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Heart pain should be referred to the chapter on "Adult Heart Pain" for reference.

Heart pain accompanied by vomiting clear water indicates worm-induced heart pain; heart pain without vomiting clear water indicates cold-induced heart pain.

[Qian Yiyuan] Lingfan San (Spiritual Alum Powder): Treats infantile heart pain caused by worm bites, where the pain is severe and nearly fatal.
Wulingzhi (Trogopterus Dung, *Excrementum Trogopterori*) (2 qian)
Baifan (Alumen, *Alumen*) (calcined and refined, 0.5 qian)
Grind the above ingredients together into powder. Take 1–2 qian per dose, decoct with one zhong of water until reduced to five fen, and take warm at any time. It is expected that worms will be vomited out.

[Qian Yiyuan] Tongue protrusion: This condition arises from slight heat in the Spleen organ, causing slight tension in the tongue collaterals, leading to intermittent protrusion of the tongue. Treatment should avoid cold-natured herbs and purgative methods. Instead, Xiahuang San (Yellow-Draining Powder) should be administered in small amounts gradually. [Tian states: For patients who are robust and fleshy, Niuhuang San (Calculus Bovis Powder) may be used.] If the child desires to drink water, and the physician mistakenly suspects heat and uses cold herbs to purge, this is incorrect. The desire to drink results from insufficient fluids in the Spleen and Stomach. When combined with a sallow complexion, emaciation, and five-palm heat (heat sensation in the palms, soles, and chest), it constitutes Gan disease (infantile malnutrition syndrome). Herbs such as Huhuanglian (Coptidis Rhizoma, *Rhizoma Coptidis*) should be added. If tongue protrusion occurs due to medication during an unresolved major illness, the prognosis is ominous.

[Tang] Double tongue: A growth resembling a smaller tongue appears attached beneath the main tongue near its root, termed double tongue (Chong She). If located under the tongue, it is called double tongue. If located in the inner cheeks or upper palate, it is called chong e. If located on the gums, it is called chong yin. These conditions can be treated by pricking to release blood.

[Tian] Treatment for double tongue. Apply Huangbai end (Phellodendron Bark, *Cortex Phellodendri*) soaked in Kuzhuli (Bamboo Sap, *Succus Bambusae in Taedia*) onto the tongue. If there is no improvement, apply Zhen Puhuang (True Pollen Typhae, *Pollen Typhae*) subsequently. Recovery usually occurs within three applications. (Use genuine Pollen Typhae, lightly stir-fried, spread on paper to dissipate fire heat, then grind finely. Sprinkle a small amount under the tongue, then gently press with a finger wrapped in cloth moistened with warm water, allowing the medicine to penetrate after pressing.)

[Yao] Treatment for infantile double tongue. Apply Mayaxiao (Natrii Sulfas Crystallized, *Natrii Sulfas*) to the sublingual area three times daily.

[Shi] Treatment for infantile double tongue and wooden tongue. First, rub the oral cavity and both sides of the tongue with fresh well water. Then, burn Zaojiaozhen (Gleditsiae Spina, *Spina Gleditsiae Sinensis*) to ash, add a small amount of Naonzi (Borneolum Syntheticum, *Borneolum*), and use half a zi quantity to sprinkle on the upper and lower surfaces of the tongue. Salivation will occur immediately with effective results.

[Zimu Beilu] Treatment for infantile double tongue. Burn Haihezhu (Cuttlebone, *Os Sepiae*) and grind finely. Mix with Jizihuang (Egg Yolk, *Ovum Gallii*) and apply to the throat and tongue.

[Jianyi Fang] Treatment for infantile double tongue causing extreme suffering. Grind Luafa hui (Ash of Human Hair, *Cinis Capillis Humani*) finely. Apply 0.5 qian under the tongue, using continuously day and night.

[Dan] Double tongue. Boil Sangbaipi (Mori Cortex, *Cortex Mori*) in water, apply the juice to the breasts, and let the infant suck and drink it. Milu records also suggest burning Qianglang (Dung Beetle, *Scarabaeus*) to powder, mixing with saliva, and applying topically.