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In the *Ling Shu Jing* (Spiritual Pivot), the Yellow Emperor asked: Some people bite their tongues; what qi mechanism causes this? This is due to jue-ni (rebellious counterflow) qi moving upward and lung qi moving in reverse. When shaoyin (Lesser Yin) qi moves upward, it bites the tongue; when shaoyang (Lesser Yang) qi moves upward, it bites the cheek; when yangming (Greater Yang) qi moves upward, it bites the lips. Treatment should target the primary disease.

If the heart pulse (Xin Mai) is hong-da (surging and large), it indicates a tongue disease characterized by stiffness and coating. If the spleen pulse (Pi Mai) is fu-hua (floating and slippery), it indicates aphasia of the tongue.

The root of tongue diseases lies in the fire-heat of the heart and spleen. When the heart and spleen are obstructed, qi and blood fail to circulate properly, leading to tongue pathology. For minor cases, topical application or rubbing with medicines suffices for recovery; for severe cases, one must address the root cause by purging the stagnant fire from the heart and spleen meridians to achieve a cure.

Zhang Hezi treated a woman suffering from mu-she (wooden tongue, where the tongue swells and stiffens like wood), her tongue swollen so much that it filled her mouth. Various medicines failed. He ordered the use of pai-zhen (arranged needles) for bi-stimulation five to seven times. The swelling subsided, and blood flowed out filling a bucket. It took three days for the condition to settle.

Another woman, after childbirth, had her tongue protruding and unable to retract. Zhang Hezi ordered cinnabar powder (Zhusha Mo) to be applied to the tongue. He then instructed her to mimic the posture of giving birth. A female attendant supported her while basins and jars were secretly placed outside the wall to make noise upon falling. Upon hearing the sound, the woman’s tongue retracted.

A man suffered from yin (aphonia/inability to speak). His right guan pulse was floating and slippery, while other pulses were normal. The right guan corresponds to the spleen, whose collaterals connect to the base of the tongue. Having slept drunk in the wind, wind-pathogen invaded the collaterals causing aphonia. He was cured after taking Zhibao Dan (Precious Treasure Pill) dissolved in jing-li (bamboo sap).

*Yi Shuo* (Medical Sayings) records treating a man whose tongue was swollen filling his mouth, unresponsive to various medicines. Applying plum-blossom bingpian (borneol) powder caused it to subside.

Swelling under the tongue protruding like a small tongue is called chong-she (double tongue) or zi-she (child tongue). This is caused by heat obstruction in the upper diaphragm. The best method is bi-stimulation and acupuncture to release blood.

For a swollen, hard tongue unable to produce sound, apply a paste made of baicaoshuang (soot from hundred herbs), salt, and vinegar.

For a white coating on the tongue accompanied by slurred speech, wipe with mint juice, white honey, and ginger slices.

Unceasing bleeding from the shu points on the tongue is called she-nv (tongue hematemesis/hemorrhage). Patients with this condition suffer from extreme heat in the heart.

Sudden tongue swelling that rapidly blocks the throat and causes suffocation is extremely urgent and requires early treatment. The swelling may resemble a pig bladder or be hard as wood/stone. Carefully examine the area under the tongue for worm-like shapes resembling ants or silkworms lying down. If the head appears slightly white, cauterize the head with a red-hot iron nail to dissipate heat. Immediately apply a thick paste of gu-dimei (coal from the bottom of the pot) mixed with vinegar to the affected areas. Alternatively, use asphalt or well water mixed with salt to form a paste. Reapply as needed until it subsides within moments. In severe cases, immediate bloodletting is required. After bloodletting, applying the paste leads to immediate recovery.

Wang Kuang treated a wealthy merchant who, due to fright, extended his tongue and could not retract it. For ten days he could not swallow food, becoming increasingly emaciated. Imperial physicians could not treat him. His family posted a notice in the market offering a thousand gold pieces for a cure. Wang Kuang, whose reputation was not yet established and skills not yet refined, consulted the *Zhen Jing* (Needle Classic) which contained acupuncture methods for this disease. He went to treat him. By needling the base of the tongue and withdrawing the needle, the tongue immediately regained its normal ability to extend and retract.

Another man had a tongue swollen extending beyond the gate of the courtyard. No doctor dared to treat him. A villager said, "I have this medicine." He returned, lit two paper wicks, and used the smoke to fumigate the area, causing the swelling to subside immediately. When asked, he reluctantly explained that a relative in his family had once suffered from this. Someone taught them to dip paper wicks in castor oil and fumigate according to this method, resulting in a cure. He thought it would work for others too. (These two cases are from *Yi Shuo*).

Another man had a tongue swollen filling his mouth, unable to speak. Doctors could not treat him. An old man applied herbal powder to the site. By evening, the condition remained unchanged. Asked about the medicine, it turned out to be pure puhuang (pollen of Typha).