口病者,足阳明之不降也。脾窍于口,脾与胃同气,脾主升清,胃主降浊,清升浊降,而口唇无病
,且口中清和而无味。若己土下陷,戊土上逆,而甲木不降,相火上炎,于是唇口肿疼,诸病作矣。且
木郁而口作酸,火郁而口作苦,金郁而口作辛,水郁而口作咸,土郁而口作甘,以五脏之郁而生五味也
。土者水火之中气,水泛于土,则湿生。火郁于土,则热作。湿热熏蒸,则口气腐秽而
臭恶。盖脾病则陷,胃病则逆,口唇之病,燥热者多,湿寒者少。然上热亦有因于下寒者,清上焦之燥
热,不助下焦之湿寒,则得之矣。如湿热熏蒸,口气秽恶者,以甘草黄芩汤主之。如口疮热肿者,以贝
母元参汤主之。如脾胃湿寒,胆火上炎而生口疮者,以桂枝姜苓汤主之。
甘草黄芩汤
甘草(二钱) 黄芩(二钱) 茯苓(三钱) 半夏(三钱) 石膏(三钱) 水煎大半杯,
热服。
贝母元参汤
贝母(三钱) 元参(三钱) 甘草(二钱) 黄芩(二钱) 水煎半杯,热漱徐咽。热甚加
黄连、石膏。
桂枝姜苓汤
芍药(四钱) 桂枝(二钱) 干姜(二钱) 茯苓(三钱) 甘草(二钱) 元参(三钱)
水煎大半杯,温服。
舌者心之官也。心窍于舌,心属火而性升,其火之不升者,金水有以敛之也。若胃逆而金水不敛,火遂
其炎上之性而
病见于舌,其疼痛热肿于是作焉,且火郁则苔生,舌苔者,心液之瘀结也。郁于土则苔黄,郁于金则苔
白,郁于水则苔黑,但黄白黑而滑润者,皆火衰而寒凝也。黄白黑而焦涩者,皆火盛而燥结也。舌虽通于
心,若舌卷不能言,又由于肝郁而筋脉不舒也。若舌萎而言迟,又由于脾绝而舌脉不荣也。若口燥舌干
而渴,又由于肾脉不贯于舌本也。盖舌之疼痛热肿,专责君火之升炎。若滑涩、燥湿、挛缩、弛长诸变,
当于各经求之也。如舌疮疼痛热肿者,以芩连芍药汤主之。如肝燥舌卷者,以桂枝地黄汤主之。
芩连芍药汤
黄芩(三钱) 黄连(一钱) 甘草(二钱) 贝母(二钱去心) 丹皮(三钱) 芍药(三钱)
水煎大半杯,热服。
桂枝地黄汤
桂枝(三钱) 芍药(三钱) 生地(三钱) 阿胶(三钱) 当归(三钱) 甘草(二钱)
水煎大半杯,温服。若中风舌强语拙,或杂证舌萎言迟,皆脾肾湿寒,不宜清凉滋润,勿服此方。
Oral diseases arise from the failure of Foot-Yangming Stomach Qi to descend. The spleen opens into the mouth, and the spleen shares the same Qi with the stomach. The Spleen governs the ascending of clear Yang, while the Stomach governs the descending of turbid Yin. When clear Yang ascends and turbid Yin descends, the lips and mouth remain free of disease, and the mouth feels fresh, harmonious, and tasteless. If Earth Qi sinks downward and Stomach Qi rebels upward, causing Jia Wood (Gallbladder) to fail to descend and Ministerial Fire (Shaoyang Fire) to flare upward, swelling and pain in the lips and mouth occur, giving rise to various ailments. Furthermore, stagnation of Wood Qi causes sourness in the mouth; stagnation of Fire Qi causes bitterness; stagnation of Metal Qi causes pungency; stagnation of Water Qi causes saltiness; and stagnation of Earth Qi causes sweetness. These five flavors arise from the stagnation of the Five Zang organs. Earth serves as the intermediary between Water and Fire. If Water floods over Earth, dampness is generated; if Fire stagnates within Earth, heat arises. Damp-heat steaming and steaming leads to putrid, foul-smelling breath. Generally, Spleen disease manifests as sinking, while Stomach disease manifests as rebellion. Oral lesions are mostly due to dryness-heat, with few cases of damp-cold. However, upper-heat may sometimes stem from lower-cold. Treatment should clear dryness-heat in the Upper Jiao without aggravating damp-cold in the Lower Jiao. For instance, when damp-heat steams causing foul breath, Gancao Huangqin Tang (Licorice and Scutellaria Decoction) is indicated. For oral ulcers with hot swelling, Beimu Yuanshen Tang (Fritillaria and Scrophularia Decoction) is indicated. For oral ulcers caused by Spleen-Stomach damp-cold and Gallbladder Fire flaring upward, Guizhi Jiangling Tang (Cinnamon Twig, Ginger, and Poria Decoction) is indicated.
Gancao Huangqin Tang (Licorice and Scutellaria Decoction)
Gancao (2 qian), Huangqin (2 qian), Fuling (3 qian), Banxia (3 qian), Shigao (3 qian). Decoct in water to obtain half a cup, take warm.
Beimu Yuanshen Tang (Fritillaria and Scrophularia Decoction)
Beimu (3 qian), Yuanshen (3 qian), Gancao (2 qian), Huangqin (2 qian). Decoct in water to obtain half a cup, gargle while hot and swallow slowly. If heat is severe, add Huanglian and Shigao.
Guizhi Jiangling Tang (Cinnamon Twig, Ginger, and Poria Decoction)
Shaoyao (4 qian), Guizhi (2 qian), Ganjiang (2 qian), Fuling (3 qian), Gancao (2 qian), Yuanshen (3 qian). Decoct in water to obtain half a cup, take warm.
The tongue is the official organ of the Heart. The Heart opens into the tongue. The Heart belongs to Fire and its nature is ascending. The reason its Fire fails to ascend is that Metal (Lung) and Water (Kidney) exert a contracting influence. If Stomach Qi rebels and Metal/Water fail to contract, Heart Fire follows its flaming-upward nature and manifests pathology on the tongue, causing pain and hot swelling. Moreover, when Fire stagnates, tongue coating forms; the tongue coating is the coagulation of Heart fluids. Stagnation in Earth yields yellow coating; stagnation in Metal yields white coating; stagnation in Water yields black coating. However, yellow, white, or black coatings that are slippery and moist indicate deficient Fire and cold coagulation. Yellow, white, or black coatings that are scorched and dry indicate excessive Fire and dry coagulation. Although the tongue connects to the Heart, if the tongue curls and speech is impaired, it is due to Liver stagnation causing tendon and vessel tension. If the tongue atrophies and speech is slow, it is due to Spleen exhaustion failing to nourish the tongue vessels. If the mouth is dry, the tongue is parched, and thirst occurs, it is because the Kidney meridian fails to penetrate the root of the tongue. Generally, tongue pain, hot swelling, and redness are specifically attributed to the flaming ascent of Ministerial/Imperial Fire. Variations such as slippery/dry, moist/dry, contraction/flaccidity, and shortening/elongation should be sought in the respective meridians. For tongue sores with pain and hot swelling, Qinlian Shaoyao Tang (Scutellaria, Coptis, and Peony Decoction) is indicated. For Liver dryness causing tongue curling, Guizhi Dihuang Tang (Cinnamon Twig and Rehmannia Decoction) is indicated.
Qinlian Shaoyao Tang (Scutellaria, Coptis, and Peony Decoction)
Huangqin (3 qian), Huanglian (1 qian), Gancao (2 qian), Beimu (2 qian, heart removed), Danpi (3 qian), Shaoyao (3 qian). Decoct in water to obtain half a cup, take warm.
Guizhi Dihuang Tang (Cinnamon Twig and Rehmannia Decoction)
Guizhi (3 qian), Shaoyao (3 qian), Shengdihuang (3 qian), Ejiao (3 qian), Danggui (3 qian), Gancao (2 qian). Decoct in water to obtain half a cup, take warm. If wind-stroke causes stiff tongue and slurred speech, or miscellaneous diseases cause atrophic tongue and slow speech, these belong to Spleen-Kidney damp-cold and should not be treated with cooling/moistening methods; do not take this formula.