【方歌】舌证发于心脾经，其证皆由积热成。重舌舌下血脉胀，
痰核舌上一核生。重〔月咢〕生于口上〔月咢〕，时觉
心烦梅子形，舌疔舌上生紫疱，其形如豆寒热增。
【注】此证无论大人、小儿，俱可以生。重舌者，由心、脾蕴
热，循经上冲舌本，逐令舌下血脉胀起，如小舌状，故
名重舌，宜用冰硼散搽之。痰核者，心、脾痰涎郁热，
舌上生核，强硬作痛，宜用衣针点破，搽冰硼散，内服
加味二陈汤。重〔月咢〕者，心、脾有热，以致上〔月
咢〕生疮，形如梅子，外无寒热，内时作烦，此属热极
，禁用针刺，宜服黄连解毒汤加桔梗，不时用紫雪散噙
化。舌疔者，心脾火毒，舌生紫疱，其形如豆，坚硬寒
热，疼痛应心，初起宜用蟾酥丸含于舌下，随化随咽，
或再三粒，以解内毒；甚者刺之，服黄连解毒汤，兼搽
紫雪散，及徐徐咽之即愈。
方剂：紫雪散
组成：犀角（镑）羚羊角（镑）石膏寒水石升麻（各一两）元
参（二两）甘草（生，八钱）沈香（锉）木香（锉，各
五钱）
水五碗，煎药剩汤一碗，将滓用绢滤去，将汤再煎
滚，投提净朴硝三两六钱，文火慢煎，水气将尽，欲凝
结之时，倾入碗内，下朱砂冰片各三公，金箔一百张，
各预研细和匀，将药碗安入凉水盆中，候冷凝如雪为度
。大人每用一钱，小儿二分，十岁者五分，徐徐咽之即
效。或用淡竹叶、灯心煎汤，化服亦可。咽喉肿痛等证
，吹之亦效。
【方歌】紫雪散医积热效，沈木犀羚元参草，寒水升膏朴硝加，
朱冰箔研入内搅。
又方：冰硼散（见口部鹅口疮）
加味二陈汤（见痰包）
黄连解毒汤（见耳部黑疔）
蟾酥丸（见疔疮门）
【方歌】舌部病症归属于心和脾两经，这些病症都是由体内积热形成的。重舌表现为舌下的血脉肿胀，痰核是在舌面上长出一个硬结。重腭（palatal abscess）生于口腔上腭处，形状像梅子，患者时常感到心烦，但体表没有寒热症状；舌疔则是在舌面上长出紫色的疱，形状像豆子，伴有恶寒发热的症状加重。
【注】这种病症无论是成人还是儿童都可能发生。所谓重舌，是由于心和脾蕴藏热气，热气沿着经络向上冲击舌根，导致舌下血脉肿胀隆起，形状像一个小舌头，因此称为重舌，适宜使用冰硼散外搽治疗。所谓痰核，是心和脾的痰涎郁结化热，在舌面上形成硬结，质地强硬且疼痛，适宜用衣针点破患处，外搽冰硼散，内服加味二陈汤。所谓重腭，是心和脾有热，导致上腭生疮，形状像梅子，体表无寒热，但内部时常感到烦闷，这属于热极之症，严禁使用针刺，适宜服用黄连解毒汤并加入桔梗，不时含化紫雪散。所谓舌疔，是心脾火毒炽盛，舌头上生出紫色疱，形状像豆子，质地坚硬，伴有寒热和剧烈疼痛（痛感放射至心脏区域），初起时适宜用蟾酥丸含于舌下，随着药丸融化随吞咽咽下，或者每次服用两三粒，以解除体内的毒素；病情严重者可以刺破排脓，服用黄连解毒汤，同时外搽紫雪散并徐徐咽下，即可痊愈。
方剂：紫雪散
组成：犀角（镑片）羚羊角（镑片）石膏、寒水石、升麻（各一两），元参（二两），甘草（生用，八钱），沉香（锉碎）、木香（锉碎，各五钱）。
煎服法：用水五碗，煎煮药物至剩余汤液一碗，将药渣用绢布过滤去除，再将药汤煮沸，投入提净朴硝三两六钱，用文火慢煎，待水分将尽、药液即将凝结时，倒入碗中，加入朱砂、冰片各三公，金箔一百张，预先研细混合均匀，将药碗放入凉水中，等待冷却凝固如雪为止。成人每次服用一钱，小儿服用二分，十岁儿童服用五分，徐徐咽下即见效。也可以用淡竹叶、灯心草煎汤，化开药粉服用亦可。咽喉肿痛等病症，吹入药粉也有效。
【方歌】紫雪散治疗积热疗效显著，包含沉香、木香、犀角、羚羊角、元参、甘草，加上寒水石、升麻、石膏、朴硝，最后加入朱砂、冰片和金箔研匀搅拌。
[Verse] Tongue disorders belong to the Heart and Spleen meridians; all such conditions arise from accumulated heat. Heavy tongue (Chong She) manifests as swelling of the blood vessels under the tongue; Phlegm nodule (Tan He) appears as a nodule growing on the surface of the tongue. Heavy palate (Chong E) occurs on the hard palate, shaped like a plum seed, with frequent internal irritability but no external chills or fever; Lingering boil on tongue (She Ding) presents as a purple blister on the tongue, shaped like a bean, accompanied by worsening chills and fever.
[Commentary] This condition can occur in both adults and children. "Heavy tongue" is caused by heat accumulation in the Heart and Spleen, which travels along the meridians upward to the root of the tongue, causing the blood vessels beneath the tongue to swell and protrude like a small tongue, hence the name. It should be treated by applying Bingpeng San externally. "Phlegm nodule" results from phlegm-fluid retention and郁 heat in the Heart and Spleen, forming a hard, painful nodule on the tongue. It should be punctured with a needle, applied with Bingpeng San externally, and treated internally with Jiawei Erchen Tang. "Heavy palate" is due to heat in the Heart and Spleen causing sores on the hard palate, shaped like a plum, with no external chills or fever but frequent internal irritability. This belongs to extreme heat and strictly prohibits needle puncture; it should be treated with Huanglian Jiedu Tang plus Jiegeng, and Zixue San should be held in the mouth and dissolved intermittently. "Tongue boil" is caused by Fire-toxin in the Heart and Spleen, producing a purple blister on the tongue, shaped like a bean, hard, with chills, fever, and severe pain radiating to the heart region. In the early stage, Chansu Wan should be held under the tongue to dissolve and swallow gradually, or two or three pills taken to resolve internal toxin; for severe cases, puncture may be used, followed by Huanglian Jiedu Tang, application of Zixue San externally, and gradual swallowing.
Formula: Zixue San (Purple Snow Powder)
Composition: Rhinoceros Horn (sliced) [Note: Substitute with Buffalo Horn in modern practice], Antelope Horn (sliced), Gypsum, Halloysitum Rubrum, Cimicifugae Rhizoma (each 1 liang), Scrophulariae Radix (2 liang), Licorice Root (raw, 8 qian), Agarwood (shredded), Costus Root (shredded, each 5 qian).
Preparation: Decoct in five bowls of water until one bowl remains. Filter the dregs through silk cloth. Boil the liquid again, add Purified Mirabilite (3 liang 6 qian), and simmer slowly over mild fire until the moisture is nearly gone and the mixture is about to solidify. Pour into a bowl, add Cinnabar and Borneolum Syntheticum (each 3 gong), and 100 sheets of Gold Leaf, all pre-ground fine and mixed evenly. Place the bowl in a basin of cold water until it cools and solidifies like snow. Adults take 1 qian per dose; children take 2 fen; ten-year-olds take 5 fen. Swallow slowly for effect. Alternatively, dissolve in decoction of Lophatheri Herba and Junci Medulla. Effective for sore throat and swelling when blown into the throat.
[Verse] Zixue San effectively treats accumulated heat; it contains Agarwood, Costus, Rhino/Antelope Horn, Scrophularia, Licorice, Halloysitum, Cimicifuga, Gypsum, and Mirabilite, finished with ground Cinnabar, Borneol, and Gold Leaf stirred in.
Other Formulas:
Bingpeng San (See Mouth Section: Thrush)
Jiawei Erchen Tang (See Phlegm Package Section)
Huanglian Jiedu Tang (See Ear Section: Black Boil)
Chansu Wan (See Boils Section)