脉左寸洪数。心热口苦。右寸浮数。肺热口辛。左关弦数而虚。胆虚口苦。洪甚而实。
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
口舌苦服凉药不愈者。宜理中汤。
夫口舌之为病。或为重舌木舌。为糜烂生疮之类。经云。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。胃热也。口臭者。乃脏腑臊腐之气。蕴积于胸
臆之间。而生热冲发于口也。口疮者。脾气凝滞。加之风热而然也。治当以清胃泻火汤
方之。此正治之法也。如服凉药不已者。乃上焦虚热。中焦虚寒。下焦虚火。各
经传变所致。当分别而治之。如发热作渴饮水口疮者。上焦虚热也。补中益气汤主之。如手
足冷。肚腹作痛。大便不实。饮食少思口疮者。中焦虚寒也。附子理中汤主之。如晡热内热
不时而热。作渴痰唾。小便频数口疮者。下焦阴火也。六味地黄丸主之。如食少便滑。面
黄。肢冷。火衰土虚也。八味丸主之。若热来复去。昼见夜伏。夜见昼伏。不时而动。或无
定处。若从
脚起。乃无根之火。亦用八味丸。及十全大补汤。加麦门、五味。更以附子末。唾津调搽涌
泉
穴。若概用凉药。损伤生气。为害非轻。一论心肺蕴热。口疮咽痛。膈闷。小便淋浊不利。
清金导赤散
黄连（六分） 黄芩（一钱五分） 栀子（二钱） 木通（二钱） 泽泻（二钱） 生地黄（四钱）
麦门冬（三钱） 甘草（八分）
上锉一剂。生姜三片。水煎。食后频频服之。
一论上焦实热。心胃二经之火。而作口舌生疮肿痛者。并咽喉牙齿耳面肿痛皆效。
清胃泻火汤
连翘 桔梗 黄连 黄芩 栀子 干葛（各七分） 元参 升麻 生地（各一钱） 薄荷（
五分） 甘草（三分）
上锉。水煎。频频温服。
一论饮酒过度。舌本强肿。言语不清。此脾虚湿热。以益气汤加神曲、麦芽、干葛、泽
泻。
一论上焦虚热。发热作渴。饮食劳役则体倦。此内伤气血。而作口舌生疮者。宜补中益气
汤。（方见内伤）根据本方加麦冬、五味子。
一论中焦虚寒。手足冷。肚腹痛大便不实。饮食少思。而作口舌生疮者。以附子理中汤
（方见中寒）根据本方。
一论晡热内热。不时而热。作渴痰唾。小便频数。而作口舌生疮者。此下焦阴火也。以
六味地黄丸（方见补益）根据本方。
一论如食少便滑。面黄肢冷。而作口舌生疮者。此火衰土虚也。以八味丸（方见补益）根据
本方
一论若热来复去。昼见夜伏。夜见昼伏。不时而动。或无定处。而作口舌生疮者。若从
脚起。乃无根之火也。以八味丸及十全大补汤。（方见补益）根据本方加麦门冬、五味子。
一论口疮臭气秽烂。久而不瘥者。黄柏五钱。青黛一钱五分。为末。每用一钱。于舌上
津咽下。
一论口疮。用黄连、川椒。等分为末。每少许搽疮上。噙漱良久。以凉水漱咽。咽喉有
疮。加孩儿茶。
一治口舌生疮。
加味阴阳散
黄连 干姜 青黛 孩儿茶（各等分）
上为末。每用少许搽患处。立效。一方。用五味子为末。掺疮上。即愈。
一治口疮良方。徐杏庄老师传。
生白矾（一钱） 朱砂（二分）
上共为末。敷上立愈。
一论口舌生疮。咽喉肿痛。咳嗽痰涎。清声润肺。宽膈除热。
上清丸 黄滨江传。
百药煎（四两） 薄荷（净末四两） 砂仁（二两） 诃子 桔梗 甘松（各五钱） 寒水石（
二两） 元明粉（五钱） 硼砂（五钱） 片脑（五分）
上为末。甘草熬膏。丸如梧子大。每服三五丸。茶送下。
一论口疮连年不愈者。此虚火也。
玄门丹
天门冬（去心） 麦门冬（去心） 玄参（各等分）
上为细末。炼蜜为丸。如弹子大。每服一丸。噙化下。
一人口内如无皮状。或咽喉作痛。喜热饮食。此中气真寒而外虚热。用加减八味丸而愈
一人舌肿舒退场门外。舌者心之苗。又脾之经络。连舌本散舌下。其热当责于心脾二经。
所谓
热胜则肿也。当用蓖麻子去壳。纸裹。捶出油。透纸作捻。烧烟熏之而愈。本草云。蓖麻主
浮肿恶气。取油涂之。叶主风肿不仁。捣蒸敷之。则其能解风肿内热也。可知矣。
一人胃弱痰盛。口舌生疮。彼服滚痰丸愈盛。反泻不止。恶食倦怠。此胃气被伤也。予
以香砂
六君子汤。数剂少可。再以补中益气汤加茯苓、半夏而愈。夫胃气不足。饮食不化。亦能
为痰。补中益气。乃治痰之法也。若虚症而用峻利之剂。岂不危哉。
一人脾胃虚。服养胃汤、枳术丸。初有效。而久反虚。口舌生疮。劳则愈盛。此中气虚
寒
用理中汤少愈。更以补中益气汤加半夏、茯苓而安。夫养胃汤。香燥之剂也。若饮食停滞。
或寒滞中焦。服则燥开胃气。宿滞消化。最为近理。使久服则津液愈燥。胃气愈虚。胃气本
虚而用之。岂不反甚其病哉。亦有房劳过度。真气衰败。或元气不足。不能上蒸。中州不运
致饮食不进。以补真丸治之。若丹田之火。上蒸脾土。脾土一和。中焦自治。饮食自进
何口疮之不愈哉。
一人舌青黑有刺。乃热剧也。良由思虑过度。怒气所得病者。要将舌来土壁上贴之方好
予制此方即效。
清心散
赤茯苓（去皮一钱） 酸枣仁（一钱） 麦门冬（去心一钱） 远志（甘草水泡去心五分） 黄
连（一钱） 胡麻仁（一钱） 枳壳（去穣八分） 小木通（八分） 小甘草（二分）
上锉。水煎。温服。
一男子口臭。牙龈赤烂。腿膝痿软。或用黄柏等药。益甚。时或口咸。此肾胃虚热。以
六味丸治之。悉愈。
一治口疮喉痛牙疼妙药。陈上余传。
硼砂（一钱） 孩儿茶（二分） 雄黄（二分） 青黛（七分） 胡黄连（三分） 冰片（一厘）
玄明粉（二厘）
上共研末。搽上。
一香薷治口气甚捷。盖口臭是脾有郁火。溢入肺中。失其清和甘美之意。而浊气上干故
也。一补舌唇方。贾兰峰传。
用鲜蟹烧灰。每二钱。用乳香、没药各二分半。涂之即生肉。如去多唇舌。用川乌、草
乌为
末。摊纸一条。以凉水调合贴之。即不觉痛。可用刀取。如流血。以陈锻石涂之。愈后舌硬
用白鸡冠血点之。即软。
一生舌方。
以活蟹一个。炙干为末。收之。如遇此患。敷上合口即已。
一治舌上肿硬。以百草霜、海盐。等分为末。井花水调敷患处。
又宜真蒲黄末。频掺舌上。内以黄连一味。煎汤服之。以泻心火。
一治舌长过寸。研冰片敷之即收。
一治舌无故出血如泉。槐花炒为末。掺之即止。
一治舌忽胀退场门外。俗云蜈蚣毒。用雄鸡冠血一小盏。浸之即缩入。
一舌吐不收。名曰阳强。
一舌缩不能言。名曰阴强。
一男子舌常破而无皮状。或咽喉作痛。服清咽利膈散益甚。予以理中汤治之。乃愈。
Pulse at the left Cun position is surging and rapid, indicating Heart Heat causing bitter taste in the mouth. Pulse at the right Cun position is floating and rapid, indicating Lung Heat causing a pungent sensation in the mouth. Pulse at the left Guan position is wiry, rapid, and deficient, indicating Gallbladder Deficiency causing bitter taste; if the pulse is surging and forceful, it indicates Liver Heat causing sour taste. Pulse at the right Guan position is deep and solid, indicating Excess Heat in the Spleen and Stomach causing sweet taste; if accompanied by a surging and rapid pulse, it may present as Mouth Ulcers (oral ulcers), or Tongue Swelling (Chong She) and Wooden Tongue (Mu She). If the pulse is deficient, it is due to Middle Qi Deficiency.
For bitter taste in the mouth and tongue that does not improve with cold-natured medicines, Li Zhong Tang (Cinnamon Twig and Ginger Decoction) is appropriate.
Diseases of the mouth and tongue may manifest as Chong She, Mu She, or erosion and ulceration. The Classics state: Liver Heat causes sour taste, 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. Bad breath results from foul odors of the Zang-Fu organs accumulating in the chest and diaphragm, generating heat that rises to the mouth. Mouth ulcers result from stagnation of Spleen Qi combined with Wind-Heat. Treatment should employ Qing Wei Xie Huo Tang (Stomach-Clearing Fire-Purging Decoction). This is the standard treatment method. If cold medicines fail to resolve the condition, it is due to Upper Jiao Deficient Heat, Middle Jiao Deficient Cold, and Lower Jiao Deficient Fire, transmitted through the meridians. Treatment must be differentiated. Fever with thirst and desire for water, along with mouth ulcers, indicates Upper Jiao Deficient Heat; Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is indicated. Cold hands and feet, abdominal pain, loose stools, poor appetite, and mouth ulcers indicate Middle Jiao Deficient Cold; Fu Zi Li Zhong Tang (Aconite and Cinnamon Twig Decoction) is indicated. Evening fever, internal heat, intermittent fever, thirst, phlegm, frequent urination, and mouth ulcers indicate Lower Jiao Yin Fire; Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) is indicated. Poor appetite, loose stools, sallow complexion, and cold limbs indicate Declining Fire and Weak Earth (Kidney Yang Deficiency and Spleen Deficiency); Ba Wei Wan (Eight-Ingredient Pill) is indicated. If fever comes and goes, appearing by day and hiding by night, or vice versa, occurring irregularly or without fixed location, especially if originating from the feet, this is Rootless Fire. Ba Wei Wan and Shi Quan Da Bu Tang (Ten Significant Tonifying Decoction) are used, added with Mai Men Dong (Ophiopogon Tuber) and Wu Wei Zi (Schisandra Berry). Additionally, Fu Zi powder mixed with saliva is applied to Yongquan (KI 1). Using cold medicines indiscriminately damages vital energy and causes significant harm.
Another discussion on Heart and Lung Heat accumulation causing mouth ulcers, sore throat, chest oppression, and turbid, difficult urination employs Qing Jin Dao Chi San (Clear Metal and Guide Out Red Powder).
Formula: Huang Lian (6 fen), Huang Qin (1.5 qian), Zhi Zi (2 qian), Mu Tong (2 qian), Ze Xie (2 qian), Sheng Di Huang (4 qian), Mai Men Dong (3 qian), Gan Cao (8 fen).
Crush into one dose, add three slices of fresh ginger, decoct in water, and take frequently after meals.
Another discussion on Upper Jiao Excess Heat, Fire from the Heart and Stomach meridians causing painful swelling and ulcers in the mouth and tongue, which is also effective for soreness and swelling of the throat, teeth, ears, and face.
Formula: Qing Wei Xie Huo Tang. Lian Qiao, Jie Geng, Huang Lian, Huang Qin, Zhi Zi, Ge Gen (each 7 fen), Yuan Shen, Sheng Ma, Sheng Di (each 1 qian), Bo He (5 fen), Gan Cao (3 fen).
Crush, decoct in water, and take warm frequently.
Another discussion on excessive alcohol consumption causing a stiff, swollen tongue base and unclear speech, attributed to Spleen Deficiency with Damp-Heat. Yi Qi Tang is used with Shen Qu, Mai Ya, Ge Gen, and Ze Xie.
Another discussion on Upper Jiao Deficient Heat, fever, thirst, fatigue after eating or labor, indicating internal injury to Qi and Blood causing mouth ulcers. Bu Zhong Yi Tang is indicated. (See Internal Injury section for formula.) Add Mai Dong and Wu Wei Zi to this formula.
Another discussion on Middle Jiao Deficient Cold, cold hands and feet, abdominal pain, loose stools, poor appetite, causing mouth ulcers. Fu Zi Li Zhong Tang is indicated. (See Middle Cold section for formula.) Use this formula.
Another discussion on evening fever, internal heat, intermittent fever, thirst, phlegm, frequent urination, causing mouth ulcers, attributed to Lower Jiao Yin Fire. Liu Wei Di Huang Wan is indicated. (See Tonification section for formula.) Use this formula.
Another discussion on poor appetite, loose stools, sallow complexion, cold limbs, causing mouth ulcers, attributed to Declining Fire and Weak Earth. Ba Wei Wan is indicated. (See Tonification section for formula.) Use this formula.
Another discussion on fever coming and going, appearing by day and hiding by night, or vice versa, occurring irregularly or without fixed location, causing mouth ulcers, especially if originating from the feet, indicating Rootless Fire. Ba Wei Wan and Shi Quan Da Bu Tang are used. (See Tonification section for formula.) Add Mai Men Dong and Wu Wei Zi to this formula.
Another discussion on foul-smelling, rotting mouth ulcers that do not heal for a long time. Huang Bai (5 qian) and Qing Dai (1.5 qian) are powdered. Take 1 qian each time, place on the tongue, and swallow with saliva.
Another discussion on mouth ulcers using Huang Lian and Chuan Jiao in equal parts, powdered. Apply a small amount to the ulcer, hold in the mouth for a long time, then rinse with cool water. For throat ulcers, add Hai Er Cha.
One treatment for mouth and tongue ulcers.
Formula: Jia Wei Yin Yang San. Huang Lian, Gan Jiang, Qing Dai, Hai Er Cha (equal parts).
Powder them. Apply a small amount to the affected area for immediate effect. Another method uses Wu Wei Zi powder sprinkled on the ulcer for cure.
One excellent prescription for mouth ulcers, passed down by Teacher Xu Xingzhuang.
Formula: Sheng Bai Fan (1 qian), Zhu Sha (2 fen).
Grind together into powder and apply to the lesion for immediate cure.
Another discussion on mouth and tongue ulcers, sore throat, cough with phlegm, having effects of clearing voice, moistening lungs, widening the diaphragm, and removing heat.
Formula: Shang Qing Wan, passed down by Huang Binjiang. Bai Yao Jian (4 liang), Bo He (pure powder 4 liang), Sha Ren (2 liang), He Zi, Jie Geng, Gan Song (each 5 qian), Han Shui Shi (2 liang), Yuan Ming Fen (5 qian), Peng Sha (5 qian), Pian Nao (5 fen).
Powder them, use Gan Cao paste to form pills the size of wu zi seeds. Take 3-5 pills with tea.
Another discussion on chronic mouth ulcers lasting years, attributed to Deficient Fire.
Formula: Xuan Men Dan. Tian Men Dong (remove heart), Mai Men Dong (remove heart), Xuan Shen (equal parts).
Grind into fine powder, make pills with refined honey the size of a bullet. Take one pill each time, dissolve in the mouth.
A patient felt like there was no skin inside the mouth, or had a sore throat, preferring hot drinks. This is True Cold of Middle Qi with exterior Deficient Heat. Jia Jian Ba Wei Wan cured it.
A patient's tongue swelled and extended outside the mouth. The tongue is the sprout of the Heart and connected to the Spleen meridians, extending from the root under the tongue. The heat should be attributed to the Heart and Spleen meridians, where excess heat causes swelling. Use Castor seeds (Bi Ma Zi), remove shells, wrap in paper, crush to extract oil. Soak a wick in the oil, burn it to smoke the tongue until healed. Materia Medica states: Bi Ma Zi treats edema and foul qi; oil applied externally. Leaves treat wind-induced numbness; crushed and steamed for application. Thus, it resolves wind swelling and internal heat.
A patient with weak Stomach and abundant phlegm suffered mouth ulcers. Taking Gun Tan Wan worsened the condition, causing diarrhea, aversion to food, and fatigue, indicating Stomach Qi damage. Xiang Sha Liu Jun Zi Tang was given, improving slightly after several doses. Then, Bu Zhong Yi Qi Tang added with Fu Ling and Ban Xia cured it. Insufficient Stomach Qi leads to undigested food generating phlegm. Tonifying the Middle and Augmenting Qi is a method to treat phlegm. Using harsh purgatives for deficiency is dangerous.
A patient with weak Spleen and Stomach took Yang Wei Tang and Zhi Zhu Wan. Initially effective, but long-term use caused more deficiency, mouth ulcers worsening with fatigue. This is Middle Qi Deficient Cold. Li Zhong Tang provided slight improvement, followed by An Ding with Bu Zhong Yi Qi Tang added with Ban Xia and Fu Ling. Yang Wei Tang is aromatic and drying. It is suitable for food stagnation or Cold stagnation in the Middle Jiao, as it dries the Stomach Qi and digests stagnation. However, long-term use dries fluids and weakens Stomach Qi further. Using it on an already weak Stomach aggravates the disease. Sexual exhaustion leading to depleted True Qi or insufficient Yuan Qi failing to ascend, causing Middle Jiao dysfunction and loss of appetite, is treated with Bu Zhen Wan. If Dantian Fire ascends to warm Spleen Earth, harmony is restored, Middle Jiao regulates itself, appetite returns, and mouth ulcers heal.
A patient with a blue-black, prickly tongue indicated severe Heat, often caused by excessive worry and anger. Placing the tongue on a clay wall was said to help. I formulated this prescription for immediate effect.
Formula: Qing Xin San. Chi Fu Ling (peeled, 1 qian), Suan Zao Ren (1 qian), Mai Men Dong (remove heart, 1 qian), Yuan Zhi (soaked in Licorice water, remove heart, 5 fen), Huang Lian (1 qian), Hu Ma Ren (1 qian), Zhi Ke (remove pith, 8 fen), Xiao Mu Tong (8 fen), Xiao Gan Cao (2 fen).
Crush, decoct in water, and take warm.
A male patient with bad breath, red and rotten gums, and weak legs and knees took Huang Bai and other herbs, worsening the condition, sometimes with a salty taste. This is Kidney and Stomach Deficient Heat. Liu Wei Wan cured all symptoms.
One wonderful medicine for mouth ulcers, sore throat, and toothache, passed down by Chen Shangyu.
Formula: Peng Sha (1 qian), Hai Er Cha (2 fen), Xiong Huang (2 fen), Qing Dai (7 fen), Hu Huang Lian (3 fen), Bing Pian (1 li), Xuan Ming Fen (2 li).
Grind together into powder and apply.
Xiang Ru treats halitosis very effectively. Halitosis is due to stagnant Fire in the Spleen overflowing into the Lung, losing its clear, harmonious, and sweet nature, allowing turbid Qi to rise.
One prescription to regenerate tongue and lip tissue, passed down by Jia Lanfeng.
Burn fresh crab to ash. Take 2 qian, mix with Ru Xiang and Mo Yao (each 2.5 fen), apply to regenerate flesh. If lips or tongue are largely missing, use Chuan Wu and Cao Wu powder spread on paper, mixed with cool water, and applied. It is painless and can be cut off if necessary. If bleeding occurs, apply Chen Duan Shi. After healing, if the tongue is hard, apply blood from a white rooster comb to soften it.
One prescription to grow tongue tissue.
Dry one live crab, powder it, and store. Apply when needed to close the wound.
One treatment for swollen and hard tongue.
Use Bai Cao Shuang and Hai Yan in equal parts, powdered, mixed with well water, and applied to the lesion.
Also, frequently sprinkle Zhen Pu Huang powder on the tongue. Internally, decoct Huang Lian alone in water and drink to purge Heart Fire.
One treatment for a tongue extending over one cun. Apply ground Bing Pian to retract it.
One treatment for spontaneous tongue bleeding like a spring. Stir-fry Huai Hua, powder it, and sprinkle to stop bleeding.
One treatment for sudden tongue swelling extending outside the mouth, commonly called centipede poison. Immerse in a small cup of blood from a male rooster comb to retract it.
Tongue protrusion without retraction is named Yang Qiang.
Tongue retraction preventing speech is named Yin Qiang.
A male patient with constant tongue abrasions lacking skin, or sore throat, worsened by Qing Yan Li Ge San. I treated him with Li Zhong Tang, resulting in recovery.