Oral ulcers are a common clinical condition, mostly occurring in the oral mucosa of the lips, cheeks, soft palate or gums, where single or multiple ulcerated surfaces with clear borders and significant burning pain are visible, with periodic, recurrent and self-limiting characteristics. Modern medicine believes that its cause is related to local trauma, mental stress, food, drugs, hormone level changes and vitamin or trace element deficiency, but there is no uniform ideal method to control its recurrence. This disease belongs to the category of “mouth chancre”, “mouth sore” and “mouth erosion” in Chinese medicine. Based on the criteria and characteristics of physical constitution classification established by the Chinese Academy of Traditional Chinese Medicine [1], Liu Xiaoyu’s experience is presented below, together with some medical cases. The first case is Wang Mou, female, 60 years old, retired worker. 2010.2.23 Initial diagnosis. She had frequent attacks of oral ulcers for more than 6 months, with an average of one attack in 3~5 days. The ulcer is as large as a grain of rice, with a sunken surface and a dull color. The pain is like a knife cut, affecting speech and eating, accompanied by soreness and weakness of the legs, and no significant discomfort. The evidence belongs to deficiency of middle energy and deficiency of fire on inflammation. The treatment is to tonify the middle energy and benefit the qi, raise the yang and lift the trap. Prescription: Atractylodes Macrocephala 15g, Angelica Sinensis 9g, Pericarpium Citri Reticulatae 9g, Astragalus Membranaceus 15g, Radix Astragali 6g, Radix Bupleurum 9g, Radix Achyranthes Bidentatae 9g. 2010.5.4 Second Consultation: After 7 postings, the ulcer was cured, so the medicine was stopped for 2 months. Recently, the ulcer recurred, full of oral cavity, size varies, light red, stinging pain is obvious, accompanied by abdominal distension, anal heavy sensation, sleep and general, two stool regulation, tongue light coating thin white greasy, pulse sunken thin. The evidence is the same as above, adding 9g of mucuna pruriens and 15g of yanhuosuo above, and also to regulate the qi and relieve pain. 2010.5.11 Third diagnosis: after 7 posts, the ulcer basically healed, the anus heavy fall feeling reduced, still have abdominal distension, thin stool, 2~3 times a day, red tongue with thin white coating, thin pulse. The evidence belongs to spleen qi sinking, transportation and transformation is not enough. Treatment is to benefit Qi, warm Yang, and at the same time move Qi to relieve pain. The above prescription was removed from Yanhuosuo, added 15g of Mu Xiang, 30g of Astragalus, 15g of Golden Cherry and 15g of Cistanches, and the symptoms were settled after 7 postings. The ulcer has not occurred since the follow-up. Comment: The patient is not rich in muscles, easily tired, short of breath and lazy to speak, and has a less florid complexion, which is identified as qi deficiency, showing signs of spleen qi deficiency and deficiency of fire on the inflammation, so the mouth ulcer recurred. The teacher in the treatment of oral ulcers like to use a medicine, Li Dongyuan said that it can “dispel the Yang Ming wind evil, rise in the stomach in the clear gas, and lead the sweet and warm medicine up, in order to supplement the spread of gastric gas and solid its surface, so the yuan qi deficiency, use this in the yin to rise Yang”. Yangming meridian more gas and blood, ascending marijuana into the Yangming meridian, and the combination of drugs, can stimulate the blood and support the righteousness and eliminate evil, the teacher ascending marijuana dosage of 3 ~ 6g, there is the beauty of the dragon point. Case 2 Qian, male, 35 years old, technician. 2009.4.20 Initial diagnosis. Recurrent mouth ulcers for more than 20 years, averaging 1 time per week, relieved by vitamin C tablets during attacks. In the past 2 months, due to work stress, the ulcer has not healed and the effect of vitamin C is not good, so he came to seek treatment. On examination: 4~5 white ulcerated surfaces of different sizes on the tongue and gingiva, with obvious stinging pain, especially when eating, accompanied by dry mouth and bitterness, several sores on the forehead, light red and without pus, slightly distended abdomen, relieved by yagging, poor nausea, easy fatigue, average sleep, smooth stool, light red tongue with teeth on the side, thin white moss, thin string pulse on the right and string on the left. The evidence belongs to Qi deficiency, blood stasis and internal heat stasis. Treatment is to dredge the liver and regulate Qi, cool the blood and eliminate blood stasis. Prescription: angelica 9g, white peony 15g, yujin 9g, gardenia carbon 9g, 6g, loquat leaf 6g, Chuanxiu Knee 9g, licorice 3g. 7 posts after the follow-up, ulcers gradually healed, visible lip light red, gingival color red, less abdominal slightly distended pain, still have dry mouth, mouth bitter, Na sleep can, two stools smooth, tongue light red coating thin white, pulse thin. In the above plus dahurica 15g, mullein 15g, yu zhu 15g, gentian herb 15g; to loquat leaves, yujin. 5 post after the ulcer healed, asked his usual self-prepared astragalus, yam consumption, follow-up 1 year of the disease safe. Comment: The patient is small and thin, with low speech and easy fatigue, and is a Qi deficiency. The internal organs are identified as spleen qi deficiency, transportation and transformation failure, abdominal distension and pain; qi deficiency and inability to move blood, long stagnation and fire, burning flesh, recurrent ulcers of the mouth and lips. Stagnation of emotions due to stress causes liver qi to become heat, resulting in dry mouth, bitter mouth, and sores and pimples. The teacher focused on the use of medicine due to deficiency and stagnation, the first consultation proposed to dredge the liver and Qi, cool the blood and eliminate stasis, so that the Qi and blood and smooth, the symptoms turned better; the effect does not change the prescription, the second consultation still focus on the regulation of Qi and blood, taking into account other symptoms such as abdominal distension, mouth bitterness; and then advised to supplement with food nourishment to improve the latter, both the symptoms and the root cause of the treatment, the efficacy is remarkable. A case of Yin deficiency. Zhang, female, 64 years old, retired worker. Initially diagnosed on 2009.12.16. He has been suffering from recurrent mouth ulcers for more than 10 years, with an average of 1~2 times per month, which are temporarily relieved by self-application of borax. On examination: red and red lips, multiple small ulcerated surfaces scattered on the lips and gums, painful and uncomfortable, affecting food intake; emotionally irritable, hot flashes, easy sweating on the hands and feet, especially when moving, difficulty sleeping for about 4 hours per night in the past 1 week, nasal discharge, dry stool, urine regulation, dark red tongue, little coating, thin yellow, thin pulse. The evidence belongs to deficiency of Qi and Blood and internal heat stasis. Treatment is to clear heat and cool the blood, nourish Yin and remove steam, and at the same time to calm the mind. Prescription: Tortoise 9g, Dragon Bone 9g, Zhu Yuanzhi 6g, Acorus calamus 9g, Hefei Bark 20g, Hefei Rice 15g, Fu Shen 15g, Shengma 9g, Gypsum 15g, Dioscorea 15g, Radix et Rhizoma 15g, Zhi Mu 9g, Mai Dong 9g, Niu Knee 9g, Artemisia 15g. 7 posts later, the ulcer improved significantly, and the hot flashes and sweating were also reduced. The ulcer did not occur after six months of follow-up. Comment: The patient is anxious, has hot hands and feet, easy to dry stools, etc. is Yin deficiency. In addition, he is over the age of the flowering age, has a deficiency of qi and blood, and suffers from diabetes mellitus, which makes him susceptible to internal deficiency heat, so he suffers from heat in the hands and feet and heart, does not control sweating, and has dry stools; his mouth sores develop when he is injured by fire; he sleeps poorly when heat disturbs the heart and mind and water and fire do not help. He used Pillow in the Middle of the Pillow as a remedy, adding Shengdi, Mai Dong and Zhi Mu to nourish Yin and clear heat, using gypsum, ground bark and Artemisia annua to cool the blood and remove steam, and using Hop Huan Pi and Hop Huan Rice to calm the mind. Blood stasis case Fan, female, 45 years old, worker. 2009.8.3 Initial diagnosis. She has been suffering from recurrent mouth ulcers for 10 years, about once every 2 months, and was relieved by taking Huang Lian Shang Qing Wan and multivitamins; in the past 1 year, she has been suffering from 2~3 episodes per month, with no significant improvement by taking the above drugs, so she came to seek treatment. On examination, there are 2 ulcerated surfaces on the inner lip and cheek mucosa, with dark yellow color and obvious pain, accompanied by vague head pain and obvious hair loss; prolonged menstruation, with acceptable volume and intermittent blood clots; poor night sleep, average appetite, dry stools, one to two lines per day, urine acceptable, dark tongue with thin white coating and thin string pulse. The evidence belongs to internal obstruction of blood stasis and internal trapping of Yang Qi. Treatment is to invigorate blood stasis, warm yang and regulate qi, and at the same time to calm the mind. Prescription: Astragalus membranaceus 15g, Cortex Eucommiae 15g, Radix Rehmanniae 15g, Rhizoma Atractylodes Macrocephalae 9g, Radix Angelicae Sinensis 9g, Rhizoma Chuanxiong 20g, Rhizoma Ligustici 6g, Radix Bupleurum Chinense 9g, Acanthopanax Bark 15g, Acanthopanax Miltiorrhizae 15g, Porphyra 15g, Radix et Rhizoma Cranberry 15g. The above formula was supplemented with 9g of ground turtle worm, 6g of licorice, 9g of ascending marijuana and 30g of Chuanxiong rhizome. 28 postings were added and reduced, the ulcer gradually healed and the vague head pain disappeared, and there was no obvious discomfort during the follow-up period of six months. Comment: The patient has a dull complexion, obvious facial pigmentation, and is easily agitated, and has blood clots during menstruation, so she belongs to blood stasis. Blood is a tangible thing, moving is the norm, and static is stasis. The patient has frequent mouth ulcers and has been taking cold products for a long time to slow down the symptoms, which cools the blood and causes stasis, resulting in prolonged periods and blood clots. The teacher started with the patient’s blood stasis constitution, invigorating the blood and removing stasis, warming the Yang and regulating the Qi, which was as effective as the rafter. In addition, hehuan bark, hehuan rice and fu shin are the common pairs of medicines used by the teacher in the treatment of insomnia. The three medicines work together to relieve depression, calm the heart and tranquilize the mind, so it is also very suitable for treating insomnia due to internal obstruction of blood stasis and Qi Qi. The case of Cao, a 33-year-old male auto repair worker, was first diagnosed on March 18, 2008. He has been suffering from recurrent mouth ulcers for more than 20 years, sometimes light and sometimes heavy, averaging 1~2 times a month, mostly at the lip mucosa, affecting eating and speech when severe, often relieved by spraying watermelon cream, and came to the clinic in search of a cure. On examination, he saw two ulcerated surfaces in the lips, of different sizes, yellowish-white in color, with sunken sores, red eyes and a dry feeling. He has dry mouth, foreign body sensation in the pharynx, easy tiredness, sleepiness, dry stools at times, but urine is fine, light red tongue, thin white fur, and thin pulse. The evidence belongs to disharmony of the liver and spleen, and Qi is not smooth. The treatment is to harmonize the liver and spleen and relax the qi flow. Prescription: Radix Angelicae Sinensis 9g, Radix Paeoniae Alba 15g, Radix Bupleurum Chinense 9g, Poria 9g, Atractylodes Macrocephala 9g, Rhizoma Atractylodis Macrocephala 3g, Radix Achyranthes Bidentatae 9g, Rhizoma Tinctoriae 15g, Tribulus terrestris 15g, Celosia argentea 15g, Glycyrrhiza Uralensis 3g. 7 posts later, the ulcer improved significantly, two punctures were visible in the lips, the eyes were still dry, so the above added Rhizoma Bidentatae 9g, Radix cassiae 15g, Tribulus terrestris 30g, Rhizoma Tinctoriae 30g. After 14 posts, the ulcer was healed and the symptoms improved, and there was no recurrence during the follow-up period of six months. Note: The patient is introverted, does not speak much, and has a foreign body sensation in the throat, which is identified as qi-yu quality. Ling Shu? The pulse degree chapter cloud: “spleen qi pass through the mouth, spleen and then the mouth can know the grains.” The recurrent mouth ulcers in this case are due to the loss of liver drainage and poor qi flow, which affects the transportation of spleen and earth for a long time. Therefore, the treatment combined with the patient’s physique to harmonize the liver and spleen, soothing the qi flow, regulating the liver qi and normalizing the drainage also helps the spleen qi to rise and clear, with the use of Prosperity San, the treatment effect is obvious. A case of phlegm-dampness Han, male, 48 years old, professor in a university. 2010.2.6 Initial diagnosis. He has been in good health and has had recurrent mouth ulcers due to exertion in the past 2 months. On examination, he sees: red and painful gums with multiple small scattered ulcerated surfaces, yellowish in color, with dry mouth and bitter mouth, cheek sores from the hair, reddish in color, sleep and sleep, bowel movement, dark red tongue, thin yellowish greasy moss, and smooth pulse. The evidence belongs to phlegm and stagnation, with inflammation of fire. Treatment is to clear heat and lower fire, resolve phlegm and eliminate stasis. Prescription: Radix et Rhizoma cassiae 30g, Rhizoma Chuanxiong 9g, Radix Panax notoginseng 9g, Radix Scutellariae 15g, Radix Chrysanthemum 9g, Rhizoma Bamboo 9g, Atractylodes Macrocephala 15g, Pericarpium Citri Reticulatae 9g, Gardenia jasminoides 9g, Glycyrrhiza glabra 6g, Rhizoma Asclepias 3g, Almond 6g, Radix Achyranthes bidentatae 9g. After 14 postings, the patient’s symptoms were rested and there was no abnormality in the follow-up period of six months. The patient’s body type is slightly fat, the skin is more greasy, usually like to eat fatty and sweet products, smooth temperament, is phlegm and damp body type. The accumulation of phlegm and dampness affects the flow of qi, which leads to stagnation of qi and stasis. The teacher combined with the phlegm-damp constitution and symptoms to clear heat and lower fire, remove phlegm and eliminate stasis, using the PING GASTRO SAN formula, adding gypsum, scutellaria, gardenia carbon, bamboo rhizome, cassia seeds to clear heat and dampness, and almonds to induce medicine into the lungs to eliminate sores and pimples, the formula was combined, and all the symptoms turned out to be safe. In summary, although the mouth ulcer is a small disease, but easy to recur, so that people have the pain of “open teeth”. According to Article 19 of the Internal Classic, “all painful and itchy sores belong to the heart”, but the sores of the mouth and lips are not solely responsible for the heart. In Liu’s clinical practice, he often treats sores by combining the patient’s constitution with evidence. The same pathogenic factor acting on the human body can result in different symptoms depending on the constitution [2]. According to the Internal Canon, it is known that the spleen opens the mouth, the heart opens the tongue, the kidney pulse connects the pharynx to the tongue, the cheeks and gums belong to the stomach and large intestine, and the pathogenesis of the disease is closely related to the internal organs, and the differences in the physical constitution make the differences in the functions of the internal organs interact. Therefore, the combination of physical identification of medicine will have a unique therapeutic effect.