灵枢经·五色 The Five Colors

Leigong asked Huangdi, saying: 'Is it solely by the Bright Hall that the five colors are judged? I do not yet understand what this means.' Huangdi said: 'The Bright Hall (mingtang) is the nose; the Palace Gate (que) is the space between the eyebrows; the Court (ting) is the forehead; the Fan (fan) is the sides of the cheeks; the Curtain (bi) is the doorway of the ear. One wishes for the area between these features to be broad and full, so that even at a distance of ten paces they are all visible from without — a person such as this will be long-lived, certainly reaching a hundred years.'

Leigong said: 'How does one distinguish among the five regions spoken of?' Huangdi said: 'When the bones of the Bright Hall are high and raised, level and straight; when the five viscera take their proper places at the center, and the six bowels flank them on either side; when the head and face rise above at the Palace Gate and the Court; when the Royal Palace lies at the lower extremity between the eyes; when the five viscera rest securely within the chest — then the true color arrives and the color of disease does not appear; the Bright Hall is moist, lustrous, and clear. How, then, could the five official regions fail to be distinguished?'

Leigong said: 'May I hear about cases where they cannot be distinguished?' Huangdi said: 'When the five colors appear, each emerges in its own regional area. If the bone beneath that regional area is sunken, the person cannot escape illness. But if the colors of the regional areas overlie one another in proper sequence, then even though the illness is severe, the person will not die.'

Leigong said: 'How does one assign meaning to the five colors?' Huangdi said: 'Green-blue and black indicate pain; yellow and red indicate heat; white indicates cold — these are called the five offices.'

Leigong said: 'How can one tell whether a disease is growing more severe or is just beginning to wane?' Huangdi said: 'This can be discerned in both the exterior and interior pulses. When one palpates the Pulse Opening — the radial pulse — and finds it slippery, small, tight, and deep, the disease is growing more severe and lies within. When the Renying pulse at the neck is large, tight, and floating, the disease is growing more severe and lies without. If the Pulse Opening is floating and slippery, the disease advances day by day; if the Renying pulse is deep and slippery, the disease diminishes day by day. If the Pulse Opening is slippery and deep, the disease advances day by day and lies within; if the Renying pulse is slippery, exuberant, and floating, the disease advances day by day and lies without. When the floating and deep qualities of the pulse, and the size of the qi at Renying and the Inch Opening, are equal to one another, the disease is difficult to cure. When disease lies in the viscera, a deep and large pulse is easy to cure, while a small pulse indicates a contrary, unfavorable course. When disease lies in the bowels, a floating and large pulse is easy to cure. When the Renying pulse is exuberant and firm, the person has been injured by cold; when the qi at the Pulse Opening is exuberant and firm, the person has been injured by food.'

Leigong said: 'How does one use the colors to speak of the interval and severity of disease?' Huangdi said: 'When the color is coarse yet bright, this indicates the disease is mild; when it is sunken and lifeless, this indicates severity. When the color moves upward, the disease is growing more severe; when the color moves downward, dispersing like clouds clearing away, the disease is about to resolve. Each of the five colors has its own regional area corresponding to a viscus, and each has an outer portion and an inner portion. When a color moves from the outer portion toward the inner portion, the disease moves from the exterior toward the interior; when the color moves from the inner portion toward the outer portion, the disease moves from the interior toward the exterior. When disease arises in the interior, one should first treat the yin, and afterward treat the yang; to reverse this order will make the disease worse. When disease arises in the yang, one should first treat the exterior, and afterward treat the interior; to reverse this order will make the disease worse. When the pulse is slippery and large, intermittent yet long, the disease has come from without; the eyes perceive certain things and the mind feels aversion toward them — this is a case of yang qi massing together, and it can be altered and cured.'

Leigong said: 'I have heard that wind is the beginning of the hundred diseases, and that reversal-counterflow arises from cold and dampness. How does one distinguish between them?' Huangdi said: 'One regularly examines the area of the Palace Gate: a color that is thin and lustrous indicates wind; a color that is turbid and congested indicates impediment (bi). A color appearing at the earth region — the chin — indicates reversal. This is the general rule; in each case one speaks of the disease according to its color.'

Leigong said: 'When a person who was not ill suddenly dies, how can one know this in advance?' Huangdi said: 'When a massive evil qi enters the viscera and bowels, the person, without having been ill, will suddenly die.' Leigong said: 'When a person's illness has slightly improved and yet he suddenly dies, how can one know this?' Huangdi said: 'If a red color appears on both cheekbones, as large as a thumb, then even though the illness has slightly improved, the person will certainly die suddenly. If a black color appears on the Court, the forehead, as large as a thumb, the person, even without illness, will certainly die suddenly.'

Leigong bowed twice and said: 'Excellent! Is there a fixed time for such a death?' Huangdi said: 'One examines the color to determine the time.' Leigong said: 'Excellent! I wish to hear it in full.' Huangdi said: 'The Court is the region of the head and face; above the Palace Gate is the throat; within the Palace Gate is the lung; the lower extremity between the eyes is the heart; directly below that is the liver; to the left of the liver's region is the gallbladder; below that is the spleen; the region above and to the side is the stomach; the central region is the large intestine; flanking the large intestine's region is the kidney; opposite the kidney's region is the navel; above the tip of the nose is the small intestine, and below the tip of the nose is the bladder and the uterus; the cheekbones correspond to the shoulders; behind the cheekbones corresponds to the arms; below the arms' region corresponds to the hands; above the inner canthus of the eyes corresponds to the breasts; along and above the rope-like ridge of the cheek corresponds to the back; along the jaw and below corresponds to the thighs; the central point below the mouth corresponds to the knees; below the knees' region corresponds to the shins; opposite the shins' region corresponds to the feet; the Great Divide corresponds to the inner thigh; the Great Bend corresponds to the kneecap. These are the regional areas of the five viscera, six bowels, and limbs and joints — each has its own allotted place. Once one has these allotted places, one uses yin to harmonize yang, and yang to harmonize yin; one must clearly understand these regional areas, and then every application will be apt. To be able to distinguish left from right is called the great Way; male and female occupy different positions, hence it is said to accord with yin and yang. To examine carefully whether the color is moist or withered — this is called being a skilled physician.'

A sunken and turbid color indicates disease in the interior; a floating and lustrous color indicates disease in the exterior. Yellow and red indicate wind; green-blue and black indicate pain; white indicates cold; a yellow color that is oily and moist indicates pus; an intensely red color indicates painful blood stasis; when this pain is extreme, it causes spasm-contracture; when cold is extreme, it causes numbness of the skin. Each of the five colors appears in its own regional area; one examines whether it is floating or sunken to know whether the disease is shallow or deep; one examines whether it is moist or withered to observe whether the disease will resolve or worsen; one examines whether it is scattered or compact to know whether onset is near or distant; one observes whether the color is above or below to know the location of the disease; one concentrates the spirit in the heart-mind to know past and present. Thus, if one's reading of the qi is not subtle and attentive, one cannot know right from wrong; one must fix the attention and not let it wander, and only then can one distinguish the new from the old. When the color is bright and not coarse, but sunken and lifeless, the disease is severe; when the color is neither bright nor lustrous, the disease is not severe. When the color is scattered, flickering and indistinct, not yet gathered together, the disease too is scattered — the qi causes pain, but no accumulation has yet formed.

When the kidney overrides the heart, the heart falls ill first and the kidney responds in kind; the colors in every such case follow this same pattern.

In a man, when the color appears at the tip of the nose, this indicates pain in the lower abdomen; below that, it indicates pain in the testicles; when the color is round and straight, it indicates pain in the penis — the upper part corresponding to the root, the lower part to the glans — this is the category of fox-mounting hernia and swollen scrotum. In a woman, when the color appears at the tip of the nose, this indicates disease of the bladder and the uterus: if the color is scattered, this indicates pain; if it is compact, this indicates a mass. Whether the color is square or round, on the left or the right, each corresponds to the shape it takes. When it extends further downward, this indicates excessive discharge; when there is moistness like the sheen of grease, this indicates that the person has recently eaten unclean food to excess.

Left corresponds to left, and right corresponds to right. When the color harbors something pathological, it gathers and disperses irregularly, without proper order — this is what the color of the face indicates. As for the colors — green-blue, black, red, white, and yellow — each, when proper, is full and settled and has its own distinct region. When a color appears outside its proper region and is red, like the red color of elm-pod seeds in size, and it appears at the tip of the nose, death will come within a matter of days. When the tip of such a color points upward, its point directed toward the vertex, this indicates the disease is above; when its tip points downward, this indicates the disease is below — and this holds in the same way for left and right. The five viscera are named by the five colors: green-blue corresponds to the liver, red to the heart, white to the lung, yellow to the spleen, and black to the kidney. The liver is matched with the sinews, the heart with the vessels, the lung with the skin, the spleen with the flesh, and the kidney with the bones.