(新订)
脉有有根无根之辨,舌苔亦何独不然。前人只论有地无地,此只可以辨热之浮沉虚实,而非所以辨中气之
存亡也。地者,苔之里一层也;根者,舌苔与舌质之交际也。夫苔者,胃气湿热之所熏蒸也。湿热者,生
气也。无苔者,胃阳不能上蒸也,肾阴不能上濡也。前人言之晰矣。至于苔之有根者,其薄苔必匀匀铺开,
紧贴舌面之上,其浓苔必四围有薄苔辅之,亦紧贴舌上,似从舌里生出,方为有根。若浓苔一片,
四围洁净如截,颇似别以一物涂在舌上,不是舌上所自生者,是无根也。此必久病,先有胃气而生苔,继
乃胃气告匮,不能接生新苔,而旧苔仅浮于舌面,不能与舌中之气相通,即胃肾之气,不能上潮以通于舌
也。骤因误服凉药伤阳,热药伤阴,乍见此象者,急救之犹或可复。若病势缠绵日久,渐
见此象,真气已索,无能为矣。常见寒湿内盛之病,舌根一块白浓苔,如久经水浸之形,急用温里,此苔
顿退,复生新薄苔,即为生机。又常见病困将死之人,舌心一块浓苔,灰
黄滞黯,四面无辅,此阴阳两竭,舌质已枯,本应无苔,而犹有此者,或病中胃强能食,五脏先败,而胃
气后竭也。或
多服人参,无根虚阳结于胸中,不得遽散,其余焰上蒸,故生此恶苔,甚或气绝之后半日胸中犹热,气口脉犹动也。
(新修订)
脉象有有根与无根的区别,舌苔难道就没有这种区别吗?前人只论述了舌苔有地气和无地气的区别,这只能用来辨别热邪的浮沉和虚实,而不是用来辨别中气(脾胃之气)的存亡。所谓“地”,是指舌苔下面的一层;所谓“根”,是指舌苔与舌质交界融合的地方。苔,是胃气中的湿热熏蒸而成的。湿热,代表着生机。没有舌苔,是因为胃阳不能向上熏蒸,肾阴不能向上濡润。前人对此阐述得很清晰了。至于舌苔有根的,薄的舌苔必定均匀铺开,紧贴舌面;厚的舌苔四周必有薄苔辅助,也紧贴舌面,看起来像是从舌体里面长出来的,这才是有根。如果是一片厚苔,四周干净得像被刀切过一样,很像用别的东西涂在舌头上,不是舌体自身生长出来的,这就是无根。这种情况多见于久病,起初有胃气而生出舌苔,后来胃气衰竭,不能接续生成新苔,而旧苔仅仅漂浮在舌面上,不能与舌中的气相通,也就是胃气和肾气不能上潮通达于舌。如果是突然因为误服凉药损伤阳气,或热药损伤阴液,乍一看出现这种现象,紧急救治或许还可以恢复。如果病情缠绵日久,逐渐出现这种现象,真气已经耗尽,就无法治疗了。常见寒湿内盛的疾病,舌根部有一块白厚苔,像久经水浸泡的样子,急用温里法治疗,这块苔顿时消退,重新生出新的薄苔,这就代表生机。又常见到病重将死的人,舌中心有一块厚苔,颜色灰黄滞涩黯黑,四周没有薄苔辅助,这是阴阳两竭,舌质已经干枯,本来应该没有舌苔,却还有这种苔,或者是病中胃气尚强还能进食,但五脏先已败坏,而胃气最后枯竭。或者是多服人参,导致无根的虚阳结聚在胸中,不能迅速消散,其余下的残火向上熏蒸,所以生出这种恶苔,甚至人在气绝之后半天,胸中仍然发热,寸口脉仍然跳动。
(Newly Revised)
There is a distinction between pulse roots and non-roots; why should tongue coating be any different? Predecessors only discussed the presence or absence of "ground" (di), which can only distinguish the floating/sinking and deficiency/excess of heat, but cannot distinguish the survival or extinction of Zhong Qi (Middle Jiao Qi/Spleen-Stomach Qi). "Ground" refers to the layer beneath the coating; "root" refers to the junction where the tongue coating meets the tongue body. Coating is formed by the steaming and steaming of damp-heat from Stomach Qi. Damp-heat represents vital energy. The absence of coating indicates that Stomach Yang cannot steam upward and Kidney Yin cannot moisten upward. This has been clearly explained by predecessors. Regarding rooted coating: thin coatings must spread evenly and adhere closely to the tongue surface; thick coatings must have thin coatings surrounding them, also adhering closely, appearing as if grown from within the tongue body. This constitutes a root. If there is a patch of thick coating with clean edges cut off sharply, resembling something applied externally rather than self-generated by the tongue, it is unrooted. This typically occurs in chronic illness: initially, Stomach Qi generates coating; subsequently, Stomach Qi becomes depleted and cannot generate new coating, leaving old coating floating on the surface without connecting to the Qi within the tongue, meaning Stomach and Kidney Qi cannot ascend to reach the tongue. If this appearance arises suddenly due to erroneous administration of cooling herbs injuring Yang or heating herbs injuring Yin, urgent rescue may still restore health. However, if the condition lingers for a long time and this appearance gradually emerges, Zhen Qi (True Qi) has already exhausted, and treatment is futile. In cases of internal excess cold-dampness, a patch of white thick coating at the tongue root may appear like it has been soaked in water for a long time; urgently applying warming interior methods will cause this coating to recede immediately, replaced by new thin coating, indicating vitality. Conversely, in patients near death from severe illness, a thick coating in the center of the tongue may appear gray-yellow, stagnant, and dark, without surrounding support. This indicates exhaustion of both Yin and Yang, with the tongue body dried up. Normally, no coating should remain; its presence suggests either that while the Stomach was strong enough to allow eating during the illness, the Five Zang organs failed first followed by Stomach Qi failure, or that excessive use of Ginseng caused unrooted deficient Yang to knot in the chest, unable to disperse quickly, with residual fire steaming upward to produce this malignant coating. Even after Qi cessation, the chest may remain warm for half a day, and the Cun Kou (Radial) pulse may still move.