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The Heavenly Master said: I have a method for tongue diagnosis in Shanghan (Cold Damage). Whenever the tongue surface presents with white coating, it indicates that the pathogenic fire is not severe; Xiaochaihu Tang (Minor Bupleurum Decoction) should be used to resolve the exterior and clear heat. If the tongue surface presents with yellow coating, it signifies heat in the Heart; Huanglian (Coptidis Rhizoma) and Zhizi (Gardeniae Fructus) can be used to cool the heart and clear heat. Whenever yellow coating mixed with grey color is observed, it indicates heat in the Stomach; Shigao (Gypsum Fibrosum) and Zhimu (Anemarrhenae Rhizoma) can be used to clear heat. Whenever yellow coating mixed with red color is observed, it indicates heat in the Small Intestine and Bladder; Zhizi (Gardeniae Fructus) can be used to clear damp-heat. When observing a red tongue with white areas, it indicates heat in the Lung; Huanglian (Coptidis Rhizoma) and Suye (Perillae Folium) should be used to resolve the exterior and clear heat. When observing a black tongue with red areas, it indicates Kidney Yin deficiency complicated by pathogenic factors; Shengdi (Rehmanniae Radix Preparata), Xuanshen (Scrophulariae Radix), along with Chaihu (Bupleuri Radix), should be used to harmonize the Shaoyang stage. When observing a red tongue with black spots, it indicates extreme heat in the Stomach; Shigao (Gypsum Fibrosum) should be used for treatment. Xuanshen (Scrophulariae Radix) and Gegen (Puerariae Lobatae Radix) are also effective, but ultimately not as exquisite as Shigao (Gypsum Fibrosum). When observing a red tongue with white spots, it indicates pathogenic factors in the Heart; Chaihu (Bupleuri Radix) and Huanglian (Coptidis Rhizoma) should be used to resolve the exterior and clear heat, treating both the Heart and Liver simultaneously. When observing a red tongue with large red spots, it indicates Stomach heat complicated by dampness; Yinchin Wuling San (Artemisiae Scopariae and Poria Decoction) must be used to promote urination and clear damp-heat. Since water-dampness must return to the Bladder to dissipate pathogens, Rougui (Cinnamomi Cortex) is required to guide the medicine into the Bladder, but only one or two fen should be used, not more. When observing white coating on the tongue with black spots, it is also Stomach heat; Shigao (Gypsum Fibrosum) should be used to cool the heat. When observing yellow coating with black areas, it indicates excess heat in the Liver channel; Chaihu (Bupleuri Radix) and Zhizi (Gardeniae Fructus) should be used to resolve the exterior and clear heat. When observing white coating turning yellow, it indicates that pathogens are about to enter the interior; Chaihu (Bupleuri Radix) and Zhizi (Gardeniae Fructus) should be urgently used to resolve the exterior and prevent the pathogens from entering the interior. Chaihu (Bupleuri Radix) governs the half-exterior half-interior stage and must be used. When observing white coating in the center of the tongue and yellow coating on the periphery, it indicates pathogens have entered the Large Intestine; Wuling San (Five-Ingredient Poria Decoction) must be used to separate fluids and dampness; once fluids are separated, diarrhea will cease. When observing yellow coating in the center of the tongue and white coating on the periphery, it indicates pathogens are inside rather than outside, and upper rather than lower; only Chaihu (Bupleuri Radix) and Zhike (Aurantii Fructus Immaturus) should be added to harmonize; Dahuang (Rhei Radix et Rhizoma) should not be used abruptly for mild purgation. Tianshui San (Tianshui Powder) combined with Wuling San (Five-Ingredient Poria Decoction) is also acceptable, but ultimately not as direct as Chaihu (Bupleuri Radix) and Zhike (Aurantii Fructus Immaturus) targeting the root cause; adding a small amount of Tianshui San (Tianshui Powder) is more appropriate, or none at all, using only Tianshui San (Tianshui Powder) combined with Wuling San (Five-Ingredient Poria Decoction) is also fine. When observing yellow coating at the root of the tongue and a smooth white surface, it is also Stomach heat complicated by dampness; Shigao (Gypsum Fibrosum) must be used as the sovereign herb, with a small addition of diuretic herbs such as Zhuling (Polyporus) and Zexie (Alismatis Rhizoma). When observing yellow coating segmented into lobes, it indicates damp-pathogens have entered the Large Intestine; Dahuang (Rhei Radix et Rhizoma) and Yinchin (Artemisiae Scopariae Herba) should be used urgently for purgation; Didang Tang (Blood-Piercing Decoction) and Shizao Tang (Ten-Jujube Decoction) are not necessary. However, if purgation is delayed, they may become necessary. One must distinguish between fluid accumulation and blood stasis; use Shizao Tang (Ten-Jujube Decoction) for fluid accumulation, and Didang Tang (Blood-Piercing Decoction) for blood stasis. When observing red areas on the tongue resembling insect erosion, it indicates that Water Qi has not risen while Fire Qi attacks; Huanglian (Coptidis Rhizoma) and Chaihu (Bupleuri Radix) should be used to harmonize. When observing a red tongue cracked like the character "Ren" (人), it indicates pathogens have just entered the Heart; Shigao (Gypsum Fibrosum) and Huanglian (Coptidis Rhizoma) should be used to resolve the exterior and clear heat. When observing a black root and a red tip, it indicates pathogens in the Kidney have not dispersed; Chaihu (Bupleuri Radix) and Zhizi (Gardeniae Fructus) should be used to resolve the exterior and clear heat. When observing a black root and a white tip, it indicates Stomach Fire attacking the Kidney; Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), and Xuanshen (Scrophulariae Radix) should be used; whether the patient is thirsty or not need not be discussed, nor whether there is diarrhea. When observing a black root and a yellow tip, it also indicates pathogens are about to enter the Kidney; Dahuang (Rhei Radix et Rhizoma) must be used urgently for purgation. However, abdominal pain must be distinguished; if pressing the abdomen causes pain and the hand cannot approach, urgent purgation is required; otherwise, only Chaihu (Bupleuri Radix) and Zhizi (Gardeniae Fructus) should be used to harmonize. When observing a purely red tongue with a uniquely black tip, it indicates Kidney Yin deficiency with pathogenic Fire attacking; Shigaotang (Gypsum Decoction) should not be used. Since the Kidney is already deficient, using cold Shigao (Gypsum Fibrosum) accelerates death; instead, 1 liang or 2 liang of Xuanshen (Scrophulariae Radix) should be used to rescue Yin, which often succeeds. When observing a red halo in the center of the tongue with pure black around the periphery, it indicates blazing Sovereign and Ministerial Fire; Dahuang (Rhei Radix et Rhizoma) combined with approximately 1 liang of Shengdi (Rehmanniae Radix Preparata) should be used urgently for purgation to rescue Yin; five or six out of ten patients can be saved. When observing central grey-black coating with slightly red periphery, it indicates pathogens knotting in the Large Intestine; purgation leads to recovery, otherwise death ensues; this is because Kidney Water is withered and cannot moisten and push waste. At this time, Shudihuang (Rehmanniae Radix Preparata) and other tonifying herbs should not be used directly; since pathogens have not dispersed, tonification increases distension and urgency, harming the patient. Only after pathogens descend can Shengdi (Rehmanniae Radix Preparata) be used to nourish Yin, but not in large amounts. When observing purely grey coating with two unique black halos in the center, it also indicates pathogens are about to enter the Kidney; urgently use approximately 1 liang of Xuanshen (Scrophulariae Radix) with a little Chaihu (Bupleuri Radix) for treatment. When observing red exterior and black interior, this is Fire extreme resembling Water; urgently use Chaihu (Bupleuri Radix), Zhizi (Gardeniae Fructus), Dahuang (Rhei Radix et Rhizoma), and Zhishi (Aurantii Fructus Immaturus) to harmonize and promote flow. If prickles appear on the tongue, Fire hyperactivity and heat are extreme; the aforementioned herbs should be increased significantly. In summary, black interior with white exterior, or black interior with yellow exterior, are previous conditions treated similarly; five out of ten patients can be saved. Only when the center is pale black, with pale red or pale white exterior, or pale yellow interior, is the condition lighter than before; the previous methods apply, saving eight out of ten patients. When observing a purely red tongue with several black lines exposed, this is Water attacking Fire, indicating a Yin syndrome; the tongue coating must be slippery, accompanied by aversion to cold and aversion to water, with vomiting upon swallowing medicine. If a purely black tongue appears, it is a fatal condition requiring no treatment. Water extreme resembles Fire, Fire extreme resembles Water; any tongue with a band of pure black is untreatable. Understanding the verification methods of tongue diagnosis in Shanghan (Cold Damage) provides assurance, preventing clinical errors.

Shanghan (Cold Damage) theory was greatly illuminated by Zhang Zhongjing, further popularized by the Heavenly Master, and now completed by my supplementary discussions, leaving nothing omitted. This tongue diagnosis method, transmitted by the Heavenly Master, is more comprehensive than *Jingjin Lu* (Record of Tongue Mirrors) and free from the risk of misdiagnosis; it is truly a boat of compassion for saving the world and a true record of rescuing lives. I hope people observe it carefully to avoid the disaster of killing people with medicine. Written by Lü Daoren in the markets of Yanjing.
(Li Zi Yong noted: Tongue diagnosis methods in *Shanghan Dacheng* are relatively complete and can be consulted.)

Lord Leigong said: I received transmission from Guangchengzi and deeply understand the medical arts. It is lamentable that people only praise my expertise in processing herbs. Now, with Yuan Gong Chen Shi duo, I can fully reveal my secrets. Your annotations of *Neijing* (Inner Canon) reveal every subtlety and conceal nothing. Although aided by Qibo, your spiritual insight is sufficient to bring them forth. However, you can only expound upon the classics based on the texts, unable to create new perspectives outside the classics. Although Qibo transmitted *Shishi Milu* (Secret Records of the Stone Chamber) to you, which is indeed remarkable in medical arts, it still has incompleteness. I now give everything to you, appending it after *Shishi Milu*, to expand upon the incompleteness of the Heavenly Master Qibo, so that future generations know my medical Dao is miraculous not only for herb processing but also for profound theory. This is a great joy. Speak in detail, and you must record it carefully.