（出丹溪）
昼则增剧 夜则安静，是阳病有余，气病而血不病也。
夜则增剧，昼则安静，是阴病有余，血病而气不病也。
昼则发热，夜则安静，是阳气自盛于阳分也。昼则安静，夜则发热烦躁，是阳气下陷入阴中也。（热入
血室。）昼则发热烦躁，夜亦发热烦躁，是重阳无阴也。（补阴泻阳。）
夜则恶寒，昼则安静，是阴气自盛于阴分也。夜则安静，
昼则恶寒，是阴气上冒于阳中也。夜则恶寒，昼亦恶寒，是重阴无阳也。（补阳泻阴。）
昼则恶寒，夜则烦躁，饮食不入，名曰阴阳交错者死。
按∶昼夜静剧，仍须辩证之寒热有余不足。即如昼静夜剧，其证见阳热之有余者，是阳陷入阴也。其
证见阴寒之不足者，是阴气自盛也。其证见虚热而不甚者，则为阴虚，而非阳盛矣。其证见微寒而不甚者，又
为阳虚，而非阴盛矣。余根据此例推之。更有寒热日夜数过，寒已即热，热已复寒，无已时者，在初病为风气
太盛，所谓风胜则动也。在汗后为里邪外争，在下后为外邪内争，皆为阴阳不和，而有病进病
退之别也。在久病为阴阳败乱，元气无主也。
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谨案∶面部当分九行，正中一行，左右各四行也。正中为天庭，为阙上，为阙中，为下极，为方上，
为面王，为中央，（此中央为人中也。）为承浆，为下颏。其侧当内 以下，为目内 ，为面王以上，为面
王以下。次侧当目睛以下，为巨分，（一名法令。）为颐口角。次侧当颧以下，为颧，（一名 ，音求。）
为中央。（此中央为颊中央也，）次侧当颧后耳前，为 ，（一作颔，以其动与
颔应也。）为颧后，（一名 ，音拙，即颧后横骨。）为循牙车以下。次侧
在面部之外，为蔽，耳门也；为蕃，颊侧也。夹绳而上者，绳为面部两侧之转角处也，下当颧，上当额角，如
引绳者。夹而上，即夹额角也。方上谓正当面王之上，即鼻柱与准相接，稍见低扼之处，能候胃气盛虚，胃有
瘕聚，即生黯 ；胃气虚怯，即见低陷。方之为义与本 篇大陵掌后两骨之间方下者也正同，旧为两迎香上
者未协。综观其位，五脏次于中央，而肾居膀胱下，（五色篇言中央有三而义各不同。）六腑夹其两
侧，而胃居脾上，肢节又居六腑之外也。刺热论谓颊下逆颧为大瘕，（大瘕泄，即痢疾也。有谓五更肾泄者
未是。）是大肠病也，是中央诊膝，又诊大肠也，故大便久秘，即其处发热。颧后为胁痛，是颧后诊臂，又
诊胁也。下牙车为腹满，是牙车以下诊股，又诊腹也。且股与股里，膝膑与膝，似俱不当两出，
疑巨分股里，当作腹里也。颊上者，膈上也，是颧后横骨之上也。
又案∶面部之内应脏腑也，有以筋所结，有以脉所过，有以气化所通，有以神明所发。如上文五色篇及
刺热论所叙，盖气化之事也。若内 膀胱，外 小肠，上唇人中大肠，下唇环口胃，耳前后耳中三焦、胆，
则脉络之事也。目上纲太阳，下纲阳明，鼻足太阳，耳中手太阳，头右角足少阳，左角手阳明，则筋络之
事也。舌心，耳肾，鼻肺，唇脾，目肝，眉胆，则神明之事也。病在筋者，视筋络之部；病在脉者，
视脉络之部；病在气化者，视气化之部；病在神明者，视神明之部，知此则分部之法虽各不同，而皆各适
其用矣。圣人之言，岂故为多歧以惑人哉，事各有当，不如此则事理不备也。兹详注面部经络如下，以便省览。
额颅头项∶膀胱脉上额交巅上下项。胃脉过客主人，循
发际至额颅。肝脉上出额，与督脉会于巅。胆脉上抵头角。
三焦脉过客主人前。三焦正脉别于巅。胃正脉上额 。胃别脉上络头项。（以上经脉所络。）心肾肺脾胃五络
皆会于耳中，上络左角。（以上络脉所络。）督脉上额交巅，入络脑，还出别下项。营气上巅下项，合足
太阳；其支者上额，循巅下项中，循脊入 ，是督脉也。（以上奇经所络。）膀胱筋上头，肾筋结于
枕骨。胆筋上额角交巅上，左络于右。三焦筋上乘颔，结于角。大肠筋上左角络头。（以上经筋所络。）
面颜∶胃阳明脉荣于面。心其华在面。心正脉出于面。胆正脉散于面。（以上经脉所络。）任脉循面。
（以上奇经所络。）膀胱筋上颜。（以上经筋所络。）
鼻柱鼻准鼻孔∶胃脉起于鼻之交 中，旁纳太阳之脉，下循鼻外。大肠脉夹鼻孔。小肠脉抵鼻。（以上经
脉所络。）膀胱筋结于鼻。胃筋结于鼻。（以上经筋所络。）
人中∶大肠脉交人中，左之右，右之左。脾气绝人中满。（以上经脉所络。按∶人中亦主膀胱、子处、督脉。）
唇口∶大肠脉夹口。胃脉夹口环唇。胃正脉出于口。肝脉环唇内，故肝气绝唇青。太阴结于太仓，故
脾气绝唇反。（以上经脉所络。）任脉环唇。（以上奇经所络。）三焦络有邪，口干。
（以上络脉所络。）胃筋夹口，寒则引颊移口，热则缓纵不收。胃小肠筋急，则口目为 。（以上经筋所络。）
承浆∶胃脉交承浆。（以上经脉所络。）
上齿下齿∶胃脉入上齿中。大肠脉入下齿中。大肠别脉
入，遍下齿。膀胱别脉入 ，遍上齿。肾气绝，齿长而垢，或齿光无垢。（以上经脉所络。）
舌中舌本舌下∶脾脉连舌本，散舌下。脾正脉贯舌中。
肾脉夹舌本。肾正脉系舌本。膀胱脉夹舌本。心别脉系舌本。少阴结于廉泉。厥阴结于玉英。脾气绝舌萎。（
以上经脉所络。癫狂篇∶舌下少阴。）膀胱筋支者，入结舌本。三焦筋系舌本。三焦络有邪，舌卷。
肝气绝，舌卷，卵缩。（以上经筋所络。）
咽喉∶胃脉循喉咙。胃别脉合诸经之气，下络喉嗌。胃正脉上循咽。脾脉夹咽。脾正脉结咽。大肠正
脉循喉咙。肺正脉循喉咙。小肠脉循咽。心正脉走喉咙。包络正脉循喉咙。胆正脉夹咽。肝脉循喉咙之后，上
入颃颡。膀胱脉循咽喉。肾脉循喉咙。营气注肺，上循喉咙，入颃颡之后，究于畜
门。（以上经脉所络。）三焦络有邪，喉痹。肾络有邪，咽痛，不
可纳食。（以上络脉所络。）任脉至咽喉，入喉。（以上奇经所络。）
目内 锐 上胞下胞∶胃脉上至目内 。膀胱脉起目内 。太阳结于命门，命门者目也。小肠脉过目
锐，至目内 。三焦脉至目锐 。胆脉起目锐 ，至锐 后，其支者别锐
。心正脉合目内 。营气注目内 。（以上经脉所络。）
任脉入目，系两目之下中央。督脉别络起目内 。阴跷之脉合太阳阳跷而上行至目内 ，故目内
痛取之阴跷。（以上奇经所络。）膀胱筋为目上纲。胃筋为目下纲。胆筋结于目 为外维。小肠筋属目外
。三焦筋属目外 。胃小肠筋急，口目为 。 急不能卒视。（以上经筋所络。目下裹大，其胆乃横；
水在腹者，目下必肿；是脾气通于下胞也。上为外 ，下为内毗。）
目系∶膀胱脉正属目本，名曰眼系。胃正脉系目系。心别脉属目系。胆正脉系目系。肝脉连目系，
故肝气绝目晕。卫气平旦出于目，目者宗脉所聚也。（以上经脉所络。脱阴者目盲，气脱者目不明。）
颧 ∶胃正脉上额 。膀胱脉入 遍上齿。大肠脉入 遍下齿。小肠脉上 ，斜络于颧。三焦脉出 。
胆脉抵 下。（按∶ ，音拙，颧后横骨也。 ，音求，即颧也，作鸠误。以上经脉所
络。）胃筋合于 。膀胱筋结于 。大肠筋结于 。胆筋结于 。（以上经筋所络。）跷脉入 ，营气出
。（以上奇经所络。）
颊颐∶大肠脉贯颊。小肠脉上颊，其支者别颊。三焦脉下颊又交颊。肝脉支者，从目系下颊里。（
以上经脉所络，）任脉上颐。（以上奇经所络。）胃筋支者，从颊结于耳前。大肠筋上颊，
其支者下右颔。（以上经筋所络。）
颔曲颊牙车∶胃脉循颐后下廉，下大迎，循颊车。胆脉下颊车。大肠别脉上曲颊。胆正脉出颐颔中。（
以上经脉所络。）大肠筋上颊，其支者下右颔。小肠筋下结于颔。胆筋下走颔。三焦筋支者，当曲颊入系
舌本，其支者上牙车。（以上经筋所络。）
耳前后耳上下角耳中∶胃脉上耳前。阳明结于颡大，颡大者钳耳也。大肠别脉其支者入耳中，合于宗脉，
耳者宗脉之所聚也。小肠脉入耳中。膀胱脉支者从巅至耳上角。三焦脉系耳后，上出耳上角，入耳中，出走
耳前。胆脉下耳后，其支者从耳后入耳中，出走耳前。少阳结于窗笼，窗笼者耳中也。包络正脉出耳后，合
三焦脉于完骨之下。胃中空则宗脉虚，故耳鸣。液脱者，骨属曲伸不利，胫酸，耳数鸣。精脱者耳聋。（
以上经脉所络。）心肝脾肺胃五络皆会于耳中，上络左角。（以上络脉所络。）胃筋结于耳前。三焦筋循
耳前。胆筋循耳后。膀胱筋结于完骨。小肠筋结于耳后完骨，其支者入耳中，直者出耳上。（以上经筋所络。）
上皆筋脉所络之事也。至于气化神明之二义，犹有可得
而言者，如额心，鼻脾，颐肾，左颊肝，右颊肺，此高下左右，以应五脏气化之正位也。又面色皆属于心，两
目四维皆属于肝，两颊皆属于肺，唇四白皆属于脾，两颧两耳叶皆属于肾，颊车皆属大肠，舌下两窍皆属胆，
又属肾，此旁见侧出，以应脏腑气化之旁溢也。目分五脏者，目虽主肝而出于脑，脑受五脏之精也。舌分五
脏者，舌虽主心而本于胃，胃为脏腑之海也，此皆气化之所通也。神明者，性情之有知觉者也，如耳能知
音也，目能知色也，鼻能知臭也，口能知味也，舌能出音也，此皆有五脏知觉以主之，而非外窍所能为
也，故曰神明所发也。病在筋失其形，病在脉失其形，或失其色，病在气化失其色，病在神明失其知觉功用
也。能通此者，即观于面，而知筋络脏腑受病之浅深，所谓洞见五脏症痞也，可称神良矣。
（出自朱丹溪）
白天病情加重，夜间安静，这是阳病有余，气分有病而血分无病。
夜间病情加重，白天安静，这是阴病有余，血分有病而气分无病。
白天安静，夜间发热烦躁，这是阳气下陷进入阴分。（热入血室证）
白天发热烦躁，夜间也发热烦躁，这是重阳无阴。（治法：补阴泻阳）
白天恶寒，夜间烦躁，饮食不能入口，这叫做阴阳交错，预后不良属死证。
按语：判断昼夜病情的轻重变化，仍须辨证分析是寒热有余还是不足。就像昼静夜剧的情况，如果证候表现为阳热有余，这是阳气陷入阴分；如果证候表现为阴寒不足，这是阴气自然旺盛；如果证候表现为虚热但不严重，这是阴虚，而非阳盛；如果证候表现为微寒但不严重，这是阳虚，而非阴盛。其余情况可据此类推。还有寒热日夜交替发作多次，寒罢即热，热罢复寒，无止息的时候，这在初病时是因为风气太盛，所谓“风胜则动”；在发汗后出现，是因为里邪与外邪相争；在攻下后出现，是因为外邪内陷与正气相争，这都是阴阳不和，有病情进展或退却的区别；在久病中出现，则是阴阳败乱，元气失去主宰。
面部脏腑肢节分位图说篇
谨案：面部应当分为九行，正中一行，左右各四行。正中部位从上到下依次是：天庭、阙上、阙中、下极、方上、面王、中央（此中央指人中）、承浆、下颏。其侧边对应的是：目内眦以下，为目内眦、面王以上、面王以下。次侧边对应的是：目睛以下，为巨分（一名法令纹）、颐口角。次侧边对应的是：颧骨以下，为颧（一名颧骨，音求），为中央（此中央指颊部中央）。次侧边对应的是：颧骨后方耳前，为颔（一作颔，因其运动与颔相应），为颧后（一名颧后横骨，音拙，即颧后横骨），沿牙车穴向下。次侧边在面部外侧，为蔽（耳门穴）；为蕃（颊侧）。夹绳而上者，“绳”指面部两侧的转角处，下当颧骨，上当额角，如同拉直的绳子。夹而上，即夹持额角处。“方上”指正当面王之上，即鼻柱与准头相接、稍见低扼之处，此处能候察胃气的盛衰，胃中有瘕聚（积聚），此处会出现黯黑；胃气虚怯，此处就会见低陷。“方”字的含义与本经《大陵掌后两骨之间方下者也》篇正相同，旧注认为是两迎香穴上方的说法不恰当。综观其位置，五脏次于中央，而肾居膀胱之下（《五色篇》言中央有三处而意义各不相同）。六腑夹在其两侧，而胃居脾之上，肢节又居于六腑之外。《刺热论》说颊下逆颧为大瘕（大瘕泄，即痢疾。有人说是五更肾泄，这种说法不对），这是大肠的病，这说明中央部位诊察膝部，又诊察大肠，所以大便长期秘结，该处就会发热。颧后部位对应胁痛，说明颧后诊察臂部，又诊察胁部。下牙车对应腹满，说明牙车以下诊察股部，又诊察腹部。而且股部与股里、膝膑与膝，似乎都不应当同时出现两处对应关系，怀疑“巨分股里”应当作“腹里”。颊上部位，对应膈上，即颧后横骨之上。
又按：面部内部对应脏腑，有的由筋结所主，有的由脉所过，有的由气化所通，有的由神明所发。如上文《五色篇》及《刺热论》所述，大概属于气化的范畴。若内应膀胱，外应小肠，上唇人中应大肠，下唇环口应胃，耳前后耳中应三焦、胆，这属于脉络的范畴。目上纲应太阳，下纲应阳明，鼻应足太阳，耳中应手太阳，头右角应足少阳，左角应手阳明，这属于筋络的范畴。舌心应肾，耳应肾，鼻应肺，唇应脾，目应肝，眉应胆，这属于神明的范畴。病在筋者，观察筋络的部位；病在脉者，观察脉络的部位；病在气化者，观察气化的部位；病在神明者，观察神明的部位，懂得这些道理，那么分部诊察的方法虽然各不相同，但都各有其适用之处。圣人的言论，难道是故意制造歧义来迷惑人吗？事物各有其适宜之处，不如此则事理不完备。现详细注释面部经络如下，以便省览。
额颅头项：膀胱脉上额交巅，下行至上下项。胃脉过客主人穴，循发际至额颅。肝脉上出额，与督脉会于巅。胆脉上抵头角。三焦脉过客主人穴前。三焦正脉别出于巅。胃正脉上额。胃别脉上络头项。（以上为经脉所络。）心、肾、肺、脾、胃五络皆会于耳中，上络左角。（以上为络脉所络。）督脉上额交巅，入络脑，还出别下项。营气上巅下项，合足太阳；其支者上额，循巅下项中，循脊入骶，是督脉也。（以上为奇经所络。）膀胱筋上头，肾筋结于枕骨。胆筋上额角交巅上，左络于右。三焦筋上乘颔，结于角。大肠筋上左角络头。（以上为经筋所络。）
面颜：胃阳明脉荣于面。心其华在面。心正脉出于面。胆正脉散于面。（以上为经脉所络。）任脉循面。（以上为奇经所络。）膀胱筋上颜。（以上为经筋所络。）
鼻柱鼻准鼻孔：胃脉起于鼻之交頞中，旁纳太阳之脉，下循鼻外。大肠脉夹鼻孔。小肠脉抵鼻。（以上为经脉所络。）膀胱筋结于鼻。胃筋结于鼻。（以上为经筋所络。）
人中：大肠脉交人中，左之右，右之左。脾气绝则人中满。（以上为经脉所络。按：人中亦主膀胱、子处、督脉。）
唇口：大肠脉夹口。胃脉夹口环唇。胃正脉出于口。肝脉环唇内，故肝气绝则唇青。太阴结于太仓，故脾气绝则唇反。（以上为经脉所络。）任脉环唇。（以上为奇经所络。）三焦络有邪，则口干。（以上为络脉所络。）胃筋夹口，寒则引颊移口，热则缓纵不收。胃小肠筋急，则口目为僻。（以上为经筋所络。）
上齿下齿：胃脉入上齿中。大肠脉入下齿中。大肠别脉入，遍下齿。膀胱别脉入，遍上齿。肾气绝，则齿长而垢，或齿光无垢。（以上为经脉所络。）
舌中舌本舌下：脾脉连舌本，散舌下。脾正脉贯舌中。肾脉夹舌本。肾正脉系舌本。膀胱脉夹舌本。心别脉系舌本。少阴结于廉泉。厥阴结于玉英。脾气绝则舌萎。（以上为经脉所络。《癫狂篇》：舌下少阴。）膀胱筋支者，入结舌本。三焦筋系舌本。三焦络有邪，则舌卷。肝气绝，则舌卷，卵缩。（以上为经筋所络。）
咽喉：胃脉循喉咙。胃别脉合诸经之气，下络喉嗌。胃正脉上循咽。脾脉夹咽。脾正脉结咽。大肠正脉循喉咙。肺正脉循喉咙。小肠脉循咽。心正脉走喉咙。包络正脉循喉咙。胆正脉夹咽。肝脉循喉咙之后，上入颃颡。膀胱脉循咽喉。肾脉循喉咙。营气注肺，上循喉咙，入颃颡之后，究于畜门。（以上为经脉所络。）三焦络有邪，则喉痹。肾络有邪，则咽痛，不可纳食。（以上为络脉所络。）任脉至咽喉，入喉。（以上为奇经所络。）
目内眦锐眦上胞下胞：胃脉上至目内眦。膀胱脉起目内眦。太阳结于命门，命门者目也。小肠脉过目锐眦，至目内眦。三焦脉至目锐眦。胆脉起目锐眦，至锐眦后，其支者别锐眦。心正脉合目内眦。营气注目内眦。（以上为经脉所络。）任脉入目，系两目之下中央。督脉别络起目内眦。阴跷之脉合太阳阳跷而上行至目内眦，故目内眦痛取之阴跷。（以上为奇经所络。）膀胱筋为目上纲。胃筋为目下纲。胆筋结于目䪼为外维。小肠筋属目外眦。三焦筋属目外眦。胃小肠筋急，则口目为僻。䪼急不能卒视。（以上为经筋所络。目下裹大，其胆乃横；水在腹者，目下必肿；是脾气通于下胞也。上为外眦，下为内眦。）
目系：膀胱脉正属目本，名曰眼系。胃正脉系目系。心别脉属目系。胆正脉系目系。肝脉连目系，故肝气绝则目晕。卫气平旦出于目，目者宗脉所聚也。（以上为经脉所络。脱阴者目盲，气脱者目不明。）
颧䪼：胃正脉上额䪼。膀胱脉入䪼遍上齿。大肠脉入䪼遍下齿。小肠脉上䪼，斜络于颧。三焦脉出䪼。胆脉抵䪼下。（按：䪼，音拙，颧后横骨也。䪼，音求，即颧也，作鸠误。以上为经脉所络。）胃筋合于䪼。膀胱筋结于䪼。大肠筋结于䪼。胆筋结于䪼。（以上为经筋所络。）跷脉入䪼，营气出䪼。（以上为奇经所络。）
颊颐：大肠脉贯颊。小肠脉上颊，其支者别颊。三焦脉下颊又交颊。肝脉支者，从目系下颊里。（以上为经脉所络。）任脉上颐。（以上为奇经所络。）胃筋支者，从颊结于耳前。大肠筋上颊，其支者下右颔。（以上为经筋所络。）
颔曲颊牙车：胃脉循颐后下廉，下大迎，循颊车。胆脉下颊车。大肠别脉上曲颊。胆正脉出颐颔中。（以上为经脉所络。）大肠筋上颊，其支者下右颔。小肠筋下结于颔。胆筋下走颔。三焦筋支者，当曲颊入系舌本，其支者上牙车。（以上为经筋所络。）
耳前后耳上下角耳中：胃脉上耳前。阳明结于颡大，颡大者钳耳也。大肠别脉其支者入耳中，合于宗脉，耳者宗脉之所聚也。小肠脉入耳中。膀胱脉支者从巅至耳上角。三焦脉系耳后，上出耳上角，入耳中，出走耳前。胆脉下耳后，其支者从耳后入耳中，出走耳前。少阳结于窗笼，窗笼者耳中也。包络正脉出耳后，合三焦脉于完骨之下。胃中空则宗脉虚，故耳鸣。液脱者，骨属曲伸不利，胫酸，耳数鸣。精脱者耳聋。（以上为经脉所络。）心肝脾肺胃五络皆会于耳中，上络左角。（以上为络脉所络。）胃筋结于耳前。三焦筋循耳前。胆筋循耳后。膀胱筋结于完骨。小肠筋结于耳后完骨，其支者入耳中，直者出耳上。（以上为经筋所络。）
上面都是筋脉所络的事情。至于气化和神明这两个方面，还有可以说的，如额应心，鼻应脾，颐应肾，左颊应肝，右颊应肺，这是高下左右，以应五脏气化的正位。另外面色皆属于心，两目四维皆属于肝，两颊皆属于肺，唇四白皆属于脾，两颧两耳叶皆属于肾，颊车皆属大肠，舌下两窍皆属胆，又属肾，这是旁见侧出，以应脏腑气化的旁溢。目分五脏者，目虽主肝而出于脑，脑受五脏之精也。舌分五脏者，舌虽主心而本于胃，胃为脏腑之海也，此皆气化之所通也。神明者，性情之有知觉者也，如耳能知音也，目能知色也，鼻能知臭也，口能知味也，舌能出音也，此皆有五脏知觉以主之，而非外窍所能为也，故曰神明所发也。病在筋失其形，病在脉失其形，或失其色，病在气化失其色，病在神明失其知觉功用也。能通此者，即观于面，而知筋络脏腑受病之浅深，所谓洞见五脏症痞也，可称神良矣。
(From Zhu Danxi)
If the condition worsens during the day and remains quiet at night, this indicates an excess of Yang pathology, where Qi is diseased but Blood is not.
If the condition worsens at night and remains quiet during the day, this indicates an excess of Yin pathology, where Blood is diseased but Qi is not.
If there is fever during the day and quietness at night, this indicates that Yang Qi is naturally abundant in the Yang aspect.
If there is quietness during the day and fever with irritability at night, this indicates that Yang Qi has sunk into the Yin aspect. (Heat entering the Blood Chamber.)
If there is fever and irritability during the day, and also fever and irritability at night, this indicates Extreme Yang without Yin. (Treatment: Nourish Yin and Drain Yang.)
If there is aversion to cold at night and quietness during the day, this indicates that Yin Qi is naturally abundant in the Yin aspect.
If there is quietness at night and aversion to cold during the day, this indicates that Yin Qi has risen to invade the Yang aspect.
If there is aversion to cold at night, and also aversion to cold during the day, this indicates Extreme Yin without Yang. (Treatment: Tonify Yang and Drain Yin.)
If there is aversion to cold during the day, irritability at night, and inability to take food or drink, this is called "Yin-Yang Intercalation," which is a fatal prognosis.
Commentary: When judging the severity changes between day and night, one must still differentiate based on whether there is excess or deficiency of Cold or Heat. For instance, in cases of quietness by day and exacerbation by night, if the syndrome presents as excess Yang-Heat, it is Yang sinking into Yin; if it presents as deficiency of Yin-Cold, it is natural abundance of Yin Qi; if it presents as deficient heat that is not severe, it is Yin deficiency, not Yang excess; if it presents as slight cold that is not severe, it is Yang deficiency, not Yin excess. The rest can be deduced from this example. There are also cases where cold and heat alternate multiple times throughout the day and night, with heat following cold and cold following heat, without end. In early-stage disease, this is due to excessive Wind pathogen, as stated, "Wind dominance causes movement." After sweating, it occurs because interior pathogens contend with exterior pathogens; after purgation, it occurs because exterior pathogens contend internally with healthy Qi. These are all cases of Yin-Yang disharmony, showing either progression or regression of disease. In chronic disease, it indicates the disarray of Yin and Yang and the loss of Yuan Qi as the master.
Face Zang-Fu and Limb Segmentation Diagram Description
According to records: The face should be divided into nine vertical rows: one central row and four rows on each side. The central row, from top to bottom, consists of: Tian Ting (Heavenly Court), Que Shang (Above the Gate), Que Zhong (Center of the Gate), Xia Ji (Lower Pole), Fang Shang (Square Above), Mian Wang (Face King), Zhong Yang (Central Center [this refers to Ren Zhong]), Cheng Jiang (Receiving Water), and Xia Ke (Lower Chin). The sides correspond to: below the inner canthus, including Nei Canthus (Inner Canthus), above Mian Wang, and below Mian Wang. The next lateral row corresponds to: below the eyeball, Ju Fen (Great Division [also known as Nasolabial Fold]), and Yi Kou Jiao (Corner of the Mouth near Chin). The next lateral row corresponds to: below the zygoma, Quan (Zygomatic Bone [also known as Zygoma, sound 'qiu']), and Zhong Yang (Central Center [this refers to the center of the cheek]). The next lateral row corresponds to: behind the zygoma and in front of the ear, Han (Jaw [one version says Han, as its movement corresponds to the jaw]), Qian Hou (Behind Zygoma [also known as Transverse Bone Behind Zygoma, sound 'zhuo']), and descending along Ya Che (Joint of the Jaw). The next lateral row is on the outer face: Bi (Ear Gate Acupoint); Fan (Side of Cheek). "Jia Sheng Er Shang" refers to the turning points on both sides of the face like a rope; below corresponds to the zygoma, above corresponds to the corner of the forehead, like a drawn rope. "Jia Er Shang" refers to flanking the corner of the forehead. "Fang Shang" refers to directly above Mian Wang, i.e., where the nasal bridge meets the nasal tip, slightly depressed; this area reflects the prosperity or deficiency of Stomach Qi. If there is a mass (Jia Ju) in the Stomach, dark discoloration appears here; if Stomach Qi is weak, this area appears sunken. The meaning of "Fang" is consistent with the statement in the *Da Ling* chapter regarding the square space behind the two bones of the palm. The old interpretation placing it above the Ying Xiang acupoints is incorrect. Summarizing these positions, the Five Zang organs are situated centrally, with the Kidney located below the Bladder (the *Wu Se* chapter mentions three meanings for "central"). The Six Fu organs flank them on both sides, with the Stomach located above the Spleen, and the limbs/joints located outside the Six Fu organs. The *Ci Re Lun* states that "reverse zygoma below the cheek indicates Da Jia" (Da Jia Xie, i.e., dysentery. Some claim it is morning diarrhea due to Kidney deficiency, which is incorrect); this is a Large Intestine disease. This shows that the central region diagnoses the knee and also the Large Intestine; thus, long-term constipation causes heat in this area. Pain in the hypochondrium corresponds to the area behind the zygoma, indicating that the area behind the zygoma diagnoses the arm and also the hypochondrium. Abdominal fullness corresponds to below the dental arch, indicating that below the dental arch diagnoses the thigh and also the abdomen. Moreover, the thigh and the inner thigh, the patella and the knee, seem unlikely to have dual correspondences; it is suspected that "Ju Fen Gu Li" should be read as "Fu Li" (Inner Abdomen). The area above the cheek corresponds to above the diaphragm, i.e., above the transverse bone behind the zygoma.
Another commentary: The internal correspondence of the face to Zang-Fu organs is determined by where tendons knot, where meridians pass, where Qi transformation connects, and where Shen Ming (Spiritual Consciousness) manifests. As described in the *Wu Se* chapter and *Ci Re Lun*, these generally belong to Qi transformation. For example, the interior corresponds to the Bladder, the exterior to the Small Intestine, the upper lip and Ren Zhong to the Large Intestine, the lower lip and surrounding mouth to the Stomach, the areas around and inside the ears to the San Jiao and Gallbladder; these belong to the meridian collaterals. The upper eyelid margin corresponds to Tai Yang, the lower to Yang Ming, the nose to Foot Tai Yang, the ear to Hand Tai Yang, the right temple to Foot Shao Yang, and the left temple to Hand Yang Ming; these belong to tendon collaterals. The center of the tongue corresponds to the Kidney, the ear to the Kidney, the nose to the Lung, the lips to the Spleen, the eyes to the Liver, and the eyebrows to the Gallbladder; these belong to Shen Ming. For diseases in the tendons, observe the tendon collateral regions; for diseases in the vessels, observe the vessel collateral regions; for diseases in Qi transformation, observe the Qi transformation regions; for diseases in Shen Ming, observe the Shen Ming regions. Understanding this, although the methods of regional diagnosis vary, each has its specific application. Did the Sages intentionally create confusion? No, things have their proper places; otherwise, principles would be incomplete. Below is a detailed annotation of the facial meridians for reference.
Forehead, Skull, Head, Neck: The Bladder Meridian ascends to the forehead, crosses the vertex, and descends to the neck. The Stomach Meridian passes through the Guest Master (Tai Yang) acupoint, follows the hairline to the forehead. The Liver Meridian ascends out of the forehead and meets the Du Meridian at the vertex. The Gallbladder Meridian ascends to touch the head corners. The San Jiao Meridian passes anterior to the Guest Master acupoint. The main San Jiao Meridian branches from the vertex. The main Stomach Meridian ascends to the forehead. The branch Stomach Meridian ascends to connect the head and neck. (These are connected by meridians.) The five collaterals of the Heart, Kidney, Lung, Spleen, and Stomach all converge in the ear and ascend to connect the left corner. (These are connected by collaterals.) The Du Meridian ascends to the forehead, crosses the vertex, enters to connect the brain, emerges, and descends separately to the neck. Ying Qi ascends to the vertex and descends to the neck, merging with Foot Tai Yang; its branch ascends to the forehead, follows the vertex down the middle of the neck, follows the spine to the sacrum, which is the Du Meridian. (These are connected by extraordinary meridians.) Bladder tendons ascend to the head; Kidney tendons knot at the occipital bone. Gallbladder tendons ascend to the forehead corners, crossing the vertex, connecting left to right. San Jiao tendons ascend to the chin, knotting at the corner. Large Intestine tendons ascend to the left corner and connect the head. (These are connected by tendon collaterals.)
Face and Cheeks: The Stomach Yang Ming Meridian nourishes the face. The Heart's brilliance manifests in the face. The main Heart Meridian emerges on the face. The main Gallbladder Meridian scatters on the face. (These are connected by meridians.) The Ren Meridian follows the face. (This is connected by an extraordinary meridian.) Bladder tendons ascend to the face. (This is connected by tendon collaterals.)
Nasal Bridge, Tip, Nostrils: The Stomach Meridian originates at the junction of the nasal bridge, receives the Tai Yang meridian laterally, and descends along the outside of the nose. The Large Intestine Meridian flanks the nostrils. The Small Intestine Meridian reaches the nose. (These are connected by meridians.) Bladder tendons knot at the nose. Stomach tendons knot at the nose. (These are connected by tendon collaterals.)
Ren Zhong (Philtrum): The Large Intestine Meridian crosses Ren Zhong, going from left to right and right to left. If Spleen Qi fails, Ren Zheng becomes full. (These are connected by meridians. Note: Ren Zhong also governs the Bladder, Uterus, and Du Meridian.)
Lips and Mouth: The Large Intestine Meridian flanks the mouth. The Stomach Meridian flanks the mouth and surrounds the lips. The main Stomach Meridian emerges from the mouth. The Liver Meridian circles inside the lips; thus, if Liver Qi fails, the lips turn cyanotic. The Tai Yin knots at the Tai Cang (Stomach); thus, if Spleen Qi fails, the lips invert. (These are connected by meridians.) The Ren Meridian circles the lips. (This is connected by an extraordinary meridian.) If the San Jiao collaterals have pathogens, dry mouth occurs. (This is connected by collaterals.) Stomach tendons flank the mouth; cold pulls the cheeks and shifts the mouth, while heat causes relaxation and inability to close. If Stomach and Small Intestine tendons are tense, the mouth and eyes deviate. (These are connected by tendon collaterals.)
Cheng Jiang (Chin Groove): The Stomach Meridian intersects Cheng Jiang. (This is connected by a meridian.)
Upper and Lower Teeth: The Stomach Meridian enters the upper teeth. The Large Intestine Meridian enters the lower teeth. The branch Large Intestine Meridian enters and covers the lower teeth. The branch Bladder Meridian enters and covers the upper teeth. If Kidney Qi fails, teeth appear elongated and dirty, or shiny and clean. (These are connected by meridians.)
Tongue Center, Root, and Underneath: The Spleen Meridian connects to the root of the tongue and scatters under it. The main Spleen Meridian pierces the center of the tongue. The Kidney Meridian flanks the root of the tongue. The main Kidney Meridian ties the root of the tongue. The Bladder Meridian flanks the root of the tongue. The branch Heart Meridian ties the root of the tongue. Shao Yin knots at Lian Quan. Jue Yin knots at Yu Ying. If Spleen Qi fails, the tongue atrophies. (These are connected by meridians. *Dian Kuang* chapter: Shao Yin under the tongue.) A branch of Bladder tendons enters and knots at the root of the tongue. San Jiao tendons tie the root of the tongue. If San Jiao collaterals have pathogens, the tongue curls. If Liver Qi fails, the tongue curls and testicles retract. (These are connected by tendon collaterals.)
Throat: The Stomach Meridian follows the throat. The branch Stomach Meridian combines with the Qi of various meridians and descends to connect the throat and pharynx. The main Stomach Meridian ascends along the pharynx. The Spleen Meridian flanks the pharynx. The main Spleen Meridian knots the pharynx. The main Large Intestine Meridian follows the throat. The main Lung Meridian follows the throat. The Small Intestine Meridian follows the pharynx. The main Heart Meridian travels to the throat. The Pericardium Main Meridian follows the throat. The main Gallbladder Meridian flanks the pharynx. The Liver Meridian follows behind the throat and ascends into the Ying Sang. The Bladder Meridian follows the throat. The Kidney Meridian follows the throat. Ying Qi enters the Lung, ascends along the throat, enters behind the Ying Sang, and terminates at the Chu Men. (These are connected by meridians.) If San Jiao collaterals have pathogens, throat obstruction occurs. If Kidney collaterals have pathogens, sore throat occurs, making swallowing difficult. (These are connected by collaterals.) The Ren Meridian reaches the throat and enters it. (This is connected by an extraordinary meridian.)
Inner Canthus, Outer Canthus, Upper and Lower Eyelids: The Stomach Meridian ascends to the inner canthus. The Bladder Meridian originates at the inner canthus. Tai Yang knots at Ming Men, which is the eye. The Small Intestine Meridian passes the outer canthus to the inner canthus. The San Jiao Meridian reaches the outer canthus. The Gallbladder Meridian originates at the outer canthus, reaches behind the outer canthus, and its branch separates at the outer canthus. The main Heart Meridian converges at the inner canthus. Ying Qi focuses on the inner canthus. (These are connected by meridians.) The Ren Meridian enters the eye, tying the center below both eyes. The branch collateral of the Du Meridian originates at the inner canthus. The Yin Qiao Meridian merges with Tai Yang and Yang Qiao and ascends to the inner canthus; thus, pain in the inner canthus is treated by selecting Yin Qiao. (These are connected by extraordinary meridians.) Bladder tendons form the upper eyelid margin. Stomach tendons form the lower eyelid margin. Gallbladder tendons knot at the outer canthus as Wai Wei. Small Intestine tendons belong to the outer canthus. San Jiao tendons belong to the outer canthus. If Stomach and Small Intestine tendons are tense, the mouth and eyes deviate. Tension in the outer canthus prevents sudden vision. (These are connected by tendon collaterals. Fullness under the eyes indicates Gallbladder excess; edema under the eyes when water is in the abdomen indicates Spleen Qi connects to the lower eyelid. Upper is outer canthus, lower is inner canthus.)
Eye System: The main Bladder Meridian properly belongs to the root of the eye, named Yan Xi. The main Stomach Meridian ties the eye system. The branch Heart Meridian belongs to the eye system. The main Gallbladder Meridian ties the eye system. The Liver Meridian connects to the eye system; thus, if Liver Qi fails, vision blurs. Wei Qi emerges from the eyes at dawn; the eyes are where the Zong Mai (Gathering Vessels) accumulate. (These are connected by meridians. Loss of Yin causes blindness; loss of Qi causes unclear vision.)
Zygoma and Temples: The main Stomach Meridian ascends to the temples. The Bladder Meridian enters the temples and covers the upper teeth. The Large Intestine Meridian enters the temples and covers the lower teeth. The Small Intestine Meridian ascends to the temples, slanting to connect to the zygoma. The San Jiao Meridian emerges from the temples. The Gallbladder Meridian touches below the temples. (Note: Zhuo refers to the transverse bone behind the zygoma. Qiu refers to the zygoma itself; writing it as 'Jiu' is an error. These are connected by meridians.) Stomach tendons combine at the temples. Bladder tendons knot at the temples. Large Intestine tendons knot at the temples. Gallbladder tendons knot at the temples. (These are connected by tendon collaterals.) Qiao Mai enters the temples; Ying Qi exits the temples. (These are connected by extraordinary meridians.)
Cheeks and Chin: The Large Intestine Meridian penetrates the cheeks. The Small Intestine Meridian ascends the cheeks, and its branch separates at the cheek. The San Jiao Meridian descends the cheeks and crosses them. A branch of the Liver Meridian descends from the eye system into the cheek interior. (These are connected by meridians.) The Ren Meridian ascends to the chin. (This is connected by an extraordinary meridian.) A branch of Stomach tendons knots at the front of the ear from the cheek. Large Intestine tendons ascend the cheek, and their branch descends to the right mandible. (These are connected by tendon collaterals.)
Mandible, Jaw Joint, Dental Arch: The Stomach Meridian follows the lower border behind the chin, descends to Da Ying, and follows the jaw joint. The Gallbladder Meridian descends the jaw joint. The branch Large Intestine Meridian ascends to the curved jaw. The main Gallbladder Meridian emerges from the chin-jaw area. (These are connected by meridians.) Large Intestine tendons ascend the cheek, and their branch descends to the right mandible. Small Intestine tendons descend and knot at the chin. Gallbladder tendons descend to the chin. A branch of San Jiao tendons enters the curved jaw to tie the root of the tongue, and its branch ascends to the dental arch. (These are connected by tendon collaterals.)
Front, Back, Top, Bottom, and Inside of Ears: The Stomach Meridian ascends in front of the ear. Yang Ming knots at Sang Da (Sang Da means clamping the ear). A branch of the branch Large Intestine Meridian enters the ear, merging with the Zong Mai, as the ear is where Zong Mai gathers. The Small Intestine Meridian enters the ear. A branch of the Bladder Meridian goes from the vertex to the upper angle of the ear. The San Jiao Meridian ties behind the ear, ascends out of the upper angle, enters the ear, and exits in front of the ear. The Gallbladder Meridian descends behind the ear, and its branch enters the ear from behind, exiting in front. Shao Yang knots at Chuang Long, which is the ear. The main Pericardium Meridian emerges behind the ear, merging with the San Jiao Meridian below Wan Gu. If the Stomach is empty, Zong Mai becomes deficient, causing tinnitus. If body fluids are depleted, bone joints move stiffly, calves ache, and ears ring frequently. If Essence is depleted, deafness occurs. (These are connected by meridians.) The five collaterals of the Heart, Liver, Spleen, Lung, and Stomach all converge in the ear and ascend to connect the left corner. (These are connected by collaterals.) Stomach tendons knot in front of the ear. San Jiao tendons follow in front of the ear. Gallbladder tendons follow behind the ear. Bladder tendons knot at Wan Gu. Small Intestine tendons knot behind the ear at Wan Gu, their branch enters the ear, and the straight part exits the upper ear. (These are connected by tendon collaterals.)
The above describes matters of tendon and vessel connections. Regarding the two aspects of Qi transformation and Shen Ming, there is more to say. For example, the forehead corresponds to the Heart, the nose to the Spleen, the chin to the Kidney, the left cheek to the Liver, and the right cheek to the Lung; this high-low, left-right correspondence aligns with the correct positions of the Five Zang Qi transformation. Additionally, facial complexion belongs to the Heart, the four corners of the eyes belong to the Liver, both cheeks belong to the Lung, the four whites of the lips belong to the Spleen, both zygomas and earlobes belong to the Kidney, the jaw muscles belong to the Large Intestine, and the two openings under the tongue belong to the Gallbladder and also the Kidney; this side-view, lateral emergence aligns with the overflow of Zang-Fu Qi transformation. The eyes divide among the Five Zang because although the eyes are governed by the Liver, they emerge from the Brain, which receives the Essence of the Five Zang. The tongue divides among the Five Zang because although the tongue is governed by the Heart, it originates from the Stomach, which is the Sea of Zang-Fu; these are all passages of Qi transformation. Shen Ming refers to the perceptual nature of temperament, such as the ear hearing sounds, the eyes seeing colors, the nose smelling odors, the mouth tasting flavors, and the tongue producing speech; these are all governed by the perceptual functions of the Five Zang, not merely by external orifices, hence called manifestations of Shen Ming. Diseases in tendons lose their shape; diseases in vessels lose their shape or color; diseases in Qi transformation lose their color; diseases in Shen Ming lose their perceptual function. Those who understand this can observe the face to know the depth of pathology in tendons, vessels, and Zang-Fu, achieving what is called "seeing through to the Zang-Fu masses," which can be called divine and excellent.