经曰∶舌为心窍。舌根属肾，舌中属脾胃，舌左属肝，舌右属肺，舌尖属心。又舌尖主
上焦，舌中主中焦，舌根主下焦。绘图于后。(林佩琴)
舌苔如地上初生之草，草必有根，无根者为浮垢，刮之即去。地如秽浊，草必畅茂。邪
气入胃，苔必浓腻。故以舌苔验病之虚实寒热，邪之浅深轻重。(《温热经纬》)
舌上无苔为在表，鲜红为火，淡白为寒。(指无苔言。)若有白苔为半表半里，黄苔为在
里，黑苔病入少阴，主危险。(陈修园)
温邪舌白而燥者，肺阴亡也。舌白如粉者，热据上焦也。白苔在杂证，是胃中积滞。白
苔在
温证，亦属积滞，定属热邪，一二日变成黄黑矣。舌白而干者多谵语，舌白而尖渐红，口渐
燥者皆属热。(《温热经纬》)
舌白为寒，如白而不燥，须问其口中和否。如口中自觉粘腻，湿渐化热。口苦而渴者，邪
已化热。或渴喜热饮，邪虽化热而痰饮内盛也。(《温热经纬》)
舌白属气，主病在气分，则白苔不必尽属于寒也。(《温热经纬》)
舌苔白浓而干燥者，胃燥气伤也。舌白而薄者，外感风寒也。若白薄而干者，肺津伤也
。(《温热经纬》)
白苔粘腻，吐涎沫而浊浓者，口必甜味也，为脾瘅病。湿热之气与谷气相搏，土有余也
。盈
满则上泛，宜芳香辛散以逐之，苔白如碱者，胃中宿滞，秽浊郁伏，急宜开泄。(叶天士)
白苔如积粉之浓，其秽浊重也。温疫病初入膜原，未归胃腑，急宜透解。(叶天士)
舌润如常而未生苔者邪在表。苔白而滑者邪入里。(周于蕃)
苔白而中黄者邪入胃。苔于白而中心黑者危。(周于蕃)
舌绛(深红色也)者，热入于营也。舌尖绛而干者，心营热炽也。舌中绛而干者，胃火热
灼也。若望之似干，以手扪之尚有津液，湿热熏蒸，浊痰蒙闭也。(叶天士)
舌初绛而兼黄白色者，气分邪尚未尽，纯绛鲜色者，病已入营也。绛而光亮者，胃阴亡
也。绛而泽润者，虽属营热，实因有痰，故不干燥也。(叶天士)
舌绛而上有粘腻，似苔非苔者，中夹秽浊之气。舌绛而短，难于抵齿者，痰阻舌根有内
风也。(叶天士)
舌绛而光亮，胃阴亡也。舌绛而有碎点或白或黄者，当生疳也。大红点者，热毒乘心也
。(叶天士)
舌绛而无苔者，热伤血分。舌绛而谵语者，热入心营。(周于蕃)
舌红者暑证，红极者温毒。舌红嫩如新，望之润而扪之干者，妄行汗下，津液竭也。(
周于蕃)
舌底绛而面有白苔者，湿热遏伏也。舌绛而干缩者，肾阴竭也。(周于蕃)
舌绛而紫，紫而暗，潮湿不干，内有瘀血。若晦而干者，精血已枯，邪热乘之，总由肾
色黑，肝色青，青黑相合而见于舌。变化紫晦，为肾肝色泛，多无治。(王孟英)
舌黄主热，为邪以入里。或淡黄，或老黄如沉香色，或中有断纹者主热。(叶天士)
温邪辨证最速，舌色一黄，顷刻即成灰黑，以其火中夹风也。天下至速者，莫如风火，
火就燥，口渴舌干，皆热邪横肆，弥漫三焦也。(周于蕃)
舌苔黄而浓腻者，热据中焦也。苔黄而或兼白者，热滞胃脘也。(周于蕃)
苔黄而滑者热尚轻，苔黄而干者热已盛。苔中黄而两边白者邪入里。(周于蕃)
苔黄而带灰色者胃热，苔黄而带黑色者危。(周于蕃)
苔黑有虚实寒热。黑而燥者为热，黑而润者为寒。(王孟英)
阳虚而舌黑者，润而不燥，或无苔而如烟煤者，是肾水来乘心火。(王孟英)
阴虚而舌黑者，不甚燥，不甚渴。其舌赤，或舌中黑而无苔垢，舌本枯而不甚赤，宜壮
水滋阴。(《温热经纬》)
舌中无苔，而舌根有黑苔干燥者，热在下焦也。(《温热经纬》)
舌本无苔，惟尖黑而燥，为心火自焚，不可救药。(《温热经纬》)
苔黑而滑者，水来克火，为虚寒证，当温之。若见短缩，肾气竭也。(《温热篇》)
舌黑而燥者，津枯火炽也。宜泻南补北。若燥而中心浓者，土燥水竭，以咸苦下之。(
《温热篇》)
舌黑而润者，外无险恶情状，胸有伏痰。暑热证夹血，亦多有之，切勿误作阴证。(何
报之)
淡红无色，或干而不荣，胃津伤而气不能化液也。(《温热篇》)
苔不拘何色，而忽生芒刺者，上焦热极也。或断纹燥裂，亦主热。(《温热篇》)
舌焦而齿煤，唇血燥裂者，火炽血涸，欲成风痉也。(《温热篇》)
有热无湿者，舌无苔，即有苔亦薄。若有湿有痰而热者，必有浊苔，但湿在表者亦无苔
。(周于蕃)
初病，苔自浓，宜宣通气分。久病，苔黄浓，宜宣通血分。病久有苔而燥，泻积救阴；
病久无苔而干，滋阴养液。(林佩琴)
杂证舌中绛而干，须清营热。杂证舌灰有津，须引火归原，杂证苔黄，其味或苦或酸，
皆脾经有热。(林佩琴)
舌黑有虚寒，有实热。虚寒者，舌必润。实热者，舌必燥。舌黑谵语属热，无谵语属寒
。(惕厉子)
舌白有寒有热，无苔而淡白者寒，有苔而浓白者热。舌白而干者热，舌白而潮者寒。而
淡白
而以为口干者，则病患自觉干，而视舌者不见其干，宜用桂附补命火，则津液薰蒸上潮于肺
，不得以口干而用寒凉。(林佩琴)
舌灰而燥者，急下存阴。舌灰有津者，宜桂附温里。肥人舌灰有津亦然。(林佩琴)
苔润有液者为寒，苔燥无液者为火。舌上无苔，如去油猪腰，为亡液。名镜面舌，主危
险。(陈修园)
舌有半边干半边湿者，为胆病。舌半边白苔，半边黄黑苔者危。(周于蕃)
舌中黑而燥，两边或白或黄者，两感证。舌中黑而润，两边白者表里皆虚。(周于蕃)
舌半黑半黄，或半黄半白，或中干边润，或尖干根润者，传并之邪。(周于蕃)
白苔有黑点者，胃热也；有红点者，火炎也。舌红有白点者，邪入心胞也；有黑点者，
胃热也。(周于蕃)
舌紫肿大者酒毒，紫暗而摸之湿者，瘀血夹热也。(周于蕃)
舌中酱色者，夹食伤寒也。舌蓝色者，肝绝也。(周于蕃)
苔灰而薄者邪轻，苔黑而浓者邪重。苔渐退者邪亦退，苔渐进者邪亦进。(林佩琴)
凡有苔而退者，由舌尖退至中，由中退至根。若舌本干燥，服药后有津，苔必退。亦有
舌尖、中、根渐薄而一起退者。(林佩琴)
苔因食酸而变者，为染苔。食橄榄则黑，食枇杷则黄。(王孟英)
舌青皆厥阴之病。凡病者舌青主寒，无治。至妇人胎死腹中，则舌灰舌青又一说也。(
林佩琴)
小儿弄舌者主热，若大病未已而弄舌者凶。(钱仲阳)
病初起，舌干而脉滑脘闷者，痰阻于中，而液不上潮，未可率投补益也。(王孟英)
舌红，而更有红点如虫蚀之状者，热毒炽盛，火在上，水在下，不能相济也。(周于蕃)
舌红而更有裂纹如人字形者，君火燔灼，热毒炎上也。舌淡红而中有大红星者，亦君火
燔炽。(周于蕃)
按∶《内经》辨色而舌苔独遗，近代诸方家详言之，实有可据。张诞先着《舌鉴》，列
图疏
方，只论伤寒，不论杂证，殊多遗漏。叶香岩《温热论》辨舌色独出手眼，超绝千古，殆所
谓别有神悟，洵不传之妙法也。故是篇本叶氏最多，聊注数语，以见向往钦佩之忱。
惕厉子于太乙燃藜照读日志
\r全舌图\pn-n4.bmp\r
舌尖属心，主上焦。舌中属脾胃，主中焦，舌根属肾，主下焦。
The *Neijing* (Inner Canon) states: The tongue is the orifice of the Heart. The root of the tongue belongs to the Kidney, the middle of the tongue belongs to the Spleen and Stomach, the left side belongs to the Liver, the right side belongs to the Lung, and the tip belongs to the Heart. Furthermore, the tip of the tongue primarily reflects the Upper Jiao (Upper Burner), the middle of the tongue primarily reflects the Middle Jiao (Middle Burner), and the root of the tongue primarily reflects the Lower Jiao (Lower Burner). A diagram follows. (Lin Peiqin)
Tongue coating is like grass newly sprouting on the ground; grass must have roots. What lacks roots is called floating debris, which can be scraped off easily. If the soil is filthy and turbid, the grass will inevitably grow luxuriantly. When pathogenic factors invade the Stomach, the tongue coating will inevitably become thick and greasy. Therefore, by observing the tongue coating, one can verify the deficiency or excess, cold or heat of the disease, as well as the depth and severity of the pathogenic factors. (*Wenre Jingwei*)
Absence of tongue coating indicates the pathogen is at the Exterior; bright red color indicates Fire; pale white color indicates Cold. (Referring to cases without coating.) Presence of white coating indicates the pathogen is in the Half-Exterior Half-Interior stage; yellow coating indicates the pathogen is in the Interior; black coating indicates the pathogen has entered the Shaoyin channel, signifying danger. (Chen Xiuyuan)
In warm diseases, a white and dry tongue coating indicates exhaustion of Lung Yin. A white coating resembling powder indicates Heat occupying the Upper Jiao. In miscellaneous diseases, a white coating indicates accumulation/stagnation in the Stomach. In warm diseases, it also belongs to accumulation/stagnation, definitely involving Heat pathogens, which will turn yellow or black within one or two days. A white and dry coating often presents with delirium; a white coating with the tip gradually turning red and the mouth becoming dry all belong to Heat patterns. (*Wenre Jingwei*)
A white coating indicates Cold. If it is white but not dry, one must ask if the patient feels their mouth is neutral/peaceful. If the mouth feels sticky, Dampness is transforming into Heat. Bitter taste and thirst indicate the pathogen has transformed into Heat. Thirst with preference for hot drinks indicates that although the pathogen has transformed into Heat, there is abundant Phlegm-Fluid retention internally. (*Wenre Jingwei*)
A white coating belongs to the Qi level, indicating pathology in the Qi aspect; thus, a white coating does not necessarily belong entirely to Cold patterns. (*Wenre Jingwei*)
A thick, dense, and dry white coating indicates Dryness injuring Qi in the Stomach. A thin white coating indicates External contraction of Wind-Cold. A thin, white, and dry coating indicates injury to Lung Jin (Body Fluids). (*Wenre Jingwei*)
A sticky white coating accompanied by spitting of turbid saliva indicates a sweet taste in the mouth, known as Pi Dan disease (Spleen Heat/Dampness). This results from the struggle between Damp-Heat and Grain Qi, representing an excess of Earth element. When full, it overflows upward; aromatic and acrid-dispersing herbs should be used to expel it. A white coating resembling alkali/powder indicates old food stagnation in the Stomach with foul turbidity constrained and hidden; urgent opening and draining are required. (Ye Tianshi)
A white coating as thick as accumulated powder indicates severe foul turbidity. When Warm Epidemic Disease initially enters the Mo Yuan (Membrane Source) and has not yet returned to the Stomach Fu organ, urgent resolution and penetration are required. (Ye Tianshi)
A moist tongue surface without coating indicates the pathogen is at the Exterior. A white and slippery coating indicates the pathogen has entered the Interior. (Zhou Yufan)
A white coating with a yellow center indicates the pathogen has entered the Stomach. A white coating with a black center indicates critical condition. (Zhou Yufan)
A crimson (deep red) tongue indicates Heat entering the Ying (Nutrient) level. A crimson and dry tip indicates blazing Heart Ying Heat. A crimson and dry middle indicates blazing Stomach Fire. If it appears dry to the eye but retains moisture when touched, it indicates steaming by Damp-Heat and obstruction by turbid Phlegm clouding the mind. (Ye Tianshi)
An initial crimson tongue with mixed yellow-white areas indicates residual pathogenic factors in the Qi level; a pure, fresh crimson color indicates the disease has entered the Ying level. A bright and glossy crimson tongue indicates exhaustion of Stomach Yin. A moist and lustrous crimson tongue, although belonging to Ying Heat, is actually due to Phlegm, hence not dry. (Ye Tianshi)
A crimson tongue with sticky material on top, resembling coating but not quite, indicates turbid Qi trapped in the middle. A short, crimson tongue that cannot reach the teeth indicates Phlegm obstructing the tongue root with internal Wind. (Ye Tianshi)
A bright and glossy crimson tongue indicates exhaustion of Stomach Yin. A crimson tongue with small spots, either white or yellow, suggests impending aphthous ulcers (Gan). Large red spots indicate Heat-Toxin attacking the Heart. (Ye Tianshi)
A crimson tongue without coating indicates Heat injuring the Blood level. A crimson tongue with delirium indicates Heat entering the Heart Ying. (Zhou Yufan)
A red tongue indicates Summerheat syndrome; extreme redness indicates Warm Toxicity. A tender, new-looking red tongue that appears moist but feels dry to the touch indicates exhaustion of Body Fluids due to improper use of sweating and purging methods. (Zhou Yufan)
A crimson underside with a white surface coating indicates constrained and latent Damp-Heat. A dry and shriveled crimson tongue indicates exhaustion of Kidney Yin. (Zhou Yufan)
A crimson and purple tongue, dark purple and moist/not dry, indicates internal Blood stasis. If dull and dry, Essence and Blood are exhausted, and Heat pathogens attack; this generally results from the combination of Kidney color (Black) and Liver color (Green) appearing on the tongue. Changes to dull purple-black represent the flooding of Kidney and Liver colors, usually untreatable. (Wang Mengying)
Yellow tongue coating indicates Heat and entry of pathogen into the Interior. Whether pale yellow, old yellow like沉香 (agarwood) color, or with cracks in the middle, all indicate Heat. (Ye Tianshi)
Warm disease differentiation is fastest; once the tongue turns yellow, it quickly turns gray-black because Fire contains Wind. Nothing in the world is faster than Wind-Fire; Fire seeks dryness. Thirst and dry tongue indicate rampant Heat pathogens permeating the Three Jiaos. (Zhou Yufan)
A thick and greasy yellow coating indicates Heat occupying the Middle Jiao. A yellow coating possibly mixed with white indicates Heat stagnation in the Epigastrium. (Zhou Yufan)
A slippery yellow coating indicates mild Heat; a dry yellow coating indicates severe Heat. A yellow center with white sides indicates the pathogen has entered the Interior. (Zhou Yufan)
A yellow coating with gray tones indicates Stomach Heat; a yellow coating with black tones indicates critical condition. (Zhou Yufan)
Black tongue coating involves Deficiency-Cold and Excess-Heat. Black and dry indicates Heat; black and moist indicates Cold. (Wang Mengying)
In Yang Deficiency with a black tongue, it is moist and not dry, or devoid of coating like soot, indicating Kidney Water overcoming Heart Fire. (Wang Mengying)
In Yin Deficiency with a black tongue, it is neither very dry nor very thirsty. The tongue is red, or the center is black without coating/fur, and the root is withered but not very red; treatment should strengthen Water and nourish Yin. (*Wenre Jingwei*)
Absence of coating in the center with dry black coating at the root indicates Heat in the Lower Jiao. (*Wenre Jingwei*)
Absence of coating at the root with only the tip black and dry indicates self-burning of Heart Fire, which is incurable. (*Wenre Jingwei*)
A black and slippery coating indicates Water overcoming Fire, a Deficiency-Cold pattern, requiring warming. If shortening is seen, it indicates exhaustion of Kidney Qi. (*Wenre Pian*)
A black and dry tongue indicates exhaustion of Jin-Ye (Body Fluids) and blazing Fire. Treatment should drain South (Heart) and tonify North (Kidney). If dry and thick in the center, it indicates Earth Dryness and Water Exhaustion; treat with salty-bitter purgatives. (*Wenre Pian*)
A black and moist tongue, without external dangerous signs but with latent Phlegm in the chest, often occurs in Summerheat-Heat syndromes complicated by Blood stasis; do not mistakenly diagnose as Yin pattern. (He Baozhi)
Pale red and colorless, or dry and lacking luster, indicates injury to Stomach Jin where Qi cannot transform fluids. (*Wenre Pian*)
Regardless of color, sudden appearance of prickles (spines) on the coating indicates extreme Heat in the Upper Jiao. Cracks and dry splitting also indicate Heat. (*Wenre Pian*)
A scorched tongue with blackened teeth and cracked, bleeding lips indicates blazing Fire and depleted Blood, predisposing to Wind-Spasms. (*Wenre Pian*)
Heat without Dampness results in no coating, or very thin coating if present. Heat with Dampness and Phlegm results in turbid coating; however, Dampness at the Exterior also results in no coating. (Zhou Yufan)
Early disease with thick coating requires promoting circulation in the Qi level. Chronic disease with thick yellow coating requires promoting circulation in the Blood level. Chronic disease with coating that is dry requires purging accumulation and saving Yin; chronic disease without coating that is dry requires nourishing Yin and fluids. (Lin Peiqin)
Miscellaneous diseases with crimson and dry middle require clearing Ying Heat. Miscellaneous diseases with gray coating and moisture require guiding Fire back to its source. Miscellaneous diseases with yellow coating, whether bitter or sour tasting, indicate Heat in the Spleen channel. (Lin Peiqin)
Black tongue involves Deficiency-Cold and Excess-Heat. Deficiency-Cold tongues are moist; Excess-Heat tongues are dry. Black tongue with delirium belongs to Heat; without delirium, it belongs to Cold. (Ti Li Zi)
White tongue involves Cold and Heat. No coating with pale white indicates Cold; thick white coating indicates Heat. White and dry indicates Heat; white and damp indicates Cold. If the patient feels dry mouth but the tongue appears pale white and not dry, use Guizhi and Fuzi to tonify Mingmen Fire, causing fluids to steam upward to the Lung; do not use Cold herbs merely for the sensation of dry mouth. (Lin Peiqin)
Gray and dry tongue requires urgent purging to preserve Yin. Gray and moist tongue requires Guizhi and Fuzi to warm the Interior; this applies similarly to obese individuals with gray and moist tongues. (Lin Peiqin)
Moist coating with fluid indicates Cold; dry coating without fluid indicates Fire. Absence of coating on the tongue, looking like a defatted pork kidney, indicates exhaustion of fluids, named "Mirror Tongue," signifying danger. (Chen Xiuyuan)
Half-dry and half-wet tongue indicates Gallbladder disease. Half-white coating and half-yellow-black coating indicates critical condition. (Zhou Yufan)
Black and dry center with white or yellow sides indicates Two-Feelings Syndrome (simultaneous exterior and interior involvement). Black and moist center with white sides indicates both Exterior and Interior Deficiency. (Zhou Yufan)
Half-black/half-yellow, or half-yellow/half-white, or dry center/moist edges, or dry tip/moist root indicates transmitted and combined pathogens. (Zhou Yufan)
White coating with black spots indicates Stomach Heat; with red spots indicates flaming Fire. Red tongue with white spots indicates pathogen entering Pericardium; with black spots indicates Stomach Heat. (Zhou Yufan)
Purple and swollen tongue indicates Alcohol Toxicity; purple-dark and moist to touch indicates Blood Stasis with Heat. (Zhou Yufan)
Sauce-colored center indicates Cold Damage complicated by Food Stagnation. Blue tongue indicates Liver Extinction. (Zhou Yufan)
Thin gray coating indicates light pathogen; thick black coating indicates heavy pathogen. Gradual retreat of coating means pathogen retreats; gradual advance means pathogen advances. (Lin Peiqin)
Coatings that recede do so from tip to center, then center to root. If the root was dry but becomes moist after medication, coating will recede. Sometimes tip, center, and root thin out simultaneously. (Lin Peiqin)
Coatings changed by eating sour foods are called stained coatings. Eating olives turns them black; eating loquats turns them yellow. (Wang Mengying)
Blue-green tongue always indicates Jueyin disease. Generally, blue-green tongue indicates Cold with no specific treatment. However, in women with fetal death in utero, gray-blue tongue is another explanation. (Lin Peiqin)
Children playing with their tongue (protruding/retracting) indicates Heat; if occurring during severe illness, it is ominous. (Qian Zhongyang)
Early disease with dry tongue, slippery pulse, and epigastric stuffiness indicates Phlegm obstruction in the middle preventing fluid ascent; do not rashly administer tonics. (Wang Mengying)
Red tongue with red spots resembling insect bites indicates blazing Heat-Toxin, Fire above and Water below failing to interact. (Zhou Yufan)
Red tongue with human-character-shaped cracks indicates blazing Sovereign Fire and ascending Heat-Toxin. Pale-red tongue with large red star-spots also indicates blazing Sovereign Fire. (Zhou Yufan)
Note: The *Neijing* differentiates colors but omits tongue coating; modern experts discuss it in detail with solid basis. Zhang Danxian's *She Jian* (Tongue Diagnosis) lists diagrams and formulas but only discusses Cold Damage, omitting miscellaneous diseases. Ye Tianyi's *Wenre Lun* (Treatise on Warm Diseases) stands out uniquely in tongue color differentiation, surpassing ages past, possessing divine insight indeed. Thus, this chapter relies heavily on Ye's teachings, with brief notes expressing admiration.
Ti Li Zi, recorded while reading under the light of Taiyi Ranli.
Full Tongue Diagram
Tip belongs to Heart, governing Upper Jiao. Middle belongs to Spleen/Stomach, governing Middle Jiao. Root belongs to Kidney, governing Lower Jiao.