五行之用。无在不彰。天一生水。水之凝者为石。其至坚者为金。而石可砻
物。金能断物。在人则齿应之。齿者胃之标。骨之余。上龈属胃。胃为艮土。故
止而不动。下龈属大肠。大肠主庚金。故动而不休。齿禀其气。无物不摧。此
造化之微。不可测也。肾中有水有火。足阳明喜寒畏热。手阳明喜热畏寒。
其气不齐。凡齿落动摇。主肾。齿龈肿溃。主胃与大肠。其间有风寒乘之。湿
热侵之。疳虫蚀之。或散或清。或荡涤。法亦不等。然必以寒热兼济。药乃有
效者何也。缘水火不可偏废。一胜则一负。土不可燥。金不可寒。即其所喜
所畏。可得用药之权衡。如细辛。少阴之热药也。黄柏。太阳之寒药也。专用
之。则各主一病。合用之。则止牙疼于俄顷。凡祛风解热凉血剂中。皆不可
缺。至真阴亏而水不足。元气伤而火有余。或益水中之火。或滋火中之水
溯厥原而疗之。能以常格论哉。
一东垣治刘经历之内。齿痛不可忍。须骑马外行。口吸凉风则痛止。至家
复作。乃湿热为邪。足阳明多血多气。加以膏粱之味助之所致。因立方。
不须骑马。当令风寒之气。生于齿间。黄连胡桐泪之苦寒。薄荷叶荆芥
穗之辛凉。四味相合而作风寒之气。治湿热为主。新升麻之苦平。行阳
明经为使。羊 骨灰补之为佐。麝香少许为引。细末擦之。痛减半。又以
调胃承气去硝加黄连治其本。下三两行。痛不复作。
一齿恶寒热。或虫疳龈肿。出血痛秽。皆手足阳明。外感风寒。内蕴湿热。风
寒。用荆防汤。湿热。用清胃散。甚则承气汤。
一牙齿动摇脱落。本足少阴经。用六味丸。火衰者。八味丸。还少丹。七情所伤。随症调之。
一风毒牙痛。或大寒所犯。用独活散。
荆防汤 治畏寒畏热。
防风 荆芥 生地 枳壳 葛根（各一钱） 细辛（三分） 蔓荆子（七分焙研） 黄柏（五分酒炒黑）
水煎。
清胃汤 治龈肿溃烂。
生地（一钱半） 石膏（二钱） 升麻（五分） 丹皮 防风 枳壳（各一钱）
水煎。
下龈甚者。加芍药、黄芩。
凉膈散 治胃有实热。
大黄（酒蒸） 朴硝 甘草 山栀（炒黑） 黄芩 薄荷（各一两） 连翘（四两）
为末。每服五七钱。水煎。
独活散
独活 川芎 羌活 防风（各五分） 细辛 荆芥 薄荷 生地黄（各二钱）
每服五钱。水煎。
丹溪治小儿走马牙疳。床一齐腐烂即死。用妇人尿桶中白垢。火 一钱。入铜绿三分。麝香
一分半。敷之立效。
立斋治中气亏损。牙齿作病。用补中益气、归脾二汤。加酒炒黑黄柏。
五行的作用，无处不在彰显。天一生水，水的凝结物成为石头，其中最为坚硬的称为金，而石头可以磨削物体，金属能够切割物体。在人体中，牙齿对应这一原理。牙齿是胃的外候，也是骨骼的余气所生。上牙龈属于胃，胃对应艮土（八卦之一，象征山），性质静止而不移动；下牙龈属于大肠，大肠主庚金，性质运动而不停止。牙齿禀受这些气化作用，无坚不摧，这是造化的精微之处，不可测度。
肾中既有水又有火。足阳明胃经喜好寒冷而畏惧炎热，手阳明大肠经喜好温暖而畏惧寒冷。它们的气机并不一致。凡是牙齿脱落动摇，病主在肾；牙龈肿胀溃烂，病主在胃与大肠。其间若有风寒侵袭，湿热侵犯，或疳虫侵蚀，治疗方法有的用发散，有的用清热，有的用荡涤攻下，方法也不尽相同。然而必须寒热并用，药物才能见效，为什么呢？因为水火不可偏废，一方胜则另一方衰。土（脾胃）不可过于干燥，金（肺与大肠）不可过于寒凉。从脏腑所喜所畏的特性，就可以得到用药的权衡标准。例如细辛，是少阴经的热性药；黄柏，是太阳经的寒性药。单独使用，各自主治一种病症；配合使用，则能瞬间止住牙痛。凡是在祛风、解热、凉血的方剂中，都不可缺少这两味药。至于真阴亏损而水不足，元气受伤而火有余的情况，或者益补水中的火，或者滋补水中的火，追溯其根源来治疗，怎么能用常规的法度来论断呢？
有一个案例：李东垣治疗刘经历的妻子，牙齿疼痛难以忍受，必须骑马外出，口吸凉风疼痛才能停止，回到家又发作。这是因为湿热为邪，足阳明胃经多血多气，加上饮食膏粱厚味助长所致。因此立下方剂：不需要骑马，应当让风寒之气生于齿间。用黄连、胡桐泪的苦寒，薄荷叶、荆芥穗的辛凉，四味药相合而产生风寒之气，以治疗湿热为主。加上新升麻的苦平之性，作为引经药行于阳明经；羊骨灰作为佐药进行补益；少许麝香作为引经药。研成细末外擦，疼痛减半。随后又用调胃承气汤去掉芒硝加入黄连来治本，服用后大便下行三两行，疼痛不再发作。
另一个情况：牙齿恶寒发热，或有虫疳、牙龈肿胀，出血且气味秽臭，皆属于手足阳明经病变，由外感风寒、内蕴湿热引起。对于风寒证，用荆防汤；对于湿热证，用清胃散；病情严重的，用承气汤。
牙齿动摇脱落，病本在足少阴肾经，用六味丸治疗；若是火衰者，用八味丸或还少丹。若因七情内伤所致，随症状调理。
风毒引起的牙痛，或因大寒所犯，用独活散。
【荆防汤】治疗畏寒畏热。
防风、荆芥、生地、枳壳、葛根（各一钱），细辛（三分），蔓荆子（七分，焙后研碎），黄柏（五分，酒炒黑）。水煎服。
【清胃汤】治疗牙龈肿胀溃烂。
生地（一钱半）、石膏（二钱）、升麻（五分）、丹皮、防风、枳壳（各一钱）。水煎服。若下牙龈症状严重，加芍药、黄芩。
【凉膈散】治疗胃有实热。
大黄（酒蒸）、朴硝、甘草、山栀（炒黑）、黄芩、薄荷（各一两），连翘（四两）。研为细末，每次服用五至七钱，水煎服。
【独活散】
独活、川芎、羌活、防风（各五分），细辛、荆芥、薄荷、生地黄（各二钱）。每次服用五钱，水煎服。
朱丹溪治疗小儿走马牙疳，若床板一起腐烂即会死亡。他用妇人尿桶中的白垢，煅烧后取一钱，加入铜绿三分、麝香一分半，敷患处，立即见效。
The functions of the Five Elements (Wu Xing) are manifested everywhere. Heaven generates Water (Tian Yi Sheng Shui); when water condenses, it becomes stone; the hardest among them is called Metal (Jin). Stone can grind objects, and metal can cut objects. In the human body, teeth correspond to this principle. Teeth are the external manifestation of the Stomach (Wei) and the surplus of Bone (Gu). The upper gums belong to the Stomach, which corresponds to Gen Earth (Gen Tu, one of the Eight Trigrams symbolizing Mountain), characterized by stillness and immobility. The lower gums belong to the Large Intestine (Da Chang), which governs Geng Metal (Geng Jin), characterized by movement and ceaselessness. Teeth inherit these Qi transformations, rendering them capable of destroying anything. This is the subtlety of creation, unfathomable.
Within the Kidney (Shen), there is both Water and Fire. the Foot-Yangming Stomach Meridian (Zu Yangming Wei Jing) prefers cold and fears heat, while the Hand-Yangming Large Intestine Meridian (Shou Yangming Da Chang Jing) prefers warmth and fears cold. Their Qi mechanisms are not uniform. Cases of tooth loss or mobility primarily involve the Kidney; cases of gum swelling and ulceration primarily involve the Stomach and Large Intestine. If Wind-Cold (Feng Han) invades, Damp-Heat (Shi Re) attacks, or Caries Worms (Gan Chong) erode the teeth, treatments may include dispersing, clearing heat, or purging, with varying methods. However, Cold and Heat must be balanced for efficacy. Why? Because Water and Fire cannot be neglected; if one prevails, the other declines. Earth (Spleen/Stomach) should not be too dry, and Metal (Lung/Large Intestine) should not be too cold. By understanding what each organ prefers and fears, one can determine the balance of medication. For instance, Xixin (Asarum Root) is a hot herb for the Shaoyin (Kidney/Heart) channel; Huangbai (Phellodendron Bark) is a cold herb for the Taiyang (Bladder/Small Intestine) channel. Used alone, each treats a specific condition; used together, they can stop toothache instantly. They are indispensable in formulas that dispel wind, clear heat, and cool blood. Regarding cases of True Yin deficiency with insufficient Water, or Yuan Qi injury with excessive Fire, whether tonifying Fire within Water or nourishing Water within Fire, tracing the root cause to treat it—how can this be discussed using conventional rules?
Case 1: Li Dongyuan treated the wife of Official Liu, who suffered unbearable tooth pain. She had to ride a horse outside and inhale cool air to relieve the pain, but it recurred upon returning home. This was due to Damp-Heat pathogenic factors. The Foot-Yangming Stomach Meridian is rich in Blood and Qi, exacerbated by a diet rich in fatty and sweet foods. He prescribed a formula: instead of riding a horse, one should generate an atmosphere of Wind-Cold between the teeth. Using the bitter-cold properties of Huanglian (Coptis Rhizome) and Hutonglei (Poplar Catkin Tears), combined with the acrid-cool properties of Boheye (Mint Leaf) and Jingjiesui (Schizonepeta Spike), these four herbs create a Wind-Cold effect to primarily treat Damp-Heat. Xinshengma (Bupleurum Root) with its bitter-neutral nature serves as the guiding herb for the Yangming channel. Sheep bone ash acts as an adjuvant for supplementation, and a small amount of Shexiang (Musk) serves as a guide. Ground into fine powder and applied externally, the pain reduced by half. Subsequently, he used Tiaowei Chengqi Tang (Regulate the Stomach Order the Qi Decoction) with Mangxiao (Mirabilite) removed and Huanglian added to treat the root cause. After three to two taels of bowel movements, the pain did not recur.
Another scenario: Teeth sensitive to cold and heat, or suffering from caries worms and gum swelling, bleeding with foul odor, all belong to the Hand and Foot Yangming meridians, caused by external Wind-Cold and internal Damp-Heat. For Wind-Cold patterns, use Jingfang Tang (Schizonepeta and Saposhnikovia Decoction); for Damp-Heat patterns, use Qingwei San (Clear the Stomach Powder); for severe cases, use Chengqi Tang (Order the Qi Decoction).
Tooth mobility and loss originate in the Foot-Shaoyin Kidney Meridian (Zu Shaoyin Shen Jing); treat with Liuwei Wan (Six-Ingredient Pill with Rehmannia). For Fire deficiency, use Bawei Wan (Eight-Ingredient Pill) or Huanshao Dan (Return to Youth Pill). If injured by Seven Emotions (Qi Qing), adjust according to symptoms.
For Toothache caused by Wind-Toxicity or severe Cold, use Duohuo San (Angelica Pubescens Powder).
[Jingfang Tang] Treats aversion to cold and heat.
Fangfeng (Saposhnikovia Root), Jingjie (Schizonepeta Spike), Shengdi (Rehmannia Root), Zhike (Aurantii Fructus), Gegen (Puerariae Radix) (each 1 qian); Xixin (Asarum Root) (3 fen); Manjingzi (Vittatis Fructus) (7 fen, roasted and ground); Huangbai (Phellodendri Cortex) (5 fen, wine-fried until black). Decoct in water and drink.
[Qingwei Tang] Treats gum swelling and ulceration.
Shengdi (Rehmannia Root) (1.5 qian); Shigao (Gypsum Fibrosum) (2 qian); Shengma (Cimicifugae Rhizoma) (5 fen); Danpi (Moutan Cortex); Fangfeng (Saposhnikovia Root); Zhike (Aurantii Fructus) (each 1 qian). Decoct in water and drink. For severe lower gum conditions, add Shaoyao (Paeoniae Radix) and Huangqin (Scutellariae Radix).
[Liangge San] Treats Excess Heat in the Stomach.
Dahuang (Rhei Radix et Rhizoma, steamed in wine); Puxiao (Natrii Sulfas); Gancao (Glycyrrhizae Radix et Rhizoma); Shanzhi (Gardeniae Fructus, fried until black); Huangqin (Scutellariae Radix); Bohe (Menthae Haplocalycis Herba) (each 1 liang); Lianqiao (Forsythiae Fructus) (4 liang). Grind into powder. Take 5-7 qian per dose, decoct in water and drink.
[Duohuo San]
Duohuo (Angelicae Pubescentis Radix); Chuanxiong (Ligustici Chuanxiong Rhizoma); Qianghuo (Notopterygii Rhizoma et Radix); Fangfeng (Saposhnikovia Root) (each 5 fen); Xixin (Asarum Root); Jingjie (Schizonepeta Spike); Bohe (Menthae Haplocalycis Herba); Shengdihuang (Rehmanniae Radix) (each 2 qian). Take 5 qian per dose, decoct in water and drink.
Zhu Danxi treated pediatric "Running Horse Dental Gangrene" (Zouma Yagan), where rapid decay leads to death. He used white scum from women's urine buckets, calcined to obtain 1 qian, mixed with Tonglv (Verdigris) 3 fen and Shexiang (Musk) 1.5 fen, applied topically for immediate effect.
Xue Lizhai treated dental diseases caused by Middle Qi deficiency, using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Guipi Tang (Restore the Spleen Decoction), adding Huangbai (Phellodendri Cortex) fried in wine until black.