【方歌】牙宣初起肿牙龈，日渐腐颓久露根，恶热恶凉当细别，
胃经客热风寒侵。
【注】此证牙龈宣肿，龈肉日渐腐颓，久则削缩，以致齿牙宣
露。总由胃经客热积久，外受邪风，寒凉相搏而成。有
喜凉饮而恶热者，系客热遇寒凉，凝滞于龈肉之间；有
喜热饮而恶凉者，系客热受邪风，稽留于龈肉之内。客
热遇寒者，牙龈出血，恶热口臭，宜服清胃汤；客热受
风者，牙龈恶凉，遇风痛甚，宜服独活散。外有龈牙腐
臭，齿根动摇者，属胃中虚火，而兼肾虚，齿乃肾之余
，宜服三因安肾丸。又有牙龈腐臭，时津白脓者，属胃
中湿，热宜服属角升麻汤，外俱用胡桐泪散擦之，以食
盐冲汤漱口。惟牙龈动摇，或兼疼痛者，日以李杲牢牙
散擦之，夜用固齿白玉膏贴之，缓缓取效。若龈肉腐烂
，露牙床骨者逆。
方剂：独活散
组成：独活 羌活
防风 川芎（各一钱六分）
薄荷 生地
荆芥（各一钱） 细辛（七分）
上为粗末，每用二钱，水煎澄渣，食后服，日用三
服。
【方歌】独活风毒注牙根，龈肿嫌凉痛莫禁，羌活防风共生地，
薄荷荆芥合芎辛。
又方：三因安肾丸
组成：补骨脂（炒） 胡庐巴（炒）
茴香（炒） 川楝子（炒）
续断（炒，各三两） 山药
杏仁（炒） 白茯苓
桃仁（炒，各二两）
共研细末，炼蜜为丸，如梧桐子大。每服二钱，空
心淡盐汤送下。
【方歌】三因安肾虚火烁，牙龈腐臭齿根摇，山药杏茴苓骨脂，
胡卢巴续川楝桃。
又方：胡桐泪散
组成：胡桐泪 细辛
川芎 白芷（各一钱五分）
寒水石（〔火段〕，二钱） 生地（一钱）
青盐（二分）
共研细末，干搽牙龈患处，待顿饭时，以温水漱去
，少时再上。
【方歌】胡桐泪散牙龈肿，津血宣露或出脓，细辛寒水石生地，
青盐白芷共川芎。
又方：李杲牢牙散
组成：龙胆草（酒浸，一两五钱） 羌活
地骨皮（各一两） 升麻（四分）
共研末，先以温水漱口，用少许搽之。
【方歌】李杲牢牙擦齿病，牙龈摇动或兼疼，胆草升麻羌地骨，
研末漱口搽有功。
又方：固齿白玉膏
组成：官粉（研，一两） 珍珠（末，三钱）
阳起石（用僵蚕四十九条，防风、当归、川芎、牙皂、
青盐、升麻、白芷、地骨皮各五钱，细新、〔
高〕本各三钱，共研粗末，长流水五碗，同药
入砂锅内，以桑柴火熬药至三碗，去渣；再入
砂锅内，煎至一碗，将龙骨、阳起石火〔火段
〕通红，入药汁内淬之。如此七次，去药汁，
将龙骨、阳起石焙干，研末）
麝香（末，二钱） 龙骨（二两）
象牙（末，五钱）
用黄蜡三两，溶化滤净，再化，离火候温，方入前
药和匀，乘热摊纸上。如膏冷，将熨斗烧热仰放，纸铺
熨斗底上摊之。用时先以温水漱口，将膏剪一小条，贴
于患处，闭口勿语。
【方歌】固齿白玉贴牙效，一切牙痛及动摇，官粉珍珠阳起麝，
龙骨象牙黄蜡熬。
又方：清胃汤（见牙衄）
犀角升麻汤（见面物颊疡）
【方歌】牙宣初起时牙龈肿胀，日渐腐烂萎缩，久则牙齿根部暴露。需仔细辨别患者是怕热还是怕冷，这分别对应胃经客热或风寒侵袭。
【注】此证表现为牙龈红肿，龈肉日渐腐烂萎缩，时间久了便收缩，导致牙齿根部显露。总归是因为胃经有客热积存日久，又外受邪风侵袭，寒凉之气与客热相互搏结而致病。有的患者喜欢喝冷饮而厌恶热饮，这是因为客热遇到寒凉之物，凝滞于龈肉之间；有的患者喜欢喝热饮而厌恶凉物，这是因为客热受到邪风侵袭，稽留于龈肉之内。若是客热遇寒者，会出现牙龈出血、厌恶热气、口臭等症状，适宜服用清胃汤（Qingwei Tang, Stomach-Clearing Decoction）；若是客热受风者，牙龈厌恶凉感，遇风疼痛剧烈，适宜服用独活散（Duhuo San, Angelicae Pubescentis Powder）。若伴有牙龈牙齿腐烂发臭、齿根动摇者，属于胃中虚火，兼有肾虚，因为“齿为肾之余”（Teeth are the surplus of the Kidney），适宜服用三因安肾丸（Sanyin Anshen Wan, Three Causes Kidney-Stabilizing Pill）。又有牙龈腐烂发臭，时常流出白色脓液者，属于胃中湿热，适宜服用角升麻汤（Jiao Shengma Tang, Horn and Cimicifugae Decoction），外用胡桐泪散（Hutonglei San, Trogopterus Dung Powder）擦拭患处，并用食盐冲水漱口。唯独牙龈动摇，或兼有疼痛者，白天用李杲（Li Gao）的牢牙散（Laoya San, Tooth-Firming Powder）擦拭，晚上用固齿白玉膏（Guchi Baiyu Gao, Tooth-Solidifying White Jade Ointment）贴敷，缓缓取效。如果龈肉腐烂，露出牙床骨者，预后不良（逆）。
方剂：独活散（Duhuo San, Angelicae Pubescentis Powder）
组成：独活（Angelicae Pubescentis Radix）、羌活（Notopterygii Rhizoma et Radix）、防风（Saposhnikoviae Radix）、川芎（Ligustici Chuanxiong Rhizoma）各一钱六分；薄荷（Menthae Haplocalycis Herba）、生地（Rehmanniae Radix）、荆芥（Schizonepetae Spica）各一钱；细辛（Asari Radix et Rhizoma）七分。
以上药材研成粗末，每次取二钱，加水煎煮后澄清去渣，饭后服用，每日服三次。
【方歌】独活散治疗风毒注于牙根，牙龈肿胀嫌凉且疼痛难忍，羌活与防风同生地相配，薄荷、荆芥合川芎、细辛共奏功效。
又一方：三因安肾丸（Sanyin Anshen Wan, Three Causes Kidney-Stabilizing Pill）
组成：补骨脂（Psoraleae Fructus，炒制）、胡芦巴（Foenugraeci Semens，炒制）、茴香（Foeniculi Fructus，炒制）、川楝子（Toosendan Fructus，炒制）、续断（Dipsaci Radix，炒制）各三两；山药（Dioscoreae Rhizoma）、杏仁（Armeniacae Semen Amarum，炒制）、白茯苓（Poria）、桃仁（Persicae Semen，炒制）各二两。
共同研成细末，用炼蜜制成梧桐子大小的丸药。每次服用二钱，空腹时用淡盐汤送服。
【方歌】三因安肾丸治疗肾虚火烁导致的牙龈腐烂发臭和齿根动摇，山药、杏仁、茴香、茯苓、补骨脂、胡芦巴、续断、川楝子、桃仁共用。
又一方：胡桐泪散（Hutonglei San, Trogopterus Dung Powder）
组成：胡桐泪（Trogopteri Excrementum）、细辛（Asari Radix et Rhizoma）、川芎（Ligustici Chuanxiong Rhizoma）、白芷（Angelicae Dahuricae Radix）各一钱五分；寒水石（Natrii Sulfatis Crystal，煅烧）二钱；生地（Rehmanniae Radix）一钱；青盐（Natrii Chloridum）二分。
共同研成细末，干擦牙龈患处，待一顿饭的时间后，用温水漱去，过一会儿再上药。
【方歌】胡桐泪散治疗牙龈肿胀，津血外露或出脓，细辛、寒水石、生地、青盐、白芷共川芎使用。
又一方：李杲牢牙散（Li Gao Laoya San, Li Gao's Tooth-Firming Powder）
组成：龙胆草（Gentianae Radix，酒浸）一两五钱；羌活（Notopterygii Rhizoma et Radix）、地骨皮（Lycii Cortex）各一两；升麻（Cimicifugae Rhizoma）四分。
共同研成粉末，先以温水漱口，取少许药粉搽涂患处。
【方歌】李杲牢牙散用于擦拭牙齿疾病，牙龈动摇或兼疼痛，龙胆草、升麻、羌活、地骨皮研末，漱口搽涂有效。
又一方：固齿白玉膏（Guchi Baiyu Gao, Tooth-Solidifying White Jade Ointment）
组成：官粉（Cerussa，研细）一两；珍珠（Margarita，研末）三钱；阳起石（Actinolite，用僵蚕四十九条，防风、当归、川芎、牙皂、青盐、升麻、白芷、地骨皮各五钱，细辛、藁本各三钱，共同研成粗末，用长流水五碗，同药放入砂锅内，以桑柴火熬药至三碗，去渣；再将药汁倒入砂锅内，煎至一碗，将龙骨、阳起石火烧通红，投入药汁中淬炼。如此七次后，去药汁，将龙骨、阳起石焙干，研成粉末）；麝香（Moschus，研末）二钱；龙骨（Fossilia Os Mastodi，二两）；象牙（Elephantis Dentis Corneum，研末）五钱。
用黄蜡三两，溶化过滤干净，再次熔化，离火后温度稍降，才加入前面的药粉混合均匀，趁热摊在纸上。如果膏体冷却，将熨斗烧热仰放，将纸铺在熨斗底上摊开。使用时先以温水漱口，将膏剪成一小条，贴于患处，闭口不要说话。
【方歌】固齿白玉膏贴敷牙齿疗效显著，治疗一切牙痛及牙齿动摇，官粉、珍珠、阳起石、麝香、龙骨、象牙与黄蜡熬制而成。
又一方：清胃汤（Qingwei Tang, Stomach-Clearing Decoction）（见牙衄条目）
犀角升麻汤（Xijiao Shengma Tang, Rhinoceros Horn and Cimicifugae Decoction）（见面部颊疡条目）
[Formula Song] At the onset of Ya Xuan (Gum Disease), the gums swell; gradually they rot and atrophy, eventually exposing the tooth roots. One must carefully distinguish whether the patient dislikes heat or cold, which corresponds to Guest Heat in the Stomach Meridian or invasion by Wind-Cold.
[Annotation] This condition presents with swollen gums, where the gingival tissue gradually rots and atrophies. Over time, it shrinks, leading to the exposure of tooth roots. It is generally caused by accumulated Guest Heat in the Stomach Meridian over a long period, combined with external invasion by pathogenic Wind. The Cold and Heat clash and bind together to form the disease. Some patients prefer cold drinks and dislike heat; this is because Guest Heat encounters cold substances, causing stagnation between the gum tissues. Others prefer hot drinks and dislike cold; this is because Guest Heat is affected by pathogenic Wind, lingering within the gum tissues. For those with Guest Heat encountering Cold, symptoms include bleeding gums, aversion to heat, and foul breath; Qingwei Tang (Stomach-Clearing Decoction) is suitable. For those with Guest Heat affected by Wind, the gums dislike cold sensations, and pain worsens upon exposure to wind; Duhuo San (Angelicae Pubescentis Powder) is suitable. If accompanied by rotting and foul odor of the gums and teeth, along with loose tooth roots, it belongs to Deficient Fire in the Stomach combined with Kidney Deficiency, as "teeth are the surplus of the Kidney"; Sanyin Anshen Wan (Three Causes Kidney-Stabilizing Pill) is suitable. In cases where the gums rot and smell foul, and white pus is occasionally discharged, it belongs to Damp-Heat in the Stomach; Jiao Shengma Tang (Horn and Cimicifugae Decoction) is suitable. Externally, Hutonglei San (Trogopterus Dung Powder) should be applied to the affected area, and rinsing with salt water is recommended. Specifically for loose gums or those accompanied by pain, Li Gao's Laoya San (Tooth-Firming Powder) should be used for rubbing during the day, and Guchi Baiyu Gao (Tooth-Solidifying White Jade Ointment) should be applied at night, taking effect slowly. If the gingival tissue rots completely, exposing the alveolar bone, the prognosis is unfavorable (Ni).
Formula: Duhuo San (Angelicae Pubescentis Powder)
Composition: Duhuo (Radix Angelicae Pubescentis), Qianghuo (Rhizoma et Radix Notopterygii), Fangfeng (Radix Saposhnikoviae), Chuanxiong (Rhizoma Ligustici Chuanxiong) each 1 qian 6 fen; Bohe (Herba Menthae Haplocalycis), Shengdi (Radix Rehmanniae Jingtenis), Jingjie (Spica Schizonepetae) each 1 qian; Xixin (Radix et Rhizoma Asari) 7 fen.
Grind the above into coarse powder. Each time use 2 qian, decoct in water, clarify and remove dregs, take after meals, three times daily.
[Formula Song] Duhuo San treats wind-toxin injecting into the tooth root; gum swelling dislikes cold and pain is unbearable. Qianghuo and Fangfeng grow with Shengdi; Bohe, Jingjie combine with Chuanxiong and Xixin.
Another Formula: Sanyin Anshen Wan (Three Causes Kidney-Stabilizing Pill)
Composition: Buguzhi (Fructus Psoraleae, stir-fried), Huluba (Semen Foenugraeci, stir-fried), Huixiang (Fructus Foeniculi, stir-fried), Chuanlianzi (Fructus Toosendan, stir-fried), Xuduan (Radix Dipsaci, stir-fried) each 3 liang; Shanyao (Rhizoma Dioscoreae), Xingren (Semen Armeniacae Amarum, stir-fried), Baifuling (Poria), Taoren (Semen Persicae, stir-fried) each 2 liang.
Grind together into fine powder, make pills with refined honey, size of Sophora japonica seeds. Take 2 qian per dose, swallow with light salt water on an empty stomach.
[Formula Song] Sanyin Anshen Wan treats kidney deficiency fire scorching; gum rot, foul odor, and loose roots. Shanyao, Xingren, Huixiang, Fuling, Buguzhi, Huluba, Xuduan, Chuanlianzi, and Taoren are used together.
Another Formula: Hutonglei San (Trogopterus Dung Powder)
Composition: Hutonglei (Excrementum Trogopteri), Xixin (Radix et Rhizoma Asari), Chuanxiong (Rhizoma Ligustici Chuanxiong), Baizhi (Radix Angelicae Dahuricae) each 1 qian 5 fen; Hanshuishi (Crystal Natrii Sulfatis, calcined) 2 qian; Shengdi (Radix Rehmanniae Jingtenis) 1 qian; Qingyan (Natrii Chloridum) 2 fen.
Grind together into fine powder, apply dry to the affected gum area. After one meal's time, rinse with warm water, and reapply after a short while.
[Formula Song] Hutonglei San treats gum swelling; fluids and blood exposed or pus discharged. Xixin, Hanshuishi, Shengdi, Qingyan, Baizhi, and Chuanxiong are combined.
Another Formula: Li Gao Laoya San (Li Gao's Tooth-Firming Powder)
Composition: Longdancao (Radix Gentianae, wine-soaked) 1 liang 5 qian; Qianghuo (Rhizoma et Radix Notopterygii), Digupi (Cortex Lycii) each 1 liang; Shengma (Rhizoma Cimicifugae) 4 fen.
Grind into powder. First rinse mouth with warm water, then apply a small amount to rub the affected area.
[Formula Song] Li Gao Laoya San rubbed for dental diseases; gum loosening or accompanied by pain. Longdancao, Shengma, Qianghuo, and Digupi ground into powder, effective when rubbed after rinsing.
Another Formula: Guchi Baiyu Gao (Tooth-Solidifying White Jade Ointment)
Composition: Guanfen (Cerussa, finely ground) 1 liang; Zhenzhu (Margarita, powdered) 3 qian; Yangqishi (Actinolite, prepared by quenching seven times in decoction made from Jiangcan [Bombyx Batryticatus], Fangfeng, Danggui, Chuanxiong, Yazao, Qingyan, Shengma, Baizhi, Digupi each 5 qian, Xixin, Gaoben each 3 qian, decocted in five bowls of running water using mulberry wood fire until three bowls remain, filtered; then reduced to one bowl, quenching red-hot Longgu and Yangqishi seven times, dried, and powdered); Shexiang (Moschus, powdered) 2 qian; Longgu (Fossilia Os Mastodi) 2 liang; Xiangya (Elephantis Dentis Corneum, powdered) 5 qian.
Melt 3 liang of Huangla (Yellow Beeswax), filter cleanly, melt again. When off the heat and slightly warm, add the aforementioned powders and mix evenly. Spread hot onto paper. If the ointment cools, heat an ironing board upside down, place paper on it, and spread. Before use, rinse mouth with warm water. Cut a small strip of the ointment and apply to the affected area. Keep mouth closed and do not speak.
[Formula Song] Guchi Baiyu Gao applied to teeth is effective; treats all toothaches and loosening. Guanfen, Zhenzhu, Yangqishi, Shexiang, Longgu, Xiangya, and Huangla are boiled together.
Another Formula: Qingwei Tang (Stomach-Clearing Decoction) (See Ya Nu entry)
Xijiao Shengma Tang (Rhinoceros Horn and Cimicifugae Decoction) (See Mian Wu Jia Yang entry)