年上微黄为正色,若平更陷夭(16)难禁。忽有黑色痢疾侯,
藿乱吐泻(17)黄色深。
鼻准微黄赤白平,深黄燥黑死难生。人中短缩吐因痢,青黑
惊风尽死形(18)。
正口常红号曰平(19),燥干脾热积黄生。白主失血黑绕口。
唇反黑侯蛔必倾(20)。
承浆青色食时惊,黄多吐逆痢红形。烦躁夜啼青色吉,久
病(21)眉红死症真。
白睛青色有肝风,若是黄时有积攻。或见黑睛黄色现,伤寒
病症此其宗。
风气两池黄吐逆,烦躁啼哭色鲜红。更有两颐胚样赤,肺家
客热此非空。
太阳青色惊方始,红色赤淋萌孽起。要知死症是如何,青色
从玆生入耳。
两脸黄为痰实咽,青色客忤红风热。伤寒赤色红主淋,二色
诸详分两颊。
吐虫青色滞颐黄,一色颐间两自详。风门黑疝(22),青惊水,
纹青金匮主惊狂。
凡看小儿疾病,先观形色,而切脉次之。盖面部气总见,而五
位青色者,惊积不散,欲发风侯,五位红色者,痰积壅盛,惊悸不
宁;五位黄色者,食积歛伤,疳候痞癖;五位白色者,肺气不实,
滑泄吐痢,五位黑色者,脏腑欲绝,为疾危恶。面青、眼青肝之
病,面赤心之病,面白肺之病,面黄脾之病,面黑肾之病。先别
其五脏,各有所主。次者。禀受盈亏,胎气虚实,阴阳二症,补过
泄多,当救其失。兼五脏六腑,表里各有相应。若能辨其标本,
则神圣工巧矣。
年寿部位(鼻准与人中之间)呈现微黄色为正常气色,如果此处平坦且凹陷,则预示病情危重难以救治。若突然显现黑色,多主痢疾之候;若伴有霍乱般的吐泻症状,面色深黄亦属病态。
鼻头(鼻准)微带黄、赤、白三色平和之象为正常;若颜色深黄、干燥或发黑,则预后不良,难以生存。人中短缩并伴有呕吐或因痢疾所致者,若面部出现青黑色及惊风征象,多为死证。
口唇常呈红色称为平人(健康状态);若口唇燥干,主脾热积滞而生黄色;白色主失血,黑色环绕口周,若唇部翻转发黑,则蛔虫必致倾覆(危殆)。
承浆穴(颏唇沟中点)部位发青,提示进食时易受惊吓;黄色多主呕吐逆乱或痢疾便红;烦躁夜啼而面色青色者为吉兆;久病患者眉间发红,则为死症的确切征象。
白睛(巩膜)发青,主肝风内动;若白睛发黄,主有积滞需攻下。若黑睛(角膜/瞳孔区域)显现黄色,此为伤寒病症的根源所在。
风气两池(耳后高骨下方凹陷处)发黄,主呕吐逆乱;烦躁啼哭且色泽鲜红,主内有郁热。若两侧面颊下部(颐)出现类似胚胎样的赤色,主肺家客热,此非虚言。
太阳穴(眼角外侧)发青,主惊风初起;发红则主赤淋(尿血等淋证)萌芽滋生。要知道死症是如何形成的,青色从此处生发并传入耳部即为死证征兆。
双颊发黄,主痰实阻滞咽喉;发青主客忤(外邪侵袭),发红主风热。伤寒病见赤色,红色主淋证,这两种颜色的变化需详细分辨于两颊。
吐出蛔虫伴青色,或涎水滞留嘴角(滞颐)发黄,这两种情况在颐间部位可自行辨别。风门部位发黑主疝气,青色主惊风水肿,掌纹青色主金匮(指小儿急慢惊风等重症)及惊狂。
大凡诊治小儿疾病,先观察其形色,然后再切脉。因为面部的气色总汇于此,若五部位(心、肝、脾、肺、肾对应区)发青,主惊积不散,欲发惊风之候;五部位发红,主痰积壅盛,惊悸不宁;五部位发黄,主食积损伤,疳积痞块;五部位发白,主肺气不实,滑泄吐痢;五部位发黑,主脏腑之气欲绝,为疾病危恶之象。面青、眼青是肝病的面色表现,面赤是心病的表现,面白是肺病的表现,面黄是脾病的表现,面黑是肾病的表现。首先要辨别五脏,各有所主。其次要考察禀赋盈亏、胎气虚实、阴阳二症,以及补益过度或泻下过多导致的偏差,应当补救其失误。兼看五脏六腑,表里各有相应关系。若能辨明标本,则医术可达到神圣工巧的境界。
The tip of the nose and the area between it and the philtrum (Nianshou) showing a slight yellow color is the normal complexion. If this area is flat and depressed, it indicates a critical condition that is difficult to cure. If black suddenly appears, it points to dysentery; if accompanied by vomiting and diarrhea resembling cholera, or if the complexion is deeply yellow, these are pathological signs.
The nasal tip (Bizhun) showing a mild mix of yellow, red, and white colors is normal. Deep yellow, dryness, or blackness indicate a poor prognosis with difficulty in survival. A short philtrum accompanied by vomiting due to dysentery, along with cyanotic-black facial features and signs of convulsions, suggests a fatal outcome.
Lips that are constantly red are considered normal (Ping). Dryness and chapping indicate spleen heat and accumulation generating yellow tones. Whiteness indicates blood loss; blackness surrounding the mouth suggests impending danger from roundworms. If the lips turn everted and black, the condition of roundworm infestation becomes critical.
Cyanosis at Chengjiang (Chengjiang, CV24) indicates fright during eating. Yellow here suggests vomiting, regurgitation, or bloody dysentery. Irritability and night crying with a cyanotic complexion are auspicious. Redness around the eyebrows in chronic illness is a true sign of death.
Cyanosis of the sclera (white part of the eye) indicates liver wind stirring internally. Yellowing of the sclera indicates accumulation requiring purgation. If yellowish hues appear on the cornea/pupil area, this is the root of shaoyang/taiyang cold damage syndromes.
Yellowing in the "two pools" behind the ears (Fengchi region) indicates vomiting and regurgitation. Restlessness, crying, and bright red coloration indicate internal heat. Redness resembling an embryo shape on both cheeks (Yi) indicates pathogenic heat in the lungs, which is not empty talk.
Cyanosis at the Taiyang point (lateral canthus) indicates the onset of fright-convulsion. Redness indicates the budding of hematuria or strangury. To know how a fatal condition arises: if cyanosis spreads from here into the ear, it signals death.
Yellow on both cheeks indicates phlegm-stuffiness obstructing the throat. Cyanosis indicates external shock (Ke Wu), while redness indicates wind-heat. In cold damage, redness indicates strangury. These two color changes must be carefully distinguished on the cheeks.
Vomiting roundworms with cyanosis, or yellow saliva pooling at the corners of the mouth (Zhiyi), can be identified by observing the Yi area alone. Blackness at the Fengmen area indicates hernia; cyanosis indicates fright-edema; blue palm lines indicate Jin Kui (severe convulsive disorders) and mania.
Generally, when examining pediatric diseases, one first observes the form and color, then palpates the pulse. Facial qi manifests comprehensively here: cyanosis in the five zones indicates unsettled fright and accumulation, predisposing to wind-convulsions; redness indicates excessive phlegm-accumulation, causing palpitations and restlessness; yellowness indicates food-damage leading to malnutrition (Gan) and masses; whiteness indicates deficient lung qi, leading to slippery discharge, vomiting, and dysentery; blackness indicates the exhaustion of zang-fu qi, representing a critical and malignant disease state. Cyanous face and eyes indicate liver disease; red face indicates heart disease; pale face indicates lung disease; yellow face indicates spleen disease; black face indicates kidney disease. First, differentiate the five zang organs, each having its specific domain. Secondly, assess constitutional strength or weakness, fetal qi deficiency or excess, yin and yang syndromes, and errors such as over-tonification or over-purging, correcting these deviations. Consider the correspondence between the five zang and six fu organs, and interior and exterior levels. If one can distinguish the root and branch, medical skill reaches the level of divine, sacred, skilled, and adept mastery.