舌苔黑滑。为太阴之寒。所谓寒水侮土。理中症也。若更兼粘腻浮胖。是湿痰寒饮伏于太阴。当用温药
和脾。如二陈、浓朴、姜汁、合五苓之类。开之逐之。痰饮自去。
舌见边黄中黑腻。热蒸脾湿痞难禁。吐呕便秘因伤酒。开泄中焦有泻心。
邵评∶舌苔边黄。中心腻黑。是胃热蒸动脾湿。蕴结中宫。以致痞闷。呕吐。便闭。用泻心汤开泄中焦。
胃热蒸脾湿。则舌黄中带黑腻。中焦痞满。呕吐。小便不利。嗜酒人多此症。
邵评∶此三条论黑苔。
寒湿常乘气分中。风兼二气自从同。舌将黄白形中取。得诀才将脉症通。
邵评∶寒湿风湿二气。只入气分。不入营分。风温之邪。则由气入营。辨其舌苔。黄白者。邪在气分。
红绛者。邪入营分。再以脉症参之。
寒湿二气。都入气分。风兼寒湿。亦入气分。风兼温热。或入气分。或入营分矣。气分之邪。于舌之
黄白取之。营分之邪。于舌之红绛取之。得此要诀。再将脉症兼参。病无遁形。
温邪暑热走营中。兼入太阴气分同。吸受心营并肺卫。暑温挟湿卫营通。
邵评∶温暑二邪。从口鼻吸入。或入心营。或入肺卫。湿邪由肌表而入。常走气分。若湿兼暑邪。
则营卫俱入矣。
温暑二气。常入营分。兼入气分。盖温暑都从口鼻吸入。则上焦先受。故或入心营。或入肺卫。或先卫
后营。惟湿邪常走气分。必暑挟湿。湿挟暑。则三焦营卫通入矣。
邵评∶二条论寒湿温暑之入气入营。
伤寒入里阳明主。热病阳明初便缠。先白后黄寒化热。纯黄少白热蒸然。
邵评∶此热病是伏气所发。初起即从阳明而达于外。与感而即发之温病。自外入内者。自是两种。不可混治。
太阳主表。阳明主里。伤寒由表达里。故在表属太阳。入里即属阳明腑病。热病自内发外。借阳明为出路。
故初起即在阳明。但看舌苔先白后黄者。伤寒由表达里。寒化为热也。若初起纯黄少白。或黄色燥刺。
是热病发于阳明。由里出表。热势蒸然。内盛也。更参外症。初起恶寒发热为伤寒。壮热无寒为热病。
邵评∶伤寒由表入里。先太阳。后阳明。故舌苔先白后黄。见症初起恶寒。热病自里出外。初起即从阳明为出路。
故舌苔纯黄少白。见症壮热不寒。胸腹灼手。以此为辨。最为粗确。
热病无寒惟壮热。黄芩、栀、豉、古今传。恶寒发热伤寒症。发汗散寒表剂先。
邵评∶此条亦伏气所发之热病。切不可辛温发汗。宜用栀、豉、黄芩、等方。清解少阳阳明。若是伤
寒。可用表剂发汗矣。
凡温热之症。不可发汗。如仲景阳明病之栀豉汤。少阳病之黄芩汤。皆可通治。
少阳温病从何断。舌绛须知木火燃。目赤耳聋身热甚。栀翘、犀角、牡丹鲜。
邵评∶舌绛赤。外症耳聋目赤者。是温病从少阳而发出也。当清解木火之郁。与伤寒少阳症之
可用表散不同。故忌汗散。
凡温病热病。初起皆纯热无寒。热病发于阳明。温病发于少阳。当从何法断之。但看舌苔黄燥为阳
明热病。绛赤为少阳温病。温病宜用犀角、栀、翘、鲜地、丹皮、之类。以解木火之郁。大忌汗散。
邵评∶此三条。论温热病由于伏气所发。以舌苔辨之。最精。
若是温邪从上受。窍中吸入肺先传。芩、翘、栀、豉、桑、蒌、杏。气燥加膏肺分宣。邪入心
营同胆治。再加元、麦、郁、菖、鲜。
邵评∶春时温邪从口鼻吸入。受而即发。舌苔白燥者。邪先入肺也。从肺卫气分治之。若舌鲜红而绛。
邪入心营也。治与少阳胆经同法。加入清心开窍之品。
温邪从内发者。以少阳胆经治之。若因天时晴燥太过。其气从口鼻吸入。则上焦心肺受邪。舌苔白燥
边红。治在气分。舌色鲜红。治在营分。营分与少阳胆经同法。亦用犀角、丹皮、鲜生地之类。再加元参、
麦冬、川郁金、鲜菖蒲。以清心开窍也。
邵评∶此即发之温病。分营卫治。与伏气内发不同。临症时最宜细辨。
寒温二气前粗辨。暑湿相循病必缠。湿病已陈粘腻舌。只将暑症再提传。
邵评∶上文论伤寒温病。以下言暑邪湿温。
暑伤气分苔因白。渴饮烦呕咳喘连。身热脉虚胸又满。无形气分热宜宣。蒌皮、贝、杏、通、芩、滑。
（通草滑石）栀、豉、翘心、竹叶、煎。或见咳红荷叶汁。痞加朴、蔻、郁金、川。
邵评∶此条暑伤气分。治从肺卫。
肺气郁。则暑邪逆入营中。故咳红。
暑入心营舌绛红。神呆似寐耳如聋。溺淋汗出原非解。失治邪干心主宫。犀、滑、翘、丹、元、地、觅。
银花、竹叶、石菖、同。欲成内闭多昏昧。再入牛黄即奏功。
邵评∶此条暑入营中。治以清营开泄。
暑热之邪。上蒙清窍。则耳聋。不与少阳同例。忌用柴胡。乘于胞络。则神昏。宜清心开闭。凡邪
在手经。忌足经药。
邵评∶凡温热暑邪。由口鼻吸受。邪在手经。从三焦立法。忌用足经药。此与治伤寒分别处也。
暑湿合邪空窍触。三焦受病势弥漫。脘闷头胀多呕恶。腹痛还防疟痢干。栀、豉、杏仁、芩、半、朴。
银花、滑石、郁、红、安。（郁金橘红）
邵评∶暑湿合邪。由口鼻吸受。三焦俱病。邪初入气分。其势尚轻。故用栀豉轻剂。若传变疟痢
等症。宜随症用药治之。
暑邪挟湿。从口鼻空窍触入。则三焦气分受病。头胀脘闷呕恶。此邪初入见症。
其势尚轻。故只用栀豉等。以清气分。暑热之邪。留于募原则变疟。入于肠胃则成痢。治宜随症加减。
邵评∶此条暑湿合邪。其症尚轻。若邪留膜原为疟邪。入肠腑成痢。脾与胃以膜
相联。故曰膜原。脾胃之交。半表半里也。犹足少阳之半表半里耳。
湿温气分流连久。舌赤中黄燥刺干。咯血毋庸滋腻入。耳聋莫作少阳看。三焦并治通、（草）茹、（竹茹）杏。金汁、
银花、膏、滑、寒。（石膏滑石寒水石）若得疹痧肌内透。再清痰火养阴安。
邵评∶湿温重症。三焦俱病。故舌赤中黄燥刺。耳聋是湿热上蒙清窍。不可作少阳治。咯血是热伤
肺络。不可用滋腻药。宜清三焦气分之邪。若邪从外达。而发疹痧。再清痰火。渐入养阴治之。
凡暑湿合邪。轻则气分微结。重则三焦俱病。清解不应。即属湿温重症。肺气不得宣畅。则酿成脓血。
湿热上蒙清窍。则耳聋无闻。治当急清三焦。气分一松。则疹痧得以外达。再议清火清痰。渐入养阴之品。
邵评∶此条湿温重症。惟恐人见咯血而认阴虚。见耳聋误作少阳施治。故特揭之。苔形粉白四边红。疫入
募原势最雄。急用达原加引药。一兼黄黑下匆匆。
邵评∶舌苔粉白边红。疫邪入于膜原也。用吴又可达原饮治法。若舌变黄燥黑苔。邪入胃腑。用承气
下之。惟达原饮中分三阳加引经药。
凡伤寒初起。苔形粉白而浓。四边红绛者。此瘟疫症也。邪在募原。其势最雄。顷刻传变。诊家不可
轻视。吴又可用达原饮。加引经表药。透之达之。如兼太阳。加羌活。阳明加葛根。少阳加柴胡。如舌变黄
燥色。乃疫邪入胃。加大黄下之。如变黑色。入里尤深。用承气下之。疫势甚者。其舌一日三变。由白变
黄。由黄变黑。当数下之。
邵评∶此条邪由膜原传胃。自表入里。故可用足经药。从吴又可达原饮。与下条邪在手经大异。
又云∶此条由膜原入胃。自表传里。故可从足经用药。下条疫邪由卫入营。逆传心包。当从三焦立法。
用手经药。与温暑治法相通。二条邪传经络不同。舌苔各别。治法用药大异。读者大宜着眼。
若见鲜红纯绛色。疫传胞络及营中。清邪解毒银、犀妙。菖、郁金、黄温暑通。
邵评∶舌绛鲜红。疫邪自卫入营。逆传胞络。当从三焦立法。用手经药清营开闭。与温暑治法相通。
较上条自表入里。大不同也。
瘟疫一症。治分两途。但看舌苔白而黄。黄而黑者。疫邪由表达里。汗之下之可也。如见舌苔鲜红绛色。
此疫邪入于营分及胞络之间。汗下两禁。惟宜清营解毒。逐秽开闭。如犀角、银花、菖蒲、郁金、西黄、金汁、
人中黄之类。与温热暑症治法相通。
邵评∶此条疫邪由卫入营。从手经用药。与温暑大致相同。
温邪时疫多 疹。临症须知提透宜。疹属肺家风与热。 因胃热发如兹。
邵评∶此条温暑 疹。与伤寒发 不同。疹属肺经风热。 是胃家伏热。时疫
疹。兼有毒瓦斯。均宜提透清解热毒。
疹 色白松肌表。血热如丹犀莫迟。舌白荆、防、翘、薄力。舌红切忌葛升医。
邵评∶白疹邪在气分。舌白淡红。宜松肌达表。从肺清透。红疹邪在营分。舌苔绛赤。宜清营宣透。断不可用柴、
葛足经药。
疹发于气分。其色淡红而白者。舌苔亦白。宜葛根、防风、蝉蜕、荆芥、连翘、薄荷、牛蒡之类。松肌达表。若
见赤 丹疹。邪在营分血分。舌必绛赤。宜犀角、连翘、鲜生地、人中黄、净银花之类。透营解毒。大忌升、葛足经之
药。
邵评∶此二条。 疹在气在营。不可用伤寒法施治也。
凡属正虚苔嫩薄。淡红微白补休迟。浓黄腻白邪中蕴。诊者须知清解宜。
不拘伤寒杂症。正气虚者。其舌苔必娇嫩而薄。或淡红。或微白。皆可投补。若见黄而浓。白而腻。总属内邪未清。
不可遽进补药。
邵评∶此条凭舌苔以验其虚实。分别宜补宜清之总诀。
Black and slippery tongue coating indicates Cold of the Taiyin (Taiyin Cold) pattern. This is referred to as "Cold Water insulting Earth" (Kidney Cold invading Spleen Earth), belonging to the Lizhong Tang syndrome. If accompanied by sticky, greasy, and swollen features, it signifies Phlegm-Dampness and Cold-Fluid latent in the Taiyin channel; warm herbs should be used to harmonize the Spleen and Stomach. Formulas such as Erchen Tang, along with Houpo (Magnolia Bark), ginger juice, combined with Wuling San (Five-Ingredient Poria Decoction), can be employed to open stagnation and drain fluids, allowing the Phlegm-Fluids to dissipate naturally.
A yellow edge with a black, greasy center on the tongue indicates Heat steaming Spleen Dampness, leading to unbearable fullness and obstruction (Pi). Vomiting, constipation, and bowel issues result from alcohol damage; treatment requires opening and draining the Middle Jiao using Xiexin Tang.
Shao's Commentary: A yellow edge and black-greasy center indicate Stomach Heat stirring Spleen Dampness, accumulating in the Middle Palace, causing fullness, vomiting, and constipation. Xiexin Tang opens and drains the Middle Jiao. Stomach Heat steaming Spleen Dampness results in a yellow tongue with black greasiness; Middle Jiao fullness, vomiting, and dysuria are common in heavy drinkers.
Shao's Commentary: These three sections discuss black tongue coatings.
Cold-Dampness often affects the Qi Level; when Wind combines with Cold-Dampness, the pathology is similar. Observe the yellow or white shape of the coating to differentiate; mastering this key allows integration of pulse and symptoms.
Shao's Commentary: Cold-Dampness and Wind-Warmth pathogens enter only the Qi Level, not the Ying (Nutritive) Level. Wind-Warmth pathogens move from Qi to Ying. Yellow/white coatings indicate pathogen in Qi Level; red/crimson coatings indicate entry into Ying Level. Correlate with pulse and symptoms for accurate diagnosis.
Both Cold-Dampness and Wind-Cold-Dampness affect the Qi Level. Wind combined with Warmth may affect either Qi or Ying Level. Pathogens in Qi Level are identified by yellow/white coatings; pathogens in Ying Level by red/crimson coatings. Mastering this principle and correlating with pulse/symptoms reveals the disease clearly.
Warm pathogens and Summerheat-Heat tend to circulate in the Ying Level, sometimes involving the Taiyin Qi Level. Inhaled pathogens affect the Heart Ying and Lung Wei levels; Summerheat-Warmth with Dampness affects both Ying and Wei levels.
Shao's Commentary: Warm and Summerheat pathogens enter via mouth/nose, affecting Heart Ying or Lung Wei. Dampness enters via skin/muscles, typically affecting Qi Level. When Dampness combines with Summerheat, both Ying and Wei levels are involved.
Warm and Summerheat pathogens often enter the Ying Level, sometimes involving Qi Level. Since they enter via mouth/nose, the Upper Jiao is affected first, impacting Heart Ying or Lung Wei, or moving from Wei to Ying sequentially. Only Dampness typically affects Qi Level; it requires Summerheat-Dampness combination to affect the Sanjiao, Ying, and Wei levels simultaneously.
Shao's Commentary: These two sections discuss how Cold-Dampness and Warm-Summerheat enter Qi and Ying Levels.
In Shanghan (Cold Damage), internal progression primarily involves the Yangming channel. In Re Bing (Heat Disease), the Yangming channel is involved from the onset. Tongue coating changing from white to yellow indicates Cold transforming into Heat; pure yellow with little white indicates steaming Heat.
Shao's Commentary: "Re Bing" here refers to diseases caused by latent pathogens manifesting internally, originating from Yangming and moving outward. This differs from Wen Bing (Warm Diseases) which originate externally and move inward; they must not be treated identically. Taiyang governs the exterior, Yangming governs the interior. Shanghan moves from exterior to interior (Taiyang to Yangming Fu organ disease). Re Bing originates internally and uses Yangming as an exit route. White-to-yellow coating indicates Shanghan (Cold transforming to Heat); pure yellow/dry coating indicates Re Bing (Heat originating in Yangming, moving outward). Initial chills and fever indicate Shanghan; high fever without chills indicates Re Bing.
Shao's Commentary: Shanghan moves from exterior to interior (Taiyang then Yangming), hence white-to-yellow coating and initial chills. Re Bing moves from interior to exterior (Yangming exit), hence pure yellow coating and high fever without chills, with hot chest/abdomen. This distinction is reliable.
Re Bing presents with high fever but no chills; ancient texts recommend Huangqin (Scutellaria Root), Zhizi (Gardenia Fruit), and Chishao (Fermented Soybean). Shanghan presents with chills and fever; treat initially with diaphoretic formulas to release the exterior and disperse Cold.
Shao's Commentary: This also refers to Re Bing from latent pathogens. Do not use acrid-warm diaphoretics. Use Zhizi, Chishao, Huangqin to clear Shaoyang and Yangming. For Shanghan, use exterior-releasing formulas.
Wenre (Warm-Heat) diseases should never be treated with diaphoresis. Zhang Zhongjing’s Zhichi Tang for Yangming disease and Huangqin Tang for Shaoyang disease are applicable.
How to diagnose Shaoyang Wen Bing? Crimson tongue indicates Wood-Fire burning. Red eyes, deafness, and severe fever require Zhi Zi (Gardenia), Qiao (Lianqiao/Forsythia), Xijiao (Rhinoceros Horn - substitute with Buffalo Horn), and Mudanpi (Tree Peony Bark).
Shao's Commentary: Crimson tongue with red eyes/deafness indicates Wen Bing emerging from Shaoyang. Clear Wood-Fire stagnation. Unlike Shanghan Shaoyang patterns where exterior release is possible, sweating/dispersing is contraindicated here.
Wen Bing and Re Bing start with pure heat, no chills. Re Bing originates in Yangming; Wen Bing in Shaoyang. Differentiate by coating: dry yellow indicates Yangming Re Bing; crimson indicates Shaoyang Wen Bing. Treat Wen Bing with Xijiao, Zhizi, Qiao, fresh Shengdi (Rehmannia), Mudanpi to clear Wood-Fire stagnation. Strictly avoid sweating/dispersing.
Shao's Commentary: These three sections discuss Wenre diseases from latent pathogens, differentiated precisely by tongue coating.
If Warm pathogen enters from above via orifices, the Lung transmits first. Use Huangqin, Qiao, Zhizi, Chishao, Sangye (Mulberry Leaf), Gualou (Trichosanthes Fruit), Xingren (Apricot Seed). For dry Qi, add Maidong (Ophiopogon) to moisten Lung. If pathogen enters Heart Ying, treat similarly to Gallbladder channel; add Yu Jin (Curcuma), Shichangpu (Acorus), Yuan Shen (Scrophularia), Maidong, and fresh herbs.
Shao's Commentary: Spring Warm pathogen enters via mouth/nose, manifesting immediately. White-dry coating indicates Lung involvement; treat Lung-Wei Qi level. Fresh-red/crimson tongue indicates Heart Ying involvement; treat like Shaoyang Gallbladder channel, adding Heart-clearing orifice-opening herbs.
For Wen Bing originating internally, treat via Shaoyang Gallbladder channel. If due to excessive dry weather, pathogen enters via mouth/nose, affecting Upper Jiao Heart/Lung. White-dry coating with red edges indicates Qi level treatment; fresh red tongue indicates Ying level treatment. Ying level treatment follows Shaoyang method: Xijiao, Mudanpi, fresh Shengdi, plus Yu Jin, Maidong, Chuan Yujin, fresh Shichangpu to clear Heart and open orifices.
Shao's Commentary: This is immediate Wen Bing, treated by distinguishing Ying/Wei, differing from latent internal origin. Careful differentiation is essential clinically.
Cold and Warm pathogens were distinguished earlier; Summerheat and Dampness cycle together, causing lingering illness. Chronic Dampness shows greasy coating; now summarize Summerheat patterns.
Shao's Commentary: Previous sections covered Shanghan/Wen Bing; below covers Summerheat/Damp-Warmth.
Summerheat damaging Qi Level shows white coating, thirst, irritability, vomiting, coughing, wheezing. Fever, weak pulse, chest fullness indicate formless Qi-level Heat requiring dispersion. Use Gualou Pi (Trichosanthes Peel), Beimu (Fritillaria), Xingren, Tongcao (Tetrapanax), Huangqin, Huashi (Talcum) [Tongcao, Huashi], Zhizi, Chishao, Qiaoxin (Forsythia Heart), Zhu Ye (Bamboo Leaf) decoction. For hemoptysis, add Lotus Leaf juice. For fullness, add Houpo, Kouren (Cardamom), Yujin, Chuan Lianzi (Coptis).
Shao's Commentary: This section discusses Summerheat damaging Qi Level, treating from Lung-Wei. Lung Qi stagnation causes Summerheat to reverse into Ying, leading to hemoptysis.
Summerheat entering Heart Ying shows crimson-red tongue, stupor-like sleep, deafness, dysuria, sweating (not resolving). Untreated, pathogen invades Heart Palace. Use Xijiao, Huashi, Qiao, Mudanpi, Yu Jin, Shengdi, Yin Hua (Honeysuckle), Zhu Ye, Shichangpu. If internal closure leads to coma, add Niuhuang (Calculus Bovis) for efficacy.
Shao's Commentary: This section discusses Summerheat entering Ying Level, treating with Ying-clearing and opening methods. Summerheat-Heat misting clear orifices causes deafness (unlike Shaoyang); avoid Chaihu. Invading Pericardium causes coma; clear Heart and open closure. Pathogens in Hand meridians contraindicate Foot meridian herbs.
Shao's Commentary: Warm/Summerheat pathogens enter via mouth/nose, affecting Hand meridians; legislate from Sanjiao. Avoid Foot meridian herbs. This distinguishes treatment from Shanghan.
Summerheat-Dampness combination enters via orifices, affecting Sanjiao with diffuse progression. Epigastric fullness, head distension, vomiting, abdominal pain risk malaria/dysentery. Use Zhizi, Chishao, Xingren, Huangqin, Banxia (Pinellia), Houpo, Yin Hua, Huashi, Yujin, Hongju (Tangerine Peel) [Yujin, Hongju].
Shao's Commentary: Summerheat-Dampness enters via mouth/nose, affecting Sanjiao. Early Qi-level invasion is mild; use light Zhichi formula. If progressing to malaria/dysentery, treat symptomatically. Summerheat-Dampness entering via orifices affects Sanjiao Qi level (head distension, epigastric fullness, vomiting). Mild early stage uses Zhichi to clear Qi. Summerheat remaining in Membrane Source causes malaria; entering intestines causes dysentery; adjust treatment accordingly.
Shao's Commentary: This section discusses mild Summerheat-Dampness. Pathogen in Membrane Source becomes malaria; in intestines becomes dysentery. Spleen/Stomach connect via membrane source (half-exterior/half-interior, like Shaoyang).
Damp-Warmth lingering in Qi Level long-term shows red tongue with yellow, dry, prickly center. Hemoptysis contraindicates cloying tonics; deafness is not Shaoyang. Treat Sanjiao with Tongcao, Zhuru (Bamboo Shavings), Xingren, Jinzhi (Human Excrement Juice), Yin Hua, Shigao (Gypsum), Huashi, Hanshui Shi (Halloysitum Rubrum). If rash appears through skin, clear Phlegm-Fire and nourish Yin.
Shao's Commentary: Severe Damp-Warmth affects Sanjiao, showing red tongue/yellow dry center. Deafness is Damp-Heat misting clear orifices (not Shaoyang). Hemoptysis is Heat damaging Lung collaterals (avoid cloying herbs). Clear Sanjiao Qi level. If pathogen exits via rash, clear Phlegm-Fire, then nourish Yin. Light Summerheat-Dampness causes Qi stagnation; severe cases affect Sanjiao. If clearing fails, it is severe Damp-Warmth. Lung Qi stagnation causes pus/blood. Damp-Heat misting orifices causes deafness. Urgently clear Sanjiao; once Qi loosens, rash emerges, then clear Fire/Phlegm, gradually nourish Yin.
Shao's Commentary: This section warns against misdiagnosing hemoptysis as Yin deficiency or deafness as Shaoyang.
Powder-white coating with red edges indicates Epidemic pathogen in Membrane Source, aggressive momentum. Urgently use Daoyin Yin with guiding herbs. If yellow/black coating appears, purge hastily.
Shao's Commentary: Powder-white/red-edge coating indicates Epidemic pathogen in Membrane Source. Use Wu Youke’s Daoyin Yin. Yellow-dry/black coating indicates pathogen in Stomach Fu; use Chengqi formulas. Daoyin Yin includes Three Yang guiding herbs.
Initial Shanghan with thick powder-white coating and red-crimson edges indicates Plague/Epidemic. Pathogen in Membrane Source is aggressive and rapid; do not underestimate. Wu Youke’s Daoyin Yin with guiding exterior herbs penetrates/reaches pathogen. Add Qianghuo for Taiyang, Gegen (Kudzu) for Yangming, Chaihu for Shaoyang. Yellow-dry coating indicates pathogen entering Stomach; add Dahuang (Rhubarb) to purge. Black coating indicates deep interior; use Chengqi to purge. Severe epidemic changes tongue daily (white→yellow→black); purge repeatedly.
Shao's Commentary: Pathogen moves from Membrane Source to Stomach (exterior to interior); Foot meridian herbs are appropriate. Differs from next section (Hand meridian). Next section: pathogen moves from Wei to Ying, reverses to Pericardium; legislate from Sanjiao, use Hand meridian herbs, consistent with Warm/Summerheat treatment. Different transmission paths and coatings require different treatments. Note carefully.
Fresh red/pure crimson coating indicates Epidemic pathogen transmitting to Pericardium and Ying Level. Clear pathogen and detoxify with Yin Hua, Xijiao. Add Shichangpu, Yujin, Huangqin to treat Warm-Summerheat smoothly.
Shao's Commentary: Crimson-fresh red tongue indicates Epidemic pathogen moving from Wei to Ying, reversing to Pericardium. Legislate from Sanjiao, use Hand meridian herbs to clear Ying and open closure. Consistent with Warm-Summerheat treatment. Differs significantly from previous exterior-to-interior transmission.
Plague/Epidemic has two treatment approaches. White-to-yellow, yellow-to-black coating indicates pathogen moving from exterior to interior; sweating or purging is acceptable. Fresh red/crimson coating indicates pathogen in Ying Level/Pericardium; both sweating and purging are contraindicated. Only clear Ying, detoxify, remove filth, and open closure. Use Xijiao, Yin Hua, Shichangpu, Yujin, Xihuang (Bezoar), Jinzhi, Renzhonghuang (Human Waste Charcoal). Consistent with Warm/Summerheat treatment.
Shao's Commentary: This section discusses Epidemic pathogen moving from Wei to Ying, using Hand meridian herbs, largely consistent with Warm-Summerheat.
Warm pathogens and epidemics often cause rashes; clinical practice requires lifting and penetrating. Rashes belong to Lung Wind-Heat; macules (ban) stem from Stomach Heat.
Shao's Commentary: Warm-Summerheat rashes differ from Shanghan macules. Rashes are Lung Wind-Heat; macules are latent Stomach Heat. Epidemic rashes involve toxic factors; all require lifting/penetrating and clearing Heat-Toxin.
White rashes loosen muscle surface; blood heat like cinnabar requires prompt Xijiao. White tongue benefits from Jingjie (Schizonepeta), Fangfeng (Siler), Qiao, Bohe (Mint). Crimson tongue strictly avoids Gegen, Shengma (Cimicifuga).
Shao's Commentary: White rash (Qi level, pale red tongue) requires loosening muscle/exterior, clearing/transmitting from Lung. Red rash (Ying level, crimson coating) requires clearing Ying and transmitting; strictly avoid Chaihu/Gegen Foot meridian herbs. Qi-level rash (pale red/white, white coating) uses Gegen, Fangfeng, Chan Tui (Cicada Slough), Jingjie, Qiao, Bohe, Niu Bangzi (Arctium) to loosen muscle/exterior. Red macules/rash (Ying/Blood level, crimson tongue) use Xijiao, Qiao, fresh Shengdi, Renzhonghuang, clean Yin Hua to transmit Ying and detoxify. Strictly avoid Shengma/Gegen Foot meridian herbs.
Shao's Commentary: These two sections state that rashes in Qi/Ying levels cannot be treated with Shanghan methods.
Deficient Zheng shows tender/thin coating; pale red/light white indicates timely tonification. Thick yellow/greasy white indicates internal pathogen accumulation; clinicians must know to clear/detoxify.
Regardless of Shanghan or miscellaneous diseases, deficient Zheng shows tender/thin coating (pale red/light white), suitable for tonification. Thick yellow/greasy white indicates unresolved internal pathogen; do not abruptly use tonics.
Shao's Commentary: This section provides general rules for verifying deficiency/excess via tongue coating to determine whether to tonify or clear.