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1. The innate constitution and physical endowment of people nowadays are vastly different from those in the past. Even for a condition such as *Ya Gan* (Gum Disease), which may clearly present as Excess Fire, using ancient methods with formulas like *Xiao Gan Yin* (Eliminate Gum Decoction) and herbs such as Huang Qin (Scutellariae Radix), Lian Zi (Corylinae Semen), and Ling Yang Jiao (Saiga Antelope Horn) often proves ineffective. If one fails to exercise flexibility and adapt to changes, errors are inevitable. However, the diagnosis must be verified by pulse taking. If both radial pulses are slow and sluggish without any surging or large characteristics, cold-natured drugs should not be administered; in such cases, *Yu Nu Jian* (Jade Woman Decoction) is particularly effective.

2. A *Hou Liu* (Throat Tumor) resembles *Shuang E* (Double Tonsillar Swelling). *Shuang E* is round in shape and located on the left and right sides of the pharyngeal gate, whereas *Hou Liu* is slightly elongated, resembling a nutmeg, and arises on both sides inside the throat gate. Its color is pale with red filaments wrapping around it. In the early stage, there is pain but no fever. This is mostly caused by Yin deficiency of the Lung and Kidney, with heat stagnating in the Lung. It can result from excessive talking damaging Qi, shouting in anger, reading too hastily, consuming strong alcohol excessively, indulging in roasted or fried foods, emotional depression, or shouting after drinking while exposed to wind. Although the causes vary, the syndrome tends to be deficient in nature. One must absolutely avoid reckless use of exterior-releasing and dispersing methods, and never cut or break it with a knife. For treatment, if fever is present at the onset, mild release and resolution can be employed. Subsequently, *Yi Qi Qing Jin Tang* (Qi-Nourishing and Lung-Clearing Decoction) should be used, removing Huang Qin (Scutellariae Radix), Shan Zhi (Gardeniae Fructus), and Zhu Ye (Bambusae Folium), and adding Sheng Di Huang (Rehmanniae Radix). If the constitution is deficient without heat, follow the previous formula modification but add 3 qian of Shu Di Huang (Prepared Rehmanniae Radix). For cases caused by depression, *Gui Pi Tang* (Restore the Spleen Decoction) added with Shan Zhi (Gardeniae Fructus) and Dan Pi (Moutan Cortex), or *Liu Wei Di Huang Wan* (Six-Ingredient Pill with Rehmannia) added with Mai Dong (Ophiopogonis Radix) and Bei Mu (Fritillariae Bulbus), can be used for internal administration, along with blowing powders such as *Xiao Liu Bi Yu San* (Tumor-Eliminating Jade Powder) or *Qing Xue Dan* (Clear Blood Pellet) externally. This condition is difficult to eradicate completely; slight exposure to the Six Evils (pathogenic factors) can trigger an attack, which is hard to calm down but generally not life-threatening. Recently, individuals with deficient constitutions often suffer from this. For long-standing cases where swelling is hard and difficult to resolve, applying *Zhen Fan Xie* (Senna Leaf) mixed with *Bi Yu San* frequently to the swollen area daily can reduce the swelling by half. If treated improperly, it may spread into ulceration that is hard to heal. The formula is recorded in Volume 66 of "Wai Ke Xin Fa" (External Medicine Core Methods) in *Yi Zong Jin Jian* (Golden Mirror of Medicine).

3. *Qing Tui Ya Gan* (Blue Leg Gum Disease) is rare among patients and is found only in border regions with miasma. Its treatment methods are also recorded in Volume 70 of "Wai Ke Xin Fa" in *Jin Jian*.

4. Swelling on both sides of the base of the tongue, about the size of a bean, yellow in color, initially soft but gradually becoming hard, or extending linearly on one side with slight pain, interfering with eating and speaking. Upon differentiation, this is not *She Yong* (Tongue Abscess), *She Gan* (Tongue Ulcer), *She Liu* (Tongue Tumor), nor *Tan Bao* (Phlegm Sac). Few practitioners know how to treat this. They often stubbornly attribute it to Heart Fire, prescribing cooling and descending methods, or administering cold-natured drugs such as *Xie Xin Dao Chi San* (Drain Heart and Guide Out Redness Powder), Niu Huang (Calculus Bovis), Xi Jiao (Rhinocerotis Cornu), and *Zi Xue Dan* (Purple Snow Pellet). This further suppresses the condition, causing increased swelling and difficulty in movement. Prolonged illness results from frequent use of cooling agents, which merely deplete Qi and Blood and damage the Spleen and Stomach, ultimately failing to produce results. The use of knives is especially contraindicated. If one assumes that excess blood requires puncturing to drain, hoping for a lucky outcome, it will likely lead to spreading ulceration involving the root of the tongue, making it extremely difficult to save. These errors stem from ignorance of the root cause, failure to distinguish between deficiency and excess, and rigid adherence to the notion that Heart Fire is the sole culprit. The Classics state: "The Jueyin Liver Meridian connects to the root of the tongue, and the Shaoyin Heart and Kidney meridians are all connected to the tongue." Tongue diseases do not exclusively belong to the Heart, as evident from this text. Careful examination is urgently needed to avoid confusion during clinical practice. Note: This condition is related to the Liver and Kidney. It may be caused by emotional depression, preference for roasted/fried foods, or excessive alcohol consumption. Although it appears as Excess Fire, it is actually due to Insufficiency of Water (Kidney Yin). In some cases, sudden swelling at the base of the tongue occurs, accompanied by swelling beside the larynx resembling phlegm nodules, which gradually become hard and painful, or swell like an inverted cup without redness. If cold-natured drugs were not taken initially, it is still easy to treat. However, if wrongly treated with cold drugs and the swelling becomes hard, it becomes difficult to cure. Nevertheless, the treatment only requires heavy doses of *Liu Wei Di Huang Tang* (Six-Ingredient Rehmannia Decoction) prepared in large quantities and taken orally. In the early stage, recovery can be achieved in just five or six doses. How difficult is that?