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The mouth is the area governed by the Spleen. The meridians of the Stomach and Large Intestine flank the mouth. The Classics state: "Spleen Qi connects with the mouth." When the Spleen functions harmoniously, the mouth can perceive the five flavors. This describes the Spleen's dominion over the mouth. It is also stated: "The Foot-Yangming Stomach Meridian flanks the mouth and descends to intersect at Chengjiang (CV24)." And again: "The Hand-Yangming Large Intestine Meridian flanks the mouth and intersects at Renzhong (GV26)." This describes how the meridians of the Stomach and Large Intestine flank the mouth.

If the Spleen has heat, the mouth tastes sweet. If the Liver has heat, the mouth tastes sour. If the Heart has heat, the mouth tastes bitter. If the Lung has heat, the mouth tastes pungent. If the Kidney has heat, the mouth tastes salty. If the Stomach has heat, the mouth tastes bland.

Regarding a sweet taste in the mouth: The Classics state that those with a sweet taste in the mouth are suffering from an overflow of the essence of the five Zang organs, a condition named Pi Dan (Spleen Heat leading to sweet taste). Treatment involves using Lan Cao (Pei Lan, *Eupatorii Herba*) to eliminate stale damp-heat. Lan Xiang Yin Zi (Orchid Fragrance Decoction) may be used. If the pulse is wiry and slippery, accompanied by a sensation of hunger discomfort (zao), it belongs to Phlegm-Fire; Gun Tan Wan (Rolling Phlegm Pill) is indicated. This refers specifically to Excess Fire. In ordinary people, if there is a sweet taste with thirst, or if urine is also sweet and turbid, it all belongs to Damp-Heat in the Earth element (Spleen/Stomach), where Spleen fluids ascend. Over time, this will inevitably develop into carbuncles and sores. One must abstain from rich foods and emotional anger, and take San Huang Tang (Three Yellow Decoction) added with Lan Ye (Orchid Leaf), Bai Shao (White Peony Root), and Sheng Di (Rehmannia Root). For severe dryness and thirst, it indicates Kidney Deficiency; taking Jia Jian Ba Wei Wan (Modified Eight-Ingredient Pill) daily can ensure safety. For Zhong Xiao (Middle Wasting-Thirst), where Spleen fluids ascend causing a sweet taste, Lan Xiang Yin Zi is used. For elderly or deficient individuals, where Spleen-Stomach Deficient-Heat fails to consolidate fluids causing a sweet taste, one should tonify Spleen Qi using Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), removing Sheng Ma (Cimicifuga Rhizome) and Chai Hu (Bupleurum Root), and adding Lan Xiang (Orchid Fragrance) and Wei Ge Gen (Calcined Kudzu Root).

Regarding a bitter taste in the mouth: The Classics state that those with a bitter taste in the mouth are suffering from Dan Dan (Gallbladder Heat). The Gallbladder is the residence of pure essence, and the five Zang organs depend on it; the throat serves as its conduit. This occurs because people hesitate in their deliberations, leading to Gallbladder Deficiency and Qi overflowing upward, causing bitterness. Long Dan Xie Gan Tang (Gentian Decoction to Drain the Liver) may be used, or Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Mai Dong (Ophiopogon Tuber) and Zao Ren (Ziziphus Seed). If ineffective, add Huang Lian (Coptis Rhizome) and Dan Cao (Gentiana Root) to the base formula.

Regarding a sour taste in the mouth: This is Excess Heat of the Liver and Gallbladder. Zuo Jin Wan (Assist Metal Pill) added with Shen Qu (Medicated Leaven) and Cao Long Dan (Gentiana Root) is indicated.

Regarding a pungent taste in the mouth: This is Lung Qi overflowing upward. Sheng Mai San (Generate the Pulse Powder) added with Sang Bai Pi (Mulberry Root Bark), Di Gu Pi (Lycium Bark), and Huang Qin (Scutellaria Root) is indicated.

Regarding a salty taste in the mouth: This is Kidney fluid ascending. Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) added with Wu Wei Zi (Schisandra Berry) and Wu Gu (Cuttlefish Bone) is indicated.

A bland taste is due to Stomach Heat, which can be either Excess or Deficiency. In Excess cases, Gan Lu Yin (Sweet Dew Decoction) added with Guang Huo Xiang (Patchouli) is used. After illness, if Stomach Deficiency causes a bland taste, Liu Jun Zi Tang (Six-Gentlemen Decoction) added with Huang Qi (Astragalus Root) and Dang Gui (Angelica Sinensis) is used.

A dry/astringent taste in the mouth: This is Liver pathogen counterflowing to the Lung, with Qi Deficiency and Fire Prosperity. Herbs include Huang Qin (Scutellaria Root), Ge Gen (Kudzu Root), Fang Feng (Saposhnikovia Root), Bo He (Mint), Gua Lou (Trichosanthes Fruit), and Fu Ling (Poria).

Mouth ulcers (Kou Chuang): The Classics state that Bladder heat is transmitted to the Small Intestine, causing obstruction in the diaphragm and intestines, rising upward to become Kou Mi (oral mucosal erosion). The Small Intestine is the Fu organ of the Heart. This merely illustrates one aspect of evil heat. The Heart belongs to Ministerial Fire and governs the fire of the five Zang and six Fu organs; thus, heat from all meridians responds to the Heart. The Heart meridian spreads over the tongue, and the Spleen meridian spreads under the tongue. Diseases of fire in these two meridians should be treated with cold/cooling herbs. However, if there is excessive saliva, phlegm-saliva must also be addressed. If Yuan Yang (Primordial Yang) is deficient and cold, with cold attacking upward causing head heat, foot cold, and mouth ulcers, use Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction) or Lian Li Tang (Coix and Licorice Decoction). Also, use Dang Gui (Angelica Sinensis) and Fu Zi (Aconite Root) honey-fried for holding in the mouth. Some use raw Fu Zi powder applied to the sole of the foot. Such methods are treatments for "Dragon Fire" (Hyperactive Ministerial Fire). When Yin pathogens press upward, preventing Heart-Lung Yang from descending, warm/hot herbs are used to treat the root. They may disperse upward or downward, according to convenience.

If there is heat in the Stomach and the pulse is surging and large/excess, take Liang Ge San (Cool the Diaphragm Powder) or Jin Hua Wan (Golden Flower Pill). Also, hold a piece of honey-fried Huang Bo (Phellodendron Bark) in the mouth. Avoid alcohol and vinegar; violating this makes healing difficult. People who enjoy drinking often have this syndrome. Li Dongyuan used Wu Ling San (Five-Ingredient Powder with Poria) and Dao Chi San (Direct Outward Red Powder) mixed together for treatment. For those not healed by cooling medicines, this is due to excess alcohol and sexual activity, labor, and sleeplessness, resulting in a smooth tongue without coating. Or it is due to worry and thought damaging Middle Qi, with Deficient Fire floating up uncontrollably. One must use Li Zhong Tang (Regulate the Middle Decoction). Severe cases add Fu Zi. Also, hold honey-fried Fu Zi in the mouth. For mouth ulcers, hold half a cun of Gan Cao (Licorice Root) and a small amount of Bai Fan (Alum), swallowing the saliva. For chronic mouth ulcers, sprinkle Mei Zi Bei (Chinese Gall) powder. Or decoct for rinsing. Or soak Bai Fan in decoction for rinsing, as sour flavors can astringe. For severe mouth ulcers, hold Yan Xiao (Saltpeter) and Peng Sha (Borax), keeping the mouth closed. Also, apply Nan Xing (Arisaema Rhizome) powder mixed with vinegar to the Yongquan (KI1) acupoint on the sole to guide heat downward. Another prescription: Mei Zi Bei (Chinese Gall) 1 liang, honey-fried Huang Bo (Phellodendron Bark) and Hua Shi (Talcum) each 0.5 liang, Tong Lv (Verdigris) 3 qian, and a little She Xiang (Musk), ground into powder and sprinkled.

For tongue ulcers and broken mouth pain, use half a Ban Dou (Croton Seed), raw and ground, mixed with rice water to the size of a bean, pounded and applied to the Yin Tang (point between eyebrows) on the forehead. Remove after about half a ke when redness appears; do not allow blistering. Reduce dose for children; recovery follows immediately.

Dai Fuan said: Lower Deficiency and Upper Excess causing mouth and tongue ulcers should be treated with sedating/heavy-settling herbs, such as Su Zi Jiang Qi Tang (Perilla Seed Descending Qi Decoction), or Yang Zheng Dan (Nourish Righteousness Pill) taken with salt water.

Bad breath (Kou Chou): In the elderly with weak Kidney Water, excessive nourishment, rich foods, and consumption of Yang-tonifying drugs, Kou Mi (oral erosion) becomes foul-smelling. Use Gan Lu Yin (Sweet Dew Decoction) added with Xi Jiao (Rhinoceros Horn - *note: substitute with Buffalo Horn in modern practice*), Yin Chen (Artemisia Capillaris), and strong decoction of Xiang Ru (Mosla) for holding in the mouth, swallowing slowly. If the mouth feels sticky and foul, use Zhi Mu (Anemarrhena Rhizome), Di Gu Pi (Lycium Bark), Sang Bai Pi (Mulberry Root Bark), Shan Zhi (Gardenia Fruit), Mai Dong (Ophiopogon Tuber), Gan Cao (Licorice Root), and Shi Yan (Salt), decocted for holding in the mouth. For robust individuals, Liang Ge San (Cool the Diaphragm Powder) is excellent. For turbid phlegm and Qi causing foul odor, induce vomiting with salt water.

Hezi treated a man in his twenties whose breath smelled like a latrine. Metal (Lung) naturally smells fishy; when Metal is overcome by Fire, Fire causes foul odors, hence such smell. Over time, it becomes putrid; putrefaction belongs to Water (Kidney). This is extreme hyperactivity mimicking Water transformation. Since the disease is in the upper jiao, emesis is appropriate. Use Gua Di San (Melon Sepal Powder) to vomit out seven-tenths of the pathogen. At night, use Shen Bao Wan and Jun Chuan San to purge five or six times. By morning, the odor ceased. However, the drug properties are harsh and should not be used lightly.