以上三十六舌。乃伤寒验舌之快捷方式。临症用心处之。百无一失。
【介按】以上验舌之法。确系诊断伤寒之快捷方式。兹以舌之部位言之。则舌尖属上脘。舌心属中脘。舌根属下脘。全舌
属胃。中心亦属胃。舌尖属心。舌根属肾。两旁属肝胆。四畔属脾。至于形色而言。则白属肺经。绛属心经。黄属胃经。
鲜红属胆经。黑属脾经。紫色属肾经。焦紫起刺属肝经。青滑亦属肝经。然苔色虽有脏腑之分。亦须根据部位为主。如
舌苔见于某部。即为某经之病者是也。原书察舌辨症之法。虽则言简意赅。尚少紫、蓝、霉酱色之诸舌。即黑苔之关于
虚寒者。亦略而不详。今特根据先贤学说。参以历年临证实验。附述如下。
（一）紫色 紫见全舌。是脏腑表里实热之证也。凡伤寒化热。内热熏蒸。误服温补。酒食湿滞者。皆有之。
惟淡紫中夹带别色。则虚寒症亦有之。如淡紫带青。青紫无苔。多水滑润而瘦小者。为伤寒直中肝肾之阴症。治宜温散
为主。又有紫色如熟猪肝上罩浮滑苔者。邪热传里。表未净也。治宜清解为主。若全紫光暗。并无附苔者。热极似寒也。
症势极危。惟有用急下之法。间有转危为安者。又有紫苔中心带青。或灰黑者。热伤血分也。治宜微下之。更有酒后中
寒。及痰热郁久者。亦有舌苔紫色者。但须辨其舌之润燥。病之原因。而分别治之。
（二）蓝色 蓝色者。绿与青碧相合。犹染色之三蓝也。如微蓝而不满舌。是邪热鸱张。肝液被灼之候。治宜
平肝熄风化毒为主。如全舌滑腻中见蓝色者。为湿痰或痰饮化热之候。治宜清化为主。如瘟疫及湿温。热郁不解。而见
蓝苔者。治宜芳香清泄。若光蓝无苔。不论何症何脉。皆属气血极亏所致。法在不治。若舌滑中而见蓝色苔者。邪热传
入厥阴。阴液受伤。法在不治。若孕妇舌见纯蓝者。胎死腹中也。宜急下之。若蓝色而有苔者。是脏腑被热伤气分。以
致经不行血。其症则颠狂怒骂。时哭时笑。大热大渴。捶胸惊怪不等。治宜十全苦寒救补汤。（见前）倍生石膏、黄连急
投之。
（三）霉酱色 霉酱色者。是黄赤兼黑之状。乃脏腑本热而夹有宿食也。凡内热久郁。实热蒸胃。宿食困脾。
伤寒传阴。中暑烦躁。腹痛泻利或秘结。大热大渴等症皆有之。治宜十全苦寒救补汤连服之。如全舌霉色。中有黄苔。
是实热郁积之症。宜大承气汤连服之。如舌中霉色浮浓。刮之不净。或刮后顷刻复生者。此宿食在中郁久化热也。先用
大承气汤。次用三黄白虎汤。循环急服之。
（四）虚寒黑色舌 凡虚寒而舌黑者。则必湿滑无苔。（口不苦。唇不燥而多津。）无朱点、无芒刺、无罅裂。
刮之明净。如水浸猪腰。有淡淡 之形者。是脏腑极寒之症也。亦有舌色全黑而不分经。且必淡白之时。忽然转黑。
其初无变黄之一境。约略望之。似有焦黑芒刺干裂之状。然刮之必净。湿之必润。环唇皆白而不红焦，是寒结在脏也。
外证亦周身大热。烦躁而恶衣被。虽亦口渴喜饮。饮则不多。与实热症相似。其实中宫寒极。外假热而内真寒也。然必
烦乱昏沉。六脉必迟弱无力。大便虽结常欲下而不下。治法均宜温补为主。又有中黑无苔而舌底湿嫩。光滑无点纹者。
乃胃经虚寒也。宜附子理中汤加肉桂、黄 以治之。
以上三十六种舌象，是诊断伤寒时观察舌象的简便方法。临证时需用心辨别，如此则百无一失。
【介按】上述验舌之法，确实是诊断伤寒的简便途径。若从舌的部位来分析，舌尖对应上脘，舌心对应中脘，舌根对应下脘，全舌对应胃，舌中心也对应胃；舌尖对应心，舌根对应肾，舌两旁对应肝胆，舌四周边缘对应脾。若从舌的颜色和形态来分析，白色对应肺经，绛色（深红色）对应心经，黄色对应胃经，鲜红色对应胆经，黑色对应脾经，紫色对应肾经，焦紫色且起刺对应肝经，青色滑润也对应肝经。然而，苔色虽有脏腑归属之分，也必须以部位为主。例如，舌苔出现在某部位，即为该经病变的表现。原书察舌辨症的方法，虽然言简意赅，但缺少紫、蓝、霉酱色等各种舌象的描述，即使是黑苔中属于虚寒的情况，也论述不详。现在特依据先贤学说，结合历年临床实验，补充叙述如下。
（一）紫色舌 全舌呈现紫色，是脏腑表里实热的证候。凡是伤寒化热，内热熏蒸，误服温补药物，或因酒食导致湿滞者，都会出现这种情况。只有淡紫色中夹杂其他颜色，才可能是虚寒证。如淡紫色带青色，青紫色无苔，多水滑润且舌体瘦小者，为伤寒直中肝肾阴经的阴证，治疗应以温散为主。又有紫色如同熟猪肝表面覆盖浮滑苔者，这是邪热传入里部，表证未完全解除，治疗应以清解为主。若全舌光暗无紫色，并无附着苔垢者，这是热极似寒的表现，病情极其危重，只有使用急下法，偶尔有转危为安的情况。又有紫苔中心带青色，或灰黑色者，这是热邪损伤血分，治疗应轻微攻下。更有酒后中寒，以及痰热郁结日久者，也会出现舌苔紫色，但必须辨别舌面的润燥及病因，分别进行治疗。
（二）蓝色舌 蓝色是绿色与青碧色相合，如同染色的“三蓝”。如微蓝色但不满舌，是邪热猖獗，肝液被灼伤的征候，治疗应以平肝熄风化毒为主。如全舌滑腻中见蓝色者，是湿痰或痰饮化热的征候，治疗应以清化为主。如瘟疫及湿温病，热郁不解而见蓝苔者，治疗应以芳香清泄为主。若舌面光蓝无苔，不论何种病症脉象，都属于气血极度亏损所致，属于不治之症。若舌中部滑润而见蓝色苔者，是邪热传入厥阴经，阴液受伤，属于不治之症。若孕妇舌见纯蓝色者，是胎死腹中，宜急下之。若蓝色而有苔者，是脏腑被热邪伤及气分，导致经络不行血，其症状则有癫狂怒骂，时哭时笑，大热大渴，捶胸惊怪等不一，治疗宜用十全苦寒救补汤（见前文），倍加生石膏、黄连，急投服用。
（三）霉酱色舌 霉酱色是黄赤兼黑的状态，乃脏腑本有热邪而夹有宿食。凡是内热久郁，实热蒸腾胃部，宿食困阻脾脏，伤寒传入阴经，中暑烦躁，腹痛泻利或便秘，大热大渴等症状都有可能出现。治疗宜连服十全苦寒救补汤。如全舌呈霉色，中有黄苔，是实热郁积的病症，宜连服大承气汤。如舌中霉色浮浓，刮之不净，或刮后顷刻复生者，这是宿食在中焦郁久化热，先用大承气汤，次用三黄白虎汤，循环急服。
（四）虚寒黑色舌 凡是虚寒而舌黑者，必定湿滑无苔。（口不苦，唇不燥且多津液。）无朱点、无芒刺、无裂纹，刮之明净，如水浸猪腰，有淡淡形状者，是脏腑极寒的病症。也有舌色全黑而不分经络，且在淡白色时忽然转黑，起初没有变黄的阶段，粗略望去，似乎有焦黑芒刺干裂的样子，但刮之必净，湿润后必润，嘴唇周围皆白而不红焦，这是寒邪结在脏腑。外证也有周身大热，烦躁而厌恶衣被，虽然也口渴喜饮，但饮水不多，与实热症相似，其实中焦寒极，外假热而内真寒。但必定烦乱昏沉，六脉必迟弱无力，大便虽结常想排便却排不出，治法均宜温补为主。又有舌中黑无苔而舌底湿嫩，光滑无点纹者，乃是胃经虚寒，宜用附子理中汤加肉桂、干姜来治疗。
The above thirty-six tongue appearances are a convenient method for diagnosing Shanghan (Cold Damage) by observing the tongue. One must apply careful attention during clinical practice; doing so ensures that errors will be rare.
[Note by Jie] The aforementioned methods of tongue diagnosis are indeed a convenient approach for diagnosing Shanghan. Speaking from the perspective of tongue regions, the tip corresponds to the Upper Jiao (Upper Burner), the center to the Middle Jiao (Middle Burner), and the root to the Lower Jiao (Lower Burner). The entire tongue corresponds to the Stomach, as does the very center of the tongue; the tip also corresponds to the Heart, the root to the Kidney, the sides to the Liver and Gallbladder, and the periphery to the Spleen. Regarding color and form, white corresponds to the Lung Meridian, crimson (deep red) to the Heart Meridian, yellow to the Stomach Meridian, bright red to the Gallbladder Meridian, black to the Spleen Meridian, purple to the Kidney Meridian, scorched purple with prickles to the Liver Meridian, and bluish-green and slippery also to the Liver Meridian. However, although coating colors have their respective organ affiliations, one must primarily rely on the location. For instance, if a coating appears in a specific region, it indicates pathology of that corresponding meridian. Although the original text's method of differentiating syndromes by tongue observation is concise and comprehensive, it lacks descriptions of various tongues such as purple, blue, and moldy-soy-sauce colored tongues. Even regarding black coatings associated with deficiency-cold, the explanation is insufficient. Therefore, based on the theories of sages past and combined with years of clinical experience, I supplement the following descriptions.
(1) Purple Tongue: A whole tongue appearing purple indicates excess-heat in both the interior and exterior of the Zang-Fu organs. This occurs whenever Shanghan transforms into heat, internal heat steams upward, warm-tonifying medicines are mistakenly taken, or dampness-stagnation results from alcohol and food intake. Only when pale purple is mixed with other colors might it indicate a deficiency-cold syndrome. For example, pale purple with a bluish tint, bluish-purple without coating, moist and slippery, and with a thin, small tongue body indicates Yin syndromes where Cold directly invades the Liver and Kidney meridians; treatment should focus on warming and dispersing. Another presentation is a purple tongue resembling a cooked pig liver covered with a floating, slippery coating; this indicates pathogenic heat has transmitted inward while the exterior syndrome is not yet fully resolved, requiring treatment focused on clearing and resolving. If the whole tongue is lusterless and dark purple without any attached coating, this represents extreme heat mimicking cold, a critical condition where only urgent purgation may occasionally turn danger into safety. If the purple coating has a bluish or gray-black center, this indicates heat damaging the Blood level; mild purgation is indicated. Furthermore, those who suffer from Cold after drinking alcohol, or where Phlegm-Heat has been stagnant for a long time, may also present with purple tongue coatings. One must distinguish between moist and dry tongues and identify the etiology to treat accordingly.
(2) Blue Tongue: Blue is a combination of green and bluish-green, akin to the "three blues" used in dyeing. If the tongue is slightly blue but not covering the whole surface, it signifies rampant pathogenic heat scorching Liver fluids; treatment should focus on pacifying the Liver, extinguishing Wind, and resolving toxicity. If the whole tongue is slippery and greasy with blue patches, it indicates Damp-Phlegm or Phlegm-Fluid transforming into Heat; treatment should focus on clearing and transforming. In cases of Plague or Damp-Warmth where Heat stagnates unresolved and blue coatings appear, treatment should focus on aromatic clearing and draining. If the tongue is smooth and blue without coating, regardless of the syndrome or pulse, it indicates extreme depletion of Qi and Blood, which is considered untreatable. If the center of the tongue is slippery with a blue coating, it indicates pathogenic heat transmitting to the Jueyin Meridian with injury to Yin fluids, also considered untreatable. If a pregnant woman presents with a purely blue tongue, it indicates a dead fetus in the womb, requiring urgent purgation. If the blue color has a coating, it indicates the Zang-Fu organs' Qi levels are damaged by Heat, leading to stagnation of blood in the channels. Symptoms include mania, cursing, alternating crying and laughing, high fever, intense thirst, chest-beating, and astonishment. Treatment requires Shiquan Kuhu Jiubu Tang (Ten Thousand Complete Bitter-Cold Rescue and Tonification Decoction) [see previous section], with doubled doses of Sheng Shigao (Gypsum Fibrosum) and Huanglian (Coptidis Rhizoma), administered urgently.
(3) Moldy-Soy-Sauce Colored Tongue: This color resembles a mixture of yellow, red, and black, indicating inherent organ Heat complicated by retained food. It appears in conditions such as prolonged internal Heat stagnation, excess Heat steaming the Stomach, retained food obstructing the Spleen, Shanghan transmitting to Yin stages, Summerheat causing irritability, abdominal pain with diarrhea or constipation, high fever, and intense thirst. Treatment involves continuous administration of Shiquan Kuhu Jiubu Tang. If the whole tongue is moldy-colored with yellow coating in the center, it indicates accumulation of excess Heat; continuous administration of Dachengqi Tang (Major Order the Qi Decoction) is appropriate. If the moldy color in the center of the tongue is thick and floating, cannot be completely scraped off, or regenerates immediately after scraping, this indicates retained food in the Middle Jiao stagnating and transforming into Heat over time. First use Dachengqi Tang, followed by Sanhuang Baihu Tang (Three-Yellow White Tiger Decoction), administering them alternately and urgently.
(4) Deficiency-Cold Black Tongue: Whenever the tongue is black due to deficiency-cold, it will necessarily be wet, slippery, and without coating. (The mouth is not bitter, lips are not dry, and there is abundant saliva.) There are no cinnabar spots, no prickles, and no fissures. It scrapes clean, resembling a pork kidney soaked in water, with a faint shape. This indicates extreme Cold in the Zang-Fu organs. There are also cases where the whole tongue is black without distinguishing meridians, turning black suddenly from a pale-white state, without passing through a yellow stage. At first glance, it may appear scorched, black, pricky, dry, and cracked, but it scrapes clean and becomes moist when wetted. The lips surrounding the mouth are white, not red or scorched, indicating Cold knotting in the Zang organs. External symptoms may include severe whole-body heat, irritability, aversion to clothing and bedding, and thirst with desire to drink, though intake is small. These resemble excess-heat syndromes, but actually represent extreme Cold in the Middle Jiao with false Heat externally and true Cold internally. However, there must be mental confusion and drowsiness, and the six pulses must be slow, weak, and forceless. Although stool may be constipated, there is an urge to defecate without success. Treatment uniformly focuses on warming and tonifying. Additionally, if the center of the tongue is black without coating, and the tongue base is wet, tender, smooth, and free of spots or lines, this indicates deficiency-cold of the Stomach Meridian. Treatment should employ Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) added with Rougui (Cinnamon Twig) and Ganjiang (Zingiberis Rhizoma).