紫舌苔者。酒后伤寒也。或大醉露卧当风。或已病而仍饮酒。或感冒不服药。而用葱姜热酒发汗。汗虽出
而酒热留于心胞。冲行经络。故舌见紫色。而又有微白苔也。苔结舌之根尖。长短浓薄。涎滑干焦。种种不同。
当参其源而治之。
\r纯紫舌\pt108a98.bmp\r
伤寒以葱酒发汗。酒毒入心。或酒后伤寒。皆有此舌。宜升麻葛根汤加石膏、滑石。若心烦懊 不安。栀
子豉汤。不然。必发斑也。
\r紫中红斑舌\pt108a99.bmp\r
舌浑紫而又满舌红斑。或浑身更有赤斑者。宜化斑汤、解毒汤。俱加葛根、黄连、青黛。有下证者。凉膈
散。
\r紫上白滑舌\pt108a100.bmp\r
舌紫而中见白苔者。酒后感寒。或误饮冷酒所致。亦令人头痛、恶寒、身热。随证解表可也。
\r淡紫青筋舌\pt108a101.bmp\r
舌淡紫带青而润。中绊青黑筋者。乃直中阴经。必身凉、四肢厥冷。脉沉面黑。四逆、理中等治之。
\r紫上赤肿干焦舌\pt108a102.bmp\r
舌边紫而中心赤肿。足阳明受邪。或已下。便食酒肉。邪热复聚所致。若赤肿津润。大柴胡微利之。若烦
躁厥逆脉伏。先用枳实理中。次用小承气。
\r紫上黄苔干燥舌\pt108a103.bmp\r
嗜酒之人伤于寒。至四五日。舌紫。上积干黄苔者。急用大承气下之。如表证未尽。用大柴胡汤。
\r紫短舌\pt108a104.bmp\r
舌紫短而团KT 者。食滞中宫而热。传厥阴也。急用大承气汤下之。下后热退脉静舌柔和者生。否则死。
\r紫上黄苔湿润舌\pt108a105.bmp\r
舌淡青紫而中有黄湿苔。此食伤太阴也。脉必沉细。心下脐旁按之硬痛或矢气者。小承气加生附子。或黄
龙汤主之。
\r紫尖蓓蕾舌\pt108a106.bmp\r
感寒之后。不戒酒食。而见咳嗽生痰。烦躁不宁。舌色淡紫。尖生蓓蕾。乃酒湿伤肺。味浓伤胃所致也。
宜小柴胡汤加减治之。
\r熟紫老干舌\pt108a107.bmp\r
舌全紫如煮熟者。乃热邪传入厥阴。至笃之兆。当归四逆汤。
\r淡紫带青舌\pt108a108.bmp\r
舌色青紫无苔。且滑润瘦小。为直中肾肝阴证。吴茱萸汤、四逆汤急温之。
\r淡紫灰心舌\pt108a109.bmp\r
舌淡紫而中心带灰。或青黑。不燥不湿者。为邪伤血分。虽有下证。只宜犀角地黄汤加酒大黄微利之。
紫色舌苔者，是酒后感受伤寒所致。或者是大醉后露天卧睡当风，或者已经患病却仍饮酒，或者感冒后不服药，而用葱、姜、热酒来发汗。虽然汗出，但酒热留于心包，冲行于经络，所以舌见紫色，且伴有微白苔。苔结于舌根或舌尖，长短浓薄不同，涎滑干焦各异，种种表现不一，应当参究其病因本源而治疗。
纯紫舌：
伤寒用葱酒发汗，酒毒入心；或者酒后感受伤寒，都有这种舌象。宜用升麻葛根汤加石膏、滑石。如果心烦懊恼不安，用栀子豉汤。否则，必然发斑疹。
紫中红斑舌：
舌色浑紫且满舌红斑，或者浑身更有赤斑者。宜用化斑汤、解毒汤，均加葛根、黄连、青黛。有可下之证候的，用凉膈散。
紫上白滑舌：
舌紫而中间见白苔者，是酒后感受寒邪，或者误饮冷酒所致。也令人头痛、恶寒、身热，随证解表即可。
淡紫青筋舌：
舌色淡紫带青而湿润，中间绊着青黑筋者，乃是寒邪直中阴经。必定身体凉、四肢厥冷，脉沉面黑。用四逆汤、理中汤等治疗。
紫上赤肿干焦舌：
舌边紫而中心赤肿，是足阳明经受邪，或者已经攻下之后，又进食酒肉，导致邪热重新聚集所致。如果赤肿津液尚润，用大柴胡汤轻微通利。如果烦躁厥逆脉伏，先用枳实理中汤，次用小承气汤。
紫上黄苔干燥舌：
嗜酒之人伤于寒，到了四五日，舌紫，上面堆积干黄苔者，急用大承气汤攻下。如表证未尽，用大柴胡汤。
紫短舌：
舌紫短而团缩者，是食滞中焦而生热，传入厥阴经。急用大承气汤攻下。下后热退脉静舌柔和者生，否则死。
紫上黄苔湿润舌：
舌淡青紫而中有黄湿苔，这是饮食损伤太阴脾经。脉必沉细，心下脐旁按之硬痛或矢气者，用小承气汤加生附子。或用黄龙汤主治。
紫尖蓓蕾舌：
感寒之后，不戒酒食，而见咳嗽生痰，烦躁不宁，舌色淡紫，舌尖生蓓蕾状突起，乃酒湿伤肺，味浓伤胃所致。宜用小柴胡汤加减治疗。
熟紫老干舌：
舌全紫如煮熟者，是热邪传入厥阴经，病势危笃的征兆。用当归四逆汤。
Purple tongue with coating: This is caused by contracting cold damage after drinking alcohol. It may result from sleeping outdoors in the wind while heavily intoxicated, continuing to drink alcohol after illness onset, or failing to take medicine for a cold and instead using scallion, ginger, and hot wine to induce sweating. Although sweat is produced, the heat of the wine remains in the Pericardium (Xinbao), rushing through the meridians and collaterals, thus causing the tongue to appear purple with a slight white coating. The coating may adhere to the root or tip of the tongue, varying in length, thickness, density, and moisture (slippery vs. dry/scorched). These manifestations differ greatly; one must investigate the source of the pathology to treat accordingly.
Pure Purple Tongue:
When treating cold damage with scallion and wine to induce sweating, wine toxin enters the Heart; similarly, contracting cold damage after drinking alcohol presents this tongue sign. Use Shengma Gegen Tang (Bupleurum and Kudzu Decoction) added with Shigao (Gypsum Fibrosum) and Huashi (Talcum). If there is mental restlessness and vexation (Ao Nu), use Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction). Otherwise, macules (Ban) will inevitably erupt.
Purple Tongue with Red Spots:
If the tongue is uniformly purple with red spots covering the entire surface, or if red spots appear all over the body, use Huaban Tang (Macule-Resolving Decoction) or Jiedu Tang (Detoxification Decoction), both added with Gegen (Puerariae Lobatae Radix), Huanglian (Coptidis Rhizoma), and Qingdai (Indigo Naturalis). If there are indications for purgation, use Liangge San (Cooling the Diaphragm Powder).
Purple Tongue with White Slippery Coating:
A purple tongue with a white coating in the center indicates catching cold after drinking alcohol or mistakenly drinking cold wine. Symptoms include headache, aversion to cold, and fever. Treat by resolving the exterior according to the specific syndrome.
Pale Purple Tongue with Cyan Veins:
A pale purple tongue that is cyan and moist, with cyan-black veins crossing the center, indicates direct invasion of the Yin meridians. Symptoms include coolness of the body, cold extremities (Jue Ni), deep pulse, and dark complexion. Treat with Sini Tang (Frigid Extremities Decoction) or Lizhong Tang (Regulate the Middle Decoction).
Purple Tongue with Red Swelling and Dry/Scorched Surface:
A purple periphery with a red, swollen center indicates pathogenic invasion of the Foot Yangming Meridian, or recurrence of pathogenic heat due to consuming wine and meat after purgation. If the swelling is moist, use Da Chaihu Tang (Major Bupleurum Decoction) to mildly promote bowel movement. If there is irritability, cold extremities, and a hidden pulse, first use Zhishi Lizhong Tang (Immature Bitter Orange Regulate the Middle Decoction), followed by Xiao Chengqi Tang (Minor Order the Qi Decoction).
Purple Tongue with Yellow Dry Coating:
In alcoholics injured by cold, on the fourth or fifth day, if the tongue is purple with accumulated dry yellow coating, urgently use Dachengqi Tang (Major Order the Qi Decoction) to purge. If exterior signs remain unresolved, use Da Chaihu Tang.
Short Purple Tongue:
A short, contracted purple tongue indicates food stagnation in the Middle Jiao generating heat, which transmits to the Jueyin Meridian. Urgently use Dachengqi Tang to purge. If heat subsides, the pulse becomes calm, and the tongue becomes soft after purgation, the patient lives; otherwise, death ensues.
Purple Tongue with Yellow Wet Coating:
A pale cyan-purple tongue with a yellow wet coating in the center indicates dietary injury to the Taiyin Spleen. The pulse will be deep and fine. Hardness and pain upon pressing below the heart or beside the umbilicus, or passage of flatus, indicate using Xiao Chengqi Tang added with Sheng Fuzi (Prepared Aconite Lateral Root) or primarily using Huanglong Tang (Yellow Dragon Decoction).
Purple Tongue with Bud-like Tip:
After catching cold, if one does not abstain from alcohol and rich food, symptoms such as cough with phlegm and mental restlessness may occur. A pale purple tongue with bud-like protrusions at the tip indicates lung injury from wine-dampness and stomach injury from rich flavors. Treat with Xiaochaihu Tang (Minor Bupleurum Decoction) modified.
Cooked/Old Dry Purple Tongue:
A tongue entirely purple like cooked meat indicates heat pathogen transmitting to the Jueyin Meridian, a sign of critical illness. Use Danggui Sini Tang (Angelica Frigid Extremities Decoction).
Pale Purple with Cyan Tongue:
A cyan-purple tongue without coating, slippery and thin/small, indicates direct invasion of Kidney and Liver Yin syndromes by cold. Warm urgently with Wuzhuyu Tang (Evodia Decoction) or Sini Tang.
Pale Purple Tongue with Ashy Center:
A pale purple tongue with an ash-gray, or cyan-black center, neither dry nor wet, indicates pathogen injuring the Blood level. Even if there are indications for purgation, only use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) added with Jiuhuangjiu (Wine-processed Rheum Radix et Rhizoma) to mildly promote bowel movement.