夏英白曰∶掐斗肘上筋,曲池下筋,曲池即肱湾处,掐之治急风。
涂蔚生曰∶曲池属阳明大肠在肱之上侧面肱湾处,宜拱手取之。
夏英白曰∶外关在肱背,对肱面内关穴处。外间使在肱背,对肱面内间使穴处。掐之,治转筋吐泻。
涂蔚生曰∶外关在肱背面,离腕后二寸。内关在肱正面,离掌后横纹二寸。内外间使各离内外关一寸,与手
腕掌后相离三寸。
夏英白曰∶此穴在肩膀骨之夹缝处,两边两穴,揉之化痰。
涂蔚生曰∶肺俞穴之取法,须得小儿坐之端正,根据平肩之第一脊椎数起,至第三椎止。再离第三节椎之两旁
各二寸,即是肺俞穴。
夏英白曰∶以左大指按儿脐下丹田不动,以右大指在儿脐周遭搓之。治水泻、膨胀脐风等症。
涂蔚生曰∶丹田在脐下二寸、一名石门穴。膀胱如釜底乘水,丹田如灶底着薪,故能治水泻等症。
夏英白曰∶此穴在膝盖里旁,一名鬼眼穴。小儿脸上风来、急在此穴掐之。若儿身后仰即止。
夏英白曰∶此穴在腿弯内,几有风时,急在此穴掐之。若儿身前扑即止。
夏英白曰∶此穴在腿下节前面膝下,亦名中廉穴,儿风望后跌,在此穴久掐最效。
涂蔚生曰∶查《针灸大成》,并无中廉穴之名称,只有上廉下廉二穴,条口居于其间。想英白之所谓中廉穴,
亦即指针灸之所谓条口边。至此穴之取法,须沿外膝眼下量起,至下八寸止,胫上两筋骨罅宛宛中。因上廉离外
穴眼六寸,下廉离上廉三寸,而条口则在下廉上一寸边。
涂蔚生曰∶以上推拿诸法,犹本草之药味罗列,性质毕布,可谓临时治儿者选择之工具也。然病有轻重,法
有繁简,有一病
而只用一方者,有一病而须用数方者,前后变换不同,临时施用自异。在医师之良者,固可因病求法而为适宜之
推拿。若夫医师之下者,则胸无成竹,未免临症眩迷。如其临症乱推乱拿,不知因症以求法,何若另立法门,使之根据
法治症。故余于采用夏英白推拿诸法而外,另将陈紫山之分门推拿诸法列入。虽治法未克精良,疗病未必完善,而随
症增减采用,多亦可为医师之一助云耳。
夏英白说:掐揉肘部的筋,以及曲池穴下方的筋。曲池穴位于肘窝处,掐揉此处可以治疗急风(小儿惊风的一种)。
涂蔚生说:曲池穴属于手阳明大肠经,位于上臂外侧的肘窝处,取穴时宜拱手(屈肘)定位。
夏英白说:外关穴位于上臂背面,正对上臂正面内关穴的位置。外间使穴位于上臂背面,正对上臂正面内间使穴的位置。掐揉这些穴位,可以治疗转筋(肌肉痉挛)、呕吐和腹泻。
涂蔚生说:外关穴位于上臂背面,距离腕后横纹二寸。内关穴位于上臂正面,距离掌后横纹二寸。内外间使穴分别距离内外关穴一寸,且均距离手腕掌后横纹三寸。
夏英白说:此穴位于肩膀骨的夹缝处,左右两边各有一穴,揉按此处可以化痰。
涂蔚生说:肺俞穴的取法,必须让小儿端正坐好,从与肩平齐的第一胸椎开始数起,数至第三胸椎止。再离开第三节胸椎两旁各两寸处,即是肺俞穴。
夏英白说:此穴位于脊梁骨的最下端,揉按此处,可以治疗水泻、腹胀及慢风(慢性惊风)。
夏英白说:用左手大拇指按住小儿脐下的丹田穴不动,用右手大拇指在小儿脐周搓揉。用于治疗水泻、腹胀及脐风等症。
涂蔚生说:丹田穴位于脐下二寸,又名石门穴。膀胱就像锅底盛着的水,丹田穴就像灶底燃烧的柴火,因此能够治疗水泻等症。
夏英白说:此穴位于膝盖内侧旁开处,又名鬼眼穴。当小儿面部出现受风症状时,应紧急在此穴掐揉。若小儿身体向后仰则停止。
夏英白说:此穴位于腿弯内侧,凡有风邪侵袭时,应紧急在此穴掐揉。若小儿身体向前扑倒则停止。
夏英白说:此穴位于小腿前侧膝下,也名为中廉穴。若小儿惊风发作时向后跌倒,在此穴长时间掐揉最为有效。
涂蔚生说:查阅《针灸大成》,其中并无“中廉穴”这一名称,只有上廉穴和下廉穴两个穴位,条口穴位于二者之间。推测夏英白所说的中廉穴,大概是指针灸中的条口穴附近。至于此穴的取法,须沿外膝眼下量起,至下八寸止,位于胫骨两侧筋骨间的凹陷处。因为上廉穴距离外膝眼六寸,下廉穴距离上廉穴三寸,而条口穴位于下廉穴上一寸处。
涂蔚生说:以上推拿诸法,如同本草纲目中罗列的药味,性质各异,可以说是临证治疗小儿时的选择工具。然而疾病有轻重之分,治法有繁简之别,有一种病只用一方剂的,也有需用多种方剂配合的,前后变换不同,临时施用自然各异。高明的医师固然可以根据病情寻求适宜的法度进行推拿。若是低劣的医师,心中没有定见,难免面对病症时感到迷惑。如果在临证时胡乱推拿,不知根据症状来寻求治法,不如另立法门,使其依据法度来诊治病症。因此,我在采纳夏英白的推拿诸法之外,又将陈紫山的分门别类推拿诸法列入书中。虽然治疗方法未必精良,治病未必完善,但随症增减采用,多也能成为医师们的辅助帮助罢了。
Xia Yingbai stated: Pinch and manipulate the tendons on the elbow, as well as the tendons below the Quchi (Curved Pool) acupoint. Quchi is located at the cubital fossa; pinching it treats acute wind (a type of pediatric convulsion).
Tu Weisheng stated: Quchi belongs to the Hand-Yangming Large Intestine Meridian, located on the lateral side of the upper arm at the cubital fossa. It is appropriate to flex the elbow when locating this point.
Xia Yingbai stated: Waiguan (Outer Pass) is located on the dorsal aspect of the forearm, opposite the Neiguan (Inner Pass) acupoint on the palmar aspect. Waijianshi (Outer Jianshi) is located on the dorsal aspect of the forearm, opposite the Neijianshi (Inner Jianshi) acupoint on the palmar aspect. Pinching these points treats muscle spasms (tetany), vomiting, and diarrhea.
Tu Weisheng stated: Waiguan is located on the dorsal aspect of the forearm, two cun distal to the posterior wrist crease. Neiguan is located on the palmar aspect of the forearm, two cun proximal to the transverse crease of the wrist. The inner and outer Jianshi points are each one cun away from their respective Guan points, and three cun away from the posterior wrist crease.
Xia Yingbai stated: This point is located in the cleft of the shoulder bone, with one point on each side. Rubbing here resolves phlegm.
Tu Weisheng stated: To locate Feishu (Lung Shu), the child must sit upright. Counting from the first thoracic vertebra level with the shoulders down to the third thoracic vertebra, move laterally two cun from both sides of the third vertebral process; this is the Feishu point.
Xia Yingbai stated: This point is located at the end of the spinal column. Rubbing it treats watery diarrhea, abdominal distension, and slow wind (chronic convulsion).
Xia Yingbai stated: Use the left thumb to press firmly on the Dantian (Elixir Field) below the umbilicus without moving it. Use the right thumb to rub around the umbilicus. This treats watery diarrhea, abdominal distension, and umbilical wind.
Tu Weisheng stated: Dantian is located two cun below the umbilicus, also known as Shimen (Stone Gate). If the bladder is like water in a cauldron, Dantian is like firewood at the bottom of the stove; thus, it can treat conditions such as watery diarrhea.
Xia Yingbai stated: This point is located beside the medial side of the knee, also named Guiyan (Ghost Eye). When wind strikes the child's face, urgently pinch this point. Stop if the child's body arches backward.
Xia Yingbai stated: This point is located inside the popliteal fossa. Whenever wind pathogens are present, urgently pinch this point. Stop if the child's body falls forward.
Xia Yingbai stated: This point is located on the anterior aspect of the lower leg, below the knee, also named Zhonglian (Middle Lian). If the child falls backward due to wind-induced convulsions, prolonged pinching at this point is most effective.
Tu Weisheng stated: Consulting the *Zhenjiu Dacheng* (Great Compendium of Acupuncture and Moxibustion), there is no mention of "Zhonglian." There are only Shanglian (Upper Lian) and Xialian (Lower Lian) points, with Tiaokou (Band Opening) situated between them. It is presumed that Xia Yingbai's "Zhonglian" refers to the vicinity of the acupuncture point Tiaokou. Regarding its location, measure eight cun down from the lateral eye of the knee, stopping in the depression between the tendons of the tibia. Shanglian is six cun from the lateral knee eye, Xialian is three cun from Shanglian, and Tiaokou is one cun above Xialian.
Tu Weisheng stated: The aforementioned tuina methods are like the listing of medicinal herbs in materia medica, displaying various properties; they serve as tools for selection when treating children clinically. However, diseases vary in severity, and methods vary in complexity. Some diseases require only one formula, while others require multiple formulas. The application changes according to the situation. A skilled physician can certainly adapt tuina techniques based on the disease. Conversely, an incompetent physician, lacking clear principles, may become confused when facing symptoms. Randomly applying tuina without seeking methods based on symptoms is inferior to establishing specific protocols for symptom-based treatment. Therefore, besides adopting Xia Yingbai's tuina methods, I have included Chen Zishan's categorized tuina methods. Although the treatments may not be perfect or comprehensive, they can still assist physicians when adjusted according to symptoms.