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When the mouth is dry, it indicates that pathogenic heat has aggregated in the Upper Jiao (Upper Burner), which is governed by the Stomach Meridian of Foot-Yangming. This condition can also occur due to Lung Heat. For Lung Heat, Liang Ge San (Cooling the Diaphragm Powder) is used; for Stomach Heat, Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) is used. If the body fever has subsided, the exterior pathogens have been resolved, but symptoms indicating the need for purgation appear, one of the Three Cheng Qi Decoctions (Three Major Purgative Formulas) should be selected according to the specific presentation. In Shaoyang Disease, characterized by a bitter taste in the mouth and dry tongue, Xiao Chai Hu Tang (Minor Bupleurum Decoction) with Banxia (Pinelliae Rhizoma) removed and Tian Hua Fen (Trichosanthis Radix) added is prescribed. In Yangming Disease, presenting with aversion to cold on the back and dry mouth, Bai Hu Tang (White Tiger Decoction) is indicated. When heat transmits to the Shaoyin channel, causing dry mouth, dry throat, thirst, cold hands and feet, and a pulse that is unexpectedly deep and choppy, this is considered an untreatable condition. Note: "Mouth dryness" differs from "thirst." Thirst implies there is still some saliva in the mouth, but the patient frequently desires to drink water. Mouth dryness with dry throat implies the mouth is cracked and dry, with a complete lack of fluids. Zhang Zhongjing, in the section on aversion to cold on the back, states that if the mouth feels neutral and not dry, it is a Yin-Cold pattern; if there is aversion to cold on the back and the mouth is dry, it is a Yang-Heat pattern. However, one must also determine cold versus heat by observing whether the patient drinks water and whether the urine is clear or red.

Regarding cracked and scorched lips and mouth, this is a sign of severe illness in the human body. In miscellaneous diseases, it involves five aspects: Spleen, Lung, Heart, and Intestines and Stomach. In external contraction diseases, it is solely governed by the Hand and Foot Yangming meridians. The upper lip, flanking the mouth, belongs to the Large Intestine Meridian of Hand-Yangming; the lower lip, flanking the mouth, belongs to the Stomach Meridian of Foot-Yangming. When Shanghan (Cold Damage) heat is in the Taiyang stage, the lips and mouth do not crack; when heat transmits to the Yangming stage, the lips and mouth become cracked and scorched. Thus, it is said that Yangming Dryness-Heat causes cracked and scorched lips and mouth. However, distinctions exist: scorched lips that allow drinking indicate Dryness-Heat; scorched lips that do not allow drinking indicate Damp-Heat. Furthermore, heat in the Qi Level results in cracking and thirst; heat in the Blood Level results in cracking without thirst. Additionally, scorched lips and mouth with thirst and ability to drink, accompanied by a comfortable chest, indicate heat without stagnation, suitable for clearing heat. Thirst without ability to drink, accompanied by chest fullness and oppression, indicate heat with food stagnation, suitable for resolving stagnation. This refers to heat in the upper part of the Foot-Yangming Stomach. Scorched lips and mouth without thirst or desire to drink, accompanied by abdominal irritability and fullness, indicate heat in the Large Intestine with dry feces. This refers to heat in the lower part of the Hand-Yangming Large Intestine. Therefore, treatments for scorched lips may include Bao He San (Preserve Harmony Powder) to resolve food stagnation in the upper stomach, or Cheng Qi Tang formulas to purge dry feces from the lower large intestine. It is not limited to the method of clearing heat with Liang Ge San. For example, in cases of delirium caused by heat, with scorched lips, dry mouth, thirst, and ability to drink, Liang Ge San and Dao Chi Ge Ban Tang (Half Dao Chi Decoction) are used to clear upper Jiao dryness-heat. In cases of delirium caused by food stagnation, with scorched lips, dry mouth, thirst, but inability to drink, Zhi Shi Dou Chi Tang (Immature Soybean and Immature Bitter Orange Decoction) and Bao He San mixed with Zhu Li (Bambusa Textilis Sap) and Lu Bo Zhi (Raphani Juice) are used to moisten dryness and resolve middle Jiao stagnation. In cases of dry accumulation in the Large Intestine, with delirium and scorched lips, Cheng Qi Tang is used to move lower Jiao dry stool. There are also cases where heat disease combined with eruptive diseases (such as smallpox/measles) involves the mistaken consumption of rich, greasy, or animal products, causing pathogenic heat and toxins to knot together unresolvedly. This leads to scorched lips and mouth, foul breath, gingival ulcers, thirst without ability to drink, irritability, fever, drowsiness, and lethargy. If treated with Bao He San to digest food, the disease will not subside. If treated with Gan Ge (Puerariae Radix), Shi Gao (Gypsum Fibrosum), Zhi Mu (Anemarrhenae Rhizoma), and San Huang (Three Bitters) to clear heat, the heat will worsen. If mistakenly diagnosed as dry stool in the Large Intestine causing scorched lips and treated with Cheng Qi Tang to purge downward, death will occur more rapidly. Physicians at this point are helpless. Based on my insights in my later years, I deduce that this is due to pathogenic heat and toxins lurking in the intestines and stomach, steaming and fermenting to emerge. Initially, Sheng Ma Gan Ge Tang (Cimicifugae and Puerariae Decoction) must be used to vent the latent toxin in Yangming. If the heat stems from rich diet accumulation, Sheng Ma Qing Wei Tang (Cimicifugae Stomach-Clearing Decoction) is required to ventilate intestinal and gastric heat; thus, to clear heat and resolve stagnation, this formula must be modified with Shan Zha (Crataegi Fructus) and Bing Lang (Arecae Semen); if meat consumption was high, add San Leng (Sparganii Rhizoma) and A Wei (Asini Corii Colla). Treating syndromes with food retention often yields survival. Heat in the Qi level, causing scorched lips and thirst, is treated with Gan Ge Shi Gao Zhi Mu Tang, a method known to all. Heat in the Blood level is treated primarily with Sheng Ma Sheng Di Chuan Lian Qing Wei Tang (Cimicifugae, Rehmanniae, and Coptidis Stomach-Clearing Decoction), a method often overlooked. One must know that Gan Ge Qing Wei Tang treats scorched lips and thirst due to Yangming Qi-level fluid consumption; Sheng Ma Qing Wei Tang treats scorched lips and thirst without fluid consumption due to Yangming Blood-level heat. I apply modifications to Sheng Ma Qing Wei Tang, representing methods beyond standard application. Using this decoction to treat Yangming Blood-level heat with thirst and no fluid consumption is another layer of methodological extension. Currently, using this decoction to treat scorched lips from rich-diet accumulation heat or meat/grease-induced heat represents further evolution of these methods. Re-examining Zhang Zhongjing’s treatment of Taiyang thirst with desire to drink, mild heat, and excessive thirst; rapid pulse with irritability and thirst; thirst after sweating; and thirst with oral irritability—he does not use methods to clear upper Jiao Lung and Stomach accumulated heat, but instead uses Wu Ling San (Five-Ingredient Powder with Poria). This is likely because Taiyang profuse sweating leads to thirst, exterior heat remains unsubsided, and both exterior and interior are affected, with heat binding in the Bladder/Lower Jiao. This differs from simple exterior or interior heat, which cannot be treated solely by releasing the exterior or clearing the interior alone. Thus, Wu Ling San is used to simultaneously resolve Taiyang. Everyone knows that thirst with ability to drink requires clearing the interior; however, few realize that when thirst with ability to drink is accompanied by exterior pathogens, clearing the interior is contraindicated.