Library

Dental bleeding (Chi Nu) differs in its involvement of the Hand Yangming, Foot Yangming, and Foot Shaoyin meridians. This is because the Hand Yangming Large Intestine Meridian enters the lower teeth, while the Foot Yangming Stomach Meridian enters the upper teeth. Since the Kidney governs the bones, and teeth are considered the surplus of the bones, dental bleeding often occurs due to Kidney deficiency. Cases belonging to the Foot Shaoyin Kidney deficiency typically manifest as a state of insufficiency; thus, there is no foul odor in the mouth, and the teeth do not ache. Even if there is pain, it is not severe, but rather characterized by loose and unstable teeth. This condition is common in individuals with Yin deficiency, emaciation, and excessive sexual indulgence. Treatment should involve both clearing heat and tonifying deficiency, which is distinctly different from other treatments, and thus must be differentiated carefully.

The *Yuanzhu* states: "Dental bleeding is mostly caused by excess heat in the Yangming." This is because both the Hand and Foot Yangming meridians enter the teeth, and the Chong and Ren vessels also attach to the Yangming meridians. The Yangming meridians are rich in both Qi and Blood. When there is heat in the Yangming, upon manifestation, it ascends along the meridians into the teeth, causing blood to surge like a tide, accompanied by unceasing pain, and in severe cases, mental confusion. I generally use two qian of Sanzhi Dahuang (Three-processed Rhubarb) powder, mixed with a small amount of Zhiqiao Tang (Immature Bitter Orange Decoction) and Tongbian (Child's Urine), taken orally. After passing several pieces of black stool, the bleeding stops immediately. It must be understood that bleeding caused by Kidney deficiency will drip out drop by drop, and the toothache will be lingering and dull, certainly not as sudden and severe as described above.

Qingwei Yin (Stomach-Clearing Drink) from Dongyuan treats unbearable toothache radiating to the head, facial fever, or rotting and ulceration of gums and teeth with continuous bleeding, resulting from drinking strong wine, eating rich flavors, or excessive use of warming herbs for the Stomach. This is Fire of the Yangming.
Ingredients: Shengdi Huang (Rehmanniae Radix, 1.5 qian), Shengma (Cimicifugae Rhizoma), Dang Gui (Angelicae Sinensis Radix), Mudan Pi (Moutan Cortex), Xijiao (Rhinocerotis Cornu), Lianqiao (Forsythiae Fructus) (each 1 qian), Gancao (Glycyrrhizae Radix et Rhizoma), Huanglian (Coptidis Rhizoma).
Usage: Decoct in water and take orally.
Commentary: For excess heat in the Yangming steaming upwards to affect the mouth and teeth, this formula is suitable for clearing. If constipation is present, Dahuang (Rhei Radix et Rhizoma) must be added to purge the heat from below.

The prescription from *Waitai Miyao* treats bleeding from all teeth in the mouth.
Method: Wash the root of Gouqi (Lycii Cortex), decoct in water, and use the liquid to gargle and swallow. Effective.

Dihuang Yinzi (Rehmannia Guide) from *Yuanrong* treats persistent dental bleeding due to Kidney deficiency.
Ingredients: Shu Dihuang (Prepared Rehmanniae Radix), Sheng Dihuang (Fresh Rehmanniae Radix), Digupi (Lycii Cortex), Gouqizi (Lycii Fructus) (equal parts).
Usage: Bake until dry, grind into powder. Take two qian each time, mixed with honey water, at any time.
*Baojian* records using this formula to treat recurrent epistaxis and other bleeding disorders that persist for a long time; taking it three times daily yields good results.

Anshen Wan (Kidney-Anchoring Pill) treats rising of Deficient Fire due to Kidney deficiency, where symptoms worsen after taking cooling medicines. It should be taken with light salt water, three to five qian at a time. Alternatively, Hei Dan (Black Pellet) may be taken intermittently, or Shenqi Wan (Kidney-Qi Pill) decocted and taken orally, which is also effective. (Note by Henian)