牙床肿痛，齿痛摇动，或黑烂、脱落，世人皆作肾虚治，殊不知此属阳明经湿热。盖齿虽属肾，而生
于牙床，上下床属阳明大肠与胃，犹木生于土也。肠胃伤于美酒浓味膏粱甘滑之物，以致湿热上攻，则牙
床不清，而为肿为痛，或出血，或生虫，由是齿不得安而动摇、黑烂、脱落也。治宜泻阳明之湿热，则牙
床清宁，而齿自安固矣。
愚按齿痛若因手足阳明经湿热，用东垣清胃散；若因风寒入脑，脑痛齿亦痛，用羌活附子细辛汤；若
因思虑伤脾，用归脾汤；若因郁火所致，用越鞠丸；若因酒面炙爆而发，用清胃散；若因饮食伤脾，用六
君子汤；若因劳伤元气，用补中益气汤；若因脾胃素弱，用六君、当归、升麻；若因肾经阴虚，用六味
丸；若因肾经阳虚，用八味丸；若阴阳俱虚，用十补丸；若脾肾虚寒，用安肾丸。徐用诚先生云∶凡齿病
恶寒热等症，属手足阳明经；齿摇、断脱，属足少阴
经；齿蚀肿痛、出血，皆胃火所致也。亦有诸经错杂之邪与外因为患者。
廷尉张中梁，齿动摇，用安肾丸；考功杨仲玉，齿动，用补中益气汤；侍御王济川，齿摇龈露，用承
气汤；文选郑伯兴，齿脑痛，用羌活附子汤；颜佥宪，齿痛，用凉膈散；郭职方，过饮，用清胃散；党吏
部，风热，用犀角升麻汤；朱工部，血气虚，用十全大补汤；沈大尹，头脑齿痛，头重，手足厥冷，此风
寒入脑，用麻黄附子细辛汤∶并愈。
牙床肿痛，牙齿疼痛且松动，或者出现黑色腐烂、脱落的情况，世人通常都将其作为肾虚来治疗，却不知道这实际上属于阳明经的湿热证。虽然牙齿在归属上属于肾，但牙齿生长于牙床之中，上下牙床分别归属于阳明大肠经和胃经，这就好比树木生长在土壤里一样。肠胃如果受到美酒、浓味以及膏粱甘滑等食物的损伤，导致湿热之气向上攻冲，那么牙床就会不清爽，从而发生肿胀和疼痛，或者出血，或者生虫，由此导致牙齿不得安宁而出现松动、黑烂、脱落等症状。治疗应当采用泻除阳明经湿热的方法，这样牙床就能恢复清宁，牙齿自然也就稳固安定了。
我按语认为：牙齿疼痛如果是由于手足阳明经湿热引起的，使用东垣的清胃散；如果是由于风寒侵入脑部，引起脑痛连带牙齿也痛，使用羌活附子细辛汤；如果是由于思虑过度损伤脾脏，使用归脾汤；如果是由于郁火所致，使用越鞠丸；如果是由于饮酒、面食及炙烤爆炒食物引发的，使用清胃散；如果是由于饮食损伤脾脏，使用六君子汤；如果是由于劳累损伤元气，使用补中益气汤；如果是由于脾胃素来虚弱，使用六君子汤加当归、升麻；如果是由于肾经阴虚，使用六味丸；如果是由于肾经阳虚，使用八味丸；如果是阴阳两虚，使用十补丸；如果是脾肾阳虚寒盛，使用安肾丸。徐用诚先生曾说：凡是牙齿疾病伴有恶寒发热等症状的，属于手足阳明经病变；牙齿松动、折断脱落的，属于足少阴经病变；牙齿腐蚀肿痛、出血的，都是胃火所致。也有各种经络错杂之邪与外因共同致病的情况。
廷尉张中梁，牙齿松动，使用安肾丸治愈；考功杨仲玉，牙齿动摇，使用补中益气汤治愈；侍御王济川，牙齿松动牙龈萎缩暴露，使用承气汤治愈；文选郑伯兴，牙齿连带头脑疼痛，使用羌活附子汤治愈；颜佥宪，牙齿疼痛，使用凉膈散治愈；郭职方，因过量饮酒引发，使用清胃散治愈；党吏部，因风热引发，使用犀角升麻汤治愈；朱工部，因血气虚弱，使用十全大补汤治愈；沈大尹，头脑及牙齿疼痛，头部沉重，手脚冰凉，这是风寒侵入脑部所致，使用麻黄附子细辛汤治愈：以上病例全部痊愈。
Swelling and pain of the gums, toothache accompanied by loosening, or black decay and shedding, are commonly treated by people as Kidney deficiency. However, it is unknown that this actually belongs to damp-heat in the Yangming channel. Although teeth are attributed to the Kidney, they grow from the gums. The upper and lower gums belong to the Yangming Large Intestine and Stomach channels, just as trees grow in soil. If the intestines and stomach are injured by fine wine, rich flavors, and greasy, sweet, and slippery foods, leading to damp-heat attacking upward, the gums become turbid, resulting in swelling and pain, bleeding, or the generation of worms. Consequently, the teeth become unstable, leading to loosening, black decay, and shedding. Treatment should aim to purge the damp-heat of the Yangming channel; once the gums are clear and tranquil, the teeth will naturally become secure.
In my opinion: If toothache is caused by damp-heat in the Hand and Foot Yangming channels, use Qingwei San (Stomach-Clearing Powder) from Dongyuan; if it is caused by wind-cold invading the brain, causing headache and toothache, use Qianghuo Fuzi Xixin Tang (Notopterygium, Aconite, and Asarum Decoction); if it is caused by excessive worry injuring the Spleen, use Guipi Tang (Restore the Spleen Decoction); if it is caused by constrained fire, use Yueju Wan (Resolve Depression Pill); if it is triggered by alcohol, wheat products, and roasted or fried foods, use Qingwei San; if it is caused by dietary injury to the Spleen, use Liujunzi Tang (Six Gentlemen Decoction); if it is caused by fatigue injuring Yuan Qi (Primal Qi), use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); if the Spleen and Stomach are inherently weak, use Liujunzi Tang with Danggui (Angelica Sinensis) and Shengma (Cimicifugae Rhizoma); if it is due to Yin deficiency of the Kidney channel, use Liuwei Wan (Six-Ingredient Pill with Rehmannia); if it is due to Yang deficiency of the Kidney channel, use Bawei Wan (Eight-Ingredient Pill with Rehmannia); if both Yin and Yang are deficient, use Shibu Wan (Ten-Ingredient Pill); if there is cold-deficiency of the Spleen and Kidney, use Anshen Wan (Calming the Kidney Pill). Mr. Xu Yongcheng stated: Any dental disease accompanied by aversion to cold and fever belongs to the Hand and Foot Yangming channels; loose, broken, or shed teeth belong to the Foot Shaoyin channel; corroded, swollen, painful, and bleeding teeth are all caused by Stomach fire. There are also cases where pathogens from various channels mix with external causes.
Zhang Zhongliang, Minister of Justice, had loose teeth and was cured using Anshen Wan; Yang Zhongyu, Examiner, had shaking teeth and was cured using Buzhong Yiqi Tang; Wang Jichuan, Censor, had loose teeth with exposed gums and was cured using Chengqi Tang (Purgative Decoction); Zheng Boxing, Literary Selection Official, had toothache radiating to the head and was cured using Qianghuo Fuzi Tang (Notopterygium and Aconite Decoction); Yan Qianxian, Judicial Commissioner, had toothache and was cured using Liangge San (Cool the Diaphragm Powder); Guo Zhifang, Military Engineer, suffered from overdrinking and was cured using Qingwei San; Dang Libu, Ministry of Personnel Official, suffered from wind-heat and was cured using Xijiao Shengma Tang (Rhinoceros Horn and Cimicifuga Decoction); Zhu Gongbu, Ministry of Works Official, suffered from blood and Qi deficiency and was cured using Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction); Shen Dayin, County Magistrate, suffered from headache and toothache, heavy head, and cold extremities, which was diagnosed as wind-cold invading the brain, and was cured using Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction): All cases were successfully cured.