《三因》矾石散,治风寒湿舌强不能语。牛黄散治舌肿强,又用蛇蜕烧存性、全蝎等分,为细末
敷之。
经云∶邪客手少阳之络,令人喉痹舌卷,口干心烦,臂外廉痛,手不及头,刺手中指、次指爪甲
上去端如韭叶,各一 。又云∶手少阳之筋,其病支痛转筋,舌卷,治在燔针劫刺,以知为数,以痛
为输。又云∶厥阴络者,甚则舌卷卵上缩。又云∶肝者,筋之合也。肝脉弗荣则筋急,筋急则引舌与
卵,故唇青舌卷卵缩,则筋先死,庚笃辛死。
风热,口中干燥,舌裂生疮,宜甘露饮、栝蒌根散、甘露丸。外敷芦荟散、玄参散、绿云散。并
以白矾末汤化洗足。曾有舌上病疮,久蚀成穴,累服凉剂不效,后有教服黑锡丹,遂得渐愈。此亦下
虚故上盛也。又有舌无故常自痹者,不可作风治,由心血不足,理中汤加当归服之。
心经热甚,及伤寒热毒攻心,及伤寒后不能调摄,往往有之,宜用珍珠末、冰
片等分,敷之即收。或用巴豆一枚,去油取霜,用纸捻卷之,内入鼻中,舌自收。(此治伤寒后不能
调摄者)。治一妇人产子,舌出不能收,令以朱砂末敷其舌,乃令作产子状,以二女掖之,乃于壁外
潜累盆盎置危处,堕地作声,声闻而舌卷矣。
《灵枢》口问篇,黄帝曰∶人之涎下者,何气使然?岐伯曰∶饮食者皆入于胃,胃中有热则虫动,
虫动则胃缓,胃缓则廉泉开,廉泉开故涎下。补足少阴。萧炳治口角流涎不止,口目 邪,手足痿软,
用神龟滋阴丸、通天愈风汤、清心导痰丸、清心牛黄丸。娄全善治宣文炳口流涎不止,喜笑舌喑,脉
洪大,用连、芩、柏、栀、白术、苍术、半夏、竹沥、姜汁服之,五日涎止笑息。(流涎者,自然流
出也)。仲景云∶大病瘥,喜出唾,久不了了者,胃上有寒,当以丸药温之,宜理中丸。东垣云∶多
唾或唾白沫者,胃口上停寒也,药中加益智仁。
《三因方》中的矾石散,用于治疗风寒湿邪导致的舌体僵硬、不能言语。牛黄散用于治疗舌体肿胀僵硬,另外也可用蛇蜕(烧至存性)、全蝎各等份,研成细末外敷患处。
《内经》记载:邪气侵犯手少阳经的络脉,会导致喉痹、舌体卷缩、口干、心烦、手臂外侧疼痛、手举不过头,治疗应针刺手中指和次指指甲角旁,距离指尖如韭菜叶宽处,每穴刺一针。又记载:手少阳经的筋脉发生病变,会出现支节疼痛、转筋、舌体卷缩,治疗采用燔针劫刺法,以病情好转为度,以痛点作为腧穴。又记载:厥阴经的络脉病变严重时,会出现舌体卷缩、睾丸上缩。又记载:肝主筋,若肝脉气血不荣养筋脉,则筋脉拘急,筋脉拘急会牵引舌体和睾丸,所以出现嘴唇发青、舌体卷缩、睾丸上缩,这是筋脉先死的征象,庚日病重,辛日死亡。
风热证,表现为口中干燥、舌裂生疮,适宜使用甘露饮、栝蒌根散、甘露丸。外用芦荟散、玄参散、绿云散敷贴。同时用白矾末调汤洗足。曾有患者舌上生疮,久不愈合形成溃疡孔洞,多次服用凉药无效,后来有人建议服用黑锡丹,逐渐痊愈。这也是下虚导致上盛的表现。又有舌体无故经常麻木者,不可按风证治疗,这是由于心血不足,宜用理中汤加当归服用。
心经热盛,以及伤寒热毒攻心,还有伤寒后调养不当,往往会出现这种情况,适宜用珍珠末、冰片各等份,外敷患处即可收敛。或者用巴豆一枚,去油取霜,用纸捻卷起,纳入鼻中,舌体自然收回。(这是治疗伤寒后调养不当的情况)。曾治一妇人产后,舌头伸出不能收回,让人用朱砂末敷在舌上,然后让她做出分娩时的样子,让两个女子搀扶着她,就在墙外悄悄放置盆罐在危险高处,使其坠落发出声响,听到声音后舌体就卷回去了。
《灵枢·口问篇》,黄帝问:人为什么流涎?岐伯答:饮食进入胃中,胃中有热则虫动,虫动则胃气缓,胃气缓则廉泉穴开,廉泉穴开故流涎。治疗应补足少阴经。萧炳治疗口角流涎不止、口眼歪斜、手足痿软,使用神龟滋阴丸、通天愈风汤、清心导痰丸、清心牛黄丸。娄全善治疗宣文炳口流涎不止、喜笑、舌喑、脉洪大,使用黄连、黄芩、黄柏、栀子、白术、苍术、半夏、竹沥、姜汁服用,五日后涎止笑停。(流涎是指口水自然流出)。张仲景说:大病初愈,喜欢吐唾沫,久久不好,是胃上有寒,应当用丸药温补,适宜理中丸。李东垣说:多唾或吐白沫的,是胃口上方有寒停留,药物中加入益智仁。
The Fanshi San (Alum Powder) from *San Yin Fang* treats tongue stiffness and inability to speak caused by wind-cold-dampness. Niuhuang San (Calculus Bovis Powder) treats swollen and stiff tongue; alternatively, snake slough (burned until carbonized but retaining its nature) and Quanxie (Scorpio) in equal parts are ground into fine powder for external application.
The Classics state: When pathogenic factors invade the collaterals of the Hand-Shaoyang meridian, it causes throat obstruction, tongue retraction, dry mouth, vexation, pain along the lateral aspect of the arm, and inability to raise the hand above the head. Treatment involves needling at the corner of the nail of the middle finger and the index finger, approximately as wide as a leek leaf from the tip, one needle per point. It is also stated: Pathological changes in the sinews of the Hand-Shaoyang meridian manifest as pain in the branches, spasms, and tongue retraction. Treatment employs burning needle and rapid puncture techniques, using the resolution of symptoms as the indicator of efficacy, and using painful areas as acupoints. Furthermore, severe pathology of the Jueyin collaterals results in tongue retraction and testicular retraction. Additionally, the Liver governs the sinews. If the Liver meridian fails to nourish the sinews, they become tight; tight sinews pull on the tongue and testes, resulting in cyanotic lips, tongue retraction, and testicular retraction. This indicates the sinews are dying first; the condition worsens on Geng days and leads to death on Xin days.
Wind-heat patterns present with dry mouth, cracked tongue, and sores, treated with Ganlu Yin (Sweet Dew Decoction), Gualou Gen San (Trichosanthes Root Powder), or Ganlu Wan (Sweet Dew Pill). Externally, Lushui San (Aloe Powder), Xuanshen San (Scrophularia Root Powder), or Lvyun San (Green Cloud Powder) may be applied. Simultaneously, feet should be washed with water dissolved with Fanshi (Alum) powder. There was a case of a sore on the tongue that eroded into an ulcer over time; repeated use of cooling agents was ineffective. Later, Heixi Dan (Black Tin Pill) was administered, leading to gradual recovery. This exemplifies deficiency below causing excess above. Another case involves spontaneous numbness of the tongue without apparent cause; this should not be treated as wind-pattern but rather as insufficient Heart Blood, treated with Lizhong Tang (Regulate the Middle Decoction) added with Danggui (Angelica Sinensis).
Excessive heat in the Heart Meridian, heat-toxin attacking the Heart in Shanghan (Cold Damage), or improper care after Shanghan often lead to these conditions. Zhenzhu Mo (Pearl Powder) and Bingpian (Borneol) in equal parts can be applied externally to achieve retraction. Alternatively, one Baidu Dou (Croton Seed), de-oiled to obtain the cake, is rolled in paper and inserted into the nose, causing the tongue to retract spontaneously (this method treats improper care post-Shanghan). A woman who delivered a baby had her tongue protruding and unable to retract. She was instructed to apply Zhusha Mo (Cinnabar Powder) to the tongue, then mimic the posture of childbirth while supported by two women. Secretly, pots and basins were placed precariously outside the wall and dropped to make a loud noise. Upon hearing the sound, the tongue retracted.
In the *Kouwen* Chapter of *Ling Shu*, the Yellow Emperor asked: What qi causes salivation? Qibo replied: Food and drink enter the stomach. Heat in the stomach causes parasites to move; movement of parasites relaxes the stomach; relaxation of the stomach opens the Lianquan acupoint; opening of Lianquan results in salivation. Treatment involves tonifying the Foot-Shaoyin meridian. Xiao Bing treated continuous drooling, facial deviation, and flaccidity of limbs using Shen Gui Zi Yin Wan (Divine Turtle Nourishing Yin Pill), Tongtian Yufeng Tang (Heaven-Penetrating Wind-Dispelling Decoction), Qingxin Daotan Wan (Clear Heart Phlegm-Guiding Pill), and Qingxin Niuhuang Wan (Clear Heart Calculus Bovis Pill). Lou Quanshan treated Xuan Wenbing’s continuous drooling, excessive laughter, aphasia, and surging pulse using Huanglian (Coptis Rhizome), Huangqin (Scutellaria Root), Huangbai (Phellodendron Bark), Zhizi (Gardenia Fruit), Baizhu (Atractylodes Macrocephala Rhizome), Cangzhu (Atractylodes Rhizome), Banxia (Pinellia Tuber), Zhuli (Bamboo Sap), and Jiangzhi (Ginger Juice). After five days, drooling ceased and laughter stopped. (Drooling refers to saliva flowing out naturally). Zhang Zhongjing stated: After a major illness resolves, if there is a tendency to expectorate saliva persistently, it indicates cold in the upper stomach; it should be warmed with pills, specifically Lizhong Wan (Regulate the Middle Pill). Li Dongyuan stated: Excessive spitting or spitting white foam indicates cold stagnation above the stomach entrance; Yi Zhi Ren (Alpinia Oxyphylla Fruit) should be added to the prescription.