夏禹铸曰∶望闻问切，固医家之不可少一者也，在大方脉则然，而小儿科惟以望为主，问继之，闻则次，而
切则无矣。经云∶切而知之之谓巧（夫小儿以脉未全，切之无可切，而巧亦无所用其巧，）问而知之之谓工（小儿于
未言时，问之无可问，即于能言者问之，多不以实对，是问不必问，而工亦无所有其工，）闻而知之之谓圣（小儿初
病时，声音或不失其常，至病久而气丧，气丧而声失，闻之无可闻，而圣又何所见其圣。）况书曰∶哭声不响赴阴
君，而亦有不赴阴君者何？无非疑其声而不得肺之绝与不绝故也，吾故曰以望为主。曰∶五脏之属，体隐而理微，
望从何处？曰∶体固隐矣，而发见于苗窍颜色之间者，用无不周；理固微矣，而昭着于四大五官之外者，无一不
显。《中庸》所谓费而隐微之显著，不可引之相发明哉？故小儿病于内，必形于外，外者内之着也。望形审窍，
自知其病，按病用药，见效之速，未有不如响之应声者。内有脏，曰心、曰脾、曰肺，曰肾、曰肝，五脏不可望，
惟望五脏之苗与窍。舌乃心之苗，红紫，心热也；肿黑，心火极也；淡白，虚也。鼻准与牙床乃脾之窍，鼻红燥，
脾热也；惨黄，脾败也；牙床红肿，热也；腋烂，胃火也。唇乃脾之窍，红紫，热也；淡白，虚也；黑者，脾将
绝也。口右扯，肝风也；左扯，脾之痰也，鼻孔肺之窍，干燥，热也；流
清涕，寒也。耳与齿乃肾之窍，耳鸣，气不和也；耳流脓，肾热也；齿如黄豆，肾气绝也。目乃肝之窍，努视而
睛转者，风也；直视而睛不转者，肝气将绝也。以目分言之，又属五脏之窍∶黑珠属肝，纯见黄色，凶证也；白
珠属肺，色青，肝风侮肺也，淡黄色，脾有积滞也，老黄色，乃肺受湿热证也；瞳人属肾，无光彩又兼发黄，肾
气虚也。大角属大肠，破烂，肺有风也；小角属小肠，破烂，心有热也。上胞属脾，肿则脾伤也；下胞属胃，青
色，胃有风也；睡而露睛者，脾胃虚极也。面有五位，五脏各有所属∶额属心，离火也；左腮属肝，震木也；右
腮属肺，兑金也；口下属肾，坎水也；鼻准属脾，坤土也。五脏里也，六腑表也。小肠心之表，小便短黄涩痛，
心热也；清长而利，心虚也。胃乃脾之表，唇红而吐，胃热也；唇惨白而吐，胃虚也；唇色平常而吐，作伤胃论。
大肠肺之表，闭结，肺有火也；肺无热而便秘，血枯也，不可攻下；脱肛，肺虚也。胆乃肝之表，口苦，胆火也；
闻声作惊，肝虚也，膀胱肾之表，筋肿筋痛，肾之寒气入膀胱也。面有五色∶一曰红，红病在心，面红者热；一
曰青，青病在肝，面青者痛；一曰黄，黄病在脾，面黄者脾伤；一曰白，白病在肺，面白者中寒，一曰黑；黑病
在肾，面黑而无润色，肾气败也。望其色，若异于平日，而苗窍之色，与面色不相符，则脏腑虚实无有不验者也。
夏禹铸说：望、闻、问、切，确实是医生不可缺少的四种诊法。对于成人内科（大方脉）来说是这样，但儿科主要以“望”为主，“问”次之，“闻”再次之，而“切”诊则几乎不用。
经典医籍中说：“通过切脉而知晓病情叫做‘巧’。”（因为小儿的脉象尚未完全形成，切脉时没有什么可切的，所谓的‘巧’也就无从施展。）“通过问诊而知晓病情叫做‘工’。”（小儿在还不能说话时，无法询问；即使能说话的小儿去询问，他们往往不能如实回答，所以‘问’也不必强求，所谓的‘工’也就无处体现。）“通过听声音而知晓病情叫做‘圣’。”（小儿初病时，声音可能还保持常态，但久病后元气丧失，元气丧失则声音改变，此时‘闻’也无可闻，所谓的‘圣’又从何体现其‘圣’呢？）
况且古书说：“哭声不响亮是阴气衰竭的表现，但也存在不表现为阴气衰竭的情况。”这是为什么呢？无非是因为对声音感到疑惑，无法确定肺气是否绝断罢了。所以我才说以“望”诊为主。
有人问：“五脏所属的形体隐蔽且道理微妙，从何处进行观察？”回答说：“形体虽然隐蔽，但在苗窍和颜色上的表现却无所不周；道理虽然微妙，但在四肢五官之外的显露却无一不显著。”这正是《中庸》所说的“费而隐微之显著”，不可以引用它来互相阐明吗？所以小儿体内有病，必然表现在外部，外部是内部的外在显现。观察形体、审视苗窍，自然就能知晓病情；根据病情用药，见效之快，没有像回声应声那样迅速的。
体内有脏，即心、脾、肺、肾、肝，五脏本身难以直接观察，只能观察五脏的“苗”与“窍”。舌是心的苗，舌色红紫，是心热；舌体肿胀发黑，是心火极盛；舌色淡白，是虚证。鼻准（鼻尖）和牙床是脾的窍，鼻尖红燥，是脾热；面色惨黄，是脾败；牙床红肿，是热证；腋下腐烂，是胃火。嘴唇是脾的窍，唇色红紫，是热证；唇色淡白，是虚证；唇色发黑，是脾将绝。口角向右歪斜，是肝风；向左歪斜，是脾痰。鼻孔是肺的窍，鼻孔干燥，是热证；流清鼻涕，是寒证。耳朵和牙齿是肾的窍，耳鸣，是气机不和；耳流脓，是肾热；牙齿干枯如黄豆状，是肾气绝。眼睛是肝的窍，瞪眼且眼球转动，是风证；直视且眼球不转动，是肝气将绝。
具体到眼睛各部分，又属于五脏之窍：黑珠（瞳孔周围黑色部分）属肝，如果纯见黄色，是凶证；白珠（巩膜）属肺，色青，是肝风侮肺；色淡黄，是脾有积滞；色老黄，是肺受湿热证。瞳人（瞳孔）属肾，无光彩又兼发黄，是肾气虚。大眼角（内眦）属大肠，破烂，是肺有风；小眼角（外眦）属小肠，破烂，是心有热。上眼睑属脾，肿胀则是脾伤；下眼睑属胃，青色，是胃有风；睡觉时眼睛露出，是脾胃虚极。
面部有五个部位，五脏各有所属：额头属心，对应离火；左腮属肝，对应震木；右腮属肺，对应兑金；口下属肾，对应坎水；鼻准属脾，对应坤土。五脏属里，六腑属表。小肠是心的表，小便短少、黄赤、涩痛，是心热；小便清长且通畅，是心虚。胃是脾的表，唇红且呕吐，是胃热；唇色惨白且呕吐，是胃虚；唇色正常但呕吐，按伤食论治胃。大肠是肺的表，便秘，是肺有火；肺无热而便秘，是血枯，不可攻下；脱肛，是肺虚。胆是肝的表，口苦，是胆火；听到声音就惊吓，是肝虚。膀胱是肾的表，筋肿筋痛，是寒气入膀胱。
面部有五色：一是红，红色病在心，面红者属热；二是青，青色病在肝，面青者主痛；三是黄，黄色病在脾，面黄者脾伤；四是白，白色病在肺，面白者中寒；五是黑，黑色病在肾，面黑而无润泽之色，是肾气败。观察面色，如果异于平日，且苗窍的颜色与面色不相符，那么脏腑的虚实就没有不准确的。
Xia Yuzhu said: Inspection (Wang), Auscultation and Olfaction (Wen), Inquiry (Wen), and Palpation (Qie) are indeed indispensable diagnostic methods for physicians. This applies to adult internal medicine (Da Fang Mai); however, in pediatrics, the primary method is Inspection (Wang), followed by Inquiry (Wen), then Auscultation and Olfaction (Wen), while Palpation (Qie) is virtually non-existent.
The classics state: "Knowing through palpation is called 'skill' (Qiao)." (Since a child's pulse is not fully formed, there is little to palpate, so the 'skill' has no place to be demonstrated.) "Knowing through inquiry is called 'craftsmanship' (Gong)." (When a child cannot speak, inquiry is impossible; even when they can speak, they often do not answer truthfully, so inquiry need not be forced, and the 'craftsmanship' has no place to be demonstrated.) "Knowing through auscultation and olfaction is called 'sagacity' (Sheng)." (In the early stages of illness, a child's voice may remain normal, but after prolonged illness, vital energy is depleted, leading to changes in voice; thus, there is nothing to hear through auscultation, and how can 'sagacity' be demonstrated?)
Moreover, ancient texts state: "A weak cry indicates the depletion of Yin, yet there are cases where this does not apply." Why is this? It arises from doubt regarding the voice, unable to determine whether Lung Qi is exhausted or not. Therefore, I say that Inspection (Wang) should be the primary method.
One might ask: "The organs of the Five Zang are hidden, and their principles are subtle; from where can one observe them?" The answer is: "Although the physical form is hidden, its manifestations in the sensory orifices and complexion are comprehensive; although the principles are subtle, their revelations outside the four limbs and five senses are unmistakable." This aligns with what *Zhong Yong* (The Doctrine of the Mean) describes as "the manifest nature of the subtle," which should be used to elucidate each other. Thus, internal diseases in children must manifest externally; the external is the manifestation of the internal. By observing the form and examining the orifices, one can naturally know the disease; prescribing medication based on the disease yields results as swift as an echo responding to a sound.
Inside are the Zang organs: Heart, Spleen, Lung, Kidney, and Liver. Since the Zang organs themselves are difficult to inspect directly, one must inspect their "buds" (Miao) and "orifices" (Qiao). The tongue is the bud of the Heart: red or purple indicates Heart Heat; swollen and black indicates extreme Heart Fire; pale white indicates Deficiency. The tip of the nose and the gums are the orifices of the Spleen: a red and dry nasal tip indicates Spleen Heat; a sallow yellow complexion indicates Spleen Failure; red and swollen gums indicate Heat; axillary ulceration indicates Stomach Fire. The lips are the orifice of the Spleen: red or purple indicates Heat; pale white indicates Deficiency; black indicates impending Spleen exhaustion. Deviation of the mouth corner to the right indicates Liver Wind; deviation to the left indicates Phlegm in the Spleen. The nostrils are the orifices of the Lung: dryness indicates Heat; clear runny nose indicates Cold. The ears and teeth are the orifices of the Kidney: tinnitus indicates Disharmony of Qi; purulent discharge from the ear indicates Kidney Heat; teeth resembling dried soybeans indicate exhaustion of Kidney Qi. The eyes are the orifice of the Liver: staring with moving eyeballs indicates Wind; fixed gaze with immobile eyeballs indicates impending exhaustion of Liver Qi.
Specifically regarding the parts of the eye, they also correspond to the orifices of the Five Zang: The black part (around the pupil) belongs to the Liver; if purely yellow, it is a ominous sign. The white part (sclera) belongs to the Lung; bluish-green indicates Liver Wind insulting the Lung; pale yellow indicates Spleen stagnation; dark yellow indicates Lung affected by Damp-Heat. The pupil belongs to the Kidney; lackluster and yellowish indicates Kidney Qi Deficiency. The inner canthus (large angle) belongs to the Large Intestine; ulceration indicates Wind in the Lung. The outer canthus (small angle) belongs to the Small Intestine; ulceration indicates Heat in the Heart. The upper eyelid belongs to the Spleen; swelling indicates Spleen injury. The lower eyelid belongs to the Stomach; bluish color indicates Wind in the Stomach. Sleeping with eyes open indicates extreme Deficiency of the Spleen and Stomach.
The face has five regions, each corresponding to a Zang organ: The forehead belongs to the Heart, corresponding to Li Fire. The left cheek belongs to the Liver, corresponding to Zhen Wood. The right cheek belongs to the Lung, corresponding to Dui Metal. The area below the mouth belongs to the Kidney, corresponding to Kan Water. The nasal tip belongs to the Spleen, corresponding to Kun Earth. The Zang organs are Interior; the Fu organs are Exterior.
The Small Intestine is the exterior of the Heart: short, yellow, scanty, and painful urination indicates Heart Heat; clear, long, and free urination indicates Heart Deficiency. The Stomach is the exterior of the Spleen: red lips with vomiting indicate Stomach Heat; pale white lips with vomiting indicate Stomach Deficiency; normal lip color with vomiting suggests Stomach injury due to food retention. The Large Intestine is the exterior of the Lung: constipation indicates Fire in the Lung; constipation without Lung Heat indicates Blood Dryness, and purgatives should not be used; rectal prolapse indicates Lung Deficiency. The Gallbladder is the exterior of the Liver: bitter taste indicates Gallbladder Fire; startle response to sound indicates Liver Deficiency. The Bladder is the exterior of the Kidney: tendon swelling and pain indicate Cold Qi entering the Bladder.
There are five colors of the face: Red corresponds to the Heart; facial redness indicates Heat. Green/Blue corresponds to the Liver; facial green/blue indicates Pain. Yellow corresponds to the Spleen; facial yellowing indicates Spleen injury. White corresponds to the Lung; facial pallor indicates Internal Cold. Black corresponds to the Kidney; facial blackness without luster indicates exhaustion of Kidney Qi. If the observed complexion differs from usual, and the color of the sensory orifices does not match the facial complexion, then the Deficiency or Excess of the Zang and Fu organs will be accurately diagnosed.