〔 附〕统属足少阴肾经(《灵枢》曰∶足少阴气绝者,则骨枯。少阴者,冬脉也,伏阴
而濡骨髓者也。故骨不濡,则肉不能着也。骨肉不相亲,则肉软却;肉软却,则齿长而垢,发无泽。发无泽者,
骨先灭,戊笃已死,土胜水也。《素问》曰∶丈夫八岁肾气实,
发长齿更。五八肾气衰,齿槁发堕。又曰∶肾热者,色黑而齿槁。少阴终者,面黑色,齿长而垢,腹胀闭塞,
上下不通而终矣。戴复庵曰∶肾虚牙浮而痛,甚则憎寒恶热,全具如欲脱之状。宜安肾丸、八味丸、黑锡丹之
类)。
〔上 〕( ,齿根肉也。亦作龈)属足阳明胃经。(《灵枢》曰∶足阳明之脉,循鼻外,入上齿中。《针
经》曰∶上齿痛,喜寒而恶热,取足阳明之原冲阳穴,在两足跗上五寸,骨间陷脉中。丹溪以谓当灸三里穴。
三里者,足阳明之合穴也,在膝下外侧辅骨下三指地,离 骨外一指许,两筋间宛宛中。又曰∶足阳明之入 遍
齿者,名曰角孙,上齿龋取之。《素问》曰∶邪客于足阳明之经。令人鼽衄。上齿寒,又缪传引上齿,齿唇寒
痛,视其手背脉血者,去之。足阳明中趾爪甲上一 。李东垣曰∶上 隶于坤土,乃足阳明胃脉之所贯络也。
止而不动,故上 牙疼,宜升麻散)。
〔下 〕属手阳明大肠经(《灵枢》曰∶手阳明有入 遍齿者,名曰大迎,下齿龋取之。又曰∶手阳明之
脉,其支者贯颊,入下齿中。《针经》曰∶下齿痛,喜热而恶寒,取手阳明之原合谷穴,在两手大指、次指岐骨
间陷中。丹溪以为当灸三间穴。三间者,手阳明之俞穴也,在两手大指、次指本节后内侧骨上缝中,赤白肉际。
王启玄曰∶手阳明脉,贯颊入下齿,故手阳明脉中商阳、二间、三间、合谷、阳溪、偏历、温溜七穴,并主齿
痛。李东垣曰∶下 嚼物,动而不休,手阳明大肠之所贯络也,故下 牙疼,宜白芷散。张洁古曰∶秦艽去下
牙痛,及除本经风湿。薛新甫曰∶大肠热而 肿痛,清胃散治之,重则调胃汤清之)。
[Appendix] The teeth are governed by the Foot-Shaoyin Kidney Meridian (The *Ling Shu* states: When the Qi of the Foot-Shaoyin meridian ceases, the bones become withered. Shaoyin is the pulse of winter, where Yin Qi lies dormant and moistens the bone marrow. Therefore, if the bones are not moistened, the flesh cannot adhere. If flesh and bone do not adhere closely, the flesh becomes soft and recedes; when the flesh recedes, the teeth appear long and accumulate dirt, and the hair loses its luster. Hair losing luster indicates that the bones are failing first; when the condition becomes critical, death ensues due to Earth overcoming Water. The *Su Wen* states: At the age of eight, a man's Kidney Qi becomes substantial, his hair grows, and his teeth change. At the age of forty, his Kidney Qi declines, his teeth become dry, and his hair falls out. It also states: In cases of Kidney Heat, the complexion turns black and the teeth become dry. When the Shaoyin meridian ends, the face turns black, the teeth appear long and dirty, abdominal distension and blockage occur, with no communication between the upper and lower parts, leading to death. Dai Fu'an stated: Kidney deficiency causes floating gums and pain; in severe cases, there is aversion to cold and heat, with symptoms resembling impending loss. Formulas such as An Shen Wan (Kidney-Anchoring Pill), Ba Wei Wan (Eight-Ingredient Pill), and Hei Xi Dan (Black Tin Pill) are suitable).
[Upper Gingiva] (Also known as Yin, referring to the gum tissue at the root of the teeth) belongs to the Foot-Yangming Stomach Meridian (The *Ling Shu* states: The Foot-Yangming meridian runs along the lateral side of the nose and enters the upper teeth. The *Zhen Jing* states: For pain in the upper teeth, which prefers cold and dislikes heat, treat with Yuan-Source point Chongyang (ST42) of the Foot-Yangming meridian, located five cun above the dorsum of the foot, in the depression between the bones where the pulse beats. Zhu Danxi suggested moxibustion on Zusanli (ST36). Zusanli is the He-Sea point of the Foot-Yangming meridian, located three finger-widths below the lateral aspect of the knee, approximately one finger-width lateral to the tibia, in the depression between two tendons. It further states: A branch of the Foot-Yangming meridian enters the teeth, named Jiaosun (GB7); for caries of the upper teeth, this point is selected. The *Su Wen* states: When pathogenic factors invade the Foot-Yangming meridian, it causes nasal congestion and epistaxis. Cold in the upper teeth, transmitted via Miao transmission, leads to cold pain in the teeth and lips; observe blood stasis in the veins on the back of the hand and remove it by bleeding. There is a point one cun above the nail on the middle toe of the Foot-Yangming meridian. Li Dongyuan stated: The upper gingiva belongs to Kun Earth and is penetrated and connected by the Foot-Yangming Stomach meridian. Since the upper gingiva remains still, for pain in the upper teeth caused by this region, Sheng Ma San (Cimicifuga Powder) is appropriate).
[Lower Gingiva] belongs to the Hand-Yangming Large Intestine Meridian (The *Ling Shu* states: The Hand-Yangming meridian has a branch entering the teeth, named Daying (LI19); for caries of the lower teeth, this point is selected. It also states: A branch of the Hand-Yangming meridian passes through the cheek and enters the lower teeth. The *Zhen Jing* states: For pain in the lower teeth, which prefers heat and dislikes cold, treat with Yuan-Source point Hegu (LI4) of the Hand-Yangming meridian, located in the depression between the metacarpal bones of the thumb and index finger. Zhu Danxi suggested moxibustion on Sanjian (LI3). Sanjian is the Shu-Stream point of the Hand-Yangming meridian, located in the medial crease of the bone behind the metacarpophalangeal joint of the thumb and index finger, at the junction of red and white skin. Wang Qixuan stated: The Hand-Yangming meridian passes through the cheek into the lower teeth; therefore, seven points in the Hand-Yangming meridian—Shangyang (LI1), Erjian (LI2), Sanjian (LI3), Hegu (LI4), Yangxi (LI5), Pianli (LI6), and Wenliu (LI7)—all govern toothache. Li Dongyuan stated: The lower gingiva moves continuously during mastication and is penetrated and connected by the Hand-Yangming Large Intestine meridian; thus, for pain in the lower teeth, Bai Zhi San (Angelica Dahurica Powder) is appropriate. Zhang Jiegu stated: Qin Jiao (Radix Gentianae Macrophyllae) removes lower toothache and clears wind-dampness from this meridian. Xue Xinpu stated: If Large Intestine Heat causes swelling and pain in the gums, Qing Wei San (Clear the Stomach Powder) treats it; in severe cases, Tiao Wei Tang (Regulate the Stomach Decoction) is used to clear heat).