初发热或为风寒所闭，一时无表散之药，须用推拿法以松肌表，其毒自出。又或其儿素
性怯弱，为风寒所束，固不得不发，又恐表虚，用药发表，有伤元气，亦用推拿之法。又或
其儿即服表药，依然身无微汗，寒邪闭锢，其症不退，欲复用表散之剂，又恐过表以损元神
，亦须用推拿之法。盖发散之药，多能耗气，推拿之法，不过松肌发窍，运动筋骸而已。窍
开则气通，筋运则血行，气血通畅而邪自出，勿谓推拿之无益也。余常用之，其效甚捷，故
用其法。取温水一碗，先用大指蘸水，于小儿两鼻孔洗擦而上推者二十四下，谓之洗井灶。
再于印堂用两手指分开擦二十四下，谓之开天门。又于小儿两手食指擦下三十六下，以泻三
关之火。又于中指擦下三十六下，以泻心经与肝之邪。又将小指数摆，谓之乌龙摆尾。再于
脉门擦下三十六下，复擦上十二下。又于掌上顺运八封周旋擦一百二十下。然后于虎口及手
足凡接骨之处，其穴有窝，于各穴窝间用力俱捏一下，脐下丹田各捏一下，背上两饭匙骨下
及背脊每骨节间各捏一下，任其啼叫，令汗出而肌松，痘毒亦从而出矣。但推拿后，宜令儿
睡发汗，不可见风，腠理既开，恐风邪之复入也。或用前顶方，将桃树皮与姜、葱擂烂，炒
温敷于脐上，一炷香久为度，亦取其发表之义也。
小儿初起发热，可能是被风寒邪气郁闭肌表，一时之间没有合适的解表药物，此时必须使用推拿法来疏通肌表，体内的毒邪自然就会排出。又或者孩子平素体质怯弱，被风寒束缚，虽然不得不发汗解表，但又担心其表虚，若用药发汗会损伤元气，这时也应当使用推拿的方法。又或者孩子已经服用了发汗解表的药物，但身上依然没有微微出汗，寒邪仍然闭塞体内，症状没有消退，想要再次使用发散的药物，又恐怕过度发汗会损害元神，这种情况下也必须使用推拿法。因为发散类的药物，大多会消耗人体正气；而推拿的方法，不过是为了松解肌肉、开启腠理、活动筋骨罢了。腠理开通则气机通畅，筋骨运动则血液运行，气血通畅后邪气自然排出，不要说推拿没有益处。我常用这种方法，效果非常迅速，所以记录此法。取一碗温水，先用大拇指蘸水，在小儿两个鼻孔处清洗擦拭并向上推二十四次，这叫做“洗井灶”。再在印堂穴用两手指分开擦拭二十四次，这叫做“开天门”。又在小儿两手食指上向下擦拭三十六次，以泻三关之火。又在中指上向下擦拭三十六次，以泻心经与肝的邪气。又将小指来回摆动，这叫做“乌龙摆尾”。再在脉门（手腕横纹处）向下擦拭三十六次，再向上擦拭十二次。又在手掌心上顺时针方向旋转擦拭一百二十次。然后在虎口以及手足凡是关节连接之处，那些有凹陷的穴位，在每个穴位窝间用力各捏一下，脐下丹田部位各捏一下，背上两侧肩胛骨下方及背部脊柱每节骨头间隙各捏一下，任凭孩子啼哭，直到出汗且肌肉松弛，痘毒也随之排出。但是推拿之后，应让孩子睡觉以助发汗，不可吹风，因为腠理已经打开，担心风邪再次侵入。或者使用前顶方，将桃树皮与姜、葱捣烂，炒温后敷在肚脐上，持续时间为一炷香左右，这也是取其发表散寒的意义。
If a child initially develops fever due to obstruction by wind-cold pathogens, and suitable exterior-releasing medicines are unavailable at the moment, Tuina (massage therapy) must be employed to relax the muscle layer and superficial tissues, allowing the pathogenic toxins to discharge naturally. Alternatively, if the child has a naturally timid constitution and is constrained by wind-cold, although sweating is necessary, there is concern regarding deficiency of the defensive qi (Wei Qi); using medicinal herbs to induce sweating might damage the primordial qi (Yuan Qi), so Tuina should also be used. Furthermore, if the child has already taken exterior-releasing medicine but still exhibits no slight perspiration, with cold pathogens remaining sealed inside and symptoms persisting, one may hesitate to administer further dispersing agents for fear of excessive sweating damaging the primordial spirit (Shen); in such cases, Tuina is also required. Generally, dispersing medicines tend to consume vital energy, whereas Tuina merely serves to relax muscles, open pores, and mobilize the sinews and bones. When pores open, qi flows freely; when sinews move, blood circulates; once qi and blood flow smoothly, pathogens exit naturally. Do not claim that Tuina is ineffective. I frequently use this method, and its efficacy is rapid; therefore, I record it here. Take a bowl of warm water. First, dip the thumb in the water, cleanse and rub the two nostrils of the child while pushing upwards twenty-four times; this is called "Washing the Well and Stove" (Xi Jing Zao). Next, use two fingers to rub apart the area at Yintang (EX-HN3) twenty-four times; this is called "Opening the Heavenly Gate" (Kai Tian Men). Then, rub downwards on the index fingers of both hands thirty-six times to drain fire from the Three Passes (San Guan). Rub downwards on the middle finger thirty-six times to drain pathogens from the Heart Meridian and the Liver. Flick the little finger back and forth; this is called "Black Dragon Wagging Its Tail" (Wu Long Bai Wei). Then, rub downwards at the pulse gate (Radial artery area at the wrist) thirty-six times, and rub upwards twelve times. Subsequently, rub clockwise in a circular motion on the palm one hundred and twenty times. Finally, pinch firmly at each depression among the acupoints at the web between the thumb and index finger (Hegu LI4) and at all joint connections of the hands and feet, pinch once at the Dantian below the navel, and pinch once at each interspace between the vertebrae of the spinal column and below the two scapulae on the back. Allow the child to cry as needed, until sweat appears and muscles relax, causing the chickenpox/smallpox toxins to discharge accordingly. However, after Tuina, the child should sleep to facilitate sweating and must avoid exposure to wind, as the interstices (Cou Li) are now open, risking re-entry of wind pathogens. Alternatively, apply the Qian Ding Fang: crush peach tree bark with ginger and green onion, stir-fry until warm, and apply to the navel for the duration of one incense stick; this also aims to release the exterior.