经曰∶中央黄色，入通于脾，开窍于口，脾败而见鱼口，则啼不出声。(《集成》)
肺主气，发于声出于口为言，肺绝，故声如鸦声也。(《集成》)
唇属脾，红紫热也，又主虫啮积痛。淡白虚也，又主吐涎呕逆诸失血证。黑者，脾将绝
也，主无治。(顾练江)
唇红而吐，胃热也。唇白而吐，胃虚也。唇色平常而吐，作伤胃论。(《指南》)
人中青，主不食，大便难通。(《大全》)
唇蹇而缩，不能盖齿者，脾绝也。口角流涎者，脾冷也。(《大全》)
凡病者人中平满为唇反，唇反者，肉先死。(顾练江)
凡唇口肿赤而齿焦者，是热极。唇燥裂者亦热。(顾练江)
凡唇口青黑者，是寒极，唇黄者，主脾受积热。(顾练江)
小儿唇红如丹，即发渴候，红甚焦黑则危。(《折衷》)
上唇生疮，虫食其脏。下唇生疮，虫食其肛。(《伤寒》狐蜮证)
口甜，是肝热脾湿，胃有痰滞也。口咸，是肾水上泛，肾热也。口淡，胃热也。口辛，
肺热
也。口臭，胃热也。口苦是心热又或胆热也。口酸，肝热也。又或脾胃气弱，木乘土位所致
也。(顾练江)
口干，脾热也，口燥，胃家热极也。(顾练江)
口有血腥味者胃热。口不知食味者津液伤。(惕厉子)
唇口生疮，声哑者虫积。唇紫者亦虫积。(惕厉子)
唇燥舌干者脾热，唇焦赤者脾热，唇燥裂者亦脾热。(周于蕃)
小儿口如鱼嘴尖起者死，口中气出不返者死，环口黧黑者死。(周于蕃)
口张、脚肿、脉绝者，五日死。口中不仁者外感。口燥齿干形脱者，不治。(周于蕃)
按∶经脉篇∶脉不营则肌肉软，肌肉软则舌萎，人中满。人中满，则唇反。《难经》二
十四
难曰∶口唇者，肌肉之本也。脉不营则肌肉不滑泽。肌肉不滑泽则肉满，肉满则唇反，唇反
则肉先死，甲日笃，乙日死。徐灵胎注∶满浮肿也，肉肿则唇亦肿，而反出于外也。藏象论
∶脾，其华在唇。唇色不一，虚实寒热从此分，死生亦从此决，辨证者可忽乎哉。(惕厉子)
《黄帝内经》说：中央方位对应黄色，与脾脏相通，开窍于口。如果脾脏衰竭而出现鱼口（嘴唇外翻如鱼嘴状），就会啼哭却发不出声音。（引自《医宗集成》）
肺主司气，气息通过口发出声音称为言。如果肺气绝败，声音就会像乌鸦叫声一样嘶哑。（引自《医宗集成》）
嘴唇归属于脾，颜色红紫表示有热，也主因虫积引起的腹痛。颜色淡白表示虚证，也主吐涎、呕吐逆气及各种失血病症。颜色发黑，表示脾脏即将衰竭，属于无药可治的危候。（顾练江注）
嘴唇发红且呕吐，是胃热的表现。嘴唇发白且呕吐，是胃虚的表现。嘴唇颜色正常但呕吐，应作为伤胃来论治。（引自《医宗指南》）
人中部位发青，主不能进食，大便难以通畅。（引自《医宗大全》）
嘴唇拘挛收缩，不能遮盖牙齿的，是脾脏衰竭的表现。嘴角流口水的，是脾脏寒冷。（引自《医宗大全》）
凡是病人人中部位平满，导致嘴唇外翻的，嘴唇外翻意味着肌肉先死。（顾练江注）
凡是嘴唇和口部红肿赤痛且牙齿焦黑的，是热邪极盛。嘴唇干燥开裂的，也是热邪所致。（顾练江注）
凡是嘴唇和口部发青黑色的，是寒邪极盛；嘴唇发黄，主脾脏受积热困扰。（顾练江注）
小儿嘴唇红润如涂丹砂，随即会出现口渴症状，如果红色过甚变成焦黑色，则病情危急。（引自《医宗折衷》）
上唇生疮，说明寄生虫侵蚀内脏。下唇生疮，说明寄生虫侵蚀肛门。（引自《伤寒论》狐蜮病证）
口中感觉甜味，是肝热脾湿，胃中有痰浊停滞。口中感觉咸味，是肾水上泛，肾有热。口中感觉淡而无味，是胃热。口中感觉辛辣，是肺热。口中口臭，是胃热。口中口苦，是心热或者胆热。口中口酸，是肝热。或者是脾胃气弱，肝木乘克脾土所致。（顾练江注）
口中有血腥味，是胃热。口不知食物味道，是津液受损。（惕厉子注）
嘴唇和口部生疮，声音嘶哑的，是虫积。嘴唇发紫的，也是虫积。（惕厉子注）
嘴唇干燥舌头干的，是脾热；嘴唇焦红的，是脾热；嘴唇干燥开裂的，也是脾热。（周于蕃注）
小儿嘴巴像鱼嘴一样尖起的是死证，口中气息呼出后不返回的是死证，口周颜色黧黑的是死证。（周于蕃注）
口张不开、脚肿、脉象断绝的，五天后死亡。口中感觉麻木不仁的，是外感病。口燥齿干、形体脱失的，无法治愈。（周于蕃注）
按语：《经脉篇》说：脉气不能濡养，则肌肉软弱，肌肉软弱则舌体萎软，人中部位饱满。人中部位饱满，则嘴唇外翻。《难经》第二十四难说：口唇，是肌肉的根本。脉气不能濡养，则肌肉不滑润。肌肉不滑润则肌肉肿胀，肌肉肿胀则嘴唇外翻，嘴唇外翻则肌肉先死，甲日病情加重，乙日死亡。徐灵胎注释：满是指浮肿，肉肿则嘴唇也肿，从而向外翻出。《藏象论》说：脾，其荣华表现在嘴唇。嘴唇颜色不一，虚实寒热由此区分，生死也由此判定，辨证施治的医生可以忽视吗？（惕厉子注）
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The central direction corresponds to the color yellow, connecting internally with the Spleen (Pi Zang), and opening into the mouth. If the Spleen fails and manifests as "fish mouth" (Yukou, lips everted like a fish's mouth), crying will occur without sound. (From *Yizong Jicheng*)
The Lung governs Qi; when Qi is emitted through the mouth, it becomes speech. If Lung Qi is exhausted, the voice becomes hoarse like that of a crow. (From *Yizong Jicheng*)
The lips belong to the Spleen. Redness and purpleness indicate Heat; they also signify abdominal pain caused by intestinal parasites. Pale whiteness indicates Deficiency; it also signifies symptoms such as salivation, vomiting, regurgitation, and various hemorrhagic conditions. Blackness indicates impending failure of the Spleen and signifies an incurable condition. (Commentary by Gu Lianjiang)
Red lips accompanied by vomiting indicate Stomach Heat. White lips accompanied by vomiting indicate Stomach Deficiency. Normal lip color accompanied by vomiting should be treated as Stomach injury. (From *Yizong Zhinan*)
Blueness in the philtrum (Ren Zhong) indicates inability to eat and difficulty in bowel movement. (From *Yizong Daquan*)
Contraction and retraction of the lips, unable to cover the teeth, indicates Spleen exhaustion. Drooling from the corners of the mouth indicates Cold of the Spleen. (From *Yizong Daquan*)
In any disease, if the philtrum is flat and full, causing the lips to evert, this eversion of the lips signifies that the flesh is dying first. (Commentary by Gu Lianjiang)
Swelling, redness, and chapped lips and mouth with scorched teeth indicate extreme Heat. Dry and cracked lips also indicate Heat. (Commentary by Gu Lianjiang)
Blue-black lips and mouth indicate extreme Cold. Yellow lips indicate the Spleen suffering from accumulated Heat. (Commentary by Gu Lianjiang)
If an infant's lips are red like cinnabar, thirst will soon develop. If the redness becomes excessive and turns scorched black, the condition is critical. (From *Yizong Zhezhong*)
Sores on the upper lip indicate parasites devouring the internal organs. Sores on the lower lip indicate parasites devouring the anus. (From *Shanghan Lun*, Fox-Yi Syndrome)
A sweet taste in the mouth indicates Liver Heat and Spleen Dampness, with phlegm stagnation in the Stomach. A salty taste indicates Kidney Water rising and Kidney Heat. A bland or tasteless sensation indicates Stomach Heat. A pungent/spicy sensation indicates Lung Heat. Bad breath indicates Stomach Heat. A bitter taste indicates Heart Heat or Gallbladder Heat. A sour taste indicates Liver Heat, or it may result from weak Qi of the Spleen and Stomach, allowing Liver Wood to overact upon Spleen Earth. (Commentary by Gu Lianjiang)
Dryness in the mouth indicates Spleen Heat. Extreme dryness of the mouth indicates extreme Heat in the Stomach. (Commentary by Gu Lianjiang)
A bloody metallic taste in the mouth indicates Stomach Heat. Loss of taste perception indicates damage to Body Fluids. (Commentary by Ti Li Zi)
Sores on the lips and mouth accompanied by hoarseness indicate intestinal parasite accumulation. Purple lips also indicate intestinal parasite accumulation. (Commentary by Ti Li Zi)
Dry lips and a dry tongue indicate Spleen Heat. Scorched red lips indicate Spleen Heat. Dry and cracked lips also indicate Spleen Heat. (Commentary by Zhou Yufan)
An infant whose mouth protrudes sharply like a fish's mouth is doomed to die. An infant whose breath exits the mouth but does not return is doomed to die. An infant with dark/black discoloration around the mouth is doomed to die. (Commentary by Zhou Yufan)
Mouth gaping open, swollen feet, and absent pulse indicate death within five days. Numbness in the mouth indicates an external contraction. Extreme dryness of the mouth and teeth with emaciation indicates an untreatable condition. (Commentary by Zhou Yufan)
Note: The *Jingmai Pian* (Chapter on Meridians) states: When meridians fail to nourish, muscles become soft; when muscles are soft, the tongue atrophies, and the philtrum becomes full. When the philtrum is full, the lips evert. The *Nanjing* (Classic of Difficult Issues), Difficulty 24, states: The lips and mouth are the root of the muscles. When meridians fail to nourish, muscles lose their smoothness. When muscles lack smoothness, they swell; when they swell, the lips evert. When lips evert, the flesh dies first; the condition worsens on Jia days and leads to death on Yi days. Xu Lingtai commented: "Full" refers to edema/swelling. Flesh swelling causes lip swelling, which then everts outward. The *Zangxiang Lun* (Chapter on Zang-Fu Manifestations) states: The Spleen's brilliance manifests in the lips. Variations in lip color distinguish between Deficiency/Excess and Cold/Heat; life and death are also determined thereby. Can practitioners of pattern differentiation afford to ignore this? (Commentary by Ti Li Zi)