难经十三难曰五脏有五色皆见于面亦当与寸口尺内相应假令色青其脉当弦而急色赤其脉
浮大而散色黄其脉中缓而大色白其脉浮涩而短色黑其脉沉濡而滑脉数尺之皮肤亦数脉急尺之
皮肤亦急脉缓尺之皮肤亦缓脉涩尺之皮肤亦涩脉滑尺之皮肤亦滑假令色青其脉浮涩而短若大
而缓为相胜色青为肝脉得浮涩而短为肺脉为金克木大而缓为脾脉为木克土是谓相胜浮大而散
若小而滑为相生也浮大而散为心脉为木生火小而滑为肾脉为水生木是谓相生
玉机真脏论曰凡治病察其形气色泽脉之盛衰病之新故乃治之无后其时形气相得谓之可治
色泽以浮谓之易已脉从四时谓之可治脉弱以滑是有胃气命曰易治取之以时形气相失谓之难治
色夭不泽谓之难治脉实以坚谓之益甚脉逆四时为不可治必察四难而明告之
五脏生成篇曰色味当五脏白当肺辛赤当心苦青当肝酸黄当脾甘黑当肾咸故白当皮赤当脉
青当筋黄当肉黑当骨
灵枢五色篇曰五脏六腑之肢节各有部分有部分用阴和阳用阳和阴当明部分万举万当和阴
阳之盛衰裒多益寡和而平之万举万当矣能别左右是谓大道男女易位故曰阴阳审察泽夭谓之良
工左右乃阴阳之道路而男女从逆不同故位亦异位定然后能察其润泽枯夭也沉浊为内浮泽为外
内为脏外为腑以沉浮别之然在色上看非心会不能得黄赤为风青黑为痛白为寒黄为膏润为脓赤
甚者为血痛甚为挛寒甚为皮不仁五色各见其部察其浮沉以知浅深察其泽夭以观成败察其散搏
以知远近视色上下以知病处浅则病浅沉则病深泽则成全夭则败亡散解者新近搏聚者久远上则
在上下则在下皆以色形知病也积神于心以知往今故相气不微不知是非属意勿去乃知新故视色
之道必积神属意乃知已往来今及新病故疾色明不 沉夭为甚不明不泽其病不甚明泽不粗显而
但见沉夭病必甚也若无沉夭虽不明泽病亦不甚其色散驹驹然未有聚其病散而气痛聚未成也驹
小马也奔逸不定言其色散无定所气虽聚痛未成形也肾乘心心先病肾为应色皆如是脏必自虚而
后贼邪乘之所见之色自是胜我者五脏皆然男子色见于面王为小腹痛下为卵痛其圜直为茎痛高
为本下为首狐疝溃阴之属也卵茎狐溃乃膀胱小肠子处之病也其部位在于面王上下故色见于彼
圜直象茎故以色见之高下分茎病之本末俗以鼻之大小验前阴之巨细有以哉女子在于面王为膀
胱子处之病散为病搏为聚方圆左右各如其色形其随而下至胝为淫有润如膏状为暴食不洁女子
部分亦同而病亦在下但所见皆冲任带脉如淫带淋浊瘕聚之类或有因暴食湿热下流而成前证者
若色搏则聚而结色散者但痛而已左为左右为右其色有邪聚散而不端面色所指者也病见于色左
右不爽故随其色之所指察聚散而知邪之搏与痛也色者青黑赤白黄皆端满有别乡别乡赤者其色
亦大如榆荚在面王为不日五色之正端满合时日者是为无邪有别乡者犹言正色之外别部又见一
色也如赤见于面王则非其部不当见而见又非其时矣其色上锐首空上向下锐下向在左右如法色
之侵乘必视其尖锐处为乘之首上锐上乘下锐下乘左右皆如其法以五色命脏青为肝赤为心白为
肺黄为脾黑为肾肝合筋心合脉肺合皮脾合肉肾合骨也别五色而知五脏因五脏而知五合再察在
何部而分生克吉凶病固无遁情矣
面上白点腹中虫积
面青白黄色不常及面上如蟹爪路一黄一白者食积两颧时赤虚火上炎
病患面无血色无寒热脉沉弦者衄也
病患见黄色光泽者为有胃气不死干黄者凶
赤色出两颧大如拇指病虽小愈必卒死
黑色出于庭大如拇指必不病而卒死
冬月面惨伤寒紫浊时病色白而肥气虚多痰黑而瘦阴虚火旺
According to the Thirteenth Difficulty of the *Nan Jing* (Classic of Difficult Issues): The Five Zang organs correspond to five colors, all of which manifest on the face, and should also correspond with the Cun Kou pulse (radial artery at the wrist) and the Chi region (distal part of the radial pulse). If the complexion is green (Qing), the pulse should be Xian (Wiry) and Ji (Rapid/Tight); if red (Chi), the pulse should be Fu (Floating), Da (Large), and San (Scattered); if yellow (Huang), the pulse should be Zhong Huan (Moderately Slow) and Da; if white (Bai), the pulse should be Fu, Se (Choppy), and Duan (Short); if black (Hei), the pulse should be Chen (Deep), Ru (Soft/Slippery), and Hua (Smooth). If the pulse is Shu (Rapid), the skin in the Chi region will feel rapid; if the pulse is Ji, the skin in the Chi region will feel tight; if the pulse is Huan, the skin in the Chi region will feel relaxed; if the pulse is Se, the skin in the Chi region will feel choppy; if the pulse is Hua, the skin in the Chi region will feel smooth. If the complexion is green but the pulse is Fu, Se, and Duan, or Da and Huan, this indicates a relationship of mutual overcoming (Xiang Sheng/Xiang Ke context: specifically Ke/Overcoming here). Green corresponds to the Liver; a Fu, Se, and Duan pulse corresponds to the Lung, representing Metal overcoming Wood; a Da and Huan pulse corresponds to the Spleen, representing Wood overcoming Earth. This is called "Xiang Sheng" (in the sense of overcoming/dominating, often translated as Overcoming or Controlling). If the pulse is Fu, Da, and San, or Xiao (Small) and Hua, this indicates a relationship of mutual generation. Fu, Da, and San correspond to the Heart pulse, representing Wood generating Fire; Xiao and Hua correspond to the Kidney pulse, representing Water generating Wood. This is called "Xiang Sheng" (Generating).
The *Yu Ji Zhen Zang Lun* chapter of the *Su Wen* states: In treating any disease, one must observe the patient's form, Qi, color, and luster, as well as the excess or deficiency of the pulse, and distinguish whether the disease is new or old, then treat it without delaying the appropriate time. If the form and Qi are harmonious, it is termed treatable; if the color and luster are bright and floating, it is termed easy to cure; if the pulse conforms to the Four Seasons, it is termed treatable; if the pulse is weak yet smooth, indicating the presence of Stomach Qi, it is named easy to treat, provided treatment is applied at the right time. If the form and Qi are discordant, it is termed difficult to treat; if the color is dull and lacks luster, it is termed difficult to treat; if the pulse is solid and hard, the condition is worsening; if the pulse goes against the pattern of the Four Seasons, it is untreatable. One must carefully examine these four critical signs and clearly inform the patient.
The *Wu Zang Sheng Cheng Pian* chapter of the *Su Wen* states: Colors and flavors correspond to the Five Zang organs: White corresponds to the Lung, Pungent flavor to the Lung; Red corresponds to the Heart, Bitter flavor to the Heart; Green corresponds to the Liver, Sour flavor to the Liver; Yellow corresponds to the Spleen, Sweet flavor to the Spleen; Black corresponds to the Kidney, Salty flavor to the Kidney. Furthermore, White corresponds to the Skin, Red to the Vessels, Green to the Tendons, Yellow to the Flesh, and Black to the Bones.
The *Se Se Pian* chapter of the *Ling Shu* states: The limbs and joints of the Five Zang and Six Fu organs each have specific regions, utilizing Yin to harmonize Yang and Yang to harmonize Yin. One must understand these regions to ensure success in every action. By balancing the excess and deficiency of Yin and Yang, making them harmonious and level, one will succeed in every attempt. Being able to distinguish left from right constitutes the Great Dao. Since the flow of Yin and Yang differs between men and women, their positional correspondences also differ. Therefore, examining whether the complexion is lustrous or dull identifies a skilled physician. Left and right are the pathways of Yin and Yang. Once positions are established, one can discern luster and dullness. Deep and turbid colors indicate internal conditions (Zang organs), while floating and lustrous colors indicate external conditions (Fu organs); they are distinguished by their depth. However, understanding these nuances through facial inspection requires mental concentration. Yellow and Red indicate Wind; Green and Black indicate Pain; White indicates Cold; Yellow indicates dampness/pus; Luster indicates pus; Excessive Red indicates Blood stasis. Severe pain leads to spasms; severe cold leads to insensibility of the skin. When the five colors appear in their respective regions, observing their floating or sinking reveals the depth of the disease; observing their luster or dullness reveals the outcome; observing their dispersion or aggregation reveals the duration; observing their upper or lower distribution reveals the location. Superficial symptoms indicate superficial disease; deep symptoms indicate deep disease; lustrous colors indicate recovery; dull colors indicate deterioration; dispersed colors indicate recent onset; aggregated colors indicate long-standing disease. Accumulate spirit in the heart to know the past and present. Thus, subtle observation of Qi is necessary to distinguish right from wrong; maintaining attention allows one to know the new and old. To inspect colors, one must accumulate spirit and focus attention to understand the progression and nature of the disease. Bright and non-dull colors indicate mild illness; dark and dull colors indicate severe illness. If there is no darkness or dullness, even if not bright, the illness is not severe. If the color is dispersed like a running foal (Ju Ju Ran), the pathogenic factor is scattered and has not yet formed a mass; although there is Qi stagnation and pain, no physical structure has formed. "Ju" refers to a young horse, running restlessly, describing dispersed color without fixed location. When Kidney evil invades the Heart, the Heart suffers first, and the Kidney responds. This applies to other Zang organs as well; diseases arise when the Zang is deficient, allowing pathogenic factors to invade. The observed color reflects the element that overcomes the affected organ. For men, abnormalities on the nose tip (Mian Wang) indicate lower abdominal pain; abnormalities below indicate testicular pain; round and straight shapes indicate penile pain; high positions indicate the root of the penis; low positions indicate the glans. These belong to conditions such as Hu Shan (Fox Hernia) and Kui Yin. Testicular, penile, and hernia issues relate to the Bladder, Small Intestine, and anterior genitalia. Their facial correspondence is above and below the Mian Wang. Round and straight shapes symbolize the penis, so color height distinguishes the root and tip of penile disease. It is said that nose size correlates with genital size. For women, abnormalities on the Mian Wang indicate Bladder and anterior genitalia diseases; dispersed color indicates wandering pathogens; aggregated color indicates accumulation. Shapes correspond to the color form. If the color descends to the umbilicus area, it indicates lascivious diseases; luster like grease indicates excessive eating of unclean food. Women's regional divisions are similar, but diseases are located lower, involving the Chong, Ren, and Dai meridians, such as leukorrhea, strangury, and masses. Some cases result from excessive eating leading to damp-heat flowing downward. Aggregated color indicates masses; dispersed color indicates pain only. Left side indicates left-sided disease; right side indicates right-sided disease. Pathogenic colors that are dispersed and irregular indicate the location of the disease. Observing the direction of color changes reveals aggregation or pain. Green, Black, Red, White, and Yellow should be regular and full. "Bie Xiang" means an abnormal color appearing in an inappropriate region, e.g., Red on the Mian Wang, which portends imminent disaster. Regular colors conforming to seasons indicate no pathogen; aberrant colors indicate pathology. If the upper part of the color is sharp, it indicates upward invasion; if the lower part is sharp, it indicates downward invasion. Using the five colors to name the Zang organs: Green is Liver, Red is Heart, White is Lung, Yellow is Spleen, Black is Kidney. Liver connects to Tendons, Heart to Vessels, Lung to Skin, Spleen to Flesh, Kidney to Bones. By distinguishing colors, one knows the Zang organs; by knowing the Zang organs, one knows their connections; by observing the location, one determines Sheng (Generation) and Ke (Overcoming) auspiciousness or inauspiciousness. Disease cannot hide its true nature.
White spots on the face indicate intestinal parasites.
Fluctuating green, white, and yellow complexions, or crab-claw-like patterns on the face, alternating yellow and white, indicate food retention. Frequent redness on the cheekbones indicates deficiency fire flaming upward.
A patient with a bloodless complexion, without aversion to cold or fever, and with a Chen Xian (Deep and Wiry) pulse indicates epistaxis (nosebleed).
A patient with a yellowish and lustrous complexion has Stomach Qi and will not die; a dry yellow complexion is ominous.
Redness on the cheekbones, large as a thumb, indicates that although the minor illness may resolve, sudden death will follow.
Blackness on the forehead (Ting), large as a thumb, indicates sudden death in a person who appears healthy.
In winter, a dismal complexion indicates Shang Han (Cold Damage); purple and turbid colors indicate seasonal epidemics; a white complexion with obesity indicates Qi deficiency with phlegm; a black complexion with emaciation indicates Yin deficiency with hyperactive fire.