霉酱色苔者。乃夹食伤寒。一二日间即有此舌。为寒伤太阴。食停胃腑之证。轻者苔色亦薄。虽腹痛。不下
利。桂枝汤加橘、半，枳、朴。痛甚加大黄。冷食不消加干姜、浓朴。其苔色浓而腹痛甚不止者。必危。舌见酱
色。乃黄兼黑色。为土邪传水。证必唇口干燥大渴。虽用下夺。鲜有得愈者。
\r纯霉酱色舌\pt108a110.bmp\r
舌见霉色。乃饮食填塞于胃。复为寒邪郁遏。内热不得外泄。湿气熏蒸。罨而变此色也。其脉多沉紧。其
人必烦躁腹痛。五七日下之不通者。必死。太阴少阴气绝也。
\r中霉浮浓舌\pt108a111.bmp\r
伤寒不戒荤腻。致苔如酱饼浮于舌中。乃食滞中宫之象。如脉有胃气。不结代。嘴不尖。齿不燥。不下利
者。可用枳实理中汤、加姜汁炒川连。若舌苔揩去复长仍前者。必难救也。
\r霉色中黄苔舌\pt108a112.bmp\r
舌霉色中有黄苔。乃湿热之物郁滞中宫也。二陈加枳实、黄连。若苔干黄。更加酒大黄下之。
蓝色苔者。乃肝木之色发见于外也。伤寒病久。已经汗下。胃气已伤。致心火无气。胃土无根据。肺无所
生。木无所畏。故乘膈上而见纯蓝色。是金木相并。火土气绝之候。是以必死。如微蓝、或稍见蓝纹。犹可用
温胃健脾。调肝益肺药治之。如纯蓝色者。是肝木独盛无畏。虽无他证。必死。
\r微蓝舌\pt108a113.bmp\r
舌见纯蓝色。中土阳气衰微。百不一生之候。切勿用药。
\r蓝纹舌\pt108a114.bmp\r
舌见蓝纹。乃胃土气衰。木气相乘之候。小柴胡去黄芩、加炮姜。若因寒物结滞。急宜附子理中、大建中汤。
霉酱色苔，是夹带食积的伤寒。在一两天内就会出现这种舌象，这是寒邪损伤太阴经，食物停滞在胃腑的证候。病情较轻者，苔色也较薄，虽然腹痛，但不下利，可用桂枝汤加陈皮、半夏、枳实、厚朴；疼痛剧烈者加大黄；因冷食不消化而致者，加干姜、厚朴。如果苔色深浓且腹痛剧烈不止，必定危险。舌见酱色，是黄色兼有黑色，为土邪传变至水脏（肾），证候必然出现唇口干燥、大渴，即使使用攻下法，很少能治愈的。
纯霉酱色舌：
舌见霉色，是因为饮食填塞于胃，又受寒邪郁遏，内热不能向外宣泄，湿气熏蒸，覆盖后变成这种颜色。其脉象多沉紧，病人必然烦躁腹痛，五到七天内攻下不通畅的，必定死亡，这是太阴和少阴之气断绝的表现。
中霉浮浓舌：
伤寒期间不注意忌口荤腥油腻，导致舌苔像酱饼一样浮在舌中，这是食滞在中焦脾胃的现象。如果脉象有胃气，不出现结代脉，嘴唇不尖削，牙齿不燥裂，不下利，可以用枳实理中汤，加用姜汁炒制的黄连。如果舌苔擦去后又重新生长，仍然像以前一样，必定难以救治。
霉色中黄苔舌：
舌霉色中有黄苔，是湿热之物郁滞在中焦脾胃。可用二陈汤加枳实、黄连。如果苔干黄，再加酒制大黄攻下。
蓝色苔，是肝木的颜色反映在外部。伤寒病日久，已经经过发汗和攻下治疗，胃气已经受损，导致心火无力，胃土没有根基，肺金无所生养，肝木无所畏惧。因此乘虚上逆而出现纯蓝色，这是金木相并、火土之气断绝的征候，所以必定死亡。如果是微蓝，或者稍微见到蓝纹，还可以用温胃健脾、调肝益肺的药物来治疗。如果是纯蓝色的，是肝木独盛而无畏惧，即使没有其他症状，也必定死亡。
微蓝舌：
舌见纯蓝色，是中土阳气衰微，百人中难有一人生还的征候，千万不要用药。
蓝纹舌：
舌见蓝纹，是胃土气衰，肝木之气相乘的征候。用小柴胡汤去掉黄芩，加炮姜。如果是因寒凉食物导致结滞，急宜用附子理中汤、大建中汤。
A moldy-soy-sauce-colored coating indicates Shaoyang disease complicated by food retention. This tongue appearance may present within one or two days, signifying Cold injuring the Taiyin channel and food stagnating in the Stomach organ. In mild cases, the coating is thin; although abdominal pain is present, there is no diarrhea. Guizhi Tang (Cinnamon Twig Decoction) combined with Chenpi (Tangerine Peel), Banxia (Pinellia Rhizome), Zhishi (Immature Bitter Orange), and Houpo (Magnolia Bark) may be used. If pain is severe, Dahuang (Rhubarb Root) is added. For cold food indigestion, Ganjiang (Dried Ginger) and Houpo (Magnolia Bark) are added. If the coating is thick and dark with unceasing severe abdominal pain, the condition is critical. A sauce-colored tongue results from yellow mixed with black, indicating Earth pathogen transmitting to Water organs. Symptoms must include dry lips and mouth with intense thirst. Even if purgative methods are employed, recovery is rare.
Pure Moldy-Soy-Sauce-Colored Tongue:
The appearance of a moldy color on the tongue occurs when food obstructs the Stomach, compounded by Cold pathogen constraint, preventing internal Heat from venting outward. Dampness steams and covers the surface, changing the color. The pulse is typically deep and tight. The patient suffers from irritability and abdominal pain. If purgatives fail to relieve obstruction after five to seven days, death is inevitable due to the exhaustion of Qi in the Taiyin and Shaoyin channels.
Central Moldy-Float-Thick Coating Tongue:
Failure to observe dietary restrictions regarding meat and greasy foods during Shaoyang disease causes the coating to float on the center of the tongue like soybean paste, indicating food stagnation in the Middle Jiao. If the pulse retains Stomach Qi, without knotted or intermittent rhythms, with non-pointed lips, non-dry teeth, and no diarrhea, Zhishi Lizhong Tang (Immature Bitter Orange and Poria Decoction) with Jiangzhi Chao Chuanlian (Jiangju-fried Coptis Rhizome) can be used. If the coating reappears identically after being scraped off, the condition is likely incurable.
Moldy Color with Yellow Coating Tongue:
Moldy color with yellow coating indicates damp-heat stagnation in the Middle Jiao. Erchen Tang (Two-Cured Decoction) with Zhishi (Immature Bitter Orange) and Huanglian (Coptis Rhizome) is indicated. If the coating is dry and yellow, Jiuhuang (Wine-processed Rhubarb Root) should be added for purgation.
Blue Coating:
The blue color represents the manifestation of Liver Wood externally. In prolonged Shaoyang disease, after sweating and purging therapies have damaged Stomach Qi, Heart Fire lacks strength, Stomach Earth has no foundation, Lung Metal lacks nourishment, and Liver Wood faces no restraint. Consequently, it overcomes upward, presenting as pure blue. This signifies Metal and Wood combining while Fire and Earth Qi exhaust, leading to certain death. If the blue is faint or shows slight streaks, treatment with herbs that warm the Stomach, strengthen Spleen, regulate Liver, and benefit Lung may still be effective. Pure blue indicates unchecked Liver Wood dominance; even without other symptoms, death is certain.
Faint Blue Tongue:
A pure blue tongue indicates the decline of Middle Earth Yang Qi, a prognosis where fewer than one in a hundred survive. Medication should absolutely be avoided.
Blue Streak Tongue:
Blue streaks on the tongue indicate declining Stomach Earth Qi and the overcoming influence of Liver Wood. Xiaochaihu Tang (Minor Bupleurum Decoction) with Huangqin (Scutellaria Root) removed and Paojiang (Prepared Ginger) added is prescribed. If caused by cold food accumulation, Fuzi Lizhong Tang (Aconite and Poria Decoction) or Dajianzhong Tang (Great Construct the Middle Decoction) should be urgently administered.