Any sensation of burning pain, spicy pain, numbness pain, or astringent pain on the tongue is referred to as tongue pain, which can occur at different parts of the tongue such as the tip, sides, center, root, or the entire tongue.

Tongue pain was first mentioned in Lingshu. Jingmai chapter: "It is the main disease of the spleen, causing pain at the root of the tongue." Later generations, due to broader observations and finer distinctions, have generally referred to it as tongue pain.

If tongue pain is caused by abscesses, sores, or toxins, it is not within the scope of this discussion and can be referred to under the "tongue sore" entry.

bubble_chart Pattern Analysis

1. Visceral Excessive Heat︰The tongue pain is severe, the tongue color is red and crimson with prickles, the coating is thin yellow or thick or dry, accompanied by thirst, bitter taste in the mouth, irritability, susceptibility to anger, insomnia, short and red urine, constipation or dry stools, and a slippery and rapid pulse. The meridians of multiple organs such as the heart, spleen, liver, and kidneys all connect to the tongue, so heat and fire pathogens from any of these organs can ascend and attack the tongue collaterals, causing tongue pain. However, the location or symptoms may differ: a red and prickly tongue tip with burning pain, irritability, and insomnia belongs to heart fire; tongue pain on both sides (tongue edges) with a bitter taste in the mouth and susceptibility to anger belongs to liver fire; pain in the center of the tongue with a yellow, thick, or dry coating, a preference for coolness, anorexia, constipation, or dry stools belongs to stomach fire; a spicy pain in the tongue is due to lung fire scorching; a numb pain with dizziness is due to phlegm-fire ascending and obstructing the tongue collaterals; a purple tongue color with pain indicates zang-fu organs heat toxin. For treatment, heart fire tongue pain should be treated with Redness-Removing Powder plus Coptis Rhizome; liver fire tongue pain should be treated with Gentian Liver-Draining Decoction, and if ineffective, use Angelica, Gentian and Aloe Pill; stomach fire tongue pain should be treated with Yellow-Draining Powder, and for dry stools, choose Major Purgative Decoction; lung fire tongue pain should be treated with White-Draining Powder plus Skullcap Root; phlegm-fire tongue pain should be treated with biotite schist Rolling Phlegm Pill; for zang-fu organs heat toxin ascending, use Three Yellow Decoction.
2. Yin Deficiency︰The tongue experiences burning pain or dry pain, with a smooth red texture, dry and lacking moisture, exhibiting horizontal cracks, and either no tongue coating or a peeling coating. Accompanied by night sweats, irritability, insomnia, vexing heat in the chest, palms, and soles, and a fine rapid pulse. A red tongue with burning pain often results from chronic sleep deprivation and overexertion damaging the true yin, where yin damage is not severe. The "Study of Tongue Inspection" states, "A red and moist tongue color with small prickly protrusions at the tip, which may be painful, is commonly seen in individuals with insomnia or those who work at night." If yin damage is more severe or deficiency fire flares upward, as described in the "Guide to Tongue Differentiation," "dryness and roughness indicate that body fluids are already depleted," "a tongue with horizontal cracks signifies inherent yin deficiency," and "a tongue without coating or spots but with cracks indicates yin deficiency with flaming fire." Symptoms often include dry mouth and a desire to drink, but only in small frequent sips rather than large gulps; the heart-spirit lacks nourishment, making it difficult to sleep at night; yin deficiency with flaming fire causes vexing heat in the chest, palms, and soles. Treatment may involve the Bamboo Leaf Decoction, combined with Liuwei Dihuang Pills.

bubble_chart Documentation

1. Qianjin Fang．The Tongue Theory states: "Excessive consumption of sweet foods causes pain at the root of the tongue and hair loss."
2. 《Medical Abstracts: Essential Methods for Miscellaneous Diseases》: "Pain, heat, and swelling of the tongue are primarily due to the rising inflammation of monarch fire."