外障无寒一句了，五轮变赤火因生，内障有虚心肾弱，故如不病损光明，火能外鉴
水内照，养神壮水自收功，五风内变诸翳障，眼科自有法能攻。
【注】外障目病，子和曰∶目不因火不病。
所以五轮变赤，气轮白睛，火乘肺也。肉轮目胞，火乘脾也。风轮黑睛，火乘肝也。水
轮瞳人，火乘肾也。血轮两 ，火自甚也。故能治火者，一句便了也。治火之法，在药则
咸寒吐之下之，在针则神庭、上星、囟会、前项、百会刺之，翳者可使立退，痛者可使立
已，昧者可使立明，肿者可使立消矣。内障目病，虽亦无寒，然有虚也。虚或兼热，亦
属虚热，故不赤肿疼痛，如不病眼人，但不精彩光明也。心虚则神不足，神者火也，火
内暗而外明，故不能外鉴而失其光明也。肾虚则精不足，精者水也，水外暗而内明，故
不能内照而失其光明也。心虚者，则养心神；肾虚者，则壮肾水，自可收功于不明也。其
五风内变诸翳，如圆翳、冰翳、清翳、涩翳、散翳、横翳、浮翳、沉翳，偃月、枣花、黄
心、黑风等翳，俱列在眼科，方书自有治法，难以尽述，此特其大概耳。
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，雠仇之意也。虫牙则一牙作痛，蚀尽一牙，又蚀一牙作痛也。
骨槽风 牙疳疮
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
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
丹皮出。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，肿痛烂臭，宜用凉膈散加升麻、石膏，以下其热可也。
温风散
温风风牙归芎细，荜茇 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、荜茇、
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
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，覆以漏斗，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
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，以肿硬消，黑色变，臭气止为度。若不能食，或隔一日，或隔二三日攻之，攻
之后渐能食，不必戒口，任其所食。虽大便
溏，仍量其轻重攻之，自见其神。若竟不思食，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。
【背景信息】
书名：杂病心法要诀 作者：吴谦等 朝代：清 章节：内外障治 / 牙齿口舌总括 类别：医论
【原文翻译】
外障眼病没有寒证这一说，一句话就能概括；五轮（指眼睛的不同部位，分别对应五脏）变红赤是因为火邪产生。内障眼病有虚证，是因为心肾虚弱，所以就像没有生病一样，只是失去了光彩和明亮。火能向外照耀，水能向内映照，通过养心神、壮肾水自然能收到功效。五风内变导致的各种翳障（角膜混浊或瘢痕），眼科自有治疗方法可以攻克。
【注】外障眼病，张子和说：“眼睛不因火邪就不会生病。”
所以五轮变红赤，气轮（白睛，对应肺）是火邪侵犯肺脏。肉轮（眼睑，对应脾）是火邪侵犯脾脏。风轮（黑睛，对应肝）是火邪侵犯肝脏。水轮（瞳孔，对应肾）是火邪侵犯肾脏。血轮（两眦，即眼角，对应心）是火邪极盛所致。所以能治疗火邪，这句话就足够了。治疗火邪的方法，在药物方面用咸寒性质的药进行催吐或泻下，在针灸方面针刺神庭穴、上星穴、囟会穴、前顶穴、百会穴，翳障可以使它立即消退，疼痛可以使它立即停止，视物昏暗可以使它立即明亮，肿胀可以使它立即消除。内障眼病，虽然也没有寒证，但是有虚证。虚证或者兼有热象，也属于虚热，所以不红赤、不肿胀、不疼痛，像没患眼病的人一样，只是眼神不精彩、不明亮。心虚则神不足，神属火，火在内则昏暗而在外则明亮，所以不能向外照耀而失去光明。肾虚则精不足，精属水，水在外则昏暗而在内则明亮，所以不能向内映照而失去光明。心虚的，就滋养心神；肾虚的，就壮补肾水，自然可以在视力不明方面收到功效。那些由五风内变引起的各种翳障，如圆翳、冰翳、清翳、涩翳、散翳、横翳、浮翳、沉翳，以及偃月翳、枣花翳、黄心翳、黑风翳等，都列在眼科书中，方书自有治疗方法，难以详尽叙述，这里只是大概介绍罢了。
牙齿是骨的余气，归属于肾；牙龈属于手阳明大肠经和足阳明胃经。牙齿过长、松动是肾气疲惫的表现；牙疼多因胃火、风寒或虫蚀引起。不怕冷热刺激的是风痛；红肿且喜冷的是火肿；得寒则痛的属于寒证；牙齿不肿、蛀牙且喜热饮的是虫牙，蛀蚀殆尽后才会生出新的牙齿。
【注】牙齿是骨之余，归属于肾。如果无故牙齿过长、稀疏松动，就是肾气衰败。上牙龈属于足阳明胃经，下牙龈属于手阳明大肠经。牙痛都是牙龈作痛，只有寒性牙痛，是客寒侵犯脑部，多为头连齿痛，属于寒邪，所以喜欢热饮，不肿也不蛀。其余的，都是因为胃火、邪风、湿热所致。火性牙疼多红肿，喜欢喝冷饮，遇到寒冷反而更疼，这是仇敌般的关系（指寒凉加剧火热之痛）。虫牙则是一颗牙痛，蚀尽一颗牙，又蚀另一颗牙痛。
骨槽风、牙疳疮
骨槽风表现为牙龈连及脸颊肿胀坚硬疼痛，牙龈腐烂出血流脓。牙疳表现为牙龈肿硬溃烂出血且有臭味，这些都是因为痘疹、癖疾之后形成的。
【注】骨槽风，是牙龈连及脸颊硬肿疼痛，牙龈腐烂，出血流脓。牙疳，是在骨槽风溃后肿硬不消，流出臭血，而不流出脓水，而且都是在痘疹、癖疾之后形成的。
清胃散
清胃散用于清除血分中的火邪所致的牙痛。方剂组成包括生地黄、当归、黄连、升麻、牡丹皮。其中“饶”是指倍加升麻和牡丹皮。如果是气分热盛，宜加入荆芥、防风、细辛。若是肠胃积热，可用凉膈散加入升麻、石膏。
【注】胃火牙痛，红肿出血的，属于血分，宜用清胃散，即生地黄、当归、黄连、升麻、牡丹皮组成。“饶”的意思是加倍使用升麻和牡丹皮。如果肿痛但牙龈不出血，属于气分，宜加入荆芥、防风、细辛，以疏散其热。如果肠胃积热，肿痛腐烂发臭，宜用凉膈散加入升麻、石膏，以泻下其热即可。
温风散
温风散用于治疗风邪所致的牙痛，方剂组成包括当归、川芎、细辛、荜茇、藁本、白芷、露蜂房。如果是寒性牙痛，可加入羌活、麻黄、附子。服用一半，含漱一半，吐出涎液即可痊愈。
【注】不甚肿痛，不怕冷热刺激的，是风牙痛，宜用温风散。即当归、川芎、细辛、荜茇、藁本、白芷、露蜂房组成。如果不怎么肿痛，喜欢喝热汤，是寒牙痛，宜在本方中再加羌活、麻黄、川附子，温散之。两个方子都服用一半，含漱一半，连同涎液一起吐出，自然就好了。
一笑丸、玉池散、熏药
各种牙痛都可以用一笑丸，将川椒七粒研末，巴豆一粒去皮研匀，用米饭做丸，用棉包裹咬在痛处，吐出涎液即止。也都宜用玉池散，即藁本、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。虫牙也宜用此法咬漱。还需要用韭菜子或葱子，放在小炉中烧着，搁在大水碗内，上面扣一个漏斗，口对着虫牙痛处熏蒸，虫子极小，都会落入水碗中，屡试屡效。
芜荑消疳汤
牙疳虽然有专科治疗，但人们都不了解连续攻下的神妙之处。如果能进食且大便软，仍然可以使用攻下法。方剂组成包括雄黄、芜荑、大黄、芦荟、黄连、胡黄连、黄芩。
【注】牙疳这一病，杀人最快，虽然有专科医生，但都不了解连续攻下的方法。所谓累攻，就是今天攻下，明天再攻下，直到肿硬消退、黑色变淡、臭气停止为止。如果不能进食，或者隔一天、隔两三天再攻下，攻下之后逐渐能进食，不必忌口，任其所食。即使大便溏薄，仍要衡量轻重进行攻下，自然能见到神效。如果完全不想吃东西，难以承受攻下，那就是死证了。攻下药使用芜荑消疳汤，即雄黄、芜荑、生大黄、芦荟、川黄连、胡黄连、黄芩组成。
[Background Information]
Book: Za Bing Xin Fa Yao Jue (Essential Principles for the Treatment of Miscellaneous Diseases)
Author: Wu Qian et al.
Dynasty: Qing
Chapter: Treatment of Internal and External Eye Obstructions / General Overview of Teeth, Mouth, and Tongue
Category: Medical Discourse
[Translation]
External eye obstructions are never caused by cold; this can be summarized in one sentence. Redness in the Five Wheels (five zones of the eye corresponding to the five Zang organs) arises from Fire pathogenic factors. Internal eye obstructions involve deficiency, specifically weakness of the Heart and Kidney, resulting in a condition resembling health but lacking luster and brightness. Fire illuminates outwardly, while Water reflects inwardly; nourishing the Spirit (Shen) and strengthening Kidney Water will naturally yield results. Various opacities (clouding or scarring of the cornea) caused by the internal transformation of the Five Winds can be treated by established ophthalmological methods.
[Note] Regarding external eye diseases, Zhang Zihe stated: "The eyes do not become diseased unless affected by Fire."
Therefore, redness in the Five Wheels indicates Fire invading specific organs: Qi Wheel (white sclera, corresponding to Lung) is invaded by Fire affecting the Lung; Flesh Wheel (eyelids, corresponding to Spleen) is invaded by Fire affecting the Spleen; Wind Wheel (black cornea, corresponding to Liver) is invaded by Fire affecting the Liver; Water Wheel (pupil, corresponding to Kidney) is invaded by Fire affecting the Kidney; Blood Wheel (canthi/corners of the eyes, corresponding to Heart) indicates excessive Fire. Thus, treating Fire resolves the issue completely. The method for treating Fire involves using salty-cold herbs for emesis or purgation, and acupuncture points such as Shenting (GV24), Shangxing (GV23), Xinhui (GV16), Qian Ding (GV20), and Baihui (GV20). Opacities can be made to recede immediately, pain to cease immediately, dim vision to brighten immediately, and swelling to dissipate immediately.
Internal eye obstructions, although also devoid of cold, involve deficiency. Deficiency may accompany heat, constituting Deficient-Heat. Consequently, there is no redness, swelling, or pain; the eyes appear healthy but lack spirit and brightness. Heart deficiency leads to insufficient Shen (Spirit); since Shen belongs to Fire, and Fire is dark internally but bright externally, it cannot illuminate outwardly, resulting in loss of brightness. Kidney deficiency leads to insufficient Jing (Essence); since Jing belongs to Water, and Water is dark externally but bright internally, it cannot reflect inwardly, resulting in loss of brightness. For Heart deficiency, nourish the Heart Spirit; for Kidney deficiency, strengthen Kidney Water. This will naturally restore vision.
Various opacities arising from the internal transformation of the Five Winds, such as Yuan Yi (Round Opacity), Bing Yi (Ice Opacity), Qing Yi (Clear Opacity), Se Yi (Rough Opacity), San Yi (Scattered Opacity), Heng Yi (Horizontal Opacity), Fu Yi (Floating Opacity), Chen Yi (Sinking Opacity), Yan Yue (Crescent Moon Opacity), Zao Hua (Jujube Flower Opacity), Huang Xin (Yellow Center Opacity), and Hei Feng (Black Wind Opacity), are listed in ophthalmology texts with their respective treatments. These cannot be fully detailed here; this is merely a general overview.
Teeth are the surplus of bone and belong to the Kidney; gums belong to the Hand Yangming Large Intestine Meridian and Foot Yangming Stomach Meridian. Elongated and loose teeth indicate exhaustion of Kidney Qi. Toothache is caused by Stomach Fire, Wind-Cold, or worms. Insensitivity to hot and cold indicates Wind pain; redness and swelling preferring cold indicate Fire swelling; pain relieved by cold indicates Cold; non-swollen, carious teeth preferring hot drinks indicate Worm toothache. New teeth grow only after decayed ones are completely eroded.
[Note] Teeth are the surplus of bone and belong to the Kidney. Spontaneous elongation, looseness, and spacing indicate Kidney exhaustion. Upper gums belong to the Foot Yangming Stomach Meridian; lower gums belong to the Hand Yangming Large Intestine Meridian. Toothache originates in the gums. Only Cold-type toothache is caused by exogenous Cold invading the brain, often radiating from head to teeth, belonging to Cold pathogen, thus preferring hot drinks, without swelling or caries. Others are caused by Stomach Fire, Evil Wind, or Damp-Heat. Fire-type toothache involves redness, swelling, and preference for cold drinks; pain worsens with cold due to antagonism. Worm toothache affects one tooth at a time, eroding it completely before moving to another.
Gu Cao Feng (Bone Trough Wind) and Ya Gan Chuang (Tooth Gangrene)
Gu Cao Feng presents with hard, swollen, painful gums extending to the cheek, with gum rotting, bleeding, and pus discharge. Ya Gan presents with hard, swollen, ulcerated gums bleeding with foul odor. Both arise after variola (smallpox), rubeola (measles), or Pi Ji (abdominal masses/stagnation).
[Note] Gu Cao Feng involves hard swelling and pain of gums and cheeks, with gum rotting, bleeding, and pus. Ya Gan occurs after Gu Cao Feng ulceration, with persistent hardness, foul blood discharge but no pus, typically following smallpox, measles, or Pi Ji.
Qing Wei San (Clear the Stomach Powder)
Qing Wei San treats toothache caused by Fire in the Blood level. Ingredients include Sheng Di Huang (Rehmanniae Radix), Dang Gui (Angelicae Sinensis Radix), Huang Lian (Coptidis Rhizoma), Sheng Ma (Cimicifugae Rhizoma), and Mu Dan Pi (Moutan Cortex). "Rao" indicates doubling the dosage of Sheng Ma and Mu Dan Pi. For Qi-level heat, add Jing Jie (Schizonepetae Herba), Fang Feng (Saposhnikoviae Radix), and Xi Xin (Asari Radix). For accumulation of Heat in intestines and stomach causing swelling, rotting, and foul odor, use Liang Ge San (Cool the Diaphragm Powder) with added Sheng Ma and Shi Gao (Gypsum Fibrosum) to purge Heat.
[Note] Stomach Fire toothache with redness, swelling, and bleeding 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" means increasing Sheng Ma and Mu Dan Pi. If swelling and pain occur without bleeding, it belongs to the Qi level; add Jing Jie, Fang Feng, and Xi Xin to disperse Heat. If intestinal and gastric Heat accumulation causes swelling, rotting, and foul odor, use Liang Ge San with Sheng Ma and Shi Gao to purge Heat.
Wen Feng San (Warm Wind Powder)
Wen Feng San treats Wind-type toothache. Ingredients include Dang Gui, Chuan Xiong (Ligustici Chuanxiong Rhizoma), Xi Xin, Bi Bo (Piperis Kadsurae Fructus), Gao Ben (Ligustici Rhizoma et Radix), Bai Zhi (Angelicae Dahuricae Radix), and Lu Feng Fang (Vespa Nidus). For Cold-type 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 recovery.
[Note] Mild swelling/pain, insensitivity to hot/cold, indicates Wind toothache; use Wen Feng San, composed of Dang Gui, Chuan Xiong, Xi Xin, Bi Bo, Gao Ben, Bai Zhi, and Lu Feng Fang. If mild swelling/pain prefers hot drinks, it is Cold toothache; add Qiang Huo, Ma Huang, and Chuan Fu Zi to warm and disperse. Administer half orally and half for gargling, spitting out saliva.
Yi Xiao Wan (Laughing Pill), Yu Chi San (Jade Pool Powder), Fumigation Medicine
For various toothaches, use Yi Xiao Wan: seven grains of Chuan Jiao (Zanthoxyli Pericarpium) powdered, one kernel of Ba Dou (Crotonis Fructus) peeled and powdered, mixed with rice paste into pills. Wrap in cotton and bite on the painful area; spitting saliva stops pain. Also use Yu Chi San: Gao Ben, Bai Zhi, Di Gu Pi (Lycii Cortex), Huai Hua (Sophorae Flos), Xi Xin, Dang Gui, Chuan Xiong, Hei Dou (Sojae Semen Nigrum), Sheng Ma, Fang Feng, Gan Cao (Glycyrrhizae Radix et Rhizoma). Decoct and gargle hot, spit cold. Worm toothache also benefits from biting/gargling. Additionally, fumigate with Jiu Zi (Trichosanthis Semen) or Cong Zi (Allii Fistulosi Semen) burned in a small stove over a large bowl of water, covered by a funnel directed at the painful tooth. Tiny worms fall into the water. This is highly effective.
Wu Ti Xiao Gan Tang (Wu Ti Eliminate Gangrene Decoction)
Although Ya Gan has specialized treatment, practitioners often fail to understand the efficacy of continuous purging. If the patient can eat and stools are soft, purging is still indicated. Ingredients include Xiong Huang (Realgar), Wu Ti (Trogopterori Faeces), Da Huang (Rhei Radix et Rhizoma), Lu Hui (Aloe), Chuan Huang Lian, Hu Huang Lian (Picrorhizae Rhizoma), and Huang Qin (Scutellariae Radix).
[Note] Ya Gan kills rapidly. Although specialists exist, they often neglect continuous purging ("Lei Gong"). This involves purging today and tomorrow until hardness subsides, black discoloration fades, and foul odor ceases. If unable to eat, purge every other day or every two-three days. After purging, appetite returns; no dietary restrictions are needed. Even if stools are loose, adjust purging based on severity for miraculous results. If anorexia persists and purging is intolerable, it is a death sign. Use Wu Ti Xiao Gan Tang, composed of Xiong Huang, Wu Ti, Da Huang, Lu Hui, Chuan Huang Lian, Hu Huang Lian, and Huang Qin.