〔Abstract〕 Recurrent aphthous stomatitis is a common clinical oral mucosal disease. Both ancient and modern medical practitioners believe that the location of the disease is closely related to the spleen, and the pathogenic factors are closely associated with heat and hot pathogens. Therefore, summarizing the experiences of various schools of thought, the core of exploring the diagnosis and treatment of recurrent aphthous stomatitis is “spleen disease generates heat”. It is divided into five syndrome types: spleen and stomach hidden heat, damp-heat accumulation, clear yang failure to rise, earth deficiency with floating fire, and blood heat and blood stasis. The treatment should invigorate the spleen and stomach to consolidate the foundation, eliminate pathogenic factors by taking advantage of the situation, regulate qi movement by raising the clear and reducing turbidity, and promote blood circulation and resolve stasis to promote blood flow. Distinguishing between right and wrong, prioritizing treatment of heat and deficiency, and treating accordingly.