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[Attributes] Gucao Feng (Bone Trough Wind) is associated with wind-fire pathogenic factors of the Hand-Shaoyang Sanjiao Meridian and Foot-Yangming Stomach Meridian. Pain manifests as a dull ache in the area anterior to the ear, extending to the parotid and cheek regions. If the condition progresses to involve rotting and ulceration of the bones and sinews, hardness and pain persist. Jaw stiffness (trismus) occurs due to the invasion of pathogenic wind.

[Note] This syndrome is also known as "Yacha Fa" (Tooth Fork Abscess) or "Chuansai Fa" (Cheek-Penetrating Abscess). It arises from wind-fire pathogens affecting the Hand-Shaoyang Sanjiao and Foot-Yangming Stomach meridians. The onset begins anterior to the ear, spreading to the parotid and cheek areas, causing dull pain in the bones and sinews. Over time, rotting and ulceration occur; the bones and sinews inside and outside the cheek remain diffusely swollen, hard, and painful, accompanied by trismus. These symptoms result from deep invasion of pathogenic wind into the bones and sinews. Since the lesion resides in the Yin aspect of the bones and sinews, initial swelling and hardness are difficult to dissipate, and post-ulceration wounds fail to heal, often leading to death. If heat signs are mild at the onset, internal treatment should employ Qingyang Sanhuo Tang (Clear Yang Disperse Fire Decoction), external application of Qingwei San (Clear Stomach Powder) for tooth brushing, and Zhenjun Miaosan (True Lord's Miraculous Powder) applied to the cheek. If, after initial diaphoresis (sweating to release the exterior), the patient exhibits intense heat and fire, use Cishi (Gallus Spinae), Dahuang (Rhei Radix et Rhizoma), Gancaojie (Cannabis Semen), Baizhi (Angelicae Dahuricae Radix), and Jiangcan (Bombyx Batryticatus) to purge downward. Subsequently, reduce the dosage of Dahuang and add Sheng Shigao (Gypsum Fibrosum) to clear heat. However, excessive use of cold-natured herbs should be avoided to prevent coagulation. In cases of long-standing induration that fails to resolve completely, indicating impending suppuration, Zhonghe Tang (Harmonizing Decoction) should be used to support the expulsion of pus. For already ulcerated lesions, follow the treatment protocols for Ulcers under the Carbuncle and Ulcer section. Some patients, due to overuse of cold-natured medicines, develop hardened, necrotic, and foul-smelling flesh; such cases require Lizhong Tang (Regulate the Middle Decoction) combined with Fuzi (Aconiti Lateralis Radix Praeparata) to restore Yang, and Jiangcan (Bombyx Batryticatus) to dispel wind. With this treatment, most symptoms subside, but if trismus persists, apply moxibustion to Jiache (ST6) using slices of Shengjiang (Zingiberis Rhizoma Recens) as a medium, 14 moxa cones daily (the acupoint is located 0.5 cun below the earlobe in the depression). Simultaneously, prick the gingiva at the posterior end of the teeth to bleed, which will relieve trismus. If chills and fever persist, the body becomes emaciated, phlegm is profuse preventing eating, or oral cavity ulceration occurs, potentially penetrating the cheek and causing tooth loss, these are considered adverse prognoses (Ni Zheng). At the initial stage of ulceration, the treatment is similar to Yagan (Dental Gangrene), representing merely an attempt to save life.

Formula: Qingwei San (Clear Stomach Powder)
Composition: Jianghuang (Curcumae Longae Rhizoma), Baizhi (Angelicae Dahuricae Radix), Xixin (Asari Radix et Rhizoma), Chuanxiong (Chuanxiong Rhizoma), in equal proportions, ground into fine powder. First rinse the mouth with salt water, then apply the powder to the painful teeth.

[Prescription Verse] Qingwei San treats tooth swelling and pain when rubbed on teeth; composed of Jianghuang, Baizhi, Xixin, and Chuanxiong. Grind together, rinse with salt water first, then rub with this medicine for miraculous efficacy.

Another Formula: Zhonghe Tang (Harmonizing Decoction)
Composition: Baizhi (Angelicae Dahuricae Radix), Jiegeng (Platycodonis Radix), Renshen (Ginseng Radix), Huangqi (Astragali Radix) (each 1 qian), Huoxiang (Agastaches Herba) (0.5 qian), Rougui (Cinnamomi Cortex) (0.5 qian), Gancao (Glycyrrhizae Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma) (soil-fried), Chuanxiong (Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba) (wine-fried, each 1 qian), Maimendong (Ophiopogonis Radix) (heart removed, 0.5 qian).
Decoct with 2 zhong of water, 3 slices of Shengjiang (Zingiberis Rhizoma Recens), and 2 dates (Jujubae Fructus) until reduced to 0.8 zhong. Add 1 cup of wine and take after meals.

[Prescription Verse] Zhonghe Tang treats Gucao Feng; for long-standing non-resolving conditions about to suppurate. Ingredients include Baizhi, Jiegeng, Renshen, boiled with Huoxiang, Rougui, Gancao, Baizhu, Chuanxiong, Danggui, Baishao, and Maimendong.

Another Formula: Lizhong Tang (Regulate the Middle Decoction) (See Ulcer Section)
Zhenjun Miaotie San (True Lord's Miraculous Adhesive Powder) (See Swollen Ulcer Section)
Shengyang Sanhuo Tang (Raise Yang Disperse Fire Decoction) (See Facial Ulcer Section)