[总诀]舌乃心苗胃亦诊,赤红便作火来侵。有胎属火分真假,枯润之间仔细详。
凡舌有胎,或兼口苦溺黄者,三焦经郁热也。宜加味柴胡汤。
柴胡(二钱) 黄芩(二钱) 甘草(一钱) 当归(三钱) 白芍(三钱) 麦冬(三钱) 车前子(
三钱) 花粉(三钱) 知母(三钱) 滑石(三钱)
歌曰∶舌胎不论白和黄,但有皆为热五内。
加味柴胡芩草粉,知冬前滑芍归良。
舌尖赤痛,或生巨齿红点者,心经之游火也。宜加减泻心汤。
黄芩(三钱) 黄连(二钱) 当归(三钱) 赤芍(三钱) 丹皮(三钱) 生地(三钱) 花粉(三
钱) 连翘(二钱) 车前子(三钱) 木通(一钱) 甘草(一钱) 牛蒡子(三钱)
歌曰∶舌尖赤痛用芩连,牛蒡翘归地芍先。
花粉车前丹草和,木通泻热火全捐。
(伯未按∶舌胀满口,生蒲黄末搽舌上,若舌胀退场门,冰片一钱研敷。)
舌胎黄燥,兼见消渴引饮者,胃中有热邪也。宜加味虎汤。
知母(三钱) 石膏(三钱) 花粉(三钱) 酒军(一钱) 甘草(一钱) 生地(三钱) 枳壳(一
钱)
歌曰∶舌胎黄燥用知膏,花粉军甘地枳调。
白虎西方金气禀,再加清品散凉 。
舌胎滑润,兼见二便清利者,真寒而假热也。宜加味益元汤。
干姜(二钱) 附片(三钱) 黄连(二钱) 知母(二钱) 党参(三钱) 白术(三钱) 五味(八
分) 吴萸(二钱) 麦冬(三钱) 艾叶(一钱) 葱白(三根) 童便(一杯)
歌曰∶舌胎滑润便清和,假热真寒姜附科。
冬味知连葱便引,艾萸参术不嫌多。
舌黑生刺,手足日晡潮热者,胃中有燥屎也。宜调胃承气汤。
芒硝(二钱) 大黄(二钱) 枳壳(二钱) 浓朴(二钱) 甘草(五分)
歌曰∶燥屎留中舌刺芒,热潮日晡细端详。
硝黄枳朴同甘草,调胃长沙有妙方。
舌黑生刺,心烦不得安卧者,心火之亢热也。宜银翘泻心汤。
黄柏(二钱) 炒栀(二钱) 黄连(二钱) 黄芩(三钱) 生地(三钱) 白芍(二钱) 花粉(三
钱) 银花(二钱) 连翘(一钱) 竹茹(二钱) 草梢(一钱) 灯心(一束)
歌曰∶舌生黑刺卧难安,栀柏芩连用苦寒。
地芍银翘花粉共,灯心甘草竹茹餐。
【总诀】舌是心的外候,胃气也可通过舌象来诊断,舌色赤红通常表示火热之邪侵袭。舌苔的存在与否可以辨别火证的虚实真假,需在干燥与湿润之间仔细详察。
凡是舌上有苔,如果兼有口苦、小便黄的症状,这是三焦经郁结化热所致。适宜使用加味柴胡汤。
柴胡(二钱) 黄芩(二钱) 甘草(一钱) 当归(三钱) 白芍(三钱) 麦冬(三钱) 车前子(三钱) 花粉(三钱) 知母(三钱) 滑石(三钱)
歌诀说:舌苔不论白色还是黄色,只要有苔都代表五脏内有热。
加味柴胡汤中用黄芩、甘草和花粉,知母、麦冬、车前子、滑石、白芍、当归疗效良好。
舌尖赤痛,或者长出像大牙齿一样的红点,这是心经游移之火所致。适宜使用加减泻心汤。
黄芩(三钱) 黄连(二钱) 当归(三钱) 赤芍(三钱) 丹皮(三钱) 生地(三钱) 花粉(三钱) 连翘(二钱) 车前子(三钱) 木通(一钱) 甘草(一钱) 牛蒡子(三钱)
歌诀说:舌尖赤痛要用黄芩、黄连,牛蒡子、连翘、当归、生地、白芍先行使用。
花粉、车前子、丹皮、甘草调和,加上木通,火热之邪即可全部消除。
(伯安按语:如果舌体肿胀充满口腔,将蒲黄粉末搽在舌上;如果舌肿消退后,用冰片一钱研末敷贴。)
舌苔黄而干燥,兼见消渴、引饮(口渴多饮)的症状,这是胃中有热邪所致。适宜使用加味虎汤。
知母(三钱) 石膏(三钱) 花粉(三钱) 酒军(一钱) 甘草(一钱) 生地(三钱) 枳壳(一钱)
歌诀说:舌苔黄燥使用知母、石膏,配合花粉、大黄、甘草、生地、枳壳调理。
此方禀受西方金气(指白虎汤之意),再加清凉药物散发凉意。
舌苔滑润,兼见大小便清利(通畅无碍)的症状,这是真寒而假热所致。适宜使用加味益元汤。
干姜(二钱) 附片(三钱) 黄连(二钱) 知母(二钱) 党参(三钱) 白术(三钱) 五味子(八分) 吴茱萸(二钱) 麦冬(三钱) 艾叶(一钱) 葱白(三根) 童便(一杯)
歌诀说:舌苔滑润且二便调和,针对假热真寒证,应用干姜、附子为主。
麦冬、五味子、知母、黄连、葱白、童便为引,艾叶、吴茱萸、党参、白术用量不必嫌多。
舌色黑且生刺,手足在下午申酉时出现潮热的症状,这是胃中有燥屎(干结粪便)所致。适宜使用调胃承气汤。
芒硝(二钱) 大黄(二钱) 枳壳(二钱) 浓朴(二钱) 甘草(五分)
歌诀说:燥屎留滞体内导致舌生黑刺,午后潮热需仔细端详。
芒硝、大黄、枳壳、厚朴同用甘草,调胃承气汤出自长沙张仲景,确有妙方。
舌色黑且生刺,心烦意乱无法安稳躺卧的症状,这是心火亢盛炽热所致。适宜使用银翘泻心汤。
黄柏(二钱) 炒栀子(二钱) 黄连(二钱) 黄芩(三钱) 生地(三钱) 白芍(二钱) 花粉(三钱) 银花(二钱) 连翘(一钱) 竹茹(二钱) 草梢(一钱) 灯心(一束)
歌诀说:舌生黑刺难以安卧,需用栀子、黄柏、黄芩、黄连等苦寒药物。
生地、白芍、银花、连翘、花粉共同使用,灯心草、甘草、竹茹煎服。
[General Verse] The tongue is the sprout of the Heart, and the Stomach Qi can also be diagnosed through it. A crimson-red tongue indicates invasion by Fire pathogen. The presence of coating helps distinguish the true or false nature of Fire; one must carefully examine whether it is dry or moist.
Whenever there is a tongue coating, if accompanied by bitter taste in the mouth and yellow urine, it indicates stagnant heat in the Sanjiao (Triple Burner) meridian. Jiawei Chaihu Tang (Modified Bupleurum Decoction) is appropriate.
Chai Hu (Bupleuri Radix, 2 qian), Huang Qin (Scutellariae Radix, 2 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian), Dang Gui (Angelicae Sinensis Radix, 3 qian), Bai Shao (Paeoniae Radix Alba, 3 qian), Mai Dong (Ophiopogonis Radix, 3 qian), Che Qian Zi (Plantaginis Semen, 3 qian), Hua Fen (Trichosanthis Radix, 3 qian), Zhi Mu (Anemarrhenae Rhizoma, 3 qian), Hua Shi (Talcum, 3 qian).
The song states: Regardless of whether the tongue coating is white or yellow, its presence indicates Heat within the Five Viscera.
In the modified Chai Hu decoction, Scutellaria, Glycyrrhiza, and Trichosanthes root are used; Anemarrhena, Ophiopogon, Plantago seed, Talcus, Paeonia alba, and Angelica sinensis yield good results.
Crimson pain at the tongue tip, or the emergence of large red spots resembling teeth, indicates wandering Fire of the Heart meridian. Jiajian Xiexin Tang (Modified Heart-Draining Decoction) is appropriate.
Huang Qin (Scutellariae Radix, 3 qian), Huang Lian (Coptidis Rhizoma, 2 qian), Dang Gui (Angelicae Sinensis Radix, 3 qian), Chi Shao (Paeoniae Radix Rubra, 3 qian), Dan Pi (Moutan Cortex, 3 qian), Sheng Di (Rehmanniae Radix, 3 qian), Hua Fen (Trichosanthis Radix, 3 qian), Lian Qiao (Forsythiae Fructus, 2 qian), Che Qian Zi (Plantaginis Semen, 3 qian), Mu Tong (Akebiae Caulis, 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian), Niu Bang Zi (Arctii Fructus, 3 qian).
The song states: For crimson pain at the tongue tip, use Scutellaria and Coptidis; Arctium, Forsythia, Angelica, Rehmannia, and Paeonia rubra should be employed first.
Trichosanthes root, Plantago seed, Moutan bark, and Glycyrrhiza harmonize; with Akebia stem, all Heat and Fire are eliminated.
(Bonan's Note: If the tongue swells to fill the mouth, apply Polygoni Multiflori Caulis powder (Pu Huang) to the tongue surface. If the swelling subsides, apply Borneolum Syntheticum (Bing Pian, 1 qian) as a topical application.)
Yellow and dry tongue coating, accompanied by Xiao Ke (wasting-thirst syndrome) and polydipsia, indicates Heat pathogen in the Stomach. Jiawei Hu Tang (Modified Tiger Decoction) is appropriate.
Zhi Mu (Anemarrhenae Rhizoma, 3 qian), Shi Gao (Gypsum Fibrosum, 3 qian), Hua Fen (Trichosanthis Radix, 3 qian), Jiu Jun (Rhei Radix et Rhizoma processed with wine, 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian), Sheng Di (Rehmanniae Radix, 3 qian), Zhi Ke (Aurantii Fructus, 1 qian).
The song states: For yellow and dry tongue coating, use Anemarrhena and Gypsum; regulate with Trichosanthes root, Rheum, Glycyrrhiza, Rehmannia, and Aurantium fruit.
This formula inherits the Metal Qi of the West (referencing Baihu Tang/White Tiger Decoction); adding cooling herbs disperses coolness.
Slippery and moist tongue coating, accompanied by clear and free urination and defecation, indicates True Cold with False Heat. Jiawei Yiyuan Tang (Modified Yiyuan Decoction) is appropriate.
Gan Jiang (Zingiberis Rhizoma, 2 qian), Fu Pian (Aconiti Lateralis Radix Praeparata, 3 qian), Huang Lian (Coptidis Rhizoma, 2 qian), Zhi Mu (Anemarrhenae Rhizoma, 2 qian), Dang Shen (Codonopsis Radix, 3 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 3 qian), Wu Wei Zi (Schisandrae Chinensis Fructus, 8 fen), Wu Zhu Yu (Evodiae Fructus, 2 qian), Mai Dong (Ophiopogonis Radix, 3 qian), Ai Ye (Artemisiae Argyi Folium, 1 qian), Cong Bai (Allii Fistulosi Bulbus, 3 stalks), Tong Bian (Human Urine, 1 cup).
The song states: Slippery and moist tongue coating with harmonious bowel and bladder movements indicates False Heat and True Cold; Ginger and Aconite are the main agents.
Ophiopogon, Schisandra, Anemarrhena, and Coptidis, guided by Allium fistulosum and Human Urine; Artemisia, Evodia, Codonopsis, and Atractylodes macrocephala need not be sparingly used.
Black tongue with prickles, and tidal fever of the hands and feet during the Shen and You hours (3 PM - 7 PM), indicates Dry Feces (Zao Shi) in the Stomach. Tiaowei Chengqi Tang (Regulate the Stomach and Purge the Bowels Decoction) is appropriate.
Mang Xiao (Natrii Sulfas, 2 qian), Da Huang (Rhei Radix et Rhizoma, 2 qian), Zhi Ke (Aurantii Fructus, 2 qian), Hou Po (Magnoliae Officinalis Cortex, 2 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 5 fen).
The song states: Dry feces retained internally cause black tongue prickles; tidal fever at sunset requires careful examination.
Natrium sulfate, Rheum, Aurantium fruit, and Magnolia bark combined with Glycyrrhiza form the excellent prescription from Changsha (Zhang Zhongjing).
Black tongue with prickles, restlessness, and inability to lie down peacefully, indicate Hyperactive Heat of Heart Fire. Yinqiao Xiexin Tang (Lonicera and Forsythia Heart-Draining Decoction) is appropriate.
Huang Bo (Phellodendri Cortex, 2 qian), Chao Zhi Zi (Gardeniae Fructus stir-fried, 2 qian), Huang Lian (Coptidis Rhizoma, 2 qian), Huang Qin (Scutellariae Radix, 3 qian), Sheng Di (Rehmanniae Radix, 3 qian), Bai Shao (Paeoniae Radix Alba, 2 qian), Hua Fen (Trichosanthis Radix, 3 qian), Yin Hua (Lonicerae Japonicae Flos, 2 qian), Lian Qiao (Forsythiae Fructus, 1 qian), Zhu Ru (Bambusae Caulis in Taeniam, 2 qian), Cao Shao (Glycyrrhizae Radix et Rhizoma tip, 1 qian), Deng Xin (Junci Medulla, 1 bundle).
The song states: Black tongue with prickles makes sleep difficult; use bitter-cold Gardenia, Phellodendron, Scutellaria, and Coptidis.
Rehmannia, Paeonia alba, Lonicera, Forsythia, and Trichosanthes root are used together; Juncus medulla, Glycyrrhiza, and Bambusa sheath are consumed as a decoction.