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The tooth gangrene occurring after smallpox is caused by the upward attack of residual toxic heat. Symptoms include bad breath, swollen gums, and severe pain. Treatment involves internal administration of Qingdu Liangxue Yin (Clearing Toxicity and Cooling Blood Decoction) and external application of Zhongbai San (Human Urine Deposit Powder), which yields excellent results.

[Note]
Tooth gangrene arising after smallpox occurs because residual toxins in the body have not been fully resolved and attack upwards towards the teeth.
In the early stage, symptoms include bad breath, swollen gums, bleeding from the gum margins, and pain;
In severe cases, the gums turn black and rot, teeth fall out, and the condition may penetrate the cheeks, damage the face, and erode the nose and lips. Such cases are often incurable.
Upon observing this condition, immediate treatment is required: internally administer Qingdu Liangxue Yin (Clearing Toxicity and Cooling Blood Decoction) and externally apply Renzhongbai San (Human Urine Deposit Powder).

[Qingdu Liangxue Yin (Clearing Toxicity and Cooling Blood Decoction)] Ingredients: Anemarrhenae Rhizoma (Zhimu), Gypsum Fibrosum (Shigao), Rehmanniae Radix Recens (Shengdi), Coptidis Rhizoma (Huanglian), Angelicae Sinensis Radix (Danggui), Paeoniae Radix Rubra (Chishao), Rheii Radix et Rhizoma (Dahuang), Gardeniae Fructus (Shanzhizi), Moutan Cortex (Danpi), Schizonepetae Spica (Jingjiesui), Forsythiae Fructum (Lianqiao) with heart removed. Decoct in water and take orally.
[Prescription Song]
Qingdu Liangxue treats tooth gangrene, Zhi Mu, Shi Gao, Sheng Di, Lian combined,
Gui, Shao, Da Huang, Shan Zhi Zi, Dan Pi, Jing Sui, Lian Qiao decocted.

[Renzhongbai San (Human Urine Deposit Powder)] Ingredients: Human Urine Deposit (Ren Zhong Bai) 2 qian (calcined), Realgar (Xiong Huang) 8 fen, Borneolum Syntheticum (Bing Pian) 4 fen, Borax (Peng Sha), Indigo Naturalis (Qing Dai), Camellia Seed Tea (Er Cha) each 1 qian. Grind all into a fine powder and rub/apply to the affected area.

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Miscellaneous syndromes during smallpox

The tongue is the sprout of the Heart and connects internally with the five zang organs. When toxic fire invades, it first manifests on the tongue. Whether the tongue appears red, purple, black, or swollen, or exhibits abnormal movements like protruding or playing with the tongue, the general principle is to clear heat and use Rhinoceros Horn (Xi Jiao) to calm the condition.

[Note]
The tongue is the sprout of the Heart and connects internally with the five zang organs. When toxic heat erupts, the tongue is affected first.
It may appear red, purple, black, or swollen, or exhibit various abnormalities such as protruding or playing with the tongue.
All these conditions are caused by heat lingering in the Heart. Treatment should focus on clearing heat, using Jiawei Xijiao Tang (Modified Rhinoceros Horn Decoction).

[Jiawei Xijiao Tang (Modified Rhinoceros Horn Decoction)] Ingredients: Schizonepetae Spica (Jingjie), Saposhnikoviae Radix (Fangfeng),炒牛蒡子 (Chao Niubangzi - Stir-fried Arctii Fructus), Raw Licorice Root (Sheng Gancao), Platycodonis Radix (Jiegeng), Cimicifugae Rhizoma (Shengma), Rhinoceros Horn (Xi Jiao), Ophiopogonis Radix (Maidong) with heart removed, Gardeniae Fructus (Zhizi), Coptidis Rhizoma (Huanglian), calcined Gypsum Fibrosum (Huan Shi Gao). Decoct in water and take orally.
[Prescription Song]
Jiawei Xijiao can dissipate heat, Jingjie, Fangfeng, Niubang together with Gancao and Jiegeng,
Shengma, Xi Jiao, Maidong, Zhizi, Huanglian, Shi Gao act swiftly.

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Miscellaneous syndromes during smallpox

The throat and pharynx govern the entry and exit of air and food. If toxic fire rushes and blazes fiercely, it causes unbearable pain. Internally using Ganjie Wanjie Ji (Licorice and Platycodon Throat-Relieving Agent), and externally blowing Niu Huang San (Calculus Bovis Powder) into the affected area brings immediate relief.

[Note]
The pharynx is the pathway for food and drink, and the larynx is the gate for respiration; this is the most critical area.
If the smallpox toxin cannot vent outward, causing fire and heat to obstruct between the diaphragm and rush upwards to the throat, it results in swelling and pain, hoarseness, or choking;
In severe cases, breathing becomes impossible, and swallowing food is difficult.
Quickly use Jiawei Ganjie Tang (Modified Licorice and Platycodon Decoction) for treatment, or use Jiajian Liyan Jiedu Tang (Modified Throat-Relieving and Toxin-Clearing Decoction), while externally blowing Niu Huang San (Calculus Bovis Powder) into the swollen area.

[Jiawei Ganjie Tang (Modified Licorice and Platycodon Decoction)] See formula under "Loss of Voice".
[Liyan Jiedu Tang (Throat-Relieving and Toxin-Clearing Decoction)] Ingredients: Saposhnikoviae Radix (Fangfeng), Sophorae Tonkinensis Radix (Shandougen), Ophiopogonis Radix (Maidong) with heart removed, stir-fried Arctii Fructus (Chao Niubangzi), Black Ginseng (Heishen - usually refers to Prepared Scrophulariae Radix or similar dark-tonic herbs in this context, often Xuan Shen), Bitter Platycodon Root (Ku Jiegeng), Raw Licorice Root (Sheng Gancao), Mung Bean (Lv Dou). Decoct in water and take orally.
[Prescription Song]
Liyan Jiedu uses Fangfeng, Shandougen and Maidong, Niubang, Heishen, Ku Jiegeng,
Gancao and Lv Dou decocted thickly.

[Niu Huang San (Calculus Bovis Powder)] Ingredients: Raw Chuan Lianlian (Chuan Huanglian) 8 fen, Raw Phellodendri Cortex (Huangbo) 8 fen, Menthae Haplocalycis Herba (Bohe) 8 fen, Realgar (Xiong Huang) 1.5 fen, Saltpeter (Huoxiao) 1.5 fen, Indigo Naturalis (Qing Dai) 1.5 fen, Calculus Bovis (Niu Huang) 1 fen, Borneolum Syntheticum (Bing Pian) 1 fen, Borax (Peng Sha) 1 fen, Cinnabar (Zhusha) 1 fen. Grind all into a fine powder. Use a small amount each time, blown into the affected area.

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Miscellaneous syndromes during smallpox