再有热传营血，其人素有瘀伤宿血在胸膈中，舌色必紫而暗，扪之潮湿，当加散血之品，如琥珀、丹参、
桃仁、丹皮等，否则瘀血与热相抟，阻遏正气，遂变如狂发狂之症。若紫而肿大者，乃酒毒冲心；紫而干晦者，
肾肝色泛也，难治。
舌若淡红无色，或干而色不荣者，乃是胃津伤而气无化液也。当用炙甘草汤，不可用寒凉药。
舌无苔而有如烟煤隐隐者，慎不可忽视。如口渴烦热而燥者，平时胃燥也，不可攻之，宜甘寒益胃；若不
渴肢寒而润者，乃挟阴病，宜甘温扶中。此何以故？外露而里无也。
舌黑而滑者，水来克火，为阴症，当温之；若见短缩，此肾气竭也，为难治。惟加人参、五味子，或救万
一。舌黑而干者，津枯火炽，急急泻南补北；若黑燥而中心浓者，土燥水竭，急以咸苦下之。
再温热之病，看舌之后，亦须验齿。齿为肾之余，龈为胃之络，热邪不燥胃津，必耗肾液，且二经之血，
走于此处。病深动血，结瓣于上，阳血色紫，紫如干漆；阴血色黄，黄如酱瓣。阳血若见，安胃为主；阴血若
见，救肾为要。然豆瓣色者多险，惟症尚不逆者犹可治，否则难治矣。此何故耶？盖阴下竭、阳上厥也。
齿若光燥如石者，胃热甚也，证见无汗恶寒，卫偏胜也，辛凉泄卫透汗为要。若如枯骨色者，肾液枯也，
为难治。若上半截润，水不上承而心火上炎也，急急清心救水，俟枯处转润为妥。
若齿垢如灰糕样者，胃气无权，津亡而湿浊用事，多死。初病齿缝流清血，痛者为胃火冲激；不痛者为龙
火内燔。齿焦无垢者死；齿焦有垢者，肾热胃劫也，当微下之，或玉女煎清胃救肾可也。
若切牙啮齿者，湿热化风，痉病；但切牙者，胃热气走其络也；切牙而脉证皆衰者，胃虚无谷以内荣也。
此何以故？虚则喜实也。舌本不缩而硬，牙关咬定难开者，此非风痰阻络，即欲作痉症。用酸物擦之即开，酸
走筋，木来泄土故也。
Furthermore, if heat transmits to the Ying (Nutrient) and Xue (Blood) levels, and the patient has a history of stagnant blood in the chest and diaphragm, the tongue color will inevitably be purple and dark, feeling moist upon palpation. In treatment, blood-dispersing agents such as Succinum (Amber), Salvia miltiorrhiza Radix et Rhizoma (Danshen), Persicae Semen (Taoren), and Moutan Cortex (Danpi) should be added. Otherwise, the stagnant blood and heat will contend with each other, obstructing the righteous Qi, leading to symptoms resembling or actual mania. If the tongue is purple and swollen, it indicates alcohol toxin rushing to the Heart; if purple and dry/dull, it reflects the colors of the Kidney and Liver manifesting externally, which is difficult to treat.
If the tongue is pale red without color, or dry and lacking luster, it signifies injury to Stomach Jin-Ye (Body Fluids) and the inability of Qi to transform fluids. In this case, Zhi Gancao Tang (Honey-Fried Licorice Decoction) should be used, and cold/cooling medicines must be avoided.
If there is no coating on the tongue but a faint black color like soot is visible, one must not disregard it. If accompanied by thirst, irritability, fever, and dryness, it indicates chronic Stomach dryness/heat; purgatives should not be used, but rather sweet-cold herbs to benefit the Stomach Yin. If there is no thirst, cold limbs, and a moist surface, it indicates a concurrent Yin syndrome (Cold); sweet-warm herbs should be used to support the Middle Jiao. Why is this? Because the pathogen is exposed externally while the interior lacks Yang.
A black and slippery tongue indicates Water overcoming Fire, belonging to a Yin syndrome, requiring warming therapy. If the tongue is short and contracted, this signifies exhaustion of Kidney Qi, making it difficult to treat. Only by adding Ginseng Radix et Rhizoma (Renshen) and Schisandrae Fructus (Wuweizi) might there be a chance of rescue. A black and dry tongue indicates exhaustion of Jin-Ye and blazing fire; urgently, one must drain the South (Heart/Fire) and tonify the North (Kidney/Water). If black, dry, and thick in the center, it indicates Earth dryness (Stomach Heat) exhausting Water (Kidney Yin); urgently, salty-bitter purgatives should be administered.
In addition, after examining the tongue in warm-heat diseases, one must also examine the teeth. Teeth are the surplus of the Kidney, and gums are the collaterals of the Stomach. If heat does not dry Stomach Jin-Ye, it must consume Kidney Ye (Essence/Fluids), and the blood of these two meridians flows to this area. When disease deepens and moves blood, clots form on the upper teeth. In Yang syndromes, the blood is purple, looking like dried lacquer; in Yin syndromes, the blood is yellow, looking like bean paste. If Yang blood is seen, regulating the Stomach is primary; if Yin blood is seen, saving the Kidney is essential. However, bean-paste colored bleeding is mostly dangerous; only if the symptoms are not yet rebellious can it be treated, otherwise it is difficult. Why? Because Yin is exhausted below and Yang is reversed above.
If teeth are shiny and dry like stone, it indicates severe Stomach heat. If symptoms include anhidrosis and aversion to cold, it indicates excess Wei (Defensive) Qi; the key is to use pungent-cool herbs to vent the Wei level and induce sweating. If teeth look like dead bones, it indicates exhaustion of Kidney fluids, which is difficult to treat. If the upper half is moist and the lower half dry, it indicates Kidney water failing to ascend while Heart fire flares upward; urgently clear the Heart and save the Water until the dry areas become moist.
If dental plaque resembles gray cake, it indicates weak Stomach Qi, loss of Jin-Ye, and dominance of damp-turbidity, often leading to death. If clear blood flows from the gum margins at the onset of disease, pain indicates Stomach fire rushing and stimulating; lack of pain indicates Dragon Fire burning internally. Blackened teeth without plaque indicate death; blackened teeth with plaque indicate Kidney heat and Stomach fluid depletion; mild purgation may be applied, or Yutou Jian (Jade Woman Decoction) to clear Stomach heat and save Kidney Yin.
Teeth grinding or clenching indicates damp-heat transforming into wind, resulting in spasm (Jing syndrome). Clenching alone indicates Stomach heat causing Qi to move through its collaterals. Clenching with weak pulse and symptoms indicates Stomach deficiency lacking grain essence to nourish internally. Why? Because deficiency tends to manifest with excess-like signs. If the root of the tongue is not shortened but stiff, and the jaw is locked tight, it is either phlegm-wind blocking the collaterals or impending spasm. Wiping with sour substances can open the jaw because sour enters the sinews, and Wood energy releases Earth energy.