舌中见白苔。外则微黄者。必作泄。宜服解毒汤。恶寒者。五苓散。
\r白苔边黄舌图\pt101a19.bmp\r
【介按】白苔属肺。黄苔属胃。兹因热炽于胃。邪尚在肺。日久不解。则肺胃之邪热。移于大肠而作泄。故用解毒
汤以清热解毒。如若外证恶寒者。则为寒湿作泻。其舌必润。故用五苓散以渗其湿也。
解毒汤 五苓散（方见前）
舌见微黄色者。表证未罢。宜用小柴胡汤。合天水散主之。可下者。大柴胡汤下之。表里双除。临证审用之。
\r微黄舌图\pt101a20.bmp\r
【介按】黄苔薄滑者。是邪初入里。表症未罢。热未伤津。犹可用柴葛芩翘。或栀豉翘薄之类。轻清泄热。以透表
邪而达肌表。若黄薄而腻者。则为湿热腻滞之候。治宜于清热之中兼用渗湿之品。故用小柴胡汤合天水散以治之。但邪
尚在半表半里之间。小柴胡内之人参，用时尚须斟酌。故曰临证者审用之也。若舌苔黄腻而垢。或干涩深黄浓腻者。此
是表邪入里之候。故宜大柴胡汤以下之。
天水散
太原甘草（炙一两） 桂府滑石（六两）
上各另为末。每服五钱。入生姜汁并蜜各少许。用葱白汤任意调服。如发表用豆豉、葱头煎汤调服。
【介按】柯韵伯曰。“滑石能上清水源。下通水道。从小便而泄。炙甘草禀草中冲和之性。调和内外。止渴生津。用
以为佐。保元气而泻虚火。则五脏自和矣。”又据原文谓“如发表，用豆豉、葱头煎汤调服”者。因葱白、豆豉即古方之
葱豉汤。为治新邪初感引动伏热之要剂。是以张路玉谓“本方药味虽轻。功效最着。凡虚人风热伏气发温。及产后感冒。
靡不随手获效”也。
大柴胡汤 小柴胡汤（二方见前）
舌中部出现白苔，边缘微黄者，必定会发生泄泻。适宜服用解毒汤。若伴有恶寒症状的，使用五苓散。
【介按】白苔归属于肺，黄苔归属于胃。此处是因为热邪炽盛于胃，而病邪尚在肺经。日久不愈，则肺与胃的病邪热气，转移至大肠从而引发泄泻。因此使用解毒汤来清热解毒。如果外部证候表现为恶寒的，则是寒湿导致的泄泻，其舌象必然湿润，因此使用五苓散来渗利湿气。
舌象呈现微黄色者，表明表证尚未解除。适宜使用小柴胡汤，配合天水散主治。可以使用下法的，用大柴胡汤攻下。以此表里双解，临证时需仔细审察后使用。
【介按】黄苔薄而滑润的，是病邪刚刚入里，表证尚未解除，热邪尚未损伤津液，仍然可以使用柴胡、葛根、黄芩、连翘，或者栀子、豆豉、连翘、薄荷这类药物，以轻清之品泄热，以透达表邪并通达肌表。如果黄苔薄而腻浊的，则是湿热黏滞的证候，治疗宜在清热之中兼用渗湿的药物。因此使用小柴胡汤合天水散来治疗。但病邪尚在半表半里之间，小柴胡汤中的人参，使用时还需斟酌。所以说临证者要审慎使用。如果舌苔黄腻且垢浊，或者干涩深黄浓腻的，这是表邪入里的征候。因此适宜用大柴胡汤来攻下。
太原甘草（炙制一两） 桂府滑石（六两）
以上各药分别研为细末。每次服用五钱，加入少许生姜汁和蜂蜜，用葱白汤任意调服。如用于发表，用豆豉、葱头煎汤调服。
【介按】柯韵伯说：“滑石能上清水源，下通水道，从小便排出。炙甘草禀受草木中冲和的性质，调和内外，止渴生津，用作佐药，保护元气而泻虚火，则五脏自然调和了。”又根据原文所说“如用于发表，用豆豉、葱头煎汤调服”，因为葱白、豆豉即古方中的葱豉汤，是治疗新感邪气初起引动伏热的关键药剂。所以张路玉说“本方药味虽然轻灵，功效最为显著，凡是虚人风热伏气发温，以及产后感冒，没有不随手获效的”。
White coating is seen in the center of the tongue, with slightly yellow edges. Diarrhea (Xie) will certainly occur. It is suitable to take Jiedu Tang (Detoxification Decoction). If accompanied by aversion to cold (Ehan), Wuling San (Five-Ingredient Poria Pill) should be used.
[Commentary by Jie] White coating belongs to the Lung (Fei), and yellow coating belongs to the Stomach (Wei). Here, heat is blazing in the Stomach, while the pathogen remains in the Lung. If unresolved for a long time, the pathogenic heat from the Lung and Stomach transfers to the Large Intestine (Dachang), causing diarrhea. Therefore, Jiedu Tang is used to clear heat and detoxify. If the external syndrome presents with aversion to cold, it is diarrhea caused by cold-dampness (Han Shi), and the tongue coating must be moist. Thus, Wuling San is used to leach out dampness.
The tongue shows a slightly yellow color, indicating that the exterior syndrome (Biao Zheng) has not yet resolved. It is suitable to use Xiao Chaihu Tang (Minor Bupleurum Decoction) combined with Tianshui San (Heavenly Water Powder) as the main treatment. For cases where purgation is applicable, Da Chaihu Tang (Major Bupleurum Decoction) should be used to purge. This achieves simultaneous resolution of both interior and exterior. Clinicians should exercise careful judgment in application.
[Commentary by Jie] When the yellow coating is thin and slippery, it indicates that the pathogen has just entered the interior, the exterior syndrome has not yet resolved, and the heat has not yet damaged the body fluids (Jin Ye). One can still use herbs such as Chai Hu (Bupleuri Radix), Ge Gen (Puerariae Lobatae Radix), Huang Qin (Scutellariae Radix), and Lian Qiao (Forsythiae Fructus), or formulas containing Zhi Zi (Gardeniae Fructus), Dou Chi (Sojae Semen Praeparatum), Lian Qiao, and Bo He (Menthae Haplocalycis Herba) to lightly clear heat, thereby penetrating the exterior pathogen and reaching the muscle layer. If the yellow coating is thin but greasy/sticky, it represents a condition of damp-heat stagnation. Treatment should involve clearing heat while simultaneously using herbs that promote diuresis to drain dampness. Hence, Xiao Chaihu Tang combined with Tianshui San is used. However, since the pathogen is still between the exterior and interior (Ban Biao Ban Li), the use of Ren Shen (Ginseng Radix et Rhizoma) in Xiao Chaihu Tang requires careful consideration. This is why it is stated that clinicians must exercise prudent judgment. If the tongue coating is yellow, greasy, and dirty, or dry, rough, deep yellow, and thick/greasy, this is a sign that the exterior pathogen has entered the interior. Therefore, Da Chaihu Tang is appropriate for purgation.
Taiyuan Gan Cao (Licorice Root, honey-fried, 1 liang) Guifu Huashi (Talcum, 6 liang)
Grind each herb separately into fine powder. Take 5 qian per dose, add a small amount of fresh ginger juice and honey, and mix arbitrarily with decoction of Cong Bai (Allii Fistulosi Bulbus). For releasing the exterior, mix with decoction made from Dou Chi (Prepared Soybean) and Cong Tou (Scallion Head).
[Commentary by Jie] Ke Yunbo stated: "Huashi (Talcum) can clear the source of water above and unblock the water passages below, excreting via urination. Honey-fried Gan Cao (Licorice Root) possesses the harmonious nature of herbs, harmonizing the interior and exterior, stopping thirst, and generating fluids. Used as an assistant herb, it protects the primordial Qi (Yuan Qi) and drains deficient fire, thereby harmonizing the five Zang organs." Furthermore, regarding the original text's statement "For releasing the exterior, use Dou Chi and Cong Tou decoction," Cong Bai and Dou Chi constitute the ancient formula Cong Chi Tang (Scallion and Fermented Soybean Decoction), which is a crucial agent for treating new pathogens initially inducing latent heat. Thus, Zhang Luyu said, "Although the ingredients of this formula are light, its efficacy is remarkable. Whether for deficiency-type wind-heat with latent qi causing fever, or postpartum colds, it yields immediate results."