The sensation of numbness in the tongue is called numbness of tongue. It can also be accompanied by symptoms of tongue stiffness.

Numbness of tongue originally referred solely to the numbness of the tongue, while the condition that also includes symptoms of tongue stiffness was called "tongue paralysis." In modern Chinese medicine books, these two terms are either mixed or combined. For example, "Essentials of Chinese Medicine Clinical Practice" uses "numbness of tongue," while the "Concise Dictionary of Chinese Medicine" retains "tongue paralysis," and "Chinese Medicine Tongue Diagnosis" refers to it as "numbness of tongue paralysis."

This book still combines these two terms into numbness of tongue.

bubble_chart Pattern Analysis

1. Blood Deficiency︰The main manifestations include a pale and numb tongue, a complexion that is pale or shallow yellow, palpitations, shortness of breath, insomnia with dreamfulness, forgetfulness, a thin and weak pulse, etc. There are two characteristics: first, the numbness of the tongue is not severe, and second, there is a series of blood deficiency symptoms, such as a shallow yellow complexion, palpitations, dizziness, forgetfulness, a pale tongue, and a thin, weak pulse, etc. This condition arises from excessive loss of blood or insufficient production, leading to a decline in nutrient-blood, which fails to nourish the tongue muscles, resulting in numbness of the tongue. However, it does not significantly hinder eating or speaking, and is accompanied by signs of blood deficiency such as a pale face, weakness, and a thin pulse, with the key emphasis on the word "deficiency." For blood deficiency numbness of the tongue, it is advisable to nourish the blood, using Returning to Spleen Decoction with the addition of Blast-Fried Ginger.
2. Internal Stirring of Liver Wind︰The main manifestations include numbness and stiffness of the tongue, difficulty speaking, dizziness, headache, or sudden collapse, hemiplegia, wiry and thin rapid pulse, etc. These are caused by deficiency of liver and kidney yin, uncontrolled yang hyperactivity, and the transformation of wind disturbing the upper body. The numbness and stiffness of the tongue affect eating and speech and are accompanied by a red tongue with rapid pulse, distending headache, or even sudden collapse. Therefore, the root cause is yin deficiency, but the symptoms arise from yang hyperactivity, with the key point being "yang hyperactivity," which should be the basis for differentiation. Liver wind causing tongue numbness primarily involves liver yang transforming into wind. The stiffness and numbness of the tongue in liver wind are manifestations of yin deficiency and yang hyperactivity, such as a red tongue with scant coating and a wiry, thin, rapid pulse. Treatment should focus on nourishing yin, pacifying the liver, and extinguishing wind, using Gastrodia and Uncaria Drink.
3. Phlegm Obstruction︰Due to the frequent coexistence of other disease causes, the manifestations also vary. The main types are: **Wind-phlegm numbness of the tongue**: Numbness and stiffness of the tongue, dizziness, blurred vision, numbness of the limbs, or sudden collapse, deviation of the mouth and eyes, hemiplegia, white and slippery or yellow and greasy tongue coating, floating-slippery or wiry-moderate pulse. **Phlegm-fire numbness of the tongue**: Red and numb tongue, stiffness of the tongue, yellow and greasy or yellow, thick, and dry tongue coating, dizziness, blurred vision, tinnitus, bitter taste in the mouth, dysphoria, irritability, difficulty in bowel movements, wiry-slippery and rapid pulse. This is caused by phlegm obstructing the orifices and collaterals, leading to dysfunction of the tongue mechanism. It has two characteristics: 1. Numbness and stiffness of the tongue with impaired speech. 2. Manifestations of excessive phlegm, such as dizziness, blurred vision, numbness of the limbs, white and slippery or yellow and greasy tongue coating, wiry-slippery pulse, etc. Phlegm obstruction causing tongue numbness primarily involves phlegm obstructing qi stagnation.
   1. The "wind" in wind-phlegm may be external wind carrying phlegm to invade internally, or excessive phlegm stirring wind. Cases of external wind carrying phlegm have a sudden onset and rapid progression, while those with excessive phlegm stirring wind usually have a history of abundant phlegm or a corpulent, phlegm-prone constitution. In summary, two key points should be grasped: 1. The "phlegm pattern." 2. External wind cases may be accompanied by cold-heat symptoms or muscle tension. The recommended treatment is **Sheng Feng Tang** (Wind-Reducing Decoction) with **Aquilaria**.
   2. **Phlegm-fire cases** arise from preexisting phlegm-dampness, compounded by exposure to fire pathogens or inherent internal heat, which scorches fluids to form phlegm. Phlegm-fire evils surge upward, resulting in tongue numbness and stiffness, thick and crimson tongue coating, bitter taste in the mouth, irritability, dizziness, and wiry-slippery-rapid pulse. This syndrome exhibits characteristics of both "phlegm pattern" and "fire pattern." The recommended treatment is **Wen Dan Tang** (Gallbladder-Warming Decoction) with additions such as **Arisaema cum Bile**, **Scorpion**, **Gastrodia Tuber**, and **Coptis Rhizome**.

bubble_chart Documentation

1. "Zheng Zhi Zhun Bu - Kou Chun Zhang": "Qi deficiency causes numbness and laxity."
2. "Bian She Zhi Nan - Guan She Zong Gang": "If the root of the tongue is yellow and the tip is white, short and contracted, not dry or hard but numb, and unable to extend, it is due to liver wind with phlegm. It is appropriate to extinguish wind and resolve phlegm."
3. "Bian She Zhi Nan - Bian She Zheng Zhi": "Tongue paralysis is characterized by stiffness and numbness, caused by mental agitation, worry, sudden anger, and the congealing of qi and phlegm-fire. Use Schizonepeta and Realgar in equal parts, decocted with Akebia Stem and taken as a decoction. For phlegm congestion and numbness of the tongue, it is appropriate to apply powdered alum or powdered tooth soap. If the tongue is stiff and speech is slow and heavy, it is due to dampness obstructing the orifice of the spleen, which resides in the tongue. There are also cases where the tongue is frequently and inexplicably paralyzed, due to insufficiency of heart blood. This should not be treated as wind-heat. It is appropriate to use Middle-Regulating Decoction with Aconite Lateral Root and Chinese Angelica, or Returning to Spleen Decoction with Blast-Fried Ginger."