Oral greasiness refers to a sticky and sluggish sensation in the mouth and tongue, which can be so severe that one cannot taste food properly.

This symptom was often mixed with conditions like "dry mouth without desire to drink" in ancient medical literature. It was not until the warm diseases school in the Qing Dynasty that it was specifically referred to as "oral stickiness" or "sticky mouth and tongue."

The symptom of oral greasiness is often accompanied by abnormal tastes such as bitter taste in the mouth, sweet taste, sour taste, or bland taste, with the main clinical manifestation being a sticky sensation in the mouth and tongue. Other conditions primarily characterized by abnormal tastes are not within the scope of this discussion and can be referred to in related entries.

bubble_chart Pattern Analysis

1. Spleen Deficiency with Dampness Retention︰The mouth feels sticky with a bland taste, no thirst, no desire for food or drink, epigastric fullness, fatigue and lack of strength, loose stools, scanty urination, a pale and swollen tongue with a white, greasy, and slippery coating, and a soggy, slow pulse. This is due to the patient's constitutional deficiency-cold of the spleen and stomach, dampness transforming from cold, and spleen yang being constrained, leading to impaired transportation and transformation. Hence, the sticky sensation in the mouth is mild, with a bland taste and a lack of thirst. Treatment should focus on aromatic herbs for resolving dampness, invigorating the spleen, and drying dampness. The recommended formulas are Patchouli Qi-Righting Powder and Stomach-Calming Powder.
2. Dampness-heat︰Sticky and astringent mouth, fetid mouth odor filthy turbidity, loss of taste, dry mouth without desire to drink, epigastric abdominal distension and fullness, reduced appetite, loose stool with foulness, dark urine, tongue texture red with yellow greasy coating, soggy and rapid or wiry and rapid pulse. Mostly due to accumulated heat in the spleen and stomach, dampness-heat steaming upward to the mouth, hence the severe stickiness and astringency in the mouth, along with fetid mouth odor filthy turbidity, thirst without desire to drink. The key points for differentiation are: in cases of cold-dampness encumbering the spleen, the stickiness in the mouth is milder, with bland taste in mouth and lack of flavor, no thirst, loose stool that is thin, pale tongue with white coating, soggy and slow pulse; in cases of dampness-heat obstructing the middle, the stickiness in the mouth is more severe, with fetid mouth odor filthy turbidity, poor taste sensation, either bitter or sweet, thirst without desire to drink, sticky and unsmooth stool, dark urine, red tongue with yellow coating, and rapid pulse. Treatment should focus on clearing heat and resolving dampness, using formulas such as Three-Kernel Decoction, Patchouli, Magnolia Bark, Pinellia and Poria Decoction. If accompanied by sweet taste in the mouth, dampness-heat is mostly in the spleen and stomach, and aromatic herbs to dispel turbidity and awaken the spleen should be added, selecting Basil Herb Drink or Sweet Dew Detoxicating Pill; if accompanied by bitter taste in mouth and hypochondriac pain, dampness-heat often involves the liver and gallbladder, and Gentian Liver-Draining Decoction may be chosen, or Coptis and Magnolia Bark Decoction with modifications.
3. Hot Phlegm︰The mouth feels sticky and greasy, thirst without desire to drink, fullness and oppression in the chest and diaphragm, restlessness and unease, yellow and sticky sputum that is difficult to expectorate, reduced appetite (anorexia), a red tongue with yellow, greasy, and dry coating, and a slippery and rapid pulse. This condition is often caused by spleen deficiency failing to transport, leading to the accumulation of dampness and the production of phlegm, which over time transforms into heat; or by qi depression transforming into fire, which scorches fluids into phlegm, resulting in phlegm-heat obstruction and the sensation of stickiness in the mouth and tongue. The clinical features include: a sticky and greasy sensation in the mouth, thirst without desire to drink, often with yellow sputum that is difficult to expectorate, fullness and oppression in the chest and diaphragm, restlessness and unease, a red tongue with yellow coating, and a slippery and rapid pulse. It is relatively easy to differentiate this from the sticky mouth caused by cold-dampness encumbering the spleen, but it can be quite similar to the sticky mouth caused by dampness-heat obstructing the middle burner. In the case of dampness-heat obstructing the middle burner, there are loose stools that are foul and incomplete, dark urine, distension and fullness in the epigastric and abdominal regions, and a pulse that is often soggy and rapid or wiry and rapid. In contrast, phlegm-heat obstruction causing a sticky mouth is often accompanied by the expectoration of thick yellow sputum, with the sensation of fullness and oppression localized to the chest and diaphragm, and a pulse that is mostly slippery and rapid. For phlegm-heat obstruction causing a sticky mouth, the treatment should focus on clearing heat and resolving phlegm. The recommended formula is Coptis RhizomeGallbladder-Warming Decoction, or alternatively, theQi-Clearing and Phlegm-Resolving Pill.