四诊以望居首、以切居末者，医师临诊之次第，非法之有轻重缓急也。前人每谓切脉为末，三诊为本，
及其着书立说，又详于脉而略于三者。明·李言闻着《四诊发明》，无传本。欲求四诊之全书，戛戛乎其不可
得。学海初尝致力脉法，临诊略能测人血气之寒热虚实矣，四诊未全，尚多隔阂。夫望闻问有在切之先者，必
待切以决其真也；有在切之后者，指下之疑又待此以决其真也。三法之与切脉，固互为主辅矣。
三法之中，又望为主而闻问为辅。古人洞见五脏症结，即操此术也。《内经》言之至精且详，《难经》、《中
藏经》、《脉经》、《千金方》、《翼方》所述扁鹊、华佗诸法，亦皆明切适用。自是以后，立说者不过约撮
大概，诠释古义，且不能全。是编也，《内经》三诊之文全在，《难经》以下，择其切要，能补《内经》未备
者收之。至于伤寒、温病之舌法，陶节庵、叶天士两家为最着，以其所言，皆其所亲见而施验也。杜青碧
之《金镜录》三十六法，张诞先之《舌鉴》一百二十法，各有专书，无烦摘录焉。署曰《形色外诊简摩》，
以望为三诊之本，故特详也。闻、问事少，附见末篇。将以质世之知者。
甲午仲冬 之
（面窍 体部）
五脏者，肺为之盖，巨肩陷咽，候见其外。心为之主，缺盆为之道， 骨有余，以候 KT 。肝者主为
将，使之候外，欲知坚固，视目大小。脾者主为卫，使之迎粮，视唇舌好恶，以知吉凶。肾者主为外，使之
远听，视耳好恶，以知其性。六腑者，胃为之海，广骸大颈张胸，五谷乃容。鼻隧以长，以候大肠。唇浓人
中长，以候小肠。目下裹大，其胆乃横。鼻孔在外，膀胱漏泄。鼻柱中央起，三焦乃约。此所以候六
腑者也。上下三等，脏安且良矣。
五脏常内阅于上七窍也，故肺气通于鼻，肺和则鼻能知臭香矣。心气通于舌，心和则舌能知五味矣。（五
脏别论曰∶五气入鼻，藏于心肺，心肺有病，而鼻为之不利也。）肝气通于目，肝和则目能辨五色矣。脾气
通于口，脾和则口能知五谷矣。肾气通于耳，肾和则耳能知五音矣。五脏不和，则六腑不通，六腑
不和，则留结为痈。（痈同壅，谓痞满、关格、肿胀之类，非专指疮痈也。）
肝开窍于目，目藏精于肝。肝病在头、在筋。心开窍于耳，耳藏精于心。心病在五脏、在脉。脾开窍
于口，口藏精于脾。脾病在舌本、在肉。肺开窍于鼻，鼻藏精于肺。肺病
在背、在皮毛。肾开窍于二阴，二阴藏精于肾。肾病在溪、在骨。（上面窍之分应脏腑也。头、脏、舌、背、
溪，以体段言，皮毛、肉，脉、筋、骨，以形层言。）
肺应皮，肺合大肠，大肠者皮其应。心应脉，心合小肠，小肠者脉其应。脾应肉，脾合胃，胃者肉
其应。肝应爪，肝合胆，胆者筋其应。肾应骨，肾合三焦、膀胱，三焦、膀胱者腠理毫毛其应。视其外应，以
知其五内，即知所病矣。（膀胱言其气之磅因礴而光大也，又言其体之孤悬无倚而光洁也。爪为筋余，齿为骨余。）
肝生筋，筋生心；心生血，血生脾；脾生肉，肉生肺；肺生皮毛，皮毛生肾；肾生骨髓，髓生肝。心合脉
也，其荣色，（面之色也。）其主肾。肺合皮也，其荣毛，其主心。肝合筋也，其荣爪，其主肺。脾合肉也，
其荣唇，（生气通无论曰∶其华在唇四白。）其主肝。肾合骨也，其荣发，其主脾。（合言其气之所
应也，荣言其血之所华也。此义生气通天。脏气法时二篇最详，以文繁，故录此。）
东风生于春，病在肝，俞在颈项。南风生于夏，病在心，俞在胸胁。西风生于秋，病在肺，俞在肩背。
北风生于冬，病在肾，俞在腰股。中央病在脾，俞在脊。（俞，应也，非俞穴也。金匮真言曰∶春气者病在
头，夏气者病在脏，秋气者病在肩背，冬气者病在四肢。诊要经终、四时刺逆从义均相类，不复琐具。）
肝气之病，内舍 胁，外在关节。心气之病，内舍膺胁，外在经络。脾气之病，内舍心腹，外在肌肉
四肢。肺气之病，内舍膺胁肩背，外在皮毛。肾气之病，内舍腰脊骨髓，外在溪谷 膝。
背为阳，阳中之阳，心也。背为阳，阳中之阴，肺也。
腹为阴，阴中之阴，肾也。腹为阴，阴中之阳，肝也。腹为阴，阴中之至阴，脾也。
肺心有邪，其气留于两肘。肝有邪，其气留于两腋。脾有邪，其气留于两髀。肾有邪，其气留于两 。凡
此八墟者，皆机关之室，真气之所过，血络之所游，邪气恶血固不得住
留，留之则伤筋络骨节，机关不得屈伸，故病挛也。（上并出《内经》。）
三焦者，水谷之道路，气之所终始也。上焦当心下、胃上口，主内而不出，其治在膻中。中焦在胃中脘，
主腐熟水谷，其治在脐旁。下焦当膀胱上口，主分别清浊，出而不内，其治在脐下一寸。故曰三焦，其腑在
气街。（其腑在气街，谓其源在气街之处，即命门也。）
腑会太仓，脏会季胁，筋会阳陵泉，髓会绝骨，（一曰枕骨。）血会膈俞，（王勋臣血府之说，正与此暗
合。）骨会大杼，脉会太渊，气会三焦外一筋直两乳内也。热病在内者，取其会之气穴也。
（上体部之分应脏腑也。诸会谓其气之所聚，非谓其所发源也。上并出《难经》。）
按∶头面七窍可望而知，筋骨血脉不可望也。第事理所关，不容缺略。医者所见谓之望，病者所自见亦
何不可谓之望。又况此篇总义者，实赅闻问于其中，不独文义相连，无可割裂也。
In the Four Diagnostic Methods (Si Zhen, four diagnostic methods), inspection (Wang, observation) is placed first and palpation (Qie, pulse diagnosis) last. This sequence reflects the order of clinical practice by physicians, not that the diagnostic methods themselves have differences in importance or urgency. Predecessors often stated that pulse diagnosis is secondary, while inspection, auscultation/olfaction, and inquiry are fundamental. However, when they wrote books and established theories, they detailed pulse diagnosis while being brief on the other three. Li Yanwen's *Si Zhen Fa Ming* (Invention of the Four Diagnostic Methods) from the Ming Dynasty has no extant copies. To find a complete work on the Four Diagnostic Methods is extremely difficult. I initially devoted myself to studying pulse methods; clinically, I could roughly deduce the cold-heat and deficiency-excess status of a patient's Qi and Blood. Yet, without mastering all four methods completely, there remained many gaps and misunderstandings. Among inspection, auscultation/olfaction, and inquiry, some precede palpation and require palpation to confirm their truth; others follow palpation, where doubts arising from the fingers' touch require these three methods to resolve. Thus, these three methods and pulse diagnosis are indeed mutually supportive.
Among these three methods, inspection is primary, while auscultation/olfaction and inquiry are secondary. The ancients could penetrate to the crux of the Five Zang Organs using this technique. The *Nei Jing* (Inner Canon) discusses it with utmost precision and detail. The *Nan Jing* (Classic of Difficult Issues), *Zhong Zang Jing*, *Mai Jing* (Pulse Classic), *Qian Jin Fang* (Essential Prescriptions Worth a Thousand Gold), and *Wai Tai Mi Yao* (Prescriptions from the Outer Cabinet) describe methods of Bian Que and Hua Tuo, which are also clear, practical, and applicable. Since then, theorists have merely summarized generalities and interpreted ancient meanings, failing to be comprehensive. This compilation includes the full text of the Three Diagnostic Methods from the *Nei Jing*. From the *Nan Jing* onwards, it selects essential content that supplements the deficiencies of the *Nei Jing*. Regarding tongue diagnosis for Shang Han (Cold Damage) and Wen Bing (Warm Diseases), the schools of Tao Jie'an and Ye Tianshi are most renowned, as what they described were based on their personal observations and verified efficacy. Du Qingbi's *Jin Jing Lu* (Record of the Golden Mirror) presents thirty-six methods, and Zhang Danxian's *She Jian* (Mirror of the Tongue) presents one hundred and twenty methods; each has its own specialized book, so excerpting them is unnecessary. The book is titled *Xing Se Wai Zhen Jian Mo* (Brief Elaboration on External Diagnosis of Form and Color), emphasizing inspection as the foundation of the three diagnostic methods, hence it is detailed specifically. Auscultation/olfaction and inquiry involve less content and are appended to the final chapter. This is offered for discussion with knowledgeable people of the world.
Mid-winter of the Jiawu Year
(Facial Orifices and Body Regions Corresponding to Zang-Fu)
The Lung acts as a canopy covering the upper body. If one observes broad shoulders and a depressed throat, the condition of the Lung can be assessed externally. The Heart is the Sovereign; the Keyuan (Supraclavicular Fossa) is the pathway for Heart Qi. If the bones at the Keyuan protrude excessively, it indicates the state of the Heart. The Liver acts as the General, directing observation of the exterior. To know if the Liver is robust, observe the size of the eyes. The Spleen acts as the Guard, receiving nourishment. By observing the condition of the lips and tongue, one can predict auspiciousness or inauspiciousness. The Kidney governs external hearing, allowing distant listening. By observing the condition of the ears, one can understand its nature. Among the Six Fu Organs, the Stomach is like the sea, accommodating grains. If one sees wide skeletal structure, a thick neck, and an expanded chest, it indicates capacity for food intake. A long nasal passage indicates the Large Intestine. Thick lips and a long philtrum indicate the Small Intestine. Swollen lower eyelids indicate excessive Gallbladder Qi. Externally flared nostrils indicate leakage/incontinence of the Bladder. A raised nasal bridge indicates constriction/tightness of the Sanjiao (Triple Burner). These are used to assess the Six Fu Organs. When the upper, middle, and lower sections are balanced, the internal organs are peaceful and healthy.
The Five Zang Organs frequently manifest in the seven orifices above. Therefore, Lung Qi connects to the nose; when Lung Qi is harmonious, the nose can distinguish odors. Heart Qi connects to the tongue; when Heart Qi is harmonious, the tongue can distinguish flavors. (The *Wu Zang Bie Lun* states: "Five qi enter through the nose and are stored in the Heart and Lung. If the Heart and Lung are diseased, the nose becomes obstructed.") Liver Qi connects to the eyes; when Liver Qi is harmonious, the eyes can distinguish five colors. Spleen Qi connects to the mouth; when Spleen Qi is harmonious, the mouth can distinguish the taste of grains. Kidney Qi connects to the ears; when Kidney Qi is harmonious, the ears can distinguish five tones. If the Five Zang Organs are disharmonious, the Six Fu Organs will not communicate; if the Six Fu Organs are disharmonious, stagnation and knotting occur, leading to Yong (obstruction/swelling) syndromes. ("Yong" is synonymous with "Yong" (obstruction), referring to conditions like distension, obstruction-regurgitation, and swelling, not specifically cutaneous abscesses.)
The Liver opens into the eyes, and the essence of the eyes is stored in the Liver. Liver disease manifests in the head and sinews. The Heart opens into the ears, and the essence of the ears is stored in the Heart. Heart disease manifests in the Five Zang Organs and vessels. The Spleen opens into the mouth, and the essence of the mouth is stored in the Spleen. Spleen disease manifests in the root of the tongue and flesh. The Lung opens into the nose, and the essence of the nose is stored in the Lung. Lung disease manifests in the back and skin/hair. The Kidney opens into the two yin openings (urethra and anus), and the essence of these openings is stored in the Kidney. Kidney disease manifests in the muscle interspaces (Xi Gu) and bones. (This describes the correspondence of the seven orifices to the Zang-Fu. Head, Zang, tongue, back, and Xi Gu refer to body segments; skin/hair, flesh, vessels, sinews, and bones refer to structural layers.)
The Lung corresponds to the skin; the Lung pairs with the Large Intestine, and the Large Intestine's function reflects in the skin. The Heart corresponds to the vessels; the Heart pairs with the Small Intestine, and the Small Intestine's function reflects in the vessels. The Spleen corresponds to the flesh; the Spleen pairs with the Stomach, and the Stomach's function reflects in the flesh. The Liver corresponds to the nails; the Liver pairs with the Gallbladder, and the Gallbladder's function reflects in the sinews. The Kidney corresponds to the bones; the Kidney pairs with the Sanjiao and Bladder, and the Sanjiao/Bladder's function reflects in the pores and body hair. Observing external correspondences allows one to know the state of the internal Zang Organs, thereby identifying the disease. (Here, the Bladder refers to its expansive Qi and its isolated, smooth physical form. Nails are the surplus of sinews; teeth are the surplus of bones.)
Liver generates sinews; sinews generate Heart. Heart generates Blood; Blood generates Spleen. Spleen generates flesh; flesh generates Lung. Lung generates skin/hair; skin/hair generates Kidney. Kidney generates Marrow; Marrow generates Liver. The Heart combines with vessels, its flourishing aspect is color (facial complexion), and it is controlled by the Kidney. The Lung combines with skin, its flourishing aspect is hair, and it is controlled by the Heart. The Liver combines with sinews, its flourishing aspect is nails, and it is controlled by the Lung. The Spleen combines with flesh, its flourishing aspect is the lips (The *Sheng Qi Tong Tian Lun* states: "Its brilliance is in the white area around the lips"), and it is controlled by the Liver. The Kidney combines with bones, its flourishing aspect is hair, and it is controlled by the Spleen. ("Combines" refers to the correspondence of Qi; "Flourishing" refers to the manifestation of Blood. This concept is detailed in the *Sheng Qi Tong Tian Lun* and *Zang Qi Fa Shi Lun*; due to length, only this excerpt is recorded.)
East wind arises in Spring, causing disease in the Liver, with corresponding points in the neck and nape. South wind arises in Summer, causing disease in the Heart, with corresponding points in the chest and hypochondrium. West wind arises in Autumn, causing disease in the Lung, with corresponding points in the shoulders and back. North wind arises in Winter, causing disease in the Kidney, with corresponding points in the waist and thighs. Central dampness causes disease in the Spleen, with corresponding points in the spine. ("Corresponding points" here mean areas of correspondence, not specific acupoints. The *Jin Gui Zhen Yan Lun* states: "Spring Qi diseases affect the head; Summer Qi diseases affect the Zang; Autumn Qi diseases affect the shoulders and back; Winter Qi diseases affect the four limbs." The *Zhen Yao Jing Zhong Lun* and *Si Shi Ci Ni Cong Lun* convey similar meanings, so they are not listed exhaustively.)
Diseases of Liver Qi lodge internally in the hypochondrium and externally in the joints. Diseases of Heart Qi lodge internally in the chest and hypochondrium and externally in the meridians and collaterals. Diseases of Spleen Qi lodge internally in the heart and abdomen and externally in the muscles and four limbs. Diseases of Lung Qi lodge internally in the chest, hypochondrium, shoulders, and back and externally in the skin and hair. Diseases of Kidney Qi lodge internally in the waist, spine, and marrow and externally in the muscle interspaces and knees.
The Back is Yang; among Yang, it is Yang within Yang, corresponding to the Heart. The Back is Yang; among Yang, it is Yin within Yang, corresponding to the Lung.
The Abdomen is Yin; among Yin, it is Yin within Yin, corresponding to the Kidney. The Abdomen is Yin; among Yin, it is Yang within Yin, corresponding to the Liver. The Abdomen is Yin; among Yin, it is Extreme Yin, corresponding to the Spleen.
If the Lung and Heart have pathogenic factors, their Qi remains in the two elbows. If the Liver has pathogenic factors, their Qi remains in the two axillae. If the Spleen has pathogenic factors, their Qi remains in the two thighs (Bi). If the Kidney has pathogenic factors, their Qi remains in the two popliteal fossae (Guo). These eight hollows (Ba Xu) are chambers of joint movement, passages of True Qi, and routes of blood collaterals. Pathogenic Qi and evil blood cannot stay here; if they do, they damage sinews, collaterals, and bone joints, preventing flexion and extension, thus causing spasms. (All above from the *Nei Jing*.)
The Sanjiao (Triple Burner) is the pathway for water and grain, and the beginning and end of Qi. The Upper Jiao is located below the Heart and at the upper opening of the Stomach; it governs reception without excretion, and its treatment point is Danzhong. The Middle Jiao is located at the Zhongwan of the Stomach; it governs the rotting and ripening of water and grain, and its treatment point is beside the umbilicus. The Lower Jiao is located at the upper opening of the Bladder; it governs the separation of clear and turbid, excreting without reabsorbing, and its treatment point is one cun below the umbilicus. Thus, the Sanjiao's Fu organ is located at the Qijie (Qi Street). (Saying its Fu organ is at Qijie means its source is at the Qijie, which is the Mingmen.)
The Meeting Point of Fu Organs is Taicui (Zhongwan); the Meeting Point of Zang Organs is Jixie (Zhangmen); the Meeting Point of Sinews is Yanglingquan; the Meeting Point of Marrow is Juegu (one theory says Occiput); the Meeting Point of Blood is Ge Shu; (Wang Xunchen's theory of Blood Mansion aligns secretly with this.); the Meeting Point of Bones is Dazhu; the Meeting Point of Vessels is Taiyuan; the Meeting Point of Qi is outside the Sanjiao, one tendon straight between the two breasts. For interior Heat diseases, select the Qi-acupoints of these Meetings.
(Above describes the correspondence of body regions to Zang-Fu. "Meetings" refer to places where Qi gathers, not necessarily the source of origin. All above from the *Nan Jing*.)
Note: The seven orifices of the head and face can be known through inspection, but sinews, bones, blood, and vessels cannot be directly seen. However, since they are logically related, they cannot be omitted. What the physician sees is called inspection; what the patient sees themselves is also arguably inspection. Moreover, the general meaning of this chapter actually encompasses inquiry and auscultation/olfaction within it; the textual meaning is connected and inseparable.