脉∶口舌生疮，脉洪疾速。若见脉虚，中气不足。
经言∶舌乃心之苗，此以窍言也。以部分言之，五脏皆有所属。以症言之，五脏皆以所主。如口舌肿痛，
或状如无皮，或发热作渴，为中气虚热；或眼如烟触、体倦少食，或午后益甚，为阴血虚热；若咽痛舌疮、口
干足热；日晡益甚，为肾经虚火；若四肢逆冷、恶寒饮食，或痰甚眼赤，为命门火衰，若发热作渴、饮冷便闭，
为肠胃实火；若发热恶寒、口干喜汤、食少体倦，为脾经虚热、若舌本作强、腮颊肿痛，为脾经湿热；若痰甚
作渴、口舌肿痛，为上焦有热；若思虑过度、口舌生疮、咽喉不利，为脾经血伤火动；若恚怒过度、寒热口苦
而舌肿痛，为肝经血伤火动。病因多端，当临时制宜。凡舌肿胀甚，宜先刺舌尖或舌上或边旁，出血泄毒，
以救其急。唯舌下濂泉穴，此属肾经，虽宜出血，亦当禁针
慎之。
口舌生疮、咽喉肿痛、燥渴便闭，此三焦实热也。用凉膈散加减，频频噙咽，不可频服，恐上热未除，
中寒复生，变症莫测也。（方见火证。）
一、口舌生疮，发热恶寒，劳则体倦，不思饮食，此中焦虚热也。用补中益气汤加麦门、五味。（方见补益）。
一、口舌生疮，口干饮汤不食，乃胃气虚而不能化生津液也。用七味白术散（方见小儿吐泻。）
一、口舌生疮，饮食不思、大便不实，中气虚也，人参理中汤；若手足逆冷腹痛，中气虚寒也，加附子。
（方见中寒。）
一、口舌生疮糜烂，或晡热内热，脉数无力，此血虚而有火也。用四物汤加白术、茯苓、麦门、五味、牡
丹、黄柏、知母。（方见补益。）
一、口舌生疮、食少便滑、面黄肢冷，火衰土虚也，用八味丸。（方见补益。）
一、口舌生疮，日晡发热、作渴、唾痰、小便频数，肾水亏损、下焦阴火也，加减八味丸；若热来复去，
昼见夜伏、夜见昼伏，不时而动，或无定处，或从脚下起，乃无根之火也，亦宜此丸；更以附子末，唾津调搽
涌泉穴。若概用寒凉，损伤生气，为疾匪轻。
口臭牙龈赤烂、腿肢痿软，或口咸，此肾经虚热，用六味丸（方见补益。）
口疮者，三焦火盛也。口舌肿大，或痛裂生疮者，治相同也。
凉膈散加减 治三焦火盛，口舌生疮。
连翘 黄芩 山栀 桔梗 黄连 薄荷 当归 生地黄 枳壳（去穣） 芍药 甘草（各等分）
上锉一剂，水煎食远服。
一方 治口舌疮，亦治赤眼。用黄连为末二三钱，好酒煎一二沸，候冷噙漱或咽下，即愈。
赴宴散 治三焦实热，口舌生疮糜烂，痛不可忍者。
黄连 黄柏 黄芩 栀子 细辛 干姜（各等分）
上为细末，先用米泔水漱口，后搽药于患处，或吐或咽不拘。
绿袍散 治口疮。
黄柏（一两） 青黛（三钱）
上为细末，搽患处噙之，吐出涎立愈。一方加密陀僧一钱。
二皂散 治口舌生疮，牙宣出血。
大皂角（烧灰存性） 牙皂（烧灰存性） 铜绿 胆矾 雄黄 孩儿茶 百草霜 枯矾。
上各等分为细末，先将米泔水漱口、洗口疮后搽药。
黄白散 治口疮如神，并口中疳疮。
黄柏 孩儿茶 枯白矾（各等分为细末）
上研匀一处。凡患人先用陈仓小米熬汤，候冷漱口洁净，次将药末掺患处不拘。三五年诸治不愈者，此药
敷三五次即愈。
郑秋官过饮，舌本强肿，言语不清，此脾虚湿热。用补中益气加神曲、麦芽、干葛、泽泻而愈。（方见补益。）
一膏梁之人患舌痛，敷服皆消肿之药，舌肿势急。余刺舌尖及两旁出紫血杯许，肿消一二；更服犀角地黄
汤一剂，翌早复肿胀，仍刺出紫血杯许，亦消一二；仍服前汤良久，舌大肿；又刺出黑血二杯许，肿渐消。忽
寒热作呕、头痛作晕，脉洪浮而数，此邪虽去而真气愈伤。以补中益气倍用参、
、归、术，四剂而安，又数剂而愈。（方见补益。）
口苦者，心热也。
黄连泻心汤 治心经蕴热。黄连（去须） 为末，水调服。
口甘者，脾热也。
三黄汤 治脾热口甜。
黄连 黄芩 山栀 石膏 芍药 白术（去芦，减半） 桔梗 陈皮 茯苓（去皮。各等分） 甘草（减半）
乌梅（一个）
上锉一剂，水煎食后服。
口辣者，肺热也。
泻白汤 治口辣肺热。
桑白皮 地骨皮（各二钱） 甘草（一钱）
上锉一剂，水煎，食远温服。
口咸者，肾热也。
滋肾丸
黄柏（二两，用酒拌湿，阴干） 知母（二两，酒浸湿，阴干） 肉桂（一钱）
上知柏气味俱阴，以固肾气，故能补肾以泻下焦火也。桂与火邪同体，故以寒因热用。凡诸病在下焦，皆
不渴也。用三味俱为末，以热水丸，百沸汤送下。
口酸而苦者，肝胆有实热也。小柴胡汤，根据本方加草龙胆、甘草、青皮，并怒则口苦，或胁胀，或发热
俱可服。
胆热而口苦者，乃谋虑不决也。小柴胡汤，根据本方加麦门冬、酸枣仁、远志、地骨皮。
补遗方
清热如圣散 治舌下肿如核大，取破出黄痰，已愈又复发。
枳壳（五分） 天花粉（五分） 黄连（八分） 连翘（一钱） 荆芥 薄荷（五分） 牛蒡子（八分）
山栀（六分） 柴胡（四分） 甘草（三分）
上锉一剂，灯草十根，水煎，食后稍冷服。忌鱼腥浓味。
又方 治舌下肿结如核，或重舌、木舌及满口生疮，以清火化痰为主。
陈皮（去白，八分） 半夏（姜制，一钱三分） 茯苓（去皮，一钱） 桔梗（去芦，五分） 黄连
（酒炒，一钱） 当归（酒洗，八分） 青竹茹（一钱） 生地（酒洗，一钱五分） 甘草梢（二分）
上锉一剂，生姜三片，水煎食后服。
碧雪膏 治一切积热，口舌生疮，心烦喉闭，燥渴肿痛。
碧雪 芒硝 马牙硝 朴硝（各一斤） 青黛 石膏 寒水石 滑石（水飞。各六两）
上为细末，甘草一斤煎水和诸药匀；再入火煎，用柳木搅匀；入青黛又搅匀；倾出盆内，候冷结成块，研
为细末。每用少许噙化。如喉闭，每用少许吹入喉中。
Pulse: Mouth and tongue sores, with a surging (Hong) and rapid pulse. If a deficient (Xu) pulse is seen, it indicates deficiency of Middle Qi (Zhong Qi).
Classics state: The tongue is the sprout of the Heart, which refers to orifices. Speaking from body parts, each Zang organ has its domain. Speaking from symptoms, each Zang organ is governed by its functions. For example, swelling and pain of the mouth and tongue, or appearing as if skinless, or accompanied by fever and thirst, belongs to deficiency heat caused by deficiency of Middle Qi; or eyes feeling as if smoky, fatigue, reduced appetite, or worsening in the afternoon, belongs to deficiency heat caused by deficiency of Yin Blood; if there is sore throat, tongue sores, dry mouth, hot feet, worsening in the late afternoon, it belongs to deficiency fire of the Kidney Meridian; if limbs are cold, aversion to cold and poor diet, or excessive phlegm and red eyes, it belongs to decline of Fire of the Gate of Vitality (Ming Men); if fever and thirst, preference for cold drinks, and constipation, it belongs to excess fire of the Stomach and Intestines; if fever and aversion to cold, dry mouth preferring warm drinks, reduced food intake and fatigue, it belongs to deficiency heat of the Spleen Meridian; if the tongue base is stiff, swelling and pain of cheeks, it belongs to damp-heat of the Spleen Meridian; if excessive phlegm and thirst, swelling and pain of mouth and tongue, it belongs to heat in the Upper Jiao; if excessive thinking, mouth and tongue sores, throat discomfort, it belongs to fire moving due to blood injury of the Spleen Meridian; if excessive anger, alternating chills and fever, bitter taste and tongue swelling/pain, it belongs to fire moving due to blood injury of the Liver Meridian. Etiologies are diverse; treatment must be adapted to the situation. When the tongue is severely swollen, one should first prick the tip, surface, or edges of the tongue to bleed and release toxins, to save the emergency. Only the Lianquan (CV23) acupoint under the tongue, which belongs to the Kidney Meridian, although bleeding is suitable, needling should be prohibited. Exercise caution.
Mouth and tongue sores, sore throat, dry thirst, and constipation indicate Excess Heat of the Three Jiao. Use Liangge San (Cool the Diaphragm Powder) with modifications, frequently holding in the mouth and swallowing, but do not take frequently, lest the upper heat is not removed while middle cold arises, leading to unpredictable complications. (Formula see "Fire Syndrome".)
1. Mouth and tongue sores, fever and aversion to cold, fatigue upon exertion, loss of appetite, this is Deficiency Heat of the Middle Jiao. Use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus). (Formula see "Tonification".)
2. Mouth and tongue sores, dry mouth desiring warm drinks but no desire to eat, this is deficiency of Stomach Qi unable to transform fluids into Jin Ye (Body Fluids). Use Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder). (Formula see "Pediatric Vomiting and Diarrhea".)
3. Mouth and tongue sores, loss of appetite, loose stools, indicating deficiency of Middle Qi, use Renshen Lizhong Tang (Ginseng Regulate the Middle Decoction); if hands and feet are cold with abdominal pain, indicating deficiency-cold of Middle Qi, add Fuzi (Aconiti Lateralis Radix Praeparata). (Formula see "Middle Cold".)
4. Mouth and tongue sores with erosion, or afternoon fever, internal heat, rapid but forceless pulse, this is Blood deficiency with Fire. Use Siwu Tang (Four Substance Decoction) plus Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Maidong, Wuweizi, Mudanpi (Moutan Cortex), Huangbai (Phellodendri Cortex), and Zhimu (Anemarrhenae Rhizoma). (Formula see "Tonification".)
5. Mouth and tongue sores, reduced food intake, slippery stools, yellow complexion, cold limbs, indicating decline of Fire and deficiency of Earth, use Bawei Wan (Eight-Ingredient Pill). (Formula see "Tonification".)
6. Mouth and tongue sores, afternoon fever, thirst, spitting phlegm, frequent urination, indicating depletion of Kidney Water and Yin Fire of the Lower Jiao, use Jiabian Bawei Wan (Modified Eight-Ingredient Pill); if heat comes and goes, appearing by day and hiding by night, or vice versa, occurring irregularly, without fixed location, or rising from the feet, this is Rootless Fire, also suitable for this pill; additionally, apply Fuzi powder mixed with saliva to Yongquan (KI1) acupoint. If all use cold-cooling herbs, it damages Sheng Qi (Vital Qi), and the disease becomes severe.
Bad breath, red and rotten gums, flaccid legs, or salty taste, this is deficiency heat of the Kidney Meridian, use Liuwei Wan (Six-Ingredient Pill). (Formula see "Tonification".)
Mouth ulcers are caused by flourishing Fire of the Three Jiao. Swelling of mouth and tongue, or painful cracking and sores, have the same treatment.
Liangge San Modified: Treats flourishing Fire of the Three Jiao, mouth and tongue sores.
Qiaofeng (Forsythiae Fructum), Huangqin (Scutellariae Radix), Shanzhi (Gardeniae Fructum), Jiegeng (Platycodonis Radix), Huanglian (Coptidis Rhizoma), Bohe (Menthae Haplocalycis Herba), Danggui (Angelicae Sinensis Radix), Shengdihuang (Rehmanniae Radix), Zhike (Aurantii Fructus, remove pith), Shaoyao (Paeoniae Radix Alba/Glabra), Gancao (Glycyrrhizae Radix et Rhizoma) (equal parts).
Chop these into one dose, decoct in water, take after meals.
Another prescription: Treats mouth and tongue sores, also treats red eyes. Use Huanglian powder, 2-3 qian, decoct in good wine for 1-2 boils, cool, hold in mouth or swallow, then cured.
Fuyan San (Banquet Powder): Treats Excess Heat of the Three Jiao, mouth and tongue sores with erosion, unbearable pain.
Huanglian, Huangbai, Huangqin, Zhizi, Xixin (Asari Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma) (equal parts).
Grind into fine powder, rinse mouth with rice water first, then apply medicine to the lesion, spit out or swallow as desired.
Lv Pao San (Green Robe Powder): Treats mouth sores.
Huangbai (1 liang), Qingdai (Indigo Naturalis) (3 qian).
Grind into fine powder, apply to lesion and hold in mouth, spit out saliva and it will cure. Another method adds Miduoseng (Lithargyri) 1 qian.
Erzao San (Two Soaps Powder): Treats mouth and tongue sores, bleeding gums.
Da Zaojiao (Gleditsiae Sinensis Spina, burn to ash keeping nature), Ya Zao (Gleditsiae Sinensis Spina, burn to ash keeping nature), Tonglv (Chrysocollae Calx), Danfan (Alumen), Xionghuang (Realgar), Haiercha (Camelliae Sinensis Seed), Baicaoshuang (Carbonis Cytisi Caulis), Kufan (Alumen calcined).
Equal parts grind into fine powder, rinse mouth with rice water and wash sores first, then apply medicine.
Huang Bai San (Yellow White Powder): Miraculous for mouth sores, and oral gan sores.
Huangbai, Haiercha, Ku Baifan (Alumen calcined) (equal parts grind into powder).
Grind uniformly. Patients first boil old millet soup, cool, rinse mouth clean, then sprinkle powder on lesions, frequency unrestricted. For those untreated for 3-5 years, applying this medicine 3-5 times cures it.
Official Zheng drank excessively, tongue base stiff and swollen, unclear speech, this is Spleen deficiency with damp-heat. Use Buzhong Yiqi Tang plus Shenqu (Massa Medicata Fermentata), Maiya (Hordei Fructus Germinatus), Genge (Puerariae Lobatae Radix), Zexie (Alismatis Rhizoma) and was cured. (Formula see "Tonification".)
A wealthy person suffered tongue pain, applied and took swelling-reducing medicines, but tongue swelling intensified. I pricked the tongue tip and sides, draining about one cup of purple blood, swelling reduced slightly; then administered Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) one dose, next morning swelling returned, still pricked draining one cup of purple blood, reduced slightly; continued taking the previous decoction for a long time, tongue greatly swollen; again pricked draining two cups of black blood, swelling gradually subsided. Suddenly chills, fever, vomiting, headache, dizziness, pulse surging, floating and rapid, this indicates pathogen gone but True Qi further injured. Use Buzhong Yiqi Tang doubling Renshen (Ginseng Radix), Huangqi (Astragali Radix), Danggui, Baizhu, four doses to stabilize, several more doses to cure. (Formula see "Tonification".)
Bitter taste in mouth is Heart Heat.
Huanglian Xiexin Tang (Coptis Decoction to Drain the Heart): Treats latent Heat in Heart Meridian. Huanglian (remove stamens) grind into powder, mix with water and take.
Sweet taste in mouth is Spleen Heat.
Sanhuang Tang (Three Yellow Decoction): Treats Spleen Heat with sweet taste.
Huanglian, Huangqin, Shanzhi, Shigao (Gypsum Fibrosum), Shaoyao, Baizhu (remove rhizome head, half dose), Jiegeng, Chenpi (Citri Reticulatae Pericarpium), Fuling (half dose), Gancao (half dose), Wumei (one).
Chop into one dose, decoct in water, take after meals.
Spicy taste in mouth is Lung Heat.
Xiebai Tang (Drain White Decoction): Treats spicy taste and Lung Heat.
Sangbaipi (Mori Cortex), Digupi (Lygodii Radix) (each 2 qian), Gancao (1 qian).
Chop into one dose, decoct in water, take warm after meals.
Salty taste in mouth is Kidney Heat.
Zishen Wan (Nourish Kidney Pill)
Huangbai (2 liang, mix with wine, moisten, dry in shade), Zhimu (2 liang, soak in wine, moisten, dry in shade), Rougui (Cinnamomi Cortex) (1 qian).
Zhimu and Huangbai have Yin flavors, to consolidate Kidney Qi, thus they tonify Kidney to drain Lower Jiao Fire. Rougui shares nature with Fire, thus using "cold for heat" method. All diseases in Lower Jiao do not cause thirst. Grind three ingredients into powder, make pills with hot water, take with boiling water.
Sour and bitter taste in mouth indicates Excess Heat in Liver and Gallbladder. Xiaochaihu Tang (Minor Bupleurum Decoction), based on original formula add Longdancao (Gentianae Radix), Gancao, Qingpi (Citri Reticulatae Pericarpium Viride). Whenever anger causes bitter taste, or hypochondriac distension, or fever, it can be taken.
Gallbladder Heat causing bitter taste is due to indecisive planning. Xiaochaihu Tang, based on original formula add Maidong, Suanzaoren (Ziziphi Spinosae Semen), Yuanzhi (Polygalae Radix), Digupi.
Supplementary Prescriptions
Qingre Rusheng San (Clear Heat Like Sage Powder): Treats sublingual swelling like a kernel, punctured to drain yellow phlegm, cured but recurred.
Zhike (5 fen), Tianhuafen (Trichosanthis Radix) (5 fen), Huanglian (8 fen), Qiaofeng (1 qian), Jingjie (Schizonepetae Spica), Bohe (5 fen), Niubangzi (Arctii Fructus) (8 fen), Shanzhi (6 fen), Chaihu (Bupleuri Radix) (4 fen), Gancao (3 fen).
Chop into one dose, with 10 roots of Dengxincao (Junci Medullae), decoct in water, take slightly cool after meals. Avoid fishy and strong flavors.
Another Prescription: Treats sublingual nodular swelling, or double tongue, wooden tongue, and full-mouth sores, mainly clearing Fire and resolving Phlegm.
Chenpi (remove white pith, 8 fen), Banxia (Pinelliae Rhizoma, ginger processed, 1 qian 3 fen), Fuling (1 qian), Jiegeng (5 fen), Huanglian (wine fried, 1 qian), Danggui (wine washed, 8 fen), Qingzhuru (Bambusae Sapta) (1 qian), Shengdi (wine washed, 1 qian 5 fen), Gancao Shao (Glycyrrhizae Radix et Rhizoma tip, 2 fen).
Chop into one dose, with 3 slices of Shengjiang (Zingiberis Rhizoma Recens), decoct in water, take after meals.
Bixue Gao (Green Snow Ointment): Treats all accumulated Heat, mouth and tongue sores, vexation, throat closure, dry thirst, swelling and pain.
Bixue, Mangxiao (Natrii Sulfas), Mayaxiao (Natrii Sulfas crystallized), Puxiao (Natrii Sulfas crude) (each 1 jin), Qingdai, Shigao, Hanshuishi (Aragonitum), Huashi (Talcum) (water-ground, each 6 liang).
Grind into fine powder, Gancao (1 jin) decocted water to mix medicines evenly; boil again, stir with willow wood; add Qingdai and stir evenly; pour into basin, cool until solidified, grind into fine powder. Use a little to dissolve in mouth. If throat closure, blow a little into throat.