閱讀難度:⭐️⭐️⭐️174Please respect copyright.PENANApWmycOkP8J
俗話說:「牙痛慘過大病。」牙齒問題由古代開始就困擾著人類。正正因為如此,人類一直用著自己的智慧去解決這些問題。在整個過程中留下了很多寶貴經驗,同時亦發現一隻小小的牙齒中其實蘊含著很大的奧秘。174Please respect copyright.PENANAMPGenohbUh
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#齲,齒蠹也174Please respect copyright.PENANAav9hRwBCCN
說到牙疾的歷史,早在3500年前就有關於齒疾敘述。「齲」字的甲骨文正是「齒」上加一條「蟲」(圖1)。再到東漢的訓詁*專著《釋名.釋疾病》得出準確字意:174Please respect copyright.PENANA49icMjifdg
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「齲,朽也,蟲齧之齒缺朽也。」174Please respect copyright.PENANAjVrb4El1R5
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《史記·扁鵲倉公列傳》中就記載了「齊中大夫病齲齒」的病例。而《黃帝內經·靈樞》亦有對齒痛、齲齒併發症、牙病針刺等作敘述:174Please respect copyright.PENANA87ly3DYfSu
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「臂陽明有入頄遍齒者,名曰大迎,下齒齲取之。臂惡寒補之,不惡寒寫之。足太陽有入頄遍齒者,名曰角孫,上齒齲取之,在鼻與頄前。方病之時其脈盛,盛則寫之,虛則補之。一日取之出鼻外。」174Please respect copyright.PENANAIWrBA2Tnk0
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而到了漢代,《金匱要略》中記載了最早的牙痛藥方「小兒疳蟲蝕齒方」:174Please respect copyright.PENANAL8NPhImg6H
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「雄黃、葶藶,右二味,末之,取臘日豬脂溶,以槐枝綿裹頭,四五枚,點藥烙之。」174Please respect copyright.PENANAo1DUco6IjE
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隋代《諸病源候論》有專門的一章《牙齒病諸候》,記載了21種牙科病的病因病機和症狀。唐朝太醫署亦設有口齒專科。174Please respect copyright.PENANA7uI01g6met
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明朝《本草綱目》引述《唐本草》中的銀膏,說明唐代就已經出現了銀汞合金補牙術:174Please respect copyright.PENANAxjMshNhpDE
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「其法用白錫和銀薄及水銀合成之,凝硬如銀,合煉有法……補牙齒缺落。」174Please respect copyright.PENANASw4e4Q3BSm
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直到清代《白士集》記載:174Please respect copyright.PENANAOxqfpgnpoJ
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「今市肆有補齒鋪,懸牌雲鑲牙如生,蓋宋以來有之。」174Please respect copyright.PENANAYsooCPzebS
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可見到了清朝乾隆年間,牙科已經成為一個成熟的技術行業。174Please respect copyright.PENANACXyyKIg8Jp
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#齒為腎之餘,齦為胃之絡174Please respect copyright.PENANAoX5MWqpFpR
在中醫理論中,口腔是人體健康的重要樞紐。它是任督二脈交會之處,也是五臟六腑所貫通之處,所以牙齒能夠反映全身健康狀況。174Please respect copyright.PENANA4iIEJ6NS7b
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督脈循行於人體背後正中線,最後會走到上唇繫帶與齒齦連接處,而任脈則循行於人體前正中線,由嘴內舌頭、下顎處往下行走,任督二脈經由舌頭抵上顎牙齦後方來相連。五臟六腑的精氣,亦經由經絡運行輸佈齒齦。牙齒、牙齦強健與否,也反映了五臟六腑精氣是否充沛。174Please respect copyright.PENANA0JQ0E5lY61
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因此,牙齒在中醫診斷裏作為一項重要依據。中醫的望診法中,除了看眼睛、舌頭、臉色等,還有一種稱之為「齒齦望診法」,而這往往是很容易就被忽略的。174Please respect copyright.PENANA4MDXQ4cBMg
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「齒為腎之餘,齦為胃之絡。」這句由《溫熱論》總結出來,反映了齒齦與臟腑的關係。而望齒與齦的重點在於注意其色澤、形態和潤燥的變化。174Please respect copyright.PENANAGmauspRQHb
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先說望牙齒的部分:牙齒不潤澤,是津液未傷;牙齒乾燥,是胃津受傷;齒燥如石,是胃腸熱極,津液大傷;齒燥如枯骨,是腎精枯竭,不能上榮於齒的表現;牙齒鬆動稀疏,齒根外露,多屬腎虛或虛火上炎;病中咬牙齒是肝風內動之徵;睡中磨牙,多為胃熱或蟲積;牙齒有洞腐臭,多為齲齒,欲稱"蟲牙"。174Please respect copyright.PENANAoJMtjgXRtZ
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再到望牙齦的部分:齦紅而潤澤是為正常;如齦色淡白,是血虛不榮;紅腫或兼出血多屬胃火上炎;齦微紅,微腫而不痛,或兼齒縫出血者,多屬腎陰不足,虛火上炎;齦色淡白而不腫痛,齒縫出血者,為脾虛不能攝血;牙齦腐爛,流腐臭血水者,是牙疳病。174Please respect copyright.PENANAkRrX0OepXP
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#牙齒與經絡174Please respect copyright.PENANAawRhC768Uh
清代中醫古籍《瘍醫大全》記載了32顆牙齒與全身臟腑的關係:174Please respect copyright.PENANA4yvgnHnNUY
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「上四門牙屬心,一云:上二門牙,下二門牙,屬心包絡;門牙旁左右上下四牙,屬肝;再左右上下四牙,屬胃;再左右上下四牙,屬脾;再左右上下四牙,屬肺;再左右上下之牙,皆屬腎。凡人齒多者貴。」174Please respect copyright.PENANAivlMnowbMJ
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由於臟腑與經絡相通,所以在治療牙病時亦會用到經絡理論。而個別牙齒亦可反映個別臟腑的疾病。174Please respect copyright.PENANAjKwPGv8mMI
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到了現代,有學者對此進行研究探討,德國的Dr.Reinhold Voll對每顆牙齒的經絡進行了逐一測定,整理出一張對應圖(圖2)。結果與古籍有所不同,兩者可分別作參考。174Please respect copyright.PENANAPtv6AATkRu
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最後,希望大家別把牙齒只當成咀嚼食物的工具,更加應該好好保護牙齒和口腔,以免承受牙痛之苦,或是掉光牙齒,變成一個「無齒之徒」。174Please respect copyright.PENANAr54slMhRuv
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*訓詁學(英語:Philology 或 Exegesis)是指傳統研究古書中詞義的學科,是中國傳統的語文學——小學的一個分支。訓詁學在譯解古代詞義的同時,也分析古代書籍中的語法、修辭現象。是從語言的角度研究古代文獻,幫助人們閱讀古典文獻。174Please respect copyright.PENANAgHp3ekNOUg