牙痈胃热肿牙床，寒热坚硬痛难当，破流脓水未收口，误犯寒凉多骨妨。
【注】此证由阳明胃经热毒所致。生于牙床，坚肿疼痛，身发寒热，腮颊浮肿。初宜
服荆防败毒散，若大渴、烦呕者，蟾酥丸汗之；便秘者，双解贵金丸下之；肿处宣软刺
破，搽冰硼散。若初时坚肿，破流血水，久不收口，过食寒凉者，必生多骨。俟骨尖刺
出，摇则内动，始可取出，其口方能收敛而愈。
荆防败毒散（见项部脑疽）
蟾酥丸（见疔疮门）
双解贵金丸（见肿疡门）
冰硼散（见口部鹅口疮）
走马牙疳证不轻，癖积疹痘毒火攻，牙根腐臭随变黑，顽肉难脱不食凶。
【注】此证多由癖疾积火、疹痘余毒上攻，最为迅速，总因积火热毒而成。牙根作烂，随
变黑腐，臭秽难闻。若癖积毒火攻牙者，初宜服芦荟消疳饮；脾胃虚者，兼服人参茯苓
粥。若疹痘余毒所中者，宜服清疳解毒汤。外势轻者，俱用尿白散擦之。若坚硬青紫，渐
腐穿腮、齿摇者，宜芦荟散擦之；如牙缝黑腐不尽，及腐烂深坑，药不能到，宜用勒马
听徽线塞之，再用手法，去其黑腐，内见红肉流鲜血者吉。其取时顽肉难脱，坚硬腐烂
渐开，以致穿腮破唇，宜贴青莲膏，身热不食者逆。但此证惟癖积攻牙成疳者，好后易
犯，由积火时时上攻也。惟在调理饮食得宜，如山药、栗子、鹅、蟹、甜、辣等物，俱当
禁忌。若稍有疏忽，必致复发，慎之，慎之。
人参茯苓粥
人参（一钱） 白茯苓（六钱）
共研末，同粳米一条盅，熬成粥。先以盐汤将口漱净，后再食粥。
【方歌】人参茯苓善扶脾，饮食短少服之宜，二味研末加粳米，熬粥食之理胃虚。
清疳解毒汤
人中黄 川黄连（生） 柴胡（各五分） 知母（生） 连翘（去心） 牛蒡子（炒，研） 犀角
（镑） 黑参 荆芥 防风（各一钱） 石膏（ ，一钱五分）
淡竹叶一钱，灯心五十寸，水二盅，煎八分，食远服。呕加芦苇根五钱。
【方歌】清疳解毒牙疳证，疹痘余毒化热成，中黄知连柴翘蒡，犀角参膏荆芥风。
尿白散
尿垢（即妇人尿桶中白碱，火锻，五钱） 白霜梅（烧存性） 枯白矾（各二钱）
上研细末，先用韭根、松萝茶，煎成浓汁，乘热以鸡翎蘸洗患处，去净腐肉，见津
鲜血，再敷此药，日敷三次。若烂至咽喉，以芦筒吹之。
【方歌】尿白散搽走马疳，尿垢白霜梅白矾，韭根茶叶煎汤涤，蘸洗腐肉敷药痊。
芦荟散
芦荟（一钱） 黄柏（末，五钱） 人言（用红枣五枚，去核，每枣纳人言一分，火烧存性，五分）
共研细末，先用米泔水漱净疳毒，后敷此药于坚硬及腐处。
【方歌】芦荟散搽牙疳烂，色紫牙摇腮硬穿，枣裹人言烧存性，再加黄柏末同研。
勒马听徽丝
白砒（末，一分） 麝香（末，三分） 青绵（撕碎） 青黛（飞末，各一两）
用香油拌匀。用时先以清米泔水漱口，次用镊尖将丝挑少许，塞于牙根缝内，日三易之。
【方歌】勒马听徽疳渐蚀，牙缝腐黑急速施，油调砒麝青绵黛，泔水漱口后塞之。
青莲膏
青黛（二钱） 乳香 轻粉（各一钱） 麝香（五分） 白砒（即人言，一分）
上为细末，用香油调稠，薄摊纸上，用锤捶实，阴干收之。每于卧时，以泔水漱净
口，拭干，随疳证大小，剪膏药贴之，至晓揭去，再以泔水将口漱净吐之，至晚再贴。
【方歌】青莲膏贴腐疳宜，化腐消坚效更奇，乳麝白砒轻粉黛，研末油调纸摊之。
芦荟消疳饮（见钻牙疳）
Tooth Abscess: Stomach heat causes swelling of the gingiva, accompanied by aversion to cold and fever, local hardness, and severe pain. If pus drains after rupture but the wound fails to heal, misusing cold-natured remedies will lead to the formation of dead bone, hindering recovery.
[Note] This condition is caused by heat-toxin in the Yangming Stomach Meridian. It arises on the gingiva, presenting as hard, swollen, and painful areas, with systemic chills and fever, and swelling of the cheeks and jaw. Initially, Jingfang Baidu San (Atractylodes and Saposhnikovia Decoction) is suitable; if there is extreme thirst, restlessness, and vomiting, Chansu Wan (Toad Venom Pill) should be used to induce sweating; if constipated, Shuangjie Guijin Wan (Dual-Resolution Noble Gold Pill) should be used to purge. Once the swollen area softens, it should be lanced and Bingpeng San (Ice and Borax Powder) applied. If initially hard and swollen, but upon rupture bleeds bloody fluid and fails to close over time due to excessive consumption of cold foods, dead bone will inevitably form. Only when the bone tip protrudes and moves internally upon shaking can it be extracted, allowing the wound to contract and heal.
Jingfang Baidu San (See Neck Carbuncle section)
Chansu Wan (See Ding Chuang/Ting Sore section)
Shuangjie Guijin Wan (See Swollen Ulcer section)
Bingpeng San (See Mouth Thrush section)
Zouma Yagan (Running Horse Gum Necrosis): This condition is serious, often caused by parasitic or food stagnation, residual toxins from exanthematous diseases (such as measles or smallpox), and fire pathogenic factors attacking upwards. The gum roots rot and emit a foul odor, rapidly turning black. If stubborn necrotic tissue cannot detach and eating becomes impossible, the prognosis is ominous.
[Note] This condition is mostly caused by stagnation-fire from parasites or food accumulation, and residual toxins from exanthematous diseases attacking upwards. It progresses most rapidly and is fundamentally due to accumulated heat-fire toxin. The gum roots rot and quickly turn black and necrotic, with a foul smell. If caused by parasite/food stagnation heat-fire attacking the gums, Lulu Xiaogan Yin (Aloe Anti-Gum-Necrosis Decoction) is suitable initially; for those with Spleen-Stomach deficiency, Renshen Fuling Zhou (Ginseng and Poria Porridge) should be taken concurrently. If caused by residual toxins from exanthematous diseases, Qinggan Jiedu Tang (Clear Gum-Toxin Detoxification Decoction) is suitable. For mild external symptoms, Niaobai San (Urine Scale Powder) should be applied. If the area is hard, cyanotic, gradually penetrating the cheek, and teeth are loose, Lulu San (Aloe Powder) should be applied. If black necrosis in the tooth gaps persists or deep ulcers form where medicine cannot reach, Lematinghui Si (Horse-Hearing-Micro Silk) should be inserted, followed by manual removal of black necrotic tissue; seeing red flesh bleeding fresh blood is a favorable sign. If stubborn tissue is difficult to remove, hardness and necrosis expand, leading to cheek penetration and lip rupture, Qinglian Gao (Green Lotus Plaster) should be applied; if accompanied by fever and inability to eat, it is an adverse sign. However, only cases where parasite/food stagnation attacks the gums causing necrosis tend to recur after healing, due to intermittent upward attack of stagnation-fire. Proper dietary regulation is key; items such as Chinese yam, chestnuts, goose, crab, sweets, and spicy foods must be strictly prohibited. Any negligence may cause recurrence; caution is essential, caution is essential.
Renshen Fuling Zhou (Ginseng and Poria Porridge)
Renshen (Ginseng Radix et Rhizoma, 1 qian) Baifuling (Poria, 6 qian)
Grind into powder, cook together with one strip of Oryza sativa var. japonica (Jingmi, Rice) in a steamer until porridge consistency. Rinse mouth thoroughly with salt water first, then consume the porridge.
[Formula Song] Ginseng and Poria benefit the Spleen well, suitable for poor appetite, grind two ingredients with rice, porridge nourishes Spleen-Stomach deficiency.
Qinggan Jiedu Tang (Clear Gum-Toxin Detoxification Decoction)
Renzhonghuang (Human Midden Yellow, Chuanlianhuan (Coptidis Rhizoma, raw), Chaihu (Bupleuri Radix, each 5 fen), Zhimu (Anemarrhenae Rhizoma, raw), Lianqiao (Forsythiae Fructus, heart removed), Niubangzi (Arctii Fructus, stir-fried and crushed), Xijiao (Rhinocerotis Cornu, shaved), Heishen (Black Ginseng), Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix, each 1 qian), Shigao (Gypsum Fibrosum, calcined, 1.5 qian).
Danzhuyeh (Lophatheri Herba, 1 qian), Dengxincao (Junci Medulla, 50 cun), Water 2 zhong, decoct to 0.8 zhong, take after meals. Add Lubigen (Phragmitis Rhizoma, 5 qian) if vomiting occurs.
[Formula Song] Clear Gum-Toxin Detoxification treats gum necrosis, residual toxins from exanthems transform into heat, Zhonghuang, Zhi, Lian, Chai, Qiao, Bang, Xijiao, Shen, Shigao, Jingjie, Fangfeng.
Niaobai San (Urine Scale Powder)
Niaogou (Urine scale, i.e., white alkali from women's urine pots, calcined, 5 qian) Baishuangmei (White Frost Plum, burnt to retain nature) Kubaijian (Dried Alum, each 2 qian)
Grind all into fine powder. First, decoct Jiugen (Allii Tuberosi Radix) and Songluocha (Song Luocha Tea) into a concentrated liquid. While hot, use a chicken feather to dip and wash the affected area, removing all necrotic tissue until serum and fresh blood appear. Then apply this medicine, three times daily. If necrosis extends to the throat, blow the powder into the throat using a reed tube.
[Formula Song] Niaobai San applied to Running Horse Gum Necrosis, Niaogou, Baishuangmei, Kubaijian, decoct Jiugen and tea leaves to cleanse, dip and wash necrotic tissue then apply medicine for cure.
Lulu San (Aloe Powder)
Lulu (Aloe, 1 qian) Huangbai (Phellodendri Cortex, powder, 5 qian) Renyan (Realgar, place 1 fen of Realgar into each of 5 pitted Red Dates, burn until nature is retained, 5 fen)
Grind into fine powder. First rinse away gum-toxin with Mi Gan Shui (Rice Wash Water), then apply this medicine to hard and necrotic areas.
[Formula Song] Lulu San applied to rotten gum necrosis, purple color, loose teeth, hard cheek penetration, Realgar wrapped in dates burnt to retain nature, mix with Huangbai powder.
Lematinghui Si (Horse-Hearing-Micro Silk)
Baipi (Realgar, powder, 1 fen) Shexiang (Musk, powder, 3 fen) Qingmian (Blue Cotton, torn) Qingdai (Indigo Naturalis, levigated powder, each 1 liang)
Mix evenly with Sesame Oil. When using, first rinse mouth with clear Rice Wash Water. Next, use tweezers to pick up a small amount of silk, insert into the gum gap, change three times daily.
[Formula Song] Lematinghui Si for gradually eroding gum necrosis, rapid application for black necrosis in tooth gaps, oil-mixed Realgar, Musk, Blue Cotton, Indigo, rinse with Rice Wash Water then insert.
Qinglian Gao (Green Lotus Plaster)
Qingdai (Indigo Naturalis, 2 qian) Ruxiang (Olibanum, 1 qian) Qingfen (Calomelas, 1 qian) Shexiang (Musk, 5 fen) Baipi (Realgar, i.e., Renyan, 1 fen)
Grind all into fine powder, mix with Sesame Oil to a thick paste. Spread thinly on paper, hammer solid, dry in shade for storage. Each night before sleep, rinse mouth with Rice Wash Water, dry, cut plaster according to size of gum necrosis, apply, remove at dawn, rinse mouth with Rice Wash Water and spit out, reapply at dusk.
[Formula Song] Qinglian Gao suitable for applying to necrotic gum, dissolves necrosis and reduces hardness with miraculous effect, Ruxiang, Shexiang, Baipi, Qingfen, Qingdai, grind powder, mix with oil, spread on paper.
Lulu Xiaogan Yin (Aloe Anti-Gum-Necrosis Decoction) (See Drilling Tooth Gum Necrosis section)