《内经》云∶脾气开于口。又云∶脾之荣在唇。盖燥则干，热则裂，风则 ，寒则揭。
若唇
情动火伤血；或因心火传授脾经；或因浓味积热伤脾。大要审本症察兼症，补脾气，生脾血
则燥自润，火自除，风自息，肿自消。若患者忽略，治者不察，妄用清热消毒之药，或用药
治验
州守刘克新患茧唇，时出血水，内热口干，吐痰体瘦，肾虚之症悉具，用济阴地黄丸，年许而愈。
一儒者因劳役感冒，唇生疮，或用四物加黄柏、知母之类而愈。后复作，彼仍用前药，益甚。腹中阴冷，余用补中
益气汤加茯苓、半夏，治之而愈。
儒者杨国华，因怒，唇口两
一男子素善怒，唇肿胀，服清胃等药，时出血水，形体骨立。余用补中益气加半夏、茯
桔梗，月余唇肿渐消，元气渐复。又以四物加柴胡、炒栀、丹皮、升麻、甘草数剂，乃去栀加参、术而痊。
一妇人怀抱久郁，或时胃口嘈辣，胸膈不利，月水不调而衰少，日晡发热，食少体倦，唇肿
年余矣。余用归脾汤如姜汁、炒黄连、山栀，少佐吴茱萸。嘈辣顿去，饮食少进，乃去黄连
，加贝母、远志。胸膈通利，饮食如常，又用加味逍遥散、归脾汤，间服百余剂，月水调而唇方愈。
一妇人怀抱久郁，患茧唇，杂用消食降火，虚症悉具，盗汗如雨，此气血虚而有热也。
用当
。更以逍遥散、归脾汤，间服百余剂而唇亦瘥。
一妇人唇裂内热，二年矣。每作服寒凉之剂，时出血水，益增他症，余用加味清胃散而
愈。后因怒，唇口肿胀，寒热而呕，用小柴胡，加山栀、茯苓、桔梗，诸症顿愈。复用加味逍遥
一妇人善怒，下唇微肿，内热体倦。用化痰药，食少作呕，大便不实，唇出血水；用理气消
导，胸膈痞满，头目不清，唇肿经闭；用清胃行血，肢体愈倦，发热烦躁，涎水涌出。余曰
∶此七情损伤肝脾，误行克伐所致。遂用济生归脾汤，食进便实；用加味逍遥散，肿消热退
；用补中益气汤，脾健涎止。后因怒，寒热耳痛，胸膈胀闷，唇 肿甚。此怒动肝火，而伤
阴血，用四物合小柴胡加山栀顿愈。又因怒，胁乳作胀，肚腹作痛，呕吐酸涎，饮食不入，
小水不利。此怒动肝木而克脾土，用补中益气加川芎、芍药而愈。又劳役怒气，饮食失节，
发热喘渴，体倦不食，下血如崩，唇肿炽甚。此肝经有火，不能藏血，脾经气虚，不能摄血
，用补中益气加炒黑山栀、芍药、丹皮而愈。
一男子内热作渴，咳唾痰涎，大便干涩，自喜壮实，问治于余。余曰∶此脾肾阴亏阳旺之症
，当壮水之主。不信，自服二陈、芩、连之类。次年下唇渐肿，小便赤涩，执守前药，唇出
血水，大便黑块，小便淋沥，请余往治。余曰∶大便结黑，小便淋沥，肝肾败也；唇口肿白
，脾气败也；辞不赴，竟殁。
一妇人月经不调，两足热，年余后而身亦热，劳则足腿酸疼。又年余，唇肿裂痛。又半
唇裂出血，形体疲倦，饮食无味，月水不通，唇下肿如黑枣。余曰∶此肝脾血虚火症。彼不
一妇人善怒，唇肿，或用消毒之药，唇胀出血，年余矣。余曰∶须养脾胃滋化源，方可
愈，彼执用前药，状如翻花瘤而死。
《黄帝内经》说：脾气的开窍在口。又说：脾的荣华表现于唇。大概燥邪则唇干，热邪则唇裂，风邪则唇颤动（注：原文“风则 ”缺字，据中医理论及上下文补意为颤动或抽搐），寒邪则唇紧缩揭起。
如果嘴唇出现异常，多因情志激动引动肝火，损伤阴血；或者因心火传移至脾经；或者因食用浓味厚腻食物积滞生热，损伤脾气。治疗的大要在于审察本症和兼症，通过补益脾气、滋生脾血，那么干燥自然滋润，火热自然清除，风邪自然平息，肿胀自然消退。如果患者忽视病情，医生不仔细诊察，妄用清热消毒的药物，或者用药不当……
苏州守备刘克新患茧唇病，时常出血水，伴有内热口干，吐痰且身体消瘦，肾虚的症状全部具备。我使用济阴地黄丸治疗，约一年后痊愈。
一位儒者因劳累过度并感受外邪，嘴唇生疮，有人使用四物汤加入黄柏、知母等药物而治愈。后来复发，他仍然使用之前的药物，病情反而加重。腹部感觉阴冷，我使用补中益气汤加入茯苓、半夏，治疗而痊愈。
儒者杨国华，因为发怒，导致嘴唇和口腔……（原文此处有缺漏，结合下文语境推测为肿胀或疼痛）。
一个男子平素容易发怒，嘴唇肿胀，服用清胃散等药物后，时常出血水，身体瘦骨嶙峋。我使用补中益气汤加入半夏、茯苓、桔梗，一个多月后嘴唇肿胀逐渐消退，元气逐渐恢复。又使用四物汤加入柴胡、炒栀子、丹皮、升麻、甘草数剂，然后去掉栀子，加入人参、白术，最终痊愈。
一位妇人长期怀抱抑郁，有时胃口嘈杂辛辣，胸膈不畅，月经不调且量少，傍晚发热，饮食少且身体疲倦，嘴唇肿胀一年多。我使用归脾汤加入姜汁、炒黄连、山栀，少量佐以吴茱萸。嘈杂辛辣感顿时去除，饮食稍微增加，然后去掉黄连，加入贝母、远志。胸膈通畅，饮食恢复正常，又使用加味逍遥散、归脾汤，交替服用一百多剂，月经调畅后嘴唇才痊愈。
一位妇人长期怀抱抑郁，患茧唇病，杂乱使用消食降火的药物，虚证全部具备，盗汗如雨，这是气血虚弱而有热。使用当归……（原文此处有缺漏，结合语境应为补血养气之药）。再用逍遥散、归脾汤，交替服用一百多剂，嘴唇也好了。
一位妇人嘴唇开裂伴内热，两年了。每次发作时服用寒凉药剂，时常出血水，增加了其他症状，我使用加味清胃散而治愈。后来因为发怒，嘴唇和口腔肿胀，伴有寒热往来且呕吐，使用小柴胡汤，加入山栀、茯苓、桔梗，各种症状顿时痊愈。又复用加味逍遥散……
一位妇人容易发怒，下唇微肿，内热且身体疲倦。使用化痰药后，饮食减少且作呕，大便不成形，嘴唇出血水；使用理气消导药后，胸膈痞满，头目不清爽，嘴唇肿胀且闭经；使用清胃行血药后，肢体更加疲倦，发热烦躁，涎水涌出。我说：这是七情损伤肝脾，误用攻伐药物所致。于是使用济生归脾汤，饮食进增，大便成形；使用加味逍遥散，肿胀消退，热退；使用补中益气汤，脾气健运，涎止。后来因为发怒，寒热耳痛，胸膈胀闷，嘴唇肿胀严重。这是怒动肝火，损伤阴血，使用四物汤合小柴胡汤加入山栀，顿时痊愈。又因为发怒，胁肋乳房胀痛，肚腹疼痛，呕吐酸涎，饮食不进，小便不利。这是怒动肝木克制脾土，使用补中益气汤加入川芎、芍药而痊愈。又因劳累和怒气，饮食失节，发热气喘口渴，身体疲倦不想吃东西，下血如崩，嘴唇肿胀炽盛。这是肝经有火，不能藏血，脾经气虚，不能摄血，使用补中益气汤加入炒黑山栀、芍药、丹皮而痊愈。
一个男子内热作渴，咳唾痰涎，大便干涩，自认为身体壮实，向我询问治疗方法。我说：这是脾肾阴亏阳旺的症状，应当滋补肾水之主（即滋阴降火）。他不相信，自行服用二陈汤、黄芩、黄连等药物。次年下唇逐渐肿胀，小便赤涩，坚持服用前药，嘴唇出血水，大便排出黑色血块，小便淋漓不尽，请我去诊治。我说：大便结黑，小便淋漓，是肝肾败坏的表现；嘴唇和口腔肿胀色白，是脾气败坏的表现；他推辞不去就诊，最终死亡。
一位妇人月经不调，两足发热，一年多后全身也发热，劳累则腿脚酸痛。又过一年多，嘴唇肿胀开裂疼痛。又过半年，嘴唇开裂出血，身体疲倦，饮食无味，月经不通，嘴唇下方肿胀像黑枣一样。我说：这是肝脾血虚火旺的症状。她不听劝告……（原文此处有缺漏，推测为拒绝治疗或误治）。
一位妇人容易发怒，嘴唇肿胀，有人使用消毒药物，导致嘴唇胀大出血，一年多。我说：必须调养脾胃以滋养化源，才可以痊愈，她坚持使用前面的药物，病情发展成翻花瘤而死。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The opening of the Spleen Qi is in the mouth. It also states: The flourishing aspect of the Spleen manifests in the lips. Generally, dryness causes dryness, heat causes cracking, wind causes trembling (or spasms), and cold causes contraction or peeling.
If abnormalities occur on the lips, they are often due to emotional agitation stirring up Liver Fire, damaging Yin blood; or Heart Fire transmitting to the Spleen Meridian; or accumulation of heat from consuming rich and heavy flavors, injuring Spleen Qi. The general principle is to examine the primary and accompanying symptoms, tonify Spleen Qi, and generate Spleen Blood. Then, dryness will naturally become moist, fire will naturally be eliminated, wind will naturally subside, and swelling will naturally disappear. If patients neglect their condition, or if practitioners fail to examine carefully and recklessly use drugs that clear heat and detoxify, or use inappropriate medications...
Liu Kexin, Prefect of Suzhou, suffered from Jiaochun (Silkworm Lip, a condition characterized by lip induration resembling a silkworm cocoon). He frequently bled fluid, had internal heat and dry mouth, expectorated phlegm, was emaciated, and exhibited all symptoms of Kidney Deficiency. I used Jiyin Dihuang Wan (Nourish Yin Rehmannia Pill) for treatment, and he recovered after about a year.
A scholar contracted an external pathogen due to overwork. Sores appeared on his lips. Someone treated him with Siwu Tang (Four Substances Decoction) added with Huangbai (Phellodendron Bark) and Zhimu (Anemarrhenae Rhizoma), and he recovered. Later, it relapsed. He continued using the previous medication, but his condition worsened. His abdomen felt cold internally. I used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Fuling (Poria) and Banxia (Pinelliae Rhizoma), and he recovered.
Yang Guohua, a scholar, became angry, resulting in [swelling/pain] of the lips and mouth [text missing].
A man who was prone to anger had swollen lips. After taking Qingwei San (Clear Stomach Powder), he frequently bled fluid and became emaciated. I used Buzhong Yiqi Tang added with Banxia (Pinelliae Rhizoma), Fuling (Poria), and Jiegeng (Platycodonis Radix). After more than a month, the lip swelling gradually subsided, and his Yuan Qi (Original Qi) gradually recovered. Then, I used Siwu Tang (Four Substances Decoction) added with Chaihu (Bupleuri Radix), fried Zhizi (Gardeniae Fructus), Danpi (Moutan Cortex), Shengma (Cimicifugae Rhizoma), and Gancao (Licorice Root) for several doses. Then, Zhizi was removed, and Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma) were added, leading to full recovery.
A woman had long harbored depression. Sometimes her stomach felt hot and spicy (acid regurgitation/burning sensation), her chest and diaphragm felt obstructed, her menstruation was irregular and scanty, she had afternoon fever, ate little, and felt fatigued. Her lips had been swollen for over a year. I used Guipi Tang (Restore the Spleen Decoction) added with Jiangzhi (Ginger Juice), fried Huanglian (Coptidis Rhizoma), and Zhizi (Gardeniae Fructus), with a small amount of Wuzhuyu (Evodiae Fructus) as an assistant. The burning sensation disappeared immediately, and her food intake slightly increased. Then, Huanglian was removed, and Beimu (Fritillariae Bulbus) and Yuanzhi (Polygalae Radix) were added. Her chest and diaphragm became unobstructed, and her diet returned to normal. She then alternately took Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) and Guipi Tang (Restore the Spleen Decoction) for over a hundred doses. After her menstruation regulated, her lips finally healed.
Another woman had long harbored depression and suffered from Jiaochun (Silkworm Lip). She indiscriminately used digestive-promoting and fire-clearing drugs, presenting all deficiency symptoms, with night sweats profuse like rain. This indicated Qi and Blood deficiency with Heat. [Text missing: likely prescribed blood-nourishing herbs]. She then alternately took Xiaoyao San (Free and Easy Wanderer Powder) and Guipi Tang (Restore the Spleen Decoction) for over a hundred doses, and her lips also healed.
A woman had cracked lips with internal heat for two years. Whenever it flared up, she took cold-natured agents, frequently bleeding fluid, which exacerbated other symptoms. I used Jiawei Qingwei San (Modified Clear Stomach Powder), and she recovered. Later, due to anger, her lips and mouth swelled, accompanied by alternating chills and fever and vomiting. I used Xiao Chaihu Tang (Minor Arcus Bupleurum Decoction) added with Zhizi (Gardeniae Fructus), Fuling (Poria), and Jiegeng (Platycodonis Radix). All symptoms instantly resolved. She then reused Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder)...
A woman prone to anger had slight swelling of the lower lip, internal heat, and fatigue. After taking phlegm-resolving drugs, she ate less, vomited, had loose stools, and her lips bled fluid. After taking Qi-regulating and digestion-promoting drugs, she experienced chest and diaphragm fullness, unclear head and eyes, lip swelling, and amenorrhea. After taking Stomach-clearing and blood-invigorating drugs, her limbs became more fatigued, she had fever and irritability, and saliva flowed excessively. I said: This is caused by Seven Emotions injuring the Liver and Spleen, and the mistaken use of attacking/draining methods. Thus, I used Jisheng Guipi Tang (Jisheng Restore the Spleen Decoction); her food intake increased and stools formed. I used Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder); the swelling subsided and heat retreated. I used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); Spleen function strengthened and saliva stopped. Later, due to anger, she had alternating chills/fever, ear pain, and chest/diaphragm distension, with severe lip swelling. This was Liver Fire stirred by anger, damaging Yin Blood. I used Siwu Tang (Four Substances Decoction) combined with Xiao Chaihu Tang (Minor Arcus Bupleurum Decoction) added with Zhizi (Gardeniae Fructus), and she recovered instantly. Again due to anger, her hypochondrium and breasts became distended, her abdomen hurt, she vomited acidic saliva, could not eat, and urination was difficult. This was Liver Wood stirred by anger overcoming Spleen Earth. I used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Chuanxiong (Ligustici Chuanxiong Rhizoma) and Shaoyao (Paeoniae Radix), and she recovered. Due to overwork and anger, with irregular diet, she had fever, panting, thirst, fatigue, anorexia, and vaginal bleeding like a flood, with extremely severe lip swelling. This was Fire in the Liver Meridian failing to store Blood, and Qi Deficiency in the Spleen Meridian failing to control Blood. I used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with fried black Zhizi (Gardeniae Fructus), Shaoyao (Paeoniae Radix), and Danpi (Moutan Cortex), and she recovered.
A man had internal heat and thirst, coughed up phlegm and saliva, and had dry, rough bowels. He believed himself to be robust and asked me for treatment. I said: This is a condition of Spleen and Kidney Yin Deficiency with Yang Hyperactivity. One should strengthen the master of Water (nourish Yin). He did not believe this and self-medicated with Erchen Tang (Two Aged Decoction), Huangqin (Scutellariae Radix), and Lianzi (Nelumbinis Semen) or similar herbs. The following year, his lower lip gradually swelled, his urine was red and difficult, and he persisted with the previous medication. His lips bled fluid, he passed black clots in stool, and urination was dribbling. He asked me to treat him. I said: Black, hard stools and dribbling urine indicate failure of the Liver and Kidneys; white swelling of the lips and mouth indicates failure of the Spleen Qi. He declined to come for treatment and eventually died.
A woman had irregular menstruation and hot feet. Over a year later, her whole body became hot, and exertion caused soreness and pain in her legs. Another year later, her lips swelled, cracked, and pained. Half a year later, her lips cracked and bled, she was physically fatigued, food lacked taste, menstruation ceased, and the area below her lips swelled like a black date. I said: This is Liver and Spleen Blood Deficiency with Fire Syndrome. She did not listen... [text missing: likely refused proper treatment].
A woman prone to anger had swollen lips. Someone used detoxifying drugs, causing her lips to swell and bleed for over a year. I said: One must nourish the Spleen and Stomach to nourish the source of transformation and production for recovery. She insisted on using the previous drugs and died with a condition resembling a Flower-Turn Tumor (a type of malignant ulcer/cancer).