喻昌曰∶人之五官百骸，赅而存者，神居之耳。色者神之旗也，神旺则色旺；神衰则色衰；神藏则色藏；神露则色
露。帝王之色，龙文凤彩。神仙之色，岳翠山光。荣华之色，珠明玉润。寿 之色，柏古松苍。乃至贫夭之色，重浊晦
滞，枯索垩黧，莫不显呈于面。而病成于内者，其色之着见，又当何如？《内经》举面目为望色之要，谓面黄目青、面
黄目赤、面黄目白、面黄目黑者，皆不死。面青目赤、面赤目白、面青目黑、面黑目白、面赤目青，皆死。盖以黄为中
土之色，病患面目显黄色，而不受他色所侵则吉。面目无黄色，而惟受他色所侵则凶。虽目色之黄，湿深热炽，要未可
论于死生之际也。然五脏善恶之色，见于面者，额颊鼻颐，各有分部∶《刺热篇》谓肝热病者，左颊先赤。心热病者，额
先赤。脾热病者，鼻先赤。肺热病者，右颊先赤。肾热病者，颐先赤。病虽未发，见赤色者刺之，名曰治未病。是则五
脏分部，见于面者，在所加察，不独热病为然矣。然更有进焉，则目下之精明，鼻间之明堂是也。《经》谓精明五色者，
气之华也。是五脏之精华，上见为五色，变化于精明之间。某色为善，某色为恶，可先知也。谓容色见上下左右，各在
其要。是明堂上下左右，可分别其色之逆从，并可分别男女色之逆从，故为要也。察色之妙，无以加矣。仲景更出精微
一法，其要则在中央鼻准，毋亦以鼻准，在天为镇星，在地为中岳，木金水火四藏，病气必归并于中土耶。其谓鼻头色
青，腹中苦冷痛者死，此一语独刊千古。后人每恨《卒病论》亡，莫由上溯渊源，不知此语正其大旨也。盖厥阴肝木之
青色，挟肾水之寒威，上征于鼻，下征于腹，是为暴病，顷之亡阳而卒死耳。其谓鼻头色微黑者，有水气，又互上句之
意。见黑虽为肾阴之色，微黑且无腹痛，但主水气，而非暴病也。谓色黄者，胸上有寒，寒字《伤寒论》中，多指为痰，
言胸有积痰也。谓色白者亡血，白者肺之色，肺主上焦以行营卫，营不充则鼻色白，故知亡血也。谓设微赤非时者死，
火之色归于土，何遽主死？然非其时而有其气，则火非生土之火，乃克金之火，又主脏燥而死矣。次补察目一法，谓其
目正圆者 不治。次补察面五法，谓色青为痛，色黑为劳，色赤为风，色黄者便难，色鲜明者有留饮，黄色鲜明为留饮，
又即色黄者胸上有寒之互辞。语语皆表章《内经》，补其未备，故可法可传也。色之善者，青如翠羽，赤如鸡冠，黄如
蟹腹，白如豕膏，黑如乌羽。色之恶者，青如草兹，赤如 血，黄如枳实，黑如 ，白如枯骨。五脏有精华则色善，无
精
华则色恶，初非以青黑为大忌也。未病先见恶色，病必恶。《灵枢》谓赤色出于两颧，大如拇指，病虽小愈，必卒死。
黑色出于天庭，大如拇指，必不病而卒死，义与容色见明堂上下左右同，而此为暴病耳。若夫久病之色，必有受病之应。
肺热病者，色白而毛败应之。心热病者，色赤而络脉溢应之。肝热病者，色苍而爪枯应之。脾热病者，色黄而肉蠕动应
之。肾热病者，色黑而齿槁应之。夫病应其色，庸工亦多见之，然冀嘘枯泽槁于无益之日，较之治未病者，不啻倍蓰无
算矣。更有久见病色，其人原不病者，庸工且心炫而窃疑之，殊不知此络脉之色，不足畏也。盖阴络之色，随其经而不
变，色之变动无常者，皆阳络之色也。寒多则凝泣，凝泣则青黑。热多则淖泽，淖泽则黄赤。《内经》谓此皆无病，何
反怪之耶？然而察色之法，亦有其传。岐伯谓生于心，如以缟裹朱。生于肺，如以缟裹红。生于肝，如以缟裹绀。生于
脾，如以缟裹黄。生于肾，如以缟裹紫。缟，素白也，加于朱、红、绀、黄、紫之上，其内色耀映于外，若隐若见。
面色由肌内而透于外，何以异此？所以察色之妙，全在察神。血以养气，气以养神，病则交病。失睡之人，神有饥色。
丧亡之子，神有呆色，气索自神失所养耳。小儿布痘，壮火内动，两目先现水晶光。不俟痘发，大剂壮水以制阳光，俾
毒火一线而出，不致燎原，可免劫厄。古今罕及此者，因并志之。
【律一条】
凡诊病不知察色之要，如舟子不识风汛，动罹复溺，卤莽粗疏，医之过也。
喻昌说：人的五官和全身骨骼肌肉，能够完整保存的，是因为“神”在其中主宰。面色是神的旗帜，神气旺盛则面色旺盛；神气衰弱则面色衰弱；神气内藏则面色含蓄；神气外泄则面色暴露。帝王的面色，像龙纹凤彩一样尊贵；神仙的面色，像山岳翠色、山光一样清奇；荣华富贵者的面色，像珍珠明亮、玉石温润一样光泽；长寿者的面色，像古柏苍松一样青苍。至于贫贱短命者的面色，沉重浑浊、晦暗滞涩，干枯索然、灰白如粉，无不显现在脸上。而疾病在体内形成后，其面色的显露，又该是怎样的呢？《黄帝内经》举出面部和眼睛作为望诊的关键，说面色黄、目色青，或面色黄、目色赤，或面色黄、目色白，或面色黄、目色黑的人，都不会死。而面色青、目色赤，或面色赤、目色白，或面色青、目色黑，或面色黑、目色白，或面色赤、目色青的人，都会死。这是因为黄色是中央土的颜色，病患的面目显现黄色，而不被其他颜色侵犯，就是吉兆。面目没有黄色，而只受其他颜色侵犯，就是凶兆。虽然目色发黄，表示湿气深重、热势炽盛，但还不至于论及生死关头。然而五脏好坏的气色，反映在脸上的部位，额头、两颊、鼻子、下巴，各有分部：《素问·刺热篇》说肝热病，左颊先发红；心热病，额头先发红；脾热病，鼻子先发红；肺热病，右颊先发红；肾热病，下巴先发红。病虽然还没发作，见到红色就可以针刺治疗，这叫治未病。那么五脏的分部，反映在脸上，需要仔细考察，不仅仅热病是这样。更进一步说，还有眼下（目下）的“精明”穴和鼻间的“明堂”穴。《内经》说精明处的五色，是气的精华表现。这是五脏的精华，向上表现在面上成为五色，变化于精明之间。哪种颜色好，哪种颜色坏，可以预先知道。说容色出现在上下左右，各在其关键部位。这说明明堂的上下左右，可以分别颜色的顺逆，也可以分别男女颜色的顺逆，所以是关键。观察面色的奥妙，没有能超过这个的了。张仲景又提出一种精微的方法，关键在于鼻准（鼻尖），大概因为鼻准在天对应镇星（土星），在地对应中岳（嵩山），木、金、水、火四脏的病气，必然归并于中土吗？他说鼻头色青，腹中苦冷痛的是死证，这一句话独自刊行千古。后人常遗憾《卒病论》失传，无法上溯渊源，不知道这句话正是其大旨。大概是厥阴肝木的青色，挟带肾水的寒威，上征于鼻，下征于腹，这是暴病，不久就会亡阳而死。他说鼻头色微黑的，有水气，这又与上一句的意思互参。见黑色虽然是肾阴的颜色，但微黑且没有腹痛，只是主水气，而不是暴病。他说面色黄的，胸上有寒，这里的“寒”字在《伤寒论》中，多指为痰，是说胸中有积痰。他说面色白的，是亡血，白色是肺的颜色，肺主上焦以运行营卫，营血不充盈则鼻色白，所以知道是亡血。他说如果微红且不在正常时节出现的会死，火的颜色归于土，为什么就主死？然而不是那个时节却有那样的气，那么火就不是生土的温和之火，而是克金的燥烈之火，又主脏燥而死。其次补充观察眼睛的方法，说眼睛正圆直视不能转动的，难治。其次补充观察面部的五种方法，说色青为痛，色黑为劳损，色赤为风邪，色黄者大便困难，色鲜明者有留饮，黄色鲜明为留饮，这也就是前面“色黄者胸上有寒”的互文。句句都在表彰《内经》，补充其未备之处，所以值得效法传承。好的面色，青得像翠鸟羽毛，赤得像鸡冠，黄得像蟹腹，白得像猪油，黑得像乌鸦羽毛。坏的面色，青得像死草，赤得像凝血，黄得像枳实，黑得像地窖里的土，白得像枯骨。五脏有精华则面色好，无精华则面色坏，起初并不是以青黑为大忌。没病先出现恶色，病一定严重。《灵枢》说赤色出于两颧，大如拇指，病即使小愈，也必突然死亡。黑色出于天庭，大如拇指，必不病而突然死亡，义理与容色见于明堂上下左右相同，但这是暴病罢了。至于久病的面色，必有受病的应验。肺热病，色白而毛发败坏与之相应。心热病，色赤而络脉溢满与之相应。肝热病，色苍而指甲枯槁与之相应。脾热病，色黄而肌肉蠕动与之相应。肾热病，色黑而牙齿枯槁与之相应。病与面色相应，庸医也常见到，然而希望使枯槁者得到滋润是在无益的日子，比起治未病的人，不只多几倍而已。更有长期出现病色，其人原本没病的，庸医且心里眩惑而偷偷怀疑它，殊不知这是络脉的颜色，不值得畏惧。大概阴络的颜色，随着经脉而不改变，颜色变动无常的，都是阳络的颜色。寒多则凝涩，凝涩则青黑。热多则润泽，润泽则黄赤。《内经》说这些都没有病，为什么反而奇怪呢？然而察色的方法，也有传承。岐伯说生于心的，像用白绢包裹朱砂。生于肺的，像用白绢包裹红色。生于肝的，像用白绢包裹绀色。生于脾的，像用白绢包裹黄色。生于肾的，像用白绢包裹紫色。缟，是素白色的，加在朱、红、绀、黄、紫之上，里面的颜色照耀映现于外面，若隐若现。面色由肌内透发于外，怎么能与此不同呢？所以察色的奥妙，全在于察神。血来养气，气来养神，生病则交相生病。失眠的人，神有饥饿之色；丧子的人，神有呆滞之色，这是气索然自神失去滋养罢了。小儿出痘疹，壮火在内动，两眼先现水晶般的光泽。不等痘疹发出，用大剂量的壮水药物以制约阳光，使毒火一线而出，不致燎原，可免劫难。古今很少达到此境界的，因此一并记下。
【律一条】
凡是诊病不知道观察面色的关键，就像船夫不认识风向潮汐，动不动就遭遇覆灭，鲁莽粗疏，是医生的过错。
Yu Chang said: The five sense organs and the hundred bones of the human body are preserved intact because "Shen" (Spirit) resides within them. Facial complexion is the banner of Shen; when Shen is vigorous, the complexion is vigorous; when Shen is weak, the complexion is weak; when Shen is concealed, the complexion is reserved; when Shen is exposed, the complexion is revealed. The complexion of an emperor resembles the patterns of dragons and phoenixes. The complexion of an immortal resembles the emerald hue of mountains and the light of peaks. The complexion of the wealthy and glorious resembles the brightness of pearls and the luster of jade. The complexion of the long-lived resembles the dark green of ancient cypresses and pines. As for the complexions of the poor and short-lived, they are heavy, turbid, dull, and stagnant, dry and withered, grayish-white like whitewash, all manifesting on the face. How much more so would the manifestation of complexion be when disease forms internally? The *Neijing* (Inner Canon) highlights the face and eyes as the key to observing complexion, stating that those with a yellow face and blue/green eyes, or yellow face and red eyes, or yellow face and white eyes, or yellow face and black eyes, will not die. However, those with a blue/green face and red eyes, or red face and white eyes, or blue/green face and black eyes, or black face and white eyes, or red face and blue/green eyes, will die. This is because yellow is the color of the Central Earth. If the patient's face and eyes show yellow without being invaded by other colors, it is auspicious. If there is no yellow in the face and eyes, but only invasion by other colors, it is inauspicious. Although yellow eyes indicate deep dampness and blazing heat, it does not necessarily reach the point of death. However, the good and bad colors of the five Zang organs manifest in specific areas of the face: the forehead, cheeks, nose, and chin each have their respective divisions. The *Ci Re Pian* (Chapter on Acupuncture for Heat Diseases) states that for Liver Heat Disease, the left cheek turns red first; for Heart Heat Disease, the forehead turns red first; for Spleen Heat Disease, the nose turns red first; for Lung Heat Disease, the right cheek turns red first; for Kidney Heat Disease, the chin turns red first. Even if the disease has not yet manifested, seeing red allows for acupuncture treatment, which is called treating disease before it arises. Thus, the division of the five Zang organs on the face must be carefully observed, not just for heat diseases. Furthermore, there is the "Jing Ming" (Bright Spirit) area under the eyes and the "Ming Tang" (Bright Hall) on the nose. The Classics state that the five colors at Jing Ming are the brilliance of Qi. These are the essences of the five Zang organs, manifesting upward as five colors on the face, changing within the Jing Ming area. One can predict which color is good and which is bad. It is said that facial colors appearing in the upper, lower, left, and right positions each have their critical points. Therefore, the Ming Tang's upper, lower, left, and right areas allow one to distinguish the compliance or rebellion of colors, and also distinguish between male and female color patterns, making them critical. The subtlety of observing complexion cannot exceed this. Zhang Zhongjing further proposed a subtle method, focusing on the nose tip (Bi Zhun). Perhaps because the nose tip corresponds to the Star of Earth (Zhen Xing) in heaven and the Central Mountain (Zhong Yue) in earth, the pathological Qi of the Wood, Metal, Water, and Fire four Zang organs must converge into the Central Earth? He stated that a blue/green nose tip with bitter cold pain in the abdomen indicates death; this single phrase stands alone through the ages. Later generations often regretted the loss of the *Zu Bing Lun* (Treatise on Acute Diseases), unable to trace its origins, not knowing that this phrase embodies its main principle. Essentially, the blue/green color of Jueyin Liver Wood, carrying the cold power of Kidney Water, manifests upward on the nose and downward on the abdomen, indicating a sudden illness where Yang Qi perishes quickly leading to sudden death. He stated that a slightly black nose tip indicates Water Qi. This complements the previous sentence. Seeing black is the color of Kidney Yin, but slight blackness without abdominal pain primarily indicates Water Qi, not a sudden illness. He stated that a yellow complexion indicates Cold in the Upper Chest. In the *Shanghan Lun* (Treatise on Cold Damage), the character "Cold" often refers to Phlegm, meaning accumulated Phlegm in the chest. He stated that a white complexion indicates Loss of Blood. White is the color of the Lung. The Lung governs the Upper Jiao to circulate Ying (Nutritive) and Wei (Defensive) Qi. If Ying is insufficient, the nose appears white, thus indicating Loss of Blood. He stated that if there is slight redness out of season, it indicates death. Why does the Fire color returning to Earth indicate death? Because if the season is wrong but the Qi is present, the Fire is not the gentle Fire generating Earth, but the harsh Fire overcoming Metal, leading to Dryness of the Zang and death. Secondly, he supplemented the method of observing the eyes, stating that eyes fixed straight open without rotation are difficult to treat. Thirdly, he supplemented five methods of observing the face: Blue/Green indicates Pain; Black indicates Exhaustion/Labor; Red indicates Wind; Yellow indicates difficulty in defecation; Bright/Sheen indicates Retained Fluids. A bright yellow complexion indicates Retained Fluids, which is also a parallel expression to "Yellow complexion indicates Cold in the Upper Chest." Every word exalts the *Neijing* and supplements its omissions, making it worthy of emulation and transmission. Good complexions: Blue/Green like a kingfisher's feather, Red like a rooster's comb, Yellow like a crab's belly, White like pig fat, Black like a crow's feather. Bad complexions: Blue/Green like dead grass, Red like congealed blood, Yellow like the fruit of the Trichosanthes root, Black like soil in a cellar, White like dry bones. When the five Zang organs have essence, the complexion is good; when they lack essence, the complexion is bad. Initially, it is not that Blue/Green and Black are the greatest taboos. If bad colors appear before illness, the illness will surely be severe. The *Lingshu* (Spiritual Pivot) states that if Red appears on both malar bones, the size of a thumb, even if the illness seems to improve slightly, sudden death will follow. If Black appears on the Tian Ting (Forehead), the size of a thumb, sudden death will occur even without apparent illness. The meaning is the same as colors seen in the upper, lower, left, and right of the Ming Tang, but this refers to sudden illness. As for the complexions of chronic illnesses, there must be corresponding signs of the affected organ. For Lung Heat Disease, the complexion is white and hair deterioration corresponds to it. For Heart Heat Disease, the complexion is red and collateral vessels overflowing correspond to it. For Liver Heat Disease, the complexion is bluish-green and nail withering correspond to it. For Spleen Heat Disease, the complexion is yellow and muscle twitching correspond to it. For Kidney Heat Disease, the complexion is black and teeth withering correspond to it. That illness corresponds to complexion is commonly seen by mediocre physicians. However, hoping to moisten the withered on useless days is far inferior to treating disease before it arises, by many times over. Moreover, for those who long display pathological colors but are originally healthy, mediocre physicians may be confused and secretly doubt it. They do not know that these are colors of the collaterals and should not be feared. The colors of Yin Collaterals remain constant with the meridians, while the colors that change unpredictably are those of Yang Collaterals. Excess Cold causes stagnation and coagulation, resulting in Blue/Green and Black. Excess Heat causes moisture and lubrication, resulting in Yellow and Red. The *Neijing* states that these indicate no illness; why then be surprised? However, the method of observing complexion has its transmission. Qibo stated that colors originating from the Heart resemble Cinnabar wrapped in white silk. Colors from the Lung resemble Red wrapped in white silk. Colors from the Liver resemble Cyan wrapped in white silk. Colors from the Spleen resemble Yellow wrapped in white silk. Colors from the Kidney resemble Purple wrapped in white silk. Silk is pure white. Placed over Cinnabar, Red, Cyan, Yellow, and Purple, the inner colors shine outward, appearing faintly visible. Facial complexion penetrates from the muscles outward; how is this different? Therefore, the subtlety of observing complexion lies entirely in observing Shen. Blood nourishes Qi, and Qi nourishes Shen. Illness causes mutual affliction. Those who lose sleep have a look of spiritual hunger. Those who have lost children have a look of spiritual呆滞 (dullness/stupor). This is because Qi is depleted and Shen loses its nourishment. In infants suffering from smallpox, vigorous Fire moves internally, and the eyes first reveal a crystal-like luster. Before the rash erupts, using large doses of herbs to tonify Water to control Solar Fire allows the toxic fire to exit in a single thread, preventing it from spreading uncontrollably, thereby avoiding disaster. Few throughout history have reached this level, so I record it together.
[Rule One]
Any physician who diagnoses illness without understanding the key to observing complexion is like a boatman who does not recognize wind and tides, frequently encountering shipwrecks due to recklessness and carelessness. This is the fault of the physician.