张景岳曰∶形色者，气之质，神之华，而皆见于面。然易见者形中之色，而难辨者色中之神。
凡病患面赤气盛，必火证。
两颧鲜赤，如脂如缕，余地不赤者，阴虚。
如面红不退，邪甚病进，为难愈。
面色白，气虚。
白兼淡黄而气不足，必失血。
面白枯，血气俱败，证有痰火，尤难治。
面青兼白，阳虚阴胜。
面黄润微赤，必主湿热。
面黄兼青，木邪犯土，多不可治。
面色青苍，主疼痛。
病瘥而面色如煤，终凶。
平人面色如尘，眼下青黑，病至必重。
女人色青，必肝强脾弱，多怒少食，或经脉不调。
颧颊鲜红，有虚火。
若久病患，面转黄苍，此欲愈也。
面肿有虚实，肿为实，浮为虚。实为风火上炎，脉紧数，症寒热，或清或散或下，邪去而肿自消。
虚浮者，无痛无热。
面目浮肺，因脾肺阳虚，输化失常，或肝肾阴虚，水邪泛溢。
然浮而就上，其形虚软者，多由乎气；肿而就下，按而成窝者，多由乎水。实而调之泄之，气虚补之，水虚
化之。然水
气有相因之治，不可执也。眼下如卧蚕者，亦水病。气浮亦有虚实∶虚者多因乎脾，或劳倦色欲，或泻痢中
寒所致，脉必微弱，气必虚馁；实者多因乎胃，或木火炽盛，或纵酒纵食，脉必滑数，症必多热。
Zhang Jingyue stated: Facial appearance and form are the substance of Qi (vital energy) and the brilliance of Shen (spirit), both manifesting on the face. However, what is easily seen is the color within the form, while what is difficult to discern is the spirit within the color.
Whenever a patient presents with a red face and abundant Qi, it must be a Fire syndrome (Fire Zheng).
Bright redness on both cheekbones, resembling grease or threads, while the rest of the face is not red, indicates Yin deficiency (Yin Xu).
If facial redness does not subside, it signifies severe pathogenic factors and advancing disease, making it difficult to cure.
A white complexion indicates Qi deficiency (Qi Xu).
White complexion combined with pale yellow and insufficient Qi necessarily indicates blood loss (Shi Xue).
A dry and withered white face indicates exhaustion of both Qi and Blood (Xue Qi Ju Bai); if the syndrome involves Phlegm-Fire (Tan Huo), it is particularly difficult to treat.
A bluish-green face combined with white indicates Yang deficiency (Yang Xu) and Yin excess (Yin Sheng).
A moist and slightly reddish-yellow face necessarily indicates Damp-Heat (Shi Re).
A yellow face combined with green indicates Wood pathogen invading Earth (Spleen/Stomach), which is often untreatable.
A dark bluish-green complexion indicates pain (Tong Tong).
If the complexion turns soot-black after the illness has subsided, the prognosis is ultimately ominous (Xiong).
In healthy individuals, a dusty complexion with dark circles under the eyes indicates that upon onset of illness, the condition will be severe.
In women, a bluish-green complexion necessarily indicates Liver excess (Gan Qiang) and Spleen weakness (Pi Ruo), characterized by irritability, poor appetite, or irregular menstruation.
Bright redness on the cheekbones and cheeks indicates Deficient Fire (Xu Huo).
If a chronic patient’s complexion turns yellowish and ashen, this indicates impending recovery.
Facial swelling has distinctions between Excess (Shi) and Deficiency (Xu); firm swelling is Excess, while pitting edema is Deficiency. Excess type results from Wind-Fire flaming upward, with tight and rapid pulse, symptoms of chills and fever; treatment may involve clearing, dispersing, or purging methods, and once pathogens are eliminated, the swelling subsides spontaneously.
Deficient puffiness presents without pain or heat.
Edema of the face and eyes relates to the Lung system, caused by Spleen-Lung Yang deficiency leading to impaired transformation and transportation, or Liver-Kidney Yin deficiency causing water pathogen overflow.
However, edema that rises upward with a soft, flaccid shape is mostly due to Qi; swelling that sinks downward leaving an indentation upon pressure is mostly due to Water. For Excess conditions, use regulating and draining methods; for Qi deficiency, use tonification; for Water deficiency/retention, use resolution/dissipation methods. The treatment of Water and Qi are interrelated and should not be approached rigidly. A silkworm-like fullness under the eyes also indicates Water disease. Qi floating/puffiness also has Excess and Deficiency types: Deficiency type is mostly due to Spleen issues, or caused by fatigue, sexual indulgence, or cold in the middle jiao due to diarrhea/dysentery, presenting with weak and faint pulse and deficient Qi; Excess type is mostly due to Stomach issues, or caused by blazing Wood-Fire, or excessive drinking and eating, presenting with slippery and rapid pulse and symptoms of heat.