13.舌心外候本泽红, 红深赤色热为轻, 外红内紫为热重, 滑白寒表
少阳经, 沉迟细紧脏寒结, 干薄气液两虚空, 黄黑胎润里热浅, 焦干
刺裂热深明, 黑滑若与三阴见, 水来克火百无生.
【注】舌者心之外候, 色应红泽为无病也. 若初感内外红深, 则为有
热.外红内紫, 则为热甚. 舌胎滑白, 则为表寒. 其胎渐厚, 则为传
少阳经也. 热者宜辛凉汗之, 寒者宜辛温汗之. 在少阳者为胸中有寒
,丹田有热也, 小柴胡汤两解之. 胸中指表也, 浅也; 丹田指里也,
深也, 非直指胸中丹田, 谓半里之热未成, 半表之寒犹在. 故舌白一
证,有寒有热也. 若其胎滑厚与阴证脉同见, 乃脏虚寒结, 以理中加
枳实温而开之. 若其胎干薄与阳证同见, 乃气虚液竭, 以白虎加人参
清而补之. 若白胎渐变黄色, 此为去表入里, 其热尚浅, 表不罢者,
宜三黄石膏汤; 己入里者, 凉膈散. 如焦干黑色, 或芒刺裂纹, 此为
里热己深, 宜栀子金花汤, 兼满痛者, 大承气汤. 红, 火色也; 黑,
水色也. 与三阳证见, 为热极反兼胜己之化, 清之下之, 尚可治也.
若与三阴证见, 则为水来克火, 百无一生. 治者以生姜擦之, 其黑色
稍退, 急用附子理中; 四逆辈救之可生.
13. 舌心（舌面中心）的外部征象本应是润泽且红润的，红色加深变为赤色表示热证较轻；外部红而内部紫表示热证较重；舌苔滑白属于表寒兼少阳经病；脉象沉、迟、细、紧表示脏腑有寒邪凝结；舌苔干燥变薄表示气和津液两虚；黄黑色舌苔若湿润表示里热尚浅；焦黑干燥并伴有芒刺裂纹表示热邪深入已明；若黑滑舌苔与三阴病同时出现，则是水克火，预后不良，百无一生。
【注】舌是心的外候，颜色呈现红润光泽为无病。如果初感外邪时内外皆红深，则为有热。外部红内部紫，则为热甚。舌苔滑白，则为表寒。其舌苔逐渐增厚，则为病传至少阳经。热证宜用辛凉药物发汗解表，寒证宜用辛温药物发汗解表。在少阳经的病证表现为胸中有寒、丹田有热，用小柴胡汤双向和解。这里的“胸中”指表、指浅；“丹田”指里、指深，并非直指胸中和丹田这两个具体部位，而是说半里的热邪尚未形成，半表的寒邪依然存在。所以舌苔白这一症状，既有寒证也有热证。如果舌苔滑厚与阴证脉象同时出现，乃是脏气虚寒凝结，用理中汤加枳实温补并开结。如果舌苔干薄与阳证同时出现，乃是气虚津液枯竭，用白虎加人参汤清热并补气生津。如果白苔逐渐变为黄色，这是病邪由表入里，热邪尚浅，表证未罢者，宜用三黄石膏汤；病邪已入里者，用凉膈散。如出现焦干黑色，或有芒刺裂纹，此为里热已深，宜用栀子金花汤，兼有腹部胀满疼痛者，用大承气汤。红色是火的颜色；黑色是水的颜色。若黑苔与三阳证同时出现，为热极反兼胜己之化（即真热假寒或热极似水），采用清法和下法治疗，尚可治愈。若黑苔与三阴证同时出现，则为水来克火，百无一生。医者可用生姜擦拭舌面，若黑色稍退，急用附子理中汤及四逆汤类方剂急救，方可生还。
13. The external manifestation of the center of the tongue (She Xin) should originally be moist and reddish; a deepening of red to crimson indicates mild heat; redness on the exterior with purpleness on the interior indicates severe heat; a slippery white coating belongs to exterior cold involving the Shaoyang channel; a sinking, slow, fine, and tight pulse indicates cold stagnation in the Zang organs; a dry and thin appearance indicates deficiency of both Qi and fluids; a yellow or black coating that is moist indicates shallow interior heat; a scorched, dry, cracked surface with prickles clearly indicates deep-seated heat; if a slippery black coating appears concurrently with Taiyin/Yueyin/Jueyin syndromes (San Yin), it signifies Water overcoming Fire, carrying a hopeless prognosis.
[Annotation] The tongue is the external manifestation of the Heart; a color that is red and lustrous indicates health. If upon initial pathogenic invasion, both the interior and exterior appear deeply red, it indicates the presence of Heat. Redness on the outside and purpleness on the inside indicate excessive Heat. A slippery white coating indicates Exterior Cold. If the coating gradually thickens, the disease has transmitted to the Shaoyang channel. For Heat syndromes, acrid-cool diaphoresis is appropriate; for Cold syndromes, acrid-warm diaphoresis is appropriate. In Shaoyang channel disorders, there is cold in the chest and heat in the Dantian; Xiao Chai Hu Tang (Minor Bupleurum Decoction) is used to harmonize both aspects. Here, "chest" refers to the exterior and superficial level; "Dantian" refers to the interior and deep level; this does not literally point to these anatomical locations but rather indicates that half-interior heat has not yet fully formed, while half-exterior cold remains. Therefore, a white tongue coating can signify either Cold or Heat. If a slippery, thick coating appears simultaneously with Yin syndrome pulses, it indicates visceral deficiency-cold stagnation, treated with Li Zhong Wan (Regulate the Middle Pill) plus Zhi Shi (Aurantii Fructus) to warm and resolve. If a dry, thin coating appears simultaneously with Yang syndrome signs, it indicates Qi deficiency and fluid exhaustion, treated with Bai Hu Jia Ren Shen Tang (White Tiger Decoction plus Ginseng) to clear heat and tonify. If a white coating gradually turns yellow, this indicates the pathogen moving from exterior to interior with shallow heat; if the exterior syndrome persists, San Huang Shi Gao Tang (Three Yellows and Gypsum Decoction) is indicated; if the pathogen has entered the interior, Liang Ge San (Cooling the Diaphragm Powder) is used. If the tongue becomes scorched, dry, and black, or develops prickles and cracks, this indicates deep interior heat, treated with Zhi Zi Jin Hua Tang (Gardenia Golden Flower Decoction); if accompanied by abdominal fullness and pain, Da Cheng Qi Tang (Major Order the Qi Decoction) is used. Red is the color of Fire; Black is the color of Water. If black coating appears with Yangming/Taiyang/Shaoyang syndromes (San Yang), it represents extreme heat mimicking its controlling element (Water); clearing and purging methods may still cure it. However, if black coating appears with Yin syndromes, it signifies Water overcoming Fire, resulting in death. If an physician wipes the tongue with Sheng Jiang (Fresh Ginger Root) and the blackness recedes slightly, Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction) and Si Ni Tang (Frigid Extremities Decoction) or similar formulas should be urgently administered to rescue the patient, offering a chance of survival.