积热喉初起，多有夜半睡觉，咽津碍气，牙关强而不开，鼻气觉有些烧，痰涎壅粘，壮
热多，憎寒少。此症属心经三焦之火，生发顶，双单鹅亦宜。每日吹真喉末二三次，每次三
匙，出痰多效。内用泻心通圣散一剂，次用清膈凉血汤数剂。若泻心通圣散服后大泻，不用
多服。若无多泻，再进本药一剂，方可吹药。一日不宽，急用三棱针刺去鹅顶毒血，三五针。
吹喉药，点之毋得迟延。日久自溃烂变成牙疳，虽不至死，臭恶半年不愈。故当速治。又
恐延迟日久，兼胃虚之人，毒攻心胃，可谓快杀。此宜深察趋行，勿怠也。
泻心通圣散
黄连（一钱） 犀角（五分） 栀子（五分） 桔梗（八分） 甘草（三分） 枳壳（五分） 黄芩
（一钱） 升麻（四分） 葛根（五分） 生地（五分） 白芍（五分） 石膏（一钱五分） 大黄（生一
钱，熟二钱） 芒硝（一钱五分） 归尾（五分） 麻黄（五分） 生姜（一片）
水二碗，煎八分，空心服。令泻为度。若无泻，再进一服，后服清膈活血汤。（炳章按∶
此证多得心经实热与时气风火为症，升、葛、麻、姜、梗等温升，皆忌，宜加辛凉散风药为要。）
清膈活血汤
黄连（一钱） 麦冬（二钱） 连翘（一钱） 栀子（五分） 石膏（一钱） 桔梗（八分） 黄芩
（一钱） 甘草（三分） 归尾（五分） 升麻（三分）
水二碗，煎七分，温服。（炳章按∶升、桔宜换为桑叶、丹皮、紫花地丁草、鲜大青等更佳。）
积热喉（因体内积热导致的咽喉疾病）初起时，多有半夜醒来时感觉吞咽津液困难、气息受阻，牙关僵硬无法张开，呼吸鼻孔感觉发热，痰涎粘稠壅盛，高热明显而恶寒轻微。此症属于心经和三焦的火邪，向上生发至头顶，无论是单侧还是双侧的鹅口疮（或扁桃体化脓性炎症）都适宜使用。每天将真喉末吹入咽喉二到三次，每次三匙，若能排出大量痰涎则疗效显著。内服泻心通圣散一剂，随后服用清膈凉血汤数剂。如果服用泻心通圣散后出现严重腹泻，则不必继续多服。如果没有出现严重腹泻，再进服本药一剂，之后方可吹敷喉药。若一日之内症状未缓解，急需用三棱针刺破鹅口顶部放出毒血，刺三五针。吹喉药和点药不得延误。若拖延日久，自然溃烂并转变为牙疳（牙龈坏死性疾病），虽然不至于死亡，但恶臭难闻，半年不愈。因此应当迅速治疗。又担心拖延日久，对于胃气虚弱的人，毒邪攻犯心胃，可谓致死极快。对此应深入体察并迅速行动，不可懈怠。
泻心通圣散
黄连（一钱） 犀角（五分） 栀子（五分） 桔梗（八分） 甘草（三分） 枳壳（五分） 黄芩（一钱） 升麻（四分） 葛根（五分） 生地（五分） 白芍（五分） 石膏（一钱五分） 大黄（生用一钱，熟用二钱） 芒硝（一钱五分） 归尾（五分） 麻黄（五分） 生姜（一片）
用水两碗，煎至剩余八分，空腹服用。以出现腹泻为度。若无腹泻，再进服一剂，随后服用清膈活血汤。（炳章按：此证多由心经实热与时行风火引起，升麻、葛根、麻黄、生姜、桔梗等温性升提药物皆忌用，宜加入辛凉疏散风热的药物为要。）
清膈活血汤
黄连（一钱） 麦冬（二钱） 连翘（一钱） 栀子（五分） 石膏（一钱） 桔梗（八分） 黄芩（一钱） 甘草（三分） 归尾（五分） 升麻（三分）
用水两碗，煎至剩余七分，温服。（炳章按：升麻、桔梗宜更换为桑叶、丹皮、紫花地丁草、鲜大青等更为佳妙。）
Jire Hou (Throat disease caused by accumulated heat) in its initial stage often presents with waking up at midnight, experiencing difficulty in swallowing saliva and obstructed qi, stiffness of the jaw making it difficult to open, a sensation of heat in the nasal breath, copious and sticky phlegm and saliva, prominent high fever with slight aversion to cold. This syndrome belongs to the fire of the Heart Meridian and Sanjiao (Triple Burner), rising to the top of the head; it is also suitable for unilateral or bilateral E Kou (Goose mouth/tonsillar abscess). Blow Zhen Hou Mo (True Throat Powder) into the throat two to three times daily, three spoons each time; expelling much phlegm yields good efficacy. Internally, administer one dose of Xiexin Tongsheng San, followed by several doses of Qingge Liangxue Tang. If severe diarrhea occurs after taking Xiexin Tongsheng San, do not take more. If no severe diarrhea occurs, take another dose of this medicine before applying throat powder. If symptoms do not relieve within one day, urgently use a Three-edged Needle to puncture the top of the Goose Mouth to drain toxic blood, five to three punctures. Do not delay the application of throat powder or drops. If delayed for a long time, it will naturally ulcerate and transform into Ya Gan (Gangrene of the gums); although not fatal, it causes foul odor and may persist for half a year without healing. Therefore, prompt treatment is essential. Furthermore, if delayed for a long time, especially in individuals with Spleen-Stomach deficiency, the toxin may attack the Heart and Stomach, leading to rapid death. One must deeply observe and act swiftly, without negligence.
Xiexin Tongsheng San
Coptidis Rhizoma (Huanglian, 黄连) (1 qian)
Rhinocerotis Cornu (Xijiao, 犀角) (0.5 qian)
Gardeniae Fructus (Zhizi, 栀子) (0.5 qian)
Platycodonis Radix (Jiegeng, 桔梗) (0.8 qian)
Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) (0.3 qian)
Aurantii Fructus Immaturus (Zhiqiao, 枳壳) (0.5 qian)
Scutellariae Radix (Huangqin, 黄芩) (1 qian)
Bupleuri Radix (Shengma, 升麻) (0.4 qian)
Puerariae Radix (Gegen, 葛根) (0.5 qian)
Rehmanniae Radix (Shengdi, 生地) (0.5 qian)
Paeoniae Radix Alba (Baishao, 白芍) (0.5 qian)
Gypsum Fibrosum (Shigao, 石膏) (1.5 qian)
Rhei Radix et Rhizoma (Dahuang, 大黄) (Raw: 1 qian, Cooked: 2 qian)
Natrii Sulfas (Mangxiao, 芒硝) (1.5 qian)
Angelicae Sinensis Radix (Guiwei, 归尾) (0.5 qian)
Ephedrae Herba (Mahuang, 麻黄) (0.5 qian)
Zingiberis Rhizoma Recens (Shengjiang, 生姜) (1 slice)
Decoct with two bowls of water until reduced to 0.8 bowl; take on an empty stomach. The goal is to induce diarrhea. If no diarrhea occurs, take another dose, then follow with Qingge Huoxue Tang. (Note by Bingzhang: This syndrome is mostly due to excess heat in the Heart and seasonal wind-fire. Warming and ascending herbs like Shengma, Gegen, Mahuang, Shengjiang, and Jiegeng are contraindicated; it is essential to add acrid-cool wind-dispersing herbs.)
Qingge Huoxue Tang
Coptidis Rhizoma (Huanglian, 黄连) (1 qian)
Ophiopogonis Tuber (Maidong, 麦冬) (2 qian)
Forsythiae Fructus (Lianqiao, 连翘) (1 qian)
Gardeniae Fructus (Zhizi, 栀子) (0.5 qian)
Gypsum Fibrosum (Shigao, 石膏) (1 qian)
Platycodonis Radix (Jiegeng, 桔梗) (0.8 qian)
Scutellariae Radix (Huangqin, 黄芩) (1 qian)
Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) (0.3 qian)
Angelicae Sinensis Radix (Guiwei, 归尾) (0.5 qian)
Bupleuri Radix (Shengma, 升麻) (0.3 qian)
Decoct with two bowls of water until reduced to 0.7 bowl; take warm. (Note by Bingzhang: Shengma and Jiegeng should be replaced with Folium Mori (Sangye), Moutan Cortex (Danpi), Violae Herba (Zihua Diding Cao), and Isatidis Radix (Daqingye) fresh, which is better.)