(出《千金方》、《翼方》)
夫为医者,虽善于脉候,而不知察于色气,终为未尽要妙也。故善为医者,必须明于五色,乃可以决死
生,定狐疑。
凡病患面色入门户为凶,不入为吉。白色见冲眉上者,肺有病,入阙庭者,夏死。黄色见鼻上者,脾有
病,入口者春夏死。青色见人中者,肝有病,入目者秋死。黑色见颧上者,肾有病,入耳者,六月死。赤色见颐
者,心有病,入口者,冬死。所谓门户∶阙庭,肺门户;目,肝门户;耳,肾
门户;口,心脾门户。若有色气入者,皆死。(入者,蔓延连合之义也。《素问》谓之交。)
凡病患有赤白青黑四气,不问大小,在年上者,病甚也,惟黄色得愈。年上在鼻上两目间如下,(如,
而古通。)黑气细如绳,发四墓及两颧上者死。四墓在两眉坐直上至发际,左为父墓,右为母墓,从口吻下
极颐为下墓。于此四墓上观四时气∶春见青气,节尽死;夏见赤气,节尽死∶长夏秋见白气,
节尽死;冬见黑气,节尽死。春见黄气,暴死,见白气至秋死,或立夏死;夏见白气,暴死,见黑气,至冬
死,或夏至死;秋见青气,暴死,见赤气,节尽死,或至夏死,或冬至死;冬见赤气,暴死,见黄气,至长
夏死,或春分死。(见本气及来克之气,皆节尽死,或至其节死,或至其胜死。见所克之气,皆暴死,
何者。一为自病,为不胜;一为所胜,所谓反侮,本气败也。)
凡病患黄色入鼻,从口入井灶,百日死。井在鼻孔上曲
中是,灶在口吻两旁上一寸是。年上有黑色横度者,不出百日死。
天中从发际两墓皆发黑色者,三年死。若颧上发黑色应之者,二百日死矣。天中当鼻直上至发际是也。目
下有黑色横度年上者,不出三十日死。黑色入口应天中者,不出一年死。(《脉经》云∶病患黑色出天中,下
至年上颧上者死。)
天中发黑色,年上命门上并黄色者,半好半恶也,以天中为主,五年内死。天中发黑色,法三年内死,所
以然者,有二处得生,故五年死。(相法,以耳前为命门,两眉之间为命宫。)
天中发黑色,两颧上发赤色应之者,不出六十日兵死。若年上发赤色应之者,不出三十日死。若命门上
发赤色应之者,不出百日市死,妇人产死兵死同。
青色如针在目下,春死,或甲乙日死。(相法,妇人目下青黯者,克丈夫。)
黄色入目匝四边,戊己日死。
赤色从眉冲下入目,五日死,或丙丁日死。赤色入口,三日死,远期丙丁日死。
黑色在左右眉上,一日死,或壬癸日死。若白色亦死,或庚
辛日,或二三日死。黑色从天中及年上入目,三日死,或壬癸
日,或百日,半年死。黑色准上行,或入目,壬癸日死,远期二十日死。若入耳鼻,三日死。(准,鼻端也。
行,谓在寿上、年上无定。)黑色横两颧入鼻,一年死。黑色如拇指在眉上,不出一
年暴死,一云三年。(前云黑色在左右眉上,一日死,当是指病甚者,此
指无病者与。)黑色从眉绕目死。赤色在口两旁死。黑色如深漆绕口,或白色,皆死。
病患面失精光,如土色,不饮食者,四日死。病患及健人面色忽如马肝,望之如青,近之如黑,必
卒死。赤色如马,黑色如乌,见面死。(原注,口两旁,左名乌,右名马,非。)
肝病少愈而卒死者,青白色大如拇指 点见颜颊上,此必卒死。凡人肝前病,目则为之无色。若肝前
死,目则为之脱精。若天中等分墓色应之,必死不治。看应增损,斟酌赊促,赊则不出四百日内,促则旬日之间。
心病少愈而卒死者,赤黑色黯点如博棋,见颜,度年上,此必卒死。凡人心前病,则口为之开张。若
心前死,则面色枯黑,语声不转。若天中等分墓色应之,必死不治。看应增损,斟酌赊促,赊则不出四百日
内,促则不出旬日之间。
脾病少愈而卒死者,青黑如拇指 点,见颜颊上,此必卒死。凡人脾前病,唇则焦枯无润。若脾前死,
唇则干,青白,渐缩急,齿噤不开。若天中等分墓色应之,必死不治。
看色浓薄,决判赊促,赊则不盈四百日内,促则不出旬日之间。
肺病少愈而卒死者,赤黑如拇指 点,见颜颊上,此必
卒死。凡人肺前病,鼻则为之孔开焦枯。若肺前死,鼻则
为之梁折孔闭,青黑色。若天中等分墓色应之,必死不治。看色浅深,斟酌赊促,远不出一年,促不延时月。
肾病少愈而卒死者,黄黑色 点如拇指,应耳,此必卒死。凡人肾前病,耳则为之焦枯。若肾前死,耳
则为之 黑焦癖。若天中等分墓色应之,必死不治。看应增损;斟
酌赊促,赊则不出四百日内,促则不出旬日之间。
凡五脏吉凶之色,见于分部。肝病者,顺顺而见青白入目,必死,不出其年。若年上不应,三年之内祸必
至也。心病者, 而见赤黑入口,必死,不出其年,名曰行尸。若年上无应,三年之内,病必死也。脾
病者,霏霏而见黑黄入唇,不出其年,若年上不应,三年之内,祸必至也。肺病
者,顺顺而见赤白入鼻,必病,不出其年,若年上不应,三年之内,祸必应也。肾病者,其人天中等分发
色不正,此是阴阳官位。相法,若不遭官事,即应死也。面目黄黑,连耳
左右,年四十以上,百日死。若偏在一边,最凶,必死。两边有,年上无,三年之内祸必至也。
(出自《千金方》、《翼方》)
作为医生,虽然擅长脉诊,但如果不懂得观察面色和气色,终究未能掌握诊疗的精髓。所以善于行医的人,必须通晓五色(青、赤、黄、白、黑),才能判断生死,消除疑惑。
凡是病患的面色气运进入“门户”为凶兆,不进入则为吉兆。白色出现在冲眉上方者,肺有病;若蔓延至阙庭(两眉之间及额部),夏季死亡。黄色出现在鼻上者,脾有病;若蔓延至口部,春夏季节死亡。青色出现在人中处者,肝有病;若蔓延至眼部,秋季死亡。黑色出现在颧骨上方者,肾有病;若蔓延至耳部,六月内死亡。红色出现在下巴颐部者,心有病;若蔓延至口部,冬季死亡。所谓的“门户”:阙庭是肺的门户;目是肝的门户;耳是肾的门户;口是心和脾的门户。如果有气色进入这些门户,皆主死亡。(所谓“入”,是指气色蔓延连接的意思。《素问》称之为“交”。)
凡是病患面部出现赤、白、青、黑四种气色,不论病情轻重,如果出现在年上(鼻准下方、两目之间的部位),说明病情严重,只有黄色出现则有望痊愈。年上位于鼻上两目之间向下延伸的区域。(“如”字古通“而”字。)如果黑色气色细如绳索,发散至四墓(面相学中代表父母寿元的部位)及两颧骨上方,主死亡。四墓的位置在两眉毛正上方直达发际线处,左边为父墓,右边为母墓,从口角吻端向下延伸至下巴极处为下墓。在这四个墓位上观察四季的气色:春季见到青色气色,节气结束时死亡;夏季见到红色气色,节气结束时死亡;长夏和秋季见到白色气色,节气结束时死亡;冬季见到黑色气色,节气结束时死亡。春季见到黄色气色,突然死亡;见到白色气色,到秋季死亡,或在立夏时死亡;夏季见到白色气色,突然死亡;见到黑色气色,到冬季死亡,或在夏至时死亡;秋季见到青色气色,突然死亡;见到红色气色,节气结束时死亡,或到夏季死亡,或到冬至时死亡;冬季见到红色气色,突然死亡;见到黄色气色,到长夏死亡,或到春分时死亡。(见到本脏对应的气色以及克制本脏的气色,都在节气结束时死亡,或者到了那个节气死亡,或者被克制的脏器败亡而死。见到被本脏克制的气色,都会突然死亡。为什么呢?一种是自身患病导致不胜任,一种是受到反侮,即本气败坏。)
凡是病患黄色气色进入鼻部,从口部蔓延至井灶(井在鼻孔上方的弯曲处,灶在口角两旁上一寸处),一百天后死亡。年上有黑色横贯者,不出百日死亡。
天中(鼻直上至发际的部位)从发际及四墓都发出黑色气色的,三年后死亡。如果颧骨上方发出黑色气色与之相应,二百天后死亡。天中位于鼻子直上至发际处。眼下有黑色横贯经过年上的,不出三十天死亡。黑色气色进入口部并与天中相应者,不出一年死亡。(《脉经》说:病患黑色气色从天中发出,下行至年上、颧上者死亡。)
天中发出黑色气色,年上、命门(相法中以耳前为命门,两眉之间为命宫)并发出黄色气色的,吉凶参半,以天中的气色为主,五年内死亡。天中发出黑色气色,按法三年内死亡,之所以这样说是因为有两处可以得生,所以推迟到五年死亡。
天中发出黑色气色,两颧骨上方发出红色气色与之相应的,不出六十天死于兵祸。如果年上发出红色气色与之相应的,不出三十天死亡。如果命门上发出红色气色与之相应的,不出一百天死于市集(或指非正常死亡),妇人难产死亡、兵死情况相同。
青色像针一样出现在眼下,春季死亡,或甲乙日死亡。(相法认为,妇人眼下呈现青暗色,会克制丈夫。)
黄色气色进入眼睛环绕四周,戊己日死亡。
红色气色从眉头冲下进入眼睛,五天死亡,或丙丁日死亡。红色气色进入口部,三天死亡,远期在丙丁日死亡。
黑色气色在左右眉毛上方,一天死亡,或壬癸日死亡。如果是白色气色也主死亡,或庚辛日,或二三天内死亡。黑色气色从天中及年上进入眼睛,三天死亡,或壬癸日,或一百天、半年死亡。黑色气色沿鼻梁上行,或进入眼睛,壬癸日死亡,远期二十天死亡。如果进入耳鼻,三天死亡。(“准”指鼻端。“行”指在寿上、年上没有固定位置。)黑色气色横穿两颧进入鼻部,一年死亡。黑色气色像拇指大小在眉毛上方,不出一年突然死亡,另一种说法是三年。(前面说黑色在左右眉毛上方一天死亡,应当是指病情严重的情况,这里是指无病之人出现的征兆。)黑色气色从眉毛绕过眼睛主死亡。红色气色在口旁两侧主死亡。黑色气色像深漆一样环绕口部,或者是白色气色,都主死亡。
病患面色失去光泽,像泥土颜色,不进食的,四天死亡。病患及健康人面色忽然像马肝一样,远看呈青色,近看呈黑色,必定突然死亡。红色像马色,黑色像乌鸦色,见面部出现这种颜色主死亡。(原注指出:口旁两侧,左边叫乌,右边叫马,此说不正确。)
肝病刚见好转却突然死亡的,青色和白色大如拇指的点状斑出现在颜颊上,这必定是突然死亡。凡人在肝病之前,眼睛会变得无色。如果肝病致死,眼睛则会精气脱失。如果天中等分墓位的气色与之相应,必定死亡且无法治疗。根据气色的增减变化,斟酌预后的长短,预后长的不出四百天,预后短的在十天之内。
心病刚见好转却突然死亡的,赤黑色暗点像棋子一样,出现在颜面,延伸到年上,这必定是突然死亡。凡人在心病之前,嘴巴会张开。如果心病致死,面色枯黑,说话声音不转。如果天中等分墓位的气色与之相应,必定死亡且无法治疗。根据气色的增减变化,斟酌预后的长短,预后长的不出四百天,预后短的不出十天。
脾病刚见好转却突然死亡的,青色和黑色像拇指大小的点,出现在颜颊上,这必定是突然死亡。凡人在脾病之前,嘴唇会焦枯无润泽。如果脾病致死,嘴唇干燥、青白,逐渐收缩紧急,牙齿紧闭无法张开。如果天中等分墓位的气色与之相应,必定死亡且无法治疗。观察气色的浓淡,决断预后的长短,预后长的不满四百天,预后短的不出十天。
肺病刚见好转却突然死亡的,赤黑色像拇指大小的点,出现在颜颊上,这必定是突然死亡。凡人在肺病之前,鼻子会变得孔开焦枯。如果肺病致死,鼻子会变得鼻梁折断、鼻孔闭合,呈现青黑色。如果天中等分墓位的气色与之相应,必定死亡且无法治疗。观察气色的浅深,斟酌预后的长短,远的不出一年,近的不会拖延月数。
肾病刚见好转却突然死亡的,黄黑色点像拇指大小,与耳朵相应,这必定是突然死亡。凡人在肾病之前,耳朵会变得焦枯。如果肾病致死,耳朵会变得黑焦且有癖块。如果天中等分墓位的气色与之相应,必定死亡且无法治疗。观察气色的增减,斟酌预后的长短,预后长的不出四百天,预后短的不出十天。
凡是五脏吉凶的气色,出现在特定的分部。肝病的人,顺理成章地出现青白色进入眼睛,必定死亡,不出当年。如果年上没有相应征象,三年内灾祸必定到来。心病的人,进而出现赤黑色进入口部,必定死亡,不出当年,名叫“行尸”。如果年上没有相应征象,三年内,病必定致死。脾病的人,纷纷显现黑黄色进入嘴唇,不出当年,如果年上没有相应征象,三年内灾祸必定到来。肺病的人,顺理成章地出现赤白色进入鼻子,必定生病,不出当年,如果年上没有相应征象,三年内灾祸必定应验。肾病的人,其人天中部分发出气色不正,这是阴阳官位的问题。相法认为,如果不遭遇官司诉讼,就会应验死亡。面目黄黑,连及耳朵左右,年龄四十岁以上,一百天死亡。如果偏在一边,最凶,必定死亡。两边都有,年上没有,三年内灾祸必定到来。
(From *Qianjin Fang* and *Yi Fang*)
As a physician, although skilled in pulse diagnosis, if one does not understand how to observe facial complexion and qi color (facial color indicating pathological changes), one has ultimately failed to grasp the essence of diagnosis. Therefore, a proficient physician must be well-versed in the Five Colors (Green/Blue, Red, Yellow, White, Black) to determine life and death and resolve doubts.
When a patient's facial qi color enters the "gateways" (specific facial zones associated with organs), it is an ominous sign; if it does not enter, it is auspicious. If white appears above the Chongmei (area between the eyebrows extending upwards), there is lung disease; if it spreads to the Que Ting (the area between the eyebrows and the forehead), death will occur in summer. If yellow appears on the nose, there is spleen disease; if it spreads to the mouth, death will occur in spring or summer. If green/blue appears at the Renzhong (philtrum), there is liver disease; if it spreads to the eyes, death will occur in autumn. If black appears above the cheekbones, there is kidney disease; if it spreads to the ears, death will occur within six months. If red appears at the Yi (chin/jaw area), there is heart disease; if it spreads to the mouth, death will occur in winter. The so-called "gateways": Que Ting is the gateway of the Lung; Eyes are the gateway of the Liver; Ears are the gateway of the Kidney; Mouth is the gateway of the Heart and Spleen. If any qi color enters these gateways, death ensues. ("Entering" refers to the spreading and connecting of the color. *Su Wen* calls this "Jiao".)
If a patient exhibits four types of qi colors—red, white, green/blue, and black—regardless of severity, if they appear on the Nianshang (the area below the nasal tip and between the eyes), the condition is severe. Only the appearance of yellow suggests recovery. Nianshang is located below the space between the two eyes on the nose. ("Ru" is anciently interchangeable with "Er", meaning 'and' or 'then'.) If black qi color is thin like a rope and spreads to the Four Tombs (areas representing parental longevity in physiognomy) and both cheekbones, death occurs. The Four Tombs are located directly above the eyebrows up to the hairline: the left is the Father's Tomb, the right is the Mother's Tomb, and from the corners of the mouth down to the extreme point of the chin is the Lower Tomb. Observe the seasonal qi colors on these four tombs: In spring, if green/blue qi appears, death occurs at the end of the solar term; in summer, if red qi appears, death occurs at the end of the solar term; in late summer and autumn, if white qi appears, death occurs at the end of the solar term; in winter, if black qi appears, death occurs at the end of the solar term. In spring, if yellow qi appears, sudden death occurs; if white qi appears, death occurs in autumn or at Lixia (Start of Summer). In summer, if white qi appears, sudden death occurs; if black qi appears, death occurs in winter or at Xiazhi (Summer Solstice). In autumn, if green/blue qi appears, sudden death occurs; if red qi appears, death occurs at the end of the solar term, or in summer, or at Dongzhi (Winter Solstice). In winter, if red qi appears, sudden death occurs; if yellow qi appears, death occurs in late summer or at Chunfen (Spring Equinox). (Seeing the qi color corresponding to the organ itself or the color that controls it leads to death at the end of the solar term, or when that solar term arrives, or when the controlled element fails. Seeing the color controlled by the organ leads to sudden death. Why? One case is self-disease due to inability to withstand; the other is counter-restriction (Fan Wu), where the original qi fails.)
If yellow qi color enters the nose from the mouth and spreads to Jing (located in the curved part above the nostrils) and Zao (located one cun above the sides of the mouth corners), death occurs in 100 days. If black crosses horizontally over Nianshang, death occurs within 100 days.
If Tianzhong (the area straight up from the nose to the hairline) shows black spreading from the hairline and all four tombs, death occurs in three years. If black spreads from the cheekbones in response, death occurs in 200 days. Tianzhong is located straight up from the nose to the hairline. If black crosses horizontally under the eyes through Nianshang, death occurs within 30 days. If black enters the mouth and corresponds with Tianzhong, death occurs within one year. (*Mai Jing* states: If black qi emerges from Tianzhong and descends to Nianshang and cheekbones, death ensues.)
If Tianzhong emits black qi, and Nianshang and Mingmen (in physiognomy, Mingmen is in front of the ears, and Minggong is between the eyebrows) emit yellow qi, the prognosis is mixed (half good, half bad), dominated by Tianzhong, with death occurring within five years. Tianzhong emitting black qi indicates death within three years according to method; however, because there are two places allowing for survival, death is delayed to five years.
If Tianzhong emits black qi, and red qi spreads from both cheekbones in response, death from violence/war occurs within 60 days. If red qi spreads from Nianshang in response, death occurs within 30 days. If red qi spreads from Mingmen in response, death occurs within 100 days in the marketplace (or implies unnatural death); this applies similarly to women dying in childbirth or from violence.
If green/blue appears like a needle under the eyes, death occurs in spring, or on Jia/Yi days. (Physiognomy holds that if a woman has dark green/blue under her eyes, she will subdue/harm her husband.)
If yellow qi enters the eyes and surrounds them completely, death occurs on Wu/Ji days.
If red qi rushes down from the eyebrows into the eyes, death occurs in five days, or on Bing/Ding days. If red qi enters the mouth, death occurs in three days, or later on Bing/Ding days.
If black appears above the left and right eyebrows, death occurs in one day, or on Ren/Gui days. If white also appears, death occurs, or on Geng/Xin days, or within two to three days. If black enters the eyes from Tianzhong and Nianshang, death occurs in three days, or on Ren/Gui days, or in 100 days, or in half a year. If black moves upward along the nasal bridge or enters the eyes, death occurs on Ren/Gui days, or later in 20 days. If it enters the nose and ears, death occurs in three days. ("Zhun" refers to the nasal tip. "Xing" means moving without fixed position on Shoushang or Nianshang.) If black crosses horizontally from both cheekbones into the nose, death occurs in one year. If black is as large as a thumb above the eyebrows, sudden death occurs within one year, or another view says three years. (The previous statement about black above the eyebrows causing death in one day referred to severe illness; this refers to signs in healthy individuals.) If black circles around the eyes from the eyebrows, death ensues. Red on both sides of the mouth indicates death. Black surrounding the mouth like deep lacquer, or white, both indicate death.
If a patient's face loses luster and looks like earth, and they do not eat, death occurs in four days. If a patient or even a healthy person's face suddenly looks like a horse's liver—greenish from afar and blackish up close—they will suffer sudden death. Red like a horse, black like a crow appearing on the face indicates death. (Original note: Left side of mouth is Crow, right is Horse; this is incorrect.)
If liver disease seems to improve slightly but then causes sudden death, and green/white spots the size of a thumb appear on the cheeks, sudden death is certain. Before liver disease, the eyes lose their luster/color. If liver disease leads to death, the eyes lose their essence. If the colors in Tianzhong and the tombs correspond, death is inevitable and untreatable. By observing the increase or decrease of colors, one can estimate the duration: long-term cases die within 400 days, short-term cases within ten days.
If heart disease seems to improve slightly but then causes sudden death, and dark red/black spots like chess pieces appear on the face extending to Nianshang, sudden death is certain. Before heart disease, the mouth opens wide. If heart disease leads to death, the complexion becomes withered and black, and the voice becomes unresonant. If the colors in Tianzhong and the tombs correspond, death is inevitable and untreatable. By observing the increase or decrease of colors, one can estimate the duration: long-term cases die within 400 days, short-term cases within ten days.
If spleen disease seems to improve slightly but then causes sudden death, and green/black spots the size of a thumb appear on the cheeks, sudden death is certain. Before spleen disease, the lips become dry and withered. If spleen disease leads to death, the lips become dry, green/white, gradually shrinking and tightening, and the teeth clench shut. If the colors in Tianzhong and the tombs correspond, death is inevitable and untreatable. By observing the thickness of the color, one can judge the duration: long-term cases die in less than 400 days, short-term cases within ten days.
If lung disease seems to improve slightly but then causes sudden death, and red/black spots the size of a thumb appear on the cheeks, sudden death is certain. Before lung disease, the nose becomes open and dry/withered. If lung disease leads to death, the nose bridge collapses, nostrils close, and the color becomes green/black. If the colors in Tianzhong and the tombs correspond, death is inevitable and untreatable. By observing the depth of the color, one can estimate the duration: long-term cases do not exceed one year, short-term cases do not drag on for months.
If kidney disease seems to improve slightly but then causes sudden death, and yellow/black spots the size of a thumb appear corresponding to the ears, sudden death is certain. Before kidney disease, the ears become dry and withered. If kidney disease leads to death, the ears become black, dry, and develop nodules. If the colors in Tianzhong and the tombs correspond, death is inevitable and untreatable. By observing the increase or decrease of colors, one can estimate the duration: long-term cases die within 400 days, short-term cases within ten days.
For the auspicious and inauspicious colors of the Five Zang Organs appearing in specific regions: In liver disease, if green/white naturally enters the eyes, death is certain within the year. If Nianshang does not show corresponding signs, disaster will strike within three years. In heart disease, if red/black enters the mouth, death is certain within the year, termed "Walking Corpse." If Nianshang shows no corresponding signs, death will occur within three years. In spleen disease, if black/yellow appears and enters the lips, death occurs within the year; if Nianshang shows no corresponding signs, disaster will strike within three years. In lung disease, if red/white naturally enters the nose, illness is certain within the year; if Nianshang shows no corresponding signs, disaster will manifest within three years. In kidney disease, if the color in Tianzhong is irregular, this relates to the positions of Yin and Yang officials. Physiognomy states that unless one suffers legal troubles, death will ensue. If the face and eyes are yellow/black, extending to both sides of the ears, and the person is over forty years old, death occurs in 100 days. If it appears on only one side, it is most ominous and fatal. If present on both sides but not on Nianshang, disaster will strike within three years.