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[Prescription Verse] Stomatitis abscess (Ya Yong) is caused by stomach heat, leading to swelling of the gingiva, accompanied by aversion to cold and fever, local hardness, and unbearable pain. If the abscess ruptures and discharges pus but the wound fails to heal, misusing cold-natured drugs will lead to the formation of dead bone, hindering healing.

[Annotation] This syndrome is caused by heat-toxin in the Yangming Stomach Meridian. The lesion arises on the gingiva, presenting as hard swelling and pain, with systemic symptoms of aversion to cold and fever, and swelling of the cheeks. In the early stage, Jingfang Sandu San is suitable; if severe thirst, irritability, and vomiting occur, Chansu Wan should be used to induce sweating; if constipation is present, Shuangjie Guijin Wan should be used to purge. Once the swollen area softens, it should be lanced and Bingpeng San applied topically. If lanced during the initial hard-swollen stage, resulting in bloody discharge and failure to heal over time, or due to excessive consumption of cold foods, multiple pieces of dead bone will inevitably form. One must wait until the bone tip protrudes and becomes loose upon manipulation before extraction can be performed, allowing the wound to contract and heal.

Formulas: Jingfang Baidu San (see Section on Carbuncle of the Neck), Chansu Wan (see Chapter on Ding Chuang), Shuangjie Guijin Wan (see Chapter on Swelling Ulcer), Bingpeng San (see Section on Thrush).

[Prescription Verse] Gangrenous stomatitis (Zouma Yagan) is a serious condition, often caused by parasitic/food accumulation, residual toxins from exanthematous diseases, and fire pathogenic factors attacking upward. The gum roots rot and emit a foul odor, turning black subsequently. If stubborn necrotic tissue fails to detach and the patient cannot eat, the prognosis is ominous.

[Annotation] This syndrome is mostly caused by heat-fire from parasitic/food accumulation or residual toxins from exanthematous diseases attacking upward, progressing rapidly, fundamentally due to accumulated heat and fire-toxin. The gum roots begin to rot, turning black and necrotic with a foul smell. For cases where parasitic/toxic fire attacks the teeth, Lulu Xiaogan Yin is suitable initially; for those with Spleen-Stomach deficiency, Renshen Fuling Zhou should be taken concurrently. For cases caused by residual toxins from exanthematous diseases, Qinggan Jiedu Tang is suitable. For mild external symptoms, Niaobai San should be applied. If the lesion is hard, cyanotic/purple, gradually penetrating the cheek, and causing tooth mobility, Lulu San should be applied topically. If black necrotic tissue remains in the interdental spaces or deep pits exist where medication cannot reach, Lematinghui Si should be inserted, followed by manual removal of black necrosis; revealing red meat with fresh blood flow indicates a favorable outcome. If stubborn tissue is difficult to remove, and hard necrosis expands causing cheek penetration and lip rupture, Qinglian Gao should be applied; presence of fever and inability to eat indicates an adverse prognosis (ni zheng). Among these, only cases caused by parasitic/food accumulation attacking the teeth tend to recur after cure, due to recurring heat-fire attack. Proper dietary regulation is key; foods such as yam, chestnut, goose, crab, sweets, and spicy items must be strictly avoided. Negligence will inevitably lead to recurrence; exercise extreme caution.

Formula: Renshen Fuling Zhou
Composition: Renshen (1 qian), Baifuling (6 qian).
Grind into fine powder, cook with one tea-cup measure of Oryza sativa var. japonica (Jingmi) into porridge. Rinse mouth thoroughly with salt water first, then consume the porridge.
[Prescription Verse] Renshen and Fuling benefit the Spleen Qi, suitable for reduced appetite; grinding these two ingredients with Jingmi and cooking into porridge regulates Stomach deficiency.

Another Formula: Qinggan Jiedu Tang
Composition: Renzhonghuang, Huanglian (raw), Chaihu (each 5 fen), Zhimu (raw), Lianqiao (heart removed), Niubangzi (stir-fried, crushed), Xijiao (shaved), Heishen, Jingjie, Fangfeng (each 1 qian), Shigao (calcined, 1.5 qian), Danzhuyeye (1 qian), Dengxincao (50 cun). Add 2 zhong of water, decoct to 0.8 zhong, take after meals. Add Lubigen (5 qian) if vomiting occurs.
[Prescription Verse] Qinggan Jiedu Tang treats gangrenous stomatitis caused by heat transformation of residual toxins from exanthems; contains Renzhonghuang, Zhimu, Huanglian, Chaihu, Lianqiao, Niubangzi, Xijiao, Shen, Shigao, Jingjie, and Fangfeng.

Another Formula: Niaobai San
Composition: Niaogou (white alkali scale from women's urine pots, calcined), Baishuangmei (calcined to retain nature), Kubaijian (each 2 qian).
Grind into fine powder. First, decoct Jiugen (Allium tuberosum root) and Songluochacha (Song pine moss tea) into a concentrated liquid. While hot, use a chicken feather to dip and wash the lesion, removing all necrotic tissue until fluid and fresh blood appear, then apply this powder. Apply three times daily. If necrosis extends to the pharynx, insufflate using a reed tube.
[Prescription Verse] Niaobai San applied to gangrenous stomatitis consists of Niaogou, Baishuangmei, and Kubaijian; washed with Jiugen and tea decoction, applied after removing necrotic tissue for recovery.

Another Formula: Lulu San
Composition: Lulu (1 qian), Huangbai (powder, 5 qian), Renyan (Arsenic trioxide, placed inside five pitted red dates, roasted to retain nature).
Grind into fine powder. Rinse mouth with rice washing water to clear gan toxin, then apply this powder to hard and necrotic areas.
[Prescription Verse] Lulu San applied to gangrenous stomatitis with purple discoloration, mobile teeth, and hard cheeks penetrating the cheek; dates are used to enclose Renyan roasted to retain nature, mixed with Huangbai powder.

Another Formula: Lematinghui Si
Composition: Baipi (powder, 1 fen), Shexiang (powder, 3 fen), Qingmian (torn), Qingdai (levigated powder, each 1 fen).
Mix evenly with Sesame oil. Before use, rinse mouth with clear rice washing water. Use tweezers to pick up a small amount of the silk-like mixture and insert it into the interdental space at the gum root. Change three times daily.
[Prescription Verse] Lematinghui Si treats gradual erosion of gan toxin; apply urgently when interdental spaces turn black and necrotic. Mix Pi, Shexiang, Qingmian, and Qingdai with oil, rinse mouth, then insert.

Another Formula: Qinglian Gao
Composition: Qingdai (2 qian), Rushen and Qingfen (each 1 qian), Shexiang (5 fen), Baipi/Renyan (1 fen).
Grind into fine powder, mix with sesame oil to a thick consistency, spread thinly on paper, hammer solid, and dry in shade. At bedtime, rinse mouth with rice washing water, dry, and apply a piece sized according to the lesion. Remove in the morning, rinse mouth again, and reapply at night.
[Prescription Verse] Qinglian Gao is suitable for applying to necrotic ulcers, effectively resolving necrosis and hardness; composed of Rushen, Shexiang, Baipi, Qingfen, and Qingdai, ground and mixed with oil on paper.

Another Formula: Lulu Xiaogan Yin (see Section on Drill-tooth Gan).