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When pathogenic heat resides in the Middle and Upper Jiao (Middle and Upper Burners), bitter taste in the mouth occurs. This is not only seen in epidemic febrile diseases (infectious epidemic diseases), but also when contracting wind-cold, a bitter taste in the mouth still belongs to the Shaoyang (Lesser Yang) heat syndrome. For instance, during an epidemic febrile disease, when chills and fever are present and the exterior syndrome is at its peak, if a bitter taste in the mouth is observed, one should double the dosage of heat-clearing herbs among the exterior-releasing formulas. For mild cases, use Huangqin (Scutellariae Radix); for severe cases, use Zhimu (Anemarrhenae Rhizoma); for even more severe cases, use Shigao (Gypsum Fibrosum).

This principle applies not only to the exterior syndromes of the Three Yang meridians, but also to the interior syndromes of the Three Yin meridians. If symptoms such as cold extremities, aversion to cold, vomiting and diarrhea, chest and abdominal fullness, and absence of thirst appear, seemingly indicating a pure cold condition without heat, the presence of a bitter taste in the mouth indicates that heat-clearing and draining herbs must be added to the warming and drying formulas. When using Banxia (Pinelliae Rhizoma), Cangzhu (Atractylodis Rhizoma), Caoguo (Tsao-ko Fruit), and Houpo (Magnoliae Officinalis Cortex), it is essential to add Mutong (Akebiae Caulis), Fuling (Poria), and Zexie (Alismatis Rhizoma), and even Zhimu (Anemarrhenae Rhizoma) and Huangqin (Scutellariae Radix). This follows the original intent of Wu又可's Da Yuan Yin (Reach the Origin Decoction).

A bitter taste in the mouth is a key indicator of heat syndromes. Whenever symptoms are ambiguous and difficult to distinguish between cold and heat, this sign is relied upon for diagnosis. Furthermore, yellow or black dry tongue coating, restlessness, thirst due to heat, and constipation indicate that heat-clearing and purging methods cannot be delayed.

Both bitter taste and sweet taste in the mouth belong to heat syndromes. Bitter taste results from dry heat located in the Upper and Middle Jiao, often accompanied by thirst, and is associated with the Three Yang meridians; sweet taste results from damp-heat located in the Middle and Lower Jiao, often without thirst, and is associated with the Three Yin meridians. The Spleen and Stomach belong to Earth, and Earth produces sweetness. If Earth pathogen descends to involve the Kidney position, the interaction between Water and Earth causes the sweet flavor to overflow into the mouth, often accompanied by vomiting. People often mistakenly diagnose this as Stomach Cold and use warming middle-jiao formulas, unaware that damp-heat resides in the Lower Jiao. Since Earth controls Water, excessive use of warming and drying agents will deplete Kidney Water. Although typical heat signs like thirst may not be apparent, vision loss may occur, leading gradually to coma and death.

For the initial stage of various diseases presenting with sweet taste in the mouth, warming and opening/dispersing agents can be used, but should not be overdosed. In epidemic febrile diseases, treatment must primarily focus on clearing heat, with resolving phlegm as secondary. If there is excessive fluid retention in the chest, adding Cangzhu (Atractylodis Rhizoma) and Banxia (Pinelliae Rhizoma) suffices. Formulas such as Er Chen Tang (Two-Cured Decoction) with Gancao (Glycyrrhizae Radix et Rhizoma) removed, plus Jiangzhi Chao Shanzhi (Gardeniae Fructus stir-fried with ginger juice), Jiangzhi Chao Huanglian (Coptidis Rhizoma stir-fried with ginger juice), Zhuru (Bambusae Caulis in Taeniam), and Huangqin (Scutellariae Radix) are essential medicines for treating sweet taste in the mouth. Wumei (Mume Fructus) is particularly effective, as sour flavor overcomes sweet flavor, following the natural principle of Five Elements mutual restriction. Alternatively, Siling San (Four-Poria Powder) with Shanzhi (Gardeniae Fructus) can be used. However, medication must always be weighed against the overall trend of the epidemic febrile disease.