罗太无治一人，伸颈而颊车蹉，但开不能合，以酒饮之令大醉，睡中吹皂角末搐其鼻，嚏透即自正矣。（《医
学纲目》。）
龚子才治一人，因怒气大叫，下颏脱落，任掇不上，众莫措手。令以乌梅槌饼，塞于两腮至牙尽头控处，
张口流涎，须臾随手掇上。
张三锡治一妇人，错下颔。古谓脱金钩，两手脉弱，用八珍汤加升、柴遂全愈。先用手法拿上，正骨科当知。
雄按∶余治一人，以大剂熟地、柏、杞、龙眼肉而愈。
张子和治南邻朱老翁，年六十余岁，身热，数日不已，舌根肿起，和舌尖亦肿，肿至满口，比原舌大二
倍。一外科以燔针刺其舌两旁下廉泉穴，病势转凶，将至颠 。张曰∶血实者宜决之。以 针磨令锋极尖，轻
砭之，日砭八九次，血出约一二盏。如此者三次，渐而血少痛减肿消。夫舌者，心之外候也，心主血，故血出
则愈。又曰∶诸痛痒疮疡，皆属心火，燔针艾火，是何义也？
元顺帝之长公主驸马刚噶勒藏庆王，因坠马得一奇疾，两眼黑睛俱无，而舌出至胸，诸医罔知所措。广惠
司卿聂济尔，乃伊芳 勒琨人也，尝识此症，遂剪去之。顷间复生一舌，亦剪之。又于真舌两边各去一指许，却
涂以药而愈。（《辍耕录》。）
宋度宗欲赏花，一夜忽舌肿满口，蔡御医用蒲黄、干姜末等分，干掺而愈。盖舌乃心之外候，而手厥阴相
火，乃心之臣使。蒲黄活血凉血，得干姜，是阴阳相济也。（芝隐方本《本草纲目》。）
《仙传外科》云∶有人偶含刀在口，割舌已垂未断，一人用鸡子白皮袋之，糁止血药于舌根，以蜡化蜜调冲，
和膏敷鸡子皮上。三日接住，乃去皮，只用蜜蜡勤敷，七日全安。若无速效，以金创药参治之。用鸡子白皮，
但取其软而薄，护舌而透药也。（《本草纲目》。）
凌汉章治一男子，病后舌吐。凌兄亦知医，谓曰∶此病后近女色太早也。舌者心之苗，肾水竭，不能制心
火，病在阴虚，其穴在左股太阳，是当以阴攻阳。凌曰∶然。如其穴针之，舌吐如故。凌曰∶此知泻而不知补
也。补数剂，舌渐复故。（《明史》。）
何首庸治前锋赖将军，舌本肿，出不能缩。何曰∶心气亟热也，倘久则饮食不下死矣。炙饮器灼之，
肿消，再投以汤剂立愈。（《云南通志》。）
龚子才治一人舌肿，舒退场门外。舌者心之苗，又脾之经络连舌本，散舌下，其热当责诸心脾二经，经所谓
热胜则肿也。用萆麻子去壳，纸裹捶出油透纸，作烧捻烟熏之，内服清利心脾之剂而愈。（不外益元合导赤。）
一人舌青黑有刺，乃热剧也。欲以舌贴土壁上稍可。良由思虑过度，怒气所得。为制一方，名清心散，服
之即效。赤茯苓、枣仁、麦冬、胡麻仁、黄连各一钱，远志五分，木通、连翘各八分，甘草三分，清水煎。
一膏粱之人患舌肿，敷服皆消肿之药，舌肿势急。与刺舌尖及两旁，出紫血杯许，肿消。二更服犀角地黄
汤二剂，翌早复肿胀。仍刺去紫血杯许，亦消一二。仍服前汤，良久舌大肿，又刺去黑血二杯许，肿渐消。忽
寒热作呕，头痛作晕，脉浮洪而数，此邪虽去而元气愈伤。与补中益气倍参、 、归、术，四剂而安，又数剂而愈。
郑秋官过饮，舌本强肿，语言不清。此脾虚湿热，用补中益气加神曲、麦芽、干葛、泽泻而愈。
柴屿青治满少司农讳兆惠，内阁侍读，同在军机处值宿，患重舌肿痛。问曰∶曾服通经散泻火，而病不除，
何也？答曰∶火有诸经，岂可混治诛伐无过？幸汝年少，未至大害。诊其右关洪实，胃火特甚。时已薄暮，清
胃散一服，而次早霍然。
薛立斋治一妇人，善怒，舌痛烦热。或用降火化痰药，前症益甚，两胁作胀。又服流气饮，肚腹亦胀，经
行不止。此肝虚不能藏血，脾虚不能摄血，而前药复伤也。用加味归脾汤加五味子而愈。
学士吴北川，过饮痰壅，舌本强硬，服降火化痰药，痰气益甚，肢体不遂。薛作脾虚湿热治之而愈。
二守韩宗器，不慎起居，舌胀如菌，痰涌便秘，服芩、连、二陈之类，脉浮而数，欲针出血。薛谓此足三
阴亏损之症，且有形而不痛者，阳之类也。法当峻补其阴，毋损其血，况虚浮之脉乎？遂朝补脾肺，夕滋肾肝
而愈。后因大劳，面目俱赤，遍身瘙痒。时已仲冬，曰∶大热而甚，寒之不寒，是无水也。乃用制火壮
水之剂而愈。
摇城金允文，舌胀吐痰，反服降火化痰，针刺出血，便秘痰甚。诊之，左尺关洪数，右寸关弦数，用滋肾
水、生肝血、益脾胃之剂，诸症少愈。因近火，头面赤，身痒，六脉弦数。薛谓∶此水竭火升之象，难免于春
二月矣。于次年清明日果卒。
大尹王汝邻，两足发热，吐痰如涌，左尺数而无力。此足三阴虚，彼反服四物、二陈、知、柏之类，喉舌
作痛。又服清热败毒之剂，其舌如赤桃，脉洪数而无力。此脾肺弱，肾经亏甚，虚火上炎，水泛而为痰也。当
滋化源以生肾水，遂用补中益气汤、六味地黄丸而愈。
李莫安抚内子，夜半忽不能言，烛之乃舌下生一舌。急取《外台》一方，用新真蒲黄，罗细末敷之。如此
五七次即愈，须吐去再敷。（《百乙方》。）
有人自行被颠，穿断舌心，血出不止。以米醋，用鸡翎刷所断处，其血即止。仍用真蒲、杏仁去皮尖、硼
砂少许，研为细末，炼蜜调药，稀稠得所，噙化而安。（《得效方》。）
冯楚瞻治李工部，一日忽发热，牙床肿烂，舌起大泡，白胎甚浓，疼痛难忍。或用清解之药，口舌肿烂益
甚，数夜不寐，精神恍惚，野狼狈不堪。其脉两关尺甚微，惟两寸稍洪耳。曰∶龙雷之火，亦能焚草木，岂必实
热，方使口舌生疮乎？盖脾元中气衰弱，不能按纳下焦，阴火得以上乘，奔溃肿烂。若一清胃，中气愈衰，阴
火愈炽。急为温中下二焦，使火有所接引而退舍矣。乃用白术八钱，炮姜三钱，温中为君；炒麦冬三钱，清上
为臣；牛膝三钱，五味一钱，下降敛纳为佐；附子一钱五分，直暖丹田为使。如是数剂，精神渐复，肿者消而
溃者愈矣。（来选入。）
一人无故舌缩，不能言，用芥菜子研末，醋调敷颈项下，即能言。服清脾降火等汤，再用紫雪冰片散，吹
之而安。
钱国宾治板桥李氏仆刘二，与租房之妇私，年余不收其租。一日，主人算账无抵，刘二坐逼，妇恨将刘舌
咬下二寸。延视，根肿满，汤水不下。制金疮药，用败龟板烧烟带黑色一两，血竭一钱，冰片三分，共末糁上，
血痛俱止，肿尚未消。其人昏昏不省，梦关帝示以半红半白鸡豆大药一粒，用无根水吞，汝即生矣。惊觉难言，
讨笔书。众人方知自是其肿渐消，可灌饮汤，至于薄粥。其舌长完，比前大小一样，日服参 归术汤愈。
蒋仲芳治一同学，年二十余，患腮肿。医以清凉散火之剂，不一夜舌忽肿塞口，命在须臾，叩门求救。诊
其脉微细而数，大便四五日不行矣。微数虽属虚火，而便结又已属实。乃用百草霜吹舌上，内用酒蒸大黄五钱，
肉桂一钱，引火下行，一剂而愈。
罗太无治疗一个人，患者颈部伸展且下颌关节脱位，嘴巴张开无法闭合。罗太无用酒让他喝到大醉，在他熟睡时用皂角末吹入鼻腔引发喷嚏，喷嚏打出后下颌关节便自动复位了。（出自《医学纲目》。）
龚子才治疗一个人，因为愤怒大叫导致下巴脱臼，任人托举也无法复位，众人束手无策。龚子才让人将乌梅捣成饼状，塞在两侧脸颊直到牙齿尽头控制的地方，患者张口流口水，片刻之后下巴便随手托回了原位。
张三锡治疗一位妇人，下颌骨错位。古人称之为“脱金钩”，诊得两手脉象虚弱，使用八珍汤加入升麻、柴胡，于是完全痊愈。先用手法治正复位，正骨科应当知晓此法。
按语：我治疗过一个人，用大剂量的熟地黄、黄柏、枸杞、龙眼肉而治愈。
张子和治疗南邻朱老翁，六十多岁，身体发热，数日不退，舌根肿胀隆起，连同舌尖也肿，肿胀充满口腔，比原来的舌头大了两倍。一位外科医生用烧红的针刺其舌头两旁下方的廉泉穴，病情反而加重，几乎危及生命。张子和说：“血实者宜决之。”他用磨得极尖的针，轻轻刺破舌部放血，每天刺八九次，放出血液大约一两杯。像这样进行了三次，逐渐地出血减少，疼痛减轻，肿胀消退。舌是心的外候，心主血脉，所以放血就能痊愈。又说：“各种痛痒疮疡，都归属于心火，用烧红的针和艾火灸治，是什么道理呢？”
元顺帝的长公主驸马刚噶勒藏庆王，因为坠马得了一种奇疾，双眼黑眼球都没有了，舌头伸出长达胸部，众医不知如何是好。广惠司卿聂济尔，是伊芳勒琨人，曾经认识这种病症，于是剪去了伸出的舌头。一会儿又生出一个新舌头，又剪去。又在真舌两边各剪去约一指宽的部分，然后涂上药物而痊愈。（出自《辍耕录》。）
宋度宗想要赏花，一夜之间突然舌头肿胀充满口腔，蔡御医用蒲黄、干姜末各等分，干粉撒敷患处而痊愈。因为舌是心的外候，而手厥阴心包经的相火，是心的臣使。蒲黄能活血凉血，得到干姜的配合，就是阴阳相互济助的意思。（此方源自芝隐，本于《本草纲目》。）
《仙传外科》记载：有人偶然把刀含在嘴里，割断舌头已垂下但未完全断开，一人用鸡蛋清皮包裹住舌头，在舌根撒上止血药，用融化的蜡蜜调制成冲剂，混合药膏敷在鸡蛋皮上。三天后接合住，然后去掉皮，只用蜜蜡勤加敷涂，七天就完全康复。如果没有速效，可以用治疗金创的药物配合治疗。使用鸡蛋清皮，只是取其柔软薄透，保护舌头并让药物渗透的作用。（出自《本草纲目》。）
凌汉章治疗一个男子，病后舌头吐出。凌汉章的哥哥也懂医术，说道：“这是病后过早行房事所致。舌是心的苗窍，肾水枯竭，不能制约心火，病在阴虚，对应的穴位在大腿内侧太阳经（此处指足少阴肾经或相关部位，原文‘左股太阳’可能有误或特指，依文意理解为下肢相关穴位），应当以阴攻阳。凌汉章说：“对。”按照那个穴位针刺，舌头吐出如故。凌汉章说：“这是只知道泻而不知道补。”服用补益药剂数剂后，舌头渐渐恢复原状。（出自《明史》。）
何首庸治疗前锋赖将军，舌根肿胀，伸出不能缩回。何首庸说：“心气极度热盛，如果久了就会因饮食不下而死。”用灼热的饮器烫熨患处，肿胀消退，再投以汤剂立刻痊愈。（出自《云南通志》。）
龚子才治疗一个人舌头肿胀，舌头舒退到场门外。舌是心的苗窍，又是脾的经络连接舌根，散布在舌下，其热应当归责于心脾二经，经书所说“热胜则肿”。用蓖麻子去壳，用纸包裹捶打出油透纸，做成燃烧捻子熏烤患处，内服清利心脾的药物而痊愈。（不外乎益元散合导赤散之意。）
另一人舌头青黑且有刺状物，这是热毒剧烈所致。想把舌头贴在土墙上稍微缓解。这主要是由于思虑过度、怒气所致。为此配制一方，名为清心散，服用即见效。赤茯苓、枣仁、麦冬、胡麻仁、黄连各一钱，远志五分，木通、连翘各八分，甘草三分，清水煎服。
一位吃精细食物的人患舌头肿胀，敷药和内服消肿药后，舌头肿胀势头急迫。给予刺破舌尖及两旁，放出紫血约一杯，肿胀消退。二更天服用犀角地黄汤两剂，第二天早上又复发肿胀。仍然刺破放出紫血约一杯，也消退了一部分。仍然服用前面的汤药，过了很久舌头又大肿，又刺破放出黑血约两杯，肿胀逐渐消退。忽然出现寒热、呕吐、头痛眩晕，脉象浮洪而数，这是邪气虽去但元气更加受伤。给予补中益气汤加倍人参、当归、白术，四剂后安定，又服几剂后痊愈。
郑秋官饮酒过量，舌根强硬肿胀，语言不清。这是脾虚湿热，用补中益气汤加神曲、麦芽、干葛、泽泻而痊愈。
柴屿青治疗满族少司农讳兆惠，内阁侍读，同在军机处值宿，患重舌肿痛。问道：“曾服用通经散泻火，但病不除，为什么呢？”回答说：“火存在于各条经脉，岂可混治而不诛伐无辜？幸好你年轻，未造成大害。”诊得右关脉洪实，胃火特别旺盛。当时已近傍晚，服用清胃散一剂，第二天早晨霍然痊愈。
薛立斋治疗一位妇人，易怒，舌痛烦热。有人用降火化痰药，前面的症状更加严重，两胁发胀。又服用流气饮，肚腹也胀，月经不止。这是肝虚不能藏血，脾虚不能摄血，而前面的药物又损伤了正气。用加味归脾汤加五味子而痊愈。
学士吴北川，饮酒过量痰壅，舌根强硬，服用降火化痰药，痰气更加严重，肢体不遂。薛立斋按脾虚湿热治疗而痊愈。
二守韩宗器，不注意起居，舌头肿胀如菌，痰涌便秘，服用黄芩、黄连、二陈汤之类，脉浮而数，想针刺放血。薛立斋认为这是足三阴亏损的病症，而且有形但不痛的，属于阳证（此处原文逻辑似有转折或特定语境，通常有形无痛多属阴或虚，但依原文翻译）。治法应当峻补其阴，不要损耗其血，何况是虚浮的脉象呢？于是早晨补脾肺，晚上滋肾肝而痊愈。后来因为过度劳累，面目都发红，遍身瘙痒。当时已是仲冬，薛立斋说：“大热而且严重，用寒凉药不能退热，这是无水（肾阴亏竭）的表现。”于是用制火壮水的药剂而痊愈。
摇城金允文，舌头肿胀吐痰，反服降火化痰药，针刺放血，便秘痰多。诊察，左尺关脉洪数，右寸关脉弦数，用滋肾水、生肝血、益脾胃的药剂，诸症稍愈。因为靠近火源，头面红，身痒，六脉弦数。薛立斋说：“这是水竭火升的现象，难免在春二月去世。”果然在次年清明日去世。
大尹王汝邻，两脚发热，吐痰如涌，左尺脉数而无力。这是足三阴虚，他反而服用四物汤、二陈汤、知母、黄柏之类，喉舌作痛。又服用清热败毒的药剂，其舌如红桃，脉洪数而无力。这是脾肺弱，肾经亏甚，虚火上炎，水泛而为痰。应当滋化源以生肾水，于是用补中益气汤、六味地黄丸而痊愈。
李莫安抚的内子，半夜突然不能说话，点灯看则是舌下生了一个舌头。急忙取《外台秘要》中的一方，用新鲜的真蒲黄，筛细末敷在上面。像这样五七次就痊愈了，必须吐掉再敷。（出自《百乙方》。）
有人自己不慎跌倒，穿断舌心，血流不止。用米醋，用鸡翎刷涂抹断裂处，血立即止住。仍然用真蒲黄、杏仁去皮尖、少许硼砂，研为细末，炼蜜调药，稀稠适中，含化而安。（出自《得效方》。）
冯楚瞻治疗李工部，一天突然发热，牙床肿烂，舌起大泡，白苔很厚，疼痛难忍。有人用清解的药，口舌肿烂更加严重，数夜不眠，精神恍惚，狼狈不堪。他的脉两关尺非常微弱，只有两寸稍洪而已。冯楚瞻说：“龙雷之火，也能焚烧草木，难道一定是实热，才会使口舌生疮吗？”这是因为脾元中气衰弱，不能按纳下焦，阴火得以上乘，奔溃肿烂。如果一清胃，中气愈衰，阴火愈炽。急忙温补中下二焦，使火有所接引而退舍。于是用白术八钱，炮姜三钱，温中为君药；炒麦冬三钱，清上为臣药；牛膝三钱，五味子一钱，下降敛纳为佐药；附子一钱五分，直暖丹田为使药。像这样数剂，精神渐渐恢复，肿的消了，溃的愈了。（来选收录。）
另一人无故舌头收缩，不能说话，用芥菜子研末，醋调敷在颈项下，就能说话。服用清脾降火等汤药，再用紫雪冰片散，吹入患处而安。
钱国宾治疗板桥李家的仆人刘二，与租房的妇人私通，一年多不收其租。一天，主人算账无抵赖，刘二坐着逼迫，妇人恨而将刘二的舌头咬下两寸。延请诊治，根部肿胀充满，汤水不下。配制金疮药，用败龟板烧烟带黑色一两，血竭一钱，冰片三分，共研为末撒在上面，血痛俱止，肿胀尚未消。其人昏昏不省人事，梦见关帝指示半红半白鸡豆大的药一粒，用无根水吞服，你就活了。惊醒后难以说话，讨笔书写。众人这才知道自此后肿胀渐消，可以灌饮汤水，至于薄粥。其舌头长全，比以前大小一样，每日服用参归术汤而愈。
蒋仲芳治疗一个同学，二十多岁，患腮肿。医生用清凉散火的药剂，不到一夜舌头突然肿胀堵塞口腔，命在须臾，叩门求救。诊察其脉微细而数，大便四五日不行了。微数虽然属于虚火，但便结又已经属实。于是用百草霜吹在舌上，内服酒蒸大黄五钱，肉桂一钱，引火下行，一剂而痊愈。
Luo Taiwu treated a patient whose neck was extended and the temporomandibular joint (TMJ) was dislocated, with the mouth open and unable to close. Luo gave him wine until he was heavily intoxicated, then blew powder of *Saposhnikovia divaricata* (Zaojiao, 皂角) into his nose while he slept. The resulting sneeze caused the jaw to automatically return to its proper position. (From *Yixue Gangmu*.)
Gong Zicai treated a patient who suffered a mandibular dislocation after shouting in anger; no matter how others tried to push it back, it would not stay. Gong had people pound *Vinegar Plum* (Wumei, 乌梅) into cakes and stuff them into both cheeks up to the end of the teeth where the jaw controls. As the patient opened his mouth and drooled, within moments the jaw could be easily pushed back into place by hand.
Zhang Sanxi treated a woman with a dislocated mandible. Ancient texts call this "dislocated golden hook." Her pulses in both hands were weak. He used Bazhen Tang (Eight Treasure Decoction) augmented with Shengma (Cimicifugae Rhizoma, 升麻) and Chaihu (Bupleuri Radix, 柴胡), resulting in a complete recovery. Manual reduction should be performed first; orthopedic practitioners should know this method.
Commentary: I once treated a patient who recovered using large doses of Shudi (Rehmanniae Radix Preparata, 熟地黄), Huangbai (Phellodendri Cortex, 黄柏), Gouqi (Lycii Fructus, 枸杞), and Longyanrou (Longan Aril, 龙眼肉).
Zihe Zheng treated an old man named Zhu from the south neighbor, aged over sixty, who had a persistent fever for several days. His tongue root swelled up, along with the tip, filling his entire mouth, twice the size of the original tongue. A surgeon pierced the sides of the tongue below the Lianquan acupoint (CV23, 廉泉) with red-hot needles, which worsened the condition, nearly leading to death. Zihe said, "When blood is excessive, it should be drained." He sharpened a needle to a fine point and lightly pricked the tongue to bleed, doing this eight or nine times a day, draining about one or two cups of blood. After three such sessions, the bleeding decreased, pain subsided, and swelling went down. The tongue is the external manifestation of the Heart; the Heart governs blood, so releasing blood leads to recovery. He further stated, "All pain, itching, sores, and ulcers belong to Heart Fire. What is the meaning of using red-hot needles and moxa?"
The Prince Consort of the Eldest Princess under Emperor Shun of Yuan contracted a strange disease after falling from a horse. Both pupils disappeared, and his tongue extended to his chest. Physicians did not know what to do. Nie Jier, Minister of Guanghui Si and a native of Yifanglekun, recognized the condition and cut off the protruding tongue. Soon, a new tongue grew, which was also cut off. He then cut away about one finger's width from both sides of the true tongue, applied medicine, and the patient recovered. (From *Chenggeng Lu*.)
Emperor Duzong of Song wanted to view flowers but suddenly woke up with his tongue swollen to fill his mouth. Imperial Physician Cai used equal parts of Puhuang (Typhae Pollen, 蒲黄) and Ganjiang (Zingiberis Rhizoma, 干姜) as dry powder applied topically, resulting in recovery. Since the tongue is the external manifestation of the Heart, and the Ministerial Fire of the Hand-Jueyin Pericardium acts as the minister to the Heart, Puhuang invigorates and cools blood. Combined with Ganjiang, this represents the mutual assistance of Yin and Yang. (This prescription originates from Zhiyin, based on *Bencao Gangmu*.)
*Xianchuan Waike* records: Someone accidentally held a knife in their mouth, cutting the tongue so it hung loose but was not completely severed. Another person wrapped the tongue in egg white skin, sprinkled hemostatic powder on the tongue root, mixed melted wax and honey into a paste, and applied it over the egg skin. After three days, it adhered, the skin was removed, and only frequent application of honey and wax was needed. Full recovery occurred in seven days. If there was no rapid effect, trauma medicines could be added. Egg white skin is used because it is soft, thin, protects the tongue, and allows drug permeation. (From *Bencao Gangmu*.)
Ling Hanzhang treated a man whose tongue protruded after illness. Ling's brother, also knowledgeable in medicine, said, "This is due to engaging in sexual activity too soon after illness. The tongue is the sprout of the Heart. Kidney Water is exhausted and cannot control Heart Fire. The disease is Yin deficiency. The relevant acupoint is on the left thigh in the Taiyang channel [Note: Text says 'Left股Taiyang', likely referring to specific points or a textual variant, interpreted here as lower limb related]. One should attack Yang with Yin." Ling said, "Correct." He needled that acupoint, but the tongue protrusion persisted. Ling said, "This shows knowledge of purging but not tonifying." After several doses of tonifying herbs, the tongue gradually returned to normal. (From *Mingshi*.)
He Shouyong treated General Lai, the Vanguard Commander, whose tongue root was swollen and could not retract. He said, "Heart Qi is extremely hot. If prolonged, death will result from inability to eat or drink." He cauterized the area with a heated drinking vessel. The swelling subsided, and subsequent decoction therapy led to immediate recovery. (From *Yunnan Tongzhi*.)
Gong Zicai treated a patient with a swollen tongue that protruded outside the gate. The tongue is the sprout of the Heart, and the Spleen meridians connect to the tongue root and scatter under the tongue. The heat should be attributed to the Heart and Spleen meridians, as the classics state, "Excessive heat causes swelling." He used *Ricinus communis* seeds (Bimaizi, 蓖麻子), shelled, pounded in paper until oil penetrated, made into a burning wick to smoke the affected area. Internally, he administered herbs to clear and drain Heat from the Heart and Spleen, resulting in recovery. (Essentially Yi Yuan San combined with Dao Chi San.)
Another patient had a blue-black tongue with prickles, indicating severe Heat. He found slight relief pressing his tongue against a dirt wall. This was caused by excessive worry and anger. A formula named Qingxin San (Clear Heart Powder) was prepared. It contained Chifuling (Poria Cocos with Red Skin, 赤茯苓), Zaoren (Ziziphi Spinosomi Semen, 枣仁), Maidong (Ophiopogonis Radix, 麦冬), Humaren (Hemsi Semen, 胡麻仁), and Huanglian (Coptidis Rhizoma, 黄连) each at 1 qian; Yuanzhi (Polygalae Radix, 远志) at 5 fen; Mutong (Akebiae Caulis, 木通) and Lianqiao (Forsythiae Fructus, 连翘) each at 8 fen; and Gancao (Glycyrrhizae Radix et Rhizoma, 甘草) at 3 fen. Decocted in clear water.
A gourmet patient suffered from tongue swelling. Topical and internal anti-swelling drugs failed as the swelling intensified. Pricking the tongue tip and sides released a cup of purple blood, reducing swelling. At the second double-hour, two doses of Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) were given, but swelling recurred the next morning. Pricking again released a cup of purple blood, reducing swelling slightly. Continuing the previous decoction, the tongue swelled greatly later. Pricking released two cups of black blood, and swelling gradually subsided. Suddenly, chills, fever, vomiting, headache, and dizziness appeared with a floating, surging, and rapid pulse. Although the pathogen was gone, the Healthy Qi was further damaged. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with doubled Renshen (Ginseng Radix, 人参), Danggui (Angelicae Sinensis Radix, 当归), and Baizhu (Atractylodis Macrocephalae Rhizoma, 白术) was given for four doses, stabilizing the condition, followed by several more doses for full recovery.
Official Zheng Qiu drank excessively, resulting in a stiff and swollen tongue root and unclear speech. This was Spleen deficiency with Damp-Heat. Bu Zhong Yi Qi Tang augmented with Shenqu (Medicated Leaven, 神曲), Maiya (Hordei Fructus Germinatus, 麦芽), Gegen (Puerariae Lobatae Radix, 干葛), and Zexie (Alismatis Rhizoma, 泽泻) resulted in recovery.
Chai Yuqing treated Manzu Shaonong Zhao Hui, an Inner Cabinet Reader serving in the Grand Council, who suffered from a swollen and painful double tongue (Chongshe). He asked, "You took Tongjing San to purge Fire, yet the illness persists. Why?" The patient replied, "Fire exists in various meridians; how can one treat indiscriminately without punishing the innocent? Fortunately, you are young, so no major harm has been done." The right Guan pulse was surging and solid, indicating extreme Stomach Fire. It was late evening. One dose of Qingwei San (Clear Stomach Powder) led to sudden recovery the next morning.
Xue Lizhai treated a woman who was prone to anger, suffering from tongue pain and irritability. Using herbs to descend Fire and resolve Phlegm worsened these symptoms and caused distension in the hypochondrium. Taking Liqi Yin (Flowing Qi Decoction) caused abdominal distension and continuous menstruation. This was Liver deficiency failing to store Blood and Spleen deficiency failing to control Blood, exacerbated by previous medications. Jiawei Guipi Tang (Modified Return to the Spleen Decoction) augmented with Wuweizi (Schisandrae Fructus, 五味子) resulted in recovery.
Academician Wu Beichuan drank excessively, causing Phlegm obstruction, a stiff tongue root. Taking herbs to descend Fire and resolve Phlegm worsened the Phlegm and Qi stagnation, leading to limb paralysis. Xue treated this as Spleen deficiency with Damp-Heat and achieved recovery.
Magistrate Han Zongqi neglected his daily routine, resulting in a mushroom-like swollen tongue, surging Phlegm, and constipation. Taking Huangqin (Scutellariae Radix, 黄芩), Huanglian (Coptidis Rhizoma, 黄连), and Erchen Tang (Two-Aged Phlegm Decoction) resulted in a floating and rapid pulse, prompting a desire to needle and bleed. Xue stated this was a deficiency of the Three Yin channels of the Foot. Although有形 (having form) and painless usually indicates Yang [Note: Classical theory often associates painless masses with Yin/Yang imbalance differently, but translating literally], the method should be to vigorously tonify Yin without damaging Blood, especially with a floating and deficient pulse. Thus, tonifying Spleen and Lung in the morning and nourishing Kidney and Liver in the evening led to recovery. Later, due to overexertion, his face and eyes turned red, and his whole body itched. It was mid-winter. Xue said, "Extreme heat that does not respond to cooling indicates lack of Water (Kidney Yin)." Treatment with herbs to subdue Fire and strengthen Water resulted in recovery.
Jin Yunwen from Yaocheng suffered from tongue swelling and expectoration. Taking herbs to descend Fire and resolve Phlegm, plus needle bleeding, worsened constipation and Phlegm. Diagnosis showed surging and rapid pulses at the left Chi and Guan positions, and wiry and rapid pulses at the right Cun and Guan positions. Herbs to nourish Kidney Water, generate Liver Blood, and benefit Spleen and Stomach improved symptoms slightly. Proximity to fire caused redness of head and face and body itching, with wiry and rapid pulses in all six positions. Xue said, "This is a sign of exhausted Water and rising Fire. Death is inevitable in the second month of Spring." Indeed, he died on Qingming Festival the following year.
County Magistrate Wang Rulin suffered from hot feet and profuse expectoration, with a rapid and forceless Chi pulse on the left. This was deficiency of the Three Yin channels of the Foot. Instead, he took Siwu Tang (Four Substance Decoction), Erchen Tang, Zhimu (Anemarrhenae Rhizoma, 知母), and Baidu (Phellodendri Cortex, 黄柏), causing throat and tongue pain. Taking clearing Heat and detoxifying herbs made his tongue look like a red peach, with a surging, rapid, and forceless pulse. This indicated weak Spleen and Lung, severe Kidney deficiency, deflected Deficient Fire flaming upward, and Water flooding creating Phlegm. The source of transformation should be nourished to generate Kidney Water. Bu Zhong Yi Qi Tang combined with Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) resulted in recovery.
Li Mo Anfu's wife suddenly lost her voice at midnight. Upon lighting a candle, a second tongue was found growing under her tongue. Urgently, a formula from *Waitai Mibi* was taken: fresh Zhen Puhuang (True Typhae Pollen, 真蒲黄) sifted into fine powder and applied. Repeating this five or seven times led to recovery. Must spit out before reapplying. (From *Baibai Fang*.)
Someone accidentally fell and severed the center of their tongue, with unceasing bleeding. Rice vinegar was brushed onto the severed area with a chicken feather, stopping the blood immediately. Then, Zhen Puhuang (True Typhae Pollen), Xingren (Pruni Armeniaci Semen, 杏仁) peeled and cored, and a small amount of Pengsha (Borax, 硼砂) were ground into a fine powder, mixed with refined honey to the appropriate consistency, and held in the mouth to dissolve, leading to safety. (From *Defang Fang*.)
Feng Chuzhan treated Li Gongbu, who suddenly developed fever, swollen and ulcerated gums, large blisters on the tongue, thick white coating, and unbearable pain. Using clearing and resolving herbs worsened the oral and tongue ulcers, causing sleeplessness for several nights, mental confusion, and extreme distress. The pulses at both Guan and Chi positions were very faint, only the Cun positions were slightly surging. Feng said, "Dragon and Thunder Fire can also burn grass and trees; must it always be Excess Heat to cause mouth and tongue sores?" This was due to weakness of Spleen Yuan and Middle Qi, failing to anchor Lower Jiao, allowing Yin Fire to ascend and cause swelling and ulceration. Clearing the Stomach would further weaken Middle Qi and intensify Yin Fire. Urgently warming and tonifying the Middle and Lower Jiao allowed the Fire to retreat. Bai Zhu (Atractylodis Macrocephalae Rhizoma, 白术) 8 qian and Pao Jiang (Prepared Zingiberis Rhizoma, 炮姜) 3 qian warmed the Middle as Sovereign; Chao Maidong (Stir-fried Ophiopogonis Radix, 炒麦冬) 3 qian cleared the Upper as Minister; Niuxi (Achyranthis Bidentatae Radix, 牛膝) 3 qian and Wuweizi (Schisandrae Fructus, 五味子) 1 qian descended and gathered as Assistant; Fuzi (Aconiti Lateralis Radix Preparata, 附子) 1.5 qian directly warmed the Dantian as Envoy. After several doses, spirit recovered, swelling subsided, and ulcers healed. (Selected by Lai.)
Another patient suddenly had a retracted tongue and could not speak. Mustard seed powder mixed with vinegar was applied to the neck, restoring speech. Decoctions to clear Spleen and descend Fire were taken, followed by Zixue Bingpian San (Purple Snow and Borneol Powder) blown into the mouth, leading to stability.
Qian Guobin treated Liu Er, a servant of the Li family in Banqiao, who had an illicit affair with a tenant woman for over a year without paying rent. One day, the master demanded payment, and Liu sat逼 (pressuring) her. In hatred, she bit off two inches of Liu's tongue. Examination showed root swelling preventing swallowing. Trauma medicine was prepared: Baiguiban (Testudinis Carapax et Plastrum, 败龟板) smoked until black, 1 liang; Xuexue (Draconis Sanguis, 血竭) 1 qian; Bingpian (Borneolum Syntheticum, 冰片) 3 fen. Ground together and sprinkled on the wound. Bleeding and pain stopped, but swelling remained. The patient was unconscious, dreaming of Lord Guan Di instructing him to swallow a half-red, half-white bean-sized pill with unrooted water, promising life. Waking up, he could not speak but wrote with a pen. People realized the swelling gradually subsided, allowing liquid diet progression to thin porridge. The tongue fully regenerated to its original size. Daily intake of Shen Gui Zhu Tang (Ginseng, Angelica, and Atractylodes Decoction) led to recovery.
Jiang Zhongfang treated a classmate, over twenty years old, suffering from mumps. The doctor used cooling and dispersing Fire herbs. Within one night, the tongue suddenly swelled to block the mouth, life hanging in the balance. Knocking for help, the pulse was faint, fine, and rapid. Bowel movements had not occurred for four or five days. Although faint and rapid suggests Deficient Fire, constipation indicates Excess. Baicaoshuang (Soot from Hundred Herbs, 百草霜) was blown onto the tongue. Internally, Jiu Zheng Dahuang (Wine-processed Rheum Palmatum Radix, 酒蒸大黄) 5 qian and Rougui (Cinnamomi Cortex, 肉桂) 1 qian were used to guide Fire downward. One dose resulted in recovery.