从舌诊发展源流看舌“胎”到舌“苔”的转变

The Change from Tongue"Coating(胎)"to Tongue"Coating(苔)"from the Development of Tongue Diagnosis

舌诊起步于《黄帝内经》,此时理论主要为经络的生理病理与舌体之间的关系,未涉及苔质。张仲景首提"胎"字,注意到"舌"与"胎"的区别,将"舌上胎"的概念运用于判断疾病病机与遣方用药中。之后有巢元方观舌辨病,孙思邈舌与脏腑病变关系等理论补充。第一部舌诊专著《敖氏伤寒金镜录》的问世,标志着舌诊理论开始走向系统化。温病学家的出现使得舌诊的发展达到了成熟。在文字上,明代以前的文献中,都写作"胎",吴鞠通之后才普遍改作"苔"。"舌胎"到"舌苔"的转变并不只是单纯的字体变化,还反映了舌诊运用于疾病诊断和转归的发展历史。因此在校读古籍时,不可随意将"胎"改为"苔"。

Tongue diagnosis started from Huangdi Neijing.At this time,the theory mainly focused on the relationship between the physiology and pathology of meridians and the tongue and did not involve the coating.Zhang Zhongjing first mentioned the word"coating(胎)",noticed the difference between"tongue"and"coating(胎)",and applied the concept of"coating(胎)on tongue"to judge the pathogenesis of disease and dispatch prescriptions.After that,there were Chaoyuan Fang′s view of tongue disease differentiation,and Sun Simiao′s theory on the relationship between tongue and viscera diseases.The publication of the first monograph on tongue diagnosis,Aoshi Shanghan Jinjinglu,marked the beginning of systematization of tongue diagnosis theory.The emergence of febrile disease experts made the development of tongue diagnosis mature.In terms of writing,in the literature before Ming Dynasty,it was written"coating(胎)",which was changed to"coating(苔)"after Wu Jutong.The change from"tongue coating(胎)"to"tongue coating(苔)"is not only a simple change of font,but also reflects the development history of tongue diagnosis used in disease diagnosis and prognosis.Therefore,when reading ancient books in school,we should not change"coating(胎)"to"coating(苔)".