舌者，心之候，脾之脉，络于舌也，二经有热，无所于泄，而发于舌。如舌络
微紧，时时舒舌，谓之弄舌。附舌下，近舌根生，形如舌而小，谓之重舌。舌渐渐
肿大，塞满口中，谓之木舌。〔曾〕凡为此证，是脾与心肝，屡受极热，有所谓重
舌、木舌，又谓之舌黄、鹅口，名虽异，皆热也，大抵重舌生于舌下，挺露如舌，
故曰重舌，然脾之络脉系舌傍，肝之络脉系舌本，心之络脉系舌根，凡此三经或为
湿热风寒所中，则舌卷缩，或舒长，或肿满，宜消黄散、绿袍散主之，及当归散、
羌活散、与服。
当归散（发热） 羌活散（发热）
〔钱〕弄舌者，脾脏微热，令舌络微紧，时时舒舌，治勿用冷药及下之，当少与
泻黄散渐服之。（田氏云∶若肥实者、用牛黄散治之。）或欲饮水，医疑为热，用冷药下
之者，非也，饮水者，脾胃津液少故也，又加面黄肌瘦，五心烦热，即为疳，宜加胡黄连辈。
若大病未已，用药后弄舌者凶。〔薛〕小儿舌微露而即收者，名弄舌，此属心脾亏
损，用温脾散补之。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，脾胃虚弱也，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。
泻黄散（脾） 温脾散（腹胀） 白术散（渴） 人参安胃散（脾） 四物汤（失血）
补中益气汤（虚羸）
舌是心的外候，脾的经脉联络于舌，心和脾两经若有热邪，无处宣泄，便会表现在舌上。如果舌系带微紧，舌头不时伸出，称为弄舌。在舌下靠近舌根处生出，形状像舌头但较小，称为重舌。舌头逐渐肿大，塞满口腔，称为木舌。〔曾氏〕凡是出现这些证候，都是脾、心、肝三经受极热所致，所谓的重舌、木舌，又被称为舌黄、鹅口，名称虽然不同，本质都是热证。大体上重舌生于舌下，挺出显露如小舌，所以叫重舌。然而脾的络脉系于舌旁，肝的络脉系于舌本（舌根），心的络脉系于舌根，这三条经络若被湿热、风寒等邪气侵袭，就会导致舌体卷缩，或伸长，或肿胀满闷，宜用消黄散、绿袍散主治，并配合服用当归散、羌活散。
当归散（用于发热） 羌活散（用于发热）
〔钱乙〕弄舌，是因为脾脏有轻微热邪，导致舌系带微紧，舌头不时伸出。治疗时不要用寒凉药及泻下药，应当少量给予泻黄散逐渐服用。（田氏说：如果是形体肥实的孩子，可用牛黄散治疗。）如果有想喝水的症状，医生怀疑是热证而用寒凉药泻下的，这是错误的。想喝水是因为脾胃津液不足的缘故，再加上面色发黄、肌肉消瘦、五心烦热，就属于疳积，宜加入胡黄连这类药物。如果大病未愈，用药后出现弄舌的，预后凶险。〔薛己〕小儿舌头微微伸出随即收回的，名叫弄舌，这属于心脾亏损，用温脾散来补益。舌头伸出很久不收回的，名叫吐舌，这是心脾积热，用泻黄散主治。或者兼有口舌生疮、口渴喜冷饮，属于胃经实热，也使用前面的方剂。口渴喜热饮，属于胃经虚热，用四君子汤。进食少且口渴，或大便不成形，是脾胃虚弱，用七味白术散。口角流涎，或腮颊患肿，是胃虚受风热，先用真人安胃散，再用七味白术散。如果症状午后加重，是脾血虚，用四物汤加人参、白术、茯苓，若无效果，用补中益气汤，并审查五脏之间的相克关系。若是因疳积消瘦所致，应当参考各疳门的治法。
泻黄散（治脾） 温脾散（治腹胀） 白术散（治渴） 人参安胃散（治脾） 四物汤（治失血） 补中益气汤（治虚羸）
The tongue is the manifestation of the Heart, and the Spleen meridian connects to the tongue. When heat exists in both meridians without an outlet, it manifests on the tongue. If the lingual frenulum is slightly tight and the tongue protrudes intermittently, it is called "protruding tongue" (Nong She). A small structure resembling a tongue but smaller, growing under the tongue near its root, is called "double tongue" (Chong She). When the tongue gradually swells and fills the mouth, it is called "wooden tongue" (Mu She). [Zeng] All these conditions result from extreme heat affecting the Spleen, Heart, and Liver. Double tongue, wooden tongue, as well as "yellow tongue" and "goat's mouth," though named differently, are all caused by heat. Generally, double tongue arises below the tongue, protruding like a small tongue. The Spleen collateral connects to the sides of the tongue, the Liver collateral connects to the root of the tongue, and the Heart collateral also connects to the root. If these three meridians are invaded by damp-heat, wind-cold, or other pathogens, the tongue may curl up, extend long, or become swollen and full. Treatment should primarily employ Xiaohuang San (Coptis Decoction) and Lv Pao San (Green Robe Powder), along with Danggui San (Angelica Decoction) and Qianghuo San (Notopterygium Decoction).
Danggui San (for fever) Qianghuo San (for fever)
[Qian Yi] Protruding tongue is caused by slight heat in the Spleen organ, making the lingual frenulum tight and causing intermittent protrusion. Do not use cold medicines or purgatives; instead, administer Xiehuang San (Spleen Heat-Purging Decoction) in small doses gradually. [Tian] For robust children, Niuhuang San (Calculus Bovis Decoction) may be used. If the child desires water, and the physician mistakenly assumes heat and uses cold purgatives, this is incorrect. Thirst indicates insufficient fluids in the Spleen and Stomach. Combined with sallow complexion, emaciation, and five-palm heat, it constitutes "infantile malnutrition" (Gan Ji), and herbs such as Huhuanglian (Coptidis Rhizoma) should be added. If protruding tongue appears after medication during a severe illness, the prognosis is ominous. [Xue Ji] When a child's tongue protrudes slightly and immediately retracts, it is called "protruding tongue," attributed to deficiency and damage of the Heart and Spleen; treat with Wenpi San (Spleen-Warming Decoction). When the tongue extends for a long time without retracting, it is called "prolapsed tongue" (Tu She), caused by accumulated heat in the Heart and Spleen; treat with Xiehuang San. If accompanied by oral ulcers and thirst for cold drinks, it indicates excess heat in the Stomach meridian, treated with the aforementioned powders. Thirst for hot drinks indicates deficient heat in the Stomach meridian; treat with Sijunzi Tang (Four Gentlemen Decoction). Poor appetite with thirst or loose stools indicates Spleen and Stomach weakness; treat with Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Decoction). Drooling at the corners of the mouth or swelling of the cheeks indicates deficient Stomach with wind-heat; first use Renshen Anwei San (Ginseng Stomach-Calming Decoction), followed by Qiwei Baizhu San. Symptoms worsening in the afternoon indicate Spleen blood deficiency; use Siwu Tang (Four Substances Decoction) plus Renshen, Baizhu, and Fuling. If ineffective, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and assess the overcoming relationships among the Five Zang organs. If caused by malnutrition-related emaciation, refer to the chapters on various types of Gan Ji.
Xiehuang San (for Spleen) Wenpi San (for abdominal distension) Baizhu San (for thirst) Renshen Anwei San (for Spleen) Siwu Tang (for hemorrhage) Buzhong Yiqi Tang (for emaciation)