齿牙者。肾之标。统属足少阴经。齿根肉曰龈。东垣曰上龈隶于坤土。足阳明之脉贯络
也。止而不动。下龈嚼物。动而不休。手阳明之脉贯络也。上 痛。喜寒饮而恶热。取足阳明也
。下 痛。喜热饮而恶冷。取手阳明也。
牙床肿痛。齿痛摇动。或黑烂脱落。世人皆作肾虚治。不知此属阳明湿热症也。盖齿虽
。而生于牙床。上下床属阳明。大肠与胃。犹木生于土也肠胃伤于美酒浓味膏粱甘滑之物。
以致湿热上攻。则牙床不清。而为肿为痛。或出血或生虫。由是齿不得安。而动摇黑烂脱落
也。治宜泻阳明之湿热。则牙床清而齿固矣。
耳前腮颊痛引筋骨。寒热如疟。牙关紧闭不能进食。不待腐溃而齿便脱落。此风毒窜入
骨槽所致。初则坚硬难消。宜用生姜片热颊车穴。艾灸二七壮。针刺齿龈以泄其毒。以冰硼元明
粉为散吹搽。内服降火化痰消肿之剂久则疮口难合非参 归芍补托兼肉桂麦冬桔梗白术之类
不能破结敛肌若腐肿不消。虚热不退形焦体削者。不治。
风寒湿三气杂合。则壅闭经络。血气不得通行而为痹。凡人气行脉外。血行脉内。气虚
则麻血虚则木。麻木不已则偏枯痿废。经曰营气虚。则不仁卫气虚则不用。营卫俱虚。则不仁且
湿痹者。湿邪痹其身中之阳气也。利其小便。则阳气通行无碍。而关节之。痹并解矣。
设小
。反欲得被盖向火者。又当微汗以通其阳也。
酒湿痹症口眼 斜。舌强肢废。浑似中风。当泻湿毒。从微汗微下之法。
皮痹者。邪在皮肤瘾疹风疮搔之不痛。宜疏风养血。故皮肤枯燥者。由血虚风邪也。肿
牙齿,是肾脏的外在表现,归属于足少阴肾经。包裹齿根的肉称为牙龈。李东垣说:上牙龈隶属于坤土(脾胃),由足阳明胃经的脉络贯穿联系。上牙龈静止不动;下牙龈咀嚼食物时运动不止,由手阳明大肠经的脉络贯穿联系。上牙龈疼痛,喜欢冷饮而厌恶热饮,治疗应取足阳明经穴位;下牙龈疼痛,喜欢热饮而厌恶冷饮,治疗应取手阳明经穴位。
牙床肿痛,牙齿疼痛松动,或者变黑腐烂脱落。世人通常都当作肾虚来治疗,却不知道这属于阳明经湿热证。因为牙齿虽然生长在牙床中,但上下牙床都属于阳明经管辖。大肠与胃的关系,就像树木生长在土壤中一样。肠胃受到美酒、浓味、膏粱肥甘滑腻食物的损伤,导致湿热之气向上攻冲,使得牙床不清洁,从而出现肿胀疼痛,或者出血、生虫。由此牙齿不得安宁,进而动摇、变黑、腐烂、脱落。治疗应当清泻阳明经的湿热,那么牙床就会清爽,牙齿也就坚固了。
耳前腮颊部疼痛牵引筋骨,寒热往来像疟疾一样,牙关紧闭不能进食,牙齿尚未腐烂溃破就先脱落。这是风毒窜入骨槽所致。初期肿块坚硬难以消散,宜用生姜片热敷颊车穴,艾灸十四壮,针刺齿龈以泄出毒气,并用冰硼散和元明粉制成散剂吹搽患处。内服降火、化痰、消肿的药物。如果日久疮口难以愈合,非用人参、当归、白芍补益托毒,兼用肉桂、麦冬、桔梗、白术等药物不能破除结聚、收敛肌肉。如果腐肿不消,虚热不退,形体消瘦枯槁的,属于不治之症。
风寒湿三种邪气混杂结合,就会壅闭经络,使气血不能正常运行而导致痹证。一般人的气运行于脉外,血运行于脉内。气虚则感觉麻木,血虚则感觉木硬。麻木不止会导致半身不遂或痿废不用。《内经》说:营气虚弱,则感觉迟钝(不仁);卫气虚弱,则肢体不能使用。营卫俱虚,则既感觉迟钝又肢体不能使用。湿痹,是湿邪痹阻身体中的阳气。通利小便,则阳气通行无阻碍,关节的痹阻也就解除了。如果是寒湿痹证,患者反而想要盖被子靠近火源取暖的,又应当用微发汗的方法来通达阳气。
The teeth are the external manifestation of the Kidney (Shen) and belong to the Foot Shaoyin Kidney Meridian. The flesh surrounding the tooth root is called the gingiva. Li Dongyuan stated that the upper gingiva belongs to Kun Earth (Spleen and Stomach) and is connected by the meridians of the Foot Yangming Stomach Meridian. The upper gingiva remains still; the lower gingiva moves constantly during mastication, connected by the meridians of the Hand Yangming Large Intestine Meridian. Pain in the upper gingiva, preferring cold drinks and disliking heat, should be treated by selecting points on the Foot Yangming Meridian. Pain in the lower gingiva, preferring hot drinks and disliking cold, should be treated by selecting points on the Hand Yangming Meridian.
Swelling and pain of the alveolar ridge, painful and loose teeth, or blackening, rotting, and shedding of teeth. People generally treat this as Kidney deficiency, unaware that it actually belongs to a damp-heat syndrome of the Yangming channel. Although the teeth grow within the alveolar ridge, both the upper and lower ridges are governed by the Yangming channels. The relationship between the Large Intestine and the Stomach is like trees growing in soil. When the intestines and stomach are damaged by fine wines, rich flavors, and greasy, sweet, and slippery foods, damp-heat attacks upward. This causes the alveolar ridge to become unclean, leading to swelling and pain, bleeding, or insect infestation. Consequently, the teeth become unstable, turning black, rotting, and falling out. Treatment should focus on draining the damp-heat of the Yangming channel, which will clear the alveolar ridge and stabilize the teeth.
Pain in the preauricular and cheek regions radiating to the muscles and bones, alternating chills and fever resembling malaria, lockjaw preventing eating, and premature tooth loss before suppuration. This is caused by wind-toxin invading the bone trough. Initially, the swelling is hard and difficult to resolve. Apply warm ginger slices to Jiache (ST6) acupoint, moxibustion for fourteen cones, needle the gingiva to drain toxicity, and apply a powder of Bingpeng San (Ice Borax Powder) and Yuanming Fen (Mirabilite) externally. Internally, administer formulas that descend fire, transform phlegm, and reduce swelling. If the ulcer fails to heal over time, non-suppurative methods using Renshen (Ginseng), Danggui (Angelica Sinensis), Baishao (White Peony Root) to tonify and expel toxins, combined with Rougui (Cinnamon Bark), Maidong (Ophiopogon), Jiegeng (Platycodon), and Baizhu (Atractylodes Macrocephala) to break up accumulations and consolidate tissue are required. If the suppurative swelling does not subside, deficiency-heat persists, and the body becomes emaciated and wasted, it is incurable.
When wind, cold, and dampness mix and combine, they obstruct the meridians, preventing the smooth flow of Qi and Blood, resulting in Bi Syndrome (Obstruction). Generally, Qi circulates outside the vessels, while Blood circulates inside. Qi deficiency leads to numbness; Blood deficiency leads to insensibility or stiffness. Persistent numbness may lead to hemiplegia or flaccid paralysis. The Classics state: Deficiency of Ying (Nutritive) Qi results in insensibility (Bu Ren); deficiency of Wei (Defensive) Qi results in inability to move. When both Ying and Wei are deficient, there is both insensibility and immobility. Damp-Bi refers to dampness pathogen obstructing the Yang Qi within the body. Promoting urination allows Yang Qi to flow freely without obstruction, thereby resolving joint Bi. In cases of Cold-Damp Bi where the patient desires covering and warmth near fire, mild sweating should be induced to unblock Yang Qi.
Bi syndrome due to alcohol-dampness presents with facial deviation, tongue stiffness, and limb dysfunction, closely mimicking Stroke. It requires draining damp-toxin through mild sweating and mild purgation.
Pi Bi (Skin Bi) involves pathogens in the skin, manifesting as wheals or wind sores that do not hurt when scratched. Treatment should dispel wind and nourish blood. Therefore, dry and rough skin is caused by Blood deficiency and Wind pathogen invasion.