灵枢：五阅五使第三十七

Ling Shu: Chapter 37 - The Five Observations and Five Envoys

Overall Paraphrase

This chapter, The Five Observations and Five Envoys, discusses the method of observing the Qi of the Five Viscera through the Five Sense Organs. The Yellow Emperor asks: In the theory of needling, there is mention of the "five sense organs and five observations" (wu guan wu yue), used to observe the Qi of the five viscera. The so-called Five Qi are the "envoys" dispatched by the five viscera to the body's surface, and they are also the external manifestations corresponding to the Five Seasons (Spring, Summer, Long Summer, Autumn, Winter). I wish to ask: from which parts do the Qi of the five viscera manifest? Qi Bo answers: The five sense organs are the external manifestations (exterior counterparts) of the five viscera.

The Yellow Emperor asks again: I wish to understand where they emerge from, so that this may serve as a standard diagnostic method. Qi Bo says: The pulse manifests at the Qi Kou (Cunkou pulse), and the complexion manifests at the Ming Tang (the nose). The five colors appear in succession, corresponding to the five seasons, each having its own normal hue. If the Qi of the meridians has already penetrated deeply into the viscera, one must regulate the interior. The Yellow Emperor praises him and then asks: Is the five-color observation determined solely from the Ming Tang? Qi Bo says: One must first observe whether the five sense organs are clear and distinct, then observe whether the Que Ting (the area between the eyebrows and the forehead) is open and broad, and only then establish the observation of the Ming Tang. If the Ming Tang is broad and elevated, the Fan Bi (the cheeks beside the nose and the regions before the ears) are exposed and manifest, the cheekbones are square, the lower jaw is thick and high like a wall's foundation, the earlobes extend outward and droop, the five colors are normal, the face is even and full—such a person may expect to live a long life of a hundred years. When one sees such a bodily appearance and complexion, needling treatment is also easy to apply effectively, because such a person's Blood and Qi are in surplus, the flesh is firm and compact, and they can withstand needling.

The Yellow Emperor says: I wish to hear the specific references of the five sense organs. Qi Bo says: The nose is the official (sense organ) of the Lungs; the eyes are the official of the Liver; the lips are the official of the Spleen; the tongue is the official of the Heart; the ears are the official of the Kidneys. The Yellow Emperor asks: What can be observed from these orifices? Qi Bo says: They observe the five viscera. Thus, if the Lungs have disease, there is wheezing and flaring of the nostrils; if the Liver has disease, the inner corners of the eyes turn bluish-green; if the Spleen has disease, the lips turn yellow; if the Heart has disease, the tongue contracts and shortens, and both cheekbones turn red; if the Kidneys have disease, both cheekbones and the forehead turn black.

The Yellow Emperor asks: How do the five pulses manifest, how do the five colors appear, and how one may distinguish between normal color and perilous or failing color? Qi Bo says: If the five sense organs cannot be clearly distinguished, the Que Ting is not open and broad, the Ming Tang is narrow and small, the Fan Bi are hidden and not manifest, the facial flesh is collapsed and sunken, the lower jaw lacks a foundation, and the earlobes and ear tips turn outward and protrude—such a person already shows signs of perilous decline in their usual state (even without disease), let alone when suffering from disease.

The Yellow Emperor further asks: The five colors manifest at the Ming Tang, and they are used to observe the Qi of the five viscera. Do the left-right, upper-lower positions each have their own patterns? Qi Bo says: The viscera and bowels reside within the body, each having its fixed order and position; their reflections from left to right and above to below on the face likewise each follow their respective standards and laws.

🧠 Deep Understanding

Core Principles 💡

• When there is something within, it must manifest outwardly: The five viscera are hidden within the body, but their Qi and blood states will manifest through the five sense organs, facial complexion, and other external parts. The sense organs act as "windows" to the viscera.
• Ming Tang is the core of color diagnosis: The nose (Ming Tang) is the center of facial observation, but it must not be examined in isolation. It must be combined with the overall form of the Que Ting, Fan Bi, cheeks, jaw, earlobes, etc., for a comprehensive assessment of Qi and blood and physical constitution.
• The Five Colors correspond to the Five Seasons: Normal complexion varies slightly with the seasons. Examining the color should take the season into account, distinguishing between the "normal color" and the "disease color."
• Harmony of form and Qi: Those with an open, full facial structure and clearly defined facial features have surplus Qi and blood and firm flesh. Not only do they live long, but they also can better tolerate needling and other treatments. This provides a basis for constitution assessment in clinical practice.
• Abnormal external symptoms signify internal disease: When the qi and color of the five sense organs are clearly abnormal, it suggests that the disease has already penetrated deeply into the five viscera. One should not treat only the superficial manifestations, but should regulate from within the deep structure.

Modern Perspectives 🌟

• Modern medicine also places value on the connection between facial appearance and internal disease. Examples include jaundice – yellowing of the sclera and skin; hypoxia – cyanotic lips; mitral valve disease – flushed cheeks; and chronic liver disease – sallow complexion. The ancient observation of "assessing the viscera through the sense organs" has a basis in empirical experience.
• However, traditional facial diagnosis, with its specific mapping of each of the five sense organs to a corresponding viscus, involves Five-Phase categorization and philosophical speculation and cannot be equated with modern anatomical findings or laboratory diagnostics. For example, "the tongue is the official of the Heart" is a model from zangxiang (organ imagery), not an anatomical claim that the tongue belongs to the heart.
• On the relationship between facial features and longevity or constitution, modern research also suggests that facial symmetry and skin luster correlate with overall health. However, inferring lifespan or treatment efficacy solely from more facial features is not rigorous or scientific.
• The phrase "though of a weakened or unstable state usually, the more so when illness afflicts them" in this chapter embodies the early awareness of "treating before disease arises." However, its specific criteria reflect historical limitations and should not be over-applied to the present.

Health Insights ⚡

• In daily life, pay reasonable attention to one's complexion, lip color, glance, and spirit. If you notice long-term dullness, pallor, yellowish discoloration, or clearly observable abnormalities, it may indicate an imbalance in routine, diet, or emotional state. It is appropriate to adjust the pace of your lifestyle promptly and to seek professional medical consultation if concerns appears.
• Maintaining a "spirited" face lies essentially in regular daily routines, a balanced and moderate diet, and equanimity of the emotions, allowing qi and blood to flourish and the body's muscle and flesh to be dense and enduring. This cannot be achieved simply through external applications or skincare.
• During the change of seasons, observe the subtle changes of your complexion. Align your body with the movement of the seasons: spread out and stretch in Spring, nourish the Heart in Summer, moisten the Lungs in Autumn, and store the essence in Winter.
• Please note: The above are only generalizations. They serve as general health observation tips, not as medical advice for any specific disease. Seek medical attention promptly if persistent signs or symptoms occur.

📚 Further Explanations

• Related Concepts: Zangxiang (organ appearance), Ming Tang, Que Ting, Fan Bi, Five-Color diagnosis, Facial region projection, Qi Kou pulse diagnosis, Five Seasons, Constitution and lifespan

• Speculative Discussion: For readers curious about further understanding: only so-called unique constitutional types are described here in a few lines, about which much could be asked—what to observe first on face, measure, body build? That is already the standpoint of clinical observational skill that passes beyond simple reading.

• Related Readings Suggested: Ling Shu, Chapter 49 – Five Colors; Su Wen, Chapter 17 – Essentials of Pulse Appraisal; Su Wen, Chapter 32 – Heatful discussions; Su Wen, Chapter 10 – The Complete Manifestation of the Five Organs

This content is based on classical Chinese medicine classics. The intention here is exclusively worthwhile learning as a piece of Chinese cultural heritage or broad and deep classical medical background; it does not in any way constitute a medical warning, herbal remedy prescription, drug requirement guide, or a medical service; if any discomfort actually exists, please promptly present in the off-line department for the physician's timely management.</s> —— Bu Gua</s>