bubble_chart Concept

A uniformly dark and dull morbid complexion on the patient's face is called "complexion lihēi," also referred to as "complexion black." The term "complexion lihēi" is mentioned in Jingui Yaolue, and in Zhongcang Jing, it is called "complexion canghēi." This color is often caused by insufficient yang qi and excessive cold-dampness, or by poor blood circulation and static blood obstruction. Lingshu．Chapter on Five Colors: "The five colors correspond to the organs: ... Black corresponds to the kidney." Zhengzhi Zhunsheng．Summary of Observing Colors: "Black belongs to water, governs cold and pain, and is the color of the Foot Shaoyin Kidney Meridian." From this, it can be seen that black is the color of the kidney and is closely related to the pathogenic factors of cold and water.

If the dark complexion is due to racial or constitutional differences, excessive sun exposure, physiological darkening during pregnancy in women, or forehead darkening due to jaundice caused by sexual intemperance, these conditions are not within the scope of this discussion.

bubble_chart Pattern Analysis

1. Kidney Yang Deficiency︰The complexion is dark and dull, with soreness and weakness in the waist and knees, tinnitus and deafness, cold body and limbs, clear urine and loose stools, or scanty urine, edema below the waist, impotence in men, and uterine cold with infertility in women. The tongue is pale, swollen, and tender with a white coating, and the pulse is deep, thin, and weak, especially at the chi positions. This is due to prolonged illness, overexertion, or excessive sexual activity, leading to kidney qi deficiency and gradual insufficiency of kidney yang, which fails to warm and nourish the blood vessels, resulting in stagnation of qi and blood. Hence, symptoms such as soreness and weakness in the waist and knees, tinnitus and deafness, cold body and limbs, scanty urine with edema, and a deep, thin, and weak pulse—especially at the chi positions—manifest. The treatment should focus on warming and tonifying kidney yang. The recommended formula is the Right-Restoring Pill with modifications. If edema is due to kidney deficiency, the approach should be to warm the kidney and promote diuresis. The recommended formulas are the True Warrior Decoction and the Life-Relieving Kidney Qi Pill with modifications.
2. Depletion of Kidney Essence︰The complexion is dark and lusterless, the ear rims are dry and withered, there is soreness and weakness in the waist and knees, dizziness, tinnitus, seminal emission, premature ejaculation, hair loss, loose teeth, dry mouth and throat, and heat in the soles of the feet. The tongue texture is red, and the pulse is thin and weak. Due to excessive sexual activity or Rebing damaging the yin of the liver and kidneys, the kidney essence is depleted, and essential qi cannot ascend to nourish the face, resulting in a dark and lusterless complexion and dry, withered ear rims. Additionally, symptoms such as soreness and weakness in the waist and knees, dizziness, tinnitus, seminal emission, premature ejaculation, hair loss, loose teeth, dry mouth and throat, and other signs of kidney essence deficiency manifest. The treatment should focus on tonifying the kidney and replenishing essence, and the prescription of choice is Left-Restoring Pill supplemented with human placenta and other ingredients. This syndrome shares some similarities with the dark complexion caused by kidney yang deficiency, but the latter primarily manifests as kidney yang deficiency (sore waist, cold limbs, scanty urine, body swelling, and a pale, swollen, and tender tongue). In contrast, this syndrome is characterized by kidney essence insufficiency (dizziness, tinnitus, hearing loss, seminal emission, premature ejaculation, heat in the soles of the feet, and a red tongue texture). These differences can help distinguish between the two.
3. Static Blood︰The complexion is dark and swarthy, the skin is scaly, there is dry mouth without desire to drink, and the hair lacks luster. Women may also experience menstrual irregularities, stabbing pain or masses in the lower abdomen, a blue or dark tongue, or ecchymosis, with a deep and rough or thin and slow pulse. This condition arises from prolonged illness or trauma leading to qi stagnation and blood stasis, or from cold congealing and blood stagnation impairing circulation, or from internal bleeding causing blood to fail in meridian tropism and accumulate outside the vessels. In addition to the dark and swarthy complexion, symptoms include scaly skin, lackluster hair, menstrual irregularities in women, abdominal masses, a blue or dark tongue with possible ecchymosis, and a thin, rough pulse—all manifestations of static blood obstruction internally. Treatment should focus on invigorating blood and resolving stasis. Prescriptions such as Rhubarb and Ground Beetle Pill or Infradiaphragmatic Stasis-Expelling Decoction may be modified for use.

A dark and sallow complexion is a manifestation of kidney deficiency or static blood obstruction. During inspection, attention should be paid to whether the complexion is moist and lustrous. A complexion that is dark, bright, and moist is favorable, while one that is dark like soot and withered is unfavorable. As mentioned in Suwen, the chapter Wucang Shengcheng states: "A complexion as dark as soot indicates death, ... while a complexion as dark as crow's feathers indicates life." Suwen．Maiyao Jingwei Lun says: "A dark complexion should resemble the color of heavy lacquer, not the color of the earth's pallor."

bubble_chart Documentation

1. Lingshu．Jingmai Chapter: "When the hand Shaoyin qi is cut off, the vessels will not be connected; when the vessels are not connected, the blood will not flow; when the blood does not flow, the hair color will not be lustrous. Therefore, if the face is as black as lacquer, the blood has died first."
2. Jingui Yaolue．Phlegm-Fluid Retention Cough Disease Pulse Syndrome and Treatment: "Thoracic fluid retention in the diaphragm, the person will have panting and fullness, epigastric stuffiness and hardness, a dark and black complexion, and a deep and tight pulse. If it has been present for several tens of days and medical purgation has not cured it, Cocculus Root Decoction should be used to treat it; if the condition is deficient, it will be cured immediately, but if it is excessive, it will recur after three days. If it recurs and does not improve, it is advisable to use Cocculus Root Decoction with Gypsum removed and Poria Mirabilite added to treat it."