色自内而达外。已言其相应矣。医从外以知内。当讲夫主病焉。夫相应之与主病。其义一也。其义一。其用
二。如湿病色黄。疸病色黄。脾病色黄。此内外相应之理也。万殊之所以一本也。然脾病之黄。不同于疸。疸
病之黄。不同于湿。此气色主病之分也。一本之所以万殊也。盖相应者。言其色之同。主病者。辨其气之异。
夫色之同者。拟议非难。而气之异者。形容不易。故今条目诸篇。惟集古圣先贤所言者。分录于后。学人不
以文害辞。不以辞害意。以意逆志。是为得之。否则如刻舟求剑。胶柱鼓瑟矣。至若病症不齐。气色各异。可
以象求。难以言尽。然能熟其提纲。识其部位。参伍诊法。错综病情。虽四海之大。百世之远。万病之殊。皆可
因望而知变。因变而知治。大哉。至哉。范围天地而不过。曲成万物而不遗。非岐黄之至圣。其孰能与于斯。
经云。青黑为痛。夫青者。肝胆之色。亦风木之色也。虽为痛为风。宜以部位诊法参观。然后言其寒热虚实。
如鼻头色青者。腹中痛也。青黑甚者。痛甚为挛也。面青而唇口撮者。疼痛方殷也。鼻头色青腹中痛。若冷
者。死证也。心痛色苍苍如死状。终日不得太息者。肝心痛也。头痛颊青黄。目眩晕不欲闭。身体沉重。兀兀
欲吐者。厥阴太阴为病。痰厥头痛也。腹痛。尿白。爪甲白。面多青。喜热饮。或腹满下利者。寒痛也。腹中作痛。
面色乍赤乍青乍白。其痛时作时止。时吐清水者。虫也。色青。脉至长而左右弹者。有积气在心下肢 。名
曰肝痹。得之寒湿。与疝同法。腰痛足清。头痛也。青而闭滞者。痹痛也。环目鼻而青者。筋骨酸痛也。目间青
脉见者。胆滞掣痛也。面目青。身痛如被杖。咽喉痛。五日可治。七日不可治者。阴毒之为病也。烦躁如狂。心
腹搅痛。头旋欲吐。面目青黑。四肢冷逆者。中砒霜之毒也。中毒。手足面皆青者。时过救之。恐不及也。 青
者。肝病也。色微苍。嗌干。善悲。善怒。时憎女子。多汗恶风。目下色青者。肝风也。风门青者。风病发搐也。乍赤
乍青者。螈 也。面青吐沫。卒不知人者。痫也。面青目反视。手足摇者。肝痫也。痫发手足厥冷。偃卧拘急。面
青吐沫。声音微小。脉沉细者。阴痫也。病发似癫痫。面色青黄者。食芹得之。蛟龙病也。色苍而爪枯者。肝热
也。耳前青者。风也。肝病色青。手足拘急。胁下苦满。或时眩冒。其脉弦长者。可治之证也。面青心闷乱。吐逆
呕沫。胁痛头眩重。耳不闻人声。偏枯筋急。曲拳而卧者。肝风发也。色青苍白。见于目下。善悲。指爪皆痛。好
转筋者。筋虚伤风。为肝虚风也。善怒嗌干。咳则胁下痛。不能转侧。脚下满痛者。筋实伤热。为肝实风也。面
目青黑。卒然喑哑不声。踞坐不得。四肢缓弱。遗失便利者。肝虚寒。厉风所损也。面青颊赤者。疟病寒热也。
疟病色苍苍然太息者。肝疟也。先头重颊痛。颜青欲呕身热。热争则腰痛不可以俯仰。腹满泄。两颔痛者。
脾热病也。小儿面青肉冷。目陷干呕。利下如水者。夏月积冷。暴凉加之。而胃气虚弱也。小儿夜啼。面色青
白。手足俱冷。不欲吮乳。曲腰不伸者。脾寒也。两颊如青黛者。中恶也。卒然面青气促者。惊怖也。小儿初生。
眉青脸赤口撮者。脐风也。小儿上气气逆。面青喘嗽。昼夜不息者。风冷入肺也。面青目瞠者。气喘也。小儿
面色时青时白时赤时黑者。险证也。青遮口角者。必难治也。目下胞青者。胃寒也。青而紫者。恶血也。瘀血
上冲。中心闷乱。色青者。死证也。筋痹好悲思。颜色苍白。四肢痿痹。手足拘挛。伸动缩急。腹中转痛者。筋虚
极也。色青逆噫。喜恍惚失气。状似悲泣之后。舌强咽喉干。寒热恶风。不可动。不嗜食。苦眩。善妄言者。脉极
也。青黑惨暗者。阳气虚也。青白形瘦如柴者。元气衰弱也。青或兼白者。阳虚阴胜也。脉涩面色青者。营气
不足也。目下色青者。或多忧惊。或多色欲也。面如尘垢者。少阳病也。咳嗽面青者。肝乘肺也。面青夺色者。
久病也。色青脉弦而细。两胁下痛。邪气走心下。足胫寒。胁痛引小腹。善转筋。爪甲枯黑。春瘥秋剧者。肝积
之病。男子积疝。女子瘕淋也。妇人面青者。肝强脾弱。或多怒少食。或经脉不调也。妊娠右目下青者。女胎
也。妊娠目上青者。生女又产难也。妊娠沟洫青者。双生也。无病而青色见于天庭者。将病瘟疫也。青如点
染者。晦气时侵也。山根年寿青者。频逢疾病也。面青多言而热者。阴中之阳邪也。面青多言而寒者。阴中
之阴邪也。面青不言而寒者死。阴之极也。面青目黄者。必难治也。青白色如拇指大。 点见于颜颊上者
肝病。虽少愈。必卒死也。青黑色如拇指大。 点见于颜颊上者脾病。虽少愈。必卒死也。青色横于正面者。
行尸也。脱色而面苍苍然者。阴阳俱脱。表里相离也。吐泻目陷。睑青如磕伤者。土败木贼也。青色绕耳者。
半年损寿也。劳病青色自发际接印堂者。死在六十日也。劳病青色自发际接印堂至鼻者。死在三十日
也。劳病青色自发际至鼻及人中者。死在十七日也。满面色青者。即死也。耳聋百节皆纵。目HT 系绝。色先
青白。乃死者。少阳终也。痰涎壅极。吞吐不能。呃逆不止。腹胀色青黑者。脾胃气绝也。眼闭不开。躁急扰乱
懊。囊缩。色青灰白者。肝脏绝也。面青但欲伏眠。汗出如水不止者。肝绝也。四肢 习。唇吻反青者。肝绝
也。面色青。眼视人不直。数泪出者。肝绝也。真肝脉至。中外急。如循刀刃。责责然。如按琴瑟弦。色青不泽。毛
折乃死者。脉无胃气。金克木也。脾病色黄体青。夫溲直视。唇反张。爪甲青。饮食吐逆。体重节痛。四肢不举。
其脉当浮大而缓。今反弦急。其色当黄而反青者。此是木克土。为大逆。十死不治。是皆青色之目也。
面色由内而外显现。前面已经论述了内外相应的道理。医生通过外在表现来了解内在病变,应当讲解主病的规律。相应与主病,其义理是一致的。义理一致,但应用却有两种情况。例如湿病面色黄,疸病面色黄,脾病面色黄,这是内外相应的道理,即万殊归于一本。然而脾病之黄不同于疸病之黄,疸病之黄不同于湿病之黄,这是气色辨别主病的区别,即一本衍生出万殊。所谓“相应”,是指颜色的相同;所谓“主病”,是辨别气的差异。颜色相同容易比拟推测,而气的差异难以形容描述。因此,现在各条目篇章中,只汇集古代圣贤所说的内容,分条记录在后面。学习者不要因文字妨碍理解词句,不要因词句妨碍领会意旨,要用心意去追溯作者的本意,这样才能有所收获。否则就像刻舟求剑、胶柱鼓瑟一样固执不通。至于病症不齐,气色各异,可以通过象数来推求,难以用言语穷尽。但是如果能熟记提纲,识别部位,参伍运用诊法,错综分析病情,即使四海之大,百世之久,万种疾病的不同,都可以因望诊而知变通,因变通而知道治疗。伟大啊!至高无上啊!涵盖天地而不越轨,成就万物而无遗漏。如果不是岐伯和黄帝的至圣境界,谁能参与到此等境界呢?
经文说:青色和黑色主痛证。青色,是肝胆的颜色,也是风木的颜色。虽然主痛和风病,适宜结合部位诊法综合观察,然后才能判断寒热虚实。例如鼻头色青,是腹中疼痛。青色黑重者,疼痛剧烈导致拘挛。面色青且嘴唇口角撮缩者,疼痛正剧烈。鼻头色青伴腹中痛,如果伴有寒冷感,是死证。心痛面色苍苍如死状,整天不能深呼吸(太息)的,是肝心痛。头痛脸颊青黄,目眩头晕不想闭眼,身体沉重,昏昏欲吐的,是厥阴太阴为病,痰厥头痛。腹痛,尿白,指甲白,面部多青,喜欢热饮,或腹胀腹泻的,是寒痛。腹中作痛,面色忽红忽青忽白,疼痛时作时止,时常吐出清水的,是虫积。色青,脉象长而左右弹指,有积气在心下及下肢,名叫肝痹,得自寒湿,治疗方法与疝气相同。腰痛足冷,头痛。青色且闭塞滞涩的,是痹痛。环绕眼睛鼻子发青的,是筋骨酸痛。两眼之间青色脉络显现的,是胆气滞涩掣痛。面目青,身体痛如被杖打,咽喉痛,五天可治,七天不可治的,是阴毒之为病。烦躁如狂,心腹搅痛,头晕欲吐,面目青黑,四肢冰冷逆冷的,是中砒霜毒。中毒,手足面部都青的,过时救治,恐怕来不及了。青色,主肝病。面色微苍,咽喉干,易悲伤,易怒,时而厌恶女性,多汗恶风,眼下色青的,是肝风。风门穴处色青的,是风病发作抽搐。忽红忽青的,是抽搐(瘛疭)。面青吐沫,突然不知人事的,是痫病。面青目睛上视,手足摇动的,是肝痫。痫病发作手足厥冷,仰卧拘急,面青吐沫,声音微小,脉沉细的,是阴痫。病发似癫痫,面色青黄的,是食芹引发的蛟龙病。面色苍而指甲枯槁的,是肝热。耳前色青的,是风邪。肝病色青,手足拘急,胁下苦满,或时常眩晕冒昧,脉弦长的,是可治之证。面青心闷乱,呕吐逆沫,胁痛头眩重,耳不闻人声,偏枯筋急,曲拳而卧的,是肝风发作。色青苍白,见于眼下,易悲伤,指爪皆痛,喜好转筋的,是筋虚伤风,为肝虚风。易怒咽干,咳嗽则胁下痛,不能转侧,脚下满痛的,是筋实伤热,为肝实风。面目青黑,突然失音不语,蹲坐不得,四肢缓弱,大小便失禁的,是肝虚寒,受厉风损伤。面颊赤红的,是疟病寒热。疟病面色苍苍然太息的,是肝疟。先头重颊痛,颜面青欲呕身热,热争则腰痛不可以俯仰,腹胀泄泻,两颔痛的,是脾热病。小儿面青肉冷,目陷干呕,利下如水样的,是夏季积冷,暴凉加之,胃气虚弱。小儿夜啼,面色青白,手足俱冷,不欲吮乳,曲腰不伸的,是脾寒。两颊如青黛色的,是中恶。突然面青气促的,是惊怖。小儿初生,眉青脸赤口撮的,是脐风。小儿上气气逆,面青喘嗽,昼夜不息的,是风冷入肺。面青目瞪的,是气喘。小儿面色时青时白时赤时黑的,是险证。青色遮盖口角的,必难治。眼下胞皮青的,是胃寒。青而紫的,是恶血。瘀血上冲,心中闷乱,色青的,是死证。筋痹好悲思,颜色苍白,四肢痿痹,手足拘挛,伸动缩急,腹中转痛,是筋虚极。色青逆噫,喜恍惚失气,状似悲泣之后,舌强咽喉干,寒热恶风,不可动,不嗜食,苦眩,善妄言的,是脉极。青黑惨暗的,是阳气虚。青白形瘦如柴的,是元气衰弱。青或兼白的,是阳虚阴胜。脉涩面色青的,是营气不足。眼下色青的,是多忧惊或多色欲。面如尘垢的,是少阳病。咳嗽面青的,是肝乘肺。面青夺色的,是久病。色青脉弦而细,两胁下痛,邪气走心下,足胫寒,胁痛引小腹,善转筋,爪甲枯黑,春轻秋重的,是肝积之病,男子积疝,女子瘕淋。妇人面青的,是肝强脾弱,或多怒少食,或经脉不调。妊娠右眼下青的,是女胎。妊娠目上青的,生女又产难。妊娠沟洑青的,是双生。无病而青色见于天庭的,将患瘟疫。青如点染的,晦气时时侵袭。山根年寿处青的,频逢疾病。面青多言而热的,是阴中之阳邪。面青多言而寒的,是阴中之阴邪。面青不言而寒的,死证,阴之极也。面青目黄的,必难治。青白色如拇指大,斑点见于颜颊上的,是肝病,虽少愈,必卒死。青黑色如拇指大,斑点见于颜颊上的,是脾病,虽少愈,必卒死。青色横于正面的,是行尸。脱色而面苍苍然的,是阴阳俱脱,表里相离。吐泻目陷,睑青如磕伤的,是土败木贼。青色绕耳的,半年损寿。劳病青色自发际接印堂的,死在六十日。劳病青色自发际接印堂至鼻的,死在三十日。劳病青色自发际至鼻及人中的,死在十七日。满面色青的,即死。耳聋百节皆纵,目系绝,色先青白,乃死者,是少阳终。痰涎壅极,吞吐不能,呃逆不止,腹胀色青黑的,是脾胃气绝。眼闭不开,躁急扰乱懊憹,囊缩,色青灰白的,是肝脏绝。面青但欲伏眠,汗出如水不止的,是肝绝。四肢瞤动,唇吻反青的,是肝绝。面色青,眼视人不直,数泪出的,是肝绝。真肝脉至,中外急,如循刀刃,责责然,如按琴瑟弦,色青不泽,毛折乃死者,是脉无胃气,金克木。脾病色黄体青,溲直视,唇反张,爪甲青,饮食吐逆,体重节痛,四肢不举,其脉当浮大而缓,今反弦急,其色当黄而反青的,此是木克土,为大逆,十死不治。这些都是青色主病的条目。
The complexion manifests from the interior to the exterior. The principle of correspondence has already been discussed. Physicians understand the interior through the exterior; thus, one must discuss the diseases indicated by specific signs. The principle of correspondence and the indication of disease share the same underlying logic. Although the logic is one, its application is twofold. For instance, dampness disease presents with a yellow complexion, jaundice disease presents with a yellow complexion, and spleen disease presents with a yellow complexion. This illustrates the principle of interior-exterior correspondence, where myriad phenomena stem from a single source. However, the yellow of spleen disease differs from that of jaundice, and the yellow of jaundice differs from that of dampness. This distinction in qi and color identifies specific diseases, where a single source gives rise to myriad variations. "Correspondence" refers to the sameness of color, while "indicating disease" involves distinguishing the differences in qi. Similar colors are easy to compare and infer, but differentiating qi is difficult to describe. Therefore, the following entries compile statements from ancient sages and worthies. Students should not let words obscure meaning, nor let phrases obscure intent; rather, they should use their mind to trace the author's intention to truly grasp it. Otherwise, they would be like carving a mark on a boat to find a sword (rigidly applying rules without context) or gluing tuning pegs to play the lute (inflexibility). Since symptoms vary and complexions differ, one can seek understanding through imagery, though words cannot fully capture them. Yet, if one masters the outline, recognizes locations, employs comprehensive diagnostic methods, and analyzes conditions intricately, then regardless of vast distances, long periods, or diverse diseases, one can know changes through observation and determine treatment through change. Great indeed! Supreme indeed! Encompassing heaven and earth without error, completing all things without omission. Only the supreme sages Qibo and Huangdi could achieve this.
The Classic states: Blue-black indicates pain. Blue is the color of the Liver and Gallbladder, and also the color of Wind-Wood. Although it indicates pain and wind disorders, one should combine location-based diagnosis for comprehensive assessment before determining cold-heat and deficiency-excess. For example, a blue nose tip indicates abdominal pain. Severe blue-black indicates severe pain leading to spasms. A blue face with puckered lips and mouth indicates intense pain. A blue nose tip with abdominal pain, especially if accompanied by cold sensations, is a death sign. Heart pain with a pale-blue face resembling a corpse-like state, unable to take deep breaths all day, is Liver heart pain. Headache with blue-yellow cheeks, dizziness unwilling to close eyes, heavy body, and drowsy urge to vomit indicates Jueyin and Taiyin diseases, specifically phlegm-Jue headache. Abdominal pain, white urine, white nails, predominantly blue face, preference for hot drinks, or abdominal fullness with diarrhea indicates cold pain. Abdominal pain with a face alternating red-blue-white, pain coming and going, and vomiting clear fluid indicates parasitic accumulation. Blue complexion with a long pulse beating left and right indicates accumulated Qi in the lower chest and legs, named Liver Bi, caused by cold-dampness, treated similarly to hernia. Lower back pain with cold feet and headache. Blue and stagnant indicates Bi pain. Blue around eyes and nose indicates soreness and pain in sinews and bones. Visible blue vessels between eyes indicate Gallbladder stagnation causing pulling pain. Blue face and eyes, body pain as if beaten, sore throat, treatable within five days, untreatable after seven days, indicates Yin Du disease. Restlessness like madness, churning pain in heart and abdomen, dizziness with urge to vomit, blue-black face and eyes, cold and inverted limbs indicates poisoning by Arsenic trioxide (Pishuang). Poisoning with blue hands, feet, and face requires immediate rescue; delayed treatment may be fatal. Blue indicates Liver disease. Slightly pale-blue face, dry throat, propensity for sadness, anger, occasional aversion to women, sweating and aversion to wind, blue under eyes indicates Liver Wind. Blue at Fengmen point indicates wind disease with convulsions. Alternating red and blue indicates clonic-tonic spasms (Chizhong). Blue face with foaming vomit and sudden loss of consciousness indicates Epilepsy (Xian). Blue face with upward-gazing eyes and shaking limbs indicates Liver Epilepsy. Epileptic attack with cold extremities, supine stiffness, blue face, foaming vomit, faint voice, and deep-thin pulse indicates Yin Epilepsy. Disease resembling epilepsy with blue-yellow face, triggered by eating celery, indicates Jiaolong disease. Pale-blue face with withered nails indicates Liver Heat. Blue in front of ears indicates Wind pathogen. Liver disease with blue complexion, stiff limbs, fullness in hypochondrium, occasional dizziness, and string-taut-long pulse is treatable. Blue face with chest oppression and confusion, vomiting foam, hypochondriac pain, heavy dizziness, deafness, hemiplegia with tendon contraction, sleeping in a fetal position indicates Liver Wind outbreak. Blue-pale complexion under eyes, sadness, pain in fingers and nails, preference for tendon cramping indicates Sinew Deficiency Wind, or Liver Deficiency Wind. Anger, dry throat, hypochondriac pain upon coughing, inability to turn sides, fullness and pain in soles indicates Sinew Excess Heat, or Liver Excess Wind. Blue-black face and eyes, sudden aphonia, inability to sit upright, weak limbs, incontinence indicates Liver Deficiency Cold, damaged by Li Feng (severe wind toxin). Red cheeks with blue face indicates Malaria cold-heat stages. Pale-blue face with sighing in malaria indicates Liver Malaria. Heavy head and cheek pain first, blue face, urge to vomit, fever, lower back pain preventing bending/straightening during heat struggle, abdominal fullness, diarrhea, and jaw pain indicates Spleen Heat disease. Infant with blue face, cold flesh, sunken eyes, dry heaving, watery diarrhea indicates summer cold accumulation exacerbated by sudden cold, with weak Stomach Qi. Infant night crying with blue-white face, cold limbs, refusal to suckle, bent waist indicates Spleen Cold. Cheeks like indigo powder indicate Zhong E (sudden evil invasion). Sudden blue face with rapid breathing indicates Fright/Terror. Newborn with blue eyebrows, red face, puckered mouth indicates Umbilical Wind. Infant with rebellious Qi, blue face, wheezing cough day and night indicates Wind-Cold entering Lungs. Blue face with staring eyes indicates Asthma. Infant face changing blue-white-red-black indicates critical condition. Blue covering mouth corners indicates difficult-to-treat case. Blue under-eye bags indicate Stomach Cold. Blue-purple indicates Evil Blood. Stasis rising to chest causing oppression with blue complexion is a death sign. Sinew Bi with sadness, pale complexion, limb flaccidity, contractures, abdominal shifting pain indicates extreme Sinew Deficiency. Blue face with belching, trance-like gas loss, resembling post-crying state, stiff tongue, dry throat, cold-heat, aversion to wind, immobility, anorexia, dizziness, delirium indicates Extreme Pulse. Dull blue-black indicates Yang Qi Deficiency. Blue-white with emaciation indicates Yuan Qi weakness. Blue or mixed with white indicates Yang Deficiency with Yin Excess. Choppy pulse with blue face indicates Ying Qi insufficiency. Blue under eyes indicates excessive worry/fright or sexual indulgence. Dust-like face indicates Shaoyang disease. Cough with blue face indicates Liver invading Lungs. Blue face with loss of luster indicates chronic disease. Blue complexion with string-taut-thin pulse, hypochondriac pain, Qi moving to epigastrium, cold calves, hypochondriac pain radiating to lower abdomen, tendon cramps, black-withered nails, mild in spring/worse in autumn indicates Liver Accumulation disease, Hernia in men, Lei-Lei in women. Women with blue face indicate strong Liver and weak Spleen, often angry, poor appetite, or irregular menstruation. Pregnant woman with blue under right eye indicates female fetus. Pregnant woman with blue above eyes indicates female birth with difficulty. Pregnant woman with blue in furrows indicates twins. No illness but blue on Tian Ting (forehead) indicates impending epidemic. Blue like spots indicates recurring bad luck. Blue on Shan Gen and Nian Shou indicates frequent illness. Blue face with talking and heat indicates Yin-within-Yang pathogen. Blue face with talking and cold indicates Yin-within-Yin pathogen. Blue face with silence and cold is death, extreme Yin. Blue face with yellow eyes is difficult to treat. Blue-white spot thumb-sized on cheeks indicates Liver disease; even if slightly better, sudden death follows. Blue-black spot thumb-sized on cheeks indicates Spleen disease; even if slightly better, sudden death follows. Horizontal blue on face indicates Xing Shi (Walking Corpse). Loss of color with pale-blue face indicates collapse of Yin and Yang, separation of interior and exterior. Vomiting/diarrhea with sunken eyes, eyelids blue like bruised, indicates Earth failing and Wood attacking. Blue circling ears indicates half-year lifespan reduction. Labor disease with blue from hairline to Yintang indicates death in 60 days. Blue from hairline to nose indicates death in 30 days. Blue from hairline to nose and Renzhong indicates death in 17 days. Full-face blue indicates immediate death. Deafness, lax joints, severed eye connections, blue-white color before death indicates end of Shaoyang. Extreme phlegm-saliva obstruction, inability to swallow/vomit, incessant hiccups, abdominal distension with blue-black color indicates collapse of Spleen-Stomach Qi. Eyes closed, restlessness, agitation, contracted scrotum, blue-gray-white color indicates collapse of Liver. Face blue, desire to lie prone, continuous sweat like water indicates collapse of Liver. Trembling limbs, blue lips/mouth corners indicates collapse of Liver. Blue face, eyes looking askance, frequent tears indicates collapse of Liver. True Liver pulse arriving, tense inside and out, like touching knife edges, buzzing like zither strings, blue non-lustrous color, withering hair indicates death due to lack of Stomach Qi in pulse, Metal overcoming Wood. Spleen disease with yellow body and blue face, urinary issues, fixed gaze, retracted lips, blue nails, vomiting food, heavy body joint pain, immobile limbs, pulse should be floating-large-slow but is instead string-taut-rapid, color should be yellow but is blue, indicates Wood overcoming Earth, major reversal, ten deaths no cure. These are all entries regarding blue complexion indications.