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When a child is ill, one must rely on pulse diagnosis. The physician uses three fingers (index, middle, ring) to press the Cun, Guan, and Chi positions to determine the pulse rate. A floating and surging pulse indicates an excess of wind; a rapid pulse often suggests fright. A deficient and cold pulse, or a deep and slow pulse, indicates internal accumulation.

For children aged one to three years, eight beats per respiration are considered normal. Nine beats indicate unrest, and ten beats indicate exhaustion. Abnormalities in the length and size of the pulse suggest pathogenic interference. A tight pulse in children indicates wind epilepsy; a deep pulse with difficulty in Qi transformation suggests impaired physiological function. Abdominal pain with a tight, wiry, firm, and solid pulse indicates constipation; a deep and rapid pulse indicates cold in the bones. A large pulse in children is mostly due to wind-heat; a heavy pulse is caused by milk and food stagnation. A wiry and long pulse often indicates liver and gallbladder wind; a tight and rapid pulse indicates wind-fright accompanied by limb convulsions. A floating and surging pulse suggests stomach heat ("stomach like fire burning"); a deep and tight pulse indicates unceasing abdominal pain; a deficient and soggy pulse indicates Qi stagnation combined with fright; a chaotic pulse often indicates dysentery with bloody stools. A pulse that is large at the front (Cun) and small at the back (Chi) is a favorable pattern for children; if it is small at the front and large at the back, it indicates Qi rebellion in the throat. A pulse with four beats that is surging, accompanied by irritability and fullness, suggests discomfort; a deep and fine pulse indicates severe abdominal pain. A slippery pulse indicates injury from dew, dampness, or cold; a wiry and long pulse clearly indicates external invasion (Ke Wu). A pulse rate of five beats appearing floating and large at night but fine during the day, or six beats appearing fine at night but floating during the day, reflects circadian variations. A harmonious pulse rate of eight to nine beats per respiration is the profound method left by immortals.

One must know the Qi color and fingerprint patterns at the Tiger's Mouth (Web between thumb and index finger). Observing the fingerprint against the light reveals five colors: yellow-red indicates peace and harmony of the five Zang organs; red-purple implies slight damage or benefit; purple-green indicates food injury, Qi deficiency, and irritability; the appearance of green indicates a adverse prognosis. If pure black suddenly appears among them, even skilled physicians may feel fear. If the fingerprint extends straight to the Wind Gate (first phalanx), its speed and length divide into two categories: resembling a spear shaft indicates impending wind-fright; branching like leaves shows various manifestations. An arc curving inward is favorable (Shun), outward is adverse (Ni); when Shun and Ni intersect, the disease is difficult to treat. Forked tips of varying lengths can still be saved; such detailed observation requires a skilled practitioner.

Boys aged two are called "Ying" (infant), three to four are "You" (young), five to six grow older, seven to eight are "Tiao" (changing teeth), nine are "Tong" (child), and ten are "Zhi" (youngster). One must identify the cause of hundreds of diseases. At eleven or twelve, epilepsy and mania-wind are common; Gan syndrome (malnutrition) attacks like consumption; Pi and Pi masses are definite signs of sedimentation; remitting fever differs from other fevers. Initially checking for heat in the palm center indicates accompanying body heat. A hot belly with cold hands and feet confirms food injury; cold feet with a hot forehead indicate wind sensation; a cold forehead with hot feet indicate fright; redness behind the ears appears when rashes erupt. For children with accumulation, resolving methods are suitable; for the two types of Shanghan (Cold Damage), releasing the exterior is prioritized. Food diarrhea usually involves accumulation; cold diarrhea requires warming the Spleen. Children should have their Zang-Fu secured with astringents, first administering formulas to disperse injuries. If a healthy child suddenly screams loudly, it is not wind-fright but Tian Diao (a sudden convulsive disorder). Loud screaming with shortness of breath and coarse voice suggests ingestion of hot toxins blocking the heart orifices. Urgent purgation after this soothes the spleen; mistaking this for wind-fright is laughable. Dysentery with straining causes furrowed brows; no straining indicates wind in the intestines. Cold-heat imbalance distinguishes red and white dysentery; rectal prolapse is caused by toxic heat attacking internally. Among twelve types of dysentery, which are malignant? Forbidden-mouth dysentery and bowel-scraping dysentery are significantly different.

Children without excess syndromes should not undergo purgation. If there is spontaneous sweating from cold-heat imbalance and spontaneous diarrhea, sunken fontanelles, cold limbs, dry retching, Qi deficiency, fearful spirit, vomiting worms, pale face, dry and brittle hair, Gan Qi with remitting fever, undigested food, nasal congestion, cough, deficiency-phlegm, fine pulse, borborygmus, and irritability—if there is still pathology, rapid unblocking (purgation) is appropriate. Improper purgation leads to collapse of the Heart Spirit. However, if a child eats hot foods and has diarrhea without harm, with a red-blue-red complexion and strong Qi, wiry-red pulse, hot abdomen, sore cheeks and throat, urine like boiling water, hard stool, abdominal distension, full hypochondrium, limb edema, prolonged night crying, widespread skin sores, and hidden abdominal pain, purgation will surely cure them and is considered excellent therapy.