知往今。故相气不微，不知是非，属意勿去，乃知新故，色明不粗，沉夭为甚，不明不泽，
其病不甚。其色散，驹驹然未有聚，其病散而气痛，聚未成也。肾乘心，心先病，肾为应，
色皆如是。男子色在于面王，为小腹痛，下为卵痛，其圜直为茎痛，高为本，下为首，狐疝
阴之属也。女子在于面王。为膀胱子处之病，散为痛，搏为聚，方圆左右，各如其色
形。其随而下至胝为淫，有润如膏状，为暴食不洁。左为左，右为右，其色有邪，聚散而不
端，面色所指者也。色者青、黑、赤、白、黄，皆端满有别乡。别乡赤者，其色亦大如榆荚
，在面王为不日。其色上锐，首空上向，下锐下向，在左右如法。以五色命藏，青为肝，赤
为心，白为肺，黄为脾，黑为肾。肝合筋，心合脉，肺合皮，脾合肉，肾合骨也。（《五色
篇》）
鼻者，肺之官也。目者，肝之官也。口唇者，脾之官也。舌者，心之官也。耳者，肾之
官也。故肺病者喘息鼻张；肝病者， 青；脾病者，唇黄；心病者，舌卷短颧赤；肾病者，
颧与颜黑（《五阅五使篇》）。色起两眉薄泽者，病在皮。唇青黄赤白黑者，病在肌肉。荣卫
濡然者，病在血气。目色青黄赤白黑者，病在筋。耳焦枯受尘垢，病在骨。（《卫气失常篇
》）
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黄帝曰∶五脏之气，阅于面者，余已知之矣。以肢节知而阅之，奈何？岐伯曰∶五脏六
腑者，肺为之盖，巨肩陷，咽喉见其外。五脏六腑者，心为之主，缺盆为之道，
骨有余，以候 KT 。肝者，主为将，使之候外，欲知坚固，视目大小。脾者，主
为卫，使之迎粮，视唇舌好恶，以知吉凶。肾者，主为外，使之远听，视耳好恶，以知其性
。黄帝曰∶善。愿闻六腑之候。岐伯曰∶六腑胃为之海，广骸大颈张胸，五谷乃容，鼻隧以
长，以候大肠。唇浓人中长，以候小肠。目下裹大，其胆乃横。鼻孔在外，膀胱漏泄。鼻柱
中央起，三焦乃约。此所以候六腑者也。（《师传论》）
赤色小理者，心小，粗理者，心大，无 KT 者，心高， KT 小短
举者，心下， KT 长者，心下坚， KT 弱小以薄者，心脆， KT
直下不举者，心端正， KT 倚一方者，心偏倾也。心小则安，邪弗能伤，易伤以忧
。心大则忧不能伤，易伤于邪。心高则满于肺中， 而善忘，难开以言。心下则藏外，
易伤于寒，易恐以言。心坚则藏安守固，心脆则善病消瘅热中，心端正则和利难伤，心偏倾
则操持不一，无守司也。
白色小理者，肺小，粗理者，肺大，巨肩反膺陷喉者，肺高，合腋张胁者，肺下，好肩
背浓者，肺坚，肩背薄者，肺脆，背膺浓者，肺端正，胁偏疏者，肺偏倾也。肺小则少饮，
不病喘喝。肺大则多饮，善病胸痹喉痹逆气。肺高则上气肩息咳。肺下则居贲迫肺，善胁下
痛。肺坚则不病咳上气，肺脆则苦病消瘅易伤，肺端正则和利难伤，肺偏倾则胸偏痛也。
青色小理者，肝小，粗理者，肝大，广胸反 者，肝高，合胁兔 者，肝下，
胸胁好者，肝坚，胁骨弱者，肝脆，膺腹好相得者，肝端正，胁骨偏举者，肝偏倾也。肝小
则脏安，无胁下之病。肝大则逼胃迫咽，迫咽则苦膈中，且胁下痛。肝高则上支贲切，胁
为息贲。肝下则逼胃胁下空，胁下空则易受邪。肝坚则藏安难伤，肝脆则善病消瘅易伤
，肝端正则和利难伤，肝偏倾则胁下痛也。
黄色小理者，脾小，粗理者，脾大，揭唇者，脾高，唇下纵者，脾下，唇坚者，脾坚，
唇大而不坚者，脾脆，唇上下好者，脾端正，唇偏举者，脾偏倾也。脾小则脏安，难伤于邪
也。脾大则苦凑 而痛，不能疾行。脾高则 引季胁而痛。脾下则下加于大肠，下
加于大肠则脏苦受邪。脾坚则脏安难伤，脾脆则善病消瘅易伤，脾端正则和利难伤，脾偏倾
则善满善胀也。
黑色小理者，肾小，粗理者，肾大，高耳者，肾高，耳后陷者，肾下，耳坚者，肾坚，
耳薄不坚者，肾脆，耳好前居牙车者，肾端正，耳偏高者，肾偏倾也。肾小则脏安难伤。肾
大则善病腰痛，不可以俯仰，易伤以邪。肾高则苦背膂痛，不可以俯仰。肾下则腰尻痛，不
可以俯仰，为狐疝。肾坚则不病腰背痛，肾脆则善病消瘅易伤，肾端正则和利难伤，肾偏倾
则苦腰尻痛也。
五脏皆小者，少病，苦焦心，大愁忧。五脏皆大者，缓于事，难使以忧。五脏皆高者，
好高举措。五脏皆下者，好出人下。五脏皆坚者，无病。五脏皆脆者，不离于病。五脏皆端
正者，和利得人心。五脏皆偏倾者，邪心而善盗，不可以为人平，反复言语也。
肺应皮，皮浓者大肠浓，皮薄者大肠薄，皮缓腹里大者大肠大而长，皮急者大肠急而短
，皮滑者大肠直，皮肉不相离者大肠结。心应脉，皮浓者脉浓，脉浓者小肠浓，皮薄者脉薄
，脉薄者小肠薄，皮缓者脉缓，脉缓者小肠大而长，皮薄而脉波小者小肠小而短，诸阳经脉
皆多纡屈者小肠结。脾应肉，肉 坚大者胃浓，肉 么者胃薄，肉 小而么者
胃不坚，肉 不称身者胃下，胃下者管约不利，肉 不坚者胃缓，肉 无小里
累者胃急，肉 多少里累者胃结，胃结者上管约不利也。肝应爪，爪浓色黄者胆浓，爪
薄色红者胆薄，爪坚色青者胆急，爪濡色赤者胆缓，爪直色白无约者胆直，爪恶色黑多纹者
胆结也。肾应骨，密理浓皮者三焦膀胱浓，粗理薄皮者三焦膀胱薄，疏腠理者三焦膀胱缓，
皮急而无毫毛者三焦膀胱急，毫毛美而粗者三焦膀胱直，稀毫毛者三焦膀胱结也。（出《本
藏篇》）
黄帝问∶余欲无视色持脉，独调其尺，以言其病，从外知内，为之奈何？岐伯曰∶审其
尺之缓急小大滑涩，肉之坚脆，而病形定矣。视人之目窠上微痈如新卧起状，其颈脉动，时
咳，按其手足上 而不起者，风水肤胀也。尺肤滑其淖泽者，风也。尺肉弱者，解 安
卧。脱肉者，寒热不治，尺肤滑而泽脂者，风也。尺肤涩者，风痹也。尺肤粗如枯鱼之鳞者
，水 饮也。尺肤热甚脉盛躁者，病温也。其脉盛而滑者，病且出也。尺肤寒其脉小者
，泄少气。尺肤炬然先热后寒者，寒热也。尺肤先寒久大之而热者，亦寒热也。肘所独热者
，腰以上热。手所独热者，腰以下热。肘前独热者，膺前热。肘后独热者，肩背热。臂中独
热者，腰腹热。肘后粗以下三四寸热者，肠中有虫。掌中热者，腹中热。掌中寒者，腹中寒
。鱼上白肉有青血脉者，胃中有寒。尺炬然热，人迎大者，当夺血。尺坚大脉小甚，少气，
有加，立死。（《论疾诊尺篇》）
〔仲〕鼻头色青，腹中痛，舌冷者，死。鼻头色微黑者，有水气。色黄者，胸上有寒。色
白者，亡血也。设微赤非时者，死。其目正圆者， ，不治。又色青为痛，色黑为劳，
色赤为风，色黄者便难也，鲜明者有留饮。言迟者，风也；摇头言者，其里痛也；行迟者，
其表 也；坐而伏者，短气也；坐而下一膝者，必腰痛也；里实护腹而怀卵者，必心痛
也。师持脉，病患欠者，无病也。脉之因伸者，无病也。假令向壁卧，闻师到不惊，起而目
盼视，若三言三止，脉之咽唾，此为诈病。假令脉自和，更言此病大重，当须服吐下药，针
灸数十百处乃愈。病者素不应食，而反暴思之，必发热也。师曰∶息摇肩者，心中坚。息引
胸中上气者，咳。息张口短气者，肺痿吐沫。师曰∶病患语声寂然，善惊呼者，骨节间病。
语声喑喑然不彻者，心膈间病。语声啾啾细而长者，头中病。
〔《脉经》〕脉一来而久住者，病在心主中治。脉二来而久住者，病在肝支中治。脉三来
而久住者，病在脾下中治。脉四来而久住者，病在肾间中治。脉五来而久住者，病在肺支中
治。五脉病，虚羸人得此者，死。所以然者，药不得而治，针不得而及。盛人可治，气全故
也。
知晓既往的病情，才能了解现在的状况。因此，如果诊察气色不细致入微，就无法辨别病情的真伪与是非；必须专心致志，不可随意离去，这样才能分辨新病与旧疾。面色鲜明而不粗糙，说明病情较轻；面色沉滞枯槁，则病情严重；面色既不鲜明也不润泽，说明病情并不严重。如果面色散乱，像马驹奔跑那样轻浮无根，尚未凝聚，说明病邪虽散但气机疼痛，积聚之证尚未形成。若肾气乘袭心脏，心脏先发病，肾脏为应验之脏，其面色表现均与此类似。
男子面色在鼻头（面王）部位显现，主小腹痛，向下牵引睾丸疼痛；若颜色呈圆形且直下，主阴茎疼痛；颜色高起处对应阴茎根部，低垂处对应阴茎头部，这属于狐疝等阴部疾病的范畴。女子面色在鼻头部位显现，主膀胱和子宫的疾病；色散主痛，色聚主积聚，无论方圆左右，都与其面色形态相应。若面色随精气下行至脐下（胝），出现淫秽分泌物，状如膏脂，这是暴食不洁之物所致。左侧病变反映在左，右侧病变反映在右；若面色有邪气，聚散无常且不端正，就是面色诊断所指出的征象。五色中的青、黑、赤、白、黄，都应端整丰满，且有别于其他脏腑对应的区域。若别区呈现赤色，色泽大如榆荚，出现在鼻头，预示不久将发生灾病（或指预后不良）。若面色上部尖锐，下部空虚向上，或下部尖锐，上部空虚向下，在左右两侧则依此法推断。用五色来配属五脏：青色属肝，赤色属心，白色属肺，黄色属脾，黑色属肾。肝合筋，心合脉，肺合皮，脾合肉，肾合骨。（出自《灵枢·五色篇》）
鼻子是肺的外候器官。眼睛是肝的外候器官。口唇是脾的外候器官。舌头是心的外候器官。耳朵是肾的外候器官。所以，肺病患者会出现喘息、鼻孔张大的症状；肝病患者面色发青；脾病患者口唇发黄；心病患者舌体卷短、颧骨发红；肾病患者颧骨和颜面发黑（出自《灵枢·五阅五使篇》）。面色在两眉之间呈现薄泽之象，病位在皮肤。口唇呈现青、黄、赤、白、黑各色，病位在肌肉。营卫之气濡润不足，病在血气。眼睛呈现青、黄、赤、白、黑各色，病位在筋。耳朵焦枯并沾染尘垢，病位在骨（出自《灵枢·卫气失常篇》）。
黄帝说：五脏的气色显露于面部，我已经知道了。如何通过肢体关节来诊察内脏呢？岐伯说：五脏六腑中，肺如盖子覆盖其上，肩膀宽大、锁骨窝凹陷、咽喉显露的人，可以观察肺的状态。五脏六腑中，心为主宰，缺盆（锁骨上窝）是气血通道，骨骼有余者，可用来候察心脏（KT此处疑为“阙”或特定解剖标志，指胸骨柄或相关部位，原文作KT，暂译为心脏相关部位）。肝主为将军，负责抵御外邪，想要知道肝脏是否坚固，需观察眼睛的大小。脾主为卫，负责运化水谷精微，通过观察口唇和舌头的状态，可以预知吉凶。肾主司外部听觉，通过观察耳朵的好坏，可以了解肾的性质。黄帝说：好。我想听听六腑的征候。岐伯说：六腑中，胃如大海，骨架宽阔、颈部粗大、胸部张开的人，能容纳五谷；鼻腔通道长，可用来候察大肠。嘴唇厚、人中沟长，可用来候察小肠。眼下胞肿胀肥大，胆气横逆。鼻孔外露，膀胱固摄无力易漏泄。鼻梁骨中央隆起，三焦约束有力。这就是候察六腑的方法（出自《灵枢·师传论》）。
面色纹理细腻者，心脏较小；纹理粗糙者，心脏较大；无锁骨窝凹陷者，心脏位置偏高；锁骨窝小而短且上举者，心脏位置偏低；锁骨窝长者，心脏位置低而坚实；锁骨窝弱小且浅薄者，心脏脆弱；锁骨窝直下不上举者，心脏位置端正；锁骨窝偏向一方者，心脏偏倾。心脏小则安定，邪气不能伤害，但容易因忧愁而受伤。心脏大则忧愁不能伤害，但容易受邪气侵袭。心脏位置高则压迫肺中，导致胸闷、健忘，难以用言语开导。心脏位置低则脏器外露，容易受寒邪伤害，容易因言语恐吓而惊恐。心脏坚实则脏器安守稳固，心脏脆弱则容易患消瘅（糖尿病类热病）和中热病。心脏端正则调和顺畅，难以受伤；心脏偏倾则行为举止不一，缺乏坚守的原则。
面色纹理细腻者，肺脏较小；纹理粗糙者，肺脏较大；肩膀宽大、胸骨反张、喉结凹陷者，肺脏位置偏高；腋下收缩、胁肋张开者，肺脏位置偏低；肩膀背部肌肉丰厚者，肺脏坚实；肩膀背部肌肉单薄者，肺脏脆弱；背部和胸部肌肉丰厚者，肺脏位置端正；胁肋部疏朗偏斜者，肺脏偏倾。肺脏小则饮水少，不易患气喘咳嗽。肺脏大则多饮水，容易患胸痹、喉痹和气逆病。肺脏位置高则气机上逆，表现为耸肩呼吸、咳嗽。肺脏位置低则位于膈肌之上压迫肺脏，容易引发胁下疼痛。肺脏坚实则不易患咳嗽气逆病，肺脏脆弱则苦于消瘅病且易受伤害。肺脏端正则调和顺畅，难以受伤；肺脏偏倾则胸部一侧疼痛。
面色纹理细腻者，肝脏较小；纹理粗糙者，肝脏较大；胸廓宽广、肋骨反张者，肝脏位置偏高；胁肋收敛、肋骨如兔形突出者，肝脏位置偏低；胸胁部肌肉匀称者，肝脏坚实；胁骨软弱者，肝脏脆弱；胸腹肌肉协调者，肝脏位置端正；胁骨偏斜高举者，肝脏偏倾。肝脏小则脏器安定，无胁下疾病。肝脏大则压迫胃部和咽喉，压迫咽喉则感到胸膈痞闷，且胁下疼痛。肝脏位置高则向上支撑膈肌，导致胁肋胀满如息贲病。肝脏位置低则压迫胃部，胁下空虚，胁下空虚则易受邪气侵袭。肝脏坚实则脏器安定，难以受伤；肝脏脆弱则容易患消瘅病且易受伤害。肝脏端正则调和顺畅，难以受伤；肝脏偏倾则胁下疼痛。
面色纹理细腻者，脾脏较小；纹理粗糙者，脾脏较大；嘴唇上翻者，脾脏位置偏高；嘴唇下垂松弛者，脾脏位置偏低；嘴唇坚实者，脾脏坚实；嘴唇大而松软者，脾脏脆弱；嘴唇上下匀称者，脾脏位置端正；嘴唇偏斜高举者，脾脏偏倾。脾脏小则脏器安定，难被邪气伤害。脾脏大则苦于腹部凑集疼痛，不能快速行走。脾脏位置高则牵引季胁疼痛。脾脏位置低则下压大肠，下压大肠则脏器苦于受邪。脾脏坚实则脏器安定，难以受伤；脾脏脆弱则容易患消瘅病且易受伤害。脾脏端正则调和顺畅，难以受伤；脾脏偏倾则容易腹胀满。
面色纹理细腻者，肾脏较小；纹理粗糙者，肾脏较大；耳朵高耸者，肾脏位置偏高；耳后凹陷者，肾脏位置偏低；耳朵坚实者，肾脏坚实；耳朵薄而不坚实者，肾脏脆弱；耳朵位置靠前，位于牙车（下颌角）前方者，肾脏位置端正；耳朵偏高者，肾脏偏倾。肾脏小则脏器安定，难以受伤。肾脏大则容易患腰痛，不能俯仰，易受邪气伤害。肾脏位置高则苦于脊背疼痛，不能俯仰。肾脏位置低则腰尻部疼痛，不能俯仰，可能发展为狐疝。肾脏坚实则不患腰背痛，肾脏脆弱则容易患消瘅病且易受伤害。肾脏端正则调和顺畅，难以受伤；肾脏偏倾则苦于腰尻部疼痛。
五脏都小的人，很少生病，但内心焦躁，常怀深愁大忧。五脏都大的人，处事迟缓，难以用忧愁使其困扰。五脏位置都高的人，喜好高高在上，举措不凡。五脏位置都低的人，喜好屈居人下。五脏都坚实的人，没有疾病。五脏都脆弱的人，离不开疾病。五脏都端正的人，性格调和顺利，得人心。五脏都偏倾的人，心存邪念，善于偷盗，不能为人公正持平，言语反复无常。
肺对应皮肤，皮肤厚实者大肠厚实，皮肤薄者大肠薄弱，皮肤松弛且腹部宽大者大肠大而长，皮肤紧绷者大肠急而短，皮肤光滑者大肠通畅，皮肉紧密结合者大肠结滞。心对应血脉，皮肤厚实者血脉厚实，血脉厚实者小肠厚实，皮肤薄者血脉薄弱，血脉薄弱者小肠薄弱，皮肤松弛者血脉松弛，血脉松弛者小肠大而长，皮肤薄且脉搏细弱者小肠小而短，诸阳经脉多有迂曲屈折者小肠结滞。脾对应肌肉，肌肉坚实丰大者胃壁厚，肌肉细小者胃壁薄，肌肉细小且软弱者胃壁不坚，肌肉与身体不相称者胃位置低下，胃位置低下则幽门约束不利，肌肉不坚实者胃气缓弱，肌肉无细微颗粒感者胃气急迫，肌肉多少有颗粒感者胃气结滞，胃气结滞则上脘约束不利。肝对应爪甲，爪甲厚实色黄者胆囊厚实，爪甲薄色红者胆囊薄弱，爪甲坚硬色青者胆囊气急，爪甲濡软色赤者胆囊气缓，爪甲直挺色白无约束者胆囊气直，爪甲恶浊色黑多纹者胆囊气结。肾对应骨骼，纹理致密皮肤厚实者三焦和膀胱厚实，纹理粗糙皮肤薄者三焦和膀胱薄弱，腠理疏松者三焦和膀胱气缓，皮肤紧绷且无毫毛者三焦和膀胱气急，毫毛美观粗壮者三焦和膀胱气直，毫毛稀疏者三焦和膀胱气结。（出自《灵枢·本藏篇》）
黄帝问：我想不看面色、不把脉，只调察尺肤，就能说出病情，从外部了解内部，该怎么做？岐伯说：仔细审察尺肤的缓急、大小、滑涩，以及肌肉的坚脆，病情就可以确定了。看人的眼睑上方轻微浮肿，像刚睡醒的样子，颈动脉跳动，时常咳嗽，按压手足背部凹陷不起者，是风水肤胀病。尺肤光滑且润滑者，是风病。尺部肌肉软弱者，是懈惰嗜卧。肌肉脱失者，是寒热病且难治。尺肤光滑且有油脂光泽者，是风病。尺肤粗糙者，是风痹病。尺肤粗糙如枯鱼鳞片者，是水饮病。尺肤灼热且脉搏盛大躁动者，是温病。脉搏盛大且滑利者，病势即将外出。尺肤寒冷且脉搏细小者，是泄泻少气。尺肤先灼热后寒冷者，是寒热病。尺肤先寒冷，久按之后变热者，也是寒热病。肘部单独发热者，腰部以上发热。手部单独发热者，腰部以下发热。肘前单独发热者，胸前发热。肘后单独发热者，肩背发热。臂中部单独发热者，腰腹部发热。肘后下方三四寸处发热者，肠中有虫。掌心发热者，腹中发热。掌心寒冷者，腹中寒冷。手掌大鱼际白肉上有青紫色血脉者，胃中有寒。尺部灼热且人迎脉大者，应当放血。尺肤坚硬大但脉搏极小者，少气，若病情加重，立即死亡。（出自《灵枢·论疾诊尺篇》）
〔张仲景〕鼻头颜色发青，腹中痛，舌头发冷者，死。鼻头颜色微黑者，有水气。颜色发黄者，胸上有寒。颜色苍白者，亡血。如果微微发红且非正常时令者，死。眼睛直视不动者，不治。另外，面色青主痛，面色黑主劳损，面色赤主风邪，面色黄主大便困难，面色鲜明者有留饮。说话迟缓者，中风；摇头说话者，体内疼痛；行走迟缓者，表证；坐着伏身者，短气；坐着时一只脚下垂者，必腰痛。里实证护住腹部并怀抱膝盖者，必心痛。医生切脉时，病人打哈欠，是无病。脉搏随之舒展，是无病。假如面向墙壁躺着，听到医生到来不惊动，起身时眼神游移不定，若说三句话停顿三次，切脉时吞咽口水，这是诈病。假如脉象平和，却声称此病很重，必须服用吐下药，针灸数十上百处才能痊愈，这也是诈病。病人平时不想吃东西，却突然暴想吃东西，必定会发热。医生说：呼吸时摇动肩膀者，心中坚满。呼吸引动胸中气上逆者，咳嗽。张口短气者，肺痿吐沫。医生说：病人说话声音寂静，但容易惊呼者，骨节间有病。说话声音暗哑不清晰者，心膈间有病。说话声音细微而长者，头部有病。
〔《脉经》〕脉搏跳一次停留时间较长者，病在心主之中治。脉搏跳两次停留时间较长者，病在肝支之中治。脉搏跳三次停留时间较长者，病在脾下之中治。脉搏跳四次停留时间较长者，病在肾间之中治。脉搏跳五次停留时间较长者，病在肺支之中治。五种脉象的病，虚羸之人得了这种脉，会死。之所以这样，是因为药物无法治疗，针石无法到达。壮实之人可治，因为正气充足。
Know the past to understand the present. Therefore, if the observation of Qi and complexion is not meticulous, one cannot discern right from wrong; one must remain attentive and not depart casually, so as to distinguish between new and old diseases. If the complexion is bright but not coarse, the disease is mild; if it is dull and withered, the disease is severe; if it is neither bright nor lustrous, the disease is not serious. If the complexion is scattered, appearing light and rootless like a running foal without gathering, the pathogenic factor is scattered causing Qi pain, but the accumulation has not yet formed. If Kidney Qi overacts on the Heart, the Heart suffers first, and the Kidney manifests correspondingly; the complexions will be similar in this regard.
In men, if the color appears at the tip of the nose (Mianwang), it indicates pain in the lower abdomen, extending downward to testicular pain; if the color is circular and straight down, it indicates penile pain; the higher part corresponds to the root, and the lower part to the head, which belongs to conditions such as Hu Shen (Fox Hernia) affecting the Yin organs. In women, if the color appears at the tip of the nose, it indicates diseases of the Bladder and Zi Chu (uterus); scattering indicates pain, gathering indicates accumulation, whether round, square, left or right, corresponding to the shape of the color. If the color descends along with fluids to the umbilicus area, manifesting as obscene discharge resembling paste, it is caused by gluttony and unclean food. Left-sided pathology reflects on the left, right-sided on the right; if the facial color shows pathogenic factors that gather and scatter irregularly and are not upright, these are the indications pointed out by color diagnosis. The five colors—Green, Black, Red, White, Yellow—should all be full and distinct, differing from other regions. If the distinct region shows Red, large as a elm seed, appearing at the nose tip, it portends disaster soon. If the upper part of the color is sharp and the lower empty facing up, or the lower sharp and upper empty facing down, the same applies to the left and right sides. Assigning the five colors to the Zang organs: Green corresponds to the Liver, Red to the Heart, White to the Lung, Yellow to the Spleen, and Black to the Kidney. The Liver connects with sinews, the Heart with vessels, the Lung with skin, the Spleen with flesh, and the Kidney with bones. (From *Pian Wu Se*)
The nose is the external opening of the Lung. The eyes are the external opening of the Liver. The lips are the external opening of the Spleen. The tongue is the external opening of the Heart. The ears are the external opening of the Kidney. Therefore, patients with Lung disease exhibit panting and flaring nostrils; those with Liver disease have a greenish complexion; those with Spleen disease have yellow lips; those with Heart disease have a curled short tongue and red cheekbones; those with Kidney disease have black cheekbones and forehead. (From *Pian Wu Yue Wu Shi*)
If the color rises at the inner ends of the eyebrows with a thin luster, the disease is in the skin. If the lips show Green, Yellow, Red, White, or Black, the disease is in the muscles. If Ying and Wei Qi are moist but deficient, the disease is in the blood and Qi. If the eyes show Green, Yellow, Red, White, or Black, the disease is in the sinews. If the ears are scorched, dry, and covered with dust, the disease is in the bones. (From *Pian Wei Qi Shi Chang*)
Huang Di said: I already know how the Qi of the Five Zang organs is observed through the face. How can we observe them through the limbs and joints? Qi Bo replied: Among the Five Zang and Six Fu organs, the Lung acts as a cover. A broad shoulder, depressed clavicular fossa, and visible throat indicate its state. The Heart is the master; the clavicular fossa is the pathway. Abundant bone structure allows us to observe the Heart. The Liver acts as the general, defending the exterior; to know if it is firm, observe the size of the eyes. The Spleen acts as the guard, receiving grain; observe the condition of the lips and tongue to know auspiciousness or misfortune. The Kidney governs the exterior and hearing; observe the condition of the ears to know its nature. Huang Di said: Good. I wish to hear about the signs of the Six Fu organs. Qi Bo said: The Stomach is the sea of the Six Fu organs. A broad frame, thick neck, and expanded chest allow for the containment of grains. A long nasal passage indicates the Large Intestine. Thick lips and a long philtrum indicate the Small Intestine. Swollen lower eyelids indicate Gallbladder excess. Exposed nostrils indicate Bladder leakage. A central ridge on the nasal column indicates San Jiao constriction. These are the ways to observe the Six Fu organs. (From *Pian Shi Chuan*)
Fine skin texture indicates a small Heart; coarse texture indicates a large Heart. Absence of clavicular depression indicates a high Heart; small and short, elevated clavicular fossa indicates a low Heart; long clavicular fossa indicates a low and firm Heart; weak and thin clavicular fossa indicates a fragile Heart; straight and non-elevated clavicular fossa indicates an upright Heart; tilted clavicular fossa indicates a tilted Heart. A small Heart is stable, protected from pathogens, but easily injured by sorrow. A large Heart is not injured by sorrow but easily by pathogens. A high Heart presses on the Lungs, causing fullness, forgetfulness, and difficulty in being persuaded by words. A low Heart exposes the viscera, easily injured by cold and fear induced by speech. A firm Heart keeps the viscera secure; a fragile Heart is prone to Xiao Dan (wasting-thirst) and internal heat. An upright Heart is harmonious and hard to injure; a tilted Heart lacks consistency and principle.
Fine skin texture indicates a small Lung; coarse texture indicates a large Lung. Broad shoulders, reversed sternum, and depressed throat indicate a high Lung; retracted axillae and spread ribs indicate a low Lung; thick shoulders and back indicate a firm Lung; thin shoulders and back indicate a fragile Lung; thick back and chest indicate an upright Lung; sparse and tilted ribs indicate a tilted Lung. A small Lung drinks little and does not suffer from asthma or cough. A large Lung drinks much and is prone to Xiong Bi (chest bi), Hou Bi (throat bi), and rebellious Qi. A high Lung causes upward Qi, shoulder breathing, and cough. A low Lung sits above the diaphragm pressing on the Lung, causing hypochondriac pain. A firm Lung does not suffer from cough and rebellious Qi; a fragile Lung suffers from Xiao Dan and is easily injured. An upright Lung is harmonious and hard to injure; a tilted Lung causes unilateral chest pain.
Fine skin texture indicates a small Liver; coarse texture indicates a large Liver. Broad chest and reversed ribs indicate a high Liver; retracted ribs and rabbit-like prominence indicate a low Liver; good chest and rib muscles indicate a firm Liver; weak rib bones indicate a fragile Liver; harmonious chest and abdomen indicate an upright Liver; raised unilateral rib bones indicate a tilted Liver. A small Liver is stable with no hypochondriac disease. A large Liver presses on the Stomach and pharynx, causing epigastric fullness and hypochondriac pain. A high Liver supports the diaphragm, causing hypochondriac distension like Xi Ben. A low Liver presses on the Stomach, leaving the hypochondrium empty and susceptible to pathogens. A firm Liver is stable and hard to injure; a fragile Liver is prone to Xiao Dan and easily injured. An upright Liver is harmonious and hard to injure; a tilted Liver causes hypochondriac pain.
Fine skin texture indicates a small Spleen; coarse texture indicates a large Spleen. Upturned lips indicate a high Spleen; drooping lips indicate a low Spleen; firm lips indicate a firm Spleen; large but soft lips indicate a fragile Spleen; well-formed upper and lower lips indicate an upright Spleen; tilted raised lips indicate a tilted Spleen. A small Spleen is stable and hard to injure. A large Spleen causes abdominal crowding pain and inability to walk quickly. A high Spleen pulls the costal margin causing pain. A low Spleen presses on the Large Intestine, making the viscera susceptible to pathogens. A firm Spleen is stable and hard to injure; a fragile Spleen is prone to Xiao Dan and easily injured. An upright Spleen is harmonious and hard to injure; a tilted Spleen is prone to fullness and distension.
Fine skin texture indicates a small Kidney; coarse texture indicates a large Kidney. High ears indicate a high Kidney; depressed behind ears indicate a low Kidney; firm ears indicate a firm Kidney; thin and unfirm ears indicate a fragile Kidney; ears positioned forward near the mandible indicate an upright Kidney; high-set ears indicate a tilted Kidney. A small Kidney is stable and hard to injure. A large Kidney is prone to lower back pain, inability to bend or twist, and susceptibility to pathogens. A high Kidney causes back and spine pain, inability to bend or twist. A low Kidney causes sacral pain, inability to bend or twist, and may develop into Fox Hernia. A firm Kidney does not suffer back pain; a fragile Kidney is prone to Xiao Dan and easily injured. An upright Kidney is harmonious and hard to injure; a tilted Kidney causes sacral pain.
Those with all Five Zang organs small rarely get sick but suffer from anxious hearts and deep sorrow. Those with all Five Zang organs large are slow in affairs and hard to worry. Those with all Five Zang organs high prefer lofty actions. Those with all Five Zang organs low prefer to yield to others. Those with all Five Zang organs firm have no disease. Those with all Five Zang organs fragile are never free from disease. Those with all Five Zang organs upright are harmonious and win people's hearts. Those with all Five Zang organs tilted have evil hearts, are prone to theft, cannot be fair, and speak inconsistently.
The Lung corresponds to the skin. Thick skin indicates a thick Large Intestine; thin skin indicates a thin Large Intestine; loose skin with a large belly indicates a large and long Large Intestine; tight skin indicates a tense and short Large Intestine; smooth skin indicates a straight Large Intestine; skin and flesh closely attached indicate a knotted Large Intestine. The Heart corresponds to the vessels. Thick skin indicates thick vessels; thick vessels indicate a thick Small Intestine; thin skin indicates thin vessels; thin vessels indicate a thin Small Intestine; loose skin indicates loose vessels; loose vessels indicate a large and long Small Intestine; thin skin with small waves in vessels indicates a small and short Small Intestine; many tortuous Yang meridians indicate a knotted Small Intestine. The Spleen corresponds to flesh. Firm and large flesh indicates a thick Stomach wall; small flesh indicates a thin Stomach wall; small and soft flesh indicates an unfirm Stomach wall; flesh disproportionate to the body indicates a low Stomach position, where the pylorus is obstructed; unfirm flesh indicates a lax Stomach; flesh without fine granules indicates a hurried Stomach Qi; flesh with many granules indicates a knotted Stomach Qi, leading to upper pyloric obstruction. The Liver corresponds to nails. Thick yellow nails indicate a thick Gallbladder; thin red nails indicate a thin Gallbladder; firm blue nails indicate a tense Gallbladder; soft red nails indicate a lax Gallbladder; straight white nails without constraint indicate a straight Gallbladder; ugly black nails with many lines indicate a knotted Gallbladder. The Kidney corresponds to bones. Dense skin and thick flesh indicate a thick San Jiao and Bladder; coarse skin and thin flesh indicate a thin San Jiao and Bladder; loose pores indicate a lax San Jiao and Bladder; tight skin without hair indicates a tense San Jiao and Bladder; beautiful and coarse hair indicates a straight San Jiao and Bladder; sparse hair indicates a knotted San Jiao and Bladder. (From *Pian Ben Cang*)
Huang Di asked: I wish to diagnose without observing color or holding the pulse, solely by adjusting the Chi (forearm) skin to speak of the disease, knowing the interior from the exterior. How should this be done? Qi Bo replied: Examine the tension, size, slipperiness, and roughness of the Chi skin, and the firmness or fragility of the flesh, and the disease form will be determined. Observe slight swelling above the eye sockets like a newly awakened person, pulsation in the neck vessels, occasional cough, and pitting edema upon pressing hands and feet that does not rise immediately; this is Feng Shui (Wind Water) skin distension. Smooth and glossy Chi skin indicates Wind. Weak Chi flesh indicates lethargy and desire to lie down. Muscle wasting indicates untreatable Cold-Heat. Smooth and oily Chi skin indicates Wind. Rough Chi skin indicates Wind Bi. Chi skin rough like dried fish scales indicates water retention. Very hot Chi skin with surging and restless pulse indicates Warm Disease. Surging and slippery pulse indicates the disease is about to exit. Cold Chi skin with small pulse indicates diarrhea and deficiency of Qi. Chi skin burning then cold indicates Cold-Heat. Chi skin cold then becoming hot after prolonged pressure also indicates Cold-Heat. Heat only at the elbow indicates heat above the waist. Heat only in the hand indicates heat below the waist. Heat only at the front of the elbow indicates heat in the anterior chest. Heat only at the back of the elbow indicates heat in the shoulder and back. Heat only in the arm indicates heat in the waist and abdomen. Heat 3-4 cun below the back of the elbow indicates worms in the intestines. Heat in the palm indicates heat in the abdomen. Cold in the palm indicates cold in the abdomen. Blue veins on the white meat of the palm大鱼际 (Da Yu Ji) indicate cold in the stomach. Burning Chi skin with a large Ren Ying (Radial) pulse indicates blood loss. Hard and large Chi skin with very small pulse and deficiency of Qi, if worsening, leads to immediate death. (From *Pian Lun Ji Chi*)
[Zhang Zhongjing] A green tip of the nose with abdominal pain and cold tongue indicates death. A slightly black nose tip indicates water qi. A yellow color indicates cold in the chest. A white color indicates loss of blood. A slight redness out of season indicates death. Eyes fixed straight ahead are untreatable. Furthermore, green color indicates pain, black indicates labor/wasting, red indicates wind, yellow indicates difficult defecation, and bright/lustrous color indicates retained fluid. Slow speech indicates wind; shaking the head while speaking indicates interior pain; slow walking indicates exterior syndrome; sitting and bending forward indicates shortness of breath; sitting with one knee down indicates lower back pain. Protecting the abdomen and hugging the knees in interior excess indicates heart pain. When the physician holds the pulse, if the patient yawns, there is no disease. If the pulse extends smoothly, there is no disease. If lying on the side facing the wall, not startled by the physician's arrival, rising with wandering eyes, speaking three times with pauses, and swallowing saliva during pulse taking, this is feigned illness. If the pulse is harmonious but the patient claims severe illness requiring emetics, purgatives, and hundreds of acupuncture points, this is also feigned illness. If a patient who usually has no appetite suddenly craves food, fever will likely occur. The physician says: Shoulder movement during respiration indicates firmness in the heart. Respiration drawing Qi upward from the chest indicates cough. Mouth-opening shortness of breath indicates Fei Wei (Lung Withering) with spittle. The physician says: Silent voice but frequent startling indicates disease in the joints. Hoarse and unclear voice indicates disease in the Heart and Diaphragm. Fine and long voice indicates disease in the head.
[Ma Jing] A pulse that stays long after one beat indicates disease in the Heart Master middle treatment. A pulse that stays long after two beats indicates disease in the Liver Branch middle treatment. A pulse that stays long after three beats indicates disease in the Spleen Lower Middle treatment. A pulse that stays long after four beats indicates disease in the Kidney Interior Middle treatment. A pulse that stays long after five beats indicates disease in the Lung Branch middle treatment. For these five pulse diseases, if seen in a wasted and emaciated person, death ensues. This is because medicine cannot treat it, and needles cannot reach it. Robust persons can be treated because their Qi is complete.