风热喉初起,牙关强闭,头面则肿,咽津则碍,憎寒壮热,属肝胆之经,生发顶鹅,双单
鹅,每日宜用真喉末吹二三次,每次三匙,内服泻肝通圣散一剂,以泻为度。如不泻,连进
几次,用消风活血汤数剂,若泻后,对时不宽,急用三棱针刺去鹅顶毒血,只三五针。随后又
点药末。若喉紧急,即以针刺毋待,次日活法行之,此乃肝胆经症。牙关闭疼,壅盛而死,或
改用皮硝散急吹用之。
泻肝通圣散
归尾(四分) 黄芩(七分) 僵蚕(五分) 赤芍(五分) 桔梗(一钱) 甘草(五分) 石膏
(二钱) 大黄(生二钱,熟二钱) 芒硝(一钱) 枳壳(七分) 黄柏(七分) 升麻(三分) 葛根
(四分) 防风(四分) 荆芥(四分) 胆草(四分) 生姜(一片)
水一碗煎七分,空心温服,令泻为度。如不泻,再进本药一剂,后方服消风凉血汤。(炳
章按∶此证去升、葛、桔、防、生姜加鲜大青、丹皮、桑叶、银翘等,则效更捷)。
消风凉血汤
白芍(七分) 黄芩(一钱五分) 鲜生地(二钱) 桔梗(一钱) 荆芥(五分) 防风(六分) 栀
子(五分) 僵蚕(四分) 黄柏(七分) 黄连(三分) 甘草(三分) 归尾(五分) 花粉(六分)
银花(五分) 山豆根(五分) 升麻(三分) 薄荷(三分) 生姜(一片)
水二碗,煎七分,空心服。(炳章按∶升、防、桔、生姜,喉症皆当慎用)
千金皮硝散 风痰盛者必用此方。
皮硝(一两,用铁挑,炙过,以干为度) 砂仁(二钱,去皮膜) 海螵蛸(二钱,去净粗壳) 硼
砂(生一钱, 五分) 雄黄(一钱五分) 朱砂(一钱五分) 冰片(二分) 直僵蚕(八分) 麝香
(五厘) 郁金(五分) 白矾(一钱六分,生 各半。)
风热喉痹初起时,牙关僵硬紧闭,头面部出现肿胀,吞咽津液感到阻碍,伴有怕冷和高热,病机归属于肝胆经。若表现为单侧或双侧的鹅口疮(咽喉部白色伪膜),每日宜使用真喉末吹入患处二至三次,每次用量为三匙;内服泻肝通圣散一剂,以大便通畅排出邪气为度。如果服药后未腹泻,可连续服用几次;或者使用消风活血汤数剂。若服药后已腹泻,但症状仍未缓解,应立即用三棱针刺破鹅口顶部放出毒血,只需针刺三五针即可。随后再点涂药末。如果喉部紧急疼痛,应立即针刺处理,不必等待,次日按此活法继续治疗,这属于肝胆经病症。若牙关紧闭且疼痛剧烈,病情壅盛可能导致死亡,此时可改用皮硝散紧急吹入患处。
泻肝通圣散
当归尾(四分) 黄芩(七分) 僵蚕(五分) 赤芍(五分) 桔梗(一钱) 甘草(五分) 石膏(二钱) 大黄(生大黄二钱,熟大黄二钱) 芒硝(一钱) 枳壳(七分) 黄柏(七分) 升麻(三分) 葛根(四分) 防风(四分) 荆芥(四分) 龙胆草(四分) 生姜(一片)
用水一碗煎至七分满,空腹温服,以大便泻下为度。如果未腹泻,再服用本方一剂,之后服用消风凉血汤。(炳章按:此证去掉升麻、葛根、桔梗、防风、生姜,加入鲜大青、丹皮、桑叶、银翘等,则疗效更迅速)。
消风凉血汤
白芍(七分) 黄芩(一钱五分) 鲜生地(二钱) 桔梗(一钱) 荆芥(五分) 防风(六分) 栀子(五分) 僵蚕(四分) 黄柏(七分) 黄连(三分) 甘草(三分) 当归尾(五分) 天花粉(六分) 金银花(五分) 山豆根(五分) 升麻(三分) 薄荷(三分) 生姜(一片)
用水二碗,煎至七分满,空腹服用。(炳章按:升麻、防风、桔梗、生姜,在治疗喉症时都应慎用)。
千金皮硝散 风痰盛者必须使用此方。
皮硝(一两,用铁器挑取,炙烤过,以干燥为度) 砂仁(二钱,去皮膜) 海螵蛸(二钱,去净粗壳) 硼砂(生硼砂一钱五分) 雄黄(一钱五分) 朱砂(一钱五分) 冰片(二分) 直僵蚕(八分) 麝香(五厘) 郁金(五分) 白矾(一钱六分,生白矾各半。)
At the initial stage of wind-heat throat obstruction (Wind-Heat Throat Obstruction), the jaw is stiff and tightly closed, swelling occurs on the head and face, swallowing saliva is obstructed, accompanied by aversion to cold and high fever. The pathogenesis belongs to the Liver and Gallbladder meridians. If presenting as unilateral or bilateral "goose mouth" (鹅口疮, a condition characterized by white pseudomembranes in the throat), it is advisable to use Zhen Hou Mo (True Throat Powder) insufflated into the affected area two to three times daily, with each dose being three spoons. Internally, take one dose of Xie Gan Tong Sheng San (Drain Liver and Unblock Holy Powder), aiming for bowel evacuation to expel pathogens. If diarrhea does not occur after taking the medicine, continue administering it several times; alternatively, use Xiao Feng Huo Xue Tang (Eliminate Wind and Invigorate Blood Decoction) for several doses. If diarrhea has occurred but symptoms persist, immediately puncture the top of the goose mouth lesion with a three-edged needle to drain toxic blood, requiring only three to five pricks. Subsequently, apply powder medication locally. If the throat condition is urgent and painful, puncture immediately without delay, and follow this active method the next day; this constitutes a syndrome of the Liver and Gallbladder meridians. If the jaw is tightly closed with severe pain, and the condition is congested and severe leading to death, switch to using Pi Xiao San (Piotiao Powder) for emergency insufflation.
Xie Gan Tong Sheng San (Drain Liver and Unblock Holy Powder)
Dang Gui Wei (Root of Angelica Sinensis, Tail part) (4 fen) Huang Qin (Scutellariae Radix) (7 fen) Jiang Can (Bombyx Batryticatus) (5 fen) Chi Shao (Paeoniae Rubra Radix) (5 fen) Jie Geng (Platycodonis Radix) (1 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma) (5 fen) Shi Gao (Gypsum Fibrosum) (2 qian) Da Huang (Rhei Radix et Rhizoma) (Raw: 2 qian, Cooked: 2 qian) Mang Xiao (Natrii Sulfas) (1 qian) Zhi Ke (Aurantii Fructus Immaturus) (7 fen) Huang Bo (Phellodendri Cortex) (7 fen) Sheng Ma (Cimicifugae Rhizoma) (3 fen) Ge Gen (Puerariae Lobatae Radix) (4 fen) Fang Feng (Saposhnikoviae Radix) (4 fen) Jing Jie (Schizonepetae Spica) (4 fen) Dan Cao (Gentianae Radix) (4 fen) Sheng Jiang (Zingiberis Rhizoma Recens) (1 slice)
Decoct one bowl of water until reduced to 0.7 parts, take warm on an empty stomach, aiming for bowel evacuation. If no diarrhea occurs, administer another dose of this formula, followed by Xiao Feng Liang Xue Tang (Eliminate Wind and Cool Blood Decoction). (Note by Bingzhang: For this syndrome, remove Sheng Ma, Ge Gen, Jie Geng, Fang Feng, and Sheng Jiang; add Xian Da Qing (Isatidis Folium), Dan Pi (Moutan Cortex), Sang Ye (Mori Folium), Yin Qiao (Lonicerae Japonicae Flos and Forsythiae Fructus); this will yield faster results.)
Xiao Feng Liang Xue Tang (Eliminate Wind and Cool Blood Decoction)
Bai Shao (Paeoniae Radix Alba) (7 fen) Huang Qin (Scutellariae Radix) (1.5 qian) Xian Sheng Di (Rehmanniae Radix Recens) (2 qian) Jie Geng (Platycodonis Radix) (1 qian) Jing Jie (Schizonepetae Spica) (5 fen) Fang Feng (Saposhnikoviae Radix) (6 fen) Zhi Zi (Gardeniae Fructus) (5 fen) Jiang Can (Bombyx Batryticatus) (4 fen) Huang Bo (Phellodendri Cortex) (7 fen) Huang Lian (Coptidis Rhizoma) (3 fen) Gan Cao (Glycyrrhizae Radix et Rhizoma) (3 fen) Dang Gui Wei (Root of Angelica Sinensis, Tail part) (5 fen) Hua Fen (Trichosanthis Radix) (6 fen) Yin Hua (Lonicerae Japonicae Flos) (5 fen) Shan Dou Gen (Sophorae Tonkinensis Radix et Rhizoma) (5 fen) Sheng Ma (Cimicifugae Rhizoma) (3 fen) Bo He (Menthae Haplocalycis Herba) (3 fen) Sheng Jiang (Zingiberis Rhizoma Recens) (1 slice)
Decoct two bowls of water until reduced to 0.7 parts, take on an empty stomach. (Note by Bingzhang: Sheng Ma, Fang Feng, Jie Geng, and Sheng Jiang should be used with caution in treating throat syndromes.)
Qian Jin Pi Xiao San (Thousand Years Pi Xiao Powder) Must be used when wind-phlegm is excessive.
Pi Xiao (Natrii Sulfas) (1 liang, scooped with iron, roasted until dry) Sha Ren (Amomi Fructus Rotundus) (2 qian, peel removed) Hai Piao Xiao (Sepiae Endoconcha) (2 qian, coarse shell removed) Peng Sha (Boris Boreax) (Raw: 1.5 qian) Xiong Huang (Realgar) (1.5 qian) Zhu Sha (Cinnabaris) (1.5 qian) Bing Pian (Borneolum Syntheticum) (2 fen) Zhi Jiang Can (Bombyx Batryticatus) (8 fen) She Xiang (Moschus) (5 li) Yu Jin (Curcumae Radix) (5 fen) Bai Fan (Alumen) (1.6 qian, raw Alumen half and half.)