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Canker Sores (Aphthous Ulcers)

How Chinese medicine differentiates canker sores, the six patterns you'll actually meet in practice, and the points for each. Acupuncture only — no herbs.

This page is educational, for practitioners and students — it is not a diagnostic tool and does not replace a proper in-person assessment. Ulcers that don't heal within two to three weeks, or that recur very frequently, need medical evaluation to rule out other causes before acupuncture is considered.
General Acupuncture Points

Acupuncture points traditionally used for canker sores — 17 key points, used across the patterns below rather than tied to just one.

PointKey action
HE-7Calms the Mind and opens the Mind's orifices. Nourishes Heart-Blood.
HE-5Calms the Mind. Tonifies Heart-Qi. Benefits the tongue.
HE-8Clears Heart-Fire, Heart Empty-Heat and Heart Phlegm-Fire. Calms the Mind.
KI-1Nourishes Yin and clears Empty-Heat. Calms the Mind.
ST-44Clears Heat. Regulates the Intestines and resolves Damp-Heat.
L.I.-4Expels exterior Wind, stops pain, removes obstructions from the channel.
ST-6Expels Wind. Removes obstructions from the channel.
KI-3Tonifies the Kidneys (Yin and Yang). Strengthens Essence.
KI-6Nourishes Kidney-Yin. Calms the Mind. Benefits the throat.
SP-6Strengthens the Spleen, resolves Dampness, nourishes Blood and Yin.
ST-40Resolves Phlegm and Dampness, subdues rebellious Qi.
ST-36Benefits Stomach and Spleen, tonifies Qi and Blood.
Ren-4Tonifies Kidney-Yang and the Original Qi.
BL-23Tonifies Kidney-Yang.
SP-10Cools Blood, invigorates Blood and eliminates stasis.
BL-17Gathering (Hui) point for Blood — moves Blood.
LR-3Subdues Liver-Yang, promotes the smooth flow of Liver-Qi, invigorates Blood.
The Six Patterns

reinforcing   reducing   even method.

1. Heart-Fire Blazing View full pattern →

Clinical manifestations: Intensely painful, burning ulcers on the tip of the tongue with red, raised edges; mental restlessness, anxiety and insomnia; thirst with a preference for cold drinks; a flushed red face.
Tongue: Red with a distinctly redder tip and a dry yellow coating. Pulse: Rapid, forceful.
Treatment principle: Clear Heart-Fire and guide it downward through the Small Intestine channel, draining the Excess-Heat driving the tongue ulcers.
Clear Heart-Fire
Nourish Yin to balance Fire
Note: no moxa. Direct match with Heart-Fire blazing — "mouth and tongue ulcers" is listed as one of its key diagnostic symptoms.

2. Stomach Fire (Stomach-Heat) View full pattern →

Clinical manifestations: Ulcers on the gums, lips and inner cheeks; sharp burning pain; foul breath; intense thirst; constipation.
Tongue: Red with a thicker red centre and a thick yellow coating. Pulse: Rapid, Slippery, full.
Treatment principle: Clear Stomach-Heat and cool the Blood while nourishing Yin, addressing the source of the burning ulcers along the Stomach channel's facial pathway.
Note: no moxa. Direct match with Stomach-Heat (or Phlegm-Heat) — "mouth ulcers" and foul breath are explicitly listed among its manifestations.

3. Empty-Heat from Yin Deficiency View full pattern →

Clinical manifestations: Recurrent, shallow ulcers with only mild burning pain; a dry mouth that worsens at night; night sweats; heat sensations in the palms and soles; fatigue brought on by overwork.
Tongue: Red, thin, dry, with cracks and little coating. Pulse: Fine, Rapid, weak on deep pressure.
Treatment principle: Nourish Yin to anchor Yang and clear the deficiency-Heat rising upward to the mouth.
Note: no moxa. Matches Kidney-Yin deficiency, Empty-Heat blazing — night sweats, five-palm heat, a dry throat at night and a Red cracked tongue without coating share the same Empty-Heat mechanism.

4. Damp-Heat in the Stomach View full pattern →

Clinical manifestations: Sunken, slow-healing ulcers that ooze a yellow fluid; a heavy body sensation; a sticky taste; bad breath; bloating and nausea; loose, incomplete bowel movements.
Tongue: Red, swollen, with a yellow greasy coating that is difficult to scrape off. Pulse: Slippery, Rapid.
Treatment principle: Clear Heat and drain Dampness while regulating Qi in the Middle Burner, resolving the sunken, weeping quality of these ulcers.
Clear Damp-Heat
Support Stomach
Note: no moxa. Direct name match with Damp-Heat in the Stomach — shares the sticky taste, heaviness and nausea of a Stomach obstructed by Damp-Heat.

5. Kidney and Spleen Yang Deficiency View full pattern →

Clinical manifestations: Pale, non-healing ulcers with little or no pain; cold hands and feet; loose stools; soreness in the lower back; fatigue and weak digestion.
Tongue: Pale, swollen, puffy with tooth marks and a white slippery coating. Pulse: Deep, weak, Slow.
Treatment principle: Warm Yang and disperse Cold to restore the digestive fire and anchor the floating Heat that is keeping these ulcers from healing.
Note: moxa applicable. Matches Kidney- and Spleen-Yang deficiency — the same constitutional Yang-deficiency-with-Cold picture (backache, cold, loose stools, Deep-Weak pulse).

6. Blood Stagnation

Clinical manifestations: A stabbing, fixed pain at the ulcer site; a dark, purplish discoloration and dusky lips; pain that worsens at night during rest; chronic, non-healing sores.
Tongue: Purple or dusky with stasis spots and distended sublingual veins. Pulse: Choppy or Wiry.
Treatment principle: Invigorate Blood and dispel stasis while moving Qi, relieving the fixed pain and discoloration of a long-standing sore.
Invigorate Blood
Support
Note: no moxa. Matches Liver-Blood stasis — purple lips and a purple or dark complexion are listed manifestations, and its clinical tip is that stabbing pain with a purple tongue is enough to diagnose this pattern.
Related conditions

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