Mouth Ulcers (Aphtha)

Question 1

What are aphtha? What do they feel like?

Answer 1

• Sores that can appear on any of the soft tissues of mouth including lips, cheeks, gums, tongue, floor and roof of mouth
• AKA canker sores
• Heat sensation, sore and painful

Question 2

Most common age for aphtha in children?

Answer 2

2-4 years old

Question 3

Organ location for aphtha?

Answer 3

Spleen
Stomach
Heart (Liver but only in combination with Heart)
Kidney

Question 4

Symptoms of aphtha?

Answer 4

• Burning or tingling around the sore
• Difficult or painful to eat, drink, swallow, talk, breathe
• May develop blisters
• Redness

Question 5

Match area of mouth aphtha with organ affected.
Tongue
Gums
Mucosa and Lips

Answer 5

Tongue: Heart (but also depends on area of tongue)
Gums: Stomach
Mucosa and Lips : Spleen

Question 6

Pathogeny/Pathogenesis slide

Answer 6

1. Poor diet
2. Heat accumulation
3. Emotions

Question 7

Diagnose cause possibilities?

Answer 7

• Emotional or psychological stress
• Hormone changes
• Intestinal issues IBS or IBD
• Smoking
• Toxins in drinking water
• Vitamin deficiency, B12 or folate
• Weakened immune system

Question 8

What are some diseases to differentiate it from?

Answer 8

Oral thrush (white candida)
Hand, foot and mouth disease (sores all over body)

Question 9

What are the three patterns/syndromes for aphtha?

Answer 9

1. Accumulation of Heat in Heart and Spleen (Flaring up of Heart Fire)
2. Empty Fire ascending to Upper Areas (Empty Heat with Yin Xu)
3. Wind Heat Invading Spleen

Question 10

Primary treatment principles for aphtha?

Answer 10

1. Clear heat, eliminate toxins
2. Nourish Yin
3. Direct fire downwards

Question 11

Flaring Up of Heart Fire S/S

Answer 11

• Dry mouth with desire to drink
• Fever maybe
• Hot burning painful sensation
• Red erosions or ulcers on tongue tip and edges
• Red face
• Restlessness
• Scanty yellow urine
• Tongue: red tip, thin yellow coat
• Pulse: rapid and thready
• Finger: purple venules

Question 12

Flaring Up of Heart Fire
TXP and Formula

Answer 12

TXP:
* Clear Heart
* Cool blood
* Drain fire
* Resolve toxins

Formula: Xie Xin Dao Chi San

Question 13

Xie Xin Dao Chi San ingredients and fx
Guide out the Red Formula modified with Huang Lian and Tong Cao

Answer 13

1. Huang Lian (Coptis) Clear heat, Drain damp, Clear HT fire
2. Mu Tong (Akebia) Clear heat from HT through SI
3. Tong Cao (Rice paper pith) Drain damp, Clear heat, Promote urination
4. Sheng Di Huang (Rehmannia) Cool HT fire, Nourish Yin, Cool blood
5. Zhu Ye (Bamboo leaves) Clear heat from HT
6. Gan Cao (tips) Treat painful urinary dysfunction

Question 14

Empty Heat with Yin Xu aphtha S/S

Answer 14

• Dry mouth
• Dry stools
• Five centre heat
• Light redness of ulcers
• Listless
• Malar flush
• Mouth ulcers recurrent or prolonged, mild pain
• Tongue: red, peeled coat
• Pulse: thready and rapid
• Finger: light purple venules

Question 15

Empty Heat with Yin Xu
TXP and Formula

Answer 15

TXP
- Enrich Yin
- Subdue fire
- Clear deficiency heat

Formula: Zhi Bai Di Huang Wan
(Zhi Mu, Huang Bai, Di Huang Wan)
Anemarrhena, Phellodendron, Rehmannia

Question 16

Zhi Bai Di Huang Wan ingredients and fx

Question 17

Wind Heat Obstructing Spleen aphtha S/S

Answer 17

• Aphtha inside lips, mouth, gums with red border and burning sensation
• Aversion to wind
• Excess salivation
• Fever maybe
• Painful swelling of throat
• Trouble eating
• Tongue: red with thin yellow coat
• Pulse: floating or floating and rapid
• Finger: purple venules

Question 18

Wind Heat Obstructing Spleen
TXP and formula

Answer 18

TXP:
- Clear wind and heat
- Drain fire
- Resolve toxins

Formula: Yin Qiao San

Question 19

Yin Qiao San
Honeysuckle and Forsythia Powder
ingredients and fx

Question 20

7 Acupuncture pts for aphtha

Answer 20

• LI11
• ST25
• ST36
• ST44
• SP15
• HT7
• PC8