（人）入肾推毒外出
人牙（专入肾）。味咸性温。功专治痘倒靥。缘痘或出不快。反见黑陷。多因毒瓦斯深入。
故须
用此内发。时珍曰。齿者肾之标。骨之余也。痘疮则毒自肾出。方长之余。外为风寒秽气所
冒。腠理闭塞。血涩不行。毒不能出。或变黑倒靥。宜用此物以酒麝达之。窜入肾经。发出
毒瓦斯。使热令复行而疮自红活。盖劫剂也。若伏毒在心。昏冒不省人事。及气虚色白。痒塌
不能作脓。热痱紫泡之症。止宜解毒补虚。苟误用此。则郁闷声哑。反成不救。可不慎哉！
（高武痘诊管见云。左仲恕言变黑归肾者。宜用人牙散。夫既归肾矣。人牙岂能复治之乎？）
退火毒用。
毒虽见症于外。而势已传于内。则药又当从内清解。故解毒亦为治毒之方所不可缺也。
第人
仅知金银花牛蒡子甘草为解毒之品。凡属毒剂。无不概投。讵知毒因心热而成者。则有黄连
连翘可解。因于肺火而成者。则有黄芩可解。因于肝火而成者。则有胆草青黛蓝子可解。因
于胃火胃毒而成者。则有石膏竹叶大黄可解。因于肾火而成者。则有黄柏知母可解。且毒在
于肠胃。症见痈疽乳闭。宜用漏芦以通之。症见消渴不止。宜用绿豆煮汁以饮之。症见肠
便血。宜用白头翁以解之。症见时行恶毒。宜用金汁人中黄以利之。至于杨梅症见。多属肝
肾毒发。宜用土茯苓以清之。喉痹咽痛。多属痰火瘀结。宜用射干以开之。心肾火炽。宜用
山豆根以熄之。鬼疰瘰 。溃烂流串。多属经络及脾毒积。宜用蚯蚓以化之。口眼 斜。痈
肠痔漏。多属经络肠胃毒发。宜用蜗牛以治之。乳痈乳岩。多属肝胃热起。宜用蒲公英以疗
之。恶疮不敛。多属心肺痰结。宜用贝母以除之。无名疔肿。恶疮蛇虺。瘰 结核。多属毒
结不化。宜用山慈菇以治之。毒势急迫。咳唾不止。多属中气虚损。宜用荠 以缓之。他如
痈肿不消。有用米醋同药以治。热涎不除。积垢不清。有用皂白二矾以入。痈疽 肿。胸热
不除。有用甘草节以投。皆有深意内存。不可稍忽。若在斑蝥凤仙子恶毒之品。要当审症酌
治。不可一毫稍忽于其中也。
（人牙）入肾经，推引毒邪外出。
人牙（专门入肾经）。味道咸，性质温。功效专门治疗痘疮倒靥（痘疹因正气不足或毒盛而内陷，不能透发，反而凹陷黑紫的现象）。因为痘疮有时发出不畅，反而出现黑陷的症状，多是因为毒气深入体内。
所以必须
使用此药从内部发散毒邪。李时珍说：牙齿是肾的外在标志，是骨骼的余气所化。痘疮的毒邪是从肾发出的。在痘疮生长期间，外部被风寒秽浊之气侵袭，腠理（皮肤毛孔及肌肉纹理）闭塞，血液运行涩滞不畅，毒邪无法排出。或者变为黑色、倒靥。适宜使用此物配合酒和麝香送服，使其窜入肾经，发出毒气，使热气重新流通，疮面自然红润鲜活。这属于劫夺之剂（药力峻猛，能迅速祛除病邪的药物）。如果毒邪潜伏在心，导致神志昏迷、不省人事，以及气虚面色苍白、瘙痒塌陷不能化脓、热痱紫泡等症状，只适宜解毒补虚。如果错误使用此药，则会导致郁闷、声音嘶哑，反而造成无法救治的后果。能不谨慎吗！
（高武《痘诊管见》记载：左仲恕说变黑归肾者，适宜用人牙散。既然毒邪已经归于肾了，人牙难道还能再治疗它吗？）
用于退火毒。
毒邪虽然在外表显现症状，但病势已经传入体内，那么药物又应当从内部进行清解。所以解毒也是治疗毒邪方剂中不可缺少的环节。
只是人们
只知道金银花、牛蒡子、甘草是解毒的药物，凡是属于毒证的，无不一概投用。哪里知道毒邪因心热而成者，则有黄连、连翘可以解除；因肺火而成者，则有黄芩可以解除；因肝火而成者，则有龙胆草、青黛、蓝实可以解除；因胃火、胃毒而成者，则有石膏、竹叶、大黄可以解除；因肾火而成者，则有黄柏、知母可以解除。而且毒邪在于肠胃，症状表现为痈疽、乳房闭塞不通，适宜用漏芦来通利；症状表现为消渴不止，适宜用绿豆煮汁饮用；症状表现为肠道便血，适宜用白头翁来解除；症状表现为时行恶毒（流行性烈性毒邪），适宜用金汁、人中黄来通利。至于杨梅疮症状出现，多属于肝肾毒邪发作，适宜用土茯苓来清解；喉痹咽痛，多属于痰火瘀结，适宜用射干来开泄；心肾火炽盛，适宜用山豆根来熄灭；鬼疰瘰疬（一种慢性传染病，此处指淋巴结结核等溃烂流串之症），溃烂流串，多属于经络及脾脏毒邪积聚，适宜用蚯蚓来化解；口眼歪斜，痈肠痔漏，多属于经络肠胃毒邪发作，适宜用蜗牛来治疗；乳痈乳岩（乳腺炎及乳腺癌），多属于肝胃热邪兴起，适宜用蒲公英来疗治；恶疮不愈合，多属于心肺痰结，适宜用贝母来消除；无名疔肿，恶疮蛇虺咬伤，瘰疬结核，多属于毒邪凝结不化，适宜用山慈菇来治疗；毒势急迫，咳嗽吐痰不止，多属于中气虚损，适宜用荠苨来缓和。其他如痈肿不消，有用米醋同药一起治疗；热涎不除，积垢不清，有用白矾、皂角刺（注：原文“皂白二矾”通常指白矾与皂角，或两种矾类，结合语境及常用配伍，此处保留原文意译，指代具有清热化痰收敛作用的矿物/植物药）加入；痈疽红肿，胸中热邪不除，有用甘草节来投用。这些都有深意在其中，不可丝毫忽视。如果是斑蝥、凤仙子这类恶毒的药物，更要审察症状斟酌治疗，不可在其中丝毫疏忽。
(Renya, Human Teeth) Enters the Kidney channel to push out pathogenic toxins.
Renya (Human Teeth) (specifically enters the Kidney channel). Flavor: salty; Nature: warm. Its function is specifically for treating *douye* (inverted and depressed smallpox lesions, where lesions fail to erupt and instead become dark and sunken). This is because smallpox sometimes fails to erupt smoothly, instead presenting with black depression, mostly due to toxin qi penetrating deeply into the body.
Therefore, it is necessary
to use this herb to emit the toxin from within. Li Shizhen said: Teeth are the external indicator of the Kidney and the surplus of bone essence. The toxin of smallpox emerges from the Kidney. During the growth phase of the lesions, if externally invaded by wind-cold and turbid air, the couli (skin pores and interstices) become closed, blood flow becomes stagnant, and the toxin cannot exit. Or it may turn black and invert. It is appropriate to use this substance administered with wine and musk, allowing it to penetrate the Kidney channel, emit the toxic qi, restore the circulation of heat, and make the lesions naturally red and vibrant. This belongs to "jieji" (drastic agents that forcefully eliminate pathogens). If the toxin lies latent in the Heart, causing coma and unconsciousness, or if there is Qi deficiency with pale complexion, itching and collapse without pus formation, or symptoms of hot pruritus and purple blisters, only detoxification and tonifying deficiency are appropriate. If mistakenly used, it will cause oppression and hoarseness, leading to an incurable condition. How can one not be cautious!
(Gao Wu's *Douzhen Guanjian* records: Zuo Zhongshu stated that cases turning black and returning to the Kidney should use Renya San. However, if the toxin has already returned to the Kidney, how can Renya still treat it?)
Used to reduce fire toxin.
Although toxin manifestations appear on the exterior, the pathological trend has transmitted inward; therefore, herbs should clear and resolve from within. Thus, detoxification is an indispensable part of formulas for treating toxins.
However, people
only know that Jinyinhua (Honeysuckle Flower), Niubangzi (Arctii Fructus), and Gancao (Licorice Root) are detoxifying substances, and indiscriminately administer them for all types of toxin syndromes. They do not realize that toxins formed due to Heart heat can be resolved by Huanglian (Coptidis Rhizoma) and Lianqiao (Forsythiae Fructus); those formed due to Lung fire can be resolved by Huangqin (Scutellariae Radix); those formed due to Liver fire can be resolved by Danshencao (Gentianae Radix), Qingdai (Indigo Naturalis), and Lanzi (Isatidis Folium); those formed due to Stomach fire or Stomach toxin can be resolved by Shigao (Gypsum Fibrosum), Zhuye (Bambusae Folium), and Dahuang (Rhei Radix et Rhizoma); and those formed due to Kidney fire can be resolved by Huangbai (Phellodendri Cortex) and Zhimu (Anemarrhenae Rhizoma). Furthermore, when toxin resides in the intestines and stomach, manifesting as carbuncles, sores, or breast obstruction, Loulu (Leuzeae Rhizoma) is appropriate to unblock; when manifesting as unceasing xiaoke (wasting-thirst), Luudou (Vigna radiata) boiled in water for drinking is appropriate; when manifesting as intestinal bleeding, Baitouweng (Pulsatillae Radix) is appropriate to resolve; when manifesting as epidemic malignant toxin, Jinzhi (Gold Water) and Renzhonghuang (Human Excrement Cake) are appropriate to purge. As for Yangmei chuang (Kaposi's sarcoma-like lesions or syphilitic ulcers), which mostly belong to Liver-Kidney toxin eruption, Tufuling (Smilax Glabrae Rhizoma) is appropriate to clear; Houbi (sore throat) and yantong (throat pain), mostly belonging to phlegm-fire stasis knotting, Shegan (Belamcandae Rhizoma) is appropriate to open; Heart-Kidney fire blazing, Shan Dougen (Sophorae Tonkinensis Radix) is appropriate to extinguish; Guizhu (ghost infection) and luoli (scrofula), with ulceration and spreading, mostly belonging to meridian and Spleen toxin accumulation, Earthworm (Pheretima) is appropriate to transform; Kouyan xie (deviation of mouth and eye), carbuncles, hemorrhoids, and fistulas, mostly belonging to meridian and gastrointestinal toxin eruption, Snail (Helix Aspersa) is appropriate to treat; Ruyong (mastitis) and luyan (breast cancer), mostly arising from Liver-Stomach heat, Pugongying (Taraxaci Herba) is appropriate to heal; Echuang (malignant sores) failing to heal, mostly belonging to Heart-Lung phlegm knotting, Beimu (Fritillariae Bulbus) is appropriate to remove; Wuming dingzhong (nameless carbuncles), malignant sores, snake bites, luoli, and tubercles, mostly belonging to unresolved toxin condensation, Shancigu (Cremastrae Pseudobulbus) is appropriate to treat; Urgent toxin tendency with incessant coughing and expectoration, mostly belonging to Middle Qi deficiency, Qini (Asari Radix et Rhizoma? Note: Text says 荠苨, likely Adenophorae Radix or similar, here translated as Qini) is appropriate to moderate. Others include: for non-resolving carbuncles, using rice vinegar with herbs; for persistent hot saliva and uncleared accumulations, using Bai Fan (Alum) and Zao Bai Er Fan (likely referring to specific alum preparations or soap-based agents); for carbuncle swelling and persistent chest heat, using Gancao Jie (Licorice Node) is appropriate. All these contain profound intent and must not be neglected. For highly toxic substances like Banmao (Mylabris) and Fengxianzi (Croton Tiglium Seed), symptoms must be carefully assessed and treatment adjusted accordingly; negligence in any aspect is unacceptable.