马云。内有五阅以观五气。及五气为五脏之使。故名。说文云。阅、察也。
刺有五官（止）五脏之使也 张云。刺法当知脏气。知脏气当于五官五阅而察之。五官如下文。
鼻者肺之官也。阅、外候也。使、所使也。副、配合也。五脏藏于中。五官见于外。内外相应。故为五脏之阅。
令可为常（止）必当治里 张云。可为常者。常行之法。五脏之脉。察于气口。五脏之色。察于
明堂。明堂者鼻也。色应其时。乃其常也。然色见于外而病在内。是为经气入脏。故当治里。
阙庭必张（止）寿中百岁 马云。阙者眉间也。庭者颜也。即首面也。（出五色篇）必开而张。
乃立明堂以阅之。明堂者鼻也。其明堂广大而为蕃为蔽者。又见于外。盖颊侧谓之蕃。耳门谓之蔽。耳四周之
壁既方。地角之基又高。引垂向外。五色又顺。平博广大。寿当中百岁也。张云。张、布列也。壁、墙壁也。
基、骨骼也。引垂居外。谓明显开豁也。此于五色
之外。而言其都位之隆浓也。形色皆佳乃为寿征。故中百岁。治、不乱也。中、宜也。堪也。志云。引垂居外
者。边陆在外。为中土之保障也。
见此者（止）可苦以针 张云。若此之人。是为血气充实。形色坚固。故刺之则病已。而可苦以针也。
然则血气内虚。形色外弱者。其不宜用针可知。 、音致。密也。
五官 张云。官者职守之谓。所以司呼吸。辨颜色。纳水谷。别滋味。听声音者也。
鼻张 蒋氏启微云。人将死则鼻柱曲缩。故孔则张大上向。又云。周礼疾医。以五色五气。 其死生。
量之以九窍之变。其斯之谓乎。
青 甲乙。 、作目。
颧赤 蒋氏启微曰。神将去矣。
颧与颜黑 蒋氏启微云。土邪来干。故色黑黄。色现颧颜。肾水将绝反乘心火也。简案、蒋以黄帝之
黄字。接上句释之。误。
五脉安出（止）如何 马云。五常之脉。安所从出。五脏之色。安所从见。其常色见者。而又至于危。
皆帝之所疑也。张云。安出安见。言脉色安然无恙也。常色殆者。谓色本如常而身亦危也。此又何如其故。
五官不辨（止）况加疾哉 将氏启微云。色脉俱安。平人也。有病则死。盖有故焉。五官者。目辨色。
鼻辨臭。口辨谷。舌辨味。耳辨声。若不能辨。脏气不全也。阙庭眉额之间。清阳之位。若不开张。阳气薄矣。
明堂、鼻也。鼻位中央而属脾。司呼吸而主肺。若其部小。脾肺气衰也。肾为先天之本。其官在耳。蔽为耳门。
蕃为颊侧。墙基为耳边。角为耳上角。垂为耳垂珠。皆肾家部分。若卑低窄小。角珠向
外。先天之气素薄。若是虽无病苦。亦难以全生。况加之疾乎。望家读此。凡病患诸部狭小者。虽平常殆莫轻
治之。简案、埤其墙。墙下无基。乃上文方壁高基之反。垂角去外。乃上文引垂居外之反。当与上文马张注参考。
腑脏之在中也（止）各如其度也 张云。腑脏居于腹中。各有左右上下之次舍。而面部所应之色。亦
如其度。如五色篇所谓庭者首面。阙者咽喉之类。皆是也。
马云说：“体内有五个窗口（五官）用来观察五脏之气，以及这五种气作为五脏的使者。因此得名。”《说文解字》说：“阅，是考察的意思。”
针刺有五官（此处指面部特定部位），它们是五脏的使者。张景岳说：“针刺疗法应当了解脏气。要了解脏气，应当在五官和五阅上进行考察。五官如下文所述。”
鼻子是肺的外在官窍。“阅”，是外在征候；“使”，是被驱使的表现；“副”，是配合的关系。五脏藏于体内，五官显露于体外，内外相互呼应，所以称为五脏的窗口。
“可以视为常规”（至）“必须治疗内脏”。张景岳说：“可以视为常规，是指常行的法则。五脏的脉象，通过气口进行察验；五脏的颜色，通过明堂（鼻部）进行察验。明堂就是鼻子。颜色顺应时令，这才是常态。然而颜色显露于外部而病邪在内，这是经气入脏，所以应当治疗内脏。”
“阙庭必定开张”（至）“寿命可达百岁”。马云说：“阙是两眉之间，庭是前额。即头面部。（出自《五色篇》）必须开阔张开，才能设立明堂来观察它。明堂就是鼻子。如果明堂宽大，并且作为藩篱和遮蔽的部分也显露在外，那么脸颊侧面称为‘蕃’，耳门称为‘蔽’。耳朵四周的墙壁既方正，地角（下颌骨基底部）又高，耳垂向下延伸向外，五色顺理，平坦博阔广大，寿命就应当达到百岁。”张景岳说：“张，是布列的意思；壁，是墙壁；基，是骨骼。引垂居外，谓明显开豁。这是在五色之外，论述其整体部位的隆起浓密。形色皆佳才是长寿的征兆，所以能活到百岁。治，是不乱；中，是适宜、能够。《志》书说：‘引垂居外’，意思是边陆在外，作为中土的保障。”
“见到这样的人”（至）“可以用针治疗”。张景岳说：“像这样的人，气血充实，形色坚固，所以针刺后病就好了，并且可以承受针刺。”然而如果血气内虚，外形羸弱，就不宜用针，这是显而易见的。“致”，音zhì，意为严密。
五官。张景岳说：“官，是指职守。用来主管呼吸，辨别颜色，接纳水谷，分辨滋味，听取声音。”
鼻子。蒋氏启微说：“人将要死亡时，鼻梁会弯曲收缩，所以鼻孔就会张大向上。又说，《周礼·疾医》用五色五气来诊断死生，以九窍的变化来衡量，说的就是这个道理吧。”
青色。《甲乙经》中，“目”写作“”。
颧骨发红。蒋氏启微说：“神气即将离去。”
颧骨和颜面发黑。蒋氏启微说：“土邪侵犯，所以色呈黑黄。颜色出现在颧部和颜面，是肾水将绝反而乘袭心火。简案：蒋氏将黄帝之‘黄’字接在上句解释，是错误的。”
“五脏的脉象安然出现”（至）“情况如何”。马云说：“五常之脉，从哪里出来？五脏的颜色，从哪里显现？常态下出现的颜色，却又到了危险境地，这都是皇帝所疑惑的。”张景岳说：“安出安见，是说脉色安然无恙。常色却出现危象，是说颜色本如正常但身体已危重。这又是为什么呢？”
“五官不能辨别”（至）“何况加上疾病呢”。蒋氏启微说：“色脉都安然，是平人。有病则死，大概是有缘故的。五官，眼睛辨别颜色，鼻子辨别气味，嘴巴辨别谷物，舌头辨别味道，耳朵辨别声音。如果不能辨别，说明脏气不全。阙庭（眉额之间），是清阳之位，如果不开放张开，阳气就薄弱了。明堂，就是鼻子。鼻位居中央属脾，主管呼吸并主肺。如果这个部位小，说明脾肺气衰。肾为先天之本，其官窍在耳。蔽是耳门，蕃是脸颊侧面，墙基是耳边，角是耳上角，垂是耳垂珠，这些都是肾家的部分。如果低矮窄小，角珠向外，说明先天之气素来薄弱。像这样即使没有病痛，也难以保全生命，何况再加上疾病呢？望诊家读到这里，凡是病患各个部位狭小的，即使平常也不要轻易治疗。简案：‘埤其墙’，墙下无基，正是上文‘方壁高基’的反面；‘垂角去外’，正是上文‘引垂居外’的反面。应当与上文的马注和张注参考对照。”
“腑脏在体内”（至）“各自符合其法度”。张景岳说：“腑脏居于腹中，各有左右上下的位置，而面部相应的颜色，也符合其法度。如《五色篇》所说‘庭是首面，阙是咽喉’之类，都是如此。”
Ma Yun stated: "Within the body, there are five orifices (Wu Guan) to observe the Qi of the five Zang organs, and these five Qi act as messengers for the five Zang organs. Hence the name." The *Shuowen Jiezi* states: "Yue means to examine."
Acupuncture involves the five orifices, which are the messengers of the five Zang organs. Zhang Jingyue said: "In acupuncture therapy, one must understand the Zang Qi. To understand Zang Qi, one must examine the five orifices and five windows (Wu Yue). The five orifices are described below."
The nose is the external organ of the Lung. "Yue" refers to external signs; "Shi" refers to the manifestation of being directed; "Fu" refers to correspondence. The five Zang organs are stored internally, while the five orifices manifest externally. Internal and external aspects correspond with each other, thus they are called the windows of the five Zang organs.
"[It] can be regarded as a routine method" ... "one must treat the interior". Zhang Jingyue said: "Can be regarded as a routine method refers to standard practices. The pulses of the five Zang organs are examined at the Qi Kou (radial artery); the colors of the five Zang organs are examined at the Ming Tang (nose). The Ming Tang is the nose. When the color corresponds to the season, it is normal. However, if color manifests externally while the disease is internal, this indicates that the Jing-Qi has entered the Zang organs, so one must treat the interior."
"The Que and Ting must be open and spread out" ... "lifespan reaches one hundred years". Ma Yun said: "Que is the area between the eyebrows; Ting is the forehead. This refers to the head and face. (From the *Se Colors Chapter*). They must be open and spread out so that the Ming Tang can be established for observation. The Ming Tang is the nose. If the Ming Tang is broad, and the parts acting as fences and shields also manifest externally, then the sides of the cheeks are called 'Fan' (fences), and the ear gates are called 'Bi' (shields). The walls around the ears are square, the foundation of the earth corner (mandibular base) is high, the earlobes hang down and outward, the five colors are harmonious, flat, broad, and large; such a person's lifespan should reach one hundred years." Zhang Jingyue said: "Zhang means distributed; Bi means wall; Ji means bone structure. 'Yin chui ju wai' means distinct and open. This discusses the prominence and density of the overall facial features beyond just the five colors. Only when both form and color are excellent is it a sign of longevity, hence reaching one hundred years. Zhi means not chaotic; Zhong means suitable or capable. The *Zhi* book says: 'Yin chui ju wai' means the borders are outside, serving as protection for the central earth."
"Seeing such a person" ... "can be treated with needles". Zhang Jingyue said: "Such a person has abundant Qi and Blood, and firm form and color. Therefore, after needling, the illness will resolve, and they can tolerate needle treatment." Conversely, if Qi and Blood are deficient internally, and the physical appearance is weak externally, it is evident that needles should not be used. "Zhi" (pronounced zhì) means dense or tight.
Five Orifices. Zhang Jingyue said: "Guan refers to official duties. They are used to govern respiration, distinguish colors, receive food and drink, differentiate flavors, and hear sounds."
Nose. Jiang Shi Qimicro said: "When a person is dying, the nasal bridge curves and shrinks, so the nostrils become large and point upward. Also, in the *Rites of Zhou - Physicians*, the five colors and five Qi are used to diagnose life and death, and changes in the nine orifices are measured; this is what is meant here."
Blue/Green Color. In the *Jia Yi Jing*, "Mu" (eye) is written as "".
Cheekbones Red. Jiang Shi Qimicro said: "The Shen (Spirit) is about to depart."
Cheekbones and Forehead Black. Jiang Shi Qimicro said: "Earth pathogen invades, resulting in blackish-yellow color. The color appearing on the cheekbones and forehead indicates that Kidney Water is failing and counter-attacking Heart Fire. Commentary: Jiang Shi incorrectly connected the character 'Huang' (yellow) from Huang Di (Yellow Emperor) to explain the previous sentence."
"Where do the five pulses arise safely" ... "how is it?". Ma Yun said: "From where do the five regular pulses arise? From where do the colors of the five Zang organs manifest? That normal colors appear yet the condition is critical—these are doubts raised by the Emperor." Zhang Jingyue said: "An chu an jian means the pulse and color are safe and sound. Chang se dai zhe means the color appears normal but the body is in danger. What is the reason for this?"
"The five orifices cannot distinguish" ... "let alone add illness". Jiang Shi Qimicro said: "If color and pulse are safe, it is a healthy person. If there is illness, death ensues, likely due to specific causes. The five orifices: eyes distinguish color, nose distinguishes smell, mouth distinguishes grain, tongue distinguishes taste, ears distinguish sound. If they cannot distinguish, it means Zang Qi is incomplete. The Que and Ting (between eyebrows and forehead) are the position of Clear Yang. If not open and spread, Yang Qi is thin. The Ming Tang is the nose. The nose is centrally located, belongs to the Spleen, governs respiration, and is associated with the Lung. If this area is small, it indicates Spleen and Lung Qi deficiency. The Kidney is the root of congenital constitution, its orifice is the ear. Bi is the ear gate, Fan is the cheek side, Qiang Ji is beside the ear, Jiao is the upper angle of the ear, Chui is the earlobe. These all belong to the Kidney system. If they are low, narrow, and small, and the angles/lobes turn outward, it indicates that congenital Qi has always been weak. Even without illness, such a person may struggle to maintain life, let alone cope with added disease. Practitioners of observation reading this should note: for patients with narrow features in various areas, even if seemingly ordinary, do not treat lightly. Commentary: 'Pi qi qiang' (lowering the wall) with no foundation is the opposite of the earlier 'square wall, high foundation'; 'Chui jiao qu wai' (lobes/angles going outward) is the opposite of 'yin chui ju wai' (hanging lobes outward). This should be cross-referenced with the annotations by Ma and Zhang above."
"The Fu and Zang organs within the body" ... "each conform to their measures". Zhang Jingyue said: "The Fu and Zang organs reside in the abdomen, each having specific positions left, right, up, and down. The corresponding colors on the face also conform to these measures. As stated in the *Se Colors Chapter*: 'Ting is the head and face, Que is the throat,' etc., are examples."