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。外有牙龈腐臭，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，宜服犀角升麻汤，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。
独活散
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，水煎澄清，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。
《三因》安肾丸
补骨脂（炒） 胡芦巴（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，胡芦巴续川楝桃。
胡桐泪散
胡桐泪 细辛 川芎 白芷（各一钱五分） 寒水石（ ，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。
李杲牢牙散
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。
固齿白玉膏
官粉（研，一两） 珍珠（末，二钱） 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，细辛、 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 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，一两） 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，一切牙疼及动摇，官粉珍珠阳起麝，龙骨象牙黄蜡熬。
清胃汤（见牙衄）
犀角升麻汤（见面部颊疡）
牙宣病初起时，牙龈出现肿胀；随着病情发展，牙龈组织日渐腐烂萎缩，长久之后导致牙根暴露。此时需仔细辨别患者是厌恶热还是厌恶凉，这分别对应胃经客热或风寒侵袭两种病机。
【注】此证表现为牙龈红肿宣露，龈肉逐渐腐烂萎缩，日久则收缩，致使牙齿根部显露。总因胃经中有客热积聚日久，又外受邪风侵袭，寒凉之气与客热相互搏结而致病。有的患者喜欢冷饮而厌恶热，这是因为客热遇到寒凉之物，凝滞于龈肉之间；有的患者喜欢热饮而厌恶凉，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，症状为牙龈出血、厌恶热、口臭，适宜服用清胃汤；若是客热受风者，症状为牙龈厌恶凉，遇风疼痛加剧，适宜服用独活散。此外，若有牙龈腐烂发臭、牙齿松动者，属于胃中虚火兼肾虚所致（因为齿为肾之余），适宜服用《三因方》中的安肾丸。又有牙龈腐烂发臭、时常流出白色脓液者，属于胃中湿热所致，适宜服用犀角升麻汤，外用胡桐泪散擦拭患处，并用食盐冲水漱口。唯独对于牙龈松动，或兼有疼痛者，白天用李杲的牢牙散擦拭，晚上用固齿白玉膏贴敷，可缓缓见效。如果龈肉完全腐烂，露出牙槽骨者，预后不良（属逆证）。
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）。
制法与用法：将上述药材捣成粗末，每次取二钱，加水煎煮后澄清药汁，饭后服用，每日服用三次。
【方歌】独活散治疗风毒注于牙根，牙龈肿胀怕凉且疼痛难忍，羌活与防风配伍生地，薄荷、荆芥合用川芎与细辛。
《三因》安肾丸
组成：补骨脂（炒）、胡芦巴（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）。
制法与用法：共研为细末，用炼蜜制成梧桐子大小的丸剂。每次服用二钱，空腹时用淡盐汤送服。
【方歌】《三因》安肾丸治疗肾虚火旺，牙龈腐烂发臭且牙齿松动，山药、杏仁、茴香、茯苓与补骨脂，配合胡芦巴、续断、川楝子和桃仁。
胡桐泪散
组成：胡桐泪、细辛、川芎、白芷（各一钱五分）；寒水石（煅，二钱）；生地（一钱）；青盐（二分）。
制法与用法：共研为细末，直接干擦于牙龈患处，待一顿饭的时间后，用温水漱去药粉，过一会儿再重新上药。
【方歌】胡桐泪散治疗牙龈肿胀，津血外露或流出脓液，细辛、寒水石、生地，配合青盐、白芷和川芎。
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）。
制法与用法：共研为末，先用温水漱口，取少许药粉涂抹患处。
【方歌】李杲牢牙散用于擦拭牙齿疾病，牙龈松动或兼有疼痛，龙胆草、升麻、羌活和地骨皮，研末后漱口涂抹功效显著。
固齿白玉膏
组成：官粉（研细，一两）；珍珠（研末，二钱）；阳起石（需用僵蚕四十九条，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，共研为粗末。用长流水五碗，同药物放入砂锅内，以桑柴火熬至三碗，去渣；再将药汁倒入砂锅内，煎至一碗。将龙骨、阳起石烧红，放入药汁中淬炼。如此重复七次，倒去药汁，将龙骨、阳起石焙干，研为细末，重一两）；麝香（研末，二钱）；龙骨（二两）；象牙（研末，五钱）。
制法与用法：用黄蜡三两，熔化并过滤干净，再次熔化，离火后温度稍降时，加入前述药粉搅拌均匀，趁热摊在纸上。若药膏冷却，可将熨斗烧热倒置，将纸铺在熨斗底部进行摊制。使用时先以温水漱口，将药膏剪成小条，贴于患处，闭口不说话。
Yaxuan (Gum Recession and Suppuration) initially presents with swelling of the gums. As the condition progresses, the gum tissue gradually rots and atrophies, eventually exposing the tooth roots over time. One must carefully distinguish whether the patient dislikes heat or cold, which corresponds to either guest-heat in the Stomach Meridian or invasion of Wind-Cold.
[Note] This syndrome is characterized by swollen and protruding gums, with the gingival flesh gradually rotting and atrophying. Over a long period, it shrinks, leading to the exposure of the teeth's roots. It is generally caused by accumulated guest-heat in the Stomach Meridian combined with external invasion of pathogenic wind, where cold and heat clash within the tissues. Some patients prefer cold drinks and dislike heat; this occurs when guest-heat encounters cold substances, causing stagnation between the gum tissues. Others prefer hot drinks and dislike cold; this happens when guest-heat is affected by pathogenic wind, lingering within the gum tissues. In cases of guest-heat encountering cold, symptoms include bleeding gums, aversion to heat, and foul breath; Qingwei Tang (Stomach-Clearing Decoction) is appropriate. In cases of guest-heat affected by wind, symptoms include aversion to cold and severe pain upon exposure to wind; Duhuo San (Angelica Pubescens Powder) is appropriate. Additionally, if there is rotten and foul-smelling gums with loose teeth, it belongs to deficiency-fire in the Stomach combined with Kidney deficiency (since teeth are the surplus of the Kidney); Anshen Wan (Kidney-Stabilizing Pill from *San Yin Fang*) is appropriate. If there is rotten and foul-smelling gums with intermittent discharge of white pus, it belongs to damp-heat in the Stomach; Xijiao Shengma Tang (Rhino Horn and Cimicifuga Decoction) is appropriate, applied externally with Hutonglei San (Trogopterus Dung Powder) and rinsed with salt water. Specifically for loose gums or those accompanied by pain, Li Gao's Laoya San (Teeth-Firming Powder) should be used for rubbing during the day, and Guchi Baiyu Gao (Teeth-Solidifying White Jade Ointment) for application at night, yielding gradual results. If the gum tissue completely rots and exposes the alveolar bone, the prognosis is unfavorable (adverse).
Duhuo San (Angelica Pubescens Powder)
Ingredients: Duhuo (Radix Angelicae Pubescentis), Qianghuo (Rhizoma et Radix Notopterygii), Fangfeng (Radix Saposhnikoviae), Chuanxiong (Rhizoma Chuanxiong) (each 1.6 qian); Bohe (Herba Menthae), Shengdi (Radix Rehmanniae), Jingjie (Fructus Schizonepetae) (each 1 qian); Xixin (Radix Asari) (0.7 qian).
Preparation and Administration: Grind into coarse powder. Use 2 qian per dose, decoct in water, clarify, and take after meals. Take three doses daily.
[Formula Song] Duhuo San treats wind-toxin lodged in the tooth roots, with swollen gums that dislike cold and unbearable pain; Qianghuo and Fangfeng generate together with Shengdi, while Bohe, Jingjie combine with Chuanxiong and Xixin.
*San Yin* Anshen Wan (Kidney-Stabilizing Pill from *San Yin Fang*)
Ingredients: Buguzhi (Fructus Psoraleae, stir-fried), Huluba (Semen Trigonellae, stir-fried), Huixiang (Fructus Foeniculi, stir-fried), Chuanlianzi (Semen Toosendan, stir-fried), Xuduan (Radix Dipsaci, stir-fried) (each 3 liang); Shanyao (Rhizoma Dioscoreae), Xingren (Semen Armeniacae, stir-fried), Baifuling (Poria, stir-fried), Taoren (Semen Persicae, stir-fried) (each 2 liang).
Preparation and Administration: Grind into fine powder, mix with refined honey to form pills the size of paulownia seeds. Take 2 qian per dose, administered on an empty stomach with light salt water.
[Formula Song] *San Yin* Anshen Wan treats kidney deficiency with fire scorching, causing rotten and foul-smelling gums and loose roots; Shanyao, Xingren, Huixiang, Fuling, and Buguzhi, along with Huluba, Xuduan, Chuanlianzi, and Taoren.
Hutonglei San (Trogopterus Dung Powder)
Ingredients: Hutonglei (Resina Trogopterori), Xixin (Radix Asari), Chuanxiong (Rhizoma Chuanxiong), Baizhi (Radix Angelicae Dahuricae) (each 1.5 qian); Hanshuishi (Lapis Calcitae, calcined) (2 qian); Shengdi (Radix Rehmanniae) (1 qian); Qingyan (Sal Marina) (0.2 qian).
Preparation and Administration: Grind into fine powder. Dry-rub onto the affected gum area. After one meal's duration, rinse with warm water, and reapply after a short interval.
[Formula Song] Hutonglei San treats gum swelling, leakage of fluids and blood, or pus discharge; Xixin, Hanshuishi, and Shengdi, combined with Qingyan, Baizhi, and Chuanxiong.
Li Gao Laoya San (Teeth-Firming Powder by Li Gao)
Ingredients: Longdancao (Radix Gentianae, soaked in wine) (1.5 liang); Qianghuo (Rhizoma et Radix Notopterygii), Digupi (Cortex Lycii) (each 1 liang); Shengma (Rhizoma Cimicifugae) (0.4 qian).
Preparation and Administration: Grind into powder. First rinse mouth with warm water, then apply a small amount to the site.
[Formula Song] Li Gao Laoya San is rubbed for dental diseases, treating loose gums or those with pain; Longdancao, Shengma, Qianghuo, and Digupi, ground into powder for rinsing and rubbing, yield merit.
Guchi Baiyu Gao (Teeth-Solidifying White Jade Ointment)
Ingredients: Guanfen (Cerussa, finely ground) (1 liang); Zhenzhu (Margarita, powdered) (2 qian); Yangqishi (Lapis Lepidoliti) (prepared as follows: use 49 silkworms, Fengfang (Radix Saposhnikoviae), Danggui (Radix Angelicae Sinensis), Chuanxiong (Rhizoma Chuanxiong), Yazao (Fructus Gleditsiae Sinensis), Qingyan (Sal Marina), Shengma (Rhizoma Cimicifugae), Baizhi (Radix Angelicae Dahuricae), Digupi (Cortex Lycii) each 5 qian; Xixin (Radix Asari), Bencao (Radix Ligustici Wallichii) each 3 qian. Grind all into coarse powder. Add 5 bowls of flowing water to a clay pot with the herbs. Boil using mulberry wood fire until reduced to 3 bowls. Strain. Return the filtrate to the clay pot and boil down to 1 bowl. Heat Longgu (Os Draconis) and Yangqishi (Lapis Lepidoliti) until red-hot, then quench them in the herbal decoction. Repeat this quenching process seven times. Discard the decoction, dry-roast the minerals, grind into fine powder (total weight 1 liang); Shexiang (Moschus, powdered) (2 qian); Longgu (Os Draconis) (2 liang); Xiangya (Elephantis Dentis Corium) (powdered) (5 qian).
Preparation and Administration: Melt 3 liang of Huangla (Cera Flava), filter cleanly, melt again. When slightly cooled off the heat, mix in the aforementioned powders evenly. Spread hot onto paper. If the ointment cools, place a heated ironing board upside down, lay paper on it, and spread the ointment. 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 for all toothaches and loosening; Guanfen, Zhenzhu, Yangqishi, and Shexiang, boiled with Longgu, Xiangya, and Huangla.
Qingwei Tang (Stomach-Clearing Decoction) (See "Ya Nu" - Gum Bleeding)
Xijiao Shengma Tang (Rhino Horn and Cimicifuga Decoction) (See "Mianbu Jia Yang" - Facial Cheek Ulcer)