凡察舌之形容。前已述其提纲。今当集其条目。盖舌者心之苗。心者身之主。故观舌之形。可诊身之病也。
舌有形容。可分脏腑。色有浅深。可辨虚实。然脏腑之病症。皆有虚实之分。则形容之气色。当有浅深之辨。
诸书谓满舌黑苔而生大刺。干燥底红者。实热也。舌生芒刺者。结热甚也。舌上无刺而津润者。中寒也。舌
赤而胀大满口者。少阴阳明之热也。舌下肿出如舌者。重舌也。舌忽肿而木硬者。木舌也。舌肿满口溢出
如猪胞。气息不得通。或硬如木石者。血壅气滞也。舌赤而有重舌者。热入心胞也。舌赤肿满不得息者。手
少阴热甚而血壅也。舌肿大者。或因热毒。或因药毒也。舌紫且肿浓者。酒毒上壅也。耳干舌肿。下血不止。
脚浮者。六日死。足肿者。九日死。肾绝也。耳干舌肿。溺血大便赤泄。足肿者。肉绝九日死。胃绝五日死也。舌
赤而出血如衄者。热伤心胞也。声乱咽嘶。舌痿声不得前者。厥而脉紧。误发其汗也。咳止利不休。胸如虫
啮。粥入则出。小便不利。两胁拘急。喘息为难。颈背相引。臂则不仁。谷气多入。口虽欲言。舌不得前者。除中
也。舌红而痿软难言者。心脾虚也。心清语涩。舌软无力难言者。营卫不足也。腹满。舌痿黄燥。不得睡者。属
黄家。言其发黄也。舌红而干瘪不能言者。死证也。舌红而干瘪能言者。因症治之。或可救也。病患身寒。口
吐涎沫。舌即难言者。邪入于脏也。舌无苔而黑瘦者。津枯血燥也。舌痿。人中满。唇反者。足太阴气绝。肉先
死也。面目相引。口偏着耳。牙车急。舌不得转者。风中血脉也。舌偏语涩。口眼 斜。手足不遂者。偏风也。舌
偏斜者。左瘫舌向左。右瘫舌向右也。舌形沿边缺陷如锯齿者。脏气虚惫。不治之症也。热病舌难伸出。伸
则频振。语言不清者。正气虚弱之险症也。舌纵涎下。烦 者。足少阴之证也。痫病喜扬目吐舌者。羊痫也。
舌出不能收。及不能语者。心绝也。吐舌伸长而收缓。面红烦躁。口渴溺赤者。心经有热也。发热口噤。临死
舌出数寸者。女劳复。阳气虚也。阴阳易。舌出数寸者。死证也。舌出数寸者。产后与中毒。大惊之候也。小儿
病舌出不能收者。心气散也。舌本缩。口噤唇青者。小肠腑寒也。言声忧惧。舌本卷缩者。木克土也。舌形灰
色。渐干缩者。死证也。舌卷缩如丹。咽唾不得。足踝小肿者。肉绝也。热病舌赤碎烂如蚕蚀者。少阴证也。舌
赤裂而生疮者。手少阴之邪热也。舌上生疮。裂破引唇揭赤者。心脏热也。口舌生疮糜烂者。心脾二经之
蕴热也。口舌生疮咽肿者。膀胱之热未已也。口舌生疮者。上焦之热也。舌黑而中烂者。不治之证也。热病。
舌本烂。热不已者。死证也。颧赤。舌卷短者。心病也。舌卷。而烦满囊缩者。厥阴病也。喉痹舌卷。口干烦心。心
痛。臂内廉痛。不可及头者。邪客于手少阳之络也。舌卷不能言者。手少阴之经病也。语声忧惧。舌本卷缩。
嗔喜无度。 闷恍惚胀满者。脾寒受风也。唇青舌卷。卵上缩者。足厥阴气绝。筋先死也。中热嗌干。善溺心
烦。甚则舌卷。卵上缩者。厥阴终也。汗出不流。舌卷黑者。心绝也。吐舌下卷者。死证也。霍乱。舌卷筋缩。卵阴
入腹者。难治也。腰痛引膺。目KT KT 然。甚则反折不能言者。昌阳之脉。令人腰痛也。热病舌干黑而短者。厥
阴热极也。舌本强。食则呕者。足太阴之病也。舌强难言。神气不清者。中风之证也。舌强不能言者。手少阴
病也。奄忽不知人。喉中噫噫然有声。舌强不能言。发其汗。身转软者生。汗不出。身直者。七日死。风懿之候
也。小儿撮口脐风。舌强直者。死证也。咽嗌不能言。邪结在舌根者。死证也。膈偏枯。男子发左。女子发右。不
喑舌转者。可治也。舌红而战动难言者。心脾虚也。失音不能言者。二日半死。阴阳俱绝也。舌木硬者。厥阴
病也。舌红而强硬失音者。死候也。弄舌摇头者。痫候也。舌在口中。时时摇动。唇焦舌干。烦热便秽者。名曰
弄舌。心脾热也。小儿面黄肌瘦。弄舌者。疳也。弄舌者。脾脏虚热也。舌黑烂而频欲啮者。必烂至根而死也。
啮舌者。厥气逆走上。少阴之脉气辈至也。舌色灰黑。时时自欲啮舌者。少阴气逆之死证也。此皆诊法之
条目。论舌之形容也。
凡是观察舌头的形态和色泽，前面已经阐述了其总纲。现在应当汇集具体的条目。因为舌头是心的外候（心之苗窍），心是身体的主宰。所以通过观察舌头的形态，可以诊断身体的疾病。
舌头的形态可以对应不同的脏腑。舌色的深浅，可以辨别病证的虚实。然而脏腑的病症都有虚实的区分，那么舌头的形态气色，也应当有深浅的辨析。
各种医书说：满舌黑苔且生有大刺，干燥且底色红者，属于实热证。舌上生芒刺者，说明热结严重。舌上没有刺且津液滋润者，属于中寒证。舌色红且胀大充满口腔者，属于少阴、阳明经的热证。舌下肿胀突出如小舌者，称为重舌。舌头突然肿胀且僵硬如木者，称为木舌。舌头肿胀充满口腔并溢出，气息不通畅，或者坚硬如木石者，属于血瘀气滞。舌色红且有重舌者，属于热邪侵入心包络。舌色红肿胀满导致呼吸不畅者，属于手少阴心经热盛且血行壅滞。舌头肿大者，可能是因为热毒，也可能是因为药毒。舌色紫且肿胀浓浊者，属于酒毒上壅。耳朵干燥、舌头肿胀、下部出血不止、脚部浮肿者，六天死亡，这是肾气绝的表现。耳朵干燥、舌头肿胀、尿血、大便赤色泄泻、足部浮肿者，肌肉之气绝，九日死亡；胃气绝则五日死亡。舌色红且出血如鼻衄者，属于热邪损伤心包络。声音混乱、咽喉嘶哑、舌头痿软不能向前伸者，属于厥逆且脉紧，是误用发汗法所致。咳嗽停止但腹泻不止，胸部感觉如虫咬，喝粥即吐出，小便不利，两胁拘急，喘息困难，颈背相互牵引疼痛，手臂麻木不仁，谷气多入但口虽想说话却舌头不能前伸者，属于除中证。舌色红且痿软难以言语者，属于心脾虚。心神清明但语言涩滞，舌体软弱无力难以言语者，属于营卫不足。腹部胀满，舌色黄而干燥痿软，无法入睡者，属于黄疸病患者（指发黄之证）。舌色红且干瘪不能言语者，属于死证。舌色红且干瘪但能言语者，根据症状治疗，或许可以挽救。病人身体寒冷，口吐涎沫，舌头难以言语者，属于邪气侵入内脏。舌无苔且黑瘦者，属于津枯血燥。舌痿软，人中部位饱满，嘴唇反卷者，属于足太阴脾气绝，肌肉先死。面目相互牵引，口角偏向一侧贴耳，牙关紧急，舌头不能转动者，属于风邪中于血脉。舌偏斜且语言涩滞，口眼歪斜，手足不能随意运动者，属于偏风（中风）。舌形一边偏斜者，左侧瘫痪则舌向左偏，右侧瘫痪则舌向右偏。舌形边缘有缺陷如锯齿状者，属于脏气虚极，是不治之症。热病时舌头难以伸出，伸出则频繁震颤，语言不清者，属于正气虚弱的险恶证候。舌纵缓流涎，烦躁不安者，属于足少阴肾经的证候。痫病喜欢睁大眼睛吐舌头者，属于羊痫风。舌头伸出不能收回，及不能言语者，属于心气绝。舌头吐出伸长且收回缓慢，面色红烦躁，口渴尿赤者，属于心经有热。发热且牙关紧闭，临死前舌头伸出数寸者，属于女劳复（房事复感），阳气虚。阴阳易病，舌头伸出数寸者，属于死证。舌头伸出数寸者，见于产后、中毒或大惊之后。小儿生病舌头伸出不能收回者，属于心气散乱。舌根收缩，牙关紧闭嘴唇青紫者，属于小肠腑寒。说话声音带有忧惧感，舌根卷缩者，属于木克土（肝木乘脾土）。舌形呈灰色，逐渐干枯收缩者，属于死证。舌头卷缩如丹砂色，吞咽唾液困难，足踝轻微肿胀者，属于肉绝。热病舌色红碎烂如蚕蚀者，属于少阴证。舌色红裂且生疮者，属于手少阴心经的邪热。舌上生疮，裂破牵引嘴唇揭起发红者，属于心脏热。口舌生疮糜烂者，属于心脾二经蕴积热毒。口舌生疮且咽喉肿痛者，属于膀胱之热未消。口舌生疮者，属于上焦热。舌黑且中间腐烂者，属于不治之证。热病舌根腐烂，热势不退者，属于死证。颧骨发红，舌头卷短者，属于心病。舌头卷曲，且烦躁胸满、睾丸收缩者，属于厥阴病。喉痹伴舌头卷曲，口干心烦，心痛，手臂内侧疼痛，手不能举过头顶者，属于邪气客于手少阳经络。舌头卷曲不能言语者，属于手少阴心经的病证。说话声音忧惧，舌根卷缩，喜怒无常，胸闷恍惚腹胀者，属于脾寒受风。嘴唇青紫，舌头卷曲，睾丸上缩者，属于足厥阴肝气绝，筋先死。体内热盛咽喉干燥，频尿心烦，严重时舌头卷曲，睾丸上缩者，属于厥阴经气终绝。出汗但不流动，舌头卷曲发黑者，属于心气绝。舌头吐出向下卷曲者，属于死证。霍乱，舌头卷曲筋脉收缩，睾丸阴囊内缩入腹者，难治。腰痛牵引胸膺，眼睛视物模糊，严重时身体反折不能言语者，是昌阳脉病变引起的腰痛。热病舌头干黑且短者，属于厥阴热极。舌根强硬，进食则呕吐者，属于足太阴脾经的病证。舌头强硬难以言语，神志不清者，属于中风证。舌头强硬不能言语者，属于手少阴心经病证。突然昏不知人，喉中有痰鸣声，舌头强硬不能言语，若发汗后身体转软者可生，若汗不出身体僵直者，七日死亡，这是风懿的征候。小儿撮口脐风，舌头强硬挺直者，属于死证。咽喉不能言语，邪气结在舌根者，属于死证。半身不遂，男子发于左侧，女子发于右侧，不失音且舌头能转动者，可治。舌红且颤抖难以言语者，属于心脾虚。失音不能言语者，二日半死亡，属于阴阳俱绝。舌头木硬者，属于厥阴病。舌红且强硬失音者，属于死候。弄舌摇头者，属于痫病征候。舌头在口中时时摇动，嘴唇焦舌干，烦热便秽者，名为弄舌，属于心脾热。小儿面黄肌瘦，弄舌者，属于疳积。弄舌者，属于脾脏虚热。舌黑烂且频繁想要咬舌者，必定烂至舌根而死。咬舌者，属于厥气逆走上行，少阴经脉气辈至。舌色灰黑，时常自己想要咬舌者，属于少阴气逆的死证。这些都是诊法的条目，论述舌头的形态。
In all observations of the tongue's appearance and color, the general principles have been previously stated. Now, specific items should be collected. The tongue is the sprout (external manifestation) of the Heart; the Heart is the master of the body. Therefore, by observing the form of the tongue, one can diagnose diseases of the body.
The tongue's form can correspond to different Zang-Fu organs. The depth of the tongue's color can distinguish between Deficiency (Xu) and Excess (Shi). However, since diseases of the Zang-Fu organs all have distinctions of Deficiency and Excess, the qi and color of the tongue's form must also have distinctions of depth.
Various texts state: If the entire tongue has a black coating with large prickles, is dry, and has a red base, it indicates Excess Heat. If prickles grow on the tongue, it indicates severe heat accumulation. If there are no prickles on the tongue but the fluids are moist, it indicates Cold in the Middle Jiao. If the tongue is red, swollen, and fills the mouth, it indicates Heat in the Shaoyin and Yangming channels. If swelling protrudes from under the tongue like a small tongue, it is called Double Tongue (Chong She). If the tongue suddenly swells and becomes stiff like wood, it is called Wooden Tongue (Mu She). If the tongue swells, fills the mouth, overflows, prevents normal breathing, or becomes hard as wood or stone, it indicates Blood Stasis and Qi Stagnation. If the tongue is red and has Double Tongue, it indicates Heat entering the Pericardium. If the tongue is red, swollen, and full, causing difficulty in breathing, it indicates excessive Heat in the Hand-Shaoyin channel with blood congestion. Tongue enlargement may be due to Heat Toxin or Medicinal Toxin. If the tongue is purple and swollen with a thick appearance, it indicates Wine Toxin rising and congesting. Dry ears, swollen tongue, continuous bleeding from below, and edema of the feet indicate death within six days; this is Kidney Exhaustion. Dry ears, swollen tongue, hematuria, reddish loose stools, and foot edema indicate Muscle Exhaustion, with death within nine days; Stomach Exhaustion leads to death within five days. If the tongue is red and bleeds like epistaxis, it indicates Heat damaging the Pericardium. Confused voice, hoarse throat, flaccid tongue unable to extend forward indicates Jue (reversal) with a tight pulse, caused by erroneous sweating therapy. Cough ceases but diarrhea continues, chest feels like insect bites, vomiting after drinking porridge, difficult urination, spasm of both hypochondria, difficult panting, neck and back pulling each other in pain, arm numbness, excessive food intake but inability to extend the tongue despite wanting to speak, indicates Chu Zhong (Middle Removal/False Recovery). Red and flaccid tongue difficult to speak indicates Heart and Spleen Deficiency. Clear mind but slurred speech, soft and weak tongue difficult to speak indicates Insufficient Ying and Wei Qi. Abdominal fullness, yellow and dry flaccid tongue, insomnia belongs to the Jaundice category (referring to yellowing). Red and shriveled tongue unable to speak is a Death Syndrome. Red and shriveled tongue able to speak may be saved with symptomatic treatment. Cold body, salivation, tongue difficult to speak indicates Pathogen entering the Zang organs. Black and thin tongue without coating indicates Fluid Depletion and Blood Dryness. Flaccid tongue, full Renzhong (philtrum), inverted lips indicates Exhaustion of Foot-Taiyin Qi, with Muscles dying first. Eyes and face pulling each other, mouth deviated towards the ear, tight jaw, tongue unable to turn indicates Wind striking the vessels. Deviated tongue with slurred speech, facial paralysis, limb dysfunction indicates Pi Feng (Hemiplegia). Left deviation of the tongue indicates left-sided paralysis; right deviation indicates right-sided paralysis. Tongue edges defective like saw teeth indicate extreme Deficiency of Zang Qi, an untreatable condition. In febrile disease, difficulty extending the tongue, frequent tremors upon extension, unclear speech indicates a critical condition of Weak Righteous Qi. Tongue laxity with drooling and restlessness indicates Foot-Shaoyin syndrome. Epilepsy characterized by wide eyes and protruding tongue is Sheep Epilepsy. Tongue protrusion unable to retract and aphasia indicates Heart Qi Exhaustion. Prolonged tongue protrusion with slow retraction, red face, irritability, thirst, and dark urine indicates Heat in the Heart Channel. Fever with trismus, tongue protruding several inches before death indicates Female Labor Relapse (recurrence after sexual activity) with Yang Qi Deficiency. Yin-Yang Exchange with tongue protruding several inches is a Death Syndrome. Tongue protruding several inches occurs in postpartum cases, poisoning, or after great fright. In children, tongue protrusion unable to retract indicates Scattered Heart Qi. Retraction of the tongue root, trismus, and blue lips indicate Cold in the Small Intestine Fu organ. Voice expressing fear, rolled-up tongue root indicates Wood overcoming Earth. Gray tongue shape gradually drying and shrinking is a Death Syndrome. Tongue curled like cinnabar, difficulty swallowing saliva, slight ankle swelling indicates Muscle Exhaustion. Febrile disease with red, fragmented, eroded tongue resembles silkworm erosion, indicating Shaoyin syndrome. Red cracked tongue with sores indicates Pathogenic Heat in the Hand-Shaoyin channel. Sores on the tongue cracking and pulling lips red indicate Heart Heat. Mouth and tongue sores and erosion indicate Accumulated Heat in the Heart and Spleen channels. Mouth and tongue sores with sore throat indicate lingering Heat in the Bladder. Mouth and tongue sores indicate Upper Jiao Heat. Black tongue with central rot is an untreatable condition. Febrile disease with rotten tongue root and unrelenting heat is a Death Syndrome. Red malar flush, short curled tongue indicates Heart Disease. Curled tongue with irritability, chest fullness, and testicular retraction indicates Jueyin Disease. Bi-throat with curled tongue, dry mouth, irritability, heart pain, inner arm pain unable to reach the head indicates Pathogen lodging in the Hand-Shaoyang collaterals. Curled tongue unable to speak indicates Hand-Shaoyin channel disease. Fearful voice, curled tongue root, extreme joy or anger, chest oppression,恍惚 (trance), and fullness indicate Spleen Cold with Wind invasion. Blue lips, curled tongue, testicular retraction indicate Exhaustion of Foot-Jueyin Qi, with Tendons dying first. Internal heat, dry throat, frequent urination, irritability, severe curled tongue, and testicular retraction indicate the end of Jueyin Qi. Non-flowing sweat, curled black tongue indicates Heart Qi Exhaustion. Protruding tongue curling downward is a Death Syndrome. Huo Luan (cholera-like disorder) with curled tongue, contracted tendons, and testicular retraction into the abdomen is difficult to treat. Lower back pain radiating to the chest, blurred vision, severe opisthotonos and aphasia indicates Changyang Meridian pathology causing lower back pain. Febrile disease with dry, black, short tongue indicates Extreme Heat in Jueyin. Stiff tongue root with vomiting after eating indicates Foot-Taiyin disease. Stiff tongue, difficulty speaking, unclear spirit indicates Stroke syndrome. Stiff tongue unable to speak indicates Hand-Shaoyin disease. Sudden unconsciousness, gurgling sound in throat, stiff tongue unable to speak: if sweating leads to soft body, survival is possible; if no sweat and body remains straight, death occurs in seven days; this is Feng Yi (Wind Imbalance) syndrome. Infant mouth-grasping umbilical wind with stiff straight tongue is a Death Syndrome. Inability to speak due to throat issues, pathogen knotting at the tongue root is a Death Syndrome. Hemiplegia affecting men on the left and women on the right, without aphasia and with mobile tongue, is treatable. Red trembling tongue difficult to speak indicates Heart and Spleen Deficiency. Aphasia indicates death in two and a half days, signifying Exhaustion of both Yin and Yang. Wooden-hard tongue indicates Jueyin disease. Red, stiff, aphasic tongue is a Death Omen. Tongue-playing and head-shaking indicates Epilepsy syndrome. Tongue moving constantly in the mouth, dry scorched lips, irritability, heat, foul stool is named "Playing Tongue," indicating Heart and Spleen Heat. Yellow face, emaciation, playing tongue in children indicates Gan (Infantile Malnutrition). Playing tongue indicates Spleen Deficiency Heat. Black, rotten tongue frequently biting itself indicates inevitable death from rot reaching the root. Biting the tongue indicates Rebellious Qi rising, arrival of Shaoyin meridian Qi. Gray-black tongue frequently biting itself indicates Death Syndrome of Shaoyin Qi Rebellion. These are all items of diagnostic methods, discussing the forms of the tongue.