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Therefore, the sages judge the condition by observing facial color: Yellowish-red indicates abundant heat; bluish-white indicates scanty heat; black indicates abundant blood and scanty qi. Blue and black signify pain; yellow and red signify heat; white signifies cold. Pale and lustrous colors indicate wind disorders; deep and turbid colors indicate bi-syndromes (obstruction syndromes); dull and stagnant colors indicate internal disorders; floating and lustrous colors indicate external disorders.

If "Da Qi" (major pathogenic qi or rebellious qi) enters the Zang-Fu organs, death may occur suddenly without prior obvious symptoms. How is this known? It is said: If a red color appears on both malar eminences, the size of a thumb, even if the illness seems to be slightly improving, sudden death will inevitably follow. If a black color appears on the forehead (Ting), the size of a thumb, sudden death will occur before any illness manifests. (The above discusses diseases governed by the five colors. The Classic states: When Da Qi enters the Zang, it causes abdominal pain and profuse diarrhea, meaning that the vital qi of the whole body has collapsed inward; thus, death can be predicted, but life cannot be restored.)

How are disorders of the skin, flesh, blood vessels, sinews, and bones distinguished? It is said: A pale and lustrous color appearing between the two eyebrows indicates a disorder in the skin. Lips showing blue, yellow, red, white, or black colors indicate a disorder in the muscle layer. Manifestation of abundant Ying-Qi (nutritive qi) indicates a disorder in the blood vessels. Eyes showing blue, yellow, red, white, or black colors indicate a disorder in the sinews. Ears that are dry, withered, and blackened as if covered in dust indicate a disorder in the bones.

The nose is the opening of the Lung. The eyes are the opening of the Liver; the lips are the opening of the Spleen; the tongue is the opening of the Heart; the ears are the opening of the Kidney. Therefore, patients with Lung disorders exhibit panting and nasal flaring; those with Liver disorders have a bluish complexion; those with Spleen disorders have yellow lips; those with Heart disorders have a curled and short tongue with red malar eminences; and those with Kidney disorders have black malar eminences and facial complexion. Each Zang organ has its corresponding location. Thus, the five colors manifesting at Ming Tang (the nasal area) are used to inspect the qi of the five Zang organs, with left and right elevations following specific standards.

The five Wei syndromes (wasting-thirst syndromes) arise from excessive heat. Heat in the Lung presents with a white complexion and hair loss. Heat in the Heart presents with a red complexion and distended collateral vessels. Heat in the Liver presents with a bluish-green complexion and brittle nails. Heat in the Spleen presents with a yellow complexion and twitching muscles. Heat in the Kidney presents with a black complexion and dry teeth. (The above discusses pathological colors of the five Zang organs.)

Facial color corresponds to the Sun, and pulse corresponds to the Moon. Color and pulse should correspond with each other when examined together. If the color is observed but the corresponding pulse is not found, and instead a controlling (overcoming) pulse is obtained, death will ensue; if a generating pulse is obtained, the disease will resolve spontaneously.

For example, if the color is green/blue, the pulse should be wiry and rapid; if red, the pulse should be floating, large, and scattered; if yellow, the pulse should be moderate, slow, and large; if white, the pulse should be floating, choppy, and short; if black, the pulse should be deep, soft, and slippery. This is what is meant by the correspondence of the five colors and pulses. If they do not correspond, the person is ill. For instance, if the color is green/blue but the pulse is floating, choppy, and short, or large and slow, this represents a controlling relationship; if the pulse is floating, large, and scattered, or small and slippery, this represents a generating relationship.

In cases of chronic illness where Zang-Fu functions are activated, thereby affecting the pulse and color, how can one distinguish between new and old onset? It is said: If the pulse is small but the color has not faded, it is a new illness; if the pulse has not faded but the color has faded, it is an old illness; if both the pulse and the five colors have faded, it is an old illness; if neither the pulse nor the five colors have faded, it is a new illness. If the Liver and Kidney pulses are present simultaneously, and the complexion is bluish-red, it suggests injury or trauma without visible bleeding; if bleeding has occurred, it indicates dampness or water poisoning.

A pulse that feels like crumbling earth and vanishes upon pressure indicates insufficiency of muscle qi. If black and white colors appear first and accumulate, death will result. (Commentary: This refers to a floating, soft, and hollow pulse, indicating Yang deficiency and Yin dispersion, described as the Spleen qi departing from the Stomach and returning externally to the Yangming channel.)

A very rapid pulse at the Chi position (cun-kou) accompanied by visible tendon tension is called Zhen Jin (rash in tendons). Abdominal tension combined with white or black facial colors indicates severe disease. (The above discusses the correspondence of color and pulse. Commentary: The character "Shu" (rapid) here likely means "Ji" (urgent/tight), referring to a tight, constricted, and unrelaxed state. "Xian" (appear) refers to the tendons bulging under the skin, indicating deep-seated cold pathogen in the sinews. The appearance of white and black colors indicates cold, crisp, and肃 (clearing) qi connecting internally to the Liver, suppressing the generation of Yang qi and preventing its dissemination.)

Yellowish-red urine with lethargy and desire to lie down indicates Huang Dan (jaundice). Feeling hungry immediately after eating indicates Wei Dan (Stomach jaundice). Yellow eyes indicate Huang Dan. Body pain with a slightly yellow complexion, yellow dental plaque, and yellow nails all indicate Huang Dan. (Chao Yuan-fang states: Jaundice with yellowing of the body and face, prominent dark blue-black veins under the tongue, stiff tongue, and inability to speak is named Jin Huang (jaw-locking jaundice), caused by stasis-heat in the Heart and Spleen. Sudden jaundice with chest fullness, asthma, and imminent death is named Ji Huang (acute jaundice). Some develop jaundice immediately upon contracting the disease; others do not realize they have jaundice until after death, presenting with fever and cardiac tremors upon onset.)

At the onset of Dian Ji (epilepsy/madness), the patient first feels unhappy, experiences heavy head pain, upward gaze, intense redness of the eyes, extreme exhaustion, followed by mental restlessness. Diagnosis is made by observing the face, and treatment involves selecting points from the Hand Taiyang, Hand Yangming, and Hand Taiyin meridians, stopping when the blood color changes. (Qian Zhong-yang states: Upward staring eyes with red cheeks indicate heat in both the Liver and Heart; one must prevent convulsions around noon the next day, which aligns with the meaning of this section. The above miscellaneously discusses jaundice and epilepsy.)