经言黑为痛。又言多血少气。盖主痛者。言其病。多血少气者。言其常。且黑者。肾与三焦膀胱之色。亦寒水
之色也。虽主痛主寒。当按其部位。审其病情。推之以四时。辨之以十法。如颧与颜黑者。肾病也。色黑齿槁
者。肾热也。黑色浅淡者。肾病水寒也。黑甚者。在脉则麻痹。在筋则拘挛也。色黑脉沉而急。脊与腰相引痛。
小腹里急。咽肿伤烂。口干。善忘。目KT KT 。骨中寒者。肾积之证。饥则见。饱则减也。色黑脉坚而大者。有积
气在小腹与阴。肾痹之证也。骨痹不已。色黑耳鸣者。复感于邪。内舍于肾也。面肿垢黑。腰脊痛。不能久立。屈
伸不利。发堕齿槁。腰背相引而痛。甚则咳唾者。骨极虚寒也。面庞然浮肿。脊痛不能正立。其色 。隐曲不
利。多汗恶风。肌上色黑者。肾风也。面黑手足不遂。腰痛难以俯仰。骨痹痛者。肾风发也。肾病色黑。其气虚
弱。吸吸少气。两耳苦聋。腰痛。时时失精。饮食减少。膝以下清。其脉沉滑而迟者。可治之证也。邪热伤肾。面
黑黄。耳色不应者。亦尚可治也。耳鸣面黑。尿赤阴疮者。肾劳也。面目干黑。精神不定。不能独卧。目视不明。
频频下泪者。肝劳也。面色黧黑。形瘦耳焦。小便浊而有脂液者。下消也。鼻头色微黑者。有水气也。色黑目
窠下微肿者。水病也。眼下如烟煤者。痰饮也。面色黧黑。其人喘满。心下痞坚。脉沉紧者。膈间有支饮也。面
色惨然青黑者。中寒也。身冷反躁。欲投井中。唇青面黑。渴欲饮水。水入则吐。大便自利。脉或伏。或沉细而
疾者。伤寒阴盛格阳也。紫浊者。时疫也。惨黑带紫者。邪气盛也。鼻孔干燥。黑如烟煤者。阳毒热深也。鼻出
冷气。滑而黑者。阴毒冷极也。阴毒身重背强。腹中绞痛。咽喉不利。心下坚强。气不得息。呕逆。唇青面黑。四
肢厥冷。其脉沉细紧数。身如被打者。毒瓦斯攻心。五六日可治。七日不可治也。黑滞而惊恐不寐者。客邪为
害也。黑如烟煤者。中恶腹痛也。耳前黑者。疝痛也。唇舌面色皆紫黯青肿者。中毒也。痫发面黑。直视不摇。
如尸状者。肾痫也。血脉不荣。颜色憔悴者。心之经病也。面见青黑斑点者。神气衰也。形枯色灰者。表虚也。
身瘦面晦暗如铅色。吐出瘀血色黑。胃脘痛。按之更痛而坚。如咬如焚。食时则痛。食后痛止者。痈在上口。
若食时不痛。食后则痛者。痈在下口也。面黑颜黑者。胃病也。小腹满。额上黑。足下热者。黑疸也。额上黑。微
汗出。手足中热。薄暮即发。膀胱急。小便自利者。名曰女劳疸。若腹如水状。则不治也。额上昏黑面黄者。亦
女劳疸也。阴黄面色黧黑。冷汗 者。死证也。阳黄黄如烟熏。目暗。唇清者。死证也。凡黄家。寸口近掌无
脉。口鼻冷黑者。皆不可治也。苍黑而枯槁者。血涸也。血凝目下。状如豚肝者。寒厥相遂。为热所壅也。妇人
羸瘦弱甚。肢体烦痛。面目瘀黑。忧恚不乐者。久虚不能食。冷结脐下也。面枯槁而略带黑者。血质有坏而
然也。妊娠色暗不开。忽尔明者。欲产也。乍暗乍明者。产难也。妇人眼眶灰黑者。崩中带下也。妇人面黑无
颜色。皮肉相连。月经失度。小腹弦急或绞痛至心。两胁肿胀。食不生肌肤者。当病崩中漏下。且腐臭也。腰
痛而面色忽红忽黑者。心肾交争。难治之证也。病患卒肿。其面苍黑者。死证也。面青黑暗。泻血者。死证也。
病患面黑。两胁下满。不能自转侧者。死证也。香港脚冲心。目额皆黑。恍惚谵妄者。水克火。命难全也。腰脚肿。
小便不通。气上喘急。目额皆黑。左尺脉绝者。香港脚入肾之死证也。真心痛。面黑四肢厥冷者。旦发夕死。夕
发旦死也。脐下忽大痛。人中黑者。死色也。破伤风。头面青黑。眼小目瞪。身汗如油者。邪入于脏。难治之证
也。吐泻之后。四肢逆冷。面黑气喘。冷汗自出。外肾搐缩。不省人事者。元气不接。脱阳之证也。面黑直视恶
风者。死证也。色泽去。面黑如黧者。手少阴气绝。血先死也。髦色不泽。面黑如漆柴者。手少阴气绝。血先死
也。脉不通。血不流。发不泽。面黑如漆叶者。血先死。手少阴气绝也。赤黑色。黯点见颜上。
若度年上者。心病少愈。必卒死也。黑色出于庭。大如拇指者。必不病而卒死也。色枯黑。语声
不转者。心先死。若天中等分。墓色应之。即死不治也。病患黑气出于天中。下至年上颧上者。
死色也。病患黑色出于额上。发际下直鼻脊。及两颧上者。死在五日中也。面黑目白者。肾气内
伤也。面黑目青者。肾气内伤。病因留积。八日当亡也。黑色横目三阳者。死在半年间也。面目
带黄黑。连耳左右者。年四旬以上。百日死也。额上黑如雾者。死在百日内也。脸上黑如雾者。
死在七日内也。人中口吻黑绕者。脾肾绝。七日死也。印堂黑暗。耳门黑气入口者。不治之证也。
气黑暗于耳前者。亦不治也。黑掩太阳者。卢医莫救也。黑如湿灰者。扁鹊不治也。气色搏聚凝
滞者。病将进。难治也。平人眼下青黑。面色如灰尘者。必病也。眼角或青或黑者。主大病也。
气如烟雾者。病欲缠身也。黑滞渐退者。病欲退也。病愈而面色如煤不开者。终不吉也。面黑齿
长而垢。腹胀闭。上下不通者。少阴终也。齿为暴枯。面为正黑。目中黄。腰欲折。自汗出如流
水者。肾绝之证。四日死也。腹胀闭。不得息。善噫善呕。呕则逆。逆则面赤。不逆则上下不通。
面黑皮毛焦者。太阴终也。病患及健人。面忽如马肝色。望之如青。近之如黑者。肝肾绝也。形
体如烟熏。直视摇头者。心绝也。鼻如烟煤者。肺绝也。鼻孔黑燥无涕者。肺绝也。环口黧黑者。
肾绝也。环口黧黑。柔汗发黄者。脾绝也。耳叶焦黑者。肾绝也。真肾脉至。搏而绝。如指弹石。
辟辟然。色黑黄不泽。毛折乃死者。脉无胃气。土克水也。心病烦闷。少气火热。热上撞心。呕
咳吐逆。狂语。汗出如珠。身体厥冷。其脉当浮。今反沉濡而滑。其色当赤。而复黑者。此是水
之克火。为大逆。十死不
治。是皆黑色之目也。（漆柴之柴。千金作叶。齿长而垢之垢。千金作枯。宜从之。）
The medical classics state that black indicates pain. It is also stated that black indicates abundant blood and deficient qi. The phrase "indicates pain" refers to the manifestation of disease, while "abundant blood and deficient qi" refers to the normal attribute of the color black. Furthermore, black is the color of the Kidney (Shen), Sanjiao (Triple Burner), and Bladder (Pangguang); it is also the color of Cold Water (Han Shui). Although black primarily indicates Pain Syndromes (Tong Zheng) and Cold Syndromes (Han Zheng), one must examine the location of the lesion, assess the condition, deduce based on the Four Seasons (Si Shi), and differentiate using the Ten Methods (Shi Fa). For instance: Blackness on the cheekbones (Quan) and forehead (Yan) indicates a Kidney Disease (Shen Bing). Black complexion with dry teeth indicates Kidney Heat (Shen Re). Pale black indicates Kidney Disease accompanied by Cold Water (Shui Han). Severe blackness manifests as numbness in the pulse and spasms in the tendons. Black complexion with a deep and rapid pulse, pulling pain between the spine and waist, urgency in the lower abdomen, swollen and ulcerated throat, dry mouth, forgetfulness, blurred vision (Mu KT KT), and cold in the bones constitute the syndrome of Kidney Accumulation (Shen Ji), which appears when hungry and diminishes when full. Black complexion with a firm and large pulse indicates accumulated Qi in the lower abdomen and yin region, constituting the syndrome of Kidney Bi (Shen Bi). If Bone Bi (Gu Bi) persists and is accompanied by black complexion and tinnitus, it indicates re-infection with pathogenic factors that have entered internally to reside in the Kidney. Facial edema with a dirty, blackish hue, lumbar and spinal pain, inability to stand for long periods, difficulty in flexion and extension, hair loss, dry teeth, pulling pain between waist and back, and severe coughing with sputum constitute the syndrome of Extreme Bone Deficiency and Cold (Gu Ji Xu Han). Puffy facial edema, spinal pain preventing upright standing, dark complexion, difficulty in urination and defecation, profuse sweating, aversion to wind, and black muscle surface indicate Kidney Wind (Shen Feng). Black face with hemiplegia, lumbar pain preventing bending and stretching, and bone Bi pain indicate the onset of Kidney Wind. In Kidney Disease, the complexion is black; if Qi is deficient and weak, with shallow breathing, deafness in both ears, lumbar pain, frequent seminal emission, reduced appetite, and cold below the knees, a deep, slippery, and slow pulse indicates a treatable condition. If pathogenic heat damages the Kidney, resulting in a black-yellow face and dull ear color, it is still treatable. Tinnitus, black face, red urine, and genital sores indicate Kidney Exhaustion (Shen Lao). Dry, dark-black face and spirit, inability to lie alone, poor vision, and frequent tearing indicate Liver Exhaustion (Gan Lao). Dark-black face, emaciation, scorched ears, and turbid urine with lipid fluid indicate Lower Xiao (Xia Xiao). Slightly black nose tip indicates Water Qi (Shui Qi). Black face with slight swelling under the eyes indicates Water Disease (Shui Bing). Eye area resembling coal smoke indicates Phlegm-Fluid Retention (Tan Yin). Dark-black face, asthma and chest fullness, epigastric hardness, and deep-tight pulse indicate Branch Fluid (Zhi Yin) in the diaphragm. Gloomy blue-black face indicates Interior Cold (Zhong Han). Cold body with restlessness, desire to jump into a well, cyan lips, black face, thirst for water but vomiting upon ingestion, spontaneous diarrhea, and pulse either hidden or deep-thin-rapid indicate Yang Repelled by Yin in Cold Damage (Shang Han Yin Sheng Ge Yang). Purple turbidity indicates Seasonal Epidemic (Shi Yi). Gloomy black with purple indicates Exuberant Pathogenic Factor (Xie Qi). Dry nostrils with blackness like coal smoke indicate Deep Heat in Yang Toxin (Yang Du Re Shen). Cold air from nostrils with smooth blackness indicates Extreme Cold in Yin Toxin (Yin Du Leng Ji). Yin Toxin presents with heavy body, stiff back, colicky abdominal pain, dysphagia, hard epigastrium, breathlessness, vomiting, cyan lips, black face, cold limbs, and deep-thin-tight-rapid pulse, feeling as if beaten; this is Toxin attacking the Heart, treatable within five to six days, untreatable after seven days. Stagnant blackness with fear and insomnia indicates Invasion by Guest Pathogen (Ke Xie). Coal-smoke-like blackness indicates Evil Attack Abdominal Pain (Zhong E Fu Tong). Blackness before the ears indicates Hernia Pain (Shan Tong). Cyan-purple-swollen lips, tongue, and face indicate Poisoning (Zhong Du). Black face during epilepsy with fixed staring and corpse-like stillness indicates Kidney Epilepsy (Shen Xian). Blood vessels failing to nourish, with haggard complexion, indicate Meridian Disease of the Heart (Xin Zhi Jing Bing). Blue-black spots on the face indicate Decline of Spirit Qi (Shen Qi Shuai). Emaciated form with gray complexion indicates Exterior Deficiency (Biao Xu). Emaciated body with lead-colored dull face, vomiting of dark blood clots, epigastric pain worsened by pressure and hardness, burning sensation, pain during eating relieved after eating, indicates Abscess at the Upper Orifice (Yong Zai Shang Kou); if no pain during eating but pain after eating, it indicates Abscess at the Lower Orifice (Yong Zai Xia Kou). Black face and chin indicate Stomach Disease (Wei Bing). Lower abdominal fullness, black forehead, and hot feet indicate Black Jaundice (Hei Dan). Black forehead, slight sweating, hot palms and soles, evening onset, bladder urgency, and spontaneous urination are named Female Labor Jaundice (Nv Lao Dan). If the abdomen resembles water accumulation, it is untreatable. Dull black forehead with yellow face is also Female Labor Jaundice. Yin Jaundice with dark-black face and cold sweat is a Death Syndrome (Si Zheng). Yang Jaundice with yellow like smoked tobacco, dim eyes, and clear lips is a Death Syndrome. In all Jaundice cases, absence of pulse near the palm at Cun Kou, and cold-black mouth/nose indicate untreatability. Cyan-black and withered indicates Blood Depletion (Xue He). Blood stasis under eyes resembling pig liver indicates Cold Jue following each other, obstructed by Heat. Extremely emaciated and weak women with limb pain, bruised-black face, and sorrow/anger indicate Long-term Deficiency with inability to eat and Cold Knot below the umbilicus. Withered face with slight blackness indicates Damaged Blood Quality. During pregnancy, sudden brightness after darkness indicates impending labor; alternating darkness and brightness indicates Difficult Labor. Gray-black eye sockets in women indicate Metrorrhagia and Leukorrhea (Beng Zhong Lou Xia). Black, lusterless face in women with skin/muscle adhesion, irregular menstruation, stringy/tense or colicky lower abdominal pain radiating to heart, distended hypochondrium, and food failing to nourish flesh indicates Metrorrhagia and Intermittent Bleeding with putrid odor. Lumbar pain with alternating red/black face indicates Heart-Kidney Conflict, a difficult-to-treat syndrome. Sudden edema with cyan-black face is a Death Syndrome. Blue-dark face with bloody stool is a Death Syndrome. Black face with bilateral hypochondriac fullness and inability to turn sideways is a Death Syndrome. Hong Kong Foot (Jiao Qi) rushing to the heart with black orbits/forehead, delirium, indicates Water overcoming Fire, life cannot be saved. Swollen legs/feet, urinary retention,急促 breathing, black orbits/forehead, and absent Left Chi pulse indicate Hong Kong Foot entering Kidney, a death syndrome. True Heart Pain with black face and cold limbs results in death same day (morning onset/evening death, or vice versa). Sudden severe pain below umbilicus with black Ren Zhong is a death sign. Tetanus with blue-black head/face, small eyes, wide stare, oily sweat indicates Pathogen entering Zang organs, difficult to treat. Post-emesis/diarrhea with cold limbs, black face, panting, cold sweat, contracted external genitals, and unconsciousness indicates Disconnection of Yuan Qi and Yang Collapse (Tuo Yang). Black face, fixed gaze, aversion to wind is a death syndrome. Loss of luster with black-as-Li face indicates Termination of Hand-Shao Yin Qi, Blood dies first. Hair lacking luster with black-as-lacquer-firewood face indicates Termination of Hand-Shao Yin Qi, Blood dies first. Unobstructed pulse, non-flowing blood, lusterless hair, black-as-lacquer-leaf face indicates Blood dies first, Termination of Hand-Shao Yin Qi. Red-black with dark spots on face extending to Nian Shang indicates Heart Disease slightly improving but leading to sudden death. Black emerging at Ting (Yin Tang), thumb-sized, indicates sudden death without prior illness. Withered black with unmodulated voice indicates Heart dies first; if dividing Tian Zhong, tomb color corresponds, death is inevitable. Black Qi emerging from Tian Zhong down to Nian Shang/Zhang Shang is a death sign. Black emerging from forehead, straight down nasal bridge to Zhang Shang, indicates death within five days. Black face with white eyes indicates Internal Injury to Kidney Qi. Black face with green eyes indicates Internal Injury to Kidney Qi with retained pathogen, death in eight days. Black across three Yang meridians under eyes indicates death within half a year. Yellow-black face connecting to ears in those over forty indicates death within one hundred days. Fog-like black forehead indicates death within one hundred days. Fog-like black face indicates death within seven days. Black around Ren Zhong and mouth indicates Termination of Spleen-Kidney, death in seven days. Dark Yin Tang with black Qi entering Ear Gate indicates untreatable. Darkness before ears indicates untreatable. Black covering Tai Yang indicates even Lu Yi cannot save. Black like wet ash indicates even Bian Que cannot treat. Aggregated stagnant Qi color indicates worsening disease, difficult to treat. Normal person with blue-black under eyes and dusty face will surely get sick. Blue/black eye corners indicate major disease. Smoke-like Qi indicates disease entangling body. Gradual retreat of stagnation indicates disease receding. Coal-like unopening face after recovery indicates ultimate misfortune. Black face, long dirty teeth, abdominal distension/closure, upper/lower blockage indicates Termination of Shao Yin. Sudden withered teeth, pure black face, yellow eyes, desire to break waist, profuse sweating indicates Termination of Kidney, death in four days. Abdominal distension/closure, dyspnea, belching/vomiting, reversal causing red face or blockage, black face/scorched skin/hair indicates Termination of Tai Yin. Sudden horse-liver colored face (blue afar, black close) in patient or healthy person indicates Termination of Liver-Kidney. Smoke-like form with fixed stare/head shaking indicates Termination of Heart. Nose like coal smoke indicates Termination of Lung. Dry black nostrils without mucus indicates Termination of Lung. Ring-mouth black indicates Termination of Kidney. Ring-mouth black with soft yellow sweat indicates Termination of Spleen. Scorched black ear lobes indicate Termination of Kidney. True Kidney Pulse arriving, beating abruptly like finger striking stone, black-yellow lusterless, withering hair indicates death due to lack of Stomach Qi, Earth overcoming Water. Heart Disease with vexation, shortness of breath, fire heat, heat hitting heart, vomiting/coughing/reversal, madness, bead-like sweat, cold body, yet pulse is deep-soft-slippery (should be floating) and color is black (should be red), indicates Water overcoming Fire, great reversal, ten deaths untreatable. These are all items regarding black complexion diagnosis. (Note: 'Chai' in lacquer-firewood is 'Ye' in Qian Jin Fang; 'Gou' in long-dirty teeth is 'Ku' in Qian Jin Fang, follow them.)