巢氏云∶小儿重舌者,心脾俱有热也,心候于舌而主血,脾之络脉出于舌下,若心脾有热则血气俱盛,附于舌根,
重生壅出如舌而短小是也。有着颊里及上 者,名曰重 。着齿龈者,曰重龈。皆当刺去其血,用真蒲黄敷之,或发灰
或马牙硝或硼砂或焰硝敷之,或竹沥浸黄柏点之亦好。又木舌症,舌者心之候,脾之脉络于舌也,脏腑壅滞,心脾积热,
热气上冲,故令舌肿渐渐胀大,塞满口中,是为木舌,若不急疗,必致害人,用朴硝二分,紫霜一分,白盐半分,同研,
每半钱,竹沥井花水调敷。不用朴硝及盐亦可。又方用黄葵花研细,黄丹伴之同研点七次。又舌胀满口,单用冰片点之,
亦妙。又弄舌者,脾脏微热,令舌络微紧,时时舒舌,治之勿用冷药下之,当少与泻黄散渐服之,亦或饮水,医疑为热,
必冷药下之非也,饮水者,脾胃虚津液少也。又加面黄肌瘦,五心烦热,即为疳瘦,宜胡黄连丸辈。大病未愈,用药后
弄舌者凶。又有舌上白胎并黑色者,用硼砂为末掺之,热甚者,加冰片,或单用黄丹如豆许,以按舌下尤妙。
泻黄散 见第三十四问。
胡黄连丸 见第七十九问。
聂氏云∶禀受肾气不足者,即髓不强,盖骨之所络而为髓,髓不足,故不能充于齿,所以齿生迟也。宜用芎 、干
地黄、山药、当归、芍药、甘草各等分研末,用熟水调服。或时以药末擦齿龈,齿即生也。
巢元方说:小儿患重舌病,是因为心和脾都有热邪。心开窍于舌并主管血液,脾的络脉从舌下发出,如果心和脾有热邪,就会导致气血亢盛,附着在舌根处,重新生长出像舌头一样但短小的肉赘。有的长在脸颊内侧及上颚的,叫做重腭;长在齿龈上的,叫做重龈。这些情况都应当针刺放血,然后敷上真蒲黄粉,或者使用发灰、马牙硝、硼砂或焰硝外敷,也可以用竹沥浸泡黄柏后点涂,效果也很好。
另外木舌症,舌是心的征候,脾的脉络联系于舌,脏腑气机壅滞,心脾积热,热气向上冲逆,导致舌头肿胀逐渐变大,塞满口腔,这就是木舌。如果不紧急治疗,必定会危及生命。可用朴硝二分、紫霜一分、白盐半分,共同研磨成细末,每次取半钱,用竹沥和井花水调匀后敷患处。不用朴硝和盐也可以。另一个方子是用黄葵花研细,配合黄丹一起研磨后点涂七次。还有舌头胀满口腔的情况,单用冰片点涂,也很奇妙。
至于弄舌症,是因为脾脏微热,导致舌部络脉轻微拘紧,舌头不时伸出。治疗时不要用寒凉药攻下,应当少量给予泻黄散逐渐服用。也有因为喝水而被误诊为热证,医生必用寒凉药攻下的,这是错误的。喝水是因为脾胃虚弱、津液不足所致。如果再加上面色发黄、肌肉消瘦、五心烦热,就属于疳瘦病,适宜使用胡黄连丸之类的药物。大病未愈,用药后出现弄舌现象的,预后凶险。又有舌苔白厚并伴有黑色的,用硼砂研末撒布患处,热势严重的,加冰片,或者单用黄豆大小的黄丹按压舌下,尤其妙效。
聂氏说:先天禀受肾气不足的人,骨髓就不强健。因为骨由髓所滋养连接,髓不足,所以不能充盈牙齿,因此牙齿生长迟缓。适宜用川芎、干地黄、山药、当归、芍药、甘草各等分,研成粉末,用温水调服。或者时常将药末擦在齿龈上,牙齿就能长出来。
Chao Yuanfang stated: In children, the condition of Chong She (Double Tongue) arises from heat in both the Heart and Spleen. The Heart manifests in the tongue and governs blood, while the collaterals of the Spleen emerge from beneath the tongue. If there is heat in the Heart and Spleen, Qi and Blood become excessive and attach to the root of the tongue, growing anew into a fleshy protrusion resembling a tongue but shorter and smaller. Those located on the inner cheek or upper palate are called Chong E (Double Palate); those on the gingiva are called Chong Yin (Double Gingiva). All these conditions should be treated by pricking to release blood, followed by applying Zhen Puhuang (True Polygonatum Rhizome Powder), or using Fahui (Hair Ash), Mayaxiao (Saltpeter), Pengsha (Borax), or Yanxiao (Niter) for topical application. Alternatively, soaking Huangbai (Phellodendron Bark) in Zhuli (Bamboo Juice) and applying it is also effective.
Regarding Mu She (Wooden Tongue), the tongue is the manifestation of the Heart, and the collaterals of the Spleen connect to the tongue. When viscera and bowels are obstructed and heat accumulates in the Heart and Spleen, hot Qi rushes upward, causing the tongue to swell and gradually enlarge until it fills the mouth. This is Mu She. If not treated urgently, it will inevitably prove fatal. Use 2 fen of Puxiao (Mirabilite), 1 fen of Zishuang (Purple Frost), and 0.5 fen of Baiyan (White Salt), grind them together finely. Take half a qian each time, mixed with Zhuli (Bamboo Juice) and Jinghua Shui (Well Water), and apply topically. It is also acceptable to omit Puxiao and salt. Another prescription involves grinding Huang Kui Hua (Yellow Mallow Flower) finely, mixing it with Huangdan (Red Lead Oxide), and applying it seven times. For cases where the tongue swells to fill the mouth, applying Bingpian (Borneol) alone is also excellent.
As for Nong She (Playing Tongue), it is caused by slight heat in the Spleen, making the tongue collaterals slightly tight, causing the tongue to extend intermittently. Treatment should avoid cold purgatives; instead, Xiahuang San (Drain Yellow Powder) should be administered in small doses gradually. Some physicians mistake the symptom of drinking water for heat syndrome and use cold purgatives, which is incorrect. Drinking water occurs due to deficiency of the Spleen and Stomach and scanty body fluids. If accompanied by sallow complexion, emaciation, and five-palm heat, it constitutes Gan Shou (Gut-Wasting Emaciation), and drugs such as Huhuanglian Wan (Coptis Pill) are suitable. If Nong She appears after medication during an unresolved severe illness, the prognosis is ominous. For white or black coating on the tongue, Pengsha (Borax) powder should be sprinkled on the lesion. For severe heat, add Bingpian (Borneol), or press a bean-sized amount of Huangdan (Red Lead Oxide) under the tongue, which is particularly effective.
Xiahuang San (Drain Yellow Powder) is described in Question 34.
Huhuanglian Wan (Coptis Pill) is described in Question 79.
Nie stated: Individuals with insufficient congenital Kidney Qi have weak marrow. Since bones are connected and nourished by marrow, a deficiency of marrow fails to充 (fill/nourish) the teeth, resulting in delayed tooth eruption. It is appropriate to use equal parts of Xiong (Ligusticum Chuanxiong), Gan Dihuang (Prepared Rehmannia Root), Shanyao (Dioscorea Rhizome), Danggui (Angelica Sinensis), Shaoyao (Peony Root), and Gancao (Licorice Root), grind them into powder, and take with warm water. Alternatively, rubbing the powder onto the gingiva periodically can promote tooth eruption.