舌上津津如常。邪尚在表。见白苔而滑。邪在半表半里。见黄苔而干燥。热已入于里。
见黑苔有二。如黑而焦裂硬刺者为火。极似炭之热。苔如黑而有水软润而滑者。为水来克火
之寒苔。又蓝色为白色之变。为寒。紫色为红色之变。为热。此伤寒症辨法也。凡舌肿胀。
重舌木舌。舌生芒刺。舌苔黄燥。皆热甚也。凡舌硬舌强舌短缩。舌卷。皆危症。又阴阳易。
出舌
难经曰。闻其五音。以知其病。以五脏有五声。以合于五音。谓肝呼应角。心言应征脾
歌应宫。肺哭应商。肾声应羽是也。然此义深奥。非寻常所能揣测者。今以古人经验简易之
法。列为声。诊脉之呻者。痛也。（言诊时之呻吟。）言迟者。风也。（迟则寒温风痰之症）
声
从室中言。此中气有湿也。言将终乃复言者。此夺气也。（谓气不续。言未终止而又言之状
也）衣被不敛。言语骂詈。不避亲疏者。神明之出也。（狂。）出言懒怯。先轻后重。此内伤
中气也。出言壮厉。先重后轻。是外感邪盛也。攒眉呻吟。苦头痛也。呻吟不能行起。腰足
痛也。叫喊以手按心。中脘痛也。呻吟不能转身。腰痛也。摇头而呻。以手扪腮唇。齿痛也。
行迟而呻者。腰脚痛也。诊时吁气者。郁结也。纽而呻者。腹痛也。形羸声哑。痨瘵之不治
者。咽中有肺花疮也。暴哑者。风痰伏火。或暴怒叫喊所致也。声嘶血败。久病不治也。
坐而气促。痰火为哮也。久病气促。危也。中年人声浊者。痰火也。诊时独言独语。首尾不
应。思虑伤神也。伤寒坏病。声哑为狐惑。上唇有疮。虫食其脏。下唇有疮。虫食其肛也。
气促喘息不足以息者。虚甚也。平人无寒热。短气不足以息者。实也。（实者是痰与火也）
新
病间呃。非火逆。即寒逆。久病间呃。胃气欲绝也。大抵声音清亮。不异于平时为吉。
舌面津液分泌正常，如同平常一样。说明邪气仍在体表。
如果舌苔呈现白色且滑润，说明邪气处于半表半里之间。
如果舌苔呈现黄色且干燥，说明热邪已经深入体内。
观察黑色舌苔有两种情况：
如果是黑色且焦裂、坚硬并伴有芒刺的，属于火证，其热度极似烧红的炭。
如果是黑色但表面有水气、柔软湿润且滑润的，属于水克火的寒证舌苔。
另外，蓝色是白色舌苔的变化，主寒证；紫色是红色舌苔的变化，主热证。这是伤寒病症的辨别方法。
凡是舌头肿胀、重舌（舌下生赘生物）、木舌（舌体僵硬麻木）、舌生芒刺、舌苔黄燥的，都属于热邪极盛。
凡是舌体僵硬、舌强直、舌短缩、舌卷曲的，都是危重病症。
此外还有阴阳易病，表现为伸舌出而难收。
《难经》说：通过听人的五种声音，可以知道其所患的疾病。因为五脏对应五种声音，并与五音相合。即肝的声音为呼，对应角音；心的声音为言，对应徵音；脾的声音为歌，对应宫音；肺的声音为哭，对应商音；肾的声音为呻，对应羽音。然而这一理论深奥玄妙，不是普通人所能揣测的。现在将古人经验总结出的简易方法，按声音分类如下：
诊脉时呻吟的，是有疼痛。（指诊脉时的呻吟声）
说话迟缓的，是有风邪。（迟缓意味着有寒、温、风、痰等病症）
从室内大声说话，这是中焦湿气阻滞所致。
话未说完又接着说的，这是元气亏损。（指气息不接续，话没说完却又继续说的状态）
衣被不整理，言语骂人，不分亲疏远近的，这是神志失常的表现。（狂证）
说话懒散怯懦，先轻后重的，这是内伤中气不足。
说话气势壮厉，先重后轻的，这是外感邪气旺盛。
皱眉呻吟，是头痛痛苦。
呻吟得不能行走起身，是腰部和足部疼痛。
叫喊并按着心口，是中脘部位疼痛。
呻吟得不能转身，是腰部疼痛。
摇头呻吟，用手摸腮帮和嘴唇，是牙齿疼痛。
行走缓慢且呻吟的，是腰脚疼痛。
诊脉时叹气的是气机郁结。
扭动身体呻吟的是腹痛。
形体消瘦且声音嘶哑的，是痨瘵这种不治之症。咽喉中有肺花疮。
突然失音的，是风痰潜伏或伏火，或者是由于暴怒大叫所致。
声音嘶哑且气血败坏的，是久病不治。
坐着呼吸急促，是痰火引起的哮证。
久病出现呼吸急促，是危象。
中年人声音浑浊的，是痰火。
诊脉时自言自语，首尾不相呼应，是思虑过度损伤心神。
伤寒坏病中，声音嘶哑且伴有狐惑病的，上唇有疮疡，是虫蚀内脏；下唇有疮疡，是虫蚀肛门。
气促喘息，呼吸不足以维持，是虚损极甚。
平素没有寒热症状，但短气呼吸不足的，是实证。（实证是指痰与火邪）
新发病中间断出现呃逆的，如果不是火邪上逆，就是寒邪上逆。
久病中间断出现呃逆的，是胃气将要断绝。
大抵而言，声音清亮，与平时无异，是吉兆。
The tongue surface has normal moisture, similar to its usual state. This indicates that the pathogenic factor remains at the exterior level.
If the tongue coating is white and slippery, it indicates that the pathogen is in the half-exterior, half-interior stage.
If the tongue coating is yellow and dry, it indicates that heat has entered the interior.
There are two types of black tongue coatings:
If the coating is black, scorched, cracked, hard, and covered with prickles (mangci), it belongs to Fire syndrome, with heat intensity resembling red-hot charcoal.
If the coating is black but moist, soft, wet, and slippery, it belongs to Cold syndrome caused by Water overcoming Fire.
Additionally, a blue color is a variation of white, indicating Cold; a purple color is a variation of red, indicating Heat. These are methods for differentiating Shaoyang disease (Shanghan).
Whenever the tongue is swollen, or presents as Chong She (double tongue), Mu She (wooden/stiff tongue), or has prickles, and the coating is yellow and dry, all indicate extreme excess of Heat.
Whenever the tongue is stiff, rigid, shortened, or curled, these are critical conditions.
Furthermore, in Yin-Yang Exchange disease (Yin Yang Yi), the tongue protrudes and is difficult to retract.
The *Nan Jing* states: By listening to the five sounds, one can know the disease. Since the five Zang organs correspond to five vocalizations, which align with the five musical tones: Liver corresponds to calling out (Hu) and the Jue tone; Heart corresponds to speaking (Yan) and the Zhi tone; Spleen corresponds to singing (Ge) and the Gong tone; Lungs correspond to weeping (Ku) and the Shang tone; Kidneys correspond to groaning (Shen) and the Yu tone. However, this principle is profound and obscure, not easily comprehended by ordinary people. Now, listing the simple methods derived from ancient experience based on voice diagnosis:
Groaning during pulse diagnosis indicates pain. (Referring to groaning during the examination.)
Slurred or slow speech indicates Wind pathogen. (Slowness implies symptoms of Cold, Warmth, Wind, or Phlegm.)
Speaking loudly from within a room indicates dampness obstructing the Middle Jiao.
Speaking again before finishing a sentence indicates depletion of Qi. (Referring to the state where breath is insufficient to continue, so the person speaks again before finishing.)
Disheveled clothing, cursing, and ignoring kinship distinctions indicate loss of Shen (Spirit). (Mania/Kuang Zheng.)
Lazy and timid speech, starting soft and becoming louder, indicates internal injury to Zhong Qi (Middle Qi).
Bold and fierce speech, starting loud and becoming softer, indicates excess external pathogenic factors.
Frowning while groaning indicates painful headache.
Groaning unable to walk or rise indicates pain in the waist and feet.
Crying out while pressing the heart region indicates pain in the Zhongwan area.
Groaning unable to turn the body indicates lumbar pain.
Shaking the head while groaning and touching the cheeks/lips with hands indicates toothache.
Walking slowly while groaning indicates pain in the waist and legs.
Sighing during pulse diagnosis indicates Qi stagnation.
Twisting the body while groaning indicates abdominal pain.
Emaciated form with hoarse voice indicates incurable Lao Zhai (consumption/tuberculosis). There are "Lung Flower Sores" (Fei Hua Chuang) in the throat.
Sudden aphonia is caused by latent Wind-Phlegm or hidden Fire, or due to sudden anger and shouting.
Hoarseness with blood/qi deterioration indicates an incurable chronic disease.
Sitting with shortness of breath indicates Xiao (asthma/wheezing) caused by Phlegm-Fire.
Shortness of breath in chronic disease is a critical sign.
Turbid voice in middle-aged individuals indicates Phlegm-Fire.
Talking alone during diagnosis, without coherence between beginning and end, indicates mental damage from excessive thought.
In complicated Shanghan diseases, hoarseness accompanied by Hu Huo disease: ulcers on the upper lip indicate worms eating the viscera; ulcers on the lower lip indicate worms eating the anus.
Shortness of breath and panting, unable to sustain respiration, indicates extreme deficiency.
A healthy person without cold/heat symptoms but with shortness of breath indicates Excess syndrome. (Excess here refers to Phlegm and Fire.)
Intermittent hiccups in new-onset disease, if not due to Fire rebellion, is due to Cold rebellion.
Intermittent hiccups in chronic disease indicate impending exhaustion of Stomach Qi.
Generally, clear and bright voice, unchanged from usual, is auspicious.