尝思诊尺肤之法。可察皮之滑涩。诊腠理之法。可察皮之粗细。然皮不仅观尺肤。法不仅观腠理。则夫周
身之皮。当讲周身之法。而尺肤腠理之诊。亦宜比例而观焉。何则。周身之皮。实由周身之脉以灌溉。周身
之脉。当分周身之部以参观。故经言。欲知皮部。以经脉为记。夫皮者。肺之合也。筋骨在内为阴。皮肤在外
为阳也。析而论之。如形充而皮肤宽缓者寿。形充而皮肤紧急者夭。皮与肉相裹则寿。皮与肉不相裹则
夭。薄皮弱肉者。不胜时之虚风。浓皮坚肉者。能胜时之虚风。皮虚者寒。皮实者热。皮肤肿胀者。邪气实。皮
肤消减者。正气虚。皮肤肿痛者。病气有余。皮肤溃烂者。形气不足。皮肤润泽者。太阴气盛。皮毛枯槁者。太
阴气衰。皮毛焦者。手太阴气绝。皮肤着者。足太阴肉绝。皮聚毛落者。肺损。皮枯毛折者。肺绝。皮毛虚弱者。
肺热叶焦。皮肤顽痹者。疠风皮病。身冷肤硬者。脾不上下。皮肤薄着者。经脉空虚。皮肤不收。肌肉坚聚者。
寒湿之证。皮肤空疏。三焦经绝者。血崩之征。肌肤甲错。两目黯黑者。内有干血。身皮甲错。腹中急痛者。内
生痈脓。皮肤溃而有疡者。疠风也。皮肤脱若蛇皮者。疠风也。疠风遍身如癣者。脾病。疠风溃烂无脓者。血
死。少年皮生黑斑者。不吉。痘儿头项皮赤者。多凶。凡肿胀。皮浓色苍者。皆属气。皮薄色泽者。皆属水。诸痛
疮疡。斑疹麻痘。色赤而红者顺。青而黑者逆。诸病症。皮寒而燥者。阳不足。皮热而燥者。阴不足。身涩而脉
滑者死。身滑而脉涩者死。此皆皮部之诊也。由是推而言之。则寿夭诊于缓急。强弱诊于浓薄。消减肿胀。
以诊其虚实。润泽枯槁。以诊其盛衰。八者交参。则诊视之法备。而皮肤之变详。夫如是。按经络而分内外
阴阳。察部位而分上下左右。参伍以观。错综以变。庶乎其有得欤。
I have pondered the method of inspecting the skin of the cubital fossa (Cubital Skin), which allows one to observe whether the skin is smooth or rough. The method of inspecting the Cou Li (interstices and pores) allows one to observe whether the skin texture is coarse or fine. However, the inspection of the skin is not limited to the cubital fossa, nor are the methods limited to observing the Cou Li. Therefore, for the skin covering the entire body, a method applicable to the whole body should be discussed, and the inspection of the cubital fossa and Cou Li should also be observed by analogy. Why is this? Because the skin of the entire body is actually irrigated and nourished by the meridians of the entire body. The meridians of the entire body should be divided into various regions of the body for comprehensive observation. Thus, the Classics state: "To know the Pi Bu (Skin Regions), take the Jing Mai (Meridians) as markers." The skin is the external correspondence of the Lung. The sinews and bones are internal and belong to Yin; the skin and hair are external and belong to Yang.
Analyzing in detail: If the physique is substantial but the skin is loose and relaxed, longevity is indicated; if the physique is substantial but the skin is tight and tense, premature death is indicated. When the skin and flesh wrap around each other tightly, longevity is indicated; when they do not wrap tightly together, premature death is indicated. Those with thin skin and weak flesh cannot withstand the empty winds (pathogenic factors) of the seasons. Those with thick skin and firm flesh can withstand the empty winds of the seasons. Deficient skin indicates Cold; solid skin indicates Heat. Swollen skin indicates Excess of pathogenic Qi; emaciated skin indicates Deficiency of Healthy Qi. Swollen and painful skin indicates an excess of disease Qi; ulcerated skin indicates insufficiency of Form and Qi. Moist and lustrous skin indicates abundance of Tai Yin Qi; withered and dry hair and skin indicate decline of Tai Yin Qi. Scorched hair indicates the exhaustion of Hand Tai Yin Lung Qi; skin adhering tightly to bone with muscle atrophy indicates the exhaustion of Foot Tai Yin Spleen flesh. Gathered skin and fallen lanugo indicate damage to the Lung; withered skin and broken hair indicate exhaustion of Lung Qi. Weakness of hair and skin indicates Lung Heat causing leaf scorching. Stubborn numbness of the skin indicates Li Feng (Leprosy/Pibian). A cold body and hard skin indicate that Spleen Qi fails to ascend and descend. Thin skin adhering closely to the body indicates emptiness of the meridians. Loose skin that does not retain shape, combined with hard and aggregated muscles, indicates a pattern of Cold-Dampness. Sparse and flaccid skin indicates the exhaustion of the San Jiao Meridian, which is a sign of blood flooding (metrorrhagia). Skin resembling scales (Jia Cuo) with dark eyes indicates dry blood (chronic blood stasis) within. Body skin resembling scales with acute abdominal pain indicates internal abscesses and pus formation. Ulcerated skin with sores indicates Leprosy. Skin shedding like snake skin indicates Leprosy. Leprosy covering the whole body like tinea indicates Spleen disease. Ulcerated Leprosy without pus indicates death of blood. Black spots appearing on the skin of youths are an inauspicious omen. Redness of the skin on the head and neck of children with smallpox often indicates a dire prognosis. In all cases of swelling, thick skin with a bluish-green color belongs to Qi disorders; thin skin with bright coloration belongs to Water disorders. For various painful sores, macules, rashes, measles, and smallpox, red and crimson colors indicate a favorable course; blue-black colors indicate an unfavorable course. In various diseases, cold and dry skin indicates insufficient Yang; hot and dry skin indicates insufficient Yin. A rough body with a slippery pulse indicates death; a smooth body with a choppy pulse indicates death. These are all methods of diagnosing the Skin Regions.
From this, we can deduce: Longevity and premature death are diagnosed by looseness and tension; strength and weakness by thickness and thinness; deficiency and excess by emaciation and swelling; decline and abundance by moisture and wither. When these eight aspects are cross-referenced, the diagnostic methods become complete, and the changes in the skin are detailed. By following the meridians to distinguish internal and external Yin and Yang, and examining the locations to distinguish upper and lower, left and right, observing comprehensively and analyzing through complex variations, one may hopefully attain understanding.