解 之证,懈倦困弱似痿,故附痿后。
冬脉大过,为病在外,则令人解 。春脉痛而少气,不欲言。(全文见治虚实法。王注云∶
寒不寒,热不热,弱不弱,壮不壮,伫不可名,谓之解 也。)
〔《素》〕尺脉缓涩,谓之解 。(平人气象论 王注云∶尺为阴部,腹肾主之。缓为热中,
涩为无血,故解名谓之解 也。)
尺内弱者解 ,安卧脱肉者寒热,不治。(全文见诊生死。)
刺骨无伤髓,髓伤则消烁 酸,体解 然不去矣。(全文见禁刺。)
足少阳之疟,令人身体解 ,寒不甚,热不甚,恶见人,见人心惕惕然,热多汗出甚,刺足
少阳。(全文见疟。)
舌属心脾二脏。经云∶心主热。又云∶在脏为心,在窍为舌。又云∶心气通于舌,心和则舌
能知五味。是舌属心也。又曰∶中央黄色,入通于脾,开窍于口,藏精于脾,故病在舌,本属脾也。
〔无〕金沸草汤治风寒伤于心脾,令人憎寒热,齿浮,舌肿痛。
荆芥穗(四两) 旋复花 前胡 麻黄(去节,各三两) 赤芍药 半夏(各一两)
上锉散,每五钱,水一盏半,姜七片,枣二枚,煎七分去渣,漱口,吐一半,吃一半。世医用
此发散伤寒伤风,及加杏仁、五味子治咳嗽皆效,独未知用之舌肿牙疼。辛未年,有人患舌肿满塞,
粥药不入,其势危甚,大煎此一剂,乘热以纸笼气熏之,遂愈。
〔世〕乌犀膏 治重舌木舌。(方见咽喉痛。)
〔《本》〕治心脾壅热,木舌肿胀。
玄参 升麻 大黄 犀角(各三分) 甘草(半两)
上为细末,每服三钱,水一盏,煎至五分,温服,不拘时。
〔世〕舌肿胀退场门。硼砂细末,切生姜蘸药,揩舌肿处即退。又云,蓖麻取油蘸纸捻烧烟熏之愈,
又治牛舌出亦好。
〔丹〕重舌,用好胆矾研细敷之。
〔无〕黑散子治舌忽然肿破。用釜底煤研细,以醋调敷舌上下,脱去更敷,能先决出血竟敷之,
尤佳。一法用
盐等分调敷。
〔《山》〕舌肿,乱发烧灰水调下
〔丹〕飞丝入口,喉舌间生泡。紫苏嚼,白汤下,立效。
针灸舌痛独取脾脉,经云∶脾足太阴之脉,所生病者舌本痛。视盛虚热寒陷下取之也。
〔《摘》〕治舌下肿,难言,口疮,舌纵,涎出,及舌根急缩∶廉泉(三分,得气即泻,灸三壮。)
〔《集》〕治舌肿∶廉泉(三分,灸。)金津 玉液(各用三棱针出血。)天突 少商
〔东〕又法∶廉泉 然谷 风府 天突 关元
〔垣〕廉泉一穴,一名舌本,在颔下结喉上。治舌下肿,难言,舌纵,涎出,口噤,舌根急缩,
下食难。刺疟论云∶舌下两脉者,廉泉也。刺禁论云∶刺舌下中脉太过,血不止,为喑。刺节真
邪论云∶取廉泉穴,血变而止。以明宜出血,禁用针。或问取廉泉穴,二说不同,一说取颔下结喉上,
一说取舌下两脉,何者为当?答曰∶舌本者,乃舌根蒂也,若取舌下两脉,是取舌梢也,舌标也,
此法误也。当取颔下者为当,此舌根也。况足阳明之脉,根于厉兑,结于廉泉,颔下乃足阳明之
所行也。若取舌下两脉,非足阳明经也。戊与癸合,廉泉足少阴也,治涎下。解云∶胃中热上溢,
廉泉开放涎下,当出血泻胃中热,又知非舌下两脉也。颔下结喉上者为准矣。胀论曰∶廉泉玉
英者,津液之道路也。(按《针经》云∶少阳结于廉泉,今曰阳明者误也。)
〔子和〕南邻朱老翁,年六十余岁,身热数日不已,舌根肿起,和舌尖亦肿,肿至满口,比
元舌大三倍。一外科以燔针刺其舌两旁下廉泉穴,病势转凶,将至颠 。戴人曰∶血实者宜决之,
以针磨令锋极尖,轻砭之,日砭八九次,出血约一二盏。如此者三次,渐觉血少,痛减肿消。
夫舌者,心之外候也。心主血,故血出则愈。又诸痛痒疮疡皆属心火,燔针艾火,皆失此义也。
〔无〕凡舌肿,下必有噤虫,状如蝼蛄卧蚕,有头尾小白,可烧铁烙,烙头上即消。
解(懈惰无力)这一病证,表现为懈怠疲倦、困倦虚弱,类似痿证,因此附在痿证之后。
冬季脉象过大,说明病邪在外,会导致人体出现解惰无力的症状。春季脉象弦痛且气少,使人不想说话。(全文详见治疗虚实之法。王冰注解说:不觉得冷,也不觉得热,不觉得弱,也不觉得壮,伫立时无法形容这种状态,称之为解惰。)
〔《素问》〕尺部脉象缓而涩,称为解惰。(《平人气象论》王冰注解说:尺部属于阴分,由腹部肾脏所主。缓脉表示内有热,涩脉表示血虚,所以将这种状态命名为解惰。)
尺部脉象弱者会出现解惰,如果身体安卧且肌肉消瘦脱失,则是寒热错杂之证,难以治愈。(全文详见诊断生死之法。)
针刺骨骼时不要损伤骨髓,如果骨髓受损,就会导致骨中酸楚消烁,身体感到懈怠无力且久久不能恢复。(全文详见禁刺之法。)
足少阳经的疟疾,使人身体懈怠无力,恶寒不明显,发热也不明显,厌恶见人,见到人心里就惊恐不安,发热多且出汗严重,应针刺足少阳经。(全文详见疟疾病治法。)
舌归属于心和脾两脏。医经说:心主热。又说:在五脏中心对应舌,在孔窍中舌为心之窍。还说:心气通于舌,心气调和则舌能辨别五味。这说明舌归属于心。又说:中央属黄色,入通于脾,开窍于口,藏精于脾,所以病在舌,根本在于脾。
〔无名字方〕金沸草汤治疗风寒损伤心脾,导致憎寒发热,牙齿浮动,舌体肿痛。
荆芥穗(四两) 旋复花 前胡 麻黄(去节,各三两) 赤芍药 半夏(各一两)
以上药物切碎成散剂,每次取五钱,加水一盏半,生姜七片,大枣二枚,煎煮至七分,去渣滓,先漱口,然后吐出一半药液,吃下一半药液。世间的医生用此方发散伤寒伤风,以及加入杏仁、五味子治疗咳嗽都有效,唯独不知道用它来治疗舌肿牙疼。辛未年,有人患舌肿满塞口腔,粥药无法入口,病情非常危急,于是大剂量煎煮这一剂药,趁热气用纸笼住熏蒸患处,随即痊愈。
〔《本草》〕治疗心脾壅滞之热,导致木舌肿胀。
玄参 升麻 大黄 犀角(各三分) 甘草(半两)
以上药物研为细末,每次服用三钱,加水一盏,煎至五分,温服,不限时间。
〔世俗方〕舌肿胀退场门穴疗法。用硼砂细末,切生姜蘸取药物,擦拭舌肿处即可消退。又有人说,用蓖麻取油蘸纸捻燃烧产生的烟熏患处也可痊愈,此法对牛舌肿大也有效。
〔无名字方〕黑散子治疗舌突然肿胀破溃。用锅底灰研细,用醋调匀敷于舌上下,脱落后再敷,如果能先刺破出血再敷药,效果更佳。另一种方法是用盐等量调敷。
〔《山》〕舌肿,用乱发烧成的灰,用水调服。
〔朱丹溪〕飞丝(异物)入口,喉舌间生泡。嚼食紫苏,白开水送下,立即见效。
针灸治疗舌痛,独取脾经脉气,医经说:足太阴脾经所生的病症包括舌根疼痛。应根据脉气的盛虚、热寒及陷下情况来选取穴位进行治疗。
〔《摘元方》〕治疗舌下肿胀,言语困难,口疮,舌纵不收,流涎,以及舌根紧急收缩:廉泉穴(深刺三分,得气后立即泻法,艾灸三壮。)
〔《集验方》〕治疗舌肿:廉泉穴(深刺三分,艾灸。)金津穴、玉液穴(各用三棱针点刺出血。)天突穴、少商穴
〔李杲/东垣〕廉泉一穴,又名舌本,位于下巴下方、喉结上方。治疗舌下肿胀,言语困难,舌纵不收,流涎,口噤不开,舌根紧急收缩,进食困难。《刺疟论》说:舌下的两条脉络,就是廉泉穴。《刺禁论》说:针刺舌下脉络如果过深,血流不止,会导致失音。《刺节真邪论》说:取廉泉穴,直到血液颜色变正常为止。这说明适宜放血,禁用针刺深入。有人问取廉泉穴,两种说法不同,一说取下巴下方喉结上,一说取舌下两条脉络,哪种正确?回答说:舌本,就是舌根的蒂头,如果取舌下两条脉络,那是取舌梢,也就是舌标,这是错误的方法。应当取下巴下方的位置才是正确的,这才是舌根。况且足阳明胃经,起于厉兑穴,结于廉泉穴,下巴下方正是足阳明经循行的部位。如果取舌下两条脉络,那不是足阳明经。戊与癸相合,廉泉穴属于足少阴肾经,主治涎水下溢。注解云:胃中热气上溢,廉泉开放导致涎水下出,应当放血以泻胃中热,由此可知不是指舌下两条脉络。以下巴下方喉结上方的位置为准。《胀论》说:廉泉、玉英,是津液运行的道路。(按:《针经》说:少阳经结于廉泉,这里说是阳明经是错误的。)
〔张子和〕南邻朱老翁,六十多岁,身体发热数日不退,舌根肿胀隆起,舌尖也肿,肿胀充满整个口腔,比原来的舌头大三倍。一位外科医生用烧红的针燔刺其舌两旁下方的廉泉穴,病情反而加重,几乎危及头顶。戴人(张子和号)说:血实者宜决之(实证宜放血),用针磨得极其尖锐,轻轻砭刺,每天砭刺八九次,放出血液大约一二盏。如此进行三次,逐渐感觉血量减少,疼痛减轻,肿胀消退。
舌,是心的外在表现。心主血,所以出血就能痊愈。另外,各种痛痒疮疡都属于心火,使用燔针艾火,都违背了这一原理。
〔无名字方〕凡是舌肿,下面一定有噤虫,形状像蝼蛄或卧蚕,头部和尾部有小白点,可以用烧红的铁器烙烫,烙烫头部虫子就会消失。
The syndrome of Xie (lethargy and weakness) manifests as lethargy, fatigue, and debility resembling Wei syndrome (flaccidity syndrome), hence it is appended after Wei syndrome.
When the Winter pulse is excessive, indicating pathogenic factors outside, it causes Xie (lethargy). When the Spring pulse is painful and accompanied by shortness of breath, the patient does not wish to speak. (For the full text, see Methods for Treating Deficiency and Excess. Wang Bing's commentary states: Not feeling cold, not feeling hot, not feeling weak, not feeling strong, standing still yet unable to describe the condition, this is called Xie.)
[Su Wen] A Huachi (distal radial) pulse that is slow and choppy is called Xie. (Wang Bing's commentary on Ping Ren Qi Xiang Lun states: The distal position belongs to the Yin aspect, governed by the abdominal Kidneys. A slow pulse indicates internal heat; a choppy pulse indicates blood deficiency. Hence, this state is named Xie.)
A weak pulse at the distal position leads to Xie. If the patient lies still with emaciated muscles, it indicates alternating cold and heat, which is difficult to treat. (For the full text, see Diagnosis of Life and Death.)
When needling the bone, do not injure the marrow. If the marrow is injured, it leads to bone soreness and wasting, and the body feels lethargic without relief. (For the full text, see Prohibited Needling.)
Malaria of the Foot Shaoyang channel causes the body to feel lethargic. The aversion to cold is slight, the fever is slight, the patient dislikes seeing people, and feels fearful upon seeing them. There is much fever and profuse sweating. Treat by needling the Foot Shaoyang channel. (For the full text, see Malaria.)
The tongue belongs to the Heart and Spleen organs. The Classics state: The Heart governs Heat. It also states: In the Zang organs, it corresponds to the Heart; in the orifices, the tongue is the orifice of the Heart. Furthermore: Heart Qi connects to the tongue; when Heart Qi is harmonious, the tongue can perceive the five flavors. Thus, the tongue belongs to the Heart. It also states: The center corresponds to Yellow, entering into communication with the Spleen, opening into the mouth, storing essence in the Spleen. Therefore, pathology in the tongue fundamentally belongs to the Spleen.
[Jin Fei Cao Tang] Jin Fei Cao Decoction treats Wind-Cold injuring the Heart and Spleen, causing aversion to cold and fever, floating teeth, and tongue swelling and pain.
Jingjie Sui (Schizonepetae Spica, 4 liang) Xuanfuhua (Inulae Flos, 3 liang) Qianhu (Peucedani Radix, 3 liang) Mahuang (Ephedrae Herba, de-segmented, 3 liang) Chishao Yao (Paeoniae Radix Rubra, 1 liang) Banxia (Pinelliae Rhizoma, 1 liang)
Crush these into a powder. Take 5 qian per dose, add 1.5 sheng of water, 7 slices of ginger, and 2 dates. Decoct until 0.7 sheng remains, strain, rinse the mouth, spit out half, and drink half. Physicians of the world use this formula to dissipate Cold Damage and Wind Strike, and adding Xingren and Wuweizi to treat cough is effective. However, they do not know to use it for tongue swelling and toothache. In the Xinwei year, a person suffered from tongue swelling filling the mouth, unable to take porridge or medicine, with critical severity. A large decoction of this formula was prepared. While hot, the steam was directed onto the area using a paper cover, leading to recovery.
[Wuxi Gao] Wuxi Ointment treats Chong She (double tongue) and Mu She (wooden tongue). (Formula see Throat Pain.)
[Ben Cao] Treats Heart and Spleen stagnation-heat causing Mu She (wooden tongue) and swelling.
Xuanshen (Scrophulariae Radix) Shengma (Cimicifugae Rhizoma) Dahuang (Rhei Radix et Rhizoma) Xijiao (Rhino Ceratosis, each 3 fen) Gancao (Glycyrrhizae Radix et Rhizoma, 0.5 liang)
Grind into fine powder. Take 3 qian per dose, add 1 sheng of water, decoct to 0.5 sheng, take warm, at any time.
[Shi Fang] Tongue Swelling Reduction Method. Use Pengsha (Borax) fine powder. Cut fresh ginger, dip in the medicine, and wipe the swollen tongue area to reduce swelling. Another method: Extract oil from Bamia (Ricini Semen), dip a paper wick, burn it to produce smoke, and fumigate the area for cure. This is also good for bovine tongue swelling.
[Danxi] For Chong She (double tongue), use high-quality Danfan (Alumen) ground finely and applied topically.
[Hei Sanzi] Hei Sanzi treats sudden tongue swelling and ulceration. Use Fu Di Mei (soot from the pot bottom) ground finely, mixed with vinegar, applied to the upper and lower tongue. Reapply as it dries off. Better if bleeding is induced first before application. Another method: Mix equal parts of Yan (Salt) and apply.
[Luanfa Hui] For tongue swelling, burn disordered hair, mix with water, and ingest.
[Danxi] If foreign filaments enter the mouth, causing blisters in the throat and tongue. Chew Zisu (Perillae Folium) and swallow with plain water for immediate effect.
For acupuncture treatment of tongue pain, exclusively select the Spleen channel pulse. The Classics state: The disease generated by the Foot Taiyin Spleen channel includes pain at the root of the tongue. Select points based on excess, deficiency, heat, cold, or sinking.
[Zhai Yuan Fang] Treats sublingual swelling, difficulty speaking, mouth sores, tongue deviation, salivation, and acute retraction of the tongue root: Lianquan (ST11) (Insert 3 cun, discharge immediately upon Deqi, moxa 3 zhu.)
[Ji Yan Fang] Treats tongue swelling: Lianquan (ST11) (Insert 3 cun, moxa.) Jinjin (EX-HN12), Yuye (EX-HN13) (Prick each with a three-edged needle to bleed.) Tiantu (CV22), Shaoshang (LU11)
[Dongyuan] Another method: Lianquan (ST11), RanGu (KI2), Fengfu (GV16), Tiantu (CV22), Guanyuan (CV4)
[Yuan/Li Gao) Lianquan (ST11), also known as Sheben, is located below the mandible, above the laryngeal prominence. It treats sublingual swelling, difficulty speaking, tongue deviation, salivation, lockjaw, acute retraction of the tongue root, and difficulty swallowing. Ci Malun states: The two vessels under the tongue are Lianquan. Cijin Lun states: Over-penetrating the vessels under the tongue causes unceasing bleeding and aphonia. Cijie Zhenxelun states: Take Lianquan point, stop when blood color changes. This clarifies that bleeding is suitable, but deep needling is prohibited. Question: Regarding Lianquan, there are two differing views: one says below the mandible above the larynx; the other says the two vessels under the tongue. Which is correct? Answer: Sheben refers to the root of the tongue. Taking the two vessels under the tongue is taking the tip (Shebiao), which is an error. One should take the location below the mandible, which is the true root. Moreover, the Foot Yangming Stomach channel originates at Lidui and terminates at Lianquan; the area below the mandible is where the Foot Yangming channel travels. The two vessels under the tongue do not belong to the Foot Yangming channel. Wu and Gui combine; Lianquan belongs to the Foot Shaoyin Kidney channel, governing salivation overflow. Commentary explains: Heat in the stomach overflows upward, Lianquan opens causing salivation; one should bleed to drain stomach heat, thus confirming it is not the sublingual vessels. The location below the mandible above the larynx is the standard. Zhang Lun states: Lianquan and Yuying are the pathways of fluids. (Note: Zhenjing states: Shaoyang terminates at Lianquan; stating Yangming here is an error.)
[Zihe/Zhang Yuhan] An old man surnamed Zhu in the south neighbor, over sixty years old, had fever for several days without abatement. The root of his tongue swelled up, and the tip also swelled, filling the entire mouth, three times larger than his original tongue. A surgeon used a red-hot needle to cauterize the sides of the tongue below the Lianquan point, worsening the condition to near death. Dairen (Zhang Yuhan) said: "Excess blood should be drained." He sharpened a needle to a fine point and lightly pricked (Bian) the area, 8-9 times daily, draining about 1-2 sheng of blood. After three such sessions, he gradually felt less blood loss, pain decreased, and swelling subsided.
The tongue is the external manifestation of the Heart. The Heart governs blood, so bleeding leads to cure. Furthermore, all pain, itching, sores, and ulcers belong to Heart Fire. Using cauterizing needles and moxibustion violates this principle.
[Any name] Whenever the tongue swells, there must be Jin Chong (mouth worms) underneath, shaped like mole crickets or silkworms lying down, with white heads and tails. These can be burned out with a red-hot iron; burning the head eliminates them.