齿统属足少阴肾经。（《素问》曰∶丈夫五八肾气衰，发堕齿槁。又曰∶肾热者，色黑而齿
槁。少阴终者，面黑，齿长而垢）。齿分上下 。（亦作龈，齿根肉也）。上 属足阳明胃经。
（《素问》曰∶邪客于足阳明之经，令人鼽衄，上齿寒。《针经》曰∶上 痛，喜寒而恶热，取足阳
明之原冲阳穴，在两足跗上五寸骨间动脉中。注∶ ，判也。左半为 ，右半为片。朱丹溪曰∶当灸
三里穴，三里、足阳明经之合穴也，在两膝下外侧辅骨下三指地，离 骨外一指许，两筋间宛宛也。）
下属手阳明大肠经。（张洁古曰∶秦艽去下牙痛，及除本经风湿。《针经》曰∶下 痛，喜热
而恶寒，取手阳明之原合谷穴，在两手大指、次指岐骨间陷中。朱丹溪曰∶当灸三间穴，三间、手阳
明经之俞穴也，在两手大指、次指本节后，内侧骨上缝中赤白肉际）。男子八岁，肾气实而齿生更，
三八真牙生，五八则齿槁，八八而齿去矣。女子亦然，以七为数。盖肾主骨，齿乃骨之余，髓之所养
也，故随天癸之盛衰也。足阳明之支者，入于上齿。手阳明之支者，入于下齿。若骨髓不足，阳明脉
虚，则齿之诸病生矣。何以言之，阳明金也，齿属肾水也。阳明之支入齿间，此乃母气荣卫其子也。
故阳明实则齿坚牢，阳明虚则齿浮动。所以齿痛者，乃阳明经有风冷湿热之邪乘虚而入，聚而为液为
涎，与齿间之气血相搏击
而痛也。若热涎壅盛则肿而痛也，热不盛则齿 微肿而根浮也。有虫牙痛者，由湿热生虫，蚀其根而
作痛也。有齿间血出者，由阳明之支有风热之邪，入齿 搏于血，故血出也。有齿龋者，亦以阳明入
风热之邪搏齿 ，气血腐化为脓出臭汁，谓之齿龋，亦曰风龋。有齿 者，是虫蚀齿至 脓烂汁臭也。
有齿挺者，由气热传入脉至齿 间，液沫为脓，气血竭，肉 消，故齿根露而挺出也。有齿动摇者，
阳明脉虚，气血不荣，故齿动摇也。有齿历蠹者，由骨髓气血不能荣盛，故令牙齿黯黑，谓之历齿。
其齿黄黑者亦然。以此而言，岂非诸齿病皆因阳明之所致哉。东垣云∶夫齿者肾之标，口者脾之窍，
诸经多有会于口者。其牙齿是手足阳明之所过，上 隶于坤土，乃足阳明胃脉之所贯络也，止而不动。
下嚼动而不休，手阳明大肠脉之所贯络也。手阳明恶寒饮而喜热，足阳明喜寒饮而恶热，故其病不
一。牙者肾之标，亦喜寒，寒者坚牢，为病不同，热甚则齿动，龈断袒脱，作痛不已，故所治疗不同
也。有恶热而作痛者，有恶寒而作痛者，有恶寒又恶热而作痛者，有恶寒饮少、热饮多而作痛者，有
恶热饮少、寒饮多而作痛者，有牙齿动摇而作痛者，有齿袒而作痛者，有齿 为疳所蚀缺少、血出而
作痛者，有齿 肿起而作痛者，有脾胃中有风
邪，但觉风而作痛者，有牙上多为虫所蚀，其齿缺少而色变为虫牙痛者，有胃中气少不能于寒、袒露
其齿作痛者，有牙齿疼痛而臭秽之气不可近者，痛既不一，岂可一药而尽之哉。刘宗浓云∶头面外冒
风寒，或口吸寒冷致牙疼者，皆外因也。实热、阴虚火动、骨蒸所致，气郁血热，虫蛀，皆内因也。
硬物所支，打击等致，皆不内外因也。薛新甫云∶湿热甚而痛者，承气汤下之，轻者清胃散调之。大
肠热而龈肿痛者，清胃散治之，重则调胃汤清之。六郁而痛者，越鞠丸解之。中气虚而痛者，补中益
气汤补之。思虑伤脾而痛者，归脾汤调之。肾经虚热而痛者，六味丸补之。肾经虚寒而痛者，还少丹
补之，重则八味丸主之。其属风热者，独活散；不愈，茵陈散。风寒入脑者，羌活附子汤。病证多端，
当临证制宜。牙痛有风毒、热壅、龋蛀、肾虚，未辨何证，俱用消风散揩抹，诸证皆宜。香附炒黑三
分，炒盐一分，研匀，揩用如常。风寒湿犯脑痛，项筋急，牙齿动摇，肉龈袒脱疼痛，宜羌活散。冬
月时，风寒湿头疼，项筋急，牙齿动摇疼痛，宜麻黄散。大寒犯脑连头痛，齿亦痛，宜细辛散、白芷
散、蝎稍散。牙齿
寒痛，用牢牙地黄散擦，或露蜂房、川椒（去目炒）等分为粗末煎漱，或荔枝壳、或核烧灰存性擦痛处。
牙痛用清凉药便痛甚者，从治之。用荜茇、川椒、薄荷、荆芥、细辛、樟脑、青盐为末，擦牙上。得
热而痛，得凉则止者，以辛凉药治之。东垣治刘经历内子年三十余，病齿痛不可忍，须骑马外行，口
吸凉风则痛止，至家则痛复作，此湿热之邪也。足阳明贯于上齿，手阳明贯于下齿，阳明多血多气，
又加以膏粱之味，助其湿热，故为此痛。因立一方，不须骑马出外，当令风寒之气常生于齿间，以黄
连、梧桐律之苦寒，新薄荷叶、荆芥穗之辛凉，四味相合而作风寒之气，治其湿热，更以升麻之苦平，
引入阳明经为使，牙齿骨之余，以羊胫骨灰补之为佐，麝香少许入内为引用，名曰馘鬼散，为细末擦
之神效。又以调胃承气汤，去芒硝，加黄连，以治其本，服之下三五行，其病良愈，不复作。风毒牙
痛，内服独活散，外用皂角寸节，实之以盐，火煨熟，汤泡，通口漱，吐下涎沫。风毒及热壅上攻，
牙龈痛，或齿缝有红肉努出，宜消风散，食后临卧入茶点，仍入荆芥、防风、白芷、蜂房之属，煎冷
频频漱口。若热壅甚，牙肿连颊，痛不可忍，宜金沸草散，去麻黄，加薄荷如其数。《三因方》云∶
一妇人牙痛，治疗不效，口颊皆肿，以金沸草散大剂
煎汤，熏漱而愈。阳明热牙疼，大黄炒焦黑存性，香附亦然，为末，入青盐少许，擦无时。因服补胃
热药，致上下牙疼痛不可忍，牵引头脑，满面发热大痛，阳明之别络入脑，喜寒恶热，乃手阳明经中
热盛而作，其齿喜冷恶热，清胃汤主之。仓公治齐中大夫病龋齿，灸左手阳明脉，苦参汤日漱三升，
五六日愈。寒热皆痛，当归龙胆散、益智木律散。寒多热少者，微恶热饮，大恶寒饮，宜草豆蔻散。
热多寒少者，微恶寒饮，大恶热饮，宜麝香散、立效散。上 牙疼，升麻散。下 牙疼，白芷散。平
昔多食肉人，口臭，牙齿动摇欲落，或血出不止，乃内伤湿热膏粱之疾也。宜神功丸、牢牙散、调胃
承气去硝加黄连汤。肾虚牙浮而痛，甚则憎寒壮热全具，如欲脱之状，宜安肾丸、八味丸、还少丹，
间进黑锡丹。病齿非肿非疼，虚不能嚼食，用《局方》嘉禾散，姜煎，食后一服，次以地骨皮煎汤漱
之，候空心，以羊腰子一对，切片勿令断，以葱丝、椒末、青盐、蒺藜去刺末，固元散二钱，拌匀，
掺于腰子内，以豆蔻叶、或荷叶包裹煨令熟，食之。服经两日，顿觉快利，饮食如故。擦药，用牢牙
散。引涎止痛方，枯矾、露蜂房（微炙）等分为末，每服二钱，水煎
乘热炸牙，冷即吐之。或用蟾酥、银朱掺和为丸，如萝卜子大。每用一丸搽患处，便不疼，至三丸吐
浓涎数口，全愈。塞耳方，雄黄定痛膏、透关散，及巴豆一粒，煨黄熟去壳，用蒜一瓣，切一头作盖，
剜去中心，入巴豆其中，以盖合之，用绵裹，随患左右塞耳中。常用刷牙，牢牙散、白牙散、麝香刷
牙散、羊胫骨灰散、长春散、沉香散、朱砂散、妙应散。
牙齿统属于足少阴肾经。（《素问》说：男子到了四十岁，肾气衰退，头发脱落，牙齿枯槁。又说：肾有热的人，面色发黑且牙齿枯槁。少阴经气竭绝时，面色发黑，牙齿显得长且有污垢）。牙齿分为上牙和下牙。（“龈”也写作“”，指牙龈，即包裹齿根的肉）。上牙归属于足阳明胃经。（《素问》说：邪气侵犯足阳明经，会导致鼻塞流涕或鼻出血，上牙感到寒冷。《针经》说：上牙疼痛，喜欢凉爽而厌恶炎热，应取足阳明经的原穴冲阳穴，位于两足背上方五寸骨间动脉处。注：“”意为分开。左半部分为“”，右半部分为“片”。朱丹溪说：应当灸足三里穴，足三里是足阳明经的合穴，位于双膝下外侧辅骨下三横指处，距离胫骨外侧约一指宽，在两筋之间的凹陷处。）下牙归属于手阳明大肠经。（张洁古说：秦艽能治疗下牙痛，并清除本经的风湿邪气。《针经》说：下牙疼痛，喜欢温暖而厌恶寒冷，应取手阳明经的原穴合谷穴，位于两手拇指与食指叉骨间的凹陷中。朱丹溪说：应当灸三间穴，三间穴是手阳明经的输穴，位于两手拇指与食指本节后的内侧，赤白肉际的骨缝中）。男子八岁时，肾气充实，乳牙生出并更换；二十四岁时（三八），智齿长出；四十岁时（五八）牙齿开始枯槁；六十四岁时（八八）牙齿脱落。女子也是如此，以七岁为一个阶段计算。这是因为肾主骨，牙齿是骨的余气，由髓液滋养，所以随天癸（生殖精气）的盛衰而变化。足阳明胃经的支脉，进入上牙。手阳明大肠经的支脉，进入下牙。如果骨髓不足，阳明经脉虚弱，那么各种牙齿疾病就会产生。为什么这样说呢？阳明属金，牙齿属肾水。阳明经的支脉进入牙齿之间，这是母气（金）滋养护卫子气（水）的表现。所以阳明经实热则牙齿坚固牢固，阳明经虚寒则牙齿松动浮动。因此，牙痛是由于阳明经中有风、冷、湿、热等邪气乘虚而入，聚集形成液体和涎沫，与牙齿间的气血相互搏击而产生疼痛。如果热邪和涎沫壅盛，就会肿胀且疼痛；如果热邪不盛，则牙齿轻微肿胀且牙根浮动。有的虫牙痛，是由湿热生虫，侵蚀牙根所致。有的牙齿间出血，是由于阳明经支脉受风热邪气侵袭，邪气侵入牙齿搏结于血分，导致出血。有的龋齿，也是因为阳明经受风热邪气侵袭，邪气搏结于牙齿，气血腐败化为脓液，流出臭汁，称为龋齿，也称为风龋。有的牙齿腐烂，是虫子侵蚀牙齿至脓烂汁臭。有的牙齿挺出，是由于气热传入脉络到达牙齿间，津液化为脓，气血枯竭，肌肉消瘦，所以牙根暴露而牙齿挺出。有的牙齿动摇，是因为阳明经脉虚弱，气血不能荣养，所以牙齿动摇。有的牙齿历蛀（牙齿逐个蛀坏），是由于骨髓气血不能荣盛，导致牙齿黯黑，称为历齿。牙齿黄黑的情况也是如此。由此看来，难道不是所有的牙齿疾病都因阳明经所致吗？李东垣说：牙齿是肾的外在表现，口是脾的窍道，许多经络都交会于口腔。牙齿是手足阳明经经过的地方，上牙隶属于坤土（脾胃），是足阳明胃脉贯穿联络的，静止不动。下牙咀嚼运动不停，是手阳明大肠脉贯穿联络的。手阳明大肠经厌恶冷饮而喜欢热饮，足阳明胃经喜欢冷饮而厌恶热饮，所以它们的病变各不相同。牙齿是肾的外候，也喜欢凉爽，凉爽则坚固牢固，但发病不同，热邪严重则牙齿松动，牙龈断裂脱落，疼痛不止，所以治疗方法也不同。有的厌恶热邪而疼痛，有的厌恶寒邪而疼痛，有的既恶寒又恶热而疼痛，有的厌恶寒饮但喜热饮多而疼痛，有的厌恶热饮但喜冷饮多而疼痛，有的牙齿动摇而疼痛，有的牙龈袒露而疼痛，有的牙齿被疳虫侵蚀缺损、出血而疼痛，有的牙龈肿胀而疼痛，有的脾胃中有风邪，只感觉风吹而疼痛，有的牙龈上部多为虫蚀，牙齿缺损变色成为虫牙痛，有的胃中气少不能抵御寒冷，牙齿袒露而疼痛，有的牙齿疼痛且口臭秽浊不可靠近。疼痛原因不一，怎么能用一种药来治愈呢？刘宗浓说：头面部外感风寒，或因口吸寒冷导致牙疼的，都是外因。实热、阴虚火动、骨蒸所致，气郁血热，虫蛀等，都是内因。硬物支撑、打击等导致的，都属于不内外因。薛新甫说：湿热严重而疼痛的，用承气汤攻下，轻的用清胃散调理。大肠热导致牙龈肿痛，用清胃散治疗，重的用调胃承气汤清热。六郁导致疼痛的，用越鞠丸解郁。中气虚导致疼痛的，用补中益气汤补益。思虑伤脾导致疼痛的，用归脾汤调理。肾经虚热导致疼痛的，用六味地黄丸补益。肾经虚寒导致疼痛的，用还少丹补益，重的用八味丸主治。属于风热的，用独活散；无效的用茵陈散。风寒入脑的，用羌活附子汤。病证多种多样，应当根据临床实际情况灵活制宜。牙痛有风毒、热壅、龋蛀、肾虚几种类型，在未辨别具体证型前，都可以用消风散涂抹擦拭，各种证型都适宜。将香附炒黑三分，炒盐一分，研匀，像平常一样刷牙使用。风寒湿邪侵犯头部引起头痛，项部筋脉拘急，牙齿动摇，牙龈袒露疼痛，宜用羌活散。冬季时节，风寒湿邪引起的头痛，项部筋脉拘急，牙齿动摇疼痛，宜用麻黄散。大寒邪气侵犯头部连带头痛，牙齿也痛，宜用细辛散、白芷散、蝎稍散。牙齿寒痛，用牢牙地黄散擦拭，或用露蜂房、川椒（去目后炒制）等分为粗末煎汤漱口，或用荔枝壳，或将核烧灰存性擦拭患处。牙痛如果用清凉药反而疼痛加剧的，采用反治法。用荜茇、川椒、薄荷、荆芥、细辛、樟脑、青盐研成粉末，擦在牙齿上。遇到热就疼痛，遇凉就停止的，用辛凉药物治疗。李东垣治疗刘经历的妻子，三十多岁，患牙痛难以忍受，必须骑马外出，口吸凉风则疼痛停止，回家后疼痛又发作，这是湿热邪气所致。足阳明胃经贯穿上牙，手阳明大肠经贯穿下牙，阳明经多血多气，再加上食用肥甘厚味的食物，助长湿热，所以产生这种疼痛。于是创立一方，不需要骑马外出，应当让风寒之气常生于齿间，用黄连、梧桐律的苦寒之性，配合新薄荷叶、荆芥穗的辛凉之性，四味药相合而形成风寒之气，以治疗湿热，再用升麻的苦平之性，引入阳明经作为引经药，牙齿是骨的余气，用羊胫骨灰补充作为佐药，加入少许麝香作为引用，名为馘鬼散，研成细末擦拭，效果神奇。又用调胃承气汤，去掉芒硝，加入黄连，以治其根本，服用后大便下行三到五次，病情痊愈，不再复发。风毒牙痛，内服独活散，外用皂角一寸长的节段，填满盐，用火煨熟，用水浸泡，通口漱口，吐出涎沫。风毒及热邪壅盛上攻，牙龈疼痛，或齿缝有红肉突出，宜用消风散，饭后临睡前用茶水调服，并加入荆芥、防风、白芷、蜂房等药材，煎煮冷却后频频漱口。如果热邪壅盛严重，牙齿肿胀连及面颊，疼痛难以忍受，宜用金沸草散，去掉麻黄，加入同等数量的薄荷。《三因方》记载：一位妇女牙痛，治疗无效，口颊全部肿胀，用大剂量的金沸草散煎汤，熏蒸漱口而痊愈。阳明热邪导致的牙疼，大黄炒焦黑存性，香附也这样处理，研成粉末，加入少许青盐，随时擦拭。因为服用补胃热药，导致上下牙疼痛难忍，牵引头脑，满面发热剧痛，阳明经的别络入脑，喜欢寒冷厌恶炎热，这是手阳明经中热盛所致，牙齿喜欢冷厌恶热，用清胃汤主治。仓公治疗齐国中大夫患龋齿，灸左手阳明经脉，用苦参汤每天漱口三次，五六天痊愈。寒热都痛的，用当归龙胆散、益智木律散。寒多热少的，轻微厌恶热饮，非常厌恶寒饮，宜用草豆蔻散。热多寒少的，轻微厌恶寒饮，非常厌恶热饮，宜用麝香散、立效散。上牙疼，用升麻散。下牙疼，用白芷散。平时多吃肉的人，口臭，牙齿动摇欲落，或出血不止，这是内伤湿热膏粱之疾。宜用神功丸、牢牙散、调胃承气汤去掉硝石加黄连汤。肾虚导致牙齿浮痛，严重时憎寒壮热具备，像要脱失的样子，宜用安肾丸、八味丸、还少丹，间歇服用黑锡丹。患牙既不肿也不痛，虚损不能咀嚼食物，用《局方》中的嘉禾散，姜汁煎服，饭后服一次，接着用地骨皮煎汤漱口，待空腹时，取羊腰子一对，切片不要切断，用葱丝、椒末、青盐、蒺藜去刺末、固元散二钱，拌匀，掺入腰子内，用豆蔻叶或荷叶包裹煨熟，食用。服药两天，顿觉爽快便利，饮食恢复正常。擦药，用牢牙散。引涎止痛方，枯矾、露蜂房（微炙）等分为末，每次服二钱，水煎趁热炸牙，冷后即吐掉。或用蟾酥、银朱掺和做成丸药，如萝卜子大小。每次用一丸搽患处，就不疼了，用到三丸吐出浓涎几口，完全痊愈。塞耳方，雄黄定痛膏、透关散，以及巴豆一粒，煨黄熟去壳，用蒜一瓣，切一头作盖，挖去中心，放入巴豆其中，盖上盖子，用棉絮包裹，根据患病左右侧塞入耳中。常用刷牙方法，可用牢牙散、白牙散、麝香刷牙散、羊胫骨灰散、长春散、沉香散、朱砂散、妙应散。
Teeth are collectively governed by the Foot-Shaoyin Kidney Meridian. (The *Suwen* states: "When men reach forty, their kidney qi declines, hair falls out, and teeth become withered." It also states: "Those with kidney heat have a dark complexion and withered teeth. When the Shaoyin meridian ends, the face turns black, and teeth appear elongated with dirt.") Teeth are divided into upper and lower teeth. ("Yin" is also written as "", referring to the gums, which are the flesh wrapping the tooth roots.) The upper teeth belong to the Foot-Yangming Stomach Meridian. (The *Suwen* states: "When pathogenic factors invade the Foot-Yangming meridian, it causes nasal congestion, epistaxis, and coldness in the upper teeth. The *Zhenjing* states: 'For pain in the upper teeth that prefers coolness and dislikes heat, take Yuan-Source points of the Foot-Yangming meridian, such as Chongyang (ST42), located five cun above the dorsum of the foot between the bones where arterial pulsation can be felt.' Note: '' means to split. The left half is '', the right half is 'pian'. Zhu Danxi said: 'One should moxa Zusanli (ST36), which is the He-Sea point of the Foot-Yangming meridian, located three finger-widths below the lateral condyle of the knee, about one finger-width away from the tibia, in the depression between two tendons.') The lower teeth belong to the Hand-Yangming Large Intestine Meridian. (Zhang Jiegu said: 'Qinjiao (Gentianae Macrophyllae Radix) treats lower toothache and eliminates wind-dampness of this meridian. The *Zhenjing* states: 'For pain in the lower teeth that prefers warmth and dislikes cold, take Yuan-Source points of the Hand-Yangming meridian, such as Hegu (LI4), located in the depression between the metacarpal bones of the thumb and index finger. Zhu Danxi said: 'One should moxa Sanjian (LI3), which is the Shu-Stream point of the Hand-Yangming meridian, located on the medial side of the bone behind the metacarpophalangeal joint of the thumb and index finger, at the junction of red and white flesh.') At eight years old, men's kidney qi becomes substantial, deciduous teeth erupt and are replaced. At twenty-four (three times eight), wisdom teeth grow. At forty (five times eight), teeth begin to wither. At sixty-four (eight times eight), teeth fall out. Women follow the same pattern but count by sevens. This is because the Kidney governs bones, and teeth are the surplus of bones, nourished by marrow; thus, they change with the rise and fall of Tian Gui (reproductive essence). Branches of the Foot-Yangming Stomach Meridian enter the upper teeth. Branches of the Hand-Yangming Large Intestine Meridian enter the lower teeth. If marrow and bone are insufficient, or the Yangming meridians are deficient, various dental diseases arise. Why? Yangming belongs to Metal, while teeth belong to Kidney Water. The branches of the Yangming meridian entering the teeth represent Mother Qi (Metal) nourishing and protecting Child Qi (Water). Thus, when Yangming is excess, teeth are firm; when Yangming is deficient, teeth are loose. Toothache occurs when Wind, Cold, Dampness, or Heat pathogens invade the Yangming meridians due to deficiency, gathering into fluids and saliva, and battling with Qi and Blood in the teeth, causing pain. If Heat and saliva are excessive, swelling and pain occur; if Heat is not excessive, slight swelling and root mobility occur. Some toothaches are caused by worms generated from Damp-Heat eroding the roots. Bleeding from the teeth results from Wind-Heat pathogens invading the Yangming branches, disturbing the blood. Dental caries (cavities) occur when Wind-Heat pathogens invade the teeth, causing Qi and Blood to rot into pus with foul odor, known as caries or wind-caries. Rotting teeth result from worm erosion leading to pus and foul discharge. Protruding teeth occur when Heat enters the vessels reaching the teeth, turning fluids into pus, exhausting Qi and Blood, wasting muscles, exposing roots, and causing teeth to protrude. Loose teeth result from deficient Yangming meridians failing to nourish the teeth. Sequentially decayed teeth (Li Du) occur when marrow and blood cannot nourish sufficiently, turning teeth dark, called Li Chi. Yellow or black teeth are similar. Thus, are not all dental diseases caused by Yangming? Li Dongyuan said: "Teeth are the exterior manifestation of the Kidney, the mouth is the orifice of the Spleen, and many meridians converge in the mouth. Teeth are traversed by the Hand and Foot Yangming meridians. Upper teeth belong to Kun Earth (Spleen/Stomach), penetrated by the Foot-Yangming Stomach Meridian, remaining still. Lower teeth move during chewing, penetrated by the Hand-Yangming Large Intestine Meridian. Hand-Yangming dislikes cold drinks and likes hot ones; Foot-Yangming likes cold drinks and dislikes heat. Hence, their pathologies differ. Teeth are the exterior of the Kidney, preferring coolness for firmness, but diseases vary. Severe Heat causes tooth mobility, gum detachment, and unceasing pain, requiring different treatments. Some hate Heat and hurt; some hate Cold and hurt; some hate both; some hate cold drinks but like hot ones; some hate hot drinks but like cold ones; some hurt due to mobility; some due to exposed gums; some due to worm erosion and bleeding; some due to gum swelling; some due to Wind in Spleen/Stomach feeling only wind; some due to worms eating gums causing discoloration; some due to deficient Stomach Qi unable to resist Cold; some due to foul breath. Since pains differ, one drug cannot cure all." Liu Zongnong said: "Head/face external Wind-Cold or inhaling cold causing toothache are external causes. Excess Heat, Yin Deficiency with Fire Hyperactivity, Bone Steaming, Qi Stagnation with Blood Heat, and worm infestation are internal causes. Hard object pressure or trauma are neither-internal-nor-external causes." Xue Xinpu said: "Severe Damp-Heat pain requires Chengqi Tang to purge; mild cases use Qingwei San. Large Intestine Heat with gum swelling/pain uses Qingwei San; severe cases use Tiaowei Chengqi Tang. Six Stagnations pain uses Yueju Wan. Middle Qi Deficiency pain uses Buzhong Yiqi Tang. Sorrow injuring Spleen pain uses Guipi Tang. Kidney Meridian Deficient Heat pain uses Liuwei Dihuang Wan. Kidney Meridian Deficient Cold pain uses Hushao Dan; severe cases use Bawei Wan. Wind-Heat uses Duohuo San; if ineffective, Yinchensan. Wind-Cold entering Brain uses Qianghuo Fuzi Tang. Pathologies are diverse; treat according to clinical presentation. For Wind-Toxin, Heat Stagnation, Caries, or Kidney Deficiency toothache, before differentiation, apply Xiaofeng San. Mix 3 fen of roasted Cyperi Rhizoma and 1 fen of roasted Salt, grind, and brush. For Wind-Cold-Damp Headache, stiff neck, loose teeth, detached gums, use Qianghuo San. Winter Wind-Cold-Damp headache, stiff neck, loose teeth pain, use Mahuang San. Severe Cold invading Brain with headache and toothache, use Xixin San, Baizhi San, or Xiezhao San. Cold toothache: rub Laoya Dihuang San, or decoct equal parts of Apis Mellifica (Fengfang) and Sichuan Pepper (Chuanjiao) for rinsing, or burn Lychee shell/kernel for rubbing. If cooling herbs worsen pain, use contrary treatment: powder of Bibai, Chuanjiao, Bohe, Jingjie, Xixin, Zhangnao, and Qingyan; rub on teeth. Pain relieved by cold, worsened by heat: treat with Acrid-Cool herbs. Li Dongyuan treated Mrs. Liu, 30+, unbearable toothache relieved by riding outside inhaling cool air, returning home to recur. This was Damp-Heat. Foot-Yangming enters upper teeth, Hand-Yangming lower teeth; Yangming has abundant Qi/Blood, exacerbated by rich food creating Damp-Heat. He created a formula to simulate Wind-Cold in teeth using bitter-cold Huanglian and Wutonglv, combined with acrid-cool Bohe and Jingjie, plus acrid-ping Shengma to guide to Yangming, sheep tibia ash to supplement bone surplus, and musk as guiding agent. Named Guogui San, applied topically with great effect. Also used Tiaowei Chengqi Tang minus Mangxiao plus Huanglian to treat the root, inducing bowel movements 3-5 times cured her. Internal Duohuo San for Wind-Toxin toothache; externally, soak salt-filled soap pod segments in water after roasting, rinse to expel saliva. Wind-Toxin/Heat attacking gums with red tissue protrusion: Xiaofeng San taken with tea after meals/sleep, adding Jingjie, Fangfeng, Baizhi, Fengfang, cooled for frequent rinsing. Severe Heat swelling jaw: Jinfeicao San minus Mahuang, add Bohe. *San Yin Fang* records a woman with swollen cheeks cured by large dose Jinfeicao San fumigation/rinsing. Yangming Heat toothache: stir-fried Da Huang and Xiangfu to charcoal, powder with Qingyan, rub anytime. Overuse of warming Stomach Heat herbs caused unbearable radiating head pain, facial heat, favoring cold/disliking heat: Hand-Yangming Heat excess, treat with Qingwei Tang. Cang Gong treated Minister Qi with caries by moxing Left Hand-Yangming meridian and rinsing with Kushen Decoction 3 sheng daily, cured in 5-6 days. Mixed Cold/Heat pain: Danggui Longdan San, Yizhi Mulu San. More Cold than Heat (dislikes cold strongly, heat slightly): Caodoukou San. More Heat than Cold (dislikes heat strongly, cold slightly): Shexiang San, Lixiao San. Upper toothache: Shengma San. Lower toothache: Baizhi San. Meat-eaters with bad breath, loose/bleeding teeth: Internal injury from Damp-Heat/Rich Food. Use Shengong Wan, Laoya San, or Tiaowei Chengqi Tang minus Xiaorenzhi plus Huanglian. Kidney Deficiency floating/painful teeth with aversion to cold/high fever resembling collapse: Anshen Wan, Bawei Wan, Hushao Dan, occasionally Heixi Dan. Non-swollen/non-painful weak teeth unable to chew: Jiahe San from *Jufang* with ginger decoction post-meal, followed by Goubipi rinse. On empty stomach, eat stewed lamb kidney slices stuffed with Congsi, Jiaomo, Qingyan, Jili powder, and Guyuan San, wrapped in Cardamom or Lotus leaf. After two days, strength returns. Rub Laoya San. Saliva-inducing pain relief: equal parts Gafan and Fengfang (lightly roasted), powder, 2 qian decocted, rinse hot, spit cold. Or Chan Su + Yinzhu pills radish-sized, rub lesion; 3 pills expel thick saliva, curing it. Ear-plugging: Xionghuang Dingtong Gao, Touguan San, or baked Croton Seed (Badou) in garlic clove, wrapped in cotton, inserted in affected ear. Daily brushing powders: Laoya San, Baiya San, Shexiang Shuaya San, Sheep Tibia Ash San, Changchun San, Chenxiang San, Zhusha San, Miaoying San.