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A commoner in Lin'an suffered from a condition where his tongue protruded more than one cun due to Cold Damage (Shanghan), and no one could cure him. He was fed porridge through a quill tube and sat at the gate daily. A Daoist master passed by, sighed, and said, "I can cure this in an instant, but I cannot obtain the medicine, what should I do?" Just then, a high-ranking official returned from duty, dismounted, observed the patient, and asked what was needed. The answer was Plum Blossom Pian Nao (Bingpian, Borneol). The Daoist laughed and said, "This is not difficult." He immediately sent his servant to fetch it quickly. The Daoist powdered the substance and sprinkled it on the tongue; the tongue retracted immediately. Five qian were used in total. (From *Yi Shuo*)

Another prescription: For tongue swelling protruding from the mouth, dip paper strips in Castor Oil (Ricini Oleum) to make wicks, ignite them to produce smoke, and fumigate the affected area.

Prescription for treating tongue swelling full like a pig's bladder:
Take soot from the bottom of a cauldron, mix with Vinegar (Acetum), and apply thickly to the upper and lower surfaces of the tongue. Reapply after it falls off, and it will subside shortly. Alternatively, pierce to drain blood first, then apply; this is even better. (Named *Baicao Shuang San* in *Qianjin Fang*)

Another method:
Mix soot from the bottom of a cauldron and Salt (Natrii Chloridum) in equal parts, blend with vinegar, and apply.

When my son, Shilu, was young, he suddenly suffered from tongue swelling. I used calcined Alum (Sulfur Alum) that had turned red, took a small amount, ground it into powder, and applied it to the tongue. After a short while, he recovered.

Mouth and tongue ulcers present two types of syndromes. One type is caused by Heat in the Heart and Stomach, where Qi rushes upward to the Upper Jiao, steaming and affecting the mouth and tongue. Symptoms include bad breath, thirst, fever, and a desire to drink cold liquids. This is treated with *Han Jian* from *Wai Tai Mi Yao*. The other type is caused by Spleen-Stomach deficiency and poor appetite, where Kidney Water Qi rebels and overcomes the middle, resulting in Interior Cold. The deficient Fire of the Spleen and Stomach is forced upward, causing ulcers. Symptoms include loss of appetite, loose stools, cold extremities, and abdominal pain. The Classics state: "When Metal is deficient in the year, Flaming Fire prevails; upon recovery, cold rain arrives violently, Jueyin is blocked, Yang rises inversely, and the people suffer from mouth ulcers." It is appropriate to use *Fuzi Lizhong Tang*, using Ginseng (Ren Shen), Atractylodes Macrocephala (Bai Zhu), and Licorice (Gan Cao) to tonify the Middle, and Dried Ginger (Gan Jiang) and Aconite Root (Fu Zi) to scatter Cold, so that when Earth is warm, Fire naturally敛 (restrains/converges).

*Wai Tai Mi Yao* Han Jian:
Cimicifugae Rhizoma (Sheng Ma), Lithospermi Radix et Rhizoma (Da Qing), Belamcandae Rhizoma (She Gan) (each 3 liang); Bitter Bamboo Leaves (Ku Zhu Ye), Gardenia Fruit (Zhi Zi), Phellodendri Cortex (Huang Bo) (each 1 sheng); Honey (Mi) (8 he); Fresh Rehmanniae Radix Juice (Sheng Di Zhi), Fresh Codonopsis Radix Juice (Sheng Yuan Shen Zhi) (each 5 he, dry weight 2 liang); Rosa Multiflora Root Bark (Qiangwei Gen Bai Pi) (5 liang).
Boil the above in 6 sheng of water until 2 sheng remain, strain, add Fresh Rehmanniae Radix Juice and Honey, boil again until viscous like maltose syrup, hold in the mouth slowly, stop when cured. *Wai Tai Mi Yao* states: Rosa Multiflora Root Bark and Setaria Verticillata Herb are divine medicines for mouth ulcers.

*Huanglian Gao* (from *Sheng Ji Zong Lu*):
Coptidis Rhizoma (Huang Lian) (3 liang), Pig Fat (Zhu Zhi) (1 jin), White Honey (Bai Mi) (4 liang), Sheep Marrow (Yang Sui) (ground, 2 liang).
Slowly fry Pig Fat to extract oil, remove dregs, add Coptidis Rhizoma and fry until black, add Sheep Marrow to melt, filter through silk cloth to remove dregs, add Honey and fry into a paste. Store in porcelain jars. Hold a date-sized amount in the mouth each time, 3-5 times a day. Swallowing saliva is acceptable.

*Fuzi Lizhong Tang*:
Fresh Ginger Decoction:
Fresh Ginger Juice (Sheng Jiang Zhi) (1 zhan), White Honey (Bai Mi) (3 liang).
Boil together for ten boils, store in a porcelain bottle. Mix one spoonful with hot water occasionally, hold in mouth and swallow.

Commentary: *Sheng Ji Zong Lu* discusses mouth ulcers as having Excess and Deficiency patterns; Excess is cleared, Deficiency is warmed, which is very clear. However, besides these two, there is another syndrome of Kidney Deficiency with Fire moving. Kidney Deficiency has two aspects: one is Kidney Yin Deficiency, where Yang has no attachment and wanders upward; treat with formulas like *Liu Wei Di Huang Wan* to strengthen Water to control Fire. The other is Interior Cold in the Kidneys, where Yang is unsettled in its residence and flies upward; treat with formulas like *Qi Wei* or *Ba Wei Di Huang Wan* to warm the viscera and restrain Yang. Although there is a theory about Yuan Organ Yin Fire attacking the mouth and tongue, using drugs like Morinda Officinalis Root (Ba Ji Tian), Angelica Dahurica Root (Bai Zhi), and Galangal Rhizome (Liang Jiang) is inappropriate. Only using Honey-fried Aconite Root (Fu Zi) held in the mouth to allow slow swallowing is advisable.

*Ji Jian Fang* for treating mouth and tongue ulcers:
Urine Pot Scale (Niao Tong Xie) (7 fen), Calcined Alum (Ku Fan) (3 fen).
Grind both finely and apply. Wipe away saliva if produced; heal after several applications.