临安民有因病伤寒而舌出过寸，无能治者。但以笔管通粥饮入口，每日坐于门。一道人
，咨嗟曰∶吾能疗此顷刻间耳，奈药不可得，何？会中贵人罢直归，下马观病者，问所须，
乃梅花片脑也。笑曰∶此不难。即遣仆驰取。道人屑为末，掺舌上，随手而缩，凡用五钱。（《医说》）
又方 舌胀退场门，以蓖麻子油蘸纸作捻，烧烟熏之。
治肿满如猪胞方
釜下墨末，以酢和，浓敷舌上下，脱去更敷，须臾即消，或先决去血汁，竟敷之弥佳。
（《千金方》名百草霜散）
一方
釜下黑和盐等分，醋调涂。
余小儿师鲁幼时，忽患舌胀，余以 过皂矾，取红色者少许研末，搽舌上，少顷便瘥。
口舌生疮，其候有二。一者心胃有热，气冲上焦，熏发口舌。其症口臭作渴，发热饮冷
是也
。《外台》含煎主之。一者胃虚食少，肾水之气逆而承之，则为寒中。脾胃虚衰之火，被迫
上炎，作为口疮。其症饮食少思，大便不实，或手足逆冷，肚腹作痛。经曰∶岁金不及，炎
火乃行，复则寒雨暴至，厥阴乃格，阳反上行，民病口疮是也。宜附子理中汤，参、术、甘
草补其中，干姜、附子散其寒，使土温则火自敛也。
《外台》含煎
升麻 大青 射干（各三两） 苦竹叶 栀子 黄柏（各一升） 蜜（八合） 生地汁 生元
参汁（各五合，干者二两） 蔷薇根白皮（五两）
上以水六升，煎服二升，去滓，入生地、蜜等同煎如饴，细细含之，瘥止。《外台
》云∶蔷薇根、角蒿，为口疮之神药。
黄连膏（《圣济》）
黄连（三两） 猪脂（一斤） 白蜜（四两） 羊髓（研，二两）
上以慢火煎猪脂，取油去滓，入黄连又煎令黑色，下羊髓令化，以绵滤去滓，入蜜更煎
成膏，瓷合盛，每含一枣大，日三五度，咽津不妨。
附子理中汤
生姜煎
生姜汁（一盏） 白蜜（三两）
同煎十沸，瓷瓶盛，时时以热水调一匙，含咽之。
按∶《圣济》论口疮，有实有虚，实则清之，虚则温之，最为明晰。然二者之外，又有
肾
虚火动一症。而肾虚之候，又有二端，一者肾脏阴虚，阳无所附，而游行于上者，宜六味之
属，壮水恋火；一者肾脏内寒，阳气不安其宅，而飞越于上者，宜七味、八味之属，温脏敛
阳也。虽有元脏阴火上攻口舌之说，乃用巴戟、白芷、良姜等味，殊去妥协，惟附子蜜炙
含差咽，为可耳。
《集简》方 治口舌生疮。
溺桶 （七分） 枯矾（三分）
二味研习敷之，有涎拭去之，数次即愈。
临安有一位百姓，因患伤寒病导致舌头伸出超过一寸，无人能治。只能用笔管通入粥饮让他入口，每天坐在门口。一位道人经过，叹息说：“我能顷刻间治好这个病，只是药找不到，怎么办？”恰逢一位有权势的官员下班回家，下马观看病人，询问需要什么药，原来是梅花片脑（冰片）。道人笑着说：“这不难。”随即派仆人飞奔去取。道人将冰片研成粉末，撒在舌上，舌头随即缩回，共用了五钱。（出自《医说》）
又一方：舌头肿胀退出口腔，用蓖麻子油蘸纸做成捻条，点燃冒烟熏烤患处。
治疗舌头肿胀满溢如猪膀胱方的方剂：
取锅底黑灰末，用醋调和，浓敷于舌头的上下表面，脱落后再敷，一会儿就消退了；或者先刺破放出血液，然后再敷效果更佳。（《千金方》中名为百草霜散）
另一方案：
取锅底黑灰与盐各等分，用醋调匀涂抹。
我的小儿师鲁小时候，突然患上舌头肿胀，我用煅过的皂矾，取少许红色部分研成粉末，搽在舌上，过了一会儿就好了。
口舌生疮，其证候有两种。一种是心胃有热，热气冲向上焦，熏蒸口舌。症状表现为口臭、口渴、发热、想喝冷饮。这是《外台秘要》中含煎主治的情况。另一种是胃虚食少，肾水之气逆而上乘，形成寒中症。脾胃虚衰产生的火气，被迫上炎，形成口疮。症状表现为饮食减少、大便不成形，或手足逆冷、肚腹疼痛。《内经》说：“岁金不及，炎火乃行，复则寒雨暴至，厥阴乃格，阳反上行，民病口疮是也。”适宜使用附子理中汤，用人参、白术、甘草补益中气，用干姜、附子散除寒邪，使土气温暖则火气自然收敛。
《外台秘要》含煎方：
升麻、大青、射干（各三两），苦竹叶、栀子、黄柏（各一升），蜜（八合），生地汁、生人参汁（各五合，干品二两），蔷薇根白皮（五两）。
以上药物用水六升，煎煮取二升，去渣，加入生地、蜂蜜等同煎至如饴糖般粘稠，细细含服，痊愈即止。《外台秘要》说：蔷薇根、角蒿，是治疗口疮的神药。
黄连膏（出自《圣济总录》）：
黄连（三两），猪脂（一斤），白蜜（四两），羊髓（研细，二两）。
以上用慢火煎猪脂，取油去渣，加入黄连再煎至黑色，加入羊髓使其融化，用绵布过滤去渣，加入蜂蜜再煎成膏状，用瓷盒盛装，每次含服枣核大小，每日三到五次，咽下津液无妨。
附子理中汤：
生姜煎方：
生姜汁（一盏），白蜜（三两）。
同煎十沸，用瓷瓶盛装，时时用热水调一匙，含服咽下。
按语：《圣济总录》论述口疮，有实有虚，实证清热，虚证温补，最为明晰。然而在这两种之外，又有肾虚火动一症。而肾虚的证候，又有两个方面，一是肾脏阴虚，阳气无所依附，而游行于上的，适宜用六味地黄丸之类的方剂，壮水之主以制阳光；一是肾脏内寒，阳气不安其宅，而飞越于上的，适宜用七味、八味地黄丸之类的方剂，温脏敛阳。虽然有关于元脏阴火上攻口舌的说法，但使用巴戟天、白芷、良姜等药物，殊不恰当，只有用蜜炙附子含服，让药性慢慢咽下，才是可取的。
《集简方》治疗口舌生疮：
溺桶垢（七分），枯矾（三分）。
两味研细敷之，有唾液流出擦去，数次即可痊愈。
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.