脉学诊断之书，以李濒湖、朱丹溪
二家最为细腻，凡相似相异之处，皆能分别清楚，用笔描摹，比拟形状，俾后学无误认之
处，可谓大有功于斯世。惜察舌一法，二公未有专书，世所传者，惟伤寒舌鉴、温疫舌鉴而
已，欲求其如脉学之详细者，未之有也。瑞因用心三十余年，将诊断试验，医治得效，历历不爽者，笔
记于册，以授徒辈，未敢自以为是也。庚戌，镇郡同志袁君桂生等创办《医学扶轮报》，以昌明医学
，瑞
舞附骥，分任印费报料之责。至庚戌岁冬，诸君有退志者甚多，印费报料因而缺乏，将成中止之
局。瑞
滥竽充数，刻印未终，至辛亥八月，而瑞等之《扶轮报》，亦与清鼎同时革命矣。今绍兴医会、上
海医会阅报诸君，时有来函，向袁、杨二君索阅全稿者。此皆阅《扶轮报》之旧友，不以葑菲见弃。殆以
管见之比拟描摹，尚有可采处。爰从二君之议，抄录全稿，加序送《绍学医学报》社，遵周君小农流通书
籍办法
亦抛砖引玉之苦心耳，是为序。伏乞诸大名家诲政，以匡不逮，是幸。
岁次柔兆执徐春分后三日刘恒瑞自序于京江之有预斋停云传舍。
舌为胃之外候，以输送食物入食管胃脘之用。其舌体之组织，系由第五对脑筋达
舌，其功用全赖此筋运动。舌下紫青筋二条，乃少阴肾脉上达，名曰金津、玉液二穴，所以生津液以濡润
舌质，
明，其辨症之识，必有毫厘千里之误，此原理之不可不讲也。夫舌之表面，乃多数极小乳头，铺合而
点，其不易见
高起
一日三餐，故苔亦日有三变，谓之活苔，无病之象也。其所以有变者，因饮食入胃时，将腐
浊之气，遏郁下降，故苔色一退；至饮食腐化，浊气上蒸，苔色又生。胃中无腐浊，则苔薄而少，
有腐
胃中正色不能直达而上，故有暂白之时；青为绝色，青绿之色，见于舌上，其人命必危。其外尚有似
黄非黄、似白非白，各类间色，皆条分于后，以备后学细心参考。
脉学诊断方面的书籍，以李时珍（字濒湖）和朱丹溪两位医家的著作为最为细致入微。他们对于相似而又有细微差别的脉象，都能分辨得清清楚楚，用笔描绘摹写，比拟其形状，使后学者不会发生误认的情况，可以说是对这个世界大有功劳。可惜在察舌这一方法上，这两位先生没有专门的著作，世间所流传的，只有《伤寒舌鉴》和《温疫舌鉴》罢了，想要找到像脉学那样详细的察舌专著，是没有的。
我（刘恒瑞）因此用心钻研三十多年，将那些经过诊断试验、医治有效、历历不爽的案例，记录在册，用来传授给徒弟们，不敢自以为是。庚戌年，镇江郡的同好袁桂生等人创办了《医学扶轮报》，旨在弘扬医学，我也借此机会附骥尾，分担了印刷费用和报纸内容的责任。到了庚戌年冬天，有很多人有退出的意向，导致印刷费和报纸内容来源缺乏，局面几乎要半途而废。我滥竽充数，刻印工作尚未完成，到了辛亥年八月，我和我们办的《扶轮报》，也随着清朝政权的更迭而革命了。如今，绍兴医学会、上海医学会阅读过该报的人士，时常来信向袁、杨二位先生索取全稿。这些都是读过《扶轮报》的老朋友，不嫌弃我的浅见。大概是因为我这种管中窥豹式的比拟描摹，还有可取之处吧。于是听从二位的建议，抄录全稿，加上序言送给《绍学医学报》社，遵循周小农先生流通书籍的办法，这也是抛砖引玉的一片苦心罢了，这就是序言。恳请各位名家指教，以弥补我的不足，这是我的荣幸。
岁次柔兆执徐（即庚戌年），春分后第三天，刘恒瑞于京江的有预斋停云传舍自序。
舌是胃的外在征候，用于输送食物进入食管和胃脘。舌体的组织，是由第五对脑神经到达舌头，其功能完全依赖这条神经的运动。舌下的两条紫青色筋脉，是少阴肾脉向上通达的，名为金津、玉液两个穴位，用来生津液以濡润舌质。如果不懂这些原理，那么辨别病症的认识，必然会有毫厘之差导致千里之谬，这是不可不讲究的原理啊。
舌的表面，铺满了多数极小的乳头，高起而不易看见。因为人一日三餐，所以舌苔也有每日三次的变化，这叫做活苔，是无病的现象。之所以会有变化，是因为饮食进入胃里时，将腐浊之气遏郁下降，所以舌苔颜色会消退；等到饮食腐化，浊气上蒸，舌苔颜色又会产生。胃中没有腐浊之气，舌苔就薄而少；如果有腐浊之气，舌苔就厚而多。胃的正色不能直接到达上面，所以舌苔有时暂时发白；青色是绝色的象征，青绿色出现在舌上，这个人的性命一定危险。此外还有似黄非黄、似白非白的各种间色，都在后面条理分明地列出，以备后学者细心参考。
Books on pulse diagnosis are most meticulous in the works of Li Binhu (Li Shizhen) and Zhu Danxi. They can clearly distinguish between similar yet distinct pulses, using writing to depict and compare their shapes, thereby preventing students from making misidentifications. This can be said to be a great contribution to the world. Alas, regarding the method of tongue inspection, these two masters did not write specialized books. What is circulated in the world are only *Shanghan Shejian* (Tongue Diagnosis of Cold Damage) and *Wenyi Shejian* (Tongue Diagnosis of Pestilential Diseases). To find a tongue diagnosis text as detailed as those on pulse diagnosis is impossible.
I have devoted myself to this for over thirty years, recording cases where diagnostic trials and treatments were effective and accurate without error, in notebooks to teach my disciples, daring not to consider myself correct. In the Gengxu year, Mr. Yuan Guisheng and other colleagues in Zhenjiang founded the *Yixue Fulun Bao* (Medical Wheel Support Newspaper) to promote medicine. I joined them, sharing the responsibilities of printing costs and content provision. By the winter of the Gengxu year, many had the intention to withdraw, leading to a lack of funds and content, threatening to halt the project midway. I was merely filling a quota, and the printing was unfinished. By August of the Xinhai year, our *Fulun Bao*, along with us, underwent revolution simultaneous with the fall of the Qing Dynasty. Now, members of the Shaoxing Medical Association and Shanghai Medical Association who have read the newspaper often write to Mr. Yuan and Mr. Yang requesting the complete manuscript. These are old friends who read the *Fulun Bao*, not discarding my humble views because they are insignificant. It seems that my descriptive analogies still have some merit. Therefore, following their advice, I copied the entire manuscript, added a preface, and sent it to the *Shaoxue Yixue Bao* society. Following Mr. Zhou Xiaonong’s method of circulating books, this is also an effort to throw a brick to attract jade. This is the preface. I humbly request guidance from all distinguished experts to correct my deficiencies, which would be my greatest fortune.
In the spring equinox, three days after, in the year Gengxu, Liu Hengrui wrote this preface at Tingyun Guesthouse, Youyu Studio, Jingjiang.
The tongue is the external manifestation of the Stomach, used for transporting food into the esophagus and stomach. The tissue of the tongue body is reached by the fifth cranial nerve, and its function relies entirely on the movement of this nerve. The two purple-blue veins under the tongue are the Shaoyin Kidney meridian ascending, named the acupoints Jinjin (Golden Spring) and Yuye (Jade Fluid), which generate saliva to moisten the tongue substance. If one does not understand these principles, the understanding of syndrome differentiation will inevitably suffer from a slight initial error leading to a massive deviation later; thus, these principles must be studied.
The surface of the tongue is covered with numerous tiny papillae, raised but not easily visible. Because people eat three meals a day, the tongue coating changes three times a day, called "living coating," which is a sign of health. The reason for these changes is that when food enters the stomach, turbid qi is suppressed and descends, causing the coating color to fade; when food decomposes, turbid qi steams upward, causing the coating color to reappear. If there is no turbidity in the Stomach, the coating is thin and scanty; if there is turbidity, the coating is thick and abundant. The true color of the Stomach cannot directly reach the surface, so the coating may temporarily appear white. Green is the color of extremity/despair; if green or bluish-green appears on the tongue, the person's life is in danger. Additionally, various intermediate colors such as yellow-like-but-not-yellow and white-like-but-not-white are listed separately below for careful reference by future students.