舌为心苗，肾阴不足，心火肝阳上升，发为舌菌。舌尖肉翻如豆，内热呛咳，头眩，心神
不安，肺肾亦亏。当滋水制阳，兼清肺肾。
鲜生地 川贝 桔梗 元参 蒲黄 连翘 沙参 麦冬 丹皮 茯神 川石斛 藕
牙菌落而复生，肝阳火郁不解，幸软而不坚，可无足虑。惟营血素亏，肝阳化风，左半头
痛，脾土又弱，腹痛便溏，右脉较起，脾肾渐有充旺之机。肝气虽强，水足而木自柔和，虚阳
自不上潜。仍从脾肾进治。
潞党参 白术 归身 白芍 枸杞子 杜仲 炙甘草 破故纸 黄 广皮 煨姜 红枣
肝火上升致发牙岩，内外穿溃，肉翻峥 ，高年得此恶候，极难调治。姑拟养阴清肝胃积热。
羚羊角 大贝 甘草 元参 连翘 细生地 丹皮 花粉 石斛 麦冬 芦根
脉神较起，惟肉翻峥 ，左腮上 出血数次，火郁阴伤。当养阴清肝。
生地 西洋参 玉露霜 川石斛 白芍 南沙参 左牡蛎 黄柏 蒲黄 怀山药 山萸肉 黑元参 坎板 人中黄
胃火上升，牙岩溃腐，肉翻且坚，难治之症。勉立一方。
羚羊角 花粉 连翘 大贝 鲜生地 麦冬 甘草 元参 桔梗 生石膏
此方服四剂后痛定肉平，颇效。复诊，加黄柏、芦梗。
心脾之火夹痰上升，舌岩坚肿，破碎，饮咽不能，症非轻浅。拟清火化痰。
麦冬 粉蛤 海藻 大贝 元参 僵蚕 桔梗 橘红 生甘草 连翘 蒲黄 地栗 竹茹
吹青阳柳华散，加琥珀、橄榄灰、蒲黄、冰片，已渐软，然未可恃，原方加羚羊片、丹皮。
The tongue is the sprout of the Heart. When Kidney Yin is insufficient, Heart Fire and Liver Yang ascend, manifesting as Shejun (Tongue Tumor). The tip of the tongue shows fleshy eversion resembling a bean, accompanied by internal heat causing choking cough, dizziness, and restlessness of the Shen (Spirit), indicating deficiency in both the Lung and Kidney. Treatment should nourish Water to control Yang, while simultaneously clearing Heat from the Lung and Kidney.
Prescription: Fresh Shengdi Huang (Rehmanniae Radix Recens), Chuan Bei Mu (Fritillariae Bulbus), Jie Geng (Platycodonis Radix), Yuan Shen (Scrophulariae Radix), Pu Huang (Typhonii Pollen), Lian Qiao (Forsythiae Fructus), Sha Shen (Glehniae Radix or Adenophorae Radix), Mai Dong (Ophiopogonis Radix), Dan Pi (Moutan Cortex), Fu Shen (Poria with Hostwood), Chuan Shi Hu (Dendrobii Caulis), Ou (Nelumbinis Rhizoma).
Yajun (Gum Tumor) recurs after falling off, indicating that Liver Yang and Stagnant Fire remain unresolved. Fortunately, the lesion is soft and not hard, so there is little cause for concern. However, Ying Blood (Nutritive Blood) has been chronically deficient, and Liver Yang transforming into Wind causes pain on the left side of the head. Spleen Earth is also weak, resulting in abdominal pain and loose stools. The Right Pulse is stronger than before, suggesting a trend toward recovery in Spleen and Kidney functions. Although Liver Qi is strong, sufficient Water ensures Wood remains gentle, preventing Deficient Yang from floating upward. Treatment continues to focus on the Spleen and Kidney.
Prescription: Lu Dang Shen (Codonopsis Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Gui Shen (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Gou Qi Zi (Lycii Fructus), Du Zhong (Eucommiae Cortex), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma), Po Gu Zhi (Psoraleae Fructus), Huang Qi (Astragali Radix), Guang Chen Pi (Citri Reticulatae Pericarpium), Wei Jiang (Prepared Zingiberis Rhizoma), Hong Zao (Jujubae Fructus).
Liver Fire ascending causes Yayan (Gum Cancer), with internal and external ulceration and rugged, elevated fleshy eversion. For an elderly patient, this is a severe condition extremely difficult to treat. Tentatively prescribe a formula to nourish Yin and clear accumulated Heat from the Liver and Stomach.
Prescription: Ling Yang Jiao (Capricornu Saigae), Da Bei Mu (Fritillariae Thunbergii Bulbus), Gan Cao (Glycyrrhizae Radix et Rhizoma), Yuan Shen (Scrophulariae Radix), Lian Qiao (Forsythiae Fructus), Xi Sheng Di Huang (Rehmanniae Radix), Dan Pi (Moutan Cortex), Hua Fen (Trichosanthis Radix), Shi Hu (Dendrobii Caulis), Mai Dong (Ophiopogonis Radix), Lu Gen (Phragmitis Rhizoma).
The pulse spirit has improved, but the flesh remains rugged and elevated, with bleeding occurring several times on the left cheek. This indicates Fire stagnation injuring Yin. Treatment should nourish Yin and clear Liver Fire.
Prescription: Sheng Di Huang (Rehmanniae Radix), Xi Yang Shen (Panacis Quinquefolii Radix), Yu Lu Shuang (a type of herbal preparation), Chuan Shi Hu (Dendrobii Caulis), Bai Shao (Paeoniae Radix Alba), Nan Sha Shen (Glehniae Radix), Zuo Mu Li (Ostreae Concha), Huang Bo (Phellodendri Cortex), Pu Huang (Typhonii Pollen), Huai Shan Yao (Dioscoreae Rhizoma), Shan Yu Rou (Corni Fructus), Hei Yuan Shen (Scrophulariae Radix processed with charcoal), Kan Ban (a specific mineral/herb), Ren Zhong Huang (Human Waste Ash).
Stomach Fire ascending leads to ulceration and putrefaction of Yayan, with fleshy eversion that is hard; this is a difficult-to-treat condition. A prescription is tentatively formulated.
Prescription: Ling Yang Jiao (Capricornu Saigae), Hua Fen (Trichosanthis Radix), Lian Qiao (Forsythiae Fructus), Da Bei Mu (Fritillariae Thunbergii Bulbus), Xian Sheng Di Huang (Fresh Rehmanniae Radix), Mai Dong (Ophiopogonis Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Yuan Shen (Scrophulariae Radix), Jie Geng (Platycodonis Radix), Sheng Shi Gao (Gypsum Fibrosum).
After taking four doses of this prescription, pain subsided and the flesh flattened, showing considerable efficacy. At the follow-up visit, Huang Bo (Phellodendri Cortex) and Lu Gen (Phragmitis Rhizoma) were added.
Fire from the Heart and Spleen,夹带 (carrying) Phlegm, ascends, causing Sheyan (Tongue Cancer) to become hard, swollen, and broken. Swallowing food and drink is impossible; the condition is not mild. Prescribe methods to clear Fire and resolve Phlegm.
Prescription: Mai Dong (Ophiopogonis Radix), Fen Ge Ke (Meretricis Shell), Hai Zao (Sargassum), Da Bei Mu (Fritillariae Thunbergii Bulbus), Yuan Shen (Scrophulariae Radix), Jiang Can (Bombyx Batryticatus), Jie Geng (Platycodonis Radix), Ju Hong (Citri Reticulatae Pericarpium Rubrum), Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma), Lian Qiao (Forsythiae Fructus), Pu Huang (Typhonii Pollen), Di Li (Dioscoreae Hypoglaucae Rhizoma), Zhu Ru (Bambusae Caulis in Taeniam).
Externally apply Qingyang Liuhua San (Qingyang Willow Flower Powder) mixed with Hu Po (Amber), Gan Lan Hui (Ash of Olive Stone), Pu Huang (Typhonii Pollen), and Bing Pian (Borneolum Syntheticum). The lesion has gradually softened, but one must not rely solely on this; add Ling Yang Pian (sliced Capricornu Saigae) and Dan Pi (Moutan Cortex) to the original formula.