若舌无苔而有如烟煤隐隐者，不渴肢寒，知挟阴病，如口渴烦热，平时胃燥舌也，不可
攻之。若燥者甘寒益胃，若润者甘温扶中，此何故外露而里无也。
若舌黑而滑者，水来克火为阴症，当温之。若见短缩，此肾气竭也，为难治。急救之。
加人
参、五味，勉希万一。舌黑而干者，津枯火炽，急急泻南补北。若燥而中心浓 者，土燥水
竭，急以咸苦下之。
舌淡红无色者，或干而色不荣者，当是胃津伤而气无化液也，当用炙甘草汤，不可用寒
凉药。
若舌白如粉而滑，四边色紫绛者，温疫者初入募原，未归胃腑。急急透解，莫待传陷而
入为
险恶之病。且见此舌者，病必见凶，须要小心。凡斑疹初见，须用纸捻照看胸背两胁，点大而
在皮肤之上者为 ，或云头隐隐，或琐碎小粒者为疹。又宜见少而不宜见多，按方书谓 色
红者属胃热，紫者热极，黑者胃烂，然亦必看外症所合，方可断之。然而春夏之间，温病俱
发疹为甚，如淡红色，四肢清，口不甚渴，脉不洪数，非虚 即阴 。或胸微见数点，面赤
足冷，或下利清谷，此阴盛格阳于上而见，当温之。若 色紫小点者，心包热也。点大而紫
，胃中热也。黑 而光亮者，热胜毒盛，虽属不治，若其人气血充者，或根据法治之，尚可救
。若黑而晦者，必死。若黑而隐隐，四旁赤色，火郁内伏，大且清凉透发，间有转红，或可
救者。若夹 带疹皆是，邪之不一，各随其部而泄，然 属血者多，疹属气者不少， 疹皆
是邪气外露之象，发出宜神情清爽，为外解里和之意。如 疹出而昏者，正不胜邪，内陷为
患，或胃津内涸之故。
再有一种白 ，小粒如水晶色者，此湿热伤肺，邪虽出而气液枯也，必得甘药补之。或
未至久延，伤及气液，乃湿伤卫分，汗出不彻之故，当理气分之邪。或白枯如骨者多凶，为气液
如果舌面上没有苔垢，但隐约可见如烟熏煤黑般的色泽，且患者口不渴、四肢发冷，可知是兼夹阴寒病证；如果口渴且伴有烦热，则是平时胃中燥热所致，不可使用攻下法。若舌面干燥的，应用甘寒之品滋养胃阴；若舌面湿润的，应用甘温之品扶助中气，这是为何外表看似有热而内部实则无热的缘故。
如果舌色黑而滑润，是水气克制心火，属于阴证，应当采用温补法治疗。如果出现舌体短缩，这是肾气衰竭的表现，属于难治之症，需紧急救治。加入人参、五味子，希望能有一线生机。如果舌色黑而干燥，是津液枯竭、火势炽盛，必须紧急采用“泻南补北”（清心火、滋肾水）的方法。如果舌黑且干燥，中心部分厚腻浓重的，是土燥（脾胃实热）导致水竭，急需用咸苦性质的药物攻下。
舌色淡红而无血色，或者干燥且色泽不荣润的，应当是胃津受损且气化功能失常无法生成津液，应当使用炙甘草汤治疗，不可使用寒凉药物。
如果舌面白如粉状且滑润，但四周颜色呈紫绛色的，这是温疫邪气初入募原（半表半里之位），尚未传入胃腑。必须紧急透邪解表，不要等待其传变陷入体内成为险恶重病。而且见到这种舌象，病情必然凶险，必须小心谨慎。凡是斑疹初现时，必须用纸捻照明查看胸背和两胁部位，斑点大而位于皮肤表面的是斑，或云头状隐隐约约，或琐碎小颗粒状的是疹。又适宜见少而不宜见多。查阅医书称：斑色红的属胃热，紫的属热极，黑的属胃烂，但也必须结合外在症状综合判断，才能确诊。然而春夏之间，温病发作多以出疹为甚，如斑疹呈淡红色，四肢清凉，口不十分渴，脉象不洪大数急，这非虚证就是阴证。或者胸部微见几点，面赤足冷，或者下利清谷（完谷不化），这是阴盛格阳于上所致，应当采用温补法。如果斑疹呈紫色小点状，是心包有热。斑点大而紫色的，是胃中有热。黑色且光亮者，是热胜毒盛，虽然属于不治之症，但如果患者气血充盛，若能根据法治之，或许还可以挽救。如果黑色且晦暗无光的，必死无疑。如果黑色且隐隐约约，四周有赤色，是火郁内伏，需用大剂量的清凉药物透发，间或有转为红色的，或许可以挽救。如果夹杂斑疹，都是邪气外露的现象，邪气性质不一，应随其所在部位而泄邪，但斑多属血分病变，疹多属气分病变。斑疹皆是邪气外露之象，发出后应当神情清爽，这是邪气外解、里气和顺的意思。如果斑疹发出后反而神昏，是正气不胜邪气，邪气内陷为患，或者是胃津内枯的缘故。
还有一种白痦，小粒如水晶色，这是湿热伤肺，邪气虽出但气液已枯，必须用甘药补益。或者病程未至久延，尚未伤及气液，乃是湿邪损伤卫分，汗出不透彻的缘故，应当调理气分之邪。如果白痦干枯如骨屑状的，大多预后不良，这是因为气液枯竭……
If the tongue surface has no coating but shows a faint, smoke-like blackish hue, and the patient is not thirsty with cold limbs, it indicates a concurrent Yin-cold syndrome. If there is thirst accompanied by irritability and heat, it is due to chronic stomach dryness; purgatives must not be used. If the tongue is dry, use sweet-cold herbs to nourish the Stomach Yin; if moist, use sweet-warm herbs to support the Middle Jiao. This explains why symptoms appear external while the interior lacks true heat.
If the tongue is black and slippery, it signifies Water overcoming Fire, constituting a Yin syndrome, which should be treated with warming methods. If the tongue body is short and contracted, this indicates exhaustion of Kidney Qi, making it difficult to treat; emergency rescue is required. Add Ren Shen (Ginseng Radix) and Wu Wei Zi (Schisandrae Fructus) to strive for a slim chance of recovery. If the tongue is black and dry, it indicates exhaustion of fluids and blazing fire; urgently apply "clearing the South and tonifying the North" (clearing Heart Fire and nourishing Kidney Water). If black, dry, and with a thick, concentrated center, it indicates Earth dryness leading to water exhaustion; urgently use salty-bitter purgatives.
If the tongue is pale red without color, or dry and lusterless, it suggests damage to Stomach fluids and failure of Qi transformation to generate fluids. Zhi Gan Cao Tang (Honey-fried Licorice Decoction) should be used; cold-cooling medicines must be avoided.
If the tongue is white like powder and slippery, but the edges are purple-red, this indicates that warm-pestilence pathogens have just entered the Mu Yuan (semi-exterior/semi-interior region) and have not yet reached the Stomach Fu organ. Urgently resolve and vent the pathogen; do not wait for transmission into the interior, which would become a perilous disease. Seeing this tongue coating indicates a severe prognosis, requiring utmost caution. When macules (ban) and papules (zhen) first appear, one must examine the chest, back, and hypochondrium using a paper torch. Large spots on the skin surface are macules (ban); cloud-like faint patches or small granular clusters are papules (zhen). Fewer lesions are preferable to many. Medical texts state: red macules indicate Stomach heat; purple indicates extreme heat; black indicates rotting of the Stomach. However, diagnosis must be confirmed by correlating with external symptoms. During spring and summer, warm diseases often manifest prominently with papules. If they are pale red, with cool limbs, slight thirst, and a pulse that is neither flooding nor rapid, it is either deficiency or Yin syndrome. If only a few points appear on the chest, with a red face and cold feet, or diarrhea with undigested food, this is Yin excess repelling Yang to the upper burner; warming treatment is indicated. Purple small points indicate heat in the Pericardium. Large purple spots indicate heat in the Stomach. Black and shiny lesions indicate excessive heat and toxicity; although generally considered incurable, if the patient's Qi and Blood are robust, following proper treatment may save them. Black and dull lesions indicate certain death. Black and faint lesions with red surroundings indicate suppressed fire within; large doses of cooling and venting herbs may turn them red and potentially save the patient. Macules and papules represent the exteriorization of pathogens. Pathogens vary, so treatment should drain them according to their location. Macules mostly involve the Blood level, while papules mostly involve the Qi level. Both are signs of pathogens emerging externally. After emergence, the spirit should be clear, indicating external resolution and internal harmony. If confusion occurs after emergence, it means righteous Qi cannot overcome pathogens, leading to internal invasion, or due to depletion of Stomach fluids.
Another type is Bai Pu (white pruritic miliary rash), small grains like crystal color. This indicates damp-heat injuring the Lung; although pathogens exit, Qi and fluids are exhausted, requiring sweet-tonifying herbs. If the duration is not long and Qi/fluids are not yet damaged, it is due to dampness injuring the Defensive level and incomplete sweating; regulate Qi-level pathogens. If Bai Pu becomes dry and bone-like, the prognosis is mostly poor, due to exhaustion of Qi and fluids...