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The root of the tongue is slightly black, and the tip is yellow. If the pulse is slippery (Hua Mai), purgation may be applied. If the pulse is floating (Fu Mai), nourishing Yin to subdue Yang should be practiced. If there is aversion to wind and cold, induce mild sweating using Shuangjie San (Double-Release Decoction). If diarrhea occurs, use Jiedu Tang (Detoxification Decoction). The prognosis is good, with seven or eight out of ten recoveries.

[Commentary by Jie] When Shaoyang disease transmits inward and transforms into heat, the tongue coating turns black. It is more common for the blackness to start from the center of the tongue and extend to the root and tip; it is less common for it to start from the root and tip and extend to the center. When heat is extreme, prickles appear, the tongue becomes dry and scorched, and cracks form. Initially, the coating must change from white to yellow, and then from yellow to black. In severe cases, it cannot be scraped off, nor does it become moist when wetted; this indicates that extreme heat has damaged body fluids. Treatment should employ bitter-cold herbs to drain heat and urgent purgation to preserve fluids. In this case, because the tongue root is slightly black, the tip is yellow, and the pulse is slippery, external symptoms must include delirium (Zhenyu), tidal fever (Chaore), abdominal fullness, and hard stool. This pattern is characterized by excess heat in the Stomach and gradual consumption of Kidney fluids. Urgent purgative formulas should be used to cleanse Stomach heat and preserve Kidney fluids. If the pulse is floating, although the pathogen has transformed into heat, it only scorches Stomach fluids; thus, one should nourish Yin fluids to retreat the pathogenic heat. If there is aversion to wind and cold, it indicates the pathogen remains between the Taiyang and Yangming channels. Therefore, Shuangjie San (Double-Release Decoction) is used to release pathogens from both the exterior and interior. If pathogenic heat sinks into the intestines causing diarrhea, this corresponds to the *Neijing* principle: "Acute violent diarrhea with tenesmus belongs to heat." Thus, Jiedu Tang (Detoxification Decoction) is used to clear heat and toxins from the intestines and stomach. Shuangjie San (Double-Release Decoction) and Jiedu Tang (Detoxification Decoction) are described previously.

If the tongue shows a slightly black root, a faintly visible yellow tip, or a single crack: if the pulse is solid (Shi Mai), use Dachengqi Tang (Major Order the Qi Decoction) for purgation. If the pulse is floating and accompanied by thirst and desire to drink water, use Liangge San (Cool the Diaphragm Powder) to resolve the condition. The survival rate is two or three out of ten.

[Commentary by Jie] If the tongue shows a black root and yellow tip, or yellow edges with a scorched black, prickle-covered center, and the pulse is solid, the umbilical and abdominal regions will necessarily be distended, full, hard, and painful. This is a syndrome of Yangming excess heat. Therefore, Dachengqi Tang (Major Order the Qi Decoction) can be used. Bitter-cold herbs drain Yangming heat, and urgent purgation rescues the deficiency of body fluids. If the pulse is floating and accompanied by thirst and desire to drink water, the pathogen has not yet entered the Fu organs, so Liangge San (Cool the Diaphragm Powder) can still be used to resolve heat.
Dachengqi Tang (Major Order the Qi Decoction) and Liangge San (Cool the Diaphragm Powder) are described previously.