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A small blister arises on the surface of the tongue; one appears, followed by another. In severe cases, there may be seven or eight, growing in a string of pearls (Lianzhu). The tongue coating is yellow, and the tongue is swollen and painful. If it occurs exclusively in the center of the tongue, it is named "Tongue Yangmei" (Plum Kernel Tongue), all of which belong to Heart Fire (Xin Huo) hyperactivity. Treatment involves blowing mouth ulcer medicine (Kougan Yao) into the lesion.

The tongue is swollen as large as a cooked pig's liver and cannot move; this is caused by melancholy (Youyu). Another type arises under the root of the tongue, resembling a white date, known as Chongshe (Double Tongue). [Commentary: This belongs to Yin Syndrome (Yin Zheng); treatment should employ greatly pungent and warm herbs to stimulate Kidney Yang (Shen Yang). Using cold-cooling herbs would be a mistake.]

Another name is Xuekou (Snow Mouth). Infants within their first month of life present with white debris covering the entire mouth and tongue, resembling Goose Mouth Ulcer (E Kou), hence the name. The appearance resembles rotting cloth; if it later turns yellow and then black, it is incurable. If the mouth opens like a fish's mouth or produces sounds like a crow, it is difficult to treat. This is caused by accumulated heat in the Heart and Spleen (Xin Pi Ji Re) and is also known as Mikou (Confused Mouth). [E's Commentary: For this condition, I used Liuhua San (Willow Flower Powder) blown into the mouth, and additionally wiped with real green cloth moistened with mint water, yielding excellent results.]

Newborns who have already absorbed heat-toxin in the womb develop this upon exposure to wind. One can identify it by looking for white spots on the gum roots that resemble brittle bone. At the onset, the infant must sneeze; holding the nipple in the mouth but swallowing or spitting without sucking indicates the disease has penetrated deeply. If not treated urgently, the pathogen enters the abdomen leading to death. Infants older than 100 days do not suffer from this disease.

Arising in the hard palate, shaped like a purple plum, hanging down to touch the tongue, the patient cannot speak, extend the tongue, or lower the head, standing only with the face upward. Red nasal discharge occurs intermittently. If not treated rapidly, the toxin enters the brain causing death. Another type (Jianju insect-toxin wind), where the hard palate is slightly swollen, preventing intake of water and food, resembling an egg or a torn perforation through the palate, is named Tianchuan (Heavenly Piercing), which is incurable. [Jinghua's Commentary: The characters "Jianju" make no logical sense, likely a transcription error; retained here for reference.]

The interior of the mouth and throat are red and swollen like a distended liver; material is vomited from the mouth, Qi rebellion causes closure, and eating/drinking is impossible. This is a ominous syndrome (Xiong Zheng).

It erupts along the meridians, occurring either in the mouth or on the tongue, without a fixed location, characterized by chronic non-healing ulcers (identify the specific meridian involved). [E's Commentary: Jiedu (Syphilitic Toxin) presents with various symptoms and is not necessarily limited to throat conditions.]