病
《内经》曰∶中央黄色，入通于脾，开窍于口，藏精于脾，故病在舌。夫口之为病，或为重舌、木舌，或
为糜烂生疮，或见酸苦辛咸味。原其所因，未有不因七情烦扰，五味过伤之所致也。经曰∶阴
之五宫，本在五味；阴之五宫，伤在五味是也。是以肝热则口酸，心热则口苦，脾热则口甘，肺热则口辛，
肾热则口咸。有口淡者，知胃热也。外有谋虑不决，肝移热于胆而口苦者。亦有脾胃气弱，木乘土位而口
酸者。或膀胱移热于小肠，膈肠不便，上为口糜，生疮溃烂，则伤寒狐惑之证，上唇生疮，虫食其脏；下
唇生疮，虫食其肛也。又舌吐不收，名曰阳强；舌缩不能言，名曰阴强。
方
绿袍散 治口疮。
黄柏（去粗皮，一两） 青黛（三钱）
上为末，掺患处噙之，吐出涎即愈。一方加密陀僧一钱。
赴宴散（段干兵传）〔批〕（按此方治口疮外敷之剂） 治口疮。
黄连 黄柏 黄芩 栀子 细辛 干姜
上各等分，为细末，先用米泔水漱口，后搽药于患处，吐咽不拘，神效。
升麻散 治上膈痈毒，舌上生疮，咽喉肿痛。
升麻 赤芍 人参 桔梗 干葛（各钱半） 甘草（七分）
上锉一剂，水煎，徐徐服之。
《内经》曰∶膀胱移热于小肠，膈肠不便，上口为糜，五苓散合导赤散一服而愈。
〔批〕（按此方治口疮内服之剂） 凡口疮服凉药不愈者，乃中气虚，相火
泛上无制，用理中汤治之即愈，甚者加附子，或用官桂末掺之。
上清丸（王天中传）〔批〕（按此方治口疮噙化之剂） 治口舌痛生疮。
薄荷叶（三两） 硼砂（五钱） 天花粉（一两） 天竺黄（五钱） 风化硝 百药
煎防风 孩儿茶（各一两） 桔梗（七钱） 甘草（一两）
上为细末，炼蜜为丸，如弹子大。每服一丸，噙口中，徐化下。
香茶饼 清膈化痰香口。
孩儿茶（四两） 桂花（一两） 南薄荷叶（一两） 硼砂（五钱）
上为末，用甘草煮汁，熬膏作饼，噙化咽下，美味香甜。
硼砂丸（王天中传）〔批〕（按此方清上香口之剂） 治口气，口干，口舌生疮。
硼砂（二钱） 片脑 麝香（各一分） 马牙硝（风化，四钱） 寒水石（ ，一钱）
上为末，用甘草膏为丸，如麻子大。不拘时含一丸，咽津。
口唇紧小，不能开口，不能饮食，不治即死，用白布作灯炷如指大，安刀斧上燃烧，令刀上汗出，拭取
敷唇上，日二三度，或用旧青布烧灰，调清服，或和猪脂涂敷。又以蛇蜕烧灰，先拭净敷之；又宜烧乱发、蜂
房、六畜毛灰，猪脂调敷。
治唇紧燥裂生疮。
橄榄不拘多少，烧灰，猪脂和敷患处。
治口唇裂破成疮（刘太府方）
炉甘石（二钱，火 ） 文蛤（一两） 黄柏（一两） 苍术（五钱）
除甘石外，三味同炒赤色，共研极细，入片脑三分，再研，用蜡油调敷唇上。
补唇舌方（太医院传）
用鲜蟹烧灰，每二钱，用乳香、没药各二分半涂之，即生肉。如多，去唇舌，用川乌、草乌为末，摊纸一
条，以凉水调合贴之，即不觉疼，可用刀取。如流血，以陈锻石涂之即止。愈后舌硬，
用鸡冠血点之即软。
舌强肿如猪胞，以针刺舌下两傍大脉，血出即消。勿刺着中央脉，令人血不止，则以火烧铜箸烙之；
或以杂草烧镬锈，醋调敷舌上下，脱去再敷，须臾即消。此患人多不识，失治则死。凡舌肿，舌下必有虫
状如蝼蛄卧蚕，有头有尾，头小白，可烧铁钉烙头上即消。
治舌上肿硬。
百草霜 海盐（各等分）
上为末，井花水调敷。
又方
真蒲黄末，频掺舌上，内以黄连一味，煎汤服之，以泻心火。
病机云∶舌长过寸，研冰片敷之即收。
治舌无故出血如线，以槐花为末，掺之即止。
治舌忽胀退场门外，俗云是蜈蚣毒，用雄鸡血一小盏浸之，即缩入。
病证论述
《黄帝内经》说：中央方位对应黄色，与脾脏相通，口为脾之外窍，精气藏于脾，所以疾病表现在舌头上。口中发生的病症，有的表现为重舌（舌下肿起如再出一舌）、木舌（舌体肿胀僵硬），有的表现为口腔黏膜糜烂生疮，或者出现酸、苦、辛、咸等异常味觉。推究其病因，没有不是因为七情（喜、怒、忧、思、悲、恐、惊）烦扰，以及五味（酸、苦、甘、辛、咸）过度损伤所导致的。经书说：阴性的五脏六腑，根本在于五味的摄入；阴性的五脏六腑，伤害也在于五味的过用。因此，肝热则口酸，心热则口苦，脾热则口甘，肺热则口辛，肾热则口咸。有口淡无味者，可知是胃热所致。外部因素中，有因谋虑不决导致肝气郁结，肝将热邪转移至胆从而口苦的。也有因脾胃气虚，肝木乘克脾土从而口酸的。或者膀胱的热邪移注于小肠，导致肠道阻塞不通，热气上蒸导致口腔黏膜糜烂，生疮溃烂，这就是伤寒狐惑病（一种以咽喉及前后二阴蚀烂为特征的疾病）的证候，上唇生疮，虫蚀内脏；下唇生疮，虫蚀肛门。还有舌头伸出不能收回，称为阳强；舌头收缩不能言语，称为阴强。
方剂
绿袍散 治疗口疮。
黄柏（去除粗皮，一两） 青黛（三钱）
以上药物研成粉末，撒在患处含漱，吐出涎液后即刻痊愈。另一配方加蜜陀僧一钱。
赴宴散（段干兵传授）〔批注〕（按：此方为治疗口疮的外敷药剂） 治疗口疮。
黄连 黄柏 黄芩 栀子 细辛 干姜
以上各药等分，研成细末，先用米泔水漱口，然后将药粉搽在患处，吐或咽不拘，效果神奇。
升麻散 治疗上膈部的痈毒，舌上生疮，咽喉肿痛。
升麻 赤芍 人参 桔梗 干葛（各钱半） 甘草（七分）
以上药物切碎为一剂，用水煎煮，慢慢服用。
《黄帝内经》说：膀胱的热邪移注于小肠，导致肠道阻塞不通，热气上蒸导致口腔糜烂，用五苓散合导赤散一次服用即可痊愈。
〔批注〕（按：此方为治疗口疮的内服药剂） 凡是口疮服用凉药不愈的，是因为中气虚弱，相火（寄居于肝肾之火）泛溢上行而无制约，用理中汤治疗即可痊愈，严重的加附子，或者用官桂末撒在患处。
上清丸（王天中传授）〔批注〕（按：此方为治疗口疮含化之剂） 治疗口舌疼痛生疮。
薄荷叶（三两） 硼砂（五钱） 天花粉（一两） 天竺黄（五钱） 风化硝 百药煎 防风 孩儿茶（各一两） 桔梗（七钱） 甘草（一两）
以上药物研成细末，用炼蜜制成丸子，如弹子大小。每次服用一丸，含在口中，慢慢化开咽下。
香茶饼 清除膈部热痰，使口气清香。
孩儿茶（四两） 桂花（一两） 南薄荷叶（一两） 硼砂（五钱）
以上药物研成粉末，用甘草煮汁，熬制成膏做成饼状，含化咽下，味道美味香甜。
硼砂丸（王天中传授）〔批注〕（按：此方为清上焦、芳香口气之剂） 治疗口臭，口干，口舌生疮。
硼砂（二钱） 片脑（冰片） 麝香（各一分） 马牙硝（风化，四钱） 寒水石（煅，一钱）
以上药物研成粉末，用甘草膏制成丸子，如麻子大小。随时含服一丸，吞咽津液。
口唇紧缩变小，不能开口，不能饮食，如果不治疗就会死亡，用白布做成灯芯粗细，放在刀斧上燃烧，让刀斧表面渗出液体（刀汗），擦拭取下来敷在嘴唇上，每天二三次，或者用旧青布烧成灰，调清水服用，或者和猪脂混合涂抹。又用蛇蜕烧成灰，先擦拭干净后敷上；还适宜烧乱发、蜂房、六畜毛的灰，用猪脂调和涂抹。
治疗嘴唇紧缩干燥开裂生疮。
橄榄不拘多少，烧成灰，用猪脂调和敷在患处。
治疗口唇裂破成疮（刘太府方）
炉甘石（二钱，煅制） 文蛤（一两） 黄柏（一两） 苍术（五钱）
除甘石外，其余三味同炒至红色，共同研磨极细，加入片脑三分，再次研磨，用蜡油调和敷在嘴唇上。
补唇舌方（太医院传授）
用鲜蟹烧成灰，每二钱，用乳香、没药各二分半涂抹，即刻长出新肉。如果组织坏死脱落，用川乌、草乌研成粉末，摊在纸上，用凉水调和贴敷，即刻不觉疼痛，可用刀切除。如果流血，用陈年锻石涂抹即可止血。愈合后如果舌头发硬，用鸡冠血点涂即刻变软。
舌体强硬肿胀如猪膀胱，用针刺舌下两侧的大脉，出血后肿胀即消。不要刺到中间的脉络，否则会导致血流不止，可以用火烧热的铜筷烙烫；或者用杂草烧成的锅锈，醋调和敷在舌上下，脱落后再敷，片刻即可消退。这种病患很多人不认识，延误治疗就会死亡。凡是舌肿，舌下必有虫状物，形如蝼蛄卧蚕，有头有尾，头部白色较小，可以烧红铁钉烙烫其头部即可消除。
治疗舌上肿胀坚硬。
百草霜 海盐（各等分）
以上药物研成粉末，用井花水调和敷贴。
又一方
真蒲黄粉末，频繁撒在舌上，内服单味黄连煎汤，以泻心火。
《病机》说：舌头伸长超过一寸，研碎冰片敷上即可收回。
治疗舌头无故出血如线状，用槐花研成粉末，撒在患处即可停止。
Disease Discussion
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The central direction corresponds to the color yellow, communicates with the Spleen organ, opens into the mouth as its orifice, and stores essence in the Spleen; therefore, diseases manifest on the tongue. Diseases of the mouth may present as Chongshe (redundant tongue/swelling under the tongue), Mushe (wooden tongue/stiffness), erosion and ulceration of the oral mucosa, or abnormal tastes such as sour, bitter, pungent, or salty. Investigating the etiology, these are invariably caused by disturbances from the Seven Emotions (joy, anger, worry, thought, sadness, fear, fright) and excessive damage from the Five Flavors (sour, bitter, sweet, pungent, salty). The classics state: The Yin organs' fundamental intake lies in the five flavors; the injury to the Yin organs also stems from the five flavors. Thus, Liver heat causes a sour taste, Heart heat causes a bitter taste, Spleen heat causes a sweet taste, Lung heat causes a pungent taste, and Kidney heat causes a salty taste. A bland taste indicates Stomach heat. Externally, indecisive deliberation can cause Liver Qi stagnation, transferring heat to the Gallbladder resulting in a bitter taste. Alternatively, weak Spleen and Stomach Qi allows Liver Wood to overact on Spleen Earth, causing a sour taste. Heat from the Bladder transferring to the Small Intestine can obstruct the bowels, with heat steaming upward causing oral erosion and ulceration; this is the syndrome of Shanghan Huhuo disease (a condition characterized by erosions of the throat and genital/anal regions), where ulcers on the upper lip indicate worm-eating of the viscera, and ulcers on the lower lip indicate worm-eating of the anus. Furthermore, a tongue protruding and unable to retract is called Yang Qiang (Yang excess); a tongue retracted and unable to speak is called Yin Qiang (Yin excess).
Formulas
Lü Pao San (Green Robe Powder) treats Kou Chuang (oral ulcers).
Huang Bo (Phellodendri Cortex, peeled of rough bark, 1 liang) Qing Dai (Indigo Naturalis, 3 qian)
Grind the above into powder, apply to the affected area and hold in the mouth; healing occurs upon expectoration of saliva. Another prescription adds Mi Tuo Seng (Lead Monoxide, 1 qian).
Fu Yan San (Banquet Powder, transmitted by Duan Ganbing) [Commentary: This formula is for external application for oral ulcers] treats Kou Chuang (oral ulcers).
Huang Lian (Coptidis Rhizoma) Huang Bo (Phellodendri Cortex) Huang Qin (Scutellariae Radix) Zhi Zi (Gardeniae Fructus) Xi Xin (Asari Radix et Rhizoma) Gan Jiang (Zingiberis Rhizoma Recens)
Equal parts of each, ground into fine powder. First rinse the mouth with rice water, then apply the powder to the lesion. Spitting or swallowing is not restricted; it is highly effective.
Sheng Ma San (Cimicifugae Powder) treats carbuncles and toxins in the upper diaphragm, ulcers on the tongue, and swelling and pain of the throat.
Sheng Ma (Cimicifugae Rhizoma) Chi Shao (Paeoniae Radix Rubra) Ren Shen (Ginseng Radix et Rhizoma) Jie Geng (Platycodonis Radix) Gan Ge (Puerariae Lobatae Radix) [each 1.5 qian] Gan Cao (Licorice Radix et Rhizoma, 0.7 qian)
Cut one dose, decoct in water, and take slowly.
The *Huangdi Neijing* states: When heat from the Bladder transfers to the Small Intestine, causing bowel obstruction and steaming upward to cause oral erosion, taking Wu Ling San combined with Dao Chi San once will result in cure.
[Commentary: This formula is for internal administration for oral ulcers] For oral ulcers that do not heal with cooling medicines, it is due to deficiency of Middle Qi, allowing Xiang Huo (Ministerial Fire) to float upward without restraint. Treat with Li Zhong Tang (Regulate the Middle Decoction); it will heal. In severe cases, add Fu Zi (Aconiti Lateralis Radix Praeparata), or apply Guan Gui (Cinnamomi Cortex) powder topically.
Shang Qing Wan (Upper Clearing Pill, transmitted by Wang Tianzhong) [Commentary: This formula is for holding in the mouth to dissolve for oral ulcers] treats pain and ulceration of the mouth and tongue.
Bo He Ye (Menthae Haplocalycis Folium, 3 liang) Peng Sha (Borax, 5 qian) Tian Hua Fen (Trichosanthis Radix, 1 liang) Tian Zhu Huang ( Bambusae Concretio Silicea, 5 qian) Feng Hua Xiao (Natrii Sulfas Efflorescens) Bai Yao Jian (Fermented Medicinal Paste) Fang Feng (Saposhnikoviae Radix) Hai Er Cha (Camelliae Sinensis Var. Assamica Leaf Extract) [each 1 liang] Jie Geng (Platycodonis Radix, 7 qian) Gan Cao (Licorice Radix et Rhizoma, 1 liang)
Grind into fine powder, make pills with refined honey, size of a bullet. Take one pill per dose, hold in the mouth, and slowly dissolve and swallow.
Xiang Cha Bing (Fragrant Tea Cake) clears the diaphragm, resolves phlegm, and freshens breath.
Hai Er Cha (Camelliae Sinensis Var. Assamica Leaf Extract, 4 liang) Gui Hua (Osmanthi Fragrans Flos, 1 liang) Nan Bo He Ye (Menthae Haplocalycis Folium, 1 liang) Peng Sha (Borax, 5 qian)
Grind into powder, use juice boiled from Gan Cao, simmer into a paste to form cakes. Hold in the mouth to dissolve and swallow; it has a delicious, fragrant taste.
Peng Sha Wan (Borax Pill, transmitted by Wang Tianzhong) [Commentary: This formula clears the upper jiao and freshens breath] treats bad breath, dry mouth, and oral/tongue ulcers.
Peng Sha (Borax, 2 qian) Pian Nao (Borneolum Syntheticum) She Xiang (Moschi Feratum) [each 1 fen] Ma Ya Xiao (Natrii Sulfas Efflorescens, wind-dried, 4 qian) Han Shui Shi (Aragoniti Rhizodium, calcined, 1 qian)
Grind into powder, make pills with Gan Cao paste, size of a hemp seed. Hold one pill in the mouth at any time, and swallow saliva.
Tight, shrunken lips preventing opening of the mouth and ingestion of food will lead to death if untreated. Use white cloth rolled like a finger as a wick, burn it on a knife or axe until sweat appears on the metal surface, wipe and collect this liquid to apply to the lips, two to three times daily. Alternatively, burn old blue cloth to ash, mix with clear water and ingest, or mix with Pig Fat (Su Zhi) for topical application. Also, burn Snake Slough (She Tui) to ash, clean the area first, then apply. It is also suitable to burn human hair, Beehive (Feng Fang), and hair of six domestic animals to ash, mixed with Pig Fat for topical application.
For tight, dry, cracked lips with ulcers:
Use any amount of Olive (Gan Lan), burn to ash, mix with Pig Fat (Su Zhi) and apply to the lesion.
For cracked lips forming ulcers (Formula from Liu Taifu):
Lu Gan Shi (Calamina, calcined, 2 qian) Wen Ge (Veneris Testa, 1 liang) Huang Bo (Phellodendri Cortex, 1 liang) Cang Zhu (Atractylodis Rhizoma, 5 qian)
Except for Lu Gan Shi, stir-fry the other three ingredients until red, grind extremely fine, add Pian Nao (Borneolum Syntheticum, 3 fen), grind again, and mix with wax oil to apply to the lips.
Formula to Supplement Lips and Tongue (Transmitted by the Imperial Hospital):
Burn fresh crab to ash. Use 2 qian, mixed with Ru Xiang (Olibanum) and Mo Yao (Myrrha) (each 2.5 fen) to apply; new flesh will grow immediately. If tissue necrosis and detachment occur, use Chuan Wu (Aconiti Radix) and Cao Wu (Aconiti Kusnezoffii Radix) powder, spread on paper, moisten with cold water, and apply; pain will be absent, allowing surgical removal. If bleeding occurs, apply Chen Duan Shi (Calcined Hematite) to stop it. After healing, if the tongue is stiff, dot with Chicken Comb Blood (Ji Guan Xue) to soften it.
For a stiff, swollen tongue resembling a pig bladder:
Prick the large vessels on both sides under the tongue with a needle; bleeding will reduce the swelling. Do not prick the central vessel, or bleeding will not stop; instead, cauterize with a copper chopstick heated by fire. Or, use rust from a pot burned with weeds, mixed with vinegar, applied above and below the tongue; replace when detached, and it will subside quickly. Many people do not recognize this condition; delayed treatment leads to death. In all cases of tongue swelling, there must be a worm-like creature under the tongue, resembling a mole or silkworm, with a head and tail, the head being small and white. Cauterize the head with a red-hot iron nail to eliminate it.
For swollen and hard tongue:
Bai Cao Shuang (Soot from hundred herbs) Hai Yan (Sea Salt) [equal parts]
Grind into powder, mix with well water (Jing Hua Shui) and apply.
Another Formula:
Apply Zhen Pu Huang (Polygoni Citini Pollen) frequently to the tongue. Internally, decoct single-ingredient Huang Lian (Coptidis Rhizoma) in water to drain Heart Fire.
The *Bingji* (Pathogenesis) states: If the tongue extends beyond one cun, apply crushed Bing Pian (Borneolum) to retract it.
For spontaneous thread-like bleeding from the tongue:
Apply Huai Hua (Sophorae Flos) powder to stop it.
For sudden tongue swelling protruding outside the mouth, commonly attributed to centipede venom:
Immerse the tongue in a small cup of Rooster Blood (Xiong Ji Xue) to retract it.