凡风寒所感。邪郁于内。非汗不足以解。原汗乃胃中津液也。故伤寒书中。最要紧关头。在
存津液三字。至热郁于内。则津液亡矣。何以能助其汗乎。今立五法以治内伤。而热病一症。无
遗义矣。（五法不单是治内伤。其专举内伤者。以凡属外感。皆本内伤也。然不若云今立五法以
存津液。而热病一症。无遗义矣。语意尤圆而该。）
一、验其舌胎白如刺。此肺病也。生脉散。加生地白芍当归黄 甘草柴胡黄芩。以生金滋水
。（治法汇云。脾热则滑而胎。脾闭则白胎如雪。东庄批云。二句不论内伤外感。皆以脾滑闭论。
皆以脾滑闭论句。恐未能该内伤外感。阅者宜审。）
一、舌胎黑滑。此肾气凌心。用八味饮。黑燥。用六味饮。以救肾阴。（无论黑白红黄。皆
当辨其燥滑若何。分治。）
一、舌黄胎。补中益气汤。加黄芩或黄连。以补土生金。如有食。去黄 。加浓朴。白术不
可去。且发其汗。纵有食罔顾也。（中气虚者必黄而湿。有食者必满舌黄胎。若舌胎下半节黄腻
湿润者。乃阳明热邪。将尽未尽。并非积滞而有黄腻胎也。宜甘露饮加丹皮归芍等。万不可消导
渗利。以竭阴液。慎之。又有一种最薄黄胎。如漆在舌上者。虽宜清火。必用参术补正为主。若
一味清火。必至气脱而毙。不可不明。）
一、舌觉转动不活。防其卷也。逍遥散。加黄芩丹皮生地。以滋水生肝。
一、舌鲜红。此心经病也。六味饮。合生脉散。以滋水清火。（凡舌上无胎。如去膜油猪腰
子者。名镜面舌。不治。以其阴津亏竭故也。又舌胎虽有而干燥者。可虑。恐阴液竭。也。不可
视为泛常。须切记之。）
凡内伤外感寒热之分。皆从舌胎颜色为准。如黑而滑者。乃肾气凌心。用八味饮。如枯黑
不润泽者。用六
味饮。其人必两颧游红。一剂战而汗愈。（东庄之治徐 村先生是也）如白而加黄。黄而加黑。
此肾凌脾。须治中宫。如补中益气之类。肾乃北方玄武之色。故属黑。且火位之下。水气承之。
水来救母。若此时泄火。火无从泄。助子以救母。则仇未有不复者也。亢则害。承乃制。其理昭
然。（火亢则刑金。水气承之。则火乃制。此亢则害承乃制之说也。各脏腑反复相循。可类
推之。如是灰色。指甲刮下无渣汁者。方是火症。乃芩连之对症也。若肾气凌心。而用芩连。则
舌上现出人字纹。必死黑而不滑。则肾水枯干。当急救其阴也。凡烈焰近炙则燔手。渐高则愈冷
。缘冷气乃火逼所致。热病之舌黑。即此理也。（取喻甚的）
太阳行身之表。是身之背也。三阴行身之里。是身之前也。少阳则半表半里。譬如该补中宫
。而邪热未除。补中益气汤合小柴胡。以治其少阳。是半表半里也。（少阳主半表半里。乃其经
也。然循行之部。又在身之侧也。）
生脉散
人参（君） 麦冬（臣） 五味（佐）
上方如无人参。以枸杞代之。
八味饮
附子（使） 肉桂（使） 熟地（君） 丹皮（佐） 茯苓（君） 泽泻（佐）
山药（臣） 萸肉（臣）
逍遥散
柴胡（臣） 白芍（臣） 归身（君） 白术（臣） 茯苓（佐） 广
皮（佐） 薄荷（使） 甘草（臣） 丹皮（使） 山栀（使）
上方加生姜大枣。邪甚者加酒芩连。虚者配人参。
Whenever Wind-Cold pathogens invade, the pathogenic factors stagnate within. Sweating is indispensable to resolve this. Originally, sweat is derived from the body fluids (Jin-Ye) of the Stomach. Therefore, in treatises on Cold Damage (Shanghan), the most critical point lies in the three characters: "Preserve Body Fluids." When Heat stagnates internally, body fluids are depleted; how then can they assist in inducing sweat? Now, five methods are established to treat Internal Injury (Neishang), thereby leaving no aspect unaddressed regarding the syndrome of Heat Disease. (These five methods are not solely for treating Internal Injury; they specifically highlight Internal Injury because all Exogenous Febrile Diseases fundamentally stem from Internal Injury. However, it would be more comprehensive to say: "Now, five methods are established to preserve body fluids, thereby leaving no aspect unaddressed regarding the syndrome of Heat Disease.")
First, observe a white tongue coating resembling prickles; this indicates a Lung pathology. Use Shengmai San (Pulse-Generating Powder) with added Shu Di Huang (Prepared Rehmannia Root), Bai Shao (White Peony Root), Dang Gui (Angelica Sinensis), Huang Qin (Scutellaria Root), Gan Cao (Licorice Root), Chai Hu (Bupleurum Root), and Huang Qin (Scutellaria Root) to generate Metal (Lung) and nourish Water (Kidney). (*Zhifa Hui* states: Spleen Heat causes a slippery coating; Spleen Closure causes a white coating like snow. Dong Zhuang's commentary notes: These two statements apply to both Internal and Exogenous conditions, arguing based on Spleen Slipperiness or Closure. It is feared that relying solely on Spleen Slipperiness/Closure cannot cover all Internal and Exogenous cases; readers should examine this carefully.)
Second, a black and slippery tongue coating indicates Kidney Qi encroaching upon the Heart. Use Ba Wei Yin (Eight-Ingredient Decoction). If the coating is black and dry, use Liu Wei Yin (Six-Ingredient Decoction) to rescue Kidney Yin. (Regardless of whether the coating is white, black, red, or yellow, one must distinguish between dryness and slipperiness to treat accordingly.)
Third, a yellow tongue coating requires Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with added Huang Qin (Scutellaria Root) or Huang Lian (Coptis Rhizome) to tonify Earth (Spleen) to generate Metal (Lung). If there is food retention, remove Huang Qin and add Hou Po (Magnolia Bark). Bai Zhu (Atractylodes Macrocephala Rhizome) must not be removed, and sweating should be induced; even if food retention exists, it should not be a concern. (Those with deficient Middle Qi will have a yellow and moist coating; those with food retention will have a full-mouth yellow coating. If the lower half of the coating is yellow, greasy, and moist, it indicates Yangming Heat pathogen that is ending but not yet gone, not necessarily food stagnation causing a greasy coating. Gan Lu Yin (Sweet Dew Decoction) with added Mu Dan Pi (Moutan Cortex), Dang Gui, and Bai Shao is appropriate. One must absolutely avoid digestive and diuretic methods to prevent exhausting Yin fluids. Be cautious. There is also a type of very thin yellow coating, like lacquer on the tongue. Although clearing Fire is suitable, the primary treatment must be tonifying Zheng Qi (Upright Qi) with Ren Shen (Ginseng) and Bai Zhu. If one merely clears Fire, Qi collapse and death will ensue. This must be understood clearly.)
Fourth, if the tongue feels stiff and lacks flexibility, guard against tongue retraction. Use Xiao Yao San (Free and Easy Wanderer Powder) with added Huang Qin (Scutellaria Root), Mu Dan Pi (Moutan Cortex), and Sheng Di Huang (Rehmannia Root) to nourish Water (Kidney) and benefit Liver (Wood).
Fifth, a bright red tongue indicates a Heart Meridian pathology. Combine Liu Wei Yin (Six-Ingredient Decoction) with Shengmai San (Pulse-Generating Powder) to nourish Water and clear Fire. (If there is no coating on the tongue, resembling a peeled pig kidney, it is called Mirror Tongue, which is incurable due to the exhaustion of Yin and fluids. Additionally, if a coating exists but is dry, it is concerning as it may indicate fluid exhaustion. Do not regard this as ordinary; remember it well.)
The distinction between Internal Injury and Exogenous Cold/Heat syndromes is determined by the color of the tongue coating. If black and slippery, it is Kidney Qi encroaching on the Heart; use Ba Wei Yin. If withered, black, and lacking moisture, use Liu Wei Yin. The patient will likely exhibit migratory redness on the malar eminences. After one dose, chills followed by sweating will lead to recovery. (This refers to Dong Zhuang's treatment of Mr. Xu Cun.) If the coating changes from white to yellow, and from yellow to black, it indicates Kidney encroaching on the Spleen. One must treat the Central Palace (Spleen/Stomach), using formulas such as Bu Zhong Yi Qi Tang. The Kidney corresponds to the color of Black Tortoise of the North, hence associated with black. Below the position of Fire, Water Qi succeeds it to control it; Water comes to save the Mother (Fire generates Earth, Earth generates Metal... context implies Water controlling excessive Fire to protect the system). If Fire is drained at this time, there is nowhere for the Fire to drain. Assisting the Child (Earth) to save the Mother (Fire) means the enemy (Water) will inevitably retaliate. "Excess leads to harm; succession brings restraint." The principle is clear. (When Fire is excessive, it attacks Metal. Water Qi succeeding it controls the Fire. This is the theory of "Excess leads to harm, succession brings restraint." The interactions among Zang-Fu organs can be extrapolated similarly. If the color is gray and scraping with a fingernail yields no residue/juice, it is truly a Fire syndrome, for which Huang Qin and Huang Lian are indicated. If Kidney Qi encroaches on the Heart but Huang Qin and Huang Lian are used, a human-character pattern appears on the tongue, leading to death. If black and not slippery, Kidney Water is dried up, and Yin must be urgently rescued. Just as intense heat near fire burns the hand, but as it rises higher it becomes colder, because cold air is forced out by the fire. The black tongue in heat diseases follows this logic. (The analogy is apt.)
The Taiyang Meridian runs on the exterior of the body, specifically the back. The Three Yin Meridians run on the interior of the body, specifically the front. Shaoyang is half-exterior and half-interior. For instance, if one needs to tonify the Central Palace (Spleen) but pathogenic Heat remains, combine Bu Zhong Yi Qi Tang with Xiao Chai Hu Tang to treat Shaoyang, which is half-exterior/half-interior. (Shaoyang governs half-exterior/half-interior as its meridian characteristic. However, its pathway is also on the side of the body.)
Shengmai San (Pulse-Generating Powder)
Ren Shen (Ginseng Root) [Monarch]
Mai Dong (Ophiopogon Tuber) [Minister]
Wu Wei Zi (Schisandra Berry) [Assistant]
If Ren Shen is unavailable, replace it with Gou Qi Zi (Goji Berry).
Ba Wei Yin (Eight-Ingredient Decoction / Jin Gui Shen Qi Wan variation)
Fu Zi (Aconite Lateral Root) [Envoy]
Rou Gui (Cinnamon Bark) [Envoy]
Shu Di Huang (Prepared Rehmannia Root) [Monarch]
Mu Dan Pi (Moutan Cortex) [Assistant]
Fu Ling (Poria) [Monarch]
Ze Xie (Alisma Rhizome) [Assistant]
Shan Yao (Dioscorea Rhizome) [Minister]
Yu Rou (Cornus Fruit) [Minister]
Xiao Yao San (Free and Easy Wanderer Powder)
Chai Hu (Bupleurum Root) [Minister]
Bai Shao (White Peony Root) [Minister]
Dang Gui (Angelica Sinensis Root) [Monarch]
Bai Zhu (Atractylodes Macrocephala Rhizome) [Minister]
Fu Ling (Poria) [Assistant]
Chen Pi (Citrus Reticulata Peel) [Assistant]
Bo He (Mentha Haplocalyx) [Envoy]
Gan Cao (Licorice Root) [Minister]
Mu Dan Pi (Moutan Cortex) [Envoy]
Zhi Zi (Gardenia Fruit) [Envoy]
Add Sheng Jiang (Fresh Ginger) and Da Zao (Jujube Fruit) to the above formula. For severe pathogenic factors, add Jiu Huang Qin (Wine-fried Scutellaria Root) and Jiu Huang Lian (Wine-fried Coptis Rhizome). For deficiency, combine with Ren Shen (Ginseng Root).