[总诀]最重咽喉出纳关,那禁邪气壅其间。清心开肺还平胃,惟望医师妙转旋。
咽喉红肿,其色多带痰粘者,风火之壅塞也。宜加味甘桔汤。
山豆根(一钱) 连翘(一钱) 炒栀(一钱) 甘草(一钱) 杏仁(三钱) 荆芥(一钱) 薄荷(五
分) 桔便(二钱) 枳壳(八分) 花粉(二钱) 枯芩(二钱) 贝母(三钱) 旋复(二钱) 射干(二钱)
歌曰∶咽喉红肿豆翘栀,甘杏荆荷枳桔宜。
花粉枯芩清火用,射旋贝母涤痰施。
(伯未按∶蜀刻本无花粉、旋复。)
(又按∶若大便燥结者,当用凉膈散三钱入煎。)
咽喉白烂,其声嘶小不出者,火热乘肺金也。宜滋肺百合汤。
百合(一钱) 知母(一钱) 天冬(二钱) 麦冬(三钱) 花粉(二钱) 杏仁(三钱) 银花(一
钱) 生地(三钱) 紫菀(一钱) 甘草(一钱) 桑叶(一钱) 五倍子(一钱)
歌曰∶咽喉白烂总宜滋,杏草银桑合倍医。
知母二冬和紫菀,地黄花粉咽徐徐。
(伯未按∶须防白喉,切勿大意。)
咽中疼痛,生黄起泡起点者,湿热之结气也。宜清散薄荷汤。
薄荷(五分) 荆芥(一钱) 柴胡(一钱) 知母(三钱) 黄芩(三钱) 槟榔(一钱) 草果(一
钱) 羌活(五分) 枳壳(一钱) 连翘(一钱) 射干(二钱) 杏仁(三钱) 僵蚕(三钱) 蝉蜕(五个)
歌曰∶咽疼起泡薄柴荆,羌枳翘干芩母清。
草果槟榔除湿积,僵蚕蝉杏热俱平。
咽中生蛾,壅塞关隘不通者,心经火上逆也。宜加减导赤散。
生地(三钱) 知母(二钱) 枳壳(一钱) 甘草(一钱) 薄荷(七分) 羌活(七分) 木通(一
钱) 竹叶(三钱) 灵仙(一钱) 皂刺(三钱) 黄连(三钱) 酒军(一钱) 山甲(炒,二片) 牛
蒡子(三钱)
歌曰∶灵仙皂刺破喉蛾,山甲知连及薄荷。
牛蒡军甘羌地枳,木通竹叶与调和。
(伯未按∶乳蛾症于结喉两旁,按之有核,可购贴喉异功散,置太乙膏上,贴之半日,即起泡,用针刺破
,易红膏药贴之。)
凡红喉证,无论痈蛾肿起者,总属血分热也。宜 点胆矾丸。
胆矾(三分) 熊胆(一钱) 皂刺(一钱) 硼砂(一钱) 火硝(一钱) 麝香(一分) 蜣螂(二
枚) 大黄(五分) 郁金(一钱) 牛黄(一分)
为末,蜜丸,点 喉间,有痰则吐去。
歌曰∶胆矾熊胆点红喉,皂刺蜣螂一例收。
硼麝二黄硝合研,郁金加入症全瘳。
(伯未按∶可另购玄参三钱泡,代茶饮。)
凡白喉证,无论癣烂疳蚀者,总属气分热也。宜吹 珠黄散。
珍珠(一钱) 牛黄(三分) 麝香(一分) 明雄(一钱) 硼砂(一钱) 甘草(一钱)
歌曰∶雄麝珠黄点白喉,硼砂甘草一分求。
须知白烂关虚热,不与红喉一例投。
[总诀] 咽喉是人体呼吸与饮食出入的关键关口,最需重视,怎能容忍邪气在此壅塞阻滞。治疗时需清心火、开肺气并调和胃气,全凭医师巧妙灵活地运用转旋之法。
咽喉红肿,其颜色多伴有痰液粘稠的,是风火邪气壅塞所致。适宜使用加味甘桔汤。
山豆根(一钱) 连翘(一钱) 炒栀子(一钱) 甘草(一钱) 杏仁(三钱) 荆芥(一钱) 薄荷(五分) 桔梗(二钱) 枳壳(八分) 天花粉(二钱) 枯黄芩(二钱) 贝母(三钱) 旋覆花(二钱) 射干(二钱)
歌诀说:咽喉红肿用山豆根、连翘、栀子,配合甘草、杏仁、荆芥、薄荷、枳壳、桔梗为宜。
天花粉、枯黄芩用于清除火热,旋覆花、贝母用于涤除痰浊。
(伯未按语:蜀刻本中没有天花粉、旋覆花。)
(又按语:如果大便干燥结滞的,应当用凉膈散三钱加入煎剂中。)
咽喉出现白色溃烂,声音嘶哑甚至发不出声的,是火热之邪乘袭肺金所致。适宜使用滋肺百合汤。
百合(一钱) 知母(一钱) 天冬(二钱) 麦冬(三钱) 天花粉(二钱) 杏仁(三钱) 金银花(一钱) 生地黄(三钱) 紫菀(一钱) 甘草(一钱) 桑叶(一钱) 五倍子(一钱)
歌诀说:咽喉白烂总宜滋阴,杏仁、甘草、金银花、桑叶、五倍子是医治良药。
知母、天冬、麦冬配合紫菀,生地黄、天花粉使咽喉舒缓徐徐好转。
(伯未按语:须防备白喉,切勿大意。)
咽部疼痛,生出黄色水泡且隆起的,是湿热之气凝结所致。适宜使用清散薄荷汤。
薄荷(五分) 荆芥(一钱) 柴胡(一钱) 知母(三钱) 黄芩(三钱) 槟榔(一钱) 草果(一钱) 羌活(五分) 枳壳(一钱) 连翘(一钱) 射干(二钱) 杏仁(三钱) 僵蚕(三钱) 蝉蜕(五个)
歌诀说:咽痛起泡用薄荷、柴胡、荆芥,羌活、枳壳、连翘、射干、黄芩、知母清热。
草果、槟榔去除湿邪积滞,僵蚕、蝉蜕、杏仁使热邪平复。
咽喉中生“蛾”(指扁桃体肿大如蚕蛾),壅塞关隘导致不通的,是心经火气上逆所致。适宜使用加减导赤散。
生地黄(三钱) 知母(二钱) 枳壳(一钱) 甘草(一钱) 薄荷(七分) 羌活(七分) 木通(一钱) 竹叶(三钱) 威灵仙(一钱) 皂角刺(三钱) 黄连(三钱) 酒大黄(一钱) 穿山甲(炒,二片) 牛蒡子(三钱)
歌诀说:威灵仙、皂角刺破除喉蛾,穿山甲、知母、黄连及薄荷同用。
牛蒡子、大黄、甘草、羌活、生地、枳壳,配合木通、竹叶以调和诸药。
(伯未按语:乳蛾症在结喉两旁,按压有硬核,可购买贴喉异功散,置于太乙膏上,贴在患处半天,即起泡,用针刺破,更换红膏药贴上。)
凡是红喉证,无论是否有痈肿或蛾状突起,总属于血分有热。适宜使用点胆矾丸。
胆矾(三分) 熊胆(一钱) 皂角刺(一钱) 硼砂(一钱) 火硝(一钱) 麝香(一分) 蜣螂(二枚) 大黄(五分) 郁金(一钱) 牛黄(一分)
研为细末,用蜂蜜制成丸药,点涂于喉间,若有痰则吐出。
歌诀说:胆矾、熊胆点治红喉,皂角刺、蜣螂一并收效。
硼砂、麝香、二黄(牛黄、雄黄)、火硝合研,加入郁金则病症全愈。
(伯未按语:可另外购买玄参三钱泡水,代茶饮用。)
凡是白喉证,无论是否有癣状溃烂或疳蚀现象,总属于气分有热。适宜使用吹珠黄散。
珍珠(一钱) 牛黄(三分) 麝香(一分) 明雄黄(一钱) 硼砂(一钱) 甘草(一钱)
歌诀说:雄黄、麝香、珍珠、牛黄点治白喉,硼砂、甘草各取一分求效。
须知白烂是由于关元虚热所致,不能与红喉证同样投药治疗。
[General Principle] The throat is the critical gateway for respiration and ingestion, demanding utmost attention; how can one tolerate pathogenic factors obstructing this area? Treatment requires clearing Heart fire, opening Lung Qi, and harmonizing Stomach Qi, relying entirely on the physician's skillful and flexible manipulation.
When the throat is red and swollen, often accompanied by sticky phlegm, it indicates obstruction by Wind-Fire pathogenic factors. Jia Wei Gan Jie Tang (Additive Licorice and Platycodon Decoction) is indicated.
* *Shandougen* (1 qian) [Sophorae Tonkinensis Radix et Rhizoma]
* *Lianqiao* (1 qian) [Forsythiae Fructum]
* *Chao Zhi* (1 qian) [Stir-fried Gardeniae Fructum]
* *Gancao* (1 qian) [Glycyrrhizae Radix et Rhizoma]
* *Xingren* (3 qian) [Armeniacae Semen Amarum]
* *Jingjie* (1 qian) [Schizonepetae Herba]
* *Bohe* (5 fen) [Menthae Haplocalycis Herba]
* *Jiegeng* (2 qian) [Platycodonis Radix]
* *Zhiqiao* (8 fen) [Aurantii Fructus Immaturus]
* *Huafen* (2 qian) [Trichosanthis Radix]
* *Ku Qin* (2 qian) [Scutellariae Radix (dried)]
* *Beimu* (3 qian) [Fritillariae Bulbus]
* *Xuanfu* (2 qian) [Inulae Flower]
* *Shegan* (2 qian) [Belamcandae Rhizoma]
Verse: For red and swollen throat, use Shandougen, Lianqiao, and Zhizi; Gancao, Xingren, Jingjie, Bohe, Zhiqiao, and Jiegeng are suitable. Huafen and Ku Qin clear Fire, while Xuanfu and Beimu eliminate Phlegm.
*(Note by Bo: The Shu edition lacks Huafen and Xuanfu.)*
*(Further Note: If there is dry stool constipation, Liang Ge San (Cool the Diaphragm Powder), 3 qian, should be added to the decoction.)*
When the throat presents with white ulceration/rotting, hoarseness, or aphonia, it indicates Heat-Fire invading Metal (Lung). Zi Fei Baihe Tang (Nourish Lung Lily Decoction) is indicated.
* *Baihe* (1 qian) [Lilii Bulbus]
* *Zhimu* (1 qian) [Anemarrhenae Rhizoma]
* *Tiandong* (2 qian) [Asparagi Radix]
* *Maidong* (3 qian) [Ophiopogonis Radix]
* *Huafen* (2 qian) [Trichosanthis Radix]
* *Xingren* (3 qian) [Armeniacae Semen Amarum]
* *Yinhua* (1 qian) [Lonicerae Japonicae Flos]
* *Shengdi* (3 qian) [Rehmanniae Radix]
* *Ziwan* (1 qian) [Asternis Radix]
* *Gancao* (1 qian) [Glycyrrhizae Radix et Rhizoma]
* *Sangye* (1 qian) [Mori Folium]
* *Wubeizi* (1 qian) [Gallae Chinensis]
Verse: White rot in the throat generally requires nourishment; Xingren, Gancao, Yinhua, Sangye, and Wubeizi are medicinal allies. Zhimu, Tiandong, Maidong, combined with Ziwan, along with Shengdi and Huafen, soothe the throat gradually.
*(Note by Bo: Beware of Diphtheria; do not be careless.)*
Pain in the throat with the formation of yellow blisters or protrusions indicates condensation of Damp-Heat. Qing San Bohe Tang (Clear and Disperse Mint Decoction) is indicated.
* *Bohe* (5 fen) [Menthae Haplocalycis Herba]
* *Jingjie* (1 qian) [Schizonepetae Herba]
* *Chaihu* (1 qian) [Bupleuri Radix]
* *Zhimu* (3 qian) [Anemarrhenae Rhizoma]
* *Huangqin* (3 qian) [Scutellariae Radix]
* *Binglang* (1 qian) [Arecae Semen]
* *Caoguo* (1 qian) [Tsaoko Fructus]
* *Qianghuo* (5 fen) [Notopterygii Rhizoma et Radix]
* *Zhiqiao* (1 qian) [Aurantii Fructus Immaturus]
* *Lianqiao* (1 qian) [Forsythiae Fructum]
* *Shegan* (2 qian) [Belamcandae Rhizoma]
* *Xingren* (3 qian) [Armeniacae Semen Amarum]
* *Jiangcan* (3 qian) [Bombyx Batryticatus]
* *Chantui* (5 pieces) [Cicadae Periostracum]
Verse: Throat pain with blisters uses Bohe, Chaihu, and Jingjie; Qianghuo, Zhiqiao, Lianqiao, Shegan, Huangqin, and Zhimu clear heat. Caoguo and Binglang remove Dampness and accumulation; Jiangcan, Chantui, and Xingren calm all heat.
The appearance of "E" (tonsillar hypertrophy/enlargement resembling a silkworm moth) in the throat, causing obstruction and blockage, indicates counter-flow of Fire from the Heart Meridian. Jia Jian Dao Chi San (Modified Guide Out Red Powder) is indicated.
* *Shengdi* (3 qian) [Rehmanniae Radix]
* *Zhimu* (2 qian) [Anemarrhenae Rhizoma]
* *Zhiqiao* (1 qian) [Aurantii Fructus Immaturus]
* *Gancao* (1 qian) [Glycyrrhizae Radix et Rhizoma]
* *Bohe* (7 fen) [Menthae Haplocalycis Herba]
* *Qianghuo* (7 fen) [Notopterygii Rhizoma et Radix]
* *Mutong* (1 qian) [Akebiae Caulis]
* *Zhuye* (3 qian) [Bambusae Folium]
* *Lingxian* (1 qian) [Clematidis Radix et Rhizoma]
* *Zaoci* (3 qian) [Gleditsiae Spina]
* *Huanglian* (3 qian) [Coptidis Rhizoma]
* *Jiu Jun* (1 qian) [Rhei Radix et Rhizoma (wine-processed)]
* *Shanjia* (fried, 2 slices) [Manis Squama]
* *Niubangzi* (3 qian) [Arctii Fructus]
Verse: Lingxian and Zaoci break down throat E; Shanjia, Zhimu, Huanglian, and Bohe are used together. Niubangzi, Jun, Gancao, Qianghuo, Shengdi, and Zhiqiao, along with Mutong and Zhuye, harmonize.
*(Note by Bo: For tonsillitis (Ru E), where lumps are palpable on both sides of the Adam's apple, purchase Tie Hou Yi Gong San, apply it on Taiyi Gao plaster, leave for half a day until blisters form, prick them with a needle, and replace with Hong Gao plaster.)*
All cases of Red Throat syndrome, regardless of whether there are abscesses or tonsillar swelling, belong to Heat in the Blood level. Dian Danfan Wan (Point with Alum Pill) is indicated.
* *Danfan* (3 fen) [Alumen]
* *Xiongdan* (1 qian) [Ursi Fel]
* *Zaoci* (1 qian) [Gleditsiae Spina]
* *Pengsha* (1 qian) [Borax]
* *Huoxiao* (1 qian) [Natrii Nitras]
* *Shexiang* (1 fen) [Moschus]
* *Dianlang* (2 pieces) [Scarabaeus]
* *Dahuang* (5 fen) [Rhei Radix et Rhizoma]
* *Yujin* (1 qian) [Curcumae Radix]
* *Niuhuang* (1 fen) [Bovis Calculus]
Grind into powder, form pills with honey, and apply to the throat. Spit out if phlegm appears.
Verse: Danfan and Xiongdan treat Red Throat; Zaoci and Dianlang are equally effective. Pengsha, Shexiang, two Huangs (Niuhuang and Xionghuang), and Huoxiao are ground together; adding Yujin ensures complete recovery.
*(Note by Bo: Alternatively, purchase 3 qian of Xuanshen, soak in water, and drink as tea.)*
All cases of White Throat syndrome (Diphtheria), regardless of whether there are patchy ulcers or gangrenous erosion, belong to Heat in the Qi level. Chui Zhu Huang San (Blow Pearl-Yellow Powder) is indicated.
* *Zhenzhu* (1 qian) [Margarita]
* *Niuhuang* (3 fen) [Bovis Calculus]
* *Shexiang* (1 fen) [Moschus]
* *Ming Xiong* (1 qian) [Realgar]
* *Pengsha* (1 qian) [Borax]
* *Gancao* (1 qian) [Glycyrrhizae Radix et Rhizoma]
Verse: Xionghuang, Shexiang, Zhenzhu, and Niuhuang treat White Throat; Pengsha and Gancao are used in equal parts. Note that white rot stems from deficiency-heat at the gate; it must not be treated identically to Red Throat.