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[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)