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Observe the body shape and facial color to distinguish the causes. When Yin is weak and Yang is strong, the method reveals hardness and softness (indicating the balance of Yin and Yang). If it is Shanghan (Cold Damage), both feet are cold; to know there is heat inside, examine the abdomen. A cold nose indicates Chuangzhen (sores and rashes); cold ears indicate Fengre Zheng (Wind-Heat syndrome). Whole-body fever indicates Fenghan (Wind-Cold); upper body heat and lower body cold indicate Shisheng Bing (Food Stagnation Disease).

If Xin Jing (Heart Meridian) has Cold, the eyes lack luster; a red face indicates Re Bing (Heat Disease). Redness at Shan Gen (root of the nose) suggests Jing Si Zu (Fright affecting four limbs); observing accumulation involves looking for Yin-Yang changes in empty spaces. If Gan Jing (Liver Meridian) has Cold, the complexion is green; if there is Heat, the shoulders and eyelids become red. White hairline suggests Jing Feng Ru (Fright-Wind invasion); yellow Shi Cang (Food Granary acupoint on index finger) indicates deep Food Accumulation. Spleen Cold should be known by yellow complexion; Bai Se (White color) in San Yang (Three Yang meridians) brings disaster from Heat. Green at the hairline generates Jing Hou (Fright condition); yellow lips and mouth indicate Ji Shang (Accumulation injury). Lung Meridian white face is due to Cold; Heat and redness at Ren Zhong (philtrum) and mouth tip. Green at Shan Gen indicates Fright affecting four limbs; Heat at hairline makes Accumulation an enemy. Black face indicates Shen Chang Han (Kidney and Intestine Cold); red Shi Cang requires checking for Heat; yellow Feng Men (Wind Gate acupoint) indicates Wind invasion. Slight heaviness of face and eyes, with redness on both sides, indicates Feng Re (Wind-Heat). Green face details Jing (Fright). Heart and Liver forms appear here. Pulse and symptoms distinguish Wen Liang (Warmth and Coolness). Spleen deficiency leads to Huang Gan Ji (Yellow Malnutrition Accumulation); Xu Han (Deficiency Cold) presents as pale/white complexion. If black Qi appears, Kidney fails and life perishes.

Yu Ci (Fish Bone pattern) indicates Jing Feng Zheng (Fright-Wind Syndrome) without doubt. Qi Guan (Qi Pass, second segment of fingernail fold) indicates Gan Bing (Malnutrition Disease) with accompanying Heat. Ming Guan (Life Pass, third segment) appearing here is difficult to treat; this is Liver disease transmitting to Spleen. Initial segment Xuan Zhen (Hanging Needle pattern) with Qi Guan pulse heat is more suspicious. Three segments penetrating straight approach Huang Quan (Yellow Springs/Death); this condition must be known as Man Pi Feng (Slow Spleen Wind). Shui Zi (Water Character pattern) generates Fright, Lung receives Wind. Qi Guan coughing with phlegm accumulation attacks. Physicians must carefully distinguish Deficiency and Excess. Exiting Ming Guan, Fright-Malnutrition Fire Syndrome is fierce. Yi Zi (Yi Character pattern) indicates Fright following Liver and Lung. Qi Guan form appears with irregular onset. If this form penetrates straight to Ming Guan, Slow Spleen Wind will soon follow. Qu Chong (Curved Worm pattern) as a sign governs generating Gan Bing (Malnutrition). If Qi Guan shows accumulated filth in Liver. Reaching Ming Guan is incurable. Know that Heart has transmitted to Liver. Double Rings indicate Liver suffering deep Gan (Malnutrition). Entering Stomach Qi Guan, vomiting and reversal occur. If Ming Guan appears, it is a death omen, causing physicians to labor in vain. Liu Zhu (Flowing Pearl pattern) appearing signals approaching death. Facial signs like this are not deep (or: though superficial, they are critical). Even with divine pills, rescue is impossible. Physicians must be careful and earnestly admonish.