Course: Diagnostics I Date: July 26, 2007 Class #: 2. Complexion in TCM

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1 Course: Diagnostics I Date: July 26, 2007 Class #: 2 Complexion in TCM Focus: what is physiological, what is pathological. What is dominant, guest. Know conforming/opposing based on dominant color. Diff kinds of face color and disease conditions related. (1/2 hour late missed some stuff) Dominant Color One s native complexion color is the one you were born with prior to environmental or life factors interfering. This remains throughout life. It is determined by race and prenatal factors. Relates to your body type. Determine the body type (see last lecture) and you will know the dominant color Guest Color The guest color is the coloring you take on when physiological, seasonal, climactic, geographic and working conditions change the coloring. Example: if you work outdoors and get a deep tan. Example: A person of wood type (liver) would have a dominant color of green. In summer the guest color could be reddish. A pathological coloring would be very deep red (liver fire). Pathological Coloring Superficial condition is mild, exterior, yang Deep Condition is severe, interior, yin. Distinct yang type of disease, superficial, upright Qi not exhausted Obscure Yin type of disease, deep, upright Qi weakened. Scattered mild disease, short duration, pathogenic factors not strong. Good prognosis Concentrated color severe disease of long duration, pathogenic factor strong. Prognosis not good. Thin like a single skimpy coat of paint. deficiency or acute disease. Thick like several heavy coats of paint. Excess or more chronic. Luster spirit good, pathogenic factors not strong, condition mild. Prognosis = good. Lusterless spirit is weak, pathogenic factors are strong. Condition is severe. Prognosis = not good. Factors affecting prognosis according to complexion. Luster/lusterless Thin/thick Page 1 of 5

2 Scattered/concentrated Conformity/deviation of color according to season Conforming and Opposing Color This is based on the five element theory. First, determine the dominant color of the person. Next, look at the color they are displaying and put it into the 5 element chart. Mother/Son relationship colors (in relation to dominant color) are pretty good. Controlling/Rebelling colors have a bad prognosis. Mother color Conforming. Prognosis = OK Son color slightly opposing. Prognosis = Not bad Overcontrolling element color opposing Prognosis = Quite bad Insulting color strongly opposing Prognosis = Awful Example: Liver type. Dominant color will be green. Complexion colors/moisture This refers to normal coloring. You must know what normal is in order diagnosis correctly. Normal complexion this refers to luster and hue/coloring of the complexion. o Luster: If there is luster, the complexion is shining, reflecting strong Qi. o Hue: a subtle reddish hue means blood is not deficiency icient. o Contained, veiled color. The color is inside of the skin and shines out indiciating that Yin and Yang are in harmony. By contrast, false Shen shows as a reddening on top of the skin as if it has been painted on. This indicates that Yin and Yang are not in harmony and the Shen has risen to the surface in preparation of leaving. The prognosis is bad. Moisture. Sufficient moisture means that there is no deficiency of or harm to body fluids. White / Pale complexion color White coloration indicates Xu (deficiency) or cold. Pale indicates either cold or lack of nourishment. Bright white. Yang deficiency. Spleen/stomach, lungs, heart, kidney. Less yang to warm you makes you white looking. Qi and blood deficiency = no way to nourish you, so paleness. Dull white More severe yang deficiency than with a bright white coloring Pale white. Qi deficiency. Pale face. Page 2 of 5

3 Sallow. Blood deficiency. Bluish white = cold, especially due to yang deficiency. Will a Yin deficiency be pale? No. A lack of Yin renders relatively too much yang which will give a red color, but only on the zygomatic areas (reddened apple-y cheeks). Sallow complexion color Sallow is a pale/yellowish color rather than a white complexion. It is dull and without luster indicating a xu (deficiency) and/or dampness. Dampness holds the color inside, so doesn t show out and = lusterless. (Dampness is sticky, grabbing even the color of the complexion.) Spleen Qi deficiency and dampness This is the classic reason for a sallow complexion Can also be a Kidney yang deficiency Sallow greyish coloration indicates Blood statis. I ve always referred to this as heart patient grey. Yellow complexion color Indicates Xu and/or dampness Pale yellow Spleen Qi deficiency, blood deficiency (anemia) Grayish yellow Spleen Qi deficiency w/stagnation of liver Qi or blood. Yellow and dry Full or empty heat in ST and SP indicating that Heat is strong, burning the fluids. Ash-like yellow Dampness Bright yellow Jaundice. Damp and heat Dark yellow Jaundice. Damp and cold. Red Color Red indicates heat. Pay attention to where the red is and to the description. Red cheeks or whole face Full or excessive heat (due to yang excess) of HT, LU, LV or ST. High fever might be one reason. Page 3 of 5

4 Red cheekbones zygomatic region only. Empty heat (due to yin deficiency) of LU, HT, ST, or K. Or blood deficiency Floating red Empty heat False heat true cold. Blue/Green Complexion Indicates cold, pain, blood stasis and inner wind. Generally speaking is due to excess of one or more of these conditions. NOT associated with deficiency. Blue/green due to impediment or blockage of circulation of Qi and/or blood, constriction of meridian(s) and blood stasis congestion and not moving. Notes: 1) Think of a bruise with it s blue/green coloring which is a trauma induced form of stasis. 2) Dampness does not cause this coloring. Dampness is more yellow. Pale blue under eyes LV Qi stagnation Dark bluish under eyes Cold in LV channel White bluish Cold or chronic pain Bluish in children Liver wind Green with a red tinge lesser yang syndrome Green with red eyes Liver fire Yellowish-green cheeks Phlegm with LV yang Green nose Stagnation of Qi with pain in abdomen Dark reddish-green Stagnation. Liver Qi turning to heat. Grass-like green Collapse of Liver Qi. Don t have to know these in detail for the test just know concept. Dark complexion color According to the Five Element Theory, dark/black is related to the Kidney. This type of complexion coloring is due to Kidney Xu (deficiency), long term Cold condition, Blood statis and Phlegm-fluid retention. Beginning of cold is pale, then long term = purple or bluish. Dark and dry Kidney Yin deficiency Page 4 of 5

5 Dull dark Kidney Yang deficiency with internal Cold Dark around the eye sockets KD deficiency w/phlegm-fluids or cold damp in LJ. Dull dark like soot damp-cold/phlegm-fluids Faintly dark damp-cold or phlegm-fluids. Very dark Blood stasis Purple Complexion Purple is really a deeper version of bluish or greenish coloration and indicates stasis. Reddish-purple blood stasis Bluish-purple internal cold leading to blood stasis or poisoning Changes of purple due to blood stasis dark-blue-purple to greenish to yellowish. Emotions and complexion colors Anger: green on cheeks, under eyes. Anger = liver = wood = green. Excessive Joy: related to heart. Reddish Worry: grayish without luster Pensiveness: sallow yellow Fear: bright white on cheeks, forehead Shock: bright white/bluish Hatred: dull greenish without luster Craving: reddish on cheeks Guilt: dark ruddy Homework paper: due last class What is the relationship between the complexion and tongue expression? 4 pages. Page 5 of 5