舌见根黄尖白者。表少里多。宜天水散一服。凉膈散二服。合而服之。脉弦者。防风通圣散主之。
\r根黄尖白舌图\pt101a27.bmp\r
【介按】舌根属下脘。舌尖属上脘。此舌根黄尖白。病系外寒里热。即世俗所谓寒邪包火之症。或表邪入里。已成
表少里多之候。外证必热多寒少。故用凉膈散合天水散。以通水道而清膈热。如若脉弦。此是邪尚在表。故用防风通圣
散。以解风热之邪也。亦有根黄尖白。不甚干燥。短缩不能伸出自如者，痰挟宿食之证也。宜用下法以治之。
天水散 凉膈散（二方见前）
防风通圣散（从名医方论新补）
防风 川芎 当归 芍药 大黄 薄荷 麻黄 连翘 芒硝（各半两） 石膏 黄芩 桔梗（各一两） 滑石（三
两） 甘草（三两） 荆芥 白术 栀子（各二钱半） 生姜（三片）
每服三钱。
【介按】吴琨曰。防风、麻黄，解表药也。风热之在皮肤者得之，由汗而泄。荆芥、薄荷。清上药也。风热之在巅
顶者得之，由鼻而泄。大黄、芒硝。通利药也。风热之在肠胃者得之，由后而泄。滑石、栀子、水道药也。风热之在决
渎者得之。由溺而泄。风淫于膈。肺胃受邪。石膏、桔梗，清肺药也。而连翘、黄芩又所以祛诸经之游火。风之为患。
肝木主之。川芎、归芍。和肝血也。而甘草、白术。所以和胃气而健脾。刘守真氏长于治火。此方之旨，详且悉哉。
舌象表现为舌根发黄、舌尖发白的，属于表证轻而里证重的情况。适宜服用一次天水散，再服用两次凉膈散（Liangge San, Cooling the Diaphragm Powder），将两方合在一起服用。如果脉象呈弦象，则以防风通圣散（Fangfeng Tongsheng San）为主进行治疗。
【介按】舌根归属于下脘，舌尖归属于上脘。这种舌根黄、舌尖白的舌象，疾病性质属于外寒内热，即世俗所说的“寒邪包火”之症。或者是表邪入里，已经形成了表少里多的病候。外在症状必定是热多寒少，所以使用凉膈散合天水散，以通利水道并清除膈部的热邪。如果脉象弦，这是邪气尚在体表，所以使用防风通圣散，以解除风热之邪。也有舌根黄、舌尖白，但不甚干燥，且舌体短缩不能自如伸出的，属于痰浊挟带宿食的证候。适宜采用泻下法来治疗。
防风通圣散（从《名医方论新补》中补充）
防风、川芎、当归、芍药、大黄、薄荷、麻黄、连翘、芒硝（各半两）、石膏、黄芩、桔梗（各一两）、滑石（三两）、甘草（三两）、荆芥、白术、栀子（各二钱半）、生姜（三片）。
每次服用三钱。
【介按】吴琨说：防风、麻黄，是解表药。风热邪气在皮肤者，服用此药后，通过出汗而排泄。荆芥、薄荷，是清上焦药。风热邪气在头顶者，服用此药后，通过鼻腔而排泄。大黄、芒硝，是通利药。风热邪气在肠胃者，服用此药后，通过后阴（大便）而排泄。滑石、栀子，是水道药。风热邪气在三焦决渎者，服用此药后，通过小便而排泄。风邪淫溢于膈部，肺胃受邪。石膏、桔梗，是清肺药。而连翘、黄芩又是用来祛除各条经络中游走的火邪。风邪为患，由肝木所主。川芎、当归、芍药，调和肝血。而甘草、白术，是用来调和胃气并健脾的。刘守真氏擅长治疗火邪，这个方子的宗旨，详尽且周到了啊。
When the tongue shows a yellow root and a white tip, it indicates that the exterior syndrome is minor while the interior syndrome is predominant. It is appropriate to administer one dose of Tianshui San (Tianshui Powder) and two doses of Liangge San (Cooling the Diaphragm Powder), taken together. If the pulse is wiry (Xian), Fangfeng Tongsheng San (Wind-Proof Universal Rescue Powder) should be used as the primary treatment.
[Commentary by Jie] The root of the tongue corresponds to the lower Wan (stomach region), and the tip corresponds to the upper Wan. This tongue presentation with a yellow root and white tip indicates a disease pattern of exterior cold and interior heat, commonly known in secular terms as "cold pathogen enveloping fire." Alternatively, it may indicate that exterior pathogens have entered the interior, resulting in a state where the exterior syndrome is minor and the interior syndrome is predominant. The external symptoms must feature more heat and less cold; therefore, Liangge San combined with Tianshui San is used to unblock the water passages and clear the heat in the diaphragm. If the pulse is wiry, this signifies that the pathogen remains at the exterior; thus, Fangfeng Tongsheng San is employed to resolve wind-heat pathogens. There are also cases where the tongue root is yellow and the tip is white, not very dry, but shortened and unable to extend freely; this is a pattern of phlegm complicated by retained food. It is appropriate to use purgative methods for treatment.
Tianshui San and Liangge San (see previous sections for these two formulas).
Fangfeng Tongsheng San (supplemented from *New Supplement to Famous Physicians' Formulas*).
Fangfeng (Saposhnikoviae Radix), Chuanxiong (Ligusticum Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix), Dahuang (Rhei Radix et Rhizoma), Bohe (Menthae Haplocalycis Herba), Mahuang (Ephedrae Herba), Lianqiao (Forsythiae Fructus), Mangxiao (Natrii Sulfas) (each half liang); Shigao (Gypsum Fibrosum), Huangqin (Scutellariae Radix), Jiegeng (Platycodonis Radix) (each one liang); Huashi (Talcum) (three liang); Gancao (Glycyrrhizae Radix et Rhizoma) (three liang); Jingjie (Schizonepetae Spica), Baizhu (Atractylodis Macrocephalae Rhizoma), Zhizi (Gardeniae Fructus) (each two qian and half); Shengjiang (Zingiberis Rhizoma Recens) (three slices).
Take three qian per dose.
[Commentary by Jie] Wu Kun stated: Fangfeng and Mahuang are exterior-resolving herbs. For wind-heat residing in the skin, administration leads to excretion through sweat. Jingjie and Bohe are herbs that clear the upper jiao. For wind-heat residing at the vertex, administration leads to excretion through the nose. Dahuang and Mangxiao are purgative herbs. For wind-heat residing in the intestines and stomach, administration leads to excretion via the posterior orifice (bowels). Huashi and Zhizi are herbs affecting the water pathways. For wind-heat residing in the jue du (san jiao waterways), administration leads to excretion through urination. When wind pathogens overflow into the diaphragm, the lungs and stomach are affected. Shigao and Jiegeng are lung-clearing herbs. Meanwhile, Lianqiao and Huangqin are used to dispel wandering fire in the various meridians. Wind pathology is governed by the Liver Wood. Chuanxiong, Danggui, and Shaoyao harmonize the liver blood. Gancao and Baizhu harmonize the stomach qi and strengthen the spleen. Liu Shouzhen was skilled in treating fire pathogens; the intent of this formula is indeed detailed and comprehensive.