钱仲阳云∶小儿之脉，气不和则弦急，伤食则沉缓，虚惊则促，急风则浮，冷则沉细，脉乱
者不治。《水镜诀》云∶阴阳运合，男女成形，已分九窍四肢，乃生五脏六腑，部分既别，
逆顺难明。若凭寸口之浮沉，必乃横亡于孩子，须明虎口辨别三关消详，用药始无差误。未
至三岁，看虎口食指，第一节名风关脉，初见易治；第二节名气关脉，见病深难治；第三节
名命关脉，见死不治。三关青是四足惊，赤是水惊，黑是人惊，紫色泻利，黄色雷惊，三关
通度是极惊之症，必死。或青或红，有纹如线一直者，是乳食伤脾，必发惊热。左右一样者
，是惊与积齐发。有三条，或散，是肺生风痰，或似 声。有赤是伤寒及嗽。如红火是泻
，红黑相兼主下痢，青多白痢，红多赤痢。紫色相兼加渴，虎口脉纹乱，主胃气不和。青是
惊与积，青黑发慢惊，脉入掌乃内钓。指纹曲里风盛，弯外食积，此论三岁以上之法。若三
岁以下，更用一指按高骨，乃分三关，定其息数呼吸，八至为平脉，九至不安，十至危困。
浮主风。沉迟主虚冷。实主有热。紧主癫痫。洪主热盛。沉缓主虚泻。微迟有积有虫。迟涩
主胃脘不和。沉主乳食难化。沉细主乳食停滞。紧弦主腹中热痛。牢实主大便秘。沉而数者
骨中有热。弦长是肝膈有风。紧数乃惊风为患，四肢掣颤。浮洪乃胃口有热。沉紧主腹痛有
寒。虚濡者有气，又主慢惊。芤主大便利血。四岁以下，用一指根据转寻三部以关为准。七八
岁移指少许。九岁次第根据三关部位寻取。十一、十二岁亦同。十四、十五岁根据大方脉部位诊
视。凡看脉先定浮沉迟数、阴阳冷热，沉迟为阴，浮数为阳。更兼看部位，青主惊风，白主
虚泻，赤主痰热，黑色病甚，黄主脾疳。以此相按，察病治疗，庶无误矣。又《全幼心鉴》
云∶小儿半岁之际，有病当于额前眉端发际之间，以名、中、食三指曲按之。儿头在左举右
手，在右举左手，食指为上，中指为中，名指为下。三指俱热，主感风邪，鼻塞气粗，发热
咳嗽；若三指俱冷，主外感风寒，内伤饮食，发热吐泻；若食、中二指热，主上热下冷；名
、中二指热，主夹惊之疾；食指热，主胸满食滞，又当参辨脉形主之。
流珠形∶主饮食所伤，内热欲吐，或肠鸣自利，烦躁啼哭，用助胃膏消饮食分阴阳。若食消
而病仍作，用香砂助胃膏以补脾胃。
环珠形∶主脾虚停食，胸膈胀满，烦渴发热，用五味异功散加山楂、枳实，健脾消食，后用
六君子汤调养中气。
长珠形∶主脾伤饮食积滞，肚腹作痛，寒热不食，先用大安丸消其积滞，次以异功散健其脾
来蛇形∶主脾胃湿热，中脘不利，干呕不食，此疳邪内作，先用四味肥儿丸治疳，后用四君
去蛇形∶主脾虚食积，吐泻烦渴，气短喘急，不食困睡，先用六君子汤加枳实，健脾消积，
次以七味白术散调补胃气。
弓反里形∶主感冒寒邪，哽气出气，惊悸倦怠，四肢稍冷，小便赤色，咳嗽吐涎，先用惺惺
散助胃气祛外邪，后以五味异功散加茯神、当归，养心血，助胃气。若外邪既解，而惊悸指
冷，脾气受伤也，宜用七味白术散补之。若闷乱气粗，喘促哽气者，难治，脾虚甚故也。
弓反外形∶主痰热，心神恍惚，夹惊夹食，风痫痰盛，先以天麻防风丸祛外邪，又用五味异
枪形∶主风热生痰发搐，先用抱龙丸，如未应，用牛黄清心丸。若传于脾肺，或过用风痰之
药，而见一切诸症者，专调补脾胃。
鱼骨形∶主惊痰发热，先用抱龙丸治之，如未应，属肝火实热，少用抑青丸以清肝，随用六
味丸以补肝。或发热少食，或痰盛发搐，乃肝木克脾土，用六君子汤加柴胡补脾土以制肝木
水字形∶主惊风，食积胸膈，烦躁顿闷，少食，或夜啼痰盛，口噤搐搦，此脾胃虚弱，饮食
积滞，而木克土也。先用大安丸消导饮食，次以六君、钩藤钩补中清肝。若已服消食化痰等
剂，而病不愈者，用四君、升麻、柴胡、钩藤钩，升补脾气，平制肝木。
针形∶主心肝热极生风，惊悸顿闷，困倦不食，痰盛搐搦。先用抱龙丸祛风化痰，次用六君
子加钩藤钩平肝实脾。
透关射指形∶主惊风，痰热聚于胸膈，乃脾肺亏损，痰邪乘聚，先用牛黄清心丸清脾肺、化
痰涎，次用六君子汤加桔梗、山药，补脾土，益肺金。
透关射甲形∶主惊风，肝木克制脾土之败症，急用六君、木香、钩藤钩、官桂，温补脾土。
未应，即加附子以回阳气，多得生者。
尝闻古人云∶小儿为芽儿，如草之芽、水之沤。盖因脏腑脆嫩，口不能言，最难投剂。当首
察面色，而知其所属；次验虎口，以辨其所因。实为治法之简要也。
\r图\p03-b29a1.bmp\r
流珠只一点红色，环珠差大，长珠圆长，以上非谓圈子，总皆经脉贯气之如此。来蛇即是长
珠散，一头大一头尖，去蛇亦如此分上下朝，故曰来去。角弓反张，向里为顺，向外为逆，
枪形直上，鱼骨分开，水字即三脉并行。针形即过关一二粒米许，射甲命脉向外透指命脉曲
里。虽然余常治之，亦有不专执其形脉而投剂者，盖但有是症即服是药，而亦多验。
治验
一小儿发热吐泻，腹胀不乳，其纹如流珠。此脾胃气伤，先用香砂助胃膏，后用六君子汤痊
一小儿寒热作呕，饮食不入，按其腹乃哭，脉纹如长珠，此饮食停滞也，用大安丸吐泻宿滞
遂安；但唇目抽动，大便稀黄，此病邪去而虚热所迫也，用六君子汤加钩藤钩而愈。
一小儿胸腹膨胀，发热顿闷，脉纹如环珠，以手按腹即哭，此属脾胃虚而饮食停滞也，先用
保和丸一服，前症如失，更加烦渴，按其腹而不哭，此宿食去而脾胃复伤也，用五味异功散加柴胡治之顿瘳。
一小儿不时干呕，乳食不进，肚腹膨胀，脉形如来蛇，此脾胃虚而成疳也。用四味肥儿丸治
疳，佐以四君加芜荑健中而痊。后伤饮食吐泻完谷，形气甚困，四肢微搐，视其纹如去蛇，
余曰∶且勿用药。次日吐止，但搐而泻青黄，此脾土虚而肝木胜也，用六君子加钩藤钩而瘥。
一小儿未及周岁，气短喘急，乳食少进，时或吐乳，视其形如去蛇，乃脾伤而食积。先用六
君子加山楂、枳实，渐愈；后乳食复伤，吐泻作渴，先与胃苓膏，继与白术散而愈。
一小儿睡卧惊悸，发热痰盛，脉形如弓之向外，此因惊木旺伤脾，而食不消也。先以天麻防
风丸，祛风定惊；后用五味异功散，壮脾止搐全瘥。
一小儿沉默昏倦，肢冷惊悸，其纹如弓之向里，此属胃气虚而外感寒邪也。先用惺惺散，以
解外邪调胃气，诸症顿愈。但手足逆冷，又用六君子汤，调补元气而安。
一小儿患咳嗽，服牛黄清心丸，加喘促腹胀。余视其右脸色赤，纹指如枪，属脾气复伤，用
六君子汤顿安。
一小儿沉困发热，惊搐不乳，视其脉纹如乱鱼骨，此风热急惊之症也。先用抱龙丸少许祛风
化痰，后用六君子汤加柴胡，壮脾平肝而愈。
一小儿咳嗽发热，右脸赤色，作渴烦闷，倦怠少食，肚腹作胀，脉纹如针，此风邪伤肺而饮
食伤脾也。先用六君子汤加桔梗、杏仁、柴胡一剂，诸症少愈；后去杏仁、柴胡，再剂而安
一小儿发热夜啼，乳食不进，昏迷抽搐，痰盛口噤，脉纹如水字，此脾肺气虚，风木所乘，
痰食积于胸腹也。先用大安丸，后用六君子加钩藤钩而愈。
一小儿发热，右脸赤，咳嗽痰盛，其脉纹透关射指，余以为风邪蕴结于肺而痰作也。用二陈
加桑皮、杏仁、桔梗治之。自用发散降火之剂，风痰不退，发热益甚。余曰∶此脾肺气虚，
治失其宜。遂用五味异功散加炒桔梗渐愈，又用六君子汤而痊。
一小儿停食发热，服芩、连、三棱、浓朴等剂，饮食日少，胸腹膨胀，其纹透至指甲。用补
中益气汤加木香、钩藤钩，温补脾气，平制肝木，数剂渐效；又用六君子汤加炮姜治之而安
。其间，间泛用金石脑麝祛逐之剂，变惊而殁者，不胜枚举。惜哉！
香砂助胃膏（方见热吐）
五味异功散
六君子汤（二方见内钓）
大安丸（方见虚羸）
四味肥儿丸（方见呕吐）
四君子汤（方见内钓）
七味白术散（方见腹痛）
惺惺散
天麻防风丸（二方见咳嗽）
抱龙丸（方见伤寒）
牛黄清心丸（方见急惊）
抑青丸（方见惊啼）
六味丸（方见肾脏）
保和丸（方见虚羸）
胃苓汤（方见霍乱吐泻）
二陈汤（方见寒冷呕吐）
钱仲阳说：小儿的脉象，气机不和则表现为弦急，伤食则表现为沉缓，虚惊则表现为急促，急风则表现为浮，受冷则表现为沉细，脉象散乱者难以治愈。《水镜诀》说：阴阳运化结合，男女形成形体，九窍四肢已分，进而产生五脏六腑，部位既已区分，逆顺难以明了。如果仅凭寸口脉的浮沉来判断，必然导致孩子横死，必须明白通过虎口指纹辨别三关来详细分析，用药才没有差错。未满三岁，看虎口食指，第一节名为风关脉，初见病易治；第二节名气关脉，见到病深难治；第三节名命关脉，见到死不治。三关青色是四足动物惊吓所致，赤色是水惊吓所致，黑色是人惊吓所致，紫色主泻利，黄色主雷惊，三关通度是极度惊风的症状，必死。或青或红，有纹路如线一直通的，是乳食损伤脾胃，必发惊热。左右一样的，是惊风与积滞同时发作。有三条纹，或散开的，是肺生风痰，或似有声。有赤色是伤寒及咳嗽。如火红色是泻，红黑相兼主下痢，青色多主白痢，红色多主赤痢。紫色相兼加口渴，虎口脉纹乱，主胃气不和。青色是惊风与积滞，青黑发慢惊，脉入掌乃内钓。指纹弯曲向里风盛，弯曲向外食积，这是论述三岁以上的方法。若三岁以下，更用一指按高骨，乃分三关，定其呼吸次数，八至为平脉，九至不安，十至危困。浮主风。沉迟主虚冷。实主有热。紧主癫痫。洪主热盛。沉缓主虚泻。微迟有积有虫。迟涩主胃脘不和。沉主乳食难化。沉细主乳食停滞。紧弦主腹中热痛。牢实主大便秘结。沉而数者骨中有热。弦长是肝膈有风。紧数乃惊风为患，四肢掣颤。浮洪乃胃口有热。沉紧主腹痛有寒。虚濡者有气，又主慢惊。芤主大便利血。四岁以下，用一指根据转寻三部以关为准。七八岁移指少许。九岁次第根据三关部位寻取。十一、十二岁亦同。十四、十五岁根据大方脉部位诊视。凡看脉先定浮沉迟数、阴阳冷热，沉迟为阴，浮数为阳。更兼看部位，青主惊风，白主虚泻，赤主痰热，黑色病甚，黄主脾疳。以此相按，察病治疗，庶无误矣。又《全幼心鉴》说：小儿半岁之际，有病当于额前眉端发际之间，以名、中、食三指曲按之。儿头在左举右手，在右举左手，食指为上，中指为中，名指为下。三指俱热，主感风邪，鼻塞气粗，发热咳嗽；若三指俱冷，主外感风寒，内伤饮食，发热吐泻；若食、中二指热，主上热下冷；名、中二指热，主夹惊之疾；食指热，主胸满食滞，又当参辨脉形主之。
流珠形：主饮食所伤，内热欲吐，或肠鸣自利，烦躁啼哭，用助胃膏消饮食分阴阳。若食消而病仍作，用香砂助胃膏以补脾胃。
环珠形：主脾虚停食，胸膈胀满，烦渴发热，用五味异功散加山楂、枳实，健脾消食，后用六君子汤调养中气。
长珠形：主脾伤饮食积滞，肚腹作痛，寒热不食，先用大安丸消其积滞，次以异功散健其脾。
来蛇形：主脾胃湿热，中脘不利，干呕不食，此疳邪内作，先用四味肥儿丸治疳，后用四君子汤去蛇形：主脾虚食积，吐泻烦渴，气短喘急，不食困睡，先用六君子汤加枳实，健脾消积，次以七味白术散调补胃气。
弓反里形：主感冒寒邪，哽气出气，惊悸倦怠，四肢稍冷，小便赤色，咳嗽吐涎，先用惺惺散助胃气祛外邪，后以五味异功散加茯神、当归，养心血，助胃气。若外邪既解，而惊悸指冷，脾气受伤也，宜用七味白术散补之。若闷乱气粗，喘促哽气者，难治，脾虚甚故也。
弓反外形：主痰热，心神恍惚，夹惊夹食，风痫痰盛，先以天麻防风丸祛外邪，又用五味异功散。
枪形：主风热生痰发搐，先用抱龙丸，如未应，用牛黄清心丸。若传于脾肺，或过用风痰之药，而见一切诸症者，专调补脾胃。
鱼骨形：主惊痰发热，先用抱龙丸治之，如未应，属肝火实热，少用抑青丸以清肝，随用六味丸以补肝。或发热少食，或痰盛发搐，乃肝木克脾土，用六君子汤加柴胡补脾土以制肝木。
水字形：主惊风，食积胸膈，烦躁顿闷，少食，或夜啼痰盛，口噤搐搦，此脾胃虚弱，饮食积滞，而木克土也。先用大安丸消导饮食，次以六君、钩藤钩补中清肝。若已服消食化痰等剂，而病不愈者，用四君、升麻、柴胡、钩藤钩，升补脾气，平制肝木。
针形：主心肝热极生风，惊悸顿闷，困倦不食，痰盛搐搦。先用抱龙丸祛风化痰，次用六君子加钩藤钩平肝实脾。
透关射指形：主惊风，痰热聚于胸膈，乃脾肺亏损，痰邪乘聚，先用牛黄清心丸清脾肺、化痰涎，次用六君子汤加桔梗、山药，补脾土，益肺金。
透关射甲形：主惊风，肝木克制脾土之败症，急用六君、木香、钩藤钩、官桂，温补脾土。未应，即加附子以回阳气，多得生者。
尝闻古人云：小儿为芽儿，如草之芽、水之沤。盖因脏腑脆嫩，口不能言，最难投剂。当首察面色，而知其所属；次验虎口，以辨其所因。实为治法之简要也。
图（略）
流珠只一点红色，环珠差大，长珠圆长，以上非谓圈子，总皆经脉贯气之如此。来蛇即是长珠散，一头大一头尖，去蛇亦如此分上下朝，故曰来去。角弓反张，向里为顺，向外为逆，枪形直上，鱼骨分开，水字即三脉并行。针形即过关一二粒米许，射甲命脉向外透指命脉曲里。虽然余常治之，亦有不专执其形脉而投剂者，盖但有是症即服是药，而亦多验。
治验
一小儿发热吐泻，腹胀不乳，其纹如流珠。此脾胃气伤，先用香砂助胃膏，后用六君子汤痊愈。
一小儿寒热作呕，饮食不入，按其腹乃哭，脉纹如长珠，此饮食停滞也，用大安丸吐泻宿滞遂安；但唇目抽动，大便稀黄，此病邪去而虚热所迫也，用六君子汤加钩藤钩而愈。
一小儿胸腹膨胀，发热顿闷，脉纹如环珠，以手按腹即哭，此属脾胃虚而饮食停滞也，先用保和丸一服，前症如失，更加烦渴，按其腹而不哭，此宿食去而脾胃复伤也，用五味异功散加柴胡治之顿瘳。
一小儿不时干呕，乳食不进，肚腹膨胀，脉形如来蛇，此脾胃虚而成疳也。用四味肥儿丸治疳，佐以四君加芜荑健中而痊。后伤饮食吐泻完谷，形气甚困，四肢微搐，视其纹如去蛇，余曰：且勿用药。次日吐止，但搐而泻青黄，此脾土虚而肝木胜也，用六君子加钩藤钩而瘥。
一小儿未及周岁，气短喘急，乳食少进，时或吐乳，视其形如去蛇，乃脾伤而食积。先用六君子加山楂、枳实，渐愈；后乳食复伤，吐泻作渴，先与胃苓膏，继与白术散而愈。
一小儿睡卧惊悸，发热痰盛，脉形如弓之向外，此因惊木旺伤脾，而食不消也。先以天麻防风丸，祛风定惊；后用五味异功散，壮脾止搐全瘥。
一小儿沉默昏倦，肢冷惊悸，其纹如弓之向里，此属胃气虚而外感寒邪也。先用惺惺散，以解外邪调胃气，诸症顿愈。但手足逆冷，又用六君子汤，调补元气而安。
一小儿患咳嗽，服牛黄清心丸，加喘促腹胀。余视其右脸色赤，纹指如枪，属脾气复伤，用六君子汤顿安。
一小儿沉困发热，惊搐不乳，视其脉纹如乱鱼骨，此风热急惊之症也。先用抱龙丸少许祛风化痰，后用六君子汤加柴胡，壮脾平肝而愈。
一小儿咳嗽发热，右脸赤色，作渴烦闷，倦怠少食，肚腹作胀，脉纹如针，此风邪伤肺而饮食伤脾也。先用六君子汤加桔梗、杏仁、柴胡一剂，诸症少愈；后去杏仁、柴胡，再剂而安。
一小儿发热夜啼，乳食不进，昏迷抽搐，痰盛口噤，脉纹如水字，此脾肺气虚，风木所乘，痰食积于胸腹也。先用大安丸，后用六君子加钩藤钩而愈。
一小儿发热，右脸赤，咳嗽痰盛，其脉纹透关射指，余以为风邪蕴结于肺而痰作也。用二陈汤加桑皮、杏仁、桔梗治之。自用发散降火之剂，风痰不退，发热益甚。余曰：此脾肺气虚，治失其宜。遂用五味异功散加炒桔梗渐愈，又用六君子汤而痊。
一小儿停食发热，服芩、连、三棱、浓朴等剂，饮食日少，胸腹膨胀，其纹透至指甲。用补中益气汤加木香、钩藤钩，温补脾气，平制肝木，数剂渐效；又用六君子汤加炮姜治之而安。其间，间泛用金石脑麝祛逐之剂，变惊而殁者，不胜枚举。惜哉！
香砂助胃膏（方见热吐）
五味异功散
六君子汤（二方见内钓）
大安丸（方见虚羸）
四味肥儿丸（方见呕吐）
四君子汤（方见内钓）
七味白术散（方见腹痛）
惺惺散
天麻防风丸（二方见咳嗽）
抱龙丸（方见伤寒）
牛黄清心丸（方见急惊）
抑青丸（方见惊啼）
六味丸（方见肾脏）
保和丸（方见虚羸）
胃苓汤（方见霍乱吐泻）
二陈汤（方见寒冷呕吐）
Qian Zhongyang stated: In children, the pulse is wiry and tense when Qi is disharmonious; deep and slow when food is injured; rapid when there is deficiency and fright; floating in acute wind-cold; deep and thin when cold; and chaotic pulses indicate a difficult-to-treat condition. The *Shuijing Jue* (Water Mirror Classic) states: Yin and Yang interact to form the body, distinguishing nine orifices and four limbs, then generating the five zang and six fu organs. Once these parts are differentiated, determining favorable or unfavorable outcomes is difficult. Relying solely on the floating or sinking of the cunkou pulse will inevitably lead to the child's sudden death. One must understand how to distinguish the three palaces by observing the Tiger's Mouth (Wuhkou) fingerprint patterns to ensure accurate medication. For children under three years old, observe the index finger at the Tiger's Mouth. The first segment is called the Wind Palace (Fengguan); its appearance indicates an easily treatable disease. The second segment is called the Qi Palace (Qiguan); its appearance indicates a deep and difficult-to-treat disease. The third segment is called the Life Palace (Mingguan); its appearance indicates a fatal condition. If the three segments are green, it is fright caused by quadrupeds; red indicates fright from water; black indicates fright from humans; purple indicates diarrhea; yellow indicates thunder fright. If all three segments are involved, it is a severe fright syndrome, which is fatal. If the pattern is green or red with a line extending straight through, it indicates spleen injury from milk and food, leading to fright-heat. Identical patterns on both hands indicate simultaneous occurrence of fright and accumulation. Three lines, whether scattered, indicate wind-phlegm generated by the lungs, possibly accompanied by wheezing sounds. Red indicates wind-cold and cough. Fire-red indicates diarrhea; red mixed with black indicates dysentery; predominantly green indicates white dysentery; predominantly red indicates bloody dysentery. Purple mixed with thirst indicates stomach Qi disharmony. Green indicates fright and accumulation; green-black indicates slow fright; if the pulse enters the palm, it is internal hooking (Neidiao). Fingerprint curving inward indicates excess wind; curving outward indicates food accumulation. This method applies to children over three years old. For children under three, use one finger to press the high bone to divide the three palaces, count breaths per pulse beat: eight beats is a normal pulse; nine beats indicates discomfort; ten beats indicates critical danger. Floating indicates wind. Deep and slow indicates deficiency-cold. Excess indicates heat. Tight indicates epilepsy. Surging indicates excessive heat. Deep and slow indicates deficiency-diarrhea. Fine and slow indicates accumulation and parasites. Slow and choppy indicates stomach epigastrium disharmony. Deep indicates difficulty digesting milk/food. Deep and thin indicates stagnation of milk/food. Tight and wiry indicates abdominal heat-pain. Firm and solid indicates constipation. Deep and rapid indicates heat in the bones. Wiry and long indicates wind in the liver and diaphragm. Tight and rapid indicates fright-wind pathology with limb twitching. Floating and surging indicates heat in the stomach. Deep and tight indicates abdominal pain due to cold. Deficient and soggy indicates Qi deficiency and slow fright. Hollow indicates profuse loose stools with blood. For children under four, use one finger to search the three positions based on the middle palace as the reference. At seven or eight years, shift the finger slightly. At nine years, follow the three palaces sequentially. Eleven and twelve years old follow the same method. Fourteen and fifteen years old are diagnosed according to adult pulse locations. Generally, first determine floating/sinking, slow/rapid, yin/yang, and cold/heat. Deep and slow are yin; floating and rapid are yang. Additionally, observe color: green indicates fright-wind; white indicates deficiency-diarrhea; red indicates phlegm-heat; black indicates severe disease; yellow indicates spleen malnutrition (Gan). By correlating these, one can examine and treat diseases without error. The *Quanyou Xinjian* (Mirror of Infant Care) states: For infants around six months old with illness, press the area between the forehead, eyebrows, and hairline with the ring, middle, and index fingers bent. 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, the middle finger the middle position, and the ring finger the lower position. Heat in all three fingers indicates wind-pathogen invasion, nasal congestion, coarse breathing, fever, and cough. Cold in all three fingers indicates external wind-cold and internal food injury, with fever, vomiting, and diarrhea. Heat in the index and middle fingers indicates upper heat and lower cold. Heat in the ring and middle fingers indicates conditions complicated by fright. Heat in the index finger indicates chest fullness and food stagnation. Pulse shape should also be considered.
Pearl-like Shape (Liuzhu): Indicates food injury, internal heat with desire to vomit, borborygmus with spontaneous diarrhea, irritability, and crying. Use Zhuwei Yigong San (Five-Ingredient Powder for Extraordinary Merit) to resolve food and differentiate yin and yang. If symptoms persist after digestion, use Xiangsha Zhugao (Aucklandia and Amomum Stomach-Assisting Paste) to tonify the spleen and stomach.
Ring-bead Shape (Huanzhu): Indicates spleen deficiency with food retention, chest and diaphragm distension, irritability, thirst, and fever. Use Wuwei Yigong San (Five-Ingredient Powder for Extraordinary Merit) added with Hawthorn Fruit (Shanzha) and Immature Bitter Orange (Zhishi) to strengthen the spleen and digest food, followed by Liujunzi Tang (Six-Gentlemen Decoction) to regulate middle Qi.
Long-bead Shape (Changzhu): Indicates spleen injury with food accumulation, abdominal pain, alternating chills and fever, and anorexia. First use Da'an Wan (Great Peace Pill) to resolve accumulation, then Yigong San to strengthen the spleen.
Coming-Snake Shape (Laishe): Indicates spleen-stomach damp-heat, epigastric dysfunction, dry retching, and anorexia, caused by internal Gan pathogen. First use Siwei Fei'er Wan (Four-Ingredient Child-Nourishing Pill) to treat Gan, then Sijunzi Tang (Four-Gentlemen Decoction).
Going-Snake Shape (Qushe): Indicates spleen deficiency with food accumulation, vomiting, diarrhea, irritability, thirst, shortness of breath, rapid breathing, anorexia, lethargy, and sleepiness. First use Liujunzi Tang added with Zhishi to strengthen the spleen and resolve accumulation, then Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder) to regulate and tonify stomach Qi.
Bow-Inward Shape (Gongfanli): Indicates cold-pathogen invasion, gasping, palpitations, fatigue, slightly cold extremities, dark urine, cough, and spitting saliva. First use Xingxing San (Awakening Powder) to assist stomach Qi and expel external pathogens, then Wuwei Yigong San added with Poria (Fushen) and Angelica Sinensis (Danggui) to nourish heart blood and assist stomach Qi. If external pathogens are resolved but palpitations and cold fingers persist, spleen Qi is injured; use Qiwei Baizhu San to tonify. If there is confusion, coarse breathing, and gasping, it is difficult to treat due to severe spleen deficiency.
Bow-Outward Shape (Gongfanwai): Indicates phlegm-heat, mental confusion, combined fright and food, wind-epilepsy with abundant phlegm. First use Tianma Fangfeng Wan (Gastrodia and Saposhnikovia Pill) to expel external pathogens, then Wuwei Yigong San.
Spear Shape (Qiang): Indicates wind-heat generating phlegm and convulsions. First use Baolong Wan (Bear-Dragon Pill); if ineffective, use Niuhuang Qingxin Wan (Calculus Bovis Heart-Clearing Pill). If transmitted to spleen and lungs, or due to overuse of wind-phlegm resolving medicines causing various symptoms, specifically regulate and tonify the spleen and stomach.
Fish-Bone Shape (Yugu): Indicates fright-phlegm and fever. First use Baolong Wan; if ineffective, it belongs to liver fire excess-heat, use Yiqing Wan (Suppressing Cyan Pill) sparingly to clear the liver, followed by Liuwei Wan (Six-Ingredient Pill) to tonify the liver. Or, if fever with poor appetite or abundant phlegm with convulsions occurs, it is liver wood overcoming spleen earth; use Liujunzi Tang added with Bupleurum (Chaihu) to tonify spleen earth to control liver wood.
Water Character Shape (Shuizi): Indicates fright-wind, food accumulation in chest/diaphragm, irritability and oppression, poor appetite, night crying with abundant phlegm, locked jaw, and convulsions. This is spleen-stomach weakness with food accumulation, where wood overcomes earth. First use Da'an Wan to guide out food, then Liujunzi Tang and Uncaria Rhynchophylla (Gouteng Gou) to tonify middle and clear the liver. If symptoms persist after taking food-resolving and phlegm-clearing agents, use Sijunzi Tang, Cimicifuga (Shengma), Bupleurum (Chaihu), and Uncaria Rhynchophylla (Gouteng Gou) to ascend and tonify spleen Qi and level liver wood.
Needle Shape (Zhen): Indicates extreme heat in heart and liver generating wind, palpitations, oppression, fatigue, anorexia, abundant phlegm, and convulsions. First use Baolong Wan to expel wind and resolve phlegm, then Liujunzi Tang added with Uncaria Rhynchophylla (Gouteng Gou) to level the liver and strengthen the spleen.
Through-Palace-Shooting-Finger Shape (Touguan Shezhi): Indicates fright-wind, phlegm-heat gathering in chest/diaphragm, spleen-lung deficiency, and phlegm pathogen accumulation. First use Niuhuang Qingxin Wan to clear spleen-lung and resolve phlegm, then Liujunzi Tang added with Platycodon (Jiegeng) and Chinese Yam (Shanyao) to tonify spleen earth and benefit lung metal.
Through-Palace-Shooting-Nail Shape (Touguan Shejia): Indicates fright-wind, a deteriorating syndrome of liver wood overcoming spleen earth. Urgently use Liujunzi Tang, Aucklandia (Muxiang), Uncaria Rhynchophylla (Gouteng Gou), and Cinnamon Twig (Guangui) to warm and tonify spleen earth. If ineffective, add Aconite Root (Fuzi) to restore Yang Qi; many survive.
I have heard the ancients say: Children are like sprouts, like grass shoots or water foam. Because their zang-fu are fragile and tender, and they cannot speak, prescribing medicine is most difficult. One must first observe facial color to know the organ involved; then examine the Tiger's Mouth to identify the cause. This is indeed a concise treatment method.
[Image omitted]
The Pearl-like shape is only a small red dot; the Ring-bead shape is larger; the Long-bead shape is round and long. These do not refer to circles, but rather the meridians conveying Qi in this manner. The Coming-Snake is a dispersed Long-bead, large at one end and pointed at the other; the Going-Snake is similarly divided into upper and lower directions, hence "coming" and "going." Opisthotonos (arched back) curving inward is favorable; outward is unfavorable. The Spear shape goes straight up; Fish-bone spreads apart; Water character has three parallel pulses. Needle shape passes through one or two rice grains; Shooting-Nail shows the life pulse penetrating outward to the finger; Life pulse curving inward. Although I often treat these, sometimes I do not strictly adhere to the shape/pulse for prescribing; rather, if there are specific symptoms, I administer corresponding medicines, which are often effective.
Clinical Cases
1. A child had fever, vomiting, diarrhea, abdominal distension, and refused milk. The fingerprint was like a Pearl. This indicated spleen-stomach Qi injury. First used Xiangsha Zhugao, then Liujunzi Tang for recovery.
2. A child had alternating chills and fever, vomiting, could not eat, cried when abdomen was pressed. Fingerprint was like a Long-bead. This indicated food stagnation. Used Da'an Wan to induce vomiting and diarrhea of retained food, bringing relief. However, lips and eyes twitched, stool was loose and yellow. This indicated pathogen removal but lingering deficiency-heat. Used Liujunzi Tang added with Uncaria Rhynchophylla (Gouteng Gou) for cure.
3. A child had chest/abdominal distension, fever, and oppression. Fingerprint was like a Ring-bead. Cried when abdomen pressed. This indicated spleen deficiency with food stagnation. First used Baohe Wan one dose; previous symptoms disappeared, but irritability and thirst increased. Did not cry when abdomen pressed. This indicated residual food removed but spleen-stomach re-injured. Used Wuwei Yigong San added with Bupleurum (Chaihu) for rapid improvement.
4. A child had frequent dry retching, poor intake, abdominal distension. Pulse shape was like a Coming-Snake. This indicated spleen deficiency leading to Gan. Used Siwei Fei'er Wan to treat Gan, assisted by Sijunzi Tang added with Coix Seed (Wuyi) to strengthen middle and recover. Later, food injury caused vomiting/diarrhea of undigested food, severe exhaustion, slight limb twitching. Fingerprint looked like a Going-Snake. I said: Do not use medicine yet. Next day, vomiting stopped, but twitching and green-yellow stool continued. This indicated spleen earth deficiency and liver wood excess. Used Liujunzi Tang added with Uncaria Rhynchophylla (Gouteng Gou) for cure.
5. A child under one year old had shortness of breath, rapid breathing, poor milk intake, occasional spitting. Shape looked like a Going-Snake. This indicated spleen injury with food accumulation. First used Liujunzi Tang added with Hawthorn Fruit (Shanzha) and Immature Bitter Orange (Zhishi), gradually improving. Later, milk/food re-injury caused vomiting, diarrhea, and thirst. First gave Weiling Gao, then Baizhu San for cure.
6. A child had sleep disturbances, palpitations, fever, and abundant phlegm. Pulse shape was like a Bow pointing outward. This indicated fright causing liver wood excess injuring spleen, leading to indigestion. First used Tianma Fangfeng Wan to expel wind and calm fright; then Wuwei Yigong San to strengthen spleen and stop convulsions for complete recovery.
7. A child was silent, drowsy, with cold limbs and palpitations. Fingerprint was like a Bow pointing inward. This indicated stomach Qi deficiency and external cold-pathogen invasion. First used Xingxing San to resolve external pathogen and regulate stomach Qi; all symptoms resolved. But extremities were cold; used Liujunzi Tang to regulate and tonify Yuan Qi for peace.
8. A child had cough, took Niuhuang Qingxin Wan, developed worsening asthma and abdominal distension. Observed red color on right face, fingerprint like a Spear. This indicated spleen Qi re-injury. Used Liujunzi Tang for immediate peace.
9. A child was lethargic, febrile, convulsing, refusing milk. Fingerprint looked like chaotic Fish-bones. This was wind-heat acute fright-wind. First used a small amount of Baolong Wan to expel wind and resolve phlegm; then Liujunzi Tang added with Bupleurum (Chaihu) to strengthen spleen and level liver for cure.
10. A child had cough, fever, red right face, thirst, irritability, fatigue, poor appetite, abdominal distension. Fingerprint was like a Needle. This indicated wind-pathogen injuring lungs and food injuring spleen. First used Liujunzi Tang added with Platycodon (Jiegeng), Apricot Kernel (Xingren), and Bupleurum (Chaihu) for one dose; symptoms improved slightly. Then removed Xingren and Chaihu, two more doses brought peace.
11. A child had fever, night crying, poor intake, coma, convulsions, abundant phlegm, locked jaw. Fingerprint was like the Water character. This indicated spleen-lung Qi deficiency, wind wood attacking, phlegm-food accumulating in chest/abdomen. First used Da'an Wan, then Liujunzi Tang added with Uncaria Rhynchophylla (Gouteng Gou) for cure.
12. A child had fever, red right face, cough, abundant phlegm. Fingerprint passed through palace shooting finger. I believed wind-pathogen trapped in lungs generating phlegm. Used Erchen Tang added with Mulberry Bark (Sangpi), Apricot Kernel (Xingren), and Platycodon (Jiegeng). Self-administered dispersing and fire-descending agents did not resolve wind-phlegm; fever worsened. I said: This is spleen-lung Qi deficiency, treatment was inappropriate. Then used Wuwei Yigong San added with stir-fried Platycodon (Jiegeng) for gradual improvement, then Liujunzi Tang for cure.
13. A child had food-retention fever, took Scutellaria (Huangqin), Phellodendron (Huanglian), Burreed Tuber (Sanleng), and Magnolia Bark (Houpo). Food intake decreased daily, chest/abdominal distension. Fingerprint extended to nail. Used Buzhong Yiqi Tang added with Aucklandia (Muxiang) and Uncaria Rhynchophylla (Gouteng Gou) to warm-tonify spleen Qi and level liver wood. Several doses showed effect; then Liujunzi Tang added with Fried Ginger (Paojiang) for peace. Among them, indiscriminate use of mineral, borneol, and muscle-expelling agents led to fright and death, too numerous to mention. Alas!
Xiangsha Zhugao (Formula seen in Hot Vomiting)
Wuwei Yigong San (Five-Ingredient Powder for Extraordinary Merit)
Liujunzi Tang (Six-Gentlemen Decoction) (Two formulas seen in Neidiao)
Da'an Wan (Great Peace Pill) (Formula seen in Emaciation)
Siwei Fei'er Wan (Four-Ingredient Child-Nourishing Pill) (Formula seen in Vomiting)
Sijunzi Tang (Four-Gentlemen Decoction) (Formula seen in Neidiao)
Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder) (Formula seen in Abdominal Pain)
Xingxing San (Awakening Powder)
Tianma Fangfeng Wan (Gastrodia and Saposhnikovia Pill) (Two formulas seen in Cough)
Baolong Wan (Bear-Dragon Pill) (Formula seen in Wind-Cold)
Niuhuang Qingxin Wan (Calculus Bovis Heart-Clearing Pill) (Formula seen in Acute Fright)
Yiqing Wan (Suppressing Cyan Pill) (Formula seen in Fright Crying)
Liuwei Wan (Six-Ingredient Pill) (Formula seen in Kidney Disease)
Baohe Wan (Harmony-Preserving Pill) (Formula seen in Emaciation)
Weiling Tang (Coptis and Atractylodes Decoction) (Formula seen in Cholera Vomiting/Diarrhea)
Erchen Tang (Two-Aged Decoction) (Formula seen in Cold Vomiting)