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Disease Discussion
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The central direction corresponds to the color yellow, communicates with the Spleen organ, opens into the mouth as its orifice, and stores essence in the Spleen; therefore, diseases manifest on the tongue. Diseases of the mouth may present as Chongshe (redundant tongue/swelling under the tongue), Mushe (wooden tongue/stiffness), erosion and ulceration of the oral mucosa, or abnormal tastes such as sour, bitter, pungent, or salty. Investigating the etiology, these are invariably caused by disturbances from the Seven Emotions (joy, anger, worry, thought, sadness, fear, fright) and excessive damage from the Five Flavors (sour, bitter, sweet, pungent, salty). The classics state: The Yin organs' fundamental intake lies in the five flavors; the injury to the Yin organs also stems from the five flavors. Thus, Liver heat causes a sour taste, Heart heat causes a bitter taste, Spleen heat causes a sweet taste, Lung heat causes a pungent taste, and Kidney heat causes a salty taste. A bland taste indicates Stomach heat. Externally, indecisive deliberation can cause Liver Qi stagnation, transferring heat to the Gallbladder resulting in a bitter taste. Alternatively, weak Spleen and Stomach Qi allows Liver Wood to overact on Spleen Earth, causing a sour taste. Heat from the Bladder transferring to the Small Intestine can obstruct the bowels, with heat steaming upward causing oral erosion and ulceration; this is the syndrome of Shanghan Huhuo disease (a condition characterized by erosions of the throat and genital/anal regions), where ulcers on the upper lip indicate worm-eating of the viscera, and ulcers on the lower lip indicate worm-eating of the anus. Furthermore, a tongue protruding and unable to retract is called Yang Qiang (Yang excess); a tongue retracted and unable to speak is called Yin Qiang (Yin excess).

Formulas
Lü Pao San (Green Robe Powder) treats Kou Chuang (oral ulcers).
Huang Bo (Phellodendri Cortex, peeled of rough bark, 1 liang) Qing Dai (Indigo Naturalis, 3 qian)
Grind the above into powder, apply to the affected area and hold in the mouth; healing occurs upon expectoration of saliva. Another prescription adds Mi Tuo Seng (Lead Monoxide, 1 qian).

Fu Yan San (Banquet Powder, transmitted by Duan Ganbing) [Commentary: This formula is for external application for oral ulcers] treats Kou Chuang (oral ulcers).
Huang Lian (Coptidis Rhizoma) Huang Bo (Phellodendri Cortex) Huang Qin (Scutellariae Radix) Zhi Zi (Gardeniae Fructus) Xi Xin (Asari Radix et Rhizoma) Gan Jiang (Zingiberis Rhizoma Recens)
Equal parts of each, ground into fine powder. First rinse the mouth with rice water, then apply the powder to the lesion. Spitting or swallowing is not restricted; it is highly effective.

Sheng Ma San (Cimicifugae Powder) treats carbuncles and toxins in the upper diaphragm, ulcers on the tongue, and swelling and pain of the throat.
Sheng Ma (Cimicifugae Rhizoma) Chi Shao (Paeoniae Radix Rubra) Ren Shen (Ginseng Radix et Rhizoma) Jie Geng (Platycodonis Radix) Gan Ge (Puerariae Lobatae Radix) [each 1.5 qian] Gan Cao (Licorice Radix et Rhizoma, 0.7 qian)
Cut one dose, decoct in water, and take slowly.

The *Huangdi Neijing* states: When heat from the Bladder transfers to the Small Intestine, causing bowel obstruction and steaming upward to cause oral erosion, taking Wu Ling San combined with Dao Chi San once will result in cure.
[Commentary: This formula is for internal administration for oral ulcers] For oral ulcers that do not heal with cooling medicines, it is due to deficiency of Middle Qi, allowing Xiang Huo (Ministerial Fire) to float upward without restraint. Treat with Li Zhong Tang (Regulate the Middle Decoction); it will heal. In severe cases, add Fu Zi (Aconiti Lateralis Radix Praeparata), or apply Guan Gui (Cinnamomi Cortex) powder topically.

Shang Qing Wan (Upper Clearing Pill, transmitted by Wang Tianzhong) [Commentary: This formula is for holding in the mouth to dissolve for oral ulcers] treats pain and ulceration of the mouth and tongue.
Bo He Ye (Menthae Haplocalycis Folium, 3 liang) Peng Sha (Borax, 5 qian) Tian Hua Fen (Trichosanthis Radix, 1 liang) Tian Zhu Huang ( Bambusae Concretio Silicea, 5 qian) Feng Hua Xiao (Natrii Sulfas Efflorescens) Bai Yao Jian (Fermented Medicinal Paste) Fang Feng (Saposhnikoviae Radix) Hai Er Cha (Camelliae Sinensis Var. Assamica Leaf Extract) [each 1 liang] Jie Geng (Platycodonis Radix, 7 qian) Gan Cao (Licorice Radix et Rhizoma, 1 liang)
Grind into fine powder, make pills with refined honey, size of a bullet. Take one pill per dose, hold in the mouth, and slowly dissolve and swallow.

Xiang Cha Bing (Fragrant Tea Cake) clears the diaphragm, resolves phlegm, and freshens breath.
Hai Er Cha (Camelliae Sinensis Var. Assamica Leaf Extract, 4 liang) Gui Hua (Osmanthi Fragrans Flos, 1 liang) Nan Bo He Ye (Menthae Haplocalycis Folium, 1 liang) Peng Sha (Borax, 5 qian)
Grind into powder, use juice boiled from Gan Cao, simmer into a paste to form cakes. Hold in the mouth to dissolve and swallow; it has a delicious, fragrant taste.

Peng Sha Wan (Borax Pill, transmitted by Wang Tianzhong) [Commentary: This formula clears the upper jiao and freshens breath] treats bad breath, dry mouth, and oral/tongue ulcers.
Peng Sha (Borax, 2 qian) Pian Nao (Borneolum Syntheticum) She Xiang (Moschi Feratum) [each 1 fen] Ma Ya Xiao (Natrii Sulfas Efflorescens, wind-dried, 4 qian) Han Shui Shi (Aragoniti Rhizodium, calcined, 1 qian)
Grind into powder, make pills with Gan Cao paste, size of a hemp seed. Hold one pill in the mouth at any time, and swallow saliva.

Tight, shrunken lips preventing opening of the mouth and ingestion of food will lead to death if untreated. Use white cloth rolled like a finger as a wick, burn it on a knife or axe until sweat appears on the metal surface, wipe and collect this liquid to apply to the lips, two to three times daily. Alternatively, burn old blue cloth to ash, mix with clear water and ingest, or mix with Pig Fat (Su Zhi) for topical application. Also, burn Snake Slough (She Tui) to ash, clean the area first, then apply. It is also suitable to burn human hair, Beehive (Feng Fang), and hair of six domestic animals to ash, mixed with Pig Fat for topical application.

For tight, dry, cracked lips with ulcers:
Use any amount of Olive (Gan Lan), burn to ash, mix with Pig Fat (Su Zhi) and apply to the lesion.

For cracked lips forming ulcers (Formula from Liu Taifu):
Lu Gan Shi (Calamina, calcined, 2 qian) Wen Ge (Veneris Testa, 1 liang) Huang Bo (Phellodendri Cortex, 1 liang) Cang Zhu (Atractylodis Rhizoma, 5 qian)
Except for Lu Gan Shi, stir-fry the other three ingredients until red, grind extremely fine, add Pian Nao (Borneolum Syntheticum, 3 fen), grind again, and mix with wax oil to apply to the lips.

Formula to Supplement Lips and Tongue (Transmitted by the Imperial Hospital):
Burn fresh crab to ash. Use 2 qian, mixed with Ru Xiang (Olibanum) and Mo Yao (Myrrha) (each 2.5 fen) to apply; new flesh will grow immediately. If tissue necrosis and detachment occur, use Chuan Wu (Aconiti Radix) and Cao Wu (Aconiti Kusnezoffii Radix) powder, spread on paper, moisten with cold water, and apply; pain will be absent, allowing surgical removal. If bleeding occurs, apply Chen Duan Shi (Calcined Hematite) to stop it. After healing, if the tongue is stiff, dot with Chicken Comb Blood (Ji Guan Xue) to soften it.

For a stiff, swollen tongue resembling a pig bladder:
Prick the large vessels on both sides under the tongue with a needle; bleeding will reduce the swelling. Do not prick the central vessel, or bleeding will not stop; instead, cauterize with a copper chopstick heated by fire. Or, use rust from a pot burned with weeds, mixed with vinegar, applied above and below the tongue; replace when detached, and it will subside quickly. Many people do not recognize this condition; delayed treatment leads to death. In all cases of tongue swelling, there must be a worm-like creature under the tongue, resembling a mole or silkworm, with a head and tail, the head being small and white. Cauterize the head with a red-hot iron nail to eliminate it.

For swollen and hard tongue:
Bai Cao Shuang (Soot from hundred herbs) Hai Yan (Sea Salt) [equal parts]
Grind into powder, mix with well water (Jing Hua Shui) and apply.

Another Formula:
Apply Zhen Pu Huang (Polygoni Citini Pollen) frequently to the tongue. Internally, decoct single-ingredient Huang Lian (Coptidis Rhizoma) in water to drain Heart Fire.

The *Bingji* (Pathogenesis) states: If the tongue extends beyond one cun, apply crushed Bing Pian (Borneolum) to retract it.

For spontaneous thread-like bleeding from the tongue:
Apply Huai Hua (Sophorae Flos) powder to stop it.

For sudden tongue swelling protruding outside the mouth, commonly attributed to centipede venom:
Immerse the tongue in a small cup of Rooster Blood (Xiong Ji Xue) to retract it.