Chapter 8 From a Five-Element perspective, the mouth and lips are the orifice of the Spleen, but they are related to many other channels. The Spleen channel is closely related to both mouth and lips and Chapter 5 of the ‘Simple Questions’ says: ‘The Spleen controls the mouth’1 and Chapter 4 of the same book says: ‘The centre pertains to the yellow colour, it connects with the Spleen which opens into the mouth.’2 Chapter 17 of the ‘Spiritual Axis’ says: ‘Spleen-Qi penetrates within the mouth, when the Spleen is harmonized, the mouth can taste the five flavours.’3 Chapter 37 of the same book says: ‘The mouth and lips are the orifice of the Spleen.’4 and Chapter 47 says: ‘When the lips are full, the Spleen is strong; when the lips are withered, the Spleen is weak; when the lips are hard, the Spleen has a Full condition; when the lips are large but soft, the Spleen is depleted. When both lips are in a good condition the Spleen is healthy; when the lips are deviated upwards, the Spleen is severely depleted.’5 The Stomach channel is, of course, closely connected to the mouth because its Main and Muscle channels both flow around the mouth. Chapter 40 of the ‘Spiritual Axis’ says: ‘The clear Qi of the Stomach ascends to the mouth.’6 The Large Intestine channel also flows to the lower part of the nose and its Muscle channels bind at the side of the nose. The mouth and lips are therefore influenced primarily by the Spleen, Stomach and Large Intestine channels; however, the Liver channel also wraps around the lips and so do the Penetrating and Directing Vessels. Chapter 10 of the ‘Spiritual Axis’ says: ‘The Liver channel flows around the inside of the lips.’7 The Governing Vessel penetrates through the upper lip and the upper gum. Internally, other channels flow to the inside of the mouth and the tongue and, in particular, the Heart Connecting channel, the Kidney Main and Divergent channel. As the Heart houses the Mind, it controls all the senses and therefore also the mouth and taste. The channels flowing to or around the mouth are illustrated in Figure 8.1, and Box 8.1 summarizes them. The following lip signs will be discussed: The patterns causing each of the lip signs discussed below are listed in greater detail in Part 5, Chapter 60. Symptoms and Signs, Chapter 60 When the lips are paler than the normal pale red, they indicate either Blood or Yang deficiency of the Spleen or Liver. In cases of Blood deficiency, especially of the Liver, they might also be slightly dry, while in cases of Yang deficiency they are usually moist. Pale-greyish lips the colour of paper indicate severe Blood deficiency. For a more detailed description of the patterns involved, see Chapter 60. Box 8.2 summarizes the patterns underlying pale lips. Symptoms and Signs, Chapter 60 Red lips are always caused by Heat, which can be Full or Empty, and acute or chronic. Full-Heat of most organs, and especially the Lungs, Heart, Stomach, Liver, Kidneys and Spleen, may cause the lips to be red and swollen; Empty-Heat of the same organs may cause the lips to be red and dry. Acute invasions of Wind-Heat may also cause the lips to become bright red but this happens mostly in children; at the Qi level of acute febrile diseases, the lips also become bright red and they are also cracked and dry in cases of Fire. For a more detailed description of the patterns involved, see Chapter 60. Box 8.3 summarizes the patterns underlying red lips. Symptoms and Signs, Chapter 60 Purple lips may reflect Blood stasis, in which case they tend to be reddish-purple, or Cold (which may be Full or Empty), in which case they tend to be bluish-purple. Bluish-purple and dark lips indicate extreme Cold. Long-standing retention of Phlegm in the Lungs often leads to Blood stasis and this may also cause the lips to be bluish-purple. Finally, the lips may become reddish-purple at the Nutritive-Qi or Blood levels in acute febrile diseases. For a more detailed description of the patterns involved, see Chapter 60. Box 8.4 summarizes the patterns underlying purple lips. Symptoms and Signs, Chapter 60 ‘Bluish-green’ is a translation of the Chinese word qing. The colour qing may be either bluish or greenish depending on the pattern involved. The lips may become bluish in case of Cold, which may be Full or Empty, and greenish in case of Blood stasis, which may affect Heart, Lungs, Stomach or Liver. For a more detailed description of the patterns involved, see Chapter 60. Box 8.5 summarizes the patterns underlying bluish-greenish lips. Symptoms and Signs, Chapter 60 Yellow lips are usually caused by Dampness in the Stomach and Spleen, which may be associated with Heat or Cold; another possible cause of yellow lips is Full-Heat with Blood stasis. For a more detailed description of the patterns involved, see Chapter 60. Box 8.6 summarizes the patterns underlying yellow lips. Symptoms and Signs, Chapter 60 Florid, red and full lips indicate a good state of the Penetrating Vessel and an easy childbirth. Pale lips in pregnancy indicate Blood deficiency and possibly a difficult childbirth. A white colour and dryness of the corners of the mouth indicate severe Blood deficiency and also the possibility of a difficult birth. Bluish lips in pregnancy indicate Blood stasis from Cold and are always considered to be a dangerous sign. A bluish face and dark lips or a dark face and bluish lips in pregnancy also signal danger. Box 8.7 summarizes patterns underlying abnormal lip colour in pregnancy. Symptoms and Signs, Chapter 60 If the upper lip is dry, it indicates Lung-Heat or Heat in the Large Intestine. If the lower lip is dry, it indicates Heat in the Stomach. If the lips are dry but red, the condition is not severe and the prognosis is good. If they are dry but dark, the condition is more serious and the prognosis less good. For a more detailed description of the patterns involved, see Chapter 60. Box 8.8 summarizes the patterns underlying dry, cracked lips. Symptoms and Signs, Chapter 60 A swelling of the lips always indicates Heat, usually either Damp-Heat or Toxic Heat affecting the Stomach and Spleen. An acute swelling of the lips may also be due to an allergic reaction. For a more detailed description of the patterns causing swollen lips, refer to Chapter 60.
OBSERVATION OF LIPS MOUTH, PALATE, TEETH, GUMS AND PHILTRUM
CHANNELS INFLUENCING THE MOUTH AND LIPS
LIPS
Abnormal colour
Pale lips
Red lips
Purple lips
Bluish-greenish lips
Yellow lips
Abnormal lip colour in pregnancy
Dry or cracked lips
Swollen lips
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