夫伤寒舌肿胀者。病在三阴也。太阴之脉。连舌本。散舌下。少阴之脉。循喉咙。侠舌
本。厥阴之脉。循喉咙之后。又手少阴心之经。其气通于舌。凡此经络。为风热所乘。随脉
至舌。热气留于血。血气壅。故令舌肿胀。诊其脉数急者。是其候也。
伤寒舌肿者。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。
方
大黄散（出圣惠方）治伤寒心脾热。舌肿。
川大黄（锉碎微炒） 黄连（去须各一两） 黄芩 川升麻 黄药（各三钱） 甘草（半
两生
锉） 上为粗散。每服四钱。水一中盏。入黑豆三十粒。煎至五分。去滓。不计时候。温服。
玄参散（出圣惠方）治伤寒上焦虚。毒热壅塞。喉咽连舌肿痛。
玄参 射干 黄药（各一两） 上为粗散。每服五钱。水二大盏。煎至五分。去滓。不
计
时候。温服。
治伤寒咽喉闭塞。舌根肿痛方。（出圣惠方）
苍耳根（两半锉） 甘草（三钱生锉） 上为粗散。每服五钱。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。（出圣惠方）
黄药（一两） 甘草（三钱生锉） 上为粗散。每服二钱。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。（出圣惠方）
羚羊角屑 黄柏（涂蜜炙微赤锉） 甘草（生锉） 川大黄（各半两锉碎微炒） 玄参
（三钱）
上为细末。每服不计时候。煎竹叶热水调下一钱。
铅霜散 治伤寒心脾壅热。舌肿。多吐痰涎。
铅霜（细研） 牛黄（各一分细研） 麦门冬（一两去心焙） 白菊花 甘草（各半两
微赤锉）
黄连（二分去须） 上为细末。入牛黄、铅霜。同研令均。不计时候。以淡竹沥二合。调下
二
钱。如无竹沥。犀角温水调下亦得。
龙胆散 治伤寒心脾热。多干舌肿。口内生疮。
龙胆（去芦头） 麦门冬（去心焙） 知母 人参（去芦头） 柴胡（去苗各半两） 甘
草（一
分锉）上为细末。不计时候。磨犀角。温水调下二钱。
升麻散 治伤寒喉中痛。舌根肿满。不能转动。此谓心脾热毒。宜先用针当舌中针
入五分
川升麻 车前子 川大黄（锉碎微炒） 甘草（生用各半两） 生干地黄（三两） 川
朴硝
（三分） 上为粗散。每服五钱。以水一大盏。煎至五分。去滓。不计时候。温服。
升麻汤 治伤寒热病。咽喉壅塞。连舌根痛。及干呕头痛。不下食。
升麻 麦门冬（去心焙） 石膏（碎各一两） 木通（锉） 黄柏（去粗皮锉） 青竹
茹（各半
两） 玄参 前胡（去芦头各三分） 朴硝（三两） 上粗捣筛。每服五钱。用水一盏。煎
至八
分。去滓。食后温服。日再。
干地黄汤 治伤寒心脾虚热。喉中有疮。连舌根肿。涕唾。不下食。
生干地黄（焙三两） 青竹茹 鸡苏 赤茯苓（去黑皮各一两） 麦门冬（去心焙一两
半）
玄参（五分） 上粗捣筛。每服五钱。水一盏半。煎至八分。去滓。食后温服。日再。
犀角汤 治伤寒脾肺虚热。毒瓦斯壅塞。咽喉连舌根。肿满疼痛。
犀角（镑屑） 当归（切焙） 白芷（各一两） 升麻 甘草（炙锉） 射干 杏仁（汤
浸去皮
尖双仁炒黄各半两） 上粗捣筛。每服三钱。水一盏。煎至七分。去滓。食后温服。
马蔺根汤 治伤寒咽喉闭塞。连舌肿疼。小便赤沥。
马蔺根 升麻（各一两） 瞿麦 射干（各三分） 犀角屑 木通（锉各半两） 玄参
（一两）
上
木通汤 治伤寒热病。咽喉闭塞。连舌根肿疼。热毒瓦斯聚于心胸。
木通（锉） 络石（碎） 朴硝（各一两） 升麻 犀角屑 山栀子仁 青竹茹（各半
两） 射
干（半分） 桔梗（炒） 芍药 玄参（各三分） 上粗捣。每服三钱。水一大盏。煎至七
分。去
滓
治伤寒上焦虚热。毒瓦斯壅塞。咽喉连舌肿痛方。
玄参 射干 当归（切培各一两） 上捣罗为散。每服三钱。水一大盏。煎至半盏。不
去
滓。食后温服。日再服。
治伤寒舌肿。口内生疮。此是心脾积热。上冲所致。汤方。
大青 升麻 大黄（锉炒各半两） 黄连（去须一分） 上粗捣筛。每服三钱。水一大
盏。
煎至
治伤寒舌出寸长。连日不收。名应手方。
上用梅花片脑为末。掺舌上。随手而收。用五钱重。
地黄煎 治伤寒心脾有热。舌本肿痛。\x
In cases of Shanghan (Cold Damage) presenting with tongue swelling, the pathology resides in the Three Yin meridians. The Foot-Taiyin Spleen meridian connects to the root of the tongue and scatters beneath it; the Foot-Shaoyin Kidney meridian follows the throat and flanks the root of the tongue; the Foot-Jueyin Liver meridian follows the posterior aspect of the throat. Furthermore, the Qi of the Hand-Shaoyin Heart meridian communicates with the tongue. When these meridians are invaded by Wind-Heat pathogenic factors, the pathogens travel along the meridians to the tongue. Heat qi lingers in the blood vessels, causing Qi and Blood stagnation, which results in tongue swelling. If the pulse is rapid and urgent, this is a sign of this condition.
Tongue swelling in Shanghan is caused by Heat-Toxin damaging the Heart and Spleen. The Heart opens into the tongue and governs the Blood; if Heart Blood is deficient and invaded by Heat, or if the large collateral of the Spleen emerging beneath the tongue is affected, Heat in the Heart and Spleen will cause tongue swelling.
Formulas:
Dahuang San (Cassiae Semen Decoction variant / Rhubarb Powder) [from *Taiping Shenghui Fang*]: Treats Heart and Spleen Heat due to Shanghan, manifesting as tongue swelling.
Ingredients: Chuan Dahuang (Rhei Radix et Rhizoma, crushed and lightly stir-fried), Huanglian (Coptidis Rhizoma, stamens removed, each 1 liang), Huangqin (Scutellariae Radix), Chuan Shengma (Bupleuri Radix), Huangyaozi (Dioscoreae Hypoglaucae Rhizoma, each 3 qian), Gancao (Glycyrrhizae Radix et Rhizoma, half liang, raw, crushed).
Preparation and Administration: Grind the above ingredients into a coarse powder. Take 4 qian per dose, add one zhong of water and 30 black beans, decoct until five fen remains, strain, and take warm at any time.
Xuanshen San (Scrophulariae Radix Powder) [from *Taiping Shenghui Fang*]: Treats deficiency of the Upper Jiao in Shanghan, with Toxic-Heat obstruction causing pain and swelling of the throat and tongue.
Ingredients: Xuanshen (Scrophulariae Radix), Shegan (Belamcandae Rhizoma), Huangyaozi (Dioscoreae Hypoglaucae Rhizoma, each 1 liang).
Preparation and Administration: Grind the above ingredients into a coarse powder. Take 5 qian per dose, add two da zhongs of water, decoct until five fen remains, strain, and take warm at any time.
Formula for treating Shanghan with throat obstruction and pain/swelling of the tongue root [from *Taiping Shenghui Fang*]:
Ingredients: Cang'er Gen (Xanthii Fructus Root, half liang, crushed), Gancao (Glycyrrhizae Radix et Rhizoma, 3 qian, raw, crushed).
Preparation and Administration: Grind the above ingredients into a coarse powder. Take 5 qian per dose, add one da zhang of water, decoct until five fen remains, strain, and take warm at any time.
Formula for treating Shanghan with Empty-Heat in Heart and Spleen and tongue swelling [from *Taiping Shenghui Fang*]:
Ingredients: Huangyaozi (Dioscoreae Hypoglaucae Rhizoma, 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 3 qian, raw, crushed).
Preparation and Administration: Grind the above ingredients into a coarse powder. Take 2 qian per dose, add one zhong of water, decoct until five fen remains, strain, and take warm at any time.
Formula suitable for treating Shanghan with Heart and Spleen Heat, mouth ulcers, tongue swelling, and throat pain [from *Taiping Shenghui Fang*]:
Ingredients: Lingyangjiao Xie (Saigae Tataricae Cornu, shaved), Huangbai (Phellodendri Cortex, honey-fried until slightly red and crushed), Gancao (Glycyrrhizae Radix et Rhizoma, raw, crushed), Chuan Dahuang (Rhei Radix et Rhizoma, each half liang, crushed and lightly stir-fried), Xuanshen (Scrophulariae Radix, 3 qian).
Preparation and Administration: Grind the above ingredients into a fine powder. Take 1 qian per dose at any time, mixed with hot water decocted from Bamboo Leaves (Zhuye).
Qianshuang San (Lead Frost Powder): Treats Shanghan with obstructive Heat in Heart and Spleen, tongue swelling, and excessive expectoration of phlegm-saliva.
Ingredients: Qianshuang (Plumbum Oxydum, finely ground), Niuhuang (Bovis Calculus, finely ground, each 1 fen), Maimendong (Ophiopogonis Radix, heart removed and baked, 1 liang), Baijuhua (Chrysanthemi Flos), Gancao (Glycyrrhizae Radix et Rhizoma, each half liang, slightly red and crushed), Huanglian (Coptidis Rhizoma, stamens removed, 2 fen).
Preparation and Administration: Grind the above ingredients into a fine powder, mix evenly with Niuhuang and Qianshuang. Take 2 qian per dose at any time, mixed with 2 he of Light Bamboo Sap (Dan Zhuli). If Bamboo Sap is unavailable, mixing with warm water and Xijiao (Rhinocerotis Cornu) is also acceptable.
Longdan San (Gentian Root Powder): Treats Shanghan with Heart and Spleen Heat, dryness of the tongue, tongue swelling, and oral ulcers.
Ingredients: Longdan (Gentianae Radix, rhizome removed), Maimendong (Ophiopogonis Radix, heart removed and baked), Zhimu (Anemarrhenae Rhizoma), Renshen (Ginseng Radix, rhizome removed), Chaihu (Bupleuri Radix, sprouts removed, each half liang), Gancao (Glycyrrhizae Radix et Rhizoma, 1 fen, crushed).
Preparation and Administration: Grind the above ingredients into a fine powder. Take 2 qian per dose at any time, mixed with scraped Xijiao (Rhinocerotis Cornu) and warm water.
Shengma San (Bupleuri Radix Powder): Treats Shanghan with throat pain, fullness and swelling of the tongue root, and inability to move the tongue. This is termed Heart and Spleen Heat-Toxin. It is advisable to first prick the center of the tongue with a needle to a depth of 5 fen.
Ingredients: Chuan Shengma (Bupleuri Radix), Cheqianzi (Plantaginis Semen), Chuan Dahuang (Rhei Radix et Rhizoma, crushed and lightly stir-fried), Gancao (Glycyrrhizae Radix et Rhizoma, raw, each half liang), Sheng Gan Dihuang (Rehmanniae Radix, fresh, 3 liang), Chuan Poxiao (Natrii Sulfas, 3 fen).
Preparation and Administration: Grind the above ingredients into a coarse powder. Take 5 qian per dose, add one da zhang of water, decoct until five fen remains, strain, and take warm at any time.
Shengma Tang (Bupleuri Decoction): Treats Shanghan Heat Disease with throat obstruction, pain extending to the tongue root, dry retching, headache, and inability to eat.
Ingredients: Shengma (Bupleuri Radix), Maimendong (Ophiopogonis Radix, heart removed and baked), Shigao (Gypsum Fibrosum, crushed, each 1 liang), Mutong (Akebiae Caulis), Huangbai (Phellodendri Cortex, rough bark removed and crushed), Qing Zhuru (Bambusa Textilis Caulis Internodes, each half liang), Xuanshen (Scrophulariae Radix), Qianhu (Peucedani Radix, rhizome removed, each 3 fen), Poxiao (Natrii Sulfas, 3 liang).
Preparation and Administration: Coarsely crush and sieve the above ingredients. Take 5 qian per dose, add one zhang of water, decoct until eight fen remains, strain, and take warm after meals, twice daily.
Gan Dihuang Tang (Rehmannia Decoction): Treats Shanghan with Empty-Heat in Heart and Spleen, sores in the throat, swelling extending to the tongue root, runny nose and saliva, and inability to eat.
Ingredients: Sheng Gan Dihuang (Rehmanniae Radix, baked, 3 liang), Qing Zhuru (Bambusa Textilis Caulis Internodes), Jisu (Elsholtziae Herba), Chi Fuling (Poria with Red Skin, black skin removed, each 1 liang), Maimendong (Ophiopogonis Radix, heart removed and baked, 1.5 liang), Xuanshen (Scrophulariae Radix, 5 fen).
Preparation and Administration: Coarsely crush and sieve the above ingredients. Take 5 qian per dose, add one and a half zhangs of water, decoct until eight fen remains, strain, and take warm after meals, twice daily.
Xijiao Tang (Rhinoceros Horn Decoction): Treats Shanghan with Empty-Heat in Spleen and Lung, accumulation of Toxic-War, and swelling/pain of the throat extending to the tongue root.
Ingredients: Xijiao (Rhinocerotis Cornu, shaved), Danggui (Angelicae Sinensis Radix, sliced and baked), Baizhi (Angelicae Dahuricae Radix, each 1 liang), Shengma (Bupleuri Radix), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried and crushed), Shegan (Belamcandae Rhizoma), Xingren (Pruni Semen, soaked in water, skin and tips removed, double-kernel, fried yellow, each half liang).
Preparation and Administration: Coarsely crush and sieve the above ingredients. Take 3 qian per dose, add one zhang of water, decoct until seven fen remains, strain, and take warm after meals.
Malin Gen Tang (Iris Root Decoction): Treats Shanghan with throat obstruction, swelling and pain extending to the tongue, and dark scanty urination.
Ingredients: Malin Gen (Iridis Tectoriae Radix), Shengma (Bupleuri Radix, each 1 liang), Qumai (Dianthi Herba), Shegan (Belamcandae Rhizoma, each 3 fen), Xijiao Xie (Rhinocerotis Cornu, shaved), Mutong (Akebiae Caulis, crushed, each half liang), Xuanshen (Scrophulariae Radix, 1 liang).
[Note: Preparation instructions missing in source text immediately following ingredients.]
Mutong Tang (Akebia Decoction): Treats Shanghan Heat Disease with throat obstruction, swelling and pain extending to the tongue root, and accumulation of Heat-Toxic-War in the Heart and Chest.
Ingredients: Mutong (Akebiae Caulis, crushed), Luoshi (Trachelospermi Caulis, crushed), Poxiao (Natrii Sulfas, each 1 liang), Shengma (Bupleuri Radix), Xijiao Xie (Rhinocerotis Cornu, shaved), Shanzhizi Ren (Gardeniae Semen, each half liang), Qing Zhuru (Bambusa Textilis Caulis Internodes), Shegan (Belamcandae Rhizoma, half fen), Jiegeng (Platycodonis Radix, fried), Shaoyao (Paeoniae Radix), Xuanshen (Scrophulariae Radix, each 3 fen).
Preparation and Administration: Coarsely crush the above ingredients. Take 3 qian per dose, add one da zhang of water, decoct until seven fen remains, strain... [Text cuts off].
Formula for treating Shanghan with Empty-Heat in Upper Jiao, Toxic-War obstruction, and pain/swelling of throat and tongue:
Ingredients: Xuanshen (Scrophulariae Radix), Shegan (Belamcandae Rhizoma), Danggui (Angelicae Sinensis Radix, sliced and baked, each 1 liang).
Preparation and Administration: Crush and sieve into a powder. Take 3 qian per dose, add one da zhang of water, decoct until half a zhang remains, do not strain, take warm after meals, twice daily.
Decoction for treating Shanghan tongue swelling and oral ulcers, caused by accumulated Heat in Heart and Spleen rushing upward:
Ingredients: Daqing (Isatidis Folium), Shengma (Bupleuri Radix), Dahuang (Rhei Radix et Rhizoma, crushed and fried, each half liang), Huanglian (Coptidis Rhizoma, stamens removed, 1 fen).
Preparation and Administration: Coarsely crush and sieve. Take 3 qian per dose, add one da zhang of water, decoct... [Text cuts off].
Formula named Ying Shou Fang (Responsive Hand Formula) for treating Shanghan where the tongue protrudes an inch long and cannot retract for days:
Usage: Use Meihua Pian Nao (Camphor) ground into powder, sprinkle on the tongue. The tongue will retract immediately. Dosage: 5 qian.
Dihuang Jian (Rehmannia Paste): Treats Shanghan with Heat in Heart and Spleen, causing pain and swelling of the tongue root.