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Whenever the breath from the mouth and nose is coarse, exiting and entering rapidly, it indicates an excess of external pathogenic factors. Whenever the breath from the mouth and nose is faint, exiting and entering slowly, it indicates a deficiency of internal healthy Qi (vital energy). This is the general method for distinguishing between interior/exterior and deficiency/excess patterns. If there is bad breath and dryness in the mouth, it is due to Stomach Heat. If there is a metallic/bloody taste in the mouth, it is also due to Stomach Heat. If the taste is bland and lacking flavor, it is due to injury of Stomach fluids. If the mouth feels sticky and tasteless, it is due to dampness stagnation in the Stomach. If the mouth is dry but there is no desire to drink, it is due to Spleen dampness retained internally. If the mouth tastes salty with foamy saliva, it is due to Kidney water floating upward. If the mouth tastes sweet, it is Pi Dan (Spleen Heat/Damp-Heat). If the mouth tastes bitter, it is Gallbladder Heat. If the mouth tastes pungent/spicy, it is Lung Heat invading the Stomach. If the mouth tastes sour, it is Liver Heat invading the Stomach. If the mouth and tongue are dry, it is Heart Heat. If the mouth is dry with a sore throat, it is Kidney Heat. If the mouth is dry with teeth grinding/clenching, it is Feng Jing (Wind-induced spasms). If the jaw is locked making speech difficult, it is Wind-Phlegm. If thin saliva flows from the corners of the mouth, it is Spleen Cold. If sticky saliva is spat from the mouth, it is Spleen Heat. If purple blood is vomited, it is injury to the Stomach collaterals. If pale blood is spat in saliva, it is the Spleen failing to control the blood. If the mouth opens wide and cannot close, it indicates Spleen exhaustion. If sounds like a crow come from the mouth, it indicates Lung exhaustion. Blackening around the mouth signifies death. Dry mouth with withered teeth signifies death. Mouth resembling the pointed lips of a fish signifies death. Breath escaping from the mouth without returning signifies death.

If the lips are scorched and red, it is Spleen Heat. If the lips are dry and cracked, it is also Spleen Heat. Scorched lips that are red indicate a favorable prognosis. Scorched lips that are black indicate an unfavorable prognosis. Dry and scorched lips indicate the Spleen suffering from dryness-heat. Pale and yellow lips indicate accumulated damp-heat in the Spleen. Pale white lips indicate Blood deficiency, and may also manifest as vomiting saliva or loss of blood. Red-purple lips indicate Blood stasis, and may also be caused by parasites causing accumulation pain. Red lips with hematemesis indicate Stomach Heat. White lips with vomiting of saliva indicate Stomach deficiency. Lips red as vermilion indicate extreme Blood heat and hyperactive Heart Fire. Lips white as snow indicate Blood depletion and impending extinction of Spleen Yang. Purple lips with hoarseness indicate parasite accumulation. Calloused lips and fissured tongue indicate toxin accumulation. Sores on the upper lip where parasites eat the viscera constitute Hu (Fox disease, likely referring to Erythema Multiforme/Behcet's-like syndrome). Sores on the lower genitalia/anus where parasites eat the anus constitute Yu (also part of Hu-Yu syndrome). Dry lips and dry tongue indicate extreme Heat in the Heart and Spleen. Swollen lips and scorched teeth indicate extreme Heat in the Spleen and Kidney. Lips that are stiff and retracted, unable to cover the teeth, indicate Spleen exhaustion. Lips that curl inward and backward, accompanied by a short frenulum, also indicate Spleen exhaustion. Lips and mouth trembling continuously signify death. Lips turning blue-green with cold breath signify death.

Regarding teeth: Teeth dry without fluid indicate Stomach Heat. Scorched and withered teeth indicate exhaustion of body fluids. Teeth clenching/grinding indicates Wind stirring and traction of oral tendons. Teeth grinding without clenching indicates severe Heat causing stiffness of the jaw. Dryness of the anterior plate teeth with a deficient pulse indicates Summerheat. Dryness of the lower teeth with a knotted (Kou) pulse indicates blood in the stool. Dryness of the upper gingiva indicates extreme Heat in the Stomach collaterals, often leading to hematemesis. Dryness of the lower gingiva indicates extreme Heat in the intestinal collaterals, often leading to hematochezia. Excessive menstruation followed by sudden tooth-clenching indicates exhaustion of the Chong and Ren vessels, indicating a critical condition. Long-term deficiency consumption followed by sudden tooth-clenching indicates exhaustion of Heart and Kidney Qi, indicating an untreatable condition.

[Supplementary Verification] Mr. Ye Tianshi stated: Teeth are the surplus of the Kidney; gums are the collaterals of the Stomach. After examining the tongue in any disease, one must also examine the teeth. Dental plaque is formed by Kidney Heat steaming Stomach turbidity. If its color resembles cake, it indicates decay with exhaustion of both fluids and Qi, and exhaustion of both Stomach and Kidney, which is untreatable. Scorched teeth with dry Kidney water and no plaque indicate exhaustion of Stomach fluids, often fatal. If there is plaque, although Fire is strong, fluids have not yet been exhausted, and mild purgation should be used. Teeth that are shiny and dry like stone indicate severe Stomach Heat; acrid-cool herbs to drain Stomach Heat should be used. Teeth that look like withered bone indicate exhaustion of Kidney fluids; sweet-salty herbs to rescue the Kidney should be used. If the upper half is moist, Water fails to ascend, and Heart Fire flares upward; clear Fire and rescue Water should be used. When Heat pathogens consume Kidney fluids, the teeth turn yellow, like soybean paste; the condition is dangerous, rescue the Kidney. When Heat pathogens consume Stomach fluids, the teeth turn purple, like dried lacquer; the condition is treatable, stabilize the Stomach. Bleeding from gum margins with pain indicates Stomach Fire rushing and striking; clear the Stomach. Bleeding from the gum roots without pain indicates Kidney Fire flaming upward; nourish the Kidney. These are all insights from Mr. Ye’s experience, sufficient to supplement the omissions in Mr. Yu’s work.

[Rongzhai’s Note] The method of observing respiration in the first paragraph of this section is incomplete. There are other most essential and practical methods, such as: Shortness of breath (Qi Duan), Panting/Asthma (Qi Chuan), Flaring of nostrils (Bi Shan), Shoulder breathing (Jian Xi), High-pitched breathing (Xi Gao), and Surging irregular breathing (Qi Xi Cha Yong), six types in total, which should be deeply understood. Furthermore, the descriptions of "Coarse breath" and "Faint breath" in this section are insufficiently detailed; here they are supplemented together:

(1) Coarse breath (Qi Cu) – Breathing is forceful but not peaceful/harmonious, often seen when Yangming Heat is severe. The manifestation is in the Lung, but the root is in the Stomach; accumulated Heat in the Stomach prevents Qi from descending clearly, forcing the Lung into coarse breathing. This is a Yangming Excess pattern.

(2) Faint breath (Qi Wei) – Breathing is low and faint, indicating various deficiencies. However, while Healthy Qi is indeed declining, Pathogenic Factors are also declining; this is commonly seen when a febrile disease has resolved but Healthy Qi has not yet recovered. In miscellaneous diseases, it is most prominent in hemorrhagic conditions; in Shanghan (Cold Damage), it is common after two stages (approx. 10 days).

(3) Shortness of breath (Qi Duan) – Breathing is shorter than normal, also a deficiency pattern. The difference between Qi Duan and Qi Wei: Qi Wei breathing is quiet and silent; Qi Duan is restless and somewhat coarse. Qi Wei indicates insufficient Qi for respiration and speech, with a natural state; Qi Duan feels obstructed, speech seems discontinuous, and the state is strained. Qi Wei mostly belongs to the late transmission of external contraction diseases; Qi Duan mostly belongs to the initial onset of internal injury diseases. Therefore, Qi Wei is a sign of disease receding, while Qi Duan is a sign of disease progressing.

(4) Panting/Asthma (Qi Chuan) – A general term for urgent breathing. Its cause is high body temperature, and its key lies in the Stomach and Lung; however, there are cases of Yin deficiency; one must pay attention to accompanying symptoms.

(5) Flaring of nostrils (Bi Shan) – This symptom involves continuous dilation of the nostrils, visible at a glance. While urgent breathing is not necessarily critical, if accompanied by flaring nostrils, it is usually dangerous, mostly belonging to lung suffocation.

(6) Shoulder breathing (Jian Xi) – Tracheal obstruction, weak physical strength, requiring full effort to inhale, thereby pulling the shoulders; this is called Shoulder breathing. The lesion is in the Lung, the source is in the Kidney, known as "Kidney failing to grasp Qi." It is often seen during severe asthma attacks.

(7) High-pitched breathing (Xi Gao) – Respiration stops at the chest, with lung movement only above the diaphragm. In Shanghan, seeing this after purgation indicates death. In miscellaneous diseases, long-term severe weakness does not fall into the critical category.

(8) Surging irregular breathing (Qi Xi Cha Yong) – This is a special acute pulmonary disease. Its panting rises and falls drastically, the chest and abdomen are both distended, like an air pump, and the nostrils feel abnormally narrow; infants suffering from this are extremely critical.