凡喉痹日久,频服清降之药,以致痰涎壅于咽喉,声如曳锯,此肺气
相绝之候也,法在难治。宜用人参膏,加橘红汤纵饮之。设无参膏,即用独参汤加橘红亦可
每参一钱,用橘红一分。早服者,可救十中之二、三,迟则不救矣。或用四君子汤亦佳。
女人经水不调,壅塞经脉,亦令喉肿,宜用四物汤,加牛膝、茺蔚
又有梅核气症,男妇皆同,喉中如有物,吞不入,吐不出,宜用甘桔汤,加苏梗、橘红
、香附、金沸草之类,渐次可愈。
凡治咽喉、口舌之症,初则疏风解毒,继则滋水养阴,若元气渐虚,急顾脾胃。如六味
滋水,四君补脾,皆为要药,否则真气亏败,势难挽矣。治者审之。
甘草(炙,三钱) 桔梗 荆芥 牛蒡子(炒) 贝母(各一钱五分) 薄荷(三分
水煎服。若内热甚,或饮食到口即吐,加黄连一钱;若口渴,唇焦舌燥,便闭溺赤,更
加黄柏、黄芩、山栀、黄连;若有肿处,加金银花五钱。
半夏桂甘汤(见伤寒咽痛。
理中汤 四逆汤(见中寒。
明雄黄(水飞,一两) 郁金(一两) 巴豆(三十五粒
共为末,醋和丸,如黄豆大。每服五、七丸,清茶下,吐出痰涎立醒。如未吐,再服。
倘人事昏愦,心头温者,急研末灌之。
牛胆南星(九制者,一两) 麝香(五分) 珍珠(五分) 冰片(五分) 黄连(二钱) 防风(一钱) 荆芥
(二钱) 五倍子(一钱) 桔梗(一钱) 元参(三钱) 茯神(一钱) 天竺黄(二钱) 明雄黄(二钱) 当归
(一钱
上为细末,和匀,甘草四两煮膏为丸,如龙眼大,辰砂为衣,日中晒干,入瓷瓶中,紧
塞,勿走气。临服薄荷汤化下一丸。
凡是喉痹(咽喉肿痛闭塞之病)病程长久,频繁服用清热降火药物,导致痰涎积聚堵塞在咽喉部,发声时声音像拉锯一样嘶哑沉重,这是肺气即将绝败的征候,治疗上属于难治之症。适宜使用人参膏,配合橘红汤大量饮用。如果无人参膏,直接使用独参汤加入橘红也可以。每用人参一钱,配伍橘红一分。早晨服用的,可以挽救十分中的两三分;服药时间晚了就无法救治了。或者使用四君子汤效果也很好。
女性月经周期不调,气血壅塞经脉,也会导致咽喉肿胀,适宜使用四物汤,加入牛膝、茺蔚草。
又有梅核气这一病症,男女患者症状相同,感觉喉咙中有异物,吞不下去也吐不出来,适宜使用甘桔汤,加入紫苏梗、橘红、香附、金沸草等药物,逐渐调理可以痊愈。
大凡治疗咽喉、口舌方面的疾病,初期应当疏风解毒,随后应当滋补肾水、滋养阴液;如果元气逐渐虚弱,必须紧急顾护脾胃。如六味地黄丸用于滋补肾水,四君子汤用于补益脾气,都是重要的药物,否则真气亏损败坏,病情就难以挽回了。诊治者务必审慎对待。
甘草(蜜炙,三钱)、桔梗、荆芥、牛蒡子(炒制,各一钱五分)、薄荷(三分),用水煎煮后服用。如果体内热邪严重,或者饮食入口即呕吐,加入黄连一钱;如果口渴,嘴唇焦枯、舌头干燥,大便闭结、小便赤黄,再加黄柏、黄芩、山栀、黄连;如果有红肿部位,加入金银花五钱。
明雄黄(水飞法处理,一两)、郁金(一两)、巴豆(三十五粒),共同研磨成细末,用醋调和制成丸药,大小如黄豆。每次服用五到七丸,用清茶送服,吐出痰涎后病人立即清醒。如果没有吐出,可以再服用一次。倘若病人人事昏沉不省,但心口处尚有余温,紧急研成粉末灌服。
牛胆南星(经过九次炮制的,一两)、麝香(五分)、珍珠(五分)、冰片(五分)、黄连(二钱)、防风(一钱)、荆芥(二钱)、五倍子(一钱)、桔梗(一钱)、玄参(三钱)、茯神(一钱)、天竺黄(二钱)、明雄黄(二钱)、当归(一钱),以上药物研成细末,混合均匀,用甘草四两煮成的膏液作为粘合剂制成丸药,大小如龙眼核,外层包裹辰砂粉,中午在阳光下晒干,装入瓷瓶中,紧紧密封,防止药气散失。临服用薄荷汤化开一丸服用。
Whenever pharyngeal obstruction (sore throat with swelling and blockage) persists for a long time, and frequent administration of clearing-heat and descending drugs leads to phlegm-saliva accumulating and blocking the throat, resulting in a hoarse voice resembling the sound of drawing a saw, this is a sign of impending exhaustion of Lung Qi. Such cases are difficult to treat. It is advisable to use Ren Shen Gao (Ginseng Paste) taken liberally with Ju Hong Tang (Tangerine Peel Decoction). If Ren Shen Gao is unavailable, Du Shen Tang (Single Ginseng Decoction) added with Ju Hong (Tangerine Peel) may also be used. For every qian (approx. 3.7g) of Ren Shen (Radix Ginseng), use one fen (approx. 0.37g) of Ju Hong. Administered in the morning, it can save two or three out of ten patients; if administered late, rescue is impossible. Alternatively, Si Jun Zi Tang (Four Gentlemen Decoction) is also effective.
In women, irregular menstruation and stagnation of blood and qi in the meridians can also cause throat swelling. Si Wu Tang (Four Substances Decoction) added with Niu Xi (Radix Achyranthis Bidentatae) and Chong Wei Cao (Herba Leonuri) is suitable.
There is also a condition known as Plum-pit Qi (a sensation of a foreign body in the throat that cannot be swallowed or expectorated), which presents similarly in both men and women. Gan Jie Tang (Licorice and Platycodon Decoction) added with Su Geng (Stem Perillae), Ju Hong (Tangerine Peel), Xiang Fu (Rhizoma Cyperi), and Jin Fei Cao (Herba Bellidionis) should be used, and gradual recovery can be expected.
Generally, when treating diseases of the throat, mouth, and tongue, the initial stage requires dispersing wind and detoxifying, followed by nourishing Kidney Water and nourishing Yin. If Yuan Qi (Original Qi) gradually becomes deficient, urgent attention must be paid to protecting the Spleen and Stomach. Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) is used to nourish Kidney Water, and Si Jun Zi Tang (Four Gentlemen Decoction) is used to tonify Spleen Qi; both are essential medicines. Otherwise, if Zhen Qi (True Qi) is depleted and ruined, the situation will be difficult to reverse. Practitioners must exercise caution.
Zhi Gan Cao (Honey-fried Radix Glycyrrhizae, 3 qian), Jie Geng (Radix Platycodonis), Jing Jie (Herba Schizonepetae), Chao Niu Bang Zi (Fried Fructus Arctii, each 1.5 qian), Bo He (Herba Menthae, 3 fen). Decoct in water and take orally. If internal heat is severe, or food is vomited immediately upon entering the mouth, add Huang Lian (Radix Coptidis, 1 qian). If there is thirst, dry lips, dry tongue, constipation, and dark urine, further add Huang Bai (Cortex Phellodendri), Huang Qin (Radix Scutellariae), Shan Zhi (Fructus Gardeniae), and Huang Lian (Radix Coptidis). If there is swelling, add Jin Yin Hua (Flos Lonicerae, 5 qian).
Ban Xia Gui Gan Tang (See treatment of sore throat in Shang Han Lun).
Li Zhong Tang (Regulate the Middle Decoction), Si Ni Tang (Reverse the Extremities Decoction) (See treatment of Cold Damage).
Ming Xiong Huang (Water-triturated Realgar, 1 liang), Yu Jin (Radix Curcumae Longae, 1 liang), Ba Dou (Semen Crotonis, 35 grains). Grind together into fine powder, mix with vinegar to form pills the size of soybeans. Take 5–7 pills per dose, washed down with clear tea. The patient will awaken immediately after vomiting up phlegm-saliva. If no vomiting occurs, administer another dose. If the patient is unconscious but the chest remains warm, urgently grind into powder and force-feed.
Niu Dan Nan Xing (Nine-processed Arisaema cum Bile, 1 liang), She Xiang (Moschus, 5 fen), Zhen Zhu (Pearl, 5 fen), Bing Pian (Borneol, 5 fen), Huang Lian (Radix Coptidis, 2 qian), Fang Feng (Radix Saposhnikoviae, 1 qian), Jing Jie (Herba Schizonepetae, 2 qian), Wu Bei Zi (Galla Chinensis, 1 qian), Jie Geng (Radix Platycodonis, 1 qian), Yuan Shen (Radix Scrophulariae, 3 qian), Fu Shen (Poria with Hostwood, 1 qian), Tian Zhu Huang (Calculus Bambusae, 2 qian), Ming Xiong Huang (Realgar, 2 qian), Dang Gui (Radix Angelicae Sinensis, 1 qian). Grind all ingredients into fine powder and mix evenly. Use 4 liang of Gan Cao (Radix Glycyrrhizae) boiled into paste as a binder to form pills the size of longan seeds. Coat with Chen Sha (Cinnabar). Dry in the sun at noon. Store in a porcelain jar, tightly sealed to prevent loss of potency. Before taking, dissolve one pill in Bo He Tang (Mint Decoction).