〔 附〕统属足少阴肾经（《灵枢》曰∶足少阴气绝者，则骨枯。少阴者，冬脉也，伏阴
而濡骨髓者也。故骨不濡，则肉不能着也。骨肉不相亲，则肉软却；肉软却，则齿长而垢，发无泽。发无泽者，
骨先灭，戊笃已死，土胜水也。《素问》曰∶丈夫八岁肾气实，
发长齿更。五八肾气衰，齿槁发堕。又曰∶肾热者，色黑而齿槁。少阴终者，面黑色，齿长而垢，腹胀闭塞，
上下不通而终矣。戴复庵曰∶肾虚牙浮而痛，甚则憎寒恶热，全具如欲脱之状。宜安肾丸、八味丸、黑锡丹之
类）。
〔上 〕（ ，齿根肉也。亦作龈）属足阳明胃经。（《灵枢》曰∶足阳明之脉，循鼻外，入上齿中。《针
经》曰∶上齿痛，喜寒而恶热，取足阳明之原冲阳穴，在两足跗上五寸，骨间陷脉中。丹溪以谓当灸三里穴。
三里者，足阳明之合穴也，在膝下外侧辅骨下三指地，离 骨外一指许，两筋间宛宛中。又曰∶足阳明之入 遍
齿者，名曰角孙，上齿龋取之。《素问》曰∶邪客于足阳明之经。令人鼽衄。上齿寒，又缪传引上齿，齿唇寒
痛，视其手背脉血者，去之。足阳明中趾爪甲上一 。李东垣曰∶上 隶于坤土，乃足阳明胃脉之所贯络也。
止而不动，故上 牙疼，宜升麻散）。
〔下 〕属手阳明大肠经（《灵枢》曰∶手阳明有入 遍齿者，名曰大迎，下齿龋取之。又曰∶手阳明之
脉，其支者贯颊，入下齿中。《针经》曰∶下齿痛，喜热而恶寒，取手阳明之原合谷穴，在两手大指、次指岐骨
间陷中。丹溪以为当灸三间穴。三间者，手阳明之俞穴也，在两手大指、次指本节后内侧骨上缝中，赤白肉际。
王启玄曰∶手阳明脉，贯颊入下齿，故手阳明脉中商阳、二间、三间、合谷、阳溪、偏历、温溜七穴，并主齿
痛。李东垣曰∶下 嚼物，动而不休，手阳明大肠之所贯络也，故下 牙疼，宜白芷散。张洁古曰∶秦艽去下
牙痛，及除本经风湿。薛新甫曰∶大肠热而 肿痛，清胃散治之，重则调胃汤清之）。
【附注】牙齿归属于足少阴肾经（《灵枢》说：足少阴经气衰竭时，骨骼就会枯槁。少阴经是冬季的脉象，潜伏着阴气并濡养骨髓。所以如果骨骼得不到濡润，肌肉就无法附着。骨肉不相亲附，肌肉就会松弛退缩；肌肉松弛退缩，牙齿看起来就显得长且污垢堆积，头发失去光泽。头发没有光泽，说明骨骼先衰败，病情危重即将死亡，这是土克水的表现。《素问》说：男子八岁时肾气充实，头发生长、牙齿更换。四十岁时肾气衰退，牙齿干枯、头发脱落。又说：肾有热邪，面色发黑且牙齿干枯。少阴经气终结时，面色发黑，牙齿显得长且污垢堆积，腹部胀满闭塞，上下不通而死亡。戴复庵说：肾虚导致牙龈浮动疼痛，严重时怕冷恶热，症状完全像要脱落的状况。适宜使用安肾丸、八味丸、黑锡丹之类方剂）。
【上龈】（即龈肉，牙齿根部的肉。也写作“龈”）归属于足阳明胃经。（《灵枢》说：足阳明经脉，沿着鼻外侧，进入上齿中。《针经》说：上齿疼痛，喜欢寒冷厌恶炎热，取足阳明经的原穴冲阳穴，位于两足背上方五寸，骨间凹陷的脉动处。朱丹溪认为应当灸足三里穴。足三里是足阳明经的合穴，位于膝下外侧辅骨下三指宽的地带，距离胫骨外侧约一指宽，两筋之间的凹陷处。又说：足阳明经进入遍布牙齿的支脉，名叫角孙穴，治疗上齿龋坏疼痛取此穴。《素问》说：邪气侵犯足阳明经，使人发生鼻塞流涕和鼻出血。上齿感到寒冷，又通过缪传引致上齿，牙齿和嘴唇寒冷疼痛，观察手背部血脉瘀血者，予以放血祛除。足阳明经在中趾爪甲上一寸处有一个穴位。李东垣说：上龈隶属于坤土，是足阳明胃脉所贯穿联络的地方。上龈静止不动，所以上龈牙疼，适宜使用升麻散）。
【下龈】归属于手阳明大肠经（《灵枢》说：手阳明经有进入遍布牙齿的支脉，名叫大迎穴，治疗下齿龋坏疼痛取此穴。又说：手阳明经脉的分支穿过脸颊，进入下齿中。《针经》说：下齿疼痛，喜欢温热厌恶寒冷，取手阳明经的原穴合谷穴，位于两手大拇指与食指叉骨间的凹陷处。朱丹溪认为应当灸三间穴。三间穴是手阳明经的输穴，位于两手大拇指与食指本节后的内侧骨缝中，赤白肉际交界处。王启玄说：手阳明经脉，穿过脸颊进入下齿，所以手阳明经中的商阳、二间、三间、合谷、阳溪、偏历、温溜七个穴位，都主治牙齿疼痛。李东垣说：下龈咀嚼食物，运动不停歇，是手阳明大肠经所贯穿联络的地方，所以下龈牙疼，适宜使用白芷散。张洁古说：秦艽能去除下牙痛，以及清除本经的风湿。薛新甫说：大肠有热导致牙龈肿痛，用清胃散治疗，严重的用调胃汤清热治疗）。
[Appendix] The teeth are governed by the Foot-Shaoyin Kidney Meridian (The *Ling Shu* states: When the Qi of the Foot-Shaoyin meridian ceases, the bones become withered. Shaoyin is the pulse of winter, where Yin Qi lies dormant and moistens the bone marrow. Therefore, if the bones are not moistened, the flesh cannot adhere. If flesh and bone do not adhere closely, the flesh becomes soft and recedes; when the flesh recedes, the teeth appear long and accumulate dirt, and the hair loses its luster. Hair losing luster indicates that the bones are failing first; when the condition becomes critical, death ensues due to Earth overcoming Water. The *Su Wen* states: At the age of eight, a man's Kidney Qi becomes substantial, his hair grows, and his teeth change. At the age of forty, his Kidney Qi declines, his teeth become dry, and his hair falls out. It also states: In cases of Kidney Heat, the complexion turns black and the teeth become dry. When the Shaoyin meridian ends, the face turns black, the teeth appear long and dirty, abdominal distension and blockage occur, with no communication between the upper and lower parts, leading to death. Dai Fu'an stated: Kidney deficiency causes floating gums and pain; in severe cases, there is aversion to cold and heat, with symptoms resembling impending loss. Formulas such as An Shen Wan (Kidney-Anchoring Pill), Ba Wei Wan (Eight-Ingredient Pill), and Hei Xi Dan (Black Tin Pill) are suitable).
[Upper Gingiva] (Also known as Yin, referring to the gum tissue at the root of the teeth) belongs to the Foot-Yangming Stomach Meridian (The *Ling Shu* states: The Foot-Yangming meridian runs along the lateral side of the nose and enters the upper teeth. The *Zhen Jing* states: For pain in the upper teeth, which prefers cold and dislikes heat, treat with Yuan-Source point Chongyang (ST42) of the Foot-Yangming meridian, located five cun above the dorsum of the foot, in the depression between the bones where the pulse beats. Zhu Danxi suggested moxibustion on Zusanli (ST36). Zusanli is the He-Sea point of the Foot-Yangming meridian, located three finger-widths below the lateral aspect of the knee, approximately one finger-width lateral to the tibia, in the depression between two tendons. It further states: A branch of the Foot-Yangming meridian enters the teeth, named Jiaosun (GB7); for caries of the upper teeth, this point is selected. The *Su Wen* states: When pathogenic factors invade the Foot-Yangming meridian, it causes nasal congestion and epistaxis. Cold in the upper teeth, transmitted via Miao transmission, leads to cold pain in the teeth and lips; observe blood stasis in the veins on the back of the hand and remove it by bleeding. There is a point one cun above the nail on the middle toe of the Foot-Yangming meridian. Li Dongyuan stated: The upper gingiva belongs to Kun Earth and is penetrated and connected by the Foot-Yangming Stomach meridian. Since the upper gingiva remains still, for pain in the upper teeth caused by this region, Sheng Ma San (Cimicifuga Powder) is appropriate).
[Lower Gingiva] belongs to the Hand-Yangming Large Intestine Meridian (The *Ling Shu* states: The Hand-Yangming meridian has a branch entering the teeth, named Daying (LI19); for caries of the lower teeth, this point is selected. It also states: A branch of the Hand-Yangming meridian passes through the cheek and enters the lower teeth. The *Zhen Jing* states: For pain in the lower teeth, which prefers heat and dislikes cold, treat with Yuan-Source point Hegu (LI4) of the Hand-Yangming meridian, located in the depression between the metacarpal bones of the thumb and index finger. Zhu Danxi suggested moxibustion on Sanjian (LI3). Sanjian is the Shu-Stream point of the Hand-Yangming meridian, located in the medial crease of the bone behind the metacarpophalangeal joint of the thumb and index finger, at the junction of red and white skin. Wang Qixuan stated: The Hand-Yangming meridian passes through the cheek into the lower teeth; therefore, seven points in the Hand-Yangming meridian—Shangyang (LI1), Erjian (LI2), Sanjian (LI3), Hegu (LI4), Yangxi (LI5), Pianli (LI6), and Wenliu (LI7)—all govern toothache. Li Dongyuan stated: The lower gingiva moves continuously during mastication and is penetrated and connected by the Hand-Yangming Large Intestine meridian; thus, for pain in the lower teeth, Bai Zhi San (Angelica Dahurica Powder) is appropriate. Zhang Jiegu stated: Qin Jiao (Radix Gentianae Macrophyllae) removes lower toothache and clears wind-dampness from this meridian. Xue Xinpu stated: If Large Intestine Heat causes swelling and pain in the gums, Qing Wei San (Clear the Stomach Powder) treats it; in severe cases, Tiao Wei Tang (Regulate the Stomach Decoction) is used to clear heat).