Tongue image is the main part of the Chinese medicine diagnosis, and is also an important basis for diagnosis and treatment in Chinese medicine. In clinical practice, if the tongue is consistent with the evidence, the accuracy of diagnosis and treatment will be greater; however, there are many clinical cases where “evidence” and “tongue” are inconsistent, mostly in patients with long-standing illnesses or difficult cases, when the doctor must consider the whole picture, identify the truth, exclude subjective assumptions and seize the main contradiction. The principle is “give up the tongue from the evidence”; because the tongue image is disturbed by more objective factors, especially the long-term use of drugs, the tongue image changes more, the above case is an example. In the “evidence” “tongue” identification contradiction, should be due to the time, according to the person, according to the disease system, can not be bound to the book, binding their own thinking and identification flexibility. This is an important method to improve clinical efficacy. The patient Zhou, male, 66 years old, stomach pain for more than 10 years, eating that is bloated, do not dare to eat more, has repeatedly gastroscopy showed “superficial gastritis”, repeatedly into the Chinese and Western drugs did not see the effect. He has been diagnosed with a bright red tongue with little coating and a slightly stringent pulse. Spleen and stomach disease should be important tongue image, this case patient tongue bright red less moss, according to the tongue image of common sense should be nourishing stomach yin cool medicine, and the patient reflected that the former doctor prescription such as more cool medicine will aggravate the disease, and usually afraid of raw, cold products, this case tongue image and the main evidence does not match, so the proposed prescription to grasp the main evidence to give up the tongue image, treatment to warm the stomach and strengthen the spleen, moving Qi to relieve pain, the prescription: Gao Liang Jiang 10g, 10g of the system of fragrance, 10g of Poria, Ginseng 15g, Angelica 10g g, Atractylodes macrocephala 10g each, Radix et Rhizoma Huaiyang 30g, Radix Salviae Miltiorrhizae 10g, Frying Erythrina 15g each, Pericarpium Citri Reticulatae 6g, Radix et Rhizoma Divinorum 10g, Glycyrrhiza Uralensis 6g. The patient was also instructed to develop a good chewing and slow swallowing diet. After five days of follow-up, the patient’s symptoms improved significantly, with bright red tongue and thin moss. Another thing to emphasize is that “giving up the tongue from the evidence” does not mean that the identification and use of medicine completely disregard the tongue, from the above example can be seen warming the stomach used warm but not dry galangal and aromatic herbs; at the same time heavy use of spleen and yin tonic yam should be based on the tongue image.