补泄分明寒与热。左转补兮右转泄。男女不同上下推。子前午后要分别。寒者温之热者凉。
虚者补之实者泄。手足温和顺可言。冷厥四肢凶莫测。十二经中看病源。穴真去病汤浇雪。
补者。往指根里推也。如推脾土。须屈小儿大指。从指之外边。侧推到HT 门。此为补。伸儿指
者非也。泄者。向指根往外推也。推脾不宜。惟推肝肾肺以泄火。如此。
掐者。用大指甲。将病处掐之。其掐数亦如推数。运者。运五经八卦也。五经用食将指平行。
八卦用大指肉侧行。惟离宫属火。不可运。医者拿小儿手。即自以大指复按之。推者。一指推去而
不返。返则向外为泄。或用大指。或用三指。穴道不同。惟心经无推。揉者。揉天枢。用大将二指。
双揉齐揉。中脘。全掌揉。曲池。阳池。将指揉。脐与龟尾。皆搓掌心。用三指揉之。或用二指。视小
儿大小。
赤筋。乃浮阳。属火。应心与小肠。主霍乱。外通赤龙燥热。干宫掐之。则阳火即散。青筋。乃
青阳。属木。应肝与胆。主温和。外通眼目。赤滥多泪。坎位掐之。则目自明。黄筋属土。居中五行。
应脾胃。主温暖。肠鸣霍乱。吐泻痢疾。皆中界总筋处掐之。淡黄筋。居中属火土。应三焦。主半寒
半热。生壅塞之症。宜中宫内牢掐之。白筋。乃浊阴。属金。应肺与大肠。外通鼻。主腹满脑昏生
痰。宜界外指臂。掐之立效。黑筋纯阴。属水。应肾与膀胱。外通两耳。主冷气昏沉。宜向边位小指
侧掐之。
补法和泄法要分清寒证与热证。向左旋转推拿为补法,向右旋转推拿为泄法。男女患者的推拿方向在上下推运时有所不同,需区分子时前与午时后的不同情况。寒证用温法治疗,热证用凉法治疗;虚证用补法,实证用泄法。若手足温暖则病情顺遂可治,若四肢冷厥则凶险难测。需在十二经脉中查找病源。穴位准确则去病如汤浇雪般迅速。
所谓“补”,是指向指根方向向内推。例如推脾土穴,必须屈起小儿的大拇指,从手指外侧边侧向推向HT门(此处指代特定穴位或部位,原文未明示具体名称,保留HT),这才是补法。伸直小儿手指进行推运则是错误的。所谓“泄”,是指向指根方向向外推。推脾土穴不宜用泄法,只有推肝、肾、肺经时才用泄法以清泻火邪。如此操作。
所谓“掐”,是用大拇指指甲掐按患病部位。掐的次数也如同推拿的次数一样。所谓“运”,是运五经和八卦。五经推拿时用食指和中指平行运转;八卦推拿时用大拇指的侧面肉际行运。唯独离宫属火,不可运。医者握住小儿的手,随即用大拇指复按在上面。所谓“推”,是一指推去而不返回,若返回则向外为泄法。可以用大拇指,也可以用三指,因穴位不同而异。唯独心经没有推法。所谓“揉”,揉天枢穴,用大拇指和二指双揉齐揉;揉中脘穴,用全掌揉;揉曲池穴、阳池穴,用中指揉;揉脐部和龟尾穴,皆搓掌心,用三指揉之,或者用二指,视小儿的大小而定。
赤色筋脉,乃是浮阳,属火,对应心与小肠,主霍乱。外通赤龙(指舌下静脉或面部红络)燥热,在干宫(乾位,对应头部或西北方)掐之,则阳火即散。青色筋脉,乃是青阳,属木,对应肝与胆,主温和病(指温热类疾病)。外通眼目,若赤滥多泪,在坎位(坎位,对应肾脏或北方)掐之,则眼睛自然明亮。黄色筋脉属土,居中五行,对应脾胃,主温暖。肠鸣霍乱、吐泻痢疾,都在中界总筋处掐之。淡黄色筋脉,居中属火土,对应三焦,主半寒半热的症状,产生壅塞之症,宜在中宫内牢处掐之。白色筋脉,乃是浊阴,属金,对应肺与大肠,外通鼻窍,主腹满、脑昏、生痰,宜在界外指臂处掐之,立见疗效。黑色筋脉纯阴,属水,对应肾与膀胱,外通两耳,主冷气昏沉,宜在向边位小指侧掐之。
The methods of tonification (Bu, 补) and sedation (Xie, 泄) must clearly distinguish between cold syndromes (Han, 寒) and heat syndromes (Re, 热). Rotating the hand to the left constitutes tonification, while rotating to the right constitutes sedation. The techniques differ for males and females regarding upward and downward pushing, requiring distinction between periods before noon (Ziqian, 子前) and after noon (Wuhou, 午后). Cold syndromes are treated with warming methods, and heat syndromes with cooling methods; deficiency syndromes are treated with tonification, and excess syndromes with sedation. If the hands and feet are warm, the condition is favorable and treatable; if there is cold rigidity of the four limbs, the prognosis is ominous and unpredictable. One must investigate the source of the disease within the twelve meridians (Shi'er Jing, 十二经). Accurate acupoint selection eliminates disease as quickly as hot water melts snow.
"Tonification" refers to pushing towards the root of the finger. For example, when pushing the Spleen Earth point (Pipi Tu, 脾土), one must flex the child's thumb and push laterally from the outer edge of the finger towards HT Gate (HT Men, HT门, a specific reference in this text). This is tonification. Pushing with the child's finger extended is incorrect. "Sedation" refers to pushing away from the finger root towards the outside. Sedation is not suitable for the Spleen Earth point; it is only used for the Liver, Kidney, and Lung meridians to clear fire. Thus operates the method.
"Squeezing" (Qia, 掐) involves using the thumbnail to pinch or press the affected area. The number of squeezes corresponds to the number of pushes. "Rotating/Moving" (Yun, 运) involves moving the Five Meridians (Wu Jing, 五经) and the Eight Trigrams (Bagua, 八卦). For the Five Meridians, use the index and middle fingers parallelly. For the Eight Trigrams, use the fleshy side of the thumb. However, the Li Palace (Li Gong, 离宫), which belongs to Fire, should not be moved. While holding the child's hand, the practitioner immediately presses down with their own thumb. "Pushing" (Tui, 推) involves pushing forward with one finger without returning; returning implies an outward motion which constitutes sedation. One may use the thumb or three fingers, depending on the acupoint. There is no pushing method for the Heart Meridian. "Rubbing" (Rou, 揉): To rub Tianshu (ST25, 天枢), use the thumb and index finger to rub simultaneously. To rub Zhongwan (CV12, 中脘), use the entire palm. To rub Quchi (LI11, 曲池) and Yangchi (TE4, 阳池), use the middle finger. To rub the Umbilicus (Shenzhu/Central Navel) and Guiwei (GV13, 龟尾), rub the palm center using three fingers, or two fingers, depending on the child's size.
Red veins represent floating Yang, belong to Fire, correspond to the Heart and Small Intestine, and govern Huoluan (cholera-like vomiting and diarrhea). They externally connect to the "Chilong" (red dragon, referring to sublingual veins or facial redness) and dry-heat. Pinching at the Qian Palace (Qian Wei, 干宫/乾位) dissipates the Yang fire. Green veins represent Green Yang, belong to Wood, correspond to the Liver and Gallbladder, and govern Warm-Heat diseases. They externally connect to the eyes; if there is excessive tearing and redness, pinching at the Kan Palace (Kan Wei, 坎位) restores vision. Yellow veins belong to Earth, centered in the Five Elements, correspond to the Spleen and Stomach, and govern warmth. For intestinal borborygmus, Huoluan, vomiting, diarrhea, and dysentery, pinch at the central tendon junction (Zhongjie Zongjin, 中界总筋). Pale yellow veins are centered and belong to Fire and Earth, correspond to the Sanjiao (Triple Burner), and govern half-cold half-heat conditions causing stagnation. Pinch firmly at the Zhonggong (Central Palace, 中宫内牢). White veins represent turbid Yin, belong to Metal, correspond to the Lung and Large Intestine, externally connect to the nose, and govern abdominal fullness, dizziness, and phlegm production. Pinching the outer arm and finger boundaries yields immediate results. Black veins are pure Yin, belong to Water, correspond to the Kidney and Bladder, externally connect to both ears, and govern cold qi and lethargy. Pinch at the lateral side of the little finger towards the edge position.