论曰膀胱移热于小肠,膈肠不便,上为口糜,夫小肠之脉,络心循咽,下膈抵胃,阴阳
和平,水谷入胃,小肠受之,通调水道,下输膀胱,今热气厥逆,膀胱移热于小肠,胃之水
谷,不得传输于下,则令肠膈塞而不便,上则令口生疮而糜烂也,大抵心胃壅热,则必熏蒸
于上,不可概以敷药,当求其本而治之。
治小肠热胀,口糜生疮,柴胡泽泻汤方
柴胡(去苗) 泽泻 陈橘皮(浸去白焙) 黄芩(去黑心) 枳实(麸炒) 旋复花 升
麻
芒硝(别研各三两) 生地黄(一升)
上九味,除芒硝外, 咀如麻豆大,每服五钱匕,水二盏,煎取一盏,去滓下芒硝末半
钱匕搅匀,食后温服。
治口糜生疮,久不瘥,及心脾中热,乍发乍退,大青丸方
大青(去根) 甘草(炙锉) 枳壳(去瓤麸炒) 苦参(锉各三分) 黄连(去须) 生
干地
黄(焙) 升麻(各一两)
上七味,捣罗为末,炼蜜和丸,如梧桐子大,每服二十丸,食后熟水下,日二服。
治口糜生疮,久不瘥,大黄散方
大黄( 灰火煨锉) 甘草(炙锉) 黄柏(炙锉各一两) 密陀僧(研) 滑石(研
各一分)
上五味,捣研为散,每用一钱匕,绵裹含,有涎即吐。
治口糜生疮,升麻丸方
升麻 黄连(去须) 黄柏(炙锉) 杏仁(汤浸去皮尖双仁各一两)
上四味,将上三味,捣罗为末,次研杏仁如膏,炼蜜三两,以药末并杏仁膏,合和为丸
,如弹子大,每服一丸,含化咽津。
治大人小儿,口糜生疮,紫金散方
黄柏(蜜涂慢火炙令紫色半两) 诃黎勒(一枚煨熟去核) 麝香(研) 腻粉(研各
少许)
上四味,捣研为散,再同研匀,每用半钱许,糁疮上。
治口糜生疮,大黄汤方
大黄(锉一两) 芒硝(研) 黄连(去须) 黄柏(炙各半两)
上四味,粗捣筛,每服三钱匕,水一盏,煎至六分,去滓入蜜半匙,酥少许,细呷含咽
治口糜生疮,痛不得食,甘草丸方
甘草(一寸炙赤色) 杏仁(二十枚汤浸去皮尖双仁研) 黄连末(一分)
上三味,捣研为末和匀,每服绵裹如杏仁大,含化咽津。
治口糜生疮,柴胡汤方
柴胡(去苗) 地骨皮(各一两)
上二味,粗捣筛,每服三钱匕,水一盏,煎至六分,去滓细含咽之。
治口糜生疮,黄柏散方
黄柏(蜜涂炙干去火毒) 白僵蚕(直者置新瓦上下以火爆蚕丝丝断出火毒)
上二味等分,捣为细散,糁疮及舌上,吐涎。
治口糜生热疮,杏仁饼子方
杏仁(汤浸去皮尖双仁十四枚别研细) 腻粉(一钱)
上二味,和研匀如膏,每饼如钱眼大,铅丹为衣,先用盐汤漱口,含一饼,涎出即吐。
治口糜生疮,大黄蜜煎方
大黄(一两切如指头大)
上一味,以蜜煎五七沸,候冷取出,每含一块咽津。
治口疮糜烂,生蜜涂方
蜜(生使)
上一味,频用涂疮上,三五次即愈。
论述说:膀胱的热邪转移至小肠,导致膈部与肠道气机阻滞不通,热气上蒸则引起口腔黏膜溃烂(口糜)。小肠的经脉,联络心脏并沿着咽喉下行,穿过膈肌到达胃部。在阴阳平衡、气血调和的状态下,水谷进入胃中,由小肠受纳,通调水道,向下输送到膀胱。如今热邪逆乱,膀胱的热邪移注于小肠,胃中的水谷精微无法向下传输,从而导致膈部和肠道阻塞而不通畅,向上则导致口腔生疮并发生糜烂。大抵心胃蕴积热邪,必然熏蒸于上部,不能一概使用外敷药物,应当寻求病根进行根本治疗。
治疗小肠热胀、口腔黏膜溃烂生疮的柴胡泽泻汤方:
柴胡(去苗)、泽泻、陈橘皮(浸去白焙)、黄芩(去黑心)、枳实(麸炒)、旋复花、升麻、芒硝(另研,各三两)、生地黄(一升)。
以上九味药,除芒硝外,切碎如麻豆大小,每次服用五钱匕,加水二盏,煎取一盏,滤去药渣后加入半钱匕芒硝末,搅匀,饭后温服。
治疗口腔黏膜溃烂生疮,久不痊愈,以及心脾有热,时发时退的大青丸方:
大青(去根)、甘草(炙锉)、枳壳(去瓤麸炒)、苦参(锉,各三分)、黄连(去须)、生干地黄(焙)、升麻(各一两)。
以上七味药,捣碎过筛为细末,用炼蜜和丸,如梧桐子大小,每次服用二十丸,饭后用温水送服,每日两次。
治疗口腔黏膜溃烂生疮,久不痊愈的大黄散方:
大黄(灰火煨锉)、甘草(炙锉)、黄柏(炙锉,各一两)、密陀僧(研)、滑石(研,各一分)。
以上五味药,捣碎研磨为散剂,每次取一钱匕,用棉布包裹含在口中,如有唾液分泌即吐出。
治疗口腔黏膜溃烂生疮的升麻丸方:
升麻、黄连(去须)、黄柏(炙锉)、杏仁(汤浸去皮尖双仁,各一两)。
以上四味药,将前三味捣碎过筛为细末,其次将杏仁研磨如膏状,加入炼蜜三两,将药末与杏仁膏混合和丸,如弹子大小,每次服用一丸,含化咽津。
治疗大人小儿口腔黏膜溃烂生疮的紫金散方:
黄柏(蜜涂慢火炙令紫色,半两)、诃黎勒(一枚煨熟去核)、麝香(研)、腻粉(研,各少许)。
以上四味药,捣碎研磨为散剂,再共同研磨均匀,每次取半钱许,撒在疮面上。
治疗口腔黏膜溃烂生疮的大黄汤方:
大黄(锉,一两)、芒硝(研)、黄连(去须)、黄柏(炙,各半两)。
以上四味药,粗捣筛,每次服用三钱匕,加水一盏,煎至六分,滤去药渣,加入半匙蜂蜜、少许酥油,细细含咽。
治疗口腔黏膜溃烂生疮,疼痛无法进食的甘草丸方:
甘草(一寸炙赤色)、杏仁(二十枚汤浸去皮尖双仁研)、黄连末(一分)。
以上三味药,捣碎研磨为细末和匀,每次取如杏仁大小的量用棉布包裹,含化咽津。
治疗口腔黏膜溃烂生疮的柴胡汤方:
柴胡(去苗)、地骨皮(各一两)。
以上二味药,粗捣筛,每次服用三钱匕,加水一盏,煎至六分,滤去药渣细细含咽。
治疗口腔黏膜溃烂生疮的黄柏散方:
黄柏(蜜涂炙干去火毒)、白僵蚕(直者置新瓦上下以火爆蚕丝丝断出火毒)。
以上二味药等分,捣为细散,撒在疮面及舌上,促使吐涎。
治疗口腔黏膜生热疮的杏仁饼子方:
杏仁(汤浸去皮尖双仁十四枚别研细)、腻粉(一钱)。
以上二味药,和研均匀如膏状,每制成如钱眼大小的饼,用铅丹为衣,先用盐汤漱口,含一饼,唾液流出即吐出。
Commentary states: When heat from the Bladder (Bladder) shifts to the Small Intestine (Small Intestine), it causes obstruction in the diaphragm and intestines. Rising upward, this heat manifests as oral ulceration (mouth canker). The meridian of the Small Intestine connects with the Heart (Heart) and runs along the pharynx, descending through the diaphragm to reach the Stomach (Stomach). When Yin and Yang are in harmony, food and drink enter the Stomach, are received by the Small Intestine, regulate water passages, and transmit downward to the Bladder. Now, due to rebellious heat, the heat of the Bladder shifts to the Small Intestine; the water and grain in the Stomach cannot be transmitted downward, causing obstruction in the diaphragm and intestines. Upward, this leads to sores and erosion in the mouth. Generally, when heat accumulates in the Heart and Stomach, it steams upward. One should not merely apply topical medications but must address the root cause for treatment.
Formula for Chaihu Zexie Tang (Bupleurum and Alisma Decoction) to treat Small Intestine heat distension and oral ulceration:
Chai Hu (Radix Bupleuri, removed seedlings), Ze Xie (Rhizoma Alismatis), Chen Ju Pi (Pericarpium Citri Reticulatae, soaked to remove white pith and baked), Huang Qin (Radix Scutellariae, removed black heart), Zhi Shi (Fructus Aurantii Immaturus, bran-fried), Xuan Fu Hua (Flos Inulae), Sheng Ma (Rhizoma Cimicifugae), Mang Xiao (Natrii Sulfas, separately ground, each 3 liang), Sheng Di Huang (Radix Rehmanniae Preparata, 1 sheng).
The above nine herbs, except Mang Xiao, are cut into pieces the size of hemp seeds. Each dose is 5 qian bi (approx. 15g), decocted in 2 zhan (approx. 400ml) of water until 1 zhan remains. Strain the dregs, add half a qian bi of Mang Xiao powder, stir well, and take warm after meals.
Formula for Da Qing Wan (Prunella Pill) to treat persistent oral ulceration, recurrent heat in the Heart and Spleen (Spleen):
Da Qing (Herba Isatidis, removed roots), Gan Cao (Radix Glycyrrhizae, roasted and crushed), Zhi Qiao (Fructus Aurantii, removed pulp and bran-fried), Ku Shen (Radix Sophorae Flavescentis, crushed, each 3 fen), Huang Lian (Rhizoma Coptidis, removed threads), Sheng Gan Di Huang (Radix Rehmanniae Preparata, dried and baked), Sheng Ma (Rhizoma Cimicifugae, each 1 liang).
The above seven herbs are pounded, sifted into fine powder, mixed with refined honey, and formed into pills the size of Sophora seeds. Each dose is 20 pills, taken after meals with warm water, twice daily.
Formula for Da Huang San (Rhubarb Powder) to treat persistent oral ulceration:
Da Huang (Radix et Rhizoma Rhei, roasted in ash fire and crushed), Gan Cao (Radix Glycyrrhizae, roasted and crushed), Huang Bo (Cortex Phellodendri, roasted and crushed, each 1 liang), Mi Tuo Seng (Lithargyrum, ground), Hua Shi (Talcum, ground, each 1 fen).
The above five herbs are pounded and ground into powder. Use 1 qian bi per application, wrapped in cotton wool and held in the mouth; spit out saliva as it forms.
Formula for Sheng Ma Wan (Cimicifuga Pill) to treat oral ulceration:
Sheng Ma (Rhizoma Cimicifugae), Huang Lian (Rhizoma Coptidis, removed threads), Huang Bo (Cortex Phellodendri, roasted and crushed), Xing Ren (Semen Pruni Armeniacae, soaked in water, skin and tips removed, double kernels, each 1 liang).
The first three herbs are pounded and sifted into fine powder. The Xing Ren is ground into a paste. Mix with 3 liang of refined honey to form pills the size of bullet seeds. Take one pill per dose, hold in the mouth to dissolve and swallow saliva.
Formula for Zi Jin San (Purple Gold Powder) to treat oral ulceration in adults and children:
Huang Bo (Cortex Phellodendri, coated with honey and slow-roasted until purple, 0.5 liang), He Li Le (Fructus Chebulae, roasted, pitted, 1 piece), She Xiang (Moschus, ground), Ni Fen (Calomelas, ground, small amount of each).
The above four herbs are pounded and ground into powder, then thoroughly mixed again. Sprinkle approximately half a qian bi onto the sores.
Formula for Da Huang Tang (Rhubarb Decoction) to treat oral ulceration:
Da Huang (Radix et Rhizoma Rhei, crushed, 1 liang), Mang Xiao (Natrii Sulfas, ground), Huang Lian (Rhizoma Coptidis, removed threads), Huang Bo (Cortex Phellodendri, roasted, each 0.5 liang).
The above four herbs are coarsely crushed and sieved. Each dose is 3 qian bi, decocted in 1 zhan of water until 0.6 zhan remains. Strain, add half a spoonful of honey and a little butter, and sip slowly while holding in the mouth.
Formula for Gan Cao Wan (Licorice Pill) to treat painful oral ulceration preventing eating:
Gan Cao (Radix Glycyrrhizae, 1 cun roasted until reddish-brown), Xing Ren (Semen Pruni Armeniacae, 20 pieces soaked in water, skin and tips removed, double kernels, ground), Huang Lian Mo (Powder of Rhizoma Coptidis, 1 fen).
The above three herbs are pounded and ground into uniform powder. Wrap an amount the size of an almond in cotton wool, hold in the mouth to dissolve, and swallow saliva.
Formula for Chai Hu Tang (Bupleurum Decoction) to treat oral ulceration:
Chai Hu (Radix Bupleuri, removed seedlings), Di Gu Pi (Cortex Lycii, each 1 liang).
The above two herbs are coarsely crushed and sieved. Each dose is 3 qian bi, decocted in 1 zhan of water until 0.6 zhan remains. Strain and hold in the mouth to swallow slowly.
Formula for Huang Bo San (Phellodendron Powder) to treat oral ulceration:
Huang Bo (Cortex Phellodendri, coated with honey, roasted dry to remove fire toxicity), Bai Jiang Can (Bombyx Batryticatus, straight specimens placed on new tiles and roasted over fire until silk breaks to remove fire toxicity).
Equal parts of the above two herbs are pounded into fine powder. Sprinkle on sores and tongue to induce salivation.
Formula for Xing Ren Bing Zi (Almond Cake) to treat hot sores in the mouth:
Xing Ren (Semen Pruni Armeniacae, 14 pieces soaked in water, skin and tips removed, double kernels, separately ground finely), Ni Fen (Calomelas, 1 qian).
Mix and grind the above two ingredients into a uniform paste. Form into cakes the size of a coin hole, coat with Qian Dan (Minium). Rinse mouth with salt water first, hold one cake in the mouth, and spit out saliva when it flows.
Formula for Da Huang Mi Jian (Rhubarb Honey Decoction) to treat oral ulceration:
Da Huang (Radix et Rhizoma Rhei, 1 liang cut into finger-sized pieces).
Decoct the single herb in honey for five or seven boils. Remove when cool. Hold one piece in the mouth and swallow saliva.
Formula for Sheng Mi Tu (Raw Honey Application) to treat mouth sore erosion:
Mi (Honey, raw).
Apply frequently to the sores. It will heal in three to five applications.