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The meridians of the Spleen channel encircle the lips and mouth. Throughout the course of variola (smallpox), it is most valuable for the lips and mouth to remain moist and ruddy. If they turn purple, crack, or become scorched and black, immediate treatment is required, following the two formulas of Gegen Jiedu Tang (Kudzu Root Detoxification Decoction).

[Note] The meridians of the Spleen channel encircle the lips and mouth; hence, the classic texts state: "The brilliance of the six fu-organs manifests in the lips." Only when body fluids are sufficient and qi and blood flow smoothly can the lips and mouth appear ruddy. Therefore, throughout the onset of variola, maintaining ruddy lips and mouth is paramount. Otherwise, if constrained by toxic heat, the toxin penetrates inward while heat blazes outward. Not only will the lips fail to remain ruddy, but they may also turn red, purple, or scorched and cracked. In such cases, treatment must not be delayed. Initially, Jiawei Shengma Gegen Tang (Modified Cinnamon Twig and Kudzu Root Decoction) is appropriate; after the pustules have risen, Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity) should be used.

Jiawei Shengma Gegen Tang (Modified Cinnamon Twig and Kudzu Root Decoction)
Chi Shao (Radix Paeoniae Rubra), Zhi Zi (Fructus Gardeniae), Huo Xiang (Herba Pogostemonis), Sheng Ma (Rhizoma Cimicifugae), Ge Gen (Radix Puerariae), Sheng Gan Cao (Radix Glycyrrhizae Preparata), Fang Feng (Radix Saposhnikoviae), Shi Gao (Gypsum Fibrosum).
Decoct in water and take orally.

[Formula Song] Jiawei Shengma Gegen Tang consists of Chi Shao, Zhi Zi, and Huo Xiang; combined with Sheng Ma, Ge Gen, and Sheng Gan Cao, decocted together with Fang Feng and Shi Gao for consumption.
Huanglian Jiedu Tang (See section on Crusting and Scabbing for formula details).

After recovery from variola, if noma (gangrenous stomatitis) occurs due to toxic heat attacking upward, symptoms include bad breath, swollen gums, and significant pain. Internally administer Qingre Liangxue Yin (Clear Heat and Cool Blood Decoction); externally apply Zhongbai San (Middle White Powder) for excellent efficacy.

[Note] Noma occurring after variola results from residual toxins that have not been resolved, attacking upward to the teeth. In the early stage, there is bad breath, gum swelling, bleeding from the gingival sulcus, and pain. In severe cases, the tissue turns black and rots, teeth fall out, and the condition perforates the cheeks and breaks the facial skin, eroding through the nose and lips, often leading to untreatable outcomes. Upon observing this, urgent treatment is necessary: internally administer Qingdu Liangxue Yin (Clear Toxin and Cool Blood Decoction) and externally apply Renzhongbai San (Human Urine Deposit Powder).

Qingdu Liangxue Yin (Clear Toxin and Cool Blood Decoction)
Zhi Mu (Rhizoma Anemarrhenae), Shi Gao (Gypsum Fibrosum), Sheng Di Huang (Radix Rehmanniae Preparata), Huang Lian (Rhizoma Coptidis), Dang Gui (Radix Angelicae Sinensis), Chi Shao (Radix Paeoniae Rubra), Da Huang (Radix et Rhizoma Rhei), Shan Zhi Zi (Fructus Gardeniae), Dan Pi (Cortex Moutan), Jing Jie Sui (Herba Schizonepetae), Lian Qiao (Fructus Forsythiae, heart removed).
Decoct in water and take orally.

[Formula Song] Qingdu Liangxue Yin treats noma; it contains Zhi Mu, Shi Gao, Sheng Di, and Huang Lian. Combined with Dang Gui, Chi Shao, Da Huang, Shan Zhi Zi, Dan Pi, Jing Jie Sui, and Lian Qiao, decoct for use.

Renzhongbai San (Human Urine Deposit Powder)
Renzhong Bai (Calculus Humanus, calcined, 2 qian), Xiong Huang (Realgar, 8 fen), Bing Pian (Borneolum Syntheticum, 4 fen), Peng Sha (Borax), Qing Dai (Indigo Naturalis), Er Cha (Camellia Seed, each 1 qian).
Grind all into a fine powder and apply topically to the affected area.