《黃帝內經素問補註釋文》Vol. 10

The heart corresponds to the vessels. Fire's nature is restless and agitated, and the movement of the vessels resembles the qi of fire. Since the heart belongs to Fire, the heart and the vessels are joined.

The heart's outward glory appears in the complexion. When fire qi rises upward, it often reddens the face. The New Collation (Xinjiao Zheng) holds that it is not appropriate to explain the heart's glory solely as redness. Any complexion that appears on the face may be called the glory of the heart, not only redness.

What the heart fears and is restrained by is the kidney. Here "governs" refers to mutual restraint. The heart belongs to Fire and the kidney belongs to Water, and Water can control Fire, so the heart is restrained by the kidney.

The lung corresponds to the skin. Metal's nature is firm, and the skin also has the quality of toughness. Since the lung belongs to Metal, the lung and the skin are joined.

The lung's outward glory appears in the body hair. Hair is attached to the skin, so hair is described as the lung's glory on the body's surface. What the lung fears and is restrained by is the heart. The lung belongs to Metal and the heart belongs to Fire, and Fire can control Metal.

The liver corresponds to the sinews. Wood's nature can bend or straighten, and the form and function of the sinews share this quality. Since the liver belongs to Wood, the liver and the sinews are joined.

The liver's outward glory appears in the nails. The nails are regarded as formed from the residual qi of the sinews, so they are described as the sinews' glory on the body's surface. What the liver fears and is restrained by is the lung. The liver belongs to Wood and the lung belongs to Metal, and Metal can control Wood.

The spleen corresponds to the flesh. Earth's nature is gentle and thick, and the flesh also has the quality of softness and thickness. Since the spleen belongs to Earth, the spleen and the flesh are joined.

The spleen's outward glory appears at the lips. The mouth is the gateway of the spleen in the body, so the spleen's glory is displayed at the lips. The "lips" here refer to the pale area around the mouth, not the red surface of the lips. What the spleen fears and is restrained by is the liver. The spleen belongs to Earth and the liver belongs to Wood, and Wood can control Earth.

The kidney corresponds to the bones. Water's nature flows and moves downward, and the kidney's essence also has the quality of circulating and nourishing. Bone is connected with essence and marrow, so the kidney and the bones are joined.

The kidney's outward glory appears in the hair. The brain is where marrow gathers, and the kidney qi governs the essence and marrow, so whether the kidney qi is abundant shows in the hair. What the kidney fears and is restrained by is the spleen. The kidney belongs to Water and the spleen belongs to Earth, and Earth can control Water.

Water is controlled by Earth, and because Earth and Water overcome each other, the kidney qi (shen qi) is restrained by the spleen's Earth.

Therefore, eating too much salty food causes the blood vessels to become congested and the complexion to change. The heart (xin) is joined with the blood vessels, and the complexion is the outward manifestation of heart qi. Salty flavor benefits the kidney, and Water overcomes Fire, so when heart qi is suppressed, the blood vessels become congested and the complexion changes.

Eating too much bitter food dries the skin and makes the hair fall out. The lung (fei) is joined with the skin, and hair is the outward manifestation of lung qi. Bitter flavor benefits the heart, and Fire overcomes Metal, so when lung qi is suppressed, the skin dries and the hair falls out.

Eating too much pungent food causes the sinews to contract and the nails to become withered. The liver (gan) is joined with the sinews, and the nails are the outward manifestation of liver qi. Pungent flavor benefits the lung, and Metal overcomes Wood, so when liver qi is suppressed, the sinews contract and the nails dry out.

Eating too much sour food causes the muscles to become coarse and wrinkled, and the lips to curl up or crack. The spleen (pi) is joined with the muscles, and the lips are the outward manifestation of spleen qi. Sour flavor benefits the liver, and Wood overcomes Earth, so when spleen qi is suppressed, the muscles become coarse and wrinkled and the lips curl.

Eating too much sweet food causes bone pain and hair loss. The kidney is joined with the bones, and hair is the outward manifestation of kidney qi. Sweet flavor benefits the spleen, and Earth overcomes Water, so when kidney qi is suppressed, bone pain and hair loss result.

The above describes the harm caused by excessive consumption of the five flavors.

When the five flavors enter the mouth, they pass through the intestines and stomach and are transported to nourish the five zang organs. Each flavor has its own particular nourishing function and its own preference. If one flavor is eaten to excess, the five organs affect one another and may even be damaged. For this reason the following text says: the heart delights in bitter flavor, the lung in pungent, the liver in sour, the spleen in sweet, and the kidney in salty.

The heart belongs to Fire, so it delights in bitter; the lung belongs to Metal, so it delights in pungent; the liver belongs to Wood, so it delights in sour; the spleen belongs to Earth, so it delights in sweet; the kidney belongs to Water, so it delights in salty. This is the correspondence between the five flavors and the five organs. Each flavor gathers and exerts its effect according to the organ qi it corresponds to.

[New Collation] points out that the Quan Yuanqi edition reads, "This is how the five flavors join with the qi of the five zang," which is the same as the Taisu (Plain Essentials) text. This wording links the preceding and following sentences so that they are read together.

When the complexion shows the following abnormalities, it is a critical sign: blue like freshly sprouting grass; yellow like zhishi (unripe bitter orange); black like the soot at the bottom of a pot; red like clotted, decayed blood; white like dry bones. These are the five complexion signs of death. "Zi," used here in place of the homophone meaning "to nourish," refers to the color of newly sprouting plants; "tai" is soot; "pei xue" is clotted, degenerated blood, dark red in color; "ku gu," dry bones, refers to a dry, lusterless white.

When the five viscera (wǔ zàng) decline, the body shows complexion signs that presage death. The Treatise on the Three Sections and Nine Indicators (Sān Bù Jiǔ Hòu Lùn) states: "When the five viscera have already deteriorated, the facial color will necessarily become withered and dull, and the person will certainly die." This passage describes exactly that situation.

Green like the feathers of a kingfisher, red like a rooster's comb, yellow like the belly of a crab, white like lard, and black like the feathers of a crow: when these five colors are bright and lustrous, they show that vital qi is still present.

The word "like" in this passage refers to color that has luster and moisture. Even when a color is pleasing to the eye, it is better still if it carries a faint, veiled radiance. The text therefore continues: the red of the heart resembles cinnabar wrapped in white silk (gǎo); the white of the lungs resembles red wrapped in white silk; the green of the liver resembles light blue-green wrapped in white silk; the yellow of the spleen resembles a trichosanthes (guā lóu) fruit wrapped in white silk; and the black of the kidneys resembles purple wrapped in white silk. This is the color that the viscera's vitality shows outwardly. Here gǎo means white silk, and gàn means a light blue-green.

These five colors are the signs by which the five viscera, rising outward, become visible on the surface of the body. Róng means a beautiful complexion with luster.

The five viscera also correspond to colors and flavors. White corresponds to the lungs, and the lungs to the pungent flavor; red corresponds to the heart, and the heart to the bitter flavor; green corresponds to the liver, and the liver to the sour flavor; yellow corresponds to the spleen, and the spleen to the sweet flavor; black corresponds to the kidneys, and the kidneys to the salty flavor. Each color and each flavor belongs to the viscus to which it corresponds.

The parts of the body are likewise nourished by the qi of their respective viscera. White corresponds to the skin, red to the vessels, green to the sinews, yellow to the muscles, and black to the bones. These correspondences reflect the nourishment each part receives from its viscus.

All the vessels connect with the eyes. The vessels are the channels through which blood gathers and circulates. The Treatise on the Proclamation of the Five Qi (Xuān Míng Wǔ Qì Piān) says that prolonged looking injures the blood, which shows that the vessels are linked to the eyes. The New Collation (Xīn Jiàozhèng) cites Huángfǔ Shì'ān, who says that the Nine Scrolls (Jiǔ Juàn) records: "The heart stores the vessels, and the vessels house the shen (spirit). The shen illuminates the whole body, so the vessels are connected to the eyes."

The marrow of the whole body converges in the brain. The brain is the sea of marrow, so all the bone marrow is connected to the brain.

The sinews of the whole body are linked to the joints. Where the sinew qi is firm and gathered, it attaches between the bones of the joints. The Treatise on the Proclamation of the Five Qi says that prolonged walking injures the sinews, which shows that the sinews are connected to the joints.

All the blood belongs to the heart. Blood circulates within the vessels, and the vessels belong to the heart. The Treatise on the Eight Correspondences and Spirit Illumination (Bā Zhèng Shénmíng Lùn) says: "Blood and qi are where the human shen resides." The shen is governed by the heart, so blood is said to belong to the heart.

All the qi of the body belongs to the lungs, because the lungs store qi and govern its circulation.

These relationships appear in the muscles at the four limbs and at the junctions around the eight joints. As blood and qi circulate, they wax and wane between day and night. Xī refers to the small junctions of the muscles, and the "eight xī" are the elbows, knees, wrists, and similar places. Qi, blood, sinews, and vessels influence one another and change in strength, so the text says they circulate through these places day and night.

When a person is asleep, the blood returns and is stored in the liver. The liver is responsible for storing blood, while the heart is responsible for propelling its movement: when a person is active, blood spreads through the various channels; when a person is at rest, blood returns to the liver for storage. This is because the liver governs the sea of blood—that is, it oversees the storage and distribution of blood in the body.

When the liver receives the nourishment of blood, the eyes can see. This speaks of the function of liver blood: the eyes are the external manifestation of the liver in the body, and so only when liver blood is sufficient can one see objects.

When the feet receive the nourishment of blood, one can walk. Blood flows only when Qi moves; therefore, only when the feet have a blood supply can one take steps.

When the palms receive the nourishment of blood, one can grasp; when the fingers receive the nourishment of blood, one can take hold. These correspond respectively to the functions of the palm holding objects and the fingers taking, pinching, and grasping. Qi and blood are the foundation of the body’s mental activities and physical functions; hence only those parts that receive blood nourishment can perform their roles.

If, after waking, a person is attacked by wind pathogen and the blood stagnates between the skin, this forms Bi disease—conditions such as numbness and pain of the skin and flesh. If it stagnates in the channels and blood movement is not smooth, it is called “se”; if it stagnates in the feet, it forms “Jue,” manifested as counterflow cold and coolness of the feet. All three situations are caused by obstruction of blood movement, so that blood cannot return to the normal channel pathways. The “spaces” mentioned here refer to the pathways of blood flow—that is, the larger channels.

The human body has twelve “great valleys,” which are larger convergence sites of channels, distributed along the areas traversed by the twelve channels. There are also 354 “small streams,” which are smaller convergence sites of the collateral vessels; among them, the “twelve shu” are the shu-points of the twelve channels. Commentators hold that, counting 365 small collaterals and subtracting the twelve shu, there should be 353 sites; the scripture writes “354,” possibly because “three” was mistakenly written as “four” in transmission. The New Corrections also says that other editions and the Quan Yuanqi edition write “shu” as “guan.”

These channel convergence sites are all places where defensive Qi stays and moves, and also places where pathogenic Qi may invade and lodge. When defensive Qi is sufficient and moves smoothly, it is difficult for pathogenic Qi to remain; when defensive Qi is insufficient and its movement is obstructed, pathogenic Qi may take advantage of the weakness and lodge therein.

Acupuncture or the use of stone needles can guide pathogenic Qi out along the channels. “Yuan” here means along or following: when pathogenic Qi lodges at channel convergence sites, needling these sites allows the pathogenic Qi to move along the channels and be expelled.

In examining the beginnings of disease, one should take five determinations as the guideline. The “five determinations” here refer to judging the condition and prognosis of life and death according to the pulse images of the five viscera. To understand the onset of pathological changes, one must first determine the “mother” to which they belong.

“Establishing” means first identifying the vigorous Qi associated with the season in charge. First determine the ruling Qi of the season, then distinguish pathogenic Qi from healthy Qi.

The “Five Diagnoses” are the pulse signs of the five zang organs.

Thus, headache and illness at the crown of the head indicate deficiency below and excess above. The disorder lies in the Foot Shaoyin (Kidney Meridian) and Foot Taiyang (Bladder Meridian). In severe cases, it penetrates deeply into the kidneys.

Foot Shaoyin is the Kidney Meridian, and Foot Taiyang is the Bladder Meridian. The Bladder Meridian begins at the inner corner of the eye and ascends to the forehead, where it converges at the crown. A branch separates from the crown and passes above the ear. The main channel enters the brain from the crown, connects with it, then emerges and descends along the back of the neck. It runs beside the spine along the inner edge of the shoulder blades to the lower back, enters and travels down the muscles on either side of the spine, connects with the kidneys, and belongs to the bladder. When Kidney Qi is weak, it cannot guide the Qi of the Bladder Meridian in its course. This causes headache and illness at the crown of the head. If the disorder in the meridian becomes severe, it enters the internal organs.

A spinning, clouded feeling before the eyes and an unsteady head indicate deficiency below and excess above, governed by Foot Shaoyang (Gallbladder Meridian) and Foot Jueyin (Liver Meridian). In severe cases, the disorder penetrates deeply into the liver.

“Xun” means swift, and “meng” means unclear. Here they describe a sudden eye disorder that makes it difficult to see. “Zhao” means to shake, and “you” means severe. Clouded vision and pronounced shaking of the head refer to a sudden onset; dim vision and deafness refer to a disorder that develops gradually. Foot Shaoyang is the Gallbladder Meridian, and Foot Jueyin is the Liver Meridian.

The Foot Jueyin Meridian ascends from the lower abdomen, runs alongside the stomach, belongs to the liver and connects with the gallbladder. It passes through the diaphragm and spreads across the ribs, then travels behind the throat to the nasopharynx and forehead, where it meets the Governing Vessel at the crown of the head. A branch separates behind the eyeball and descends along the inner cheek. The Foot Shaoyang Meridian begins at the outer corner of the eye, ascends to the temple, then descends behind the ear and along the neck into the hollow above the clavicle. One branch enters the ear from behind it. Another branch separates from the outer corner of the eye, passes over the cheekbone and along the jaw, then descends to the neck and joins the first branch in the hollow above the clavicle. From there, the meridian descends into the chest, passes through the diaphragm, connects with the liver, and belongs to the gallbladder. In this case, the Qi of the meridians is insufficient, giving rise to these symptoms.

The New Corrected Edition says that Wang Bing’s explanation of “xun meng” as a sudden eye disorder with unclear vision is not sufficiently clear. “Xun meng” probably refers to rapid twitching of the eyelids and clouded, unclear vision. In addition, where the Foot Shaoyang Meridian passes “below the cheekbone,” the Jia Yi Jing reads “below the zhuo,” meaning the area beneath the cheekbone.

Abdominal fullness and distension, a sense of pressure and distension in the chest, ribs, and below the ribs, together with coldness below and clouded awareness above, indicate a disorder governed by Foot Taiyin (Spleen Meridian) and Foot Yangming (Stomach Meridian).

“Qu” refers to the area above the flank. “Qi surging upward from below and clouding above” means that Qi runs counter to its usual course, surging up from below and obscuring the eyes. The passage refers here to the Foot Taiyin Spleen channel and the Foot Yangming Stomach channel. The Foot Taiyin channel enters the abdomen along the front edge of the inner thigh, connects with the Spleen and links to the Stomach, then travels upward through the diaphragm. The Foot Yangming channel begins beside the nose, meets at the root of the nose, runs down along the outer side of the nose, and links to the chin and jaw. It then passes from the throat into the supraclavicular fossa, the hollow above the collarbone, connects with the Stomach and links to the Spleen. Its direct branch descends from the supraclavicular fossa along the inner side of the breast, passes beside the navel, and enters the Qi Street, an area near the groin. Another branch begins at the lower opening of the Stomach and runs along the inner abdomen to the Qi Street, where it joins the main channel before descending to the hip area near the root of the thigh. This is why these symptoms arise.

Coughing, Qi surging upward, and counterflow Qi lodged in the chest are associated with disorders of the Hand Yangming and Hand Taiyin channels. Hand Yangming is the Large Intestine channel, and Hand Taiyin is the Lung channel. The Hand Yangming channel ascends along the front edge of the shoulder, near the Jianyu acupoint, reaches the meeting point at the collarbone near the base of the neck, then descends into the supraclavicular fossa, connects with the Lung, passes through the diaphragm, and belongs to the Large Intestine. The Hand Taiyin channel begins in the Middle Burner, the abdominal area where the Spleen and Stomach are located. It descends to link with the Large Intestine, then returns along the opening of the Stomach, passes upward through the diaphragm, and belongs to the Lung. From the Lung network, it extends laterally to the armpit. This explains the symptoms of coughing, Qi surging upward, and counterflow Qi lodged in the chest. The New Collation notes that, according to the Jia Yi Jing, the character “jue” is written as “illness.”

A sense of oppression in the heart and headache, with the disorder located in the diaphragm, are associated with the Hand Taiyang and Hand Shaoyin channels. Hand Taiyang is the Small Intestine channel, and Hand Shaoyin is the Heart channel. The Hand Taiyang channel ascends from the shoulder, enters the supraclavicular fossa, connects with the Heart, descends through the throat and diaphragm, reaches the Stomach, and belongs to the Small Intestine. Its branch runs from the supraclavicular fossa up the neck, passes along the cheek, and reaches the outer corner of the eye. The Hand Shaoyin channel begins in the Heart, emerges and connects with the Heart network, then descends through the diaphragm to link with the Small Intestine. Thus, the location of heart oppression and headache is in the chest. The New Collation notes that, according to the Jia Yi Jing, the passage here reads: “Pain in the chest, fullness along the sides, and pain drawing between the lower back and the back,” with the disorder associated with the Hand Shaoyin and Hand Taiyang channels.

The size, smoothness or roughness, and floating or sinking quality of the pulse can be distinguished by touch. A fine, small pulse is called “small”; one that feels full and broad is called “large.” A pulse whose movement is smooth and flowing is called “slippery”; one whose movement is rough and impeded is called “rough.” A pulse felt with a light touch is called “floating”; one felt only when pressing down is called “sinking.” Though pulses vary in many ways, a skilled touch and focused attention make it possible to distinguish them by hand.

The manifestations of the Five Zang organs can be inferred from their corresponding signs. Here, “manifestations” refers to the organs’ Qi and its signs. Although the Five Zang organs are hidden within the body and cannot be seen, their manifestations…

The nature and functions of the Five Phases (Wood, Fire, Earth, Metal, Water) can be inferred from the characteristics of things in the same category. The liver corresponds to Wood, which bends and extends; the heart corresponds to Fire, which rises and surges upward; the spleen corresponds to Earth, which is stable and still; the lungs correspond to Metal, which is firm and decisive; and the kidneys correspond to Water, which moistens and flows downward. These are only basic outlines that summarize the main characteristics of the five viscera. How the viscera manifest can change with specific circumstances, but their patterns can still be inferred by analogy from similar images and principles.

The sounds of the five viscera can be discerned through attentive listening.

“Sounds” here refers to the five tones: the liver corresponds to the Jue tone, the heart to the Zhi tone, the spleen to the Gong tone, the lungs to the Shang tone, and the kidneys to the Yu tone. These are the usual correspondences. When the Qi of the five viscera affects one another, the sounds may change in strength or quality. Someone with sensitive hearing and a perceptive mind can still detect these changes by listening closely.

Subtle changes in the five colors can be observed with the eyes.

“Colors” here means complexion: the liver corresponds to green, the heart to red, the spleen to yellow, the lungs to white, and the kidneys to black. These are the usual correspondences in complexion. When the Qi of the five viscera affects one another, subtle changes in color may reveal signs of good or ill fortune. A keen-eyed person with far-reaching insight can observe and interpret them.

Combining the pulse with the complexion can greatly improve the confidence of a diagnosis.

In general, a green complexion corresponds to a wiry pulse, red to a hooked pulse, yellow to an intermittent pulse, white to a floating pulse, and black to a firm pulse. Compare the complexion and the pulse to see whether they agree, then assess how the illness is changing. In this way, one can make a careful and reliable judgment without being misled. The following examples explain the relationship between complexion, pulse, and illness.

Red complexion with a firm pulse: The pulse comes rapidly, like panting, and feels firm. The diagnosis is a buildup of Qi within the body that often interferes with eating. This condition is called “heart impediment,” an impediment caused by the heart’s Qi failing to circulate freely.

The commentator explains that “panting” describes a pulse that comes like a person suddenly gasping for breath. When illness affects organs situated higher in the body, the pulse tends to feel rapid; this is why the heart and lungs are singled out here. A rapid pulse indicates that the heart’s Qi is insufficient, while a firm pulse indicates an excess of pathogenic Qi. The heart’s pulse originates in the chest, so the text describes a buildup of Qi within the body that often interferes with eating. “Buildup” means that pathogenic Qi has gathered, while “impediment” means that the Qi of the viscera cannot flow freely.

This illness results from the invasion of an external pathogen. When someone worries excessively and the heart’s Qi grows weak, the pathogen takes advantage of this weakness, enters the body, and remains there.

White complexion with a floating pulse: The pulse comes rapidly and feels floating, indicating deficiency in the upper part of the body and excess in the lower part. The person is easily startled and has a buildup of Qi in the chest. If the rapid pulse is also weak, the condition is called “lung impediment with cold and heat.”

The commentator explains that a rapid pulse indicates deficiency, while a floating pulse shows that the lungs’ Qi is weak. In principle, weakness in the upper part of the body should be accompanied by fullness in the lower part. But when Qi is insufficient, the person is easily startled and develops symptoms such as alternating cold and heat.

Qi has accumulated in the chest, so the pulse is rapid and floating. This shows that Lung Qi is deficient. The shortness of breath and weakness occur because Heart Qi surges upward and overwhelms the lungs. When the lungs are heated, Qi cannot circulate normally; this is called “Lung impediment” (obstruction of Lung Qi). When the illness affects the exterior, it may appear as alternating chills and fever.

This illness is caused by having sexual intercourse while drunk. Alcohol tastes bitter and has a drying nature, and drinking it makes Heart Qi relatively strong. Having intercourse while drunk further strengthens Heart Qi, which then rises and presses down Lung Qi.

When a green pulse appears, it is long and forcefully flicks from side to side. This indicates that Qi has accumulated below the heart and is pulling at the flanks. It is called “Liver impediment” (obstruction of Liver Qi). A long, flicking pulse has a taut, tight quality: a tight pulse indicates cold, while a taut pulse is associated with dampness. The Liver governs the flanks, which lie near the area below the heart. Thus Qi accumulates below the heart and pulls at the flanks. The Illustrated Treatise on Correct Principles: Examples of Pulse Names says that a tight pulse feels like a taut cord beneath the fingers, its beats flicking from side to side.

This illness is caused by cold and dampness, and its pathology is the same as that of hernia disorders. Lower back pain, cold feet, and headache occur because cold and dampness have lodged in the lower body. The Liver channel ascends from the feet, passes through the head and face, and reaches the crown. Thus, when the Liver channel is affected, the feet become cold and a headache may occur. “Clear” here means cold. (“Hernia” is pronounced shàn.)

When a yellow pulse appears, it is large and deficient. This indicates that Qi has accumulated in the abdomen and that rebellious Qi is surging upward; the condition is called “reversal hernia.” A large pulse indicates abundant Qi, while a deficient pulse indicates that the body’s vital Qi is weak. Because Qi is abundant while vital Qi is weak, Spleen Qi accumulates in the abdomen. If Kidney Qi rebels upward, reversal hernia develops; if it does not rise, the person instead shows weakness along with an accumulation of Spleen Qi.

Women can show the same pulse patterns. The illness is caused by sudden overexertion, followed by sweating from the limbs and then exposure to wind and cold. Wind Qi is associated with the Liver. Exposure to wind after sweating may cause Spleen Qi to accumulate, making the abdomen distended and full.

When a black pulse appears, the upper part of the cun pulse is firm and large. This indicates that Qi has accumulated in the lower abdomen and genital area, a condition called “Kidney impediment” (obstruction of Kidney Qi). “Upper” here refers to the cun position of the pulse. The Kidneys govern the lower burner, so Qi accumulates in the lower abdomen and genital area.

This illness is caused by lying down after bathing in cold water. Dampness damages the lower body and settles in the Kidneys. Lying down after bathing, before the body has dried and warmed, makes a person more susceptible to dampness. The Lingshu Jing says that the lower half of the body is prone to being exposed to dampness.

When abnormal pulses corresponding to the five colors of the face are observed, a yellow face with green, red, white, or black eyes does not indicate that the person will die.

“Unusual pulses” here refers to cases in which the pulse pattern does not correspond to the complexion. A yellow complexion indicates that “Stomach Qi”—the vital energy that, in Chinese medicine, sustains life—is still present, so death is not imminent.

The editorial note in the revised edition says: On consulting the Jiayi Jing, the words “unusual pulses” do not appear there.

The following combinations of complexion and eye color are all considered signs of impending death: a blue-green face with blue-green eyes; a red face with white eyes; a blue-green face with black eyes; a black face with white eyes; and a red face with blue-green eyes.

None of these cases includes yellow, so they are considered to lack Stomach Qi. The five organs depend on Stomach Qi as their foundation; therefore, any case without yellow is judged to be a sign of impending death.