丹溪云∶诸阳聚于头，则面为阳中之阳，鼻居面中央，而阳明起于 中，一身
之血运到面鼻阳部，皆为至清至精之气矣。酒性善行而喜升，大热而有峻急之毒。多酒之人，酒气熏
蒸面鼻，血得酒为极热，热血得冷为阴气所搏，污浊凝结滞而不行，宜其先为紫而后为黑色也。须用
融化滞血使得流通，滋生新血可以运化，病乃可愈。予尝以酒制四物汤，加酒炒片芩、陈皮、生甘草、
酒红花、生姜煎，调下五灵脂末饮之。气弱形肥者，加酒黄 ，无有不应。入好酒数滴，为引使。
口者，脾之所主，胃大肠脉之所挟。经云∶中央黄色，入通于脾，开窍于口，藏精于脾。又云∶
脾主口，在藏为脾，在窍为口。又云∶脾气通于口，脾和则口能知五味矣，此脾之主于口也。又经云∶
胃足阳明之脉，挟口下交承浆。又云∶大肠手阳明之脉，挟口交人中，此胃大肠之脉挟于口也。脾
热则口甘，肝热则口酸，心热则口苦，肺热则口辛，肾热则口咸，胃热则口淡。
【口甘】 生地黄、芍药、黄连，及三黄丸。
【口苦】 柴胡、黄芩、黄连、苦参、龙胆草，及小柴胡汤加麦门冬、酸枣仁、地
骨皮、远志。《内经》曰∶有病口苦，名曰胆瘅。乃肝主谋虑，胆主决断，盛汁七合，是清净之腑，
取决于胆，胆或不决，为之恚怒，则气上逆，胆汁上溢故口苦，或热甚使然也。龙胆泻肝汤主之。
【口酸】 黄连、龙胆（泻肝）、神曲、萝卜（消食郁）。
【口辛】 黄芩、栀子（泻肺）、芍药（泻脾）、麦门（清心）。
【口淡】 白术、半夏、生姜、茯苓（燥脾渗湿）。
【口 】 知母、乌贼鱼骨（淡胃）。
【口涩】 黄芩（泻火）、葛根（生津）、防风、薄荷（疏风）、栝蒌、茯苓（行痰）。
【口糜】 《内经》云∶膀胱移热于小肠，膈肠不便，上为口糜。东垣云∶好饮酒人多有此疾。易老
用五苓散、导赤散相合服之，神效。经云∶少阳之复，火气内发，上为口糜。治以苦寒，胡黄连散、
必效散，皆苦寒之剂，以辛温佐之。口糜，野蔷薇根煎汤漱之良。
【口疮】 有二∶一曰热。经云∶少阳司天，火气下临，肺气上从，口疡是也。
二曰寒。经云∶岁金不及，炎火乃行，复则寒雨暴至，阴厥且格，阳反上行，病口疮是也。或问口疮
如何得之？曰∶经云，膀胱移热于小肠，膈肠不便，上为口糜。盖小肠者，心之腑也，此举由邪热之
端耳。心属君火，是五脏六腑之火主，故诸经之热皆应于心，心脉布舌上，若心火炎上，熏蒸于口，
则为口舌生疮。脾脉布舌下，若脾热生痰，热涎相搏，从相火上炎，亦生疮者尤多。二者之病，诸寒
凉剂皆可治。但有涎者，兼取其涎。然则有用理中汤加附子以治者，又何如？曰∶夫火有虚实，因诸
经元有热而动者谓之实，无热而动者谓之虚。实则正治，寒凉之剂是也，虚则从治，如此用温热是也。
理中汤者，因胃虚谷少，则所胜肾水之气逆而承之，反为寒中，脾胃衰虚之火，被迫炎上作为口疮，
故用参、术、甘草补其土，姜、附散其寒，则火得所助，接引其退舍矣。至《圣济总录》有谓元脏虚
冷上攻口疮者，用巴戟、白芷、高良姜末，猪腰煨服。又有用丁香、胡椒、松脂、细辛末，苏木汤调
涂疮上。及不任食者，用当归、附子、白蜜含咽者。有用生附涂脚心者。有用吴茱萸末，醋熬膏，入
生地龙末，涂两足心者。若此之类，皆是治龙火。按寒水上迫，
心肺之阳不得下降，故用温热之剂，或散于上，或散于下，或从阴随阳，所攸利者也。胃中有热，脉
洪大，宜服凉膈散、甘桔汤加芩、三补丸、金花丸，漱以黄连升麻汤，敷以绿袍散、蜜柏散。丹溪用
西瓜浆水徐徐饮之，如无以皮烧灰噙之，外用细辛、黄柏末掺，取涎。胡氏方，以好墨研蝼蛄极细，
敷之立效。按此治膀胱移热于小肠者之正剂也。盖蝼蛄专走小肠膀胱，而通利膈肠者，因力峻气猛，
阴虚气上致疮者，戒勿用。唯体实有热在上焦者，宜之。张子和治一男子病口疮数年，上至口中至咽
嗌，下至胃脘皆痛，不敢食热物。一涌一泄一汗，十去其九，次服黄连解毒汤，十余日皆释。（以上
治实热）。服凉药不愈者，此酒色过度，劳役不睡，舌上光滑而无皮，或因忧思损伤中气，虚火泛上
无制，用理中汤，甚者加附子，或官桂噙之。薛新甫云∶口疮，上焦实热，中焦虚寒，下焦阴火，各
经传变所致，当分别治之。如发热作渴饮冷，实热也，轻则用补中益气汤，重则用六君子汤。饮食少
思，大便不实，中气虚也，用人参理中汤。手足逆冷，肚腹作痛，中气虚寒也，用附子理中汤。晡热
内热，不时而热，血虚也，用八物加丹皮、五味、麦门冬。发热作渴唾痰，小便频数，肾水亏也，用
加减八味丸。食少便滑，面黄肢冷，火衰土虚也，用八味丸。
日晡发热，或从腹起，阴虚也，用四物、参、术、五味、麦门。不应，用加减八味丸。若热来复去，
昼见夜伏，夜见昼伏，不时而动，或无定处，或从脚起，乃无根之火也，亦用前丸，及十全大补加麦
门、五味，更以附子末，唾津调搽涌泉穴。若概用寒凉损伤生气，为害匪轻。（以上治虚火）。治少
阴口疮，半夏散。声绝不出者，是寒遏绝阳气不伸。半夏制一两，桂、乌头各一字，同煎一盏，分二
服。治太阴口疮，甘矾散。以甘草二寸，白矾栗子大，含化咽津。治赤口疮，乳香散。以乳香、没药
各一钱，白矾半钱，铜绿少许，研为末，掺之。治白口疮，没药散。以乳香、没药、雄黄各一钱，轻
粉半钱，巴豆霜少许，为末掺之。口疮久不愈，以五倍末搽之，或煎汤漱，或煎汤泡白矾、或胆矾漱。
盖酸能收敛。戴复庵云∶下虚上盛，致口舌生疮，若用镇坠之药，以降气汤，或盐水下养正丹，或黑
锡丹，仍于临卧热汤洗足，炒拣净吴茱萸，小撮拭足了，便乘炒热置足心，用绢片扎之，男左女右。
【口臭】 常熟严文靖公，年逾七十，未断房室，日服温补之药无算，兼以人参煮粥，苁蓉作羹，致
滋胃热，满口糜烂，牙齿动摇，口气臭秽，殆不可近，屡进寒凉清胃之药
不效，有欲用姜桂反佐者，请决于予，予曰用之必大剧，主用加减甘露饮，八剂而平。香薷煮浓汁含
之。噙鸡舌香，即沉香花。如无，沉香可代。口中如胶而臭，知母、地骨皮、桑白皮、山栀、麦门冬，
甘草盐汤噙，早起汲井中第一汲水，即井华水，含之，吐弃厕下，即瘥。心气不足口臭，益智仁加甘
草少许为末，干咽或汤点。张子和治一男子二十余岁，病口中气出臭如登厕。夫肺金本主腥，金为火
所乘，火主臭，应便如是也。久则成腐，腐者肾也。此亢极则反兼水化也。病在上宜涌之，以茶调散
涌而去其七分，夜以舟车丸、浚川散下五七行，比旦而臭断。（药性犷悍，不宜轻用）。罗谦甫治梁
济民膏粱多饮，因劳心过度，肺金有伤，以致气出腥臭，涕唾稠粘，咽嗌不利，口苦干燥，以加减泻
白散主之。《难经》云∶心主五臭，入肺为腥臭，此其一也。因洪饮大热之气所伤，从心火刑于肺金，
以桑白皮、地骨皮苦微寒，降肺中伏火而补气为君；以黄芩、知母苦寒，治气腥臭，清利肺气为臣；
肺欲收，急食酸以收之，五味子酸温，以收肺气，麦门冬苦寒，治涕唾稠粘，口苦干燥为佐；桔梗辛
温，体轻浮，治痰逆、利咽膈为使也。
朱丹溪说：所有的阳经都汇聚于头部，因此面部是阳中之阳。鼻子位于面部的中央，而阳明经脉起始于鼻旁（此处原文“起于 中”疑为脱字，结合语境指阳明经起于鼻旁/迎香穴附近），全身运行的血液到达面部和鼻子的阳经部位时，都已经化为极其清纯、极其精微的气了。酒的特性善于运行且喜好上升，性质大热且具有猛烈急迫的毒性。长期饮酒的人，酒气熏蒸面部和鼻子，血液受到酒的影响变得极热；热血遇到寒冷，被阴气所搏击，导致污浊凝结、停滞而不流通，所以病情往往先呈现紫色，随后变为黑色。治疗应当使用能够化解停滞之血使其流通的方法，并滋生新血以促进运化，疾病才能痊愈。我曾经用经过酒制的四物汤，加入酒炒的黄芩、陈皮、生甘草、酒制红花、生姜煎煮，服药时调入五灵脂粉末饮用。对于气虚且形体肥胖的人，加入酒制的黄柏，没有不奏效的。服用时滴入几滴好酒作为引经药。
口，由脾所主管，胃经和大肠经的脉气挟持着口。医经上说：中央对应的颜色是黄色，内通于脾，开窍于口，精气藏于脾。又说：脾主管口，在脏腑归属为脾，在孔窍表现为口。又说：脾气的通畅与口相关，脾功能调和则口能辨别五味，这就是脾对口的支配作用。另外医经上说：足阳明胃经的脉气，挟持口部向下交汇于承浆穴。又说：手阳明大肠经的脉气，挟持口部交汇于人中穴，这是胃和大肠的经脉挟持于口。脾有热则口中发甜，肝有热则口中发酸，心有热则口中发苦，肺有热则口中发辛，肾有热则口中发咸，胃有热则口中发淡。
【口苦】 使用柴胡、黄芩、黄连、苦参、龙胆草，以及小柴胡汤加麦门冬、酸枣仁、地骨皮、远志。《内经》说：有一种病表现为口苦，名叫胆瘅。这是因为肝主谋虑，胆主决断，胆中储存胆汁七合，属于清净之腑，人的决断取决于胆，如果胆不能决断，人就会产生愤怒情绪，导致气机上逆，胆汁上溢从而口苦，或者是热邪过盛导致的。治疗以龙胆泻肝汤为主。
【口酸】 使用黄连、龙胆草（用于泻肝火）、神曲、萝卜（用于消解食积郁滞）。
【口辛】 使用黄芩（用于泻肺火）、栀子（用于泻肺火）、芍药（用于泻脾火）、麦门冬（用于清心火）。
【口淡】 使用白术、半夏、生姜、茯苓（用于燥湿健脾、渗利水湿）。
【口涩】 使用黄芩（用于泻火）、葛根（用于生津液）、防风、薄荷（用于疏风邪）、栝蒌、茯苓（用于行化痰饮）。
【口糜】 《内经》说：膀胱的热邪转移至小肠，导致胸膈肠道不通畅，热气上冲形成口糜。李东垣说：喜欢喝酒的人多患此病。罗天益（易老）将五苓散与导赤散合并服用，效果神奇。医经说：少阳之气复旺，火气在内发动，向上熏蒸形成口糜。治疗应用苦寒药物，如胡黄连散、必效散，都是苦寒的药剂，辅以辛温药物佐使。口糜患者，用野蔷薇根煎汤漱口疗效良好。
【口疮】 有两种类型：一是热证。医经说：少阳司天之年，火气下临，肺气随之而上从，出现口腔溃疡，就是这种情况。二是寒证。医经说：岁金不及之年，炎火盛行，报复之时寒雨暴至，阴寒厥逆且格拒阳气，阳气反而上行，导致口疮。有人问口疮是如何得的？回答说：医经说，膀胱移热于小肠，胸膈肠道不便，热气上冲形成口糜。因为小肠是心的腑，这举的是由邪热引起的例子。心属君火，是五脏六腑之火的主宰，所以各经的热邪都应于心。心脉布散于舌上，如果心火炎上，熏蒸于口，就会造成口舌生疮。脾脉布散于舌下，如果脾热生痰，热涎相互搏结，随着相火上炎，也容易生疮，这种情况尤其多见。这两种病证，各种寒凉药剂都可以治疗。但是如果有痰涎的，应兼用祛痰药。那么为什么有用理中汤加附子来治疗的呢？回答说：火有虚实之分，因为各经原本就有热邪而引发的叫做实火，没有热邪而引发的叫做虚火。实证用正治法，即寒凉药剂；虚证用从治法，即用温热药剂。理中汤是因为胃虚谷少，导致所胜的肾水之气逆行克制它，反而变成寒中症，脾胃衰虚产生的虚火，被迫炎上形成口疮，所以用人参、白术、甘草补益脾气，用干姜、附子散除寒邪，这样火得到补助，就能引导其退去。至于《圣济总录》中提到元脏虚冷上攻导致口疮的，使用巴戟天、白芷、高良姜末，配合猪腰煨熟服用。又有用丁香、胡椒、松脂、细辛末，用苏木汤调匀涂抹疮面的。还有不能进食者，用当归、附子、白蜜含咽。有用生附子涂抹脚心的。有用吴茱萸末，醋熬成膏，加入生地龙末，涂抹双足心。像这类方法，都是治疗“龙火”（命门之火妄动）。按照寒水上迫，心肺的阳气不能下降，所以使用温热药剂，或发散于上，或发散于下，或从阴随阳，都是有利的。胃中有热，脉象洪大，适宜服用凉膈散、甘桔汤加黄芩、三补丸、金花丸，用黄连升麻汤漱口，外敷绿袍散、蜜柏散。朱丹溪用西瓜浆水慢慢饮用，如果没有西瓜，可将瓜皮烧成灰噙在口中，外用细辛、黄柏末掺敷，以引出痰涎。胡氏方，用好墨研磨蝼蛄至极细，敷贴患处立效。按：这是治疗膀胱移热于小肠的正剂。因为蝼蛄专门走窜小肠和膀胱，且通利胸膈肠道，因其药力峻猛，阴虚气上导致的口疮，严禁使用。只有体质壮实、上焦有热者适宜。张子和治疗一名男子，患口疮数年，从上至口中咽喉，下至胃脘皆痛，不敢吃热物。通过一涌吐、一泻下、一发汗的方法，去除了十分之九的病邪，接着服用黄连解毒汤，十余日痊愈。（以上治疗实热证）。服用凉药无效的，这是由于酒色过度、劳役失眠，舌上光滑无苔，或因忧思损伤中气，虚火泛上无法制约，使用理中汤，严重的加附子，或官桂含服。薛己（薛新甫）说：口疮，上焦实热，中焦虚寒，下焦阴火，由各自经络传变所致，应当分别治疗。如发热口渴喜冷饮，是实热，轻则用补中益气汤，重则用六君子汤。饮食减少不思食，大便不成形，是中气虚，用人参理中汤。手足逆冷，肚腹疼痛，是中气虚寒，用附子理中汤。傍晚发热、内部发热、不时发热，是血虚，用八物汤加牡丹皮、五味子、麦门冬。发热口渴吐痰，小便频数，是肾水亏虚，用加减八味丸。食少便溏，面色黄、四肢冷，是火衰土虚，用八味丸。下午发热，或从腹部发起，是阴虚，用四物汤加人参、白术、五味子、麦门冬。无效，用加减八味丸。如果热势来时又退去，白天出现晚上潜伏，晚上出现白天潜伏，不时发作，或位置不定，或从脚发起，这是无根之火，也用前面的药丸，以及十全大补汤加麦门冬、五味子，再用附子末，用唾液调匀搽涂涌泉穴。如果一概使用寒凉药损伤生机，危害不小。（以上治疗虚火证）。治疗少阴口疮，用半夏散。声音嘶哑不出声的，是寒邪遏制阳气不得伸展。制半夏一两，肉桂、乌头各一字，同煎一盏，分两次服用。治疗太阴口疮，用甘矾散。取甘草二寸，白矾如栗子大小，含化咽津。治疗赤色口疮，用乳香散。取乳香、没药各一钱，白矾半钱，铜绿少许，研为末，掺敷患处。治疗白色口疮，没用没药散。取乳香、没药、雄黄各一钱，轻粉半钱，巴豆霜少许，研为末掺敷。口疮久不愈，用五倍子末搽敷，或煎汤漱口，或煎汤泡白矾、或胆矾漱口。因为酸味能收敛。戴复庵说：下虚上盛，导致口舌生疮，如果用镇坠的药物，可用降气汤，或用盐水送服养正丹，或黑锡丹，并在临睡前用热水洗脚，取少量炒干净的吴茱萸，擦拭双脚后，趁热置于足心，用绢片扎紧，男性左足，女性右足。
【口臭】 常熟严文靖公，年龄超过七十岁，未停止房事，每天服用无数温补药物，兼用人参煮粥，肉苁蓉做羹，导致滋生胃热，满口糜烂，牙齿动摇，口气臭秽，几乎不可靠近，多次进用寒凉清胃的药物无效，有人想用姜、桂反佐，请示于我，我说用了必然病情加重，主张用加减甘露饮，八剂后平复。用香薷煮浓汁含漱。含服鸡舌香，即沉香花。如果没有，沉香可以代替。口中感觉粘胶且臭，用知母、地骨皮、桑白皮、山栀、麦门冬，甘草盐汤含服，早起汲取井中第一桶水，即井华水，含漱后吐弃于厕所下，即可痊愈。心气不足导致口臭，用益智仁加少许甘草为末，干咽或开水冲服。张子和治疗一名二十多岁的男子，病人口中呼出气味臭如登厕。肺金本主腥味，金被火乘，火主臭，应该像这样。久了会变成腐臭，腐臭对应肾。这是亢极则反兼水化的表现。病在上宜用涌吐法，用茶调散涌吐去除七分病邪，夜间用舟车丸、浚川散泻下五六次，到第二天早晨臭味就断了。（药性猛烈，不宜轻易使用）。罗谦甫治疗梁济民，饮食肥甘厚味且多饮酒，因劳心过度，损伤肺金，导致呼出气味腥臭，鼻涕唾液稠粘，咽喉不利，口苦干燥，用加减泻白散主治。《难经》说：心主五臭，入肺为腥臭，这是其中一种。因大量饮酒大热之气所伤，从心火刑克肺金，以桑白皮、地骨皮苦微寒，降肺中伏火并补气为君药；以黄芩、知母苦寒，治疗气腥臭，清利肺气为臣药；肺欲收，急食酸味以收敛之，五味子酸温，以收敛肺气，麦门冬苦寒，治疗涕唾稠粘、口苦干燥为佐药；桔梗辛温，体轻浮，治疗痰逆、利咽喉膈膜为使药。
Zhu Danxi said: All yang meridians converge on the head, therefore the face is "yang within yang". The nose is located in the center of the face, and the Yangming meridian originates near the nose. When blood from the whole body reaches the yang regions of the face and nose, it has already transformed into extremely pure and refined qi. Wine has the nature of promoting circulation and ascending; it is extremely hot and possesses a fierce and urgent toxicity. In people who drink excessively, wine qi steams the face and nose, making the blood extremely hot due to the wine. When this hot blood encounters cold, it is constrained by yin qi, causing turbidity to congeal and stagnate without flowing. Therefore, the condition typically first presents as purple and later turns black. Treatment should employ methods to resolve stagnant blood to restore flow, and generate new blood to facilitate transformation, so that the disease may be cured. I once used Siwu Tang (Four Substances Decoction) processed with wine, adding Huangqin (Scutellaria Root) stir-fried with wine, Chenpi (Tangerine Peel), Sheng Gancao (Raw Licorice Root), Honghua (Safflower) processed with wine, and Shengjiang (Fresh Ginger), decocted together, taken while mixing in Wulingzhi (Trogopterus Dung) powder. For those with weak qi and obese physique, add Huangbai (Phellodendron Bark) processed with wine; there are no cases where this does not work. Add a few drops of good wine as a guiding agent.
The mouth is governed by the Spleen, and the meridians of the Stomach and Large Intestine flank it. The Classics state: "Yellow corresponds to the Center, internally connecting to the Spleen, opening into the mouth, and storing essence in the Spleen." It also states: "The Spleen governs the mouth; in the zang organs it is the Spleen, in the orifices it is the mouth." Furthermore: "Spleen qi communicates with the mouth; when the Spleen is harmonious, the mouth can perceive the five flavors." This describes the Spleen's governance over the mouth. Additionally, the Classics state: "The Foot-Yangming Stomach meridian flanks the mouth and crosses downward at Chengjiang (CV24)." And: "The Hand-Yangming Large Intestine meridian flanks the mouth and crosses at Renzhong (GV26)." This describes how the Stomach and Large Intestine meridians flank the mouth. Heat in the Spleen causes a sweet taste in the mouth; heat in the Liver causes sourness; heat in the Heart causes bitterness; heat in the Lung causes acridity; heat in the Kidney causes saltiness; heat in the Stomach causes blandness.
[Sweet Taste in Mouth] Use Shengdihuang (Rehmannia Root), Shaoyao (Peony Root), Huanglian (Coptis Rhizome), and Sanhuang Wan (Three Yellows Pill).
[Bitter Taste in Mouth] Use Chaihu (Bupleurum Root), Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), Kushen (Sophora Root), Longdancao (Gentian Root), and Xiaochaihu Tang (Minor Bupleurum Decoction) added with Maimendong (Ophiopogon Tuber), Suanzaoren (Ziziphus Seed), Digupi (Lycium Bark), and Yuanzhi (Polygala Root). The *Neijing* says: "A disease presenting with bitter taste in the mouth is called Dan Dan (Gallbladder Heat)." This is because the Liver governs planning, and the Gallbladder governs decision-making. The Gallbladder stores seven he of bile juice; it is a clear and pure fu organ. Decision-making depends on the Gallbladder. If the Gallbladder fails to decide, resentment and anger arise, causing qi to rebel upward, leading to bile overflowing upward and causing bitterness in the mouth, or it may be caused by excessive heat. Longdan Xiegan Tang (Gentian Liver-Draining Decoction) is the primary treatment.
[Sour Taste in Mouth] Use Huanglian (Coptis Rhizome), Longdancao (Gentian Root) [to drain Liver fire], Shenqu (Medicated Leaven), and Luobo (Radish) [to resolve food stagnation].
[Acrid Taste in Mouth] Use Huangqin (Scutellaria Root) [to drain Lung fire], Zhizi (Gardenia Fruit) [to drain Lung fire], Shaoyao (Peony Root) [to drain Spleen fire], and Maimendong (Ophiopogon Tuber) [to clear Heart fire].
[Bland Taste in Mouth] Use Baizhu (Atractylodes Macrocephala Rhizome), Banxia (Pinellia Tuber), Shengjiang (Fresh Ginger), and Fuling (Poria) [to dry dampness and strengthen the Spleen, leaching out dampness].
[Sticky/Greasy Taste in Mouth] Use Zhimu (Anemarrhena Rhizome) and Haiwuzhegu (Cuttlefish Bone) [to clear Stomach heat].
[Astringent/Dry Taste in Mouth] Use Huangqin (Scutellaria Root) [to drain fire], Gegen (Kudzu Root) [to generate fluids], Fangfeng (Saposhnikovia Root), Bohe (Mint), Gualou (Trichosanthes Fruit), and Fuling (Poria) [to move phlegm].
[Mouth Ulceration/Mucositis] The *Neijing* states: "Bladder heat transfers to the Small Intestine, causing obstruction in the chest and intestines, rising upward to cause mouth ulceration." Li Dongyuan said: People who enjoy drinking alcohol often suffer from this disease. Luo Tianyi (Yi Lao) combined Wuling San (Five-Ling Powder) and Daochi San (Guide Out Redness Powder) for administration, achieving miraculous effects. The Classics state: "When Shaoyang qi rebounds, fire qi erupts internally, rising upward to cause mouth ulceration." Treatment uses bitter-cold agents, such as Huhuanglian San (Coptis Rhizome Powder) and Bixiao San (Must-Efficacy Powder), both bitter-cold formulas assisted by acrid-warm herbs. For mouth ulceration, rinsing with decoction of Wild Rose Root is beneficial.
[Mouth Sores/Canker Sores] There are two types: one is Heat. The Classics state: "When Shaoyang governs the year, fire qi descends, Lung qi follows upward, resulting in oral ulcers." The other is Cold. The Classics state: "When Metal is deficient in the year,炎火 (flaming fire) prevails. In retaliation, cold rain arrives suddenly, Yin rebellion occurs and blocks, Yang qi rebels upward, causing mouth sores." Someone asked how mouth sores are acquired? The answer is: The Classics state, "Bladder heat transfers to the Small Intestine, causing obstruction in the chest and intestines, rising upward to cause mouth ulceration." Since the Small Intestine is the Fu organ of the Heart, this example illustrates acquisition via pathogenic heat. The Heart belongs to Minister Fire (Jun Huo) and is the master of fire in the five zang and six fu organs. Thus, heat from all meridians corresponds to the Heart. The Heart meridian spreads over the tongue; if Heart fire blazes upward and steams the mouth, mouth and tongue sores form. The Spleen meridian spreads under the tongue; if Spleen heat generates phlegm, and hot saliva interacts, rising with Minister Fire, sores also form, especially frequently. Both conditions can be treated with various cold-cooling agents. However, if there is saliva/phlegm, phlegm-resolving measures should be added. Then why use Lizhong Tang (Regulate the Middle Decoction) plus Fuzi (Aconite Root)? The answer is: Fire has deficiency and excess. If triggered by pre-existing heat in various meridians, it is called Excess Fire; if triggered without pre-existing heat, it is called Deficiency Fire. Excess is treated directly with cold-cooling agents; Deficiency is treated by following the symptoms with warm-hot agents. Lizhong Tang is indicated because Stomach deficiency and insufficient grain lead to the counteracting Qi of Water (which the Spleen controls) rebelling against it, turning into Cold in the Middle. The fire generated by Spleen-Stomach decline and deficiency is forced upward, forming mouth sores. Therefore, Renshen (Ginseng), Baizhu (Atractylodes), and Gancao (Licorice) tonify Earth, while Jiang (Ginger) and Fuzi (Aconite) disperse Cold. Thus, the fire receives assistance and is guided to retreat. Regarding *Shengji Zonglu*, it mentions Yuan Zang (Primordial Viscera) deficiency-cold attacking upward causing mouth sores, treated with Bajitian (Morinda Root), Baizhi (Angelica Dahurica Root), Gaoliangjiang (Galangal Rhizome) powder, stewed with Pig Kidney. Another method uses Dingxiang (Clove), Hujiao (Pepper), Songzhi (Pine Resin), Xixin (Asarum) powder, mixed with Sumu (Sappan Wood) decoction to apply to sores. For those unable to eat, Danggui (Angelica Sinensis), Fuzi (Aconite), and Baimi (White Honey) are held in the mouth and swallowed. Some apply raw Fuzi to the soles of the feet. Some use Wuzhuyu (Evodia Fruit) powder, boiled with vinegar into a paste, mixed with Sheng Dilong (Earthworm) powder, applied to both soles. Such methods treat "Dragon Fire" (Hyperactive Mingmen Fire). According to the theory, when Cold Water presses upward, the Yang Qi of Heart and Lung cannot descend; thus, warm-hot agents are used, dispersing upward or downward, or following Yin with Yang, which is beneficial. If there is Heat in the Stomach with a洪大 (Surging-Large) pulse, Liangge San (Cool the Diaphragm Powder), Ganjie Tang (Licorice and Platycodon Decoction) plus Huangqin (Scutellaria), Sanbu Wan (Three Tonics Pill), Jinhua Wan (Golden Flower Pill) are suitable. Rinse with Huanglian Shengma Tang (Coptis and Cimicifuga Decoction), apply Lv Pao San (Green Robe Powder) or Mi Bai San (Honey and Phellodendron Powder). Zhu Danxi recommended slowly drinking watermelon juice; if unavailable, burn the rind to ash and hold in the mouth. Externally, apply Xixin (Asarum) and Huangbai (Phellodendron) powder to induce salivation. Hu Shi's formula grinds Lougu (Mole) with good ink to extreme fineness and applies it for immediate effect. Note: This is the correct formula for Bladder heat transferring to the Small Intestine. Since Lougu specifically travels to the Small Intestine and Bladder and unblocks the chest and intestines, its action is fierce; it is contraindicated for mouth sores caused by Yin deficiency with rebellious Qi. It is only suitable for those with strong constitution and Upper Jiao heat. Zhang Zihe treated a man with mouth sores for years, extending from the mouth/throat down to the stomach, painful and unable to eat hot food. After one emetic, one purgative, and one diaphoretic treatment, nine-tenths of the disease was removed. He then took Huanglian Jiedu Tang (Coptis Detoxification Decoction), recovering in over ten days. (Above treats Excess Heat). For those unresponsive to cold medicines, this is due to excessive wine and sexual activity, labor, and sleeplessness, resulting in a smooth, skinless tongue, or emotional distress damaging Middle Qi, causing Deficiency Fire to float up uncontrollably. Use Lizhong Tang, adding Fuzi (Aconite) for severe cases, or Guigui (Cinnamon Bark) to hold in the mouth. Xue Ji (Xue Xinpu) stated: Mouth sores, whether Upper Jiao Excess Heat, Middle Jiao Deficiency-Cold, or Lower Jiao Yin Fire, result from transmission through respective meridians and must be differentiated. Fever with thirst for cold drinks indicates Excess Heat; mild cases use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), severe cases use Liu Junzi Tang (Six Gentlemen Decoction). Poor appetite and loose stools indicate Middle Qi Deficiency; use Renshen Lizhong Tang (Ginseng Regulate-Middle Decoction). Cold extremities and abdominal pain indicate Middle Qi Deficiency-Cold; use Fuzi Lizhong Tang (Aconite Regulate-Middle Decoction). Afternoon fever, internal heat, or intermittent heat indicate Blood Deficiency; use Bawu Tang (Eight Substance Decoction) plus Mudanpi (Tree Peony Bark), Wuweizi (Schisandra Berry), Maimendong (Ophiopogon Tuber). Fever, thirst, expectoration, and frequent urination indicate Kidney Water Deficiency; use Jiajian Bawei Wan (Modified Eight-Ingredient Pill). Poor appetite, slippery stools, yellow complexion, and cold limbs indicate Fire Decline and Earth Deficiency; use Bawei Wan (Eight-Ingredient Pill). Fever in the afternoon or originating from the abdomen indicates Yin Deficiency; use Siwu Tang (Four Substances Decoction) plus Renshen (Ginseng), Baizhu (Atractylodes), Wuweizi (Schisandra), Maimendong (Ophiopogon). If ineffective, use Jiajian Bawei Wan. If heat comes and goes, appearing by day and hiding by night, or vice versa, occurring irregularly or in undefined locations, or rising from the feet, it is Rootless Fire. Use the aforementioned pills, plus Shiquan Dabu Tang (Complete Great Tonifying Decoction) with Maimendong and Wuweizi, and additionally apply Fuzi (Aconite) powder mixed with saliva to Yongquan (KI1). Using cold-cooling agents indiscriminately damages vital Qi, causing significant harm. (Above treats Deficiency Fire). To treat Shaoyin mouth sores, use Banxia San (Pinellia Powder). For loss of voice, indicating Cold obstructing Yang Qi preventing extension: Processed Banxia (Pinellia) 1 liang, Rougui (Cinnamon Bark) and Wutou (Aconite Mother Root) each 1 zi, decoct together in one cup, divide into two doses. To treat Taiyin mouth sores, use Ganfan San (Licorice and Alum Powder): Hold 2 cun of Gancao (Licorice) and an alum piece the size of a chestnut in the mouth, dissolving and swallowing saliva. To treat red mouth sores, use Ruxiang San (Frankincense Powder): Ruxiang (Frankincense), Moyao (Myrrh) each 1 qian, Baifan (Alum) 0.5 qian, Tonglv (Verdigris) a little, grind to powder and apply. To treat white mouth sores, use Moyao San (Myrrh Powder): Ruxiang (Frankincense), Moyao (Myrrh), Xionghuang (Realgar) each 1 qian, Qingfen (Calomel) 0.5 qian, Badoushuang (Croton Seed Frost) a little, grind to powder and apply. For chronic mouth sores not healing, apply Wubeizi (Chinese Gall) powder, or rinse with decoction, or soak Baifan (Alum) or Danfan (Chalcanthite) in decoction for rinsing. Sour flavor can astringe. Dai Funan said: Lower Deficiency and Upper Excess causing mouth and tongue sores: If using sedating drugs, use Jiangqi Tang (Direct Qi Downward Decoction), or administer Yangzheng Dan (Nourish Righteous Elixir) or Heixi Dan (Black Tin Pill) with salt water. Also, wash feet with hot water before bed, take a small pinch of stir-fried, cleaned Wuzhuyu (Evodia), rub on feet, place hot on soles immediately, and bind with silk cloth. Men: left foot; Women: right foot.
[Bad Breath] Yan Wenjing Gong of Changshu, over seventy years old, did not abstain from sexual intercourse, consumed countless warming-tonic medicines daily, ate porridge cooked with Renshen (Ginseng), and made soup with Congrong (Cistanche), leading to Stomach Heat proliferation, full-mouth erosion, loose teeth, and foul breath nearly unbearable. Multiple administrations of cold-cooling Stomach-clearing medicines were ineffective. Someone suggested using Jiang (Ginger) and Gui (Cinnamon) as reverse assistants and consulted me. I said using them would surely worsen the condition severely. I prescribed Jiagan Ganlu Yin (Modified Sweet Dew Drink); after eight doses, it resolved. Rinse with thick decoction of Xiangru (Mosla). Hold Jitingxiang (Chicken Tongue Fragrance, i.e.,沉香花 Agallocha Flower) in the mouth; if unavailable, Chenxiang (Agallocha Wood/Aloeswood) can substitute. For sticky and foul mouth odor, use Zhimu (Anemarrhena), Digupi (Lycium Bark), Sangbaipi (Mulberry Root Bark), Shanzhi (Gardenia), Maimendong (Ophiopogon), and Gancao Salt Water to hold in the mouth. In the morning, draw the first bucket of well water (Jinghua Water), hold in mouth, spit into toilet, and recover. For Bad Breath due to Heart Qi Deficiency: Yizhiren (Alpinia Oxyphylla) plus a little Gancao (Licorice) ground to powder, swallow dry or with water. Zhang Zihe treated a man in his twenties whose breath smelled like a latrine. Lung Metal naturally governs fishy smell; when Metal is overcome by Fire, and Fire governs stench, the breath becomes like this. Over time it becomes putrid; putrefaction corresponds to Kidney. This is Hyperactivity reversing to assume Water transformation. Disease in the upper part should be treated with emesis. Use Chatiao San (Tea Regulation Powder) to vomit out seven-tenths of the pathogen; at night, use Zhouche Wan (Boat Cart Pill) and Xunchuan San (River-Dredging Powder) to purge five to six times. By dawn, the odor ceased. (Medicinals are fierce; do not use lightly). Luo Qianfu treated Liang Jimin, who consumed rich foods and drank heavily, injuring Lung Metal through mental overwork, causing fishy-stinky breath, thick sticky sputum/nasal discharge, throat discomfort, bitter dry mouth. He treated with Jiajian Xiebai San (Modified Drain-Lung Powder). The *Nanjing* states: "Heart governs the five odors; entering Lung it becomes fishy-stinky." This is one instance. Injury from heavy drinking and hot qi, with Heart Fire punishing Lung Metal: Sangbaipi (Mulberry Root Bark) and Digupi (Lycium Bark), bitter and slightly cold, descend latent Lung fire and tonify Qi as Sovereign herbs; Huangqin (Scutellaria) and Zhimu (Anemarrhena), bitter and cold, treat fishy-stinky qi and clear/benefit Lung Qi as Ministers; Lung desires astringency, urgently eat sour to astringe it; Wuweizi (Schisandra), sour and warm, astringes Lung Qi; Maimendong (Ophiopogon), bitter and cold, treats thick sputum and bitter dry mouth as Assistants; Jiegeng (Platycodon), acrid and warm, light and floating, treats phlegm rebellion and benefits throat/diaphragm as Envoys.