凡一切风火虫牙、牙痈、牙疳、槽风,皆汇于此部中,以便检阅参治。
齿燥无津液者,是阳明热极。齿如热者,病难治。前板齿燥,兼脉虚者,是中暑。
经曰∶阳明之脉,循颊车入齿缝,风寒中之,轻则战栗鼓颔,重则口噤不开。
又曰∶凡卒中昏倒,牙关紧急者,此中风痰也。
又曰∶风入颔颊之间,则口 而牙紧。
又曰∶卒暴中风,牙关紧急,药不得下,用通关散。(细辛、薄荷、猪牙皂、雄黄各二钱,
研细。)每用少许,吹入鼻中,俟喷嚏后,然后进药。如不嚏者,不治。牙关紧甚,前
药中加麝香少许,或用乌梅,或白梅去核,用药擦牙。盖酸先入筋,使牙关酸软即开。
亦木能克土之义,因牙龈属阳明胃土也。
又曰∶骨槽风、颊车疽,风热太甚,痰涎滞膈。风喜伤肝,复能燥物,是以筋燥
劲迫而牙关拘紧,此实邪耳。
冯鲁瞻曰∶口噤者,足阳明之病,颊车穴主之。盖阳明经络挟口环唇,循颊车,
而诸阳筋脉皆上于头,三阳之筋并络颔颊,夹于口,风寒乘虚而客其经,则筋挛急,牙关紧,而口噤。
中风牙关紧急 乌梅肉揩牙即开。
小儿牙关不开 天南星煨熟,乘热纸裹,不要透气。将纸剪芡实大一窍,透
气,塞于儿鼻孔中,牙关即开。
凡患喉齿,口不能张。
猪牙皂 青黛 北细辛 僵蚕(各一钱) 山豆根 元参(各五分)
共研细末。吹男左女右鼻中即开。
Any cases of wind-fire toothache, dental abscess (Ya Yong), noma (Ya Gan), or alveolar osteomyelitis (Cao Feng) are compiled in this section for easy reference and treatment.
Dry teeth without saliva indicate extreme heat in the Yangming channel. Teeth feeling hot suggest a difficult-to-treat condition. Dryness of the anterior plate teeth accompanied by a deficient pulse indicates heatstroke.
The Classics state: The Yangming meridian follows the cheekbone into the interdental space. If invaded by wind-cold, mild cases present with shivering and jaw quivering, while severe cases result in trismus (lockjaw).
It is also stated: Sudden collapse with trismus is caused by wind-stroke phlegm obstruction.
Furthermore: When wind enters the submandibular and cheek regions, it causes oral dysfunction and tight teeth.
In cases of sudden severe wind-stroke with trismus where medication cannot be swallowed, use Tongguan San (Passing Through Obstruction Powder). [Ingredients: Xixin (Asari Radix et Rhizoma), Bohe (Menthae Haplocalycis Herba), Zhuya Zao (Gleditsiae Sinensis Fructus cum Spina), Xionghuang (Realgar), each 2 qian, ground to fine powder.] Use a small amount, insufflate into the nose, wait for sneezing, then administer medicine. If no sneeze occurs, the condition is considered untreatable. For severe trismus, add a small amount of Shexiang (Moschus) to the previous prescription, or use Wumei (Mume Fructus) or Bai Mei (White Plum Fruit) pitted, and apply to the teeth using the medicine. Sour flavors enter the sinews first, causing the jaw to relax and open. This aligns with the principle that Wood controls Earth, as the gums belong to the Yangming Stomach Earth.
Regarding Gu Cao Feng (Alveolar Osteomyelitis) and Jia Che Ju (Cheek Carcinoma/Abscess), excessive wind-heat and phlegm-fluid stagnation in the diaphragm occur. Wind tends to injure the Liver and dries substances, leading to dry, tense sinews that force the jaw into spasm; this is an excess pathogen.
Feng Luzhan stated: Trismus is a disease of the Foot-Yangming meridian, primarily treated by the Jiache acupoint. The Yangming meridians flank the mouth and encircle the lips, following the Jiache point. All Yang sinews ascend to the head, and the sinews of the Three Yang meridians interconnect at the submandibular and cheek regions, flanking the mouth. When wind-cold invades these meridians due to deficiency, the sinews become spasmodic, causing trismus and lockjaw.
For trismus caused by wind-stroke, rubbing the teeth with Wumei meat (Mume Fructus pulp) will cause the jaw to open.
For infants with lockjaw, roast Tian Nanxing (Arisaematis Rhizoma) until cooked, wrap it in paper while hot ensuring no air leakage. Cut a hole in the paper the size of a Chinese chestnut seed to allow ventilation, and place it over the infant's nostril; the jaw will open.
For any throat or dental conditions where the mouth cannot open:
Zhuya Zao (Gleditsiae Sinensis Fructus cum Spina), Qingdai (Indigo Naturalis), Beixixin (Asari Radix et Rhizoma), Jiangcan (Bombyx Batryticatus), each 1 qian; Shandougen (Sophorae Tonkinensis Radix), Yuan Shen (Scrophulariae Radix), each 0.5 qian.
Grind all ingredients into a fine powder. Insufflate into the left nostril for males or the right nostril for females to open the mouth.