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【歌】积黄青色是惊风,热赤伤寒紫淡红。黑痛白为虚冷嗽,更参随部用神工。
【论】看小儿左右叉手处,名曰虎口。自虎口而上,第一节名曰风关,第二节名曰气关,第三节名曰命关。
有纹见于风关,易治;通过气关,渐难;过三关,多死。候左手之纹,病应心、肝;右手之纹,病应脾、肺。
纹有五色∶紫者,风邪在表;惊则纹青;淡红则寒热在表;深红必发伤寒、痘疹;青红者,惊热。纹乱则病久;
纹细则腹痛多啼,乳食不消;纹粗直射指甲,必主惊风恶候;纹黑如墨,大抵困重难治。
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【歌】小儿有病须凭脉,一指三关定其息。浮洪风热数为惊,虚冷沉迟实有积。
【论】浮脉为风,秋得之曰平,余时主伤风寒,头疼壮热,或夜热昼凉,咳嗽喷嚏,鼻塞清涕,呕逆不食。
洪脉为热,夏得之曰平,余时主风热壅盛,身体温壮,发惊,疮疡,血泄。
数脉为惊,春得之曰平,余时主惊风抽掣。脉数小者,多睡惕跳,直视恐怖,盗汗,梦中切牙,吐舌,喘
吐。脉数大者,一、二日间必发搐搦。
沉迟为虚冷,四时得之,主脾胃虚弱,滑泄脱肛,吐痢不止,日渐 羸,以成脾困,或作疳劳。
实脉为积滞,冬得之曰平,余时主食伤、积聚、腹胀或痛。发竖吐利,缓治即成疳劳、丁奚、哺露候,当
取积后补。
【歌诀】指纹呈现黄色、青色,提示为惊风;呈现红色,多为伤寒;紫色或淡红色,亦属伤寒范畴。黑色主痛证,白色主虚寒咳嗽,此外还需结合指纹所在的部位进行精细辨证施治。
【论述】观察小儿左右手虎口叉开处的指纹,称为“虎口”。从虎口向手指方向延伸,第一节称为“风关”,第二节称为“气关”,第三节称为“命关”。
如果指纹仅显现于风关,病情较轻,容易治疗;若指纹延伸至气关,病情逐渐加重,治疗难度增加;若指纹透达三关(即直达指尖),预后大多不良,多致死亡。观察左手指纹,病变多对应心、肝二脏;观察右手指纹,病变多对应脾、肺二脏。
指纹有五种颜色:紫色者,表示风邪在表;受惊则指纹呈青色;淡红色表示寒热之邪在表;深红色必然发展为伤寒或痘疹;青红相间者,为惊热之象。指纹杂乱无章,表示病程较长;指纹细弱,主腹痛且啼哭不止,乳食不消化;指纹粗直且射向指甲,必定主惊风的危重证候;指纹黑如墨色,大多病情沉重,难以治愈。
【歌诀】小儿患病必须依靠脉诊,医生用一指涵盖三关以测定脉搏频率。浮脉主风热,数脉主惊风;虚脉和迟脉主虚冷,实脉主积滞。
【论述】浮脉主风邪,秋季出现浮脉属于平脉(正常脉象),其他季节出现则主伤风寒,症状包括头痛、高热,或者夜间发热白天凉爽,伴有咳嗽、打喷嚏、鼻塞流清涕、呕吐逆气、食欲不振。
洪脉主热证,夏季出现洪脉属于平脉,其他季节出现则主风热壅盛,症状包括身体温热壮热、发惊、疮疡、便血泄泻。
数脉主惊风,春季出现数脉属于平脉,其他季节出现则主惊风抽搐。脉数而小者,多见嗜睡易惊、跳动不安、直视恐惧、盗汗、梦中磨牙、吐舌、气喘呕吐。脉数而大者,在一两天内必然发生抽搐。
沉脉和迟脉主虚冷,四季出现此脉,主脾胃虚弱,症状包括滑泄脱肛、呕吐腹泻不止,日渐消瘦羸弱,形成脾困,或者发展为疳劳病。
实脉主积滞,冬季出现实脉属于平脉,其他季节出现则主食伤、积聚、腹胀或疼痛。头发竖起、呕吐下利,若治疗迟缓则会发展成疳劳、丁奚、哺露等危重证候,应当在攻逐积滞之后进行补益治疗。
[Verse] Yellow and cyan patterns indicate wind-stroke due to fright; red indicates cold damage; purple or pale red also relates to cold damage. Black signifies pain, while white indicates deficiency-cold cough. Further divine skill is required by referring to the specific section where the pattern appears.
[Discussion] Observe the area at the junction of the thumb and index finger on either hand of the child, known as the "Tiger's Mouth" (Hu Kou). Extending from the Tiger's Mouth towards the finger, the first segment is named the "Wind Gate" (Feng Guan), the second segment the "Qi Gate" (Qi Guan), and the third segment the "Life Gate" (Ming Guan).
If the pattern is visible only at the Wind Gate, it is easy to treat; if it extends through the Qi Gate, it becomes gradually more difficult; if it penetrates all three gates, death is likely. Observing the left-hand pattern, the disease corresponds to the Heart and Liver; observing the right-hand pattern, the disease corresponds to the Spleen and Lungs.
There are five colors of patterns: Purple indicates wind pathogen in the exterior; fright causes a cyan pattern; pale red indicates cold-heat in the exterior; deep red inevitably leads to cold damage or smallpox/variol; cyan and red mixed indicate fright-heat. A chaotic pattern indicates a long-standing disease; a thin pattern indicates abdominal pain with frequent crying and indigestion of milk/food; a thick pattern straight towards the nail indicates severe wind-stroke due to fright; a black pattern like ink generally indicates a critical condition that is difficult to treat.
[Verse] For pediatric diseases, pulse diagnosis is essential; one finger covers the three gates to determine the respiration/pulse rate. Floating pulse indicates wind-heat; rapid pulse indicates fright; deficient and slow pulses indicate deficiency-cold; excess pulse indicates accumulation/stagnation.
[Discussion] The floating pulse indicates wind pathogen. In autumn, it is considered a normal pulse (Ping); in other seasons, it indicates injury by wind-cold, manifesting as headache, high fever, or night fever with daytime coolness, coughing, sneezing, nasal congestion with clear discharge, vomiting/regurgitation, and anorexia.
The surging pulse indicates heat. In summer, it is considered a normal pulse; in other seasons, it indicates abundant wind-heat, manifesting as warm-to-hot body temperature, fright, sores/ulcers, and bloody diarrhea.
The rapid pulse indicates fright. In spring, it is considered a normal pulse; in other seasons, it indicates wind-stroke with convulsions. A small rapid pulse often presents with excessive sleep, startle/jumping, staring straight ahead, fearfulness, night sweats, teeth grinding in dreams, tongue protrusion, wheezing, and vomiting. A large rapid pulse will inevitably lead to convulsions within one or two days.
Deep and slow pulses indicate deficiency-cold. Appearing in any season, they indicate Spleen-Stomach weakness, manifesting as slippery diarrhea with rectal prolapse, continuous vomiting and dysentery, gradual emaciation leading to Spleen exhaustion, or developing into infantile malnutrition (Gan) and consumption.
The excess pulse indicates stagnation/accumulation. In winter, it is considered a normal pulse; in other seasons, it indicates food injury, accumulation, abdominal distension, or pain. With hair standing on end, vomiting, and diarrhea, if treated slowly, it may develop into severe conditions such as Gan malnutrition, Ding Xi (severe emaciation with prominent abdomen), or Bu Lu (failure to thrive with sunken eyes), requiring supplementation after removing the accumulation.