凡诸病之色，如云撤散，主病将愈，易治也；抟聚凝滞，主病渐进，难治也。
上以内外、上下、左右分顺逆，此以浅深、晦明、聚散分顺逆也。
黑庭赤颧，出如拇指，病虽小愈，亦必卒死。
唇面黑青，五官黑起，擦残汗粉，白色皆死。
【注】此明非常之色，诊人暴死之法也。出如拇指，谓成块成条，抟聚不散也。
黑色出如拇指于天庭，赤色出如拇指于两颧，此皆水火相射之候，故病者虽或小愈，
亦必卒然而死也。病者唇面青黑，及五官忽起黑色白色，如擦残汗粉之状，
虽不病，亦皆主卒死也。
善色不病，于义诚当，恶色不病，必主凶殃，
五官陷弱，庭阙不张，蕃蔽卑小，不病神强。
【注】此明见其色不见其病之诊法也。善色者，气色并至之好色也，
其人于理当不病也。恶色者，沉深滞晦之色也，其人即不病，亦必主凶殃也。
凶殃者，即相家所谓红主焦劳口舌，白主刑罚孝服，黑主非灾凶死，
青主忧讼暴亡之类也。五官陷弱者，谓五官骨陷肉薄也。庭阙不张者，
谓天庭、阙中不丰隆张显也。蕃蔽卑小者，谓颊侧耳门卑低不广也。
此皆无病而有不寿之形，若加恶色，岂能堪哉！其有不病者，必其人
神气强旺素称其形也。
肝病善怒，面色当青，左有动气，转筋胁疼。
诸风掉眩，疝病耳聋，目视恍恍，如将捕惊。
【注】此下五条，皆明色病相合，本脏自病，虚实之诊法也。怒者，
肝之志，故病则好怒也。青者，肝之色，故病则面色当青也。
肝之部位在左，故病则左胁有动气而胁疼也。肝主筋，故病则转筋也。
掉者，动摇抽搐也。眩者，昏黑不明也。肝主风。故病则掉眩也。
疝主肝，故病疝也。肝与胆为表里，故病耳聋也。此皆肝实之病。
若肝虚，则目视恍恍无所见，以肝开窍于目也。肝虚则胆薄，
故不时而有如人将捕之惊也。
心赤善喜，舌红口干，脐上动气，心胸痛烦。
健忘惊悸，怔忡不安，实狂昏冒，虚悲凄然。
【注】喜者心之志，故病则好喜也。赤者心之色，故病则面色赤也。
心开窍于舌，故病则舌赤红也。心主热，故病则口干心烦也。
心之部位在上，故病则脐上有动气也。胸者心肺之宫城也，
故病则心胸痛也。健忘、惊悸、怔忡，皆心神不安之病也。
热乘心实，则发狂昏冒也。神怯心虚，则凄然好悲也。
脾黄善忧，当脐动气，善思食少，倦怠乏力，
腹满肠鸣，痛而下利，实则身重，胀满便闭。
【注】黄者脾之色，故病则面色黄也。忧思者，脾之志，故病则好忧思也。
脾之部位在中，故病则当脐有动气也。脾主味，故病则食少也。脾主四肢，
故病则倦怠乏力也。脾主腹，故病则腹满肠鸣痛而下利也。
此皆\k脾虚\k之病也。脾主肉，故实则病身重、腹胀满、便闭也。
肺白善悲，脐右动气，洒淅寒热，咳唾喷嚏，
喘呼气促，肤痛胸痹，虚则气短，不能续息。
【注】白者肺之色，故病则面色白也。悲者肺之志，故病则好悲也。
肺之部位在右，故病则右胁有动气也。肺主皮毛，故病则洒淅寒热肤痛也。
咳嗽唾痰，喷嚏流涕，喘呼气促，皆肺本病也。胸者肺之府也，
故病则胸痹而痛也。肺虚则胸中气少，故喘咳皆气短不能续息也。
肾黑善恐，脐下动气，腹胀肿喘，溲便不利，
腰背少腹，骨痛欠气，心悬如饥，足寒厥逆。
【注】黑者肾之色，故病则面色黑也。恐者肾之志，故病则好恐也。
肾之部位在下，故病则脐下有动气也。肾主水，故病则水蓄腹胀、肿满、
喘不得卧也，肾开窍于二阴，故病则溲便不利也。肾主骨，肾与膀胱为表里，
故病则少腹满，背与骨俱痛也。肾主欠，故病则呵欠也。肾邪上乘于心，
故病则心空如饥也。诸厥属下，故病则足寒厥逆也。
正病正色，为病多顺，病色交错，为病多逆。
母乘子顺，子乘母逆。相克逆凶，相生顺吉。
【注】此以五色合五病顺逆生死之诊法也。假如肝病色青，是正病正色。
_芋C若反见他色，是病色交错也。若见黑色，为母乘子，相生之顺也。
若见赤色，为子乘母，相生之逆也。若见黄色，为病克色，其病不加，
凶中顺也。若见白色，为色克病，其病则甚，凶中逆也。曰相克逆凶者，
谓相克为凶，凶中顺尚可也。凶中逆必凶也。曰相生顺吉者，谓相生为吉，
如子乘母，为吉中小逆也，如母乘子，为吉中大顺也。其余四脏皆仿也。
色生于脏，各命其部。神藏于心，外候在目。
光晦神短，了了神足。单失久病，双失即故。
【注】此以色合二目之神，诊病生死之法也。五色生于五脏，
各命其部而见于面。神藏于心，虽不可得而识，然外候在目，
视其目光晦暗，此为神短病死之候也。若目睛清莹，了了分明，
此为神足不病之候也。单失者，谓或色或神，主久病也。双失者，
神色俱失，故主即死也。
面目之色，各有相当，交互错见，皆主身亡，
面黄有救，眦红疹疡，眦黄病愈，睛黄发黄。
【注】此以色合二目之色，诊病之法也。面目之色，各有相当之色，
如面之色，肝青、心赤、脾黄、肺白、肾黑；目之色，如睛瞳黑、
乌珠青、白珠白、两红也。若目青、目赤、目白、目黑，与面色但有不同，
皆为交互错见，病者皆主身亡也。惟面色黄者，为土未败，五行有救，
皆不死也。若伤寒两目红，则为发疹疡之兆
。两目皆黄，则为病将愈之征。若两睛通黄，则为主发黄疸之候也。
闭目阴病，开目病阳，朦胧热盛，时瞑衄常，
阳绝戴眼，阴脱目盲，气脱眶陷，睛定神亡。
【注】此诊目阴阳生死之法也。凡病者闭目，则为病在阴也；开目，
则为病在阳也。朦胧昏不了了，非开目也，则为热盛伤神也。视而时瞑，
非开目也，则为衄血之常候也。目上直视，谓之戴眼，则为阳绝之候也。
视不见物，谓之目盲，则为阴脱之候也。目眶忽陷，则为气脱之候也。
睛定不转，则为神亡之候也。
五色既审，五音当明。声为音本，音以声生。
声之余韵，音遂以名。角征宫商，并羽五声。
【注】此明五音，乃天地之正气，人之中声也。有声而后有音，
故声为音本，音以声生也。声之余韵则谓之音，非声之外复有音也。
五色命乎五脏，诊人之病，既已审矣；而五音通乎五脏，诊人之病，
亦当明也。角属木通乎肝，微属火通乎心，宫属土通乎脾，商属金通乎肺，
羽属水通乎肾也。
中空有窍，故肺主声。喉为声路，会厌门户。
舌为声机，唇齿扇助。宽隘锐钝，厚薄之故。
【注】此明声音各有所主之诊法也。凡万物中空有窍者皆能鸣焉，
故肺象之而主声也。凡发声必由喉出，故为声音之路也。必因会厌开阖，
故为声音门户也。必借舌为宛转，故为声音之机也。必资之于牙齿唇口，
故为声音之扇助也。五者相须，故能出五音而宣达远近也。若夫喉有宽隘，
宽者声大，隘者声小。舌有锐钝，锐者声辨，钝者不真。会厌有厚薄，
厚者声浊，薄者声清。唇亦有厚薄，厚者声迟，薄者声疾。牙齿有疏密，
疏者声散，密者声聚。五者皆无病之声音，乃形质之禀赋不同也。以此推之，
在喉、在会厌、在舌、在齿、在唇之故，当有别也。
舌居中发，喉音正宫，极长下浊，沉厚雄洪。
开口张颚，口音商成，次长下浊，铿锵肃清。
撮口唇音，极短高清，柔细透彻，尖利羽声。
舌点齿音，次短高清，抑扬咏越，征声始通。
角缩舌音，条畅正中，长短高下，清浊和平。
【注】此明五脏声音不病之常之诊法也。经曰：天食人以五气，
五气入鼻藏于心肺，上使五色修明，声音能彰。故五脏各有正声，
以合于五音也。如舌居中，发音自喉出者，此宫之正音也；其声极长、
极下、极浊，有沉洪雄厚之韵，属土入通于脾。开口张，音自口出者，
此商之正音也；其声次长、次下、次浊，有铿锵清肃之韵，属金入通于肺。
撮口而发，音自唇出者，此羽之正音也；其声极短、极高、极清，
有柔细尖利之韵，属水入通于肾。以舌点齿成音者，乃征之正音也；
其声次短、次高、次清，有抑扬咏越之韵，属火入通于心。
内缩其舌而成音者，乃角之正音也；其声长短、高下、清浊相和，
有条畅中正之韵，属木入通于肝。此五脏不病之常声也。
者，齿本肉也。
喜心所感，忻散之声。怒心所感，忿厉之声。
哀心所感，悲嘶之声。乐心所感，舒缓之声。
敬心所感，正肃之声。爱心所感，温和之声。
【注】前以咽喉、会厌、舌、齿、口唇禀赋不同，以别非病之音。
此又复以人之情、感物成声，以明非病之声也。如为喜感于心者，
则其发声必忻悦以散也。怒感于心者，则其发声必忿急而厉也。
哀感于心者，则其发声必悲凄以嘶也。乐感于心者，则其发声必舒畅不迫也。
敬感于心者，则其发声必正直肃敛也。爱感于心者，则其发声必温柔以和也。
医者于此比类而推不病之音，自可识有病之音也。
五声之变，变则病生，肝呼而急，心笑而雄，
脾歌以漫，肺哭促声，肾呻低微。色克则凶。
【注】此以五声变而生病之诊法也。五声失正，则谓之变，变则病生也。
肝呼而声急，肝声失正，故知病生肝也。心笑而声雄，心声失正，
故知病生心也。脾歌而声漫，脾声失正，故知病生脾也。肺哭而声促，
肺声失正，故知病生肺也。肾呻而低微，肾声失正，故知病生肾也。
所谓色克则凶者，假如肝病呼急，得相克之白色，主凶也。余脏仿此。
好言者热，懒言者寒。言壮为实，言轻为虚。
言微难复，夺气可知。谵妄无伦，神明已失。
【注】此以声音诊病寒热、虚实、生死之法也。《中藏经》
曰：阳候多语、热也，阴候无声、寒也。发言壮厉，实也；
发言轻微，虚也。若言声微小不能出喉，欲言不能复言者，
此夺气也。谵言妄语，不别亲疏，神明失也，皆主死候。
失音声重，内火外寒。疮痛而久，劳哑使然。
哑风不语，虽治命难。呕歌失音，不治亦痊。
【注】此明失音为病不同之诊也。失音声粗重，乃内火为外寒所遏，
郁于肺也。若不粗重，且疮烂而痛，日久流连者，是因劳哑使然也。
小儿抽风不语，大人中风不语，皆谓之哑风，虽竭力治之，
而命则终难挽回，以金不能制木也。讴歌失音者，是因歌伤喉，
不治亦可痊也。
声色既详，问亦当知，视其五人，以知起止。
心主五臭，自入为焦，脾香肾腐，肺腥肝臊。
脾主五味，自入为甘，肝酸心苦，肺辛肾咸。
肾主五液，心汗肝泣，自入为唾，脾涎肺涕。
【注】此明五入问病之诊法也。肺主五声，肝主五色，前已详明，
而问之之道，亦所当知也。经曰：治之极于一。一者，
问其因而得其情也。其要在视其五入，即可以知病情之起止也。
假如心主五臭，凡病者喜臭、恶臭，皆主于心，此统而言之也。
若分而言之，则自入喜焦，病生心也；入脾喜香，病生脾也；
入肾喜腐，病生肾也；入肺喜腥，病生肺也；入肝喜臊，病生肝也。
脾主五味，凡病者喜味、恶味，皆主于脾，此统而言之也。
若分而言之，则自入喜甘，病生脾也；入肝喜酸，病生肝也；
入心喜苦，病生心也；入肺喜辛，病生肺也；入肾喜咸，病生肾也。
肾主五液，凡病者多液、少液，皆主于肾，此统而言之也。
若分而言之，则自入出而为唾，病生肾也；入心出而为汗，
病生心也；入肝出而为泪，病生肝也；入脾出而为涎，病生脾也；
入肺出而为涕，病生肺也。其声之微壮，色之顺逆，法同推也。
百病之常，昼安朝慧，夕加夜甚，正邪进退。
潮作之时，精神为贵，不衰者实，困弱虚累。
【注】此以问知精神盛衰、虚实之诊法也。凡病朝慧者，
以朝则人气始生，卫气始行，故慧也。昼安者，以日中则人气长，
长则胜邪，故安也。夕加者，以夕则人气始衰，邪气始生，故加也。
夜甚者，以夜半则人气入脏，邪气独居于身，故甚也。此百病消长，
邪正进退之常也，凡病来潮发作之时，精神为贵者，以病至精神不衰，
则为邪气不能胜正，正气实也；病至精神困弱，则为正气不能胜邪，
正气虚也。
昼剧而热，阳旺于阳。夜剧而寒，阴旺于阴。
昼剧而寒，阴上乘阳。夜剧而热，阳下陷阴。
昼夜寒厥，重阴无阳。昼夜烦热，重阳无阴。
昼寒夜热，阴阳交错，饮食不入，死终难却。
【注】此以问知昼夜起居，诊病阴阳、气血、生死之法也。
昼，阳也；热，阳也。凡病，昼则增剧烦热，而夜安静者，
是阳自旺于阳分，气病而血不病也。夜，阴也；寒，阴也。
凡病，夜则增剧寒厥，而昼安静者，是阴自旺于阴分，
血病而气不病也。凡病，昼则增剧寒厥而夜安静者，
是阴上乘于阳分之病也。凡病，夜则增剧烦热而昼安静者，
In all diseases, if the facial color dissipates like clouds scattering, it indicates that the illness is about to heal and is easy to treat; if the color gathers and stagnates, it indicates that the illness is progressing and is difficult to treat.
The previous section distinguished between favorable (Shun) and unfavorable (Ni) conditions based on internal/external, upper/lower, and left/right aspects; this section distinguishes them based on the depth, clarity/darkness, and aggregation/scattering of the color.
Black appearing in the Tian Ting (central forehead) and red appearing on both cheekbones, shaped like a thumb, indicate that even if the illness temporarily improves slightly, sudden death will inevitably occur.
Blackish-green lips and face, black appearance rising around the five sense organs, resembling smudged sweat powder, and white complexion all indicate death.
[Note] This clarifies the method of diagnosing sudden death based on abnormal colors. "Appearing like a thumb" refers to the color forming blocks or strips, aggregating without dispersing.
Black appearing in the Tian Ting like a thumb, and red appearing on both cheekbones like a thumb, are signs of water and fire clashing; thus, although the patient may temporarily improve slightly, sudden death will inevitably occur.
If the patient's lips and face are cyan-black, and the five sense organs suddenly appear black or white, resembling smudged sweat powder, even if they are not ill, these signs all indicate sudden death.
A favorable color indicates no illness, which is logically correct; an unfavorable color indicating no illness must portend disaster.
Sunken and weak five sense organs, non-protruding Tian Ting and Que Zhong (area between eyebrows), low and small Fan Bi (cheek sides near ears) indicate longevity despite the lack of illness, provided the spirit is strong.
[Note] This clarifies the diagnostic method of seeing the color but not the disease. A favorable color is a good color where Qi and color arrive together; logically, such a person should not be ill. An unfavorable color is a deep, stagnant, and dark color; even if such a person is not ill, it must portend disaster.
Disaster refers to what physiognomists call: red indicates anxiety and oral disputes, white indicates punishment and mourning, black indicates unnatural disaster and violent death, and green indicates worry, litigation, and sudden death.
Sunken and weak five sense organs refer to sunken bones and thin flesh around the five sense organs. Non-protruding Tian Ting and Que Zhong refer to the Tian Ting and Que Zhong areas not being full and prominent. Low and small Fan Bi refers to the cheek sides and ear gates being low and narrow.
These are all forms indicating short life without illness; if unfavorable colors are added, how could one endure them! Those who do not fall ill must have spirits and Qi that are robust and match their physical form.
Liver disease manifests as irritability; the complexion should be green. There is moving Qi on the left side, tendon spasms, and hypochondriac pain.
Various wind diseases cause tremors and dizziness, hernia, deafness, blurred vision, and a feeling of being pursued or frightened.
[Note] The following five paragraphs clarify the diagnostic methods for colors matching diseases, primary organ self-diseases, and deficiency/excess patterns. Irritability is the emotion of the Liver; thus, when ill, one tends to be irritable. Green is the color of the Liver; thus, when ill, the complexion should be green.
The location of the Liver is on the left; thus, when ill, there is moving Qi and pain in the left hypochondrium. The Liver governs tendons; thus, when ill, tendon spasms occur.
"Tremor" refers to shaking and convulsions. "Dizziness" refers to darkness and unclear vision. The Liver governs Wind; thus, when ill, tremors and dizziness occur.
Hernia belongs to the Liver; thus, when ill, hernia occurs. The Liver and Gallbladder are interior-exterior partners; thus, when ill, deafness occurs. These are all Liver Excess diseases.
If the Liver is Deficient, vision becomes blurred and unclear because the Liver opens into the eyes. Liver Deficiency leads to thin Gallbladder Qi,
causing frequent feelings of fear as if being pursued.
Heart color is red; emotion is joy. The tongue is red with dry mouth. There is moving Qi above the navel, and chest/heart pain and vexation.
Forgetfulness, palpitations, and restlessness are symptoms. Excess causes mania and coma; Deficiency causes sadness and despair.
[Note] Joy is the emotion of the Heart; thus, when ill, one tends to feel joyful. Red is the color of the Heart; thus, when ill, the complexion is red.
The Heart opens into the tongue; thus, when ill, the tongue is red. The Heart governs Heat; thus, when ill, there is dry mouth and heart vexation.
The location of the Heart is upper; thus, when ill, there is moving Qi above the navel. The chest is the palace of the Heart and Lungs;
thus, when ill, there is chest and heart pain. Forgetfulness, palpitations, and restlessness are all diseases of unsettled Heart Spirit.
Heat invading Heart Excess causes mania and coma. Spirit weakness and Heart Deficiency cause sadness and despair.
Spleen color is yellow; emotion is worry. There is moving Qi at the navel. There is excessive thinking, poor appetite, fatigue, and weakness.
Abdominal fullness, borborygmus, pain, and diarrhea occur. Excess causes heavy body, fullness, and constipation.
[Note] Yellow is the color of the Spleen; thus, when ill, the complexion is yellow. Worry and thought are the emotions of the Spleen; thus, when ill, one tends to worry and think.
The location of the Spleen is central; thus, when ill, there is moving Qi at the navel. The Spleen governs taste; thus, when ill, appetite is poor. The Spleen governs the four limbs;
thus, when ill, there is fatigue and weakness. The Spleen governs the abdomen; thus, when ill, there is abdominal fullness, borborygmus, pain, and diarrhea.
These are all Spleen Deficiency diseases. The Spleen governs flesh; thus, in Excess, there is heavy body, abdominal fullness, and constipation.
Lung color is white; emotion is grief. There is moving Qi to the right of the navel. Chills and fever occur. Cough, expectoration, and sneezing happen.
Wheezing and rapid breathing, skin pain, and chest bi syndrome occur. Deficiency causes shortness of breath and inability to continue breathing.
[Note] White is the color of the Lung; thus, when ill, the complexion is white. Grief is the emotion of the Lung; thus, when ill, one tends to grieve.
The location of the Lung is on the right; thus, when ill, there is moving Qi in the right hypochondrium. The Lung governs skin and hair; thus, when ill, there are chills, fever, and skin pain.
Cough, expectoration, sneezing, and runny nose, wheezing, and rapid breathing are all primary Lung diseases. The chest is the mansion of the Lung;
thus, when ill, there is chest bi and pain. Lung Deficiency leads to less Qi in the chest; thus, wheezing and coughing involve shortness of breath and inability to continue breathing.
Kidney color is black; emotion is fear. There is moving Qi below the navel. Abdominal distension, swelling, and wheezing occur. Urination and defecation are difficult.
Lower back, lower abdomen, and bone pain, along with yawning, occur. The heart feels empty like hunger. Feet are cold and inverted (Jue).
[Note] Black is the color of the Kidney; thus, when ill, the complexion is black. Fear is the emotion of the Kidney; thus, when ill, one tends to fear.
The location of the Kidney is lower; thus, when ill, there is moving Qi below the navel. The Kidney governs Water; thus, when ill, water accumulation causes abdominal distension, swelling,
and wheezing preventing lying down. The Kidney opens into the two yin openings; thus, when ill, urination and defecation are difficult. The Kidney governs bones, and the Kidney and Bladder are interior-exterior partners;
thus, when ill, there is lower abdominal fullness, and pain in the back and bones. The Kidney governs yawning; thus, when ill, there is yawning. Kidney pathogenic factors ascend to attack the Heart;
thus, when ill, the heart feels empty like hunger. All Jue syndromes belong to the lower part; thus, when ill, feet are cold and inverted.
Primary disease with primary color indicates many favorable conditions; mixed disease and color indicates many unfavorable conditions.
Mother overcoming Son is favorable; Son overcoming Mother is unfavorable. Mutual overcoming is unfavorable and ominous; mutual generating is favorable and auspicious.
[Note] This is the diagnostic method of determining favorable/unfavorable and life/death by combining five colors with five diseases. For example, Liver disease with green color is primary disease with primary color.
If another color is seen instead, it is mixed disease and color. If black is seen, it is Mother overcoming Son, a favorable condition of mutual generation.
If red is seen, it is Son overcoming Mother, an unfavorable condition of mutual generation. If yellow is seen, the disease overcomes the color; the illness does not worsen,
which is favorable within the ominous. If white is seen, the color overcomes the disease; the illness worsens,
which is unfavorable within the ominous. Saying "mutual overcoming is unfavorable and ominous" means that while mutual overcoming is ominous, favorable within the ominous is acceptable. Unfavorable within the ominous is definitely ominous. Saying "mutual generating is favorable and auspicious" means that mutual generation is auspicious;
for example, Son overcoming Mother is a minor unfavorable within the auspicious; Mother overcoming Son is a major favorable within the auspicious. The other four Zang organs follow this pattern.
Colors originate from the Zang organs, each assigned to its region. Spirit resides in the Heart, manifesting externally in the eyes.
Dark and dim light indicates short spirit; clear and bright indicates sufficient spirit. Loss of only one (color or spirit) indicates chronic illness; loss of both indicates immediate death.
[Note] This is the method of diagnosing life and death by combining color with the spirit of the two eyes. Five colors originate from the five Zang organs,
each assigned to its region and manifesting on the face. Spirit resides in the Heart; although it cannot be directly identified, its external manifestation is in the eyes.
Observing dim and dark gaze indicates short spirit and impending death. If the eyeballs are clear and bright, distinct and sharp,
this indicates sufficient spirit and no illness. Loss of only one refers to either color or spirit being lost, indicating chronic illness. Loss of both refers to
both color and spirit being lost, indicating immediate death.
Facial and eye colors have corresponding relationships; mixed appearances all indicate death.
Yellow face can be saved; red corners with rash/ulcers; yellow corners indicate recovery; yellow sclera indicates jaundice.
[Note] This is the method of diagnosing illness by combining color with the color of the two eyes. Facial and eye colors have corresponding colors,
such as facial colors: Liver green, Heart red, Spleen yellow, Lung white, Kidney black; eye colors: pupil black,
iris blue-green, sclera white, two corners red. If the eyes are green, red, white, or black, differing from the facial color,
all are called mixed appearances, and the patient is indicated to die. Only a yellow face indicates that Earth has not failed, and the Five Elements provide salvation,
so death does not occur. If both eyes are red in Shang Han (Cold Damage), it is a sign of developing rashes and ulcers.
If both eyes are entirely yellow, it is a sign that the illness is about to heal. If both eyeballs are completely yellow, it indicates the onset of jaundice.
Closed eyes indicate Yin disease; open eyes indicate Yang disease. Blurred vision indicates excess Heat; frequent blinking indicates common epistaxis.
Yang exhaustion presents with upward staring eyes (Dai Yan); Yin depletion presents with blindness. Qi depletion presents with sunken orbits; fixed pupils indicate loss of spirit.
[Note] This is the method of diagnosing life and death of the eyes regarding Yin and Yang. Generally, closed eyes in patients indicate Yin disease; open eyes indicate Yang disease.
Blurred and confused vision, not simply opening eyes, indicates Heat damaging the spirit. Looking and frequently closing eyes,
not simply opening eyes, indicates a common sign of epistaxis. Upward fixed staring eyes are called Dai Yan, indicating Yang exhaustion.
Seeing nothing is called blindness, indicating Yin depletion. Sudden sunken eye orbits indicate Qi depletion.
Fixed pupils not turning indicate loss of spirit.
Since the five colors have been examined, the five tones should also be understood. Sound is the root of tone; tone arises from sound.
The lingering resonance of sound becomes tone, named accordingly. Jue, Zhi, Gong, Shang, Yu constitute the five tones.
[Note] This clarifies that the five tones are the righteous Qi of Heaven and Earth, and the moderate sound of humans. Sound exists before tone;
thus, sound is the root of tone, and tone arises from sound. The lingering resonance of sound is called tone; there is no tone outside of sound.
Five colors correspond to the five Zang organs; having diagnosed the illness by examining colors,
one must also understand that five tones correspond to the five Zang organs. Jue belongs to Wood and corresponds to the Liver; Zhi belongs to Fire and corresponds to the Heart; Gong belongs to Earth and corresponds to the Spleen; Shang belongs to Metal and corresponds to the Lung;
Yu belongs to Water and corresponds to the Kidney.
Hollow and perforated, the Lung governs sound. The throat is the pathway of sound; the epiglottis is the gate.
The tongue is the mechanism of sound; lips and teeth assist. Width, narrowness, sharpness, and bluntness result from thickness and thinness.
[Note] This clarifies the diagnostic method where sounds are governed by different parts. All hollow and perforated things can resonate;
thus, the Lung resembles this and governs sound. All vocalization must exit through the throat; thus, it is the pathway of sound. It requires the opening and closing of the epiglottis;
thus, the epiglottis is the gate of sound. It relies on the tongue for articulation; thus, the tongue is the mechanism of sound. It depends on teeth and lips;
thus, teeth and lips assist in sound production. These five elements interact; thus, the five tones can be produced and conveyed far and wide. Regarding the throat, if wide,
the sound is loud; if narrow, the sound is soft. If the tongue is sharp, the sound is distinct; if blunt, the sound is indistinct. If the epiglottis is thick,
the sound is turbid; if thin, the sound is clear. Lips also vary in thickness; thick lips produce slow sound, thin lips produce fast sound. Teeth vary in density;
sparse teeth produce scattered sound, dense teeth produce focused sound. These five types of sound without illness are due to differences in physical endowment. Inferring from this,
there should be distinctions in the throat, epiglottis, tongue, teeth, and lips.
Tongue centered produces sound; throat tone is correct Gong, extremely long, low, and turbid, deep, thick, and majestic.
Mouth open and jaw raised produces Shang tone, next long, low, and turbid, resonant and clear.
Pursed lip tone is extremely short, high, and clear, soft, fine, penetrating, and sharp Yu tone.
Tongue touching teeth tone is next short, high, and clear, modulating and soaring, Zhi tone begins to connect.
Jue tone involves retracting the tongue, smooth and central, varying in length and pitch, balanced in clarity and turbidity.
[Note] This clarifies the normal diagnostic method of the five tones when not ill. The Classic says: Heaven feeds humans with five Qi,
entering the nose and storing in the Heart and Lungs, making the five colors bright and the sound clear. Thus, each Zang organ has a correct tone,
corresponding to the five tones. For example, tongue centered, sound emerging from the throat, is the correct Gong tone; its sound is extremely long,
extremely low, extremely turbid, with a deep, grand, and vigorous rhyme, belonging to Earth and connecting to the Spleen. Mouth open and jaw raised, sound emerging from the mouth,
is the correct Shang tone; its sound is next long, next low, next turbid, with a resonant and clear rhyme, belonging to Metal and connecting to the Lung.
Pursed lips to produce sound, emerging from the lips, is the correct Yu tone; its sound is extremely short, extremely high, extremely clear,
with a soft, fine, and sharp rhyme, belonging to Water and connecting to the Kidney. Tongue touching teeth to produce sound is the correct Zhi tone;
its sound is next short, next high, next clear, with a modulating and soaring rhyme, belonging to Fire and connecting to the Heart.
Retracting the tongue internally to produce sound is the correct Jue tone; its sound varies in length, pitch, clarity, and turbidity harmoniously,
with a smooth and central rhyme, belonging to Wood and connecting to the Liver. These are the normal sounds of the five Zang organs when not ill.
Yin is the gum tissue at the base of the teeth.
Joy felt by the Heart produces a joyful and dispersed sound. Anger felt by the Heart produces an angry and harsh sound.
Sorrow felt by the Heart produces a mournful and hoarse sound. Happiness felt by the Heart produces a relaxed and slow sound.
Reverence felt by the Heart produces a upright and solemn sound. Love felt by the Heart produces a gentle and harmonious sound.
[Note] Previously, differences in endowment of the throat, epiglottis, tongue, teeth, and lips were used to distinguish non-ill sounds.
Here, human emotions and responses to stimuli producing sound are used to clarify non-ill sounds. For instance, if Joy affects the Heart,
the vocalization will be joyful and dispersed. If Anger affects the Heart, the vocalization will be urgent and harsh.
If Sorrow affects the Heart, the vocalization will be mournful and hoarse. If Happiness affects the Heart, the vocalization will be comfortable and unforced.
If Reverence affects the Heart, the vocalization will be upright and restrained. If Love affects the Heart, the vocalization will be gentle and harmonious.
Physicians can infer non-ill sounds by analogy and thus recognize ill sounds.
Changes in the five tones indicate the emergence of disease. Liver calls out urgently; Heart laughs vigorously,
Spleen sings leisurely; Lung cries with hurried voice; Kidney groans softly. Color overcoming indicates ominous outcomes.
[Note] This is the diagnostic method of disease arising from changes in the five tones. Deviation from the correct five tones is called change; change leads to disease.
Liver calls out with urgent voice; Liver tone deviates from correctness, indicating disease originates in the Liver. Heart laughs with vigorous voice; Heart tone deviates,
indicating disease originates in the Heart. Spleen sings with leisurely voice; Spleen tone deviates, indicating disease originates in the Spleen. Lung cries with hurried voice;
Lung tone deviates, indicating disease originates in the Lung. Kidney groans softly; Kidney tone deviates, indicating disease originates in the Kidney.
Saying "color overcoming indicates ominous outcomes" means, for example, if Liver disease manifests as urgent calling, and the corresponding white color (Metal overcoming Wood) is seen, it indicates an ominous outcome. The other organs follow this pattern.
Speaking much indicates Heat; speaking little indicates Cold. Loud speech indicates Excess; quiet speech indicates Deficiency.
Faint speech difficult to repeat indicates Qi depletion. Delirious and chaotic speech indicates loss of Spirit.
[Note] This is the method of diagnosing Cold/Heat, Excess/Deficiency, and life/death using voice. The *Zhong Zang Jing*
says: Yang syndromes speak much (Heat); Yin syndromes are silent (Cold). Loud and fierce speech indicates Excess;
quiet and slight speech indicates Deficiency. If the voice is faint, unable to emerge from the throat, and the patient wishes to speak but cannot continue,
this is Qi depletion. Delirious and nonsensical speech, failing to distinguish relatives and strangers, indicates loss of Spirit, all portending death.
Loss of voice with rough sound indicates internal Heat constrained by external Cold. Chronic sores and pain cause labor-induced aphonia.
Aphonic wind causing silence is hard to cure even with treatment. Singing-induced loss of voice heals without treatment.
[Note] This clarifies the diagnosis of different causes of loss of voice. Loss of voice with rough sound is caused by internal Heat constrained by external Cold,
stagnating in the Lung. If not rough, but accompanied by rotting and painful sores persisting for a long time, it is caused by labor-induced aphonia.
Silence due to pediatric convulsions or adult stroke is called Aphonic Wind; even with diligent treatment,
life is difficult to save, as Metal cannot control Wood. Loss of voice due to singing is caused by throat injury from singing;
it can heal without treatment.
Having detailed voice and color, inquiry should also be known. Observing the five entries allows knowing the progression.
Heart governs five odors; self-entry is scorched; Spleen likes fragrant; Kidney likes putrid; Lung likes fishy; Liver likes rank.
Spleen governs five tastes; self-entry is sweet; Liver likes sour; Heart likes bitter; Lung likes pungent; Kidney likes salty.
Kidney governs five fluids; Heart produces sweat; Liver produces tears; self-entry is saliva; Spleen produces phlegm/spittle; Lung produces mucus.
[Note] This clarifies the diagnostic method of asking about the five entries. Lung governs five sounds, Liver governs five colors, previously detailed;
the method of inquiry should also be known. The Classic says: Treatment culminates in one. One is
asking the cause to obtain the condition. The key lies in observing the five entries, allowing knowledge of the start and end of the illness.
For example, Heart governs five odors; generally, patients' preference or aversion to odors relates to the Heart.
Specifically, self-entry liking scorched odor indicates Heart disease; entering Spleen liking fragrant odor indicates Spleen disease;
entering Kidney liking putrid odor indicates Kidney disease; entering Lung liking fishy odor indicates Lung disease; entering Liver liking rank odor indicates Liver disease.
Spleen governs five tastes; generally, patients' preference or aversion to tastes relates to the Spleen.
Specifically, self-entry liking sweet taste indicates Spleen disease; entering Liver liking sour taste indicates Liver disease;
entering Heart liking bitter taste indicates Heart disease; entering Lung liking pungent taste indicates Lung disease; entering Kidney liking salty taste indicates Kidney disease.
Kidney governs five fluids; generally, patients' excessive or deficient fluids relate to the Kidney.
Specifically, self-entry producing saliva indicates Kidney disease; entering Heart producing sweat indicates Heart disease;
entering Liver producing tears indicates Liver disease; entering Spleen producing spittle indicates Spleen disease;
entering Lung producing mucus indicates Lung disease. The subtlety or loudness of voice, and the favorability of color, are inferred similarly.
Commonality of hundred diseases: peace during day, clarity in morning, worsening in evening, severity at night, reflecting the advance and retreat of righteous and pathogenic factors.
At the time of paroxysm, spirit is precious; unweakened indicates Excess; weakened indicates Deficiency and exhaustion.
[Note] This is the diagnostic method of determining the flourishing/waning and Excess/Deficiency of spirit through inquiry. Patients clear in the morning
are so because human Qi begins to generate and Wei Qi begins to circulate in the morning, hence clarity. Peace during the day
is because human Qi grows at noon, growth overcoming pathogenic factors, hence peace. Worsening in the evening
is because human Qi begins to decline and pathogenic factors begin to arise in the evening, hence worsening. Severity at night
is because human Qi enters the Zang organs at midnight, leaving pathogenic factors alone in the body, hence severity. This is the common waxing and waning of hundred diseases,
the advance and retreat of pathogenic and righteous factors. At the time of paroxysmal illness, if spirit remains unweakened,
it means pathogenic factors cannot overcome righteous factors, indicating righteous Excess; if spirit becomes weakened and exhausted,
it means righteous factors cannot overcome pathogenic factors, indicating righteous Deficiency.
Worsening during day with Heat indicates Yang flourishing in Yang. Worsening at night with Cold indicates Yin flourishing in Yin.
Worsening during day with Cold indicates Yin ascending to overcome Yang. Worsening at night with Heat indicates Yang sinking into Yin.
Chills and cold extremities day and night indicate severe Yin and absence of Yang. Vexation and heat day and night indicate severe Yang and absence of Yin.
Cold during day and Heat during night indicate intermingling of Yin and Yang; inability to eat indicates death is inevitable.
[Note] This is the method of diagnosing Yin/Yang, Qi/Blood, and life/death by inquiring about day/night routines.
Day is Yang; Heat is Yang. Illness worsening with vexation and Heat during day and quiet at night
indicates Yang flourishing in Yang aspect, Qi disease but not Blood disease. Night is Yin; Cold is Yin.
Illness worsening with chills and cold extremities at night and quiet during day
indicates Yin flourishing in Yin aspect, Blood disease but not Qi disease. Illness worsening with chills and cold extremities during day and quiet at night
indicates Yin ascending to the Yang aspect. Illness worsening with vexation and Heat at night and quiet during day,