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(Attached: Scrofula and Wind Sores)
Tongue Gan (Ulcer of the Tongue) is formed by toxic fire in the Heart and Spleen. It resembles a bean or a mushroom, presenting with pain, ulceration, and redness. As it gradually progresses to resemble a blooming lotus, it makes eating difficult. Prolonged ulceration eventually transforms into Scrofula (Lymphatic Tuberculosis) and Wind Sores.

[Note] This condition is caused by toxic fire in the Heart and Spleen. The prognosis is dire. Initially, it appears like a bean, then like a mushroom, with a large head and small stalk, also known as Tongue Mushroom (Glossitis fungoides). It presents with pain, redness, ulceration, and loss of skin integrity. Symptoms are lighter in the morning and heavier in the evening. Beiting Dan (Northern Court Powder) should be applied immediately to the lesion for natural resolution and cure. If neglected or improperly treated, swelling may protrude resembling a blooming lotus, or take the shape of a rooster's comb. The tongue body becomes short and retracted, unable to extend, hindering speech and swallowing. Foul-smelling saliva is frequently discharged. Additionally, if anger rises upward, sudden rupture may occur with uncontrollable bleeding. Over time, this spreads to the neck and mandible, where lumps form like tubercles—hard, painful, with normal skin color but a slightly soft apex that is dark red and woody. After rupture, foul-smelling fluid is discharged; the tissue rots like cotton. Although ulcerated, hardness, pain, and swelling persist without receding, termed "Cotton-like Ulceration" (Mian Kui). In severe cases, it penetrates through the tongue and cheek, causing leakage of fluids when drinking, hence also named Scrofula Wind Sore. Generally, the root of the tongue belongs to the Heart, and the sides belong to the Spleen. Mental agitation generates Fire, while excessive worry injures the Spleen leading to Qi stagnation. Severe stagnation results in this disease. Externally, its presentation closely resembles Throat Wind (Hou Feng), but in Throat Wind, the throat is often swollen preventing swallowing; here, the throat is not swollen, allowing liquids to pass, and appetite remains. However, due to the tongue's inability to move, hard food cannot be processed effectively, leading to insufficient intake, empty stomach, exacerbation of deficiency syndromes, and gradual decline. At onset, Daochi Tang (Drain the Heart Decoction) with Huanglian (Coptis Rhizome) is indicated. For deficiency patterns, Guipi Tang (Restore the Spleen Decoction) is used. For severe heat, Qingliang Ganlu Yin (Cooling Sweet Dew Drink) combined with Guipi Tang is prescribed. For loose stools, Guishao Yigong Tang (Guishao Extraordinary Efficacy Decoction) is suitable. For submandibular nodules at onset, Jindiluo (Radix Speranskiae) ground thickly with vinegar should be applied externally. After ulceration, Shuicheng Gao (Water-Clarified Ointment) should be applied. Although many treatments have existed since ancient times, this condition is almost invariably fatal; even with medication, survival is merely prolonged temporarily.

Qingxi Secretly Transmitted Beiting Dan
Fan Zhusha (Parrot Sand/Red Lead variant), Renzhongbai (Human Tooth Ash) (each 0.5 fen); Wasang Qingtai (Green Moss on Roof Tiles), Wasong (Tile Pine), Tang Jishi (Chicken Manure from Wet Places) (each 1 qian).
Use two silver jars. Place the herbs inside, seal the mouths tightly together, and seal the exterior with salt mud. Heat over charcoal fire until red hot. Continue for the duration of three incense sticks. Allow to cool, open the jar, remove the medicine, add Shexiang (Musk) and Bingpian (Borneol) (each 1 fen), and grind into fine powder. Use a porcelain needle to puncture the Tongue Mushroom, apply a small amount of the powder, and cover with Huangpu (Polygoni Multiflori Caulis).

[Formula Verse] Beiting Dan treats Tongue Mushroom growth,
With Tile Pine, Chicken Droppings, and Human Ash.
Roof Moss and Red Lead powder,
Sealed in jar, fired with Musk and Borneol added.

Guishao Yigong Tang
Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried with soil), Guang Chenpi (Citri Reticulatae Pericarpium), Baishao (Paeoniae Radix Alba, stir-fried with wine), Danggui (Angelicae Sinensis Radix, body portion) (each 1 qian), Baifuling (Poria), Gancao (Licorice Root, honey-fried) (0.5 fen).
Dengxin (Junci Medullae) 50 cun, decocted in water, taken on an empty stomach.

[Formula Verse] Guishao Yigong supports Spleen Qi,
Strengthens Stomach and stops diarrhea.
Si Jun Zi plus Guishao and Chenpi,
With Dengxin as guide, it is a good remedy.

Shuicheng Gao
Zhusha (Cinnabar, water-triturated, 2 qian), Baiji (Bletillae Rhizoma), Bailian (Pancracii Bulbus), Wubeizi (Galla Chinensis), Yujin (Curcumae Radix) (each 1 liang), Xionghuang (Realgar), Ruxiang (Olibanum) (each 5 qian).
Grind all into fine powder. Mix thickly with Rice Vinegar. Apply on thick paper as a plaster.

[Formula Verse] Shuicheng Gao applied to ulcerated nodules,
Water-triturated Cinnabar two qian.
Baiji, Bailian, Yujin, Realgar, and Frankincense,
Ground together with Wubeizi, spread with vinegar.

Daochi Tang (See Mouth Section: Oral Thrush)
Guipi Tang (See Breast Section: Breast Nodules)
Qingliang Ganlu Yin (See Lip Section: Callous Lip)