升麻(一钱) 当归(一钱五分) 荆芥(一钱五分) 防风(一钱五分) 白芍(一钱五分) 蝉衣(四钱) 牛
蒡(三钱) 甘草(四分)
加减 里举 汤 服透邪汤后痧仍不达再服此汤
升麻(一钱) 柴胡(一钱) 当归(二钱) 白芍(一钱酒炒) 白芷(一钱) 炙山甲(一钱五分) 浮萍
痧隐不达或达而后没服前方托之用芫荽两许酒水煎以苎麻根蘸酒扑擦熏之亦可
时喉白烂吹药 西黄(二分) 珍珠(六分) 琥珀(五分) 青黛(八分) 壁钱(五个) 指甲(五分)
象牙屑(八分) 马勃(三分) 冰片(一分) 共研末凡遇喉症均可吹得
陈实功曰咽喉虽属于肺然所致各有不同有虚火实火之分紫喉漫喉之说咽为心肺肝肾呼吸之门饮食声音出纳之道此
关系一身害人迅速虚火色淡微肿脉亦细微小便清白大便自利此乃思虑过多中气不足脾气不能中获虚火易于上炎咽嗌干燥
饮食妨碍咳吐痰涎呼吸不利斑生苔藓累若虾蟆皮有如茅草常刺喉中又如硬物嗌于咽下呕吐酸水哕出甜涎甚则苔
上白色唇生矾色声音雌哑气喘多痰以上现症皆出于虚火元气不足中来治此不可误用寒凉上午痛者属气虚补中益气汤加
麦冬五味牛蒡元参午后痛者属阴虚四物汤加知母桔梗元参黄柏如服不效必加姜附以为引导即佐治之法也实火者醇酒辛
烈热积于中久则火动痰生发为咽肿甚则风痰上壅咽喉闭塞少顷汤水不入声音不出此为喉痹紧喉风是也用药不及先用针
刺喉间发泄毒血随用鸡羽蘸桐油探吐稠痰务使痰毒出尽咽门得松汤药可入语声得出乃止内服清咽利膈汤疏利余毒牙关
紧闭难入必当先刺少商穴出血其闭自开如针刺无血刺出黄水探吐无痰声如拽锯鼻掀痰喘汤水不下语声不出真死候也
不治岐天师曰如虚火沸腾于咽喉口齿之间用寒凉之药入口稍快少顷又甚又用寒凉腹泻肚痛而上热益炽欲用热药凉饮而
病患不信不肯轻治乃用外治之法引之而愈方用附子一个为末醋调成膏贴在涌泉穴上少顷火气衰又少顷而热止退变成冰
凉世界然后以六味地黄大剂与之则火不再沸腾盖此火乃雷火见水则愈酷烈子不见雷霆之震浓阴大雨之时愈加震动
惊天轰地更作威势一见太阳当空则雨歇声消寂然不闻又不见冬令之天地耶严寒霜雪冰冻郊原雨雪霏霏阴雨惨厉此天气下
行而地气反上升盖下势则上自寒也又不见夏日之天地乎酷曰炎蒸蕴隆火热烁木焚林燔汤沸水天气上升地气下降此上热
而下寒也人身虚火亦犹是也今既火腾于上则下自冰冷今以附子大热之药涌泉引之者盖涌泉虽是水穴水之中实有火气存
焉火性炎上而穴中正寒忽然得火则水自沸温水温则火自降同气相交必归于窟宅之中矣火既归于窟宅又何至沸腾于天上
哉此咽喉口齿之火忽然消除有不知其然而然之妙此引治之巧又当知之者此即外施引火归原之法也
冯鲁瞻曰咽喉者一身之 要水谷出入之道路也若胸膈之间蕴结热毒致生风痰壅滞不散发为咽喉之疾或内生疮状如
肉腐窒塞不通吐咽不下如单肉蛾双肉蛾及 腮肿胀甚者内外皆肿上攻头面治宜先吐风痰以通咽膈然后解热毒清肺胃迟则
不救
咽疮喉痛多属虚火血虚虚火游行无制客于咽喉也虚者八味地黄汤加牛膝五味子煎与食前冷服实者黄连荆芥薄荷姜
汁硝密噙化喉痛治用荆芥阴虚火炎上必用元参有用茜草一两作一服者以其能降血中之火也
喉与咽不同喉者肺脘呼吸之门户主出而不纳咽者胃脘水谷之道路主纳而不出盖咽喉司呼吸主升降此一身之紧关橐
龠也经曰足少阴所生病者口渴舌干咽痛咽肿上气嗌干素问云邪客于足少阴之络令人咽痛不可纳食又曰足少阴之络循喉
咙通舌本凡喉痛者皆少阴之病但有寒热虚实之分少阴之火直如奔马逆冲于上到此咽喉紧锁处气郁结而不得舒故或肿或
痛也其症必内热口干痰涎涌上尺脉必数而无力盖缘肾水亏损相火无制而然 用六味地黄汤如麦冬五味子大剂作汤服之又
有色欲过度元阳亏损无根之火游行无制客于咽喉者 用八味肾气丸大剂煎成冰冷与饮引火归原
庶几可救此论阴虚咽痛者如此治法正褚氏所谓上病疗下也
阴气大虚虚火无制孤阳飞越客于咽喉遂成咽痛脉必浮大重取必涩去死则近人参一味浓煎细细饮之如作实症用以清
降之药祸在反掌遇谓人参必同童便制附子同煎温和食前顿服则监制虚火下归乃愈如单用人参细细饮之恐浮火益炽亦非
稳当奈世人但知热咽痛不知有寒咽痛也经曰太阳在泉寒淫所胜民病咽痛颔肿陈藏器用附子去皮脐炮制切片以蜜涂炙令
蜜入内含咽其津甘味尽更易之仲景云下利清谷里寒外热脉微欲绝而面赤咽痛以通脉四逆汤又曰冬月伏寒在于肾经发则
咽痛下利附子汤温其经则愈
又有司天运气其年乡村传染若恶寒者多是暴寒折热寒闭于外热郁于内忌胆凡酸寒之味点喉反使阳郁不
伸又忌硝黄等寒药下之反使阳陷入里祸不旋踵 用表散若甘桔汤之类
又有咽痛而诸药不效者此非咽痛乃是鼻中一条红线如发悬一黑泡大如樱桃垂挂到咽门而止难以探取宜用土牛膝根
直而肥者捣取汁入醋四五滴再捣绞汁和前汁滴入鼻中二三滴即刻丝断珠破吐出瘀血即安
李东垣曰夏月伤寒伏于肾少经之经多咽痛者名曰肾经伤寒也宜热药冷冻饮料之
陈远公曰咽喉干燥久而疼痛人以为肺经之燥热也孰知肾水涸竭乎夫肺金生肾水也肺气清肃自下生水惟肺气虚则肺
液只可自养无如肾水大耗故欲救肺之干燥必先救肾之涸也子母两富汤熟地麦冬各五钱熟地加半亦可服一剂燥稍止三服
疼稍止十服全愈
夫咽喉之症有三十六种总不外乎风火痰初起不论缓急好歹只以下气清痰为主次后清火凉血为要看明虚实虚火宜温
补肾水引火归原为主若不分先后虚实混乱用药非惟难以见功而且生死攸关大抵风热者俱多阴虚者亦复不少火症者十之
三寒症者十之一二医者审其病由KT 之时令探吐其痰针其少商穴风热散之火甚者下之虚寒者温之若初起骤用寒凉之
药则上热未除中寒又生其毒邪乘虚而入即喘不休死不救矣
凡喉症初起大便秘结者宜大黄元明粉下之则大便通而易痊若至五六日久而不食大便结秘用之立毙盖病久元气已虚
岂宜再用硝黄当有善法以处之
凡生长膏粱素耽于酒色劳心过度以致咽喉臭痛人以为肺气伤也谁知乃心火太盛移热于肺乎夫饮酒伤胃胃热熏蒸宜
乎肺热矣然胃火熏肺而胃土实生肺也故饮酒尚不伤肺惟劳心过度则火起于心而肺受刑矣胃火助之则火旺炎上而咽喉成
燔烧之路自然唾涕稠粘口舌干燥气味腥臭而痛矣盖心主五臭入肺为腥臭矣解腥汤主之
解腥汤 甘草 桔梗 生地 麦冬 贝母(各五) 桑皮 天冬 丹皮(各三) 黄芩(一) 水煎服二剂痛
止四剂臭除
此方治肺而兼治心又兼治胃者也因膏梁之人心肺之气血原虚下滋二经之气血但泻其火则胃之气血必伤反
增火之焰矣妙在补肺以凉肺补心以凉心补胃以清胃火自退舍不止喉痛而喉痛自止也
伤寒病四五日发热鼻干口燥咽痛者阳明自病也阳明属胃汗多则胃汁干故津液不能潮咽干痛者宜用人参败毒散
伤寒三五日咽喉中肿其色鲜红痰涎自出头痛项强须知属太阳邪气入于经络触动心间积热之毒攻咽则咽喉肿痛宜甘桔
汤加牛蒡子元参川连三味伤寒八九日已上身无潮热腹痛自利而咽喉痛者此太阳经受病也伤寒得汗已不解转入太阴腹满
时痛自利而咽喉肿其色微白此症可治用真武汤主之所谓真武者能补下元助阳正气以手足和暖为妙经曰但要口中红活有
痰可治宜随症加减用药若口中黑则血已枯干声哑目上视汗出者不能治矣切宜仔细看症
伤寒八九日已上得汗已不散咽喉痛舌干唇燥者此少阴经自病也太阴经受病得汗后未解传入少阴经少阴属肾汗多则
肾汁干其肾水不能潮润咽喉故其病也如自利腹中痛于足厥冷咽中肿痛不可吞咽如无涎唾吐及舌上干者不治病患八九日
已上身微热无他症但喉中痛而无肿声哑者不治伤寒十余日已上得汗已病解无潮热脉平静而咽喉痛者此余毒上攻也宜用
粘子解毒汤
阴毒伤寒身体重背强眼痛不堪任小腹急痛青黑毒瓦斯冲心四肢厥冷恶心吐逆咽喉不利脉沉细若能速治调医数十日内
可痊否则难生
男妇咽喉痛法则一般惟女人喉中有肿而色红者此月经不调也经不能行则壅塞于上故咽肿痛也盖由荣卫不和但男子
以气为主女人以血为主男妇各随其气血之分调治宜调荣汤可也如病势重其色微白脚者此虚阳上攻宜降气汤探吐痰涎及
吹药妇人有孕心头痛者不治
妇人伤寒身热或发潮热咽痛者此经行也活人书云妇人伤寒经水适来昼则明了入暮则谵语如见鬼神状此乃热入血室无
犯胃气及上二焦不可下也小柴胡汤主之今咽喉痛而潮往来面赤唇红者此热邪上壅也不用小柴胡汤宜用竹叶石羔汤清上
膈除心烦所以为妙次用四物汤
喉中有疮其色带红者黄色者探痰再吹药宜鼠粘子解毒汤咽喉间生肉层层相叠渐渐肿起有孔出臭气用真枸橘叶煎汤频
频服之而愈要煎浓汁
虚阳上攻气不升降致结患咽嗌痰涎壅寒治以苏子降气汤主之
喉肿乃毒瓦斯起于脾经因食煎爆油腻等物及饮酒太过而行房事以致毒瓦斯不能流行聚结于喉根若不速治溃毒闭急即死
先用针法吐法最妙
咽喉之病近世最多者有数症曰单乳蛾双乳蛾曰子舌胀木舌胀缠喉痹走马喉痹其极气上行转于喉之两旁近外结肿以
其形似是为乳蛾一为单二为双也其比乳蛾差小者为喉痹热结舌下复生小舌名曰子舌胀结热于舌中舌为之肿名曰木舌胀
木舌者强硬而不柔和也热结于咽喉肿绕于外且麻且痒肿而大者名缠喉风痹暴发痰涎涌盛水浆不入然名虽不同总不外乎
手少阴君火手少阳相火为病也二脉并络于喉气热则内结结甚则肿胀甚则痹痹甚则不通而死矣其危者可以咸软之而大者
以辛之如薄荷乌头僵蚕朴硝白矾之数用之自可消除至于走马喉痹则非此所疗以其生死只在反掌之间耳急救之法无如砭
针出血血出则病已此上策也后之患者万勿畏针以自毙其命后之君子万勿执小方而曰吾药不动脏腑又妙于不用针砭出血在
小疾幸而获愈而大疾必致死亡特为拈出以告病者医者祈勿自误而误人也
咽喉为人身饮食之门户呼吸关隘方寸之地受病危险其症甚繁大约总归于火盖少阴少阳君相二火其脉皆络于咽喉故
往往为火症之所结聚君火势缓则结而为疼为肿相火势速则肿甚不仁而为痹痹甚不通而痰塞以死经云一阴一阳结谓之喉
痹火者痰之本痰者火之标火有虚实之火实火因过食煎炒炙爆蕴结积毒其症烦渴二便秘塞风痰上壅将发喉痹必先胸膈不
利脉弦而数治宜先去风痰后解热毒虚火或因饮酒过度或因忿怒或因色欲火炎上攻咽喉干燥必二便如常少脉微治宜补虚
泻火凡用药不宜纯用寒凉取效目前上热未除中虚复起毒瓦斯乘虚入腹胸前高肿上喘下泻手足指甲青黑七日以后全不进饮
食口如鱼口者死且治咽喉最忌发汗针砭出血已属发汗之意何堪更发其汗凡伤寒于肾及帝丁(喉名)肿者断不宜针至如内
伤虚损咽喉失音无法可治
喉症初起一日寒战即生发者发后身凉口不碎又无重舌或二便俱利不可认作热症皆因阴气虚寒而发其痰不可吊尽此
痰即身内之津液所化与热症乳蛾重舌之痰壅一处以流尽则毒愈者不同若亦流尽则精神竭而必毙先宜药吹或用水换之法
使喉一通即便服药初剂发散和解次即施温补滋养设三四日再发寒战或心痛骨痛胁痛等症皆属难治
咽喉发时牙关紧闭舌喉俱肿口碎而臭或有重舌及舌上有黄屑者发后下午再发寒热二便闭塞者即作热症用石羔败毒
散主之然亦易愈之症如渐起三四日后再寒热者虽极凶亦不为害惟有症未减而牙关反不紧闭唇口不肿纹如好人者不治舌
肿满口者不治色如胡桃如茄子如砂纸者不治若连重舌发寒热者犹可治也舌以筋按之若色雪白起筋紫红色者此身内血已死
然口若臭犹可生尤忌口渴气急痰多而稠如桃胶者死期已速
又曰一颈俱红肿者亦极危也面带红紫面青带白神气少者俱无救不语者死略能语者尚可有生之机面色少神喜坐低处者
亦难治帝丁(喉也)乃性命攸关舌系下通于肾白肿不治伤之者死凡喉症至五日即重三日前症虽重尚未成脓药能清散若至
五六日患处多成脓随便穿破后烂成窝为难治用口疳药吹多加龙骨珍珠
凡吹喉症须吹药四五管方得痰多三次可以全愈其出痰初吹宜多用金丹必直对帝中吹之急提出管恐痰即呕出也
妇人喉症肿痛有因经闭致火上攻而成者宜内服通经药月事通则愈
凡喉中无形红肿者当用灯心
凡喉症凶者面发肿白亮无光彩脉微沉无力是神气外泄无阳之症断乎不治若面发红肿脉来洪大有力症虽极重是有元
气火盛治之易痊
凡吹喉症欲出痰涎药中用皂角末少许
三黄解毒汤 黄连 黄芩 黄柏 栀子
清胃汤 生地 升麻 连翘 丹皮 黄连
引火汤 熟地(五) 元参(五) 萸肉(四) 茯苓(四) 山药(四) 五味(二) 肉桂(一) 白芥
子(三)
败毒散 牛蒡子 花粉 元参 黄柏 薄荷 丹皮 银花 熟石羔 赤芍 甘草 竹叶 灯心
犀角解毒丸 治小儿诸疮毒及痧后余毒喉齿等症
升麻(一钱) 当归(一钱五分) 荆芥(一钱五分) 防风(一钱五分) 白芍(一钱五分) 蝉蜕(四钱) 牛蒡子(三钱) 甘草(四分)
加减方:透邪汤。服用透邪汤后,痧疹仍未透发者,再服此汤。
升麻(一钱) 柴胡(一钱) 当归(二钱) 白芍(一钱,酒炒) 白芷(一钱) 炙穿山甲(一钱五分) 浮萍
若痧疹隐伏不透,或透出后又隐没,服用前方托毒外出无效时,可用芫荽约两许,酒水煎煮,用苎麻根蘸药酒扑擦、熏蒸患处,亦可奏效。
治疗时疫烂喉的吹喉药:西黄(二分) 珍珠(六分) 琥珀(五分) 青黛(八分) 壁钱(五个) 指甲(五分) 象牙屑(八分) 马勃(三分) 冰片(一分)。共研为细末。凡遇咽喉病症均可吹入。
陈实功说:咽喉虽然归属于肺,但致病原因各有不同,有虚火、实火之分,有紫喉、漫喉之说。咽是心、肺、肝、肾呼吸之门,也是饮食和声音出入之道,这关系到全身,危害迅速。虚火表现为颜色淡、微肿,脉象细微,小便清白,大便正常,这是思虑过多导致中气不足,脾气不能运化,虚火易于上炎。症状包括咽喉干燥,饮食受阻,咳吐痰涎,呼吸不利,舌苔生如苔藓,累赘如虾蟆皮,又像茅草常刺喉中,又似硬物卡在咽下,呕吐酸水,呃逆出甜涎,甚至舌苔白色,嘴唇生矾色,声音嘶哑,气喘多痰。以上这些现症都源于虚火,元气不足。治疗此症不可误用寒凉药物。上午疼痛者属气虚,用补中益气汤加麦冬、五味子、牛蒡子、元参;午后疼痛者属阴虚,用四物汤加知母、桔梗、元参、黄柏。如果服药无效,必须加姜、附子作为引导,这就是佐治的方法。实火者,因醇酒辛辣热积于中,久则火动痰生,发为咽喉肿痛,甚则风痰上壅,咽喉闭塞,片刻后汤水不入,声音不出,此为喉痹、紧喉风。用药不及时,先用针刺喉间发泄毒血,随即用鸡羽蘸桐油探吐稠痰,务必使痰毒出尽,咽门得松,汤药可入,语声得出,才停止。内服清咽利膈汤疏利余毒。牙关紧闭难进药者,必当先刺少商穴出血,其闭自开。如针刺无血,刺出黄水,探吐无痰,声如拽锯,鼻翼扇动,痰喘,汤水不下,语声不出,是真死候也,不治。
岐天师说:如虚火沸腾于咽喉口齿之间,用寒凉之药入口稍快,少顷又加重,再用寒凉则腹泻肚痛,而上热更炽。欲用热药,病人又怕凉饮而不信,不肯轻治。乃用外治之法引之而愈。方用附子一个为末,醋调成膏贴在涌泉穴上,少顷火气衰,又少顷而热止退,变成冰凉世界,然后以六味地黄丸大剂与之,则火不再沸腾。盖此火乃雷火,见水则愈酷烈。子不见雷霆之震浓阴大雨之时愈加震动惊天轰地更作威势,一见太阳当空则雨歇声消寂然不闻?又不见冬令之天地耶?严寒霜雪冰冻郊原雨雪霏霏阴雨惨厉,此天气下行而地气反上升,盖下势则上自寒也。又不见夏日之天地乎?酷暑炎蒸蕴隆火热烁木焚林燔汤沸水,天气上升地气下降,此上热而下寒也。人身虚火亦犹是也。今既火腾于上则下自冰冷,今以附子大热之药从涌泉引之者,盖涌泉虽是水穴,水之中实有火气存焉。火性炎上而穴中正寒,忽然得火则水自沸,温水温则火自降,同气相交必归于窟宅之中矣。火既归于窟宅又何至沸腾于天上哉?此咽喉口齿之火忽然消除,有不知其然而然之妙,此引治之巧,又当知之者。此即外施引火归原之法也。
冯鲁瞻说:咽喉是一身的重要部位,是水谷出入的道路。若胸膈之间蕴结热毒,致生风痰壅滞不散发,发为咽喉之疾,或内生疮状如肉腐,窒塞不通,吐咽不下,如单肉蛾、双肉蛾及腮肿胀,甚者内外皆肿,上攻头面。治宜先吐风痰以通咽膈,然后解热毒清肺胃,迟则不救。
咽疮喉痛多属虚火,血虚虚火游行无制,客于咽喉也。虚者用八味地黄汤加牛膝、五味子煎与食前冷服。实者用黄连、荆芥、薄荷、姜汁、硝密噙化。喉痛治用荆芥。阴虚火炎上必用元参,有用茜草一两作一服者,以其能降血中之火也。
喉与咽不同。喉者肺脘呼吸之门户,主出而不纳;咽者胃脘水谷之道路,主纳而不出。盖咽喉司呼吸主升降,此一身之紧关橐龠也。经曰:足少阴所生病者,口渴舌干,咽痛,咽肿,上气,嗌干。素问云:邪客于足少阴之络,令人咽痛不可纳食。又曰:足少阴之络循喉咙通舌本。凡喉痛者皆少阴之病,但有寒热虚实之分。少阴之火直如奔马,逆冲于上,到此咽喉紧锁处,气郁结而不得舒,故或肿或痛也。其症必内热口干,痰涎涌上,尺脉必数而无力。盖缘肾水亏损,相火无制而然。用六味地黄汤如麦冬、五味子大剂作汤服之。又有色欲过度,元阳亏损,无根之火游行无制,客于咽喉者,用八味肾气丸大剂煎成冰冷与饮,引火归原,庶几可救。此论阴虚咽痛者如此,治法正褚氏所谓上病疗下也。
阴气大虚,虚火无制,孤阳飞越,客于咽喉,遂成咽痛。脉必浮大,重取必涩。去死则近。人参一味浓煎细细饮之。如作实症用以清降之药,祸在反掌。遇谓人参必同童便制附子同煎温和食前顿服,则监制虚火下归乃愈。如单用人参细细饮之,恐浮火益炽,亦非稳当。奈世人但知热咽痛,不知有寒咽痛也。经曰:太阳在泉,寒淫所胜,民病咽痛颔肿。陈藏器用附子去皮脐炮制切片以蜜涂炙令蜜入内含咽,其津甘味尽更易之。仲景云:下利清谷,里寒外热,脉微欲绝而面赤咽痛,以通脉四逆汤。又曰:冬月伏寒在于肾经,发则咽痛下利,附子汤温其经则愈。
又有司天运气,其年乡村传染,若恶寒者多是暴寒折热,寒闭于外,热郁于内,忌胆凡酸寒之味点喉,反使阳郁不伸。又忌硝黄等寒药下之,反使阳陷入里,祸不旋踵。用表散若甘桔汤之类。
又有咽痛而诸药不效者,此非咽痛乃是鼻中一条红线如发悬一黑泡大如樱桃垂挂到咽门而止,难以探取。宜用土牛膝根直而肥者捣取汁,入醋四五滴,再捣绞汁和前汁滴入鼻中二三滴,即刻丝断珠破吐出瘀血即安。
李东垣说:夏月伤寒伏于肾少经之经多咽痛者,名曰肾经伤寒也,宜热药冷冻饮料之。
陈远公说:咽喉干燥久而疼痛,人以为肺经之燥热也,孰知肾水涸竭乎?夫肺金生肾水也,肺气清肃自下生水,惟肺气虚则肺液只可自养,无如肾水大耗,故欲救肺之干燥必先救肾之涸也。子母两富汤:熟地、麦冬各五钱,熟地加半亦可。服一剂燥稍止,三服疼稍止,十服全愈。
夫咽喉之症有三十六种,总不外乎风火痰。初起不论缓急好歹,只以下气清痰为主,次后清火凉血为看。要明虚实,虚火宜温补肾水引火归原为主。若不分先后虚实混乱用药,非惟难以见功,而且生死攸关。大抵风热者俱多,阴虚者亦复不少,火症者十之三,寒症者十之一二。医者审其病由KT之时令,探吐其痰,针其少商穴。风热散之,火甚者下之,虚寒者温之。若初起骤用寒凉之药,则上热未除,中寒又生,其毒邪乘虚而入,即喘不休死不救矣。
凡喉症初起大便秘结者,宜大黄、元明粉下之,则大便通而易痊。若至五六日久而不食,大便结秘,用之立毙。盖病久元气已虚,岂宜再用硝黄?当有善法以处之。
凡生长膏粱,素耽于酒色,劳心过度,以致咽喉臭痛,人以为肺气伤也,谁知乃心火太盛移热于肺乎?夫饮酒伤胃,胃热熏蒸宜乎肺热矣,然胃火熏肺而胃土实生肺也,故饮酒尚不伤肺,惟劳心过度则火起于心而肺受刑矣。胃火助之则火旺炎上而咽喉成燔烧之路,自然唾涕稠粘,口舌干燥,气味腥臭而痛矣。盖心主五臭,入肺为腥臭矣。解腥汤主之。
解腥汤:甘草、桔梗、生地、麦冬、贝母(各五),桑皮、天冬、丹皮(各三),黄芩(一)。水煎服二剂痛止,四剂臭除。
此方治肺而兼治心,又兼治胃者也。因膏梁之人心肺之气血原虚,下滋二经之气血,但泻其火则胃之气血必伤,反增火之焰矣。妙在补肺以凉肺,补心以凉心,补胃以清胃,火自退舍不止喉痛而喉痛自止也。
伤寒病四五日发热,鼻干口燥咽痛者,阳明自病也。阳明属胃,汗多则胃汁干,故津液不能潮,咽干痛者,宜用人参败毒散。
伤寒三五日咽喉中肿,其色鲜红,痰涎自出,头痛项强,须知属太阳邪气入于经络,触动心间积热之毒,攻咽则咽喉肿痛,宜甘桔汤加牛蒡子、元参、川连三味。伤寒八九日已上身无潮热,腹痛自利而咽喉痛者,此太阳经受病也。伤寒得汗已不解,转入太阴腹满时痛自利而咽喉肿,其色微白,此症可治,用真武汤主之。所谓真武者能补下元助阳正气,以手足和暖为妙。经曰:但要口中红活有痰可治,宜随症加减用药。若口中黑则血已枯干,声哑目上视,汗出者不能治矣。切宜仔细看症。
伤寒八九日已上得汗已不散,咽喉痛舌干唇燥者,此少阴经自病也。太阴经受病得汗后未解传入少阴经,少阴属肾,汗多则肾汁干,其肾水不能潮润咽喉,故其病也。如自利腹中痛于足厥冷,咽中肿痛不可吞咽,如无涎唾吐及舌上干者不治。病患八九日已上身微热无他症,但喉中痛而无肿声哑者不治。伤寒十余日已上得汗已病解无潮热,脉平静而咽喉痛者,此余毒上攻也,宜用粘子解毒汤。
阴毒伤寒身体重背强眼痛不堪任,小腹急痛,青黑毒瓦斯冲心,四肢厥冷,恶心吐逆,咽喉不利,脉沉细。若能速治调医数十日内可痊,否则难生。
男妇咽喉痛法则一般,惟女人喉中有肿而色红者,此月经不调也。经不能行则壅塞于上,故咽肿痛也。盖由荣卫不和,但男子以气为主,女人以血为主,男妇各随其气血之分调治,宜调荣汤可也。如病势重其色微白脚者,此虚阳上攻,宜降气汤探吐痰涎及吹药。妇人有孕心头痛者不治。
妇人伤寒身热或发潮热咽痛者,此经行也。活人书云:妇人伤寒经水适来,昼则明了,入暮则谵语如见鬼神状,此乃热入血室,无犯胃气及上二焦,不可下也,小柴胡汤主之。今咽喉痛而潮往来,面赤唇红者,此热邪上壅也,不用小柴胡汤,宜用竹叶石膏汤清上膈除心烦,所以为妙。次用四物汤。
喉中有疮其色带红者,黄色者,探痰再吹药,宜鼠粘子解毒汤。咽喉间生肉层层相叠渐渐肿起,有孔出臭气,用真枸橘叶煎汤频频服之而愈,要煎浓汁。
虚阳上攻,气不升降,致结患咽嗌,痰涎壅寒,治以苏子降气汤主之。
喉肿乃毒瓦斯起于脾经,因食煎爆油腻等物及饮酒太过而行房事,以致毒瓦斯不能流行聚结于喉根,若不速治溃毒闭急即死。先用针法吐法最妙。
咽喉之病近世最多者有数症,曰单乳蛾、双乳蛾,曰子舌胀、木舌胀、缠喉痹、走马喉痹。其极气上行转于喉之两旁近外结肿,以其形似是为乳蛾,一为单二为双也。其比乳蛾差小者为喉痹。热结舌下复生小舌名曰子舌胀,结热于舌中舌为之肿名曰木舌胀。木舌者强硬而不柔和也。热结于咽喉肿绕于外且麻且痒肿而大者名缠喉风,痹暴发痰涎涌盛水浆不入。然名虽不同,总不外乎手少阴君火、手少阳相火为病也。二脉并络于喉,气热则内结,结甚则肿胀,甚则痹,痹甚则不通而死矣。其危者可以咸软之而大者以辛之,如薄荷、乌头、僵蚕、朴硝、白矾之数用之自可消除。至于走马喉痹则非此所疗,以其生死只在反掌之间耳。急救之法无如砭针出血,血出则病已,此上策也。后之患者万勿畏针以自毙其命,后之君子万勿执小方而曰吾药不动脏腑,又妙于不用针砭出血,在小疾幸而获愈,而大疾必致死亡,特为拈出以告病者医者,祈勿自误而误人也。
咽喉为人身饮食之门户,呼吸关隘,方寸之地,受病危险,其症甚繁,大约总归于火。盖少阴少阳君相二火,其脉皆络于咽喉,故往往为火症之所结聚。君火势缓则结而为疼为肿,相火势速则肿甚不仁而为痹,痹甚不通而痰塞以死。经云:一阴一阳结谓之喉痹。火者痰之本,痰者火之标。火有虚实,火实火因过食煎炒炙爆蕴结积毒,其症烦渴,二便秘塞,风痰上壅,将发喉痹必先胸膈不利,脉弦而数,治宜先去风痰后解热毒。虚火或因饮酒过度,或因忿怒,或因色欲,火炎上攻,咽喉干燥,必二便如常,少脉微,治宜补虚泻火。凡用药不宜纯用寒凉,取效目前,上热未除,中虚复起,毒瓦斯乘虚入腹,胸前高肿,上喘下泻,手足指甲青黑,七日以后全不进饮食,口如鱼口者死。且治咽喉最忌发汗,针砭出血已属发汗之意,何堪更发其汗。凡伤寒于肾及帝丁(喉名)肿者,断不宜针。至如内伤虚损咽喉失音无法可治。
喉症初起一日寒战即生发者,发后身凉口不碎,又无重舌或二便俱利,不可认作热症,皆因阴气虚寒而发。其痰不可吊尽,此痰即身内之津液所化,与热症乳蛾重舌之痰壅一处以流尽则毒愈者不同。若亦流尽则精神竭而必毙。先宜药吹或用水换之法,使喉一通即便服药,初剂发散和解,次即施温补滋养。设三四日再发寒战或心痛骨痛胁痛等症,皆属难治。
咽喉发时牙关紧闭,舌喉俱肿,口碎而臭,或有重舌及舌上有黄屑者,发后下午再发寒热二便闭塞者,即作热症,用石膏败毒散主之。然亦易愈之症。如渐起三四日后再寒热者,虽极凶亦不为害。惟有症未减而牙关反不紧闭,唇口不肿纹如好人者不治。舌肿满口者不治,色如胡桃、如茄子、如砂纸者不治。若连重舌发寒热者犹可治也。舌以筋按之,若色雪白起筋紫红色者,此身内血已死,然口若臭犹可生。尤忌口渴气急痰多而稠如桃胶者,死期已速。
又曰:一颈俱红肿者亦极危也。面带红紫,面青带白,神气少者,俱无救。不语者死,略能语者尚可有生之机。面色少神喜坐低处者亦难治。帝丁(喉也)乃性命攸关,舌系下通于肾,白肿不治,伤之者死。凡喉症至五日即重,三日前症虽重尚未成脓,药能清散。若至五六日患处多成脓,随便穿破后烂成窝,为难治,用口疳药吹多加龙骨珍珠。
凡吹喉症须吹药四五管方得痰多,三次可以全愈。其出痰初吹宜多用金丹,必直对帝中吹之,急提出管,恐痰即呕出也。
妇人喉症肿痛有因经闭致火上攻而成者,宜内服通经药,月事通则愈。
凡喉中无形红肿者,当用灯心。
凡喉症凶者,面发肿白亮无光彩,脉微沉无力,是神气外泄无阳之症,断乎不治。若面发红肿,脉来洪大有力,症虽极重是有元气火盛,治之易痊。
引火汤:熟地(五)、元参(五)、萸肉(四)、茯苓(四)、山药(四)、五味(二)、肉桂(一)、白芥子(三)。
败毒散:牛蒡子、花粉、元参、黄柏、薄荷、丹皮、银花、熟石膏、赤芍、甘草、竹叶、灯心。
犀角解毒丸:治小儿诸疮毒及痧后余毒喉齿等症。
Shengma (Cimicifugae Rhizoma, 1 qian) Danggui (Angelicae Sinensis Radix, 1.5 qian) Jingjie (Schizonepetae Herba, 1.5 qian) Fangfeng (Saposhnikoviae Radix, 1.5 qian) Baishao (Paeoniae Radix Alba, 1.5 qian) Chanyi (Cicadae Periostracum, 4 qian) Niubangzi (Arctii Fructus, 3 qian) Gancao (Glycyrrhizae Radix et Rhizoma, 0.4 qian)
Modification: Touxié Tang (Decoction for Expelling Pathogenic Factors). If the macules/rash still fail to emerge after taking Touxié Tang, take this decoction again.
Shengma (Cimicifugae Rhizoma, 1 qian) Chaihu (Bupleuri Radix, 1 qian) Danggui (Angelicae Sinensis Radix, 2 qian) Baishao (Paeoniae Radix Alba, 1 qian, stir-fried with wine) Baizhi (Angelicae Dahuricae Radix, 1 qian) Zhi Shanjiya (Hematitum prepared with honey, 1.5 qian) Fuping (Urticae Herba)
If the macules/rash remain hidden and do not emerge, or emerge and then disappear, and the previous formula fails to push out the toxin, use about two liang of Yuanxu (Coriandri Fructus), decocted in a mixture of water and wine. Dip Ramie root (Zhumagen) into the medicinal wine to dab, wipe, and fumigate the affected area; this may also be effective.
Powder for blowing into the throat for epidemic sore throat with ulceration: Xihuang (Moschus, 0.2 fen) Zhenzhu (Margarita, 0.6 fen) Hupo (Succinum, 0.5 fen) Qingdai (Indigo Naturalis, 0.8 fen) Biqian (Cella Oecobi, five pieces) Zhijia (Unguis Humanus, 0.5 fen) Xiangyaxie (Dentale Elephantis, 0.8 fen) Mabo (Pleuroti Fructus, 0.3 fen) Bingpian (Borneolum Syntheticum, 0.1 fen). Grind all into a fine powder. This can be blown into the throat for any throat condition.
Chen Shigong said: Although the throat and pharynx belong to the Lung, the causes of disease vary, divided into deficiency fire and excess fire, and there are distinctions between Zi Hou (Purple Throat) and Man Hou (Diffuse Throat). The pharynx is the gate for respiration of the Heart, Lung, Liver, and Kidney, and the pathway for food intake and voice production; it relates to the whole body and causes rapid harm. Deficiency fire presents with pale color, slight swelling, subtle pulse, clear urine, and normal stool. This results from excessive worry leading to Middle Qi deficiency, where Spleen Qi fails to transform properly, allowing deficiency fire to easily flare upward. Symptoms include dryness of the throat and pharynx, difficulty swallowing, coughing up saliva, breathing difficulties, tongue coating resembling moss, feeling like frog skin or thatch scratching the throat, sensation of a hard object stuck in the pharynx, vomiting sour water, belching sweet saliva, white tongue coating, alum-colored lips, hoarseness, asthma with much phlegm. All these symptoms stem from deficiency fire and insufficient Yuan Qi. Treatment must not mistakenly use cold/cooling herbs. Pain in the morning indicates Qi deficiency; use Buzhong Yiqi Tang (Decoction for Replenishing the Middle and Augmenting Qi) plus Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus), Niubangzi (Arctii Fructus), Yuanshen (Scrophulariae Radix). Pain in the afternoon indicates Yin deficiency; use Siwu Tang (Four Substances Decoction) plus Zhimu (Anemarrhenae Rhizoma), Jiegeng (Platycodonis Radix), Yuanshen (Scrophulariae Radix), Huangbai (Phellodendri Cortex). If ineffective, add Jiang (Zingiberis Rhizoma) and Fu Zi (Aconiti Lateralis Radix Praeparata) as guides; this is the method of assisting treatment. Excess fire arises from accumulation of heat from strong alcohol and pungent/spicy foods in the interior; over time, fire moves and phlegm generates, causing throat swelling. Severe cases involve wind-phlegm blocking upward, closing the throat, preventing intake of fluids and speech within moments; this is Hou Bi (Throat Obstruction) or Jin Hou Feng (Tight Throat Wind). If medication is delayed, first puncture the throat to release toxic blood, then use a chicken feather dipped in tung oil to induce vomiting of thick phlegm, ensuring all phlegm-toxin is expelled until the throat opens, allowing medicine and speech. Internally administer Qingyan Lige Tang (Decoction for Clearing the Throat and Purging the Diaphragm) to disperse residual toxins. For locked jaw making oral administration difficult, first puncture Shaoshang (LU-11) acupoint to bleed; the lock will open spontaneously. If no blood comes but yellow fluid appears upon puncture, and no phlegm is induced by vomiting, with sound like sawing wood, nasal flaring, panting with phlegm, inability to swallow or speak, this is a true death sign, untreatable.
Qi Tianshi said: When deficiency fire boils in the throat and teeth, cold herbs provide brief relief but worsen shortly after. Further use of cold herbs causes diarrhea and abdominal pain while upper heat intensifies. Patients distrust using hot herbs due to fear of cold drinks and refuse mild treatment. Instead, use external methods to guide the fire down for cure. Use one Fu Zi (Aconiti Lateralis Radix Praeparata) ground into powder, mixed with vinegar into a paste, applied to Yongquan (KI-1) acupoint. After a short time, fire energy subsides, heat stops, and the area becomes cool. Then administer a large dose of Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) to prevent fire from boiling again. This fire is like thunder-fire; seeing water makes it fiercer. Have you not seen thunder during heavy rain? It shakes heaven and earth with greater force, but when the sun shines, rain stops and silence returns. Have you not observed winter? Severe cold, frost, snow, and gloomy weather occur when heavenly qi descends and earthly qi rises; thus, lower cold leads to upper cold. Have you not observed summer? Intense heat steams, scorching wood and burning forests; heavenly qi rises and earthly qi descends, resulting in upper heat and lower cold. Human deficiency fire is similar. Since fire floats upward, the lower part becomes cold. Using the hot herb Fu Zi to guide from Yongquan works because although Yongquan is a water point, fire exists within the water. Fire nature is to flare upward, but the point is cold; suddenly receiving fire causes water to boil, warming the water lowers the fire. Similar energies interact and return to their origin. Once fire returns to its residence, how can it boil in the sky? This sudden elimination of fire in the throat and teeth has a miraculous effect unknown to the patient. This clever guiding treatment demonstrates the external method of "Guiding Fire Back to its Source."
Feng Luzhan said: The throat is a vital passage for food and drink. If heat-toxin accumulates in the chest and diaphragm, generating wind-phlegm obstruction without dispersing, it causes throat diseases, such as internal ulcers resembling rotting flesh, blocking passage, preventing swallowing, like Single Meat Moth (Dan Ru E), Double Meat Moth (Shuang Ru E), or swollen cheeks. Severe cases swell internally and externally, attacking the head and face. Treatment should first induce vomiting of wind-phlegm to clear the throat and diaphragm, then resolve heat-toxin and clear Lung/Stomach. Delay leads to death.
Sore throat and throat pain mostly belong to deficiency fire. Blood deficiency allows deficiency fire to wander uncontrollably and lodge in the throat. For deficiency, use Bawei Dihuang Tang (Eight-Ingredient Rehmannia Decoction) plus Niuxi (Achyranthis Bidentatae Radix) and Wuweizi (Schisandrae Fructus), decocted and taken cold before meals. For excess, hold in mouth黄连 (Coptidis Rhizoma), Jingjie (Schizonepetae Herba), Bohe (Menthae Haplocalycis Herba), Ginger juice, and salt. For throat pain, use Jingjie (Schizonepetae Herba). For Yin deficiency with fire flaming upward, Yuanshen (Scrophulariae Radix) is essential; some use Qiancao (Rubiae Cordifoliae Radix) one liang per dose to descend fire in the blood.
The larynx (Hou) and pharynx (Yan) differ. The larynx is the gateway of the Lung for respiration, governing exit but not entry. The pharynx is the pathway of the Stomach for food and drink, governing entry but not exit. Together they govern respiration and ascending/descending, acting as the critical bellows of the body. The Classics state: Diseases of Foot-Shaoyin include thirst, dry tongue, sore throat, swollen throat, rising Qi, and dryness of the throat. Suwen says: Pathogens invading the collateral of Foot-Shaoyin cause sore throat and inability to eat. Also, the collateral of Foot-Shaoyin runs through the throat to the root of the tongue. All throat pains are Shaoyin diseases, differing in cold/heat and deficiency/excess. Shaoyin fire rushes like a horse, counter-flowing upward to the tight lock of the throat, where Qi stagnates and cannot relax, causing swelling or pain. Symptoms include internal heat, dry mouth, surging phlegm-saliva, and a rapid yet weak Chi pulse. This stems from Kidney Water depletion and uncontrolled Ministerial Fire. Use Liuwei Dihuang Tang (Six-Ingredient Rehmannia Decoction) with Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus) in large doses as a decoction. For those with excessive sexual activity depleting Yuan Yang, causing rootless fire to wander and lodge in the throat, use Bawei Shenqi Wan (Eight-Ingredient Kidney Qi Pill) decocted in large doses, cooled before drinking, to guide fire back to its source; this may save them. This treats Yin-deficiency throat pain, following Chu Shi's principle of treating upper disease by addressing the lower.
When Yin Qi is severely deficient and deficiency fire uncontrolled, solitary Yang flies away, lodging in the throat causing pain. Pulse is floating and large, but deep pressure reveals choppy quality. Near death. Use Ren Shen (Ginseng Radix) alone, decocted strongly, sipped slowly. If treated as excess with clearing/descending herbs, disaster follows instantly. Some say Ren Shen must be processed with child's urine and Fu Zi (Aconiti Lateralis Radix Praeparata), decocted warm and taken at once before meals to control deficiency fire and guide it downward. Using Ren Shen alone sipped slowly may intensify floating fire, which is unsafe. Yet people only know hot throat pain, not cold throat pain. The Classics state: When Taiyang is in the fountain, excessive cold causes people to suffer sore throat and swollen chin. Chen Cangqi used Fu Zi (Aconiti Lateralis Radix Praeparata), peeled, baked, sliced, coated with honey, roasted until honey penetrates, held in mouth until taste fades, then replaced. Zhang Zhongjing stated: With diarrhea of undigested food, interior cold exterior heat, faint pulse, red face, and sore throat, use Tongmai Sini Tang (Pulse-Recovering Counterflow Decoction). Also: Winter latent cold in Kidney Meridian causes sore throat and diarrhea upon manifestation; Fuzi Tang warms the meridian for cure.
Regarding Heavenly Stem and Earthly Branch influences, if village epidemics occur in that year, chills indicate sudden cold suppressing heat, cold closed outside, heat郁 (stagnant) inside. Avoid sour/cold flavors dropped in throat, as they hinder Yang expansion. Avoid purgatives like Xiaoshi (Natrii Sulfas) and Huanglian (Coptidis Rhizoma) which drive Yang inward, causing immediate disaster. Use exterior-dispersing formulas like Gancao Jiegeng Tang (Licorice and Platycodon Decoction).
For throat pain unresponsive to other medicines, this may not be throat pain but a black blister the size of a cherry hanging from a thread-like red line in the nose to the throat gate, hard to reach. Use straight, fat roots of Tuniuqi (Achyranthis Bidentatae Radix), crush to extract juice, add 4-5 drops of vinegar, crush again, mix juices, and drip 2-3 drops into the nose. The thread breaks, blister bursts, blood is expectorated, and relief follows.
Li Dongyuan said: Summer cold damage latent in the Kidney/Shaoyin meridian often causes sore throat, named Kidney Meridian Cold Damage. Treat with hot medicine served cold.
Chen Yuangong said: Chronic dryness and pain in the throat is thought to be Lung Dryness-Heat, but who knows it is Kidney Water exhaustion? Metal generates Water; Lung Qi clears and generates water from below. Only when Lung Qi is deficient does Lung fluid suffice for self-nourishment, unable to replenish depleted Kidney Water. Thus, to save Lung dryness, one must first save Kidney exhaustion. Zimu Liangfu Tang: Shudi (Rehmanniae Radix Preparata) and Maidong (Ophiopogonis Radix) each 5 qian; Shudi can be increased. One dose stops dryness, three doses stop pain, ten doses cure completely.
There are thirty-six types of throat diseases, generally involving Wind, Fire, and Phlegm. Initially, regardless of severity, prioritize descending Qi and clearing phlegm, followed by clearing fire and cooling blood. Distinguish deficiency/excess. Deficiency fire requires warming Kidney Water and guiding fire back to source. Confusing sequence and nature leads to failure and death risk. Mostly Wind-Heat and Yin Deficiency; Fire patterns 30%, Cold patterns 10-20%. Physicians must assess timing, induce vomiting of phlegm, puncture Shaoshang (LU-11). Disperse Wind-Heat, purge severe Fire, warm Cold-Deficiency. Sudden use of cold herbs initially leaves upper heat unresolved while creating middle cold, allowing pathogens to enter deeply, causing unstoppable asthma and death.
For initial throat disease with constipation, use Dahuang (Rhei Radix et Rhizoma) and Yuanmingfen (Natrii Sulfas) to purge; bowel movement facilitates recovery. By day 5-6, if fasting and constipated, purgatives cause instant death as Yuan Qi is depleted. Do not use harsh purgatives; find better methods.
Those indulging in rich food, alcohol, sex, and mental labor causing foul-smelling throat pain think it is Lung injury, but it is actually excessive Heart Fire transferring heat to Lung. Alcohol damages Stomach, heat steams to Lung, but Stomach Earth generates Lung Metal, so alcohol doesn't severely injure Lung. Mental labor starts fire in Heart, punishing Lung. Stomach fire assists, causing fire to flare upward, turning throat into a burning path, with sticky saliva, dry mouth/tongue, foul odor, and pain. Heart governs odors; entering Lung it becomes fishy/foul. Jieqing Tang (Decoction for Removing Foul Odor) is indicated.
Jieqing Tang: Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), Shengdi (Rehmanniae Radix), Maidong (Ophiopogonis Radix), Beimu (Fritillariae Cirrhosae Bulbus) each 5 qian; Sangbai (Mori Cortex), Tiandong (Asparagi Radix), Danpi (Moutan Cortex) each 3 qian; Huangqin (Scutellariae Radix) 1 qian. Decoct in water. Two doses stop pain, four doses remove odor.
This formula treats Lung, Heart, and Stomach. Rich-food consumers have deficient Qi/Blood in Lung/Heart. Simply purging fire damages Stomach Qi/Blood, increasing fire. Its brilliance lies in tonifying and cooling Lung, tonifying and cooling Heart, clearing Stomach fire. Fire retreats voluntarily, stopping throat pain.
Cold damage day 4-5 with fever, dry nose/mouth, sore throat is Yangming self-disease. Yangming belongs to Stomach; excessive sweating dries Stomach fluid, failing to moisten throat. Use Renshen Baidu San (Ginseng Rescue Powder).
Cold damage day 3-5 with bright red throat swelling, spontaneous phlegm-saliva, headache, stiff neck indicates Taiyang pathogen entering collaterals, stirring accumulated heat-toxin in Heart attacking throat. Use Gancao Jiegeng Tang plus Niubangzi (Arctii Fructus), Yuanshen (Scrophulariae Radix), Chuanlian (Coptidis Rhizoma). Day 8-9 cold damage with no tidal fever, abdominal fullness/pain, diarrhea, and sore throat indicates Taiyang meridian disease. After sweating, if unresolved, transitioning to Taiyin with abdominal fullness/pain/diarrhea and slightly white throat swelling is treatable with Zhenwu Tang (True Warrior Decoction), which tonifies lower Yuan, aids Yang Zheng Qi, aiming for warm extremities. Classics say: If mouth is red/vibrant with phlegm, treatable with modifications. Black mouth indicates dried blood; hoarse voice, eyes rolling up, sweating means untreatable. Carefully examine symptoms.
Day 8+ cold damage with persistent sore throat, dry tongue/lips after sweating indicates Shaoyin self-disease. Taiyin disease transitioning to Shaoyin after sweating: Shaoyin belongs to Kidney; sweating dries Kidney fluid, failing to moisten throat. If accompanied by diarrhea, abdominal pain, cold feet, swollen/painful throat unable to swallow, and absence of phlegm-saliva or dry tongue, it is untreatable. Patient with slight fever, no other symptoms, only throat pain without swelling and hoarseness on day 8+ is untreatable. Day 10+ cold damage with resolved illness, no tidal fever, calm pulse, but sore throat indicates residual toxin attacking upward; use Niubangzi Jiedu Tang (Arctii Fructus Detoxification Decoction).
Yin Toxic Cold Damage: Heavy body, stiff back, unbearable eye pain, urgent lower abdominal pain, dark poison gas rushing to Heart, cold limbs, nausea/vomiting, throat discomfort, deep/fine pulse. Quick treatment cures in dozens of days; otherwise difficult survival.
Men and women throat pain follow same rules, except women with red swelling in throat indicate irregular menstruation. Blocked menses obstruct upward, causing swelling/pain due to Ying/Wei disharmony. Men prioritize Qi, women prioritize Blood; adjust accordingly using Tiaoying Tang (Regulate Ying Decoction). If severe with pale color and cold feet, it is deficient Yang attacking upward; use Jiangqi Tang (Descend Qi Decoction) to induce vomiting of phlegm and apply powder. Pregnant women with heart/headache are untreatable.
Women with cold damage fever, tidal fever, sore throat during menstruation: Huoren Shu says menstrual onset with daytime clarity and nighttime delirium is Heat entering Blood Chamber. Do not violate Stomach Qi or Upper/Middle Jiao; do not purge. Xiao Chaihu Tang (Minor Bupleurum Decoction) is primary. Now, with throat pain, tidal fluctuations, red face/lips indicating Heat-Toxin blocking upward, do not use Xiao Chaihu Tang; use Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) to clear upper diaphragm and relieve irritability, followed by Siwu Tang (Four Substances Decoction).
Ulcers in throat with red/yellow color: induce phlegm then blow powder; use Niubangzi Jiedu Tang. Flesh growing in layers in throat with foul smell: decoct Zhen Gouju Ye (Real Citrus Aurantium Leaf) thickly and drink frequently for cure.
Deficient Yang attacking upward, Qi failing to ascend/descend causing phlegm-cold congestion in throat/pharynx: treat with Suzi Jiangqi Tang (Perilla Fruit Descending Qi Decoction).
Throat swelling originates from Spleen Meridian toxin due to fried/greasy food, excessive alcohol, and sexual activity, causing toxin stagnation at throat root. Without quick treatment, ulceration and closure cause death. Needle and vomit methods are best.
Common modern throat diseases include Single/Double Ru E (Tonsils), Ziteng Zhang (Sublingual Swelling), Muteng Zhang (Wooden Tongue Swelling), Chan Hou Bi (Entangling Throat Obstruction), Zouma Hou Bi (Running Horse Throat Obstruction). Qi rises to sides of throat forming swelling resembling teats (Ru E), single or double. Smaller than Ru E is Hou Bi. Heat in sublingual area creates small tongue (Ziteng Zhang); heat in tongue center causes swelling (Muteng Zhang). Wooden tongue is stiff/hard. Heat in throat with outer swelling, numbness, itching, large swelling is Chan Hou Feng. Sudden onset with surging phlegm, inability to swallow fluids. Though names differ, all relate to Hand-Shaoyin Ministerial Fire and Hand-Shaoyang Triple Burner Fire. These meridians connect to throat; heat causes internal knotting, swelling, obstruction, and death. Dangerous cases softened by salty/sour, large ones dispersed by pungent/herbs like Bohe (Menthae Haplocalycis Herba), Wutou (Aconiti Radix), Jiangcan (Bombyx Batryticatus), Poxiao (Natrii Sulfas), Baifan (Alumen). Zouma Hou Bi is not treated this way as life hangs in balance. Emergency method: scarification bleeding. Blood release cures; this is superior. Do not fear needles. Do not cling to small formulas claiming non-invasiveness; minor illnesses may heal, major ones die. Warn patients and physicians.
Throat is gateway for food/respiration, square inch area, dangerous disease, mostly Fire-related. Shaoyin/Shaoyang fires connect to throat, gathering fire pathogens. Ministerial fire slow causes pain/swelling; Associate fire fast causes severe swelling, insensitivity, obstruction, phlegm-block death. Classics: One Yin One Yang knotting is Hou Bi. Fire is root of phlegm, phlegm branch of fire. Excess fire from fried/spicy food accumulation causes thirst, constipation, wind-phlegm blocking, chest discomfort, string-taut rapid pulse. First disperse wind-phlegm, then resolve heat. Deficiency fire from alcohol, anger, sex causes throat dryness with normal bowels, faint pulse. Tonify deficiency, purge fire. Avoid pure cold herbs; temporary relief leaves upper heat, middle deficiency, toxin enters abdomen, chest swelling, asthma, diarrhea, cyanotic nails. Death after 7 days if no intake, fish-mouth appearance. Sweating is taboo in throat disease; needle bleeding counts as sweating. Do not needle Kidney/Diding (throat) swelling in cold damage. Internal deficiency causing loss of voice is untreatable.
Initial throat disease with chills and eruption, followed by cool body, no mouth sores, normal bowels, is not heat but Yin-Cold deficiency. Do not exhaust phlegm; this phlegm is body fluid, different from heat-type phlegm. Exhausting it depletes spirit and causes death. First use powder blowing or water-changing method to open throat, then take medicine. Initial dose disperses/harmonizes, next warms/nourishes. If chills/heart/bone/flank pain recur days 3-4, difficult to treat.
Throat disease with locked jaw, swollen tongue/throat, foul mouth, heavy tongue, yellow scales, afternoon chills/fever, closed bowels: treat as heat with Shigao Baidu San (Gypsum Rescue Powder). Easy to cure. Gradual onset days 3-4 with chills/fever, though severe, not harmful. Untreatable if symptoms persist without locked jaw, normal lips/skin lines. Untreatable if tongue fills mouth, walnut/eggplant/sandpaper colored. Treatable if combined with heavy tongue/chills. Pale purple/red tongue with veins indicates dead blood; foul smell suggests survival. Avoid thirst,急促 breathing, thick peach-gum phlegm (death imminent).
Neck-wide red swelling is critical. Red-purple face, blue-white face, lack of spirit: untreatable. Speechlessness: death. Slight speech: chance of life. Low-spirited preferring low seats: difficult. Diding (throat) connects to Kidney via tongue tie; white swelling untreatable, injury causes death. Day 5 severe throat disease: first 3 days pre-suppurative, medicine clears. Days 5-6 suppuration, rupture, ulcers difficult to treat; use mouth ulcer powder with Longgu (Os Draconis) and Zhenzhu (Margarita).
Blowing powder requires 4-5 tubes for sufficient phlegm expulsion; three times cures. Initial blowing uses more Jin Dan (Golden Pill), aimed directly at Diding, withdraw quickly to avoid vomiting.
Women with throat swelling/pain due to amenorrhea and fire attacking upward: use menstruation-regulating internal medicine; cure when menses flow.
Formless red swelling in throat: use Dengxin (Junci Medulla).
Critical throat disease with pale/swollen face, dull pulse, weak/deep pulse indicates leaking Spirit and Yang deficiency; untreatable. Red/swollen face with strong/rapid pulse indicates robust Yuan Qi and excess fire; easy to cure.
To expel phlegm-saliva when blowing powder, add small amount of Zaogiao (Gleditsiae Sinensis Spina) powder.
Sanhuang Jiedu Tang (Three Yellows Detoxification Decoction): Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex), Zhizi (Gardeniae Fructus).
Qingwei Tang (Clear Stomach Decoction): Shengdi (Rehmanniae Radix), Shengma (Cimicifugae Rhizoma), Lianqiao (Forsythiae Fructus), Danpi (Moutan Cortex), Huanglian (Coptidis Rhizoma).
Yinhuo Tang (Guide Fire Decoction): Shudi (Rehmanniae Radix Preparata, 5 qian), Yuanshen (Scrophulariae Radix, 5 qian), Yurou (Corni Fructus, 4 qian), Fuling (Poria, 4 qian), Shanyao (Dioscoreae Rhizoma, 4 qian), Wuwei (Schisandrae Fructus, 2 qian), Rougui (Cinnamomi Cortex, 1 qian), Baijiez (Brassicae Semis Albus, 3 qian).
Baidu San (Rescue Powder): Niubangzi (Arctii Fructus), Huafen (Trichosanthis Radix), Yuanshen (Scrophulariae Radix), Huangbai (Phellodendri Cortex), Bohe (Menthae Haplocalycis Herba), Danpi (Moutan Cortex), Yinhua (Lonicerae Japonicae Flos), Shu Shigao (Prepared Gypsum), Chishao (Paeoniae Radix Rubra), Gancao (Glycyrrhizae Radix et Rhizoma), Zhuye (Bambusae Folium), Dengxin (Junci Medulla).
Xijiao Jiedu Wan (Rhinoceros Horn Detoxification Pill): Treats pediatric sores/toxins and residual toxins after rash affecting throat/teeth.