小子 张云。诸臣之中。惟雷公独少。故自称小子。
庭者颜也(止)寿必中百岁 张云。颜为额角。即天庭也。蕃蔽者。屏蔽四旁。即藩篱之义。十步之
外而骨骼明显。其方大丰隆可知。故能寿终百岁。盖五色之决。不独于明堂也。马云。此节大义。与前五阅五
使篇第二节相同。
明堂骨高(止)恶得无辨乎 张云。肺心肝脾之候。皆在鼻中。六腑之候。皆在四旁。故一曰次于中
央。一曰挟其两侧。下极居两目之中。心之部也。心为君主故曰王宫。惟五脏和平。而安于胸中。则其正色自
致。病色不见。明堂必然清润。此五官之所以有辨也。
其不辨者 张云。不辨者。色失常度。而变易难辨也。
各出其邪部(止)不死矣 诸本邪、作色。当改。张云。五色之见。各有其部。惟其部骨弱陷之处。
然后易于受邪。而不免于病矣。若其色部虽有变见。但得彼此生王。互相乘袭。而无克贼之见者。虽病甚不死。
志云。乘袭者。子袭母气也。如心部见黄。肝部见赤。肺部见黑。肾部见青。此子
之气色。乘袭于母部。虽病甚不死。盖从子以泄其母病也。
官五色奈何 甲乙作五官具五色何也。是。
外内皆在焉(止)其病益甚在外 张云。益甚言进。方衰言退也。外内皆在。表里俱当察也。脉口者。
太阴脏脉也。故曰在中而主五脏。人迎者。阳明腑脉也。故曰在外而主六腑。脉口滑小紧沉者。阴分之邪盛也。
人迎太紧以浮者。阳分之邪盛也。故病皆益甚。
其脉口浮滑者(止)日进在外 张云。脉口为阴。浮滑者。以阳加阴。故病日进。人迎为阳。沉滑者。
阳邪渐退。故病日损。损、减也。脉口人迎。经分表里。故其沉滑浮滑而病日进者。有在内在外之辨也。
脉之浮沉(止)其病易已 张云。人迎寸口之脉。其浮沉大小相等者。非偏于阴则偏于阳。故病难已。
按禁服篇曰。春夏人迎微大。秋冬寸口微大,如是者命曰平人。则义有可知矣。病在脏者在六阴也。阴本当沉。
而大为有神。有神者阴气充也。故易已。若沉而细小。则真阴衰而为逆矣。病在腑者在六阳也。阳病得阳脉者
为顺。故浮而大者病易已。若或浮小。亦逆候也。
人迎盛坚者(止)伤于食 甲乙二坚字并作紧。张云。人迎主表。脉盛而坚者。寒伤三阳也。是为外
感。气口主里。脉盛而坚者。食伤三阴也。是为内伤。此古有之法也。今则止用寸口诊法。不为不妙。然本无
以左右分内外之说。自王叔和以来。谬以左为人迎。右为气口。其失表里之义久矣。
其色粗(止)病方已 甲乙以明下有者为间三字。沉夭作沉垩。李云。粗者。明爽之义。沉夭者。晦
滞之义。言色贵明爽。若晦滞者。为病甚也。色上行者浊气方升。故病甚。下行者浊气色退。故病已。简案、
甲乙。粗以明者为间。义
自明。
五色有脏部(止)反者益甚 志云。脏部、脏腑之分部也。五脏次于中央为内部。六腑挟其两侧为外
部。色从外部走内部者。外因之病从外走内也。其色从内走外者。内因之病从内走外也。盖腑为阳而主外。脏
为阴而主内也。故病生于内者。先治其阴。后治其阳。反者益甚。其病生于阳者。先治其外。后治其内。反者
益甚也。
其脉滑大(止)可变而已 马云。既观其色。又观其脉。方为详审。其脉滑而带大、带代、带长者。
皆阳脉也。乃为病从外来。其外证目有所妄见。志有所妄恶。乃阳气之并于外也。即当先治其阳。后治其阴。
使之变焉。而病已矣。即此而推。则其脉涩而带小、带代、带短者。皆阴脉也。乃为病从内来。其内证而目有
所见。志有所独处。乃阴气之并于内也。即当先治其阴。后治其阳。使之变焉。而病亦已矣。
常候阙中(止)言其病 甲乙作当候眉间。张云。阙中、眉间也。风病在阳。皮毛受之。故色薄
而泽。痹病在阴。肉骨受之。故色冲而浊。冲、深也。至如厥逆。病起四肢。则病在下。而色亦见于地。地者
面之下部也。此其常候。故可因其色以言其病。李云。地者相家所谓地阁。即巨分、巨屈之处也。
大气入于脏(止)察色以言其时 张云。大气大邪之气也。大邪之入者。未有不由元气大虚。而
后邪得袭之。故致卒死。如拇指者。成块成条。聚而不散也。此为最凶之色。赤者固不佳。而黑者为尤甚。皆
卒死之色也。察色以言时。谓五色有衰王。部位有克贼。色藏部位。辨察明而时可知也。李云。大气者。大邪
之气也。如水色见于火部。火色见于金部之类。此元气大虚。贼邪已至。虽不病。必卒然而死矣。形如拇指。
最凶之色。赤者出于颧。颧者应在肩。亦为肺部。火色克金。病虽愈。必卒死。天庭处于最高。黑者干之。是
肾绝矣。虽不病。必卒死也。楼氏云。赤色出两颧。即脉诀所谓暴病如妆。不久居者是也。马云。拇指、足大
趾也。简案、说文。拇、将指也。易咸卦疏。足大趾也。
庭者首面也 甲乙。庭、作颜。张云。庭者颜也。相家谓之天庭。天庭最高。色见于此者。上应首面之疾。
阙上者咽喉也 甲乙。阙上、作眉间以上。张云。阙在眉心。阙上者。眉心之上也。其位亦高。故
应咽喉之疾。
阙中者肺也 甲乙。阙中、作眉间以中。张云。阙中、眉心也。中部之最高者。故应肺。蒋示吉云。即中正。
下极者心也 张云。下极者。两目之间。相家谓之山根。心居肺之下。故下极应心。蒋示吉云。即印堂。
直下者肝也 肝左者胆也 马云。肝之左即为胆。则在鼻挟颧之间矣。张云。下极之下为鼻柱。相家
谓之年寿。肝在心之下。故直下应肝。胆附于肝之短叶。故肝左应胆。而在年寿之左右也。蒋示吉云。胆在肝
之短叶间。属木。位东。南面行令。胆位在左。故山根之左。胆之部分。
下者脾也 方上者胃也 马云。肝之下为脾。方者鼻隧也。面王者。鼻心之端也。鼻隧之上。即迎香
之上。为胃。张云。年寿之下者。相家谓之准头。是为面王。亦曰明堂。准头属土。居面之中央。故以应脾。
准头两旁为方上。即迎香之上鼻隧是也。相家谓之兰台廷尉。脾与胃为表里。脾居中而胃居外。故方上应胃。
蒋示吉云。胃者脾之腑。为阳。阳居上。故脾之方上。胃之部分。方、始也。始上于脾。脾胃相为表里。言其
相去不远也。简案、据上文。五脏次于中央。六腑挟其两侧。蒋说恐非也。
中央者大肠也(止)脐也 马云。胃之外为大肠。乃正颧之下。大肠之外为肾。则大肠为中央。而胃
与肾所以挟大肠也。张云。中央者面之中央。谓迎香之外。颧骨之下。大肠之应也。挟大肠者。颊之上也。四
脏皆一。惟肾有两。四脏居腹。惟肾附脊。故四脏次言中央。而肾独应于两颊。肾与脐对。故当肾之下应脐。
面王以上者(止)子处也 甲乙。子上有字字。下并同。似是。张云。面王、鼻准也。小肠为腑。应
挟两侧。故面王之上。两颧之内。小肠之应也。面王以下者。人中也。是为膀胱子处之应。子处、子宫也。凡
人人中平浅而无髭者。多无子。是正子处之应。以上皆五脏六腑之应也。李云。妇人亦以人中深长者善产育。
蒋示吉云。方书曰。准头黄者小便难。师傅篇曰。鼻孔在外。膀胱漏泄。下文曰。男子色见于面王。为少腹痛。
下为卵痛。其圜直为茎痛。若女子当为膀胱子处之病。
颧者肩也(止)膺乳也 张云。此下复言肢节之应也。颧为骨之本。而居中部之上。故以应肩。臂接
乎肩。故颧后以应臂。手接乎臂。故臂下者手也。目内 上者。阙下两旁也。胸两旁高处为膺。膺乳者。应胸
前也。蒋示吉云。目内 、目之近山根处。即精明穴。足太阳经所起。朱晦庵中庸注曰。膺、胸也。胸乳间部
分。候于目内 。
挟绳(止)膝膑也 张云。颊之外曰绳。身之后为背。故背应于挟绳之上。牙车、牙床也。牙车以下
主下郭。故以应股。中央、两牙车之中央也。胫接于膝。足接于胫。以次而下也。巨分者。口旁大纹处也。股
里者。股之内侧也。巨屈、颊下曲骨也。膝膑、膝盖骨也。此盖统指膝部而言。蒋示吉云。绳耳边也。耳边如
绳突起。故曰绳。马氏曰。颊外为绳。
义未当也。凡部分明堂为内。耳旁为外。脏腑为内。膺乳次之。臂背为外。挟、近也。故近耳边直上之部分。
所以候背之病。牙车即颊车穴。在耳前陷中。凡人身在上者肩背。在下者股膝。故背部之下颊车。颊车之下。
所以候股。巨分者。巨之为言大也。上下齿床大分处。以候股里。齿床司开合。亦犹股里任屈伸也。上下唇大
为屈转。交接处是地仓穴。以候膝膑。唇为语言饮食之门户。亦犹膝膑为屈伸奔走之关节。俱动而不休。故应候。
各有部分(止)谓之良工 甲乙泽夭作泽垩。下夭字并同。张云。部分既定。阴阳乃明。阳胜者阴必衰。
当助其阴以和之。阴胜者阳必衰。当助其阳以和之。阴阳之用。无往不任。知其盛衰。万举万当矣。阳从左。
阴从右。左右者。阴阳之道路也。故能别左右。是谓大道。男女异位者。男子左为逆。右为从。女子右为逆。
左为从。故曰阴阳。阴阳既办。又必能察其润泽枯夭。以决善恶之几。庶足谓之良工也。
沉浊为内(止)为皮不仁 甲乙浮泽作浮清。李云。色之浮浊晦滞者为里。色之浮泽光明者为表。凡五
色之见于面者。可因是而测其病矣。痛甚即青黑之极也。寒甚白之极也。志云。风乃天之阳邪。故色见黄赤。
痛为阴痹。故色见青黑。色白为寒。色黄而膏润为痈脓。赤甚者为留血。痛在筋骨。故甚则为拘挛。寒伤皮肤。
故甚为皮不仁。
察其散抟 以知远近 马云。察其色之散而可以知病之近。若抟聚则久矣。抟、团同。
积神于心(止)乃知新故 马云。积神气于己心。而病之为己往。为今病者。皆能知之。故相视气色。
不能至于精微者。不知病之为是为非。惟属意专心。而无所摇夺。则凡病之为新为故者。洞然也。
色明不粗(止)聚未成也 李云。粗者显也。言色之光明不显。但见沉滞枯夭。病必甚也。若虽不明
泽。而不至于沉夭者。病必不甚也。驹、马之小者。未装鞍辔。散而不聚也。譬色之散而无定者。病亦散而无
坚积聚也。即有痛者。不过因无形之气耳。
肾乘心(止)皆如是 张云。水邪克火。肾乘心也。肾邪乘心。心先病于中而肾色则应于外。如以下极而
见黑色者是也。不惟心肾。诸脏皆然。凡肝部见肺色。肺部见心色。肾部见脾色。脾部见肝色。及六腑之相克
者。其色皆如是也。
男子色在于面王(止) 阴之属也 李云。面王下应有上字。面王上为小肠。下为膀胱子处。卵者
睾丸也。圜直指人中。水沟、穴也。人中有边。圜而直者。故人中色见。主阴茎作痛。在人中上半者曰高。为
茎根痛。在人中下半者为茎头痛。凡此皆狐疝 阴之属也。 即 也。马云。圜、圆同。简案、马志。本首之
解不明晰。李则本于张注。更加详。故从之。
女子在于面王(止)不洁 甲乙子下有色字。马云。女子之色在面王。当为膀胱经及妊子处之有病。
即胞络宫也。其气色散者。为痛而不至成聚。若气色抟聚不散。则成聚而不止于痛。然其聚之在内者。或方或
圆。或左或右。各如其外色之形耳。若其色随而下行。至于尾 。则其病之在下者。当有浸淫之物。(素问痿
论谓之白淫)润泽如膏之状者在也。不然。则为暴食间。即出不洁之物耳。何也。其下行之势。内外一致也。
张云。或暴因饮食。即下见不洁。盖兼前后而言也。 、当胝。音底。尻臀之间也。李云。面王下宜有下字。
面王上为人中。主膀胱子处。色散为痛。无形之气滞也。色抟为聚。有形之血凝也。积之或方或圆。或左或右。
各如其外见之形。
若其色从下行而至尾 。则为浸淫带浊。有润如膏之物。此症多因暴食不洁所致。不洁犹言不节。非污秽之谓
也。或多食冷物。或多食热物。一切非宜之物皆是也。志云。其色润如膏状者。为暴食不洁之物。盖腑为阳而
主外。主纳水谷。传导糟粕。是以外受风寒。或内伤饮食。皆为病腑。而色见于腑部也。简案、不洁未知孰是。
李不节之解。似不稳当。
左为左(止)所指者也 志云。色见于左。则为病在左。色见于右。则为病在右。其所见之色。或聚或
散。皆斜而不端。其抟聚之面色。所谓如指者也。张云。凡色有斜而聚散不端者。病之所在也。故但察面色所
指之处。而病可知矣。简案、指、志为前节母指之义。非也。
皆端满有别乡(止)在面王为不日 别目、诸本作别乡。当改。甲乙马志。亦大、作赤大。甲乙。不日、
作不月。马云。别者异也。别乡者。即分部也。所谓色者。即青黑赤白黄之色。皆端正盈满。各有分部。假如
心色主赤。小肠亦赤。其色如榆荚之大。在面王之部。则是小肠有病。非止于一日也。张云。正色凡五。皆宜
Xiaozi (Young Scholar): Zhang Yun points out that among the ministers, only Leigong is the youngest, hence he refers to himself as "Xiaozi" (Young Scholar).
Ting (Courtyard/Forehead) is Yan (Face) (up to) Longevity must reach a hundred years: Zhang Yun explains that "Ting" refers to the forehead, i.e., the Heavenly Court. "Fanbi" means shielding the surroundings, like a fence. If one's bones are clearly visible and square, large, and full from ten steps away, it can be known that such a person will live to a hundred years. This is because the judgment of the Five Colors does not depend solely on Mingtang (the nose). Ma Yun believes that the main meaning of this section is the same as in Section 2 of the previous "Five Visits and Five Envoys" chapter.
Mingtang bone is high (up to) How can there be no distinction?: Zhang Yun states that the indications for the Lung, Heart, Liver, and Spleen are all located in the middle of the nose; the indications for the Six Fu organs are all located on both sides of the nose. Hence, some say it is located in the center, others say it flanks the two sides. Xiaji (the point between the eyes) is situated in the middle of the two eyes and is the division of the Heart. Because the Heart is the monarch, it is called the Royal Palace. Only when the Zang organs are harmonious and peaceful, residing safely in the chest, will their true colors manifest naturally, and pathological colors will not appear. The Mingtang will inevitably be clear and moist. This is why the five orifices can be distinguished.
Those who cannot be distinguished: Zhang Yun explains that "cannot be distinguished" means the color has lost its normal degree and changes are difficult to identify.
Each emerges from its pathological region (up to) Death will not occur: In various editions, "Xie" (Pathogen) is written as "Se" (Color), which should be corrected. Zhang Yun points out that the manifestation of the Five Colors each has its corresponding region. It is only in regions where the bone is weak and depressed that one is prone to pathogenic invasion and disease. If the color in the respective region shows changes but obtains mutual generation and prosperity, with mutual influence but without destructive overcoming, even if the illness is severe, death will not occur. Zhi Yun states: "Chengxi" (Overcoming and influencing) refers to the child qi influencing the mother qi. For example, yellow appears in the Heart region, red in the Liver region, black in the Lung region, and green in the Kidney region. This is the child organ's color influencing the mother organ's region. Although the illness is severe, death will not occur, because the child qi helps to drain the mother organ's pathology.
How to observe the official Five Colors?: The *Jia Yi Jing* reads "Why do the five orifices possess all five colors?", which is correct.
Both external and internal are present (up to) The illness worsens externally: Zhang Yun explains that "Yi shen" means progression, while "Fang shuai" means regression. "External and internal both present" implies that both exterior and interior must be examined. the Mai Kou (Cun Kou pulse) is the Taiyin Zang pulse, hence it is said to be in the middle and governs the five Zang organs. the Ren Ying pulse is the Yangming Fu pulse, hence it is said to be outside and governs the six Fu organs. If the Mai Kou is slippery, small, tight, and deep, it indicates excess pathogen in the Yin aspect. If the Ren Ying pulse is excessively tight and floating, it indicates excess pathogen in the Yang aspect. Therefore, the illness will worsen.
If the Mai Kou is floating and slippery (up to) Daily progression externally: Zhang Yun notes that the Mai Kou belongs to Yin. Floating and slippery indicates Yang added to Yin, so the illness progresses daily. The Ren Ying belongs to Yang. Deep and slippery indicates that Yang pathogen is gradually receding, so the illness diminishes. "Sun" means reduction. The Mai Kou and Ren Ying correspond to the exterior and interior of the meridians. Thus, regarding deep/slippy and floating/slippery pulses leading to daily progression, there is a distinction between internal and external locations.
Floating and sinking of the pulse (up to) The illness is easily cured: Zhang Yun states that if the Ren Ying and Cun Kou pulses are equal in floating/sinking and size, it indicates bias towards either Yin or Yang, making the illness difficult to cure. According to the *Jin Fu* chapter, in spring and summer the Ren Ying pulse is slightly larger, and in autumn and winter the Cun Kou pulse is slightly larger; such a person is called a healthy individual. The principle can be understood thus. Illness in the Zang organs belongs to the six Yins. Yin pulses should naturally be deep. If large and vigorous with spirit, it indicates abundant Yin Qi, so recovery is easy. If deep and fine/small, it indicates depletion of True Yin, which is an adverse sign. Illness in the Fu organs belongs to the six Yangs. Yang illness obtaining a Yang pulse is favorable. Thus, if floating and large, the illness is easily cured. If floating and small, it is also an adverse sign.
Ren Ying is盛大 and firm (up to) Injury from food: The *Jia Yi Jing* writes "Jian" (Firm) as "Jin" (Tight) for both instances. Zhang Yun states that Ren Ying governs the exterior. A pulse that is盛大 and firm indicates Cold damaging the Three Yang meridians, constituting an external contraction. Qi Kou (Cun Kou) governs the interior. A pulse that is盛大 and firm indicates dietary injury to the Three Yin meridians, constituting an internal injury. This is the ancient method. Nowadays, only the Cun Kou diagnostic method is used, which is not bad. However, originally there was no theory of distinguishing internal/external by left/right. Since Wang Shuhe, erroneously taking the left as Ren Ying and the right as Qi Kou, the meaning of exterior-interior has been lost for a long time.
The color is coarse (up to) The illness is just healing: The *Jia Yi Jing* adds "Zhe wei jian" (those who are clear are intermediate) after "Ming". "Chen yao" is written as "Chen e". Li Yun explains that "Cu" (Coarse) means bright and clear, while "Chen yao" means dull and stagnant. Color values brightness and clarity; if dull and stagnant, the illness is severe. If color moves upward, turbid Qi is rising, so the illness is severe. If moving downward, turbid color recedes, so the illness is healing. The commentary notes that the *Jia Yi Jing* saying "Coarse interpreted as clear indicates an intermediate state" makes the meaning self-evident.
Five Colors have Zang regions (up to) Reversal leads to worsening: Zhi Yun states that "Zang bu" refers to the regional divisions of the Zang organs. The five Zang organs are arranged next to the center as the internal region, and the six Fu organs flank the two sides as the external region. When color moves from the external region to the internal region, it signifies an exogenous illness moving from outside to inside. When color moves from the internal region to the external region, it signifies an endogenous illness moving from inside to outside. Generally, Fu organs are Yang and govern the exterior, while Zang organs are Yin and govern the interior. Therefore, for illnesses arising internally, treat the Yin first, then the Yang; reversing this worsens the condition. For illnesses arising externally, treat the exterior first, then the interior; reversing this worsens the condition.
If the pulse is slippery and large (up to) Change is possible and the illness ends: Ma Yun points out that observing both color and pulse constitutes a detailed examination. Pulses that are slippery and accompanied by large, Dai (intermittent), or long qualities are all Yang pulses, indicating illness coming from outside. Externally, symptoms include visual hallucinations and mental aversions, representing Yang Qi converging externally. One should treat the Yang first, then the Yin, causing transformation, and the illness will end. By analogy, pulses that are choppy and accompanied by small, Dai, or short qualities are all Yin pulses, indicating illness coming from inside. Internally, symptoms include specific visual perceptions and isolated mental states, representing Yin Qi converging internally. One should treat the Yin first, then the Yang, causing transformation, and the illness will end.
Regularly observe Que Zhong (up to) Speak of the illness: The *Jia Yi Jing* reads "Dang hou Mei Jian" (Should observe the space between eyebrows). Zhang Yun explains that "Que Zhong" is the space between the eyebrows. Wind diseases affect Yang and the skin/hair, so the color is thin and lustrous. Bi diseases affect Yin and muscle/bone, so the color is deep and turbid. "Chong" means deep. As for Jue Ni (Cold Reversal), the illness originates in the four limbs, so the illness is lower, and the color also appears in the "Earth" area. "Earth" refers to the lower part of the face. This is the regular observation method, so one can speak of the illness based on the color. Li Yun explains that "Earth" is what physiognomists call the "Earth Pavilion," i.e., the areas of Ju Fen and Ju Qu.
Great Qi enters the Zang (up to) Observe color to speak of the timing: Zhang Yun explains that "Da Qi" is Great Pathogenic Qi. For Great Pathogen to enter, it is invariably due to a great deficiency of Yuan Qi, allowing the pathogen to invade, leading to sudden death. A shape like a thumb, forming blocks or strips, gathering without dispersing, is the most ominous color. Red is certainly not good, but black is even worse; both are colors of sudden death. Observing color to speak of timing means that the Five Colors have phases of decline and prosperity, and regions have overcoming relationships. Color hides in regions; if observed clearly, the timing can be known. Li Yun explains that "Da Qi" is Great Pathogenic Qi, such as Water color appearing in the Fire region, or Fire color in the Metal region. This indicates great deficiency of Yuan Qi and arrival of Treacherous Pathogen. Even if not yet symptomatic, sudden death is inevitable. A shape like a thumb is the most ominous color. Red emerging from the cheekbones corresponds to the shoulders and also the Lungs; Fire overcomes Metal. Even if the illness heals, sudden death is inevitable. The Heavenly Court is at the highest point; if invaded by black, it indicates Kidney exhaustion. Even if asymptomatic, sudden death is inevitable. Lou Shi says, red emerging from both cheekbones corresponds to the *Mai Jue* saying "Sudden illness like makeup, will not last long." Ma Yun says "Mu" refers to the big toe of the foot. The commentary notes that *Shuo Wen* defines "Mu" as the thumb, while *I Ching* commentary defines it as the big toe.
Ting is the head and face: The *Jia Yi Jing* writes "Ting" as "Yan". Zhang Yun explains that "Ting" is the face, known in physiognomy as the Heavenly Court. The Heavenly Court is the highest point; color appearing here corresponds to diseases of the head and face.
Que Shang is the throat: The *Jia Yi Jing* writes "Que Shang" as "Above the space between eyebrows". Zhang Yun explains that "Que" is at the inner canthus/eyebrow gap. "Que Shang" is above the eyebrow gap. Its position is also high, so it corresponds to throat diseases.
Que Zhong is the Lung: The *Jia Yi Jing* writes "Que Zhong" as "Middle of the space between eyebrows". Zhang Yun explains that "Que Zhong" is the eyebrow gap. Being the highest point in the middle section, it corresponds to the Lung. Jiang Shiji says it is the central upright position.
Xia Ji is the Heart: Zhang Yun explains that "Xia Ji" is the space between the two eyes, known in physiognomy as Shan Gen (Mountain Root). The Heart resides below the Lung, so Xia Ji corresponds to the Heart. Jiang Shiji says it is the Yin Tang.
Straight down is the Liver; Left of the Liver is the Gallbladder: Ma Yun says the left of the Liver is the Gallbladder, located between the nose and cheeks. Zhang Yun explains that below Xia Ji is the nasal bridge, known in physiognomy as Nian Shou. The Liver is below the Heart, so straight down corresponds to the Liver. The Gallbladder attaches to the short lobes of the Liver, so the left of the Liver corresponds to the Gallbladder, located on the left and right of Nian Shou. Jiang Shiji says the Gallbladder is between the short lobes of the Liver, belongs to Wood, is positioned East, commands South, and its position is on the left. Thus, the left side of Shan Gen is the Gallbladder's region.
Below is the Spleen; Fang Shang is the Stomach: Ma Yun says below the Liver is the Spleen. "Fang" refers to the nasal tunnel. "Mian Wang" refers to the tip of the nose. Above the nasal tunnel, i.e., above Ying Xiang, is the Stomach. Zhang Yun explains that below Nian Shou is known in physiognomy as Zhun Tou, which is Mian Wang, also called Mingtang. Zhun Tou belongs to Earth and is centrally located on the face, so it corresponds to the Spleen. The sides of Zhun Tou are Fang Shang, i.e., the nasal tunnel above Ying Xiang, known in physiognomy as Lan Tai Ting Wei. Spleen and Stomach are interior-exterior pairs; Spleen is central and Stomach is external, so Fang Shang corresponds to the Stomach. Jiang Shiji says the Stomach is the Fu organ of the Spleen, is Yang, and Yang resides upper. Thus, Fang Shang of the Spleen is the Stomach's region. "Fang" means beginning; beginning rises to the Spleen. Spleen and Stomach are interior-exterior pairs, indicating they are close. The commentary notes that according to the earlier text "Five Zang next to the center, Six Fu flank the sides," Jiang's interpretation may be incorrect.
The center is the Large Intestine (up to) Umbilicus: Ma Yun says outside the Stomach is the Large Intestine, directly below the cheekbones. Outside the Large Intestine is the Kidney. Thus, the Large Intestine is central, and the Stomach and Kidney flank it. Zhang Yun explains that "Center" refers to the center of the face, specifically outside Ying Xiang and below the zygomatic bone, corresponding to the Large Intestine. Flanking the Large Intestine is the upper cheek. The four Zang organs are single, except the Kidney which is paired. Four Zang reside in the abdomen, only the Kidney attaches to the spine. Hence, four Zang are next to the center, while the Kidney uniquely corresponds to both cheeks. The Kidney opposes the umbilicus, so below the Kidney corresponds to the umbilicus.
Above Mian Wang (up to) Zi Chu (Uterus): The *Jia Yi Jing* has the character "Shang" (Above) before "Zi", consistent below, which seems correct. Zhang Yun explains that "Mian Wang" is the nasal tip. The Small Intestine is a Fu organ and corresponds to flanking the sides. Thus, above Mian Wang, inside the two cheekbones, is the Small Intestine's region. Below Mian Wang is the Ren Zhong (Human Middle), which corresponds to the Bladder and Zi Chu. "Zi Chu" is the uterus. People whose Ren Zhong is flat/shallow and hairless often lack offspring, which is the correct correspondence for Zi Chu. The above are all correspondences for the five Zang and six Fu organs. Li Yun says women with deep and long Ren Zhong are good at childbirth. Jiang Shiji says medical texts state: Yellow Zhun Tou indicates difficulty urinating; *Shi Chuan* chapter says nostrils outward indicate bladder leakage. The following text says men with color on Mian Wang suffer lower abdominal pain, lower testicular pain, round/straight shape indicates penile pain. For women, it should be Bladder and Zi Chu diseases.
Cheekbones are shoulders (up to) Chest and breasts: Zhang Yun points out that the following discusses limb/joint correspondences. Cheekbones are the root of bone and located upper-middle, so they correspond to shoulders. Arms connect to shoulders, so behind cheekbones correspond to arms. Hands connect to arms, so below arms correspond to hands. Above the inner canthus is the area beside Que Xia. High points on both sides of the chest are Ying. Ying Ru corresponds to the front of the chest. Jiang Shiji says the inner canthus is near Shan Gen, specifically the Jing Ming acupoint, where the Foot Taiyang Meridian begins. Zhu Xi's commentary on *Zhong Yong* states: "Ying" is the chest, the chest-breast area is observed at the inner canthus.
Jia Sheng (up to) Kneecaps: Zhang Yun explains that the outer cheek is called "Sheng". The back of the body is the back, so the back corresponds to above Jia Sheng. "Ya Che" is the jaw. Below Ya Che governs the lower frame, so it corresponds to the thighs. Center is between the two Ya Ches. Calves connect to knees, feet connect to calves, sequentially downwards. "Ju Fen" is the large wrinkle beside the mouth. "Gu Li" is the inner thigh. "Ju Qu" is the curved bone under the cheek. "Xi Bin" is the kneecap. This generally refers to the knee region. Jiang Shiji says "Sheng" is the ear edge. The ear edge protrudes like a rope, hence "Sheng". Ma Shi says outer cheek is Sheng. This interpretation is deemed inappropriate. Generally, Mingtang parts are internal, ear sides are external, Zang organs are internal, Ying/Ru are secondary, arms/back are external. "Jia" means near. Thus, the part vertically above near the ear observes back diseases. "Ya Che" is the Jiache acupoint, in the depression before the ear. Upper body parts (shoulders/back) correspond to lower body parts (thighs/knees). Thus, below the back and below Jiache observe the thighs. "Ju Fen": "Ju" means large. The large division of upper/lower dental arches observes the inner thigh. Dental arches govern opening/closing, similar to how inner thighs govern flexion/extension. Upper/lower lips undergo large rotation; the junction is the Dicang acupoint, observing kneecaps. Lips are portals for speech/eating, similar to how kneecaps are joints for flexion/running. Both move continuously, hence the correspondence.
Each has its part (up to) Called a skilled physician: The *Jia Yi Jing* writes "Ze Yao" as "Ze E", and subsequent "Yao" characters are the same. Zhang Yun states that once parts are fixed, Yin and Yang become clear. If Yang prevails, Yin must decline; assist Yin to harmonize. If Yin prevails, Yang must decline; assist Yang to harmonize. The use of Yin and Yang is universally applicable. Knowing their excess and deficiency ensures success in every action. Yang follows left, Yin follows right. Left and right are the pathways of Yin and Yang. Thus, distinguishing left and right is called the Great Dao. Men and women have different positions: for men, left is adverse, right is compliant; for women, right is adverse, left is compliant. Hence, Yin and Yang. Once Yin and Yang are distinguished, one must also observe luster vs. dryness to determine auspiciousness/misfortune. Only then can one be called a skilled physician.
Deep and turbid is internal (up to) Skin insensitivity: The *Jia Yi Jing* writes "Fu Ze" as "Fu Qing". Li Yun explains: Color that is floating, turbid, and dull indicates interior; color that is floating, lustrous, and bright indicates exterior. From the five colors appearing on the face, one can deduce the illness. Severe pain manifests as extreme blue/black. Severe cold manifests as extreme white. Zhi Yun states: Wind is Heaven's Yang pathogen, so color appears yellow/red. Pain is Yin Bi, so color appears blue/black. White color indicates cold. Yellow and greasy/lustrous indicates abscess/pus. Extreme red indicates retained blood. Pain in sinews/bones leads to spasms when severe. Cold damaging skin leads to skin insensitivity when severe.
Observe its dispersion or aggregation To know distance/recency: Ma Yun states: Observing dispersed color indicates recent illness. If aggregated, the illness is chronic. "Tuan" is synonymous with "Tuan" (ball/clump).
Accumulate spirit in the heart (up to) Then know new vs. old: Ma Yun states: Accumulate spirit/Qi in one's own heart, and one can know whether the illness is past or current. Those who observe Qi/color cannot reach subtlety do not know the correctness of the illness. Only by focusing attention and being unshaken can one clearly understand whether the illness is new or old.
Color bright but not coarse (up to) Aggregation not yet formed: Li Yun explains: "Cu" means prominent. Bright color not prominent, but showing dull/stagnant/dry qualities, indicates severe illness. If not bright/lustrous but not dull/dry, illness is not severe. "Ju" is a foal, un-saddled, scattered not gathered. Metaphorically, scattered color without fixation indicates illness scattered without solid accumulation. Even if painful, it is due to formless Qi.
Kidney overcomes Heart (up to) All are like this: Zhang Yun states: Water pathogen overcomes Fire; Kidney overcomes Heart. Kidney pathogen overcomes Heart, Heart suffers internally while Kidney color manifests externally, e.g., black appearing at Xia Ji. This applies to all Zang organs, not just Heart/Kidney. If Lung color appears in Liver region, Heart color in Lung region, Spleen color in Kidney region, Liver color in Spleen region, and among Six Fu organs in overcoming relationships, the colors are all like this.
Men's color at Mian Wang (up to) Belongs to Yin: Li Yun says "Shang" (Above) should follow "Mian Wang". Above Mian Wang is Small Intestine, below is Bladder/Zi Chu. "Luan" are testes. "Yuan Zhi" points to Ren Zhong, the Shui Gou acupoint. Ren Zhong has borders; round and straight indicates color appearing there, governing penile pain. Upper half of Ren Zhong is "Gao", indicating root pain. Lower half is "Jing Tou", indicating shaft pain. All these are Hu Han (fox hernia), belonging to Yin. i.e., Hernia. Ma Yun says "Yuan" is round. Commentary notes Ma's explanation of the first chapter is unclear; Li bases on Zhang's note and is more detailed, so Li is adopted.
Women's at Mian Wang (up to) Impure: The *Jia Yi Jing* has "Se" (Color) after "Zi". Ma Yun states: Women's color at Mian Wang indicates illness in Bladder meridian or Zi Chu, i.e., Bao Luo Gong. Dispersed Qi/color indicates pain but not aggregation. If Qi/color aggregates and does not disperse, it forms a mass beyond just pain. The aggregation inside may be square, round, left, or right, matching the external color's shape. If color descends to Wei Di (sacrum), the lower illness involves exudative discharge. (*Su Wen · Wei Lun* calls this Bai Yin). Lustrous/greasy substances exist. Otherwise, it is due to binge eating/immoderation, resulting in impure discharge. Why? The downward momentum is consistent internally and externally. Zhang Yun says: Or sudden dietary cause, resulting in lower impurity. Refers to both anterior and posterior orifices. "Di" should be pronounced "Di", the area between buttocks. Li Yun says "Xia" (Down) should follow "Mian Wang". Above Mian Wang is Ren Zhong, governing Bladder/Zi Chu. Dispersed color is pain, formless Qi stagnation. Aggregated color is mass, formless Blood coagulation. Accumulations vary in shape/position, matching external appearance.
If color descends to Wei Di, it is exudative turbidity with lustrous/greasy matter. This syndrome is mostly caused by binge eating/immoderation. "Bu Jie" means immoderation, not filth. Eating too much cold or hot food, or any unsuitable food. Zhi Yun states: Lustrous/greasy color indicates binge eating impure food. Fu organs are Yang, govern exterior, accept water/grain, transmit waste. Thus, external wind-cold or internal dietary injury damage Fu organs, and color appears in Fu regions. Commentary notes uncertainty on "Bu Jie". Li's interpretation of "Bu Jie" as "immoderation" seems unstable.
Left is left (up to) That which is pointed to: Zhi Yun states: Color appearing on left indicates illness on left. Color on right indicates illness on right. The observed color, whether aggregated or dispersed, is slanted and not upright. The aggregated facial color is what is called "like a finger". Zhang Yun states: Any color that is slanted with irregular aggregation/dispersion indicates the location of illness. Thus, observing where the facial color points reveals the illness. Commentary notes "Zhi" in Zhi's note refers to "thumb" from previous section, which is incorrect.
All are upright and full with distinct regions (up to) At Mian Wang indicates not days: Note: Various editions write "Bie Xiang" instead of "Bie Mu", should be corrected. *Jia Yi Jing* and Ma Shi also write "Chi Da" instead of "Da". *Jia Yi Jing* writes "Bu Yue" instead of "Bu Ri". Ma Yun states: "Bie" means different. "Bie Xiang" means distinct region. The so-called color refers to Blue/Black, Red, White, Yellow. All are upright and full, each having a region. For example, Heart color governs Red, Small Intestine is also Red. If the color is the size of a elm seed, in the Mian Wang region, it indicates Small Intestine illness, lasting more than one day. Zhang Yun states: There are five true colors, all suitable...