1.牙者骨余属乎肾, 牙龈手足两阳明, 齿长豁动为肾惫, 牙疼胃火
风寒虫. 不怕冷热为风痛, 火肿喜冷得寒疼, 寒不肿蛀喜热饮, 虫牙
蚀尽一牙生.
【注】牙齿者, 骨之余, 属乎肾也. 若无故齿长, 疏豁而动, 则为肾
衰惫也. 上牙龈属足阳明, 下牙龈属手阳明. 牙痛皆牙龈作痛, 惟寒
牙痛, 则为客寒犯脑, 多头连齿痛, 为寒邪也, 故喜热饮, 不肿不蛀
也.余者, 皆为胃火, 邪风, 湿热也. 火牙疼多肿喜饮冷, 得寒则更
疼者,?? 仇之意也. 虫牙则一牙作痛, 蚀尽一牙, 又蚀一牙作痛也.
骨槽风 牙疳疮
2.骨槽龈颊肿硬疼, 牙龈腐烂出血脓, 牙疳肿硬溃血臭, 皆因痘疹
癖疾成.
【注】骨槽风者, 牙龈连颊硬肿疼痛, 牙龈腐烂, 出血脓也. 牙疳,
以骨槽溃后肿硬不消, 然出臭血, 而不出脓水也, 且皆痘疹癖疾之后
而成也.
清胃散
3.清胃血分火牙痛, 生地归连升牡饶, 气分宜加荆防细, 积热凉膈
入升膏.
【注】胃火牙痛, 赤肿出血者, 则为血分, 宜用清胃散, 即生地, 当
归,黄连, 升麻, 牡丹皮也. 饶者, 倍加升麻, 丹皮也. 若肿痛牙龈
不出血者, 则为气分, 宜加荆芥, 防风, 细辛, 以散其热. 若肠胃积
热,肿痛澜臭, 宜用凉膈散加升麻, 石膏, 以下其热可也.
温风散
4.温风风牙归芎细, 荜苃?? 芷露蜂房, 寒牙痛加羌麻附, 半服含漱
吐涎良.
【注】不甚肿痛, 不怕冷热, 为风牙痛, 宜用温风散. 即当归, 川芎
,细辛, 荜苃, ??本, 白芷, 露蜂房也. 不肿痛甚, 喜饮热汤, 为寒
牙痛, 宜本方再加羌活, 麻黄, 川附子温而散之. 二方俱服一半, 含
漱一半, 连涎吐之自好也.
一笑丸 玉池散 熏药
17.诸牙椒巴饭丸咬, 玉池??芷骨槐辛, 归芎大豆升防草, 虫牙葱韭
子烟熏.
【注】诸牙, 谓诸牙痛也. 均宜一笑丸, 即川椒七粒为末, 巴豆一粒
去皮研匀, 饭为丸, 绵裹咬痛处, 吐涎即止, 均宜用玉池散, 即??
本, 白芷, 地骨皮, 槐花, 细辛, 当归, 川芎, 黑豆, 升麻, 防风,
甘草, 煎汤, 热漱冷吐. 虫牙亦宜此咬漱. 更须用韭子或葱子, 置小
炉中烧之, 搁在大水碗内, 复以漏斗, 口向虫牙痛处熏之, 其虫极小
,皆落水碗之中, 累效.
芜荑消疳汤
18.牙疳虽有专科治, 然皆未晓累攻神, 能食便软犹当下, 雄荑黄荟
二连芩.
【注】牙疳一病, 杀人最速, 虽有专科, 然皆未晓累攻之法. 累攻者
,今日攻之, 明日又攻之, 明日又攻之, 以肿硬消, 黑色变, 臭气止
为度. 若不能食, 或隔一日, 彧隔二, 三日攻之, 攻之后渐能食, 不
必戒口, 任甚所食. 虽大便溏, 仍量其轻重攻之, 自见甚神. 若意不
思食, 难任攻下, 则死证也. 攻药用芜荑消疳汤, 即雄黄, 芜荑, 生
大黄, 芦荟, 川黄连, 胡黄连, 黄芩也.
1. 牙齿是骨骼的余气，归属于肾脏；牙龈分别属于手阳明大肠经和足阳明胃经。牙齿变长、缝隙变大且松动，是肾气疲惫衰败的表现；牙痛多由胃火、风寒或虫蛀引起。不怕冷热刺激的是风痛；红肿且喜冷恶热的是火痛；不红肿但蛀牙且喜热饮的是寒痛；虫牙则是腐蚀完一颗牙齿后，又腐蚀另一颗牙齿产生疼痛。
【注】牙齿是骨骼的余气，归属于肾脏。如果无故出现牙齿变长、疏豁松动的情况，就是肾气衰惫的表现。上牙龈属于足阳明胃经，下牙龈属于手阳明大肠经。牙痛都是牙龈在作痛，只有寒性牙痛，是由于客寒侵犯脑部所致，常表现为头部连带牙齿疼痛，这是寒邪引起的，所以喜欢热饮，且不红肿、无蛀牙。其余的情况，都是由胃火、邪风、湿热引起。火性牙痛多伴有红肿，喜欢冷饮，遇到寒冷则疼痛加剧，这是因为“仇”（即对抗、排斥）的意思。虫牙则是一颗牙齿疼痛，腐蚀完这颗牙齿后，又腐蚀下一颗牙齿产生疼痛。
骨槽风 牙疳疮
2. 骨槽风表现为牙龈连及面颊部位肿胀、坚硬、疼痛；牙疳疮表现为牙龈腐烂、出血流脓；牙疳（此处指重症）表现为肿胀坚硬、溃烂出血且有臭味，这些病症都是因为痘疹或癖疾（积聚类疾病）之后形成的。
【注】骨槽风，是指牙龈连及面颊部位硬肿疼痛，牙龈腐烂，流出血液和脓液。牙疳，是在骨槽风溃烂后，肿胀坚硬不消退，排出臭血，而不流出脓水，并且都是在痘疹或癖疾之后才形成的。
清胃散
3. 清胃散用于治疗血分有火的牙痛，方中含有生地、当归、黄连、升麻、牡丹皮，若需重用则加倍使用升麻和丹皮。若是气分有热，适宜加入荆芥、防风、细辛；若有积热，可加入凉膈散中的升麻和石膏。
【注】胃火引起的牙痛，若牙龈赤肿出血，属于血分病变，适宜使用清胃散，该方由生地、当归、黄连、升麻、牡丹皮组成。“饶”的意思是加倍使用升麻和丹皮。如果牙龈肿痛但不出血，属于气分病变，适宜加入荆芥、防风、细辛，以疏散其热。如果是肠胃积热，导致肿痛且口臭，适宜使用凉膈散加入升麻、石膏，以泻下其热。
温风散
4. 温风散治疗风邪引起的牙痛，方中含有当归、川芎、细辛、荜茇、藁本、白芷、露蜂房。若是寒性牙痛，可在原方中加入羌活、麻黄、附子。服用一半药液，含漱一半药液，吐出涎液后效果良好。
【注】疼痛不甚严重，不怕冷热刺激，属于风邪牙痛，适宜使用温风散。该方由当归、川芎、细辛、荜茇、藁本、白芷、露蜂房组成。若不甚肿痛，喜欢饮用热汤，属于寒性牙痛，适宜在本方基础上再加羌活、麻黄、川附子，以温散寒邪。这两个方剂都要服用一半，含漱一半，连同涎液一起吐出，自然痊愈。
一笑丸 玉池散 熏药
17. 各种牙痛可用花椒、巴豆拌饭制成丸剂咬嚼，玉池散含有藁本、白芷、地骨皮、槐花、细辛、当归、川芎、大豆、升麻、防风、甘草。虫牙可用葱、韭菜子的烟来熏治。
【注】“诸牙”，指的是各种牙痛。都适宜使用一笑丸，即用七粒川椒研成粉末，一粒巴豆去皮研匀，用米饭做成丸剂，用棉布包裹咬在疼痛处，吐出涎液即可止痛。也都适宜使用玉池散，即由藁本、白芷、地骨皮、槐花、细辛、当归、川芎、黑豆、升麻、防风、甘草煎煮成的汤剂，趁热含漱，冷却后吐出。虫牙也适宜用此法咬嚼和含漱。更须要用韭子或葱子，放在小炉中烧灼，置于大水碗上方，上面倒扣漏斗，漏斗口对着虫牙疼痛处进行熏蒸，那些虫子极小，都会落入大水碗中，屡试屡效。
芜荑消疳汤
18. 治疗牙疳虽然有专科方法，但人们都不知晓连续攻伐的神妙之处。只要患者能进食且大便偏软，就应当使用攻下法，药用雄黄、芜荑、大黄、芦荟、黄连、胡黄连、黄芩。
【注】牙疳这一疾病，致死速度最快，虽然设有专科治疗，但医生们都不知晓连续攻伐的方法。所谓连续攻伐，就是今天攻伐它，明天再攻伐它，后天继续攻伐，直到肿胀坚硬消退、黑色变为正常颜色、臭气停止为止。如果患者不能进食，或者隔一天、隔两天、隔三天进行一次攻伐，攻伐之后逐渐能够进食，不必严格忌口，任由食用各种食物。即使大便溏薄，仍然根据病情的轻重程度进行攻伐，自会显现出神奇的效果。如果患者不想吃东西，难以承受攻下之法，那就是死证了。用于攻伐的药物是芜荑消疳汤，即由雄黄、芜荑、生大黄、芦荟、川黄连、胡黄连、黄芩组成。
1. The teeth are the surplus of bone and belong to the Kidney; the gums belong to the Hand-Yangming Large Intestine channel and Foot-Yangming Stomach channel. Teeth elongation, spacing, and mobility indicate Kidney exhaustion; toothache is caused by Stomach Fire, Wind-Cold, or worms. Insensitivity to hot and cold indicates Wind pain; swelling with a preference for cold and aversion to heat indicates Fire pain; non-swelling with caries and a preference for hot drinks indicates Cold pain; worm-induced toothache involves the erosion of one tooth followed by another.
[Note] Teeth are the surplus of bone and belong to the Kidney. If teeth unexpectedly elongate, become spaced, and loose, it signifies Kidney Qi exhaustion. The upper gums belong to the Foot-Yangming Stomach channel, and the lower gums belong to the Hand-Yangming Large Intestine channel. Toothaches generally stem from gum pain. Only cold-type toothache is caused by exogenous Cold invading the brain, often manifesting as headache radiating to the teeth due to Cold pathogen, hence preferring hot drinks without swelling or caries. Other cases are caused by Stomach Fire, Wind pathogens, or Damp-Heat. Fire-type toothache often presents with swelling and a preference for cold drinks; pain worsening upon exposure to cold reflects the principle of "rejection" (antagonism). Worm-induced toothache affects one tooth at a time; after one is eroded, the next becomes painful.
Gu Cao Feng (Bone Trough Wind) and Ya Gan Chuang (Tooth Gangrene Ulcer)
2. Gu Cao Feng presents with swelling, hardness, and pain in the gums extending to the cheek; Ya Gan Chuang presents with gum rotting, bleeding, and suppuration; severe Ya Gan presents with swelling, hardness, ulceration, bloody discharge, and foul odor. These conditions arise following variola (smallpox/varioloid) or Pi Ji (accumulation disorders).
[Note] Gu Cao Feng refers to hard swelling and pain in the gums extending to the cheek, with gum rotting and discharge of blood and pus. Ya Gan refers to persistent hard swelling after the ulceration of Gu Cao Feng, discharging foul-smelling blood but not pus, occurring subsequent to variola or Pi Ji.
Qing Wei San (Clear the Stomach Powder)
3. Qing Wei San treats toothache due to Fire in the Blood level, containing Sheng Di Huang (Rehmanniae Radix), Dang Gui (Angelicae Sinensis Radix), Huang Lian (Coptidis Rhizoma), Sheng Ma (Cimicifugae Rhizoma), and Mu Dan Pi (Moutan Cortex). For greater effect, increase Sheng Ma and Mu Dan Pi. For Heat in the Qi level, add Jing Jie (Schizonepetae Herba), Fang Feng (Saposhnikoviae Radix), and Xi Xin (Asari Radix et Rhizoma). For accumulated Heat, add Sheng Ma and Shi Gao (Gypsum Fibrosum) from Liang Ge San (Cool the Diaphragm Powder).
[Note] Toothache due to Stomach Fire with red, swollen, and bleeding gums belongs to the Blood level; use Qing Wei San, composed of Sheng Di Huang, Dang Gui, Huang Lian, Sheng Ma, and Mu Dan Pi. "Rao" implies doubling the dosage of Sheng Ma and Mu Dan Pi. If gums are swollen and painful without bleeding, it belongs to the Qi level; add Jing Jie, Fang Feng, and Xi Xin to dissipate Heat. For intestinal and gastric accumulated Heat causing swelling, pain, and foul breath, use Liang Ge San augmented with Sheng Ma and Shi Gao to purge Heat downward.
Wen Feng San (Warm Wind Powder)
4. Wen Feng San treats Wind-induced toothache, containing Dang Gui, Chuan Xiong (Ligustici Chuanxiong Rhizoma), Xi Xin, Bi Bo (Piperis Kadsurae Fructus), Xi Xin (Ligustici Wallichii Rhizoma - *Note: Text says ?? Ben, likely Gao Ben*), Bai Zhi (Angelicae Dahuricae Radix), and Lu Feng Fang (Vespa Nidus). For Cold toothache, add Qiang Huo (Notopterygii Rhizoma et Radix), Ma Huang (Ephedrae Herba), and Chuan Fu Zi (Aconiti Lateralis Radix Praeparata). Take half orally and gargle with half, spitting out saliva for good results.
[Note] Mild pain insensitive to temperature changes indicates Wind toothache; use Wen Feng San, composed of Dang Gui, Chuan Xiong, Xi Xin, Bi Bo, Gao Ben (Ligustici Rhizoma), Bai Zhi, and Lu Feng Fang. If there is little swelling/pain but a preference for hot drinks, it indicates Cold toothache; augment this formula with Qiang Huo, Ma Huang, and Chuan Fu Zi to warm and dissipate Cold. Both formulas should be taken half orally and used half for gargling, spitting out saliva, leading to recovery.
Yi Xiao Wan (One Smile Pill), Yu Chi San (Jade Pool Powder), Fumigation Medicine
17. Various toothaches can be treated by biting pills made of Hua Jiao (Zanthoxyli Pericarpium) and Ba Dou (Crotonis Fructus) mixed with rice. Yu Chi San contains Gao Ben, Bai Zhi, Di Gu Pi (Lycii Cortex), Huai Hua (Sophorae Flos), Xi Xin, Dang Gui, Chuan Xiong, Da Dou (Sojae Semen Nigrum), Sheng Ma, Fang Feng, and Gan Cao (Glycyrrhizae Radix et Rhizoma). Worm toothache can be fumigated with smoke from Cong Zi (Allii Fistulosi Semen) or Jiu Zi (Allii Tuberosi Semen).
[Note] "Zhu Ya" refers to various types of toothache. Yi Xiao Wan is suitable for all: grind seven grains of Chuan Jiao into powder, peel and grind one grain of Ba Dou uniformly, mix with rice paste to form pills, wrap in cotton, and bite on the painful area until saliva is expelled and pain stops. Yu Chi San is also suitable: decoct Gao Ben, Bai Zhi, Di Gu Pi, Huai Hua, Xi Xin, Dang Gui, Chuan Xiong, Hei Dou, Sheng Ma, Fang Feng, and Gan Cao. Gargle while hot and spit out when cool. This method is also suitable for worm toothache. Additionally, burn Jiu Zi or Cong Zi in a small stove over a large bowl of water, cover with a funnel directing smoke toward the painful tooth. The tiny worms will fall into the water bowl; this has proven effective repeatedly.
Wu Ti Xiao Gan Tang (Trogopterori Decoction for Eliminating Gangrene)
18. Although there are specialized treatments for Ya Gan, practitioners often fail to understand the efficacy of continuous purgation. If the patient can eat and stools are soft, purgation is indicated using Xiong Huang (Realgar), Wu Ti (Trogopterori Faeces), Da Huang (Rhei Radix et Rhizoma), Lu Hui (Aloe), Huang Lian, Hu Huang Lian (Coptidis Chinensis Rhizoma - *Note: Text distinguishes Huang Lian and Hu Huang Lian*), and Huang Qin (Scutellariae Radix).
[Note] Ya Gan is rapidly fatal. Although specialized treatments exist, doctors often do not master the method of continuous attack ("Lei Gong"). Continuous attack means purging today, tomorrow, and the day after, until swelling and hardness subside, black discoloration resolves, and foul odor ceases. If the patient cannot eat, purge every one to three days. After purging, if appetite returns, no strict dietary restrictions are needed; allow normal food intake. Even if stools are loose, adjust the intensity of purgation based on severity, yielding miraculous results. If the patient lacks appetite and cannot tolerate purgation, it is a death sign. The purgative medicine is Wu Ti Xiao Gan Tang, composed of Xiong Huang, Wu Ti, Sheng Da Huang, Lu Hui, Chuan Huang Lian, Hu Huang Lian, and Huang Qin.