Library

Lei Gong asked Huang Di, "Does the diagnosis of the five colors on the face depend solely on the Ming Tang (nose)? I do not understand what this means."

Huang Di said, "The Ming Tang is the nose. The Que is the area between the eyebrows. The Ting is the forehead. The Fan is the side of the cheeks. The Bi is the ear gate. The area between these parts should be square and large, visible from ten paces away. Those with such facial features will surely live to a hundred years."

This follows the discussion in Chapter 37 regarding the "Five Orifices" (Wu Yue) and "Five Envoys" (Wu Shi), further distinguishing the Qi of the Five Zang Organs manifesting as color in the Ming Tang, and the pulse manifesting at the Qi Kou (Cunkou). By observing the color and palpating the pulse, one can know the severity of the disease and the longevity or shortness of life. The chapter "Wu Yue Wu Shi" states: "Once the five orifices are distinguished, the Que and Ting must be open, thereby establishing the Ming Tang. If the Ming Tang is broad, the Fan and Bi are visible externally, the walls are square and high, and the hanging flesh is external, the five colors will be harmonious. Flat, smooth, broad, and large indicates a lifespan of a hundred years." Therefore, the Emperor explained again: The Ming Tang is the nose, the Que is the space between the eyebrows, the Ting is the forehead, the Fan is the cheek sides, and the Bi is the ear gate. The area between them should be square and large, visible from ten paces. Such people will surely live to a hundred years. This refers to the shape and color of the face corresponding to the form and Qi of Heaven and Earth, requiring clarity and breadth. Since the Five Zang Organs are born from the Five Elements of the Earth, and the Five Elements of the Earth present the Five Colors of Heaven, along with the Six Qi of the Three Yin and Three Yang, the color manifests in the Ming Tang and the pulse emerges from the Qi Kou. This is the Qi of the Five Zang Organs, manifesting in color and responding in the pulse. Thus it is said that the "Five Qi" are the envoys of the Five Zang Organs and the deputies of the Five Seasons. The Qi Kou, referring to the Ren Ying (Human Welcome) on the left and Cunkou (Inch Port) on the right, is used to observe the Qi of the Three Yin and Three Yang. The Three Yin and Three Yang are the Qi of the Five Zang and Six Fu Organs. Master Zhu said: "According to the 'Generation of Five Zang Organs' chapter: When observing the odd pulses of the five colors, if the face is yellow with green eyes, yellow face with red eyes, yellow face with white eyes, or yellow face with black eyes, none will die. If the face is green with red eyes, red face with white eyes, green face with black eyes, black face with white eyes, or red face with green eyes, all will die." This is because the Qi color of the Five Zang Organs manifests on the face, while the Blood color manifests in the eyes. The "Essential Requirements for Pulse Observation" chapter states: "The outer part of the Chi (尺) area observes the Kidney; moving inward to the middle, the left outer part observes the Liver, and the right observes the Spleen; moving upward to the upper part, the right outer part observes the Lung, and the left observes the Heart." This shows that the有形 (form) of the Five Zang Organs is observed in the Cun, Guan, and Chi positions of the left and right wrists, while the Qi of the Five Zang Organs is observed at the Qi Kou. It is said that when the floating and sinking of the pulse, and the size equality of the Ren Ying and Cunkou Qi occur, the disease is difficult to cure. This is because the form and Qi of the Five Zang Organs have their respective observation sites. Heaven and Earth endow life to establish form and fix Qi. Therefore, to judge longevity and determine the death or survival of a disease, one must understand this principle.

Lei Gong asked, "How should the five orifices be distinguished?"

Huang Di said, "If the bone of the Ming Tang (nose) is high and raised, flat and straight, the Five Zang Organs are arranged sequentially in the center, and the Six Fu Organs flank on both sides. The Qi of the head and face ascends to the Que and Ting. The Wang Gong (Palace of the King/Heart) is located at the Xia Ji (lower pole). The Five Zang Organs reside peacefully in the chest, the True Color appears, the Pathological Color is absent, and the Ming Tang is moist and clear. How could the five orifices fail to be distinguished?" (Note: 'E' is pronounced 'wu', meaning 'how').

The five orifices are the external manifestations of the Five Zang Organs. The Ming Tang is the nose. The cartilage of the nose is best when high, raised, flat, and straight. The Five Zang Organs are arranged sequentially in the center: within the Que and Ting is the Lung; below the Que is the Heart; directly downward is the Liver; further down is the Spleen. The Zang Organs belong to Yin and govern the interior, so their observation site is in the center. The Six Fu Organs flank on both sides: to the left of the Liver is the Gallbladder; above the square area (Fang Shang) is the Stomach; in the middle secondary position is the Large Intestine; above the Face King (Mian Wang/Nose Tip) is the Small Intestine; below the Face King is the Bladder and Uterus. The Fu Organs belong to Yang and govern the exterior, so their position is on the sides. The Kidney is the Water Organ, so it flanks the Large Intestine and is located outside the Fan and Bi, corresponding to the earth being central and the sea being external. The Qi of the head and face ascends to the Que and Ting, and the Wang Gong is at the lower pole, corresponding to the Heavenly Que above and the Wang Gong below, representing the three regions of Heaven, Earth, and Humanity. The Que and Ting correspond to the Lung, which governs Heaven and resides above; the lower pole corresponds to the Spleen, which governs Earth and resides below; the Wang Gong corresponds to the Heart, the Monarch, which resides in the center. The Five Zang Organs dwell peacefully in the chest, and the True Color of the Zang manifests externally. How could the five orifices fail to be distinguished?

Lei Gong asked, "Can you explain the cases where they cannot be distinguished?"

Huang Di said, "When the five colors appear, each emerges from its respective color region. If the bone of that region is depressed, the person will inevitably fall ill. If the colors in the regions invade or succeed each other (e.g., child organ showing mother organ's color), even if the disease is severe, the person will not die."

Zhu Yongnian stated: "By 'not distinguished,' it means failing to distinguish the True Color and only distinguishing the Pathological Color. 'The five colors appear, each emerging from its color region' means that the pathological colors of the Five Zang Organs appear in their respective regions. The 'Treating Heat' chapter says: 'Color shining on the zygomatic bone indicates heat disease.' 'Bone of the region depressed' means the color of the specific region is faintly sunken into the bone, indicating inevitable illness. Generally, diseases arising internally develop outward; when color appears faintly in the bone, the disease has already formed. 'Succession' refers to the Child Qi succeeding the Mother Qi. For example, seeing yellow in the Heart region, red in the Liver region, black in the Lung region, and green in the Kidney region. This is the Child's color succeeding the Mother's region. Even if the disease is severe, the person will not die, as the Child vents the Mother's disease."

Lei Gong asked, "How does one judge diseases by the five colors?"

Huang Di said, "Green and Black indicate Pain; Yellow and Red indicate Heat; White indicates Cold. These are the diseases governed by the five orifices (colors)."

Ni Chongzhi said: "This is observing the colors of the five regions to know diseases caused by external pathogens. Green and Black are the colors of Wind and Cold, hence indicating Pain. Yellow and Red are the colors of Fire and Earth, hence indicating Heat. White is the color of Clear and肃 (Solemn/Cooling) Qi, hence indicating Cold. These are what the five colors govern, constituting diseases caused by external factors. Mo Ziyu said: The previous section discussed the pathological colors of the Five Zang Organs appearing in their respective regions; this section discusses the Wind and Cold of Heaven appearing in the five colors. Distinguishing internal and external is the mark of a skilled physician."

Lei Gong asked, "What is the difference between the worsening of a disease and its gradual decline?"

Huang Di said, "Both internal and external conditions are involved. Palpate the Mai Kou (Cunkou): if the pulse is slippery, small, tight, and deep, the disease is worsening and located internally. If the Ren Ying pulse is large, tight, and floating, the disease is worsening and located externally. If the Mai Kou pulse is floating and slippery, the disease progresses daily. If the Ren Ying pulse is sinking and slippery, the disease diminishes daily. If the Mai Kou pulse is slippery and sinking, the disease progresses daily internally. If the Ren Ying pulse is slippery, vigorous, and floating, the disease progresses daily externally. When the floating and sinking of the pulse, and the size equality of the Ren Ying and Cunkou Qi occur, the disease is difficult to cure. For diseases in the Zang, a deep and large pulse indicates easy recovery; a small pulse is adverse. For diseases in the Fu, a floating and large pulse indicates easy recovery. A vigorous and firm Ren Ying pulse indicates injury by Cold; a vigorous and firm Qi Kou pulse indicates injury by food."

This involves palpating the Mai Kou and Ren Ying to know the severity and location (internal/external) of the disease. External diseases move from outside to inside, from Yang to Yin; internal diseases move from inside to outside, from Yin to Yang. The Mai Kou governs the interior, and the Ren Ying governs the exterior. Thus it is said "both internal and external are present," meaning by observing the Mai Kou and Ren Ying, one can know the severity and decline of both external infections and internal injuries. Therefore, if the Mai Kou pulse is slippery, small, tight, and deep, the disease is severe internally; if the Ren Ying pulse is large, tight, and floating, the disease is severe externally. Floating belongs to Yang, sinking to Yin. A floating and slippery Mai Kou pulse indicates Yang Qi in the Yin division, so the disease progresses daily. A sinking and slippery Ren Ying pulse indicates Yin Qi emerging to Yang, so the disease diminishes daily. A slippery and sinking Mai Kou pulse indicates disease progressing daily internally; a slippery and floating Ren Ying pulse indicates disease progressing daily externally. The floating and sinking of the pulse refer to the Cun, Guan, and Chi positions of the left and right wrists. When the size and floating/sinking of the Ren Ying and Cunkou Qi are equal, the form and Qi of the Zang and Fu organs are both diseased, making it difficult to cure. For Zang diseases, a deep and large pulse is Yin disease showing Yang pulse, hence easy to cure; small is adverse. For Fu diseases, a floating and large pulse is Yang disease in the exterior, hence easy to dissipate. The Ren Ying governs the exterior, so a vigorous and firm Ren Ying indicates injury by Cold, an external cause. The Qi Kou governs the interior, so a vigorous and firm Qi Kou indicates injury by food, an internal cause. The Ren Ying and Qi Kou govern the Yin and Yang Qi of the Zang and Fu organs; thus, by observing these two pulses, internal and external diseases are revealed.

Lei Gong asked, "How does one judge the severity of disease by color?"

Huang Di said, "Colors that are coarse and bright indicate mild disease; colors that are deep and withered indicate severe disease. Colors moving upward indicate worsening disease; colors moving downward like dispersing clouds indicate the disease is resolving. Each of the Five Zang Organs has its own region, with an external part and an internal part. If color moves from the external part to the internal part, the disease moves from outside to inside. If color moves from the internal part to the external part, the disease moves from inside to outside. For diseases arising internally, treat the Yin first, then the Yang; reversing this worsens the disease. For diseases arising externally, treat the exterior first, then the interior; reversing this worsens the disease."

Zhu Yongnian stated: "This is observing color to know the severity and location of the disease. Coarse and bright indicate Yang; deep and large indicate Yin. The intersection of Yin and Yang indicates severe disease. Color is the Qi of the Five Zang and Five Elements, emerging from within, rising from bottom to top, and manifesting on the face. Upward-moving color indicates flourishing pathogenic Qi, hence worsening. Earthly Qi rises to become clouds, and heavenly Qi descends to disperse them, hence the disease resolves. 'Zang Region' refers to the division of Zang and Fu organs. The Five Zang arranged in the center constitute the internal part; the Six Fu flanking on both sides constitute the external part. Color moving from external to internal indicates external pathogens moving inward; color moving from internal to external indicates internal pathogens moving outward. Generally, Fu organs are Yang and govern the exterior, while Zang organs are Yin and govern the interior. Thus, for diseases arising internally, treat Yin first, then Yang; reversing this worsens the disease. For diseases arising externally, treat the exterior first, then the interior; reversing this worsens the disease."

If the pulse is slippery, large, intermittent (Dai), and long, the disease comes from outside. Seeing visions and having aversions in will indicate the conjunction of Yang Qi, which can be changed and cured.

Continuing from the previous text discussing Qi-level diseases merging into the blood vessels: The previously mentioned Yin-Yang and internal-external referred to diseases in the Qi level, where pulse appears at the Qi Kou and color appears in the Ming Tang. If Qi merges into Blood, the pulse appears in the Cun, Guan, and Chi positions, and color appears in the eyes. Slippery represents Cold-Water imagery; large represents Summer-Heat-Fire imagery; Dai (intermittent) represents Wet-Earth imagery; long represents Wind-Wood imagery. These are the external pathogens of Wind, Cold, Summer-Heat, and Dampness merging into the blood vessels, producing these pulses. Hence "Dai" and "Long" mean either slippery-large or dai-long, all indicating disease coming from outside, not necessarily four pathogens simultaneously merging to produce this single pulse. "Seeing visions" means color appears in the eyes; "aversions in will" means the Shen (Spirit) of the Five Zang is unsettled. This is the conjunction of Yang Qi. It can be changed and cured by treating the exterior first and then the interior, allowing transformation externally so the disease resolves.

Lei Gong asked, "I have heard that Wind is the beginning of all diseases, and Jue Ni (Reversal Cold) arises from Cold-Dampness. How should they be distinguished?"

Huang Di said, "Always observe the Que Zhong (center of eyebrows). Thin and glossy color indicates Wind; turbid and muddy color indicates Bi Syndrome; color sunk in the lower part (Di Ge) indicates Jue. This is the general rule. Judge the disease according to the color."

The "Di" (Earth) refers to the lower part of the face, named Di Ge (Earth Pavilion). Wind is Heavenly Qi, so it is observed in the Que and Ting. Cold-Damp is Earthly Qi, so it is observed in the Di region. Wind is a Yang pathogen, so its color is thin and glossy. Cold-Damp is a Yin pathogen, so its color is turbid and muddy. This is transitional text stating that Wind-Cold-Damp pathogens can merge into the vessels, enter the Zang and Fu, and cause sudden death that cannot be saved. Thus, evil wind arrives swiftly like wind and rain, being the chief of all diseases. Therefore, the skilled healer treats the skin and hair first; next, the muscles and skin; next, the sinews and vessels; next, the Zang and Fu. Treating the Zang and Fu results in half-dead, half-alive outcomes. Thus, physicians must understand the regional divisions, examine internal and external conditions, use Yin to harmonize Yang, and use Yang to harmonize Yin, preventing evil from entering the Zang to become incurable. This is called a skilled physician, achieving success in every attempt. Zhu Yongnian said: "When Qi merges into vessels, blood vessels transmit smoothly; when Great Qi enters the Zang, life cannot be sustained. Generally, if evil is in the blood vessels, it can still be changed; once it enters the Zang, is it not too late? Therefore, the Sage teaches observing color and differentiating pulse, aiming to treat disease before it forms and disorder before it occurs. Ni Chongzhi said: Bian Que observing the color of Duke Huan was precisely to encourage treating disease before it forms. What is meant by 'before disease' is that the disease has not yet transmitted to the deep tunnels."

Lei Gong asked, "How can one know if a person who seems healthy will die suddenly?"

Huang Di said, "When Great Qi enters the Zang and Fu, the person dies suddenly without apparent illness."

Lei Gong asked, "How can one know if a person with a minor illness will die suddenly?"

Huang Di said, "If red color appears on both cheekbones, the size of a thumb, although the illness seems slightly better, sudden death will certainly occur. If black color appears on the Tian Ting (forehead), the size of a thumb, the person will die suddenly without prior illness."

This continues the previous discussion on external and internal diseases merging into blood vessels and entering the Zang, all leading to sudden death. Great Qi entering the Zang refers to external pathogenic evils entering the Zang and Fu, causing sudden death without prior symptoms. "No illness" means no external physical signs. Disease slightly improving followed by sudden death is an internal cause, involving mutual overacting of Zang organs. Red color on the cheekbones and black color on the forehead correspond to the following text: Kidney overacting on Heart, Heart sick first, Kidney responding. The colors are alike. Red is the color of Fire; Black is the color of Water. "Slightly better" means Water nourishes Fire; "sudden death" means Water excess extinguishes Fire. Generally, the Qi of the Five Elements, when regulated, generates and transforms; when excessive, it leads to extinction. Diseases in the Qi level have colors that scatter and do not gather; those invading the vessels have colors that gather and do not scatter. "Size of a thumb" refers to the gathered color in the blood vessels. The Kidney Meridian flows into the chest and connects to the Heart. Red color on the cheekbones indicates Kidney overacting on Heart, with Heart Fire Qi exiting externally. Black color on the forehead indicates Kidney overacting on Heart, Heart sick first, Kidney responding and also exiting externally, hence the colors are alike. "All alike" means the colors are all the size of a thumb. Generally, Zang means storing; the five colors appearing on the face are the Qi of the Five Zang manifesting in color. Gathered color appearing externally is the leakage of the True Zang Qi. Ni Chongzhi said: "When Water overacts on Heart, Heart gets sick first, hence 'disease' and 'slightly better'. When Kidney Qi overacts, it vacates its original position, then responds later and exits upward, hence dying suddenly without prior illness. 'No illness' means not overacted upon by other Zang but self-dissipating."

Zhu Yongnian said: "The Qi of the Five Elements has mutual generation and mutual control. Regulation leads to generation and transformation; excessive control leads to extinction. Thus, slight improvement in disease is regulation leading to transformation; slight improvement followed by sudden death is excessive control. Taking Heart and Kidney as examples applies to all Five Zang. Gao Shizong said: Ting is the Tian Ting (Heavenly Court). Water connects to Heaven, circulating up and down. Black color appearing on the Ting is Water returning to Heaven, losing the mechanism of circulation. In humans, this is sudden death; in Heaven, it is chaos."

Lei Gong bowed twice and said, "Excellent! Is there a time limit for death?"

Huang Di said, "Observe the color to know the time."

Lei Gong said, "Excellent! I wish to hear it completely."

Huang Di said, "The Ting is the head and face. Above the Que is the throat. In the center of the Que is the Lung. At the lower pole is the Heart. Directly below is the Liver. To the left of the Liver is the Gallbladder. Below is the Spleen. Above the Fang Shang is the Stomach. In the center is the Large Intestine. Flanking the Large Intestine is the Kidney. Opposite the Kidney is the Umbilicus. Above the Mian Wang (Nose Tip) is the Small Intestine. Below the Mian Wang is the Bladder and Uterus. The Zygoma is the shoulder. Behind the zygoma is the arm. Below the arm is the hand. Above the inner canthus is the chest and breast. Along the jawline upwards is the back. Following the jaw downwards is the thigh. In the center is the knee. Below the knee is the leg. Below the leg is the foot. Ju Fen is the groin. Ju Qu is the kneecap. These are the regions of the Five Zang, Six Fu, limbs, and joints. Each has its region. With regions, use Yin to harmonize Yang, and Yang to harmonize Yin. Clearly understanding the regions ensures success in every attempt. Distinguishing left and right is called the Great Dao. Men and women have different positions, hence called Yin and Yang."

Observing color to speak of time means observing the colors of the Five Zang and Five Elements to know the time of death. For example, if red color appears on the cheekbones, the time of death is Ren and Gui days, at midnight. If black color appears on the Tian Ting and death occurs, the day is Wu and Ji, and the hours are Xu, Chou, and Wei. Each Zang and Fu possesses the colors of the Five Elements and has its respective governing region. Thus, one must clearly understand the regions, use Yin to harmonize Yang, and Yang to harmonize Yin. When Yin and Yang are harmonized, success is achieved in every attempt. Left and Right are the pathways of Yin and Yang. Yang moves from the left, Yin from the right. Distinguishing left and right is called the Great Dao of Heaven and Earth. The color of men moves from left to right; the color of women moves from right to left. Men and women have different positions, hence called Yin and Yang. Ni Chongzhi said: "Men from left, women from right is the smooth flow of Qi. Smoothness leads to dispersion. If men from right, women from left, it is the reverse flow of Qi. Reversal leads to gathering. Gathering leads to harm from excessive overcoming and extinction. This section discusses the colors of internal causes, having distinctions of Yin-Yang, left-right, life-death, and reversal-smoothness."

Examining glossiness and witheredness is called a skilled physician. Deep and turbid indicates internal; floating and glossy indicates external. Yellow and red indicate Wind; green and black indicate Pain; white indicates Cold. Yellow and greasy/moist indicates Pus; intense red indicates Blood. Severe pain indicates spasms; severe cold indicates insensitivity of the skin. The five colors each appear in their respective regions. Observe their floating and sinking to know depth. Observe their glossiness and witheredness to observe success and failure. Observe their scattering and clustering to know proximity. View the upward and downward movement of color to know the location of the disease. Accumulate spirit in the heart to know past and present. Therefore, if observing Qi is not subtle, one cannot know right from wrong. Focus attention without leaving, then know new from old. If color is bright but not coarse, yet appears deep and withered, the disease is severe. If color is neither bright nor glossy, but not deep and withered, the disease is not severe.

This speaks of examining color to know external diseases. Deep and turbid indicates internal; floating and glossy indicates external. External diseases move from outside to inside; observing the floating and sinking of color reveals the internal and external location of the disease. Wind is a Heavenly Yang pathogen, so color appears yellow and red. Pain is a Yin Bi syndrome, so color appears green and black. White color indicates Cold. Yellow and greasy/moist color indicates abscess/pus. Intense red indicates retained blood. Pain in sinews and bones, if severe, leads to spasms. Cold injuring skin, if severe, leads to skin insensitivity. These external pathogens appear in the five colors, each in their respective regions. Observing the floating and sinking of color knows the depth of disease; observing glossiness and witheredness observes human success/failure; observing scattering and clustering knows the duration/proximity of disease; viewing upward/downward color movement knows the location of disease. Color and pulse are highly valued by the Supreme Being and transmitted by ancient masters. In ancient times, Qiu Dai Ji was sent to organize color and pulse to connect with the Divine Spirit, combining them with the Four Seasons, Five Elements, Eight Winds, and Six Directions, never departing from their constants.

Therefore, accumulating spirit in the heart allows one to know past and present. If observing Qi is not subtle, one cannot discern right from wrong. Maintain focus without distraction to distinguish new from old. If color is bright and not coarse, but instead appears deep and withered, the disease is severe. If color is neither bright nor glossy, but not deep and withered, the disease is not severe. Generally, external diseases should dissipate from the outside and should not enter internally. If color scatters like a foal running (Ju Ju Ran) without gathering, the disease is scattered with Qi pain, and gathering has not yet formed. Kidney overacting on Heart, Heart sick first, Kidney responding, colors are all alike.

This reiterates that internal diseases have distinctions of gathering/scattering and life/death. If Zang disease is scattered and not gathered, its color scatters like a foal running, and the disease has not yet gathered. If it clusters in the Zang, blood vessels overact, showing clustered color and leading to sudden death disease. "Ju Ju Ran" means like a foal passing through a crack, moving without staying. Its color moves...