小儿三关食指。男左女右先详。初风中气命三关。风关惊起小恙。侵气病可进退。命关逆候
多亡。生又珠点透三关。蒿里歌声恸唱。三关筋色纯黑。死期不日可伤。弓反里外更难当。恶候筋
纹此样。食指筋纹五色。红寒紫热须详。伤食青紫气虚烦。青黑逆多惆怅。小儿指纹青色。多因胎
气不全。深青夜卧不安然。腹病微青必见。黑气盘肠内吊。牵抽发搐连绵。黄兼面白泻来缠。紫色
伤风不免。指筋若有红色。惊入脾窍分明。红微不痢腹中寒。吐泻脾虚食禁。三关深红筋见。身强
发热常惊。纹弓余食膈中停。面黄脾经积病。三关纹生紫色。胎惊热毒熏蒸。惊时啼哭又呻吟。多
因紫青筋甚。微紫筋因伤热。弓纹吐泻频频。紫青黑色常悬针。曲指风热为病。了悬针。主水
泻。水川字。主痰涎轻症。
小儿六岁须凭脉。一指三关定数息。迟冷数热古今传。浮风沉积当先识。左手人迎主外邪。
右手气口主内疾。外邪风寒暑湿侵。内症乳食痰兼积。洪紧无汗是伤寒。浮缓伤风有汗液。浮而
洪大风热甚。沉而细滑积乳食。沉医腹中痛不休。沉弦喉内作喘急。紧促之时疹痘生。紧数之时
惊风疾。虚软慢惊作螈 。(音计纵小儿风病)紧盛风痫发搐掣。软而细者为疳虫。牢而实者必便
结。滑主痰壅食所伤。芤脉必主于失血。虚而有气为之惊。弦急客忤君须识。大小不匀为恶候。三至为脱
二至卒。五至为虚四至损。六至平和曰无疾。七至八至病尤轻。九至十至病势急。十一二死无疑。
此诀万中无一失。
凡小儿三岁以上。用一指按寸关尺三部。常以六七至为平脉。添则为热。减则为寒。浮洪风
盛。数则多惊。沉滞为虚。沉实为积。
小儿指纹观察主要看食指上的三关。诊断时,男孩看左手,女孩看右手,需仔细辨别。指纹从指尖向指根分为风关、气关、命关三个部位。若指纹仅现于风关,表示病邪初起,病情轻微;若延伸至气关,说明病情可进可退,处于变化之中;若直达命关,则预后不良,多伴有死亡的危险。如果指纹出现珠点状且透达三关,往往预示病情危重,令人悲痛。若三关筋色纯黑,则死期不远,极为凶险。若指纹形态如弓背般反张,内外皆见,也是恶候的表现。
食指的指纹有五种颜色,红色主寒证,紫色主热证,必须详细分辨。伤食积滞可见青紫色,气虚烦躁亦见青色,若见青黑色多为逆证,令人惆怅。小儿指纹呈青色,多因胎气不足所致。深青色者夜间卧睡不安,腹部有病时可见微青色。黑气盘绕如肠内吊痛,伴随抽搐发作连绵不断。黄色兼面色苍白,多被腹泻缠绕。紫色多见于伤风。若指筋呈现红色,表明惊邪已入脾窍。红色轻微者不患痢疾但腹中受寒,或为吐泻脾虚及饮食禁忌之症。三关纹色深红,表现为身体强壮发热且常受惊吓。若纹形如弓,余食停滞于膈中,面色发黄,属脾经积滞病。三关纹生紫色,多为胎惊热毒熏蒸所致,惊啼哭闹并呻吟。多因紫青色筋纹严重所致。轻微紫色因伤热引起,纹形如弓且频繁吐泻。紫、青、黑色常呈悬针纹,弯曲手指为风热致病。了字纹主水泻。川字纹主痰涎轻症。
六岁以下小儿须凭脉诊判断,医生用一指按在寸、关、尺三部,定数呼吸次数以测脉率。迟脉主冷证,数脉主热证,这是古今相传的经验。浮脉主风邪,沉脉主积滞,应当首先识别。左手人迎脉主要反映外邪,右手气口脉主要反映内疾。外邪由风寒暑湿侵袭引起,内症则由乳食、痰饮和积滞导致。洪大紧实且无汗是伤寒,浮缓且有汗是伤风。浮而洪大是大风热甚,沉而细滑是乳食积滞。沉脉主腹中疼痛不止,沉弦脉主喉内作喘急。紧促之时疹痘将生,紧数之时惊风疾病发作。虚软慢惊表现为抽搐(音计纵,指小儿风病)。紧盛脉象见于风痫发作时的抽搐掣动。软而细的脉象主疳虫。牢而实的脉象必伴大便干结。滑脉主痰壅和食物损伤。芤脉必主失血。虚而有气则为惊,弦急脉象主客忤,必须识别。大小不均匀为恶候。一息三至为脱证,二至为卒死。五至为虚证,四至为损证。六至平和称为无病。七至八至病情较轻。九至十至病势危急。十一二至无疑为死证。此诀万无一失。
凡小儿三岁以上,用一指按诊寸、关、尺三部。通常以六七至为平脉。脉率增加则为热证,减少则为寒证。浮洪脉主风盛,数脉主多惊。沉滞脉主虚,沉实脉主积滞。
The observation of the pediatric fingerprint focuses on the three sections of the index finger. For diagnosis, the left hand is examined for males and the right hand for females, requiring careful differentiation. The fingerprint is divided into three sections from the fingertip towards the root: the Wind Section (Feng Guan), the Qi Section (Qi Guan), and the Life Section (Ming Guan). If the fingerprint appears only in the Wind Section, it indicates that pathogenic factors have just begun and the condition is mild; if it extends to the Qi Section, it suggests that the disease may progress or recede, being in a state of change; if it reaches the Life Section, the prognosis is poor, often associated with danger of death. If bead-like points appear in the fingerprint and penetrate all three sections, it often foreshadows a critical condition, causing great sorrow. If the color of the tendons in all three sections is purely black, death is imminent, which is extremely ominous. If the fingerprint shape resembles an inverted bow, visible both inside and out, it is also a sign of evil prognosis.
The fingerprints on the index finger exhibit five colors: red indicates cold syndromes, and purple indicates heat syndromes, which must be distinguished in detail. Food stagnation can present as cyanotic-purple, while qi deficiency with irritability also shows cyanosis; seeing cyanotic-black is mostly a counter-indication, causing lamentation. A cyanotic fingerprint in children is often due to incomplete fetal qi. Deep cyanosis indicates restless sleep at night, and slight cyanosis is seen when there are abdominal diseases. Black qi coiling like intestinal colic is accompanied by continuous convulsions. Yellow combined with a pale face is often entangled with diarrhea. Purple is mostly seen in wind injury. If the finger tendon appears red, it indicates that shock pathogens have entered the spleen orifice. Slight redness implies no dysentery but cold in the abdomen, or vomiting/diarrhea due to spleen deficiency and dietary restrictions. Deep red lines in all three sections manifest as strong body, fever, and frequent fright. If the line shape is like a bow, with residual food stagnating in the diaphragm and yellowish face, it belongs to spleen meridian accumulation disease. Purple lines in all three sections are mostly due to fetal shock and heat-toxin steaming, with crying, wailing, and groaning during fright. This is often caused by severe purple-cyanotic tendons. Slight purple is due to heat injury, with bow-shaped lines and frequent vomiting and diarrhea. Purple, cyanotic, and black colors often form a Hanging Needle pattern (Xuan Zhen); bent fingers indicate wind-heat pathology. The "Liao" character pattern indicates watery diarrhea. The "Chuan" character pattern indicates mild phlegm-fluid conditions.
For children under six years old, pulse diagnosis is required. The physician places one finger on the Cun, Guan, and Chi positions, counting breaths to determine the pulse rate. A slow pulse indicates cold syndromes, and a rapid pulse indicates heat syndromes, which is experience passed down through ancient and modern times. A floating pulse indicates wind pathogens, and a deep pulse indicates stagnation/accumulation, which should be identified first. The Renying pulse on the left hand mainly reflects external pathogens, while the Qikou pulse on the right hand mainly reflects internal diseases. External pathogens are caused by invasion of wind, cold, summer-heat, and dampness, while internal diseases are caused by milk/food, phlegm, and accumulation. A full, large, tight, and empty-sweat pulse indicates Cold Damage (Shang Han); a floating, moderate, and sweaty pulse indicates Wind Injury (Shang Feng). Floating and full/large indicates severe wind-heat; deep, fine, and slippery indicates milk/food accumulation. A deep pulse indicates unceasing abdominal pain; a deep and wiry pulse indicates wheezing and urgency in the throat. Tight and hurried pulses indicate the emergence of rashes and smallpox; tight and rapid pulses indicate the onset of convulsive diseases. A deficient, soft, and slow pulse manifests as slow convulsions with twitching (Ji Zong, referring to pediatric wind disease). A tight and vigorous pulse is seen in wind epilepsy with convulsions and pulling. A soft and fine pulse indicates worm infestation (Gan Chong). A firm and solid pulse necessarily accompanies constipation. A slippery pulse indicates phlegm congestion and food injury. A hollow pulse (Kou Mai) necessarily indicates blood loss. Deficiency with qi disturbance leads to fright; a wiry and urgent pulse indicates sudden fright (Ke Wu), which must be recognized. Unequal size and rhythm constitute an evil prognosis. Three beats per respiration indicate collapse (Tuo), two beats indicate sudden death. Five beats indicate deficiency, four beats indicate damage. Six beats per respiration is peaceful and called disease-free. Seven to eight beats indicate mild illness. Nine to ten beats indicate critical disease progression. Eleven to twelve beats are undoubtedly fatal. This verse is infallible.
For children over three years old, the Cun, Guan, and Chi sections are palpated with one finger. Typically, six to seven beats per respiration is considered a normal pulse. An increase indicates heat syndromes, and a decrease indicates cold syndromes. Floating and full pulses indicate excessive wind; rapid pulses indicate frequent fright. Deep and stagnant pulses indicate deficiency; deep and solid pulses indicate accumulation.