First, we have to look at the Four Level ‘patterns:’
DEFENSIVE-QI (WEI) LEVEL
Wind-Heat
Summer-Heat
Damp-Heat
Dry-Heat
Ql LEVEL
Lung-Heat (Heat in chest and diaphragm)
Stomach-Heat
Intestines Dry-Heat
Gall Bladder-Heat
Damp-Heat in Stomach and Spleen
NUTRITIVE-QI (YING) LEVEL
Heat in Nutritive-Qi level
Heat in the Pericardium
BLOOD LEVEL
Heat victorious moving Blood
Heat victorious stirring Wind
Empty-Wind agitating in the Interior
Collapse of Yin
Collapse of Yang
From here, we can think about which ones would cause a tongue to change. The tongue in question 25 has a thick-yellow coating over a red tongue with red-raised prickles. This diagnosis, based on tongue alone, is generalized Damp-Heat. Overall Damp-Heat is a Qi-Level diagnosis.