论
《内经》曰∶百病之起，有生于本者，有生于标者。夫齿者，肾之标，骨之余也。足阳明胃之脉贯络于齿上龈，手
阳明大肠之脉贯络于齿下龈，手阳明恶寒饮而喜热饮，足阳明恶热饮而喜寒饮，故其为痛有恶寒恶热之不同也。有开口
呷风则痛甚者，肠胃中有风邪也。有开口则秽臭不可近者，肠胃中有积热也。或谓痛而齿动摇，或谓痛而虫侵蚀，又有
齿缝疏豁饮食不便者，比比是也。大抵齿龈宣露而动摇者，肾元虚也，治宜滋阴补肾为要。憎寒恶热而口臭秽者，胃气
热也，治宜安胃泻火为良。其所谓风邪虫蚀之证，盖因热生风而风生虫也。肠胃之火既平，更加以擦牙诛虫之药以治其
标，无有不安之理也，学人详之。
脉法
右寸关脉洪数，或弦而洪，肠胃中有风热，齿痛。
尺脉洪大而虚者肾虚，主齿动摇疏豁，相火上炎而痛。
方法
丹溪曰∶牙痛或出血，属热，胃中有热，有风寒，有虫，有湿热。实热肿痛，调胃承气加黄连，又用升麻、白芷、
防风、荆芥、薄荷、甘草、桔梗之类，外用胡桐泪、麝香擦之。
灸法∶上片痛，灸足三里二穴（在足阳明经，膝下三寸， 骨外，大筋内陷中，灸七壮）；下片痛，灸手
三间二穴（在手大指次指本节后内侧陷中，手阳明大肠经，灸七壮）。
治虫牙痛，用韭菜子，以黄蜡包之，外以瓦片烧红，将韭子蜡丸置于其上，又别糊一纸袋如巨螺样，上以小竹管为
袋嘴，将袋复于蜡丸上，以竹管拄于齿窍中，接烟熏之，其虫即死而愈。
治走马牙疳方，其效如神。
干姜 南枣（各烧存性） 枯白矾
上各等分为末，敷之即愈。
小儿走马牙疳，牙床一齐腐烂即死，此方神效。
妇人尿桶中白垢，火 一钱，入铜绿三分，麝香一分半，敷之立愈。
（以上丹溪方法凡五条）
麝香散（东垣） 治热多寒少，牙龈露，肉脱血出，齿动欲落，疼痛妨食，恶寒少，恶热多。
熟地黄（二分） 益智仁（二分半） 当归身 生地黄 麻黄根 酒汉防己 人参（各五分） 升麻（一钱） 草
豆蔻 黄连（各一钱五分） 羊胫骨灰（二钱） 麝香（少许）
上为末，先用温水漱口净，擦之。
草豆蔻散（东垣） 治寒多热少，牙齿疼痛。
细辛叶 防风（各二分） 羊胫骨灰 熟地黄（各五分） 当归（六分） 草豆蔻 黄连（各一钱三分） 升麻（二
钱五分）
上为细末，如前法擦之。
羌活散 治客寒犯脑，及风寒凑袭，脑痛项筋急，牙齿痛动摇，肉龈袒脱疼痛。
本 香白芷 桂枝（各三分） 苍术 升麻（各五分） 当归身（六分） 草豆蔻（一钱） 羌活（一钱五分） 羊
胫骨灰（二钱） 麻黄（去根节） 防风（去芦，各三钱） 柴胡（五钱） 细辛（少许）
上为细末，如前法擦之，立愈。
白牙散（东垣）
白芷（七分） 升麻（一钱） 石膏（一钱五分） 羊胫骨灰（二钱） 麝香（少许）
上为细末，如前法擦之，立效。
独圣散（东垣） 治一切牙痛风疳等证。
北地蒺藜（不拘多少，阴干）
上为细末，每用刷牙，以热浆水漱牙，外用粗末熬浆水刷牙，大有神效。
立效散（东垣） 治牙齿痛不可忍，微恶寒饮，大恶热饮，其脉上中下三部阴胜阳虚，是五脏内盛，六腑阳道
脉微小，小便滑数。
细辛（三分） 炙甘草（五分） 升麻（七分） 防风（一钱） 草龙胆（洒洗，三钱）
上为细末，作一服，水一盏，煎至七分，去渣，以匙抄在口中，漱痛处，待少时则止。如多恶热饮，更加草龙胆一
钱。此法不定，随寒热多少，临时加减。若更恶风作痛，加豆蔻、黄连各五分，勿加草龙胆。
牢牙散（东垣） 治牙龈肉绽有根，牙疳肿痛，牙齿动摇欲落，牙齿不长，牙黄口臭。
羌活（一两） 草龙胆（酒洗，一两五钱） 羊胫骨灰（二两） 升麻（四两）
上为细末，临卧时贴牙龈上。
清胃散（东垣） 治因服热药，或食辛热之物，致使上下牙疼痛不可忍，牵引头脑，满面发热大痛，足阳明之
别络入脑，喜寒恶热，乃是手阳明经中热盛而作也，其齿喜冷恶热。
当归身 黄连（夏月倍用） 生地黄（酒制，各三分） 牡丹皮（五分） 升麻（一钱）
上为细末，作一服，水一盏半，煎至一盏，滤去渣，带凉服。
神功丸（东垣） 治多食肉人，口臭不可近，牙齿疳蚀，牙龈肉将脱，牙齿落，血不止。
兰香叶（如无藿香代之） 当归身 藿香叶 木香（各一钱） 升麻（一钱） 生地黄（酒洗） 甘草（生，
各三钱） 黄连（酒洗） 缩砂仁（各五钱）
上共为细末，汤浸蒸饼为丸，如绿豆大，每服一百丸，或加至二百丸止，白汤下，食远服。此药兼治血痢，及血崩，
及血下不止，血下褐色，或紫色，或黑色，及肠 下血，空心服，米汤下，其脉洪大而缓者，及治麻木，血气上冲，逆
气上行，妄闻妄见者，皆效。
（祖传方）
治胃有实热齿痛，或上 痛尤甚者。
用凉膈散，以大黄酒蒸为君，加知母、石膏、升麻为佐，频频含咽即愈。
又方 治胃热齿痛，口臭秽不可近者。
用大黄牡荆一、二十斤，于火上烹沥，入姜汁六分之一，时时含咽，甚效。
又擦牙止痛方
用黄虿蜂窠一个，以川椒填满其窍，更以白盐一钱封口，烧存性，入香白芷、羊胫骨灰各一钱，同研为细末，先以
清茶漱口净，然后以此药擦之，及敷痛处。如有虫蛀孔作痛，以少许塞于孔中立愈。
又灸法亦妙∶
列缺二穴，在手太阴肺经与阳明经相连，叉手取穴中指尽处、又看其浮脉丫叉之间，灸七壮，其痛立止，永不再发。
Discussion
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The onset of various diseases arises either from the root (ben, fundamental cause) or from the branch (biao, superficial manifestation). Teeth are the external manifestation of the Kidney and the surplus of bone essence. The Foot-Yangming Stomach Meridian penetrates and connects with the upper gums, while the Hand-Yangming Large Intestine Meridian penetrates and connects with the lower gums. The Hand-Yangming meridian dislikes cold drinks and prefers hot drinks; the Foot-Yangming meridian dislikes hot drinks and prefers cold drinks. Therefore, toothache may present differently as either aversion to cold or aversion to heat. Cases where pain worsens upon opening the mouth to inhale wind indicate Wind pathogen in the intestines and stomach. Cases where an offensive odor emanates upon opening the mouth indicate accumulated Heat in the intestines and stomach. Some report pain accompanied by loose teeth, some report pain due to worm erosion, and others report difficulty eating due to wide interdental spaces; such cases are common. Generally, receding gums exposing the roots and loose teeth indicate deficiency of Kidney Yuan Qi; treatment should prioritize nourishing Yin and tonifying the Kidney. Aversion to cold, dislike of heat, and foul breath indicate Heat in Stomach Qi; treatment should soothe the Stomach and purge Fire. The so-called Wind pathogen and worm erosion syndromes generally arise because Heat generates Wind, and Wind generates worms. Once the Fire in the intestines and stomach is pacified, applying topical drugs for cleaning teeth and eliminating worms to treat the branch symptoms will ensure recovery. Students of medicine should study this carefully.
Pulse Diagnosis
A surging and rapid pulse at the Cun and Guan positions on the right hand, or a wiry and surging pulse, indicates Wind-Heat in the intestines and stomach causing toothache.
A surging yet empty pulse at the Chi position indicates Kidney deficiency, manifesting as loose teeth and wide interdental spaces, with ministerial fire flaming upward causing pain.
Methods
Zhu Danxi stated: Toothache or bleeding belongs to Heat syndrome. It may be caused by Heat in the Stomach, Wind-Cold, worms, or Damp-Heat. For excess Heat causing swelling and pain, use Tiaowei Chengqi Tang (Regulate the Stomach Orderly Laxative Decoction) added with Huanglian (Coptidis Rhizoma). Additionally, use Shengma (Cimicifugae Rhizoma), Baizhi (Angelicae Dahuricae Radix), Fangfeng (Saposhnikoviae Radix), Jingjie (Schizonepetae Spica), Bohe (Menthae Haplocalycis Herba), Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), etc. Externally, apply Hutonglei (Tinosporae Caulis) and Shexiang (Moschus) for rubbing.
Moxibustion Method: For upper jaw pain, moxa-burn two points of Zusanli (ST36) (located on the Foot-Yangming meridian, three cun below the knee, lateral to the patella, in the depression within the large tendon; seven moxa cones). For lower jaw pain, moxa-burn two points of Sanjian (LI3) (located medial to the depression proximal to the metacarpophalangeal joint of the index finger, on the Hand-Yangming Large Intestine meridian; seven moxa cones).
To treat caries-induced toothache, use Chuijiazi (Trichosanthis Semen) wrapped in beeswax. Place the wax pill on a red-hot tile. Prepare a paper bag shaped like a large snail with a small bamboo tube as the spout. Cover the wax pill with the bag, insert the bamboo tube into the dental cavity, and smoke the area with the fumes until the worms die and the condition resolves.
Formula for treating Gangrenous Gingivitis (Zouma Yagan), which is highly effective.
Ganjiang (Zingiberis Rhizoma), Nanzao (Jujubae Fructus) (both calcined to retain nature), Kubaifan (Alumen).
Grind equal parts into powder and apply to the affected area for immediate cure.
For pediatric gangrenous gingivitis, if the gum tissue necrotizes completely, death ensues; this formula is miraculous.
White scale from women's urine buckets, calcined (1 qian), mixed with Tonglv (Chalcostyptum) (3 fen) and Shexiang (Moschus) (1.5 fen); apply for immediate cure.
(Above are five methods from Danxi)
Shexiang San (Musk Powder) (Li Dongyuan): Treats Heat predominating over Cold, receding gums, muscle atrophy with bleeding, loose teeth threatening to fall out, pain interfering with eating, slight aversion to cold, severe aversion to heat.
Shudihuang (Rehmanniae Radix Praeparata) (2 fen), Yizhiren (Alpiniae Oxyphyllae Fructus) (2.5 fen), Dangguishen (Radix Angelicae Sinensis - root body), Shengdihuang (Rehmanniae Radix), Mahuanggen (Ephedrae Radix et Rhizoma), Jiu Hanfangji (Stephaniae Tetrandrae Radix prepared with wine), Renshen (Ginseng Radix et Rhizoma) (each 5 fen), Shengma (Cimicifugae Rhizoma) (1 qian), Caodoukou (Alpiniae Katsumadai Semen), Huanglian (Coptidis Rhizoma) (each 1.5 qian), Yangjingguhui (Ash of Sheep Tibia Bone) (2 qian), Shexiang (Moschus) (a little).
Grind into powder. Rinse mouth thoroughly with warm water first, then apply/rub.
Caodoukou San (Alpiniae Katsumadai Seed Powder) (Li Dongyuan): Treats Cold predominating over Heat, toothache.
Xixin Ye (Asari Folium), Fangfeng (Saposhnikoviae Radix) (each 2 fen), Yangjingguhui (Ash of Sheep Tibia Bone), Shudihuang (Rehmanniae Radix Praeparata) (each 5 fen), Danggui (Angelicae Sinensis Radix) (6 fen), Caodoukou (Alpiniae Katsumadai Semen), Huanglian (Coptidis Rhizoma) (each 1.3 qian), Shengma (Cimicifugae Rhizoma) (2.5 qian).
Grind into fine powder and apply/rub as described above.
Qianghuo San (Notopterygii Rhizoma et Radix Powder): Treats invading Cold affecting the brain, and Wind-Cold aggregation causing headache, neck stiffness, toothache with loosening, and exposed/detached painful gingiva.
Bencao (Ligustici Rhizoma et Radix), Xiangbaizhi (Angelicae Dahuricae Radix), Guizhi (Cinnamomi Ramulus) (each 3 fen), Cangzhu (Atractylodis Rhizoma), Shengma (Cimicifugae Rhizoma) (each 5 fen), Dangguishen (Radix Angelicae Sinensis - root body) (6 fen), Caodoukou (Alpiniae Katsumadai Semen) (1 qian), Qianghuo (Notopterygii Rhizoma et Radix) (1.5 qian), Yangjingguhui (Ash of Sheep Tibia Bone) (2 qian), Mahuang (Ephedrae Herba - remove root joints), Fangfeng (Saposhnikoviae Radix - remove radicles) (each 3 qian), Chaihu (Bupleuri Radix) (5 qian), Xixin (Asari Radix et Rhizoma) (a little).
Grind into fine powder and apply/rub as described above for immediate cure.
Baiya San (White Tooth Powder) (Li Dongyuan):
Baizhi (Angelicae Dahuricae Radix) (7 fen), Shengma (Cimicifugae Rhizoma) (1 qian), Shigao (Gypsum Fibrosum) (1.5 qian), Yangjingguhui (Ash of Sheep Tibia Bone) (2 qian), Shexiang (Moschus) (a little).
Grind into fine powder and apply/rub as described above for immediate effect.
Dusheng San (Single Holy Powder) (Li Dongyuan): Treats all types of toothache, Wind-tooth conditions, and gingivitis.
Beidi Jili (Tribuli Fructus from Northern regions) (any amount, dried in shade).
Grind into fine powder. Use for brushing teeth each time, rinse with hot starch water. Externally, brush teeth with coarse powder decocted in starch water; highly effective.
Lixiao San (Immediate Effect Powder) (Li Dongyuan): Treats unbearable toothache, slight aversion to cold drinks, severe aversion to hot drinks. Pulse shows Yin excess and Yang deficiency across Upper, Middle, and Lower positions, indicating internal fullness of the Five Zang organs and minute Yang meridians of the Six Fu organs, with slippery and rapid urination.
Xixin (Asari Radix et Rhizoma) (3 fen), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) (5 fen), Shengma (Cimicifugae Rhizoma) (7 fen), Fangfeng (Saposhnikoviae Radix) (1 qian), Cao Longdan (Gentianae Macrophyllae Radix - washed with liquor) (3 qian).
Grind into fine powder. Take as one dose. Decoct in one cup of water until reduced to 0.7 cups. Strain. Spoon into mouth, rinse painful area, hold for a moment, then spit out. If severe aversion to hot drinks exists, add Cao Longdan (Gentianae Macrophyllae Radix) 1 qian. This method is flexible; adjust based on degree of Cold/Heat. If wind-aversion causes pain, add Doukou (Cardamomi Fructus) and Huanglian (Coptidis Rhizoma) 0.5 qian each; do not add Cao Longdan.
Laoya San (Teeth-Firming Powder) (Li Dongyuan): Treats gingival tearing with roots, gingivitis with swelling/pain, loose teeth threatening to fall out, failure of teeth to erupt, yellow teeth, and bad breath.
Qianghuo (Notopterygii Rhizoma et Radix) (1 liang), Cao Longdan (Gentianae Macrophyllae Radix - wine-washed) (1.5 liang), Yangjingguhui (Ash of Sheep Tibia Bone) (2 liang), Shengma (Cimicifugae Rhizoma) (4 liang).
Grind into fine powder. Apply to gums before sleep.
Qingwei San (Stomach-Clearing Powder) (Li Dongyuan): Treats unbearable pain in upper and lower teeth caused by taking hot medicines or eating spicy/hot foods, radiating to the head, causing facial fever and severe pain. The collateral of Foot-Yangming enters the brain; it prefers cold and dislikes heat. This is due to excess Heat in the Hand-Yangming meridian; teeth prefer cold and dislike heat.
Dangguishen (Radix Angelicae Sinensis - root body), Huanglian (Coptidis Rhizoma) (double dose in summer), Shengdihuang (Rehmanniae Radix - wine-processed) (each 3 fen), Mudanpi (Moutan Cortex) (5 fen), Shengma (Cimicifugae Rhizoma) (1 qian).
Grind into fine powder. Take as one dose. Decoct in 1.5 cups of water until reduced to 1 cup. Strain. Take cool.
Shengong Wan (Divine Merit Pill) (Li Dongyuan): Treats halitosis intolerable to others, dental caries, impending gingival detachment, tooth loss, and unceasing bleeding in those who consume excessive meat.
Lanxiangye (Perillae Folium; substitute Huoxiang Pogostemonis Herba if unavailable), Dangguishen (Radix Angelicae Sinensis - root body), Huoxiangye (Pogostemonis Herba), Muxiang (Aucklandiae Radix) (each 1 qian), Shengma (Cimicifugae Rhizoma) (1 qian), Shengdihuang (Rehmanniae Radix - wine-rinsed), Gancao (Glycyrrhizae Radix et Rhizoma - raw) (each 3 qian), Huanglian (Coptidis Rhizoma - wine-washed), Suosharen (Amomi Fructus Rotundus) (each 5 qian).
Grind together into fine powder. Soak in soup, steam with rice cake dough, and form pills the size of mung beans. Take 100 pills per dose, up to 200 pills, with plain warm water, taken well after meals. This medicine also treats bloody dysentery, uterine bleeding, persistent lower bleeding, brown/purple/black colored blood, intestinal bleeding; take on an empty stomach with rice gruel. It is effective for surging yet slow pulses, numbness, rising blood/qi, rebellious qi ascending, auditory/visual hallucinations.
(Ancestral Formula)
For toothache due to excess Heat in the Stomach, or especially severe upper pain.
Use Liangge San (Cool the Chest Powder), using Da Huang (Rhei Radix et Rhizoma - steamed with wine) as the sovereign herb, adding Zhimu (Anemarrhenae Rhizoma), Shigao (Gypsum Fibrosum), and Shengma (Cimicifugae Rhizoma) as assistant herbs. Frequently hold in mouth and swallow for cure.
Another Formula: For toothache due to Stomach Heat and intolerable foul breath.
Use Da Huang (Rhei Radix et Rhizoma) and Mujing (Vitexis Trilobae Fructus) 1 to 20 jin. Cook over fire to extract juice. Add 1/6th ginger juice. Hold in mouth and swallow frequently; very effective.
Another Tooth-Rubbing Pain Relief Formula
Take one hornet nest of Huangchai Feng. Fill its holes with Chuanjiao (Sichuan Pepper). Seal with 1 qian of Baiyan (Halitum). Calcine until nature is retained. Add Xiangbaizhi (Angelicae Dahuricae Radix) and Yangjingguhui (Ash of Sheep Tibia Bone) 1 qian each. Grind to fine powder. Rinse mouth with clear tea first, then rub with this powder and apply to painful areas. If pain is from worm holes, insert a small amount into the hole for immediate cure.
Another Moxibustion Method is also excellent:
Lieque (LU7) two points. Located where the Hand-Taiyin Lung Meridian connects with the Yangming meridian. Cross hands to find the point at the end of the middle finger, looking between the fork-like pulse branches. Moxa-burn seven cones; pain stops immediately and never recurs.