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Li Dongyuan treated a thirty-year-old woman. She suffered from severe toothache, which temporarily ceased when she inhaled cool air but recurred when her mouth was closed. This was a Damp-Heat syndrome. The Foot-Yangming Stomach Meridian passes through the upper teeth, and the Hand-Yangming Large Intestine Meridian passes through the lower teeth. The Yangming meridians are rich in blood and qi; compounded by a diet rich in fatty and sweet foods that exacerbate Damp-Heat, this disease arose. He used Huanglian (Coptidis Rhizoma) and Wutong Lei (Liquidambaris Resina), both bitter and cold, to primarily clear heat and dry dampness; Bohe (Menthae Haplocalycis Herba) and Jingjie Sui (Schizonepetae Spica), both acrid and cool, to assist in clearing heat; Shengma ( Cimicifugae Rhizoma), bitter and acrid, as a guiding herb to lead the action into the Yangming meridians. Since teeth are considered the surplus of bones, Yang Gu Fen (Bone Ash of Sheep) was used as an adjuvant to tonify. A small amount of Shexiang (Moschus) was added as a guide. The herbs were ground into a fine powder for external application, reducing pain by half. Subsequently, Tiaowei Chengqi Tang (Regulate the Stomach Order the Qi Decoction) with Mangxiao (Natrii Sulfas) removed and Huanglian (Coptidis Rhizoma) added was used to treat the root cause. After two or three bowel movements, the treatment stopped, and the illness was thoroughly cured without recurrence.

Another patient, due to taking warming and tonifying stomach-heat herbs, suffered unbearable pain in both upper and lower teeth, radiating to the head, accompanied by facial fever and severe pain. The collateral vessels of the Foot-Yangming Stomach Meridian enter the brain. The patient preferred cold and disliked heat, indicating excessive heat in the Hand-Yangming Large Intestine Meridian. His teeth favored cold and disliked heat. He was cured using Qingwei San (Clear the Stomach Powder).

Yu Zhen’s commentary: Toothache belongs either to the Yangming meridian or the Shaoyin kidney meridian. These two cases, along with the subsequent case by Yi Silan, represent the two major primary approaches to discussing dental diseases.

*Weisheng Shiquan Fang* (Complete Ten Thousand Prescriptions for Health Preservation) records: One person’s teeth gradually grew longer, swelling so much that opening the mouth became difficult, hindering eating. This was attributed to marrow overflow. Only Baizhu (Atractylodis Macrocephalae Rhizoma) was taken, resulting in a cure.

Wei commented: This shows that those with Kidney Deficiency should not take Baizhu (Atractylodis Macrocephalae Rhizoma).

Yi Silan treated a man suffering from dental disease. Whenever he engaged in sexual intercourse or became angry, his teeth would feel like they were growing longer, causing unbearable pain. Neither hot nor cold liquids could be tolerated. The condition lasted three to five days, with indescribable suffering. He eventually abstained from sex and took Buyin Wan (Tonify Yin Pill) and Qingwei Yin (Clear the Stomach Drink), but neither was effective. Yi diagnosed his pulse: the Cun and Guan positions (upper parts) showed normal pulses, but the Chi positions (lower parts) were Hong (Surging), Shu (Rapid), Forceful, and hard upon pressure. He said, “Chen Ru Hua (Deep, Soft, Slippery) is the Kidney pulse; Hong Shu Youli (Surging, Rapid, Forceful) is the Heart pulse. Now, seeing the Heart pulse in the Kidney position indicates ‘the unconquered insulting the conquered’ (Water failing to control Fire), akin to the wife overpowering the husband. The fire pathogen in the Kidney is excessive. Qingwei Yin is suitable only when the Stomach pulse is Surging and Rapid; now that the Stomach pulse is peaceful, what benefit is there in clearing heat? The Kidney governs bones, and teeth are the surplus of bones. Excessive fire causes the sensation of teeth growing; what benefit is there in tonification? Moreover, Ganjiang (Zingiberis Rhizoma) is present, which is even more inappropriate.” Therefore, he used Huangbai (Phellodendri Cortex) 3 qian to nourish Water and drain Fire; Qinyan (Halitum) 1 qian as a guide; and Shengma (Cimicifugae Rhizoma) 1 qian to ascend and expel the fire pathogen from the Kidney. Upon ingestion, the patient swished and swallowed the medicine, immediately feeling heat rising from the Dantian and exiting through the throat. After two more doses, the illness was completely cured.

Yu Zhen’s commentary: The medical theory in this case is explained with utmost precision. Because the pulse diagnosis was accurate and combined with ingenious reasoning, every prescription hit the mark. The mediocrity of Qingwei San (Clear the Stomach Powder) is indeed blameless; even the generalized use of Yin-nourishing herbs is hard to apply effectively. With just these three ingredients, the explanation is very clear. Indeed, one ingredient cannot be omitted, nor is another necessary. In my hometown, there was a person suffering from toothache for years, unresponsive to various medicines. Mr. Ye Tianshi used Shanyurou (Corni Fructus), Bei Wuweizi (Schisandrae Chinensis Fructus), Nuzhenzi (Ligustri Lucidi Fructus), and Hanliancao (Ecliptae Herba), each 3 qian, along with Huai Niuxi (Dioscoreae Hypoglaucae Rhizoma) and Qinyan (Halitum), each 1 qian, resulting in a complete cure. This method utilizes the descending nature of Sour and Salty flavors to guide the fire of the Kidney meridian back to its source. It can be immortalized alongside Master Yi’s formula, although their underlying principles differ.