经曰∶南方生热，热生火，火生心，心主舌，在窍为舌。又曰∶心气通于舌，心和则舌能知五味矣。夫舌为
心之苗，胃之根。小儿多生舌病，以心脾之积热也，故有重舌、木舌、弄舌、舌胎等证，宜辨其虚实而治之。
重舌者，心脾有热。盖脾之大络，出于舌下，有热则气血俱盛。附舌根下，忽重生一舌而短小，内服沆瀣
丹，外以针刺去恶血，用蒲黄、黄柏末敷之。
木舌者，心脾积热之气上冲，故令舌肿，
渐渐长大，塞满口中。若不急救，必致害人。内服沆瀣丹，外以针刺去恶血，以碧雪散、竹沥调匀敷之。
弄舌者，脾脏虚热，令舌络紧，时时舔舌，俗人称为蛇丝惊者是也。切勿以寒凉攻下治之，少与泻黄散服
之，不效，四君子汤。或渴欲饮水，面无红赤色，此脾胃津液不足，不可误认为热，宜七味白术散。
面黄肌瘦，五心烦热而弄舌者，此疳证也。须从疳证门参考，宜集圣丸。
大病后精神困倦，饮食少思而弄舌者，凶候。盖气血两虚，精神将脱。速以十全大补汤挽救之。
舌上黑苔，其热已剧，急以薄荷煎汤洗之。如舌转红色者，可治，凉膈散下之；洗不红者，不治。
泄泻后舌上白苔，此津液不深，不能上潮于口，为虚热也。理中汤。
集成沆瀣丹 方见卷一胎疾门。
碧雪散 方见卷四口疮门。
泻黄散 方见卷四口疮门。
七味白术散 方见卷三泄泻门。
集圣丸 方见卷三疳证门。
十全大补汤 方见卷一保产门。
凉膈散 治心脾有热，舌上黑苔。
净连翘（一钱） 黑栀仁（六分） 锦大黄（五分） 薄荷叶（六分） 片黄芩（六分） 芒硝（五分）
生甘草（四分）
竹叶七片，灯芯十茎，水煎，临服加生蜜十匙对服。
The Classics state: The South generates heat, heat generates fire, fire generates the Heart. The Heart governs the tongue, and its orifice is the tongue. It is also stated: Heart Qi connects with the tongue; when Heart Qi is harmonious, the tongue can perceive the five flavors. The tongue is the sprout of the Heart and the root of the Stomach. Children are prone to tongue diseases due to accumulated heat in the Heart and Spleen. Therefore, conditions such as double tongue (Chong She), wooden tongue (Mu She), playing tongue (Nong She), and tongue coating (She Tai) may occur. Treatment should be based on distinguishing between deficiency and excess.
Double tongue (Chong She) is caused by heat in the Heart and Spleen. The large collateral vessels of the Spleen emerge from under the tongue. When heat is present, both Qi and Blood become abundant. A short, small tongue suddenly grows attached beneath the root of the tongue. Internally administer Huangxie Decoction (Huangxie Dan). Externally, puncture with a needle to release bad blood, and apply powder of Poria Cocos (Puhuang) and Phellodendron Bark (Huangbai).
Wooden tongue (Mu She) is caused by the upward rush of accumulated heat in the Heart and Spleen, causing the tongue to swell. It gradually enlarges until it fills the mouth. If not treated urgently, it will inevitably lead to death. Internally administer Huangxie Decoction (Huangxie Dan). Externally, puncture with a needle to release bad blood, and apply Bixue Powder (Bixue San) mixed with Bamboo Sap (Zhuli).
Playing tongue (Nong She) is caused by deficient heat in the Spleen, causing the tongue meridians to tighten, leading to frequent licking of the tongue. This is commonly known as "Snake Silk Convulsion" (Shesi Jing). Do not treat with cold and purgative methods. Administer a small amount of Xiehuang Powder (Xiehuang San). If ineffective, use Sijunzi Decoction (Sijunzi Tang). If there is thirst with desire to drink water, but the face lacks a red hue, this indicates insufficiency of Stomach and Spleen fluids, not excess heat. Use Qiwei Baizhu Powder (Qiwei Baizhu San).
If the face is yellow, muscles are emaciated, there is five-palm heat (Wu Xin Fan Re), and playing tongue occurs, this is Gan Syndrome (Gan Zheng). Refer to the Gan Syndrome chapter for reference. Use Jisheng Pill (Jisheng Wan).
After a severe illness, if there is mental fatigue, poor appetite, and playing tongue, this is an ominous sign. It indicates dual deficiency of Qi and Blood, with Spirit about to collapse. Immediately rescue with Shiquan Dabu Decoction (Shiquan Dabu Tang).
Black coating on the tongue indicates intense heat. Wash the tongue urgently with decoction of Mint (Bohe). If the tongue turns red, it is treatable; purge with Liangge Decoction (Liangge San). If it does not turn red after washing, it is untreatable.
White coating on the tongue after diarrhea indicates that fluids are insufficient and cannot moisten the mouth, constituting deficient heat. Use Lizhong Decoction (Lizhong Tang).
*Notes on Formulas:*
- Huangxie Decoction (Huangxie Dan): See Volume 1, Section on Fetal Diseases.
- Bixue Powder (Bixue San): See Volume 4, Section on Mouth Sores.
- Xiehuang Powder (Xiehuang San): See Volume 4, Section on Mouth Sores.
- Qiwei Baizhu Powder (Qiwei Baizhu San): See Volume 3, Section on Diarrhea.
- Jisheng Pill (Jisheng Wan): See Volume 3, Section on Gan Syndrome.
- Shiquan Dabu Decoction (Shiquan Dabu Tang): See Volume 1, Section on Obstetrics.
*Liangge Decoction (Liangge San)* treats heat in the Heart and Spleen with black coating on the tongue.
Ingredients:
Clean Forsythia Fruit (Lianqiao) - 1 qian
Black Gardenia Seed (Zhiren) - 6 fen
Brocade Rhubarb Root (Dahuang) - 5 fen
Mint Leaf (Bohe Ye) - 6 fen
Scutellaria Root (Huangqin) - 6 fen
Mirabilite (Mangxiao) - 5 fen
Raw Licorice Root (Gancao) - 4 fen
Decoct seven leaves of Bamboo Leaf (Zhuye) and ten stems of Rush Pith (Dengxin) in water. Before administration, add ten spoons of raw honey and mix well.