Library

(From *Qianjin Fang* and *Yi Fang*)

As a physician, although skilled in pulse diagnosis, if one does not understand how to observe facial complexion and qi color (facial color indicating pathological changes), one has ultimately failed to grasp the essence of diagnosis. Therefore, a proficient physician must be well-versed in the Five Colors (Green/Blue, Red, Yellow, White, Black) to determine life and death and resolve doubts.

When a patient's facial qi color enters the "gateways" (specific facial zones associated with organs), it is an ominous sign; if it does not enter, it is auspicious. If white appears above the Chongmei (area between the eyebrows extending upwards), there is lung disease; if it spreads to the Que Ting (the area between the eyebrows and the forehead), death will occur in summer. If yellow appears on the nose, there is spleen disease; if it spreads to the mouth, death will occur in spring or summer. If green/blue appears at the Renzhong (philtrum), there is liver disease; if it spreads to the eyes, death will occur in autumn. If black appears above the cheekbones, there is kidney disease; if it spreads to the ears, death will occur within six months. If red appears at the Yi (chin/jaw area), there is heart disease; if it spreads to the mouth, death will occur in winter. The so-called "gateways": Que Ting is the gateway of the Lung; Eyes are the gateway of the Liver; Ears are the gateway of the Kidney; Mouth is the gateway of the Heart and Spleen. If any qi color enters these gateways, death ensues. ("Entering" refers to the spreading and connecting of the color. *Su Wen* calls this "Jiao".)

If a patient exhibits four types of qi colors—red, white, green/blue, and black—regardless of severity, if they appear on the Nianshang (the area below the nasal tip and between the eyes), the condition is severe. Only the appearance of yellow suggests recovery. Nianshang is located below the space between the two eyes on the nose. ("Ru" is anciently interchangeable with "Er", meaning 'and' or 'then'.) If black qi color is thin like a rope and spreads to the Four Tombs (areas representing parental longevity in physiognomy) and both cheekbones, death occurs. The Four Tombs are located directly above the eyebrows up to the hairline: the left is the Father's Tomb, the right is the Mother's Tomb, and from the corners of the mouth down to the extreme point of the chin is the Lower Tomb. Observe the seasonal qi colors on these four tombs: In spring, if green/blue qi appears, death occurs at the end of the solar term; in summer, if red qi appears, death occurs at the end of the solar term; in late summer and autumn, if white qi appears, death occurs at the end of the solar term; in winter, if black qi appears, death occurs at the end of the solar term. In spring, if yellow qi appears, sudden death occurs; if white qi appears, death occurs in autumn or at Lixia (Start of Summer). In summer, if white qi appears, sudden death occurs; if black qi appears, death occurs in winter or at Xiazhi (Summer Solstice). In autumn, if green/blue qi appears, sudden death occurs; if red qi appears, death occurs at the end of the solar term, or in summer, or at Dongzhi (Winter Solstice). In winter, if red qi appears, sudden death occurs; if yellow qi appears, death occurs in late summer or at Chunfen (Spring Equinox). (Seeing the qi color corresponding to the organ itself or the color that controls it leads to death at the end of the solar term, or when that solar term arrives, or when the controlled element fails. Seeing the color controlled by the organ leads to sudden death. Why? One case is self-disease due to inability to withstand; the other is counter-restriction (Fan Wu), where the original qi fails.)

If yellow qi color enters the nose from the mouth and spreads to Jing (located in the curved part above the nostrils) and Zao (located one cun above the sides of the mouth corners), death occurs in 100 days. If black crosses horizontally over Nianshang, death occurs within 100 days.

If Tianzhong (the area straight up from the nose to the hairline) shows black spreading from the hairline and all four tombs, death occurs in three years. If black spreads from the cheekbones in response, death occurs in 200 days. Tianzhong is located straight up from the nose to the hairline. If black crosses horizontally under the eyes through Nianshang, death occurs within 30 days. If black enters the mouth and corresponds with Tianzhong, death occurs within one year. (*Mai Jing* states: If black qi emerges from Tianzhong and descends to Nianshang and cheekbones, death ensues.)

If Tianzhong emits black qi, and Nianshang and Mingmen (in physiognomy, Mingmen is in front of the ears, and Minggong is between the eyebrows) emit yellow qi, the prognosis is mixed (half good, half bad), dominated by Tianzhong, with death occurring within five years. Tianzhong emitting black qi indicates death within three years according to method; however, because there are two places allowing for survival, death is delayed to five years.

If Tianzhong emits black qi, and red qi spreads from both cheekbones in response, death from violence/war occurs within 60 days. If red qi spreads from Nianshang in response, death occurs within 30 days. If red qi spreads from Mingmen in response, death occurs within 100 days in the marketplace (or implies unnatural death); this applies similarly to women dying in childbirth or from violence.

If green/blue appears like a needle under the eyes, death occurs in spring, or on Jia/Yi days. (Physiognomy holds that if a woman has dark green/blue under her eyes, she will subdue/harm her husband.)

If yellow qi enters the eyes and surrounds them completely, death occurs on Wu/Ji days.

If red qi rushes down from the eyebrows into the eyes, death occurs in five days, or on Bing/Ding days. If red qi enters the mouth, death occurs in three days, or later on Bing/Ding days.

If black appears above the left and right eyebrows, death occurs in one day, or on Ren/Gui days. If white also appears, death occurs, or on Geng/Xin days, or within two to three days. If black enters the eyes from Tianzhong and Nianshang, death occurs in three days, or on Ren/Gui days, or in 100 days, or in half a year. If black moves upward along the nasal bridge or enters the eyes, death occurs on Ren/Gui days, or later in 20 days. If it enters the nose and ears, death occurs in three days. ("Zhun" refers to the nasal tip. "Xing" means moving without fixed position on Shoushang or Nianshang.) If black crosses horizontally from both cheekbones into the nose, death occurs in one year. If black is as large as a thumb above the eyebrows, sudden death occurs within one year, or another view says three years. (The previous statement about black above the eyebrows causing death in one day referred to severe illness; this refers to signs in healthy individuals.) If black circles around the eyes from the eyebrows, death ensues. Red on both sides of the mouth indicates death. Black surrounding the mouth like deep lacquer, or white, both indicate death.

If a patient's face loses luster and looks like earth, and they do not eat, death occurs in four days. If a patient or even a healthy person's face suddenly looks like a horse's liver—greenish from afar and blackish up close—they will suffer sudden death. Red like a horse, black like a crow appearing on the face indicates death. (Original note: Left side of mouth is Crow, right is Horse; this is incorrect.)

If liver disease seems to improve slightly but then causes sudden death, and green/white spots the size of a thumb appear on the cheeks, sudden death is certain. Before liver disease, the eyes lose their luster/color. If liver disease leads to death, the eyes lose their essence. If the colors in Tianzhong and the tombs correspond, death is inevitable and untreatable. By observing the increase or decrease of colors, one can estimate the duration: long-term cases die within 400 days, short-term cases within ten days.

If heart disease seems to improve slightly but then causes sudden death, and dark red/black spots like chess pieces appear on the face extending to Nianshang, sudden death is certain. Before heart disease, the mouth opens wide. If heart disease leads to death, the complexion becomes withered and black, and the voice becomes unresonant. If the colors in Tianzhong and the tombs correspond, death is inevitable and untreatable. By observing the increase or decrease of colors, one can estimate the duration: long-term cases die within 400 days, short-term cases within ten days.

If spleen disease seems to improve slightly but then causes sudden death, and green/black spots the size of a thumb appear on the cheeks, sudden death is certain. Before spleen disease, the lips become dry and withered. If spleen disease leads to death, the lips become dry, green/white, gradually shrinking and tightening, and the teeth clench shut. If the colors in Tianzhong and the tombs correspond, death is inevitable and untreatable. By observing the thickness of the color, one can judge the duration: long-term cases die in less than 400 days, short-term cases within ten days.

If lung disease seems to improve slightly but then causes sudden death, and red/black spots the size of a thumb appear on the cheeks, sudden death is certain. Before lung disease, the nose becomes open and dry/withered. If lung disease leads to death, the nose bridge collapses, nostrils close, and the color becomes green/black. If the colors in Tianzhong and the tombs correspond, death is inevitable and untreatable. By observing the depth of the color, one can estimate the duration: long-term cases do not exceed one year, short-term cases do not drag on for months.

If kidney disease seems to improve slightly but then causes sudden death, and yellow/black spots the size of a thumb appear corresponding to the ears, sudden death is certain. Before kidney disease, the ears become dry and withered. If kidney disease leads to death, the ears become black, dry, and develop nodules. If the colors in Tianzhong and the tombs correspond, death is inevitable and untreatable. By observing the increase or decrease of colors, one can estimate the duration: long-term cases die within 400 days, short-term cases within ten days.

For the auspicious and inauspicious colors of the Five Zang Organs appearing in specific regions: In liver disease, if green/white naturally enters the eyes, death is certain within the year. If Nianshang does not show corresponding signs, disaster will strike within three years. In heart disease, if red/black enters the mouth, death is certain within the year, termed "Walking Corpse." If Nianshang shows no corresponding signs, death will occur within three years. In spleen disease, if black/yellow appears and enters the lips, death occurs within the year; if Nianshang shows no corresponding signs, disaster will strike within three years. In lung disease, if red/white naturally enters the nose, illness is certain within the year; if Nianshang shows no corresponding signs, disaster will manifest within three years. In kidney disease, if the color in Tianzhong is irregular, this relates to the positions of Yin and Yang officials. Physiognomy states that unless one suffers legal troubles, death will ensue. If the face and eyes are yellow/black, extending to both sides of the ears, and the person is over forty years old, death occurs in 100 days. If it appears on only one side, it is most ominous and fatal. If present on both sides but not on Nianshang, disaster will strike within three years.