齿者肾之标，口者肾之窍。诸经多有会于口者，齿牙是也。徐用诚先生云∶齿恶寒热等
症，
杂之邪，与外因为患。治法∶湿热甚而痛者，承气汤下之，轻者清胃散调之；大肠热而龈肿
痛者，清胃散治之，重则调胃丸清之；六郁而痛者，越鞠丸解之；中气虚而痛者，补中益气
汤补之；思虚伤脾而痛者，归脾汤调之；肾经虚热而痛者，六味丸补之；肾经虚寒而痛者，
还少丹补之，重则八味丸主之；其属风热者，独活散；大寒犯脑者，血芷散；风寒入脑者，
羌活附子汤。病症多端，当临症制宜。
治验
宗伯毛三江，胃经虚热，齿牙作痛，用补中益气加熟地、丹皮、茯苓、芍药寻愈。
廷尉张中梁齿动，或用清胃散，肢体倦怠，饮食少思，牙齿作痛。余曰∶此脾肾亏损，
用安肾丸、补中益气汤兼服。外用羌活散而愈。或牙根溃烂，如喜寒恶热者，乃胃血伤也，用清
胃散。若恶寒喜热者，胃气伤也，用补中益气汤。
杨考功齿动作渴，属脾胃虚弱，阴火炽甚，用补中益气加酒炒黑黄柏四剂，又服加减八
味丸，诸症顿愈。又用补中益气汤而痊愈。
王侍御齿摇龈露，喜冷冻饮料食，此胃经湿热。先用承气汤以退火，又用清胃散以调理而齿
固。继而用六味丸以补肾水，羌活散以祛外邪，而寻愈。
王吏部。患齿痛，或用祛风等剂，更加寒热体倦，懒食欲呕。彼以为火盛。余曰∶病因
元气不足，前药复伤。遂用补中益气加茯苓、半夏，元气复而诸症愈。
郭职方善饮，齿痛腮颊 肿。此胃经湿热，用清胃散加干葛、荆、防而愈。
郑吏部仲冬牙痛连脑，此肾经风寒所犯。用羌活附子汤一服即愈。此症不问冬夏，肾虚
者多患之，急用此药可瘳，缓则不救。
朱工部午后有热，遇劳遗精，甚齿即痛。此脾肾虚热。先用补中益气送六味丸，更以十全大补汤而愈。
党吏部齿根肿痛， 连 颊。此胃经风热，用犀角升麻汤即愈。
表兄颜佥宪牙痛，右寸后半指脉洪而有力。余曰∶此大肠积热，当用寒凉之剂。自泥年
高，服补阴之药，呻吟彻夜。余与同舟赴京，煎凉膈散加荆、防、石膏，与服一钟即愈。
大尹余时正素善饮，齿常浮痛，腹痛作泻。此酒积伤脾。食后用清胃散，食前解醒汤而
膳部钟复斋，每劳心则齿缝胀而不能咀嚼，此元气虚弱。先用补中益气汤而痊。更用十
全大补汤，虽劳不作。
儒者柴济美善饮，牙蛀不生，或时作痛，用桃仁承气汤二剂，又以清胃散加山栀、葛根
一男子晡热内热，牙痛龈溃，常取小虫，此足三阴虚火，足阳明经湿热。先用桃仁承气
汤二剂，又用六味地黄丸而愈。
一男子患齿痛，饮食难化，大便不实。此脾肾不足。用还少丹而愈。
一男子每足发热，牙即浮肿。此足三阴虚火。用加减八味丸，而不复作。
一男子齿浮作痛，耳面黧色，口干作渴，日晡则剧。此脾虚弱也。用补中益气汤、加减
一妇人因怒齿痛，寒热作呕，用清胃等药益甚。此肝火伤胃，寒药复伤。用六君子加芍
一妇人胃中嘈辣，甚则热痛，后患齿痛。此胃火生痰也。用二陈加芩、连下越鞠丸而瘳
一妇人发热齿痛，日晡益甚，月水不调。此脾经血虚所致。用逍遥散加升麻寻愈。后因
怒复痛，仍以前药加川芎而痊。
一妇人因怒，牙痛寒热。用小柴胡加芎、归、苓、术、山栀而疼痛止，用加味逍遥散，
荆妇每产后，齿根皆动，必逾日乃止。后复怀妊，临月时，立斋翁偶至，言及此症，留十全
大补汤二剂，令产后煎服，齿不复动矣。果如言，愚奇其神异，敢缀数言，附之卷末。后有
作者，皆得观法焉，则先生之德，垂之永久矣。后学吴江史羊生顿首谨书。
貌云叔父芝岩先生，齿根浮肿，痛不可忍，命貌求治于立翁先生。翁曰∶此痛龈浮而不动，
属于坤土，乃足阳明脉所贯络也，因胃有湿热故尔。用清胃散加山栀、玄参进一服，应手而
瘥。貌谨记其梗概，以附医录，将俾后之学医者，有所准则云。嘉靖丁未仲秋，晚眷生郁貌顿首拜书。
牙齿是肾脏的外在表现，口腔是肾脏的孔窍。多条经络都会聚于口腔，牙齿便是其中之一。徐用诚先生曾说：牙齿对寒热等病症敏感，多由杂合之邪与外因共同致病。治疗方法：湿热严重导致疼痛的，用承气汤攻下；症状较轻的，用清胃散调理；大肠有热导致牙龈肿痛者，用清胃散治疗，严重的用调胃丸清除；六郁（气、血、痰、火、湿、食六种郁结）导致疼痛的，用越鞠丸解郁；中气虚弱导致疼痛的，用补中益气汤补益；思虑过度损伤脾气导致疼痛的，用归脾汤调理；肾经虚热导致疼痛的，用六味丸滋补；肾经虚寒导致疼痛的，用还少丹补益，严重的用八味丸主治；属于风热的，用独活散；大寒侵袭脑部者，用血芷散；风寒侵入脑部者，用羌活附子汤。病症种类繁多，应当根据具体症状灵活施治。
医案记录：
宗伯毛三江，胃经有虚热，牙齿疼痛，使用补中益气汤加入熟地黄、牡丹皮、茯苓、芍药，不久便痊愈。
廷尉张中梁牙齿松动，有人给他用清胃散，结果肢体倦怠，饮食减少且不想进食，牙齿疼痛。我说：这是脾肾亏损，让他同时服用安肾丸和补中益气汤。外用羌活散，病就好了。如果牙根溃烂，喜欢寒冷厌恶炎热的，是胃血受损，用清胃散。如果厌恶寒冷喜欢温暖的，是胃气受损，用补中益气汤。
杨考功牙齿松动且口渴，属于脾胃虚弱，阴火炽盛，使用补中益气汤加入酒炒黑黄柏，服用四剂，又服用加减八味丸，各种症状立刻痊愈。随后又服用补中益气汤而完全康复。
王侍御牙齿摇动、牙龈萎缩外露，喜欢冷冻饮料食物，这是胃经湿热。先用承气汤以退去火气，再用清胃散调理从而使牙齿稳固。继而用六味丸以补肾水，用羌活散以祛除外邪，不久便痊愈。
王吏部患牙齿疼痛，有人使用祛风等药剂，反而加重了寒热、身体疲倦、懒于食欲且想呕吐的症状。他认为这是火气旺盛。我说：病因是元气不足，之前的药物再次损伤了正气。于是用补中益气汤加入茯苓、半夏，元气恢复后各种症状痊愈。
郭职方善于饮酒，牙齿疼痛且腮颊肿胀。这是胃经湿热，用清胃散加入干葛、荆芥、防风而痊愈。
郑吏部仲冬时节牙痛牵连到脑部，这是肾经受到风寒侵袭。服用一剂羌活附子汤即痊愈。这种病症不分冬夏，肾虚的人大多会患此病，急用此药可以治愈，拖延则无法挽救。
朱工部午后发热，劳累后遗精，严重时牙齿就疼痛。这是脾肾虚热。先用补中益气汤送服六味丸，再用十全大补汤而痊愈。
党吏部齿根肿痛，牵连到面颊。这是胃经风热，用犀角升麻汤即痊愈。
表兄颜佥宪牙齿疼痛，右手寸脉后半指处脉象洪大有力。我说：这是大肠积热，应当使用寒凉药剂。他自己固执于年事已高，服用滋阴的药物，整夜呻吟痛苦。我与他同船赴京，煎制凉膈散加入荆芥、防风、石膏，给他服用一钟（量词），立刻痊愈。
大尹余时正素来善于饮酒，牙齿经常浮痛，腹痛腹泻。这是酒积损伤脾胃。饭后服用清胃散，饭前服用解醒汤。
膳部钟复斋，每次用心劳神则感觉齿缝胀满而不能咀嚼，这是元气虚弱。先用补中益气汤而痊愈。更用十全大补汤，即使劳累也不再发作。
儒者柴济美善于饮酒，牙齿蛀蚀不生新牙，有时疼痛，用桃仁承气汤两剂，又以清胃散加入山栀、葛根……（原文此处似有缺漏或断句问题，依文意推测为后续治疗描述，但根据“提取规则”只提取明确实体，翻译尽量忠实原文结构，此处原文似乎中断或排版错误，按现有文本翻译）……一男子傍晚发热伴有内热，牙痛牙龈溃烂，常取出小虫，这是足三阴虚火，足阳明经湿热。先用桃仁承气汤两剂，又用六味地黄丸而痊愈。
一男子患牙齿疼痛，饮食难以消化，大便不成形。这是脾肾不足。用还少丹而痊愈。
一男子每当下肢发热，牙齿就浮肿。这是足三阴虚火。用加减八味丸，之后不再复发。
一男子牙齿浮动疼痛，耳面部面色黧黑，口干口渴，傍晚时分加剧。这是脾脏虚弱。用补中益气汤、加减……（原文此处似有缺漏）……一妇人因愤怒导致牙齿疼痛，寒热交替并呕吐，服用清胃等药物后病情加重。这是肝火损伤胃腑，寒性药物再次损伤正气。用六君子汤加入芍药……（原文此处似有缺漏）……一妇人胃中嘈杂辛辣感，严重时热痛，后来患牙齿疼痛。这是胃火生痰。用二陈汤加入黄芩、黄连，再服用越鞠丸而痊愈。
一妇人发热牙齿疼痛，傍晚时分更加严重，月经不调。这是脾经血虚所致。用逍遥散加入升麻不久便痊愈。后来因为愤怒再次疼痛，仍然用以前药物加入川芎而痊愈。
一妇人因愤怒，牙齿疼痛伴寒热。用小柴胡汤加入川芎、当归、茯苓、白术、山栀而疼痛停止，用加味逍遥散……（原文此处似有缺漏）……荆氏每次产后，齿根都松动，必须过几天才停止。后来再次怀孕，临产时，立斋先生偶然到访，谈及此症，留下十全大补汤两剂，令其产后煎服，牙齿不再松动了。果然如所言，我惊叹其神奇，敢写几句，附在卷末。后来的作者，都能参考学习，那么先生的恩德，将流传永久。后学吴江史羊生恭敬书写。
貌云叔父芝岩先生，齿根浮肿，疼痛难忍，命令貌云向立斋先生求治。先生说：这种疼痛牙龈浮肿但牙齿不松动，属于坤土（脾），是足阳明经脉所贯通络系的部位，因为胃中有湿热所致。用清胃散加入山栀、玄参，进服一剂，应手而愈。貌云谨记其梗概，以附于医录，将使后来的学习者有所准则。嘉靖丁未年仲秋，晚生眷属郁貌恭敬书写。
Teeth are the external manifestation of the Kidney (Shen), and the mouth is the orifice of the Kidney. Many meridians converge in the mouth, and the teeth are part of this convergence. Mr. Xu Yongcheng stated: Teeth are sensitive to symptoms such as aversion to cold and heat; these are caused by mixed pathogens acting together with external factors. Treatment methods: For pain caused by severe damp-heat, use Chengqi Tang (Cathartic Decoction) to purge; for mild cases, regulate with Qingwei San (Stomach-Clearing Powder); for gum swelling and pain due to Heat in the Large Intestine, treat with Qingwei San, and for severe cases, clear with Tiaowei Wan (Regulate Stomach Pill); for pain due to Six Stagnations (Qi, Blood, Phlegm, Fire, Dampness, Food), resolve with Yueju Wan (Resolve Depression Pill); for pain due to deficiency of Middle Qi, tonify with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); for pain due to Spleen injury from overthinking, regulate with Guipi Tang (Restore the Spleen Decoction); for pain due to Deficient Heat in the Kidney Meridian, tonify with Liuwei Wan (Six-Ingredient Pill with Rehmannia); for pain due to Deficient Cold in the Kidney Meridian, tonify with Huanshao Dan (Rejuvenating Pill), and for severe cases, use Qianwei Wan (Eight-Ingredient Pill) as the main treatment; for cases belonging to Wind-Heat, use Duohuo San (Angelica Pubescens Powder); for invasion of severe Cold into the Brain, use Xuezhi San (Zanthoxylum and Ligusticum Powder); for Wind-Cold invading the Brain, use Qianghuo Fuzi Tang (Notopterygium and Aconite Decoction). There are many types of symptoms; one must adapt treatment to the specific clinical presentation.
Clinical Cases:
Mao Sanjiang, Secretary of Rites, had Deficient Heat in the Stomach Meridian causing toothache. He was treated with Buzhong Yiqi Tang added with Shudi (Prepared Rehmannia Root), Mudanpi (Tree Peony Bark), Fuling (Poria), and Shaoyao (Peony Root), and recovered shortly.
Zhang Zhongliang, Minister of Justice, had loose teeth. Someone administered Qingwei San, resulting in limb fatigue, poor appetite, and toothache. I said: This is a deficiency of the Spleen and Kidney. Have him take Anshen Wan (Kidney-Anchoring Pill) and Buzhong Yiqi Tang concurrently. Apply Qianghuo San externally, and he recovered. If the gum roots ulcerate and the patient prefers cold and dislikes heat, it indicates damage to Stomach Blood; use Qingwei San. If the patient dislikes cold and prefers heat, it indicates damage to Stomach Qi; use Buzhong Yiqi Tang.
Yang Kaogong had loose teeth and thirst, indicating Spleen and Stomach weakness with blazing Yin-Fire. He was treated with Buzhong Yiqi Tang added with Jiuchao Hei Huangbai (Wine-fried Black Phellodendron Bark) for four doses, followed by Jiajian Bawei Wan (Modified Eight-Ingredient Pill), after which all symptoms resolved. Subsequently, he took Buzhong Yiqi Tang to fully recover.
Wang Shiyu had loose teeth and receding gums, preferring cold drinks and food, indicating Damp-Heat in the Stomach Meridian. First, use Chengqi Tang to reduce fire, then use Qingwei San to regulate so that the teeth become firm. Then, use Liuwei Wan to nourish Kidney Water, and Duohuo San to dispel external pathogens, leading to recovery.
Wang Libu suffered from toothache. After using wind-dispelling agents, his chills, fever, body fatigue, anorexia, and nausea worsened. He believed it was excessive Fire. I said: The cause is insufficient Yuan Qi (Primal Qi), and previous medicines further injured it. Thus, use Buzhong Yiqi Tang added with Fuling and Banxia (Pinellia Rhizome); once Yuan Qi recovers, all symptoms heal.
Guo Zhifang drank excessively, suffering from toothache and swollen cheeks/jaw. This is Damp-Heat in the Stomach Meridian. Treat with Qingwei San added with Ge Gen (Kudzu Root), Jing Jie (Schizonepeta), and Fang Feng (Saposhnikovia), resulting in recovery.
Zheng Libu experienced toothache radiating to the brain in mid-winter, caused by Wind-Cold invading the Kidney Meridian. One dose of Qianghuo Fuzi Tang cured him immediately. Regardless of season, those with Kidney deficiency often suffer this; urgent application of this medicine can cure it, but delay leads to incurability.
Zhu Gongbu had afternoon fever, seminal emission after exertion, and severe toothache. This is Deficient Heat of the Spleen and Kidney. First, use Buzhong Yiqi Tang to deliver Liuwei Wan, then use Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction) to recover.
Dang Libu had swollen and painful gum roots radiating to the cheek. This is Wind-Heat in the Stomach Meridian. Use Xijiao Shengma Tang (Rhinoceros Horn and Cimicifuga Decoction) for immediate recovery.
My cousin, Yan Jianxian, had toothache with a surging and forceful pulse at the right Cun position (half finger width back). I said: This is accumulated Heat in the Large Intestine; cold-natured medicines should be used. Stubbornly believing his advanced age required Yin-tonifying drugs, he suffered night-long groaning. While traveling to Beijing together, I decocted Liangge San (Cool the Chest Powder) added with Jing Jie, Fang Feng, and Shigao (Gypsum), gave him one cup, and he recovered instantly.
Yu Shizheng, Da Yin (Magistrate), drank excessively, suffering from floating tooth pain, abdominal pain, and diarrhea. This is Alcohol Accumulation injuring the Spleen. Take Qingwei San after meals and Jie Xing Tang (Wake-Up Decoction) before meals.
Zhong Fuzhai, Shanbu (Ministry of Revenue Official), felt bloating in the gum gaps preventing chewing whenever mental labor occurred, indicating weak Yuan Qi. First, use Buzhong Yiqi Tang to recover. Further use Shiquan Dabu Tang; even with labor, symptoms do not recur.
Chai Jimi, a scholar, drank excessively, had decayed teeth that did not regenerate new ones, and occasional pain. Use Taoren Chengqi Tang (Peach Kernel Cathartic Decoction) for two doses, then Qingwei San added with Zhizi (Gardenia) and Ge Gen.
A man had evening fever and internal heat, toothache with gum ulceration, and frequently extracted small insects. This is Deficient Fire of the Three Foot-Yin Meridians and Damp-Heat of the Foot-Yangming Meridian. First, use Taoren Chengqi Tang for two doses, then Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) to recover.
A man suffered toothache, difficulty digesting food, and loose stools. This is insufficiency of the Spleen and Kidney. Use Huanshao Dan to recover.
A man had hot feet, followed by swollen gums. This is Deficient Fire of the Three Foot-Yin Meridians. Use Jiajian Bawei Wan, after which it did not recur.
A man had floating, painful teeth, dark complexion around ears and face, dry mouth, and thirst, worsening in the late afternoon. This is Spleen weakness. Use Buzhong Yiqi Tang and Jiajian... [Text incomplete in source].
A woman had toothache due to anger, alternating chills/fever, and vomiting. Taking Qingwei-type medicines worsened it. This is Liver Fire injuring the Stomach, compounded by cold medicines injuring further. Use Liujunzi Tang (Six-Gentlemen Decoction) added with Shaoyao... [Text incomplete in source].
A woman had stomach burning sensation, severe heat/pain, later developing toothache. This is Stomach Fire generating Phlegm. Use Erchen Tang (Two-Aged Decoction) added with Huangqin (Scutellaria) and Huanglian (Coptis), followed by Yueju Wan to recover.
A woman had fever and toothache, worsening in the late afternoon, with irregular menstruation. This is caused by Blood deficiency in the Spleen Meridian. Use Xiaoyao San (Free and Easy Wanderer Powder) added with Shengma (Cimicifuga) for quick recovery. Later, anger caused recurrence; still using previous medicine added with Chuanxiong (Sichuan Lovage Rhizome) led to cure.
A woman had toothache with chills/fever due to anger. Use Xiao Chaihu Tang (Minor Bupleurum Decoction) added with Xiong (Ligusticum), Danggui (Angelica Sinensis), Fuling, Baizhu (Atractylodes Macrocephala), and Zhizi to stop pain, then use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder)... [Text incomplete in source].
Jing Shi experienced loose gum roots after every childbirth, resolving only after days. During a subsequent pregnancy near term, Lizhai visited and discussed this condition, leaving two doses of Shiquan Dabu Tang to be decocted and taken postpartum; the teeth no longer loosened. As predicted, I marveled at its efficacy and wrote these words to append to the volume. Future authors may learn from this, preserving the Master's virtue forever. Humble student Shi Yangsheng of Wujiang respectfully wrote this.
Uncle Zhiyan of Mao Yun had swollen gum roots with unbearable pain, ordering Maoyun to seek treatment from Mr. Lizhai. The Master said: This pain involves gum swelling but stable teeth, belonging to Kun Earth (Spleen), traversed by the Foot-Yangming Meridian, caused by Damp-Heat in the Stomach. Use Qingwei San added with Zhizi and Xuanshen (Scrophularia) for one dose, recovering promptly. Maoyun recorded this summary to attach to the medical records, hoping future students will have a standard. Mid-Autumn of Dingwei Year (Jiajing Era), humble dependent Yu Mao bows and writes.