🌿 Folk Prescriptions

Stomatitis is a common clinical condition. Due to differences in duration (acute vs. chronic), syndrome patterns (deficiency vs. excess), varied etiologies, and diverse accompanying symptoms, treatment approaches differ accordingly. The main six therapeutic methods are summarized as follows:
1. Clearing and Draining Spleen and Stomach Heat: This method targets stomatitis caused by accumulated heat in the Spleen and Stomach. Accumulated heat often results from irregular diet, excessive consumption of spicy, fragrant, or dry foods, or rich, fatty, alcoholic, or sweet foods. Symptoms include multiple oral ulcers with red, swollen perilesional areas, accompanied frequently by thirst with desire for cold drinks, dark yellow urine, hard stools, red tongue with yellow coating, and deep, solid or large, slippery pulse. Treatment should clear and drain heat from the Spleen and Stomach. Use Xie Huang San (9g each of Magnoliae Flos, Saposhnikoviae Radix, 30g Raw Gypsum, 15g Gardenia Fructus, 6g Glycyrrhizae Radix) plus 9g Coptidis Rhizoma. If constipation persists after medication, add 9g Rhubarb; discontinue once bowel movement occurs. After recovery, take Bamboo Leaf and Gypsum Decoction (9g each of Moslae Herba, Pinelliae Rhizoma Praeparatum, 24g Raw Gypsum, 15g each of Codonopsis Radix, Oryzae Semen, 18g Ophiopogonis Radix, 6g Glycyrrhizae Radix) for tonification to prevent recurrence!
2. Clearing Heart Fire and Guiding Heat Downward: This method treats stomatitis due to Heart Fire spreading to the Small Intestine. Traditional Chinese medicine holds that the Heart and Small Intestine are interior-exterior partners; when Heart Fire arises, it spreads to the Small Intestine. In addition to oral ulcers, symptoms commonly include mental restlessness, irritability, insomnia, thirst, burning or painful urination, hematuria, red tongue, and rapid pulse. Treatment should clear Heart Fire and guide heat downward. For this condition, I commonly use Dao Chi San (15g Rehmanniae Radix Praeparata, 9g each of Bambusae Caulis in Taeniam, Uncariae Ramulus Cum Uncis, 3g Glycyrrhizae Radix) plus 9g Coptidis Rhizoma, 15g Forsythiae Fructus, and 30g Imperatae Rhizoma.
3. Tonifying Qi and Strengthening the Spleen: This method addresses stomatitis caused by Spleen Qi deficiency. Spleen Qi deficiency often stems from overwork, fatigue, excessive vomiting, or post-illness damage to Spleen Qi. Symptoms include non-red, non-swollen ulcers with mild pain and prolonged duration, along with frequent fatigue, limb weakness, poor appetite, loose stools, pale tongue with thin coating, and weak pulse. Treatment should tonify Qi and strengthen the Spleen. Use Shen Ling Bai Zhu Wan or Xiang Sha Yang Wei Wan as the base formula—highly effective.
4. Tonifying Qi and Generating Body Fluids: This method treats stomatitis due to deficiency of Spleen and Stomach fluids and Qi. Deficiency often results from invasion of warm-heat pathogens damaging Spleen and Stomach fluids and Qi. Symptoms include mouth sores accompanied by restlessness, dry mouth, fatigue, lack of appetite, minimal thirst, shortness of breath with sweating, red tongue with little coating, and fine, weak, rapid pulse. Treatment should tonify Spleen and Stomach fluids and Qi. Use Zhongjing Mai Men Dong Tang (18g Ophiopogonis Radix, 9g each of Ginseng, Pinelliae Rhizoma, 12g Jujubae Fructus, 30g Oryzae Semen, 6g Glycyrrhizae Radix) plus 15g Dendrobii Herba and 15g Prunus Mume.
5. Nourishing Yin and Clearing Fire: This method treats stomatitis due to Yin deficiency with hyperactive fire. Yin deficiency with hyperactive fire often results from emotional overexertion harming Heart Yin or injury to yin after febrile diseases. In addition to recurrent, intermittent, and persistent oral ulcers, symptoms include restlessness, insomnia with vivid dreams, red tip of the tongue, scanty or absent coating, and fine, rapid pulse. Treatment should nourish Yin and clear fire. Use Huang Lian E Jiao Ji Zi Huang Tang (6g Coptidis Rhizoma, 9g each of Scutellariae Radix, Colla Corii Asini, 15g Paeoniae Alba Radix, 1 egg yolk) modified—very effective. If symptoms worsen with severe throat dryness at night, lower back soreness, leg weakness, or premature ejaculation, this indicates Kidney Yin deficiency with hyperactive fire. Treatment should nourish Yin and reduce fire—use Zhi Bai Di Huang Wan.
6. Warming and Tonifying Yang Qi: This method treats stomatitis due to Yang deficiency. Stomatitis caused by Yang deficiency is relatively rare clinically. Causes often include congenital Yang deficiency, excessive sweating or purging, or long-term illness damaging body Yang. Over my 40 years of clinical practice, I have treated 12 such cases: 6 cured, 4 markedly improved, 2 ineffective. Experience shows: for Spleen Yang deficiency presenting with abdominal coldness and distension, intermittent pain, loose stools, poor appetite, white coating, and deep, weak pulse, use Li Zhong Tang (9g Ginseng, 12g each of Dry Ginger, Atractylodis Macrocephalae Rhizoma, 6g Glycyrrhizae Radix) plus 9g Sandalwood, 9g Amomi Fructus, 30g Germinated Rice, 15g Hawthorn. For Kidney Yang deficiency presenting with aversion to cold without fever, cold lumbar and dorsal pain, impotence, and seminal emission, use Jin Kui Shen Qi Wan as the base formula. For combined Spleen and Kidney Yang deficiency, use Si Shen Wan (15g Psoraleae Fructus, 9g each of Evodiae Fructus, Myristicae Semen, 6g Schisandrae Fructus) plus 9g Prepared Aconite Root.