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1. The teeth are the surplus of bone and belong to the Kidney; the gums belong to the Hand-Yangming Large Intestine channel and Foot-Yangming Stomach channel. Teeth elongation, spacing, and mobility indicate Kidney exhaustion; toothache is caused by Stomach Fire, Wind-Cold, or worms. Insensitivity to hot and cold indicates Wind pain; swelling with a preference for cold and aversion to heat indicates Fire pain; non-swelling with caries and a preference for hot drinks indicates Cold pain; worm-induced toothache involves the erosion of one tooth followed by another.
[Note] Teeth are the surplus of bone and belong to the Kidney. If teeth unexpectedly elongate, become spaced, and loose, it signifies Kidney Qi exhaustion. The upper gums belong to the Foot-Yangming Stomach channel, and the lower gums belong to the Hand-Yangming Large Intestine channel. Toothaches generally stem from gum pain. Only cold-type toothache is caused by exogenous Cold invading the brain, often manifesting as headache radiating to the teeth due to Cold pathogen, hence preferring hot drinks without swelling or caries. Other cases are caused by Stomach Fire, Wind pathogens, or Damp-Heat. Fire-type toothache often presents with swelling and a preference for cold drinks; pain worsening upon exposure to cold reflects the principle of "rejection" (antagonism). Worm-induced toothache affects one tooth at a time; after one is eroded, the next becomes painful.

Gu Cao Feng (Bone Trough Wind) and Ya Gan Chuang (Tooth Gangrene Ulcer)
2. Gu Cao Feng presents with swelling, hardness, and pain in the gums extending to the cheek; Ya Gan Chuang presents with gum rotting, bleeding, and suppuration; severe Ya Gan presents with swelling, hardness, ulceration, bloody discharge, and foul odor. These conditions arise following variola (smallpox/varioloid) or Pi Ji (accumulation disorders).
[Note] Gu Cao Feng refers to hard swelling and pain in the gums extending to the cheek, with gum rotting and discharge of blood and pus. Ya Gan refers to persistent hard swelling after the ulceration of Gu Cao Feng, discharging foul-smelling blood but not pus, occurring subsequent to variola or Pi Ji.

Qing Wei San (Clear the Stomach Powder)
3. Qing Wei San treats toothache due to Fire in the Blood level, containing Sheng Di Huang (Rehmanniae Radix), Dang Gui (Angelicae Sinensis Radix), Huang Lian (Coptidis Rhizoma), Sheng Ma (Cimicifugae Rhizoma), and Mu Dan Pi (Moutan Cortex). For greater effect, increase Sheng Ma and Mu Dan Pi. For Heat in the Qi level, add Jing Jie (Schizonepetae Herba), Fang Feng (Saposhnikoviae Radix), and Xi Xin (Asari Radix et Rhizoma). For accumulated Heat, add Sheng Ma and Shi Gao (Gypsum Fibrosum) from Liang Ge San (Cool the Diaphragm Powder).
[Note] Toothache due to Stomach Fire with red, swollen, and bleeding gums belongs to the Blood level; use Qing Wei San, composed of Sheng Di Huang, Dang Gui, Huang Lian, Sheng Ma, and Mu Dan Pi. "Rao" implies doubling the dosage of Sheng Ma and Mu Dan Pi. If gums are swollen and painful without bleeding, it belongs to the Qi level; add Jing Jie, Fang Feng, and Xi Xin to dissipate Heat. For intestinal and gastric accumulated Heat causing swelling, pain, and foul breath, use Liang Ge San augmented with Sheng Ma and Shi Gao to purge Heat downward.

Wen Feng San (Warm Wind Powder)
4. Wen Feng San treats Wind-induced toothache, containing Dang Gui, Chuan Xiong (Ligustici Chuanxiong Rhizoma), Xi Xin, Bi Bo (Piperis Kadsurae Fructus), Xi Xin (Ligustici Wallichii Rhizoma - *Note: Text says ?? Ben, likely Gao Ben*), Bai Zhi (Angelicae Dahuricae Radix), and Lu Feng Fang (Vespa Nidus). For Cold toothache, add Qiang Huo (Notopterygii Rhizoma et Radix), Ma Huang (Ephedrae Herba), and Chuan Fu Zi (Aconiti Lateralis Radix Praeparata). Take half orally and gargle with half, spitting out saliva for good results.
[Note] Mild pain insensitive to temperature changes indicates Wind toothache; use Wen Feng San, composed of Dang Gui, Chuan Xiong, Xi Xin, Bi Bo, Gao Ben (Ligustici Rhizoma), Bai Zhi, and Lu Feng Fang. If there is little swelling/pain but a preference for hot drinks, it indicates Cold toothache; augment this formula with Qiang Huo, Ma Huang, and Chuan Fu Zi to warm and dissipate Cold. Both formulas should be taken half orally and used half for gargling, spitting out saliva, leading to recovery.

Yi Xiao Wan (One Smile Pill), Yu Chi San (Jade Pool Powder), Fumigation Medicine
17. Various toothaches can be treated by biting pills made of Hua Jiao (Zanthoxyli Pericarpium) and Ba Dou (Crotonis Fructus) mixed with rice. Yu Chi San contains Gao Ben, Bai Zhi, Di Gu Pi (Lycii Cortex), Huai Hua (Sophorae Flos), Xi Xin, Dang Gui, Chuan Xiong, Da Dou (Sojae Semen Nigrum), Sheng Ma, Fang Feng, and Gan Cao (Glycyrrhizae Radix et Rhizoma). Worm toothache can be fumigated with smoke from Cong Zi (Allii Fistulosi Semen) or Jiu Zi (Allii Tuberosi Semen).
[Note] "Zhu Ya" refers to various types of toothache. Yi Xiao Wan is suitable for all: grind seven grains of Chuan Jiao into powder, peel and grind one grain of Ba Dou uniformly, mix with rice paste to form pills, wrap in cotton, and bite on the painful area until saliva is expelled and pain stops. Yu Chi San is also suitable: decoct Gao Ben, Bai Zhi, Di Gu Pi, Huai Hua, Xi Xin, Dang Gui, Chuan Xiong, Hei Dou, Sheng Ma, Fang Feng, and Gan Cao. Gargle while hot and spit out when cool. This method is also suitable for worm toothache. Additionally, burn Jiu Zi or Cong Zi in a small stove over a large bowl of water, cover with a funnel directing smoke toward the painful tooth. The tiny worms will fall into the water bowl; this has proven effective repeatedly.

Wu Ti Xiao Gan Tang (Trogopterori Decoction for Eliminating Gangrene)
18. Although there are specialized treatments for Ya Gan, practitioners often fail to understand the efficacy of continuous purgation. If the patient can eat and stools are soft, purgation is indicated using Xiong Huang (Realgar), Wu Ti (Trogopterori Faeces), Da Huang (Rhei Radix et Rhizoma), Lu Hui (Aloe), Huang Lian, Hu Huang Lian (Coptidis Chinensis Rhizoma - *Note: Text distinguishes Huang Lian and Hu Huang Lian*), and Huang Qin (Scutellariae Radix).
[Note] Ya Gan is rapidly fatal. Although specialized treatments exist, doctors often do not master the method of continuous attack ("Lei Gong"). Continuous attack means purging today, tomorrow, and the day after, until swelling and hardness subside, black discoloration resolves, and foul odor ceases. If the patient cannot eat, purge every one to three days. After purging, if appetite returns, no strict dietary restrictions are needed; allow normal food intake. Even if stools are loose, adjust the intensity of purgation based on severity, yielding miraculous results. If the patient lacks appetite and cannot tolerate purgation, it is a death sign. The purgative medicine is Wu Ti Xiao Gan Tang, composed of Xiong Huang, Wu Ti, Sheng Da Huang, Lu Hui, Chuan Huang Lian, Hu Huang Lian, and Huang Qin.