东垣曰刘经历之内年三十余病齿痛不可忍须骑马外行口吸凉风则痛止至家则其痛复作家
人以
为祟神祷于巫师而不能愈病乃湿热为邪也足阳明多血多气加以膏粱之味助其湿热故为此病因
立
一方不须骑马常令风寒之气生于齿间以黄连胡桐泪之苦寒新薄荷叶荆芥穗之辛凉四味相合而
作风寒之气治其湿热为主以新升麻之苦平行阳明经为使牙齿骨之余以羊 骨灰补之为佐麝香
少许入肉为引用为细末擦之痛乃减半又以调胃承气汤去硝加黄连以治其本服之下三两行其痛
良愈遂不复行
按此论实热例而合辛凉风剂盖风能胜湿苦以泄热也今世俗有以大戟芫花小麦椒细辛苍耳
熬汤
热嗽而牙痛立止者正同此例大抵人之牙齿致病实多内则气郁血热骨蒸等因外则咀炙热受寒冰
咸酸辛辣之味适口岂不渍搏耶且如以醋沃石则石为苏况人之骨余者乎然虽经络之喜寒热气不
同所受病异者则岂全在标尔
局方细辛散治风蛀牙疼腮颔浮肿
荆芥穗 细辛(各一两) 砂仁(半两) 白芷 红椒 草乌(各二两) 鹤虱 牙皂角 荜
茇(各半两)
上为末每少许频擦患处有涎吐之仍用水灌嗽
按此手阳明足少阴厥阴药也
三因玉池散治风蛀牙疼肿痒动摇牙龈溃烂宣露出血口气
地骨皮 白芷 升麻 防风 细辛 川芎 槐花 当归 本 甘草(等分)
上为末每用一字揩之痛甚取二钱水盏半黑豆半合姜三片煎嗽
按此手足阳明厥阴药也
百一选方治风牙疼
白芷(一两) 朱砂(一分)
上为末炼蜜丸樱桃大每一丸擦牙上
按此手阳明之的药也
御药院方独活散治风毒牙疼牙根肿痛
川芎 独活 羌活 防风(各半两) 细辛 荆芥 薄荷 生地黄(各二钱)
上 咀每三钱水煎漱咽
按此足太阳厥阴少阴药也
元戎立效散治牙疼
小椒 露蜂房 青盐(等分)
上为细末煎数沸热嗽即止
按此足少阴药也
东垣羌活散治风寒寒湿犯脑项筋急牙齿动摇肉龈袒脱疼痛苦楚
麻黄(去节三两) 羌活(一钱半) 柴胡(半两) 升麻 苍术(各半两) 草豆蔻(一钱)
防风
(三分半) 本(三分) 细辛(少许) 当归身(六分) 白芷 桂(各三分) 羊胫骨灰(二钱
半)
上为末先以温水漱过擦之
按此足三阳太阴药也
李东垣说：刘经历的妻子，三十多岁，患牙痛剧烈难以忍受。必须骑马外出，口吸凉风才能止痛；回到家疼痛就复发。
人们认为这是鬼神作祟，向巫师祈祷也无法治愈疾病。这其实是湿热之邪致病。足阳明胃经多血多气，加上饮食肥甘厚味助长湿热，因此导致此病。
于是创立一方：不需要骑马，常让风寒之气生于齿间。用黄连、胡桐泪的苦寒，新薄荷叶、荆芥穗的辛凉，四味药相合而作风寒之气，以治疗湿热为主；用新升麻的苦平，行于阳明经为使药；牙齿为骨之余，用羊胫骨灰补之为佐药；麝香少许，入肉为引经药。将药物研为细末擦患处，疼痛减半。又用调胃承气汤去掉芒硝加入黄连，以治其根本，服用后大便下行三两行，疼痛大愈，从此不再需要骑马外出。
按语：此论属于实热证例，兼用辛凉祛风剂。大概风能胜湿，苦能泄热。如今世俗有人用大戟、芫花、小麦、花椒、细辛、苍耳子熬汤，用于热嗽和牙痛立止的情况，正与此例相同。大抵人的牙齿致病原因很多，内则有气郁、血热、骨蒸等原因，外则有咀嚼炙烤燥热食物、受寒冰、咸酸辛辣等适口之物，难道不会浸渍搏结吗？况且如用醋浇灌石头，石头就会酥碎，何况是人的骨之余呢？然而虽然经络对寒热气的喜好不同，所受的病证各异，但这岂全在表象（标）呢？
《局方》细辛散：治疗风蛀牙疼，腮颔浮肿。
荆芥穗、细辛（各一两），砂仁（半两），白芷、红椒、草乌（各二两），鹤虱、牙皂角、荜茇（各半两）。
以上研为末，每次取少许频繁擦拭患处，有涎液则吐出，仍用水漱口。
按语：此为手阳明大肠经、足少阴肾经、足厥阴肝经的药物。
《三因方》玉池散：治疗风蛀牙疼，肿痒动摇，牙龈溃烂宣露出血，口气臭秽。
地骨皮、白芷、升麻、防风、细辛、川芎、槐花、当归、藁本、甘草（等分）。
以上研为末，每次用“一字”量揩擦患处，疼痛甚者取二钱，加水一盏半、黑豆半合、生姜三片，煎汤漱口。
按语：此为手足阳明经、厥阴经的药物。
《百一选方》：治疗风牙疼。
白芷（一两），朱砂（一分）。
以上研为末，炼蜜制成樱桃大小的丸药，每一丸擦在牙齿上。
按语：此为手阳明大肠经的专药。
《御药院方》独活散：治疗风毒牙疼，牙根肿痛。
川芎、独活、羌活、防风（各半两），细辛、荆芥、薄荷、生地黄（各二钱）。
以上切碎，每次取三钱，水煎后含漱咽下。
按语：此为足太阳膀胱经、足厥阴肝经、足少阴肾经的药物。
《元戎》立效散：治疗牙疼。
小椒、露蜂房、青盐（等分）。
以上研为细末，煎煮数沸，热时漱口即止。
按语：此为足少阴肾经的药物。
李东垣羌活散：治疗风寒寒湿侵犯脑项，筋脉拘急，牙齿动摇，肉龈袒脱，疼痛痛苦。
麻黄（去节三两），羌活（一钱半），柴胡（半两），升麻、苍术（各半两），草豆蔻（一钱），防风（三分半），藁本（三分），细辛（少许），当归身（六分），白芷、桂枝（各三分），羊胫骨灰（二钱半）。
以上研为末，先用温水漱口后擦拭。
按语：此为足三阳经、足太阴脾经的药物。
Li Dongyuan said: The wife of Liu Jingli, in her thirties, suffered from unbearable toothache. She had to ride a horse outside and inhale cool air through her mouth to relieve the pain; upon returning home, the pain would recur.
People believed it was caused by malevolent spirits (Gui Shen, 鬼祟), and praying to shamans could not cure the disease. This is actually an illness caused by damp-heat pathogenic factors (Shi Re Wei Xie, 湿热为邪). The Foot-Yangming Stomach Meridian (Zu Yangming Wei Jing, 足阳明胃经) is rich in blood and qi, and the consumption of rich and sweet foods exacerbates the damp-heat, thus causing this condition.
Therefore, a prescription was established: there is no need to ride a horse; one should constantly allow cool wind and cold air to generate between the teeth. Using the bitter-cold properties of Huanglian (Coptidis Rhizoma, 黄连) and Hutonglei (Tamarisci Cacumen, 胡桐泪), and the acrid-cool properties of Xin Boheye (Menthae Haplocalycis Folium, 新薄荷叶) and Jingjiesui (Schizonepetae Spica, 荆芥穗), these four herbs are combined to create a "cool wind and cold air" effect, treating damp-heat as the primary focus. Xin Shengma (Cimicifugae Rhizoma, 新升麻) with its bitter-ping (neutral) nature guides the action along the Yangming Meridian as the envoy herb. Since teeth are the surplus of bones, Yangjing Guhui (Ash of Sheep Tibia Bone, 羊胫骨灰) is used as an assistant herb to tonify. A small amount of Muxiang (Moschus, 麝香) enters the flesh as a guiding herb. The medicines are ground into fine powder and applied to the affected area, reducing the pain by half. Additionally, Tiaowei Chengqi Tang (Regulate the Stomach and Order the Qi Decoction, 调胃承气汤) with Mangxiao (Natrii Sulfas, 芒硝) removed and Huanglian added was used to treat the root cause. After taking it, three or two bowel movements occurred, and the pain was greatly relieved, so she no longer needed to ride out.
Commentary: This discussion pertains to excess-heat patterns, combined with acrid-cool wind-dispelling agents. Generally, wind can overcome dampness, and bitter flavors can drain heat. Nowadays, laypeople sometimes use Daji (Euphorbiae Pekinensis Radix, 大戟), Yuanhua (Genkwa Flos, 芫花), Xiaomai (Tritici Fructus, 小麦), Jiaojiao (Zanthoxyli Pericarpium, 花椒), Xixin (Asari Radix, 细辛), and Can'erzi (Xanthii Fructus, 苍耳子) boiled in water to instantly stop hot coughs and toothaches, which follows the same principle. Broadly speaking, there are many causes for dental diseases in humans. Internally, there are factors such as qi stagnation, blood heat, and bone-steaming fever. Externally, there is chewing roasted/hot foods, exposure to ice/cold, and consuming salty, sour, spicy, or pungent tastes. Would these not cause infiltration and binding? Moreover, just as vinegar poured on stone makes the stone crumble, how much more so for the surplus of human bones? However, although meridians have different preferences for cold and heat, and the diseases contracted vary, is it entirely due to superficial manifestations (Biao, 标)?
Ju Fang (Prescriptions of the Bureau) Xixin San (Asari Powder, 细辛散): Treats wind-carved toothache and swelling of the cheeks and jaw.
Jingjiesui (Schizonepetae Spica, 荆芥穗) and Xixin (Asari Radix, 细辛) (1 liang each), Sharen (Amomi Fructus Rotundus, 砂仁) (0.5 liang), Baizhi (Angelicae Dahuricae Radix, 白芷), Hongjiao (Capsici Fructus Ruber, 红椒), Caowu (Aconiti Radix Preparata, 草乌) (2 liang each), Heshi (Chrysanthemi Indici Fructus, 鹤虱), Yazaorou (Gleditsiae Sinensis Spina, 牙皂角), Bibo (Piperis Kadsurae Fructus, 荜茇) (0.5 liang each).
Grind all into powder. Take a small amount frequently to rub the affected area. If saliva is produced, spit it out. Rinse the mouth with water.
Commentary: These are herbs for the Hand-Yangming Large Intestine Meridian, Foot-Shaoyin Kidney Meridian, and Foot-Jueyin Liver Meridian.
San Yin Fang (Formulas of Three Causes) Yuchi San (Jade Pool Powder, 玉池散): Treats wind-carved toothache, swelling, itching, loosening, gingival ulceration, recession, bleeding, and foul breath.
Digupi (Phellodendri Cortex, 地骨皮), Baizhi (Angelicae Dahuricae Radix, 白芷), Shengma (Cimicifugae Rhizoma, 升麻), Fangfeng (Saposhnikoviae Radix, 防风), Xixin (Asari Radix, 细辛), Chuanxiong (Ligusticum Chuanxiong Rhizoma, 川芎), Huaihua (Sophorae Flos, 槐花), Danggui (Angelicae Sinensis Radix, 当归), Gaoben (Ligustici Wallichii Rhizoma et Radix, 藁本), Gancao (Glycyrrhizae Radix et Rhizoma, 甘草) (equal parts).
Grind into powder. Use a "yi zi" (approx. 0.3-0.6g) amount to rub the affected area. For severe pain, take 2 qian, add 1.5 cups of water, 0.5 he of black beans, and 3 slices of ginger. Decoct and rinse the mouth.
Commentary: These are herbs for the Hand-Yangming, Foot-Yangming, and Jueyin meridians.
Bai Yi Xuan Fang (Selected Formulas for Hundred Diseases): Treats wind toothache.
Baizhi (Angelicae Dahuricae Radix, 白芷) (1 liang), Zhusha (Cinnabaris, 朱砂) (1 fen).
Grind into powder. Make pills with refined honey the size of a cherry. Rub one pill on the teeth.
Commentary: These are specific herbs for the Hand-Yangming Large Intestine Meridian.
Yu Yao Yuan Fang (Imperial Medical Institute Formulas) Du Huo San (Angelicae Pubescentis Powder, 独活散): Treats wind-toxin toothache and swelling/pain of the tooth roots.
Chuanxiong (Ligusticum Chuanxiong Rhizoma, 川芎), Du Huo (Angelicae Pubescentis Radix, 独活), Qiang Huo (Notopterygii Rhizoma et Radix, 羌活), Fangfeng (Saposhnikoviae Radix, 防风) (0.5 liang each), Xixin (Asari Radix, 细辛), Jingjie (Schizonepetae Herba, 荆芥), Bohe (Menthae Haplocalycis Herba, 薄荷), Sheng Dihuang (Rehmanniae Radix Nova, 生地黄) (2 qian each).
Cut into pieces. Take 3 qian, decoct in water, swish and swallow.
Commentary: These are herbs for the Foot-Taiyang Bladder Meridian, Foot-Jueyin Liver Meridian, and Foot-Shaoyin Kidney Meridian.
Yuan Rong Li Xiao San (Effectiveness Powder by Yuan Rong): Treats toothache.
Xiao Jiao (Zanthoxyli Pericarpium, 小椒), Lu Fengfang (Vespa Nidus, 露蜂房), Qingyan (Halitum, 青盐) (equal parts).
Grind into fine powder. Decoct for a few boils, rinse the mouth while hot to stop pain.
Commentary: These are herbs for the Foot-Shaoyin Kidney Meridian.
Dongyuan Qiang Huo San (Qiang Huo Decoction by Dongyuan): Treats invasion of brain and neck by wind-cold and cold-dampness, leading to tendon stiffness, loose teeth, receding gums, and painful suffering.
Mahuang (Ephedrae Herba, 麻黄) (de-stemmed, 3 liang), Qiang Huo (Notopterygii Rhizoma et Radix, 羌活) (1.5 qian), Chaihu (Bupleuri Radix, 柴胡) (0.5 liang), Shengma (Cimicifugae Rhizoma, 升麻), Cangzhu (Atractylodis Rhizoma, 苍术) (0.5 liang each), Caodoukou (Alpiniae Katsumadai Semen, 草豆蔻) (1 qian), Fangfeng (Saposhnikoviae Radix, 防风) (0.35 qian), Gaoben (Ligustici Wallichii Rhizoma et Radix, 藁本) (0.3 qian), Xixin (Asari Radix, 细辛) (a little), Dangguishen (Radix Angelicae Sinensis, 当归身) (0.6 fen), Baizhi (Angelicae Dahuricae Radix, 白芷), Gui (Cinnamomi Ramulus, 桂) (0.3 fen each), Yangjing Guhui (Ash of Sheep Tibia Bone, 羊胫骨灰) (2.5 qian).
Grind into powder. First rinse with warm water, then apply.
Commentary: These are herbs for the Foot-San Yang (Three Yang) and Foot-Taiyin Spleen meridians.