此卷为溧阳沈青芝先生所赠青芝具活人术与予交十年见其治疾无不应手而效喉科尤为擅长每询其法必有所选则唯
应不肯以视予日者或谓予曰仆老矣仆之喉科一法非君所欲见而未得者乎因授余以此卷且曰仆之一生心血尽在于斯稽古
以来喉症一科不乏奇方名论然皆有验有不验加以汗牛充楝好学之士欲窥门径而不得一失之偏为害匪细此卷所列论方皆
出自师传或由古书及经历而得百试百验有益世者不少君曷公之同好俾初学人得以入门而高明者爱而指谬也时维
光绪辛已孟秋
定远方燕昭伯融识于邗上寓圆之温翠轩
喉证之凶险者当针则针不可乱针当吐则吐不可妄吐性命攸关死生立见苟不识其标本而治之则祸不旋踵矣余细阅各
大家喉科其凶险者不外喉痹喉风缠喉风白喉风烂喉痧阴虚喉咙等症死而不救者年年有之而旱荒尤甚乾隆五十四年秋间
曾时行白喉风症北直最多咸丰六年此症南北大行医者多不识为何证因 经云肺属金其色白肺为相传之官娇嫩之藏无论
少壮老小值以夏月不雨之天复感阴湿之气如枯木日久发菌故生此症所以服风燥之药不救惟用清润之剂得生每见有不服
药而亦得生者若误服药则难医其症初起头痛恶寒发热喉中色白凸起身热手心中如火一团肌肤似乎隐约痧疹红点身热干
亢无汗烦躁刻不能安或有头面浑身皮肤红赤如火嗌燥舌干苔黑唇口焦裂喉中疼痛难忍牙关系锁汤水难下但有汗可以得生
尚须细察面色五行生克辨明脉情寒热虚实立方用药然方出于古人予阅张君之用龙虎二仙汤即古人之龙胆泻肝汤白虎汤
普济消毒饮犀角地黄汤黄连解毒汤数方化出惟除去升提辛温风燥酸涩之品故十难之论大可为后学之法也光绪辛已年方
观察伯融曾同余集各大家喉科三十六种其中症之虚实以及用药并吐法针法均以备细详明庚寅季春白喉风症时行而邗江
尤甚城乡患者不一而足竟至朝发夕死传染者不可胜屈十八之中得其生者抑不过二三人而已余由实应旋邗始知白喉风症时
行生者竟属寥寥予实为惨目与道光岁皖江一带时疫烂喉痧稍异较之尤险余自幼至壮精习岐黄数十年来无论寒暑日为之不
辍恨未克得窥全豹至于喉咙之症余尤加讲习惜乎未得精微之奥细审喉咙延五谷出纳之区人命之攸关岂可忽略而言之余
力心励精研治亟学毫发不容间断数年朝思夕索力心求治活人之法不辞心劳力瘁日以专工集成喉科数十余种分门别证丝
发无谬予不敢秘密以宣于世可谓救人之实筏云尔观察方公以白镪视余购阅余曰实非沽名于世延济人之诚心耳镇扬一带
患白喉风者来余处就治者十得生其七八踵门而求购者亦属不少余辞不受余曰实非渔利而设不过以公于世故不揣谫陋及将
巳验
略摘数条列后并名之曰喉科集腋分为上下二卷余愿钟鸣鼎食之家明哲之士更正付诸梨枣实而藏之抑可为裨益于世也夫岁
光绪庚寅仲冬濑江后学沈青芝谨识于广陵橘井山房
这一卷书是溧阳沈青芝先生赠送的。沈青芝具备救死扶伤的本领，与我交往十年，我见他治疗疾病没有不随手见效的，其中尤其擅长喉科。每次询问他的治疗方法，他必定有所选择，总是应该做而不肯展示给我看。有一天有人对我说：“您老了，您想要见而尚未得到的喉科一法，不是就在这里吗？”于是把这一卷书传授给我，并且说：“我一生的心血都倾注在这里了。考察古以来，喉症这一科不乏奇方名论，然而都有验与不验之分，加上书籍汗牛充栋，好学之士想要窥探门径却不得其法，一旦失之偏颇，危害不小。这一卷所列的论述和方剂，都出自师传，或由古书及亲身经历所得，百试百验，对世人有益者不少。您何不公开给同好之人，使初学者得以入门，让高明者喜爱并指出谬误呢？”时间是光绪辛巳年孟秋（秋季第一个月）。定远方燕人昭伯融在邗上寓所圆之温翠轩识记。
喉证中凶险的，应当针刺的就针刺，不可乱刺；应当催吐的就催吐，不可妄吐。性命攸关，生死立见。如果不识别疾病的标本而进行治疗，那么灾祸很快就会降临。我仔细查阅各大家喉科的著作，那些凶险的病症不外乎喉痹、喉风、缠喉风、白喉风、烂喉痧、阴虚喉咙等症，每年都有不治而死的情况，而在旱荒之年尤为严重。乾隆五十四年秋天，曾流行白喉风症，以北直隶最多。咸丰六年，此症在南北各地大行，医生多不认识这是什么证候。《内经》云：肺属金，其色白，肺为相传之官，是娇嫩的脏腑。无论老少，如果在夏天无雨的日子，又感受阴湿之气，就像枯木日久生出菌类一样，所以产生此症。因此服用风燥的药物不能治愈，只有使用清润的药剂才能得生。我常见有不服药而也能痊愈的，如果误服药则难治。此症初起时头痛、恶寒、发热，喉中颜色发白且凸起，身热，手心如火一团，肌肤似乎隐约可见红点状的痧疹，身热干燥亢奋，无汗，烦躁片刻不得安宁。或者有头面浑身皮肤红赤如火，咽喉干燥，舌干苔黑，嘴唇口角焦裂，喉中疼痛难忍，牙关紧闭，汤水难下。只要有汗出就可以得生，但仍须细察面色，运用五行生克理论，辨明脉象的寒热虚实来立方用药。然而方剂出于古人，我阅读张君使用的龙虎二仙汤，即由古人的龙胆泻肝汤、白虎汤、普济消毒饮、犀角地黄汤、黄连解毒汤等方化裁而来，只是去除了升提、辛温、风燥、酸涩的药物，所以“十难”的论述大可成为后学的法则。光绪辛巳年，观察使方公伯融曾与我一起收集各家喉科三十六种，其中关于病症的虚实以及用药，还有吐法和针法，都以备细详明。庚寅年季春（春季最后一个月），白喉风症流行，而邗江地区尤为严重，城乡患者络绎不绝，竟至早晨发病晚上死亡，传染者不可胜数，十八人中能活下来的不过两三人而已。我从实应地回到邗江，才知道白喉风症流行时，存活者竟然寥寥无几。我实在看得惨目惊心。这与道光年间皖江一带流行的时疫烂喉痧稍有不同的地方，比较起来更为凶险。我从小到壮年，精心研习岐黄之术数十年，无论寒暑，每日都不停止，遗憾未能窥探全貌。至于喉咙的病症，我更加讲究研习，可惜未能精通其中的奥妙。仔细审视喉咙，这是五谷纳出的区域，是人命攸关之处，岂可忽略而言？我心力交瘁，极力研究治疗之法，学习毫发不容间断，数年朝思夕索，力求找到救人的方法，不辞心劳力瘁，日以继夜专心工作，集成喉科数十余种，分门别证，细致无误。我不敢秘密私藏，而是宣扬于世，这可以说是救人的实际筏子。观察方公用白银视余购阅，我说这实在不是为了沽名钓誉于世，而是怀着救济人心的诚心罢了。镇扬一带患白喉风的人来到我这里接受治疗，十个能救活七八个，登门求购的人也属不少，我推辞不接受。我说这实在不是为了渔利而设，不过是把它公开于世罢了。所以不揣浅陋，将已验证的略摘数条列在后面，并命名为《喉科集腋》，分为上下二卷。我希望钟鸣鼎食之家、明哲之士予以更正，刻印出版，实际上收藏它或许可以对世人有裨益。时间是光绪庚寅年仲冬。濑江后学沈青芝谨识于广陵橘井山房。
This volume was presented by Mr. Shen Qingzhi of Liyang. Shen Qingzhi possesses the art of saving lives; having interacted with him for ten years, I have observed that his treatments for diseases are invariably effective, particularly in the field of Throat Diseases (Houke). Whenever I inquired about his methods, he would always select specific ones but refused to show them to me. One day, someone said to me, "You are aging. Is not the method of treating throat diseases that you desire to see but have not yet obtained contained herein?" Thus, he handed this volume to me and said, "My life's blood and heart are poured into this. Since ancient times, there have been no lack of miraculous prescriptions and famous theories regarding throat disorders. However, some are effective while others are not. With books filling warehouses (numerous), those who love learning find it difficult to penetrate the gate. A deviation can cause significant harm. The discussions and formulas listed in this volume are derived from master-to-student transmission, ancient texts, or personal experience, tested a hundred times with consistent results, benefiting many people. Why do you not make it public among your peers, allowing beginners to enter the field and experts to appreciate and correct any errors?" The time is the first month of autumn in the Xinsi year of the Guangxu reign. Recorded by Zhao Borong, a scholar from Dingyuan, at the Wencui Pavilion in Yangzhou (Han Shang).
For critical cases of throat disorders, acupuncture should be performed when indicated, avoiding random needling; emesis should be induced when appropriate, avoiding reckless administration. Life and death hang in the balance, determined instantly. If one treats without identifying the root (Ben) and branch (Biao) of the disease, disaster will follow swiftly. Upon carefully reviewing the works of various masters in throat medicine, the critical conditions generally involve Throat Bi (Houbi), Wind-Throat (Houfeng), Entangling Wind-Throat (Chanhoufeng), White-Throat-Wind (Baihouteng), Rotten-Throat-Scarlet-Like-Rash (Lanhou sha), and Yin-Deficiency Throat disorders. Deaths occur annually, especially during droughts. In the autumn of the 54th year of Qianlong, White-Throat-Wind epidemics were most prevalent in Zhili. In the 6th year of Xianfeng, this condition spread widely across north and south China, and many physicians did not recognize the syndrome. The *Neijing* states: The Lung belongs to Metal, its color is white, and it is the official of transmission, a delicate organ. Regardless of age, if during a rainless summer day one contracts damp-cold qi, it is like dry wood growing fungus over time, thus generating this disease. Therefore, administering wind-drying herbs fails to cure, whereas using clearing and moistening agents leads to recovery. I often observe patients recovering without medication; however, misprescribed drugs make treatment difficult. Initially, symptoms include headache, aversion to cold, fever, whitish swelling in the throat, high body heat, palms feeling like burning coals, faint red macules resembling scarlet rash on the skin, dry and agitated heat, anhidrosis, restlessness, and inability to remain still. Alternatively, the face and whole body may appear red as fire, with dry throat, dry tongue with black coating, cracked lips and mouth, unbearable throat pain, trismus (lockjaw), and difficulty swallowing liquids or solids. Survival is possible if sweating occurs, but one must carefully observe facial complexion, apply the Five Elements generation-restriction theory, and differentiate pulse qualities (cold/heat, deficiency/excess) to formulate prescriptions. These formulas are derived from ancients; for instance, Zhang Jun's Longhu Erxian Tang is modified from ancient formulas such as Longdan Xiegan Tang, Baihu Tang, Puji Xiaodu Yin, Xijiao Dihuang Tang, and Huanglian Jiedu Tang, by removing ascending, acrid-warm, wind-drying, and astringent herbs. Thus, the concept of "Ten Difficulties" serves as a guide for later learners. In the Xinsi year of Guangxu, Inspector Fang Borong and I collected thirty-six types of throat treatments from various masters, detailing syndromes of deficiency/excess, herbal usage, emetic methods, and acupuncture techniques clearly. In the last month of spring in the Gengyin year, White-Throat-Wind epidemics were severe in Hanjiang, with continuous patients in urban and rural areas, leading to morning onset and evening death. Contagion was rampant; out of eighteen cases, only two or three survived. Returning to Hanjiang, I found survival rates extremely low, which was heartbreaking. This differs slightly from the epidemic Rotten-Throat-Scarlet-Like-Rash in the Wanjiang region during the Daoguang era, being even more perilous. From youth to adulthood, I studied the Yellow Emperor's Inner Canon and Spirit Pivot for decades, practicing daily regardless of weather, regretting not mastering the entirety. Regarding throat disorders, I focused intensely, though I lamented not grasping the profound subtleties. Examining the throat closely, it is the passage for food and drink, crucial for life, and cannot be ignored. I exerted great mental and physical effort, studying continuously for years, seeking healing methods tirelessly, compiling dozens of throat disorder categories, classified meticulously without error. I dare not keep this secret but publish it for the world, serving as a practical raft for saving lives. Inspector Fang offered silver for my review, but I stated my intent was not fame but sincere compassion. Many patients from Zhenjiang and Yangzhou came to me; seven or eight out of ten survived, and many sought to buy the book, which I declined. My purpose was not profit but public service. Presuming my limitations, I selected verified cases, named this work *Houke Jiye* (Collected Fragments of Throat Medicine), divided into upper and lower volumes. I hope noble families and wise scholars will correct it and facilitate printing, thereby benefiting society. Recorded in the second month of winter in the Gengyin year of Guangxu by Shen Qingzhi, junior student from Laijiang, at the Jujing Shufang in Guangling.