bubble_chart Concept

Fetid mouth odor refers to foul-smelling breath emitted from the mouth, which can be noticed by oneself or others.

Due to the varying causes and degrees of fetid mouth odor, historical literature has recorded different descriptions such as "fishy odor," "sticky odor in the mouth," and "fetid mouth odor with a foul and repulsive smell," all of which fall within the scope of this discussion.

bubble_chart Pattern Analysis

1. Stomach Heat︰Fetid mouth odor, thirst with preference for cold drinks, red lips, oral ulcers or erosion, or red, swollen, and painful gums, dark urine, constipation, red tongue with yellow coating, and rapid, forceful pulse. These symptoms often appear in warm febrile diseases, aphthae, gingival atrophy, or due to a diet rich in spicy and greasy foods, leading to internal heat and upward flaming of fire-heat. Manifestations include a red tongue or oral erosion and ulcers, swollen and painful gums with pus and bleeding, dental caries, foul-smelling breath, thirst with preference for cold drinks, dark urine, constipation, red tongue with yellow coating, and other signs of excess heat in the stomach. Treatment should focus on clearing the stomach and purging heat. Stomach-Clearing Decoction or Cimicifuga Rhizome and Coptis Rhizome Pills with modifications can be used. If accompanied by constipation due to excess in the bowels, Diaphragm-Cooling Powder is recommended.
2. Phlegm-heat Congesting the Lung︰Fetid mouth odor, accompanied by chest pain, cough with turbid sputum, or coughing up purulent blood, dry throat, bitter taste in the mouth, dry tongue, reluctance to drink water, yellow and greasy tongue coating, slippery and rapid pulse. Commonly seen in conditions such as lung heat or lung abscess. The disease mechanism involves phlegm-heat congesting the lungs, scorching qi and blood, leading to stasis and abscess formation, with decayed blood turning into pus. Hence, symptoms include coughing up turbid phlegm or purulent blood, fetid mouth odor, chest pain, etc. Treatment should focus on clearing the lung and resolving phlegm to dispel turbidity. Prescriptions include the Thousand Gold Phragmites Stem Decoction or White-Draining Powder.
3. Food Stagnation in the Stomach and Intestines︰Sour and foul breath, epigastric {|###|}abdominal distension and fullness{|###|}, frequent {|###|}belching{|###|}, loss of appetite, alternating constipation or diarrhea, foul-smelling {|###|}flatus{|###|}, thick greasy or curdy greasy {|###|}tongue coating{|###|}, and wiry slippery {|###|}pulse manifestation{|###|}. The syndrome arises from dietary irregularities, impaired gastrointestinal transportation, and stagnation of {|###|}retained food{|###|}, leading to {|###|}food accumulation{|###|}. The clinical features include {|###|}fetid mouth odor{|###|} resembling sour putrefaction or the smell of raw food, as described in the {|###|}Cold-Damage Disease{|###|} Treatise as "dry retching with food odor." It is also accompanied by symptoms of {|###|}food injury (dyspepsia){|###|}, such as epigastric {|###|}abdominal distension and fullness{|###|}, loss of appetite, foul {|###|}belching{|###|}, and greasy dirty {|###|}tongue coating{|###|}. Treatment should focus on resolving stagnation and promoting digestion, with formulas such as Harmony-Preserving Pill or Immature Orange Fruit Stagnation-Removing Pill.

Fetid mouth odor is often caused by the accumulation of heat in the zang-fu organs, or by dampness-heat, food accumulation, or phlegm turbidity. The principle is "similar to the foul smell of damp and stagnant filth" (Jingyue Quanshu). The three syndromes discussed in this section are all excess pattern. In clinical differentiation, stomach heat rising to cause fetid mouth odor is characterized by thirst for cold drinks, mouth and tongue sores, constipation, yellow urine, and a yellow tongue coating; gastrointestinal food accumulation causing fetid mouth odor can be distinguished based on a history of food injury (dyspepsia), dry and foul-smelling breath, acid regurgitation, belching with a rotten smell, abdominal distension and fullness, and a greasy tongue coating; phlegm-heat congesting the lungs causing fetid mouth odor is characterized by coughing up foul-smelling sputum and chest fullness with pain. By grasping the characteristic features of the syndromes, they can be differentiated.

bubble_chart Documentation

1. Rumen ShiqinVolume 6: "A man in his twenties from the Quping Shang family suffered from a condition where his breath emitted a foul odor, as pungent as a latrine. Even his relatives refused to speak with him face-to-face. Dai Ren said: 'The lung metal originally governs the sense of smell. When metal is refined by fire, and fire governs scorched odors, this is the result. Over time, it leads to decay, and decay is associated with the kidneys. This extreme heat then takes on the characteristics of water transformation. For diseases located in the upper body, it is appropriate to induce vomiting. First, use the Tea-Regulating Powder to induce vomiting and remove seven-tenths of the condition. At night, use Boats and Carts Pill and Jun Chuan Powder to induce five to seven bowel movements. By the next morning, the foul odor was completely gone. Alas! There are people who suffer from fetid mouth odor and live with it until old age. The world mistakenly believes that it is due to a misalignment of the lung system connecting with the stomach, causing the odor. This is a false theory.'"
2. Shoushi BaoyuanVolume 6: "A man with fetid mouth odor, red and ulcerated gums, and weak legs and knees was treated with Phelloendron Bark and other medicines, which only worsened his condition. At times, he also experienced a salty taste in his mouth. This was due to deficient heat in the kidney meridian. He was cured entirely with the Six-Ingredient Pill."