小儿噤口之证，失治多致不救，其候舌上生疮，如粟米状，吮乳不得，啼声不出，因胎热所致也，古用清
热疏利之法，主龙胆汤（如柴胡、黄芩、生甘草、钩藤钩、赤芍、煨大黄、龙胆
草、槟榔、桔梗、赤苓，引用枣肉等味）。若肚腹胀硬，二便不通者，主紫霜丸（方见二便不通）。又有一种口
吐白沫，牙关紧急者，此胎热内结，复为风邪外袭，主秘方擦牙散（如生南星、龙脑、二味，共研极细末，用指
蘸合生姜汁，放大牙根擦之，立开，如不开者，其药设法吹入小儿鼻内，立时即刻开关），次服辰砂全蝎散（如
辰砂、全蝎、硼砂、龙脑、麝香五味研极细末，以乳母唾调抹口唇里及牙龈上，证退），再以匀气散（方见不
乳）调和脾胃。
〔真按〕噤口系热毒流于心脾，胎中久蕴，故生后遂发于口舌之间，一名鹅口疮，倘治之稍迟，必口舌糜烂，
难于痊愈，急宜清热泻脾，但用金钗石斛、黄连、生地、赤苓、灯芯五味各少许煎服，外用枯白矾、朱砂、马牙
硝，研末，名保命散，以冷开水调涂舌与口角上，白退自安。
撮口者，口撮如囊而不乳也，舌强唇青，面色黄赤，亦系心脾之热，受自胎中而然也，其证为危候，急当随
证治之，如气高痰盛者，古法主辰砂姜蚕散（如辰砂、姜蚕、蛇蜕皮、麝香四味研末），用蜜调敷唇口，二便秘
结者，古法主紫霜丸（方见二便不通），身热多惊者，古法主龙胆汤（方见噤口），手足抽搐者，古法主撮风散
（如赤脚蜈蚣、钩藤钩、朱砂、直僵蚕、全蝎尾、麝香等味，以竹沥汁调服）。
〔真按〕撮口为初生七日内之笃疾，若口出白沫，四肢冰冷，尤为恶候，急看儿齿龈上，有小泡子如粟米状，
以棉裹纸蘸温水，轻轻擦破，用青黛、冰片、略涂口内，即能吮乳，不必服药，或用朱砂僵蚕散调敷唇上，可以
采用，或研真西牛黄末少许，调竹沥汁沫儿口中亦佳。
The syndrome of neonatal trismus (Jinkou, 噤口) in infants, if left untreated, often leads to untreatable conditions. Its manifestations include sores on the tongue resembling millet grains, difficulty in suckling milk, and an inability to cry. This is caused by fetal heat (Tai Re, 胎热). Ancient methods employed clearing heat and promoting drainage therapies, primarily using Longdan Tang (Coptis Decoction), which contains Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma), Gouteng Gou (Uncariae Ramulus cum Uncis), Chi Shao (Paeoniae Radix Rubra), Wei Da Huang (Prepared Rheum Palmatum Radix et Rhizoma), Long Dan Cao (Gentianae Radix), Bing Lang (Arecae Semen), Jie Geng (Platycodonis Radix), Chi Ling (Poria Cocos with Red Hosta Root), and references Zao Rou (Date Flesh) among other ingredients. If abdominal distension and hardness occur, along with obstruction of both urination and defecation, the primary formula is Zishuang Wan (Purple Frost Pill) (see "Obstruction of Urination and Defecation"). Another variant presents with foaming at the mouth and locked jaw; this results from internal accumulation of fetal heat compounded by external invasion of wind pathogens. The primary treatment is a secret formula for tooth-rubbing powder (Caoya San, 擦牙散), composed of Sheng Nan Xing (Arisaematis Rhizoma Preparatum) and Long Nao (Borneolum Syntheticum), ground into an extremely fine powder. Using a finger dipped in a mixture of fresh ginger juice, rub the gums of the large molars to immediately open the jaws; if it does not open, attempt to blow the powder into the infant's nose to instantly release the lock. Subsequently, administer Chen Sha Quan Xie San (Cinnabar and Whole Scorpion Powder), consisting of Chen Sha (Cinnabaris), Quan Xie (Scorpio), Peng Sha (Borax), Long Nao (Borneolum Syntheticum), and She Xiang (Moschus), ground into an extremely fine powder. Mix with the nursing mother's saliva and apply to the inner lips and gums until symptoms subside. Finally, use Yunqi San (Harmonizing Qi Powder) (see "Failure to Suckle") to harmonize the spleen and stomach.
[Chen Shouzhen's Note] Trismus is caused by heat-toxin flowing into the heart and spleen, accumulating during gestation, thus manifesting on the tongue and mouth after birth. It is also known as Oral Thrush (E Kou Chuang, 鹅口疮). If treatment is delayed even slightly, it will inevitably lead to erosion of the mouth and tongue, making recovery difficult. Urgently clear heat and purge the spleen. Use small amounts of Jin Chai Shi Hu (Dendrobii Nobile Caulis), Huang Lian (Coptidis Rhizoma), Sheng Di Huang (Rehmanniae Radix Praeparata), Chi Ling (Poria Cocos with Red Hosta Root), and Deng Xin Cao (Junci Medullia) decocted together for oral administration. Externally, use Ku Bai Fan (Alumen Exsiccatum), Zhu Sha (Cinnabaris), and Ma Ya Xiao (Natrii Sulfas Crystallisatus), ground into powder, named Baoming San (Life-Preserving Powder). Mix with cold boiled water and apply to the tongue and corners of the mouth; once the white coating recedes, peace returns.
Suo Kou (Neonatal Lip Locking, 撮口) is characterized by the mouth puckering like a purse, preventing suckling, accompanied by a stiff tongue, cyanotic lips, and a yellow-red complexion. This is also due to heat in the heart and spleen inherited from the fetus. This condition is critical and requires immediate symptomatic treatment. For cases with high-pitched breathing and profuse phlegm, ancient methods prescribe Chen Sha Jiang Can San (Cinnabar and Ginger Silkworm Powder), containing Chen Sha (Cinnabaris), Jiang Can (Bombyx Batryticatus treated with ginger), She Tui Pi (Ophichthus Skin), and She Xiang (Moschus), ground into powder and mixed with honey to apply to the lips and mouth. For constipation of both urine and stool, ancient methods prescribe Zishuang Wan (Purple Frost Pill) (see "Obstruction of Urination and Defecation"). For fever and frequent惊悸 (palpitations/fright), ancient methods prescribe Longdan Tang (Coptis Decoction) (see "Trismus"). For convulsions of the hands and feet, ancient methods prescribe Cuofeng San (Wind-Grasping Powder), containing Chi Jiao Wu Gong (Scolopendra Subspinipes mutilans), Gouteng Gou (Uncariae Ramulus cum Uncis), Zhu Sha (Cinnabaris), Zhi Jiang Can (Bombyx Batryticatus), Quan Xie Wei (Tail of Scorpio), and She Xiang (Moschus), taken with bamboo sap (Zhu Li, 竹沥汁).
[Chen Shouzhen's Note] Suo Kou is a severe disease within the first seven days after birth. If foaming occurs at the mouth and the four limbs are cold, it is a particularly ominous sign. Urgently examine the infant's gums for small blisters resembling millet grains. Gently rupture them using cotton-wrapped paper dipped in warm water. Apply Qing Dai (Indigo Naturalis) and Bing Pian (Borneolum) lightly inside the mouth; suckling can resume without medication. Alternatively, applying a mixture of Zhu Sha (Cinnabaris) and Jiang Can (Bombyx Batryticatus) to the lips is also acceptable. Or, mix a small amount of genuine Xi Niu Huang (Bovis Calculus) powder with bamboo sap foam and drip into the infant's mouth, which is also effective.