《难经》云∶肾，外证面黑，善恐欠。罗谦甫治一妇人，年几三十，忧思不已，饮食失节，脾胃
有伤，面色黧黑不泽，环唇尤甚，心悬如饥状，又不欲食，气短而促。大抵心肺在上，行荣卫而光泽
于外，宜显而藏。肝肾在下，养筋骨而强于内，当隐而不见。脾胃在中，主传化精微，以灌四旁，冲
和而不息。其气一伤，则四脏失所，忧思不已，气结而不行，饮食失节，气耗而不足，使阴气上溢于
阳中，故黑色见于面。又经云∶脾气通于口，其华在唇。今水反来侮土，故黑色见于唇，此阴阳相反
病之逆也。上古天真论云∶阳明脉衰于上，面始焦。故知阳明之气不足，非助阳明生发之剂，无以复
其色，故以冲和顺气汤主之。《内经》曰∶上气不足，推而扬之。以升麻苦平，葛根甘温，自地升天，
通行阳明之气为君。人之气，以天地之风名之，气留而不行者，以辛散之。防风辛温，白芷甘辛温，
以散滞气为臣。苍术苦辛，蠲除阳明经之寒，白芍药之温酸，安太阴经之怯弱。《十剂》云∶补可去
弱，人参羊肉之属。人参、黄 、甘草甘温，补益正气为佐。至真要大论云∶辛甘发散为阳。
生姜辛热，大枣甘温，和荣卫，开腠理，致津液，以复其阳气，故以为使。每服早饭后、午饭前，取
阳升之时，使人之阳气易达故也。数服而愈。孙兆治一人，满面黑色，相者断其死。孙诊之曰∶非病
也，乃因登溷，感非常臭气而得。去至臭，无如至香，令用沉、檀碎劈，焚于炉中，安帐内以熏之，
明日面色渐变，旬日如故。盖肾臭腐属水，脾臭香属土。今夫厕臭者，腐臭也，故闻之则入肾而面黑。
沉香者，香臭也，故熏之则脾土胜肾水而色还也。浙全夫人，忽日面上生黑斑数点，日久满面俱黑，
遍求医治不效。忽遇一草泽医人云∶夫人中食毒，治之一月平复。后校其方，止用生姜汁服之。问其
故，云食斑鸠，盖此物常食半夏苗，中毒，故以姜解之。针灸面黑有二法∶其一取胃。经云∶胃足阳
明之脉，是动则病洒洒振寒，颜黑。其二取肾。经云∶足少阴之脉，是动则病饥不欲食，面如漆柴。
视盛、虚、热、寒、陷下取之也。少阴终者，面黑，齿长而垢，腹胀闭。太阴终者，腹胀闭不得息，
善噫呕逆则面赤，不逆则面黑，皮毛黑。洗面药七白散，白蔹、白术、白牵牛、白附子、白芷、白芍
药、白僵蚕。
面上细疮，常出黄水，桃花阴干，加当归或杏花作末洗面。面上热毒恶疮，柏
连散涂。面上五色疮，用盐汤绵浸塌疮上，日五六度易瘥。面上黄水疮，并目生疮，三月三日桃花阴
干为末，食后熟水下方寸匕，日三良。
面上豆痕，或斑 ，密陀僧细末，夜以人乳汁调敷有效。
面上粉刺，用不语唾涂之，或捣菟丝子汁涂之，或以白矾末少许，酒调涂之。
《斗门方》治黑 ，令人面色好，白僵蚕、黑牵牛、北细辛，粗末作澡豆，去小儿胎秽。
面里皮痛，何首乌末，姜汁调成膏敷之，帛盖，以火炙鞋底热熨之。
面赤酒 ，生附子、川椒、野葛少许，锉，醋浸一宿，取出，用猪脂同煎，以附子黄为度，去滓，
时时涂之。又，硫黄半两，蜗牛壳自死枯干小者为上，木香各半两，虢丹半两，俱为末，杏仁半两，
去皮研膏，入腊月猪脂调成膏。夜卧时用浆水先洗面，令干，以药涂患处，平明洗去。湿癣，以米泔
水洗，却上前药。指爪破面，用生姜自然汁调轻粉，敷破处，更无瘢瑕。
《难经》说：肾的外在证候表现为面色发黑，容易恐惧、打哈欠。罗谦甫治疗一位近三十岁的妇人，因长期忧思过度，饮食不规律，导致脾胃受损，面色黧黑无光泽，嘴唇周围尤为严重，心中空虚如饥饿感，却又不想进食，气短且急促。大抵心肺位于上部，运行营卫之气而使其光泽显露于体表，应当显达而内藏；肝肾位于下部，滋养筋骨而使体内强健，应当隐伏而不外露；脾胃位于中部，主管传输和化生精微物质，以灌溉四肢百骸，保持冲和之气不息。一旦脾胃之气受伤，则其他四脏失去滋养来源。长期忧思导致气机郁结而不能运行，饮食失节导致正气耗损而不足，使得阴气上溢于阳分之中，所以黑色显现于面部。又《内经》说：脾气通于口，其荣华表现在唇部。如今水气反来克制土气（水侮土），所以黑色显现于唇部，这是阴阳逆乱的病证。《上古天真论》说：阳明脉在上部衰退，面部开始憔悴枯槁。因此知道是阳明之气不足，若非助长阳明生发之气的方剂，无法恢复其色泽，所以用冲和顺气汤为主治方。《内经》说：上部之气不足，应推举并升扬它。以升麻苦平、葛根甘温，自地升天，通行阳明之气作为君药。人的气，可以用天地之风来比喻，气停留而不能运行的，用辛味药发散它。防风辛温、白芷甘辛温，以疏散滞气作为臣药。苍术苦辛，能祛除阳明经的寒邪；白芍药性温酸，能安定太阴经的怯弱状态。《十剂》说：补益可以去除虚弱，人参、羊肉属于此类。人参、黄芪、甘草甘温，补益正气作为佐药。《至真要大论》说：辛甘发散为阳。生姜辛热、大枣甘温，调和营卫，开泄腠理，促进津液生成，以恢复阳气，所以作为使药。每次服用在早饭后、午饭前，选取阳气上升之时，使人体阳气容易到达的缘故。服药数次后痊愈。孙兆治疗一个人，满面黑色，相面的人断定他必死。孙兆诊察后说：这不是病，是因为上厕所时，受到异常臭气熏染所致。去除极臭之气，没有比极香之物更好的了，让人将沉香、檀香碎块劈开，放在炉中焚烧，安置在帐幕内用来熏蒸，第二天面色逐渐变化，十天恢复正常。大概肾的臭味是腐臭，属水；脾的臭味是香气，属土。现在厕所的臭味是腐臭，所以闻之则入肾而面色发黑。沉香是香臭，所以熏之则脾土胜肾水而颜色恢复。浙全夫人，忽然脸上生出几点黑斑，日久满面皆黑，遍求医治无效。忽然遇到一个民间草泽医生说道：夫人中了食毒，治疗一个月即可康复。后来核对他的药方，只用了生姜汁服用。问其原因，说是吃了斑鸠，因为这种鸟常吃半夏苗，导致中毒，所以用姜来解毒。针灸治疗面黑有两种方法：其一取胃经穴位。《内经》说：足阳明胃经发生变动，就会生病，表现为瑟瑟怕冷，颜面发黑。其二取肾经穴位。《内经》说：足少阴肾经发生变动，就会生病，表现为饥饿但不想进食，面色像漆柴一样黑。根据盛、虚、热、寒、陷下等不同情况选取穴位。少阴经气终绝时，面色发黑，牙齿变长且污垢堆积，腹胀闭塞。太阴经气终绝时，腹胀闭塞不能呼吸，喜欢嗳气，呕吐则面色发红，不呕吐则面色发黑，皮毛枯黑。洗面药七白散，由白蔹、白术、白牵牛、白附子、白芷、白芍药、白僵蚕组成。
脸上细疮，经常流出黄水，用桃花阴干，加入当归或杏花研末洗脸。脸上热毒恶疮，用柏连散涂抹。脸上五色疮，用盐汤浸湿绵花贴在疮上，每天换五六次可愈。脸上黄水疮，以及眼睛生疮，三月三日采集桃花阴干研末，饭后用温水送服一方寸匕，每日三次效果好。
脸上粉刺，用不说话时的唾液涂抹，或捣菟丝子汁涂抹，或用少许白矾末，酒调匀涂抹。
《斗门方》治疗黑斑，使人面色美好，用白僵蚕、黑牵牛、北细辛，粗末制成澡豆，去除小儿胎毒秽浊。
面部皮肤疼痛，用何首乌末，姜汁调成膏敷贴，用丝绸覆盖，用火烤热鞋底熨烫患处。
面部赤酒渣鼻，用生附子、川椒、野葛少许，切碎，醋浸泡一夜，取出，用猪脂同煎，以附子呈黄色为度，去渣，时常涂抹。另外，硫黄半两，蜗牛壳以自然死亡干枯的小者为上品，木香各半两，铅丹半两，都研为末，杏仁半两，去皮研成膏，加入腊月猪脂调成膏。夜间睡觉时用浆水先洗脸，擦干，用药涂患处，天亮时洗去。湿癣，用米泔水洗，再用上述药物。手指甲抓破脸，用生姜自然汁调轻粉，敷在破损处，更不留疤痕。
The *Nan Jing* (Classic of Difficult Issues) states: The external manifestations of Kidney disorders include a dark complexion, frequent fearfulness, and yawning. Luo Qianfu treated a woman nearly thirty years old who had been suffering from excessive worry and thought, with irregular diet, resulting in damage to the Spleen and Stomach. Her complexion was dark and lusterless, especially around the lips; she felt a hollow hunger sensation but had no appetite, and suffered from shortness of breath and rapid breathing. Generally, the Heart and Lung are located superiorly, circulating Ying and Wei Qi to manifest luster on the exterior; they should be prominent yet internally stored. The Liver and Kidney are located inferiorly, nourishing sinews and bones to strengthen the interior; they should be hidden and not conspicuous. The Spleen and Stomach are located centrally, governing the transportation and transformation of refined essences to irrigate the four peripheries, maintaining a harmonious and unceasing Qi. Once the Qi of the Spleen and Stomach is injured, the other four Zang organs lose their source of nourishment. Excessive worry causes Qi stagnation and failure to circulate; irregular diet causes Qi depletion and insufficiency. This allows Yin Qi to overflow into the Yang realm, causing blackness to appear on the face. Furthermore, the Classics state: Spleen Qi connects to the mouth, and its brilliance manifests on the lips. Now, Water counter-attacks Earth (Water insulting Earth), hence blackness appears on the lips; this is a pathological reversal of Yin and Yang. The *Shanggu Tianzhen Lun* (Treatise on Heavenly Truth in Ancient Times) states: When the Maiyang (Stomach) meridian declines superiorly, the face begins to wither. Thus, it is known that there is an insufficiency of Maiyang Qi. Without agents that assist the generation and rising of Maiyang Qi, color cannot be restored; therefore, Chonghe Shunqi Tang (Harmonizing and Regulating Qi Decoction) is used as the principal formula. The *Nei Jing* (Inner Canon) states: When Qi in the upper part is insufficient, it should be pushed up and elevated. Shengma (Cimicifugae Rhizoma), bitter and neutral, and Gegen (Puerariae Lobatae Radix), sweet and warm, rise from earth to heaven, unblocking Maiyang Qi, serving as the Sovereign drug. Human Qi can be likened to the wind of heaven and earth; when Qi remains stagnant and fails to circulate, acrid herbs disperse it. Fangfeng (Saposhnikoviae Radix), acrid and warm, and Baizhi (Angelicae Dahuricae Radix), sweet, acrid, and warm, disperse stagnant Qi, serving as the Minister drugs. Cangzhu (Atractylodis Rhizoma), bitter and acrid, eliminates Cold in the Maiyang meridian; Baishao (Paeoniae Radix Alba), warm and sour, stabilizes the weakness of the Taiyin meridian. The *Shi Ji* (Ten Formulas) states: Tonification removes deficiency; Ren Shen (Ginseng Radix) and mutton belong to this category. Ren Shen (Ginseng Radix), Huangqi (Astragali Radix), and Gancao (Glycyrrhizae Radix), sweet and warm, tonify upright Qi, serving as the Assistant drugs. The *Zhizhen Yao Da Lun* (Great Treatise on the Most Essential Truths) states: Acrid and sweet disperse and are Yang. Shengjiang (Zingiberis Rhizoma Recens), acrid and hot, and Dazao (Jujubae Fructus), sweet and warm, harmonize Ying and Wei, open the interstices (Couli), promote fluid production, and restore Yang Qi, serving as the Envoy drugs. Each dose is taken after breakfast and before lunch, taking advantage of the time when Yang Qi rises, making it easier for human Yang Qi to reach its destination. After several doses, the patient recovered. Sun Zhao treated a man with a completely black face; a physiognomist predicted his death. Sun Zhao diagnosed him and said: "This is not a disease, but caused by ascending to a latrine and being exposed to an extremely foul odor." To remove extreme filth, nothing is better than extreme fragrance. He ordered crushed Chenxiang (Aquilariae Lignum) and Tanxiang (Santalum Album Lignum) to be burned in a censer, placed inside a tent for fumigation. The next day, the facial color gradually changed, and within ten days, it returned to normal. Essentially, the odor of the Kidney is putrefactive, belonging to Water; the odor of the Spleen is fragrant, belonging to Earth. The odor of a latrine is putrefactive; thus, inhaling it enters the Kidney and causes blackness. Chenxiang is fragrant; thus, fumigating with it allows Spleen Earth to overcome Kidney Water, restoring the color. Lady Quan Zhe suddenly developed several black spots on her face, which eventually covered her entire face. Medical treatment proved ineffective until she met a folk practitioner who said: "You have ingested food poison. Treatment will restore you to health in one month." Upon checking the prescription, it consisted only of fresh ginger juice. Asked for the reason, he replied: "She ate turtle dove, which often consumes Banxia (Pinelliae Rhizoma) seedlings, leading to poisoning; thus, ginger is used to resolve the toxicity." There are two acupuncture methods for treating facial blackness: One involves selecting Stomach meridian points. The Classics state: When the Foot-Yangming Stomach meridian undergoes change, disease occurs, characterized by shivering chills and darkening of the face. The other involves selecting Kidney meridian points. The Classics state: When the Foot-Shaoyin Kidney meridian undergoes change, disease occurs, characterized by hunger without desire to eat, and a face as black as lacquered wood. Selection depends on excess, deficiency, heat, cold, or sinking conditions. When Shaoyin Qi terminates, the face turns black, teeth grow long and become dirty, and abdominal distension and closure occur. When Taiyin Qi terminates, abdominal distension and closure prevent breathing; frequent belching occurs. If vomiting reverses, the face turns red; if not, the face turns black, and hair/skin becomes black. The Seven Whites Face-Washing Powder consists of Bailian (Bletillae Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Baiqianniu (Euphorbiae Lathyridis Semen), Baifuzi (Typhonii Rhizoma), Baizhi (Angelicae Dahuricae Radix), Baishao (Paeoniae Radix Alba), and Baijiangcan (Bombyx Batryticatus). For fine sores on the face that frequently discharge yellow fluid, use Taohua (Persicae Flos) dried in shade, added with Danggui (Angelicae Sinensis Radix) or Xinghua (Pruni Armeniacae Flos), ground into powder for washing the face. For toxic heat and malignant sores on the face, apply Bailian San (Coptidis and Phellodendri Powder). For five-colored sores on the face, soak cotton in salt water and apply to the sores, changing 5-6 times daily until healed. For yellow-water sores on the face and sores on the eyes, use Taohua (Persicae Flos) collected on the third day of the third lunar month, dried in shade, ground into powder. Take one cubic inch spoonful with warm cooked water after meals, three times daily, for good results. For acne scars or pigmentation spots on the face, use Miduoseng (Lithargyri Pulvis) fine powder, mixed with human breast milk at night for effective application. For acne comedones on the face, apply saliva obtained while not speaking, or apply juice from Tusizi (Cuscutae Semen), or mix a small amount of Baifan (Alumen) powder with wine for topical application. The *Doumen Fang* treats black spots and improves facial complexion using Baijiangcan (Bombyx Batryticatus), Heiqianniu (Euphorbiae Lathyridis Semen), and Beixixin (Asari Radix et Rhizoma), ground into coarse powder to make bath bean, used to remove infantile fetal impurities. For painful skin on the face, apply Hemushouwu (Polygoni Multiflori Radix) powder mixed with ginger juice to form a paste, cover with silk, and apply heat by warming shoe soles with fire and ironing over the area. For facial rosacea (red nose), use raw Fuzi (Aconiti Lateralis Radix Praeparata - note: text says raw, usually processed), Chuanjiao (Zanthoxyli Pericarpium), and Yege (Aristolochiae Radix) in small amounts, chopped, soaked in vinegar overnight, removed, and fried with pork fat until the Fuzi turns yellow. Strain and apply occasionally. Alternatively, use Huangshi (Sulfur) half tael, snail shells (preferably small, naturally dead and dry), Muxiang (Aucklandiae Radix) half tael each, Guodan (Minii Preparatum) half tael, all ground into powder; Xingren (Armeniacae Semen Amarum) half tael, peeled and ground into paste, mixed with pork fat from the twelfth lunar month to form a paste. Before sleep, wash face with fermented grain water, dry, apply medicine to affected areas, and wash off at dawn. For damp tinea, wash with rice washing water, then apply the aforementioned medicines. For fingernail scratches on the face, mix fresh ginger juice with Qingfen (Calomelas) and apply to the broken skin; this leaves no scars.