齿痛人之最小之疾也然不得其阴阳之道最不能愈而最苦也齿之部位不同有脏腑之各属然
而各
分脏腑之名目反致炫惑不若单言阴阳易于认识虽然阴阳终于何而辨之仍亦辨之脏腑而已矣大
约阳症之痛多属于阳明胃经之火此火多是实火发作之时牙床必肿口角流涎喉咙作痛欲食甚难
不
食作痛汗出而口渴舌燥而便闭倘以补阳补气之药祛风杀虫之方治之多有不效即或少有效
验亦随止而
随痛牵连作楚者比比也法当用竹叶石膏汤一剂而痛轻二剂而全愈不必三剂也至于虚症之痛多
是
肾经之病肾水熬干肾火上越齿乃骨之余骨髓无肾水以相资使致齿中作痛倘亦以祛风散火杀虫
之品急救之不特无济于事而痛且更甚从前或一齿之痛后必上下之齿全痛矣法当用六味地黄汤
加麦冬五味骨碎补治之一剂而痛失真奇异之法也二方治虚实之齿痛实为至妙惟是虫牙作祟不
可拘于虚实之分以五灵脂为细末先以净水嗽口后以醋调灵脂含漱多时立时虫死而痛除又不可
不知也
心痛之宜辨虚实也古人云痛无补法是痛不可以虚实言也然虚可补而实可泻心痛言虚实即
宜言
补泻矣人恐不相信不知心痛有可补之道人未之知也如心痛之时昼夜呼号饮食难进此实火也断
断不可用补一补而痛必更甚必有死亡之祸然而能于补中泻火亦未尝不可却病盖补正气少而去
火
之药多又何患乎补也方用先攻散治之一剂即止痛神方也论此方有白芍之酸收似乎不宜治火痛
之心病谁知栀子枳壳贯众各皆祛火散邪之药而无芍药以调和之则过于杀伐未必不使穷寇之
死斗妙在用芍药以解纷则剿抚兼施实有人谋不测之机也至于可补之心痛亦因其虚而可补故补
之也其痛必时重而时轻喜手按而不喜不按与之饮食而可吞此痛名为去来痛也去来痛原是虚症
岂可执痛无补法而不用纯补之药哉吾今立一方名为消痛补虚饮一剂而痛如失二剂全愈不再发
亦神方也盖去来之痛全在心气之虚少有微寒留于膻中之下寒远则不痛寒近则少痛也此等之病
往往有经岁经年而不愈者亦因人不敢用补邪无所畏留住于皇畿内地时时偷窃作祟耳今吾用
大剂
补药以补其膻中譬如相臣得令英察精明必然擒贼小偷细盗焉敢潜住皇居左右哉此方之所以神
耳
先攻散
芍药(五钱) 栀子(五钱) 枳壳(五钱) 贯众(五钱)水煎服
消痛补虚饮
人参(五钱) 白术(五钱) 茯神(五钱) 枳壳(一钱) 广木香(一钱) 白芍(一两) 当归(五
钱) 甘草(一钱) 附子(一片重二分) 白芥子(三钱)水煎服
牙齿疼痛是人体中最轻微的疾病,然而如果不掌握阴阳辨证的道理,就最难治愈,也最让人痛苦。牙齿的部位不同,分别归属于不同的脏腑,但如果仅仅罗列脏腑的名称,反而会导致困惑,不如直接谈论阴阳,这样更容易认识和理解。虽然最终还是要通过辨别阴阳来确定病因,但归根结底还是要辨别脏腑而已。
大约阳证引起的疼痛多属于阳明胃经的实火。这种火大多是实火,发作时牙床必然肿胀,口角流涎,喉咙疼痛,想吃东西却很难下咽,不吃东西则疼痛加剧,伴有出汗、口渴、舌燥和大便闭结。如果用补阳补气或祛风杀虫的药物来治疗,大多没有效果;即使偶尔有一点疗效,疼痛也会随即复发,牵连作痛的情况比比皆是。治疗方法应当使用竹叶石膏汤,服用一剂疼痛减轻,两剂即可痊愈,不需要三剂。
至于虚证引起的疼痛,多是肾经的疾病。肾水枯竭,肾火上炎,因为齿为骨之余,骨髓缺乏肾水的滋养,导致牙齿内部疼痛。如果也用祛风散火杀虫的药物急救,不仅无济于事,疼痛反而会加重。以前可能只是一颗牙齿疼痛,后来必定上下所有牙齿都痛。治疗方法应当用六味地黄汤加麦冬、五味子、骨碎补,服用一剂后疼痛消失,这是奇异的方法。这两个方子治疗虚实两种牙齿疼痛,确实非常精妙。
但是,如果是虫牙作祟,就不能拘泥于虚实的区分。将五灵脂研成细末,先用清水漱口,然后用醋调匀五灵脂含漱较长时间,虫子会立即死亡,疼痛也随之消除,这一点也不可不知道。
心痛需要辨别虚实。古人说“痛无补法”,意思是疼痛不能简单地用虚实来概括。然而,虚证可以补,实证可以泻,谈到心痛的虚实,就应该涉及补泻之法。人们恐怕不相信,是因为不知道心痛有可以补治的道理,世人对此并不了解。比如心痛发作时,昼夜呼号,饮食难进,这是实火,绝对不可用补法,一旦进补,疼痛必然更加严重,甚至会有死亡的祸患。然而,如果在补益正气的基础上清泻火热,也未尝不可以治病。只要补正气的药少,而清火的药多,又何必担心是补呢?方剂使用先攻散,服用一剂即能止痛,是神方。
论述这个方子,因为有白芍的酸收之性,似乎不适合治疗火痛引起的心痛。谁知栀子、枳壳、贯众都是祛火散邪的药物,如果没有芍药来调和,药性就会过于猛烈杀伐,未必不会使病邪做困兽之斗。妙处在于用芍药来解纷纠葛,使得剿灭与安抚兼施,实在有人谋不测的玄机。
至于可以补治的心痛,也是因为它属于虚证,所以采用补法。其疼痛特点是时重时轻,喜欢用手按压而不喜欢不按,给予饮食能够吞咽。这种疼痛称为“去来痛”(游走性疼痛)。去来痛原本是虚证,怎么能执着于“痛无补法”而不使用纯补的药物呢?我现在设立一方,名为消痛补虚饮,服用一剂疼痛如失,两剂痊愈且不再复发,也是神方。
这种去来来的疼痛,完全在于心气虚弱,稍有微寒停留在膻中下方。寒气远离就不痛,寒气靠近就轻微疼痛。这类疾病往往经过一年甚至多年都不愈,也是因为人们不敢用补法,导致邪气无所畏惧,盘踞在体内要害之地,时时偷窃作祟。现在我使用大剂量的补药来补益膻中,就像宰相得到授权,英明察断,必然擒获盗贼,小偷小盗怎敢潜伏在皇宫左右呢?这就是此方之所以神奇的原因。
先攻散:
芍药(五钱)、栀子(五钱)、枳壳(五钱)、贯众(五钱),水煎服。
消痛补虚饮:
人参(五钱)、白术(五钱)、茯神(五钱)、枳壳(一钱)、广木香(一钱)、白芍(一两)、当归(五钱)、甘草(一钱)、附子(一片,重二分)、白芥子(三钱),水煎服。
Dental pain is the mildest ailment in the human body; however, without grasping the principles of Yin and Yang differentiation, it is the most difficult to cure and causes the greatest suffering. Different parts of the teeth belong to different Zang-Fu organs. However, merely listing the names of these organs leads to confusion, whereas directly discussing Yin and Yang is easier to understand. Although the ultimate differentiation lies in Yin and Yang, it ultimately boils down to differentiating the Zang-Fu organs.
Generally, pain from Yang syndromes (Yang Zheng) belongs to the fire of the Yangming Stomach Meridian (Yangming Wei Jing). This fire is mostly Excess Fire (Shi Huo). During an attack, the gums must swell, saliva flows from the corners of the mouth, the throat hurts, eating is very difficult, and not eating causes pain. It is accompanied by sweating, thirst, dry tongue, and constipation. If treated with herbs that tonify Yang or Qi, or prescriptions for dispelling wind and killing parasites, there are often no effects. Even if there is slight efficacy, the pain returns immediately, and radiating pain is common. The method should be to use Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction); one dose lightens the pain, two doses result in complete recovery, and three doses are unnecessary.
As for pain from Deficiency syndromes (Xu Zheng), it is mostly a disease of the Kidney Meridian. When Kidney Water (Shen Shui) is exhausted and Kidney Fire (Shen Huo) flares upward, since teeth are the surplus of bones and marrow, the lack of nourishment from Kidney Water causes pain within the teeth. If one also uses emergency treatments for dispelling wind, scattering fire, and killing parasites, not only will it be useless, but the pain will worsen. Previously, pain might have been in one tooth, but later all upper and lower teeth would hurt. The method should be Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) added with Maidong (Ophiopogon Radix), Wuweizi (Schisandra Fruit), and Gusui Bu (Drynaria Rhizome). One dose eliminates the pain; this is a miraculous method. These two formulas treat dental pain of both Excess and Deficiency excellently.
However, if molar decay (worm teeth) is the culprit, one cannot stick rigidly to the distinction between Excess and Deficiency. Grind Wulingzhi (Trogopterus Dung) into fine powder. First rinse the mouth with clean water, then mix the powder with vinegar and hold it in the mouth for a long time. The worms will die instantly, and the pain will cease. This point must not be ignored.
Heart pain requires differentiation between Excess and Deficiency. The ancients said "pain has no tonification," meaning pain cannot be simply categorized by Excess or Deficiency. However, Deficiency can be tonified, and Excess can be purged. Discussing Excess and Deficiency in heart pain implies the need for tonifying or purging methods. People may doubt this because they do not know that heart pain has ways to be treated by tonification; this knowledge is unknown to many. For instance, when heart pain occurs, the patient cries out day and night and finds it hard to eat or drink. This is Excess Fire. Tonification must absolutely be avoided; otherwise, the pain will worsen, potentially leading to death. However, tonifying the Righteous Qi while simultaneously clearing Fire is not impossible for curing the disease. As long as the herbs tonifying Righteous Qi are few and those clearing Fire are many, why worry about the harm of tonification? The prescription used is Xiangong San (First Attack Powder). One dose stops the pain; it is a miraculous formula.
Regarding this formula, the sour astringency of Shaoyao (White Peony Root) seems unsuitable for treating Heart pain caused by Fire. Who would know that Zhizi (Gardenia Fruit), Zhike (Aurantium Fructus), and Guanzhong (Cyrtomium Rhizome) are all herbs that clear Fire and scatter pathogens? Without Shaoyao to harmonize them, the action would be too harsh and destructive, possibly forcing the pathogen to fight desperately. The brilliance lies in using Shaoyao to resolve conflict, combining suppression with pacification, possessing unpredictable strategic wisdom.
As for heart pain that can be tonified, it is due to its Deficient nature, so tonification is applied. The pain is characterized by fluctuating severity (sometimes heavy, sometimes light), preference for pressure, and ability to swallow food. This pain is called "Qu Lai Tong" (Wandering Pain). Qu Lai Tong is originally a Deficiency syndrome. How can one adhere to the saying "pain has no tonification" and refuse pure tonifying drugs? I now establish a formula named Xiaotong Buxu Yin (Pain-Relieving and Deficiency-Tonifying Drink). One dose makes the pain disappear; two doses result in full recovery and no recurrence. It is also a miraculous formula.
This wandering pain is entirely due to Heart Qi Deficiency, with slight Cold lingering below the Danzhong (Chest Center). When the Cold is distant, there is no pain; when close, there is mild pain. Such diseases often persist for years without healing because people dare not use tonification, allowing Pathogenic Factors to remain fearless and lurk in the vital regions of the body, causing trouble. Now, I use large doses of tonifying herbs to tonify the Danzhong. This is like a minister receiving authority, acting with wisdom and clarity, inevitably capturing thieves. How dare petty thieves hide near the imperial residence? This is why the formula is miraculous.
Xiangong San:
Shaoyao (5 qian), Zhizi (5 qian), Zhike (5 qian), Guanzhong (5 qian). Decoct in water and take orally.
Xiaotong Buxu Yin:
Renshen (5 qian), Baizhu (5 qian), Fushen (5 qian), Zhike (1 qian), Guangmuxiang (1 qian), Shaoyao (1 liang), Danggui (5 qian), Gancao (1 qian), Fuzi (1 slice, weighing 2 fen), Baijiezi (3 qian). Decoct in water and take orally.