Library

A boil arising in the alveolar ridge (Ya Kuang) is essentially the same whether it occurs on the upper or lower teeth, both being types of dental abscess (Ya Yong). Merely using a lancing needle to bleed, combined with the application of Jiao Yao (a type of stimulating external medicated powder), yields miraculous results.

Whenever a toxic boil arises in the alveolar ridge, presenting as either generalized redness and swelling of the entire ridge or localized redness and swelling, one should first use Bing Peng San (Ice and Borax Powder) mixed with Jiao Yao for holding in the mouth (Qin). Internally, Zi Di Tang should be administered.

Regarding the differentiation between Ya Yong (Dental Abscess) and Sou Ya (Search Tooth), the boundary lies in the height of the alveolar ridge. Lesions located at the higher part of the alveolar ridge are termed Sou Ya; those at the lower part are termed Ya Yong. These conditions may also arise internally or externally. In all cases, a lancing needle can be used to puncture and drain pus and blood, which will naturally prove effective.

Mr. Shufu stated: This condition is caused by heat-toxin in the Yangming Stomach channel. Initially, the patient presents with aversion to cold and fever, along with swollen, red, and painful cheeks and jaw. The aforementioned treatment method should be employed. However, in the early stages, this is often misdiagnosed as simple toothache. Overuse of cold-natured clearing-fire medications leads to hard swelling with pale coloration. If it spontaneously ruptures, yellow fluid drains out; over time, necrosis extends to the tooth roots and spreads to the throat. This is named Gu Cao Feng (Bone Trough Wind), also known as Fu Gu (Attached Bone) or Chuan Zhu (String of Pearls). The treatment should involve decocting Er Chen Tang (Two-Cured Decoction) with Yang He Wan (Yang-Harmonizing Pill) for oral administration, or using Yang He Tang (Yang-Harmonizing Decoction) to dissipate the swelling. If ulceration has occurred, Yang He Tang and Xi Huang Wan (Rhino Horn Yellow Pill) should be taken alternately morning and evening. If sequestra (dead bone) are present, Che Che San (Pushcart Powder) should be insufflated into the lesion. After one night, the dead bone will cease to hurt and may expel itself. One must wait until the tip of the bone protrudes and feels loose upon manipulation before gradually removing it, followed by further insufflation. If no bone expels the next day, Sheng Ji San (Flesh-Regenerating Powder) should be insufflated, and Bao Yuan Tang (Protect-Yuan Decoction) supplemented with Rou Gui (Cinnamon Bark), Dang Gui (Angelica Sinensis), Chuan Xiong (Sichuan Lovage Rhizome), and Sheng Gan Cao (Raw Licorice Root) should be taken internally. Recovery will naturally follow.

In the initial stage of Gu Cao Feng, there is pain in the alveolar bone and inside the cheek, without redness or swelling, unless the swelling involves the facial bones; this indicates Gu Cao Feng. However, dental disorders vary. One type involves "Chi Shi" (Tooth Erosion), where worms erode the teeth down to the gums. This is formed by the accumulation of stasis, dampness, wind, and fire in the Stomach channel, manifesting as distending pain at the tooth root, rotting tissue, and intermittent discharge of foul-smelling pus and blood. Another type is "Chi Qu" (pronounced jù), caused by wind-heat pathogens invading the Yangming channel and condensing with qi and blood in the gums, leading to rotting and discharge of foul-smelling pus and blood. This is called Chi Qu. There is also "Chi Li Du," caused by the inability of marrow qi to nourish the teeth, resulting in darkened, blackened teeth, known as Li Chi. All these conditions stem from the Yangming channel but require different treatments. Detailed notes are provided in the sequel collection.