既知牙齿之提纲。当知牙齿之条目。诸书谓杂病切牙者。胃实也。痘症切牙者。死候也。痘症切牙齿落者。
无不死也。小儿齿嚼咬人者。肾绝之证也。人之自啮舌者。厥逆走上。脉气不至也。啮舌者。少阴气至也。啮
颊者。少阳气至也。啮唇者。阳明气至也。胸满口噤。卧不着席。脚挛急。又 齿者。痉病也。痉者腰折螈 。齿
噤也。小儿蚀齿者。疳虫之候也。齿龋者。手阳明络实。则龋聋之证也。肉濡而却。齿长而垢。发无润泽者。
骨先死。少阴绝也。骨枯肉软。齿长而垢。发无泽者。骨先死。足少阴气绝也。面黑齿长而垢。腹胀闭。上下不
通者。少阴终也。肾中风者。其人踞坐而腰痛。视胁下左右。未有黄色如饼粢大者。尚可治。若齿黄赤。鬓发
直。面土色者。不可治也。小儿齿落久不生者。肾气亏也。病患齿黄枯落者。骨绝也。牙黄落者骨绝。十日死
也。牙床腐烂。牙齿脱落者。牙疳之凶候也。龈肉赤烂疼痛。口臭血出。牙枯脱落。穿腮蚀唇者。牙疳也。牙疳
穿腮齿落者。难治也。齿如黄豆者。肾气绝也。齿如熟小豆。其脉躁者。阴阳俱竭也。齿垢黄。面目爪甲上黄
者。黄胆也。唇肿齿黑者。死证也。唇肿唇黑齿焦者。肿胀之死证也。病患齿忽变黑者。十三日死也。目无精
光。齿龈黑者。心肝绝也。色黑而齿槁者。肾热也。热病唇焦齿燥者。津液耗也。虚极之病。唇枯齿干者。死候
也。齿为暴枯。面为正黑。目中黄。腰欲折。自汗出如流水者。四日死。一曰人中平。八日死。肾绝也。病无所在。
汗注不休。齿本槁痛者。骨寒热也。骨寒热。病无所安。汗注不休。齿未槁者可治。齿已槁者不可治。骨厥亦
然也。齿黑腰痛。足逆冷者。骨蒸也。至若黄发儿齿者。寿考之征也。唇亡齿寒者。衰惫之兆也。牙床红肿者。
阳明之病也。牙床溃烂者。肠胃之证也。重龈病齿。龈肿如水泡者。热蓄于胃也。小儿面色黧黑。齿龈出血。
口中气臭。足冷如冰。腹痛泄泻。啼哭不已者。肾疳也。齿龈间津津出血不止者。阳明之经病也。牙肉色白
者。非久病血少。即失血过多也。牙肉之际。有蓝迹一线者。沾染铅毒也。若服水银轻粉。亦令牙床壅肿也。
此皆诊齿之目也。
Having understood the general principles of observing the teeth, one must know the specific items. Various texts state that in miscellaneous diseases, teeth grinding indicates excess heat in the Stomach (Wei). In smallpox/variolous diseases, teeth grinding is a sign of impending death; if teeth fall out during these diseases, death is inevitable. If a child grinds their teeth and bites, it is a syndrome of Kidney Qi exhaustion. If a person bites their own tongue, it is due to Jue-Ni (rebellious cold/qi) rising upward, causing pulse qi to fail to reach the extremities. Biting the tongue indicates the arrival of Shaoyin (Lesser Yin) qi; biting the cheek indicates the arrival of Shaoyang (Lesser Yang) qi; biting the lip indicates the arrival of Yangming (Greater Yang) qi. Chest fullness, jaw stiffness (mouth locked shut), inability to lie flat with the back touching the bed, leg spasms, and clenched teeth constitute Jing-Bing (Spasm Disease). Jing-Bing manifests as opisthotonos (back arching), convulsions, and trismus (clenched teeth). If a child's teeth are eroded, it is a sign of Ganchong (worms causing malnutrition/decay). Dental caries indicate excess in the collateral vessels of the Hand-Yangming Large Intestine channel, leading to symptoms of caries and deafness. Gum recession, teeth appearing long with accumulated debris, and hair lacking luster indicate that the bones are dying first, representing the severance of Foot-Shaoyin Kidney Qi. Bone dryness with soft flesh, teeth appearing long with debris, and hair lacking luster also indicate bone death and the severance of Foot-Shaoyin Kidney Qi. A black complexion, teeth appearing long with debris, abdominal distension and closure, and blockage between upper and lower body indicate the termination of Shaoyin Qi. When the Kidney is invaded by Wind, the patient sits in a squatting posture with lower back pain. Observing the left and right hypochondriac regions, if there are no yellow patches the size of a cake crumb, it is still treatable. However, if the teeth are yellow-red, the sideburn hair stands erect, and the face has an earthy color, it is untreatable. If a child's deciduous teeth fall out and do not regrow for a long time, it is due to deficient Kidney Qi. If a patient's teeth are yellow, withered, and fall out, it indicates the severance of Bone Qi. Yellow and fallen teeth also indicate severed Bone Qi, leading to death within ten days. Rotting gums and falling teeth are ominous signs of Yagan (Noma/Gangrenous stomatitis). Red, rotting, painful gums, bad breath, bleeding, withered and fallen teeth, and perforation of the cheek and lips characterize Yagan. Yagan with cheek perforation and tooth loss is difficult to treat. Teeth resembling soybeans indicate Kidney Qi exhaustion. Teeth resembling cooked mung beans with a restless pulse indicate exhaustion of both Yin and Yang. Yellow dental plaque on teeth, accompanied by yellowing of the face, eyes, and nails, indicates Huangdan (Jaundice). Swollen lips with black teeth indicate a fatal syndrome. Swollen lips, black lips, and scorched teeth indicate a fatal stage of swelling disorders. Sudden blackening of teeth in a patient predicts death in thirteen days. Eyes lacking luster and black gums indicate the exhaustion of Heart and Liver Qi. A black complexion with withered teeth indicates Kidney Heat. In febrile diseases, scorched lips and dry teeth indicate consumption of Body Fluids (Jin Ye). In cases of extreme deficiency, withered lips and dry teeth are a sign of death. Sudden withering of teeth, a truly black complexion, yellowish hue in the eyes, sensation of the waist wanting to break, and profuse sweating like flowing water predict death in four days; another view states that if the Renzhong (philtrum) becomes flat, death occurs in eight days; this is Kidney Qi exhaustion. With undefined disease location, continuous dripping sweat, and withered, painful tooth roots, it is Gu Hanre (Bone Cold-Heat Disorder). In Bone Cold-Heat Disorder, the body feels unsettled, sweat drips continuously; if teeth are not yet withered, it is treatable; if withered, it is untreatable. Gu-Jue (Bone Reversal/Cold) presents similarly. Black teeth, lower back pain, and cold feet extending upwards indicate Gu Zheng (Bone Steaming). Regarding gray hair and the eruption of deciduous teeth (children's teeth), these are signs of longevity. Exposed teeth due to missing lips (gingival recession) are a兆 (sign) of decline and fatigue. Red and swollen gums indicate a Yangming disorder. Ulcerated gums indicate a gastrointestinal syndrome. Double gums with tooth involvement and gum swelling resembling blisters indicate heat accumulation in the Stomach. A dark complexion, bleeding gums, foul breath, ice-cold feet, abdominal pain, diarrhea, and incessant crying in children characterize Shen Gan (Kidney Malnutrition). Continuous oozing and bleeding from the gums indicate a Hand-Yangming channel disorder. Pale gum tissue indicates either blood deficiency from chronic illness or excessive blood loss. A blue line between the gum tissues indicates lead poisoning. Ingestion of Mercury (Shuiyin) or Calomel (Qingfen) can also cause gum swelling. These are all the specific items for diagnosing through the teeth.