大意
中央黄色。入通于脾。开窍于口。藏精于脾。（内经）故口之为病。乃脾热也。（绳墨）
内因
味入于口。藏精于脾胃。运化津液以养五脏。若五味过偏。则五脏之气亦偏。而诸病生焉。（大全）
外候
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。胃热则口淡。（正传）此脏气偏胜为病也。
亦有谋虑不决。肝移热于胆而口苦者。有脾胃气弱。木乘土位而口酸者。有膀胱移热于小肠。膈肠不便。
上为口糜。而生疮溃烂者。（内经）有热积心胸之间。脾气凝滞。不能运化。浊气熏蒸而口臭者。此脏气移热
为病也。（汇补）
口疮赤白
口疮虽由脾热所使然。亦当分赤白二种。白者肺热。赤者心热。赤白相兼者心肺俱热。不独脾家病也。（汇补）
脉法
脉洪数为实火。浮大为虚火。
治法
五脏之气。皆统于脾。凡七情六欲五味。皆能致病。治当因病而求之。（绳墨）若服凉药而不愈者。此中焦元
气不足。虚火炎上。又当温补。
用药
心热口苦。黄连泻心汤。肝热口酸。柴胡清肝汤。脾热口臭。清胃汤。肺热口辛。泻白散。肾热口咸。滋肾丸。如
谋虑不决。胆虚口苦。用逍遥散为君。柴胡、胆草为使。如中气不足。木乘土位口苦。用四君子为君。芍药、柴
胡为佐。如膀胱移热。口烂溺涩。用导赤散专治下而口病亦愈。如中土虚寒。胃阳浮上。用理中汤温补其
中而上焦自安。如下焦火炎。用八味丸温暖丹田而火焰炎自熄。
【附唇病】
唇属于脾。经合于胃。脾胃受邪。则唇为之病。（大全）风胜则动。寒胜则缩。燥胜则干。热胜则裂。气郁则生疮。
血少则无色。脾冷则紫。脾败则黑。脾寒则青。脾虚则白。脾衰则黄。脾实则红。（绳墨）若唇口肿起。白皮皱裂。
名曰茧唇。（类要）宜养血调脾。凡茧唇紧小。不能开合。难进饮食。不治则死。（折衷）
唇动。用消风散。唇缩。用理中汤。唇干。用三黄丸。唇裂。用凉膈散。唇肿。用苡仁汤。唇疮既久。血虚火炎者。
当滋补。无任苦寒。
【附舌病】
心脉系舌根。脾络系舌傍。肝脉络舌本。肾液出舌端。虽分布五脏。而心脾实主之。故二脏不和。变生诸症。
（玉策）中风痰则舌卷难言。伤七情则舌肿难食。三焦蕴热。则舌胎燥而咽干。心脾热炽。则舌粗重而口苦。
（绳墨）气虚则麻纵。阴火则点黑。湿痰则肿胀。郁热则衄血。心火则生疮。脾热则干涩。胃热则舌本强直。肝
热则舌卷且缩。肺热则舌燥而咽门声哑。肾热则津竭而舌心干焦。（汇补）
治法
舌属火。其性炎上。治舌之法。当降火滋阴为要。（绳墨）风痰。用二陈加南星、竹沥。郁痰。用二陈加香附、青皮。
三焦郁热。凉膈散。心脾郁热。三黄丸。思虑伤脾。血耗火动。归脾汤。郁怒伤肝。血虚火盛。逍遥散。肾虚阴火。
津竭舌干者。滋肾丸。
【附啮舌】
心脾之虚。恒通于舌。阳明之经。直入齿缝。故邪入心脾。则舌自挺。邪入阳明。则口自噤。一挺一噤。故令嚼
舌。治宜清其风火。则病自愈。
口病选方
黄连泻心汤 治心热口苦。
大黄 黄芩 黄连
加生地、甘草、木通。
柴胡清肝饮 治肝火口酸。
柴胡 黄芩 黄连 山栀 当归 川芎 生地 升麻 丹皮 甘草
加味清胃散 治脾热口臭。
黄连 生地 升麻 丹皮 当归
加芍药、山栀。
加味泻白散 治肺热口辛。
桑皮 地骨皮 甘草 粳米
加片芩、知母、麦冬、桔梗、姜枣。
滋肾丸 治肾虚火炎。
肉桂（二钱） 知母 黄柏（各二两）
凉膈散 三黄丸
逍遥散 治肝胆虚火。
导赤散 治膀胱移热小肠而口疮。（以上四方俱见火症）
理中汤 治中焦虚寒。邪火偏旺之假象（方见中寒）
八味丸 治肾虚水冷。火不归经之假象。（方见中风）
消风散（宝鉴） 治受风唇动。
川芎 羌活 防风 茯苓 白僵蚕 藿香 荆芥 甘草 蝉蜕（各二两） 浓朴 陈皮（各五钱）
为末。每服二钱。清水下。
薏苡仁汤
赤小豆 薏苡仁 防己（各三钱） 甘草（一钱）
水煎。
白术散 治脾胃虚火。
人参 藿香 白术 茯苓 甘草 干葛 木香
外治口疮法
用黄柏蜜浸含之。 口臭。香薷含之。一方。用蔷薇浓煎汁含之。夏用叶。冬用根。日三次。夜一次。
外治舌病法
舌肿出外。以蓖麻油拈纸烧烟熏之。舌外不收。以冰片糁之。舌衄不止。以槐花末糁之。
冰柏丸
片脑 薄荷 黄柏 硼砂（各等分）
蜜丸含。 又方加青黛少许为末。吹入口中。
绿袍散（方见齿症）
【大意】
中央对应黄色，其气通于脾脏，开窍于口，精气藏于脾。（《内经》）因此，口的疾病，多由脾热引起。（《绳墨》）
【内因】
饮食入口，精气储藏于脾胃，运化津液以滋养五脏。如果五味摄入过于偏颇，则五脏之气也会偏盛或偏衰，从而产生各种疾病。（《大全》）
【外候】
肝热则口中发酸，心热则口中发苦，脾热则口中发甜，肺热则口中发辛（辣味感），肾热则口中发咸，胃热则口中发淡。（《正传》）这是脏腑之气偏胜导致的疾病。
也有因谋虑不决，肝将热邪移于胆而致口苦的；有因脾胃气弱，肝木乘克脾土而致口酸的；有因膀胱将热邪移于小肠，导致膈部与肠道不通畅，热气上蒸导致口腔糜烂、生疮溃烂的。（《内经》）有因热邪积聚在心胸之间，脾气凝滞，不能运化，浊气熏蒸而导致口臭的。这是脏腑之气移热导致的疾病。（《汇补》）
【口疮赤白】
口疮虽然由脾热引起，但也应当分为赤色和白色两种。白色属于肺热，赤色属于心热。赤白相兼者，是心肺俱热，不仅仅是脾脏的疾病。（《汇补》）
【治法】
五脏之气，都统摄于脾。凡是七情六欲和五味的失调，都能致病。治疗应当根据病因寻求对策。（《绳墨》）如果服用清热凉药而不愈者，这是因为中焦元气不足，虚火上炎，又应当采用温补的方法。
【用药】
心热口苦，用黄连泻心汤。肝热口酸，用柴胡清肝汤。脾热口臭，用清胃汤。肺热口辛，用泻白散。肾热口咸，用滋肾丸。如谋虑不决，胆虚口苦，以逍遥散为主方，柴胡、龙胆草为使药。如中气不足，肝木乘脾土位致口苦，以四君子汤为主方，芍药、柴胡为佐药。如膀胱移热，口烂尿涩，用导赤散专门治疗下部病变，而口病也随之痊愈。如中土虚寒，胃阳浮越于上，用理中汤温补中焦，上焦自然安宁。如下焦火炎，用八味丸温暖丹田，火焰自熄。
【附唇病】
唇属于脾，经脉合于胃。脾胃受邪，则唇发生疾病。（《大全》）风邪胜则唇动，寒邪胜则唇缩，燥邪胜则唇干，热邪胜则唇裂，气郁则生疮，血少则唇无色，脾冷则唇紫，脾败则唇黑，脾寒则唇青，脾虚则唇白，脾衰则唇黄，脾实则唇红。（《绳墨》）如果唇口肿起，有白皮皱裂，名叫茧唇。（《类要》）宜养血调脾。凡是茧唇紧小，不能开合，难以进食，不治疗则会死亡。（《折衷》）
唇动，用消风散。唇缩，用理中汤。唇干，用三黄丸。唇裂，用凉膈散。唇肿，用苡仁汤。唇疮日久，血虚火炎者，应当滋补，不可任其使用苦寒药物。
【附舌病】
心脉系于舌根，脾络系于舌旁，肝脉络于舌本，肾液出于舌端。虽然分布五脏，但主要由心脾二脏主宰。所以这两脏不和，变生各种症状。（《玉策》）中风痰阻则舌卷难言，伤七情则舌肿难食，三焦蕴热则舌苔燥而咽干，心脾热炽则舌体粗重而口苦。（《绳墨》）气虚则舌麻纵，阴火则舌现黑点，湿痰则舌肿胀，郁热则鼻衄出血，心火则舌生疮，脾热则舌干涩，胃热则舌本强直，肝热则舌卷且缩，肺热则舌燥而咽喉声哑，肾热则津液枯竭而舌心干焦。（《汇补》）
【治法】
舌属火，其性炎上。治疗舌病的法则，当以降火滋阴为关键。（《绳墨》）风痰，用二陈汤加南星、竹沥。郁痰，用二陈汤加香附、青皮。三焦郁热，用凉膈散。心脾郁热，用三黄丸。思虑伤脾，血耗火动，用归脾汤。郁怒伤肝，血虚火盛，用逍遥散。肾虚阴火，津竭舌干者，用滋肾丸。
【附啮舌】
心脾之虚，常反映于舌。阳明经直接入于齿缝。所以邪入心脾，则舌头自挺出；邪入阳明，则口自紧闭。一挺一噤，所以导致咬舌。治疗宜清风火，则病自愈。
【口病选方】
黄连泻心汤：治心热口苦。
大黄、黄芩、黄连。
加生地、甘草、木通。
柴胡清肝饮：治肝火口酸。
柴胡、黄芩、黄连、山栀、当归、川芎、生地、升麻、丹皮、甘草。
加味清胃散：治脾热口臭。
黄连、生地、升麻、丹皮、当归。
加芍药、山栀。
加味泻白散：治肺热口辛。
桑皮、地骨皮、甘草、粳米。
加片芩、知母、麦冬、桔梗、姜枣。
消风散（宝鉴）：治受风唇动。
川芎、羌活、防风、茯苓、白僵蚕、藿香、荆芥、甘草、蝉蜕（各二两）、浓朴、陈皮（各五钱）。
研为末，每服二钱，清水送下。
薏苡仁汤：
赤小豆、薏苡仁、防己（各三钱）、甘草（一钱）。
水煎。
白术散：治脾胃虚火。
人参、藿香、白术、茯苓、甘草、干葛、木香。
【外治口疮法】
用黄柏蜜浸含之。口臭，用香薷含之。另一方法，用蔷薇浓煎汁含之，夏用叶，冬用根，日三次，夜一次。
【外治舌病法】
舌肿出外，用蓖麻油捻纸烧烟熏之。舌外不收，用冰片撒之。舌衄不止，用槐花末撒之。
冰柏丸：
片脑、薄荷、黄柏、硼砂（各等分）。
蜜丸含化。又一方加少许青黛为末，吹入口中。
绿袍散（方见齿症章节）
[General Principle]
The center corresponds to the color yellow; its qi connects with the Spleen, opens into the mouth, and stores essence in the Spleen. (*Neijing*) Therefore, diseases of the mouth are caused by Spleen Heat (Spleen Excess Heat). (*Shengmo*)
[Internal Causes]
Food and drink enter the mouth, and their essence is stored in the Stomach and Spleen, which transform and transport body fluids to nourish the Five Zang Organs. If the five flavors are consumed excessively or imbalanced, the qi of the five organs will also become biased, giving rise to various diseases. (*Daquan*)
[External Manifestations]
Liver Heat causes a sour taste in the mouth; Heart Heat causes a bitter taste; Spleen Heat causes a sweet taste; Lung Heat causes a pungent/spicy sensation; Kidney Heat causes a salty taste; Stomach Heat causes a bland taste. (*Zhengchuan*) These are diseases caused by the excess of organ qi.
There are also cases where indecisive thinking causes Liver heat to transfer to the Gallbladder, resulting in a bitter taste; cases where weak Stomach and Spleen qi allow Wood (Liver) to overact on Earth (Spleen), causing a sour taste; and cases where bladder heat transfers to the Small Intestine, leading to obstruction in the diaphragm and intestines, with heat steaming upward causing oral ulceration, sores, and rotting. (*Neijing*) There are cases where heat accumulates between the heart and chest, causing Spleen qi stagnation and failure to transform, with turbid qi steaming upward causing bad breath. These are diseases caused by the transfer of heat between organs. (*Huibu*)
[Red and White Mouth Ulcers]
Although mouth ulcers are caused by Spleen Heat, they should be divided into two types: red and white. White indicates Lung Heat; red indicates Heart Heat. Red and white mixed indicate both Heart and Lung Heat, not merely a Spleen disease. (*Huibu*)
[Pulse Diagnosis]
A surging and rapid pulse indicates Excess Fire; a floating and large pulse indicates Deficient Fire.
[Treatment Principles]
The qi of the five organs is unified under the Spleen. All emotional disturbances, desires, and dietary imbalances can cause disease. Treatment should seek the root cause based on the illness. (*Shengmo*) If cooling medicines fail to cure the condition, it is due to insufficient primal qi in the Middle Jiao, with deficient fire flaming upward; in such cases, warming and tonifying methods should be used.
[Medication]
For Heart Heat with bitter taste, use Huanglian Xiexin Tang (Coptis Decoction to Drain the Heart). For Liver Heat with sour taste, use Chaihu Qinggan Tang (Bupleurum Decoction to Clear the Liver). For Spleen Heat with bad breath, use Qingwei Tang (Clear the Stomach Decoction). For Lung Heat with pungent taste, use Xiebai San (Drain the White Powder). For Kidney Heat with salty taste, use Zishen Wan (Kidney-Nourishing Pill). If indecisive thinking leads to Gallbladder deficiency and bitter taste, use Xiaoyao San (Free and Easy Wanderer Powder) as the principal formula, with Chai Hu (Bupleuri Radix) and Long Dan Cao (Gentianae Radix) as guiding agents. If Middle Qi deficiency allows Wood to overact on Earth causing bitter taste, use Sijunzi Tang (Four Gentlemen Decoction) as the principal formula, with Shaoyao (Paeoniae Radix) and Chai Hu as assistants. If bladder heat transfers causing oral sores and painful urination, use Daochi San (Directing Red Powder) to treat the lower part, which will also resolve the mouth disease. If Middle Earth is deficient and cold, with Stomach Yang floating upward, use Lizhong Tang (Regulate the Middle Decoction) to warm and tonify the middle, calming the upper Jiao. If Lower Jiao fire flares up, use Bawei Wan (Eight-Ingredient Pill) to warm the Dantian, extinguishing the flame.
[Appendix: Lip Diseases]
Lips belong to the Spleen, and their meridians connect with the Stomach. When the Stomach and Spleen are invaded by pathogens, the lips become diseased. (*Daquan*) Wind excess causes movement/trembling; Cold excess causes contraction; Dryness excess causes dryness; Heat excess causes cracking; Qi stagnation causes sores; Blood deficiency causes lack of color; Cold Spleen causes purple color; failing Spleen causes black color; Cold Spleen causes green/blue hue; Deficient Spleen causes pale/white color; Declining Spleen causes yellow color; Excess Spleen causes red color. (*Shengmo*) If lips swell and develop wrinkled, peeling white skin, it is called "Silkworm Lip" (Jianchun). (*Lei Yao*) One should nourish blood and regulate the Spleen. If Silkworm Lip is tight and small, unable to open or close, making eating difficult, and remains untreated, it leads to death. (*Zhezong*)
For lip trembling, use Xiaofeng San (Dispel Wind Powder). For lip contraction, use Lizhong Tang. For dry lips, use Sanhuang Wan (Three Yellows Pill). For cracked lips, use Liangge San (Cool the Diaphragm Powder). For swollen lips, use Yiren Tang (Coix Seed Decoction). For chronic lip sores with blood deficiency and flaming fire, tonification is required; avoid harsh bitter-cold herbs.
[Appendix: Tongue Diseases]
The Heart meridian connects to the root of the tongue; the Spleen collateral connects to the sides of the tongue; the Liver meridian winds around the tongue base; Kidney fluids emerge from the tip of the tongue. Although distributed among the five organs, the Heart and Spleen primarily govern them. Thus, disharmony in these two organs generates various symptoms. (*Yuce*) Stroke-phlegm causes tongue curling and difficulty speaking; emotional injury causes tongue swelling and difficulty eating; Three Jiao heat accumulation causes dry tongue coating and throat dryness; blazing Heart and Spleen heat causes coarse, heavy tongue and bitter taste. (*Shengmo*) Qi deficiency causes numbness; Yin fire causes black spots; damp-phlegm causes swelling; stagnant heat causes epistaxis; Heart fire causes sores; Spleen heat causes dryness and roughness; Stomach heat causes stiffness of the tongue base; Liver heat causes tongue curling and retraction; Lung heat causes dry tongue and hoarse voice; Kidney heat causes exhaustion of fluids and dry, scorched tongue center. (*Huibu*)
[Treatment Principles]
The tongue belongs to Fire, and its nature is flaming upward. The method for treating tongue diseases must focus on descending fire and nourishing yin. (*Shengmo*) For wind-phlegm, use Erchen Tang (Two Aged Substances Decoction) added with Nanxing (Arisaematis Rhizoma) and Zhuli (Bambusae Caulis in Succo). For stagnant phlegm, use Erchen Tang added with Xiangfu (Cyperi Rhizoma) and Qingpi (Citri Reticulatae Pericarpium Viride). For Three Jiao stagnant heat, use Liangge San. For Heart and Spleen stagnant heat, use Sanhuang Wan. For worry injuring the Spleen, consuming blood and stirring fire, use Guipi Tang (Restore the Spleen Decoction). For anger injuring the Liver, with blood deficiency and excess fire, use Xiaoyao San. For Kidney deficiency with Yin fire and exhausted fluids causing dry tongue, use Zishen Wan.
[Appendix: Tongue Biting]
Deficiency of Heart and Spleen often manifests in the tongue. The Yangming Meridian enters directly into the tooth gaps. Thus, when pathogens enter the Heart and Spleen, the tongue protrudes; when pathogens enter Yangming, the jaw locks. This protrusion and locking lead to biting the tongue. Treatment should clear wind and fire for spontaneous recovery.
[Selected Formulas for Mouth Diseases]
Huanglian Xiexin Tang: Treats Heart Heat with bitter taste.
Dahuang (Rhei Radix et Rhizoma), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma).
Add Shengdi (Rehmanniae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Mutong (Akebiae Caulis).
Chaihu Qinggan Yin: Treats Liver Fire with sour taste.
Chaihu (Bupleuri Radix), Huangqin, Huanglian, Shanzhi (Gardeniae Fructus), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shengdi, Shengma (Cimicifugae Rhizoma), Danpi (Moutan Cortex), Gancao.
Jiawei Qingwei San: Treats Spleen Heat with bad breath.
Huanglian, Shengdi, Shengma, Danpi, Danggui.
Add Shaoyao, Shanzhi.
Jiawei Xiebai San: Treats Lung Heat with pungent taste.
Sangpi (Mori Cortex), Digupi (Lyctipellis Cortex), Gancao, Jingmi (Oryza Sativa).
Add Pian Qin (Scutellariae Radix), Zhimu (Anemarrhenae Rhizoma), Maidong (Ophiopogonis Radix), Jiegeng (Platycodonis Radix), Jiang (Zingiberis Rhizoma), Zao (Jujubae Fructus).
Zishen Wan: Treats Kidney Deficiency with flaming fire.
Rougui (Cinnamomi Cortex) (2 qian), Zhimu, Huangbai (Phellodendri Cortex) (2 liang each).
Liangge San, Sanhuang Wan.
Xiaoyao San: Treats Liver-Gallbladder Deficient Fire.
Daochi San: Treats bladder heat transferring to Small Intestine causing mouth ulcers. (The above four formulas are all found in the Fire Syndrome chapter.)
Lizhong Tang: Treats Middle Jiao deficiency-cold, a false appearance of excessive pathogenic fire. (Formula seen in Cold Syndrome chapter.)
Bawei Wan: Treats Kidney deficiency with cold water, fire not returning to its source—a false appearance. (Formula seen in Stroke chapter.)
Xiaofeng San (*Baojian*): Treats wind-induced lip trembling.
Chuanxiong, Qianghuo (Notopterygii Rhizoma), Fangfeng (Saposhnikoviae Radix), Fuling (Poria), Baijiangcan (Bombyx Batryticatus), Huoxiang (Agastaches Herba), Jingjie (Schizonepetae Spica), Gancao, Chantui (Cicadae Periostracum) (2 liang each), Nongpo (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium) (5 qian each).
Grind into powder, take 2 qian per dose, wash down with clear water.
Yiyiren Tang:
Chixiaodou (Vigna Semen Rubrum), Yiyiren (Coicis Semen), Fangji (Stephaniae Tetrandrae Radix) (3 qian each), Gancao (1 qian).
Decoct in water.
Baizhu San: Treats Spleen-Stomach Deficient Fire.
Renshen (Ginseng Radix et Rhizoma), Huoxiang, Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling, Gancao, Gange (Puerariae Radix), Muxiang (Aucklandiae Radix).
[External Treatment for Mouth Ulcers]
Soak Huangbai (Phellodendri Cortex) in honey and hold in the mouth. For bad breath, hold Xiangru (Elsholtziae Herba) in the mouth. Another method: hold concentrated decoction of Qiangwei (Rosae Rugosae Flos), using leaves in summer and roots in winter, three times daily and once at night.
[External Treatment for Tongue Diseases]
If the tongue swells out, smoke it with paper twisted with Ricinus oil (Bimayan). If the tongue protrudes and cannot retract, sprinkle Bingpian (Borneolum Syntheticum). If tongue bleeding does not stop, sprinkle Huaihua (Sophorae Flos) powder.
Bingbai Wan:
Bingpian, Bohe (Menthae Haplocalycis Herba), Huangbai, Pengsha (Borax) (equal parts).
Make pills with honey and hold in mouth. Another formula adds a small amount of Qingdai (Indigo Naturalis), grind into powder, and blow into the mouth.
Lvpaosan (Green Robe Powder) (Formula seen in Tooth Disease chapter.)