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First, observe the child's eye color turning cyan; next, check if the back feels cold as ice. For a male infant, twitching of the left hand is harmless, but twitching of the right hand is alarming. For a female infant, twitching of the right hand is still treatable, whereas twitching of the left hand indicates a severe condition. Facial paralysis (wry mouth and eyes) is ultimately not fatal, though even immortal elixirs may not cure it. Swelling of the fontanelle definitely indicates wind pathogen; this condition should be known as ominous. If it suddenly collapses into a pit like the bottom of a cup, life will end within seven days. Cyanosis and dryness at the nose with unbearable thirst, black complexion and cyan lips indicate impending death. Abdominal distension with visible blue veins are all evil signs, especially when accompanied by blue patterns on the abdomen. Suddenly seeing purple mixed with cyan between the eyebrows suggests that wind convulsions will arise immediately. Mixed cyan and red patterns indicate that wind is about to rise, inevitably leading to symptoms of malnutrition (Gan syndrome) and diaphragmatic qi stagnation. Interlaced chaotic patterns with purple and cyan require urgent medical attention to avoid death. If purple is intense and accompanied by body heat, one must know that internal organs are prone to generating evil wind. Less purple and more red indicates livestock fright; equal amounts of purple and red indicate the formation of Gan syndrome; purple-black with red spots like rice grains can be assessed as wind-cold complicated with food retention. Scattered purple indicates wind transmitting to the Spleen; purple and cyan with thirst indicate wind epilepsy; deeply hidden purple is difficult to treat, but life can be saved by dispelling wind-phlegm. Light black is treatable, bringing recovery from near-death; floating red/赤 indicates cold and phlegm accumulation; red and cyan together indicate skin affected by wind pathogen; cyan and black together indicate slow convulsions caused by Spleen wind. Connected red/赤 indicates mild wind-heat; it implies the nursing mother's diet is inappropriate; sudden absence of pulse in both hands indicates shock or spiritual offense.

Cold fingertips indicate fright that cannot be settled; warmth in the middle finger indicates Cold Damage (Shanghan). Coldness isolated to the middle finger indicates measles or smallpox; for females, check the right hand, for males, the left, examining clearly. Heart heat with palpitations indicates fright; heat without palpitations indicates wind-cold; coolness with upturned eyes indicates water fright. This is the introductory diagnostic secret.

The Wind Gate is easy to treat, the Qi Gate is difficult, and the Life Gate is a sign of death. The left hand corresponds to the Heart and Liver; the right hand corresponds to the Spleen and Lung. Males are examined on the left hand, females on the right. The Three Gates refer to the three segments of the index finger. The first segment is the Wind Gate, corresponding to the Yin position; the second is the Qi Gate, corresponding to the Mao position; the third is the Life Gate, corresponding to the Chen position. When a newborn's five zang organs' blood and qi are not yet stable, and respiration is rapid, one must distinguish the colors and pulses of the Tiger's Mouth to ascertain the essence of the disease. Males are verified using the left hand, females using the right. This is based on the principle that the left hand belongs to Yang, dominant in males; the right hand belongs to Yin, dominant in females. However, both males and females possess Yin and Yang in their bodies, so both hands should be consulted. The patterns on the left hand correspond to the Heart and Liver, while those on the right correspond to the Spleen and Lung. From this, one grasps the subtle changes and flexibility.

When the pathological line first appears at the Tiger's Mouth or in the initial gate, it is mostly red. As it transmits to the middle gate, the color becomes red-purple. If it transmits further to show purple-cyan, the heat is deep and severe. If the color is cyan-black, or cyan with chaotic lines, the condition worsens. Pure black indicates critical, untreatable danger. Lines in the initial gate are easy to treat; passing the middle gate makes treatment difficult; penetrating all three gates is untreatable. As the ancients said, "Wind Gate involvement is still manageable, but transmission to Qi and Life gates is hard to recover from." Red color indicates mild wind-heat; bright red indicates strong wind-heat; purple indicates fright-heat; cyan indicates fright-stagnation. Equal parts cyan and red indicate both fright-stagnation and wind-heat, primarily acute convulsions. Pale cyan with light purple, extending and retracting, indicates slow convulsions. Purple, cyan, or black threads, faintly mixed and seemingly emerging, also indicate slow convulsions. Four-limb convulsions imply cyan lines in all three gates. Water fright implies black lines in all three gates. Human fright implies red lines in all three gates. Thunder fright implies yellow lines. Or cyan or red, with thread-like straight lines, indicating Spleen injury from milk/food and heat-induced fright. Symmetrical lines on both hands indicate simultaneous fright and stagnation. Forked or scattered lines indicate wind-phlegm generated by the Lungs. Patterns resembling sound waves with cyan indicate Cold Damage and cough. Fire-red indicates diarrhea; mixed with black and thirst without deficiency, chaotic Tiger's Mouth pulses indicate disharmony of Qi. Generally, pulse lines show five colors: yellow, red, purple, cyan, black. Yellow-red with color but no form is a peaceful pulse. Form indicates a pathological pulse. Due to disease progression, colors change: excessive yellow turns red, excessive red turns purple, excessive purple turns cyan, excessive cyan turns black. Pure black is difficult to treat. One must also distinguish the forms:

Liu Zhu (Flowing Pearl): A single red dot. Indicates diaphragmatic heat, Sanjiao disharmony, dietary injury, desire to vomit/diarrhea, borborygmus, spontaneous diarrhea, restlessness, and crying. Treatment: Digest food, tonify Spleen and Stomach.
Huan Zhu (Ring Pearl): Larger than Liu Zhu. Indicates Spleen deficiency with food stagnation, chest/abdominal fullness, irritability, thirst, and fever. Treatment: Strengthen Spleen and Stomach, digest food, regulate Qi.
Chang Zhu (Long Pearl): Large at one end, pointed at the other. Indicates Spleen injury from diet, stagnation abdominal pain, alternating cold/heat, and anorexia. Treatment: Digest food, strengthen Stomach.
Lai She (Incoming Snake): Thick at the lower end. Indicates Damp-Heat in Spleen/Stomach, obstruction in Zhongwan, dry heaving, anorexia, and internal Gan pathogen. Treatment: Resolve food stagnation, tonify Spleen and Stomach.
Qu She (Outgoing Snake): Thick at the upper end. Indicates Spleen deficiency with cold stagnation, vomiting/diarrhea, irritability/thirst, shortness of breath, mental fatigue, lethargy, and anorexia. Treatment: Strengthen Spleen and Stomach, resolve stagnation, stop vomiting/diarrhea first.
Gong Fan Li Wan Xiang Zhong Zhi (Bow bending inward toward middle finger): Indicates invasion of cold/heat pathogens, heavy head/eyes, mental fright/palpitations, fatigue, slightly cold limbs, dark urine, cough, and vomiting. Treatment: Induce sweating to expel fright, clear Heart fire, push Spleen, rub Lungs.
Gong Fan Wai Wan Xiang Da Zhi (Bow bending outward toward thumb): Indicates Phlegm-Heat, mental confusion with heat, combined fright/food stagnation, and wind epilepsy. Patterns bending inward are auspicious; outward are ominous.
Qiang Xing (Spear Shape): Indicates Wind-Heat, generating phlegm and convulsions.
Zhen Xing (Needle Shape): Indicates extreme Heat in Heart/Liver generating Wind, sudden palpitations/oppression, fatigue/anorexia, abundant phlegm, and convulsions. Also called Xuan Zhen (Hanging Needle), indicates diarrhea.
Yu Gu Xing (Fish Bone Shape): Indicates Fright-Phlegm with fever, severe cases have abundant phlegm, convulsions, or anorexia. It is Liver excess overcoming Spleen. Treatment: Expel fright, induce vomiting/downward draining of phlegm, then tonify/restrain Spleen.
Yu Ci (Fish Spine): Initial gate indicates fright; Qi gate indicates Gan; Life gate indicates deficiency, difficult to treat.
Shui Zi Xing (Water Character Shape): Indicates Fright-Wind and food stagnation, restlessness, oppression, reduced intake, night crying, abundant phlegm, locked jaw, and convulsions. This is Spleen deficiency with stagnation, Wood overcoming Earth. Also called Shui Zi, indicating Lung disease, meaning Fright-Wind entering Lungs.
Yi Zi (Yi Character Shape): Initial gate indicates Liver fright; second gate indicates acute convulsions; third gate indicates slow convulsions/Spleen wind.
Qu Chong (Curved Worm): Indicates severe Liver disease.
Ru Huan (Like a Ring): Indicates toxicity in Kidney.
Qu Xiang Li (Curving Inward): Indicates Qi Gan.
Qu Xiang Wai (Curving Outward): Indicates Wind Gan.
Xie Xiang You (Slanting Right): Indicates Cold Damage.
Xie Xiang Zuo (Slanting Left): Indicates Wind-Cold.
Gou Mai (Hook Pulse): Indicates Cold Damage.
Chang Chong (Long Worm): Indicates Cold Injury.
Qiu Wen (Coiled Pattern): Indicates Heart worm movement.
Tou Guan She Zhi (Penetrating Gate Shooting Finger): Bending inward is She Zhi. Indicates Fright-Wind, Phlegm-Heat gathering in chest/diaphragm, Spleen/Lung damage, and phlegm pathogen aggregation. Treatment: Clear Spleen/Lungs, transform phlegm-saliva.
Tou Guan She Jia (Penetrating Gate Shooting Nail): Bending outward is She Jia. Indicates severe Fright-Wind, fright transmitted to meridians. Wind-Heat arises, ten deaths for one survival.
Cyan-white-purple veins on the ring finger's three gates are difficult to treat; on the middle finger's three gates, they are easy to treat.