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It is stated that the disease of Lou Gan (Gum Fistula with Caries) arises from wind-pathogenic toxic qi lodging in the Hand-Yangming Large Intestine Meridian, attacking and rushing towards the interdental spaces. This causes the gingival flesh to become vacuously swollen, with continuous oozing of pus and pain. The condition persists for a long time without healing, flaring up and subsiding intermittently; hence it is named Lou Gan.

For treating Lou Gan where worms erode the cheekbone causing ulceration, the Qingfan San (Green Alum Powder) formula:
Qingfan (Calcined and ground), Huangfan (Calcined and ground), Xionghuang (Realgar, separately ground), Baifan (White Alum, calcined and ground), Xixin (Asari Root, radix removed, each 0.5 liang), Langdangzi (Datura Seed, skin and embryo removed, stir-fried, separately ground), Qingdai (Indigo Naturalis, ground, each 0.5 liang).
The above twelve ingredients are pounded, sieved into a powder, further ground finely in a mortar. Apply a small amount to the affected area externally. For severe cases, mix half a qian with well-water (Jinghua Shui) and take orally on an empty stomach.

For treating Lou Gan with rotting gums, persistent tooth exposure, itching and pain in lips and gums, and dental caries, the Huangyin San (Yellow Silver Powder) formula:
Huanglian (Coptis Rhizome, mustards removed), Puhuang (Typha Pollen, each 1 fen), Shenggan Dihuang (Rehmanniae Radix Preparata, dried and baked), Wutoujian (Aconiti Lateralis Radix Premna, raw), Danggui (Angelicae Sinensis Radix, sliced and baked), Tonglü (Verdigris), Xixin (Asari Root, radix removed), Xingren (Armeniacae Semen Amarum, skin and embryo removed, stir-fried with bran until slightly yellow, separately ground into powder), Huangdan (Lithargyrum, stir-fried until red, separately ground).
The above nine ingredients are pounded into a fine powder. Rinse the mouth thoroughly first, dip fingers into the medicine, and apply evenly to the affected area. After a while, rinse with warm water. Frequent application yields results.

For treating Lou Gan with worm erosion, the Ben San (Ligusticum Powder) formula:
Bencao (Ligustici Chuanxiong Rhizoma, radix and soil removed), Xionghuang (Realgar, ground), Xiong (Chuanxiong Rhizoma), Guizhi (Cinnamomi Ramulus, coarse bark removed), Xixin (Asari Root, radix removed), Danggui (Angelicae Sinensis Radix, sliced and baked), Xingren (Armeniacae Semen Amarum, skin and embryo removed, stir-fried with bran until slightly yellow, separately ground into powder).
The above seven ingredients are pounded and sieved into a powder. Use one "zi" (a traditional measure, approx. 0.3-0.5g) per dose, wrap in cotton, and insert into the worm hole. Check daily; efficacy is indicated when the worm hole gradually shrinks.

For treating Lou Gan with oral and dental ulcers and sores, the Qingtingzi (Green Stick) formula:
Xinpi (Arsenic Trioxide, stir-fried on porcelain tile until half-cooked), Fenshuang (Calomel, stir-fried on porcelain tile until half-cooked), Danfan (Blue Vitriol, stir-fried on porcelain tile until half-cooked, each 1 fen), Tonglü (Verdigris, raw), Qingfen (Calomel), Mituoseng (Litharge, ground), Kufan (Burnt White Alum, ground).
The above seven ingredients are ground together into a fine powder. Rinse the mouth with salt water first. Then, rub the medicine between the palm and rice grains to form sticks as large as needle heads, and place them in the interdental spaces.

For treating Lou Gan where erosions affect lips, nose, and teeth causing foul odor, the Lushui San (Aloe Powder) formula:
Lushui (Aloeswood Resin, 0.5 fen, ground), Shexiang (Moschus, burned), Qingfan (Green Alum, calcined and ground), Huangfan (Yellow Alum, calcined and ground), Baifan (White Alum, calcined and ground, each 1 fen), Xiaha (Toad Ash, 0.5 liang).
The above six ingredients are mixed and ground evenly into a powder. First, wipe away bad blood from the gums with cotton, then apply half a qian-bi (approx. 1-2g) of the medicine. Apply three times daily.

For treating Lou Gan with bleeding and inability to eat, the Huanglian San (Coptis Powder) formula:
Huanglian (Coptis Rhizome, mustards removed), Huangyaozi (Dioscoreae Hypoglaucae Rhizoma), Mayaxiao (Sodium Sulfate, ground, each 1 liang), Baifan (White Alum, calcined and ground, 1 fen), Longnao (Borneolum Syntheticum, 1 qian, ground).
The above five ingredients are pounded and ground into a powder, then mixed uniformly. Apply half a qian to the affected area.

For treating Lou Gan with worm erosion creating fistulas, the Longshi San (Dragon Solid Powder) formula:
Longshi (Fossilized Bones containing deep yellow or pale earth-yellow/brownish hard pieces that stick to the tongue), Baifan (White Alum, calcined and ground), Woniuqiao (Helicis Shell), Hufen (Lead Carbonate), Niuhuang (Bovis Calculus, ground).
The above five ingredients are ground into a fine powder. Apply a small amount to the interior of the fistula/orifice.

For treating Lou Gan oral ulcers, the Kuigen San (Malva Root Powder) formula:
Kuigen (Malvae Root, sliced), Chixiaodou (Adzuki Bean), Tuguagen (Trichosanthes Thunbergiana Radix, each 1 liang), Shexiang (Moschus, ground, 1 fen).
The above four ingredients are pounded and sieved into a powder. Apply one "zi" to the ulcer.

For treating Lou Gan with tooth exposure, the Heisan (Black Powder) formula:
Bencao (Ligustici Chuanxiong Rhizoma, radix and soil removed), Shengma (Cimicifugae Rhizoma), Zaojiao (Gleditsiae Sinensis Fructus, non-borer pods, burned to ash retaining nature, each 0.5 liang), Shigao (Gypsum Fibrosum, 1.5 liang, crushed).
The above four ingredients are pounded and sieved into a powder. Before sleep, dip fingers in the powder and rub the teeth. Rinse slightly to retain the medicinal aroma. It also serves to strengthen teeth and remove bad breath.