《脉要精微论》曰∶夫精明五色者,气之华也(精明见于目,五色显于面,皆气之华也,言气而血在其中矣),赤欲
如白裹朱,不欲如赭;白欲如鹅羽,不欲如盐∶青
欲如苍璧之泽,不欲如蓝;黄欲如罗裹雄黄,不欲如黄土;黑欲如重漆色,不欲如地苍(五色之欲者,皆取其
润泽。五色之不欲者,皆恶其枯槁也)。五色精微象见矣,其寿不久也(此皆五色精微之象也,凶兆既见,寿不
久矣)。夫精明者,所以视万物,别白黑,审长短,以长为短,以白为黑,如是则精衰矣(脏腑之精气,皆上朝
于目而为光明,故曰精明。若精明不能上奉,则颠倒错乱,岂能保其生耶)。
《灵枢·五色篇》曰∶明堂者鼻也,阙者眉间也,庭者颜也,蕃者颊侧也,蔽者耳门也。其间欲方大,去
之十步,皆见于外,如是者寿必中百岁(庭者,天庭也,俗名额角,蕃蔽者,屏蔽四旁也,十步之外而部位显
然,则方大可知,故寿可百岁也)。
明堂骨高以起,平以直,五脏次于中央,六腑挟其两侧,首面上于阙庭,王宫在于下极,五脏安于胸中,
真色以致,病色不见,明堂润泽以清(五脏之候皆在中央,六腑之候皆在四旁。次者,居也。挟者,附也。下
极,居两目之中,心之部也。心为君主,故称王宫。若五脏安和,正色自显,明堂必清润也)。五色之见也,
各出其色部。部骨陷者,必不免于病矣。其色部乘袭者,虽病甚不死矣(五色之见,各有部位。若有一部骨弱
陷下之处,则邪乘之而病。若色部虽有变见,但得彼此生王,有乘袭而无克贼者。病虽甚不死矣)。青黑为
痛,黄赤为热,白为寒(此言五色之所主也)。
其色粗以明,沉夭者为甚,其色上行者病益甚,其色下行如云彻散者病方已(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,浊气已退,故病已)。五色各有藏部,有外部,有内部也。色从外部走内部者,其
病从外走内;其色从内走外者,其病从内走外。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(五色各有藏部,言脏而腑在其中矣。外部者,六腑之表,六腑挟其两侧也。内
部者,五脏之里,五脏次于中央也。凡病色先起外部,而后及内部者,其病自表入里,是外为本而内为标,当先
治其外,后治其内。若先起内部,而后及外部者,其病自里出表,是阴为本而阳为标,当先治其阴,后治其阳。
若反之者,皆为误治,病必转甚矣)。
常候阙中,薄泽为风,冲浊为痹,在地为厥,此其常也,各以其色言其病(阙中,眉间也,肺之部也。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。厥逆为寒湿之变,病起于下,故色之先于地。
地者,相家所谓地阁,即巨分巨屈之处也)。
大气入于脏腑者,不病而卒死(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)。
赤色出两颧,大如拇指者,病虽小愈,必卒死。黑色出于庭,大如拇指,必不病而卒死(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)。
庭者,首面也(天庭处于最高,应首面之有疾)。阙上者,咽喉也(阙上者,眉心之上也,应咽喉之有
疾)。阙中者,肺也(阙中者,正当两眉之中也,色见者,其应在肺)。下极者,心也(下极者,眉心之下也,相家谓之
山根,心居肺下,故下极应心)。直下者,肝也(下极之下为鼻柱,相家谓之年寿。肝在心之下,故直下应肝)。肝
左者,胆也(胆附于肝之短叶,故肝左应胆,而在年寿之左右也)。下者,脾也(年寿之下,相家谓之准头,亦
名土星,本经谓之面王,又名明堂。准头居面之中央,故属土应脾)。方上者,胃也(准头两旁为方上,即迎香之
上,鼻隧是也。相家谓之兰台廷尉,与胃为表里,脾居中而胃居外,故方上应胃)。中央者,大肠也(人中外五
分迎香穴,大肠之应也,亦在面之中,故曰中央)。挟大肠者,肾也(挟大肠迎香穴者,颊之上也。四脏皆一,惟
肾有两,四脏居腹,惟肾附脊,故四脏次于中央,而肾独应于两颊)。当肾者,脐也(肾与脐对,故当肾之下
应脐)。面王以上者,小肠也(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,膀胱子处也(面王以下者,人中也,乃膀胱子处之应。子处者,子宫也。凡人人中,平浅而无髭
者,多主无子。妇人亦以人中深长者,善产育。此以上皆五脏六腑之应也)。颧者,肩也(此下皆言肢节之应也。
颧为骨之本,居中部之上,故以应肩)。颧后者,臂也(臂接于肩,故颧后以应臂)。臂下者,手也。目内
上者,膺乳也(目内 上者,阙下两旁也。胸两旁高处为膺,膺乳者,应胸前也)。挟绳而上者,背也(颊之外曰绳,
身之后曰背,故背应于挟绳之上)。循牙车以下者,股也(牙车,牙床也。牙车以下主下部,故以应股)。中央者,
膝也(中央者,牙车之中央也。)膝以下者,胫也。当胫以下者,足也(胫次于膝,足接于胫,以次而下也)。巨分者,
股里也(巨分者,口旁大纹处也,股里者,股之内侧也)。巨阙者,膝膑也(巨阙,颊下曲骨也。膝膑者,膝盖骨也,此
盖统指膝部而言)。
\r《灵枢》脏腑肢节应于面之图\pt14a3.bmp\r
各有部分,有部分,用阴和阳,用阳和阴,当明部分,万举万当(部分既明,阴阳不爽,阳亢则滋其阴,
谓之用阴和阳。阴寒则补其火,谓之用阳和阴。故明部分而施治法,万举万当也),能别左右,是谓大道;男女
异位,故曰阴阳,审察泽夭,谓之良工(阳左阴右。左右者,阴阳之道路也,故能别左右,是为大道。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。阴阳既辨,然后审其色之润泽枯夭,以决死生,
医之良也)。沉浊为内,浮泽为外(色之沉浊晦滞者为里,色之浮泽光明者为表);黄赤为风,青黑为痛,白为寒,黄而
膏润为脓,赤甚者为血;痛甚为挛,寒甚为皮不仁
(凡五色之见于面者,可因是而测其病矣。痛甚即青黑之极也,寒甚即白之极也),五色各见其部,察其浮
沉,以知浅深;察其泽夭,以观成败;察其散抟(音团)。以知远近;视色上下,以知病处(色之浮者病浅,
色之沉者病深;润泽者有成,枯夭者必败;散而不聚者病近,抟而不散者病远。上下者,即前脏腑肢节之见于
面者也)。
色明不粗,沉夭为甚;不明不泽,其病不甚(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)。其色散,驹驹然未有聚,其病散而气痛,聚未成也(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,
心先病,肾为应,色皆如是(肾乘心者,水邪克火也。心先病于内,而肾之色则应于外,如黑色见于下极是也。
不惟心肾,诸脏皆然,此举一以例其余也)。男子色在于面王,为小腹痛,下为卵痛,其圜直为茎痛,高为本,
下为首,狐疝 阴之属也(面王上,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 阴之病也。 即 也)。女子在于面王,为膀胱子处之病,散为痛,抟为聚,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(面王下,宜有下字。面王下为人中。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)。
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(五色皆宜端满。端者,正色
也,满者,充润也。别乡犹言它乡,即别部位也。如赤
者心色,应见于两目之间,是其本乡。今见于面王,是别乡矣。不日者,不日而愈也。火色见于土位,是其相
生之乡也。此举赤色为例,而五色缪见者,皆可类推矣)。其色上锐,首空上向,下锐下向,在左右如法(邪
色之见,各有所向。其尖锐之处是乘虚所犯之方,故上锐者以首虚,故上向也。下锐亦然,其在左右者皆同此
法)。
《五脏生成论》曰∶面黄目青,面黄目赤,面黄目白,面黄目黑者,皆不死(黄者,中央土之正色,五行
以土为本,胃气犹在,故不死也)。面青目赤,面赤目白,面青目黑,面黑目白,面赤目青,皆死也(色中无
黄,则胃气已绝,故皆死也)。
愚按∶望闻问切,谓之四诊,而望色居四诊之先,未有独凭一脉,可以施疗者。经曰∶切脉动静而视精
明,察五色,观五脏有余不足、六腑强弱,形之盛衰,以此参伍,决死生之分。又曰∶形气相得,谓之可治。
色泽以浮,谓之易已。又曰∶能合色脉,可以万全。仲景尝以明堂阙庭尽不见察,为世医咎。好古尝论治妇人
不能行望色之神,为病家咎,则色固不要欤,而医顾可忽欤?
《脉要精微论》说:眼睛的神采和面部的五色,是脏腑精气的外在荣华表现(眼睛的神采显现于目,面部的五色显露于面,都是气的荣华表现,这里说气,其中也包含了血),面色红想要像白绢包裹着朱砂那样红润含蓄,不想要像赭石那样暗红无光;面色白想要像鹅毛那样洁白润泽,不想要像盐那样苍白干枯;面色青想要像青玉那样温润有光泽,不想要像蓝草染出的颜色那样枯暗;面色黄想要像丝绸包裹着雄黄那样明润含蓄,不想要像黄土那样枯槁晦暗;面色黑想要像重漆过的器物那样黑亮润泽,不想要像地苍土那样枯暗(五色中“欲”的状态,都是取其润泽;五色中“不欲”的状态,都是厌恶其枯槁)。如果面部呈现出五色精微败露的征象,那么寿命就不会长了(这些都是五色精气败露的征象,凶兆既然出现,寿命就不长了)。所谓精明,是用来观察万物、辨别黑白、审察长短的功能,如果把长的看成短的,把白的看成黑的,这说明精气已经衰败了(脏腑的精气,都上注于眼睛而表现为光明,所以叫精明。如果精明不能上注于目,就会颠倒错乱,怎么能保全生命呢)。
《灵枢·五色篇》说:明堂指鼻子,阙指两眉之间,庭指前额,蕃指脸颊两侧,蔽指耳门。这些部位应该方正宽大,站在十步之外,都能看得清楚,这样的人寿命必定能活到百岁(庭,就是天庭,俗称额角;蕃和蔽,是屏蔽四周的意思,十步之外部位依然明显,说明方正宽大,所以寿命可达百岁)。
鼻骨高起且平直,五脏的部位依次排列在中央,六腑的部位依附在两侧,头面的征象反映在阙庭,心(王宫)位于下极(两目之间的下方),五脏安和于胸中,正常的本色显现,病色不现,明堂(鼻部)润泽清明(五脏的征候都在中央,六腑的征候都在四旁。次,指居位。挟,指依附。下极,位于两目之间,是心的分部。心为君主之官,所以称为王宫。如果五脏安和,正色自然显现,明堂必然清润)。五色的显现,各自出现在对应的色部。如果对应部位的骨骼陷下,必定免不了生病。如果五色出现的部位相互乘袭(相生),即使病很重也不会死(五色的显现,各有对应的部位。如果有一个部位骨骼弱而陷下,邪气就会乘虚而入导致生病。如果色部虽然有变化,但彼此之间是相生关系,只有乘袭而没有相克贼害,病虽然重也不会死)。青色和黑色主痛,黄色和红色主热,白色主寒(这是说五色所主病症的道理)。
面色鲜明清爽,沉滞枯夭的为病重;面色向上蔓延的,病势加重;面色向下消退如云雾消散的,病即将痊愈(粗,指明爽的意思。沉夭,指晦滞的意思。说面色贵在明爽,如果晦滞说明病重。色向上行,说明浊气正在上升,所以病重。色向下行,说明浊气已退,所以病愈)。五色各有对应的藏部,有外部,有内部。色从外部走向内部的,病从体表传入体内;色从内部走向外部的,病从体内传出体表。病生于体内的,先治阴分,后治阳分,反之则病更重;病生于体表的,先治外部,后治内部,反之则病更重(五色各有对应的藏部,说脏而腑也在其中。外部,是六腑的表,六腑依附在两侧。内部,是五脏的里,五脏依次排列在中央。凡是病色先从外部开始,然后波及内部的,病是从表入里,这是外为本内为标,应当先治外,后治内。如果先从内部开始,然后波及外部的,病是从里出表,这是阴为本阳为标,应当先治阴,后治阳。如果反过来治疗,都是误治,病一定会加重)。
通常观察眉间(阙中)的颜色,色薄而泽的是风病,色冲而浊的是痹病,色见于下部(地阁)的是厥逆,这是一般的规律,可以根据颜色的变化来推断病情(阙中,即眉间,是肺的分部。风病在阳,侵犯皮毛,所以色薄而泽。痹病在阴,侵犯肉骨,所以色冲而浊。厥逆是寒湿的变化,病起于下部,所以色先见于地。地,是指相家所说的地阁,即巨分、巨屈的地方)。
大邪之气侵入脏腑的,人虽然没有明显症状,但会突然死亡(大气,指大邪之气,比如水色出现在火部,火色出现在金部之类。这是元气大虚,贼邪已到,虽然没有发病,但必然会突然死亡)。
红色出现在两颧,大小如拇指,病即使稍微好转,也必然会突然死亡。黑色出现在天庭,大小如拇指,人虽然没有发病,也必然会突然死亡(形状如拇指,是最凶险的颜色。红色出于颧,颧对应肩,也是肺部的反映,火色克金,病虽愈必死。天庭处于最高处,黑色干犯它,是肾气绝的表现。虽然没发病,也必死无疑)。
庭,对应首面(天庭处于最高处,对应首面的疾病)。阙上,对应咽喉(阙上是眉心之上,对应咽喉的疾病)。阙中,对应肺(阙中正当两眉之中,色见者,其应在肺)。下极,对应心(下极是眉心之下,相家称为山根,心居肺下,所以下极应心)。直下,对应肝(下极之下为鼻柱,相家称为年寿。肝在心之下,所以直下应肝)。肝左,对应胆(胆附在肝的短叶上,所以肝左应胆,而在年寿的左右)。下,对应脾(年寿之下,相家称为准头,也叫土星,本经称为面王,又名明堂。准头居面部中央,所以属土应脾)。方上,对应胃(准头两旁为方上,即迎香穴之上,鼻隧之处。相家称为兰台廷尉,与胃为表里,脾居中而胃居外,所以方上应胃)。中央,对应大肠(人中中外五分处的迎香穴,是大肠的对应部位,也在面部中间,所以说中央)。挟大肠者,对应肾(挟持迎香穴上方的是颊的上部。四脏都是一对一的,只有肾有两个,四脏居腹中,只有肾附着在脊柱,所以四脏依次在中央,而肾单独对应两颊)。当肾者,对应脐(肾与脐相对,所以当肾的下方对应脐)。面王以上,对应小肠(面王是鼻准,小肠为腑,应挟两侧,所以面王以上,两颧之内,是小肠的对应部位)。面王以下,对应膀胱和子宫(面王以下是人中,是膀胱和子宫的对应部位。子处,就是子宫。一般人的口唇人中沟,平坦浅而无胡须的,多主无子。妇女也以人中深长为好,利于生育。这以上是五脏六腑的对应部位)。颧,对应肩(这下面说的都是肢节的对应。颧是骨的根本,居中部之上,所以对应肩)。颧后,对应臂(臂连接在肩上,所以颧后对应臂)。臂下,对应手。目内眦上方,对应膺乳(目内眦上方,是阙下两旁。胸两旁高处为膺,膺乳对应胸前)。挟绳而上,对应背(颊的外侧叫绳,身体的后面叫背,所以背对应挟绳之上)。循牙车以下,对应股(牙车,即牙床。牙车以下主下部,所以对应股)。中央,对应膝(中央,即牙车的中央)。膝以下,对应胫。当胫以下,对应足(胫次于膝,足接于胫,依次而下)。巨分,对应股里(巨分,是口旁大纹处,股里是股的内侧)。巨阙,对应膝膑(巨阙,是颊下的曲骨。膝膑是膝盖骨,这里统指膝部)。
《灵枢》脏腑肢节应于面之图 [图片]
面部各有对应的部分,明确了部分,就能用阴调和阳,用阳调和阴,必须明白对应的部位,才能万举万当(部分既已明确,阴阳就不会差错,阳亢盛就滋养阴,这叫用阴和阳。阴寒盛就补火,这叫用阳和阴。所以明白对应部位而施治法,就能万举万当),能够辨别左右,这就叫做大道;男女位置不同,所以称为阴阳,审察色泽的荣枯,才叫做良工(阳左阴右。左右,是阴阳的道路,所以能辨别左右,是为大道。男女异位,男子左为逆、右为顺,女子右为逆、左为顺,所以称阴阳。阴阳既已分辨,然后审察其色的润泽或枯夭,以决断生死,这才是良医)。色沉浊为病在里,色浮泽为病在表(色之沉浊晦滞者为里证,色之浮泽光明者为表证);黄赤为风,青黑为痛,白为寒,黄而膏润为脓,赤甚者为血;痛甚则肢体拘挛,寒甚则皮肤麻木不仁(凡是五色见于面部,都可以据此推测病情。痛甚即是青黑的极致,寒甚即是白色的极致)。五色各自显现于对应的部位,观察其浮沉,可以知道病位的深浅;观察其润泽枯夭,可以观察预后的成败;观察其散漫或聚结,可以知道病程的远近;视其色上下移动,可以知道病处(色浮者病浅,色沉者病深;润泽者预后好,枯夭者预后差;散而不聚者病近,抟而不散者病远。上下,即前面所说的脏腑肢节在面部的对应部位)。
色光明但不显扬,沉滞枯夭的为病重;色不明也不润泽,病不会太重(粗,指显扬的意思。说色之光明但不显扬,只见到沉滞枯夭,病一定很重。如果虽然不明泽,但不至于沉夭,病一定不重)。色散漫,像小马驹一样未装鞍辔般散而不聚,其病散而气痛,积聚尚未形成(驹,是小马,未装鞍辔,散而不聚。比喻色散而无定形,病也散而无坚硬的积聚,即使有痛,也不过是因无形之气所致)。肾气乘袭心气,心先病,肾色应现,其他脏腑的颜色变化也是如此(肾乘心,是水邪克火。心先在内部生病,而肾的颜色则应现在外部,比如黑色出现在下极。不只是心肾,其他脏腑也是这样,这里举一个例子来类推其余)。
男子的色出现在面王,是小腹痛,向下延伸到睾丸痛,人中沟圆直的是阴茎痛,上部是茎根痛,下部是茎头痛,属于狐疝等阴部疾病(面王上,应有“上”字。面王上是小肠,下面是膀胱和子宫。卵,是睾丸。圜直,指人中水沟穴,人中有边圆而直的,所以人中色见主阴茎作痛。在人中上半的叫高,为茎根痛,在人中下半的叫茎头痛,凡此皆狐疝等阴部疾病。 即 疝)。女子色出现在面王,是膀胱和子宫的病,色散为痛,色聚为积聚,方圆左右,各如其色形。如果色随之下行至尾骶,则为带下淫浊,有润如膏状之物,这是由于暴食且不节制饮食所致(面王下,宜有“下”字。面王下为人中,主膀胱和子宫。色散为痛,是无形的滞气;色聚为积聚,是有形的血凝。积块或方或圆,或左或右,各如其外在显现的形状。如果色从下行至尾骶,则为浸淫带浊,有润如膏之物,此症多因暴食且不节制饮食所致。不洁犹言不节,不是污秽的意思。或多食冷物,或多食热物,一切不宜之物皆是)。
色,有青、黑、赤、白、黄,都要端正饱满且有别于他部。别部出现赤色,其色也大如榆荚,在面王出现预示不久将愈(五色都宜端正饱满。端,指正色,满,指充润。别乡犹言他乡,即别的部位。比如赤色是心色,应见于两目之间,是其本乡。现在见于面王,是别乡了。不日,是不久就痊愈。火色见于土位,是其相生之乡。这里举赤色为例,而五色错见于他部者,皆可类推)。色向上尖锐,头部空虚向上向;向下尖锐,向下向;在左右也一样(邪色的显现,各有方向。其尖锐之处是乘虚侵犯的方向,所以上锐者因为头部虚,所以上向。下锐亦然,在左右者都同此法)。
《五脏生成论》说:面黄目青,面黄目赤,面黄目白,面黄目黑的,都不会死(黄是中央土的正色,五行以土为本,胃气还在,所以不死)。面青目赤,面赤目白,面青目黑,面黑目白,面赤目青,都会死(色中没有黄,说明胃气已绝,所以都会死)。
我按语:望、闻、问、切,称为四诊,而望色居于四诊之首,没有单凭一脉就可以施治的。经文说:切脉动静并观察眼睛神采,察视五色,观察五脏的有余不足、六腑的强弱,形体的盛衰,以此综合参验,决断死生的界限。又说:形气相得,叫做可治。色泽浮润,叫做易愈。又说:能结合色脉,可以万全。张仲景曾认为世医不观察明堂阙庭,是医生的过错。李好古曾论述治疗妇人不能运用望色之神,是病人的过错,那么望色固然重要,医生怎么可以忽视呢?
The *Lunyu Jingwei* (Treatise on the Essence and Subtlety of Pulse Diagnosis) states: The spirit in the eyes and the five colors of the face are the external manifestations of Qi (vital energy) (The spirit manifests in the eyes, and the five colors appear on the face; both are the splendor of Qi, implying that Blood is included within Qi). A healthy red color should resemble white silk wrapping cinnabar—lustrous and contained—not like jasper (a dull, dark red). A healthy white color should resemble goose feathers—pure and moist—not like salt—dry and stark. A healthy green color should resemble the luster of dark jade—not like the color of indigo plants (dull and lifeless). A healthy yellow color should resemble raw chrysocolla wrapped in silk—bright and refined—not like loess soil—dry and muddy. A healthy black color should resemble heavy lacquer—dark and glossy—not like earth cyan (dull and withered). The "desirable" states of the five colors all seek moisture and luster; the "undesirable" states all detest dryness and withering. If the subtle images of the five colors' essence are exposed (indicating the depletion of vital essence), longevity will be short (These are signs of the exhaustion of the five colors' essence; once ominous signs appear, life will not be long).
The term "Jingming" (Spirit Brightness) refers to the ability to see all things, distinguish black from white, and judge length and shortness. If one perceives long as short or white as black, it indicates that Jing (Essence) has declined (The essential Qi of the Zang-Fu organs ascends to the eyes to create brightness, hence called "Jingming". If this brightness cannot ascend, confusion ensues, and life cannot be preserved).
The *Lingshu · Se Pian* (Chapter on Facial Color) states: The Mingtang (Bright Hall) is the nose; the Que (Palace Gate) is the space between the eyebrows; the Ting (Courtyard) is the forehead; the Fan (Screen) is the cheek sides; and the Bi (Shield) is the ear gates. These areas should be square and broad, visible from ten paces away; such a person will surely live to a hundred years (The Ting is the upper forehead, commonly called the forehead corners. The Fan and Bi act as screens for the sides. If these features are distinct from ten paces away, they are broad and square, indicating a lifespan of a century).
If the Mingtang bone is high and rising, flat and straight, the five Zang organs are arranged sequentially in the center, and the six Fu organs flank them on both sides. The head and face correspond to the Que and Ting; the Wanggong (Royal Palace, i.e., Heart) is located at the Xiaji (Lower Pole, below the eyes). When the five Zang organs are harmonious in the chest, the true color appears, pathological colors are absent, and the Mingtang is clear and moist (The signs of the five Zang are in the center; the signs of the six Fu are on the periphery. 'Ci' means position. 'Xia' means attachment. The Xiaji, between the eyes, corresponds to the Heart. As the Monarch organ, the Heart is called the Royal Palace. If the Zang organs are harmonious, the true color naturally appears, and the Mingtang must be clear and moist). When the five colors appear, each emerges in its corresponding color zone. If the bone in a specific zone is depressed, illness is inevitable. However, if the color zones show mutual generation (Sheng cycle) despite changes, even severe illness will not lead to death (Each color has its specific zone. If a zone's bone is weak and depressed, evil Qi invades causing disease. If the color changes but follows a generative relationship without destructive control, the disease, though severe, will not be fatal). Green and black indicate pain; yellow and red indicate heat; white indicates cold (This explains the pathology associated with each color).
A color that is coarse yet bright indicates mild disease; sunken and withered indicates severe disease. If the color moves upward, the disease worsens; if it moves downward like dispersing clouds, the disease is resolving (Coarse here means bright/clear. Sunken and withered means dull/stagnant. A healthy color should be bright; dullness indicates severe disease. Upward movement suggests turbid Qi is rising, worsening the condition. Downward movement suggests turbid Qi is receding, indicating recovery). The five colors have internal and external storage zones. Color moving from external to internal indicates disease progressing from exterior to interior; color moving from internal to external indicates disease progressing from interior to exterior. For diseases originating internally, treat Yin first, then Yang; reversing this worsens the condition. For diseases originating externally, treat the exterior first, then the interior; reversing this worsens the condition (The zones refer to Zang and Fu. External zones are the exterior of the Fu organs; internal zones are the interior of the Zang organs. If disease color starts externally and moves inward, it is Exterior-Basis/Interior-Branch; treat exterior first. If it starts internally and moves outward, it is Yin-Basis/Yang-Branch; treat Yin first. Reversing this constitutes misdiagnosis and aggravates the disease).
Usually observe the Que (space between eyebrows): thin and moist indicates Wind; turbid and dense indicates Bi (Obstruction); appearing on the lower part (Di Ge) indicates Jue (Cold Reversal). This is the general rule; infer the disease from the color (The Que corresponds to the Lung. Wind affects Yang/skin, so color is thin/moist. Bi affects Yin/flesh/bone, so color is turbid/dense. Jue involves cold-damp starting from below, so color appears on the Di Ge/lower face).
When Great Evil Qi enters the Zang-Fu, sudden death occurs even without prior symptoms (Great Qi refers to major pathogenic factors, e.g., Water color appearing in Fire zones. This indicates massive deficiency of Yuan Qi and arrival of hostile pathogens; sudden death is inevitable).
Red appearing on both zygomatic arches, size of a thumb, indicates that even if the illness seems to improve, sudden death will follow. Black appearing on the Ting (forehead), size of a thumb, indicates sudden death even without apparent illness (Thumb-sized discoloration is extremely ominous. Red on the cheeks relates to Lungs/Liver Wood-Fire conflict; death is certain. Black on the highest point (Ting) indicates Kidney exhaustion; death is certain).
The Ting corresponds to the head and face. The area above the Que corresponds to the throat. The Que (between eyebrows) corresponds to the Lungs. The Xiaji (below the eyes) corresponds to the Heart. The area directly below the Xiaji (nose bridge) corresponds to the Liver. To the left of the Liver area corresponds to the Gallbladder. Below the nose tip (Zhuntou/Mingtang) corresponds to the Spleen. The Fangshang (sides of the nose tip) corresponds to the Stomach. The Central area (cheeks near Da Ying acupoint) corresponds to the Large Intestine. Flanking the Large Intestine area corresponds to the Kidneys. Opposite the Kidney area corresponds to the Umbilicus. Above the Mingtang (nose tip) corresponds to the Small Intestine. Below the Mingtang corresponds to the Bladder and Zi Chu (Uterus). The Zygomatic arches correspond to the shoulders. Behind the zygomatic arches correspond to the arms. Below the arms correspond to the hands. Above the inner canthus corresponds to the Ying and breasts. Above the Cheek Rope (outer cheek) corresponds to the Back. Below the Jaw (Yache) corresponds to the Thighs. The center of the jaw corresponds to the Knees. Below the knees corresponds to the Shins. Below the shins corresponds to the Feet. The Ju Fen (corner of mouth) corresponds to the Inner Thigh. The Ju Que (jaw angle) corresponds to the Knee Cap.
[Image: Diagram of Zang-Fu and Limbs Corresponding to the Face in Lingshu]
Having distinct parts allows one to use Yin to harmonize Yang and Yang to harmonize Yin. Understanding these parts ensures accurate treatment. Distinguishing left and right is the Great Dao; knowing that men and women have different positional correspondences defines Yin and Yang. Examining luster versus withering makes one a skilled practitioner (Left is Yang, Right is Yin. Men: Left is adverse, Right is favorable. Women: Right is adverse, Left is favorable. After distinguishing Yin/Yang, assess color luster to determine prognosis). Sunken/turbid color indicates Interior disease; floating/moist color indicates Exterior disease. Yellow/Red indicates Wind; Green/Black indicates Pain; White indicates Cold; Yellow with greasy luster indicates Pus; Deep Red indicates Blood stasis. Severe pain causes spasms; severe cold causes skin anesthesia.
Observing the five colors in their respective zones: Float/Sunken reveals depth; Luster/Withering reveals prognosis; Scattered/Aggregated reveals duration; Upward/Downward movement reveals location. Bright but not coarse indicates mild disease; sunken/withered indicates severe disease. Not bright/moist but not sunken/withered indicates mild disease. Scattered color (like a foal unbridled) indicates dispersed Qi pain without solid accumulation. Kidney water overcoming Heart fire: Heart disease precedes, Kidney color appears externally (e.g., black at Xiaji). This pattern applies to other Zang pairs.
In men, color at the Mingtang indicates lower abdominal pain or testicular pain. Round/straight color in the Philtrum indicates penile pain (upper root, lower head), characteristic of Hu Hernia (Yin disorders). In women, color at the Mingtang indicates Bladder/Zi Chu disease. Scattered color indicates Qi pain; aggregated color indicates Blood mass. Shape matches the color form. Color descending to the coccyx indicates leukorrhea (greasy discharge) due to dietary indiscretion.
The five colors (Green, Black, Red, White, Yellow) should be proper and full, distinct from other zones. Red appearing in the "other zone" (Mingtang) like an elm seed implies quick recovery (Yellow is Earth's true color; presence of Wei Qi guarantees survival. Absence of Yellow in mixed colors indicates Wei Qi exhaustion and death). Sharp color points indicate the direction of invasion.
The *Wuzang Shengcheng Lun* (Treatise on the Generation of the Five Zang) states: Yellow face with green/red/white/black eyes indicates survival (Yellow represents Earth/Wei Qi). Green face with red eyes, Red face with white eyes, etc., indicate death (Absence of Yellow indicates exhausted Wei Qi).
Commentary: Inspection, Auscultation/Olfaction, Inquiry, and Palpation constitute the Four Diagnostic Methods. Inspection of color is primary. One cannot treat based on pulse alone. The Classic states: Combine pulse, eye spirit, and facial colors to assess Zang-Fu excess/deficiency and形体 (form) prosperity/decline to determine life and death. "Form and Qi compatible" is treatable. "Color and luster floating" is easily cured. "Combining color and pulse" ensures safety. Zhang Zhongjing criticized physicians who failed to inspect the Mingtang and Que. Li Haogu noted that failing to use inspection in gynecology is a patient's fault. Thus, color diagnosis is indispensable; how can physicians ignore it?