小儿脉应二周前，一指分关寸尺全；六至号为无病子，不和气主按如弦；浮洪风热
数惊候，虚冷沉迟实积坚；指滞脾经时缓应，过犹不及乱难痊。
叔和脉经曰∶孩儿三岁至五岁，呼吸须将八至看，乃以八至为平。及观张氏脉诀云∶
小儿常脉，只多大人二至为平。予尝指下审之，果一息六至为平。若七至八至，乃是数
脉，主发热作惊。由此而论，则脉之微妙，不可不察，学人当审而切之，庶无错误。凡把
幼稚之脉，仅二三岁者，但以一指揣按关部，侧指于关前取寸口，侧指于关后取尺泽，至
四五岁余，却密下三指，按三部，明标本，察病证，然后可以克进退，决安危。盖周岁以
前，气血未完，脉难根据，周岁以后，气血和平，始可诊脉。二岁以前，只根据一指按关
部取法为率。若弦紧主气不和，先与顺之，然后调中快气，浮洪主风热，先与解之，然后
疏风除热。急数主受惊，先与发散，然后镇心退惊。沉迟主虚冷，先与温之，然后理虚
去寒。实滑主伤积。先与表之，然后疏涤积聚。沉缓主宿冷滞脾，钱氏脉诀云∶沉缓为
积，此又因宿冷积滞于脾，则脾气弱而不能磨化谷食，遂成积也。先与和解，然后去积
温脾。以上脉病，皆宜对证调治，有传作乖异，尤在临机应变，不可执一，所谓医者意
也。其有旨哉。若一息十余至为危急，谓之太过；一息仅二至为虚极，谓之不及。大小
不同为恶候，谓之乱，皆难治也。若年至十二三以上，又当参诸大方脉，以明得病之由，
因其所制之方以为治，斯不误矣。
小儿的脉象诊察方法与成人不同，通常用食指、中指、无名指三指并拢，在寸、关、尺三部进行诊察；但在婴幼儿时期，由于手腕短小，仅用一指即可涵盖关、寸、尺三部。脉搏每分钟跳动六次（一息六至）被称为健康无病的婴儿脉象；若脉象不和，按之如琴弦般紧绷，则提示气机不畅。脉象浮而洪大或数急，主风热或受惊；脉象虚冷、沉迟主虚寒证；脉象实而坚主积滞实证。脉象涩滞且脾经症状明显时，脉率常缓；脉率过快或过慢均属于紊乱难治之候。
王叔和在《脉经》中说：三岁至五岁的儿童，呼吸之间脉搏跳动八次为正常平脉。但查看张氏《脉诀》记载：小儿的正常脉象比成人快两次即为平和。我曾亲自诊察验证，确实发现一呼一吸间脉搏跳动六次为平脉。如果达到七至八次，则属于数脉，主发热和惊风。由此看来，脉理的微妙之处，不可不仔细考察，学习者应当审慎切脉，以免出现错误。
凡是诊察两三岁幼童的脉象，只需用一指揣按关部，将侧指置于关前取寸口脉，置于关后取尺泽脉；等到四五岁以上，再密排三指，同时按诊寸、关、尺三部，明确病证的标本，察看病证性质，然后才能灵活进退施治，判断安危。大概周岁以前，气血尚未充盈完善，脉象难以作为依据；周岁以后，气血趋于平和，才可以诊脉。两岁以前，只以一指按关部取法为标准。
若脉象弦紧，主气机不和，应先予以顺气调理，然后再调和脾胃、行气导滞；若脉象浮洪，主风热，应先予以解表，然后再疏风清热；若脉象急数，主受惊，应先予以发散邪气，然后再镇心安神、退除惊风；若脉象沉迟，主虚冷，应先予以温里，然后再调理虚损、驱散寒气；若脉象实滑，主伤食积滞，应先予以解表透邪，然后再疏通涤荡积聚；若脉象沉缓，主宿冷停滞于脾。钱氏《脉诀》说：沉缓脉主积滞，这又是因为宿冷积滞于脾，导致脾气虚弱而不能磨化谷食，从而形成积滞。应先予以和解调理，然后再去除积滞、温补脾脏。以上脉病，都应当对证调治，若有传变成为怪异病症，更在于临证时的随机应变，不可固执一端，所谓“医者意也”，其中的深意是很丰富的。
如果一呼一吸间脉搏跳动十余次，称为太过，属于危急重症；如果一呼一吸间脉搏仅跳动两次，称为虚极，属于不及之候。脉象大小不一，称为乱脉，都属于恶候，都难以治疗。如果年龄到了十二三岁及以上，就应当参考成人（大方脉）的诊法，以明确发病的原因，根据所制定的方剂进行治疗，这样就不会出错了。
The pulse diagnosis method for infants and young children differs from that of adults. Typically, the index, middle, and ring fingers are placed together to palpate the Cun (Inch), Guan (Bar), and Chi (Cubit) positions; however, in infancy and early childhood, due to the short wrist, a single finger can cover all three positions (Guan, Cun, Chi). A pulse rate of six beats per respiratory cycle (one Xi) is considered the normal pulse for a healthy infant. If the pulse is discordant and feels taut like a string upon pressure, it indicates disharmony of Qi. A floating, surging, or rapid pulse indicates Wind-Heat or fright; a deficient, cold, deep, and slow pulse indicates deficiency-cold; a solid and firm pulse indicates accumulation/excess stagnation. When the pulse feels choppy and spleen meridian symptoms are present, the pulse rate tends to be slow; both excessively fast and excessively slow rates belong to chaotic and difficult-to-treat conditions.
Wang Shuhe stated in *Mai Jing* (Pulse Classic): For children aged three to five, eight beats per respiratory cycle are considered the normal, balanced pulse. However, Zhang's *Mai Jue* (Pulse Mantra) records: The normal pulse of children is two beats faster than that of adults. I have personally verified this through palpation and indeed found that six beats per respiratory cycle constitute the normal pulse. If the rate reaches seven or eight beats, it is classified as a Rapid Pulse (Shu Mai), indicating fever and fright. From this discussion, it is evident that the subtleties of pulse diagnosis must not be overlooked; learners should examine and palpate with caution to avoid errors.
When palpating the pulse of toddlers aged two or three, one need only use a single finger to palpate the Guan position, placing the adjacent fingers anteriorly to access the Cun position and posteriorly to access the Chi position. By the age of four or five, the three fingers should be closely arranged to simultaneously palpate the three positions, clarifying the root and branch aspects and observing the disease pattern, thereby enabling flexible treatment adjustments and accurate prognosis of safety and danger. Generally, before one year of age, Qi and Blood are not yet fully developed, making pulse diagnosis unreliable; after one year of age, when Qi and Blood become harmonious, pulse diagnosis becomes feasible. Before the age of two, the standard method is to use a single finger at the Guan position.
A Taut/Chord-like (Xian) or Tight (Jin) pulse indicates Qi disharmony; initially, one should soothe the Qi, followed by regulating the Middle Jiao and promoting Qi movement. A Floating (Fu) and Surging (Hong) pulse indicates Wind-Heat; initially, one should release the exterior, followed by dispersing Wind and clearing Heat. An Urgent/Rapid (Ji/Shu) pulse indicates Fright; initially, one should disperse pathogenic factors, followed by calming the Heart and subduing fright. A Deep (Chen) and Slow (Chi) pulse indicates Deficiency-Cold; initially, one should warm the interior, followed by tonifying deficiency and dispelling Cold. A Solid (Shi) and Slippery (Hua) pulse indicates Food Accumulation/Stagnation; initially, one should release the exterior, followed by unblocking and purging the accumulation. A Deep (Chen) and Slow (Huan) pulse indicates chronic Cold stagnating in the Spleen. Qian's *Mai Jue* states: "Deep and slow pulses indicate accumulation." This occurs because chronic cold and stagnation in the Spleen weaken Spleen Qi, impairing its ability to transform food, thus leading to accumulation. Initially, one should harmonize, followed by eliminating accumulation and warming the Spleen. All the aforementioned pulse-disease correlations require syndrome-specific treatment. If transmission leads to atypical manifestations, clinical flexibility is paramount; one must not adhere rigidly to fixed rules. As the saying goes, "The physician relies on intuition," which holds profound significance.
If the pulse rate exceeds ten beats per respiratory cycle, it is termed "Excessive" (Tai Guo) and indicates a critical condition. If the pulse rate is only two beats per respiratory cycle, it is termed "Deficient Extreme" (Bu Ji). Irregular variations in pulse size are termed "Chaotic" (Luan) pulses. These are all ominous signs and are difficult to treat. For children aged twelve or older, adult pulse diagnosis methods (Da Fang Mai) should be referenced to determine the etiology, and treatment should follow established formulas accordingly to ensure accuracy.