黄苔者。里证也。伤寒初病无此舌。传至少阳经。亦无此舌。直至阳明府实。胃中火盛。火乘土位。故有此苔。当
分轻重泻之。初则微黄。次则深黄有滑。甚则干黄焦黄也。其证有大热、大渴、便秘、谵语、痞结、自利。或因失
汗发黄。或蓄血如狂。皆湿热太盛。小便不利所致。若目白如金。身黄如橘。宜茵陈蒿汤，五苓散。栀子柏皮汤等。如
蓄血在上焦。犀角地黄汤。中焦、桃仁承气汤。下焦，代抵当汤。凡血证见血则愈。切不可与冷水。饮之必死。大抵舌
黄证虽重。若脉长者。中土有气也。下之则安。如脉弦下利、舌苔黄中有黑色者。皆危证也。
\r纯黄微干舌\pt108a30.bmp\r
舌见黄苔。胃热之极。土色见于舌端也。急宜调胃承气下之。迟则恐黄老变黑。为恶候。
\r微黄苔舌\pt108a31.bmp\r
舌微黄而不甚燥者。表邪失汗而初传里也。用大柴胡汤。若身目俱黄者。茵陈蒿汤。
\r黄干舌\pt108a32.bmp\r
舌见干黄。里热已极。急下勿缓。下后脉静身凉者生。反大热而喘脉躁者死。
\r黄苔黑滑舌\pt108a33.bmp\r
舌黄而有黑滑者。阳明里证具也。虽不干燥。亦当下之。下后身凉脉静者生。大热脉躁者死。
\r黄苔黑斑舌\pt108a34.bmp\r
黄苔中乱生黑斑者。其证必大渴谵语。身无斑者。大承气下之。如脉涩、谵语，循衣摸床、身黄斑黑者。俱
不治。下出稀黑粪者死。
\r黄苔中黑通尖舌\pt108a35.bmp\r
黄苔从中至尖通黑者。乃火土燥而热毒最深也。两感伤寒必死。恶寒甚者亦死。如不恶寒。口燥咽干而下
利臭水者。可用调胃承气汤下之。十中可救四五。口干齿燥。形脱者。不治。
\r老黄隔瓣舌\pt108a36.bmp\r
舌黄干涩而有隔瓣者。乃邪热入胃。毒结已深。烦躁而渴者。大承气汤。发黄者。茵陈蒿汤。少腹痛者。有
瘀血也。抵当汤。结胸。大陷胸汤。
\r黄尖舌\pt108a37.bmp\r
舌尖苔黄。热邪初传胃腑也。当用调胃承气汤。如脉浮恶寒。表证未尽。大柴胡两解之。
\r黄苔灰根舌\pt108a38.bmp\r
舌根灰色而尖黄。虽比黑根少轻。如再过一二日。亦黑也。难治。无烦躁直视。脉沉而有力者。大柴胡加减治之。
\r黄尖红根舌\pt108a39.bmp\r
根红而尖黄者。乃湿热乘火位也。瘟热初病。多有此舌。凉膈解毒等药。消息治之。
\r黄尖黑根舌\pt108a40.bmp\r
舌黑根多而黄尖少者。虽无恶证恶脉。诚恐暴变一时。以胃气竭绝故耳。
\r黄苔黑刺舌\pt108a41.bmp\r
舌苔老黄极而中有黑刺者。皆由失汗所致。邪毒内陷已深。急用调胃承气下之。十中可保一二。
\r黄大胀满舌\pt108a42.bmp\r
舌黄而胀大者。乃阳明胃经湿热也。证必身黄、便秘、烦躁。茵陈蒿汤。如大便自利而发黄者。五苓散加
茵陈、栀子、黄连等治之。
\r黄尖白根舌\pt108a43.bmp\r
舌根白尖黄。其色倒见。必是少阳经传阳明府病。若阳明证多者。大柴胡汤。少阳证多者。小柴胡汤。如
谵语烦躁者。调胃承气汤。
\r黄根白尖舌\pt108a44.bmp\r
舌尖白根黄。乃表邪少而里邪多也。天水散、凉膈散合用。如阳明无汗、小便不利、心中懊 者。必发黄。
茵陈蒿汤。
\r黄根灰尖舌\pt108a45.bmp\r
舌乃火位。今见根黄尖灰。是土来侮火也。不吐不利、心烦而渴者。乃胃中有郁热也。调胃承气加黄连。
\r黄根白尖短缩舌\pt108a46.bmp\r
舌见根黄尖白而短硬。不燥不滑。但不能伸出。证多谵妄烦乱。此痰挟宿食占据中宫也。大承气加姜、半主之。
黄苔，属于里证。伤寒初起时没有这种舌象。病邪传至少阳经时，也没有这种舌象。直到病邪传入阳明腑实阶段，胃中火热炽盛，火气侵犯土位（脾胃），才会出现这种舌苔。此时应当根据病情的轻重进行泻下治疗。初期舌苔微黄，随后变为深黄色且表面湿润光滑，严重时则表现为干燥发黄或焦黑发黄。伴随的症状有大热、大渴、便秘、胡言乱语、心下痞满结块、自发性腹泻等。有的因为发汗不及时而发黄，有的因瘀血蓄积导致神志狂乱，这些都是由于湿热太盛、小便不利所致。如果眼白如金色，身体黄如橘子色，适宜使用茵陈蒿汤、五苓散、栀子柏皮汤等方剂。如果瘀血蓄积在上焦，用犀角地黄汤；在中焦，用桃仁承气汤；在下焦，用代抵当汤。凡是血证，见出血症状后病情就会好转，千万不可给予冷水饮用，否则必死无疑。大抵而言，舌苔发黄虽然病情较重，但如果脉象长，说明中土（脾胃）还有正气，使用泻下法即可痊愈。如果脉象弦细且伴有腹泻，或者舌苔黄中间夹杂黑色，都是危重证候。
纯黄微干舌：
舌头出现黄苔，是胃热到了极点，脾土之色显现于舌端。应当紧急使用调胃承气汤进行泻下，拖延则恐怕黄色变老转为黑色，成为不良征兆。
微黄苔舌：
舌苔微黄且不甚干燥，是表邪因未发汗而初传至里的表现。应使用大柴胡汤。如果全身和眼睛都发黄，使用茵陈蒿汤。
黄干舌：
舌头出现干燥的黄苔，说明里热已至极点，必须紧急泻下，不可迟缓。泻下后如果脉象平静、身体凉爽的会存活；如果反而出现大热、气喘、脉象躁动的则会死亡。
黄苔黑滑舌：
舌苔黄且带有黑色、表面湿润光滑，说明阳明里证具备。即使不干燥，也应当使用泻下法。泻下后身体凉爽、脉象平静的会存活；如果大热、脉象躁动的则会死亡。
黄苔黑斑舌：
黄苔中杂乱生出黑色斑点，其症状必定是大渴、胡言乱语。身上没有斑点的，使用大承气汤泻下。如果脉象涩滞、胡言乱语、手指抓摸衣被床沿、身体发黄且斑点呈黑色的，都属于不治之症。泻下排出稀薄的黑色粪便的也会死亡。
黄苔中黑通尖舌：
黄苔从舌中部一直延伸到舌尖全部变黑，这是火土燥热且热毒极深的表现。两感伤寒（表里同病）必定死亡，恶寒严重的也会死亡。如果不恶寒，口燥咽干且腹泻流出臭水的，可以使用调胃承气汤泻下，十个人中可救活四五个。如果口干齿燥、形体脱败的，属于不治之症。
老黄隔瓣舌：
舌苔黄、干燥涩滞且有裂纹隔瓣，这是邪热进入胃中，毒结已经很深。烦躁且口渴的，使用大承气汤；发黄的，使用茵陈蒿汤；小腹部疼痛的，是有瘀血，使用抵当汤；结胸证的，使用大陷胸汤。
黄尖舌：
舌尖苔黄，是热邪初传胃腑的表现。应当使用调胃承气汤。如果脉象浮、恶寒，说明表证尚未完全解除，可用大柴胡汤表里双解。
黄苔灰根舌：
舌根灰色而舌尖黄，虽然比黑根稍轻，但如果再过一两天，也会变成黑色，难以治疗。如果没有烦躁、直视、脉象沉而有力的情况，可用大柴胡汤加减治疗。
黄尖红根舌：
舌根红而舌尖黄，这是湿热乘袭火位（心/上焦）。瘟热初起时，多有这种舌象。使用凉膈解毒等药物，斟酌病情进行治疗。
黄尖黑根舌：
舌根黑色多而舌尖黄色少，虽然没有恶证和恶脉，但诚恐突然发生变故，这是因为胃气竭绝的缘故。
黄苔黑刺舌：
舌苔老黄至极且中间有黑色刺状突起，都是由失汗导致的。邪毒内陷已经很深，紧急使用调胃承气汤泻下，十个人中可保全一两个。
黄大胀满舌：
舌苔黄且舌体胀大，这是阳明胃经湿热的表现。症状必定包括身黄、便秘、烦躁。使用茵陈蒿汤。如果大便自利（通畅）却发黄的，使用五苓散加茵陈、栀子、黄连等药物治疗。
黄尖白根舌：
舌根白而舌尖黄，颜色倒置，必定是少阳经病传变为阳明腑病。如果阳明证多的，使用大柴胡汤；少阳证多的，使用小柴胡汤。如果出现胡言乱语、烦躁的，使用调胃承气汤。
黄根白尖舌：
舌尖白而舌根黄，说明表邪少而里邪多。将天水散、凉膈散合用。如果阳明病无汗、小便不利、心中懊恼烦闷的，必定发黄，使用茵陈蒿汤。
黄根灰尖舌：
舌属火位，现在见到舌根黄而舌尖灰，这是土来侮火（脾土反克心火）。如果不呕吐、不腹泻、心烦且口渴的，是胃中有郁热，使用调胃承气汤加黄连。
黄根白尖短缩舌：
舌头见到舌根黄、舌尖白且短硬，不干燥也不湿润，但不能伸出。症状多为胡言乱语、烦乱，这是痰浊挟带宿食占据中宫（脾胃）所致。使用大承气汤加生姜、半夏为主治方。
Yellow coating indicates interior syndrome. This tongue manifestation is absent in the initial stage of cold damage (Shanghan). It is also absent when the pathogen transmits to the Shaoyang channel. It appears only when the pathogen reaches the Yangming fu-organ excess stage, where stomach fire flares up excessively, and fire invades the earth position (Spleen/Stomach), thus producing this coating. Treatment should involve purging according to the severity. Initially, the coating is slightly yellow; subsequently, it becomes deep yellow and slippery; in severe cases, it is dry yellow or scorched yellow. Symptoms include high fever, intense thirst, constipation, delirium, epigastric fullness and obstruction, and spontaneous diarrhea. Some patients develop jaundice due to failure to sweat initially, while others exhibit mania-like behavior due to blood stasis accumulation. All these are caused by excessive damp-heat and difficult urination. If the whites of the eyes are golden and the body is orange-yellow, Yinchen Hao Tang (Artemisiae Scopariae Decoction), Wuling San (Five-Ingredient Powder with Poria), and Zhizi Bopi Tang (Gardeniae and Phellodendri Bark Decoction) are appropriate. If blood stasis accumulates in the Upper Jiao, Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) is used; for the Middle Jiao, Tao Ren Chengqi Tang (Prunus Persica Seed and Rhubarb Decoction); for the Lower Jiao, Dai Didang Tang (Substitute Dandang Decoction). In all blood syndromes, improvement occurs upon bleeding. Cold water must never be given, as ingestion will lead to death. Generally, although a yellow tongue coating indicates a serious condition, if the pulse is long, it signifies that the central earth (Spleen/Stomach) still has qi, and the patient can be cured with purgation. However, if the pulse is wiry accompanied by diarrhea, or if the yellow coating has black in the center, these are critical conditions.
Pure Yellow Slightly Dry Tongue:
A tongue with yellow coating indicates extreme stomach heat, with the color of earth appearing at the tip of the tongue. Immediate purgation with Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction) is required. Delay may cause the yellow to age and turn black, indicating an adverse prognosis.
Slightly Yellow Coating Tongue:
A slightly yellow coating that is not very dry indicates that exterior pathogens have begun to transmit inward due to lack of sweating. Dachaihu Tang (Major Bupleurum Decoction) should be used. If the whole body and eyes are yellow, Yinchen Hao Tang (Artemisiae Scopariae Decoction) is indicated.
Dry Yellow Tongue:
A dry yellow coating indicates extreme interior heat. Urgent purgation is necessary without delay. Survival is expected if the pulse becomes calm and the body cools after purgation; death is likely if there is rebound high fever, panting, and a restless pulse.
Yellow Coating with Black Slippery Tongue:
A yellow coating with black and slippery characteristics indicates complete Yangming interior syndrome. Purging is required even if the tongue is not dry. Survival is expected if the body cools and the pulse calms after purgation; death is likely with high fever and a restless pulse.
Yellow Coating with Black Spots Tongue:
Chaotic black spots appearing within a yellow coating indicate symptoms of extreme thirst and delirium. For those without skin spots, Dachengqi Tang (Major Order to Discharge Decoction) should be used for purgation. If the pulse is choppy, delirium is present, the patient picks at clothes and bedsheets, and the body is yellow with black spots, the condition is untreatable. Passing loose black stool after purgation also indicates death.
Yellow Coating with Black Extending to Tip Tongue:
Yellow coating turning black from the center to the tip indicates extreme dryness of fire and earth, with the deepest heat toxicity. Bi-gan Shanghan (simultaneous contraction of exterior and interior pathogens) is fatal. Severe aversion to cold is also fatal. If there is no aversion to cold, but dry mouth and throat with foul-smelling diarrhea, Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction) can be used for purgation; four or five out of ten may be saved. Dry mouth, dry teeth, and emaciation are untreatable.
Old Yellow Fissured Tongue:
A yellow, dry, rough coating with fissures indicates that evil heat has entered the stomach and toxicity has deeply accumulated. For irritability and thirst, Dachengqi Tang (Major Order to Discharge Decoction) is used; for jaundice, Yinchen Hao Tang (Artemisiae Scopariae Decoction); for lower abdominal pain indicating blood stasis, Didang Tang (Dandang Decoction); for chest binding (Jie Xiong), Daxianxiong Tang (Major Thorax-Penetrating Decoction).
Yellow Tip Tongue:
Yellow coating on the tongue tip indicates that heat pathogens have just transmitted to the stomach fu-organ. Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction) should be used. If the pulse is floating and there is aversion to cold, indicating unresolved exterior syndrome, Dachaihu Tang (Major Bupleurum Decoction) should be used to resolve both exterior and interior.
Yellow Coating with Grey Root Tongue:
A grey root with a yellow tip is slightly less severe than a black root, but if left untreated for one or two days, it will turn black and become difficult to treat. In the absence of irritability, staring fixedly, and with a deep yet forceful pulse, Dachaihu Tang (Major Bupleurum Decoction) modified can be used.
Yellow Tip with Red Root Tongue:
A red root with a yellow tip indicates damp-heat invading the fire position (Heart/Upper Jiao). This tongue is common in the early stages of warm epidemic febrile diseases. Cooling the diaphragm and detoxifying herbs should be used, adjusting treatment based on the specific presentation.
Yellow Tip with Black Root Tongue:
A tongue with extensive black root and little yellow tip, even without adverse symptoms or pulses, risks sudden deterioration due to exhaustion of stomach qi.
Yellow Coating with Black Prickles Tongue:
An old, extremely yellow coating with black prickles in the center results from failure to sweat. Pathogenic toxins have deeply collapsed inward. Urgent purgation with Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction) is required; only one or two out of ten may survive.
Yellow Swollen and Full Tongue:
A yellow and swollen tongue indicates damp-heat in the Yangming stomach meridian. Symptoms include jaundice, constipation, and irritability. Yinchen Hao Tang (Artemisiae Scopariae Decoction) is used. If stools are loose but jaundice persists, Wuling San (Five-Ingredient Powder with Poria) plus Yinchen, Zhizi, and Huanglian is used.
Yellow Tip with White Root Tongue:
A white root and yellow tip indicate inverted colors, signifying transmission from the Shaoyang channel to the Yangming fu-organ. If Yangming symptoms predominate, Dachaihu Tang (Major Bupleurum Decoction) is used; if Shaoyang symptoms predominate, Xiaochaihu Tang (Minor Bupleurum Decoction) is used. For delirium and irritability, Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction) is indicated.
Yellow Root with White Tip Tongue:
A white tip and yellow root indicate fewer exterior pathogens and more interior pathogens. Combine Tianshui San (Heavenly Water Powder) and Liangge San (Cool the Diaphragm Powder). If Yangming syndrome presents with no sweat, difficult urination, and mental restlessness (Ao Nao), jaundice will certainly develop; use Yinchen Hao Tang (Artemisiae Scopariae Decoction).
Yellow Root with Grey Tip Tongue:
The tongue belongs to the fire position. A yellow root and grey tip indicate earth insulting fire (Spleen overacting on Heart). Without vomiting or diarrhea, but with heart vexation and thirst, it indicates constrained heat in the stomach. Use Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction) plus Huanglian.
Yellow Root with White Shortened Tip Tongue:
A tongue with a yellow root, white tip, short and stiff texture, neither dry nor slippery, but unable to extend, indicates symptoms of delirium and confusion. This is caused by phlegm and retained food occupying the central palace (Spleen/Stomach). Dachengqi Tang (Major Order to Discharge Decoction) plus Shengjiang (Fresh Ginger) and Banxia (Pinellia) is the primary treatment.