Library

Master Qi said: When the human tongue protrudes and refuses to retract, it is due to the exuberance of Yang fire. (From *Mi Lu*)

Dou Hanqing said: In cold damage (*Shanghan*), if the tongue protrudes more than one cun and remains unretracted for several days, apply five qian of plum blossom borneol powder to the tongue surface, and it will immediately retract. (From *Quan Shu*)

Zhang Zhongjing said: In cold damage (*Shanghan*), protrusion of the tongue indicates a fatal condition.

If the tongue retracts several cun from the mouth opening, apply borneol powder topically.

When the human tongue protrudes and cannot retract, it is due to the exuberance of Yang fire. After applying borneol locally, administer the following decoction.

Coptidis Rhizoma (Huanglian), Ginseng Radix (Renshen), Paeoniae Radix Alba (Baishao) (each 3 qian); Bupleuri Radix (Chaihu), Acori Tatarinowii Rhizoma (Shichangpu) (each 1 qian).
Decoct in water and take orally; two doses result in cure.

Another prescription: Grind Semen Cannabis (Bimazi) into powder, pack into paper strips, ignite, and fumigate the affected area. If saliva flows from the nostrils, the condition resolves.

Master Qi said: When the human tongue shrinks into the throat and speech becomes impossible, it is due to cold qi congealing in the chest and abdomen. (From *Mi Lu*)

Cheng said: The tongue is the sprout of the Heart. Both Qi deficiency and accumulated heat in the Heart and Spleen can cause tongue shortening; it is not solely caused by cold congealing in the chest and abdomen, so careful differentiation is required.

Miraculous Formula: Treats sudden shrinking of the tongue into the throat with inability to speak, caused by cold qi congealing in the chest and abdomen.
Ginseng Radix (Renshen) (3 qian), Atractylodis Macrocephalae Rhizoma (Baizhu) (5 qian), Cinnamomi Cortex (Rougui), Zingiberis Rhizoma Recens (Ganjiang), Aconiti Lateralis Radix Praeparata (Shufuzi) (each 1 qian).
Decoct in water and take orally; the tongue will naturally extend.

For tongue shortening due to Qi deficiency, decoct Ginseng Radix (Renshen) in water and take.
For tongue shortening due to accumulated heat in the Heart and Spleen, use Coptidis Rhizoma (Huanglian) or Gypsum Fibrosum (Shigao), either singly or combined, decoct in water and take.

The Classics state: The tongue is the sprout of the Heart. It is also stated that the Heart opens into the tongue. When Heart fire is hyperactive and Kidney Yin fails to ascend to restrain it, the tongue protrudes outward. Liver fire assists the flames; since wind governs movement and tremor, and Stomach heat fans the flames, the tongue finds it difficult to remain within the mouth. The tongue moves like a snake licking, extending, retracting, and trembling left, right, up, and down; this is termed "playing tongue" (*Nongshe*). One should clear the fire of the Heart and Stomach, and the Liver wind will subside spontaneously.

Feng Luzhan said: "Playing tongue" results from slight heat in the Spleen organ causing slight tension in the tongue collaterals, leading to frequent protrusion of the tongue. Treatment should avoid excessive use of cooling herbs. Even if the patient desires to drink water, it is due to Spleen deficiency and insufficient body fluids. If "playing tongue" appears prior to the onset of a major illness, the prognosis is ominous.
It is further stated: When the tongue extends long and retracts slowly, it is called "extending tongue" (*Shushe*); when it barely protrudes before retracting, accompanied by dryness, swelling, and roughness of the tongue, it is called "playing tongue" (*Nongshe*).

Luo Qian'an said: Sudden elongation, sudden curling/shrinking, or sudden swelling of the tongue all belong to conditions of exuberant Wind-Heat interfering with nursing and food intake. Yan Shou Dan (Longevity Pill) is appropriate.