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Yellow coating indicates interior syndrome. This tongue manifestation is absent in the initial stage of cold damage (Shanghan). It is also absent when the pathogen transmits to the Shaoyang channel. It appears only when the pathogen reaches the Yangming fu-organ excess stage, where stomach fire flares up excessively, and fire invades the earth position (Spleen/Stomach), thus producing this coating. Treatment should involve purging according to the severity. Initially, the coating is slightly yellow; subsequently, it becomes deep yellow and slippery; in severe cases, it is dry yellow or scorched yellow. Symptoms include high fever, intense thirst, constipation, delirium, epigastric fullness and obstruction, and spontaneous diarrhea. Some patients develop jaundice due to failure to sweat initially, while others exhibit mania-like behavior due to blood stasis accumulation. All these are caused by excessive damp-heat and difficult urination. If the whites of the eyes are golden and the body is orange-yellow, Yinchen Hao Tang (Artemisiae Scopariae Decoction), Wuling San (Five-Ingredient Powder with Poria), and Zhizi Bopi Tang (Gardeniae and Phellodendri Bark Decoction) are appropriate. If blood stasis accumulates in the Upper Jiao, Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) is used; for the Middle Jiao, Tao Ren Chengqi Tang (Prunus Persica Seed and Rhubarb Decoction); for the Lower Jiao, Dai Didang Tang (Substitute Dandang Decoction). In all blood syndromes, improvement occurs upon bleeding. Cold water must never be given, as ingestion will lead to death. Generally, although a yellow tongue coating indicates a serious condition, if the pulse is long, it signifies that the central earth (Spleen/Stomach) still has qi, and the patient can be cured with purgation. However, if the pulse is wiry accompanied by diarrhea, or if the yellow coating has black in the center, these are critical conditions.

Pure Yellow Slightly Dry Tongue:
A tongue with yellow coating indicates extreme stomach heat, with the color of earth appearing at the tip of the tongue. Immediate purgation with Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction) is required. Delay may cause the yellow to age and turn black, indicating an adverse prognosis.

Slightly Yellow Coating Tongue:
A slightly yellow coating that is not very dry indicates that exterior pathogens have begun to transmit inward due to lack of sweating. Dachaihu Tang (Major Bupleurum Decoction) should be used. If the whole body and eyes are yellow, Yinchen Hao Tang (Artemisiae Scopariae Decoction) is indicated.

Dry Yellow Tongue:
A dry yellow coating indicates extreme interior heat. Urgent purgation is necessary without delay. Survival is expected if the pulse becomes calm and the body cools after purgation; death is likely if there is rebound high fever, panting, and a restless pulse.

Yellow Coating with Black Slippery Tongue:
A yellow coating with black and slippery characteristics indicates complete Yangming interior syndrome. Purging is required even if the tongue is not dry. Survival is expected if the body cools and the pulse calms after purgation; death is likely with high fever and a restless pulse.

Yellow Coating with Black Spots Tongue:
Chaotic black spots appearing within a yellow coating indicate symptoms of extreme thirst and delirium. For those without skin spots, Dachengqi Tang (Major Order to Discharge Decoction) should be used for purgation. If the pulse is choppy, delirium is present, the patient picks at clothes and bedsheets, and the body is yellow with black spots, the condition is untreatable. Passing loose black stool after purgation also indicates death.

Yellow Coating with Black Extending to Tip Tongue:
Yellow coating turning black from the center to the tip indicates extreme dryness of fire and earth, with the deepest heat toxicity. Bi-gan Shanghan (simultaneous contraction of exterior and interior pathogens) is fatal. Severe aversion to cold is also fatal. If there is no aversion to cold, but dry mouth and throat with foul-smelling diarrhea, Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction) can be used for purgation; four or five out of ten may be saved. Dry mouth, dry teeth, and emaciation are untreatable.

Old Yellow Fissured Tongue:
A yellow, dry, rough coating with fissures indicates that evil heat has entered the stomach and toxicity has deeply accumulated. For irritability and thirst, Dachengqi Tang (Major Order to Discharge Decoction) is used; for jaundice, Yinchen Hao Tang (Artemisiae Scopariae Decoction); for lower abdominal pain indicating blood stasis, Didang Tang (Dandang Decoction); for chest binding (Jie Xiong), Daxianxiong Tang (Major Thorax-Penetrating Decoction).

Yellow Tip Tongue:
Yellow coating on the tongue tip indicates that heat pathogens have just transmitted to the stomach fu-organ. Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction) should be used. If the pulse is floating and there is aversion to cold, indicating unresolved exterior syndrome, Dachaihu Tang (Major Bupleurum Decoction) should be used to resolve both exterior and interior.

Yellow Coating with Grey Root Tongue:
A grey root with a yellow tip is slightly less severe than a black root, but if left untreated for one or two days, it will turn black and become difficult to treat. In the absence of irritability, staring fixedly, and with a deep yet forceful pulse, Dachaihu Tang (Major Bupleurum Decoction) modified can be used.

Yellow Tip with Red Root Tongue:
A red root with a yellow tip indicates damp-heat invading the fire position (Heart/Upper Jiao). This tongue is common in the early stages of warm epidemic febrile diseases. Cooling the diaphragm and detoxifying herbs should be used, adjusting treatment based on the specific presentation.

Yellow Tip with Black Root Tongue:
A tongue with extensive black root and little yellow tip, even without adverse symptoms or pulses, risks sudden deterioration due to exhaustion of stomach qi.

Yellow Coating with Black Prickles Tongue:
An old, extremely yellow coating with black prickles in the center results from failure to sweat. Pathogenic toxins have deeply collapsed inward. Urgent purgation with Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction) is required; only one or two out of ten may survive.

Yellow Swollen and Full Tongue:
A yellow and swollen tongue indicates damp-heat in the Yangming stomach meridian. Symptoms include jaundice, constipation, and irritability. Yinchen Hao Tang (Artemisiae Scopariae Decoction) is used. If stools are loose but jaundice persists, Wuling San (Five-Ingredient Powder with Poria) plus Yinchen, Zhizi, and Huanglian is used.

Yellow Tip with White Root Tongue:
A white root and yellow tip indicate inverted colors, signifying transmission from the Shaoyang channel to the Yangming fu-organ. If Yangming symptoms predominate, Dachaihu Tang (Major Bupleurum Decoction) is used; if Shaoyang symptoms predominate, Xiaochaihu Tang (Minor Bupleurum Decoction) is used. For delirium and irritability, Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction) is indicated.

Yellow Root with White Tip Tongue:
A white tip and yellow root indicate fewer exterior pathogens and more interior pathogens. Combine Tianshui San (Heavenly Water Powder) and Liangge San (Cool the Diaphragm Powder). If Yangming syndrome presents with no sweat, difficult urination, and mental restlessness (Ao Nao), jaundice will certainly develop; use Yinchen Hao Tang (Artemisiae Scopariae Decoction).

Yellow Root with Grey Tip Tongue:
The tongue belongs to the fire position. A yellow root and grey tip indicate earth insulting fire (Spleen overacting on Heart). Without vomiting or diarrhea, but with heart vexation and thirst, it indicates constrained heat in the stomach. Use Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction) plus Huanglian.

Yellow Root with White Shortened Tip Tongue:
A tongue with a yellow root, white tip, short and stiff texture, neither dry nor slippery, but unable to extend, indicates symptoms of delirium and confusion. This is caused by phlegm and retained food occupying the central palace (Spleen/Stomach). Dachengqi Tang (Major Order to Discharge Decoction) plus Shengjiang (Fresh Ginger) and Banxia (Pinellia) is the primary treatment.