bubble_chart Concept

Carcinoma of tongue refers to a swelling near the base of the tongue, resembling a small tongue growing beneath the tongue, hence it is called "carcinoma of tongue," also known as "child tongue."

Carcinoma of tongue must be differentiated from "tongue cushion," "lotus fine tongue," and "curled tongue abscess." Although the latter also involves swelling beneath the tongue, its shape does not resemble the form of a tongue. "Tongue cushion" refers to a sudden high swelling beneath the tongue, like something is cushioning it. "Lotus fine tongue" refers to peaks growing beneath the tongue (with three, five, or seven peaks), sharp like the shape of a lotus flower, hence the name. "Curled tongue abscess" is recorded in "Jiao's Secret of Throat Diseases" as: "growing beneath the tongue, either on the left, right, or in the center, shaped like a longan or a date pit..." Therefore, they should be distinguished.

bubble_chart Pattern Analysis

1. Excessive Heat in the Spleen︰The area beneath the tongue is red, swollen, and protruding, resembling a small tongue. In mild cases, there is no pain, while in severe cases, it causes pain, dysphoria, crying, and even local ulceration. It may also be accompanied by fever, flushed face, dry mouth, red and swollen lips and teeth, sores on the tongue, burning and erosive sensations in the mouth, scanty dark urine, foul-smelling stools, a red tongue tip, and purple stagnant finger veins. This indicates a syndrome of excess heat in the spleen. It is often caused by the mother consuming excessive spicy or rich foods during pregnancy or mistakenly taking warming medications, leading to excessive fetal heat. Alternatively, postnatal over-warming, improper feeding, or milk and food stagnation may disrupt spleen and stomach functions, accumulating internal heat. Pathogenic heat ascends along the meridians, combines with external toxins, and steams the mouth and tongue, resulting in the growth of an additional small tongue beneath the root of the tongue, causing difficulty in speaking and swallowing. When fire and heat flare upward, it manifests as a red face and lips. Internal blazing of heart fire leads to dysphoria, restlessness, scanty dark urine, and a red tongue tip. Excess heat in the spleen and stomach causes dry mouth, thirst, and foul-smelling stools. The condition can be classified as mild or severe. Mild cases may resolve without treatment, while severe cases require urgent intervention. Treatment focuses on clearing heat, purging heart fire, and removing toxins. Internally, Qingre Yin (Heat-Clearing Drink) can be taken, and externally, Liangxin San (Heart-Cooling Powder) can be applied.
2. Deficiency Fire Flaming Upward︰Swelling and protrusion under the root of the tongue, resembling a small tongue, accompanied by pale complexion with flushed cheeks, fatigue and reluctance to speak, dry mouth without thirst, or low-grade fever, night sweat, vexing heat in the chest, palms, and soles, dry stool or loose stools, tongue texture pale or red with scant moisture, and other symptoms. Mostly caused by constitutional yin deficiency or the late stage [third stage] of Rebing, where yin fluids are depleted, water fails to control fire, and deficiency fire flares upward, leading to illness. Yin deficiency results in internal heat, hence symptoms such as vexing heat in the chest, palms, and soles, restlessness, pale complexion with flushed cheeks, red tongue with scant moisture, and other signs of yin deficiency with effulgent fire. Treatment should focus on nourishing kidney yin, using Modified Anemarrhena, Phelloendron and Rehmannia Pill.

The former is excess heat, with the disease located in the heart and spleen; the latter is deficient fire, with the disease attributed to the kidneys. Clinically, by grasping the characteristics of the disease cause and mechanism of disease, and combining them with clinical manifestations, it is not difficult to differentiate.

bubble_chart Documentation

1. Youyou Jicheng．Tongue Disease Treatment: "Carcinoma of the tongue is caused by heat in the heart and spleen. The spleen's major collateral emerges below the tongue, and when there is heat, both qi and blood are excessive, leading to the sudden growth of a small additional tongue beneath the root of the tongue. Internally, take Hangxie Dan, and externally, use acupuncture to remove the bad blood, then apply a powder made of Typha and Phelloendron Bark."