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The method of observing facial color, after examining the various regions of the face, should also be discussed in conjunction with the theory of "gateways" (Mén Hù). This is because when inspecting colors at the Ming Tang (nose), if pathological colors invade the gateways, it indicates an ominous sign. The so-called "gateways" refer to: Que Ting (the area between the eyebrows) is the gateway of the Lung; the eyes are the gateway of the Liver; the ears are the gateway of the Kidney; and the mouth/lips are the gateways of the Heart and Spleen. If any pathological color invades these areas, it signifies death.

Specifically: White appearing above the eyebrows along the Chong vessel indicates a disease of the Lung; if the color invades Que Ting, death occurs in Summer. Yellow appearing on the nose indicates a disease of the Spleen; if the color invades the mouth, death occurs in Spring. Cyan appearing in the philtrum indicates a disease of the Liver; if the color invades the eyes, death occurs in Autumn. Black appearing above the cheekbones indicates a disease of the Kidney; if the color invades the ears, death occurs within six days. Red appearing on the chin (Yi) indicates a disease of the Heart; if the color invades the mouth, death occurs in Winter. This is because the pathological colors of the Five Zang Organs each invade the gateway corresponding to their own organ, and the time of death corresponds to the season or day when they are overcome by the controlling element. However, this diagnosis holds only if the color is observed to be deep-set and dull/dry (Chen Yao).

The *Mai Jing* (Pulse Classic) states: If black qi arises in the head region of a patient—specifically around the eyes, ears, mouth, and nose—and enters the mouth, it is called "entering the gateway," and such a condition is fatal. This further identifies black as the color of death qi and the mouth as the gateway. The essential principles of observing voice and color by Bian Que and Hua Tuo state: In Liver disease, if the skin is white, death occurs on Geng-Xin days (Metal overcoming Wood); in Heart disease, if the eyes are black, death occurs on Ren-Gui days (Water overcoming Fire); in Spleen disease, if the lips are cyan, death occurs on Jia-Yi days (Wood overcoming Earth); in Lung disease, if the cheeks are red and eyes swollen, death occurs on Bing-Ding days (Fire overcoming Metal); in Kidney disease, if the face is swollen and lips yellow, death occurs on Wu-Ji days (Earth overcoming Water). Furthermore, whether in patients or healthy individuals, if black or white qi arises entering the eyes, nose, or mouth, death will occur within three days. These two sections both contain distinctions regarding auspiciousness and inauspiciousness via gateways, and divisions of generation and restriction via regions. Students should reference the ten methods and integrate them with the four seasons to understand both normal patterns and variations.

I have stated that when colors are divided into the Five Elements, there are relationships of generation and restriction; when colors are divided into Yin and Yang, there are appropriate (Yi) and inappropriate/contraindicated (Ji) manifestations. It is appropriate for Yang diseases to present with Yang colors, and for Yin diseases to present with Yin colors. It is contraindicated for Yang diseases to present with Yin colors, and for Yin diseases to present with Yang colors. Therefore, when pathogenic factors are abundant in the exterior, the complexion should be floating and clear; if instead it appears deep and turbid, it is contraindicated. When Qi is deficient in the interior, the complexion should be deep and turbid; if instead it appears floating and clear, it is contraindicated. In cases of fever, restlessness, delirium, and妄言 (wild speech), the complexion should be red; if instead there is cold extremities and a cyan face, it is contraindicated. After treating Cold Damage (Shang Han) with sweating, vomiting, or purging, the complexion should be yellow; if instead heat is excessive and the color is red, it is contraindicated. In cases of blood loss or depletion of body fluids, the complexion should be yellowish-white; if instead the face is bright red, it is contraindicated. In dysentery with pus and blood in the stool, the complexion should be yellow and dull; if instead there is fever and a red face, it is contraindicated. For measles, smallpox, macules/rashes, and various painful sores/ulcers, the complexion should generally be red; if instead it is cyan or black, it is contraindicated. In cholera with vomiting and diarrhea, or various other vomitings and diarrheas, the complexion should generally be yellow; if instead it is cyan and dark, it is contraindicated. By extending this reasoning, each disease has its specific appropriateness and contraindications, and each symptom has its own. Whenever the color corresponds to the disease, it is appropriate; when it contradicts, it is contraindicated. Mild contradictions are difficult to treat; severe contradictions lead immediately to death. However, there is a crucial aspect: one must observe the luster versus dullness to know success or failure; observe the floating versus sinking to know depth or superficiality; observe the clustering versus scattering to know proximity or remoteness of the pathology; view the upper and lower distribution of color to locate the disease site; and concentrate the spirit in the heart to understand the past and present of the illness. Thus, the Classics say: "If observation of Qi is not subtle, one cannot discern right from wrong; if attention is not maintained without departure, one cannot know the new from the old." This is what is meant. As for the appropriateness and contraindications of voice, pulse, and respiration, they can also be deduced by analogy based on correspondence or contradiction.