儿科自古最为难，毫厘之差千里愆，气血末充难据脉，神识未发不知言，
惟凭面色识因病，再向三关诊热寒。听声审病兼切脉，表里虚实随证参。
[注]
儿科一道，自古为难，
盖以小儿形质柔脆，易虚易实，调治少乖，则毫厘之失遂致千里之谬，
气血末充者，气血尚未充盈也，
难据脉者，脉无定准，不可只以脉为主也，
神识未发者，茫然无知识也，
不知言者，不能言其疾苦也，
诊小儿之病，惟凭察面部形色，识其因何而生也，
三关者，手虎口处风气命三关也，当视脉纹形色以诊其属热属寒也，
听声音，听其五声所主之病也，
审病者，审其安烦苦欲饮食二便也，
切脉者，切脉之浮沉迟数，滑涩大小，有力无力也，
医者诚能以四诊参合表里虚实寒热之病，则可保万全也。
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欲识小儿百病源，先从面部色详观，五部五色应五藏，诚中形外理昭然，
额心颏肾鼻脾位，右腮属肺左属肝，青肝赤心黄脾色，自为肺色黑肾颜，
青主惊风赤火热，黄伤脾食白虚寒，黑色主痛多恶候，明显浊晦轻重参，
部色相生为病顺，部色相克病多难，相生实者邪助病，相克虚者正难堪，
天庭青暗惊风至，红主内热黑难痊，太阳青惊人耳恶，印堂青色惊泻缠，
风气青惊紫吐逆，两眉青吉红热烦，鼻赤脾热黑则死，唇赤脾热白脾寒，
左腮赤色肝经热，右腮发赤肺热痰，承浆青惊黄呕吐，黑主抽搐病缠绵，
此是察色之大要，还将脉证一同参。
[注]
小儿之病，先从面部气色观之，详察五部之色，
则五藏之病自昭然可见矣，
五部者，额属心，颏属肾，鼻属脾，左腮属肝，右腮属肺也，
五色者，青为肝色，赤为心包，黄为脾色，自为肺色，黑为肾色也，
如面青主是惊风之证，面赤主火热，面黄主伤脾伤食，
面白主虚寒，面黑主痛，多是恶候，
总之五色明显为新病，其证轻，浊晦为久病，其证重，
部色相生为顺者，如脾病色黄，此正色也，若见红色，乃火能生土，故为顺也，
若见青色，乃木来克土，故为逆也，余病仿此，
若气血充实，又遇部色相生，纵有外邪助病，亦易为治疗，
若久病气血虚弱，又遇部色相克，则正气不支，每难治疗，
如天庭青暗主惊风，红主内热，黑则不治，
太阳青主惊风，青色入耳者死，印堂青主惊泻，
风池在眉下，气池在眼下，二处青主惊风，紫多吐逆，
两眉青主吉，红色主多烦热，
鼻赤主脾热，鼻黑则死，
唇赤主脾热，白主脾寒，
左腮发赤主肝经有热，右腮发赤主肺热痰盛，
承浆青主惊，黄主吐，黑主抽搐，
此皆察色之大要，再以脉证参之，庶治得其要矣。
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儿科自古以来就最为难治，毫厘之间的差错会导致千里般的谬误。因为小儿气血尚未充盈，难以依据脉象诊断；神识尚未发育，无法用言语表达病情。只能凭借面色来识别病因，再结合虎口三关的脉纹来判断寒热。同时听取声音以审察病症，并结合切脉，根据表里虚实的证候进行综合参详。
[注]
儿科这一领域，自古便被认为难以诊治。这是因为小儿形体质地柔弱脆弱，病情容易由虚转实或由实转虚，如果调理治疗稍有偏差，那么毫厘的失误就会导致千里般的错误。所谓“气血末充”，是指气血尚未充盈；所谓“难据脉”，是指脉象没有固定的准则，不能仅凭脉象作为主要诊断依据。所谓“神识未发”，是指茫然无知、缺乏认知能力；所谓“不知言”，是指不能诉说自己的病痛。诊断小儿的疾病，只能依靠观察面部的形色，来识别疾病产生的原因。“三关”是指手虎口处的风关、气关、命关，应当观察脉纹的形色来判断属于热证还是寒证。听声音，是听取五声所主应的病症；审病，是审察其安静或烦躁、痛苦与否、饮食欲望以及大小便情况；切脉，是切按脉象的浮沉迟数、滑涩大小、有力无力等特征。医生如果能将四诊合参，综合分析表里虚实寒热的病机，就可以保证万无一失。
想要了解小儿各种疾病的根源，先从详细观察面部色泽开始。面部的五个部位和五种颜色对应五脏，内在脏腑的情况必然反映在外部形态上，道理非常明白。额头对应心，下巴（颏）对应肾，鼻子对应脾，右腮对应肺，左腮对应肝。青色属肝，赤色属心，黄色属脾，白色属肺，黑色属肾。青色主惊风，赤色主火热，黄色主脾伤食积，白色主虚寒，黑色主疼痛且多为恶候。色泽明显者轻，晦暗浊者重。部位与颜色相生为病势顺，部位与颜色相克则病势难治。如果是实证遇到相生，邪气虽助长病情但仍有转机；如果是虚证遇到相克，正气难以承受。天庭出现青暗之色预示惊风将至，红色主内热，黑色则难治愈。太阳穴处青色并伴有耳部异常提示惊风严重，印堂青色提示惊泻纠缠。风关青色提示惊风，紫暗提示呕吐逆乱，两眉间青色为吉，红色提示烦热。鼻头赤色为脾热，黑色则预后不良甚至死亡。嘴唇赤色为脾热，白色为脾寒。左腮赤色为肝经有热，右腮发红为肺热痰盛。承浆穴处青色提示惊风，黄色提示呕吐，黑色提示抽搐且病程缠绵。这是察色的主要要点，还需要将脉象和证候一同参详。
[注]
小儿的疾病，先从观察面部的气色入手，详细察看五部的颜色，那么五脏的病变自然清晰可见。所谓五部，是指额头属心，下巴属肾，鼻子属脾，左腮属肝，右腮属肺。所谓五色，是指青色为肝色，赤色为心包色，黄色为脾色，白色为肺色，黑色为肾色。例如面青主惊风证，面赤主火热，面黄主伤脾伤食，面白主虚寒，面黑主痛，多是恶候。总之，五色明显为新病，证候较轻；晦暗浊滞为久病，证候较重。部位与颜色相生为顺，如脾病见黄色是本脏正色，若见红色，乃火能生土，故为顺证；若见青色，乃木来克土，故为逆证，其余病症仿照此理。如果气血充实，又遇到部位与颜色相生，即使有外邪助长病情，也容易治疗；如果久病气血虚弱，又遇到部位与颜色相克，则正气不支，往往难以治疗。如天庭青暗主惊风，红主内热，黑则不治。太阳穴青色主惊风，青色入耳者死，印堂青色主惊泻。风池在眉下，气池在眼下，这两处青色主惊风，紫色多主吐逆。两眉青色主吉，红色主烦热。鼻赤主脾热，鼻黑则死。唇赤主脾热，白主脾寒。左腮发红主肝经有热，右腮发红主肺热痰盛。承浆青色主惊，黄色主吐，黑色主抽搐。这些都是察色的主要要点，再结合脉证参详，治疗就能抓住要领了。
Pediatrics has been the most difficult field since ancient times; a difference of a hair's breadth can lead to an error of a thousand miles. Because Qi and Blood (vital energy and blood) are not yet fully developed, it is difficult to rely on pulse diagnosis (pulse taking); because Shen (spirit/mind) is not yet developed, children cannot speak about their ailments. One must rely solely on observing facial complexion to identify the cause of illness, and further diagnose heat or cold by examining the three passes (San Guan, three sections of the finger vein in infants). Listening to the voice to examine the disease combined with pulse taking allows for reference to exterior-interior, deficiency-excess patterns according to the symptoms.
[Note]
The field of pediatrics has been considered difficult since ancient times. This is because children have soft and fragile physical constitutions, prone to shifting between deficiency and excess states. If treatment and regulation deviate slightly, a minute error will result in a massive mistake. "Qi and Blood not yet full" means that Qi and Blood are not yet abundant. "Difficult to rely on pulse" means that the pulse lacks a fixed standard and cannot be used as the sole basis for diagnosis. "Shen not yet developed" refers to a state of blankness without knowledge or cognition. "Unable to speak" means they cannot verbalize their suffering. To diagnose pediatric diseases, one relies only on inspecting the facial form and color to identify the origin of the illness. The "Three Passes" refer to the Wind, Qi, and Life passes located at the tiger's mouth area of the hand; one should observe the shape and color of the pulse veins to diagnose whether the condition belongs to heat or cold. Listening to the voice involves hearing the diseases associated with the five vocal tones. Examining the disease involves assessing whether the child is calm or restless, painful or comfortable, their desire for food and drink, and the condition of urination and defecation. Pulse taking involves feeling the floating, sunken, slow, rapid, slippery, choppy, large, small, forceful, and forceless qualities of the pulse. If a physician can integrate the four diagnostic methods to analyze the disease patterns of exterior-interior, deficiency-excess, and cold-heat, then safety and completeness can be ensured.
To understand the sources of the hundred diseases in children, one must first carefully observe the colors of the face. The five facial regions and five colors correspond to the five Zang organs; what is internal manifests externally, and the principle is clear. The forehead corresponds to the Heart, the chin to the Kidney, the nose to the Spleen, the right cheek to the Lung, and the left cheek to the Liver. Green corresponds to the Liver, red to the Heart, yellow to the Spleen, white to the Lung, and black to the Kidney. Green indicates convulsions and wind; red indicates fire and heat; yellow indicates Spleen injury and food retention; white indicates deficiency and cold; black indicates pain and is often a malignant sign. Prominent colors indicate mild conditions, while turbid/dull colors indicate severe conditions. Generation between region and color indicates a favorable prognosis; overcoming (clashing) between region and color indicates a difficult prognosis. In excess cases, generation helps the pathogen but the disease is manageable; in deficiency cases, overcoming makes it hard for the healthy Qi to endure. A dark green tint on the Forehead (Tian Ting) indicates impending convulsions; red indicates internal heat; black indicates incurability. Green at the Tai Yang point with ear involvement indicates severe convulsions; green at the Yin Tang point indicates entangled convulsive diarrhea. Green at the Feng Guan indicates convulsions; purple indicates vomiting and reflux. Green between the eyebrows is auspicious; red indicates irritability and heat. Redness of the nose indicates Spleen heat; blackness indicates death. Lip redness indicates Spleen heat; whiteness indicates Spleen cold. Redness of the left cheek indicates Heat in the Liver Meridian; redness of the right cheek indicates Lung heat with phlegm. Cyanosis at Cheng Jiang indicates convulsions; yellow indicates vomiting; black indicates convulsions and lingering disease. These are the main essentials of complexion inspection, which must be combined with pulse and symptom analysis.
[Note]
Diseases in children should first be observed through the Qi and color of the face. By carefully examining the colors of the five regions, the diseases of the five Zang organs become clearly visible. The "Five Regions" refer to: the forehead belonging to the Heart, the chin to the Kidney, the nose to the Spleen, the left cheek to the Liver, and the right cheek to the Lung. The "Five Colors" refer to: green being the color of the Liver, red being the color of the Pericardium (Heart), yellow being the color of the Spleen, white being the color of the Lung, and black being the color of the Kidney. For example, a green face indicates Convulsions and Wind; a red face indicates Fire and Heat; a yellow face indicates Spleen injury and Food Retention; a white face indicates Deficiency and Cold; a black face indicates pain, which is mostly a malignant sign. In general, bright and distinct colors indicate new diseases with mild symptoms; turbid and dull colors indicate chronic diseases with severe symptoms. Region-color generation is favorable; for instance, if a Spleen disease presents with yellow color, this is the proper color of the organ. If red appears, it signifies Fire generating Earth, thus it is favorable. If green appears, it signifies Wood overcoming Earth, thus it is unfavorable. Other diseases follow this logic. If Qi and Blood are substantial and encounter region-color generation, even if external pathogens assist the disease, it is easy to treat. If the disease is chronic with deficient Qi and Blood, and encounters region-color overcoming, then Healthy Qi cannot withstand it, making treatment difficult. For example, dark green on the Tian Ting indicates convulsions; red indicates internal heat; black indicates untreatable conditions. Green at Tai Yang indicates convulsions; green entering the ears indicates death. Green at Yin Tang indicates convulsive diarrhea. Feng Chi is below the eyebrows; Qi Chi is below the eyes; green in these two areas indicates convulsions; purple indicates vomiting and reflux. Green between the eyebrows is auspicious; red indicates irritability and heat. Red nose indicates Spleen heat; black nose indicates death. Red lips indicate Spleen heat; white lips indicate Spleen cold. Redness of the left cheek indicates Heat in the Liver Meridian; redness of the right cheek indicates Lung heat with abundant phlegm. Cyanosis at Cheng Jiang indicates convulsions; yellow indicates vomiting; black indicates convulsions. These are all the major essentials of complexion inspection. By combining them with pulse and symptom analysis, the essence of treatment can be grasped.