欲愈之病目 黄。
熊宗立曰。目 有内外。内 属胃。今见黄色。是胃土之正色。外 虽属
膀胱。今见黄色。是脾胃之气生。故能克去膀胱水。是知病当愈。愚谓十
二经之卫气。俱从目 出入。今目 而见黄色。是病从内而出外。胃气
复生故也。脉经亦云。病患两目 有黄色起者。其病方愈。
眼胞忽陷定知亡。
三部九候论云。伤内陷者死。张介宾释云。五脏六腑之清气。皆上注于
目。而为之精。目内陷者。阳精脱矣。故必死。熊宗立张世贤。俱引五轮以
为释。似属繁文。
按玉机真藏论。大骨枯槁。大肉陷下。胸中气满。腹内痛。心中不便。肩项
身热。破 脱内。目眶陷。真藏见。目不见人立死。其见人者。至其不胜之
时则死。脉经云。病患阴阳绝竭。目眶陷者死。中藏经云。阴阳俱绝。目眶
陷者死。
耳目口鼻黑色起。入口十死七难当。
五脏之华。萃于面。眼耳鼻舌居焉。犹如天日宜清净光明。不宜翳蔽惨
暗。凡耳目口鼻。但有一处见其黑色。即为不真。脾开窍于口。舌居其中。
为心之苗。若见黑色从外而入于口内。为秽恶之气。犯其谷神。并及心
主。其不祥莫大焉。若人见此。虽十人而必死其七焉。脉经云。病患耳目
口鼻。有黑色起。入于口者必死。此之谓也。诸家之释。俱以黑色为肾之
色。似乎欠通。何也。若以黑为肾之色。似于耳赤无妨矣。张世贤释。又以
火之成数在七。至第七日当死。亦未必然。
面黄目青酒乱频。邪风在胃丧其身。
五脏生成论云。凡相五色之奇脉。面黄目青。面黄目赤。面黄目白。面黄
目黑者。皆不死也。脉经则曰。面黄目青。九日必死。是谓乱经。饮酒当风
邪。入胃经。胆气妄泄。目则青。虽有天枚。不可复生。似乎与内经相背。脉
经又云。面黄目青者不死。青如草滋死。合而观之。则面黄目青。未必不
死。亦未必尽死。但青而明润不死。青而惨暗则死也。池氏释曰。饮酒过
多。伤乎脾胃。致脾经积热。热则生风。风生于肝。肝属木。木气盛克乎脾
土。必损其身。此说似太转折。不若脉经所谓乱经饮酒。风邪入胃。胆气
妄泄。目则青之说。为简而当也。
面黑目白命门取。困极八日死来侵。
脉经云。面黑目白者不死。又曰。病患面黑目白也。八日死。肾气内伤。病
因留积。非前后之说相违也。亦准前白如明润者不死。白如惨暗者死
也。然经云。肾气内伤。此则云。命门败者何也。盖命门右肾也。若云肾败。
则当云面白目黑。而此云面黑目白者。张世贤曰。黑水也。目。木也。白。金
也。命门。火也。水浸淫而贼火之气。金克木而伐火之源。所以命门火败。
火之成数七。七日火极矣。故死于第八日也。其说亦通。池氏为命门乃
厥阴之说。欠稳。
面色忽然望之青。进之如黑卒难当。
洁古曰。青黑之色。为肝肾色也。先青后黑。是回则不转。神去则死也。池
氏曰。青属肝。黑属水。水干木枯。肾肝皆绝。故泄其气于外。其说亦遍。脉
经云。病患及健人。面忽如马肝色。望之如青。近之如黑者死。此之谓也。
面赤目白忧息气。待过十日定存亡。
脉经云。面赤目白者十日死。忧恚思虑。心气内索。面色反好。急求棺 。
此之谓也。张世贤曰。息气喘逆也。赤色属火。白色属金。火来克金。必作
喘逆。金之成数在九十。乃土之成数也。土能生金。今土不能生金。则死。
故曰待过十日也。氏曰。心属火。肺属金。火克金。过得十日。至水数而火
方退。则不死。火气不退。再至心。数日。必死。
按五脏生成论云。面赤目白。皆死也。
面赤目青众恶伤。荣卫不通立须亡。（他本无此二句）
张世贤曰。面赤。火也。目青。木也。木火色见。风热伤于五脏六腑。脏腑受
伤。血气衰。肌肉不滑荣卫之道。涩而不通。其死也可立而待。愚谓面赤。
火也。目青。木也。皇极内篇有云。火木相得。则然从其类也。脉经云。目青
者。病在肝。面赤目青。则肝肺俱伤。血气俱涩。而荣卫不得宣通。当为暴
死之证。非常病也。
按五脏生成论云。面赤目青皆死也。脉经云。面赤目青者。六日死。
黄黑白色起入目。更兼口鼻有灾殃。
池氏曰。黄属脾。黑属肾。白属肺。目属肝。口属脾。鼻属肺。而肾胜乎脾土。
土弱不能生金。此灾殃之所以至也。此说似属勉强。张世贤曰。独见者。
谓之正色。杂见者。谓之邪色。黄黑白之三色。杂见于面。或当于目。或入
于口。或入于鼻。乃病气从外而之内。故有灾殃。此说近是。愚按脉经云。
面目俱等者不死。可见杂色入目。俱为不祥。若入口鼻。其灾更甚。何也。
口鼻者。阳明开窍处也。凡有杂色来现。皆属阴邪。故曰有灾殃也。
按脉经云。病患及健人黑色。若白色起入目。及口鼻。死在三日中。
面青目黄中时死。余候须看两日强。
熊宗立释云。肝木克乎脾土。中时即死。虽有余证。亦不过二日。此说不
明。张世贤曰。中时即午时。午时属火。面青目黄。肝木克乎。脾土。到午时
木得火而不畏金。木势愈盛。人以胃气为木土绝则死。故死在是时。其
他相克。看过旺二日。而断其生死。此说近是。但于余候。须看两日强之
句。亦不甚明了。愚按脉经云。目黄者。病在脾。面青则为肝气盛。是为肝
木克乎脾土。若以时候之当。死在中时。若以日候之。当强在两日。何也。
中时者。午时也。火盛则木寡于畏。而脾土愈伤。故曰中时。其余则以日
候之矣。两日。乃火之生数也。火能生土。故至两日而复望其强耳。
按脉经云。病患面青目黄者。五日死。
目无精光齿龈黑。面白目黑亦灾殃。
池氏云。目无精光而神散。乃心肝皆绝齿龈黑。乃脾绝。面白如枯骨。乃
肺绝。目黑。乃肾绝。五脏皆绝。必然断之以死云。张世贤曰。目无精光者。
神短也。齿龈黑者。脾绝也。面白者。少血也。目黑者。肾虚也。有是四者。则
非常久之客。愚谓目无精光。神散也。齿属肾。为骨之余。上下牙龈属阳
明。齿龈黑者。为肾水枯竭。不能荣养其余。面白目黑。则当根据经文荣华
已去。血脉空存为释也。张氏之说。已属多文。
按脉经云。病患目无精光。及牙齿黑色者不治。又曰。病患面白目黑者
死。此谓荣华已去。血脉空存。又曰。病患齿忽变黑者。十三日死。
口如鱼口不能合。气出不返命飞阳。
洁古曰。火胜迫于肺火。喘而死。肺败也。池氏曰。口乃脾之窍。口如鱼口。
脾气已绝也。李 范曰。呼出心于肺。吸入肾于肝。呼因阳出。吸随阴入。
肝肾先败。止有心肺未绝。所以有出而无入也。李氏之说近是。
按脉经云。病患口如鱼口。不能复闭。而气出不能反者死。
肩息直视及唇焦。面肿苍黑也难逃。
张世贤曰。肩息者。气喘而两肩动也。直视者。睹物而不转睛也。唇焦。心
家热也。面乃心之候。黑乃肾之色。上句是心绝。下句是肝绝。心肝既绝。
命故难逃。愚谓肩息肺绝。直视肝绝。唇焦脾绝。面肿心绝。苍黑肾绝。
按脉经云。病患目直视肩息者。一日死。又曰。病患唇口忽干者。不治。又
曰。病患卒肿。其面苍黑者死。经云。病心绝一日死。何以知之。肩息回视
立死。
妄言错乱及不语。尸臭元知寿不高。
脉经云。病患妄言错乱。及不能语者。不治。热病者可治。又曰尸臭者。不
可治。愚谓妄言错乱。神妄失守也。心脾肾三经之脉。皆循喉咙夹舌本。
不语者。三经之脉。不能上通于舌也。人将死必有一脏先坏腐。坏则秽
恶之气外泄。故尸臭也。
人中尽满兼唇青。三日须知命必倾。
愚按。人中及唇。乃脾胃之所主也。人中满而唇青。则脾胃之土已坏。而
厥阴之木乘之。以日数断之。三乃木之主数。土得木而绝矣。
按脉经云。病患唇青人中满者死。
两颊颧赤人病久。
灵枢五色篇云。赤色出两颧。大如拇指者。病虽小愈。必卒死。魏氏曰。眼
眶下高骨之中。名颧。颧下名脸。面外名颊。颧面颊脸。心火所属。久病而
赤。乃精神外泄。脉经云。病患耳目。及颧颊赤者。死在五日中。戴氏以两
颊为赘词。而改为庭黑。何也。
口张气直命难存。
熊宗立曰。口乃脾之窍。脾绝口不能合。肺绝则气出不能返。
按脉经云。病患口张者。三日死。又曰。脉绝口张。足肿。五日死。
足趺趾肿膝如斗。十日须知难保守。
张世贤曰。脾主四肢。足趺乃胃经所行之处。脾胃将绝。则有是证。脾胃
属土。十日者。土之成数也。故死不过十日也。
按脉经云。足趺肿。两膝大如斗者十日死。又云。足趺肿。呕吐头重者死。
项筋舒直定知殂。（他本直作展。）
张世贤曰。项筋舒展。因督脉已绝是也。熊宗立谓肾脉绝非也。
掌内无纹也不久。
张世贤曰。掌内无纹。心包络脉绝也。脉经云。病患掌肿无纹者死。
唇青体冷反遗尿。背面饮食四日期。
池氏曰。唇青体冷。乃真气欲绝。遗尿不禁。乃膀胱不藏。背面饮食。乃神
去不守。人之神气生于肝。神不守。则肝绝不出金数而死也。池氏之说
亦是。愚谓唇青体冷。则纯阴而无阳。背面饮食。则畏阳而就阴。遗尿则
肾气已绝而无藏德。至四日而金寒水冷。魂魄不拘矣。不死何俟。
按脉经云。脾病唇青。肝之色。甲乙日死。又曰。病唇青。人中。及三日死。
手足爪甲皆青黑。能过八日定难医。
李 范曰。肝之余筋也。其荣爪。肝色青。肾色黑。肾水不能生肝。水木二
脏俱败。故泄其色于外。肝至木成数而死可知矣。李氏之言如此。与理
不合何也。夫既曰肝色青。又兼黑色。则为肾水来生肝木。何为二脏俱
败也。况肝至八日。既遇木之成数。适当其旺。何云死也。据愚言之。当曰
肝色青。内其主血。外其荣筋。爪者。筋之余也。得血以养。故赤色华之。今
肝脏已败。则血先竭。而厥阴真藏之色。现于爪。厥阴者。阴之尽也。木死
则如已燃之薪。故色兼黑然八日之内。尚有木之成数。故曰能过八日。
至九日则为金之成数。木得金而折。故死也。
按脉经云。病患爪甲青者死。又云。病患手足爪甲下肉黑者。八日死。
脊痛腰重反复难。此是骨绝五日看。
肾主骨。腰者肾之府。肾水足则有髓。二道夹脊而上通于脑。今肾衰则
精髓枯竭。故脊痛。脊痛腰重而至不可反侧。则肾将惫。而骨已绝矣。五
为土之生数。水见土则绝。
体重溺赤时不止。肉绝六日便高拼。
张世贤曰。体重肉绝。脾也。溺出不止。肾也。土胜水死期。故曰六日。六乃
水成数也。张氏之言如此。夫既以体重肉绝为脾败。则土已不能胜水
矣。何以又云土胜水死。期在六日也。愚按华佗内照云。肉绝六日死。何
以知之。舌肿溺血。大便赤然也。华佗之言如此。此为心火炽甚之疾。火
炎则土燥。故肌肉消灼而体重也。心火甚。则移于小肠。故溺赤不止也。
亢极则害。承乃制。故至水之成数之日而死也。戴起宗脉诀刊误。不知
华佗内照。而但曰中藏经元无谓脉诀自增。可耻甚矣。
手足甲青呼骂多。筋色九日定难过。
李 范曰。爪者。筋之余。筋者。肝之余。肝主怒。在声为呼。今爪甲皆青。怒
声呼骂。乃肝气太过。过则极。极则绝。肝属木。至金成数。九日而死。
按经云。病患筋绝九日死。何以知之手足爪甲青。呼骂不休。又发直如
麻。甲青者死。
发直如麻半日死。
熊宗立释发直。乃心与小肠绝。谓发为血之余。血败则发枯硬直。其说
亦是。但半日死未详。疑误不敢强释。姑俟后考。张世贤又云。发如麻者。
肺气绝也。
按脉经云。病患发直者。十五日死。又曰。发如干麻善怒者死。又曰。发与
眉冲起者死。据中藏经曰。肠绝发直。汗出不止。不得屈伸者。六日死。又
曰。发直者。十五日死。
寻衣语死十知么。
张世贤曰。寻衣语死。神不守舍也。愚谓若根据死在十日。当是肾衰水涸。
不能上荣于目。致目虚眩。视物不真。故循衣语死。至十日则为土之成
数。水见土而绝矣。
按脉经云。病患循衣缝 语者。不可治。
又按丹溪心法。能合色脉。可以万全论。欲知其内者。当以观乎外。诊于
外者。斯以知其内。盖有诸内者。形诸外。苟不以相参而断其病邪之逆
顺。不可得也。为工者。深烛厥理。故望其五色。以青黄赤白黑。以合于五
脏之脉。穷其应与不应。切其五脉急大缓涩沉。以合其五脏之色。顺与
不顺。诚能察其精微之色。诊其精妙之脉。内外相参而治之。则万举万
全之功。可坐而致矣。素问曰。能合色脉。可以万全。其意如此。原夫道之
一气。判而为阴阳。散而为五行。而人之所禀。皆备焉。夫五脉者。天之真。
行血气。通阴阳。以荣于身。五色者。气之华。应五行。合四时。以彰于面。唯
For a disease that is about to heal, observe the eyes.
Xiong Zongli said: The eyes have an interior and exterior aspect. The interior belongs to the Stomach (Wei). Now seeing yellow color indicates the true color of Earth (Tu) of the Stomach. Although the exterior belongs to the Bladder (Pangguang), seeing yellow now signifies the generation of Qi from the Spleen and Stomach. Thus, it can overcome the Water (Shui) of the Bladder. From this, we know the disease will heal. I believe that the Wei Qi (Defensive Qi) of the twelve meridians all enter and exit through the eyes. Now seeing yellow in the eyes means the pathogen is moving from the interior to the exterior, which is due to the recovery and generation of Stomach Qi. The *Mai Jing* (Pulse Classic) also states: If a patient has yellow appearing in both eyes, the disease is about to heal.
If the eyelids suddenly sink, death is certain.
The *Su Wen: San Bu Jiu Hou Lun* says: Those with internal collapse of essence die. Zhang Jiabin explained: The clear Qi of the five Zang and six Fu organs all ascend to the eyes to form their spirit. If the eyes are sunken, the Yang Jing (Essence) has departed. Therefore, death is inevitable. Xiong Zongli and Zhang Shixian both cited the Five Wheels theory for explanation, which seems overly verbose.
According to the *Su Wen: Yu Ji Zhen Zang Lun*: If the large bones are emaciated, the large muscles are sunken, there is fullness of Qi in the chest, pain in the abdomen, discomfort in the heart, heat in the shoulders, neck, and body, diarrhea with anal incontinence, sunken eye orbits, and the True Zang pulse appears, if the person cannot see others, they die immediately; if they can still see others, they will die when the time comes when they cannot withstand the controlling element. The *Mai Jing* states: If a patient's Yin and Yang are exhausted and the eye orbits are sunken, they will die. The *Zhong Zang Jing* states: If Yin and Yang are both exhausted and the eye orbits are sunken, they will die.
If black color appears in the ears, eyes, mouth, and nose, and enters the mouth, seven out of ten cases are difficult to save.
The splendor of the five Zang organs gathers in the face, where the eyes, ears, nose, and tongue reside. It should be like the sun and sky, clear and bright, not obscured or dark. For the ears, eyes, mouth, and nose, if any one of them shows black color, it is abnormal. The Spleen opens into the mouth, and the tongue resides within, being the sprout of the Heart. If black color is seen entering the mouth from the outside, it is foul and evil Qi invading the Grain Spirit (Spleen/Stomach) and affecting the Heart Master. There is no greater omen of misfortune than this. If a person presents this, even among ten, seven will surely die. The *Mai Jing* states: If a patient has black color appearing in the ears, eyes, mouth, and nose, and it enters the mouth, they will surely die. This is what is meant. Various explanations attribute black color to the Kidney, which seems inappropriate. Why? If black were the color of the Kidney, would red ears be without issue? Zhang Shixian explained that the completion number of Fire is seven, so death would occur on the seventh day, but this is not necessarily so.
Yellow face, green eyes, drinking while exposed to wind, pathogenic wind in the Stomach leads to loss of life.
The *Su Wen: Wu Zang Sheng Cheng Lun* states: Regarding the observation of the five colors and unusual pulses, those with a yellow face and green eyes, yellow face and red eyes, yellow face and white eyes, or yellow face and black eyes, will not die. However, the *Mai Jing* says: Yellow face and green eyes mean death in nine days, called "disordered meridians." Drinking while exposed to wind pathogens, the pathogen enters the Stomach meridian, causing reckless leakage of Gallbladder Qi, making the eyes green. Even with heavenly endowment, life cannot be restored. This seems to contradict the *Nei Jing*. The *Mai Jing* also states: Yellow face and green eyes do not die, but if the green is like dead grass, they will die. Observing these together, yellow face and green eyes may or may not lead to death. Only if the green is bright and lustrous will they survive; if dull and bleak, they will die. Chi Shi explained: Excessive drinking damages the Spleen and Stomach, leading to accumulated heat in the Spleen meridian. Heat generates wind, wind arises from the Liver. The Liver belongs to Wood, and excessive Wood Qi controls Earth (Spleen), inevitably damaging the body. This explanation seems too convoluted. The explanation in the *Mai Jing* regarding "disordered meridians from drinking, wind pathogen entering the Stomach, reckless leakage of Gallbladder Qi, resulting in green eyes" is simpler and more appropriate.
Black face, white eyes, failure of the Ming Men (Gate of Life), extreme exhaustion leads to death in eight days.
The *Mai Jing* states: Black face and white eyes do not die. It also says: A patient with a black face and white eyes will die in eight days. This is because Kidney Qi is internally injured, and the pathogen remains stagnant. This does not contradict previous statements. It follows the earlier rule: White that is bright and lustrous does not die; white that is dull and bleak dies. However, the classic mentions internal injury to Kidney Qi, while here it mentions failure of the Ming Men. Why? Generally, the Ming Men is considered the right Kidney. If it were Kidney failure, it should be stated as white face and black eyes. Here it is black face and white eyes. Zhang Shixian said: Black is Water, eyes belong to Wood, white is Metal, and the Ming Men belongs to Fire. Water inundates and harms the Qi of Fire; Metal controls Wood and attacks the source of Fire, thus causing the failure of Ming Men Fire. The completion number of Fire is seven; at seven days, Fire reaches its peak, so death occurs on the eighth day. This explanation is also plausible. Chi Shi's view that the Ming Men is Jueyin is less stable.
Face suddenly appears blue/green from afar, looking black up close, sudden and hard to bear.
Jie Gu said: Blue/green and black colors are the colors of the Liver and Kidney. First blue/green then black indicates reversal without return; when Shen (Spirit) departs, death occurs. Chi Shi said: Green belongs to the Liver, black to Water. When Water dries and Wood withers, both Kidney and Liver are exhausted, so Qi leaks outward. This explanation is comprehensive. The *Mai Jing* states: If a patient or healthy person's face suddenly looks like horse liver color, appearing green from afar and black up close, they will die. This refers to that situation.
Red face, white eyes, worry and panting; wait over ten days to determine survival.
The *Mai Jing* states: Red face and white eyes mean death in ten days. Worry, anger, and contemplation deplete Heart Qi internally, yet the facial color appears improved; urgently seek a coffin. This refers to that situation. Zhang Shixian said: "Xi" refers to panting and counterflow. Red belongs to Fire, white to Metal. Fire controls Metal, inevitably causing panting and counterflow. The completion number of Metal is nine and ten, which is also the completion number of Earth. Earth generates Metal; now since Earth cannot generate Metal, death ensues. Hence, "wait over ten days." Dai Shi said: Heart belongs to Fire, Lung to Metal. Fire controls Metal. After ten days, when the Water number arrives, Fire retreats, and they will not die. If Fire Qi does not retreat, after a few more days, they will surely die.
According to the *Su Wen: Wu Zang Sheng Cheng Lun*: Red face and white eyes both indicate death.
Red face, green eyes, everyone considers it ominous; Ying and Wei (Nutritive and Defensive) blocked, death follows immediately. (These two lines are absent in other editions.)
Zhang Shixian said: Red face is Fire, green eyes is Wood. The appearance of Wood and Fire colors indicates wind-heat injuring the five Zang and six Fu organs. Organ injury leads to decline of Blood and Qi, lack of lubrication in muscles, and stagnation/blockage of the Ying and Wei pathways. Death can be expected immediately. I believe: Red face is Fire, green eyes is Wood. The *Huang Ji Nei Pian* states: When Fire and Wood interact, they burn according to their nature. The *Mai Jing* states: Green eyes indicate disease in the Liver. Red face and green eyes mean both Liver and Lung are injured, Blood and Qi are stagnant, and Ying and Wei cannot circulate freely. This should be a syndrome of sudden death, not a common illness.
According to the *Su Wen: Wu Zang Sheng Cheng Lun*: Red face and green eyes both indicate death. The *Mai Jing* states: Red face and green eyes mean death in six days.
Yellow, black, and white colors rising in the eyes, combined with disaster in the mouth and nose.
Chi Shi said: Yellow belongs to the Spleen, black to the Kidney, white to the Lung, eyes to the Liver, mouth to the Spleen, and nose to the Lung. Since Kidney (Water) controls Spleen (Earth), if Earth is weak and cannot generate Metal, this is why disaster arrives. This explanation seems forced. Zhang Shixian said: Unique appearance is called "True Color," mixed appearance is called "Evil Color." The three colors of yellow, white, and black appearing mixed on the face, or in the eyes, or entering the mouth or nose, indicate pathogenic Qi moving from exterior to interior, hence disaster. This explanation is closer to truth. I note that the *Mai Jing* states: If face and eyes show consistent colors, they do not die. Thus, mixed colors entering the eyes are inauspicious. If they enter the mouth and nose, the disaster is worse. Why? The mouth and nose are the openings of the Yangming meridians. Any mixed colors appearing belong to Yin pathogens, hence "disaster."
According to the *Mai Jing*: If a patient or healthy person has black or white color rising in the eyes and mouth/nose, death occurs within three days.
Blue/green face, yellow eyes, death at midday; observe remaining signs for two days to judge strength.
Xiong Zongli explained: Liver Wood controls Spleen Earth, so death occurs at midday. Even with other signs, it will not exceed two days. This explanation is unclear. Zhang Shixian said: Midday (Zhong Shi) is Wu hour, which belongs to Fire. With a blue/green face and yellow eyes, Liver Wood controls Spleen Earth. At Wu hour, Wood receives Fire support and fears Metal less, so Wood Qi becomes stronger. Humans rely on Stomach Qi; when Wood and Earth are severed, death occurs. For other controlling relationships, observe for two extra days to judge life or death. This explanation is close to truth. However, the phrase "observe remaining signs for two days to judge strength" is not very clear. I believe according to the *Mai Jing*: Yellow eyes indicate disease in the Spleen. Blue/green face indicates excess Liver Qi, which is Liver Wood controlling Spleen Earth. Judging by time, death occurs at midday. Judging by days, one must look at the strength over two days. Why? Midday is Wu hour; excessive Fire makes Wood uncontrolled, further injuring Spleen Earth, hence death at midday. The rest is judged by days. Two days is the generating number of Fire. Fire generates Earth, so after two days, there is hope for strengthening.
According to the *Mai Jing*: Patient with blue/green face and yellow eyes will die in five days.
Eyes lacking luster, gums black; white face and black eyes are also disasters.
Chi Shi said: Eyes lacking luster and scattered spirit indicate exhaustion of Heart and Liver. Black gums indicate exhaustion of Spleen. White face like dry bone indicates exhaustion of Lung. Black eyes indicate exhaustion of Kidney. With exhaustion of all five Zang organs, death is certain. Zhang Shixian said: Eyes lacking luster indicate short Shen. Black gums indicate exhaustion of Spleen. White face indicates deficiency of Blood. Black eyes indicate Kidney deficiency. Having these four conditions means the patient is not a long-term guest. I believe: Eyes lacking luster indicate scattered Shen. Teeth belong to the Kidney and are the surplus of bone; upper and lower gums belong to Yangming. Black gums indicate depletion of Kidney Water, unable to nourish the surplus. White face and black eyes should be interpreted according to the classic text: "Splendor gone, blood vessels empty." Zhang's explanation is already too verbose.
According to the *Mai Jing*: Patients with eyes lacking luster and black teeth are incurable. It also states: Patients with white face and black eyes die. This is called "splendor gone, blood vessels empty." It also states: Patients whose teeth suddenly turn black will die in thirteen days.
Mouth open like a fish's mouth, unable to close; Qi exits but does not return, life flies to Yang.
Jie Gu said: Excess Fire presses on Lung Fire, causing panting and death; this is Lung failure. Chi Shi said: The mouth is the orifice of the Spleen; mouth like a fish's mouth indicates Spleen Qi exhaustion. Li Chan said: Exhalation is governed by Heart and Lung; inhalation by Kidney and Liver. Exhalation follows Yang out; inhalation follows Yin in. If Kidney and Liver fail first, only Heart and Lung remain intact, so there is exhalation but no inhalation. Li's explanation is close to truth.
According to the *Mai Jing*: Patients with mouth open like a fish's mouth, unable to close again, with Qi exiting but not returning, will die.
Shoulder breathing, fixed gaze, chapped lips; facial swelling with cyan-black color is also hard to escape.
Zhang Shixian said: Shoulder breathing is panting with shoulder movement. Fixed gaze is looking without moving the eyeballs. Chapped lips indicate Heat in the Heart family. The face reflects the Heart; black is the color of the Kidney. The first line indicates Heart exhaustion; the second, Liver exhaustion. With Heart and Liver exhausted, life is hard to save. I believe: Shoulder breathing indicates Lung exhaustion; fixed gaze indicates Liver exhaustion; chapped lips indicate Spleen exhaustion; facial swelling indicates Heart exhaustion; cyan-black color indicates Kidney exhaustion.
According to the *Mai Jing*: Patients with fixed gaze and shoulder breathing will die in one day. It also states: Patients with suddenly dry lips and mouth are incurable. It also states: Patients with sudden swelling and cyan-black face will die. The classic says: Disease of Heart exhaustion leads to death in one day. How do we know? Shoulder breathing and looking back lead to immediate death.
Delirious speech, confusion, and muteness; corpse odor certainly indicates short lifespan.
The *Mai Jing* states: Patients with delirious/confused speech and inability to speak are incurable. Those with febrile diseases may be curable. It also states: Corpse odor is incurable. I believe: Delirious and confused speech indicates Shen losing its residence. The meridians of the Heart, Spleen, and Kidney all pass through the throat and flank the base of the tongue. Muteness means these three meridians cannot connect upward to the tongue. Before death, one Zang organ must rot first; rotting causes foul Qi to leak outward, hence corpse odor.
Nose groove filled and lips cyan; know in three days that life will perish.
I believe: The nose groove (Ren Zhong) and lips are governed by the Spleen and Stomach. Fullness in the nose groove and cyan lips indicate destruction of Spleen/Stomach Earth, allowing Jueyin Wood to invade. Judging by day numbers, three is the master number of Wood; Earth is severed by Wood.
According to the *Mai Jing*: Patients with cyan lips and full nose groove will die.
Redness on cheekbones in chronic illness.
The *Ling Shu: Se Wu Pian* states: If redness appears on the cheekbones, large as a thumb, although the disease may slightly improve, sudden death will follow. Wei Shi said: The high bone under the eye orbit is called Quan (cheekbone); below Quan is Lian; outside the face is Jia (cheek). Quan, Jia, and Lian belong to Heart Fire. Redness in chronic illness indicates spirit leaking outward. The *Mai Jing* states: Patients with redness in ears, eyes, Quan, and cheeks will die within five days. Dai Shi considered "two cheeks" redundant and changed it to "black forehead," why?
Mouth open, Qi straight, life hard to sustain.
Xiong Zongli said: The mouth is the orifice of the Spleen; Spleen exhaustion prevents closing. Lung exhaustion prevents Qi from returning.
According to the *Mai Jing*: Patients with open mouth will die in three days. It also states: Pulse exhaustion with open mouth and swollen feet will die in five days.
Swelling on dorsum of foot and toes, knees like bowls; know in ten days that preservation is difficult.
Zhang Shixian said: Spleen governs the four limbs; the dorsum of the foot is where the Stomach meridian travels. Impending exhaustion of Spleen and Stomach produces these signs. Spleen and Stomach belong to Earth; ten is the completion number of Earth. Thus, death will not exceed ten days.
According to the *Mai Jing*: Swelling on dorsum of foot and knees large as bowls means death in ten days. It also states: Swelling on dorsum of foot with vomiting and heavy head means death.
Neck tendons stretched straight, death is certain. (Other editions have "straight" as "extended".)
Zhang Shixian said: Neck tendons extending is due to exhaustion of the Du Mai (Governing Vessel). Xiong Zongli attributed it to Kidney meridian exhaustion, which is incorrect.
No lines in palm, life is short.
Zhang Shixian said: No lines in the palm indicate exhaustion of the Pericardium meridian. The *Mai Jing* states: Patients with swollen palms and no lines will die.
Cyan lips, cold body, involuntary urination; aversion to food/drink, expect death in four days.
Chi Shi said: Cyan lips and cold body indicate impending exhaustion of True Qi. Involuntary urination indicates Bladder failing to store. Aversion to food/drink indicates Shen departing and not guarding. Human Shen Qi is born from the Liver; if Shen does not guard, Liver exhausts, and death occurs before the Metal number. Chi Shi's explanation is also correct. I believe: Cyan lips and cold body indicate pure Yin without Yang. Aversion to food/drink indicates fearing Yang and seeking Yin. Urinary incontinence indicates Kidney Qi exhausted and lacking storage virtue. By the fourth day, Metal is cold and Water is freezing, souls and spirits are unrestrained. How could they not die?
According to the *Mai Jing*: Spleen disease with cyan lips is the color of the Liver; death on Jia/Yi days. It also states: Disease with cyan lips and full nose groove leads to death in three days.
Cyan-black fingernails and toenails; surviving eight days makes it hard to cure.
Li Chan said: Nails are the surplus of sinews; sinews are the surplus of the Liver. Liver color is green, Kidney color is black. If Kidney Water cannot generate Liver, both Water and Wood organs fail, so their colors leak outward. Death upon reaching the completion number of Wood is known. Li's words are thus, but inconsistent with logic. Why? If it says Liver color is green and additionally black, it implies Kidney Water generating Liver Wood, why say both organs fail? Moreover, at eight days, encountering the completion number of Wood, it should be prosperous, why say death? According to my view: Liver color is green, governing Blood internally and nourishing sinews externally. Nails are the surplus of sinews, nourished by Blood, thus shining red. Now that Liver organ has failed, Blood is depleted first, and the True Zang color of Jueyin appears on the nails. Jueyin is the end of Yin. Wood dying is like burnt firewood, hence color includes black. However, within eight days, there is still the completion number of Wood, hence "surviving eight days." By the ninth day, it is the completion number of Metal; Metal breaks Wood, hence death.
According to the *Mai Jing*: Patients with cyan nails will die. It also states: Patients with black flesh under fingernails/toenails will die in eight days.
Back pain, heavy waist, difficulty turning over; this is Bone exhaustion, observe for five days.
Kidney governs bone; waist is the mansion of the Kidney. Abundant Kidney Water produces Marrow, which flows up the spine to the brain. Now Kidney decline leads to depletion of Essence and Marrow, hence back pain. Back pain and heavy waist with inability to turn over indicate Kidney exhaustion and Bone exhaustion. Five is the generating number of Earth; Water meets Earth and is severed.
Heavy body, red urine, constant incontinence; Flesh exhaustion, death in six days is inevitable.
Zhang Shixian said: Heavy body and flesh exhaustion relate to the Spleen. Constant urine output relates to the Kidney. Earth controlling Water determines the death period, hence six days. Six is the completion number of Water. Zhang's words are thus. If heavy body and flesh exhaustion indicate Spleen failure, then Earth can no longer control Water. Why again say Earth controls Water and death is in six days? I believe according to *Hua Tuo Nei Zhao*: Flesh exhaustion leads to death in six days. How do we know? Swollen tongue, bloody urine, red stool. Hua Tuo's words are thus. This is a disease of extreme Heart Fire. Fire blazing dries Earth, hence muscle consumption and heaviness. Extreme Heart Fire transfers to the Small Intestine, hence red and constant urine. Extreme亢 (hyperactivity) brings harm; control follows. Thus, death occurs on the completion number day of Water. Dai Qizong's *Mai Jue Kan Wu*, unaware of *Hua Tuo Nei Zhao*, merely claimed the *Zhong Zang Jing* originally had nothing and the *Mai Jue* added it, which is shameful.
Cyan-black fingernails/toenails, frequent shouting and cursing; Sinew exhaustion, surviving nine days is definitely impossible.
Li Chan said: Nails are the surplus of sinews; sinews are the surplus of the Liver. Liver governs anger, sound is shouting. Now nails are all cyan, angry shouting and cursing indicate Liver Qi excess. Excess leads to extremity, extremity leads to exhaustion. Liver belongs to Wood; reaching the completion number of Metal, death occurs in nine days.
According to the classic: Patient with Sinew exhaustion dies in nine days. How do we know? Cyan fingernails/toenails, incessant shouting/cursing, hair straight like hemp, cyan nails mean death.
Hair straight like hemp, death in half a day.
Xiong Zongli explained straight hair as exhaustion of Heart and Small Intestine, stating hair is the surplus of Blood; blood failure makes hair dry, hard, and straight. This explanation is also correct. But "death in half a day" is unclear. Suspecting error, I dare not force an explanation, leaving it for future verification. Zhang Shixian also said: Hair like hemp indicates Lung Qi exhaustion.
According to the *Mai Jing*: Patients with straight hair will die in fifteen days. It also states: Hair like dry hemp with irritability means death. It also states: Hair and eyebrows standing up means death. According to the *Zhong Zang Jing*: Intestine exhaustion with straight hair, continuous sweating, inability to bend/extend means death in six days. It also states: Straight hair means death in fifteen days.
Seeking clothes and speaking nonsense, know death in ten days.
Zhang Shixian said: Seeking clothes and speaking nonsense indicates Shen not guarding the residence. I believe if based on death in ten days, it should be Kidney decline and water drying, unable to nourish the eyes upward, causing visual dizziness and false vision, hence seeking clothes and speaking nonsense. Reaching ten days is the completion number of Earth; Water meets Earth and is severed.
According to the *Mai Jing*: Patients picking at clothing seams and speaking are incurable.
Also according to *Dan Xi Xin Fa* chapter "Combining Color and Pulse for Perfection": To know the interior, one must observe the exterior. To diagnose the exterior is to know the interior. What exists inside manifests outside. Without mutual reference to judge the reversal or smoothness of pathogenic Qi, it is impossible. For practitioners, deeply understanding this principle, observing the five colors (green, yellow, red, white, black) to match the five Zang pulses, exhausting whether they correspond or not. Palpating the five pulses (rapid, large, slow, choppy, deep) to match the five Zang colors. Whether smooth or not, truly observing the subtle colors and diagnosing the exquisite pulses, combining interior and exterior for treatment, the merit of perfect success can be achieved sitting still. The *Su Wen* says: "Combining color and pulse allows for perfection." Its meaning is thus. Originally, the One Qi of the Dao splits into Yin and Yang, scatters into the Five Elements, and what humans inherit is complete therein. The five pulses are Heaven's truth, circulating Blood and Qi, connecting Yin and Yang, to nourish the body. The five colors are the splendor of Qi, responding to the Five Elements, harmonizing with the four seasons, to manifest on the face. Only...