骨槽风火三焦胃，耳前腮颊隐隐疼，腐溃筋骨仍硬痛，牙关拘急夹邪风。
\r骨槽风图\p04-34a48.bmp\r
【注】此证一名牙叉发，一名穿腮发。乃手少阳三焦、足阳明胃二经风火也。起于耳前，连及腮颊，筋骨隐痛，日
久腐溃，腮之里外筋骨，仍然漫肿硬痛，牙关拘急，皆由邪风深袭筋骨故也。此证属在筋骨阴分，故初起肿硬难消，溃
后疮
口难合，多致不救。
初起热不盛者，内宜服清阳散火汤，外以清胃散擦牙，真君妙贴散敷腮，如初起发表之
后，人壮火盛者，用皂刺、大黄、甘草节、白芷、僵蚕下之，后减大黄，加生石膏以清
之。然亦不可过用寒凉之药，恐其凝结也。有硬肿日久失治，不能尽消者，脓势将成，
宜用中和汤托之。已溃按痈疽溃疡门治法。亦有过服寒凉，以致肌肉坚凝腐臭，非理中
汤佐以附子不能回阳，非僵蚕不能搜风。如法治之，诸证俱减，惟牙关拘急不开，宜用
生姜片垫灸颊车穴二七壮（其穴在耳垂下五分陷中处），每日灸之，兼用针刺口内牙尽
处出血，其牙关即开。若寒热不退，形焦体削，痰盛不食，或口内腐烂，甚则穿腮落齿
者，俱为逆证。当腐烂之初，治法即同牙疳，亦不过稍尽人事耳。
清胃散
姜黄 白芷 细辛 川芎
各等分，共研细末。先以盐汤漱口，擦牙痛处。
【方歌】清胃散擦牙肿疼，姜黄白芷细辛芎，同研先以盐汤漱，后擦此药有奇功。
中和汤
白芷 桔梗 人参 黄 （各一钱） 藿香（五分） 肉桂（五分） 甘草 白术（土炒） 川芎
当归 白芍（酒炒，各一钱） 麦门冬（去心，五分）
水二盅，姜三片，枣二枚，煎八分，加酒一杯食远服。
【方歌】中和汤治骨槽风，日久不消欲溃脓，芷桔参 藿桂草，术芎归芍麦门冬。
理中汤（见溃疡门）
真君妙贴散（见肿疡门）
升阳散火汤（方见颊疡）
骨槽风（一种以耳前腮颊疼痛、腐溃筋骨为特征的外科疾病）的病机涉及三焦经和胃经的火邪，表现为耳前及腮颊部位隐隐作痛，若腐烂溃破后筋骨依然僵硬疼痛，且伴有牙关拘急（张口困难），这是夹带邪风所致。
【注释】此证又名“牙叉发”或“穿腮发”。这是由于手少阳三焦经和足阳明胃经的风火之邪引起。病位起于耳前，蔓延至腮颊，筋骨出现隐痛；日久则腐烂溃破，腮部里外的筋骨仍然弥漫性肿胀、坚硬且疼痛，牙关拘急，这都是因为邪风深入侵袭筋骨所致。此证病位在筋骨的阴分，因此初起时肿胀坚硬难以消散，溃破后疮口难以愈合，多导致死亡。
初起热势不盛者，内服清阳散火汤，外用清胃散擦牙，用真君妙贴散敷贴腮部。如果初起发表之后，人体壮实且火邪炽盛者，使用皂刺、大黄、甘草节、白芷、僵蚕等药物攻下；随后减少大黄用量，加入生石膏以清热。然而也不可过度使用寒凉药物，恐怕导致气血凝结。若有硬肿日久失治，不能全部消散，脓势即将形成者，宜用中和汤托毒外出。已经溃破的，按照痈疽溃疡门的治法处理。也有因过服寒凉药物，导致肌肉坚硬凝固、腐烂发臭的，非理中汤配合附子不能回阳救逆，非僵蚕不能搜剔风邪。按此法治疗，诸症皆减，唯独牙关拘急无法张开，宜用生姜片垫在颊车穴上施灸十四壮（该穴位位于耳垂下方五分处的凹陷中），每日施灸，同时针刺口腔内牙齿尽头处使其出血，牙关即可张开。如果出现寒热不退，形体消瘦枯槁，痰多不能进食，或者口腔内腐烂，甚至穿透腮部脱落牙齿的，都属于逆证（预后不良）。当刚开始腐烂时，治疗方法同于牙疳，也不过是尽力挽救罢了。
清胃散
组成：姜黄、白芷、细辛、川芎，各等分，共同研成细末。先用盐水漱口，然后擦拭牙痛部位。
【方歌】清胃散用于擦牙治疗肿痛，由姜黄、白芷、细辛、川芎组成，一同研磨，先用盐水漱口，再擦拭此药有奇效。
中和汤
组成：白芷、桔梗、人参、黄芪（各一钱）、藿香（五分）、肉桂（五分）、甘草、白术（土炒）、川芎、当归、白芍（酒炒，各一钱）、麦门冬（去心，五分）。
用法：水两盅，生姜三片，大枣二枚，煎至八分，加酒一杯，饭后服用。
【方歌】中和汤治疗骨槽风，病程日久不消欲化脓，包含白芷、桔梗、人参、藿香、肉桂、甘草、白术、川芎、当归、白芍、麦门冬。
Gucao Feng (a surgical disease characterized by pain in the preauricular and cheek regions, with rotting of bones and sinews) involves fire pathogens of the Sanjiao (Triple Burner) and Stomach meridians. It presents as a dull pain in the area anterior to the ear and the cheeks. If it suppurates and ulcerates, the bones and sinews remain stiff and painful, accompanied by trismus (lockjaw), which is caused by the invasion of pathogenic wind.
[Note] This condition is also known as "Yacha Fa" or "Chuansai Fa." It arises from wind-fire pathogens of the Hand-Shaoyang Sanjiao Meridian and the Foot-Yangming Stomach Meridian. The pathology begins anterior to the ear and extends to the cheeks, causing dull pain in the bones and sinews. Over time, it suppurates and ulcerates; the bones and sinews inside and outside the cheek remain diffusely swollen, hard, and painful, with trismus. These symptoms are all due to pathogenic wind deeply invading the bones and sinews. Since this condition resides in the Yin aspect of the bones and sinews, the initial swelling and hardness are difficult to dissipate, and after ulceration, the wound fails to heal, often leading to death.
In the early stage, if heat is not severe, internally administer Qingyang Sanhuo Tang (Clear Yang and Disperse Fire Decoction). Externally, use Qingwei San (Stomach-Clearing Powder) to rub the teeth, and apply Zhenjun Miaotie San (True Lord's Miraculous Paste Powder) to the cheek. If, after releasing the exterior in the early stage, the patient is robust and fire pathogens are blazing, use Cishi (Spines of Trichosanthes Fruit), Dahuang (Rhubarb Root), Gancaojie (Ganoderma Lucidum Stem End), Baizhi (Angelicae Dahuricae Radix), and Jiangcan (Bombyx Batryticatus) to purge. Subsequently, reduce the dosage of Dahuang and add Sheng Shigao (Gypsum Fibrosum) to clear heat. However, cold-cooling herbs should not be overused, lest they cause coagulation. If there is hard swelling that has persisted for a long time due to neglected treatment and cannot fully dissipate, and pus formation is imminent, use Zhonghe Tang (Harmonizing Decoction) to support the healthy qi and expel toxins. For cases already ulcerated, follow the treatment methods outlined in the Ulcerative Sores section. There are also cases where excessive consumption of cold-cooling herbs leads to muscles becoming hard, solid, rotten, and foul-smelling. In such cases, Lizhong Tang (Regulate the Middle Decoction) combined with Fuzi (Aconite Lateral Root) is required to restore Yang, and Jiangcan (Bombyx Batryticatus) is needed to search out wind. Following this treatment, most symptoms will subside. However, if trismus persists and the mouth cannot open, place slices of fresh ginger on the Jiache acupoint (located 0.5 cun below the earlobe in the depression) and moxibustion should be applied for 14 moxa cones (Zhuang). Perform moxibustion daily. Additionally, prick the area at the end of the teeth inside the mouth to induce bleeding, which will relieve the trismus. If chills and fever persist, the body becomes emaciated and withered, phlegm is profuse and eating is impossible, or oral rot occurs, even penetrating the cheek and causing tooth loss, these are all adverse signs (indicating poor prognosis). When rot first begins, the treatment is similar to that for Yagan (Gangrenous Gingivitis/Stomatitis); it is merely an attempt to do one's utmost.
Qingwei San (Stomach-Clearing Powder)
Ingredients: Jianghuang (Curcuma Longae Rhizoma), Baizhi (Angelicae Dahuricae Radix), Xixin (Asari Radix et Rhizoma), Chuanxiong (Ligusticum Chuanxiong Rhizoma), in equal parts, ground into fine powder. First rinse the mouth with salt water, then rub the powder on the painful teeth.
[Fang Ge - Prescription Verse] Qingwei San rubbed on the teeth treats swelling and pain; composed of Jianghuang, Baizhi, Xixin, and Chuanxiong. Grind together, rinse with salt water first, then apply this medicine externally for miraculous efficacy.
Zhonghe Tang (Harmonizing Decoction)
Ingredients: Baizhi (Angelicae Dahuricae Radix), Jiegeng (Platycodonis Radix), Renshen (Ginseng Radix), Huangqi (Astragali Membranacei Radix) (each 1 qian), Huoxiang (Pogostemonis Herba) (0.5 qian), Rougui (Cinnamomi Cortex) (0.5 qian), Gancao (Glycyrrhizae Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried with soil), Chuanxiong (Ligusticum Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba, wine-fried) (each 1 qian), Maimendong (Ophiopogonis Radix, heart removed) (0.5 qian).
Preparation: Add two cups of water, three slices of fresh ginger, and two jujubes. Decoct until reduced to 0.8 cup. Add one cup of wine and take after meals.
[Fang Ge - Prescription Verse] Zhonghe Tang treats Gucao Feng, for long-standing cases not resolving, about to form pus. Contains Baizhi, Jiegeng, Renshen, Huoxiang, Rougui, Gancao, Baizhu, Chuanxiong, Danggui, Baishao, and Maimendong.
Lizhong Tang (Regulate the Middle Decoction) (See Ulcerative Sores Section)
Zhenjun Miaotie San (True Lord's Miraculous Paste Powder) (See Swollen Ulcers Section)
Shengyang Sanhuo Tang (Raise Yang and Disperse Fire Decoction) (Formula seen in Cheek Ulcers Section)