夫伤寒舌肿者。是热毒伤于心脾也。心候于舌。主于血。血虚为热所乘。又脾之大络出
于舌下。若心脾有热。则令舌肿也。
治伤寒心脾热。舌肿。宜服大黄散方。
川大黄（一两锉碎微炒） 黄连（一两去须） 黄芩（三分） 川升麻（三分） 黄药
（三分）
甘草（半两生锉）
上件药。捣筛为末。每服四钱。以水一中盏。入黑豆三十粒。煎至五分。去滓。不计时
候温服。
治伤寒。上焦虚。毒瓦斯热壅塞。咽喉连舌肿痛。宜服玄参散方。
玄参（一两） 射干（一两） 黄药（一两）
上件药。捣筛为末。每服五钱。以水一大盏。煎至五分。去滓。不计时候温服。
治伤寒。咽喉闭塞。舌根肿痛方。
苍耳根（一两半锉） 甘草（三分生锉）
上件药。捣筛为散。每服五钱。以水一大盏。煎至五分。去滓。不计时候温服。
治伤寒。心脾虚热舌肿方。
黄柏（一两） 甘草（三分生锉）
上件药。捣细罗为散。每服二钱。以水一中盏。煎至五分。去滓。不计时候温服。
治伤寒。心脾热。口疮舌肿。咽喉疼痛。宜服此方。
羚羊角屑（半两） 玄参（三分） 黄柏（半两涂蜜微炙锉） 甘草（半两生锉） 川
大黄（半
两锉碎微炒）
上件药。捣细罗为散。每服。不计时候。煎竹叶熟水调下二钱。
治伤寒。心脾壅热。舌肿。多吐痰涎。宜服铅霜散方。
铅霜（一分细研） 牛黄（一分细研） 麦门冬（一两去心焙） 白菊花（半两） 黄
连（三分
去须） 甘草（半两炙微赤锉）
上件药。捣细罗为散。入牛黄铅霜。同研令匀。不计时候。以淡竹沥二合。调下二钱。
如无竹沥。磨犀角。温水调下亦得。
治伤寒心脾热。唇干舌肿。口内生疮。宜服龙胆散方。
龙胆（半两去芦头） 麦门冬（半两去心焙） 知母（半两） 人参（半两去芦头） 甘
草（一
分生锉） 柴胡（半两去苗）
上件药。捣细罗为散。不计时候。磨犀角温水调下二钱。
\x治伤寒喉中痛。舌根肿满。不能转动。此为心脾热毒。宜先用针。当舌中针入五分。
出
川升麻（半两） 车前子（半两） 川大黄（半两锉碎微炒） 甘草（半两生用） 生
干地黄（
三两） 川朴硝（三分）
上件药。捣筛为散。每服五钱。以水一大盏。煎至五分。去滓。不计时候温服。
In cases of Shanghan (Cold Damage) presenting with tongue swelling, the etiology is heat-toxin damaging the Heart and Spleen. The Heart opens into the tongue and governs Blood; when Heart Blood is deficient, Heat pathogens invade. Furthermore, the great collateral of the Spleen emerges from beneath the tongue. If there is Heat in the Heart and Spleen, it results in tongue swelling.
For Shanghan-induced Heart and Spleen Heat manifesting as tongue swelling, Da Huang San (Rhubarb Powder) is indicated.
Ingredients: Chuan Da Huang (Rhei Radix et Rhizoma, 1 liang, crushed and lightly stir-fried), Huang Lian (Coptidis Rhizoma, 1 liang, whiskers removed), Huang Qin (Scutellariae Radix, 3 qian), Chuan Sheng Ma (Bupleuri Radix, 3 qian), Huang Yao (likely referring to a specific local herb or variant, kept as Huang Yao, 3 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 0.5 liang, raw and crushed).
Preparation and Administration: Crush the above ingredients and sieve into powder. Take 4 qian per dose. Add 30 black beans to one zhong of water, decoct until only 0.5 zhong remains, strain, and take warm at any time.
For Shanghan with deficiency of the Upper Jiao, where toxic heat qi is congested and obstructed, causing pain and swelling of the throat and tongue, Xuan Shen San (Scrophulariae Radix Powder) is indicated.
Ingredients: Xuan Shen (Scrophulariae Radix, 1 liang), She Ye (Belamcandae Rhizoma, 1 liang), Huang Yao (Huang Yao, 1 liang).
Preparation and Administration: Crush the above ingredients and sieve into powder. Take 5 qian per dose. Add one da of water, decoct until 0.5 da remains, strain, and take warm at any time.
For Shanghan causing throat obstruction and pain/swelling of the tongue root:
Ingredients: Cang Er Gen (Xanthii Fructus Caulis et Folium root, 1.5 liang, crushed), Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 qian, raw and crushed).
Preparation and Administration: Crush the above ingredients and sieve into powder. Take 5 qian per dose. Add one da of water, decoct until 0.5 da remains, strain, and take warm at any time.
For Shanghan-induced deficiency-Heat in the Heart and Spleen manifesting as tongue swelling:
Ingredients: Huang Bo (Phellodendri Cortex, 1 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 qian, raw and crushed).
Preparation and Administration: Pulverize the above ingredients finely and sieve into powder. Take 2 qian per dose. Add one zhong of water, decoct until 0.5 zhong remains, strain, and take warm at any time.
For Shanghan-induced Heart and Spleen excess-Heat manifesting as mouth ulcers, tongue swelling, and sore throat:
Ingredients: Ling Yang Jiao (Saiga Tataricae Cornu, 0.5 liang), Xuan Shen (Scrophulariae Radix, 3 qian), Huang Bo (Phellodendri Cortex, 0.5 liang, coated with honey, lightly roasted, and crushed), Gan Cao (Glycyrrhizae Radix et Rhizoma, 0.5 liang, raw and crushed), Chuan Da Huang (Rhei Radix et Rhizoma, 0.5 liang, crushed and lightly stir-fried).
Preparation and Administration: Pulverize the above ingredients finely and sieve into powder. At any time, mix 2 qian with hot water prepared by boiling bamboo leaves, and ingest.
For Shanghan-induced congestion and excess-Heat in the Heart and Spleen manifesting as tongue swelling and excessive expectoration of phlegm-saliva, Qian Shuang San (Lead Frost Powder) is indicated.
Ingredients: Qian Shuang (Plumbum Carbonicum, 1 fen, finely ground), Niu Huang (Bovis Calculus, 1 fen, finely ground), Mai Men Dong (Ophiopogonis Tuber, 1 liang, heart removed and dried), Bai Ju Hua (Chrysanthemi Flos, 0.5 liang), Huang Lian (Coptidis Rhizoma, 3 qian, whiskers removed), Gan Cao (Glycyrrhizae Radix et Rhizoma, 0.5 liang, honey-fried until slightly red and crushed).
Preparation and Administration: Pulverize the base ingredients finely and sieve into powder. Mix in the Niu Huang and Qian Shuang, grinding uniformly. At any time, mix 2 qian with 2 he of Dan Zhu Li (Bambusae Sap), and ingest. If Dan Zhu Li is unavailable, Xi Jiao (Rhinocerotis Cornu) can be ground and mixed with warm water for ingestion.
For Shanghan-induced Heart and Spleen Heat manifesting as dry lips, tongue swelling, and oral ulcers, Long Dan San (Gentianae Radix Powder) is indicated.
Ingredients: Long Dan (Gentianae Radix, 0.5 liang, rhizome removed), Mai Men Dong (Ophiopogonis Tuber, 0.5 liang, heart removed and dried), Zhi Mu (Anemarrhenae Rhizoma, 0.5 liang), Ren Shen (Ginseng Radix et Rhizoma, 0.5 liang, rhizome removed), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 fen, raw and crushed), Chai Hu (Bupleuri Radix, 0.5 liang, crown removed).
Preparation and Administration: Pulverize the above ingredients finely and sieve into powder. At any time, mix 2 qian with Xi Jiao (Rhinocerotis Cornu) powder prepared with warm water, and ingest.
For Shanghan causing throat pain, swelling and fullness of the tongue root, and immobility, this is attributed to Heart and Spleen heat-toxin. Initially, acupuncture should be applied: insert the needle 5 fen deep into the center of the tongue. Subsequently, administer the following formula:
Ingredients: Chuan Sheng Ma (Bupleuri Radix, 0.5 liang), Che Qian Zi (Plantaginis Semen, 0.5 liang), Chuan Da Huang (Rhei Radix et Rhizoma, 0.5 liang, crushed and lightly stir-fried), Gan Cao (Glycyrrhizae Radix et Rhizoma, 0.5 liang, raw), Sheng Di Huang (Rehmanniae Radix, 3 liang), Chuan Po Xiao (Natrii Sulfas, 3 qian).
Preparation and Administration: Crush the above ingredients and sieve into powder. Take 5 qian per dose. Add one da of water, decoct until 0.5 da remains, strain, and take warm at any time.