素问曰∶望而知之谓之神。闻而知之谓之圣。问而知之谓之工。切脉而知之谓之巧。灵
枢脏腑病形篇曰色青者其脉弦赤者其脉钩。黄者其脉代。白者其脉毛。黑者其脉石。见其色而不
得其脉。反得其相胜之脉则死也。得其相生之脉。则病已矣。又曰先定其五色五脉之应。其病
乃可别也。又曰赤色出两颊。大如拇指者。病虽小愈必卒死。黑色见于天庭。大如拇指。必
不病而卒死。又曰青黑为痛。黄赤为风。黄而膏润为脓。赤甚为血。白为寒。是为五色也。
又曰五色微诊。可以目察。能合色脉。可以万全。赤脉之至。喘而坚。诊有积气在中。时
害于食。名曰心痹。得之外疾思虑而心虚。故邪从之。白脉之至。喘而浮。上虚下实。兼有
积气在胸。喘而虚。名曰肺痹。寒热得之醉而使内也。青脉之至。长而左右弹。有积气在
心下
支。名曰肝痹。得之寒湿。与疝同法。腰痛足清。头脉紧。黄脉之至大而虚。有积气在腹
中。有厥气。名曰厥疝。女子同法。得之疾。使四支汗出当风。黑脉之至上紧而大。有积气
在小腹与阴。名曰肾痹。得之浴清水而卧。
又曰夫精明五色者气之华也。赤欲如帛裹朱。不欲如赭。白欲如鹅羽。不欲如监。青欲
如苍
璧之泽。不欲如蓝。黄欲如罗裹雄黄。不欲如黄土。黑欲如重漆色。不欲如地苍。五色精微
象见矣。寿不久也。夫五色者身之强也。头者精明之府。头倾视深。精神将夺矣。背者胸中
之府。背曲肩随。府将坏矣。腰者肾之府。转摇不能。肾将惫矣。膝者筋之府。屈伸不能。
行则偻附。筋将惫矣。骨者髓之府。不能久立。行则振掉。骨将惫矣。得强者生。失强者死
。
五脏之气败色见形。青如草滋。黄如枳实。黑如烟煤。赤如 血。白如枯骨。皆死也。
青如翠羽。赤如鸡冠。黄如蟹腹。白如豚膏。黑如乌羽。此皆生也。
青色见于太阴太阳及鱼尾正面口角。如大青蓝叶怪恶之状者。肝气绝死。若如翠羽柏皮
者。
只是肝邪。有惊风风病目病之属。红色见如唇口。及三阴三阳上下。如马肝之色。死血之状
者。心气绝死。若如橘红。马尾色者。只是心病。有怔忡及惊悸。夜卧不宁。白色见于鼻准
及正面。如枯骨。及擦残汗粉者。为肺绝。丙丁日死。若如腻粉梅花白绵者。只是肺邪。咳
嗽之病。有孝服之忧。黄色见于鼻。干燥若土偶之形。为脾气绝死。若如桂花杂以黑晕。只
是脾病。饮食不快四支倦怠妻外家之累。
黑色见于耳。或轮廓内外。命门悬壁。若污水烟煤之状。为肾绝则死。若如蜘蛛网眼乌
羽之泽者。只是肾虚火邪乘水之病。
凡望五色以知其病。如面青肝病。面赤心病。面黄脾病。面白肺病。面黑肾病。此知病
之属也。
凡相五色之奇脉。面黄目青。面黄目赤。面黄目白。面黄目黑者。皆不死。面青目青。
面赤
目白。面青目黑。面黑目白。面赤目青。皆死也。凡望病患目睛不了了。鼻中呼不出吸不出
。气短
促而冷者阴病也。病患目睛了了。鼻中呼吸出入。能往能来。口鼻息长而皆长者阳病也。
病患
及健人黑色。若白色起入目及口鼻。三日中死。久病患耳目及颧骨赤者。五日死。病患目无
精光。若土色。不受饮食。四日死。望病患两目 有黄色起者将愈。病患面目俱黄者不死。
病患面唇青黑者皆死。望健人及病患面如马肝色望之如青。近之如黑者死。
《素问》说：通过观察面色就能诊断疾病，称为“神”；通过听声音就能诊断疾病，称为“圣”；通过询问病情就能诊断疾病，称为“工”；通过切脉就能诊断疾病，称为“巧”。
《灵枢·脏腑病形篇》说：面色青的，其脉象应为弦脉；面色赤的，其脉象应为钩脉；面色黄的，其脉象应为代脉；面色白的，其脉象应为毛脉；面色黑的，其脉象应为石脉。如果见到某种面色却得不到相应的脉象，反而得到相克（相胜）的脉象，则预示死亡；如果得到相生之脉，则疾病将愈。又说：先确定五色与五脉的对应关系，才能辨别疾病。又说：两颊出现如拇指大小的赤色，即使病情轻微好转，也必然突然死亡；天庭出现如拇指大小的黑色，即使目前看似无病，也必然突然死亡。又说：青色和黑色主痛证；黄色和赤色主风证；黄色且光泽润泽主脓疡；赤色深重主血证；白色主寒证。这就是五色的主病规律。又说：对五色细微变化的诊察，可以用眼睛观察；若能结合面色与脉象进行综合判断，诊疗就可以万无一失。
赤脉到来时，急促而坚实，诊察发现胸中有积气，时常影响进食，名为心痹。这是由于外感邪气、思虑过度导致心气虚弱，所以邪气乘虚而入。白脉到来时，急促而浮浅，上部虚下部实，兼有积气在胸部，急促而虚弱，名为肺痹。这是由于醉酒行房所致。青脉到来时，脉长且左右弹指，有心下支撑胀满的积气，名为肝痹。这是由于感受寒湿所致，治疗方法与疝病相同，症状包括腰痛、足冷、头部脉紧。黄脉到来时，脉大而虚弱，腹中有积气，伴有厥逆之气，名为厥疝。女子患病机理相同。这是由于疾走时四肢出汗当风所致。黑脉到来时，脉上紧而下大，小腹与阴部有积气，名为肾痹。这是由于洗冷水澡后躺卧所致。
又说：目光精明、面色润泽是脏腑精气的外在表现。赤色应当像白绸包裹着朱砂那样红润含蓄，不应当像赭石那样暗红无光；白色应当像鹅羽毛那样洁白轻盈，不应当像镜子（或铜镜）那样苍白死板；青色应当像青玉那样温润有光泽，不应当像蓝草染料那样晦暗；黄色应当像丝绸包裹雄黄那样明润含蓄，不应当像黄土那样枯槁；黑色应当像多层漆涂过的颜色那样黑亮，不应当像苍黑色的土地那样干枯。如果五色中显露出精微败坏之象，寿命就不会长久。这五色反映身体的强弱状况。头是精神汇聚之所，如果头低垂、眼窝深陷，说明精神即将耗竭；背是胸中脏腑所在之处，如果背部弯曲、肩膀下垂，说明脏腑功能即将败坏；腰是肾脏所在之处，如果腰部转动困难，说明肾脏即将衰惫；膝是筋脉汇聚之处，如果屈伸不利，行走时弯腰驼背依附他物，说明筋脉即将衰惫；骨是骨髓所在之处，如果不能久立，行走时身体颤抖摇晃，说明骨骼即将衰惫。获得正气旺盛者生，失去正气旺盛者死。
五脏之气败绝时，面色出现在形体上：青色像枯死的草，黄色像枳实，黑色像烟煤，赤色像干血，白色像枯骨，这些都是死证。青色像翠鸟羽毛，赤色像鸡冠，黄色像蟹腹，白色像猪油，黑色像乌鸦羽毛，这些都属于生证。
青色出现在太阴、太阳经循行部位及鱼尾、正面、口角处，形状像大青蓝叶一样怪异可怖的，是肝气绝，主死；如果像翠鸟羽毛或柏树皮那样，只是肝经受邪，属于惊风、风病、目病之类。红色出现在嘴唇口舌及三阴三阳经脉上下，颜色像马肝一样暗沉，形状像死血的，是心气绝，主死；如果像橘红色或马尾色那样，只是心脏有病，表现为怔忡、惊悸、夜间睡眠不安。白色出现在鼻准头及面部正面，像枯骨或擦剩的汗粉那样惨白的，是肺气绝，丙丁日死；如果像腻粉、梅花白或白绵那样，只是肺经受邪，表现为咳嗽等疾病，可能伴有丧事之忧。黄色出现在鼻子，干燥得像土偶一样的，是脾气绝，主死；如果像桂花混杂着黑晕那样，只是脾脏有病，表现为饮食不佳、四肢倦怠以及家庭琐事劳累。
黑色出现在耳朵，或耳廓内外、命门、悬壁等处，像污水或烟煤一样黯淡的，是肾气绝，主死；如果像蜘蛛网眼或乌鸦羽毛那样有光泽的，只是肾虚火邪乘袭水脏的病证。
凡是观察五色来了解疾病，如面青主肝病，面赤主心病，面黄主脾病，面白主肺病，面黑主肾病。这是判断疾病所属脏腑的方法。
凡是观察五色与奇脉的配合：面黄而目青、面黄而目赤、面黄而目白、面黄而目黑的，都主不死；面青而目青、面赤而目白、面青而目黑、面黑而目白、面赤而目青的，都主死。凡是观察病患眼神昏花不明，鼻孔呼吸出入困难，气短促且冷的，是阴病；病患眼神清明，鼻孔呼吸出入顺畅，气息往来自如，口鼻呼吸长而均匀的，是阳病。
健康人或病患如果出现黑色，或者白色侵入眼睛及口鼻，三天内会死；长期患病的病患，如果眼睛、耳朵及颧骨发红，五天内会死；病患眼神没有光彩，面色像土色，不能进食，四天内会死；观察病患两眼周围有黄色出现的，预示将要痊愈；病患面目都发黄的，不会死。病患面唇青黑的，都主死。观察健康人或病患，面色像马肝色，远看像青色，近看像黑色的，主死。
The *Suwen* (Basic Questions) states: To know [the disease] through observation is called "Shen" (Divine); to know through hearing and smelling is called "Sheng" (Sage); to know through questioning is called "Gong" (Skilled); to know through palpation of the pulse is called "Qiao" (Clever).
The chapter "Zang-Fu Organs, Diseases, and Forms" in the *Ling Shu* (Spiritual Pivot) states: When the complexion is green, the pulse should be Xian (Wiry); when red, it should be Gou (Hook-like); when yellow, it should be Dai (Moderate/Intermittent); when white, it should as Mao (Feather-like); when black, it should be Shi (Stone-like). If one observes a certain complexion but does not find the corresponding pulse, and instead finds a pulse that overcomes [the complexion's element], death ensues. If one finds a pulse that generates [the complexion's element], the disease will resolve. It further states: First determine the correspondence between the Five Colors and the Five Pulses, then the disease can be distinguished. It also states: If redness appears on both cheeks, the size of a thumb, even if the illness is slightly improving, sudden death will occur. If blackness appears on the Tian Ting (Forehead), the size of a thumb, although seemingly healthy, sudden death will occur. It further states: Green and black indicate Pain; Yellow and Red indicate Wind; Yellow with luster indicates Pus; Intense Red indicates Blood stasis; White indicates Cold. These are the indications of the Five Colors. It further states: Subtle diagnosis of the Five Colors can be observed by the eye. By combining color and pulse analysis, one can achieve perfection in treatment.
When the Chi (Red) pulse arrives, rapid and firm, indicating accumulation of Qi in the middle jiao, occasionally hindering food intake, it is named Xin Bi (Heart Bi Syndrome). This results from external pathogens and excessive thinking leading to Heart Qi deficiency, allowing evil to enter. When the Bai (White) pulse arrives, rapid and floating, with emptiness above and fullness below, accompanied by accumulation of Qi in the chest, rapid and weak, it is named Fei Bi (Lung Bi Syndrome). This results from sexual activity while drunk. When the Qing (Green) pulse arrives, long and pulsating left and right, with accumulation of Qi supporting beneath the heart, it is named Gan Bi (Liver Bi Syndrome). This results from cold-dampness, treated similarly to Shan (Hernia), with symptoms of lower back pain, cold feet, and tight head pulses. When the Huang (Yellow) pulse arrives, large and weak, with accumulation of Qi in the abdomen and Jue Qi (Rebellious Qi), it is named Jue Shan. The mechanism is the same for women. This results from running vigorously with sweaty limbs exposed to wind. When the Hei (Black) pulse arrives, tight above and large below, with accumulation of Qi in the lower abdomen and yin organs, it is named Shen Bi (Kidney Bi Syndrome). This results from bathing in cold water and lying down.
It further states: Clear vision and bright complexion are the brilliance of Qi. Red should resemble white silk wrapping cinnabar (subtle and vibrant), not like hematite (dull and dark). White should resemble goose feathers (pure and light), not like a mirror (pale and lifeless). Green should resemble the luster of bluish jade (moist and clear), not like indigo dye (dark and muddy). Yellow should resemble raw realgar wrapped in silk (bright and contained), not like yellow earth (dry and dull). Black should resemble multiple layers of lacquer (deep and shiny), not like dark earth (dry and cracked). If the subtle images of the Five Colors reveal exhaustion, longevity will be short. The Five Colors reflect the strength of the body. The head is the mansion of Jing Shen (Spirit); if the head droops and eyes are sunken, Spirit is being depleted. The back is the mansion of the chest organs; if the back is curved and shoulders hang, the organs are failing. The waist is the mansion of the Kidneys; if turning and shaking is difficult, the Kidneys are exhausted. The knees are the mansion of the Sinews; if flexion and extension are impossible, and walking requires stooping or leaning, the Sinews are exhausted. The bones are the mansion of the Marrow; if standing for long periods is impossible, and walking causes trembling, the Bones are exhausted. Those who retain strength live; those who lose strength die.
When the Qi of the Zang organs fails, colors appear on the form: Green like dead grass, yellow like zhi shi (immature bitter orange), black like soot, red like dried blood, white like dry bones—all indicate death. Green like kingfisher feathers, red like rooster combs, yellow like crab bellies, white like pig fat, black like crow feathers—these all indicate life.
If green appears in the Tai Yin and Tai Yang regions, at the fish tail (outer canthus), face, or corners of the mouth, resembling the strange and ugly shape of large blue leaves, Liver Qi is exhausted, indicating death. If it resembles kingfisher feathers or cypress bark, it is merely Liver pathogenic factors, belonging to categories such as convulsions, wind diseases, or eye diseases. If red appears on lips and mouth, and along the three Yin and three Yang channels, resembling the color of horse liver and the appearance of dead blood, Heart Qi is exhausted, indicating death. If it resembles tangerine red or horse-tail color, it is merely Heart disease, manifesting as palpitations, fright, and restless sleep. If white appears on the nose tip and front face, resembling dry bones or leftover sweat powder, Lung Qi is exhausted, indicating death on Bing-Ding days. If it resembles fine powder, plum blossom white, or white cotton, it is merely Lung pathogenic factors, manifesting as coughs, possibly associated with mourning. If yellow appears on the nose, dry like a clay idol, Spleen Qi is exhausted, indicating death. If it resembles osmanthus flowers mixed with dark halos, it is merely Spleen disease, manifesting as poor appetite, limb fatigue, and domestic burdens.
If black appears in the ears, inside or outside the helix, Ming Men (Gate of Life), or Xuan Bi (hanging wall), resembling dirty water or soot, Kidney Qi is exhausted, indicating death. If it resembles spider webs or has the luster of crow feathers, it is merely Kidney deficiency with Fire evil attacking Water.
Generally, observing the Five Colors identifies the disease: Green face indicates Liver disease, Red face indicates Heart disease, Yellow face indicates Spleen disease, White face indicates Lung disease, Black face indicates Kidney disease. This is how to identify the organ involved.
Regarding the unusual combinations of Five Colors and Pulses: A yellow face with green eyes, red eyes, white eyes, or black eyes all indicate survival. A green face with green eyes, red face with white eyes, green face with black eyes, black face with white eyes, or red face with green eyes all indicate death. Observing patients with unclear vision, difficulty breathing in and out of the nose, short and cold breath indicates Yin disease. Patients with clear vision, smooth nasal breathing, free movement of Qi, and long, uniform oral/nasal breathing indicates Yang disease. If a healthy person or patient exhibits blackness, or whiteness invading the eyes and nose, death occurs within three days. In chronic patients, redness in the eyes, ears, and cheekbones indicates death within five days. Patients with eyes lacking luster, complexion like earth, and inability to eat, die within four days. If yellow rises around the eyes of a patient, recovery is imminent. Patients with yellow face and eyes do not die. Patients with blue-black face and lips die. Observing a healthy person or patient whose face resembles horse liver color, appearing green from afar and black up close, indicates death.