（出《灵枢》）
赤色，小理者心小，粗理者心大。无 KT （音遏污，一读曷于，心蔽骨，一名鸠尾。）者心高， KT
小短举者心下， KT 长者心下坚， KT 弱小以薄者心脆， KT 直下不举者心端正， KT 倚
一方者心偏倾也。
心小则安，邪弗能伤，易伤以忧。心大则忧不能伤，易
伤于邪。心高则满于肺中， （音冤，一读郁，一读闷。）而善忘，难开以言。心下则脏外，（谓脏体外露于
肺下。）易伤于寒，易恐以言。心坚则脏安守固。心脆则善病消瘅热中。心端正则和利难伤。心偏倾则
操持不一，无守司也。（司，去声。）
白色，小理者肺小，粗理者肺大，巨肩反膺陷喉者肺高，合腋张胁者肺下，好肩背浓者肺坚，肩背薄者
肺脆，背膺浓者肺端正，胁偏疏者肺偏倾也。
肺小则少饮，不病喘喝；肺大则多饮，善病胸痹喉痹逆气；肺高则上气肩息咳∶肺下则居贲迫肺，善胁下
痛；肺坚则不病咳上气；肺脆则善病消瘅易伤；肺端正则和利难伤；肺偏倾则胸偏痛也。（迫肺似当作迫肝，
肝体半在膈下，半在膈上，肺下即逼压之，故胁下痛。贲，膈也。）
青色，小理者肝小，粗理者肝大，广胸反 者肝高，合胁兔 者肝下，胸胁好者肝坚，胁骨弱者肝脆，
膺腹好相得者肝端正，胁骨偏举者肝偏倾也。
肝小则脏安，无胁下之病；肝大则逼胃迫咽，迫咽则苦膈中，且胁下痛；肝高则上支贲切胁，（谓拄膈而
迫于胁也。） 为息贲∶肝下则逼胃，胁下空，（肝下不得逼胃，此胃当指小肠。）胁下空则易受邪；肝坚
则脏安难伤；肝脆则善病消瘅，易伤∶肝端正则和利难伤；肝偏倾则胁下痛也。
黄色，小理者脾小，粗理者脾大，揭唇者脾高，唇下纵者脾下，唇坚者脾坚，唇大而不坚者脾脆，
唇上下好者脾端正，唇偏举者脾偏倾也。
脾小则脏安，难伤于邪也；脾大则苦凑 而痛，（凑，迫也。 ，音杪，腰两旁空软处。）不能疾行；
脾高则 引季胁而痛；脾下则下加于大肠，则脏善受邪；脾坚则脏安难伤；脾脆则善
病消瘅，易伤∶脾端正则和利难伤；脾偏倾则善满善胀也。（肝居胃后而附脊，脾居胃下而附腹；肝下即迫
小肠，脾下即迫大肠也。）
黑色，小理者肾小，粗理者肾大，高耳者肾高，耳后陷者肾下，耳坚者肾坚，耳薄不坚者肾脆，好耳前
居牙车者肾端正，耳偏高者肾偏倾也。
肾小则脏安难伤；肾大则善病腰痛，不可以俯仰，易伤于邪。肾高则其背膂痛，不可以俯仰；肾
下则腰尻痛，不可以俯仰，为狐疝。肾坚则不病腰背痛；肾脆则善病消瘅，易伤。肾端正则和利难伤；肾偏倾
则苦腰尻痛也。凡此诸变者，持则安，减则病矣。
五脏皆小者，少病，苦 心，大愁忧；五脏皆大者，缓于事，难使以忧。五脏皆高者，好高举措；五脏皆
下者，好出人下。五脏皆坚者，无病；五脏皆脆者，不离于病。五脏皆端正者，和利得人心；五脏皆偏倾者，
邪心而善盗，不可以为人平，反复言语也。（ ，音灼。上叙五脏形证。）
肺应皮，皮浓者大肠浓；皮薄者，大肠薄，皮缓，腹裹大者，大肠大而长；皮急者，大肠急而短；皮
滑者，大肠直；皮肉不相离者，大肠结也。（肺合大肠，大肠者皮其应。）
心应脉，皮浓者脉浓，脉浓者小肠浓∶皮薄者脉薄，脉薄者小肠薄；皮缓者脉缓，脉缓者小肠大而长，皮薄
而脉波小者，小肠小而短；诸阳经脉皆多纡屈者，小肠结也。（心合小肠，小肠者脉其应。）
脾应肉，肉 （手臂腿肚浓肉，皆谓之 。）坚大者胃浓，肉 么者胃薄。（么，么么，尖小也。）肉
小而么者胃不坚，肉 不称身者胃下，胃下者下脘约不利。肉 不坚者胃缓。肉 无小裹累者胃急。（裹音
果，作里误，肉内坚结而大小成颗者。）肉 多小裹累者胃结，胃结者上脘约不利也。（脾合胃，胃者肉其应。）
肝应爪，爪浓色黄者（色即爪下肉色。）胆浓，爪薄色红者胆薄。爪坚色青者胆急，爪濡色赤者胆缓。
爪直色白无约者胆直，（约，即爪上横纹。）爪恶色黑多纹者胆结也。（肝合胆，胆者筋其应。）
肾应骨，密理浓皮者三焦膀胱浓，粗理薄皮者三焦膀胱薄。疏腠理者三焦膀胱缓，皮急而无毫毛者三焦
膀胱急。毫毛美而粗者三焦膀胱直，稀毫毛者三焦膀胱结也。（肾合三焦膀胱，三焦膀胱者，腠理毫毛其应。
上叙六腑外形。）
故五脏有小大、高下、坚脆、端正、偏倾，六腑有小大、
长短、浓薄、结直、缓急，视其外应以决其五内，即知所病矣。
(From *Ling Shu*)
A ruddy complexion with fine skin texture indicates a small Heart; a coarse skin texture indicates a large Heart. The absence of the xiphoid process (Jiuwei, also known as Xibi Gu) indicates a high-positioned Heart; a short and elevated xiphoid process indicates a low-positioned Heart; a long xiphoid process indicates a firm, low-positioned Heart; a weak and thin xiphoid process indicates a fragile Heart; a xiphoid process that hangs straight down without elevation indicates an upright Heart; a xiphoid process tilted to one side indicates a deviated Heart.
A small Heart is stable, resistant to pathogenic invasion, but susceptible to injury by sorrow. A large Heart is resistant to sorrow but susceptible to pathogenic invasion. A high-positioned Heart causes fullness in the Lungs, leading to forgetfulness and difficulty in verbal communication. A low-positioned Heart allows visceral qi to leak outward (below the Lungs), making it susceptible to Cold and easily frightened by words. A firm Heart ensures visceral stability. A fragile Heart is prone to Xiao Shan (wasting-thirst syndrome) and Re Zhong (internal heat). An upright Heart maintains harmony and is hard to injure. A deviated Heart lacks focus and steadfastness.
A white complexion with fine skin texture indicates a small Lung; a coarse skin texture indicates a large Lung. Broad shoulders, a protruding chest, and a depressed larynx indicate a high-positioned Lung; retracted axillae and spread ribs indicate a low-positioned Lung. Thick muscles on the shoulders and back indicate a firm Lung; thin muscles on the shoulders and back indicate a fragile Lung. Thick muscles on the back and chest indicate an upright Lung; slanted and sparse rib bones indicate a deviated Lung.
A small Lung drinks little and does not suffer from asthma or panting; a large Lung drinks much and is prone to Xiong Bi (chest bi syndrome), Hou Bi (throat bi syndrome), and Qi Ni (rebellious Qi). A high-positioned Lung leads to upward rebellious Qi, shoulder breathing, and cough; a low-positioned Lung compresses the diaphragm against the Liver (Note: "compressing Lung" likely refers to compressing the Liver, as the Liver spans above and below the diaphragm; lower Lung position presses the Liver, causing hypochondriac pain), leading to hypochondriac pain. A firm Lung is free from cough and rebellious Qi; a fragile Lung is prone to Xiao Shan and easy injury. An upright Lung maintains harmony and is hard to injure. A deviated Lung causes unilateral chest pain.
A bluish complexion with fine skin texture indicates a small Liver; a coarse skin texture indicates a large Liver. A broad chest with reversed ribs indicates a high-positioned Liver; retracted ribs with rabbit-like prominence indicates a low-positioned Liver. Well-proportioned chest and ribs indicate a firm Liver; weak rib bones indicate a fragile Liver. Harmonious chest and abdomen indicate an upright Liver; slanted and raised rib bones indicate a deviated Liver.
A small Liver ensures visceral stability and absence of hypochondriac disease; a large Liver compresses the Stomach and pharynx, causing epigastric discomfort and hypochondriac pain. A high-positioned Liver pushes up against the diaphragm and ribs (Note: pressing the diaphragm and affecting the ribs), forming Xi Ben (accumulation disease); a low-positioned Liver compresses the Stomach, leaving the hypochondrium empty (Note: "Stomach" here likely refers to the Small Intestine), making it susceptible to pathogens. A firm Liver ensures stability and resistance to injury; a fragile Liver is prone to Xiao Shan and easy injury. An upright Liver maintains harmony and is hard to injure. A deviated Liver causes hypochondriac pain.
A yellowish complexion with fine skin texture indicates a small Spleen; a coarse skin texture indicates a large Spleen. Upturned lips indicate a high-positioned Spleen; drooping and loose lips indicate a low-positioned Spleen. Firm lips indicate a firm Spleen; large but soft lips indicate a fragile Spleen. Well-proportioned upper and lower lips indicate an upright Spleen; slanted and raised lips indicate a deviated Spleen.
A small Spleen ensures stability and resistance to pathogens; a large Spleen causes abdominal tightness and pain (Note: Cou means pressure; Miao refers to the soft area beside the waist), preventing rapid walking. A high-positioned Spleen pulls on the costal margin causing pain; a low-positioned Spleen presses down on the Large Intestine, making the viscera susceptible to pathogens. A firm Spleen ensures stability and resistance to injury; a fragile Spleen is prone to Xiao Shan and easy injury. An upright Spleen maintains harmony and is hard to injure. A deviated Spleen causes fullness and distension. (Note: The Liver is behind the Stomach attached to the spine; the Spleen is below the Stomach attached to the abdomen. Low Liver position presses the Small Intestine; low Spleen position presses the Large Intestine.)
A blackish complexion with fine skin texture indicates a small Kidney; a coarse skin texture indicates a large Kidney. High-set ears indicate a high-positioned Kidney; sunken areas behind the ears indicate a low-positioned Kidney. Firm ears indicate a firm Kidney; thin and unfirm ears indicate a fragile Kidney. Ears aligned with the jawbone indicate an upright Kidney; slanted and high-set ears indicate a deviated Kidney.
A small Kidney ensures stability and resistance to injury; a large Kidney is prone to lower back pain, inability to bend or twist, and susceptibility to pathogens. A high-positioned Kidney causes back and spinal pain, preventing bending or twisting; a low-positioned Kidney causes pain in the loins and sacrum, preventing bending or twisting, resulting in Hu Shan (fox hernia). A firm Kidney is free from back pain; a fragile Kidney is prone to Xiao Shan and easy injury. An upright Kidney maintains harmony and is hard to injure. A deviated Kidney causes pain in the loins and sacrum. Regarding these variations, balance brings health, while imbalance brings disease.
Those with all five Zang organs small rarely fall ill but suffer from internal anxiety and deep sorrow; those with all five Zang organs large are slow in action and difficult to worry. Those with all five Zang organs positioned high prefer to be superior; those with all five Zang organs positioned low prefer to be subordinate. Those with all five Zang organs firm have no disease; those with all five Zang organs fragile are constantly ill. Those with all five Zang organs upright are harmonious and well-liked; those with all five Zang organs deviated harbor evil thoughts, are prone to theft, lack fairness, and speak inconsistently. (Zhuo, sound zhuó. The above describes the morphology and syndromes of the five Zang organs.)
The Lung corresponds to the skin. Thick skin indicates a thick Large Intestine; thin skin indicates a thin Large Intestine. Loose skin with a large abdominal cavity indicates a large and long Large Intestine. Tight skin indicates a tense and short Large Intestine. Smooth skin indicates a patent Large Intestine. Skin and flesh tightly adhered indicate a knotted Large Intestine. (The Lung pairs with the Large Intestine; the Large Intestine corresponds to the skin.)
The Heart corresponds to the vessels. Thick skin indicates thick vessels, which indicate a thick Small Intestine; thin skin indicates thin vessels, which indicate a thin Small Intestine. Loose skin indicates relaxed vessels, which indicate a large and long Small Intestine. Thin skin with small and weak pulses indicates a small and short Small Intestine. All Yang meridians being tortuous indicate a knotted Small Intestine. (The Heart pairs with the Small Intestine; the Small Intestine corresponds to the vessels.)
The Spleen corresponds to the muscles. Firm and large muscles on arms and calves indicate a thick Stomach; small and delicate muscles indicate a thin Stomach. (Mei means small/delicate.) Small and delicate muscles indicate an unfirm Stomach; muscles disproportionate to the body indicate a low-positioned Stomach, where the lower Wan (pylorus) has poor constriction. Unfirm muscles indicate a lax Stomach. Muscles lacking internal nodules indicate a tense Stomach. (Guo sounds like guo; if written as Li, it is an error. It refers to firm, grain-like structures within the muscle.) Many small nodules in the muscles indicate a knotted Stomach, where the upper Wan (cardia) has poor constriction. (The Spleen pairs with the Stomach; the Stomach corresponds to the muscles.)
The Liver corresponds to the nails. Thick nails with yellowish color (color refers to the flesh under the nail) indicate a thick Gallbladder; thin nails with reddish color indicate a thin Gallbladder. Hard nails with bluish color indicate a tense Gallbladder; soft nails with reddish color indicate a lax Gallbladder. Straight nails with white color and no transverse lines indicate an upright Gallbladder. (Yue refers to the transverse lines on the nail.) Malformed, black nails with many lines indicate a knotted Gallbladder. (The Liver pairs with the Gallbladder; the Gallbladder corresponds to the sinews.)
The Kidney corresponds to the bones. Dense texture and thick skin indicate a thick San Jiao and Bladder; coarse texture and thin skin indicate a thin San Jiao and Bladder. Loose interstices indicate a lax San Jiao and Bladder. Tight skin without body hair indicates a tense San Jiao and Bladder. Beautiful and coarse body hair indicates a patent San Jiao and Bladder; sparse body hair indicates a knotted San Jiao and Bladder. (The Kidney pairs with the San Jiao and Bladder; the San Jiao and Bladder correspond to the interstices and body hair. The above describes the external morphology of the six Fu organs.)
Thus, the five Zang organs vary in size, position, firmness, and alignment, while the six Fu organs vary in size, length, thickness, patency, and tension. By observing external manifestations to determine internal conditions, one can identify the diseases present.