经云∶手少阴之经通于舌，足太阴之经通于口。因心脾二经有热，则口舌生疮也。当察面图部位，分经络虚实而药
之。若元气无亏，暴病口生白屑，或重舌者，用乱发缠指，醮井水揩之，或刺出毒血，敷以柳花散。敷之上以肿胀或有
泡者， 令刺破，敷前散，或以青黛搽之，刺后又生，又刺。若唇吻热烈者，用当归膏调柳花散敷之。若元气
亏损，或服寒凉之药，或兼作呕少食者，此虚热也，用五味异功散加升麻、柴胡。若泄泻作渴者，脾胃虚弱也，用
七味白术散。若腹痛恶寒者，脾胃虚寒也，用六君、姜、桂。若因母食酒面
煎者，用清胃散。若因母饮食劳役者，用补中益气汤。肝脾血气者，用加味逍遥散。郁怒内热者，用加味归脾汤，子
母服。若泥用降火，必变慢脾风矣，仍参吐舌弄舌治之。凡针重舌，以线针直刺，不可横挑，恐伤舌络，致言语不清
也。
一小儿口舌生疮，手热饮冷。属胃经实热，用柳花散、加味解毒散而愈。后因伤食吐血，不时弄舌，属脾经虚热，
用四君子汤而痊。
一小儿口舌生疮，延及头面胸背，脓水淋漓，此胎毒也，内用牛黄解毒丸，外以当归膏调黄柏末，涂之而愈。
一小儿发热饮冷，口患疮，额鼻黄赤，吐舌流涎，余用导赤、泻黄二散而愈。后复作，自服清热化毒之药，益甚，
更加弄舌，余用五味异功散加钩藤钩及六君子汤而愈。盖吐舌为脾之实热也，弄舌为脾之虚热也。治者审之！
一小儿患前症，久不愈，恪服清凉之剂，痰喘不已，口开流涎，手足 冷。又欲治痰，余谓∶经云，脾主涎，肺主
气。此因脾土虚寒，不能生肺金而然，非痰火为患也。先用温中丸二服，痰喘顿止，又用五味异功散而痊。
一小儿口内生疮，用寒凉之剂，更发热饮汤不绝，此中气虚寒，隔阳于外，非实热也。用补中益气汤加炮姜，一剂
而愈。
陈湖陆钦若，子患前症，敷服寒剂，手足 冷，口唇时动，余曰∶此中气虚寒，而变慢脾风也。后果殁。
东垣清胃散 治胃经有热，牙齿作痛，或饮冷作渴，口舌生疮，或唇口肿痛， 连头面，或重舌马牙，吐舌流
涎。若因服克伐之剂，脾胃虚热，口舌生疮，或弄舌流涎，或呕吐困睡，大便不实者，用五味异功散。
升麻（五分） 生地黄（四分） 黄连 牡丹皮（各三分） 当归稍（四分）
上水煎服，婴儿母亦服。
清热消毒散 治实热，口舌生疮，及一切疮疡肿痛，形病俱实者。
黄连（炒） 山栀（炒） 连翘 当归（各五分） 川芎 芍药（炒） 生地黄（各六分） 金银花（一钱） 甘
草（二分）
上水煎服，婴儿母同服。
四君子汤 治脾气虚热，口舌生疮。或但胃气复伤，饮食少思，或食而难化。若作呕泄泻，尤宜用之。如兼痰
嗽气逆，肢体倦怠，面目浮肿，宜用六君子汤。
六君子汤 治脾胃气虚，吐泻不食，肌肉消瘦。或肺虚痰嗽，喘促恶寒。或惊搐口直口噤诸症。（二方见腹痈）
五味异功散 治脾胃虚热，口舌生疮。或因误服克伐之剂，脾胃复伤，而口舌生疮。或弄舌流涎，吐泻不止，
饮食少思。或惊搐痰嗽，睡而露睛，手足 冷。若母有病，致儿患者，子母并服。（方见用败毒之剂）
人参理中汤
人参 白术（炒） 干姜（泡） 甘草（炙。各等分）
上每服一二钱，水煎蜜丸，即人参理中丸，加附子，即人参理中汤。
四物汤 治疮疡血虚，发热烦躁。或晡热作渴，头目不清。若因脾虚不能生血者，用四君子汤。（方见腹痈）
柳叶散 治热毒口疮。
黄柏（炒） 蒲黄 青黛（真正者） 人中白（ ，各等分）
上为末，敷之。
加味解毒散
牛黄解毒丸（二方见胎毒疮疥）
The *Yellow Emperor's Inner Canon* states: The meridians of the Hand-Shaoyin (Heart) connect with the tongue, and the meridians of the Foot-Taiyin (Spleen) connect with the mouth. If there is heat in the Heart and Spleen meridians, sores will arise in the mouth and tongue. One should observe the manifestations on the face and body, differentiate the deficiency or excess of the meridians, and prescribe medication accordingly.
If the primordial Qi (Yuan Qi) is not depleted, and acute illness causes white patches to appear in the mouth, or if "double tongue" (Re She, swelling of the sublingual area resembling a second tongue) occurs, wrap disordered hair around the finger, dip it well water, and wipe the affected area; or prick to release toxic blood, then apply Liu Hua San (Willow Flower Powder). If swelling or blisters persist after application, prick them open, reapply the aforementioned powder, or apply Qing Dai (Indigo Naturalis); if they regrow after pricking, prick again. If the lips and corners of the mouth feel burning hot, use Dang Gui Gao (Angelica Ointment) to mix and apply Liu Hua San externally.
If the primordial Qi is depleted, or if cold-natured medicines have been taken, or if accompanied by vomiting and poor appetite, this indicates deficient heat. Use Wu Wei Yi Gong San (Five-Ingredient Powder for Extraordinary Merit) augmented with Sheng Ma (Cimicifugae Rhizoma) and Chai Hu (Bupleuri Radix). If diarrhea occurs with thirst, this is due to Spleen-Stomach weakness; use Qi Wei Bai Zhu San (Seven-Ingredient White Atractylodes Macrocephala Powder). If abdominal pain and aversion to cold occur, this is Spleen-Stomach deficient cold; use Liu Jun Zi Tang (Six-Gentleman Decoction) augmented with Sheng Jiang (Zingiberis Rhizoma Recens) and Rou Gui (Cinnamomi Cortex). If caused by the mother consuming alcohol, wheat products, or fried foods, use Qing Wei San (Stomach-Clearing Powder). If caused by the mother's dietary irregularities or overexertion, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). If due to disharmony of Liver-Spleen Blood and Qi, use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder). If due to frustration causing internal heat, use Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction), administered to both mother and child. If one stubbornly uses only fire-clearing methods, it will inevitably transform into Man Pi Feng (Slow Spleen Wind, a critical pediatric condition); treatment should still refer to the management of Tu She (tongue protrusion) and Nong She (tongue fidgeting). For acupuncture treating double tongue, use a thread needle to pierce vertically; do not pick horizontally, lest damage to the tongue collaterals cause unclear speech.
A child presented with sores in the mouth and tongue, hot hands, and a preference for drinking cold water. This belongs to Excess Heat in the Stomach Meridian. It was cured using Liu Hua San and Jia Wei Jie Du San (Modified Detoxification Powder). Later, due to food stagnation leading to hematemesis and frequent tongue fidgeting, it belonged to Deficient Heat in the Spleen Meridian, and was recovered using Si Jun Zi Tang (Four-Gentleman Decoction).
Another child had sores in the mouth and tongue spreading to the head, face, chest, and back, with dripping pus and water. This was fetal toxin. Internally, Niu Huang Jie Du Wan (Calculus Bovis Detoxification Pill) was used; externally, Dang Gui Gao mixed with Huang Bo Mo (Phellodendri Cortex Powder) was applied, resulting in recovery.
Another child presented with fever, preference for cold drinks, oral ulcers, yellow-red forehead and nose, tongue protrusion, and drooling. I treated him with Dao Chi San (Guide Out Redness Powder) and Xie Huang San (Drain Yellow Powder), resulting in recovery. The condition later recurred; the child self-administered heat-clearing and detoxifying medicines, worsening the condition and adding tongue fidgeting. I treated him with Wu Wei Yi Gong San augmented with Gou Teng (Uncariae Ramulus Cum Uncis) and Liu Jun Zi Tang, resulting in recovery. Generally, tongue protrusion indicates Excess Heat of the Spleen, while tongue fidgeting indicates Deficient Heat of the Spleen. Practitioners must examine this carefully!
A child suffered from the aforementioned symptoms for a long time without recovery. Strictly taking cooling agents led to persistent phlegm and wheezing, open mouth with drooling, and cold extremities. Wanting to treat the phlegm, I stated: The *Canon* says, the Spleen governs saliva, and the Lung governs Qi. This is due to Spleen Earth being deficient and cold, failing to generate Lung Metal, rather than being caused by phlegm-fire. First, two doses of Wen Zhong Wan (Warm the Middle Pill) were given, stopping the phlegm and wheezing immediately; subsequently, Wu Wei Yi Gong San was used for full recovery.
A child developed oral sores. After using cold-natured medicines, he became more feverish and constantly desired warm drinks. This is Deficiency-Cold of the Middle Qi, with Yang being repelled to the exterior, not Excess Heat. It was cured with one dose of Bu Zhong Yi Qi Tang augmented with Pao Jiang (Prepared Zingiberis Rhizoma).
Lu Qinruo of Chenhu Lake: His son suffered from the aforementioned condition. After applying and ingesting cold agents, his extremities became cold, and his lips twitched occasionally. I said: This is Deficiency-Cold of the Middle Qi, transforming into Man Pi Feng. He eventually died.
Dong Yuan's Qing Wei San: Treats Heat in the Stomach Meridian, toothache, or thirst induced by drinking cold water, sores in the mouth and tongue, swelling and pain of lips and mouth extending to the head and face, or double tongue, horse teeth (milk spots), tongue protrusion, and drooling. If due to taking attacking/cold-natured medicines causing Spleen-Stomach deficient heat, with sores in mouth and tongue, tongue fidgeting, drooling, vomiting, drowsiness, or loose stools, use Wu Wei Yi Gong San.
Prescription: Sheng Ma (5 fen), Sheng Di Huang (4 fen), Huang Lian, Mu Dan Pi (3 fen each), Dang Gui Shao (4 fen).
Decoct in water and take orally. The infant's mother should also take it.
Qing Re Xiao Du San: Treats Excess Heat, sores in the mouth and tongue, and all swellings and pains of sores/ulcers where both constitution and pathology are Excess.
Prescription: Huang Lian (stir-fried), Shan Zhi (stir-fried), Lian Qiao, Dang Gui (5 fen each), Chuan Xiong, Shao Yao (stir-fried), Sheng Di Huang (6 fen each), Jin Yin Hua (1 qian), Gan Cao (2 fen).
Decoct in water and take orally. The infant and mother take it together.
Si Jun Zi Tang: Treats Spleen Qi Deficient Heat, sores in the mouth and tongue. Or if only Stomach Qi is re-injured, with poor appetite or difficulty digesting food. Especially suitable if accompanied by vomiting and diarrhea. If accompanied by phlegm-cough and rebellious Qi, limb fatigue, and facial/ocular edema, use Liu Jun Zi Tang.
Liu Jun Zi Tang: Treats Spleen-Stomach Qi Deficiency, vomiting, diarrhea, anorexia, and emaciation. Or Lung Deficiency with phlegm-cough, panting, and aversion to cold. Or various symptoms such as convulsions, jaw stiffness, and locked jaw. (See these two formulas under "Abdominal Abscess").
Wu Wei Yi Gong San: Treats Spleen-Stomach Deficient Heat, sores in the mouth and tongue. Or due to mistaken use of attacking medicines injuring the Spleen-Stomach again, causing sores. Or tongue fidgeting, drooling, incessant vomiting/diarrhea, poor appetite. Or convulsions, phlegm-cough, sleeping with eyes half-open, and cold extremities. If the mother is ill causing the child's disease, both mother and child take it. (See formula under "Use of Daemonic Agents").
Ren Shen Li Zhong Tang
Prescription: Ren Shen, Bai Zhu (stir-fried), Gan Jiang (soaked), Zhi Gan Cao (roasted). Equal parts.
Take 1-2 qian per dose. Decoct in water and make honey pills. This is Ren Shen Li Zhong Wan; add Fu Zi to become Ren Shen Li Zhong Tang.
Si Wu Tang: Treats Blood Deficiency from sores/ulcers, fever, and irritability. Or evening fever with thirst, and clouded head/eyes. If due to Spleen Deficiency failing to generate blood, use Si Jun Zi Tang. (See formula under "Abdominal Abscess").
Liu Ye San: Treats Heat-Toxin oral ulcers.
Prescription: Huang Bo (stir-fried), Pu Huang, Qing Dai (authentic quality), Ren Zhong Bai (calcined). Equal parts.
Grind into powder and apply externally.
Jia Wei Jie Du San
Niu Huang Jie Du Wan (See these two formulas under "Fetal Toxin Sores and Scabies")