（增补）
张三锡曰∶“《金镜录》载三十六舌以辨伤寒之法已备，再三讨论，不过阴阳、表里、虚实、寒热而
已。”陶节庵曰∶“伤寒邪在表，则舌无苔；热邪传里，舌苔渐生，自白而黄，黄而黑，甚则
黑裂。黑苔多凶，如根黑、中黑、尖黑皆属热；全黑属热极，为难治矣。”
外感挟内伤宿食重而结于心下者，五六日舌渐黄；或中干旁润，名中焙舌，则里热未重；若全干黄黑，
皆为里症，分轻重下之。如下之或再下之不减者，尚有宿垢结于中宫也。必切其脉之虚实，及中气之何如。
实者宜润而下之，不可再攻。虚人神气不足，宜回其津液，固其中气，有用生脉散对解毒汤而愈者，此则阳
极似阴之症；有用附子理中汤冷服而愈者，此则阴极似阳之症，不可不辨。
白苔属寒，外症烦躁，欲坐卧泥水中，乃阴寒逼其无根之火而然，脉虽大而不鼓，当从阴症治；若
不大躁者、呕吐者，当从食阴治。
（增补）
尸臭。（肉绝。）舌卷及囊缩。（肝绝。）口不合。（脾绝）肌肿唇反。（胃绝。）发直齿
枯。（骨绝。）遗尿。（肾绝）毛焦。（肺绝。）
面黑直视。目瞑不见。（阴绝。）目眶陷，目系倾。汗出如珠。（阳绝。）
手撒戴眼。（太阳绝。）病后喘泻。（脾肺将绝。）目正圆，痉。（不治。）
吐沫面赤。面青黑。唇青，人中满。发与眉冲起。爪甲下肉黑。手掌无纹。脐突。足趺肿。声如鼾睡。脉
浮无根。面青伏眠，目盲。汗出如油。（以上肝绝，八日死。）眉倾。（胆绝。）手足爪甲青，或
脱落，呼骂不休。（筋绝，八日死。）肩息回视（心绝，立死。）发直如麻，不得屈伸，自
汗不止。（小肠绝，六日死。）口冷足肿，腹热胪胀，泄利无时。（脾绝，五日死。）脊骨疼
肿，身重不可转侧。（胃绝，五日死。）耳干舌肿，溺血，大便赤泄。（肉绝，九日死。）
口张，气出不反（肺绝，三日死。）泄利无度。（大肠绝。）齿干枯，面黑目黄，腰欲折，自汗。（肾绝。）
(Added Supplement)
Zhang Sanxi stated: "The *Jin Jing Lu* (Record of the Golden Mirror) records thirty-six tongue appearances for differentiating Shanghan (Cold Damage), and its methods are already comprehensive. Repeated discussion reveals that it essentially revolves around the principles of Yin-Yang, Exterior-Interior, Deficiency-Excess, and Cold-Heat." Tao Jian'an stated: "When Shanghan pathogens are in the exterior, there is no coating on the tongue; when heat pathogens transmit to the interior, tongue coating gradually appears, turning from white to yellow, and then to black. In severe cases, it may crack. Black coating is mostly ominous; blackness at the root, center, or tip all indicate Heat syndromes; a completely black tongue indicates extreme Heat and is difficult to treat."
In cases where an external contraction is complicated by internal injury and heavy retention of undigested food, which knots below the heart, after five or six days the tongue gradually turns yellow. If the center is dry while the sides remain moist, this is called a 'Zhong Bei Tongue' (Middle-Baked Tongue), indicating that the interior heat is not yet severe. If the entire tongue is dry with yellow or black coating, these are all Interior Syndromes, requiring purgation according to severity. If symptoms do not improve after purgation or repeated purgation, it indicates that residual fecal matter remains knotted in the Middle Jiao (Central Palace). One must palpate the pulse to determine deficiency or excess, and assess the state of the Middle Qi (Spleen-Stomach Qi). For Excess patterns, moistening purgation is suitable, and one should not attack again. For deficient individuals with insufficient Shen Qi (Spirit Qi), it is appropriate to restore body fluids and consolidate Middle Qi. There are cases cured using Sheng Mai San (Generate the Pulse Powder) combined with Jie Du Tang (Resolve Toxicity Decoction); this represents a Yang-extreme resembling Yin syndrome. There are also cases cured by taking Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) cold; this represents a Yin-extreme resembling Yang syndrome. These two must be carefully distinguished.
White coating belongs to Cold. If accompanied by external restlessness, with the patient desiring to sit in mud or water, this is caused by Yin-Cold forcing the rootless fire upward. Although the pulse is large, it does not beat vigorously against the fingers; treatment should follow the Yin Syndrome protocol. If the patient is not extremely restless or has vomiting, treatment should follow the Food-Stagnation Yin Syndrome protocol.
(Added Supplement)
Corpse-like odor. (Indicates Ru Jue - Extinction of Flesh.) Tongue rolling and testicular retraction. (Indicates Gan Jue - Extinction of Liver.) Mouth unable to close. (Indicates Pi Jue - Extinction of Spleen.) Muscle swelling and lip eversion. (Indicates Wei Jue - Extinction of Stomach.) Hair standing erect and teeth withered. (Indicates Gu Jue - Extinction of Bone.) Enuresis. (Indicates Shen Jue - Extinction of Kidney.) Brittle hair. (Indicates Fei Jue - Extinction of Lung.)
Dark complexion with fixed gaze. Eyes closed and unable to see. (Indicates Yin Jue - Extinction of Yin.) Sunken eye sockets, tilted ocular axis. Sweating like pearls. (Indicates Yang Jue - Extinction of Yang.)
Hand relaxation and eyes rolling upward. (Indicates Taiyang Meridian Extinction.) Post-illness wheezing and diarrhea. (Indicates impending extinction of Spleen and Lung.) Eyes fixed straight, spasms. (Incurable.)
Spitting foam with red face. Dark green-black face. Cyan lips, fullness in the philtrum. Hair and eyebrows pointing upward. Black flesh under fingernails. Palm without lines. Umbilical protrusion. Dorsum pedis swelling. Snoring sound. Floating pulse without root. Dark green complexion with prone posture, blindness. Sweating like oil. (All above indicate Liver Extinction, death within eight days.) Eyebrow loss. (Indicates Gallbladder Extinction.) Cyan nails on hands and feet, or nail shedding, incessant shouting and cursing. (Indicates Sinew Extinction, death within eight days.) Shoulder breathing and backward gaze. (Indicates Heart Extinction, immediate death.) Hair straight like hemp, inability to flex or extend, continuous spontaneous sweating. (Indicates Small Intestine Extinction, death within six days.) Cold mouth and swollen feet, abdominal heat and distension, unregulated diarrhea. (Indicates Spleen Extinction, death within five days.) Spinal pain and swelling, heaviness of body unable to turn. (Indicates Stomach Extinction, death within five days.) Dry ears and swollen tongue, hematuria, red loose stools. (Indicates Flesh Extinction, death within nine days.)
Mouth open, breath exits but does not return. (Indicates Lung Extinction, death within three days.) Unremitting diarrhea. (Indicates Large Intestine Extinction.) Withered teeth, dark face, yellow sclera, sensation of waist breaking, spontaneous sweating. (Indicates Kidney Extinction.)