In clinical practice, TCM surgery has prepared various pills, powders, and ointments for external use, aimed at treating various wounds (injuries). These preparations accelerate the shedding of necrotic tissue, suppress inflammatory responses, promote granulation tissue growth, and facilitate wound healing. They have a broad antibacterial spectrum and strong antibacterial and sterilizing power, with a long history and extensive clinical applications. Among them, external powders cover a large area and can simultaneously provide protection, astringency, and promote wound healing, making them widely used in surgery, such as the famous Yunnan Baiyao.
Yunnan Baiyao is often used for trauma and pain relief by invigorating blood circulation and resolving blood stasis. The pain it treats is quite severe. In daily life, there is another type of pain that is not very intense but comes and goes unexpectedly, often occurring when one is enjoying food. In a commonly used dialect, it is referred to as “ge ying,” which is none other than the infamous canker sore. As a practitioner of Chinese medicine, one must not stop taking medicine. Today, I will introduce a commonly used external powder for treating recurrent canker sores—Yang Yin Sheng Ji San.
Yang Yin Sheng Ji San
[Formula] Xiong Huang (Realgar) 0.62g, Ren Gong Niu Huang (Artificial Bovine Bile) 0.15g, Qing Dai (Indigo) 0.93g, Long Dan Cao (Gentian) 0.62g, Huang Bai (Phellodendron) 0.62g, Huang Lian (Coptis) 0.62g, Duan Shi Gao (Calcined Gypsum) 0.62g, Gan Cao (Licorice) 0.62g, Bing Pian (Borneol) 0.62g, Bo He (Peppermint) 0.62g.
[Equipment and Analysis Balance, Medicine Spoon, Mortar, Medicine Sieve, etc.
[Preparation Method]
(1) Crush all the medicinal materials and sieve through a 120-mesh sieve.
(2) Place Huang Lian, Huang Bai, Long Dan Cao, and Gan Cao in the mortar,
Grind evenly and pour out.
(3) Place Xiong Huang in the mortar, add Duan Shi Gao
Grind evenly and pour out.
(4) Take Qing Dai and grind evenly, pour out.
(5) Place Bing Pian and Bo He in the mortar, lightly grind,
After grinding evenly, sequentially add Qing Dai, Ren Gong Niu Huang, and Xiong Huang-Duan Shi Gao mixture, ensuring thorough mixing after each addition.
(6) Then add the mixed powder of Huang Lian and the other three herbs, grind evenly until the color is uniform, and bottle it.
After preparation, remember to seal it well, as components like menthol will volatilize. After I finish, I wrap it in paper and put it in my bag. The next day, when I use the tissue from my bag, it becomes fragrant, and thus, my bag turns into a fragrant pouch.
Canker sores, or oral ulcers, are the most common ulcerative lesions of the oral mucosa, primarily characterized by localized round or oval ulcers on the oral mucosa. The ulcers are superficial, pale yellow or white, with a central depression, neat edges, surrounded by a red halo, and are painful, with eating exacerbating the pain. They can be single or multiple and can occur anywhere in the oral mucosa, commonly on the lips, cheeks, and tongue edges. TCM often attributes their occurrence to excessive heart fire, accumulation of heat in the heart and spleen, or internal heat due to yin deficiency. Recurrent canker sores are very common in clinical practice, characterized by periodic recurrence of localized ulcerative lesions of the oral mucosa. Due to the complex etiology, treatment is relatively difficult, and the exact cause is not very clear. It may be related to immune dysfunction, nutritional deficiencies, infections, gastrointestinal diseases, endocrine disorders, microcirculation disturbances, and psychological stress.
Canker sores are common oral mucosal diseases and can be an independent condition or a manifestation of different stages of other diseases in the oral cavity. Although the ulcers have a self-healing characteristic, the pain often brings various suffering and inconvenience to patients. Currently, there is no single medication that can prevent recurrence, so in principle, all medications that can reduce inflammation, relieve pain, and promote ulcer healing can be used for local treatment of oral ulcers.
In Yang Yin Sheng Ji San, Qing Dai is bitter and cold, with effects of cooling blood, detoxifying, and clearing heat; Niu Huang clears heat and detoxifies, calming and cooling; Huang Bai clears heat, drains fire, dries dampness, and resolves ulcer toxicity; Duan Shi Gao absorbs moisture, promotes tissue regeneration, and astringes ulcers; Xiong Huang detoxifies, kills parasites, dries dampness, and resolves phlegm; Long Dan Cao clears heat and dries dampness, draining liver and gallbladder fire; Huang Lian drains lung and stomach fire; Bing Pian opens the orifices, awakens the spirit, clears heat, relieves pain, and facilitates the penetration of medication into the lesion for antiseptic and anti-swelling effects; Bo He disperses wind-heat, reduces swelling and pain, and when used externally, can cause vasoconstriction of skin and mucosal blood vessels; Gan Cao tonifies the spleen, benefits qi, clears heat, detoxifies, and alleviates pain. Yang Yin Sheng Ji San reduces swelling and pain, promotes tissue regeneration, and astringes ulcers, effectively clearing excess heat while nourishing yin, directly acting on the ulcer surface. Compared to systemic medications, it has the advantages of lower dosage, rapid absorption, and effective pain relief, making it suitable for various types of canker sores and an effective medication for treating recurrent canker sores. Clinical observations and patient feedback indicate that Yang Yin Sheng Ji San is generally well-tolerated, significantly reducing pain after use, and patients are generally willing to accept it. Additionally, the ingredients are easy to obtain and inexpensive.
In outpatient settings, very few people come specifically for a canker sore. Most people ask the doctor for a prescription during regular visits, as they seem reluctant to go through the hassle and prefer simple and practical external treatments. Among these, doctors often recommend using powders, and Yang Yin Sheng Ji San is a good choice. However, users often find that it easily falls off and disappears with swallowing. Therefore, there is now a development of film agents for Yang Yin Sheng Ji San, which allows the medication to form a film over the affected area. (Yang Yin Sheng Ji Film is also part of our experimental content…) Commonly used medications include Bing Bor San and Xi Gua Shuang, which are also very inexpensive.
Regarding the treatment of canker sores, I would like to conclude with a truth from the TCM community: Eat well and sleep well!
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