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Also wind gān of the mouth. A vesicle on the upper or lower surface of the tongue. Tongue blisters are attributed to spleen-kidney vacuity heat flaming upward or accumulated spleen-heart heat.

Patterns

Spleen-kidney vacuity heat flaming upward (脾肾虚火上炎 pí shèn xū huǒ shàng yán) gives rise to red, white or yellow tongue blisters of different sizes, configured in strings of five or six. The pulse is vacuous and forceless.

Medicinal therapy: Nourish yīn and clear heat. Use formulas such as Anemarrhena, Phellodendron, and Rehmannia Pill (知柏地黄丸 zhī bǎi dì huáng wán) plus white atractylodes (Atractylodis Macrocephalae Rhizoma, 白朮 bái zhú) and dioscorea (Dioscoreae Rhizoma, 山药 shān yào). Willow Flower Powder (柳花散 liǔ huā sǎn) can be applied as an insufflation.

Accumulated spleen-heart heat (心脾积热 xīn pí jī rè) causes blisters forming configured strings of five or six on the upper surface of the tongue, that are painful, burst, and ulcerate. These are associated with a forceful surging pulse.

Medicinal therapy: Clear the heart and cool the diaphragm. Use formulas such as Diaphragm-Cooling Powder (凉膈散 liáng gé sǎn) for oral medication combined with an insufflation such as Tin-Like Powder (锡类散 xí lèi sǎn).

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