Mouth and Tongue

Mouth and Tongue

All the five zang organs and six fu organs derive their qi from the stomach, and the qi of all these organs is also manifested in the stomach. The mouth is the gateway of the stomach, so the qi of all the five zang organs and six fu organs is reflected here. Bitter taste in the mouth indicates gallbladder heat, and Xiaochaihu Decoction combined with Huanglian is used for treatment. Sweet taste in the mouth indicates spleen heat, and Jiaji Huatu Tang combined with Hua Tianfen, Yinchen, Stir-fried Zhizi, Fuling, Citrus Aurantium, Houpu, Huangqin, and Gypsum is used for treatment. Sour taste in the mouth indicates damp-heat; observing meat soup left overnight during hot weather reveals that sourness is caused by damp-heat, and Ge Gen Huanglian Huangqin Tang combined with Fangji, Yinchen, Mutong, Huashi, Flower Powder, and Yunling is used for treatment, or alternatively, Cangzhu, Huangbo, Huanglian, and Wuju are also effective. Salty taste in the mouth indicates spleen dampness; when moisture descends and becomes salty, it means the spleen cannot transform water, hence the saltiness. Erchen Tang combined with Xuanfuhua, Huoxiang, Bai Shao, Sandalwood, and Wuju is used for treatment, and Weiling Tang is also effective, or Liuwei Dihuang Tang combined with Xuanfuhua, Niuxi, and Baqian Gen can be used to transform water from the kidney and direct it downward, thereby alleviating the problem. Bland taste in the mouth indicates stomach deficiency, and Liu Junzi Tang is adjusted according to cold or heat for treatment. Astringent taste in the mouth indicates wind-heat, and Tongsheng Powder combined with Mangxiao and Dahuang is used for treatment. Numbness in the mouth indicates blood deficiency, and Shengyu Tang combined with Peppermint is used for treatment. Bad breath indicates food accumulation and heat, and Pingwei Powder combined with Hawthorn, Shenqu, Malt, Huangqin, and Gypsum is used for treatment. Oral ulcers occur when residual heat from the bladder leaks into the small intestine, preventing the heat from dissipating, thus spreading to the mouth; Daochi Powder combined with Tiancongbai is used for treatment. Deficient fire in blood-related cases also requires Dihuang Tang combined with Cinnamon, Niuxi, Wuweizi, and Dragon Bone to guide the fire.

Furthermore, any tongue swelling, tongue cracking, or painful sores are all due to heart-spleen fire toxicity, and Xie Xin Tang is used for treatment, as is Da Qingliang Tang. If the base of the tongue is stiff or the tongue is shortened, it indicates internal movement of pathogenic wind in the Shaoyin meridian, with ascending deficient fire; in such cases, Dihuang Yinzi combined with Antelope Horn is used for treatment.

The above-mentioned oral and lingual conditions are also seen in blood-related cases, so treatment should primarily focus on blood-related issues, while also considering the above-mentioned methods. This approach balances primary and secondary considerations.

[Commentary] The spleen and stomach are the foundation of postnatal life, and the qi of all the five zang organs and six fu organs originates from them. The stomach opens its orifice to the mouth, and the tongue resides in the mouth, so the manifestations of all the five zang organs and six fu organs are inevitably reflected in the mouth and tongue. This section provides a detailed summary of the clinical manifestations of the mouth and tongue and proposes treatment principles and prescriptions for readers’ reference.

Bitter taste indicates gallbladder heat, treated with Xiaochaihu Decoction. Sweet taste indicates spleen heat, treated with Jiaji Huatu Tang. Sour taste indicates damp-heat, treated with Ge Gen Huanglian Huangqin Tang and Zuojin Pill. Salty taste indicates spleen dampness, treated with Erchen Tang, Weiling Tang, and Liuwei Dihuang Tang. Bland taste indicates stomach deficiency, treated with Liu Junzi Tang. Astringent taste indicates wind-heat, treated with Fangfeng Tongsheng Powder. Numbness in the mouth indicates blood deficiency, treated with Shengyu Tang. Bad breath indicates food accumulation and heat, treated with Pingwei Powder and Gypsum-based formulations. Oral ulcers occur when residual heat from the bladder leaks into the small intestine, preventing the heat from dissipating, thus spreading to the mouth; Daochi Powder combined with Tiancongbai is used for treatment. Throat odor indicates lung fire and phlegm stagnation, treated with Xiebai Powder combined with Ganju Tang.

Regarding tongue coating, this section considers thin coating as the exterior and thick coating as the interior; white coating indicates damp-heat, yellow coating indicates dry-heat, and black coating indicates genuine winter-heat. The discussion on tongue diagnosis is largely based on the author’s clinical experience and differs from what is generally described in books, so it can only be used as a reference.