巢氏云∶儿初生，口里白屑满舌上，如鹅之口，故名，由在胎受谷气盛，心脾
热气，熏发于口。治用发缠指头，蘸井花水揩拭之，睡时，黄丹 ，出火气，掺于
舌上。如用前法，其舌上白屑不脱，可煮栗 汁令浓，以绵缠指头拭之，若春夏无
栗，可煮栗木皮，如用井花水法。《简要》用牙硝细研，于舌上掺之，日三五度。
《秘录》用桑白皮汁和胡粉敷之。鸡 黄皮，烧末，水和服。
张涣保命散 治婴儿初生七日内胎毒者，其舌上有白屑如米连舌下，有膜如石榴子
大，令儿语不发，名曰鹅口病。
白矾（烧灰） 朱砂（水飞。各二钱半） 马牙硝（半两）
上各研极细，再同研。每服一字，取白鹅粪，以水搅取汁，调涂舌上、颔颊内。
未用药时，先以手指缠乱发，揩拭舌上垢，然后使药敷之。
茅先生论∶儿喉中壅一块肉瘤闭却，为喉痹。身大热，舌硬不转，为木舌。口
开满口黄如膏，名鹅口。三候皆热甚生风，风壅热毒至，此为实热，先用三解牛黄
散（见实热门）微与通吐恶涎，后用匀气散（见胃气不和门）及用天竺黄散（见重舌门）夹牛黄
膏（见发热门）与服，愈。如喉响似锯，及眼视，面青黑，不奶食，死候。
外证舌强唇青，聚口撮面，面目黄赤，气息喘急，啼声不出，饮乳有妨。若口
出白沫而四肢冷者，不可救疗。其或肚胀青筋，吊肠卵疝，内气引痛，皆肠胃郁结
不通致之，治法贵乎疏利（辰砂膏是也。）初生一腊乃免（七日也）。
《千金》云∶小儿初出腹，骨肉未敛，肌肉犹是血也，血凝，乃坚成肌肉耳，其
血沮败，不成肌肉，则使面目绕鼻口左右悉黄而啼，闭目，聚口，撮面，口中干燥，
四肢不能伸缩者，皆是血脉不敛也，多不育，若有如此者，皆宜与龙胆汤也。
龙胆汤方 治婴孩小儿胎惊，月内气盛发热，脐风撮口壮热。
龙胆草 钓藤 柴胡（去芦） 黄芩（炒） 桔梗（去芦，炒） 赤芍药（炒） 茯苓（去皮）
甘草（炙。各五钱） 蜣螂（二枚，去翅足，炙） 大黄（一分，纸裹煨）
上合研为极细末。用枣去核煎，或加防风去芦、麦门冬去心，以导心热，食前调服。
张涣云∶婴儿胎气挟热，亦因母有邪热传染，或生下洗浴当风，襁褓失度，致
令婴儿啼声不出，乳哺艰难，名曰撮口不开，病七日之内尤甚，急风散主之。
急风散方
蛇蜕皮（微炒） 钓藤 干蝎稍（各一分，捣罗为细末） 朱砂（一分，细研、水飞） 好麝香
真牛黄（各半钱，并研极细）
上件，都拌匀，再研为细末。每服一字，取竹沥一两，点同乳汁、调下。
辰砂僵蚕散 治初生撮口。
辰砂（水飞，半钱） 僵蚕（真的，去丝嘴炒，一钱） 蛇蜕皮（炒，一钱） 麝香（研，半钱）
上为极细末。少许，用蜜调敷唇口。
撮风散 治小儿撮口。
赤脚蜈蚣（半条，炙） 钓藤（二钱半） 朱砂 直僵蚕（焙） 全蝎稍（各一钱） 麝香（一字）
上为末。每服一字，取竹沥调下。竹沥解热极好。
辰砂膏
辰砂（三钱） 硼砂 马牙硝（各一钱五分） 玄明粉（二钱） 全蝎 真珠末（各一钱） 麝香（一字）
上为末，和枣同好单包起，自然成膏。每服一字，或一豆许。治诸惊，用金银
薄荷汤下，潮热、甘草汤下，月内婴儿用乳汁调敷奶上，令吮下。
脐风锁口方
金头蜈蚣（一个） 蝎稍（五个） 直僵蚕（七个） 瞿麦（半钱）
上为末。每一字，吹入鼻中，啼。则可用薄荷汤调下一字，然后服《千金》龙
胆汤、朱银丸。
僵蚕方
直僵蚕（二枚，去嘴，略炒，为末。调敷唇口中。）
甘草方 治小儿撮口，取吐。
甘草（一钱）
上，煎服。令吐出痰涎，即以猪乳点入口中，即瘥。
巢元方说：婴儿刚出生时，口腔内白色碎屑布满舌面，形状像鹅的嘴巴，因此得名。这是由于胎儿在母体内时谷气过盛，导致心脾积热，热气上熏于口所致。治疗时，可用丝线缠绕手指，蘸取清晨汲取的井水擦拭患处；睡觉时，将经过煅烧去火气的黄丹粉末撒在舌上。如果使用前法，舌上的白屑仍不脱落，可煮栗子汁使其浓稠，用棉布包裹手指擦拭；若春夏季节没有栗子，可煮栗树树皮，用法同井花水。《简要方》使用细研的牙硝，撒在舌上，每日三至五次。《秘录》使用桑白皮汁调和胡粉敷涂。鸡卵黄皮烧成末，用水调服。
张涣的保命散用于治疗婴儿出生后七日内患有胎毒者，其舌上有如米粒般的白屑连及舌下，有一块如石榴籽大小的膜，导致婴儿无法发声，称为鹅口病。
配方：白矾（烧成灰）、朱砂（水飞法处理，各二钱半）、马牙硝（半两）。
以上药物分别研磨至极细，再共同研磨均匀。每次服用“一字”量，取白鹅粪，用水搅拌取汁，调和后涂抹于舌上及下巴脸颊内侧。未用药前，先用缠有乱发的手指擦拭舌上污垢，然后再使药物敷涂。
茅先生论述：婴儿喉中壅塞一块肉瘤闭塞气道，称为喉痹。身体高热，舌头僵硬不能转动，称为木舌。口张开满口黄色如膏状物，称为鹅口。这三种情况都是热极生风，风邪与热毒壅盛所致，属于实热证。先用三解牛黄散（见实热门）轻微给予以通吐恶涎，后用匀气散（见胃气不和门）以及天竺黄散（见重舌门）配合牛黄膏（见发热门）一起服用，即可痊愈。如果喉咙响声像拉锯，眼睛凝视，面色青黑，不吃奶，这是死症。
外证表现为舌强唇青，口角收缩面部扭曲，面目黄赤，呼吸喘急，啼哭无声，吃奶受阻。如果口中流出白沫且四肢冰冷，则不可救治。如果有肚胀青筋、吊肠卵疝、内气牵引疼痛等症状，都是由于肠胃郁结不通所致，治疗方法贵在疏利（辰砂膏即是此类）。这种情况通常在出生后一周（七日）内免除（注：此处原文意指若度过七日或指特定时间段，但结合上下文“初生一腊乃免”通常指新生儿期易患，此处依文意译为需警惕时期或特定疗法适用期，原文语境稍显模糊，直译为：初生一周内需注意/免除此忧，视具体医案理解，此处按字面意思保留结构）。
《千金方》说：小儿刚出生时，骨肉尚未收敛，肌肉还是血液状态，血液凝固后才坚实成为肌肉。如果血液败坏，不能形成肌肉，就会导致面目环绕鼻口左右发黄而啼哭，闭目，聚口，撮面，口中干燥，四肢不能伸缩，这些都是血脉不收敛的表现，大多难以存活。如果有这种情况，都适宜服用龙胆汤。
龙胆汤方：治疗婴孩小儿胎惊，月内气盛发热，脐风撮口壮热。
药材：龙胆草、钓藤、柴胡（去芦头）、黄芩（炒）、桔梗（去芦头，炒）、赤芍药（炒）、茯苓（去皮）、甘草（炙，各五钱）、蜣螂（二枚，去翅足，炙）、大黄（一分，纸裹煨）。
以上混合研磨为极细末。用大枣去核煎煮，或加防风去芦、麦门冬去心，以引导心热，饭前调服。
张涣说：婴儿胎气挟带热邪，也常因母亲有邪热传染，或出生后洗浴时当风，襁褓护理失度，导致婴儿啼哭不出，吃奶困难，称为撮口不开。此病在出生后七日内尤为严重，由急风散主治。
急风散方：
药材：蛇蜕皮（微炒）、钓藤、干蝎梢（各一分，捣罗为细末）、朱砂（一分，细研、水飞）、好麝香、真牛黄（各半钱，并研极细）。
以上所有药物拌匀，再研磨为细末。每次服用“一字”量，取竹沥一两，点入乳汁中调匀后喂下。
辰砂僵蚕散：治疗初生儿撮口。
药材：辰砂（水飞，半钱）、僵蚕（真品，去丝嘴炒，一钱）、蛇蜕皮（炒，一钱）、麝香（研，半钱）。
以上制成极细末。取少许，用蜂蜜调匀敷于唇口。
撮风散：治疗小儿撮口。
药材：赤脚蜈蚣（半条，炙）、钓藤（二钱半）、朱砂、直僵蚕（焙）、全蝎梢（各一钱）、麝香（一字）。
以上制成末。每次服用“一字”量，取竹沥调匀后喂下。竹沥清热效果极好。
辰砂膏：
药材：辰砂（三钱）、硼砂、马牙硝（各一钱五分）、玄明粉（二钱）、全蝎、真珠末（各一钱）、麝香（一字）。
以上制成末，与大枣一同用好的单纸包起，自然形成膏状。每次服用“一字”，或如一豆大小。治疗各种惊风，用金银花薄荷汤送下；潮热，用甘草汤送下；月内婴儿用乳汁调敷于乳头处，令婴儿吮吸。
脐风锁口方：
药材：金头蜈蚣（一个）、蝎梢（五个）、直僵蚕（七个）、瞿麦（半钱）。
以上制成末。每次取“一字”量，吹入鼻中，引起啼哭。则可以再用薄荷汤调下一字，然后服用《千金方》中的龙胆汤、朱银丸。
Chao Yuanfang stated: When a newborn infant is first born, white flakes fill the tongue in the mouth, resembling the beak of a goose, hence the name. This is caused by excessive grain qi during fetal development, leading to heat accumulation in the Heart and Spleen, which steams upward to the mouth. For treatment, wrap thread around the finger, dip it in well water drawn at dawn (Jinghua Shui), and wipe the affected area. At bedtime, sprinkle Huangdan (Cinnabar processed with fire) powder onto the tongue after removing its "fire qi" through calcination. If the white flakes on the tongue do not detach using the previous method, boil chestnut juice until thick, and wipe with a cotton-wrapped finger. If chestnuts are unavailable in spring or summer, boil chestnut tree bark, using the same method as for well water. *Jianyao Fang* (Essential Formulas) uses finely ground Yaxiao (Mirabilite) sprinkled on the tongue, three to five times daily. *Milu* (Secret Records) uses juice from Mulberry Root Bark (Sangbaipi) mixed with Hufen (Lead White) applied topically. Chicken eggshell membrane burned to ash, mixed with water and taken orally.
Zhang Huan's Baoming San (Preservation of Life Powder) treats infants within seven days of birth suffering from fetal toxins. Their tongues have white flakes like rice grains extending under the tongue, with a membrane the size of a pomegranate seed, preventing the infant from vocalizing. This is called Goose Mouth Disease.
Ingredients: BaiFan (Alum, calcined to ash), Zhusha (Cinnabar, water-triturated, each 2.5 qian), Mayaxiao (Mirabilite, 0.5 liang).
Grind each ingredient separately to an extremely fine powder, then mix them thoroughly. Take one "yi zi" dose per administration. Extract juice from white goose droppings by stirring in water, mix with the powder, and apply to the tongue and inside the cheeks/jaw. Before applying medicine, first wipe the debris off the tongue with a finger wrapped in loose hair, then apply the medication.
Master Mao discussed: A lump of flesh obstructs the infant's throat, blocking the airway, known as Hou Bi (Throat Bi). High fever and a stiff tongue that cannot move is called Mu She (Wood Tongue). The mouth opens wide filled with yellow substance like paste, known as E Kou (Goose Mouth). All three conditions result from extreme heat generating wind, where wind and heat-toxin accumulate; this is excess-heat syndrome. First, use Sanjie Niuhuang San (Three-Resolving Realgar and Bezoar Powder, see Fever Section) to mildly induce vomiting of foul saliva. Then, use Yunqi San (Qi-Balancing Powder, see Stomach Qi Disharmony Section) along with Tianzhu Huang San (Heavenly Bamboo Yellow Powder, see Double Tongue Section) combined with Niuhuang Gao (Bezoar Paste, see Fever Section) administered together for recovery. If the throat sounds like sawing, eyes stare fixedly, face turns cyanotic/black, and the infant refuses milk, these are signs of impending death.
External symptoms include a stiff tongue and cyanotic lips, mouth corners pulling inward with facial distortion, yellow-red complexion, rapid breathing, inability to cry, and difficulty nursing. If white foam issues from the mouth accompanied by cold limbs, the condition is incurable. Abdominal distension with visible blue veins, intestinal torsion or hernia, and internal pain drawing inward are all caused by stagnation and blockage in the intestines and stomach. Treatment prioritizes unblocking and promoting circulation (Chensha Gao is an example of this). These issues typically resolve or require special attention within the first week (seven days) after birth.
The *Qianjin Fang* states: When a child is first born, bones and flesh are not yet consolidated; muscles are still in a blood-like state. Blood coagulates to form solid muscle. If the blood becomes corrupted and fails to form muscle, it causes yellowing around the nose and mouth, crying, closed eyes, pulled-in mouth corners, facial contraction, dry mouth, and inability to extend or flex limbs. These are all signs of blood vessels failing to consolidate, and such infants often do not survive. In such cases, Longdan Tang (Gentian Decoction) is appropriate.
Longdan Tang Formula: Treats infantile fetal fright, heat due to vigorous qi within the first month, umbilical convulsions, mouth closure, and high fever.
Ingredients: Longdan Cao (Gentian Root), Diaoteng (Uncaria Rhynchophylla), Chaihu (Bupleurum Root, remove rhizome), Huangqin (Scutellaria Root, stir-fried), Jiegeng (Platycodon Root, remove rhizome, stir-fried), Chi Shaoyao (Red Peony Root, stir-fried), Fuling (Poria, remove skin), Gancao (Licorice Root, honey-fried, each 5 qian), Qianglang (Dung Beetle, two pieces, remove wings and feet, roast), Dahuang (Rhubarb Root, 1 fen, wrapped in paper and baked).
Grind all ingredients into an extremely fine powder. Decoct dates (pitted) in water, or add Fangfeng (Saposhnikovia Root, remove rhizome) and Maidong (Ophiopogon Tuber, remove heart) to guide out Heart heat. Mix and take before meals.
Zhang Huan said: Infantile qi carries heat, often transmitted from the mother's pathogenic heat, or caused by bathing in drafts after birth, or improper swaddling. This leads to the infant being unable to cry and having difficulty nursing, called Cuokou Bu Kai (Mouth Closure Inability). The condition is most severe within seven days of birth, treated primarily with Jifeng San (Urgent Wind Powder).
Jifeng San Formula:
Ingredients: Shetui Pi (Snake Slough, slightly roasted), Diaoteng (Uncaria Rhynchophylla), Ganxie Shao (Dried Scorpion, tip only, each 1 fen, pounded and sieved), Zhusha (Cinnabar, 1 fen, finely ground and water-triturated), Hao Shexiang (Good Musk), Zhen Niuhuang (Real Bear Bile Stone, each half qian, both ground extremely fine).
Mix all ingredients evenly and grind into a fine powder. Take one "yi zi" dose per administration. Take one liang of Zhuli (Bamboo Sap), mix with breast milk, and administer.
Chensha Jiangcan San (Cinnabar and Silkworm Powder): Treats initial onset of mouth closure in newborns.
Ingredients: Chensha (Cinnabar, water-triturated, half qian), Jiangcan (Silkworm, authentic, remove silk mouth and stir-fry, 1 qian), Shetui Pi (Snake Slough, roasted, 1 qian), Shexiang (Musk, ground, half qian).
Grind into an extremely fine powder. Take a small amount, mix with honey, and apply to the lips and mouth.
Cuofeng San (Wind-Closing Powder): Treats pediatric mouth closure.
Ingredients: Chijiao Wugong (Red-footed Centipede, half strip, roasted), Diaoteng (Uncaria Rhynchophylla, 2.5 qian), Zhusha (Cinnabar), Zhi Jiangcan (Straight Silkworm, baked), Quanxie Shao (Whole Scorpion tip, each 1 qian), Shexiang (Musk, one yi zi).
Grind into powder. Take one "yi zi" dose per administration, mixed with Zhuli (Bamboo Sap). Zhuli is excellent for clearing heat.
Chensha Gao (Cinnabar Paste):
Ingredients: Chensha (Cinnabar, 3 qian), Pengsha (Borax), Mayaxiao (Mirabilite, each 1.5 qian), Xuanmingfen (Thenardite, 2 qian), Quanxie (Whole Scorpion), Zhenzhu Mo (Pearl Powder, each 1 qian), Shexiang (Musk, one yi zi).
Grind into powder, mix with dates, and wrap tightly in good single-layer paper to naturally form a paste. Take one "yi zi" dose, or the size of a bean. For various types of fright, administer with Yinchen Bohe Tang (Artemisia and Mint Decoction); for tidal fever, with Gancao Tang (Licorice Decoction); for infants within the first month, mix with breast milk, apply to the nipple, and let the infant suckle.
Qifeng Suokou Fang (Umbilical Wind Lock-Mouth Formula):
Ingredients: Jintou Wugong (Golden-headed Centipede, one piece), Xie Shao (Scorpion tips, five pieces), Zhi Jiangcan (Straight Silkworm, seven pieces), Qumai (Dianthus Herb, half qian).
Grind into powder. Blow one "yi zi" dose into the nose to induce crying. Then, administer another "yi zi" dose mixed with Bohe Tang (Mint Decoction), followed by Longdan Tang (Gentian Decoction) and Zhu Yin Wan (Cinnabar Silver Pill) from the *Qianjin Fang*.
Jiangcan Fang (Silkworm Formula):
Ingredients: Zhi Jiangcan (Straight Silkworm, two pieces, remove mouth, lightly roasted, ground into powder. Mix and apply to lips and mouth.)
Gancao Fang (Licorice Formula): Treats pediatric mouth closure, aiming to induce vomiting.
Ingredients: Gancao (Licorice Root, 1 qian).
Decoct and take orally. Induce vomiting of phlegm-saliva, then drip pig milk into the mouth immediately for recovery.