Library

Question: For infants under three years of age, what is the rationale behind observing the color and pattern of the collateral vessels at the "Three Passes" on the tiger's mouth (base of the thumb)?
Answer: The Qi and Blood of infants are not yet robust, and their meridians are not yet fully developed, making it impossible to distinguish pulse images through palpation. Therefore, diagnosis is made by observing the visible color and shape of the collateral vessels on the index finger. These collaterals are the origin points for the Cun, Guan, and Chi positions. Regarding color: purple indicates Wind-Heat; red indicates Cold Damage (Shanghan); green/blue indicates Fright or Alarm; white indicates Gan Accumulation (malnutrition). A faint yellow or a faint light red is considered a normal sign. The appearance of black is critical and indicates danger. If there are chaotic patterns across the Three Passes on the tiger's mouth, it suggests Neidiao (a pediatric condition characterized by abdominal pain and qi disharmony), accompanied by abdominal pain, qi disharmony, chaotic pulse, fever, anorexia, vomiting after eating, and bead-like formations on the upper lip, which indicates Bianzheng (physiological changes during infant growth). Among these, patterns in the Fengguan (Wind Gate, the first segment near the tiger's mouth) indicate mild conditions; patterns in the Qiguan (Qi Gate, the middle segment) indicate severe conditions; and patterns in the Mingguan (Life Gate, the segment near the nail) indicate particularly severe conditions. Specifically, the first segment of the index finger near the tiger's mouth is the Fengguan, the middle segment is the Qiguan, and the segment above the nail is the Mingguan. However, straight and thin patterns indicate Deficiency-Cold and insufficient Qi, which are difficult to cure; thick and distinct patterns indicate Pathogenic factors interfering with Healthy Qi, which are easier to treat. Patterns that are discontinuous like flowing pearls indicate retained food. Patterns extending from outside to inside indicate Wind-Cold; patterns extending from inside to outside indicate Food Retention. Qibo stated: "The color of Yin collaterals corresponds to the meridian; the color of Yang collaterals varies without constant rule, changing with the four seasons." Excess cold causes coagulation and stagnation, resulting in blue-black colors; excess heat causes moisture and luster, resulting in yellow-red colors. These are all normal phenomena. For children over three years old, one finger is used to palpate the Cun, Guan, and Chi positions. The infant's pulse should normally beat six times per breath cycle; an increase indicates Heat, and a decrease indicates Cold. A floating and wiry pulse indicates Ru Xian (infant epilepsy); a wiry and tight pulse indicates Feng Xian (wind epilepsy); a deficient and choppy pulse indicates Man Jing (slow convulsion); a deep and wiry pulse indicates abdominal pain; a wiry and excess pulse indicates qi disharmony; a firm and excess pulse indicates constipation; a deep and fine pulse indicates indigestion of cold milk; a deep and slippery pulse indicates undigested retained food. Whether small or choppy, or deep or fine, these all indicate retained food stagnation. A floating and large pulse indicates injury by Wind; a hidden and knotted pulse indicates accumulation of masses; a wiry and fine pulse indicates Gan Lao (chronic malnutrition leading to deficiency); a deep and rapid pulse indicates bone-steaming fever. In infants suffering from Chi Ban Sun Xie (dysentery with blood and undigested food), if the pulse is small and hands/feet are cold, recovery is difficult; if the pulse is small but hands/feet are warm, the diarrhea will easily resolve. If a child exhibits red cheeks, red eyes, yawning, restlessness, alternating chills and fever, coldness isolated to the extremities, trembling and aversion to cold, facial redness, surging Qi, copious tears and nasal discharge, red thread-like patterns behind the ears, and a rapid and abundant pulse, these are all signs of Dou Zhen (smallpox or measles). Many decoctions are contraindicated in this stage; do not administer medications recklessly to avoid causing harm.