治喉痹。
牛蒡子 玄参 升脉 桔梗 犀角 黄芩 木通 甘草（各等分） 水煎服。
解风热上攻，咽喉肿痛。
桔梗（一钱五分） 薄荷 荆芥 甘草 山豆根（各一钱五分，俱焙，为末） 牙硝 硼
砂朴硝 雄黄 朱砂（各一钱，俱不见火，研为细末） 和匀，干敷舌上，或温浓茶
调搽少，咽下亦可。
治痰热上攻，缠喉喉痹，双鹅肿痛，汤药不下，咽痛颏肿，用此吐之。
雄黄（一两） 巴豆（去油，十四个） 郁金（一钱） 为末，醋糊丸。如黍米大，热茶清
下七丸至十丸，吐出顽涎即苏。如口噤，以物挖开灌之，缠喉急痹，缓治而死。雄黄能
破结气，郁金能散恶血，巴豆能下稠涎，下咽无不活着。
又方
治喉痹。
用陈年霜梅，入蜒蚰令化，每患喉痹等症，用梅噙于口中，神效。
《经》曰∶一阴一阳，结谓之喉痹。一阴，少阴君火也。一阳，少阳相火也。手少
阴心脉挟咽，足少阴肾脉循喉咙，其人膈间素有痰涎，或因饮酒过度，或因忿怒失常，
或因房室不节。盖饮酒过度，胃火动也，富贵者，多犯之。忿怒失常，肝火动也，妇人
多犯之。房室不节，肾火动也，男子多犯之。火动痰上，而痰热潘灼，壅塞咽隘之
间，痰者，火之本，火者，痰之标，火性急速，所以内外肿痛，水浆不入，乃外症之最
危者。治疗之法，急则治标，缓则治本，治标用丸散以吐痰散热；治本用汤药以降火补
虚。奈何治者？但云治脾肺火，而未云降肝肾火也。必须以《内经》从治之法，切不可
骤用寒凉，盖促其危耳。故实火须用正治，虚火须用从治，须分明白，不可少误。
咽与喉，会厌与舌，四者同在一门，其用各异。喉以纳气，故喉气通于天；咽以纳
食，故咽气近于地∶会厌管乎上，以主开辟。掩其气喉，令水谷能进食喉而不错，四
者，交相为用，关一则饮食废而死矣。云喉痹者，谓喉中呼吸不通，言语不出，而天气
闭塞也。云咽痛及嗌痛者，为咽喉不能纳唾与食，而地气闭也。云喉痹咽嗌痛者，谓咽
喉诸病，天地之气并闭塞也。嗌即咽之低处。
咽在后主食，喉在前主气。十二经中，唯足太阳主表，别下项余经，皆内循咽喉，
尽得以病之，而统在君相二火，喉主天气，属肺金，变动为燥，燥则涩而闭。咽主地
气，属脾土，变动为湿，湿则肿而胀，皆火郁上焦，致痰涎气血结聚，咽喉肿达于外，
麻痒且痛，为缠喉风。肿于两旁为喉痹，其单蛾双蛾，水舌舌胀，缠喉风，走马喉风，
病同于火，故不分也。惟缠喉走马，杀人最速，子和曰∶治喉痹，用针出血，最为上
策。《内经》“火郁发之”，发谓发汗，出血者，乃发汗之一端也。喉痹多属痰热，重
者，用桐油探吐，肺绝喉闭，其脉浮散而微细，其声如鼾，有如痰在喉中响者，此为肺
绝之候，宜速用人参汤调入竹沥姜汁服之。若早者，十全七八，次则十全三四，迟则十
不救一。缠喉风亦属痰热，谓其咽喉里外皆肿者是也。亦用桐油，以鹅翎探吐。喉闭
者，取山豆根汁，含咽即开，有药不能进者，急取病患两臂捋数十次，便血聚大指
上，以发绳扎住拇指，针刺指甲缝边出血，如放沙一般，左右手皆然，其喉即宽。咽疮
喉痛，多属虚热、血虚，虚火游行无制，客于咽喉也。虚者，八味加牛膝，五味子煎与
食前冷服。实者，黄连、荆芥、薄荷、姜汁硝蜜噙化。喉痛必用荆芥，阴虚火炎上必甲
玄参。有方，用茜草一两，作一服者，以其能降血中之火也。有咽痛而诸药不效者，此
非咽痛，乃是鼻中生一条红线如发，悬一黑泡，大如樱珠，垂挂到咽门而止，难用深
取，宜用土牛膝根，（即鼓槌草，）独条直而肥大者，捣碎入好醋三五滴，同研取汁，滴入鼻
中二三点，即系断珠破，吐出瘀血立安。痰结块在喉中，如梗状者，梅核气也，宜噙化
丸。阴虚咳嗽，久之喉中痛者，必有疮名肺花疮，坎离加玄参甘桔，不可用冰片吹药。
恐辛散疮转溃也。
喉与咽不同，喉者，脘呼吸之门户，主出而不纳。咽者，胃脘。谷之道路，主纳
而不出。盖喉咽司呼吸，主升降，此一身之紧关橐禽也。《经》曰∶足少阴所生病者，
口渴，舌干咽肿，上气嗌干及痛。《素问》云∶邪客于足少阴之络，令人咽痛，不可纳
食。又曰∶足少阴之络，循喉咙通舌本。凡喉痛者，皆少阴之病，但有寒热虚实之分，
少阴之火，直如奔马逆冲于上，到此咽喉紧锁处，气郁结而不得舒、故或肿或痛也，其
症必内热口干而赤，痰涎涌上，尺脉必数而无力，盖缘肾水亏损，相火无制而然。须用
六味地黄麦冬五味大剂，作汤服之。又有色欲过度，元阳损亏，无根之火游行无制，客
于咽喉者，须八味肾气丸大剂，煎成冰冷与饮，引火归源，庶几可救。此论阴虚咽痛
者，如此治法，正褚氏所谓上病疗下也，其间有乳鹅缠喉，二名不同，肿于咽两旁者为
双鹅，易治。肿于一边者为单鹅，难治。如有恶寒表症，用荆防败毒散散之。不恶寒而
无表症者，惟为辛凉清利，外用鹅翎蘸米醋搅喉中，去尽痰涎，复以鹅翎探吐之。令着
实一咯，咯破鹅中紫血即溃，或紫金锭磨下即安，慎勿轻用刀针。古方有用巴豆油染纸
作燃子，点火吹灭，以烟熏鼻中，实时口鼻流涎，牙关自开，再用此搐患处即愈。
有阴气大虚，虚火无制、孤阳飞越，客于咽喉，遂成咽痛者，脉必浮大，重取必
涩，去死为近，宜人参一味浓煎，细细饮之。如作实症，用以清降之药，祸在反掌。
（愚见人参必同童便制附子同煎，温和食前顿服，则监制虚火下归乃愈。如单用人参细细饮
之，恐浮火益炽，亦非稳当。）奈世人但知热咽痛，不知有寒咽痛也。
《经》曰∶太阳在泉，寒淫所胜，民病咽痛颌肿。陈藏器用附子去皮、脐，炮，炙，切
叶，以蜜涂炙，令蜜入内，噙咽其津，甘味尽更易之。仲景云∶下利清谷，里寒外热，
脉微欲绝，而赤咽痛，以通脉四逆汤。又曰∶冬月伏寒，在于肾经，发则咽痛下利，
附子汤温其经则愈。又有司天运气，其年乡村相染。若恶寒者，多是暴寒折热，寒闭于
外，热郁于内，切忌胆矾酸寒之剂点喉，反使阳郁不伸。又忌∶硝黄等寒剂下之，反使
阳陷入里，祸不旋踵，须用表散。若甘桔汤之类，东垣曰夏伤寒伏于肾，少阴之经，多
咽痛者名肾伤寒也，宜热药冷冻饮料之。
又有喉间作痛，溃烂久而不愈，此必杨梅疮毒，须以萆 汤为主，随症佐以别药。
治疗喉痹。
牛蒡子、玄参、升麻、桔梗、犀角、黄芩、木通、甘草（各等分），水煎服。
解除风热上攻引起的咽喉肿痛。
桔梗（一钱五分）、薄荷、荆芥、甘草、山豆根（各一钱五分，均焙干，研为粉末）、牙硝、硼砂、朴硝、雄黄、朱砂（各一钱，均不经过火炼，研成细末），混合均匀，干敷于舌上，或用温浓茶调少量搽涂，咽下也可以。
治疗痰热上攻引起的缠喉风、喉痹、双鹅喉（扁桃体双侧红肿）肿痛，汤药无法下咽，咽痛下巴肿胀，用此方催吐。
雄黄（一两）、巴豆（去油，十四个）、郁金（一钱），研为粉末，用醋糊制成丸剂。大小如黍米，用热茶清送服七丸至十丸，吐出顽固的涎液后即可苏醒。如果牙关紧闭，用器具撬开灌入，缠喉急痹症，若治疗迟缓会导致死亡。雄黄能破除结聚之气，郁金能消散恶血，巴豆能排出稠厚的涎液，服用后没有不救活的。
又一方
治疗喉痹。
使用陈年的霜梅，放入蜒蚰（蜗牛类软体动物）使其融化，每当患喉痹等疾病时，将梅子含在口中，效果神奇。
《内经》说：一阴一阳，结聚称为喉痹。一阴，指少阴君火。一阳，指少阳相火。手少阴心经的脉管挟持咽喉，足少阴肾经的脉管循行经过喉咙。如果患者膈间素来有痰涎，或者因为饮酒过度，或者因为愤怒失常，或者因为房事不节制。大概饮酒过度，会引发胃火，富贵之人多犯此病；愤怒失常，会引发肝火，妇人多犯此病；房事不节制，会引发肾火，男子多犯此病。火动则痰随气上逆，痰热煎熬，壅塞在咽喉之间。痰是火的根本，火是痰的表现，火性急速，所以内外肿痛，连水浆都无法进入，这是外症中最危险的情况。治疗的方法，急则治其标，缓则治其本。治标用丸散来催吐痰液、散热；治本用汤药来降火、补虚。然而，为什么有的医生只说治疗脾肺之火，而不说降肝肾之火呢？必须采用《内经》中“从治”的方法，切不可骤然使用寒凉药物，因为这会加速危象的发生。所以实火必须用正治法，虚火必须用从治法，必须分辨清楚，不可稍有差错。
咽与喉，会厌与舌，这四者同在一个门户，但功能各异。喉用来纳气，所以喉气通天；咽用来纳食，所以咽气近地。会厌主管上方，主宰开启和闭合，掩盖气道，使水谷能进入食道而不误入气管。这四者相互为用，只要有一个环节出问题，饮食废绝就会死亡。所谓喉痹，是指喉中呼吸不通，言语不出，天气闭塞。所谓咽痛及嗌痛，是指咽喉不能吞咽唾液和食物，地气闭塞。所谓喉痹咽嗌痛，是指咽喉诸病，天地之气同时闭塞。嗌即咽的低处。
咽在后面主司食物，喉在前面主司气息。十二经脉中，只有足太阳膀胱经主表，其余经脉别下行项部，都内循咽喉，都能导致疾病，统摄于君火和相火。喉主天气，属肺金，变动表现为燥，燥则涩而闭塞。咽主地气，属脾土，变动表现为湿，湿则肿而胀。这都是火郁在上焦，导致痰涎气血结聚，咽喉肿胀达于外部，麻木瘙痒且疼痛，称为缠喉风。肿胀在两旁称为喉痹，至于单蛾、双蛾、水舌、舌胀、缠喉风、走马喉风，病因同于火，所以不加以区分。只有缠喉风和走马喉风，杀人最快。张子和说：治疗喉痹，用针刺出血，是最上策。《内经》说“火郁发之”，发指发汗，出血也是发汗的一种形式。喉痹多属于痰热，重症用桐油探吐。肺绝喉闭，脉象浮散而微细，声音像打鼾，好像喉中有痰响，这是肺绝的征候，应立即用人参汤调入竹沥、姜汁服用。如果在早期治疗，十分可愈七八；次之十分可愈三四；迟则十分救不回一个。缠喉风也属于痰热，是指咽喉里外都肿胀。也用桐油，用鹅毛翎探吐。喉闭者，取山豆根汁，含咽即可开通。如果有药不能进者，急忙取患者两臂捋数十次，便血液聚集在大拇指上，用头发绳扎住拇指，针刺指甲缝边出血，像放沙一样，左右手都一样，喉部随即宽松。咽疮喉痛，多属于虚热、血虚，虚火游行无制，客居于咽喉。虚证，用八味丸加牛膝、五味子煎服，饭前冷服。实证，用黄连、荆芥、薄荷、姜汁、硝石、蜂蜜噙化。喉痛必用荆芥，阴虚火炎上必用玄参。有方子，用茜草一两，作一服，因为它能降血中之火。有咽痛而诸药无效的，这不是咽痛，而是鼻中生一条红线如发，悬挂一个黑泡，大如樱桃珠，垂挂到咽门为止，难以深入取出，宜用土牛膝根（即鼓槌草），独条直而肥大者，捣碎加入好醋三五滴，同研取汁，滴入鼻中二三点，即刻系断珠破，吐出瘀血立即安宁。痰结块在喉中，如梗状者，是梅核气，宜用噙化丸。阴虚咳嗽，久则喉中痛者，必有疮名为肺花疮，用坎离丸加玄参、甘桔，不可用冰片吹药。恐怕辛散药物使疮转溃。
喉与咽不同，喉是呼吸的门户，主出而不纳。咽是胃脘，是五谷的道路，主纳而不出。喉咽司呼吸，主升降，这是全身的关键枢纽。《内经》说：足少阴肾经所生的病，口渴，舌干咽肿，上气嗌干及痛。《素问》说：邪气客居足少阴之络，令人咽痛，不能进食。又说：足少阴之络，循喉咙通舌本。凡喉痛者，都是少阴的病，但有寒热虚实之分。少阴之火，直如奔马逆冲于上，到达咽喉紧锁之处，气郁结而不能舒展，所以或肿或痛。其症状必定内热口干而赤，痰涎涌上，尺脉必数而无力，这是因为肾水亏损，相火无制所致。必须用六味地黄丸加麦冬、五味子大剂，作汤服用。又有因色欲过度，元阳损亏，无根之火游行无制，客居于咽喉的，必须用八味肾气丸大剂，煎成冰冷后饮用，引火归源，或许可以挽救。这种论述阴虚咽痛者的治疗方法，正是褚氏所说的上病疗下。其中有乳鹅、缠喉，二名不同，肿于咽两旁的是双鹅，易治。肿于一边的是单鹅，难治。如有恶寒表症，用荆防败毒散发散。不恶寒而无表症者，只用辛凉清利，外用鹅毛翎蘸米醋搅喉中，去尽痰涎，再用鹅毛翎探吐。令着实咳出一咯，咯破鹅中紫血即溃，或用紫金锭磨下即安，切勿轻用刀针。古方有用巴豆油染纸作燃子，点火吹灭，以烟熏鼻中，实时口鼻流涎，牙关自开，再用此搐患处即愈。
有阴气大虚，虚火无制、孤阳飞越，客居于咽喉，遂成咽痛的，脉必浮大，重按必涩，离死不远，宜用人参一味浓煎，细细饮之。如果当作实证，用清降的药物，祸患就在反掌之间。（愚见认为人参必须同童便制的附子同煎，温和后饭前顿服，则能监制虚火下归乃愈。如果单用人参细细饮之，恐怕浮火更炽盛，也不稳妥。）无奈世人只知道热咽痛，不知道有寒咽痛。
《内经》说：太阳在泉，寒淫所胜，百姓病咽痛颌肿。陈藏器用附子去皮、脐，炮炙，切叶，以蜜涂炙，令蜜渗入，含咽其津液，甘味尽后再更换。仲景说：下利清谷，里寒外热，脉微欲绝，面赤咽痛，用通脉四逆汤。又说：冬月伏寒，在于肾经，发作则咽痛下利，附子汤温其经则愈。又有司天运气，该年乡村相互传染。如果恶寒者，多是暴寒折热，寒闭于外，热郁于内，切忌用胆矾酸寒之剂点喉，反而使阳气郁结不能伸展。又忌用硝黄等寒剂下之，反而使阳气陷入里，祸患不久即至，必须用表散法。若甘桔汤之类，东垣说夏伤寒伏于肾，少阴之经，多咽痛者名肾伤寒也，宜用热药冷冻饮料之。
又有喉间作痛，溃烂久而不愈，这一定是杨梅疮毒，须以萆薢汤为主，随症佐以别药。
Treats throat obstruction (Hou Bi).
Babaozi (Arctii Fructus), Xuanshen (Scrophulariae Radix), Shengma (Cimicifugae Rhizoma), Jiegeng (Platycodonis Radix), Xijiao (Rhinocerotis Cornu - *Note: Substitute with Buffalo Horn in modern practice*), Huangqin (Scutellariae Radix), Mutong (Akebiae Caulis), Gancao (Glycyrrhizae Radix et Rhizoma) (equal parts), decocted in water and taken orally.
Resolves wind-heat attacking upward, causing swelling and pain in the throat.
Jiegeng (Platycodonis Radix) (1.5 qian), Bohe (Menthae Haplocalycis Herba), Jingjie (Schizonepetae Spica), Gancao (Glycyrrhizae Radix et Rhizoma), Shandougen (Sophorae Tonkinensis Radix) (each 1.5 qian, all baked dry and ground into powder), Yaxiao (Natrii Sulfas), Pengsha (Borisovi Borax), Puxiao (Natrii Sulfas), Xionghuang (Realgar), Zhusha (Cinnabaris) (each 1 qian, none processed by fire, ground into fine powder), mixed evenly. Apply dry powder on the tongue, or mix a small amount with warm strong tea to apply externally; swallowing is also permissible.
Treats phlegm-heat attacking upward, causing winding-throat-wind (Chan Hou Feng), throat obstruction (Hou Bi), bilateral tonsillar swelling (Shuang E), severe pain preventing the intake of liquid medicine, throat pain with chin swelling. Use this formula to induce vomiting.
Xionghuang (Realgar) (1 liang), Badou (Crotonis Semen, oil removed) (14 seeds), Yujin (Curcumae Radix) (1 qian), ground into powder, formed into pills with vinegar paste. Size like millet grains. Take 7 to 10 pills with clear hot tea. Vomiting out stubborn saliva will lead to recovery. If the jaw is clenched, pry it open and administer. Winding-throat acute obstruction requires urgent treatment; delayed treatment leads to death. Xionghuang breaks up stagnant qi; Yujin disperses evil blood; Badou expels thick saliva. Administration ensures survival.
Another prescription
Treats throat obstruction (Hou Bi).
Use aged frost plums (Chen Nian Shuang Mei), place snails (Yanyou) inside to dissolve them. Whenever suffering from throat obstruction or similar conditions, hold the plum in the mouth. This is miraculous.
The *Classic* states: "One Yin and One Yang, when knotted together, is called Throat Obstruction (Hou Bi)." One Yin refers to Shaoyin Jun Fire. One Yang refers to Shaoyang Xiang Fire. The Hand-Shaoyin Heart meridian flanks the throat; the Foot-Shaoyin Kidney meridian follows the throat. If the patient has had phlegm-saliva in the diaphragm since childhood, or due to excessive drinking, or abnormal anger, or immoderate sexual activity. Excessive drinking stirs Stomach Fire, common among the wealthy. Abnormal anger stirs Liver Fire, common among women. Immoderate sexual activity stirs Kidney Fire, common among men. When Fire moves, Phlegm rises with Qi; Phlegm-Heat cauterizes and obstructs the throat passage. Phlegm is the root of Fire; Fire is the branch of Phlegm. Fire nature is rapid, hence internal and external swelling and pain, inability to ingest liquids or water, which is the most critical external symptom. The treatment principle is: treat the branch in acute cases, treat the root in chronic cases. To treat the branch, use pills and powders to vomit out phlegm and dissipate heat; to treat the root, use decoctions to descend Fire and tonify deficiency. Why do some physicians only speak of treating Spleen and Lung Fire without mentioning descending Liver and Kidney Fire? One must employ the "conforming treatment" (Cong Zhi) method from the *Inner Classic*. Do not abruptly use cold-cooling herbs, as this accelerates danger. Thus, Excess Fire requires direct treatment (Zheng Zhi); Deficiency Fire requires conforming treatment (Cong Zhi). These must be distinguished clearly to avoid error.
The Pharynx (Yan) and Larynx (Hou), Epiglottis (Hui Yan) and Tongue (She), these four share one gate but have different functions. The Larynx receives Qi, thus its Qi connects to Heaven; the Pharynx receives food, thus its Qi is close to Earth. The Epiglottis manages the upper part, governing opening and closing, covering the airway so that food and drink enter the esophagus correctly. These four function mutually; if one fails, diet ceases and death ensues. "Throat Obstruction" (Hou Bi) means breathing through the larynx is blocked, speech is impossible, and Heavenly Qi is obstructed. "Pharyngeal Pain" (Yan Tong) and "Oesophageal Pain" (Ai Tong) mean the throat cannot swallow saliva and food, and Earthly Qi is obstructed. "Throat Obstruction with Pharyngeal/Oesophageal Pain" means various throat diseases where both Heavenly and Earthly Qi are obstructed. Ai refers to the lower part of the Pharynx.
The Pharynx is posterior, governing food; the Larynx is anterior, governing Qi. Among the Twelve Meridians, only the Foot-Taiyang Bladder Meridian governs the exterior; other meridians descend to the neck and internally follow the throat, all capable of disease, unified under Jun and Xiang Fire. The Larynx governs Heavenly Qi, belongs to Lung Metal, changes manifest as Dryness, leading to astringency and obstruction. The Pharynx governs Earthly Qi, belongs to Spleen Earth, changes manifest as Dampness, leading to swelling and distension. All result from Fire stagnating in the Upper Jiao, causing accumulation of Phlegm-Saliva, Qi, and Blood, swelling the throat externally, causing numbness, itching, and pain, termed Winding-Throat-Wind (Chan Hou Feng). Swelling on both sides is Throat Obstruction (Hou Bi). Single Tonsil (Dan E), Bilateral Tonsils (Shuang E), Water Tongue (Shui She), Tongue Swelling (She Zhang), Winding-Throat-Wind, Running-Horse-Throat-Wind (Zou Ma Hou Feng) all share the same Fire etiology and are not differentiated. Only Winding-Throat and Running-Horse-Throat kill fastest. Hezi said: Treating Throat Obstruction with needle bleeding is the best strategy. The *Inner Classic* says "Disperse Fire Stagnation"; dispersion implies sweating, and bleeding is a form of sweating. Throat Obstruction mostly belongs to Phlegm-Heat. Severe cases use Tung Oil to induce vomiting. Lung Exhaustion with Laryngeal Closure presents with floating, scattered, minute pulse, sound like snoring, rattling phlegm in throat. This is a sign of Lung Exhaustion; immediately use Ginseng Decoction mixed with Bamboo Sap and Ginger Juice. Early treatment yields 70-80% cure; moderate yields 30-40%; late yields less than 1%. Winding-Throat-Wind also belongs to Phlegm-Heat, characterized by swelling inside and out of the throat. Also use Tung Oil with goose feather to induce vomiting. For Laryngeal Closure, take Shandougen juice, hold and swallow to open. If medicine cannot enter, vigorously rub the patient's arms dozens of times until blood gathers at the thumb. Tie the thumb tightly with hair, prick the nail seam to bleed like sand release. Do this on both hands; the throat will relax. Pharyngeal sores and throat pain mostly belong to Deficiency Heat and Blood Deficiency, with wandering Deficiency Fire lodging in the throat. For Deficiency, use Ba Wei Wan (Eight-Ingredient Pill) plus Niuxi (Achyranthis Bidentatae Radix) and Wuweizi (Schisandrae Fructus), decocted and taken cold before meals. For Excess, use Huanglian (Coptidis Rhizoma), Jingjie (Schizonepetae Spica), Bohe (Menthae Haplocalycis Herba), Ginger Juice, Xiaoshuo (Saltpeter), and Honey to hold and melt. Throat pain must use Jingjie; Yin Deficiency with Fire flaming upward must use Xuanshen (Scrophulariae Radix). There is a formula using Qiancao (Rubiae Cordifoliae Radix) 1 liang per dose, as it descends Fire in the blood. For throat pain unresponsive to drugs, this is not throat pain but a red line like hair growing in the nose, hanging a black blister the size of a cherry, reaching the throat gate. Difficult to extract deeply; use Tubixie (Achyranthis Radix, i.e., Drumstick Grass), single straight and fat root, crush with 3-5 drops of good vinegar, grind to extract juice, drip 2-3 drops into the nose. The blister breaks, blood is expelled, and relief follows. Phlegm nodules in the throat feeling like a lump is Plum-Pit Qi (Mei He Qi), treat with Qin Hua Wan. Yin Deficiency cough lasting long causes throat pain, indicating Lung Flower Sore (Fei Hua Chuang). Use Kan Li Wan plus Xuanshen and Gan-Jie (Licorice and Platycodon). Do not use Bingpian (Borneolum Syntheticum) insufflation, fearing acrid dispersal will ulcerate the sore.
Larynx and Pharynx differ. Larynx is the portal for respiration, governing exit not entry. Pharynx is the stomach tube, the path for grain, governing entry not exit. Larynx and Pharynx manage respiration and ascending/descending, the crucial bellows of the body. The *Classic* states: Diseases generated by Foot-Shaoyin include thirst, dry tongue, swollen throat, rising Qi, dry and painful throat. *Su Wen* says: Pathogen lodging in Foot-Shaoyin collateral causes throat pain and inability to eat. It also says: Foot-Shaoyin collateral follows the throat to the tongue base. All throat pains are Shaoyin diseases, differing in Cold/Heat and Excess/Deficiency. Shaoyin Fire rushes upward like a galloping horse, reaching the tight lock of the throat, where Qi stagnates and cannot relax, causing swelling or pain. Symptoms must include internal heat, dry red mouth, surging phlegm-saliva, and rapid yet weak Chi pulse. This is due to Kidney Water depletion and unconstrained Xiang Fire. Must use Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) plus Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus) in large doses as decoction. For those with excessive sexual desire damaging Yuan Yang, with rootless Fire wandering unconstrained lodging in the throat, use Ba Wei Shen Qi Wan (Eight-Ingredient Kidney Qi Pill) in large doses, cooled before drinking, to guide Fire back to its source, perhaps saving life. This treatment for Yin Deficiency throat pain aligns with Chu Shi's "treat lower for upper disease." Regarding Ru E (Milky Goose) and Chan Hou (Winding Throat), names differ. Swelling on both sides of pharynx is Bilateral Goose, easy to treat. Swelling on one side is Single Goose, difficult to treat. If accompanied by aversion to cold and exterior symptoms, use Jing Fang Bai Du San to disperse. If no aversion to cold or exterior symptoms, use only Acrid-Cool clearing and draining. Externally, use goose feather dipped in rice vinegar to stir the throat, removing all phlegm, then use feather to induce vomiting. Force a cough; bursting the purple blood in the "goose" resolves it, or applying ground Zi Jin Ding (Purple Gold Tablet) brings relief. Do not lightly use needles/knives. Ancient formulas used paper dyed with Badou oil, lit and blown out, smoking into the nose to cause salivation and jaw opening, then insufflating the lesion for cure.
For severe Yin Deficiency, unconstrained Deficiency Fire, solitary Yang flying away, lodging in the throat causing pain: Pulse is floating and large, deep pressure reveals choppy quality, near death. Use single Ginseng, decoct strongly, sip slowly. If treated as Excess with cooling/descending herbs, disaster follows instantly. (My opinion: Ginseng must be decocted with Tongbian-treated Fuzi, taken warm before meals to control Deficiency Fire descending. Using Ginseng alone may exacerbate floating Fire, which is unsafe.) Yet people only know Hot Throat Pain, not Cold Throat Pain.
The *Classic* states: Taiyin in泉, excess Cold wins, people suffer throat pain and chin swelling. Chen Cangqi uses Fuzi (Aconiti Lateralis Radix Praeparata), peeled and baked, cut leaves, coated with honey, baked again, held in mouth to swallow saliva, changing when sweet taste fades. Zhang Zhongjing says: Diarrhea with undigested food, interior Cold exterior Heat, pulse minute nearly absent, red face and throat pain, use Tong Mai Si Ni Tang (Pulse-Unblocking Four-Reverse Decoction). Also: Winter latent Cold in Kidney Meridian, erupting as throat pain and diarrhea, Fu Zi Tang warms the meridian and cures. In years of specific Climate-Qi influence, village epidemics occur. If aversion to cold exists, it is often sudden Cold suppressing Heat, Cold closed outside, Heat郁 inside. Strictly avoid Danfan (Alumen) acid-cold throat drops, which further constrain Yang. Avoid Xiao (Saltpeter) and Huang (Rhubarb) cold purgatives, which drive Yang inward, causing immediate disaster. Must use exterior-dispersing methods. For Gan Jie Tang (Licorice and Platycodon Decoction), Dong Yuan says Summer Cold latent in Kidney, Shaoyin Meridian, many throat pains named Kidney Cold, should be treated with hot medicine served cold.
Also, throat pain with ulceration persisting long is likely Syphilis toxin (Yang Mei Chuang Du). Main formula is Bi Xie Tang (Dioscoreae Hypoglaucae Rhizoma Decoction), supplemented by other herbs based on symptoms.