是故圣人视其颜色∶黄赤者多热气，青白者少热气，黑
色者多血少气。青黑为痛，黄赤为热，白为寒，薄泽为风，冲浊为痹，沉浊为内，浮泽为外。
大气入于脏腑者，不病而卒死，何以知之？曰∶赤色出两颧，大如拇指者，病虽小愈，必卒死。黑色出
于庭，大如拇指，必不病而卒死也。（上论五色所主之病。经曰∶大气入脏，腹痛下
淫，谓周身元气皆内陷也，故可以知死，不可以致生。）
何以知皮肉气血筋骨之病也？曰∶色起两眉薄泽者，病在皮肤。唇色青黄赤白黑者，病在肌肉。营
气霈然者，病在血脉。目色青黄赤白黑者，病在筋。耳焦枯如受尘垢者，病在骨。
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。五脏各有次舍，故五色之见于明堂，以候五脏之气，左右高下，各如其度也。
五痿者，生于大热也。肺热者，色白而毛败。心热者，色赤而络脉溢。肝热者，色苍而爪枯。脾热者，
色黄而肉蠕动。肾热者，色黑而齿槁。（上论五脏病色。）
色以应日，脉以应月，色之与脉，当参相应。见其色而不得其脉，反得相胜之脉者即死；
得相生之脉者病即自已。
假令色青，其脉当弦而急；色赤，其脉当浮大而散；色黄，其脉当中缓而大；色白，其脉当浮涩而短；色黑，
其脉当沉濡而滑。此所谓五色之与脉参相应者也，其不应者病矣。假令色青，其脉浮涩而短，若大而缓为相胜；
浮大而散，若小而滑为相生也。
有故病，五脏发动，因伤脉色，各何以知其久暴至之病乎。曰∶征其脉小，色不夺者，新病也；征其
脉不夺，其色夺者，久病也；征其脉与五色俱夺者，此久病也；征其脉与
五色俱不夺者，新病也。肝与肾并至，其色苍赤，当病毁伤不见血；已见血，湿若中水也。
脉至如颓土之状，按之不得，是肌气予不足也。五色先
见黑白，垒（即 字。）发死。（按∶此浮濡而芤，阳虚阴散，所谓脾气去胃，外归阳明也。）
尺脉数甚，筋急而见，此谓疹筋。腹急，白色黑色见，则病甚。（上论色脉相应。按∶此脉数字，似当
作急字解，谓紧敛急引而不舒和也。见，谓挺鼓于皮上也，此寒气深痼于筋中也，故曰疹筋，白黑色见，是寒凉
清肃之气，内连肝脏，克制生阳之气化，不得宣发也。）
溺黄赤，安卧者，黄胆。已食如饥者，胃疸。目黄者，黄胆。身痛而色微黄，齿垢黄，爪甲上黄，黄胆
也。（巢氏云∶身面发黄，舌下大脉起青黑色，舌强不能言者，名曰噤黄，心脾二脏瘀热所为
也。卒然发黄，心满气喘，命在顷刻者，名曰急黄。有得病即身面发黄者；有初不知是黄，死
后乃身面黄者，其候得病即发热心战者是也。）
癫疾始生，先不乐，头重痛，视举，目赤甚，作极，已而烦心。候之于颜，取手太阳、阳明、太阴，血
变而止。（钱仲阳云∶目直视而腮赤，肝心俱热，明日午间，预防惊搐，即此节义。上杂论疸癫。）
因此，圣人通过观察面色来判断病情：面色黄赤的，多体内热气盛；面色青白的，多体内热气少；面色黑的，多血多而气少。青色和黑色主痛证，黄色和赤色主热证，白色主寒证；色泽浅淡润泽的属风病，色泽深浊的属痹证，色泽沉滞的属内伤病，色泽浮露润泽的属外感病。
如果大气（指邪气或逆乱之气）侵入脏腑，人不会先表现出明显病症就突然死亡，怎么知道呢？回答说：如果赤色出现在两颧，大小如拇指，即使病情看似轻微好转，也必定会突然死亡。如果黑色出现在天庭（前额中央），大小如拇指，必定在未发病时就突然死亡。（以上论述五色所主之病。《内经》说：大气入脏，会导致腹痛、下利不止，这是因为周身元气全部内陷，所以可以预知死亡，但无法使其生还。）
怎么判断皮、肉、气血、筋、骨的病变呢？回答说：面色在两眉间出现浅淡润泽的，病在皮肤。唇色呈现青、黄、赤、白、黑中的某一种颜色的，病在肌肉。营气运行盛大显露的，病在血脉。目色呈现青、黄、赤、白、黑中的某一种颜色的，病在筋。耳朵干枯焦黑像蒙受尘垢的，病在骨。
鼻子是肺的外窍。眼睛是肝的外窍；口唇是脾的外窍；舌头是心的外窍；耳朵是肾的外窍。所以，肺病患者，会出现喘息、鼻翼扇动；肝病患者，面色发青；脾病患者，口唇发黄；心病患者，舌体卷缩短小，颧部发红；肾病患者，颧部和颜面发黑。五脏各有其对应的部位，所以五色显现于明堂（鼻部），用来候察五脏之气，左右高低，各有一定的法度。
五种痿证，是由大热引起的。肺热者，面色白且毛发枯败。心热者，面色赤且络脉充盈溢出。肝热者，面色苍青且指甲枯槁。脾热者，面色黄且肌肉跳动。肾热者，面色黑且牙齿枯槁。（以上论述五脏病的病色。）
面色对应太阳，脉象对应月亮，面色与脉象应当参合相应。看到面色却诊不到相应的脉象，反而得到相克（相胜）的脉象的，就会死亡；得到相生脉象的，疾病自然痊愈。
假如面色青，脉象应当弦而急；面色赤，脉象应当浮大而散；面色黄，脉象应当中缓而大；面色白，脉象应当浮涩而短；面色黑，脉象应当沉濡而滑。这就是所说的五色与脉象参合相应的情况，如果不相应就是病了。假如面色青，脉象却浮涩而短，或者大而缓，这是相克（相胜）的关系；如果出现浮大而散，或者小而滑，这是相生的关系。
如果有旧病，五脏功能发动，因而损伤了脉象和面色，各怎样辨别是新病还是久病呢？回答说：征验其脉象细小，但面色没有衰败的，是新病；征验其脉象没有衰败，但面色衰败的，是久病；征验其脉象与五色都衰败的，这是久病；征验其脉象与五色都不衰败的，是新病。肝脉与肾脉同时搏动，面色苍中带赤，应当是有外伤瘀血但未见出血的症状；如果已经见血，则是湿邪或中水毒所致。
脉象来得像颓土一样松软，按之不得，这是肌气不足的表现。五色先出现黑白相间，垒积不散，将会死亡。（按语：这属于浮濡而芤的脉象，阳虚阴散，所谓脾气离去胃，外归于阳明经。）
尺部脉数疾严重，筋脉拘急显现，这称为疹筋。腹部拘急，如果面色出现白色或黑色，则病情加重。（以上论述色脉相应。按语：此处的“数”字，似乎应当解释为“急”字，指紧敛急引而不舒和的状态。“见”，指挺鼓于皮上，这是寒气深伏于筋中，所以称为疹筋。出现白黑色，是寒凉清肃之气，内连肝脏，克制生发阳气，导致不得宣发。）
小便黄赤，嗜睡安卧的，是黄疸。吃完饭却感觉像饿一样的，是胃疸。眼睛黄的，是黄疸。身体疼痛且面色微黄，齿垢黄，指甲上黄，都是黄疸的表现。（巢元方说：身面发黄，舌下大脉起青黑色，舌强不能言语的，名叫噤黄，是心脾二脏瘀热所致。突然发黄，心满气喘，命在顷刻的，名叫急黄。有得病即身面发黄的；有起初不知道是黄疸，死后才身面发黄的，其症状是得病即发热、心中战栗的。）
癫疾刚开始发作时，先表现为不快乐，头重痛，视物向上翻，眼睛红得很厉害，极度疲惫，随后心烦意乱。在颜面部进行候察，取手太阳、手阳明、手太阴经穴治疗，直到血色改变为止。（钱乙说：目直视且腮部红赤，是肝心俱热，第二天中午，要预防惊厥抽搐，即为此节的含义。以上杂论黄疸和癫疾。）
Therefore, the sages judge the condition by observing facial color: Yellowish-red indicates abundant heat; bluish-white indicates scanty heat; black indicates abundant blood and scanty qi. Blue and black signify pain; yellow and red signify heat; white signifies cold. Pale and lustrous colors indicate wind disorders; deep and turbid colors indicate bi-syndromes (obstruction syndromes); dull and stagnant colors indicate internal disorders; floating and lustrous colors indicate external disorders.
If "Da Qi" (major pathogenic qi or rebellious qi) enters the Zang-Fu organs, death may occur suddenly without prior obvious symptoms. How is this known? It is said: If a red color appears on both malar eminences, the size of a thumb, even if the illness seems to be slightly improving, sudden death will inevitably follow. If a black color appears on the forehead (Ting), the size of a thumb, sudden death will occur before any illness manifests. (The above discusses diseases governed by the five colors. The Classic states: When Da Qi enters the Zang, it causes abdominal pain and profuse diarrhea, meaning that the vital qi of the whole body has collapsed inward; thus, death can be predicted, but life cannot be restored.)
How are disorders of the skin, flesh, blood vessels, sinews, and bones distinguished? It is said: A pale and lustrous color appearing between the two eyebrows indicates a disorder in the skin. Lips showing blue, yellow, red, white, or black colors indicate a disorder in the muscle layer. Manifestation of abundant Ying-Qi (nutritive qi) indicates a disorder in the blood vessels. Eyes showing blue, yellow, red, white, or black colors indicate a disorder in the sinews. Ears that are dry, withered, and blackened as if covered in dust indicate a disorder in the bones.
The nose is the opening of the Lung. The eyes are the opening of the Liver; the lips are the opening of the Spleen; the tongue is the opening of the Heart; the ears are the opening of the Kidney. Therefore, patients with Lung disorders exhibit panting and nasal flaring; those with Liver disorders have a bluish complexion; those with Spleen disorders have yellow lips; those with Heart disorders have a curled and short tongue with red malar eminences; and those with Kidney disorders have black malar eminences and facial complexion. Each Zang organ has its corresponding location. Thus, the five colors manifesting at Ming Tang (the nasal area) are used to inspect the qi of the five Zang organs, with left and right elevations following specific standards.
The five Wei syndromes (wasting-thirst syndromes) arise from excessive heat. Heat in the Lung presents with a white complexion and hair loss. Heat in the Heart presents with a red complexion and distended collateral vessels. Heat in the Liver presents with a bluish-green complexion and brittle nails. Heat in the Spleen presents with a yellow complexion and twitching muscles. Heat in the Kidney presents with a black complexion and dry teeth. (The above discusses pathological colors of the five Zang organs.)
Facial color corresponds to the Sun, and pulse corresponds to the Moon. Color and pulse should correspond with each other when examined together. If the color is observed but the corresponding pulse is not found, and instead a controlling (overcoming) pulse is obtained, death will ensue; if a generating pulse is obtained, the disease will resolve spontaneously.
For example, if the color is green/blue, the pulse should be wiry and rapid; if red, the pulse should be floating, large, and scattered; if yellow, the pulse should be moderate, slow, and large; if white, the pulse should be floating, choppy, and short; if black, the pulse should be deep, soft, and slippery. This is what is meant by the correspondence of the five colors and pulses. If they do not correspond, the person is ill. For instance, if the color is green/blue but the pulse is floating, choppy, and short, or large and slow, this represents a controlling relationship; if the pulse is floating, large, and scattered, or small and slippery, this represents a generating relationship.
In cases of chronic illness where Zang-Fu functions are activated, thereby affecting the pulse and color, how can one distinguish between new and old onset? It is said: If the pulse is small but the color has not faded, it is a new illness; if the pulse has not faded but the color has faded, it is an old illness; if both the pulse and the five colors have faded, it is an old illness; if neither the pulse nor the five colors have faded, it is a new illness. If the Liver and Kidney pulses are present simultaneously, and the complexion is bluish-red, it suggests injury or trauma without visible bleeding; if bleeding has occurred, it indicates dampness or water poisoning.
A pulse that feels like crumbling earth and vanishes upon pressure indicates insufficiency of muscle qi. If black and white colors appear first and accumulate, death will result. (Commentary: This refers to a floating, soft, and hollow pulse, indicating Yang deficiency and Yin dispersion, described as the Spleen qi departing from the Stomach and returning externally to the Yangming channel.)
A very rapid pulse at the Chi position (cun-kou) accompanied by visible tendon tension is called Zhen Jin (rash in tendons). Abdominal tension combined with white or black facial colors indicates severe disease. (The above discusses the correspondence of color and pulse. Commentary: The character "Shu" (rapid) here likely means "Ji" (urgent/tight), referring to a tight, constricted, and unrelaxed state. "Xian" (appear) refers to the tendons bulging under the skin, indicating deep-seated cold pathogen in the sinews. The appearance of white and black colors indicates cold, crisp, and肃 (clearing) qi connecting internally to the Liver, suppressing the generation of Yang qi and preventing its dissemination.)
Yellowish-red urine with lethargy and desire to lie down indicates Huang Dan (jaundice). Feeling hungry immediately after eating indicates Wei Dan (Stomach jaundice). Yellow eyes indicate Huang Dan. Body pain with a slightly yellow complexion, yellow dental plaque, and yellow nails all indicate Huang Dan. (Chao Yuan-fang states: Jaundice with yellowing of the body and face, prominent dark blue-black veins under the tongue, stiff tongue, and inability to speak is named Jin Huang (jaw-locking jaundice), caused by stasis-heat in the Heart and Spleen. Sudden jaundice with chest fullness, asthma, and imminent death is named Ji Huang (acute jaundice). Some develop jaundice immediately upon contracting the disease; others do not realize they have jaundice until after death, presenting with fever and cardiac tremors upon onset.)
At the onset of Dian Ji (epilepsy/madness), the patient first feels unhappy, experiences heavy head pain, upward gaze, intense redness of the eyes, extreme exhaustion, followed by mental restlessness. Diagnosis is made by observing the face, and treatment involves selecting points from the Hand Taiyang, Hand Yangming, and Hand Taiyin meridians, stopping when the blood color changes. (Qian Zhong-yang states: Upward staring eyes with red cheeks indicate heat in both the Liver and Heart; one must prevent convulsions around noon the next day, which aligns with the meaning of this section. The above miscellaneously discusses jaundice and epilepsy.)