天师曰∶我有伤寒相舌法。凡见舌系白苔者，邪火未甚也，用小柴胡汤解之。舌系黄苔者，心热也，
可用黄连、栀子以凉之。凡见黄而带灰色者，系胃热也，可用石膏。知母
以凉之。凡见黄而带红者，乃小肠膀胱热也，可用栀子以清之。见舌红而白者，乃肺热也，用黄连、苏
叶以解之。见舌黑而带红者，乃肾虚而挟邪也，用生地，元参，又入柴胡以和解之。见舌红而有黑星
者，乃胃热极也，用石膏以治之，元参、干葛亦可，终不若石膏之妙。见舌红而有白点者，乃
心中有邪也，宜用柴胡、黄连以解之，心肝同治也。见舌红。而有大红点者，乃胃热而带湿也，须茵
陈五苓散以利之。盖水湿必归膀胱以散邪，非肉桂不能引入膀胱，但止可用一二分，不可多入。见舌白
苔而带黑点，亦胃热也，宜用石膏以凉之。见舌黄而有黑者，乃肝经实热也，用柴胡、栀子以解之。
见舌白而黄者，邪将入里也，急用柴胡、栀子以解之，不使入里；柴胡乃半表半里，不可不用之也。见
舌中白而外黄者，乃邪入大肠也，必须五苓散以分水，水分则泄止矣。见舌中黄而外白者，乃邪在内而
非外，邪在上而非下，止可加柴胡、枳壳以和解，不可骤用大黄以轻下也∶天水加五苓亦可，终不若柴
胡、枳壳直中病原，少加天水则更妥，或不加，用天水加五苓散亦可也。见根黄而光白者，亦胃热而
带湿也，亦须用石膏为君，而少加去水之品，如猪苓、泽泻之味也。见舌黄而隔一瓣一瓣者，乃邪湿已入
大肠，急用大黄、茵陈下之，不必用抵当、十枣汤也，若下之迟，则不得不用之。然须辨水与血之分，下
水用十枣，下血用抵当也。见舌有红中如虫蚀者，乃水未升而火来乘也，亦须用黄连、柴胡以和解之。见
舌红而开裂如人字者，乃邪初入心，宜用石膏、黄连以解之。见舌有根黑而尖带红者，乃肾中有邪未散，
宜用柴胡、栀子以解之。见舌根黑而舌尖白者，乃胃火乘肾，宜用石膏、知母、元参以解之，不
必论其渴与不渴
不必问其下利也。舌根黑而舌尖黄者，亦邪将入肾，须急用大黄下之。然须辨其腹痛与不痛，按之腹
痛而手不能近者，急下之，否则，只用柴胡，栀子以和解之。见舌纯红而独尖黑者，乃肾虚而邪火来
乘也，不可用石膏汤，肾既虚而又用石膏，是速之死也，当用元参一两或二两以救之，多有能生
者。见舌有中心红晕，而四围边防纯黑者，乃君相之火炎腾，急用大黄加生地两许，下而救之，十人
中亦可救五六人。见舌有中央灰黑，而四边微红者，乃邪结于大肠也，下之则愈，不应则死；以肾水枯
槁，不能润之推送，此时又不可竟用熟地补肾之药；盖邪未散不可补，补则愈加胀急，适所以害之
也；必邪下而后以生地滋之则可，然亦不可多用也。见舌有纯灰色，中间独两晕黑者，亦邪将入肾
也，急用元参两许，少加柴胡治之。见舌有外红而内黑者，此火极似水也，急用柴胡、栀子、大黄、
枳实以和利之；若舌又见刺，则火亢热之极矣，尤须多加前药。总之，内黑而外白，内黑而外黄，
皆前症也，与上同治，十中亦可得半生也。惟舌中淡黑，而外或淡红，外或淡白，内或淡黄者，较前少
轻，俱可以前法治之，十人中可得八人生也。见舌有纯红而露黑纹数条者，此水来乘火，乃阴症也，其
舌苔必滑，必恶寒恶水，下喉必吐。倘现纯黑之舌，乃死症也，不须治之。水极似火，火极似水，
一带纯黑，俱不可治。伤寒知舌之验法，便有把握，庶不至临症差误耳。
伤寒得仲景而大彰，今又得天师而大着，又得吾子之补论，而无遗蕴矣。兹相舌法，正天师所
传，较《金镜录》更备，且无误治之虞，诚济世之慈航，救生之实录也。愿世
人细心观之，保无有操药杀人之祸矣。吕道人书于燕市。
（伤寒大成中，相舌法较备，可参看。李子永识）
雷公真君曰∶我受广成夫子之传，深知医道。世人止推我炮制，可慨也。今得远公陈子，可以尽
泄吾秘。汝注《内经》，无微不扬，无隐不出，虽岐公之助，然亦妆之灵机足以发之也。第其中止可因
经发明，不能于经外另出手眼秘奥。虽岐公传汝《石室秘录》，实为医术之奇，而其中尚有未备，
我今罄予子，附于《石室秘录》之后，以广岐天师之未备，使后世知我医道之神，不止以炮制
见长，亦大快事也。当详言之，子细记之可耳。
天师说：我有诊断伤寒的舌诊方法。凡是见到舌面上有白苔的，说明邪火不严重，用小柴胡汤来解表清热。舌面上有黄苔的，是心经有热，可以用黄连、栀子来清热凉心。凡是见到黄色中带有灰色的，是胃中有热，可以用石膏、知母来清热。凡是见到黄色中带有红色的，是小肠和膀胱有热，可以用栀子来清利湿热。见到舌头红而带白的，是肺中有热，用黄连、苏叶来解表清热。见到舌头黑而带红的，是肾阴虚兼夹邪气，用生地、玄参，并加入柴胡来和解少阳。见到舌头红而有黑色星点的，是胃热到了极点，用石膏来治疗，玄参、葛根也可以，但终究不如石膏巧妙。见到舌头红而有白色点的，是心经有邪气，适宜用柴胡、黄连来解表清热，这是心肝同治的方法。见到舌头红且有大红点的，是胃热兼夹湿气，必须用茵陈五苓散来利湿清热。因为水湿必然归入膀胱以发散邪气，非肉桂不能引导药力进入膀胱，但只可用一两分，不可多放。见到舌面有白苔而带有黑点的，也是胃热，适宜用石膏来清热。见到舌苔黄而带有黑色的，是肝经实热，用柴胡、栀子来解表清热。见到舌苔白而变黄的，说明邪气将要入里，急用柴胡、栀子来解表，防止邪气入里；柴胡主治半表半里之证，是不可不用的。见到舌中间白而四周黄的，是邪气进入大肠，必须用五苓散来分利水湿，水湿分利则泄泻自止。见到舌中间黄而四周白的，是邪气在体内而非体表，在上部而非下部，只可加柴胡、枳壳来和解，不可骤用大黄来轻下攻积；天水散加五苓散也可以，但终究不如柴胡、枳壳直中病源，稍加天水散则更稳妥，或者不加，只用天水散加五苓散也可以。见到舌根部黄而舌面光白的，也是胃热兼夹湿气，也必须用石膏为君药，并少加利水药物，如猪苓、泽泻之类。见到舌苔黄而呈一瓣一瓣状的，是邪湿已经进入大肠，急用大黄、茵陈来攻下，不必用抵当汤、十枣汤，如果攻下太迟，就不得不使用它们了。然而必须辨别是水结还是血结，下水结用十枣汤，下血结用抵当汤。见到舌面有红色部分像被虫蚀一样的，是水气未上升而火气来乘袭，也须用黄连、柴胡来和解。见到舌头红而开裂像“人”字形的，是邪气刚进入心经，适宜用石膏、黄连来解表清热。见到舌根黑而舌尖带红的，是肾中有邪气未散，适宜用柴胡、栀子来解表清热。见到舌根黑而舌尖白的，是胃火乘袭肾脏，适宜用石膏、知母、玄参来清热，不必讨论其是否口渴，也不必询问是否有下利症状。见到舌根黑而舌尖黄的，也是邪气将要进入肾脏，须急用大黄攻下。然而必须辨别其腹痛与否，按压腹部疼痛且手不能靠近的，急下攻之，否则，只用柴胡、栀子来和解。见到舌头纯红而唯独舌尖黑的，是肾阴虚而邪火来乘袭，不可用石膏汤，肾既已虚而又用寒凉的石膏，是加速死亡的做法，应当用一两或二两玄参来救阴，大多能救活。见到舌面中心有红晕，而四周围边防全是黑色的，是君火和相火炎腾，急用大黄加一两左右的地黄，攻下以救阴，十个人中也可以救活五六个人。见到舌面中央灰黑，而四边微红的，是邪气结聚在大肠，攻下则可痊愈，若不攻下则会死亡；这是因为肾水枯槁，不能滋润推送糟粕，此时又不可以直接用熟地黄等补肾药物；因为邪气未散不可进补，进补则会更加胀满急迫，这恰恰是害了他；必须待邪气下行后，再用生地黄来滋阴才可以，但也不可多用。见到舌面有纯灰色，中间唯独有两圈黑色的，也是邪气将要进入肾脏，急用一两左右玄参，少加柴胡来治疗。见到舌面外红而内黑的，这是火极似水的假象，急用柴胡、栀子、大黄、枳实来和解通利；如果舌面又出现芒刺，则是火热亢盛到了极点，尤其需要多加上述药物。总之，内黑外白，内黑外黄，都是前面的病症，治疗方法相同，十个人中也可救活一半。只有舌中淡黑，而外部或淡红、或淡白、内部或淡黄的，比前述情况较轻，都可以用前面的方法治疗，十个人中可得八人生还。见到舌面纯红而露出几条黑色纹路的，这是水气来乘袭火气，属于阴证，其舌苔必定滑润，必定恶寒恶水，药液咽下必呕吐。如果出现纯黑色的舌象，是死症，不需要治疗。水极似火，火极似水，舌色一带纯黑，都不可治。伤寒懂得舌诊的验证方法，便有把握，才不至于临症出错罢了。
伤寒学说得到张仲景而大大彰显，现在又得到天师的补充而更加显著，再加上我的补充论述，就没有遗漏的了。这种舌诊方法，正是天师所传授的，比《金镜录》更全面，而且没有误治的担忧，确实是济世的慈航，救生的实录。希望世人细心观察，保证不会有拿药杀人的祸患。吕道人写于燕京集市。
（《伤寒大成》中，舌诊方法较为完备，可以参考。李子永识）
雷公真君说：我受广成子传授，深知医道。世人只推崇我的炮制技术，真是令人感慨。现在得到远公陈子，可以尽泄我的秘密。你注释《内经》，无微不显，无隐不出，虽然有岐伯公的帮助，但也依靠你的灵机足以发挥出来。只是其中只能依据经文发明义理，不能在经文之外另出手眼秘奥。虽然岐伯公传给你《石室秘录》，实为医术之奇，但其中尚有不完备之处，我现在倾囊相授，附于《石室秘录》之后，以扩充岐天师的不完备之处，使后世知道我的医道之神妙，不仅仅以炮制见长，也是一件大快人心的事。应当详细讲述，你要仔细记下来才行。
The Heavenly Master said: I have a method for tongue diagnosis in Shanghan (Cold Damage). Whenever the tongue surface presents with white coating, it indicates that the pathogenic fire is not severe; Xiaochaihu Tang (Minor Bupleurum Decoction) should be used to resolve the exterior and clear heat. If the tongue surface presents with yellow coating, it signifies heat in the Heart; Huanglian (Coptidis Rhizoma) and Zhizi (Gardeniae Fructus) can be used to cool the heart and clear heat. Whenever yellow coating mixed with grey color is observed, it indicates heat in the Stomach; Shigao (Gypsum Fibrosum) and Zhimu (Anemarrhenae Rhizoma) can be used to clear heat. Whenever yellow coating mixed with red color is observed, it indicates heat in the Small Intestine and Bladder; Zhizi (Gardeniae Fructus) can be used to clear damp-heat. When observing a red tongue with white areas, it indicates heat in the Lung; Huanglian (Coptidis Rhizoma) and Suye (Perillae Folium) should be used to resolve the exterior and clear heat. When observing a black tongue with red areas, it indicates Kidney Yin deficiency complicated by pathogenic factors; Shengdi (Rehmanniae Radix Preparata), Xuanshen (Scrophulariae Radix), along with Chaihu (Bupleuri Radix), should be used to harmonize the Shaoyang stage. When observing a red tongue with black spots, it indicates extreme heat in the Stomach; Shigao (Gypsum Fibrosum) should be used for treatment. Xuanshen (Scrophulariae Radix) and Gegen (Puerariae Lobatae Radix) are also effective, but ultimately not as exquisite as Shigao (Gypsum Fibrosum). When observing a red tongue with white spots, it indicates pathogenic factors in the Heart; Chaihu (Bupleuri Radix) and Huanglian (Coptidis Rhizoma) should be used to resolve the exterior and clear heat, treating both the Heart and Liver simultaneously. When observing a red tongue with large red spots, it indicates Stomach heat complicated by dampness; Yinchin Wuling San (Artemisiae Scopariae and Poria Decoction) must be used to promote urination and clear damp-heat. Since water-dampness must return to the Bladder to dissipate pathogens, Rougui (Cinnamomi Cortex) is required to guide the medicine into the Bladder, but only one or two fen should be used, not more. When observing white coating on the tongue with black spots, it is also Stomach heat; Shigao (Gypsum Fibrosum) should be used to cool the heat. When observing yellow coating with black areas, it indicates excess heat in the Liver channel; Chaihu (Bupleuri Radix) and Zhizi (Gardeniae Fructus) should be used to resolve the exterior and clear heat. When observing white coating turning yellow, it indicates that pathogens are about to enter the interior; Chaihu (Bupleuri Radix) and Zhizi (Gardeniae Fructus) should be urgently used to resolve the exterior and prevent the pathogens from entering the interior. Chaihu (Bupleuri Radix) governs the half-exterior half-interior stage and must be used. When observing white coating in the center of the tongue and yellow coating on the periphery, it indicates pathogens have entered the Large Intestine; Wuling San (Five-Ingredient Poria Decoction) must be used to separate fluids and dampness; once fluids are separated, diarrhea will cease. When observing yellow coating in the center of the tongue and white coating on the periphery, it indicates pathogens are inside rather than outside, and upper rather than lower; only Chaihu (Bupleuri Radix) and Zhike (Aurantii Fructus Immaturus) should be added to harmonize; Dahuang (Rhei Radix et Rhizoma) should not be used abruptly for mild purgation. Tianshui San (Tianshui Powder) combined with Wuling San (Five-Ingredient Poria Decoction) is also acceptable, but ultimately not as direct as Chaihu (Bupleuri Radix) and Zhike (Aurantii Fructus Immaturus) targeting the root cause; adding a small amount of Tianshui San (Tianshui Powder) is more appropriate, or none at all, using only Tianshui San (Tianshui Powder) combined with Wuling San (Five-Ingredient Poria Decoction) is also fine. When observing yellow coating at the root of the tongue and a smooth white surface, it is also Stomach heat complicated by dampness; Shigao (Gypsum Fibrosum) must be used as the sovereign herb, with a small addition of diuretic herbs such as Zhuling (Polyporus) and Zexie (Alismatis Rhizoma). When observing yellow coating segmented into lobes, it indicates damp-pathogens have entered the Large Intestine; Dahuang (Rhei Radix et Rhizoma) and Yinchin (Artemisiae Scopariae Herba) should be used urgently for purgation; Didang Tang (Blood-Piercing Decoction) and Shizao Tang (Ten-Jujube Decoction) are not necessary. However, if purgation is delayed, they may become necessary. One must distinguish between fluid accumulation and blood stasis; use Shizao Tang (Ten-Jujube Decoction) for fluid accumulation, and Didang Tang (Blood-Piercing Decoction) for blood stasis. When observing red areas on the tongue resembling insect erosion, it indicates that Water Qi has not risen while Fire Qi attacks; Huanglian (Coptidis Rhizoma) and Chaihu (Bupleuri Radix) should be used to harmonize. When observing a red tongue cracked like the character "Ren" (人), it indicates pathogens have just entered the Heart; Shigao (Gypsum Fibrosum) and Huanglian (Coptidis Rhizoma) should be used to resolve the exterior and clear heat. When observing a black root and a red tip, it indicates pathogens in the Kidney have not dispersed; Chaihu (Bupleuri Radix) and Zhizi (Gardeniae Fructus) should be used to resolve the exterior and clear heat. When observing a black root and a white tip, it indicates Stomach Fire attacking the Kidney; Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), and Xuanshen (Scrophulariae Radix) should be used; whether the patient is thirsty or not need not be discussed, nor whether there is diarrhea. When observing a black root and a yellow tip, it also indicates pathogens are about to enter the Kidney; Dahuang (Rhei Radix et Rhizoma) must be used urgently for purgation. However, abdominal pain must be distinguished; if pressing the abdomen causes pain and the hand cannot approach, urgent purgation is required; otherwise, only Chaihu (Bupleuri Radix) and Zhizi (Gardeniae Fructus) should be used to harmonize. When observing a purely red tongue with a uniquely black tip, it indicates Kidney Yin deficiency with pathogenic Fire attacking; Shigaotang (Gypsum Decoction) should not be used. Since the Kidney is already deficient, using cold Shigao (Gypsum Fibrosum) accelerates death; instead, 1 liang or 2 liang of Xuanshen (Scrophulariae Radix) should be used to rescue Yin, which often succeeds. When observing a red halo in the center of the tongue with pure black around the periphery, it indicates blazing Sovereign and Ministerial Fire; Dahuang (Rhei Radix et Rhizoma) combined with approximately 1 liang of Shengdi (Rehmanniae Radix Preparata) should be used urgently for purgation to rescue Yin; five or six out of ten patients can be saved. When observing central grey-black coating with slightly red periphery, it indicates pathogens knotting in the Large Intestine; purgation leads to recovery, otherwise death ensues; this is because Kidney Water is withered and cannot moisten and push waste. At this time, Shudihuang (Rehmanniae Radix Preparata) and other tonifying herbs should not be used directly; since pathogens have not dispersed, tonification increases distension and urgency, harming the patient. Only after pathogens descend can Shengdi (Rehmanniae Radix Preparata) be used to nourish Yin, but not in large amounts. When observing purely grey coating with two unique black halos in the center, it also indicates pathogens are about to enter the Kidney; urgently use approximately 1 liang of Xuanshen (Scrophulariae Radix) with a little Chaihu (Bupleuri Radix) for treatment. When observing red exterior and black interior, this is Fire extreme resembling Water; urgently use Chaihu (Bupleuri Radix), Zhizi (Gardeniae Fructus), Dahuang (Rhei Radix et Rhizoma), and Zhishi (Aurantii Fructus Immaturus) to harmonize and promote flow. If prickles appear on the tongue, Fire hyperactivity and heat are extreme; the aforementioned herbs should be increased significantly. In summary, black interior with white exterior, or black interior with yellow exterior, are previous conditions treated similarly; five out of ten patients can be saved. Only when the center is pale black, with pale red or pale white exterior, or pale yellow interior, is the condition lighter than before; the previous methods apply, saving eight out of ten patients. When observing a purely red tongue with several black lines exposed, this is Water attacking Fire, indicating a Yin syndrome; the tongue coating must be slippery, accompanied by aversion to cold and aversion to water, with vomiting upon swallowing medicine. If a purely black tongue appears, it is a fatal condition requiring no treatment. Water extreme resembles Fire, Fire extreme resembles Water; any tongue with a band of pure black is untreatable. Understanding the verification methods of tongue diagnosis in Shanghan (Cold Damage) provides assurance, preventing clinical errors.
Shanghan (Cold Damage) theory was greatly illuminated by Zhang Zhongjing, further popularized by the Heavenly Master, and now completed by my supplementary discussions, leaving nothing omitted. This tongue diagnosis method, transmitted by the Heavenly Master, is more comprehensive than *Jingjin Lu* (Record of Tongue Mirrors) and free from the risk of misdiagnosis; it is truly a boat of compassion for saving the world and a true record of rescuing lives. I hope people observe it carefully to avoid the disaster of killing people with medicine. Written by Lü Daoren in the markets of Yanjing.
(Li Zi Yong noted: Tongue diagnosis methods in *Shanghan Dacheng* are relatively complete and can be consulted.)
Lord Leigong said: I received transmission from Guangchengzi and deeply understand the medical arts. It is lamentable that people only praise my expertise in processing herbs. Now, with Yuan Gong Chen Shi duo, I can fully reveal my secrets. Your annotations of *Neijing* (Inner Canon) reveal every subtlety and conceal nothing. Although aided by Qibo, your spiritual insight is sufficient to bring them forth. However, you can only expound upon the classics based on the texts, unable to create new perspectives outside the classics. Although Qibo transmitted *Shishi Milu* (Secret Records of the Stone Chamber) to you, which is indeed remarkable in medical arts, it still has incompleteness. I now give everything to you, appending it after *Shishi Milu*, to expand upon the incompleteness of the Heavenly Master Qibo, so that future generations know my medical Dao is miraculous not only for herb processing but also for profound theory. This is a great joy. Speak in detail, and you must record it carefully.