MOUTH, TONGUE, TEETH, GUMS, LIPS, PALATE AND PHILTRUM

MOUTH, TONGUE, TEETH, GUMS, LIPS, PALATE AND PHILTRUM

Chapter contents

Cracked corners of the mouth

Itching around the mouth

Dribbling from the corners of the mouth

Trembling mouth

Deviation of the mouth

Numbness of the tongue

Dry and white teeth

Dry and dull teeth

Yellow and dry teeth

Upper teeth moist and lower teeth dry

Gums oozing pus

Bluish-greenish lips

Dry or cracked lips

Abnormal lip colour in pregnancy

Dull-pale palate

Stiff-looking philtrum

Bluish-greenish philtrum

MOUTH

Mouth ulcers

Observation, Chapter 8; Interrogation, Chapter 35

Stomach-Heat

Ulcers with a red rim on the gums or inside cheeks, bleeding gums, thirst, foul breath, burning epigastric pain, sour regurgitation, nausea, excessive hunger, a feeling of heat, Red tongue with a yellow coating, Overflowing-Rapid pulse.

Heart-Fire

Tongue ulcers, thirst, bitter taste, palpitations, mental restlessness, a feeling of agitation, insomnia, dream-disturbed sleep, a feeling of heat, red face, Red tongue with redder tip and yellow coating, Overflowing and Rapid pulse.

Yin deficiency with Empty-Heat

Ulcers with a pale rim aggravated by overwork and lack of sleep, dry throat at night, a feeling of heat in the evening, night sweating, five-palm heat, malar flush, Red tongue without coating, Floating-Empty and Rapid pulse.

Other symptoms and signs depend on the organ involved.

Stomach and Spleen-Qi deficiency with Yin Fire

Pale ulcers on the gums or inside cheeks, slightly red face or pale face with a floating red colour on the cheeks, an intermittent and recurrent feeling of heat in the face but cold limbs, intermittent sore throat, dry mouth, dry lips, exhaustion, poor appetite, poor digestion, weak limbs, Pale tongue, Weak or Overflowing-Empty pulse.

These ulcers are due to Yin Fire as described by Li Dong Yuan in his ‘Discussion on Stomach and Spleen’ (see Chapter 55).

Liver-Fire

Ulcers inside the cheeks, very painful and red in colour, thirst, bitter taste, headache, red face, dizziness, tinnitus, irritability, propensity to outbursts of anger, constipation, dark urine, Red tongue with redder sides and dry yellow coating, Wiry-Rapid pulse.

Toxic Heat

Ulcers inside the cheeks, red and festering, oozing sticky yellow pus, fever, thirst, Red tongue with red points and thick, sticky yellow coating, Overflowing-Slippery-Rapid pulse.

Invasion of Wind-Heat with Phlegm

Ulcers inside the cheeks, red and swollen, oozing thin yellow pus, aversion to cold, fever, cough, sore throat, stuffed or runny nose with yellow discharge, headache, body aches, slight sweating, slight thirst, swollen tonsils, nausea, vomiting, a feeling of oppression of the chest, tongue slightly Red on the sides in the chest area or on front part, Floating-Rapid pulse.

Invasion of Wind-Cold with Kidney deficiency

Ulcers inside the cheeks, white rim around them, swollen, aversion to cold, fever, cough, itchy throat, slight breathlessness, stuffed or runny nose with clear watery discharge, sneezing, occipital headache, body aches, thin white tongue coating, lower backache, dizziness, tinnitus, Pale tongue, Floating-Tight pulse.

• Remember: for mouth ulcers on gums and inside cheeks in women treat the Directing Vessel irrespective of the pattern causing them.

• If they are on the tongue, treat the Heart channel and especially HE-5 Tongli.

Cold sores

Observation, Chapter 8; Interrogation, Chapter 35

Invasion of Wind-Heat

Cold sores at the corner of the mouth or on the edge of the upper lip, aversion to cold, fever, cough, sore throat, stuffed or runny nose with yellow discharge, headache, body aches, slight sweating, slight thirst, swollen tonsils, tongue slightly Red on the sides in the chest area or on front part, Floating-Rapid pulse.

Stomach Damp-Heat

Cold sores at the corner of the mouth or on the edge of the lower lip, a sticky taste, thirst with no desire to drink, facial pain, stuffed nose or thick sticky nasal discharge, a feeling of fullness and pain of the epigastrium, a feeling of heaviness, nausea, a feeling of heat, dull-yellow complexion, Red tongue with sticky yellow coating, Slippery-Rapid pulse.

Stomach-Heat

Cold sores at the corner of the mouth or on the edge of the lower lip, foul breath, thirst, burning epigastric pain, sour regurgitation, nausea, excessive hunger, a feeling of heat, Red tongue with a yellow coating, Overflowing-Rapid pulse.

Stomach-Yin deficiency with Empty-Heat

Cold sores at the corner of the mouth or on the edge of the lower lip, dry mouth in the evening, dull or burning epigastric pain, a feeling of heat in the afternoon, thirst with a desire to drink in small sips, dry stools, a slight feeling of fullness after eating, night sweating, five-palm heat, bleeding gums, Red tongue (or Red centre only) without coating in the centre, Floating-Empty and Rapid pulse.

Heat in the Large Intestine

Cold sores on the upper lip, constipation with dry stools, a burning sensation in the mouth, dry tongue, burning and swelling in the anus, scanty dark urine, thick yellow (or brown or black) dry tongue coating, Full-Rapid pulse (often Wiry on both Rear positions).

Damp-Heat in the Large Intestine

Cold sores on the upper lip, abdominal pain that is not relieved by a bowel movement, diarrhoea, mucus and blood in stools, offensive odour of stools, burning in the anus, scanty dark urine, fever, sweating which does not decrease the fever, a feeling of heat, thirst without a desire to drink, a feeling of heaviness of the body and limbs, a feeling of oppression of the chest and epigastrium, Red tongue with sticky yellow coating, Slippery-Rapid pulse or pulse that is Slippery and Wiry on both the Rear positions.

• I use LI-4 Hegu contralaterally for the corners of the mouth, that is, on the left for cold sore on the right and vice versa.

Cracked corners of the mouth

Observation, Chapter 8

Stomach-Heat

Cracked corners of the mouth, thirst, burning epigastric pain, sour regurgitation, nausea, excessive hunger, foul breath, a feeling of heat, Red tongue with a yellow coating, Overflowing-Rapid pulse.

Stomach-Yin deficiency

Cracked corners of the mouth, dry mouth with desire to sip water, no appetite or slight hunger but no desire to eat, constipation (dry stools), dull or slightly burning epigastric pain, dry mouth and throat especially in the afternoon, a slight feeling of fullness after eating, normal-coloured tongue without coating, or without coating in the centre, Floating-Empty pulse.

Stomach-Yin deficiency with Empty-Heat

Cracked corners of the mouth, dry mouth and throat especially in the afternoon, thirst with a desire to drink in small sips, bleeding gums, dull or burning epigastric pain, a feeling of heat in the afternoon, dry stools, a slight feeling of fullness after eating, night sweating, five-palm heat, bleeding gums, Red tongue (or Red centre only) without coating in the centre, Floating-Empty and Rapid pulse.

Itching around the mouth

Stomach-Heat

Intense itching around mouth and especially at the corners and below the mouth, cold sores, foul breath, burning epigastric pain, thirst, sour regurgitation, nausea, excessive hunger, foul breath, a feeling of heat, Red tongue with a yellow coating, Overflowing-Rapid pulse.

Liver-Blood deficiency with Empty-Wind

Slight itching around the mouth, dryness around the mouth, greenish colour around the mouth, trembling mouth, facial tic, slight flapping of the eyelid, blurred vision, floaters, unilateral numbness/tingling of a limb, Pale and Thin tongue, Choppy or Fine and slightly Wiry pulse.

Damp-Heat in Stomach and Spleen

Itching around mouth, wet rash around mouth, cold sores, sticky taste, thirst with no desire to drink, a feeling of fullness and pain of the epigastrium and lower abdomen, poor appetite, a feeling of heaviness, thirst without a desire to drink, nausea, loose stools with offensive odour, a feeling of heat, dull-yellow complexion, sticky taste, Red tongue with sticky yellow coating, Slippery-Rapid pulse.

Disharmony of Penetrating and Directing Vessels

Itching around mouth at period time or during the menopausal time, lower backache, dizziness, tinnitus, irregular periods.

Other symptoms and signs depend on whether there is a deficiency of Kidney-Yin or Kidney-Yang.

• The area around the mouth is controlled by the Liver channel and the Penetrating and Directing Vessels.

Dribbling from the corners of the mouth

Observation, Chapter 8

Spleen-Qi deficiency

Dribbling from the corners of the mouth, poor appetite, tiredness, slight abdominal distension, pale complexion, loose stools, Pale tongue, Empty pulse.

Lung-Qi deficiency with Empty-Cold

Dribbling from the corners of the mouth, chronic runny nose with watery white discharge, sneezing, slight shortness of breath, slight cough, weak voice, spontaneous daytime sweating, dislike of speaking, bright-white complexion, tendency to catch cold, tiredness, dislike of cold, a feeling of cold, cold limbs, Pale tongue, Weak pulse.

Stomach and Spleen-Heat

Dribbling from the corners of the mouth, painful tongue, mouth ulcers, dry mouth and lips, burning epigastric/abdominal pain, thirst, sour regurgitation, nausea, excessive hunger, foul breath, a feeling of heat, excessive hunger, red tip of the nose, dry stools, scanty dark urine, yellow complexion, Red tongue with dry yellow coating, Overflowing-Rapid pulse.

This dribbling is due to Stomach-Heat flaring upwards causing the fluids in the mouth to evaporate.

Wind-Phlegm

Dribbling from the corners of the mouth, severe dizziness, blurred vision, tremors, numbness or tingling of the limbs, tinnitus, nausea, sputum in the throat, a feeling of oppression of the chest, Stiff or Deviated and Swollen tongue, Wiry-Slippery pulse.

Invasion of external Wind

Dribbling from the corners of the mouth, numbness of the face, deviation of eye and mouth, inability to shut eyelid completely, watery eyes.

This is not an invasion of external Wind in the Lung’s Defensive-Qi system (as when one catches a cold) but an invasion of external Wind attacking the channels of the face causing facial paralysis (Bell’s palsy).

Trembling mouth

Liver-Blood and Liver-Yin deficiency with internal Wind

Slightly trembling mouth, dizziness, numbness/tingling of the limbs, blurred vision, floaters in the eyes, dry eyes, scanty menstruation, dull-pale complexion but with red cheek bones, withered and brittle nails, dry skin and hair, night sweating.

The tongue and pulse presentation depends on whether Blood or Yin deficiency predominates.

Qi stagnation and Phlegm

Trembling mouth, dribbling from the corners of the mouth, epigastric or abdominal distension, a feeling of muzziness of the head, sputum in the throat, a feeling of oppression of the chest, irritability, a feeling of a lump in the throat, Wiry-Slippery pulse.

Stomach-Heat

Trembling mouth, thirst, foul breath, burning epigastric pain, sour regurgitation, nausea, excessive hunger, a feeling of heat, Red tongue with a yellow coating, Overflowing-Rapid pulse.

Liver-Wind

Trembling mouth, tremors, severe dizziness, tinnitus, headache, numbness of limbs, tics, Stiff, Deviated or Moving tongue, Wiry pulse.

Mouth open

Observation, Chapter 8

Lung-Qi deficiency with Phlegm

Mouth open, chronic cough which is worse on exertion, scanty phlegm that is difficult to expectorate or dilute watery phlegm, spontaneous sweating, a feeling of cold, shortness of breath, a feeling of oppression of the chest, weak voice, tongue Pale and slightly Swollen in the front, pulse Empty on the right Front position and slightly Slippery.

Heart-Fire

Mouth open, tongue ulcers, red face, palpitations, thirst, mental restlessness, feeling agitated, insomnia, dream-disturbed sleep, a feeling of heat, bitter taste, Red tongue with redder tip and yellow coating, Overflowing-Rapid pulse.

Heart-Qi deficiency

Mouth open, palpitations, mental dullness, palpitations, shortness of breath on exertion, pale face, tiredness, slight depression, spontaneous sweating, Pale tongue, Empty pulse.

Deviation of the mouth

Observation, Chapter 8

Liver-Wind

Deviation of mouth, tremors, severe dizziness, tinnitus, headache, numbness of the limbs, tics, Stiff, Deviated or Moving tongue, Wiry pulse.

Liver-Wind and Phlegm

Deviation of mouth, severe dizziness, blurred vision, tremors, numbness/tingling of the limbs, tinnitus, nausea, sputum in the throat, a feeling of oppression of the chest, Stiff or Deviated and Swollen tongue, Wiry-Slippery pulse.

Invasion of Wind-Cold in the channels of the face

Sudden deviation of mouth, numbness of the face.

This is due to an invasion of Wind-Cold, not in the Lungs Defensive-Qi portion (as in the common cold and influenza) but in the channels of the face.

Liver-Qi stagnation

Intermittent deviation of mouth depending on emotional moods, hypochondrial or epigastric distension, irritability, moodiness, a feeling of a lump in the throat, premenstrual tension, Wiry pulse.

Deficiency of Qi and Blood

Slight deviation of mouth, poor appetite, loose stools, weak voice, tiredness, blurred vision, dizziness, numbness/tingling of limbs, palpitations, dull-pale complexion, Pale tongue, Weak or Choppy pulse.

Toxic Heat in the channels of the face

Deviation of mouth, thirst, bitter taste, swelling and pain of the face, toothache, headache, red eyes, swollen face, Red tongue with red points with thick, sticky yellow coating, Overflowing-Slippery-Rapid pulse.

TONGUE

The tongue signs discussed in this chapter deal only with a few unusual tongue signs; tongue diagnosis itself is discussed in full in Chapters 23–27.

Itchy tongue

Interrogation, Chapter 35

Heart-Fire

Itchy tip or front of the tongue, burning sensation of the tongue, palpitations, thirst, mouth and tongue ulcers, mental restlessness, a feeling of agitation, insomnia, dream-disturbed sleep, a feeling of heat, red face, bitter taste, Red tongue with redder tip and yellow coating, Overflowing-Rapid pulse.

Heart-Yin deficiency with Empty-Heat

Slight itching of the tongue especially in the evening, dry mouth and throat, palpitations, insomnia, dream-disturbed sleep, poor memory, anxiety, tendency to be easily startled, mental restlessness, uneasiness, ‘feeling hot and bothered’, thirst with a desire to sip fluids, a feeling of heat in the evening, malar flush, night sweating, five-palm heat, Red tongue redder on the tip with no coating, Floating-Empty and Rapid pulse.

Heart and Kidney-Yin deficiency

Itchy tongue, palpitations, insomnia, dream-disturbed sleep, anxiety, poor memory, dizziness, tinnitus, hardness of hearing, lower backache, night sweating, scanty dark urine, normal-coloured tongue without coating, Floating-Empty pulse.

Invasion of Wind-Heat

Itchy tongue with acute onset, aversion to cold, fever, cough, sore throat, stuffed or runny nose with yellow discharge, headache, body aches, slight sweating, slight thirst, swollen tonsils, tongue slightly Red on the sides in the chest area or on front part, Floating-Rapid pulse.

Painful tongue

Interrogation, Chapter 35

Heart-Fire

Painful tongue especially on the tip, tongue ulcers, palpitations, thirst, mouth and tongue ulcers, mental restlessness, a feeling of agitation, insomnia, dream-disturbed sleep, a feeling of heat, red face, bitter taste, Red tongue with redder tip and yellow coating, Overflowing-Rapid pulse.

Heart-Yin deficiency with Empty-Heat

Slight pain of the tongue especially in the evening, dry mouth and throat, palpitations, insomnia, dream-disturbed sleep, poor memory, anxiety, tendency to be easily startled, mental restlessness, uneasiness, ‘feeling hot and bothered’, dry mouth and throat, thirst with a desire to sip fluids, a feeling of heat in the evening, malar flush, night sweating, five-palm heat, Red tongue redder on the tip with no coating, Floating-Empty and Rapid pulse.

Stomach-Fire

Painful tongue, bleeding gums, foul breath, intense thirst with a desire to drink cold liquids, burning epigastric pain, mental restlessness, dry mouth, mouth ulcers, dry stools, sour regurgitation, nausea, vomiting soon after eating, a feeling of heat, sour regurgitation, Red tongue with a thick, dry dark-yellow coating, Deep-Full-Rapid pulse.

Stomach-Yin deficiency with Empty-Heat

Slightly painful tongue, dull or burning epigastric pain, a feeling of heat in the afternoon, dry mouth and throat especially in the afternoon, thirst with desire to drink in small sips, dry stools, a slight feeling of fullness after eating, night sweating, five-palm heat, bleeding gums, Red tongue (or Red centre only) without coating in the centre, Floating-Empty and Rapid pulse.

Liver-Fire

Painful tongue, thirst, bitter taste, headache, red face, dizziness, tinnitus, irritability, propensity to outbursts of anger, constipation, dark urine, Red tongue with redder sides and dry yellow coating, Wiry-Rapid pulse.

Phlegm-Fire harassing the Heart

Painful tongue, thirst, bitter taste, sputum in throat, palpitations, mental restlessness, red face, a feeling of oppression of the chest, expectoration of phlegm, sputum in the throat, insomnia, dream-disturbed sleep, agitation, mental confusion, incoherent speech, rash behaviour, uncontrolled laughter or crying, shouting, depression, manic behaviour, Red tongue with redder swollen tip and Heart crack with a sticky, dry yellow coating inside it, Slippery-Rapid or Slippery-Overflowing-Rapid pulse.

Numbness of the tongue

Interrogation, Chapter 35

Heart-Blood deficiency

Numbness of the tongue, palpitations, dizziness, insomnia, dream-disturbed sleep, poor memory, anxiety, tendency to be easily startled, dull-pale complexion, pale lips, Pale and Thin tongue, Choppy or Fine pulse.

Phlegm obstructing the Heart

Numbness of the tongue, swollen tongue, dizziness, a feeling of oppression of the chest, sputum in the throat, numbness/tingling of the limbs, sticky tongue coating, Slippery pulse.

Liver-Wind

Numbness of the tongue, tremors, severe dizziness, tinnitus, headache, tics, convulsions, rigidity of the neck, tremor of limbs, stiff neck, opisthotonos, in severe cases coma, Stiff, Moving or Deviated tongue, Wiry pulse.

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Tags: Diagnosis in Chinese Medicine A Comprehensive Guide

Apr 15, 2017 | Posted by admin in GENERAL & FAMILY MEDICINE | Comments Off

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