牙疳，由内蕴胎毒，外感热毒，毒瓦斯上攻，牙根溃烂，随变黑腐，臭秽难闻，辨证最速
，名为走马牙疳。内治以泻毒清热主之。
分阴阳，(二百遍。)推三关，(一百遍。)退六腑，(二百遍。)清天河水，(二百遍。)水
里捞
明月，(五十遍。)摇头，(三十遍。)凡推用香麝葱汤水。金枣砒一枚，用红枣一个去核，以
红砒黄豆大一粒入枣内，湿纸重重包裹，慢火上 至烟尽为度，研细末。穿肠骨一钱，(即
狗屎中未化骨，于白色屎内寻之即得)珍珠、牛黄各五分，冰片八分，广木香一钱二分，铜
绿二钱五分，人中白( )三钱。共八味，各研细末，秤准和匀，先用防风二钱，马兜铃三钱
，甘草一钱，煎汤洗患处。以旧青布拭净毒血，用前药末一分，磨陈京墨调药擦之，大有神
功。韭根松萝茶各二钱，煎成浓汁，乘热以鸡翎蘸洗患处，去净腐肉。
按∶牙疳一证，因热毒攻胃上发，龈肉赤烂肿痛，口臭出血，牙齿脱落，穿腮蚀唇，病
势危
急。外用前药敷之，内治如芩、连、硝、黄、芦荟、芜荑、雄黄之属。或加犀、羚、白虎之
品，
以清火解毒为先，方期有济。然此证专恃胃强能食，堪胜峻药，否则终无生机也。(惕厉子)
脾之脉络系舌旁，肝之脉络系舌本，心之脉络系舌根。心脾蕴热，则气血俱盛，肿附舌
根，
其形状似舌，如舌下又一小舌，故曰重舌也。宜针刺出血，向旁挑之，不可深刺正中主筋之
上也。内治以清心泄热主之。
分阴阳，(二十四遍。)推食指三关，(三十六遍。)推心经，(三十六遍。)推脾经，(一
百遍。
)推六腑，(三十六遍。)运八卦，(三十六遍。)运水入土，(五十遍。)清天河水。(三十六遍
。)凡推用葱汤。
按∶《医宗金鉴·幼科心法》所列吐舌、弄舌、木舌、以及重舌等证。仅例重舌，有举
一漏
万之弊。吐舌，则面红，尿赤，口渴，烦躁不安，宜导赤，泻心火也；弄舌，以儿舌在口内
摇动者，唇焦舌干，烦热便秽，治以泻黄汤，藿、防、山栀、石膏、甘草之属。木舌者，舌
硬如木，不能转动，内治以泻心热，外以紫雪丹涂舌上，是将《心法》所列者补其阙也。然
是书祗列二十四证，遗漏甚多，亦以仍周氏之旧尔。(惕厉子)
牙疳，是由于体内蕴藏胎毒，外部感受热毒，毒气向上攻冲，导致牙根溃烂，随后变黑腐烂，气味臭秽难以忍受，病情变化迅速，被称为走马牙疳。内治以泻除毒邪、清热为主。
推拿操作：分阴阳（二百遍），推三关（一百遍），退六腑（二百遍），清天河水（二百遍），水里捞明月（五十遍），摇头（三十遍）。凡进行推拿操作时，使用香麝葱汤水作为介质。
药物制备：取金枣砒一枚，用一个红枣去核，将红砒（如黄豆大小的一粒）放入枣内，用湿纸层层包裹，在慢火上煨至烟尽为止，研成细末。穿肠骨一钱（即狗粪便中未消化的骨头，在白色粪便中寻找即可得到），珍珠五分，牛黄五分，冰片八分，广木香一钱二分，铜绿二钱五分，人中白三钱。共八味药，分别研成细末，称量准确后混合均匀。先用防风二钱，马兜铃三钱，甘草一钱，煎汤清洗患处。用旧青布擦净毒血，取上述药末一分，用陈年京墨磨汁调药涂抹擦拭，效果极佳。取韭根二钱，松萝茶二钱，煎成浓汁，趁热用鸡毛蘸取清洗患处，去除腐肉。
按语：牙疳这一病症，因热毒攻胃上发，导致牙龈红肿溃烂疼痛，口臭出血，牙齿脱落，甚至穿腮蚀唇，病势危急。外用前文所述药物敷贴，内治则选用黄芩、黄连、芒硝、大黄、芦荟、芜荑、雄黄等药物。或者加入犀角、羚羊角、白虎汤类的药物，以清火解毒为先，才期望有疗效。然而此证专门依赖患者胃气强盛、能够进食，才能承受峻猛的药物，否则最终没有生机。（惕厉子）
脾的脉络联系舌旁，肝的脉络联系舌根底部，心的脉络联系舌根。心脾蕴积热邪，则气血俱盛，肿胀附着于舌根，其形状类似舌头，像舌头下面又长出一个小舌头，所以称为重舌。适宜针刺出血，向旁边挑刺，不可深刺正中主筋的地方。内治以清心泄热为主。
推拿操作：分阴阳（二十四遍），推食指三关（三十六遍），推心经（三十六遍），推脾经（一百遍），推六腑（三十六遍），运八卦（三十六遍），运水入土（五十遍），清天河水（三十六遍）。凡进行推拿操作时，使用葱汤作为介质。
按语：《医宗金鉴·幼科心法》所列出的吐舌、弄舌、木舌以及重舌等证候，仅举例重舌，有举一漏万的弊端。吐舌，表现为面红、尿赤、口渴、烦躁不安，适宜导赤散，以泻心火；弄舌，指小儿舌头在口内摇动，伴有唇焦舌干、烦热便秽，治疗以泻黄汤为主，选用藿香、防风、山栀、石膏、甘草等药物。木舌者，舌头僵硬如木，不能转动，内治以泻心热，外治用紫雪丹涂于舌上，这是补充《心法》所列内容的缺失。然而此书只列出二十四种证候，遗漏甚多，也是沿袭周氏旧有的内容罢了。（惕厉子）
Yagan (Gangrene of the Gums), caused by internal accumulation of fetal toxin and external contraction of heat toxin, with toxic qi attacking upward, leads to ulceration of the gum roots, followed by blackening and rotting, accompanied by a foul odor that is difficult to bear. The condition changes rapidly and is named Zouma Yagan (Running Horse Gangrene of the Gums). Internal treatment focuses on purging toxins and clearing heat.
Tuina manipulation: Fen Yin Yang (Dividing Yin and Yang) (200 times), Tui San Guan (Pushing the Three Gates) (100 times), Tui Liu Fu (Pushing the Six Bowels) (200 times), Qing Tian He Shui (Clearing the Heavenly River Water) (200 times), Shui Li Lao Ming Yue (Fishing for the Bright Moon in the Water) (50 times), Yao Tou (Shaking the Head) (30 times). For all manipulations, use Xiangshe Congtang Shui (Musk and Scallion Decoction Water) as a medium.
Medication preparation: Take one Jin Zao Pi (Gold Date Arsenic), remove the pit from one red date, insert a grain of Hong Pi (Red Arsenic, size of a soybean) into the date, wrap it heavily in wet paper, and slow-roast over fire until smoke ceases, then grind into fine powder. Chuan Chang Gu (Bone Passing Through Intestines, i.e., undigested bone found in white dog feces) 1 qian, Zhenzhu (Pearl) 5 fen, Niuhuang (Calculus Bovis) 5 fen, Bingpian (Borneolum Syntheticum) 8 fen, Guang Muxiang (Costus Root) 1.2 qian, Tonglv (Verdigris) 2.5 qian, Renzhongbai (Calcinata Hominis) 3 qian. These eight herbs are each ground into fine powder, weighed accurately, and mixed uniformly. First, decoct Fangfeng (Saposhnikovia Root) 2 qian, Madouling (Aristolochiae Fructus) 3 qian, and Gancao (Licorice Root) 1 qian in water to wash the affected area. Wipe away toxic blood with an old blue cloth, take 1 fen of the aforementioned powder, mix with Chen Jingmo (Aged Beijing Ink) paste, and apply to the area; this yields miraculous results. Take Jiugen (Garlic Chive Root) 2 qian and Songluocha (Pine Moss Tea) 2 qian, decoct into a concentrated liquid, and while hot, use a chicken feather to dip and wash the affected area to remove necrotic tissue completely.
Commentary: Yagan is a condition where heat toxin attacks the stomach and manifests upwards, causing redness, swelling, ulceration, pain, halitosis, bleeding gums, tooth loss, and even perforation of the cheek and erosion of the lips. The disease progresses critically. Externally, apply the aforementioned medication; internally, treat with herbs such as Huangqin (Scutellaria Root), Lianhua (Coptis Rhizome), Xiaoshi (Natrii Sulfas), Dahuang (Rhei Radix et Rhizoma), Lvhua (Aloe), Wuyi (Terminalia Chebula Retusa), and Xionghuang (Realgar). Alternatively, add rhinoceros horn, antelope horn, or Baihu Tang (White Tiger Decoction) to clear fire and detoxify first, hoping for efficacy. However, this condition relies specifically on strong stomach Qi and the ability to eat to withstand harsh medications; otherwise, there is no hope for survival. (Tilizi)
The meridians of the Spleen connect to the sides of the tongue, the meridians of the Liver connect to the root of the tongue, and the meridians of the Heart connect to the base of the tongue. If Heat accumulates in the Heart and Spleen, Qi and Blood become excessive, leading to swelling attached to the tongue root. Its shape resembles the tongue, appearing like a small tongue under the main tongue, hence it is called Chongshe (Double Tongue). Acupuncture to induce bleeding is suitable; pierce laterally, avoiding deep insertion into the central tendon. Internal treatment focuses on clearing the Heart and draining Heat.
Tuina manipulation: Fen Yin Yang (Dividing Yin and Yang) (24 times), Tui Shi Zhi San Guan (Pushing the Three Gates of the Index Finger) (36 times), Tui Xin Jing (Pushing the Heart Meridian) (36 times), Tui Pi Jing (Pushing the Spleen Meridian) (100 times), Tui Liu Fu (Pushing the Six Bowels) (36 times), Yun Ba Gua (Rotating the Eight Trigrams) (36 times), Yun Shui Ru Tu (Moving Water into Earth) (50 times), Qing Tian He Shui (Clearing the Heavenly River Water) (36 times). For all manipulations, use Congtang (Scallion Decoction) as a medium.
Commentary: The "Yi Zong Jin Jian · You Ke Xin Fa" lists conditions such as Tuthe (Protruding Tongue), Nongshe (Playing Tongue), Muthe (Wooden Tongue), and Chongshe (Double Tongue). Listing only Chongshe has the flaw of mentioning one while missing ten thousand others. Tuthe presents with a red face, dark urine, thirst, and restlessness; it is suitable for Daochi San to drain Heart Fire. Nongshe refers to a child shaking their tongue inside the mouth, accompanied by dry lips and tongue, irritability, heat, and foul stool; it is treated with Xiehuang Tang, using Huoxiang (Patchouli), Fangfeng (Saposhnikovia), Shanzhi (Gardenia), Shigao (Gypsum), and Gancao (Licorice). Muthe involves a tongue stiff as wood, unable to move; internally treat by draining Heart Heat, and externally apply Zixue Dan (Purple Snow Pill) to the tongue. This supplements the omissions in the "Xin Fa." However, this book only lists twenty-four conditions, omitting many, merely following Zhou's old content. (Tilizi)