雷公问于黄帝曰。五色独决于明堂乎。小子未知其所谓也。黄帝曰。明堂者。鼻也。阙者。眉间也。
庭者。颜也。蕃者。颊侧也。蔽者。耳门也。其间欲方大。去之十步。皆见于外。如是者。寿必中百
岁。
此承三十七章之五阅五使。复辨明五脏之气。见色于明堂。见脉于气口。察其色。切其脉。以知
病之间甚。人之寿夭也。五阅章曰。五官已辨。阙庭必张。乃立明堂。明堂广大。蕃蔽见外。方壁高
基。引垂居外。五色乃治。平博广大。寿中百岁。故帝复释之曰。明堂者。鼻也。阙者。眉间也。庭者。
颜者。蕃者。颊侧也。蔽者。耳门也。其间欲方大。去之十步。皆见于外。如是者寿必中百岁。盖言
面部之形色。应天地之形气。欲其清明而广浓也。夫五脏生于地之五行。地之五行。上呈天之五色。及三
阴三阳之六气。故色见于明堂。脉出于气口。乃五脏之气。见于色而应于脉也。故曰五气者。五脏之使
也。五时之副也。气口者。左之人迎。右之寸口。所以候三阴三阳之气。三阴三阳者。五脏六腑之气也。
朱氏曰。按五藏生成篇云。凡相五色之奇脉。面黄目青。面黄目赤。面黄目白。面黄目黑者。皆不死也。
面青目赤。面赤目白。面青目黑。面黑目白。面赤目青。皆死也。盖五脏之气色见于面。五脏之血色
见于目也。脉要精微论曰。尺外以候肾。中附上。左外以候肝。右以候脾。上附上。右外以候
肺。左外以候心。是五脏之有形。候见于左右三部之寸关尺。五脏之气。候见于气口也。故曰脉之浮
沉。及人迎与寸口气小大等者病难已。此五脏之形气。各有所候也。夫天地之生命。所以立形定气。故
视人之寿夭。决病之死生者。必明乎此。
雷公曰。五官之辨奈何。黄帝曰。明堂骨高以起。平以直。五脏次于中央。六腑挟其两侧。首面上
于阙庭。王宫在于下极。五脏安于胸中。真色以致。病色不见。明堂润泽以清。五官恶得无辨乎。（恶叶乌）
五官者。五脏之外候也。明堂者。鼻也。鼻之准骨。贵高起而平直者也。五脏次于中央。阙庭之
中。肺也。阙下者。心也。直下者。肝也。再下者。脾也。脏为阴而主中。故候次于中央也。六腑挟其两侧。
肝左者。胆也。方上者。胃也。中次者。大肠也。面王以上者。小肠也。面王以下者。膀胱子处也。腑
为阳而主外。故位次于两侧也。肾为水脏。故挟大肠而位于蕃蔽之外。应地居中而海水之在外也。首面上于
阙庭。王宫在于下极。应天阙在上。王宫在下。有天地人之三部也。阙庭者。肺也。肺主天而居上也。极下者。
脾也。脾主地而居下也。王宫者。心之部也。心为君主而居中也。五脏安居于胸中。而脏真之色。致见于外。
五官恶得无辨乎。
雷公曰。其不辨者。可得闻乎。黄帝曰。五色之见也。各出其色部。部骨陷者。必不免于病矣。其色部乘
袭者。虽病甚不死矣。
朱永年曰。不辨者。谓不辨其真色。而辨其病色也。五色之见。各出其色部者。谓五脏之病色。各见于本
部也。刺热论曰。色荣颧骨。热病也。部骨陷者。谓本部之色。隐然陷于骨间者。必不免于病矣。盖病生于
内者。从内而外。色隐现于骨者。病已成矣。承袭者。谓子袭母气也。如心部见黄。肝部见赤。肺部见黑。肾部见
青。此子之气色承袭于母部。虽病甚不死。盖从子以泄其母病也。
雷公曰。官五色奈何。黄帝曰。青黑为痛。黄赤为热。白为寒。是为五官。
倪冲之曰。此察五部之色。而知外淫之病也。青黑者。风寒之色。故为痛。黄赤者。火土之色。
故为热。白者。清肃之气。故为寒。是为五色之所司。而为外因之病也。莫子瑜曰。上节论五脏之病色。
各出其部。此论天之风寒。见于五色。审别外内。是为良工。
雷公曰。病之益甚。与其方衰如何。黄帝曰。外内皆在焉。切其脉口。滑小紧以沉者。病益甚在中。
人迎气大紧以浮者。其病益甚在外。其脉口浮滑者。病日进。人迎沉而滑者。病日损。其脉口滑而沉者。
病日进。在内。其人迎脉滑盛以浮者。其病日进在外。脉之浮沉及人迎与寸口气小大等者。病难已。病
之在脏。沉而大者易已。小为逆。病在腑。浮而大者。其病易已。人迎盛坚者。伤于寒。气口盛坚者。
伤于食。
此切其脉口人迎。以知病之间甚外内也。夫外因之病。从外而内。自阳而阴。内因之病。从内而外。
由阴而阳。脉口主内。人迎主外。故曰外内皆在。谓候其脉口人迎。而外感内伤之病。皆可以知其甚
衰也。故切其脉口滑小紧以沉者。病甚在内也。人迎气大紧以浮者。病甚在外也。夫浮为阳。沉为阴。其
脉口浮滑者。阳气在阴。故病主日进。人迎沉而滑者。阴气出阳。故病日损也。其脉口滑以沉者。病日
进在内也。其人迎滑以浮者。病日进在外也。脉之浮沉。谓左右寸关尺三部之脉。与人迎寸口之气。大
小浮沉等者。此脏腑之形气俱病。故
为难已。病之在脏。沉而大者。此阴病见阳脉。故为易已。是以小则为逆病在腑浮而大者。阳病在外。
故其病易散也。人迎主外。是以人迎盛坚者伤于寒。病因于外也。气口主中。是以气口盛坚者伤于食。
病因于内也。人迎气口。主脏腑阴阳之气。故候其两脉。而外内之病皆在焉。
雷公曰。以色言病之间甚奈何。黄帝曰。其色粗以明。沉夭者为甚。其色上行者病益甚。其色下
行如云彻散者病方已。五脏各有脏部。有外部。有内部也。色从外部走内部者。其病从外走内。其色从
内走外者。其病从内走外。病生于内者。先治其阴。后治其阳。反者益甚。其病生于阳者。先治其外。
后治其内。反者益甚。
朱永年曰。此察其色。而知病之间甚外内也。粗明主阳。沉大主阴。阴阳交见。故为病甚。夫色乃
五脏五行之气。从内而出。自下而上。以见于面。其色上行者。病气方殷。故为益甚。夫地气升而为云。
得天气降而彻散。故病方已也。脏部。脏腑之分部也。五脏次于中央为内部。六腑挟其两侧为外部。色
从外部走内部者。外因之病。从外走内也。其色从内走外者。内因之病。从内走外也。盖腑为阳而主外。
脏为阴而主内也。故病生于内者。先治其阴。后治其阳。反者益甚。其病生于阳者。先治其外。后治其
内。反者益甚也。
其脉滑大以代而长者。病从外来。目有所见。志有所恶。此阳气之并也。可变而已。
承上文而言气分之病。并于血脉也。上文之所谓阴阳外内者。病在气也。故脉见于气口。色见于明
堂。若气并于血。则脉见寸关尺之三部。而色见于目矣。滑者。寒水之象。大者。暑热之象。代者。湿土
之象。长者。风木之象。此外因风寒暑湿之气。并于血脉而见此胗。故曰以代。曰而长。谓或滑大。或
代或长。皆病从外来。非四气
之同并。而同见此脉也。目有所见者。色见于目也。志有所恶者。五脏之神志。有所不安也。此阳气
之并也可变而已。谓先治其外后治其内。使之通变于外而病可已也。
雷公曰。小子闻风者。百病之始也。厥逆者。寒湿之起也。别之奈何。黄帝曰。常候阙中。薄泽
为风。冲浊为痹。在地为厥。此其常也。各以其色言其病。
地者。面之下部。名地阁也。风乃天气。故常候于阙庭。寒湿者地气。故候在地部。风乃阳邪。故
其色薄泽。寒湿者阴邪。故其色冲浊。此承上启下之文。言风寒湿邪。可并于脉中。可入于脏腑。而为
卒死之不救。故邪风之至。疾如风雨。而为百病之长。故善治者治皮毛。其次治肌肤。其次治筋脉。
其次治脏腑。治脏腑者。半死半生也。是以医者当明于分部。审察外内。用阴和阳。用阳和阴。勿使邪
入于脏而成不救。斯谓之良工。而万举万当也。朱永年曰。气并于脉。则血脉传溜。大气入脏。不可以致
生。盖邪在血脉。尚可变而已。已入于脏。不亦晚乎。是故圣人之教人。察色辨脉。盖欲其不治已病
而治未病。不治已乱。治未乱也。倪冲之曰。扁鹊望见桓侯之色。正欲其治未病也。所谓未病者。病未
传溜于深隧也。
雷公曰。人不病卒死。何以知之。黄帝曰。大气入于脏腑者。不病而卒死矣。雷公曰。病小愈而
卒死者。何以知之。
黄帝曰。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。
此承上文而言外因内因之病。并于血脉而入脏者。皆为卒死也。大气入脏者。外淫之邪。入于脏
腑。故不病而卒死矣。不病者。无在外之形证也。病小愈而卒死者内因之病。脏腑相乘也。赤色出两
颧。黑色出于庭。即
下文之所谓肾乘心。心先病。肾为应。色皆如是。盖赤者火之色。黑者水之色也。小愈者。水济其
火也。卒死者。水淫而火灭也。盖五行之气。制则生化。淫胜则绝灭矣。夫病在气者。其色散而不聚。
乘于脉中者。其色聚而不散。大如拇指者。血脉之聚色也。肾脉注胸中。上络心。赤色出两颧者。肾
上乘心。而心火之气外出也。黑色出于庭者。肾乘心而心先病。肾为应而亦随之外出。故色皆如是。
皆如是者。色皆如拇指也。盖脏者藏也。五色之见于面者。五脏之气。见于色也。聚色外见者。脏真
之外泄也。倪冲之曰。水上乘心。则心先病。故曰病。曰小愈。肾气上乘。则自虚其本位矣。复为后
应而上出。故不病而卒死。不病者。不为他脏所乘而自脱也。
朱永年曰。五行之气。有相生。有承制。制则生化。胜制太过。则绝灭矣。故病之小愈者。制则
生化也。小愈而卒死者。胜制太过也。举心肾而五脏皆然。高士宗曰。庭者天庭也。水通于天。上
下环转。黑色出于庭。乃水归于天。而无施转之机矣。在人则卒死。在天为混 。
雷公再拜曰。善哉。其死有期乎。黄帝曰。察色以知其时。雷公曰善乎。愿卒闻之。黄帝曰。庭
者。首面也。阙上者。咽喉也。阙中者。肺也。下极者。心也。直下者。肝也。肝左者。胆也。下者。
脾也。方上者。胃也。中央者。大肠也。挟大肠者。肾也。当肾者。脐也。面王以上者。小肠也。面
王以下者。膀胱子处也。颧者。肩也。颧后者。臂也。臂下者。手也。目内 上者。膺乳也。挟绳而
上者。背也。循牙车以下者。股也。中央者。膝也。膝以下者。胫也。当胫以下者。足也。巨分者。股
里也。巨屈者。膝膑也。此五脏六腑肢节之部也。各有部分。有部分。用阴和阳。用阳和阴。当明部
分。万举万当。能别左右。是谓大道。男女异位。故曰阴阳。
察色以言其时者。察五脏五行之色。以知
所死之时也。如赤色出于两颧者。所死之期。其日壬
癸。其时夜半也。黑色出于庭而死者。其日戊己。其时辰戌。丑未时也。脏腑各具五行之色。各有所
主之部。故当明其部分。用阴和阳。用阳和阴。阴阳和调。万举万当矣。左右者。阴阳之道路。阳从
左。阴从右。能别左右。是谓天地之大道。男子之色。从左而右。女子之色。从右而左。男女异位。故
曰阴阳。倪冲之曰。男从左。女从右。气之顺也。顺则散。如男从右。女从左。气之逆也。逆则聚。
聚则有胜克绝灭之患。此节论内因之色。有阴阳左右死生逆顺之分。
审察泽夭。谓之良工。沉浊为内。浮泽为外。黄赤为风。青黑为痛。白为寒。黄而膏润为脓。赤
甚者为血。痛甚为挛。寒甚为皮不仁。五色各见其部。察其浮沉。以知浅深。察其泽夭。以观成败。
察其散抟。以知远近。视色上下。以知病处。积神于心。以知往今。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。
此言审察其色。以知外因之病也。沉浊为内。浮泽为外。谓外因之病。从外而内。察其色之浮沉。
则知病之外内也。风乃天之阳邪。故色见黄赤。痛为阴痹。故色见青黑。色白为寒。色黄而膏润为痈脓。
赤甚者为留血。痛在筋骨。故甚则为拘挛。寒伤皮肤。故甚为皮不仁。此外因之邪。见于五色。而各见
其部。察其色之浮沉。以知病之浅深。察其色之泽夭。以观人之成败。察其色之散抟。以知病之远近。
视其色之上下。以知病之所在。夫色脉者。上帝之所贵。先师之所传也。上古使僦贷季理色脉而通神明。
合之四时五行。八风六合。不离其常。
是以积神于心。然后以知往古来今。故相气不微。不知是非。属意勿去。乃知新故。若色明不粗。而反
见沉夭者。其病为甚。其色虽不明泽。而不沉夭者。其病不甚。盖外因之病。宜从外散。而不宜内入也。
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。
此复申明内因之病。有聚散死生之别。夫脏病之散而不聚。则其色散如驹驹然而病未有聚也。若
抟聚于脏。血脉相乘。则见抟聚之色。而为卒死之病矣。驹驹然者。如驹之过隙。行而不留者也。其色行
雷公向黄帝问道：“面部的五色诊断，难道只取决于明堂（鼻部）吗？我不太明白其中的含义。”
黄帝说：“明堂，就是鼻子。阙，就是两眉之间。庭，就是前额。蕃，就是脸颊两侧。蔽，就是耳门。这些部位之间的区域应当方正宽大，在十步之外都能看清。具备这种面部特征的人，寿命必定能活到百岁。”
这是承接第三十七章中关于“五阅”和“五使”的论述，进一步辨析五脏之气显现于明堂的颜色，脉象显现于气口（手腕寸口处）的情况。通过观察颜色、切按脉象，来了解疾病的轻重缓急以及人的寿夭。《五阅五使》篇中说：“五官已经分辨清楚，阙庭开阔张开，才能确立明堂的地位。明堂广大，蕃蔽显露在外，方壁高基，垂肉居外，五色调和。平坦宽阔广大，寿命可达百岁。”所以黄帝再次解释说道：明堂是鼻子，阙是眉间，庭是前额，蕃是颊侧，蔽是耳门。它们之间的区域要方正宽大，在十步之外都能看见。具备这种特征的人寿命必达百岁。这说的是面部的形色，应合天地的形气，要求清明而广厚。因为五脏生于地之五行，地之五行上呈天之五色，以及三阴三阳的六气。所以颜色显现于明堂，脉象出于气口，这是五脏之气，显现在颜色上并应于脉象。所以说，“五气”是五脏的使者，“五时”的副手。气口，左边是人迎穴（此处指左手关前一分或泛指左脉），右边是寸口（右手关前一分或泛指右脉）。用来候察三阴三阳之气。三阴三阳，就是五脏六腑之气。朱氏说：“按照《五脏生成篇》所说：凡是观察五色与奇脉的配合，面色黄目青、面色黄目赤、面色黄目白、面色黄目黑的，都不会死。面色青目赤、面色赤目白、面色青目黑、面色黑目白、面色赤目青的，都会死。”这是因为五脏的气色显现于面部，五脏的血色显现于眼睛。《脉要精微论》说：“尺肤外侧以候肾，中部附上，左侧外侧以候肝，右侧以候脾；上部附上，右侧外侧以候肺，左侧外侧以候心。”这就是五脏有形之体，候察于左右三部（寸、关、尺）；五脏之气，候察于气口。所以说，脉象的浮沉，以及人迎与寸口气血大小相等者，病难治愈。这是五脏的形气，各有其候察的部位。天地赋予生命，以此确立形体、定住气机。所以要视断人的寿夭、决断病的死生，必须明了这个道理。
雷公说：“如何辨别五官？”
黄帝说：“明堂（鼻部）骨骼高起，平坦而直。五脏依次排列在中央，六腑夹在两侧。首面之气上应于阙庭，王宫（心）位于下极（鼻尖下方）。五脏安守于胸中，真色呈现，病色不现，明堂润泽清明，五官怎能不分辨清楚呢？”（“恶”读作 wū，意为怎么、哪里）
五官，是五脏的外在征候。明堂，就是鼻子。鼻子的准骨，贵在高起而平直。五脏依次排列在中央，即阙庭之中为肺，阙下为心，正下方为肝，再往下为脾。脏属阴而主内，所以候察位置次于中央。六腑夹在两侧，肝左侧为胆，方上（鼻翼上方）为胃，中间次位为大肠，面王（鼻尖）以上为小肠，面王以下为膀胱和子宫。腑属阳而主外，所以位置次于两侧。肾为水脏，所以夹在大肠之外，位于蕃蔽之外，对应大地居中而海水在外。首面之气上应于阙庭，王宫位于下极，对应天阙在上，王宫在下，有天、地、人三部。阙庭对应肺，肺主天而居上；极下对应脾，脾主地而居下；王宫对应心，心为君主而居中。五脏安居于胸中，而脏真之色，显现于外，五官怎能不分辨清楚呢？
雷公说：“那些不能分辨的情况，可以讲给我听吗？”
黄帝说：“五色的显现，各自出自其所属的色部。如果该部位的骨骼凹陷，必然不免于患病。如果该部位的颜色相互乘袭（如子部见母部之色等），即使病重也不会死。”
朱永年说：“所谓‘不辨’，是指不能分辨真色，而只能分辨病色。‘五色之见，各出其色部’，是说五脏的病色，各自出现在本脏腑对应的部位。《刺热论》说：‘色荣颧骨，热病也。’‘部骨陷者’，是指本部的颜色，隐约陷于骨间，必然不免于患病。大概病生于内部的，从内向外发展，颜色隐现于骨间，说明病已成。‘承袭’，是指子气承袭母气。例如在心部见到黄色，在肝部见到赤色，在肺部见到黑色，在肾部见到青色。这是子的气色承袭于母部，即使病重也不会死。大概是因为从子泄母病。”
雷公说：“如何根据五色判断疾病？”
黄帝说：“青色、黑色主痛；黄色、赤色主热；白色主寒。这就是五官（五色）的主病。”
倪冲之说：“这是通过观察五部的颜色，来了解外感邪气的疾病。青色、黑色，是风寒的颜色，所以主痛。黄色、赤色，是火土的颜色，所以主热。白色，是清肃之气，所以主寒。这是五色所主管的，属于外因引起的疾病。莫子瑜说：上一节论述五脏的病色，各自出现在本部；这一节论述天的风寒，显现于五色。审别内外，这才是高明的医生。”
雷公说：“病情加重和逐渐衰退，有什么区别？”
黄帝说：“无论是内伤还是外感，都可以通过脉象来判断。切按脉口（寸口），如果脉象滑小紧且沉，说明病势加重且在体内；人迎脉大紧且浮，说明病势加重且在体表。如果脉口脉象浮滑，说明病情每日进展；人迎脉象沉滑，说明病情每日减轻。如果脉口脉象滑而沉，说明病势每日进展且在体内；人迎脉象滑盛而浮，说明病势每日进展且在体表。脉象的浮沉，以及人迎与寸口气血大小相等者，病难治愈。病在脏，脉象沉而大的容易痊愈，脉象小的是逆证；病在腑，脉象浮而大的，病容易痊愈。人迎脉盛坚，是伤于寒；气口脉盛坚，是伤于食。”
这是通过切按脉口和人迎，来了解疾病的轻重及内外。外感的病，从外向内，自阳入阴；内伤的病，从内向外，由阴出阳。脉口主内，人迎主外。所以说“外内皆在”，意思是候察脉口和人迎，外感内伤的病，都可以知道其轻重衰退。所以切按脉口，若滑小紧以沉，说明病甚在内部；人迎脉大紧以浮，说明病甚在外部。浮属阳，沉属阴。脉口浮滑，说明阳气在阴分，所以病主每日进展；人迎沉滑，说明阴气出阳分，所以病每日减轻。脉口滑而沉，病每日进展在内部；人迎滑而浮，病每日进展在外部。脉的浮沉，指左右寸关尺三部脉，与人迎寸口气的大小浮沉相等，这是脏腑的形气都病了，所以难治。病在脏，沉而大，这是阴病见阳脉，所以易愈；小则为逆。病在腑，浮而大，阳病在外，所以病易散。人迎主外，所以人迎盛坚者伤于寒，病因在于外；气口主中，所以气口盛坚者伤于食，病因在于内。人迎气口，主脏腑阴阳之气，所以候察这两部脉，内外之病就都在其中了。
雷公说：“通过颜色来判断疾病的轻重，是怎么回事？”
黄帝说：“颜色粗疏明亮的，病轻；颜色深沉枯夭的，病重。颜色向上发展的，病益重；颜色向下发展如云雾消散的，病将愈。五脏各有其脏部，有外部，有内部。颜色从外部走向内部的，病从外走内；颜色从内部走向外部的，病从内走外。病生于内部的，先治其阴，后治其阳，反之则病加重；病生于外部的，先治其外，后治其内，反之则病加重。”
朱永年说：“这是通过观察颜色，来了解疾病的轻重及内外。粗明主阳，沉大主阴，阴阳交见，所以病重。颜色是五脏五行之气，从内而出，自下而上，显现于面部。颜色向上发展的，病气正盛，所以病加重。地气升而为云，得天气降而彻散，所以病将愈。脏部，是脏腑的分部。五脏依次排列在中央为内部，六腑夹在两侧为外部。颜色从外部走向内部的，是外因之病，从外走内；颜色从内部走向外部的，是内因之病，从内走外。大概腑属阳而主外，脏属阴而主内。所以病生于内部的，先治其阴，后治其阳，反之则病加重；病生于外部的，先治其外，后治其内，反之则病加重。”
如果脉象滑大、代而长，说明病从外来。眼睛看到幻象，意志厌恶某些事物，这是阳气相并的结果，可以通过治疗改变而痊愈。
承接上文谈论气分的病，并入血脉。上文所说的阴阳内外，病在气分，所以脉见于气口，色见于明堂。如果气并入血，则脉见于寸关尺三部，而色见于眼睛。滑，是寒水的象；大，是暑热的象；代，是湿土的象；长，是风木的象。这是外因的风寒暑湿之气，并入血脉而出现这些脉象，所以说“代”、“而长”，意思是或滑大，或代或长，都是病从外来，并非四气同时并至而同见此脉。目有所见，是色见于目；志有所恶，是五脏的神志不安。这是阳气相并，可以先治其外后治其内，使其通变于外，病即可愈。
雷公说：“我听说风是百病之始，厥逆是寒湿之起，如何区分它们？”
黄帝说：“常候察阙中（眉间），颜色薄泽的是风，颜色冲浊的是痹，颜色沉滞于下部（地阁）的是厥。这是一般的规律。各自根据颜色来判断疾病。”
下部，指面之下部，名叫地阁。风乃天气，所以常候察于阙庭；寒湿者地气，所以候察在地部。风乃阳邪，所以颜色薄泽；寒湿者阴邪，所以颜色冲浊。这是承上启下的文字，说明风寒湿邪，可并于脉中，可入于脏腑，而导致猝死的不可救治。所以邪风到来，疾如风雨，为百病之长。所以善于治病的人，治皮毛；其次治肌肤；其次治筋脉；其次治脏腑；治脏腑者，半死半生。所以医者应当明于分部，审察内外，用阴和阳，用阳和阴，不要使邪气入脏而成不治之症，这才叫高明医生，万举万当。朱永年说：“气并入脉，则血脉传溜，大气入脏，不可以致生。大概邪在血脉，尚可变而已，已入于脏，不是晚了吗？所以圣人的教导人，察色辨脉，大概是想让人不治已病而治未病，不治已乱而治未乱。倪冲之说：扁鹊望见桓侯之色，正是想让他治未病。所谓未病，是病未传流于深隧。”
雷公说：“人不生病却突然死亡，怎么知道？”
雷公说：“病轻微却突然死亡的，怎么知道？”
黄帝说：“红色出现在两颧，大如拇指的，病虽然轻微，必定突然死亡。黑色出现在天庭，大如拇指的，必定不生病却突然死亡。”
这是承接上文而言外因内因之病，并入血脉而入脏的，都是猝死。大气入脏，是外淫之邪，入于脏腑，所以不生病却突然死亡。“不病”，是没有在外的形证。病小愈而卒死者，是内因之病，脏腑相乘。红色出现于两颧，黑色出现于天庭，即下文所说的肾乘心，心先病，肾为应，颜色都是这样。大概红色是火之色，黑色是水之色。小愈，是水济其火；卒死，是水淫而火灭。大概五行之气，制则生化，淫胜则绝灭。病在气者，其色散而不聚；乘于脉中者，其色聚而不散。大如拇指，是血脉聚色。肾脉注胸中，上络心。红色出现于两颧，是肾上乘心，而心火之气外出；黑色出现于天庭，是肾乘心而心先病，肾为应而亦随之外出，所以颜色都是这样。“皆如是”，是颜色都像拇指大小。大概脏者藏也，五色见于面，是五脏之气见于色。聚色外见，是脏真之外泄。倪冲之说：“水上乘心，则心先病，所以曰病，曰小愈。肾气上乘，则自虚其本位矣，复为后应而上出，所以不病而卒死。不病，是不为他脏所乘而自脱。”
朱永年说：“五行之气，有相生，有承制。制则生化，胜制太过，则绝灭。所以病之小愈，是制则生化；小愈而卒死，是胜制太过。举心肾而五脏皆然。高士宗说：庭是天庭，水通于天，上下环转。黑色出于庭，乃水归于天，而无施转之机矣。在人则卒死，在天为混沌。”
雷公再拜说：“好啊！死亡有期限吗？”
黄帝说：“通过观察颜色来知道时间。”
雷公说：“好啊！希望听完它。”
黄帝说：“庭，是首面。阙上，是咽喉。阙中，是肺。下极，是心。直下，是肝。肝左，是胆。下，是脾。方上，是胃。中央，是大肠。挟大肠，是肾。当肾，是脐。面王以上，是小肠。面王以下，是膀胱和子宫。颧，是肩。颧后，是臂。臂下，是手。目内眦上，是膺乳。挟绳而上，是背。循牙车以下，是股。中央，是膝。膝以下，是胫。当胫以下，是足。巨分，是股里。巨屈，是膝膑。这是五脏六腑肢节的分部。各有部分，有部分，用阴和阳，用阳和阴。当明部分，万举万当。能别左右，是谓大道。男女异位，故曰阴阳。”
察色以言其时，是察五脏五行之色，以知所死之时。如赤色出于两颧者，所死之期，是壬癸日，时间是夜半。黑色出于庭而死者，是戊己日，时辰是戌、丑、未时。脏腑各具五行之色，各有所主之部，所以当明其部分，用阴和阳，用阳和阴，阴阳和调，万举万当。左右，是阴阳的道路。阳从左，阴从右。能别左右，是谓天地之大道。男子的颜色，从左向右；女子的颜色，从右向左。男女异位，故曰阴阳。倪冲之说：“男从左，女从右，气之顺也。顺则散，如男从右，女从左，气之逆也。逆则聚，聚则有胜克绝灭之患。此节论内因之色，有阴阳左右死生逆顺之分。”
审察泽夭，称为良工。沉浊为内，浮泽为外。黄赤为风，青黑为痛，白为寒。黄而膏润为脓，赤甚者为血。痛甚为挛，寒甚为皮不仁。五色各见其部，察其浮沉，以知浅深。察其泽夭，以观成败。察其散抟，以知远近。视色上下，以知病处。积神于心，以知往今。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。
这是说审察其色，以知外因之病。沉浊为内，浮泽为外，谓外因之病，从外而内，察其色之浮沉，则知病之外内。风乃天之阳邪，故色见黄赤；痛为阴痹，故色见青黑；色白为寒；色黄而膏润为痈脓；赤甚者为留血；痛在筋骨，故甚则为拘挛；寒伤皮肤，故甚为皮不仁。此外因之邪，见于五色，而各见其部。察其色之浮沉，以知病之浅深；察其色之泽夭，以观人之成败；察其色之散抟，以知病之远近；视其色之上下，以知病之所在。夫色脉者，上帝之所贵，先师之所传也。上古使僦贷季理色脉而通神明，合之四时五行，八风六合，不离其常。是以积神于心，然后以知往古来今。故相气不微，不知是非。属意勿去，乃知新故。若色明不粗，而反见沉夭者，其病为甚。其色虽不明泽，而不沉夭者，其病不甚。盖外因之病，宜从外散，而不宜内入也。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。
这是再次申明内因之病，有聚散死生之别。夫脏病之散而不聚，则其色散如驹驹然而病未有聚也。若抟聚于脏，血脉相乘，则见抟聚之色，而为卒死之病矣。驹驹然者，如驹之过隙，行而不留者也。其色行
Lei Gong asked Huang Di, "Does the diagnosis of the five colors on the face depend solely on the Ming Tang (nose)? I do not understand what this means."
Huang Di said, "The Ming Tang is the nose. The Que is the area between the eyebrows. The Ting is the forehead. The Fan is the side of the cheeks. The Bi is the ear gate. The area between these parts should be square and large, visible from ten paces away. Those with such facial features will surely live to a hundred years."
This follows the discussion in Chapter 37 regarding the "Five Orifices" (Wu Yue) and "Five Envoys" (Wu Shi), further distinguishing the Qi of the Five Zang Organs manifesting as color in the Ming Tang, and the pulse manifesting at the Qi Kou (Cunkou). By observing the color and palpating the pulse, one can know the severity of the disease and the longevity or shortness of life. The chapter "Wu Yue Wu Shi" states: "Once the five orifices are distinguished, the Que and Ting must be open, thereby establishing the Ming Tang. If the Ming Tang is broad, the Fan and Bi are visible externally, the walls are square and high, and the hanging flesh is external, the five colors will be harmonious. Flat, smooth, broad, and large indicates a lifespan of a hundred years." Therefore, the Emperor explained again: The Ming Tang is the nose, the Que is the space between the eyebrows, the Ting is the forehead, the Fan is the cheek sides, and the Bi is the ear gate. The area between them should be square and large, visible from ten paces. Such people will surely live to a hundred years. This refers to the shape and color of the face corresponding to the form and Qi of Heaven and Earth, requiring clarity and breadth. Since the Five Zang Organs are born from the Five Elements of the Earth, and the Five Elements of the Earth present the Five Colors of Heaven, along with the Six Qi of the Three Yin and Three Yang, the color manifests in the Ming Tang and the pulse emerges from the Qi Kou. This is the Qi of the Five Zang Organs, manifesting in color and responding in the pulse. Thus it is said that the "Five Qi" are the envoys of the Five Zang Organs and the deputies of the Five Seasons. The Qi Kou, referring to the Ren Ying (Human Welcome) on the left and Cunkou (Inch Port) on the right, is used to observe the Qi of the Three Yin and Three Yang. The Three Yin and Three Yang are the Qi of the Five Zang and Six Fu Organs. Master Zhu said: "According to the 'Generation of Five Zang Organs' chapter: When observing the odd pulses of the five colors, if the face is yellow with green eyes, yellow face with red eyes, yellow face with white eyes, or yellow face with black eyes, none will die. If the face is green with red eyes, red face with white eyes, green face with black eyes, black face with white eyes, or red face with green eyes, all will die." This is because the Qi color of the Five Zang Organs manifests on the face, while the Blood color manifests in the eyes. The "Essential Requirements for Pulse Observation" chapter states: "The outer part of the Chi (尺) area observes the Kidney; moving inward to the middle, the left outer part observes the Liver, and the right observes the Spleen; moving upward to the upper part, the right outer part observes the Lung, and the left observes the Heart." This shows that the有形 (form) of the Five Zang Organs is observed in the Cun, Guan, and Chi positions of the left and right wrists, while the Qi of the Five Zang Organs is observed at the Qi Kou. It is said that when the floating and sinking of the pulse, and the size equality of the Ren Ying and Cunkou Qi occur, the disease is difficult to cure. This is because the form and Qi of the Five Zang Organs have their respective observation sites. Heaven and Earth endow life to establish form and fix Qi. Therefore, to judge longevity and determine the death or survival of a disease, one must understand this principle.
Lei Gong asked, "How should the five orifices be distinguished?"
Huang Di said, "If the bone of the Ming Tang (nose) is high and raised, flat and straight, the Five Zang Organs are arranged sequentially in the center, and the Six Fu Organs flank on both sides. The Qi of the head and face ascends to the Que and Ting. The Wang Gong (Palace of the King/Heart) is located at the Xia Ji (lower pole). The Five Zang Organs reside peacefully in the chest, the True Color appears, the Pathological Color is absent, and the Ming Tang is moist and clear. How could the five orifices fail to be distinguished?" (Note: 'E' is pronounced 'wu', meaning 'how').
The five orifices are the external manifestations of the Five Zang Organs. The Ming Tang is the nose. The cartilage of the nose is best when high, raised, flat, and straight. The Five Zang Organs are arranged sequentially in the center: within the Que and Ting is the Lung; below the Que is the Heart; directly downward is the Liver; further down is the Spleen. The Zang Organs belong to Yin and govern the interior, so their observation site is in the center. The Six Fu Organs flank on both sides: to the left of the Liver is the Gallbladder; above the square area (Fang Shang) is the Stomach; in the middle secondary position is the Large Intestine; above the Face King (Mian Wang/Nose Tip) is the Small Intestine; below the Face King is the Bladder and Uterus. The Fu Organs belong to Yang and govern the exterior, so their position is on the sides. The Kidney is the Water Organ, so it flanks the Large Intestine and is located outside the Fan and Bi, corresponding to the earth being central and the sea being external. The Qi of the head and face ascends to the Que and Ting, and the Wang Gong is at the lower pole, corresponding to the Heavenly Que above and the Wang Gong below, representing the three regions of Heaven, Earth, and Humanity. The Que and Ting correspond to the Lung, which governs Heaven and resides above; the lower pole corresponds to the Spleen, which governs Earth and resides below; the Wang Gong corresponds to the Heart, the Monarch, which resides in the center. The Five Zang Organs dwell peacefully in the chest, and the True Color of the Zang manifests externally. How could the five orifices fail to be distinguished?
Lei Gong asked, "Can you explain the cases where they cannot be distinguished?"
Huang Di said, "When the five colors appear, each emerges from its respective color region. If the bone of that region is depressed, the person will inevitably fall ill. If the colors in the regions invade or succeed each other (e.g., child organ showing mother organ's color), even if the disease is severe, the person will not die."
Zhu Yongnian stated: "By 'not distinguished,' it means failing to distinguish the True Color and only distinguishing the Pathological Color. 'The five colors appear, each emerging from its color region' means that the pathological colors of the Five Zang Organs appear in their respective regions. The 'Treating Heat' chapter says: 'Color shining on the zygomatic bone indicates heat disease.' 'Bone of the region depressed' means the color of the specific region is faintly sunken into the bone, indicating inevitable illness. Generally, diseases arising internally develop outward; when color appears faintly in the bone, the disease has already formed. 'Succession' refers to the Child Qi succeeding the Mother Qi. For example, seeing yellow in the Heart region, red in the Liver region, black in the Lung region, and green in the Kidney region. This is the Child's color succeeding the Mother's region. Even if the disease is severe, the person will not die, as the Child vents the Mother's disease."
Lei Gong asked, "How does one judge diseases by the five colors?"
Huang Di said, "Green and Black indicate Pain; Yellow and Red indicate Heat; White indicates Cold. These are the diseases governed by the five orifices (colors)."
Ni Chongzhi said: "This is observing the colors of the five regions to know diseases caused by external pathogens. Green and Black are the colors of Wind and Cold, hence indicating Pain. Yellow and Red are the colors of Fire and Earth, hence indicating Heat. White is the color of Clear and肃 (Solemn/Cooling) Qi, hence indicating Cold. These are what the five colors govern, constituting diseases caused by external factors. Mo Ziyu said: The previous section discussed the pathological colors of the Five Zang Organs appearing in their respective regions; this section discusses the Wind and Cold of Heaven appearing in the five colors. Distinguishing internal and external is the mark of a skilled physician."
Lei Gong asked, "What is the difference between the worsening of a disease and its gradual decline?"
Huang Di said, "Both internal and external conditions are involved. Palpate the Mai Kou (Cunkou): if the pulse is slippery, small, tight, and deep, the disease is worsening and located internally. If the Ren Ying pulse is large, tight, and floating, the disease is worsening and located externally. If the Mai Kou pulse is floating and slippery, the disease progresses daily. If the Ren Ying pulse is sinking and slippery, the disease diminishes daily. If the Mai Kou pulse is slippery and sinking, the disease progresses daily internally. If the Ren Ying pulse is slippery, vigorous, and floating, the disease progresses daily externally. When the floating and sinking of the pulse, and the size equality of the Ren Ying and Cunkou Qi occur, the disease is difficult to cure. For diseases in the Zang, a deep and large pulse indicates easy recovery; a small pulse is adverse. For diseases in the Fu, a floating and large pulse indicates easy recovery. A vigorous and firm Ren Ying pulse indicates injury by Cold; a vigorous and firm Qi Kou pulse indicates injury by food."
This involves palpating the Mai Kou and Ren Ying to know the severity and location (internal/external) of the disease. External diseases move from outside to inside, from Yang to Yin; internal diseases move from inside to outside, from Yin to Yang. The Mai Kou governs the interior, and the Ren Ying governs the exterior. Thus it is said "both internal and external are present," meaning by observing the Mai Kou and Ren Ying, one can know the severity and decline of both external infections and internal injuries. Therefore, if the Mai Kou pulse is slippery, small, tight, and deep, the disease is severe internally; if the Ren Ying pulse is large, tight, and floating, the disease is severe externally. Floating belongs to Yang, sinking to Yin. A floating and slippery Mai Kou pulse indicates Yang Qi in the Yin division, so the disease progresses daily. A sinking and slippery Ren Ying pulse indicates Yin Qi emerging to Yang, so the disease diminishes daily. A slippery and sinking Mai Kou pulse indicates disease progressing daily internally; a slippery and floating Ren Ying pulse indicates disease progressing daily externally. The floating and sinking of the pulse refer to the Cun, Guan, and Chi positions of the left and right wrists. When the size and floating/sinking of the Ren Ying and Cunkou Qi are equal, the form and Qi of the Zang and Fu organs are both diseased, making it difficult to cure. For Zang diseases, a deep and large pulse is Yin disease showing Yang pulse, hence easy to cure; small is adverse. For Fu diseases, a floating and large pulse is Yang disease in the exterior, hence easy to dissipate. The Ren Ying governs the exterior, so a vigorous and firm Ren Ying indicates injury by Cold, an external cause. The Qi Kou governs the interior, so a vigorous and firm Qi Kou indicates injury by food, an internal cause. The Ren Ying and Qi Kou govern the Yin and Yang Qi of the Zang and Fu organs; thus, by observing these two pulses, internal and external diseases are revealed.
Lei Gong asked, "How does one judge the severity of disease by color?"
Huang Di said, "Colors that are coarse and bright indicate mild disease; colors that are deep and withered indicate severe disease. Colors moving upward indicate worsening disease; colors moving downward like dispersing clouds indicate the disease is resolving. Each of the Five Zang Organs has its own region, with an external part and an internal part. If color moves from the external part to the internal part, the disease moves from outside to inside. If color moves from the internal part to the external part, the disease moves from inside to outside. For diseases arising internally, treat the Yin first, then the Yang; reversing this worsens the disease. For diseases arising externally, treat the exterior first, then the interior; reversing this worsens the disease."
Zhu Yongnian stated: "This is observing color to know the severity and location of the disease. Coarse and bright indicate Yang; deep and large indicate Yin. The intersection of Yin and Yang indicates severe disease. Color is the Qi of the Five Zang and Five Elements, emerging from within, rising from bottom to top, and manifesting on the face. Upward-moving color indicates flourishing pathogenic Qi, hence worsening. Earthly Qi rises to become clouds, and heavenly Qi descends to disperse them, hence the disease resolves. 'Zang Region' refers to the division of Zang and Fu organs. The Five Zang arranged in the center constitute the internal part; the Six Fu flanking on both sides constitute the external part. Color moving from external to internal indicates external pathogens moving inward; color moving from internal to external indicates internal pathogens moving outward. Generally, Fu organs are Yang and govern the exterior, while Zang organs are Yin and govern the interior. Thus, for diseases arising internally, treat Yin first, then Yang; reversing this worsens the disease. For diseases arising externally, treat the exterior first, then the interior; reversing this worsens the disease."
If the pulse is slippery, large, intermittent (Dai), and long, the disease comes from outside. Seeing visions and having aversions in will indicate the conjunction of Yang Qi, which can be changed and cured.
Continuing from the previous text discussing Qi-level diseases merging into the blood vessels: The previously mentioned Yin-Yang and internal-external referred to diseases in the Qi level, where pulse appears at the Qi Kou and color appears in the Ming Tang. If Qi merges into Blood, the pulse appears in the Cun, Guan, and Chi positions, and color appears in the eyes. Slippery represents Cold-Water imagery; large represents Summer-Heat-Fire imagery; Dai (intermittent) represents Wet-Earth imagery; long represents Wind-Wood imagery. These are the external pathogens of Wind, Cold, Summer-Heat, and Dampness merging into the blood vessels, producing these pulses. Hence "Dai" and "Long" mean either slippery-large or dai-long, all indicating disease coming from outside, not necessarily four pathogens simultaneously merging to produce this single pulse. "Seeing visions" means color appears in the eyes; "aversions in will" means the Shen (Spirit) of the Five Zang is unsettled. This is the conjunction of Yang Qi. It can be changed and cured by treating the exterior first and then the interior, allowing transformation externally so the disease resolves.
Lei Gong asked, "I have heard that Wind is the beginning of all diseases, and Jue Ni (Reversal Cold) arises from Cold-Dampness. How should they be distinguished?"
Huang Di said, "Always observe the Que Zhong (center of eyebrows). Thin and glossy color indicates Wind; turbid and muddy color indicates Bi Syndrome; color sunk in the lower part (Di Ge) indicates Jue. This is the general rule. Judge the disease according to the color."
The "Di" (Earth) refers to the lower part of the face, named Di Ge (Earth Pavilion). Wind is Heavenly Qi, so it is observed in the Que and Ting. Cold-Damp is Earthly Qi, so it is observed in the Di region. Wind is a Yang pathogen, so its color is thin and glossy. Cold-Damp is a Yin pathogen, so its color is turbid and muddy. This is transitional text stating that Wind-Cold-Damp pathogens can merge into the vessels, enter the Zang and Fu, and cause sudden death that cannot be saved. Thus, evil wind arrives swiftly like wind and rain, being the chief of all diseases. Therefore, the skilled healer treats the skin and hair first; next, the muscles and skin; next, the sinews and vessels; next, the Zang and Fu. Treating the Zang and Fu results in half-dead, half-alive outcomes. Thus, physicians must understand the regional divisions, examine internal and external conditions, use Yin to harmonize Yang, and use Yang to harmonize Yin, preventing evil from entering the Zang to become incurable. This is called a skilled physician, achieving success in every attempt. Zhu Yongnian said: "When Qi merges into vessels, blood vessels transmit smoothly; when Great Qi enters the Zang, life cannot be sustained. Generally, if evil is in the blood vessels, it can still be changed; once it enters the Zang, is it not too late? Therefore, the Sage teaches observing color and differentiating pulse, aiming to treat disease before it forms and disorder before it occurs. Ni Chongzhi said: Bian Que observing the color of Duke Huan was precisely to encourage treating disease before it forms. What is meant by 'before disease' is that the disease has not yet transmitted to the deep tunnels."
Lei Gong asked, "How can one know if a person who seems healthy will die suddenly?"
Huang Di said, "When Great Qi enters the Zang and Fu, the person dies suddenly without apparent illness."
Lei Gong asked, "How can one know if a person with a minor illness will die suddenly?"
Huang Di said, "If red color appears on both cheekbones, the size of a thumb, although the illness seems slightly better, sudden death will certainly occur. If black color appears on the Tian Ting (forehead), the size of a thumb, the person will die suddenly without prior illness."
This continues the previous discussion on external and internal diseases merging into blood vessels and entering the Zang, all leading to sudden death. Great Qi entering the Zang refers to external pathogenic evils entering the Zang and Fu, causing sudden death without prior symptoms. "No illness" means no external physical signs. Disease slightly improving followed by sudden death is an internal cause, involving mutual overacting of Zang organs. Red color on the cheekbones and black color on the forehead correspond to the following text: Kidney overacting on Heart, Heart sick first, Kidney responding. The colors are alike. Red is the color of Fire; Black is the color of Water. "Slightly better" means Water nourishes Fire; "sudden death" means Water excess extinguishes Fire. Generally, the Qi of the Five Elements, when regulated, generates and transforms; when excessive, it leads to extinction. Diseases in the Qi level have colors that scatter and do not gather; those invading the vessels have colors that gather and do not scatter. "Size of a thumb" refers to the gathered color in the blood vessels. The Kidney Meridian flows into the chest and connects to the Heart. Red color on the cheekbones indicates Kidney overacting on Heart, with Heart Fire Qi exiting externally. Black color on the forehead indicates Kidney overacting on Heart, Heart sick first, Kidney responding and also exiting externally, hence the colors are alike. "All alike" means the colors are all the size of a thumb. Generally, Zang means storing; the five colors appearing on the face are the Qi of the Five Zang manifesting in color. Gathered color appearing externally is the leakage of the True Zang Qi. Ni Chongzhi said: "When Water overacts on Heart, Heart gets sick first, hence 'disease' and 'slightly better'. When Kidney Qi overacts, it vacates its original position, then responds later and exits upward, hence dying suddenly without prior illness. 'No illness' means not overacted upon by other Zang but self-dissipating."
Zhu Yongnian said: "The Qi of the Five Elements has mutual generation and mutual control. Regulation leads to generation and transformation; excessive control leads to extinction. Thus, slight improvement in disease is regulation leading to transformation; slight improvement followed by sudden death is excessive control. Taking Heart and Kidney as examples applies to all Five Zang. Gao Shizong said: Ting is the Tian Ting (Heavenly Court). Water connects to Heaven, circulating up and down. Black color appearing on the Ting is Water returning to Heaven, losing the mechanism of circulation. In humans, this is sudden death; in Heaven, it is chaos."
Lei Gong bowed twice and said, "Excellent! Is there a time limit for death?"
Huang Di said, "Observe the color to know the time."
Lei Gong said, "Excellent! I wish to hear it completely."
Huang Di said, "The Ting is the head and face. Above the Que is the throat. In the center of the Que is the Lung. At the lower pole is the Heart. Directly below is the Liver. To the left of the Liver is the Gallbladder. Below is the Spleen. Above the Fang Shang is the Stomach. In the center is the Large Intestine. Flanking the Large Intestine is the Kidney. Opposite the Kidney is the Umbilicus. Above the Mian Wang (Nose Tip) is the Small Intestine. Below the Mian Wang is the Bladder and Uterus. The Zygoma is the shoulder. Behind the zygoma is the arm. Below the arm is the hand. Above the inner canthus is the chest and breast. Along the jawline upwards is the back. Following the jaw downwards is the thigh. In the center is the knee. Below the knee is the leg. Below the leg is the foot. Ju Fen is the groin. Ju Qu is the kneecap. These are the regions of the Five Zang, Six Fu, limbs, and joints. Each has its region. With regions, use Yin to harmonize Yang, and Yang to harmonize Yin. Clearly understanding the regions ensures success in every attempt. Distinguishing left and right is called the Great Dao. Men and women have different positions, hence called Yin and Yang."
Observing color to speak of time means observing the colors of the Five Zang and Five Elements to know the time of death. For example, if red color appears on the cheekbones, the time of death is Ren and Gui days, at midnight. If black color appears on the Tian Ting and death occurs, the day is Wu and Ji, and the hours are Xu, Chou, and Wei. Each Zang and Fu possesses the colors of the Five Elements and has its respective governing region. Thus, one must clearly understand the regions, use Yin to harmonize Yang, and Yang to harmonize Yin. When Yin and Yang are harmonized, success is achieved in every attempt. Left and Right are the pathways of Yin and Yang. Yang moves from the left, Yin from the right. Distinguishing left and right is called the Great Dao of Heaven and Earth. The color of men moves from left to right; the color of women moves from right to left. Men and women have different positions, hence called Yin and Yang. Ni Chongzhi said: "Men from left, women from right is the smooth flow of Qi. Smoothness leads to dispersion. If men from right, women from left, it is the reverse flow of Qi. Reversal leads to gathering. Gathering leads to harm from excessive overcoming and extinction. This section discusses the colors of internal causes, having distinctions of Yin-Yang, left-right, life-death, and reversal-smoothness."
Examining glossiness and witheredness is called a skilled physician. Deep and turbid indicates internal; floating and glossy indicates external. Yellow and red indicate Wind; green and black indicate Pain; white indicates Cold. Yellow and greasy/moist indicates Pus; intense red indicates Blood. Severe pain indicates spasms; severe cold indicates insensitivity of the skin. The five colors each appear in their respective regions. Observe their floating and sinking to know depth. Observe their glossiness and witheredness to observe success and failure. Observe their scattering and clustering to know proximity. View the upward and downward movement of color to know the location of the disease. Accumulate spirit in the heart to know past and present. Therefore, if observing Qi is not subtle, one cannot know right from wrong. Focus attention without leaving, then know new from old. If color is bright but not coarse, yet appears deep and withered, the disease is severe. If color is neither bright nor glossy, but not deep and withered, the disease is not severe.
This speaks of examining color to know external diseases. Deep and turbid indicates internal; floating and glossy indicates external. External diseases move from outside to inside; observing the floating and sinking of color reveals the internal and external location of the disease. Wind is a Heavenly Yang pathogen, so color appears yellow and red. Pain is a Yin Bi syndrome, so color appears green and black. White color indicates Cold. Yellow and greasy/moist color indicates abscess/pus. Intense red indicates retained blood. Pain in sinews and bones, if severe, leads to spasms. Cold injuring skin, if severe, leads to skin insensitivity. These external pathogens appear in the five colors, each in their respective regions. Observing the floating and sinking of color knows the depth of disease; observing glossiness and witheredness observes human success/failure; observing scattering and clustering knows the duration/proximity of disease; viewing upward/downward color movement knows the location of disease. Color and pulse are highly valued by the Supreme Being and transmitted by ancient masters. In ancient times, Qiu Dai Ji was sent to organize color and pulse to connect with the Divine Spirit, combining them with the Four Seasons, Five Elements, Eight Winds, and Six Directions, never departing from their constants.
Therefore, accumulating spirit in the heart allows one to know past and present. If observing Qi is not subtle, one cannot discern right from wrong. Maintain focus without distraction to distinguish new from old. If color is bright and not coarse, but instead appears deep and withered, the disease is severe. If color is neither bright nor glossy, but not deep and withered, the disease is not severe. Generally, external diseases should dissipate from the outside and should not enter internally. If color scatters like a foal running (Ju Ju Ran) without gathering, the disease is scattered with Qi pain, and gathering has not yet formed. Kidney overacting on Heart, Heart sick first, Kidney responding, colors are all alike.
This reiterates that internal diseases have distinctions of gathering/scattering and life/death. If Zang disease is scattered and not gathered, its color scatters like a foal running, and the disease has not yet gathered. If it clusters in the Zang, blood vessels overact, showing clustered color and leading to sudden death disease. "Ju Ju Ran" means like a foal passing through a crack, moving without staying. Its color moves...