Toothache So Bad She Rode a Horse to Suck in Cold Air?

Opening scene: “toothache is not a disease”? Tell that to anyone who has had one

💬 Note from Doctor Luo: Today we look at Doctor Li Dongyuan treating toothache. Almost everyone has experienced toothache — it’s a widespread problem for Chinese people. Dental care is a major issue these days; few of my own contemporaries have good teeth. The more we know, the better off we are.

To be fair, dental disease is a weak spot of traditional Chinese medicine — ancient Chinese doctors struggled with teeth, and so did doctors in the ancient West. But modern dentistry has advanced enormously (root canals, implants). Does that mean the ancients have nothing to offer on teeth? No. Look at Doctor Li’s cases and you’ll find we still have many methods.

Toothache must be sorted by type:

• Cavities (a tooth half destroyed with a big hole) → modern dentistry has the advantage
• A sound tooth that aches from “fire” → Chinese medicine is clearly effective
• Exposed gums, periodontitis → modern dentistry has few options here either, but Chinese medicine has some methods

Who was the patient? The comic picture of riding a horse to suck in cool air

The patient was the wife of Liu Jingli (an official), in her early thirties, with unbearable toothache.

How bad was it? Almost comical — she had to mount a horse and ride out at a gallop, then open her mouth and suck in the cool wind, inhaling continuously — while she was sucking in cool air, the pain seemed to stop; the moment she got home, it started again. So she could only keep riding, keep running, keep sucking in cool air.

💬 Note from Doctor Luo: Does any toothache sufferer recognize this — sucking in cool air feels good? This lady was like someone today riding a bicycle furiously with her mouth open, or sticking her head out the sunroof of a car cruising the ring road to feel comfortable. Isn’t that funny? But comfort is not a treatment.

Her family thought: this is strange — could some spirit be causing trouble? They called in a shaman to perform a ritual — after the ritual, nothing improved. That ruled out ghosts.

So they came to Doctor Li. He listened to the whole story and said: “This illness is damp-heat acting as the pathogen.”

Pattern analysis: damp-heat of the yangming channels attacking upward

Doctor Li explained the theory:

• The foot-yangming stomach channel runs through the upper teeth — the upper teeth connect to the stomach channel
• The hand-yangming large intestine channel runs through the lower teeth — the lower teeth connect to the large intestine channel

💬 Note from Doctor Luo: So you should know — the upper and lower teeth connect to different channels: upper to the stomach, lower to the large intestine. Upper and lower toothache can therefore differ. But both are yangming channels.

The yangming channels are characterized by abundant blood and abundant qi; add rich, fatty, sweet food feeding the damp-heat — Liu Jingli was an official, his household ate well, so the damp-heat in the body ran deep. The damp-heat attacked upward and caused the toothache — this is the heat pattern of toothache.

Doctor Li said: “I will now establish a formula; once you use it, you won’t need the horse, and you won’t need to suck cool air — ‘let the wind-cold qi be born between the teeth for a long time’ — cool your teeth down, and when they are cool, they won’t hurt.”

The prescription: an external formula — powder rubbed onto the teeth, pain halved

Doctor Li used the bitter-cold of huang lian and hu tong lei, combined with the acrid-cool of bo he and jing jie sui — all four together are cooling, and can generate wind-cold qi.

Then sheng ma (cimicifuga) (bitter, neutral): the channel-guiding herb for the yangming — carries the medicine into the yangming channels, and where the yangming has stagnation, helps open it (as assistant-envoy).

Then yang jing gu hui (sheep shin bone ash) (tonifying, as assistant): the teeth are the surplus of bone, so they are connected to bone.

💬 Note from Doctor Luo: Two distinctive herbs deserve special mention:

Hu tong lei (poplar resin) — in Xinjiang there are poplar trees; the tree resin drips into the sand beneath and forms this substance (newer name “mu lü”). Zhang Yuansu valued this herb especially: for scrofula lumps (swollen nodules) on the neck and arms, he said nothing but hu tong lei could resolve them. It also treats swollen painful throat, toothache, and ulcerated gums — in Doctor Li’s toothache formulas, hu tong lei appears at a very high rate. And most of his toothache formulas are external — ground into powder and applied to the teeth.

Yang jing gu hui (sheep shin bone ash) — besides hu tong lei, Doctor Li used sheep shin bone (the shin bone of a sheep’s leg) constantly for toothache. The ancients genuinely used sheep shin bone for tooth pain; the mechanism still needs study today. There are several preparations: ground into powder (ancient women also used it to whiten the skin, like egg white masks today); some texts record burning it to ash — but I suspect burning bone to ash requires extremely high temperatures (like a blacksmith’s forge), hard to achieve in an ordinary home; many later doctors simply copied Doctor Li without ever using it themselves. I suspect the “sheep shin bone ash” Doctor Li meant was actually very finely ground powder. Pharmacies today probably don’t stock it; it might be on Taobao — sometime I’ll try burning some myself to see.

Finally, a little she xiang (musk) as the guiding envoy — it penetrates the skin and opens the surface, letting the medicinal power reach in. Grind all these into powder and rub it onto the teeth — an external medicine.

The result: the pain was halved — the toothache actually improved by half.

The internal formula: Tiaowei Chengqi Tang minus mirabilite, plus coptis, to treat the root

Doctor Li also gave an oral formula to treat the root: Tiaowei Chengqi Tang, minus mang xiao, plus huang lian.

💬 Note from Doctor Luo: Tiaowei Chengqi Tang is simple — three herbs: da huang (rhubarb), mang xiao (mirabilite), and zhi gan cao (honey-fried licorice). Rhubarb and mirabilite both purge downward; licorice guards the center and harmonizes. Here mirabilite is removed and coptis added — coptis clears the heat of the stomach and intestines, rhubarb purges the damp-heat of the stomach and intestines, clearing downward, and licorice guards the center. This formula flushes out the damp-heat accumulated in the stomach and intestines from all those years of rich food.

The result: after taking it, she had two or three bowel movements, and the toothache was cured — and never returned!

💬 Note from Doctor Luo: Look how accurately Doctor Li judged: this person’s illness was caused by damp-heat (an addiction to rich, fatty, sweet food); the damp-heat put heat in the yangming channels (stomach and large intestine), and his targeting was precise — he cleared heat from the start. Remember the two signature herbs: hu tong lei and sheep shin bone powder/ash — these are Doctor Li’s specialties.

Bonus: Doctor Li’s other dental formulas

💬 Note from Doctor Luo: Doctor Li had several more dental formulas, all following the same idea: regulate the internal organs, and the mouth heals itself:

1. Langya San (Wolf Tooth Powder) — for swollen painful gums (periodontitis), loose teeth, yellow teeth and bad breath: sheng ma, qiang huo (notopterygium), long dan cao (gentian), and sheep shin bone ash; rinse the mouth with warm water daily and rub upward. Also external. For swollen painful gums of this kind, Chinese herbal treatment works especially well.

2. Shengong Wan (Divine Merit Pill) — for heavy meat eaters with bad breath, rotten teeth, receding and ulcerated gums (all manner of periodontal disease): huang lian (coptis), sha ren (amomum), gan cao (licorice), huo xiang ye (patchouli leaf), sheng di huang (raw rehmannia), mu xiang (costus root), sheng ma (cimicifuga), dang gui (angelica)… made into small pills taken orally to regulate the stomach and intestines and clear heat — by regulating the internal state of the organs and gut, the periodontal condition improves.

The ancients believed the mouth is closely tied to the internal organs, especially the yangming (spleen-stomach and intestines). Regulate the internal state, and the mouth gradually recovers — where there is no serious structural destruction, the body repairs itself, and the improvement in periodontal disease is excellent. Some friends of mine used Doctor Li’s formulas for periodontal disease and reported genuinely good results — quite unexpected.

How to choose: whatever can be improved through internal regulation, regulate internally; for a tooth already half destroyed with deep damage, go to the dental clinic for modern treatment — the two approaches are compatible. But in regulating periodontal disease, Chinese medicine can play a major role — that is our advantage.

Modern takeaway: protect your teeth by protecting your gut

💬 Note from Doctor Luo: This case tells us: the teeth and mouth are connected to the internal organs, especially the gastrointestinal tract. Keep the gastrointestinal tract healthy, and you can prevent dental problems — many of us already have dental issues; we should protect what we have.

Case source: Lan Shi Mi Cang (Secrets from the Orchid Chamber) by Doctor Li Dongyuan (compiled by his disciple Luo Tianyi); commentary based on public lectures by Doctor Luo Dalun (PhD in TCM diagnostics, Beijing University of Chinese Medicine).