诊龋痛,按其阳明之来,有过者独热,在左者左热,在右右热,在上上热,在下下热。
臂之阳明,有入鼽齿者,名曰大迎,下齿龋取之臂,恶寒补之(一作取之),不恶泻之(《灵
枢》名曰禾 ,或曰大迎。详大迎乃足阳明脉所发,则当云禾 是也。然而下齿龋又当取足
阳明大迎,当试可知耳)。手太阳有入 遍齿者,名曰角孙,上齿龋,取之在鼻与鼽(
一作 )前。方病之时,其脉盛,脉盛则泻之,虚则补之。一曰取之眉外,方病之时
,盛泻虚补。齿动痛,不恶清饮,取足阳明;恶清饮,取手阳明。舌缓羡下烦闷,
取足少阴。重舌,刺舌柱以 针。
上齿龋肿,目窗主之。上齿龋痛,恶风寒,正营主之。齿牙龋痛,浮白及完骨主之。齿
痛,颧 及二间主之。上齿龋,兑端及耳门主之。齿间出
血者,有伤酸,齿床落痛,口不可开,引鼻中,龈交主之。颊肿,口急,颊车痛,不可以嚼
,颊车主之。上齿龋痛,恶寒者,上关主之。厥口僻,失欠,下牙痛,颊肿,恶寒,口不收
,舌不能言,不得嚼,大迎主之。失欠,下齿龋,下牙痛, 肿,下关主之。齿牙不可
嚼,龈肿,角孙主之。口僻不正,失欠口不开,翳风主之。舌下肿,难言,舌纵, 戾不
端,通谷主之。舌下肿,难以言,舌纵涎出,廉泉主之。口僻,刺太渊,引而下之。口中
肿臭,劳宫主之。口中下齿痛,恶寒 肿,商阳主之。齿龋痛,恶清,三间主之。口
僻,偏历主之。口齿痛,温留主之。下齿龋,则上齿痛,腋门主之。齿痛,四渎主之。上牙
龋痛,阳谷(一作阳溪)主之。齿龋痛,合谷主之,又云少海主之。舌纵HT 下,烦闷,
阴交主之。
诊察龋齿疼痛时,按压阳明经的脉动处,若有病邪则局部独热,病在左侧则左侧发热,在右侧则右侧发热,在上部则上部发热,在下部则下部发热。
手阳明大肠经有一条分支进入鼻腔和牙齿,穴位名为大迎(注:此处原文有误,大迎属足阳明,手阳明入齿者应为禾髎),下牙龋齿取此穴,若伴有恶寒症状用补法(一说取穴),若不恶寒用泻法。(《灵枢》中该穴名为禾髎,或称大迎。详细考证大迎乃足阳明胃经所发穴位,则应当是禾髎穴才对。然而下牙龋齿也应当取足阳明胃经的大迎穴,实际临床验证可知)。手太阳小肠经有一条分支遍布牙齿,穴位名为角孙,上牙龋齿,取位于鼻翼与鼻孔前方的穴位(一作禾髎之前方)。刚发病时,其脉象盛大,脉盛则用泻法,脉虚则用补法。另一种说法是取眉外侧穴位,刚发病时,脉盛用泻法,脉虚用补法。牙齿松动疼痛,不厌恶冷饮,取足阳明胃经穴位;厌恶冷饮,取手阳明大肠经穴位。舌体松弛下垂且心烦闷乱,取足少阴肾经穴位。重舌(舌下肿胀如复舌),用针刺舌柱(舌系带)。
上牙龋齿肿痛,由目窗穴主治。上牙龋齿疼痛,恶风寒,由正营穴主治。牙齿龋痛,由浮白穴及完骨穴主治。牙齿疼痛,由颧髎穴及二间穴主治。上牙龋齿,由兑端穴及耳门穴主治。齿间出血,有损伤酸腐之物,齿龈萎缩疼痛,口不能张开,牵引至鼻中,由龈交穴主治。脸颊肿胀,口唇拘急,颊车穴疼痛,不能咀嚼,由颊车穴主治。上牙龋齿疼痛,恶寒,由上关穴主治。口眼歪斜,打哈欠,下牙痛,脸颊肿,恶寒,口不能闭合,舌不能言语,不能咀嚼,由大迎穴主治。打哈欠,下牙龋齿,下牙痛,腮部肿胀,由下关穴主治。牙齿不能咀嚼,牙龈肿胀,由角孙穴主治。口眼歪斜不正,打哈欠口张不开,由翳风穴主治。舌下肿胀,言语困难,舌体纵缓,歪斜不正,由通谷穴主治。舌下肿胀,难以言语,舌体纵缓流涎,由廉泉穴主治。口眼歪斜,刺太渊穴,引导气机下行。口中肿胀口臭,由劳宫穴主治。口中下牙痛,恶寒腮肿,由商阳穴主治。牙齿龋痛,厌恶清凉,由三间穴主治。口眼歪斜,由偏历穴主治。口齿疼痛,由温溜穴主治。下牙龋齿,导致上牙痛,由腋门穴主治。牙齿疼痛,由四渎穴主治。上牙龋痛,由阳谷穴(一作阳溪穴)主治。牙齿龋痛,由合谷穴主治,又说由少海穴主治。舌体纵缓下垂,心烦闷乱,由阴交穴主治。
When diagnosing toothache due to dental caries, press upon the pulsating points of the Yangming channels; if there is pathogenic influence, there will be localized heat. If the condition is on the left, the left side will be hot; if on the right, the right side will be hot; if superior, the superior part will be hot; if inferior, the inferior part will be hot.
The Hand-Yangming Large Intestine channel has a branch entering the nose and teeth, named Daying (Note: The text contains an error here; Daying belongs to Foot-Yangming Stomach, while the point entering teeth from Hand-Yangming should be Heliao). For lower dental caries, this point is selected. If accompanied by aversion to cold, tonification is applied (some versions say selection of the point); if not aversive to cold, sedation is applied. (*Lingshu* names this point Heliao, or alternatively Daying. Detailed examination shows that Daying is issued from the Foot-Yangming channel, so it should indeed be Heliao. However, for lower dental caries, one should also select Daying of the Foot-Yangming Stomach channel, which can be verified in practice). The Hand-Taiyang Small Intestine channel has a branch spreading through the teeth, named Jiaosun. For upper dental caries, select the point located anterior to the nose and nostril (one version says before Heliao). At the onset of the disease, the pulse is vigorous; if vigorous, apply sedation; if deficient, apply tonification. Another method states to select the point lateral to the eyebrow; at the onset, if the pulse is vigorous, sedate; if deficient, tonify. For loose and painful teeth without aversion to cold drinks, select Foot-Yangming Stomach channel points; with aversion to cold drinks, select Hand-Yangming Large Intestine channel points. For flaccid tongue drooping with vexation and oppression, select Foot-Shaoyin Kidney channel points. For polyglottis (swelling under the tongue resembling a second tongue), puncture the lingual frenulum with a needle.
For swelling and pain of upper dental caries, Mucuang (GB16) governs. For painful upper dental caries with aversion to wind-cold, Zhengying (GB17) governs. For dental caries pain, Fubai (GB12) and Wanggu (GB12) govern. For toothache, Quanliao (SI18) and Erjian (LI2) govern. For upper dental caries, Duanduan (CV15) and Ermen (TE21) govern. For bleeding between teeth, injury from sour/rotten substances, receding gums with pain, inability to open the mouth, and traction to the nasal cavity, Yinjiao (DU28) governs. For cheek swelling, tight lips, pain at Jiache (ST6), and inability to masticate, Jiache (ST6) governs. For painful upper dental caries with aversion to cold, Shangguan (ST7) governs. For facial paralysis (deviation of mouth and eye), yawning, lower toothache, cheek swelling, aversion to cold, inability to close the mouth, inability to speak, and inability to masticate, Daying (ST5) governs. For yawning, lower dental caries, lower toothache, and parotid swelling, Xiaguan (ST7) governs. For inability to masticate due to toothache and swollen gums, Jiaosun (TE14) governs. For facial paralysis with deviation, inability to open the mouth after yawning, Yifeng (TE17) governs. For swelling under the tongue, difficulty speaking, flaccid tongue, and deviation/malalignment, Tonggu (BL63 or BL89 depending on context, likely BL63 Taixi area or local point) governs. For swelling under the tongue, difficulty speaking, flaccid tongue with salivation, Lianquan (CV23) governs. For facial paralysis, puncture Taiyuan (LU9) to guide the qi downward. For swelling and foul odor in the mouth, Laogong (PC8) governs. For lower toothache in the mouth with aversion to cold and swelling, Shangyang (LI1) governs. For dental caries pain with aversion to coolness, Sanjian (LI3) governs. For facial paralysis, Pianli (TE6) governs. For mouth and tooth pain, Wenliu (LI7) governs. For lower dental caries causing upper toothache, Yimen (EX-HN?) governs. For toothache, Sidu (TE10) governs. For upper toothache, Yanggu (SI4) (one version says Yangxi LI5) governs. For dental caries pain, Hegu (LI4) governs; it is also said that Shaohai (HT3) governs. For flaccid tongue drooping with vexation and oppression, Yinjiao (CV13) governs.