论曰乳石发口舌疮烂者，以食饮不时。谷气不足，石性暴烈，其热乘于心脾也，脾主
口，心主舌，热积而疮，疮甚而烂。复不得食，则热极可知，解之之剂，不可缓也。
治乳石发体热烦闷，口中疮烂，表里如烧痛，不能食。栀子仁汤方
栀子仁（十枚） 黄芩（去黑心） 大黄（锉炒各三两） 豉（二合）
上四味，粗捣筛，每服五钱匕，水一盏半，入香豉一合，煎至八分，去滓食前温服。
治乳石发动，口中伤烂，舌强而燥，不得食味者为食少谷气不足，药气积在胃脘故
也，宜。香豉汤方
豉（半升） 葳蕤 甘草（炙锉各半两） 黄柏（去粗皮蜜炙锉） 麦门冬（去心焙各
一两）
上五味，粗捣筛，每服五钱匕，水一盏半，煎至八分，去滓温服，日再。
治乳石发，头项烦痛，胸胁胀满，寒热，手足逆冷，或口生疮烂，或干呕恶闻食气，上
气欲绝。前胡汤方
前胡（去芦头） 芍药 大黄（锉炒） 甘草（炙锉） 黄芩（去黑心各二两）
上五味，粗捣筛，每服五钱匕，水一盏半，枣五枚擘破，煎至八分，去滓温服，日再。
若气实者，加茯苓去黑皮二两，胸满塞者，加枳壳去瓤麸炒一两，吐逆胸中冷者，加干姜炮
二两，口燥者，加麦门冬去心焙二两，增减以意量之。
治乳石发，食饮失度，口中发疮，漱。黄芩汤方
黄芩（去黑心三两） 石膏（碎五两） 甘草（炙锉） 升麻（各二两）
上四味，粗捣筛，每服五钱匕，水一盏半，煎至八分，去滓放冷，用漱口，一日十遍，
喉咽有疮，稍稍咽之。
治乳石发动，口舌生疮。铅霜散方
铅霜（研） 白矾（烧灰） 黄柏（去粗皮蜜炙各一两） 麝香（研一钱）
上四味，捣研为散，每用半钱匕，掺疮上，有涎即吐之。
治乳石发口疮。黄柏汤方
黄柏（去粗皮蜜炙二两） 龙胆（一两半） 黄连（去须） 升麻（各一两）
上四味，粗捣筛，每服五钱匕，水一盏半，煎至八分，去滓时时含咽。
治乳石发动，口舌生疮。龙脑散方
龙脑（半钱） 铅霜 滑石（各一分）
上三味，各研为细末和匀，每用一字，掺疮上，吐涎，瘥。
治乳石发，腹内胸中悉有疮。升麻汤方
升麻（一两半） 乌梅（十枚去核炒） 黄芩（去黑心） 黄连（去须） 栝蒌根 甘
草（炙各
一两）
上六味，粗捣筛，每服五钱匕，水一盏半，煎至一盏，去滓细细含咽，日三四服。
治乳石发动，口舌生疮，连颊肿痛。升麻散方
升麻 防风（去叉） 甘草（炙各半两） 鸡肠草（三分） 芎 大青（各一分）
上六味，捣罗为散，每先于疮肿处，针出恶血，盐汤漱后，用药半钱匕，贴疮上，日三。
治乳石发动，口舌生疮。浮萍丸方
干浮萍草 升麻 黄药 铅丹（炒研各半两）
上四味，捣研为末，炼蜜丸如鸡头实大，每服一丸，含化咽津。
Discussion: The etiology of mouth and tongue ulcers caused by Ru Shi (Stone Powder) is irregular diet. This leads to a deficiency of Gu Qi (Qi derived from food and water), while the nature of Ru Shi is violent and its heat pathogen invades the Heart and Spleen. The Spleen opens into the mouth, and the Heart opens into the tongue; heat accumulation forms sores, and severe sores lead to ulceration. If one cannot eat at this point, it indicates that the heat has reached an extreme level, and heat-clearing agents must not be delayed.
For treating body heat, irritability, oral ulceration, burning pain in both exterior and interior, and inability to eat caused by Ru Shi activation, use Zhizi Ren Tang (Gardenia Kernel Decoction):
Zhizi Ren (Fructus Gardeniae, 10 pieces), Huang Qin (Radix Scutellariae, removed black heart), Dahuang (Radix et Rhizoma Rhei, chopped and stir-fried, each 3 liang), Chi (Folium Sojae Praeparatum, 2 he).
The above four herbs are coarsely pounded and sieved. Each dose consists of 5 qian bi, boiled with 1.5 zhan of water and 1 he of Xiang Chi until reduced to 0.8 zhan. Strain and take warm before meals.
For treating Ru Shi activation causing oral injury and ulceration, stiff and dry tongue, and inability to taste due to insufficient food intake and Gu Qi, with medicinal qi accumulating in the epigastrium, use Xiang Chi Tang (Aromatic Soybean Decoction):
Chi (Folium Sojae Praeparatum, 0.5 sheng), Weirui (Rhizoma Polygonati Odorati), Gancao (Radix Glycyrrhizae, honey-fried and chopped, each 0.5 liang), Huangbai (Cortex Phellodendri, bark removed, honey-fried and chopped), Maimendong (Radix Ophiopogonis, core removed and baked, each 1 liang).
The above five herbs are coarsely pounded and sieved. Each dose consists of 5 qian bi, boiled with 1.5 zhan of water until reduced to 0.8 zhan. Strain and take warm, twice daily.
For treating Ru Shi activation causing headache and neck pain, chest and hypochondriac fullness, alternating chills and fever, cold extremities, or oral ulceration, dry retching, aversion to food odors, and rising Qi threatening to cease, use Qianhu Tang (Peucedani Radix Decoction):
Qianhu (Radix Peucedani, rhizome removed), Shaoyao (Radix Paeoniae Alba), Dahuang (Radix et Rhizoma Rhei, chopped and stir-fried), Gancao (Radix Glycyrrhizae, honey-fried and chopped), Huang Qin (Radix Scutellariae, removed black heart, each 2 liang).
The above five herbs are coarsely pounded and sieved. Each dose consists of 5 qian bi, boiled with 1.5 zhan of water and 5 broken Jujubae Fructus until reduced to 0.8 zhan. Strain and take warm, twice daily.
If Qi is excess, add Fuling (Poria, removed black skin) 2 liang; if there is chest fullness and obstruction, add Zhike (Exocarpium Citri Grandis, pulp and bran removed, stir-fried) 1 liang; if there is vomiting and cold in the chest, add Ganjiang (Rhizoma Zingiberis Recens, processed) 2 liang; if there is dry mouth, add Maimendong (Radix Ophiopogonis, core removed and baked) 2 liang. Adjust dosages according to circumstances.
For treating Ru Shi activation causing dietary irregularity and oral ulcers, use Huang Qin Tang (Scutellaria Decoction) for rinsing:
Huang Qin (Radix Scutellariae, removed black heart, 3 liang), Shigao (Gypsum Fibrosum, crushed, 5 liang), Gancao (Radix Glycyrrhizae, honey-fried and chopped), Shengma (Rhizoma Cimicifugae, each 2 liang).
The above four herbs are coarsely pounded and sieved. Each dose consists of 5 qian bi, boiled with 1.5 zhan of water until reduced to 0.8 zhan. Strain and let cool. Use for rinsing the mouth ten times a day. If there are ulcers in the throat and pharynx, swallow slightly.
For treating Ru Shi activation causing mouth and tongue ulcers, use Qianshuang San (Lead Frost Powder):
Qianshuang (Sublimated Lead Oxide, ground), Baifan (Alumen, burned to ash), Huangbai (Cortex Phellodendri, bark removed, honey-fried, each 1 liang), Shexiang (Moschus, ground, 1 qian).
The above four herbs are pounded and ground into powder. Use half a qian bi per application, sprinkled on the ulcer. Spit out saliva if produced.
For treating Ru Shi-induced oral ulcers, use Huangbai Tang (Phellodendron Bark Decoction):
Huangbai (Cortex Phellodendri, bark removed, honey-fried, 2 liang), Longdan (Radix Gentianae, 1.5 liang), Huanglian (Rhizoma Coptidis, whiskers removed), Shengma (Rhizoma Cimicifugae, each 1 liang).
The above four herbs are coarsely pounded and sieved. Each dose consists of 5 qian bi, boiled with 1.5 zhan of water until reduced to 0.8 zhan. Strain and hold in the mouth, swallowing occasionally.
For treating Ru Shi activation causing mouth and tongue ulcers, use Longnao San (Borneol Powder):
Longnao (Borneolum Syntheticum, half a qian), Qianshuang (Sublimated Lead Oxide), Huashi (Talcum, each 1 fen).
The above three herbs are each ground into fine powder and mixed evenly. Use one zi amount per application, sprinkled on the ulcer. Spit out saliva for recovery.
For treating Ru Shi activation causing ulcers throughout the abdomen and chest, use Shengma Tang (Cimicifuga Decoction):
Shengma (Rhizoma Cimicifugae, 1.5 liang), Wumei (Fructus Mume, 10 pieces, pitted and stir-fried), Huang Qin (Radix Scutellariae, removed black heart), Huanglian (Rhizoma Coptidis, whiskers removed), Gualougen (Radix Trichosanthis), Gancao (Radix Glycyrrhizae, honey-fried, each 1 liang).
The above six herbs are coarsely pounded and sieved. Each dose consists of 5 qian bi, boiled with 1.5 zhan of water until reduced to 1 zhan. Strain and hold in the mouth, swallowing slowly, three to four times daily.
For treating Ru Shi activation causing mouth and tongue ulcers with swelling and pain extending to the cheeks, use Shengma San (Cimicifuga Powder):
Shengma (Rhizoma Cimicifugae), Fangfeng (Radix Saposhnikoviae, forked parts removed), Gancao (Radix Glycyrrhizae, honey-fried, each 0.5 liang), Jichangcao (Herba Siegesbeckiae, 3 fen), Xiong (Radix Ligustici Chuanxiong), Daqing (Folium Isatidis, each 1 fen).
The above six herbs are pounded and sieved into powder. First, prick the swollen area to release bad blood, rinse with salt water, then apply half a qian bi of the powder to the ulcer, three times daily.
For treating Ru Shi activation causing mouth and tongue ulcers, use Fuping Wan (Duckweed Pill):
Gan Fupingcao (Herba Lemnae, dried), Shengma (Rhizoma Cimicifugae), Huangyao (unknown herb, likely referring to a specific local herb or typo for another herb like Huangbo/Huanglian in some contexts, but kept as Huangyao here), Qiandan (Lithargyrum, stir-fried and ground, each 0.5 liang).
The above four herbs are pounded and ground into powder. Mix with refined honey to form pills the size of a chicken head seed. Take one pill per dose, holding it in the mouth to dissolve and swallow saliva.