论
《内经》曰∶一阴一阳结，谓之喉痹。王注谓一阴即厥阴，肝与胞络是也。一阳即少阳，胆与三焦是也。
四经皆有相火存焉。子和曰∶胆与三焦寻火，治肝和胞络都无异。东垣曰∶火与元气不两立，一胜则一负。盖元气一虚，
则相火随起，而喉痹等暴病作矣。夫喉之为会厌者，经谓之吸门是也。以其司呼吸，主升降，为人身紧关之 门户也。
若夫卒然肿痛，水浆不入，言语不通，死在须臾，诚可惊骇。其会厌之两傍肿者，俗谓之双乳蛾，易治；会厌之一边肿
者，俗谓之单乳蛾，难治。古方通谓之喉痹，皆相火之所冲逆耳。经曰∶一水不能胜二火。又曰∶一水不能胜五火。甚
言其真水之易亏，而相火之易动也。如大怒则火起于肝，房劳则火起于肾，饮食失节则火起于脾胃之类。是故知火者痰
之本，痰者火之标，火性急速，故病发则暴悍。治之之法，必先大涌其痰，或以铍针刺其肿处，此急则治标之法也。用
药者，必须以内经从治之法，而以桔梗、甘草、玄参、升麻、防风、羌活、荆芥、人参、白术、茯苓之类，少加干姜、
附子等药为向导，徐徐频与，不可顿服，此为治之大法也。切不可骤服寒凉之药，非徒无益，而且促其死耳。俗人未谙
此理，而峻用芩、连、栀、柏之类而正治之，又甚者杂进以大寒草药，频与顿服，但觉肿势稍退，语言略通，而医者病
者皆谓获效而喜。殊不知上热未除，中寒复生，其毒瓦斯乘虚而入腹，渐而至于发喘不休，不可治矣，良可叹哉！外有天
行一种，名曰大头病，俗呼捏颈瘟，其证甚为凶恶，染此者十死八、九，宜推运气治之，治法亦不甚相远也，东垣普济
消毒饮子甚妙，实为百发百中之剂，学人再宜详究而扩充之，务活人于斯世也，幸甚。
脉法
两寸脉浮洪而溢者，喉痹也。脉微而伏者死。
方法
丹溪曰∶喉痹多属痰，重者宜用吐法，或只以桐油灯油脚，用鹅翎探吐之。病轻者，新取园中李实根噙之，更研水
于项上敷之。
卢氏曰∶按本草∶蠡实根即马蔺草根也，能治喉痹，北方多有之。此又曰园中李实根，未知孰是。
缠喉风，属痰热，亦宜吐之。
又方 用远志去心为末，水调敷项上。
又方 用灯心草烧灰，吹入喉中。
一方 治咽喉肿痛。
荆芥穗 当归身 桔梗 甘草（各等分）
上细切，水煎放温，嗽而服之。有热加黄芩、枳壳。宜刺少商出血，立愈。
又方 治喉干燥痛，用四物汤加桔梗、荆芥、黄柏、知母，立已。
又方 治喉疮并痛者，多属虚火游行无制，用人参、黄柏（蜜炙）、荆芥。虚火，用人参、竹沥。血虚，用四物
汤加竹沥。
又方 用黄撩郎根（俗名倒摘刺），入好酒少许研汁，滴入喉中愈。
又方 以灯笼草炒焦为末，酒调敷喉中。
泻实热火，用黄连、荆芥、薄荷、硝石为末，姜汁蜜调噙化。
喉舌之疾，皆属火热，虽有数种之名，轻重之异，乃火之微甚故也。微而轻者，可以缓治；甚而急者，惟用砭针刺
血，最为上策。
（以上丹溪方法凡十一条）
通关饮（东垣） 治喉痹肿痛不能语言者，但可进药，无不愈者，此从治之法也。一方，有鼠粘子，无白术、
茯苓、干姜、附子，名利膈汤，治一切咽喉生疮肿痛。
人参 白术 茯苓（各一钱） 炙甘草（一钱五分） 桔梗（去芦，二钱） 防风（去芦，七分） 荆芥（五分） 薄
荷（五分） 干姜（炮，五分） 或加附子（炮，五分）
上细切，作一服，水二盏，煎七分，徐徐与之。
又方（东垣） 治喉痹。
用鸭嘴胆矾三分或五分，吹入喉中，吐痰愈。
普济消毒饮子（东垣） 治天行喉痛等证。（方见瘟疫门。）
桔梗汤（东垣） 治咽喉微觉肿痛，声破难语。
当归身 马勃（各一钱） 白僵蚕（炒） 黄芩（各三分） 麻黄（去节，五分） 桔梗（去芦） 甘草（炙，各
一钱） 桂枝（少许）
上细切，作一服，水二盏，煎至一盏，去渣温服。
又治喉痹方 新取青艾叶杵汁，灌入喉中即愈。
又方 用蛇床子于有嘴瓶中烧，令病者以瓶嘴含口中，吸烟入喉内，立愈。
吹喉散 治咽喉一切肿痛。
胆矾（五钱，别用青鱼胆一个，以矾研细入胆内，阴干） 巴豆（七粒，去壳） 朴硝（二钱五分，另研） 铜青
（一钱） 轻粉（五分） 青黛（些少，另研）
上将胆矾同巴豆肉于铜铫内飞过，去巴豆，合朴硝以下四味，再加麝香少许研匀，每用一字，吹入喉中，吐出痰血，
立愈。
圣烟筒 治喉痹。
蓖麻子取肉捶碎，纸卷作筒，烧烟吸之。
（祖传方）
治喉痹神效。
马兰菊 五爪龙草 车前草（各一握，俗名虾蟆衣）
上以三物杵汁，徐徐饮之。
又方 治喉痹及喉中热痛等证。
用上好消梨杵汁，频频饮之。如患者能自嚼咽下，亦可。多食为良，大解热毒。惟金疮产妇及诸脱血证不可食，以
其破血故也。其余一应痈疽发背等证，多食极妙。
论
《黄帝内经》说：一阴和一阳之气郁结，称为喉痹。王冰注释认为，一阴指的是厥阴经，对应肝脏和心包络。一阳指的是少阳经，对应胆和三焦。这四条经脉中都有相火存在。张子和说：治疗胆与三焦之火，以及肝与心包络之火，方法没有不同。李东垣说：火与元气不能两立，一方强盛则另一方衰弱。大概元气一旦虚弱，相火就会随之亢盛，导致喉痹等急性疾病发作。咽喉中的会厌部位，经络称之为“吸门”。因为它主管呼吸，主持气机升降，是人体生命活动的重要门户。
如果突然发生肿痛，连水浆都无法咽下，言语不能通畅，短时间内就有生命危险，确实令人惊恐骇怕。如果会厌两侧肿胀，俗称“双乳蛾”，容易治疗；会厌一侧肿胀，俗称“单乳蛾”，难以治疗。古方通称这类病为喉痹，都是相火上冲逆乱所致。经文说：一点真水不能胜过二火。又说：一点真水不能胜过五火。这是极力强调真阴（肾水）容易亏损，而相火容易妄动的道理。例如大怒则火起于肝，房事过度则火起于肾，饮食不节制则火起于脾胃等等。因此知道，火是痰的根本，痰是火的表象，火性急迫迅速，所以发病时猛烈凶悍。治疗的方法，必须先大量涌吐其痰，或者用铍针刺破肿胀处，这是紧急情况下治标的办法。用药方面，必须遵循《内经》从治（反佐）的原则，使用桔梗、甘草、玄参、升麻、防风、羌活、荆芥、人参、白术、茯苓等药物，少量加入干姜、附子等药作为向导，慢慢频繁服用，不可一次性顿服，这是治疗的根本大法。切不可突然服用寒凉药物，这不仅无益，反而加速死亡。世俗之人不懂这个道理，却峻烈地使用黄芩、黄连、栀子、黄柏等药物进行正治（清热泻火），更严重的甚至混杂使用大寒的草药，频繁且一次性顿服，只觉得肿胀稍微消退，语言略微通畅，医生和患者都以为见效而高兴。殊不知上部的热邪未除，中焦的寒邪又生，毒气乘虚进入腹部，逐渐发展到气喘不停，就无法治愈了，实在令人叹息！此外有一种流行性疾病，名为大头病，俗称捏颈瘟，病情非常凶险，染上此病的人十有八九死亡，应当推演运气学说进行治疗，治疗方法也与上述情况不太远。李东垣的普济消毒饮子非常妙，确实是百发百中的良方，学习者应当详细研究并加以扩充，务必在世间救人，那是很大的幸事。
脉法
方法
朱丹溪说：喉痹多属于痰证，重症适宜用催吐法，或者只用桐油灯芯底部的油，用鹅毛管探喉催吐。病情轻的，新鲜采摘园中李子树的根含在口中，再研磨成水涂抹在颈部。
卢氏说：查阅本草，蠡实根就是马蔺草根，能治疗喉痹，北方很多。这里又说园中李子树根，不知道哪个是正确的。
另一个方子：用远志去掉心后研成粉末，用水调匀敷在颈部。
一个方子：治疗咽喉肿痛。
荆芥穗、当归身、桔梗、甘草（各等分）。
以上切碎，用水煎煮放温，漱口后服用。有热象加黄芩、枳壳。适宜刺破少商穴出血，立刻痊愈。
又一个方子：治疗喉咙干燥疼痛，用四物汤加桔梗、荆芥、黄柏、知母，立刻好转。
又一个方子：治疗喉疮并伴有疼痛的，多属于虚火游走无制，用人参、黄柏（蜜炙）、荆芥。如果是虚火，用人参、竹沥。如果是血虚，用四物汤加竹沥。
又一个方子：用黄撩郎根（俗名倒摘刺），加入少许好酒研磨取汁，滴入喉中即愈。
又一个方子：将灯笼草炒焦研成粉末，用酒调匀敷在喉中。
泻实热火，用黄连、荆芥、薄荷、硝石研成粉末，用姜汁和蜂蜜调匀含化。
喉舌的疾病，都属于火热，虽然有几种名称，轻重不同，不过是火势微弱或强烈的缘故。微弱而轻的，可以缓慢治疗；强烈而急重的，只有用砭针刺血，才是最好的策略。
（以上是丹溪的方法共十一条）
通关饮（李东垣）：治疗喉痹肿痛不能说话的，只要还能进药，没有不愈的，这是从治的方法。另一个方子，有鼠粘子（牛蒡子），没有白术、茯苓、干姜、附子，名叫利膈汤，治疗一切咽喉生疮肿痛。
人参、白术、茯苓（各一钱），炙甘草（一钱五分），桔梗（去芦头，二钱），防风（去芦头，七分），荆芥（五分），薄荷（五分），干姜（炮制，五分），或者加附子（炮制，五分）。
以上切碎，作一剂服用，水两盏，煎至七分，慢慢喂服。
又一个方子（李东垣）：治疗喉痹。
用鸭嘴胆矾三分或五分，吹入喉中，吐出痰液即愈。
普济消毒饮子（李东垣）：治疗天行喉痛等症状。（方剂见瘟疫门。）
桔梗汤（李东垣）：治疗咽喉微微感觉肿痛，声音嘶哑难语。
当归身、马勃（各一钱），白僵蚕（炒），黄芩（各三分），麻黄（去节，五分），桔梗（去芦头），甘草（炙，各一钱），桂枝（少许）。
以上切碎，作一剂服用，水两盏，煎至一盏，去渣温服。
又一个治疗喉痹的方子：新鲜采摘青艾叶捣碎取汁，灌入喉中即愈。
又一个方子：用蛇床子在带嘴的瓶中燃烧，让病人含着瓶嘴，将烟雾吸入喉内，立刻痊愈。
吹喉散：治疗咽喉一切肿痛。
胆矾（五钱，另外取一个青鱼胆，将胆矾研细放入胆内，阴干），巴豆（七粒，去壳），朴硝（二钱五分，另研），铜青（一钱），轻粉（五分），青黛（少许，另研）。
先将胆矾同巴豆肉在铜锅中飞过，去掉巴豆，合入朴硝及以下四种药，再加少许麝香研匀，每次用一字量，吹入喉中，吐出痰血，立刻痊愈。
圣烟筒：治疗喉痹。
取蓖麻子仁捶碎，用纸卷成筒状，燃烧烟雾吸入。
（祖传方）
治疗喉痹神效。
马兰菊、五爪龙草、车前草（各一把，俗名虾蟆衣）。
以上三种药物捣碎取汁，慢慢饮用。
又一个方子：治疗喉痹及喉中热痛等症状。
用好消梨捣碎取汁，频频饮用。如果患者能自己咀嚼咽下也可以。多吃为好，能大大解除热毒。只有金创、产妇以及各种失血证不可食用，因为它破血的缘故。其余各种痈疽发背等证，多吃极好。
Treatise
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "When one Yin and one Yang become knotted, it is called Hou Bi (throat obstruction)." Wang Bing's commentary explains that "one Yin" refers to the Jueyin (Jueyin Meridian), corresponding to the Liver and Pericardium. "One Yang" refers to the Shaoyang (Shaoyang Meridian), corresponding to the Gallbladder and Sanjiao (Triple Burner). These four meridians all contain Xianghuo (Ministerial Fire). Zhang Zihe stated: "Treating fire in the Gallbladder and Sanjiao, as well as in the Liver and Pericardium, involves no difference." Li Dongyuan stated: "Fire and Yuanqi (Original Qi) cannot coexist; when one prevails, the other declines." Generally, when Yuanqi becomes deficient, Xianghuo (Ministerial Fire) rises accordingly, causing acute diseases such as Hou Bi (throat obstruction) to erupt. The epiglottis in the throat is referred to in the classics as Xi Men (Gate of Inhalation). Because it governs respiration and directs the ascending and descending of Qi, it serves as a critical gateway for human life.
If swelling and pain occur suddenly, preventing the intake of water or food, and speech is impaired, death may ensue within moments, which is indeed terrifying. If both sides of the epiglottis are swollen, commonly known as Shuang Ru E (Double Tonsillar Swelling), it is easy to treat; if only one side is swollen, commonly known as Dan Ru E (Single Tonsillar Swelling), it is difficult to treat. Ancient formulas generally refer to these conditions as Hou Bi (throat obstruction), caused by the counterflow of Xianghuo (Ministerial Fire). The classics state: "A single unit of Water cannot overcome two Fires." And again: "A single unit of Water cannot overcome five Fires." This emphasizes how easily Zhen Shui (True Kidney Water/Yin) can be depleted and how easily Xianghuo (Ministerial Fire) can become agitated. For instance, great anger causes fire to arise from the Liver; sexual exhaustion causes fire to arise from the Kidneys; irregular diet causes fire to arise from the Spleen and Stomach, etc. Therefore, it is understood that Fire is the root of Phlegm, and Phlegm is the branch manifestation of Fire. Since Fire nature is rapid and swift, the disease onset is violent and fierce. The treatment method must first induce copious expectoration of Phlegm, or use a Pi needle (a type of surgical knife/needle) to prick the swollen area. This is the method of treating the branch in emergencies. When using herbs, one must follow the principle of Congzhi (following/treating according to the nature, often implying paradoxical treatment or adding warming agents to cold herbs) from the *Neijing*, using herbs such as Jiegeng (Platycodon Root), Gancao (Licorice Root), Xuanshen (Scrophularia Root), Shengma (Cimicifuga Rhizome), Fangfeng (Saposhnikovia Root), Qianghuo (Notopterygium Rhizome), Jingjie (Schizonepeta Spike), Renshen (Ginseng Root), Baizhu (Atractylodes Rhizome), and Fuling (Poria), with small amounts of Ganjiang (Dried Ginger) and Fuzi (Prepared Aconite Root) added as guides. These should be administered slowly and frequently, not in a single large dose. This is the fundamental method of treatment. One must absolutely avoid suddenly administering cold-natured drugs, as this will not only be ineffective but also hasten death. Laypeople, unfamiliar with this principle, harshly employ drugs like Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), Zhizi (Gardenia Fruit), and Huangbai (Phellodendron Bark) for direct treatment (clearing heat). Worse still, they mix in strongly cold herbal medicines and administer them frequently and in large doses. They feel that although the swelling subsides slightly and speech improves somewhat, both doctor and patient rejoice at the apparent efficacy. Little do they know that the heat above remains unremoved, while cold arises in the middle jiao. The pathogenic toxin enters the abdomen through the deficiency, gradually leading to incessant asthma, which becomes incurable. This is truly lamentable! Additionally, there is a type of epidemic disease called Datou Bing (Big Head Disease), commonly called Niejing Wen (Neck-Pinch Plague). Its symptoms are extremely malignant; eight or nine out of ten who contract it die. It should be treated by analyzing the Six Qi movements (Yunqi theory). The treatment methods are not very different from those described above. Li Dongyuan's Puji Xiaodu Yinzi (Universal Benefit Decoction to Eliminate Toxins) is excellent and truly a formula that never misses. Students should study it in detail and expand upon it, striving to save lives in this world, which would be a great fortune.
Pulse Diagnosis
If the pulses at both Cun (Inch) positions are floating, surging, and overflowing, it indicates Hou Bi (throat obstruction). If the pulse is minute and hidden/deep, it indicates death.
Methods
Zhu Danxi stated: "Hou Bi (throat obstruction) mostly belongs to Phlegm. In severe cases, emesis (vomiting) therapy is appropriate. Alternatively, one can use the oil residue from a tung oil lamp wick, inserting it into the throat with a goose feather to induce vomiting. For mild cases, freshly gathered roots of garden plum trees can be held in the mouth, and the juice ground and applied to the neck."
Mr. Lu stated: "According to the Materia Medica, Lishi Gen (root of *Iris lactea*) is the same as Malin Gen (root of *Iris lactea*), which can treat Hou Bi (throat obstruction) and is common in the north. Here it mentions garden plum roots; it is unknown which is correct."
Chan Feng (Coiling Throat Wind) belongs to Phlegm-Heat and is also suitable for emesis therapy.
Another prescription: Use Yuanzhi (Polygala Root), remove the heart, grind into powder, mix with water, and apply to the neck.
Another prescription: Burn Dengxincao (Juncus Effusus Stem) to ash, and blow it into the throat.
One prescription for treating sore throat and swelling:
Jingjie Sui (Schizonepeta Spike), Danggui Shen (Angelica Sinensis Root Base), Jiegeng (Platycodon Root), Gancao (Licorice Root) (equal parts).
Finely cut, decoct in water, let cool to warm, gargle and swallow. Add Huangqin (Scutellaria Root) and Zhike (Bitter Orange) if there is heat. Pricking Shaoshang (LU11) to bleed brings immediate cure.
Another prescription for treating dry and painful throat: Use Siwu Tang (Four Substances Decoction) plus Jiegeng (Platycodon Root), Jingjie (Schizonepeta Spike), Huangbai (Phellodendron Bark), and Zhimu (Anemarrhena Rhizome). Immediate relief occurs.
Another prescription for treating throat ulcers with pain: Mostly due to Deficient Fire wandering without restraint. Use Renshen (Ginseng Root), Huangbai (Phellodendron Bark) (honey-fried), and Jingjie (Schizonepeta Spike). For Deficient Fire, use Renshen (Ginseng Root) and Zhuli (Bamboo Sap). For Blood Deficiency, use Siwu Tang (Four Substances Decoction) plus Zhuli (Bamboo Sap).
Another prescription: Use Huang Liaolang Gen (root of *Rubus parvifolius*, commonly called Dao Zhai Ci) with a little good wine, grind to extract juice, and drip into the throat for cure.
Another prescription: Stir-fry Denglong Cao (Lantern Grass) until charred, grind into powder, mix with wine, and apply to the throat.
To drain Excess Heat and Fire: Use Huanglian (Coptis Rhizome), Jingjie (Schizonepeta Spike), Bohe (Mint), and Xiaoshi (Saltpeter) ground into powder. Mix with ginger juice and honey, hold in mouth to dissolve.
Diseases of the throat and tongue all belong to Heat and Fire. Although there are several names and differences in severity, this is merely due to the slightness or intensity of the Fire. Slight and mild cases can be treated slowly; intense and urgent cases require only bloodletting with Bian needles (stone/surgical knives), which is the supreme strategy.
(Above are eleven methods from Danxi.)
Tongguan Yin (Li Dongyuan): Treats Hou Bi (throat obstruction) with swelling, pain, and inability to speak. As long as medication can be taken, cure is certain. This is the method of Congzhi (following treatment). Another version contains Niubangzi (Arctii Fructus) but lacks Baizhu (Atractylodes Rhizome), Fuling (Poria), Ganjiang (Dried Ginger), and Fuzi (Prepared Aconite Root). It is named Lige Tang (Diaphragm-Opening Decoction) and treats all sores and swelling/pain in the throat.
Renshen (Ginseng Root), Baizhu (Atractylodes Rhizome), Fuling (Poria) (each 1 qian), Zhi Gancao (Honey-fried Licorice Root) (1.5 qian), Jiegeng (Platycodon Root, remove radicle) (2 qian), Fangfeng (Saposhnikovia Root, remove radicle) (0.7 qian), Jingjie (Schizonepeta Spike) (0.5 qian), Bohe (Mint) (0.5 qian), Ganjiang (Dried Ginger, processed) (0.5 qian), or add Fuzi (Prepared Aconite Root, processed) (0.5 qian).
Finely cut, prepare as one dose. With two cups of water, decoct to 0.7 cup, administer slowly.
Another prescription (Li Dongyuan): Treats Hou Bi (throat obstruction).
Use Yazui Danfan (Duck-bill Alum) 3 or 5 fen, blow into the throat. Vomiting phlegm leads to cure.
Puji Xiaodu Yinzi (Li Dongyuan): Treats epidemic sore throat and other symptoms. (Formula see Plague Section.)
Jiegeng Tang (Li Dongyuan): Treats slight swelling and pain in the throat, hoarseness, and difficulty speaking.
Danggui Shen (Angelica Sinensis Root Base), Mabo (Polyporus Umbellatus) (each 1 qian), Bai Jiangcan (Silkworm, stir-fried), Huangqin (Scutellaria Root) (each 0.3 qian), Mahuang (Ephedra Stem, remove joints) (0.5 qian), Jiegeng (Platycodon Root, remove radicle), Gancao (Licorice Root, honey-fried) (each 1 qian), Guizhi (Cinnamon Twig) (a little).
Finely cut, prepare as one dose. With two cups of water, decoct to one cup, remove dregs, and take warm.
Another prescription for treating Hou Bi (throat obstruction): Freshly gather Qing Ai Ye (Green Mugwort Leaf), pound to extract juice, and pour into the throat for immediate cure.
Another prescription: Place Shechuangzi (Cnidium Fruit) in a bottle with a spout, burn it, and have the patient hold the spout in their mouth to inhale the smoke into the throat for immediate cure.
Chui Hou San (Throat-Blowing Powder): Treats all swelling and pain in the throat.
Danfan (Alum) (5 qian, separately take one Green Fish Gallbladder, grind alum finely into the gallbladder, dry in shade), Badou (Croton Seed) (7 grains, remove shell), Puxiao (Mirabilite) (2.5 qian, grind separately), Tongqing (Verdigris) (1 qian), Qingfen (Calomel) (0.5 qian), Qingdai (Indigo Naturalis) (a little, grind separately).
First, fly Danfan (Alum) together with Badou (Croton Seed) meat in a copper pot, remove Badou (Croton Seed). Combine with Puxiao (Mirabilite) and the following four ingredients. Add a little Shexiang (Musk) and grind uniformly. Use one zi amount each time, blow into the throat. Vomiting phlegm and blood brings immediate cure.
Sheng Yan Tong (Holy Smoke Tube): Treats Hou Bi (throat obstruction).
Take Bimazi (Castor Bean) meat, crush it, roll in paper to make a tube, burn, and inhale the smoke.
(Ancestral Prescription)
Godly efficacy for treating Hou Bi (throat obstruction).
Malanju (Kalimeris Indica), Wuzhao Long Cao (Polygonum Multiflorum Vine?), Cheqian Cao (Plantago Seed Herb) (each one handful, commonly called Hamayi).
Pound the three substances to extract juice, drink slowly.
Another prescription for treating Hou Bi (throat obstruction) and heat-pain in the throat:
Use high-quality Xiao Li (Pear), pound to extract juice, drink frequently. If the patient can chew and swallow it themselves, that is also fine. Eating more is beneficial, greatly resolving heat toxins. However, those with metal wounds, postpartum women, and various hemorrhagic syndromes must not eat it, because it breaks blood. For other carbuncles, sores, and back infections, eating more is extremely good.