1. Observing the changes in the superficial collateral vessels on the palmar side of the child’s index finger. Refer to the fingerprint diagram (see image). Location: The first section of the index finger is called Fengguan (Wind Gate), which is between the transverse line of the metacarpophalangeal joint and the second transverse line; the second section is called Qiguan (Qi Gate), which is between the second and third transverse lines; the third section is called Mingguan (Life Gate), which is from the third transverse line to the fingertip. Method: Hold the child’s index finger towards the light with the left hand, and with the right thumb apply moderate pressure from Mingguan towards Qiguan and Fengguan, pushing several times until the fingerprints become more pronounced for observation. Normal appearance: The normal fingerprint color is light red, a mix of red and yellow, subtly visible within Fengguan; it is mostly not prominent, and may even be indistinct, often appearing slanted, single-branched, and of moderate thickness. 2. Clinical significance of observing children’s fingerprints. ① Location: When the fingerprint is visible at Fengguan, it indicates that the pathogenic qi has entered the collaterals, suggesting a mild condition. If the fingerprint extends from Fengguan to Qiguan and its color is darker, it indicates that the pathogenic qi has entered the meridians, suggesting a more severe condition. If the fingerprint is visible at Mingguan, it indicates that the pathogenic qi has penetrated the internal organs, which may be life-threatening, hence it is referred to as Mingguan. If the fingerprint reaches the fingertip, it is termed “Toguan Shejia” (penetrating the gate and shooting the nail), indicating a more dangerous condition with a poor prognosis. ② Floating and sinking: A floating fingerprint indicates a superficial condition, commonly seen in exterior syndromes. A sinking fingerprint indicates an internal condition, often seen in both exterior and internal injuries. ③ Depth: A deep color indicates a severe condition, while a light color indicates a mild condition; a pale color suggests deficiency, while a stagnant color suggests excess. ④ Color: A purple-red color indicates internal heat; a bright red color indicates an exterior syndrome; a blue color indicates wind and various pain syndromes; a pale color indicates deficiency; a purple-black color indicates blood stasis, suggesting a critical condition. ⑤ Shape: A thickened collateral vessel often indicates a heat syndrome or excess condition; a thin vessel often indicates a cold syndrome or deficiency condition.
Teaching you to identify diseases in children through “fingerprints” (Image)
“Life Times”
In Traditional Chinese Medicine (TCM), diagnosis relies on the four diagnostic methods: observation, listening, inquiry, and palpation. A special method for diagnosing diseases in young children is to observe their “fingerprints.”
“The ‘fingerprint’ actually refers to a blue vein on the palmar side of the child’s index finger, near the thumb. Observing the ‘fingerprint’ is one of the methods in traditional Chinese medicine to diagnose the cold-heat and deficiency-excess conditions in children, generally used for children under three years old,” explained Dr. Hao Hongwen, Deputy Chief Physician of Pediatrics at the Dongfang Hospital affiliated with Beijing University of Chinese Medicine, to a reporter from “Life Times.” To differentiate diseases through the ‘fingerprint,’ one must first understand the “Three Gates of the Tiger’s Mouth” (see image). The normal child’s ‘fingerprint’ should be a mix of red and yellow, subtly visible beneath the skin. After illness, the color, location, and floating-sinking of the ‘fingerprint’ will change accordingly.
A floating fingerprint indicates a mild condition, while a sinking fingerprint indicates a severe condition. For example, when a child has a cold, the ‘fingerprint’ is clearly visible; if it develops into bronchitis or pneumonia, the ‘fingerprint’ may become less distinct.
The color of the fingerprint indicates cold or heat. If a child has an exterior wind-cold condition, the ‘fingerprint’ will be bright red and superficial; if the ‘fingerprint’ is pale red and sinks, it indicates spleen and stomach deficiency-cold. A purple ‘fingerprint’ indicates heat. If the ‘fingerprint’ is dark purple and sinks beneath the skin, it suggests that pathogenic heat is stagnating within the body. A purple-black ‘fingerprint’ indicates deep-seated heat, obstructing the blood vessels, suggesting a critical condition.
Lightly pressing the ‘fingerprint’ can reveal deficiency or excess. If the ‘fingerprint’ is pale and disappears upon pressing, only to reappear after a while, it often indicates lung deficiency or spleen deficiency, with symptoms such as poor appetite, diarrhea, or constipation. If pressing the ‘fingerprint’ shows no significant change, it often indicates an excess condition, or that the pathogenic factor is retained within the body.
The length of the ‘fingerprint’ reflects the severity of the condition. A shorter ‘fingerprint’ generally indicates a milder condition, usually only seen at Fengguan. If the ‘fingerprint’ extends to Qiguan, it indicates a more severe condition. If the ‘fingerprint’ is also visible at Mingguan, or even penetrates Mingguan and extends towards the fingertip, it is referred to in ancient medicine as “Toguan Shejia,” indicating that the disease has reached a very dangerous stage.
(Zhou He)
Observing children’s ‘fingerprints’ mainly involves looking at the blue vein on the palmar side of the index finger, near the thumb, in children under three years old. Ancient texts refer to the fingerprint as the “Three Gates of the Tiger’s Mouth.” The three gates refer to Feng, Qi, and Ming, dividing the fingerprints on the index finger into three parts named Feng, Qi, and Ming. The side closer to the thumb is Fengguan, while the side closer to the fingertip is Mingguan, with the area between them called Qiguan. The normal child’s fingerprint should be a mix of red and yellow, subtly visible beneath the skin. If the child is ill, the color, location, and floating-sinking of the fingerprint will change accordingly. Ancient texts summarize these changes in four phrases: floating-sinking distinguishes between exterior and interior, red and purple differentiate cold and heat, pale and stagnant determine deficiency and excess, and the three gates measure severity. If the disease is superficial, the child’s fingerprint will be floating and visible on the surface, such as at the onset of a cold; if the disease is internal, the child’s fingerprint will be sinking and deeply hidden beneath the skin, such as in cases of food stagnation or internal injury. If the disease is cold, the fingerprint will appear red, such as in exterior wind-cold; if the fingerprint is pale red and sinks, it indicates spleen and stomach deficiency-cold. If the disease is heat, the fingerprint should show purple, such as in exterior wind-heat; if the fingerprint is dark purple and sinks beneath the skin, it indicates that pathogenic heat is stagnating within the body. A pale fingerprint that disappears upon pressing and reappears after a while often indicates a deficiency condition. A pale red color indicates insufficient qi and blood, while a pale purple color indicates deficiency with heat, suggesting the presence of deficiency fire. If the fingerprint does not change upon pressing, it often indicates an excess condition, or that the pathogenic factor is retained within the body, such as phlegm-dampness, food stagnation, or heat accumulation. If the disease is mild, the fingerprint is generally only seen at Fengguan. If the fingerprint extends to Qiguan, it indicates a more severe condition. If the fingerprint is also visible at Mingguan, or even penetrates Mingguan and extends towards the fingertip, ancient physicians referred to this as “Toguan Shejia,” indicating that the disease has reached a very dangerous stage. The combination of the four diagnostic methods ensures accurate diagnosis.
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