Toothache and Constant Nasal Discharge? What to Do

What people search for: toothache / tooth pain / constant turbid nasal discharge / excess nasal mucus / heat-related toothache / chronic pharyngitis with dry throat / mouth ulcers / trigeminal neuralgia

In medical terms: deficiency-fire toothache · kidney essence deficiency · deficiency fire flaring upward · upper heat with lower cold · unclear lung qi

Opening scene: a gentleman pushing seventy, so healthy the doctor praises him at length first

In the late Ming and early Qing, an old gentleman of nearly seventy walked into the consulting room of Doctor Yu Jiayan, the celebrated physician of Jiangxi. He was Jiang Dingweng Gongzu — a retired official.

Interestingly, Doctor Yu did not hurry to write a prescription. Instead, he praised the old gentleman first: vigorous in spirit, firm in pulse, loud and clear in voice, full of energy when he spoke. He handled a great deal of daily business without ever tiring of it, and everything he did was orderly and clear-headed.

💬 Note from Doctor Luo: When ancient physicians wrote cases for the great and powerful, they often opened with a round of flattery — it was the custom of the time, so don’t take it too literally. But one line is real: the pulse was firm and strong — the pulse beat with real power, which shows the old gentleman’s constitution had always been excellent. So here’s the question: with health this good, what was he seeing the doctor for?

Who was the patient? A fine constitution, but a stream of small complaints

The old gentleman explained: occasionally his chest felt blocked and not fresh — a stuffy, unsettled feeling in the chest; his lung qi was unclear — a bit of cough, a bit of phlegm; and his nose was off too — he constantly had turbid nasal discharge, a feeling of something rising up from inside.

💬 Note from Doctor Luo: Look at that — every one of these is a small complaint of the upper burner: the chest, the lung, the nose — all above. However strong the old gentleman was, this “not-fresh” feeling above never quite cleared, so he came to Doctor Yu Jiayan to be regulated.

And on the very day of the consultation, the old gentleman’s tooth began to ache.

Toothache — what to do? First, an honest word: cavities are a job for the dentist

Toothache was a problem for the whole world in ancient times.

💬 Note from Doctor Luo: To be honest, there was only so much ancient Chinese medicine could do for dental disease. Chinese medicine stresses protecting the teeth when healthy and regulating the body — but if it is a true cavity, with a hole in the tooth, that kind of pain was genuinely beyond the reach of classical methods. Modern dentistry — filling, root canal, pulp treatment — has advanced enormously, and that is simply the truth. Praising Chinese medicine does not mean claiming it is perfect and flawless; that would not be honest either.

So what kind of toothache did the old gentleman have? Not the searing pain of a cavity with a hole in it. It was a dull ache deep inside the tooth. After examining him, Doctor Yu Jiayan wrote a prescription built on a handful of herbs: Tian Men Dong (asparagus root), Shu Di Huang (prepared rehmannia), Zao Pi (the flesh of cornus fruit — Shan Zhu Yu), Mu Dan Pi (moutan bark), and Gou Qi Zi (wolfberry fruit), plus a tiny bit of Rou Gui (cassia bark) as the guide. Four doses in all.

💬 Note from Doctor Luo: The ancient commentary explains that “zao pi” is the flesh of the cornus fruit (shan zhu yu), the herb that tonifies the essence of the liver and kidney. Does this prescription look familiar? Right — it is the path of the Jin Gui Shen Qi Wan (Kidney Qi Pill from the Essentials of the Golden Cabinet) by Zhang Zhongjing. It was a specialty of the Jiangnan physicians of the late Ming and early Qing: tonify kidney essence and guide the fire back home (yin huo gui yuan).

Four doses in: the toothache stopped at once, and the turbid discharge cleared

What happened? After taking it, the toothache stopped immediately — the pain was gone. The nose felt lighter — the turbid discharge cleared, and his nose was fresh and clean.

💬 Note from Doctor Luo: This is what Chinese medicine means by “treating the lower part for a disease of the upper part” (shang bing xia qu). The toothache and the nasal discharge looked like problems above, but the root was below. With this kind of deficiency-fire toothache, often even a single dose will basically stop the pain — the effect is immediate.

But there was a small twist: after taking the medicine, the old gentleman felt his throat was a little dry — and he refused to take any more.

Doctor Yu’s “defense speech”: he stopped the medicine because people talked him out of it

At this point, the doctors under the old gentleman’s patronage stepped in to “flatter” him: wherever it hurts, there must be fire, so clear the fire — treat heat as heat. A few heat-clearing herbs and done, how convenient! They had no idea where the root of the illness lay. The old gentleman listened, decided tonics were unreliable, and simply stopped.

Doctor Yu Jiayan saw this would not do — the reasoning had to be explained. So he wrote a formal treatise, titled “On the Medicine Suitable for Preserving the Vital Harmony of the Honorable Dingweng,” laying out from beginning to end why clearing fire was wrong and why tonifying kidney essence was right. This case record is, in fact, Doctor Yu’s defense speech.

💬 Note from Doctor Luo: The old gentleman probably stopped taking the medicine because someone had spoken ill of it — tonics are useless, they said; when you have fire you should clear it. Doctor Yu wrote this essay precisely so it could be read: you say I prescribed wrongly — let me lay out my reasoning and let everyone judge. Even in ancient case records, physicians carried a stubborn, truth-seeking energy.

Reading the man: yang abundant, yin essence deficient — fire above, emptiness below

How did Doctor Yu Jiayan argue his case? First, look at the man — the old gentleman had received especially deep congenital yang: even in winter he could rise early and sleep late, and he could eat sugarcane and pears — think about it: to dare eat cold things means strong yang and vigorous digestion. His hair was jet black.

But while his yang was strong, his yin essence was insufficient: he walked slowly and deliberately; he could raise his arms easily and lightly, yet his lower back felt heavy; his yang rose readily but his essence was hard to hold — in sexual matters, his body could not retain what it should; he could eat well above but could not hold below — he was prone to loose stools.

💬 Note from Doctor Luo: This cluster of signs is classic: strong yang above, depleted yin essence below. Chinese medicine says “the lower body is not originally deficient, but the essence is secretly channeled upward” — the essence of the lower body is quietly sent up to supply the upper body, and the more it is supplied, the emptier below becomes. The upper body looks substantial, but in fact it is “clear yang being crowded together by yin” — the yin presses up against it. When yin gathers above: in the eyes it becomes tears, in the nose it becomes nasal discharge, in the mouth it becomes salty saliva. So where did the old gentleman’s turbid nasal discharge come from? Yin qi running upward, emerging as tears, mucus, and saliva.

The Nei Jing (Inner Canon) says it plainly: “At forty, yin qi is half gone” — from around forty, the force of yin begins to decline, and once yin declines it can no longer gather and hold on its own, so the yang is repeatedly driven upward — yang qi keeps rushing up. So the root of this illness is four words: yin essence is insufficient.

An iron rule of elderly health: in the young, fear fire; in the old, fear the lack of fire

So what to do? Doctor Yu Jiayan said: gather and guide back to the origin (shou she gui yuan) — bring back what has run to the upper body and return it to the lower origin.

All the ancient formulas for serving and nourishing the aged made warming and tonifying the lower origin their central task. But warming and tonifying does not mean simply tonifying yang — it means tonifying essence plus warming yang. Why? Doctor Yu Jiayan said it in one famous line:

💬 Note from Doctor Luo: “In treating the young, fear fire; in treating the old, fear the lack of fire.” The young are feared to have too much fire, and when fire is excessive it must be cleared. But the old — you fear them losing their fire. When the fire of ming men (life gate) declines, transformation slows, and the person ages. With fire, one is spirited and vigorous, slow to age. But note: this fire is not deficiency fire — it is the “true fire” that comes from ample kidney essence and full yang qi. It is the treasure of the aged and must never be lightly injured. So when you see an old person with a little heat above, do not rush to clear it — first ask whether the lower body is depleted.

Old person with a dry throat? The Eight-Ingredient Pill is the “sacred medicine” — adding fuel beneath the cauldron

Doctor Yu Jiayan also addressed a particular situation: old people with dry throats. In the past, he said, for this kind of substantial, stubborn dry throat, what did physicians use? The Eight-Ingredient Pill — Ba Wei Wan, the Gui Fu Di Huang Wan, the path of the Jin Gui Shen Qi Wan. It is the “sacred medicine.”

Why? Here is the image: adding fuel beneath the cauldron. Throw more firewood under the pot, the fire flares up, the steam from the water rises and goes upward — and the upper body is naturally moistened again.

💬 Note from Doctor Luo: In my clinical work I see many cases of chronic pharyngitis that are caused by kidney essence deficiency with deficiency fire rushing upward. Just moistening the throat and clearing the throat does not work. Tonify the kidney essence fully — add a little yin-nourishing medicine if the person tends toward yin deficiency, a little yang-warming medicine if they tend toward yang deficiency — and once the fire of ming men is restored, the deficiency fire above naturally withdraws. Add a small amount of cassia bark to warm things slightly, and the deficiency fire of the upper burner returns home. This is an extremely important principle of Chinese medicine: a great many of the body’s imbalances arise exactly this way.

Yang qi values concealment: oil in the lamp, ash over the coals

Doctor Yu Jiayan continued the reasoning: the heat you see above is not merely true yin deficiency — the true yang is also deficient. Why? Because yang qi values concealment — yang hidden below, concealed and not rising defiantly, can keep working steadily. If it keeps steaming up above, that is the problem.

💬 Note from Doctor Luo: The Yi Jing (Book of Changes) explains this thoroughly: it is like a lamp — you must keep adding oil inside, and the lamp burns brighter and brighter; cover the stove with a little ash, and the fire will not go out. Lone yang floats upward and hovers above, looking like heat — why not gather it and bring it back down? Once it is brought down, the turbid discharge in the nose ceases, and clear fluids are ever present in the mouth — the mouth is moist, the saliva fresh, and nothing is dry anymore.

In his own prescription, Doctor Yu Jiayan likewise tonified kidney essence while pairing it with Tian Dong to nourish yin, Dan Pi to clear heat, and a touch of “clear, tonifying, downward-moistening remedies” to restrain the deficient heat — tonifying yin and yang together, guiding the fire home. With a prescription this complete, what room was left for doubt?

Modern lesson: fire in the upper body — do not rush to clear it

This small case holds a very deep principle. Doctor Luo Dalun especially wants everyone to remember:

💬 Note from Doctor Luo: In modern life, we meet far too many fire patterns in the upper burner — ears, eyes, nose; mouth ulcers, toothache, trigeminal neuralgia, headache; even a red lump on the skin, red, swollen, hot, and painful. If you find the problem above, suspect strongly whether it is deficiency fire from insufficient kidney essence. Many of my followers have learned this principle: when they see redness, swelling, heat, or pain above, instead of rushing to Niu Huang Jie Du Wan (Bezoar Detoxification Pills) or heat-clearing, toxin-removing medicines, they use the guide-the-fire-home approach — Shu Di Huang (prepared rehmannia) with a little Rou Gui (cassia bark) to tonify kidney essence. Often the problem is resolved very quickly — take it once, and the pain disappears.

Why is it so effective? Because the root of the illness has been found.

A forgotten chapter of history: after the warm-disease school rose, this approach was lost

Finally, let us trace the history. The root of this approach is Zhang Zhongjing’s Jin Gui Shen Qi Wan. In the late Ming and early Qing, the Jiangnan physicians — Zhang Jingyue, Chen Shiduo, Doctor Yu Jiayan — explained with great clarity that “the fire in the upper body is very often deficiency fire from insufficient kidney essence.” They tonified kidney essence, regulated yin and yang together, and tucked the fire away — this is called guiding the fire back home (yin huo gui yuan).

💬 Note from Doctor Luo: Sadly, after the rise of the warm-disease school, everyone’s thinking turned to clearing heat and resolving toxins, and this method was gradually forgotten. Some even questioned Zhang Jingyue: “Why does he always tell people to tonify the kidney?” In my view, the Qing dynasty went down a wrong road here — the physicians of the late Ming and early Qing all understood this principle, yet later generations could no longer treat these diseases. In modern times, the late master Doctor Li Ke placed great weight on Yin Huo Tang (Fire-Guiding Decoction) and used it to treat many cases of trigeminal neuralgia and upper-burner pain — he was rediscovering this very path. For my part, from the angle of medical history and literature, I have brought the thought of these late-Ming, early-Qing physicians back into the light. Everyone must take this seriously: deficiency fire flaring upward and dragon-thunder fire rushing up from kidney-essence deficiency — tonify the kidney essence, guide the fire home, and let the upper-burner heat vanish. This is an enormously important treatment principle.

One more physician stands as supporting evidence: Doctor Xue Lizhai left behind so many case records — why did he turn in his later years to the Eight-Ingredient Pill (Gui Fu Di Huang Wan)? Because a great many people have deficient kidney essence and need to tonify essence and seal yang qi away — which brings real, concrete benefits for longevity and health.

Closing: for the elderly, yang qi is best stored in secret

In this one case, Doctor Yu Jiayan explained the old person’s rule of health completely: yang qi is best stored in concealment; with kidney essence sufficient and the source of the kidney cared for, a person can live long. When the lower origin is not deficient, deficiency fire does not flare upward, and the toothache, the turbid nasal discharge, the dry throat — all these upper-burner complaints — naturally disappear.

What to take away

• Not every toothache is “fire” to be cleared. A dull ache deep in the tooth, without a cavity, in an older person, is often deficiency fire from kidney essence running low — the classic “treat the lower for a disease of the upper” (shang bing xia qu) case.
• Tonify essence, then add a little warmth. The classic structure: Shu Di Huang (prepared rehmannia) in generous dose + Tian Men Dong, Gou Qi Zi, Shan Zhu Yu, Mu Dan Pi, with a small amount of Rou Gui (cassia bark) to guide fire back home. The root formula is Zhang Zhongjing’s Jin Gui Shen Qi Wan.
• “In the young, fear fire; in the old, fear the lack of fire.” Ming men fire is the treasure of the aged — when an old person has “heat” above, check below before clearing.
• Dry throat in the elderly — chronic pharyngitis that will not clear with throat-moistening — often needs the Eight-Ingredient Pill: adding fuel beneath the cauldron so the steam rises again.
• Upper-body heat today — mouth ulcers, toothache, trigeminal neuralgia, headache, red swollen painful skin — suspect kidney-essence deficiency with deficiency fire; tonify essence plus a little cassia bark, and the fire returns home.

Compiled from Doctor Luo Dalun’s commentary on the case records of Doctor Yu Jiayan; the case is from Yu Yi Cao (《寓意草》, completed 1643).