【方歌】舌疳心脾毒火成，如豆如菌痛烂红，渐若泛莲难饮食，
绵溃久变瘰历风。
【注】此证由心、脾毒火所致，其证最恶，初如豆，次如菌，
头大带小，又名舌菌。疼痛红烂无皮，朝轻暮重，急用
北庭丹点之，自然消缩而愈。若失于调治，以致焮肿，
突如泛莲，或有状如鸡冠，舌本短缩，不能伸舒，妨碍
饮食言语，时津臭涎，再因怒气上冲，忽然崩裂，血出
不止，久久延及项颔，肿如结核，坚硬〔兴〕痛，皮色
如常，顶软一点，色暗木红，破后时津臭水；腐如烂棉
，其证虽破，坚硬肿痛，仍前不退，此为绵溃，甚至透
舌穿腮，汤水漏出是以又名瘰历风也。盖舌本属心，舌
边属脾，因心绪烦扰则注火，思虑伤脾则气郁，郁甚而
成斯疾。其证外势，颇类喉风，但喉风咽喉常肿，汤水
不能下咽；此证咽喉不肿，可以下咽汤水，胃中亦思饮
食，因舌不能转动，迭送硬食，故每食不能充足，致令
胃中空虚而怯证悉添，日渐衰败。初起宜服导赤汤加黄
连，虚者服归脾汤，热甚者服温凉甘露饮合归脾汤，便
溏者服归芍异功汤。颔下肿核，初起宜用锦地罗蘸醋磨
浓敷之，溃后宜水澄膏贴之。自古治法虽多，然此证百
无一生，纵施药饵，不过苟延岁月而已。
方剂：清溪秘传北庭丹
组成：番硵砂 人中白（各五分）
瓦上青苔 瓦松
溏鸡矢（各一钱）
用倾银罐二个，将药装在罐内，将口封严，外用盐
泥封固，以炭火煆红，待三炷香为度；候冷开罐，将药
取出，入麝香、冰片各一分，共研细末。用磁针刺破舌
菌，用丹少许点上，再以蒲黄盖之。
【方歌】北庭丹点舌菌生，瓦松溏鸡矢人中，瓦上青苔番硵末，
罐封火煆入麝冰。
又方：归芍异功汤
组成：人参 白术（土炒）
广陈皮 白芍（酒炒）
当归（身）（各一钱） 白茯苓（二钱）
甘草（炙，五分）
灯心五十寸，水煎空心服。
【方歌】归芍异功扶脾气，健胃又能止泻利，四君归芍广陈皮，
引加灯心是良剂。
又方：水澄膏
组成：朱砂（水飞二钱） 白蔹
白芨 五倍子
郁金（各一两） 雄黄
乳香
上为细末，米醋调浓，以厚纸摊贴之。
【方歌】水澄膏贴溃核验，水飞朱砂末二钱，及敛郁金雄黄乳，
五倍同用研醋摊。
又方：导赤汤（见口部口糜）
归脾汤（见乳部乳中结核）
清凉甘露饮（见唇部茧唇）
【方歌】舌疳是由心、脾的毒火形成的，症状像豆粒或菌类，疼痛溃烂发红，逐渐发展像泛开的莲花一样难以进食，长期不愈溃烂流脓会演变成瘰疬风。
【注】此病证由心、脾的毒火所致，病情最为凶险。初期像豆粒，后来像菌类，头大蒂小，又名舌菌。疼痛、发红、溃烂无皮，早晨轻晚上重，急需使用北庭丹点涂患处，自然消退痊愈。如果失于调理治疗，导致红肿加剧，突然像泛开的莲花，或者形状像鸡冠，舌根短缩，不能伸展，妨碍饮食和言语，时常流出臭秽的唾液；再加上怒气上冲，突然崩裂，出血不止，日久蔓延到颈部和下颌，肿块像结核一样，坚硬且疼痛，皮肤颜色正常，顶部软一点，颜色暗红，破后时常流出臭水；腐烂像烂棉花，虽然破溃，但坚硬肿痛依然不退，这叫绵溃，甚至穿透舌头穿过脸颊，汤水漏出，所以又名瘰疬风。大概舌根属于心，舌边属于脾，因为心绪烦扰则注火，思虑伤脾则气郁，郁结严重而形成此病。其外在症状，很像喉风，但喉风咽喉常肿胀，汤水不能下咽；此病证咽喉不肿，可以下咽汤水，胃中也想饮食，因为舌头不能转动，反复送硬食，所以每次吃饭不能吃饱，导致胃中空虚而怯弱之证全部添加，日渐衰败。初起宜服用导赤汤加黄连，体虚者服用归脾汤，热势严重者服用温凉甘露饮合归脾汤，大便溏稀者服用归芍异功汤。下颌下的肿核，初起宜用锦地罗蘸醋磨浓敷贴，溃破后宜用水澄膏贴敷。自古以来治疗方法虽多，然而此病证百无一活，即使施用药物，也不过是苟延残喘而已。
方剂：清溪秘传北庭丹
组成：番硵砂、人中白（各五分）
瓦上青苔、瓦松、溏鸡矢（各一钱）
用两个倾银罐，将药装在罐内，将口封严，外用盐泥封固，以炭火煅烧至红透，待三炷香的时间为度；冷却后开罐，将药取出，加入麝香、冰片各一分，共同研成细末。用磁针刺破舌菌，用少许丹药点上，再用蒲黄覆盖。
【方歌】北庭丹点舌菌生，瓦松溏鸡矢人中，瓦上青苔番硵末，罐封火煅入麝冰。
又一方：归芍异功汤
组成：人参、白术（土炒）
广陈皮、白芍（酒炒）
当归（身）（各一钱）、白茯苓（二钱）
甘草（炙，五分）
灯心五十寸，水煎空腹服用。
【方歌】归芍异功扶脾气，健胃又能止泻利，四君归芍广陈皮，引加灯心是良剂。
又一方：水澄膏
组成：朱砂（水飞二钱）、白蔹、白芨、五倍子、郁金（各一两）、雄黄、乳香
以上研成细末，米醋调浓，用厚纸摊贴。
[Prescription Verse] Shegan (Tongue Ulcer) is formed by toxic fire of the Heart and Spleen; resembling beans or fungi, it causes painful, ulcerated redness. Gradually expanding like a lotus flower, it makes eating difficult. Prolonged ulceration may transform into Luoli Feng (Scrofula Wind).
[Annotation] This condition is caused by toxic fire of the Heart and Spleen. It is the most malignant of conditions. Initially, it resembles a bean; subsequently, it resembles a fungus, with a large head and small stalk, also known as Shejun (Tongue Fungus). It presents with pain, redness, and ulceration without skin. Symptoms are lighter in the morning and heavier in the evening. One must urgently apply Beiting Dan to the affected area for natural resolution and cure. If neglected and untreated, leading to intense swelling, it may suddenly resemble an expanded lotus, or take the shape of a rooster's comb. The root of the tongue becomes shortened and cannot extend, hindering diet and speech. There is frequent discharge of foul saliva. Additionally, due to anger rushing upward, sudden rupture occurs with unceasing bleeding. Over time, this extends to the neck and mandible, where swellings resemble tubercles: hard and painful, with normal skin color, but a softer apex that is dark red. After rupture, foul-smelling fluid is discharged; the tissue rots like cotton. Although ulcerated, hardness, swelling, and pain persist unchanged. This is called Miankui (Cotton-like Ulceration). In severe cases, it penetrates through the tongue and cheek, causing fluids to leak out, hence also named Luoli Feng. Generally, the root of the tongue belongs to the Heart, and the sides belong to the Spleen. Mental agitation generates fire; overthinking injures the Spleen, causing Qi stagnation. Severe stagnation leads to this disease. Externally, its appearance resembles Houfeng (Throat Wind), but in Houfeng, the throat is often swollen, preventing swallowing; in this condition, the throat is not swollen, allowing swallowing of liquids, and the stomach desires food. However, because the tongue cannot move to manipulate solid food, one cannot eat enough, leading to an empty stomach and the addition of deficiency symptoms, resulting in gradual decline. At the onset, one should ingest Daochi Tang added with Huanglian. For those with deficiency, Guipi Tang should be taken. For severe heat, Wenliang Ganlu Yin combined with Guipi Tang is indicated. For loose stools, Guishao Yigong Tang is used. For submandibular nodules, at onset, Jindiluo soaked in vinegar and ground thickly should be applied topically. After ulceration, Shuicheng Gao should be applied. Although many treatments have existed since ancient times, this condition is almost invariably fatal. Even with medication administration, survival is merely prolonged temporarily.
Prescription: Qingxi Mituan Beiting Dan
Composition: Fanlousha (Sal Ammoniac), Renzhongbai (Human Urine Deposit) (each 5 fen); Wasang Qingtai (Moss on Roof Tiles), Wasong (Sedum sarmentosum), Tangjishi (Chicken Droppings) (each 1 qian).
Use two silver jars. Place the herbs inside, seal the mouths tightly, and secure externally with salt mud. Roast over charcoal fire until red hot. Wait for three incense sticks' duration. Upon cooling, open the jar, remove the medicine, add Shexiang (Musk) and Bingpian (Borneol) (each 1 fen), and grind together into a fine powder. Use a magnetic needle to pierce the Shejun, apply a small amount of the powder, and cover with Huangpuhuang (Polygoni Cuspidati Rhizoma et Radix).
[Verse] Beiting Dan applied to Tongue Fungus grows, Sedum, Chicken Droppings, Human Deposit, Moss on Tiles, Sal Ammoniac powder, Jar sealed, Fire roasted, Musk and Borneol added.
Another Prescription: Guishao Yigong Tang
Composition: Renshen (Ginseng Root), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried with soil); Guangchenpi (Citri Reticulatae Pericarpium), Baishao (Paeoniae Radix Alba, stir-fried with wine); Danggui (Angelica Sinensis Root Body) (each 1 qian); Baifuling (Poria, 2 qian); Gancao (Licorice Root, honey-fried, 5 fen).
Dengxin (Junci Medullae, 50 cun), decocted in water, taken on an empty stomach.
[Verse] Guishao Yigong supports Spleen Qi, strengthens the Stomach and stops diarrhea; Si Jun Zi Tang plus Dang Gui, Bai Shao, and Chen Pi, guided by Deng Xin, is a good remedy.
Another Prescription: Shuicheng Gao
Composition: Zhusha (Cinnabar, water-triturated, 2 qian); Bailian (Ampelopsis Radix); Baiji (Bletillae Rhizoma); Wubeizi (Galla Chinensis); Yujin (Curcumae Longae Radix) (each 1 liang); Xionghuang (Realgar); Ruxiang (Olibanum).
Grind all into a fine powder. Mix thickly with rice vinegar. Spread on thick paper and apply.
[Verse] Shuicheng Gao applied to ulcerated nodules verifies efficacy; Water-triturated Cinnabar powder 2 qian, Astringent Curcuma, Realgar, Olibanum, Used together with Galla Chinensis, ground with vinegar and spread.
Another Prescription: Daochi Tang (See Mouth Section: Koumi)
Guipi Tang (See Breast Section: Ru Zhong Hejie)
Qingliang Ganlu Yin (See Lip Section: Jianchun)