[Image] Ring-bead shape (Huan Zhu Xing): Indicates qi disharmony, spleen and stomach weakness, food stagnation, abdominal distension, fever combined with food retention, empty irritability, and sudden oppression.

[Image] Long bead shape (Chang Zhu Xing): Indicates combined accumulation and stagnation, abdominal pain, possible chills and fever, tightness in the hypochondrium, indigestion, restless movement of parasites.

[Image] Incoming Snake shape (Lai She Xing): Indicates disharmony of the Middle Jiao (Epigastrium), attacking accumulated qi, inability to eat, transmission of Gan Qi (malnutrition qi), visceral unrest, abdominal distension, and dry heaving.

[Image] Outgoing Coiled Snake shape (Qu She Juan Xing): Indicates spleen deficiency with cold accumulation leading to diarrhea, vomiting or thirst, irritability, coarse breathing, panting, indigestion, mental fatigue, and excessive sleepiness.

[Image] Bow Reversing Inward shape (Gong Fan Li Xing): Cold pathogen invading internally, heavy dizziness, palpitations, lethargy, mental dullness, slight coldness in limbs, cough with profuse phlegm (red urine).

[Image] Bow Reversing Outward shape (Gong Wai Xing): Indicates phlegm-heat, mental restlessness, unstable sleep, fever combined with fright and food retention, wind-phlegm epilepsy syndromes.

[Image] Spear shape (Qiang Xing): Indicates evil heat and abundant phlegm generating wind, trance-like state, stability when lying down, impending convulsions, transmission of wind-fright.

[Image] Fish Bone shape (Yu Gu Xing): Indicates established wind-fright and phlegm-heat syndromes; wind can be stopped, phlegm resolved, fright calmed, and heat reduced without malignant complications. If the pathogen has transmitted further, other syndromes will arise.

[Image] Water Character shape (Shui Zi Xing): Indicates fright, accumulation, food stagnation, diaphragmatic heat, irritability, mental confusion, night crying, Triple Burner disharmony, overflowing phlegm, salivary flooding, locked jaw, and convulsions.

[Image] Needle shape (Zhen Xing): Indicates heart and lung heat, extreme heat generating wind, palpitations, irritability, lethargy, anorexia, mental fatigue, flaccid limbs, and sudden onset of wind-stroke (with overflowing phlegm and convulsions).

[Image] Penetrating Joint Shooting Finger Face (Tou Guan She Zhi Mian): Indicates the aggregation of four conditions—wind-fright, phlegm, and heat—in the chest and diaphragm, unable to disperse. Although severe, if compliant with treatment principles, it can be cured.

[Image] Penetrating Joint Shooting Nail (Tou Guan She Jia): Indicates malignant wind-fright, fright transmitted to meridians, occurrence of wind-heat, involvement of the Eight Signs (Ba Hou), deficiency with non-discharging phlegm, critical malignant syndrome, difficult to treat.