“天河水”是小儿推拿临床最常用的清热要穴，正如《幼科推拿秘书》所说，天河水具有“取凉退热，并治淋疴昏睡”之功效，故而此穴为众多临床推拿医家所推崇。笔者在治疗中，每遇热证，必用“天河水”，其间也难免有清热效果不佳之时。后由恩师指点：对于“清天河”清热无效时? “Tianhe Water” is the most commonly used heat massage point for pediatric massage clinics. As the secretary of the Department of Pediatrics said, Tianhe water has the effect of “taking cool and fever, and treating drench and sleepy” Medical advocates. In the treatment, every case of heat syndrome, will use “Milky Way water” during which inevitably have poor heat removal effect. After the mentor: For “Qing Tianhe” heat is invalid?