《内经·刺热论》专论赤色所见部位，以决五脏吉凶，已录入面部首篇。又
热病顺逆色证，已录入形部顺逆篇，兹不复赘，以省繁文。
天地不外燥湿，病亦不外燥湿，色亦不外燥湿。燥属天气，色多有光而浮；湿属地气，色多有体而晦。（
光体义见前察色真诀篇。）风燥寒燥，由外搏来，主收敛，收敛则急，面多绷急而光洁。燥搏津液，痰饮外
溢于面，色多红润而浮，夹湿多红润而晦。燥邪化热，色多干红，苗窍干涩，多烦渴，甚则变枯而青黑。枯
而青黑则真阴亏极，而色无光体矣。寒湿内生，色必滞暗，变黄变黑，皆沉晦不明。湿兼风，色润
而浮，多自汗。湿与暑合，与热合，或湿土郁蒸之温邪，三者皆由口鼻吸入，三焦主蒸散，蒸散则缓，面色多
松缓垢晦，甚者浊邪由内蒸而外溢，如油腻烟熏者然。若由湿化燥，则又晦而且干，晦而干则湿邪未去，真阴
又亏，色由无光而无体矣。经言色见部位内应脏腑，外辨病证之说，不可枚举，
亦不能尽拘。所当权于其大，以燥湿二字为纲，以兼风、兼
寒、兼暑、化火、未化火为权衡，以色中之光体为神气，大道不外是矣。（《医原》。）
青色出于太阴太阳，（两额，左为太阳，右为太阴。）及鱼尾正面口角，如大青蓝叶，怪恶之状者，
肝气绝，主死。若如翠羽柏皮者，只是肝邪，有惊病、风病、目病之属。（以下五条出徐春甫《古今医统》。）
红色见于口唇，及三阴三阳上下，如马肝之色，死血之状者，心气绝，主死。若如橘红马尾色者，
只是心病，有怔忡，惊悸，夜卧不宁等证。
白色见于鼻准及正面，如枯骨及擦残汗粉者，为肺绝，丙丁日死。若如腻粉、梅花、白绵者，只是
肺邪，咳嗽之病，有孝服之忧。
黄色见于鼻，干燥如土偶之形，为脾气绝，主死。若如
桂花，杂以黑晕，只是脾病，饮食不快，四肢怠惰，妻外家之累。
黑色见于耳叶廓内外，命门悬壁，如污水烟煤之状，为肾气绝，即死。若如蜘蛛网眼，鸟羽之泽者，
只是肾虚，火邪乘水之病。
肺主气，气虚则色白。肾属水，水涸则面黧。青为怒气伤肝，赤为心火炎上。萎黄者内伤脾胃，紫浊
者外感客邪。惟悴黯黑，必悒郁而神伤；消瘦淡黄，乃久病而体惫。山根明亮，须知欲愈之 ；环口黧黑，
休治已绝之肾。（张三锡。）
面黑为阴寒，面青为风寒。青而黑，主风，主寒，主痛。
黄而白，为湿，为寒，为热，为气不调。青而白，为风，为
气滞，为寒，为痛也。大抵黑气见于面，为病最凶。若暗中有光，准头年寿亮而滋润者生，枯夭者死。（王宇泰。）
黄属脾胃。若黄而肥盛，胃中有痰湿也。黄而枯 ，胃中有火也。黄而色淡，胃中本虚也。黄而色黯，津
液久耗也。黄为中央之色，其虚实寒热之机，又当以饮食便溺消息之。
白属肺。白而薄泽，肺胃之充也。肥白而按之绵软，气虚有痰也。白而消瘦，爪甲鲜赤，气虚有火也。白
而夭然不泽，爪甲色淡，肺胃虚寒也。白而微青，或臂多青脉，气虚不能统血也；若兼爪甲色青，则为阴寒
之证矣。白为气虚之象，纵有失血发热，皆为虚火，断无实热之理。
苍黑属肝与肾。苍而理粗，筋骨劳 也。苍而枯槁，营血之涸也。黑而肥泽，骨髓之充也。黑而瘦削，
阴火内戕也。苍黑为下焦气旺，虽犯风寒，亦必蕴为邪热，绝少虚寒之候。
赤属心主三焦。深赤色坚，素禀多火也。赤而 坚，营血之充也。微赤而鲜，气虚有火也。赤而索泽，
血虚火旺也。赤为火炎之色，只虑津枯血竭，亦无虚寒之患。大抵火形之人，从未有肥盛多湿者，即有痰
嗽，亦燥气耳。（石顽。）
色贵明润，不欲沉夭。凡暴感客邪之病，不妨昏浊壅滞。病久气虚，只宜瘦削清 。若病邪方锐，而清白
少神。虚羸久困，而妩媚鲜泽，咸非正色。五色之中，青黑黯惨，无论病之新久，总属阳气不振。唯黄色见于
面目，而不至索泽者，皆为向愈之候。若眼胞上下如烟煤者，寒痰也。眼黑颊赤者，热痰也。眼黑而行步
艰难，呻吟者，骨节疼痛，痰饮入骨也。眼黑而面带土色，四肢痿痹，屈伸不便者，风痰也。
病患见黄色，光泽为有胃气，干黄者是津液之槁。目睛黄者，
非瘅即衄。目黄大烦为病进。（《三昧》。仲景云∶脉和，其人大烦。目
重，睑内际黄者，为欲解也。不得遽指为病进。）
面目色同为顺，色异为逆。同者谓其如常而未改也，异者谓其一部独异于常也。
面色夭然不泽，其脉空虚，为夺血。伤寒汗不出，大颧发赤，哕者死。颧见青气者死。黄兼青紫，脉
芤者，瘀血在胃，或胁内有块。面上多白点，是虫积。面色青黄白不常，及有如蟹爪路，一黄一白者，主
食积。（亦有白斑如钱大。晕满额面者。）目睛黄者，酒疸；面黄白及肿连眼胞者，谷疸，其人必
心下痞；面黑者，女劳疸，一曰黑疸。明堂眼下青色，多欲劳伤，精神不爽，即夜未睡。（李士材。）
The *Neijing* (Yellow Emperor's Inner Classic) · *Ci Re Lun* (Treatise on Acupuncture for Heat Diseases) specifically discusses the locations where the red color appears on the face to determine the auspicious or inauspicious outcomes of the five Zang organs. This has been recorded in the first chapter on facial inspection. Furthermore, the facial signs of favorable and unfavorable courses of heat diseases have been recorded in the chapter on favorable and unfavorable signs of body shape; thus, there is no need to repeat them here to avoid redundancy.
Heaven and Earth are nothing but dryness and dampness; diseases are nothing but dryness and dampness; and facial colors reflect nothing but dryness and dampness. Dryness belongs to Heavenly Qi, and the color often appears lustrous and floating; Dampness belongs to Earthly Qi, and the color often appears substantial and dull. (For the meaning of "luster" and "substance," see the previous chapter on the True Principles of Facial Inspection.) Wind-dryness and Cold-dryness come from external invasion, governing contraction. Contraction leads to tension, so the face often appears tight, urgent, and smooth. If Dryness combines with Body Fluids, causing Phlegm-Fluids to overflow onto the face, the color tends to be ruddy and floating; if combined with Dampness, it is ruddy yet dull. When Dryness pathogen transforms into Heat, the color tends to be dry red, with dry and astringent orifices (Miao Qiao), accompanied by irritability and thirst. In severe cases, it changes to withered cyan-black. Withered cyan-black indicates extreme deficiency of True Yin, resulting in a loss of both luster and substance. Internal Cold-Dampness causes the color to be stagnant and dark; changes to yellow or black all appear deep, dull, and unclear. Dampness combined with Wind results in a moist and floating color, often with spontaneous sweating. Dampness combined with Summerheat or Heat, or Warm pathogens generated by the stagnation and steaming of Damp-Earth, are all inhaled through the mouth and nose. The San Jiao (Triple Burner) governs steaming and dispersing; this dispersion leads to relaxation, so the facial color often appears loose, greasy, and dull. In severe cases, turbid pathogens steam internally and overflow externally, resembling oil stains or smoke soot. If Dampness transforms into Dryness, the color becomes both dull and dry. Dullness and dryness indicate that the Damp pathogen remains while True Yin is also deficient, leading to a loss of luster and substance. The classic theory states that the location of facial color corresponds internally to the Zang organs and externally differentiates diseases. These theories are too numerous to enumerate and cannot be rigidly adhered to. One should grasp the general principles, using "Dryness" and "Dampness" as the main纲 (guiding principles), weighing factors such as combinations with Wind, Cold, Summerheat, transformation into Fire, or non-transformation into Fire, and using the luster and substance within the color to assess Shen Qi (Spiritual Energy). The Great Dao does not go beyond this. (From *Yi Yuan*.)
Cyan color appearing in the Taiyin and Taiyang areas (the two temples, left is Taiyang, right is Taiyin), as well as at the corners of the eyes (fish tail), forehead, and mouth corners, looking like large indigo leaves or having a grotesque and repulsive appearance, indicates Liver Qi exhaustion and signifies death. If the color resembles kingfisher feathers or cypress bark, it merely indicates Liver pathogen involvement, belonging to disorders of fright, wind, or eyes. (The following five items are from Xu Chunfu's *Gu Jin Yi Tong*.)
Red color appearing on the lips and throughout the three Yin and three Yang channels, resembling the color of horse liver or showing signs of dead blood stasis, indicates Heart Qi exhaustion and signifies death. If the color resembles orange-red or horsehair, it merely indicates Heart disease, accompanied by symptoms such as palpitations, fright, and restless sleep at night.
White color appearing on the tip of the nose and the center of the face, resembling bleached bones or leftover sweat powder, indicates Lung exhaustion and predicts death on Bing-Ding days. If the color resembles fine white powder, plum blossoms, or white cotton, it merely indicates Lung pathogen involvement, belonging to cough diseases, possibly associated with mourning attire (bereavement).
Yellow color appearing on the nose, dry and shaped like a clay idol, indicates Spleen Qi exhaustion and signifies death. If the color resembles osmanthus flowers mixed with dark halos, it merely indicates Spleen disease, characterized by poor appetite, lethargy of the four limbs, and burdens related to the wife's family.
Black color appearing inside and outside the ear cartilage and the hanging wall of Mingmen (below the earlobe), resembling muddy water or coal smoke, indicates Kidney Qi exhaustion and signifies immediate death. If the color resembles spider web holes or the gloss of bird feathers, it merely indicates Kidney deficiency, representing a disorder where Fire pathogen attacks Water.
The Lungs govern Qi; Qi deficiency leads to a white complexion. The Kidneys belong to Water; Water depletion leads to a dark complexion. Cyan color results from anger injuring the Liver; Red color results from Heart Fire flaring upward. Withered yellow results from internal injury to the Spleen and Stomach; Purple-turbid color results from external invasion by guest pathogens. Haggard and dark-black complexions must stem from depression damaging the Spirit; emaciated and pale-yellow complexions result from chronic illness exhausting the body. A bright Shangen (root of the nose) indicates impending recovery; a black ring around the mouth indicates irrecoverable Kidney exhaustion and should not be treated. (Zhang Sanxi.)
A black face indicates Yin-Cold; a cyan face indicates Wind-Cold. Cyan and black together indicate Wind, Cold, and Pain. Yellow and white together indicate Dampness, Cold, Heat, and Qi imbalance. Cyan and white together indicate Wind, Qi stagnation, Cold, and Pain. Generally, black Qi appearing on the face indicates the most ominous illness. However, if there is luster within the darkness, and the nose tip and Nianshou area are bright and moist, life is preserved; if withered and premature, death ensues. (Wang Yutai.)
Yellow belongs to the Spleen and Stomach. If yellow and fat, there is Phlegm-Dampness in the Stomach. If yellow and withered, there is Fire in the Stomach. If yellow and pale, the Stomach is originally deficient. If yellow and dark, Body Fluids have been long consumed. Yellow is the color of the Center; its mechanisms of deficiency/excess and cold/heat should be discerned through diet and urination/defecation.
White belongs to the Lungs. White and thin/lustrous indicates充盈 (fullness) of the Lungs and Stomach. Fat and white, soft to touch, indicates Qi deficiency with Phlegm. White and emaciated, with bright red fingernails, indicates Qi deficiency with Fire. White and prematurely aged without luster, with pale fingernails, indicates Lung and Stomach deficiency-cold. White with slight cyan, or many blue veins on the arms, indicates Qi deficiency failing to control Blood; if accompanied by cyan fingernails, it is a Yin-Cold syndrome. White is the sign of Qi deficiency; even with bleeding or fever, it is always Deficient Fire, never Excess Heat.
Cyan-black belongs to the Liver and Kidneys. Cyan and coarse texture indicates strain on sinews and bones. Cyan and withered indicates depletion of Ying Blood. Black and fat/lustrous indicates fullness of Marrow. Black and emaciated indicates internal damage by Deficient Fire. Cyan-black indicates vigorous Qi in the Lower Jiao; even if attacked by Wind-Cold, it inevitably transforms into Pathogenic Heat, rarely presenting as deficiency-cold.
Red belongs to the Heart and San Jiao. Deep red and firm indicates a constitution prone to Fire. Red and thick/firm indicates full Ying Blood. Slightly red and fresh indicates Qi deficiency with Fire. Red and dry/shriveled indicates Blood deficiency with hyperactive Fire. Red is the color of Fire flaring upward; one only fears depletion of fluids and exhaustion of blood, with no concern for deficiency-cold. Generally, individuals with a Fire constitution are never fat and damp; even if they have phlegm-cough, it is due to Dryness. (Shi Wan.)
Facial color values clarity and moisture, disliking stagnation and premature aging. For acute external invasions, turbidity and obstruction are acceptable. For chronic Qi deficiency, emaciation and clarity are appropriate. If the pathogen is sharp but the face is clear-white with little spirit, or if the patient is chronically weak and emaciated but the face is charmingly lustrous, these are not normal colors. Among the five colors, cyan, black, and dark/dull hues always indicate failure of Yang Qi to rise, regardless of whether the disease is new or old. Only when yellow appears on the face and eyes without being dry and shriveled is it a sign of recovery. If the eyelids look like soot, it is Cold-Phlegm. Dark eyes and red cheeks indicate Hot-Phlegm. Dark eyes with difficulty walking and groaning indicate joint pain with Phlegm-Fluids entering the bones. Dark eyes with a earthy facial color, limb flaccidity, and difficulty bending/extending indicate Wind-Phlegm.
If a patient presents with yellow color, luster indicates the presence of Stomach Qi; dry yellow indicates exhaustion of Body Fluids. Yellow sclera indicates either Jaundice or Epistaxis. Yellow sclera with severe irritability indicates disease progression. (From *San Mei*. Zhang Zhongjing said: If the pulse is harmonious, the patient feels severe irritability, and upon close inspection, the inner eyelids are yellow, this indicates resolution of the disease. Do not hastily diagnose it as progression.)
Same color on face and eyes is a favorable sign (Shun); different colors are unfavorable (Ni). "Same" means unchanged from normal; "Different" means one part is abnormally different.
Prematurely aged and lusterless face with empty pulse indicates loss of Blood. In Shanghan (Cold Damage) with no sweat, red malar flush, and hiccups, death occurs. Cyan qi on the malar area indicates death. Yellow combined with cyan-purple and a knotted pulse indicates Blood stasis in the Stomach or masses in the hypochondrium. Many white spots on the face indicate intestinal parasites. Irregular cyan-yellow-white facial color, or patterns like crab claws, alternating yellow and white, indicates food stagnation. (There are also white spots the size of coins covering the forehead.) Yellow sclera indicates Wine Jaundice; yellow-white face with swelling extending to eyelids indicates Grain Jaundice, accompanied by epigastric fullness; black face indicates Female Labor Jaundice, also called Black Jaundice. Cyan color under the Mingtang (under the eyes) indicates sexual exhaustion, mental fatigue, or lack of sleep. (Li Shicai.)