Library

To understand internal conditions, one must observe external manifestations; by diagnosing the exterior, one can thereby know the interior. This is because what exists within manifests externally. If one does not cross-reference these signs to determine the progression or regression of pathogenic factors, accurate diagnosis is impossible. A skilled physician deeply comprehends this principle; thus, by observing the Five Colors (Qing, Huang, Chi, Bai, Hei) and correlating them with the pulses of the Zang organs, one investigates their correspondence; by palpating the Five Pulses (Ji, Da, Huan, Se, Chen) and correlating them with the colors of the Zang organs, one determines their harmony or disharmony. If one can meticulously examine the subtle nuances of complexion and diagnose the delicate characteristics of the pulse, treating based on the cross-reference of internal and external signs, then the achievement of perfect efficacy in every case can be readily attained. The *Suwen* states: "Able to combine color diagnosis and pulse diagnosis, one can achieve perfection." This is precisely its meaning.

Tracing back to the origin, the Qi of the Dao divides into Yin and Yang, scatters into the Five Elements, and all that humans are endowed with contains these elements. The pulses of the five Zang organs are the true Qi of Heaven; they circulate Blood and Qi, connect Yin and Yang, and nourish the body. The five colors are the brilliance of Qi; they correspond to the Five Elements, harmonize with the Four Seasons, and manifest on the face. Only by examining both color and pulse without bias can one discern the mechanism of disease, differentiate it as Cold or Heat, attribute it to specific Zang-Fu organs, treat according to the syndrome, and thereby achieve complete recovery. This fundamentally relies on the ability to combine color and pulse diagnosis.

For example, if the Liver's color resembles the green of a kingfisher's feather, and its pulse is slightly wiry and rapid, this indicates vitality. However, if the pulse is floating, choppy, and short, and the color appears like dead grass, how can life be sustained? If the Heart's color resembles the red of a rooster's comb, its pulse should be floating, large, and scattered, indicating a favorable condition. But if the pulse is deep, soft, and slippery, and the color appears like coagulated blood, how can it be considered favorable? If the Spleen's color resembles the yellow of a crab's belly, its pulse should be moderate, slow, and large, indicating compliance. Yet if the pulse is slightly wiry and rapid, and the color appears like the dark yellow of unripe citrus fruit (*Zhi Shi*), how can it be compliant? If the Lung's color resembles the white of pig fat, its pulse should be floating, choppy, and short, indicating auspiciousness. But if the pulse is floating, large, and scattered, and the color appears like dry bone, how can it be auspicious? As for the Kidney, if its color resembles the black of a crow's feather, and its pulse is deep, soft, and slippery, this indicates life; but if the pulse comes slowly and is large, and the color appears like ash, this indicates death. The principles of life and death depend entirely on the cross-reference of diagnosis and observation. Given this, when the medication corresponds accurately to the syndrome, there has never been a case where the severe illness was not cured.

I have previously discussed that facial complexions appear in specific regions on the left, right, upper, and lower parts; pulse movements occur at specific positions in the Cun, Guan, and Chi areas. The left cheek corresponds to the Liver region, aligning with the Guan position of the left hand, representing the Liver and Gallbladder, associated with Wind-Wood as the First Qi. The forehead (Yan) corresponds to the Heart region, aligning with the Cun-kou of the left hand, representing the Heart and Small Intestine, associated with Ministerial Fire as the Second Qi. The nose corresponds to the Spleen region, aligning with the Guan pulse of the right hand, representing the Stomach and Spleen, associated with Damp-Earth as the Fourth Qi. The right cheek corresponds to the Lung region, aligning with the Cun-kou of the right hand, representing the Lung and Large Intestine, associated with Dry-Metal as the Fifth Qi. The chin (Yi) corresponds to the Kidney region, aligning with the Chi position of the left hand, representing the Kidney and Bladder, associated with Cold-Water as the Final Qi. Regarding the Ministerial Fire as the Third Qi, it corresponds to the right hand, representing the Mingmen (Gate of Vitality) and Sanjiao (Triple Burner). The principles of Yin-Yang and the generation and restriction among the Five Elements should be deduced by correlating them with color and pulse. Therefore, the *Mai Yao Jing Wei Lun* states: "Color corresponds to the Five Elements, pulse corresponds to Yin and Yang." The *Nan Jing, Thirteenth Difficulty* states: "Color and pulse should correspond mutually." However, the perfect efficacy in treating diseases cannot be achieved unless one combines color and pulse diagnosis. The *Wang Zang Sheng Cheng Pian* says: "The Heart correlates with the pulse, and its brilliance is shown in the color." The size, slipperiness, roughness, floating, and sinking of the pulse can be distinguished by fingers; the subtle diagnosis of the five colors can be observed by eyes. Following this, by combining color and pulse diagnosis, one can achieve perfection. Here, the five colors are mentioned first, followed by the five pulses, intending for future scholars to use inspection and palpation to verify each other. Later, Bian Que understood this principle and stated: "Knowing through observation is called divine; knowing through pulse-taking is called skillful," which deeply grasps the principles of the *Neijing*. In later generations, those who formulated prescriptions termed their work "Divine Skill and Perfect Completeness," which indeed carries profound significance.