Library

If the tip of the nose is slightly black, it indicates the presence of fluid retention (Shui Qi). If the complexion appears yellow, it indicates cold in the chest. A pale complexion indicates loss of blood (Wang Xue). If a slight redness appears out of season, death will ensue.

In observing the subtle changes of facial color, nothing takes precedence over the area around Jingming (BL1) under the eyes and the Ming Tang (Bright Hall) on the nose. The classics state, "The clear spirit and five colors are the splendor of Qi." This refers to the essence of the Five Zang organs manifesting as five colors upon the face, changing within the clear spirit; one can predict in advance which color signifies auspiciousness and which signifies ominous signs. Zhang Zhongjing further elaborated on these subtleties, particularly emphasizing the importance of the central Nose Tip (Bi Zhun). Is it not because the Nose Tip corresponds to the Star of Earth (Zhen Xing) in the heavens and the Central Prison (Zhong Yu) on earth, implying that the Qi of the Liver (Wood), Lung (Metal), Kidney (Water), and Heart (Fire) must converge into the Spleen/Stomach (Earth)? He stated, "If the nose tip is green and the abdomen feels bitterly cold, death will occur." This statement is unique through the ages. Later generations often lamented the loss of the *Treatise on Acute Diseases* (*Zu Bing Lun*), making it impossible to trace its origins, yet they did not realize that this statement is indeed of major significance. It is likely that the green color of the Jueyin Liver Wood, carrying the cold power of Kidney Water, manifests upward at the nose and downward at the abdomen. This constitutes an acute disease, leading to the sudden collapse of Yang Qi and immediate death. His statement, "If the nose tip is slightly black, there is fluid retention," continues the meaning of the previous sentence. Although black is the color of Kidney Yin, if it is only slightly black and accompanied by no abdominal pathology, it primarily indicates fluid retention rather than an acute disease. His statement, "If the color is yellow, there is cold in the chest," uses the term "cold" in the *Treatise on Cold Damage* (*Shang Han Lun*) to mostly refer to phlegm, indicating accumulated phlegm in the chest. His statement, "If the color is white, there is loss of blood," notes that white is the color of the Lung. The Lung governs the Upper Jiao to circulate Ying (Nutritive) and Wei (Defensive) Qi. When Ying Qi is insufficient, the nose appears white, thus indicating loss of blood. His statement, "If it is slightly red but out of season, death will ensue," asks why fire color returning to earth would indicate death. However, if the climate does not match the season, this fire is not the warming fire that generates earth, but the scorching fire that overcomes metal, leading to dryness of the Zang organs and death.

If the nose tip is yellow, urination will certainly be difficult. (A yellow nose tip also indicates cold in the chest; cold impairs the transportation of water and grain, hence difficulty in urination.) In my clinical practice, cases with a bluish-yellow tip of the nose invariably suffer from Lin syndrome (strangury). If the nose is green, accompanied by abdominal pain and a cold tongue, death will occur. If the nostrils suddenly turn upward, the time of death can be predicted shortly. If the nose appears withered and dull, death is imminent. If the nose is cold extending to the cheeks and jaw, fewer than one in ten will survive. (The nose belongs to Earth and serves as the passage for Lung Qi. With the divine mechanism of the Lung and Stomach exhausted, the nose becomes withered and cold; how could life persist?)