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Yagan (Gangrene of the Gums), caused by internal accumulation of fetal toxin and external contraction of heat toxin, with toxic qi attacking upward, leads to ulceration of the gum roots, followed by blackening and rotting, accompanied by a foul odor that is difficult to bear. The condition changes rapidly and is named Zouma Yagan (Running Horse Gangrene of the Gums). Internal treatment focuses on purging toxins and clearing heat.

Tuina manipulation: Fen Yin Yang (Dividing Yin and Yang) (200 times), Tui San Guan (Pushing the Three Gates) (100 times), Tui Liu Fu (Pushing the Six Bowels) (200 times), Qing Tian He Shui (Clearing the Heavenly River Water) (200 times), Shui Li Lao Ming Yue (Fishing for the Bright Moon in the Water) (50 times), Yao Tou (Shaking the Head) (30 times). For all manipulations, use Xiangshe Congtang Shui (Musk and Scallion Decoction Water) as a medium.

Medication preparation: Take one Jin Zao Pi (Gold Date Arsenic), remove the pit from one red date, insert a grain of Hong Pi (Red Arsenic, size of a soybean) into the date, wrap it heavily in wet paper, and slow-roast over fire until smoke ceases, then grind into fine powder. Chuan Chang Gu (Bone Passing Through Intestines, i.e., undigested bone found in white dog feces) 1 qian, Zhenzhu (Pearl) 5 fen, Niuhuang (Calculus Bovis) 5 fen, Bingpian (Borneolum Syntheticum) 8 fen, Guang Muxiang (Costus Root) 1.2 qian, Tonglv (Verdigris) 2.5 qian, Renzhongbai (Calcinata Hominis) 3 qian. These eight herbs are each ground into fine powder, weighed accurately, and mixed uniformly. First, decoct Fangfeng (Saposhnikovia Root) 2 qian, Madouling (Aristolochiae Fructus) 3 qian, and Gancao (Licorice Root) 1 qian in water to wash the affected area. Wipe away toxic blood with an old blue cloth, take 1 fen of the aforementioned powder, mix with Chen Jingmo (Aged Beijing Ink) paste, and apply to the area; this yields miraculous results. Take Jiugen (Garlic Chive Root) 2 qian and Songluocha (Pine Moss Tea) 2 qian, decoct into a concentrated liquid, and while hot, use a chicken feather to dip and wash the affected area to remove necrotic tissue completely.

Commentary: Yagan is a condition where heat toxin attacks the stomach and manifests upwards, causing redness, swelling, ulceration, pain, halitosis, bleeding gums, tooth loss, and even perforation of the cheek and erosion of the lips. The disease progresses critically. Externally, apply the aforementioned medication; internally, treat with herbs such as Huangqin (Scutellaria Root), Lianhua (Coptis Rhizome), Xiaoshi (Natrii Sulfas), Dahuang (Rhei Radix et Rhizoma), Lvhua (Aloe), Wuyi (Terminalia Chebula Retusa), and Xionghuang (Realgar). Alternatively, add rhinoceros horn, antelope horn, or Baihu Tang (White Tiger Decoction) to clear fire and detoxify first, hoping for efficacy. However, this condition relies specifically on strong stomach Qi and the ability to eat to withstand harsh medications; otherwise, there is no hope for survival. (Tilizi)

The meridians of the Spleen connect to the sides of the tongue, the meridians of the Liver connect to the root of the tongue, and the meridians of the Heart connect to the base of the tongue. If Heat accumulates in the Heart and Spleen, Qi and Blood become excessive, leading to swelling attached to the tongue root. Its shape resembles the tongue, appearing like a small tongue under the main tongue, hence it is called Chongshe (Double Tongue). Acupuncture to induce bleeding is suitable; pierce laterally, avoiding deep insertion into the central tendon. Internal treatment focuses on clearing the Heart and draining Heat.

Tuina manipulation: Fen Yin Yang (Dividing Yin and Yang) (24 times), Tui Shi Zhi San Guan (Pushing the Three Gates of the Index Finger) (36 times), Tui Xin Jing (Pushing the Heart Meridian) (36 times), Tui Pi Jing (Pushing the Spleen Meridian) (100 times), Tui Liu Fu (Pushing the Six Bowels) (36 times), Yun Ba Gua (Rotating the Eight Trigrams) (36 times), Yun Shui Ru Tu (Moving Water into Earth) (50 times), Qing Tian He Shui (Clearing the Heavenly River Water) (36 times). For all manipulations, use Congtang (Scallion Decoction) as a medium.

Commentary: The "Yi Zong Jin Jian · You Ke Xin Fa" lists conditions such as Tuthe (Protruding Tongue), Nongshe (Playing Tongue), Muthe (Wooden Tongue), and Chongshe (Double Tongue). Listing only Chongshe has the flaw of mentioning one while missing ten thousand others. Tuthe presents with a red face, dark urine, thirst, and restlessness; it is suitable for Daochi San to drain Heart Fire. Nongshe refers to a child shaking their tongue inside the mouth, accompanied by dry lips and tongue, irritability, heat, and foul stool; it is treated with Xiehuang Tang, using Huoxiang (Patchouli), Fangfeng (Saposhnikovia), Shanzhi (Gardenia), Shigao (Gypsum), and Gancao (Licorice). Muthe involves a tongue stiff as wood, unable to move; internally treat by draining Heart Heat, and externally apply Zixue Dan (Purple Snow Pill) to the tongue. This supplements the omissions in the "Xin Fa." However, this book only lists twenty-four conditions, omitting many, merely following Zhou's old content. (Tilizi)