Observation of the Color

Both the color and luster of the face are observed. There are five discolorations, namely, blue, yellow, red, pale and dark gray. Observation of the luster of the face is to distinguish whether the complexion is bright and moist or dark and haggard.

People of different races have different skin colors, and there is wide variation among people of the same race. However, a lustrous skin with natural color is considered normal.

The color and luster of the face are the outward manifestations of the relative strength of qi and blood of the zang - fu organs. Their changes often suggest various pathological conditions. Observation of these changes is valuable for diagnosing disease. Here are the descriptions of the indications of the five discolorations.

• A red color often indicates heat syndromes, which may be of deficiency type or of excess type. When the entire face is red, it is a sign of a heat syndrome of excess type resulting from either exposure to exogenous pathogenic factors with the symptom of fever, or hyperactivity of yang of zang - fu organs. The presence of malar flush accompanied by tidal fever and night sweating suggests an interior heat syndrome due to yin deficiency.
• A pale color indicates cold syndromes of deficiency type and loss of blood. A pale complexion is often due to yin excess or yang deficiency. A bright white face with a puffy, bloated appearance is a sign of deficiency of yang qi. If the pale face is withered, it signifies blood deficiency.
• A yellow color indicates syndromes of deficiency type and damp syndromes. When the entire body, including the face, eyes and skin, is yellow, it is jaundice. If the yellowness tends toward bright orange, it is called yang jaundice resulting from damp heat. If the yellow is smoky dark, it is called yin jaundice resulting from either cold damp or long - term stagnation of blood. A pale yellow complexion without brightness is a sign of deficiency of both qi and blood.
• A blue color indicates cold syndromes, painful syndromes, stagnation of blood and convulsion. A pale complexion with a blue tinge is seen in a syndrome of excessive yin and cold with the symptom of severe pain in the epigastrium and abdomen. Blue purplish face and Ups with the intermittent pain in the pericardial region or behind the sternum are due to stagnation of the heart blood. Blue purplish face and lips accompanied by high fever and violent movement of the limbs in children are signs of infantile convulsion. A dark grey color indicates deficiency of the kidney and stagnation of blood. A pale and dark complexion accompanied with lumbar soreness and cold feet suggests insufficiency of the kidney yang. A dark complexion without brightness, accompanied by scaly skin signifies prolonged stagnation of blood.

Generally speaking, a lustrous and moist complexion indicates that the disease is mild, qi and blood are not deficient, and the prognosis is good ; whilst a dark and haggard complexion suggests that the disease is severe, essential qi is already injured, and the prognosis is poor.

As to the clinical significance of the color of secretions and excretions, such as nasal discharge, sputum, urine and vaginal discharge, those clear and white in color generally denote deficiency and cold, while those turbid and yellow in color indicate excess and heat.