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A moldy-soy-sauce-colored coating indicates Shaoyang disease complicated by food retention. This tongue appearance may present within one or two days, signifying Cold injuring the Taiyin channel and food stagnating in the Stomach organ. In mild cases, the coating is thin; although abdominal pain is present, there is no diarrhea. Guizhi Tang (Cinnamon Twig Decoction) combined with Chenpi (Tangerine Peel), Banxia (Pinellia Rhizome), Zhishi (Immature Bitter Orange), and Houpo (Magnolia Bark) may be used. If pain is severe, Dahuang (Rhubarb Root) is added. For cold food indigestion, Ganjiang (Dried Ginger) and Houpo (Magnolia Bark) are added. If the coating is thick and dark with unceasing severe abdominal pain, the condition is critical. A sauce-colored tongue results from yellow mixed with black, indicating Earth pathogen transmitting to Water organs. Symptoms must include dry lips and mouth with intense thirst. Even if purgative methods are employed, recovery is rare.

Pure Moldy-Soy-Sauce-Colored Tongue:
The appearance of a moldy color on the tongue occurs when food obstructs the Stomach, compounded by Cold pathogen constraint, preventing internal Heat from venting outward. Dampness steams and covers the surface, changing the color. The pulse is typically deep and tight. The patient suffers from irritability and abdominal pain. If purgatives fail to relieve obstruction after five to seven days, death is inevitable due to the exhaustion of Qi in the Taiyin and Shaoyin channels.

Central Moldy-Float-Thick Coating Tongue:
Failure to observe dietary restrictions regarding meat and greasy foods during Shaoyang disease causes the coating to float on the center of the tongue like soybean paste, indicating food stagnation in the Middle Jiao. If the pulse retains Stomach Qi, without knotted or intermittent rhythms, with non-pointed lips, non-dry teeth, and no diarrhea, Zhishi Lizhong Tang (Immature Bitter Orange and Poria Decoction) with Jiangzhi Chao Chuanlian (Jiangju-fried Coptis Rhizome) can be used. If the coating reappears identically after being scraped off, the condition is likely incurable.

Moldy Color with Yellow Coating Tongue:
Moldy color with yellow coating indicates damp-heat stagnation in the Middle Jiao. Erchen Tang (Two-Cured Decoction) with Zhishi (Immature Bitter Orange) and Huanglian (Coptis Rhizome) is indicated. If the coating is dry and yellow, Jiuhuang (Wine-processed Rhubarb Root) should be added for purgation.

Blue Coating:
The blue color represents the manifestation of Liver Wood externally. In prolonged Shaoyang disease, after sweating and purging therapies have damaged Stomach Qi, Heart Fire lacks strength, Stomach Earth has no foundation, Lung Metal lacks nourishment, and Liver Wood faces no restraint. Consequently, it overcomes upward, presenting as pure blue. This signifies Metal and Wood combining while Fire and Earth Qi exhaust, leading to certain death. If the blue is faint or shows slight streaks, treatment with herbs that warm the Stomach, strengthen Spleen, regulate Liver, and benefit Lung may still be effective. Pure blue indicates unchecked Liver Wood dominance; even without other symptoms, death is certain.

Faint Blue Tongue:
A pure blue tongue indicates the decline of Middle Earth Yang Qi, a prognosis where fewer than one in a hundred survive. Medication should absolutely be avoided.

Blue Streak Tongue:
Blue streaks on the tongue indicate declining Stomach Earth Qi and the overcoming influence of Liver Wood. Xiaochaihu Tang (Minor Bupleurum Decoction) with Huangqin (Scutellaria Root) removed and Paojiang (Prepared Ginger) added is prescribed. If caused by cold food accumulation, Fuzi Lizhong Tang (Aconite and Poria Decoction) or Dajianzhong Tang (Great Construct the Middle Decoction) should be urgently administered.