齿者骨之余,骨者肾之络。初生儿有重龈重 者,骨不敛髓,故颊里生物,与芦择
相似,用绵裹针微刺之,令泻血汁,先以淡盐汤洗,次以细辛散频擦之。
齿 ,上属足阳明胃,下属手阳明大肠。而其为病也,责胃居多,但所伤有胃血胃气
之异。胃血伤者,喜寒而恶热,清胃汤;胃气伤者,喜热而恶寒,益胃汤。
叶锡侯曰∶胃病者,口极臭,肾病则否。
小儿卧时,开口当风,吸入风邪,留连不解,令齿缝酸痛,治以胡桐泪汤。胃虚湿
热壅盛不得下行,牙齿肿痛,清胃合五苓(见口)治之。又有牙疳出血,口臭肉烂,芦荟丸(见疳)治之。
小儿禀赋虚怯,数岁后牙齿时疼,虫疳风吼,九味地黄丸主之。肾气不足,髓脉不
充,七八月齿仍不出,或难出而无力嚼物,芎 散治之。
细辛散 治一切风蛀牙疼,腮颔浮肿。
细辛 荆芥穗(各一两) 砂仁 荜茇 鹤虱 皂角(各五钱) 白芷 细椒 草乌(各二钱)
为末,擦患处,有涎吐之,仍用水灌漱。
清胃汤
当归 生地 丹皮 升麻 甘草 连翘 黄连
益胃汤
当归 茯苓 白术 陈皮 黄 甘草 防风 升麻
九味地黄丸
生地 山萸 山药 丹皮 茯苓 当归 川芎 使君子 川楝肉
高鼓峰曰∶此方直泻厥阴风木,乃肾肝同治之法。缘虫疳为风木之化,有可伐之理。
然伐其子则伤其母,故用五者补之。去泽泻者,肾不宜再泄也。
胡桐泪汤
白芷 麦冬 当归 生地 花粉 石膏 细辛 升麻 干葛 胡桐泪
芎 散
川芎 生地 山药 芍药 当归 甘草
为末。每服二钱,白汤下。
牙齿是骨骼的余气所生,而骨骼与肾脏经络相连。初生的婴儿如果有重龈(牙龈重叠)或重𦟌(舌下肉阜肿胀)的情况,是因为骨骼不能收敛骨髓,导致脸颊内部生出异物,形状像芦苇中的薄膜一样,用棉絮包裹针具轻微刺破,放出血液和汁液,先用淡盐水清洗,再用细辛散频繁擦拭患处。
牙齿的上部归属于足阳明胃经,下部归属于手阳明大肠经。牙齿的疾病,责任大多在胃,但损伤有胃血和胃气的区别。胃血受损的,喜欢寒凉而厌恶热邪,用清胃汤治疗;胃气受损的,喜欢温热而厌恶寒邪,用益胃汤治疗。
小儿睡觉时,如果张口对着风,吸入风邪,滞留体内不解,会导致牙缝酸痛,用胡桐泪汤治疗。胃虚导致湿热壅盛,不能向下排泄,引起牙齿肿痛,用清胃汤合五苓散(见口齿篇)治疗。又有患牙疳出血、口臭、牙龈腐烂的,用芦荟丸(见疳积篇)治疗。
小儿先天禀赋虚弱怯弱,几岁之后牙齿时常疼痛,患有虫疳风吼(一种以牙齿疼痛、松动为特征的儿科疾病),用九味地黄丸主治。肾气不足,髓脉不充盈,七八个月大时牙齿仍然不出,或者难出且无力咀嚼食物,用川芎散治疗。
细辛散:治疗各种风蛀引起的牙疼,以及腮帮和下颌浮肿。
细辛散方:细辛、荆芥穗(各一两)、砂仁、荜茇、鹤虱、皂角(各五钱)、白芷、细椒、草乌(各二钱)。研为细末,擦涂患处,如有唾液流出则吐出,仍用水漱口。
九味地黄丸方:生地、山萸、山药、丹皮、茯苓、当归、川芎、使君子、川楝肉。
高鼓峰说:这个方子直接泻厥阴风木之气,是肾肝同治的方法。因为虫疳是由风木之气化生而来,有可以攻伐的道理。但是攻伐其子(肝木之子为心火,此处指通过泻肝来间接影响,或指方中药物对肝经的作用)会伤及其母(肾水),所以用五味药来补益。去掉泽泻的原因,是因为肾脏不宜再被渗泄。
胡桐泪汤方:白芷、麦冬、当归、生地、花粉、石膏、细辛、升麻、干葛、胡桐泪。
研为细末。每次服用二钱,用白开水送服。
Teeth are the surplus of bones, and bones are connected to the meridians of the Kidney. In newborn infants, if there is duplication of the gums (Chongyin) or swelling of the sublingual caruncle (Chongzhi), it is because the bones fail to consolidate the marrow. Consequently, abnormal tissue grows inside the cheeks, resembling the membrane of a reed. It should be pricked slightly with a needle wrapped in cotton to drain blood and fluid. First, wash with light salt water, then frequently apply Xixin San (Asarum Powder).
The upper part of the teeth belongs to the Foot-Yangming Stomach Meridian, and the lower part belongs to the Hand-Yangming Large Intestine Meridian. Diseases of the teeth are mostly attributed to the Stomach, but the injury may differ between Stomach Blood and Stomach Qi. When Stomach Blood is injured, the patient prefers cold and dislikes heat; Qingwei Tang (Clear the Stomach Decoction) is used. When Stomach Qi is injured, the patient prefers heat and dislikes cold; Yiwei Tang (Benefit the Stomach Decoction) is used.
Ye Xihou stated: Patients with Stomach disease have extremely foul breath, whereas those with Kidney disease do not.
When children sleep with their mouths open facing the wind, they inhale Wind Pathogens that linger unresolved, causing soreness and pain in the tooth gaps. This is treated with Hutonglei Tang (Poplar Gum Decoction). If Stomach deficiency leads to excessive damp-heat stagnation that cannot descend, resulting in swollen and painful teeth, Qingwei Tang combined with Wuling San (Five-Ingredient Powder with Poria) [see Mouth section] is used. For cases of gingival ulcers (Yagan) with bleeding, foul breath, and rotting flesh, Lushui Wan (Aloe Pill) [see Gan accumulation section] is used.
Children with congenital weakness and timidity may experience intermittent toothache after several years of age, suffering from Chonggan Fenghou (a pediatric condition characterized by tooth decay and pain due to wind). Jiwei Dihuang Wan (Nine-Ingredient Rehmannia Pill) is the primary treatment. Due to insufficient Kidney Qi and unfilled marrow channels, teeth may fail to erupt at seven or eight months, or erupt weakly with difficulty chewing. Xiong Qusan (Ligusticum Powder) is used for this.
Xixin San (Asarum Powder): Treats all types of wind-induced toothache caused by dental caries, along with swelling of the cheeks and jaw.
Formula Composition: Asarum (Xixin) and Schizonepeta Spike (Jingjie Sui) (1 liang each); Amomum Fruit (Sharen), Long Pepper Fruit (Bibo), Pyrethrum Root (Heshi), and Gleditsia Sinensis Pod (Zaojiao) (5 qian each); Angelica Dahurica (Baizhi), Piper Longum (Xijiao), and Aconite Root (Caowu) (2 qian each). Grind into powder, apply to the affected area. Spit out saliva if produced, and rinse with water.
Qingwei Tang (Clear the Stomach Decoction): Angelica Sinensis (Danggui), Rehmannia Root (Shengdi), Moutan Bark (Danpi), Cimicifuga Rhizome (Shengma), Licorice Root (Gancao), Forsythia Fruit (Lianqiao), Coptis Rhizome (Huanglian).
Yiwei Tang (Benefit the Stomach Decoction): Angelica Sinensis (Danggui), Poria (Fuling), Atractylodes Macrocephala Rhizome (Baizhu), Tangerine Peel (Chenpi), Astragalus Root (Huangqi), Licorice Root (Gancao), Saposhnikovia Root (Fangfeng), Cimicifuga Rhizome (Shengma).
Jiwei Dihuang Wan (Nine-Ingredient Rehmannia Pill): Rehmannia Root (Shengdi), Cornus Fruit (Shanyuzhu), Dioscorea Rhizome (Shanyao), Moutan Bark (Danpi), Poria (Fuling), Angelica Sinensis (Danggui), Ligusticum Rhizome (Chuanxiong), Quisqualis Fruit (Shijunzi), Toosendan Fruit (Chuanlianrou).
Gao Gufeng stated: This formula directly drains the Wind-Wood of the Jueyin meridian, representing a method of treating the Kidney and Liver simultaneously. Since Chonggan arises from the transformation of Wind-Wood, there is a rationale for purging it. However, purging the "son" (Liver/Wood) harms the "mother" (Kidney/Water), so five ingredients are used to tonify. Ze Xie (Alisma Rhizome) is omitted because the Kidney should not be drained further.
Hutonglei Tang (Poplar Gum Decoction): Angelica Dahurica (Baizhi), Ophiopogon Tuber (Maidong), Angelica Sinensis (Danggui), Rehmannia Root (Shengdi), Trichosanthes Root (Huafen), Gypsum (Shigao), Asarum (Xixin), Cimicifuga Rhizome (Shengma), Kudzu Root (Gegen), Poplar Gum (Hutonglei).
Xiong Qusan (Ligusticum Powder): Ligusticum Rhizome (Chuanxiong), Rehmannia Root (Shengdi), Dioscorea Rhizome (Shanyao), Peony Root (Shaoyao), Angelica Sinensis (Danggui), Licorice Root (Gancao).
Grind into powder. Take 2 qian per dose, washed down with plain boiled water.