舌属心脾二经。小儿舌微露而即收者,名弄舌,此属心脾亏损,用温胃散补之。舌舒长而良
久不收者,名吐舌,乃心脾积热,用泻黄散主之;或兼口舌生疮,作渴饮冷,属胃经实热,
亦用前散。作渴饮热,属胃经虚热,用四君子汤。食少作渴,或大便不实,脾肾虚弱也,用
七味白术散。口角流涎,或腮颊患肿,胃虚风热也,先用人参安胃散,次用七味白术散。若
午后甚者,脾血虚也,四物多加参、术、茯苓。未应,用补中益气汤,及审五脏相胜。若因
疳瘦所致,当参诸疳门。
治验
一小儿弄舌发搐,手指不冷。余谓肝脾虚热。用异功散加升麻、柴胡而愈。后伤乳腹胀,服
克滞,作泻弄舌,手指发热,审乳母肝火,与小柴胡汤加升麻、白术治之,母子并愈。
一小儿乳食过多,患吐泻,用大剂异功散加柴胡、升麻,母子服之而愈。后因惊,服至宝丹
之类,发搐弄舌,几至慢惊,余用六君子汤加白附子,服之而愈。
一小儿吐舌,发热饮冷,额鼻黄赤,吐舌流涎,余谓心脾实热,用导赤、泻黄二散,而愈。
后复作,别服清热等药,更弄舌,余用异功散加钩藤钩而安;又用六君子汤,痊愈。
一小儿七岁,食生冷之物,腹痛便秘,服峻利之剂,连泻五次,噫气腹痛,余谓心脾虚寒,
用异功散加姜桂、木香治之,不从;反治胃火,更加吃逆。余仍以前药加附子一片,一服诸
症顿退;乃去附子,又三剂而愈。其时同患是症,用清胃化痰者殁,而手足俱黯。
四物汤(方见急惊)
补中益气汤(方见虚羸)
小柴胡汤(方见痉症)
导赤散(方见心脏)
泻黄散
人参安胃散(二方见脾脏)
七味白术散(方见积痛)
异功散
六君子汤
四君子汤(三方见天钓)
五苓散(方见五淋)
舌归属于心和脾两条经脉。小儿舌头微微伸出随即收回的,称为弄舌,这属于心脾亏损,使用温胃散进行补益。舌头舒展伸长且长时间不能收回的,称为吐舌,这是心脾积热所致,以泻黄散为主治方;如果兼有口舌生疮、口渴喜饮冷水,则属于胃经实热,也使用前面的泻黄散。若口渴喜饮热水,属于胃经虚热,使用四君子汤。饮食减少且口渴,或者大便不成形,是脾肾虚弱,使用七味白术散。口角流涎,或者腮颊部位患肿,是胃虚受风热侵袭,先用人参安胃散,随后使用七味白术散。如果症状在午后加重,是脾血虚,使用四物汤并加入人参、白术、茯苓。如果无效,使用补中益气汤,并仔细审查五脏之间的相克关系。如果是因疳积消瘦引起的,应当参考各疳证门类。
治疗案例:
一个小孩出现弄舌并发抽搐,手指不冷。我认为是肝脾虚热。使用异功散加入升麻、柴胡而治愈。后来因为吃奶过多导致腹胀,服用消食导滞药后,出现腹泻、弄舌,手指发热,诊察发现是乳母肝火旺盛,给予小柴胡汤加入升麻、白术治疗,母子同时痊愈。
一个小孩乳食过量,患上呕吐腹泻,使用大剂量异功散加入柴胡、升麻,母子同服而痊愈。后来因为受惊,服用了至宝丹之类的药物,引发抽搐、弄舌,几乎发展为慢惊风,我使用六君子汤加入白附子,服用后痊愈。
一个小孩出现吐舌,发热且想喝冷水,额头和鼻子发黄发红,吐舌并流涎,我认为是心脾实热,使用导赤散和泻黄散两个方剂,而治愈。后来病情复发,另服清热等药物,反而出现弄舌,我使用异功散加入钩藤钩使病情安定;又使用六君子汤,彻底痊愈。
一个七岁的小孩,吃了生冷食物,腹痛便秘,服用了峻猛的泻下剂,连续腹泻五次,打嗝且腹痛,我认为是心脾虚寒,使用异功散加入干姜、肉桂、木香治疗,家属不听;反而去治疗胃火,更加出现呃逆。我仍然用前面的药方加上一片附子,一服药后各种症状立刻消退;于是去掉附子,又服三剂而痊愈。当时同样患有此症的人,使用清胃化痰药的都死亡了,而且手足颜色发暗。
四物汤(方剂见急惊章节)
补中益气汤(方剂见虚羸章节)
小柴胡汤(方剂见痉症章节)
导赤散(方剂见心脏章节)
泻黄散
人参安胃散(以上二方见脾脏章节)
七味白术散(方剂见积痛章节)
异功散
六君子汤
四君子汤(以上三方见天钓章节)
五苓散(方剂见五淋章节)
The tongue is associated with the Heart and Spleen meridians. When a child's tongue protrudes slightly and retracts immediately, it is called "manipulating the tongue" (Nong She), which belongs to Heart and Spleen deficiency; treat with Wenwei San (Stomach-Warming Powder). When the tongue extends fully and remains out for a long time, it is called "protruding the tongue" (Tu She), caused by accumulation of heat in the Heart and Spleen; treat primarily with Xiehuang San (Spleen-Draining Powder). If accompanied by sores in the mouth and tongue, thirst, and a desire to drink cold liquids, it indicates excess heat in the Stomach meridian; also use the aforementioned Xiehuang San. If there is thirst with a desire to drink hot liquids, it indicates deficient heat in the Stomach meridian; treat with Sijunzi Tang (Four Gentlemen Decoction). If there is poor appetite with thirst, or loose stools, it indicates weakness of the Spleen and Kidney; treat with Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder). If there is drooling from the corners of the mouth, or swelling of the cheeks, it indicates stomach deficiency with wind-heat; first use Renshen Anwei San (Ginseng-Stomach-Calming Powder), followed by Qiwei Baizhu San. If symptoms worsen in the afternoon, it indicates Spleen blood deficiency; use Siwu Tang (Four Substances Decoction) with added Ginseng, Atractylodes Macrocephala, and Poria. If there is no response, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), and carefully examine the mutual overcoming relationships among the Five Zang organs. If caused by malnutrition emaciation (Gan syndrome), refer to the various Gan syndrome categories.
Treatment Cases:
A child presented with manipulating the tongue and convulsions, with warm fingers. I diagnosed Liver and Spleen deficient heat. Treated with Yigong San (Extraordinary Efficacy Powder) with added Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix), resulting in recovery. Later, due to overfeeding, abdominal distension occurred; after taking digestive aids, diarrhea and manipulating the tongue appeared, with warm fingers. Upon examination, it was determined that the nursing mother had Liver fire; treated with Xiaochaihu Tang (Minor Bupleurum Decoction) with added Shengma and Baizhu, resulting in recovery for both mother and child.
A child suffered from vomiting and diarrhea due to excessive milk and food intake. Treated with a large dose of Yigong San with added Chaihu and Shengma; both mother and child took it and recovered. Later, due to fright, the child took Zhibao Dan (Precious Pearl Pill) and similar substances, leading to convulsions and manipulating the tongue, nearly developing into slow convulsion syndrome. I treated with Liujunzi Tang (Six Gentlemen Decoction) with added Baifu Zi (Typhonii Rhizoma), resulting in recovery.
A child presented with protruding the tongue, fever, desire to drink cold water, yellow-red forehead and nose, protruding tongue, and drooling. I diagnosed excess heat in the Heart and Spleen. Treated with Daochi San (Guide Out Redness Powder) and Xiehuang San, resulting in recovery. The condition recurred later; after taking other heat-clearing medicines, manipulating the tongue appeared instead. I treated with Yigong San with added Gouteng (Uncariae Ramulus cum Uncis), stabilizing the condition; subsequently treated with Liujunzi Tang, resulting in complete recovery.
A seven-year-old child ate raw and cold foods, suffering from abdominal pain and constipation. After taking harsh purgatives, the child experienced five consecutive diarrheal episodes, belching, and abdominal pain. I diagnosed Heart and Spleen deficient cold. Treated with Yigong San with added Jiang (Zingiberis Rhizoma), Rougui (Cinnamomi Cortex), and Muxiang (Aucklandiae Radix); the family refused. Instead, they treated for Stomach fire, leading to increased hiccups. I persisted with the previous prescription plus one slice of Fuzi (Aconiti Lateralis Radix Praeparata). After one dose, all symptoms subsided instantly; then Fuzi was removed, and after three more doses, full recovery was achieved. At that time, others suffering from the same condition who used Stomach-clearing and phlegm-resolving treatments died, with darkened hands and feet.
Siwu Tang (Formula see Ji Jing chapter)
Buzhong Yiqi Tang (Formula see Xu Lei chapter)
Xiaochaihu Tang (Formula see Jing Zheng chapter)
Daochi San (Formula see Xin Zang chapter)
Xiehuang San
Renshen Anwei San (These two formulas see Pi Zang chapter)
Qiwei Baizhu San (Formula see Ji Tong chapter)
Yigong San
Liujunzi Tang
Sijunzi Tang (These three formulas see Tian Diao chapter)
Wuling San (Formula see Wu Lin chapter)