论
《内经》曰∶中央黄色，入通于脾，开窍于口，藏精于脾，故病在舌。夫口之为病，或为重舌木舌，或为糜烂生疮，
或见酸苦甘辛盐味，原其所因，未有不由七情烦扰、五味过伤之所致也。经曰阴之五宫，本在五味，阴之五宫，伤在五
味是也。是以肝热则口酸，心热则口苦，脾热则口甘，肺热则口辛，肾热则口咸。有口淡者，知胃热也。外有谋虑不决，
肝移热于胆而口苦者。亦有脾胃气弱，木乘土位而口酸者。或膀胱移热于小肠，膈肠不便，上为口糜。生疮溃烂则伤寒
狐惑之证，上唇生疮，虫食其脏，下唇生疮，虫食其肛。其为口之为病，种种不同，医者各类推而治之，无有不安者也。
脉法
《脉经》曰∶左寸洪数，心热口苦。右寸浮数，肺热口辛。左关弦数而虚，胆虚口苦。甚洪而实，肝热口酸。右关
沉实，脾胃有实热口甘。兼洪数者，口疮，或为重舌木舌。
脉虚者，中气不足，口疮，若服凉药不愈，宜理中汤。
方法
丹溪曰∶脾热口甘，三黄丸主之。
三黄丸 兼治五痨七伤，消渴不生肌肉。
黄芩（春四、夏秋六、冬三两） 黄连（春四、夏五、秋三、冬二两） 大黄（春三、夏五、秋二、冬一两）
上三味，炼蜜为丸，如梧桐子大，每服五丸，未愈加至七丸，日三服，一月病愈，久服行及奔马。愚按∶此方惟实
热者可用，虚者勿用。
胆热口苦，谋虑不决所致，小柴胡汤加麦门冬、酸枣仁、地骨皮、远志，煎服。
益胆汤 治谋虑不决，肝胆虚气上溢则口苦证。
黄芩（去朽） 甘草（炙） 人参（各一钱） 官桂（五分） 苦参 茯神（各三分） 远志（取肉去骨，七分）
上细切，作一服，水一盏半，煎至一盏，去渣温服。
柴胡地骨皮汤 治膀胱移热于小肠，膈肠不便，上为口糜，生疮溃烂，心胃壅热，水谷不化等证。
柴胡（去芦） 地骨皮（各等分）
上细切，每服五钱，水一盏半，煎至一盏，食后温服。如病患大便实者，加大黄、朴硝以利之。
治口疮，用西瓜浆水徐徐饮之。无瓜时，以瓜皮烧灰敷之。
又方 细辛、黄柏（炒）各等分为末，掺舌上，吐涎乃愈。
又方 用焰硝、硼砂含口勿开，外以南星为末，醋调贴足心涌泉穴上，神效。
又方 用好酒煮黄连成汁，呷下即愈。
又方 用五倍子一两，黄柏蜜炙、滑石各五钱，铜绿五钱，麝香一字，为末掺之，极效。
凡口疮服凉药不愈者，乃中气不足，虚火泛上无制，用理中汤反治之而愈。甚者，加附子，或用官桂噙之亦妙。
又方 治赤口疮。
白矾（枯） 没药（另研） 乳香（另研，各一钱） 铜绿（另研，少许）
上为细末掺之。
又方 治白口疮。
雄黄 没药 乳香（各一钱） 轻粉（五分） 巴豆霜（少许）
上为细末掺之。
治实热口中生疮，用凉膈散、甘桔汤皆效。
一小儿口疮不下食，众以狐惑治之，必死，后以矾汤于脚上浸半日顿宽，更以黄柏（蜜炙）、僵蚕（炒）为末敷之而
愈。
又方 治唇紧燥裂生疮。用青皮烧灰敷之立愈。
又方 治唇紧。以皮纸然于刀上，熏取沥敷，立效。
又方 治口糜。用野蔷薇花根，煎汤漱之。（一云白蔷薇根，杵汁敷之。）
又方 治口内生疮用。
明矾（枯） 黄丹（炒） 盐白梅（烧存性，各一钱） 人中白（半钱， ） 麝香（另研，少许）
上为细末，干掺口内。甚者加硼砂五分，片脑一分。
（以上丹溪方法凡十八条）
硼砂散 治口舌生疮，及咽喉肿病，皆效。
硼砂 马牙硝 滑石 寒水石 枯白矾（各二钱） 片脑（二分）
上为细末，每服半钱许，食后新汲水调下。
碧雪 治口疮，及咽喉肿痛，神效。
蒲黄 青黛 硼砂 焰硝 生甘草
上各等分，为细末敷之，咽喉肿痛，鹅管吹入。
（祖传方）
治舌肿大塞口，不能饮食者。
真蒲黄一味，频刷舌上，自退。若能咽药，即以黄连一味煎浓汁，细细呷之，以泻心经之火，则愈。
（丹溪活套）云∶肝胆有实热，令人口酸而苦，小柴胡汤加甘草、龙胆、青皮之类。甚者，当归龙荟丸。若谋虑不
决、肝胆虚而苦者，人参、远志、茯神、甘草为君，柴胡、草龙胆为佐使。甚者，钱氏地黄丸，虚者补其母也。心热而
口苦，或口舌生疮，黄连泻心汤、牛黄清心丸、凉膈散之类。脾热而口甘者，三黄丸、平胃散之类。肺热而口辛者，甘
桔汤、泻白散、金沸草散之类。肾热而口咸者，滋肾丸、大补阴丸、滋阴大补丸之类。
Treatise
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "In the Central region, the color is yellow; its qi communicates with the Spleen; the orifice opens at the mouth; essence is stored in the Spleen; therefore, diseases manifest in the tongue." Regarding diseases of the mouth, some present as Chongshe (Double Tongue, swelling of the sublingual area resembling a second tongue) or Mushi (Wooden Tongue, stiffness and immobility of the tongue), some present as erosion and ulceration, and some present with abnormal tastes of sour, bitter, sweet, pungent, or salty. Investigating their etiology, none arise other than from disturbance by the Seven Emotions (Joy, Anger, Worry, Pensiveness, Grief, Fear, Fright) and excessive injury from the Five Flavors (Sour, Bitter, Sweet, Pungent, Salty). The classics state: "The five palaces of Yin derive their origin from the five flavors, and the injury to the five palaces of Yin lies in the five flavors." Therefore, Liver Heat causes sour taste in the mouth, Heart Heat causes bitter taste, Spleen Heat causes sweet taste, Lung Heat causes pungent taste, and Kidney Heat causes salty taste. A bland taste indicates Stomach Heat. Externally, bitterness in the mouth can result from indecisive deliberation, where Liver heat transfers to the Gallbladder. It can also result from weak Spleen and Stomach Qi, where Wood overacts on Earth (Liver overacting on Spleen/Stomach), causing sourness. Or, Bladder heat transfers to the Small Intestine, causing obstruction in the chest and intestines, with heat rising to cause oral erosion (Koumi). Ulceration and sores are signs of the Shanghan Huhuo syndrome (a condition characterized by ulcers of the mouth, eyes, and genitals); sores on the upper lip indicate worms eating the viscera, while sores on the lower lip indicate worms eating the anus. Diseases of the mouth vary greatly; physicians should deduce the cause and treat accordingly, ensuring recovery.
Pulse Diagnosis
The *Maijing* (Pulse Classic) states: A surging and rapid pulse at the Left Cun position indicates Heart Heat and bitter taste. A floating and rapid pulse at the Right Cun position indicates Lung Heat and pungent taste. A wiry, rapid, and deficient pulse at the Left Guan position indicates Gallbladder deficiency and bitter taste. A very surging and excess pulse indicates Liver Heat and sour taste. A deep and solid pulse at the Right Guan position indicates Spleen-Stomach excess heat and sweet taste. If accompanied by a surging and rapid pulse, it indicates oral ulcers, or Double Tongue and Wooden Tongue.
A deficient pulse indicates insufficiency of Middle Qi and oral ulcers; if cooling medicines fail to cure, Lizhong Tang (Regulate the Middle Decoction) is appropriate.
Methods
Zhu Danxi stated: For Spleen Heat causing a sweet taste, Sanhuang Wan (Three Yellows Pill) is the primary treatment.
Sanhuang Wan (Three Yellows Pill) Also treats the Five Exhaustions and Seven Injuries (chronic deficiency syndromes), and Xiao Ke (Wasting-Thirst syndrome) with failure to build muscle.
Huangqin (Scutellariae Radix, Spring: 4 liang, Summer/Autumn: 6 liang, Winter: 3 liang) Huanglian (Coptidis Rhizoma, Spring: 4 liang, Summer: 5 liang, Autumn: 3 liang, Winter: 2 liang) Dahuang (Rhei Radix et Rhizoma, Spring: 3 liang, Summer: 5 liang, Autumn: 2 liang, Winter: 1 liang)
These three ingredients are processed with refined honey into pills the size of Sophora seeds. Take 5 pills per dose, increasing to 7 if ineffective, taken three times daily. The disease cures in one month; long-term use enhances vitality like a galloping horse. My commentary: This formula is only suitable for Excess Heat patterns; it must not be used for Deficiency patterns.
For Gallbladder Heat causing bitter taste due to indecisive deliberation, Xiaochaihu Tang (Minor Bupleurum Decoction) added with Maidong (Ophiopogonis Radix), Suanzaoren (Ziziphi Spinosae Semen), Digupi (Lycii Cortex), and Yuanzhi (Polygalae Radix) is decocted and taken.
Yidan Tang (Benefit Gallbladder Decoction) Treats indecisive deliberation and bitter taste caused by deficiency Qi of the Liver and Gallbladder overflowing upward.
Huangqin (Scutellariae Radix, remove rotten parts) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) Renshen (Ginseng Radix et Rhizoma) [each 1 qian] Guigui (Cinnamomi Cortex) [0.5 qian] Kushen (Sophorae Flavescentis Radix) Fushen (Poria with Hostwood) [each 0.3 qian] Yuanzhi (Polygalae Radix, remove woody core) [0.7 qian]
Finely chop, prepare as one dose. Add 1.5 cups of water, decoct to 1 cup, strain, and take warm.
Chaihu Digupi Tang (Bupleurum and Lycium Bark Decoction) Treats Bladder heat transferring to the Small Intestine, obstruction of the chest and intestines, oral erosion (Koumi), ulceration, Heart-Stomach congestion heat, and indigestion.
Chaihu (Bupleuri Radix, remove rhizome) Digupi (Lycii Cortex) [equal parts]
Finely chop. Take 5 qian per dose with 1.5 cups of water, decoct to 1 cup, take warm after meals. If the patient has dry stools, add Dahuang (Rhei Radix et Rhizoma) and Puxiao (Natrii Sulfas) to promote bowel movement.
To treat oral ulcers, drink watermelon juice slowly. If watermelons are unavailable, burn the rind to ash and apply topically.
Another prescription: Equal parts Xixin (Asari Radix et Rhizoma) and Huangbai (Phellodendri Cortex, stir-fried) ground into powder, sprinkled on the tongue. Recovery follows the expulsion of saliva.
Another prescription: Contain Yanxiao (Natrii Nitras) and Pengsha (Borax) in the mouth without opening. Externally, apply powder of Nanxing (Arisaematis Rhizoma) mixed with vinegar to the Yongquan acupoint (KI1) on the sole of the foot. This is miraculous.
Another prescription: Decoct Huanglian (Coptidis Rhizoma) in good wine until it becomes a liquid, sip slowly for recovery.
Another prescription: Wubeizi (Gallnut) 1 liang, Huangbai (Phellodendri Cortex, honey-fried) 5 qian, Huashi (Talcum) 5 qian, Tonglv (Malachite) 5 qian, Shexiang (Moschus) 1 zi (approx. 0.5-1g). Grind into powder and sprinkle. Extremely effective.
For oral ulcers that do not respond to cooling medicines, this indicates insufficient Middle Qi with uncontrolled floating Deficient Fire. Treat with Lizhong Tang (Regulate the Middle Decoction) using reverse therapy (treating cold with heat). Severe cases may add Fuzi (Aconiti Lateralis Radix Praeparata) or hold Guigui (Cinnamomi Cortex) in the mouth, which is also excellent.
Another prescription: Treats red oral ulcers.
Baifan (Alumen, calcined) Moyao (Myrrha) Rushi (Olibanum) [separately ground, each 1 qian] Tonglv (Malachite) [separately ground, a small amount]
Grind into fine powder and sprinkle.
Another prescription: Treats white oral ulcers.
Xionghuang (Realgar) Moyao (Myrrha) Rushi (Olibanum) [each 1 qian] Qingfen (Calomelas) [0.5 qian] Badoushuang (Crotonis Fructus Frost) [a small amount]
Grind into fine powder and sprinkle.
For oral ulcers caused by Excess Heat, Liangge San (Cool the Diaphragm Powder) and Ganjie Tang (Licorice and Platycodon Decoction) are both effective.
A child suffered from oral ulcers and could not eat. Others treated it as Huhuo disease, which would have been fatal. Later, soaking the feet in Alum Water (Fantang) for half a day provided immediate relief. Subsequently, applying powder of Huangbai (Phellodendri Cortex, honey-fried) and Jiangcan (Bombyx Batryticatus) cured the condition.
Another prescription: Treats lips that are tight, dry, cracked, and ulcerated. Apply ash of Qingpi (Citri Reticulatae Pericarpium) burned to char. Immediate cure.
Another prescription: Treats tight lips. Burn paper skin on a knife, collect the dripping liquid, and apply. Immediate effect.
Another prescription: Treats oral erosion (Koumi). Decoct roots of wild rose (Yeqiangwei Gen) and rinse the mouth. (Alternatively, use white rose roots, crush and apply juice.)
Another prescription: For treating oral ulcers.
Mingfan (Alumen, calcined) Huangdan (Minii Oxidum, stir-fried) Yanbaiming (Salted White Plum, burned to retain nature) [each 1 qian] Renzhongbai (Urinae Humanus Depuratum) [0.5 qian] Shexiang (Moschus) [separately ground, a small amount]
Grind into fine powder and sprinkle dry into the mouth. For severe cases, add Pengsha (Borax) 0.5 qian and Pian Nao (Camphora) 0.1 fen.
(Above are eighteen methods from Danxi.)
Pengsha San (Borax Powder) Treats oral and lingual ulcers, as well as throat swelling. All are effective.
Pengsha (Borax) Mayaxiao (Saltpeter) Huashi (Talcum) Hanshui Shi (Aqua Marina) Baifan (Alumen, calcined) [each 2 qian] Pian Nao (Camphora) [0.2 fen]
Grind into fine powder. Take approx. 0.5 qian per dose, mixed with fresh drawn water after meals.
Bixue (Green Snow) Treats oral ulcers and throat swelling/pain. Miraculous efficacy.
Puhuang (Typhae Pollen) Qingdai (Indigo Naturalis) Pengsha (Borax) Yanxiao (Natrii Nitras) Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma)
Equal parts, grind into fine powder and apply. For throat swelling/pain, blow into the throat using a goose quill tube.
(Ancestral Prescription)
For swollen tongue obstructing the mouth, preventing eating and drinking.
Use pure Puhuang (Typhae Pollen) alone, frequently brushing it onto the tongue. The swelling will recede naturally. If swallowing medicine is possible, decoct Huanglian (Coptidis Rhizoma) alone into a thick liquid, sip slowly to drain Heart Fire, and recover.
(Danxi Flexible Patterns) states: Excess Heat in the Liver and Gallbladder causes sour and bitter taste. Use Xiaochaihu Tang (Minor Bupleurum Decoction) added with Gancao (Glycyrrhizae Radix et Rhizoma), Longdan (Gentianae Radix), Qingpi (Citri Reticulatae Pericarpium), etc. For severe cases, Danggui Longhui Wan (Angelica and Gentian Pill). If indecisive deliberation causes Liver-Gallbladder deficiency with bitterness, use Renshen (Ginseng Radix et Rhizoma), Yuanzhi (Polygalae Radix), Fushen (Poria with Hostwood), and Gancao (Glycyrrhizae Radix et Rhizoma) as sovereign herbs, with Chaihu (Bupleuri Radix) and Caolongdan (Gentianae Radix) as minister and courier herbs. For severe cases, use Qianshi Dihuang Wan (Qian's Rehmannia Pill), following the principle of tonifying the mother in deficiency. Heart Heat causing bitter taste or oral/lingual ulcers: use Huanglian Xiexin Tang (Coptis Decoction to Drain the Heart), Niuhuang Qingxin Wan (Buffalo Horn and Calculus Bovis Clearing Heart Pill), or Liangge San (Cool the Diaphragm Powder). Spleen Heat causing sweet taste: use Sanhuang Wan (Three Yellows Pill) or Pingwei San (Calm the Stomach Powder). Lung Heat causing pungent taste: use Ganjie Tang (Licorice and Platycodon Decoction), Xiebai San (Drain the White Powder), or Jinfeicao San (Boiling Grass Powder). Kidney Heat causing salty taste: use Zishen Wan (Nourish Kidney Pill), Dabuyin Wan (Great Tonify Yin Pill), or Ziyin Dabuwang (Great Nourish Yin Great Tonify Pill).