凡喉症无痰者不治。痰响如雷者危。气声如拖锯者死。声哑者不治。色如腥熟者死。面
黑神
惨者死。口噤者危。齿脚肉包过牙者死。怒目直视者死。肚痛者死。鼻内出血不止者死。大
便泄出黑色者死。潮热不退者危。口动言语乱者死。喉内生肉笋针刺不痛者死。脓血不腥不
臭者死。气出无收者死。手不能提足不能步者死。满喉尽膜者不治。气臭者死。 中子白膜
遮尽者死。牙齿脱者不治。失舌者死。痰火升喉痛者不治。瘰 火升喉痛者不治。以上皆死
症，百中可救一二而已。
夫咽喉之症，皆由五脏六腑发来。脏腑生病，其形色见于咽喉， 中以内者谓之咽，
中以
外者谓之喉，咽喉形色各有阴阳，虚实之毒，卒然发起，牙关紧急，痰涎壅盛，气出不收，
朝发夕死，是乃急症。医者不明，往往谓此为痰热，孰不知有阴阳虚实之分。外症为阳，内
症为阴，虚则温之，实则泻之，有热去热，有风去风，有毒解毒，有膜去膜，有痰化痰，有
涎去涎，关闭用开关药，至内面红黄白烂点，可用药散吹之，外面红肿结核，则用药散敷，
结核成脓用针刺，审症用药勿慌忙。此真口诀也。
─火症喉痹，悉宜以抽薪饮主之。
─火不胜者，宜徙薪饮主之。
─凡胆肝之火盛者，宜以芍药、栀子、草龙胆为主。
─阳明胃火盛者，宜以生石膏为主。大便闭结不通，宜加大黄、芒硝之属通其便，而火
自降。
─凡火浮于上，而热结于头面咽喉者，最宜清降，切不可误用升阳散风等剂，盖此火由
中发
来，得升愈炽。经曰∶高者抑之，正此之谓也，非火郁宜发及升阳散火之义，学人于此最要
体察，勿谓误认其面目为嘱。
─凡外治火症肿痛之法，宜以木鳖子磨醋，用鹅毛蘸擦喉中，引去其痰。或另少和清水
，免
致太酸，时时呷嗽喉中，不可咽下，引吐其痰为更喜。嗽后以代匙散吹之，仍内服汤药，自
无不愈。
─凡火壅于上，而食物之治，最宜梨浆、绿豆汤之属为妙。若南方少梨之处，或以好萝
卜捣汁，和以泉水，少加元明粉搅匀，徐徐饮之，既可消痰，亦可清火。
─凡单双乳鹅，若毒未甚，脓未成者，治之自可消散。若势甚而危，必须砭出其血，庶
可速退，此因其急，亦不得已而用之也。又古法治喉痹，用三针刺少商穴，血出即愈。
─阴虚喉痹。其症亦内热口渴喉干，或唇红颊赤，痰涎壅盛，然必六脉无神，或六脉虽
数，
浮软无力，但察其过于酒色，或素禀阴气不足，多倦少力者，是皆肾阴亏损，水不制火而然
。火甚者滋阴八味煎，加减一阴煎之类主之。火微而不喜冷物及大便不硬，小便不热者，宜
六味地黄汤、一阴煎之类主之。若思虑焦劳兼动心火者，宜用二阴煎主之。
─格阳喉痹。由火不归元，则无根之火寓于咽喉而然，其症在上热下寒，全非火症。凡
辨此
者，但诊其六脉微弱，全无滑大之意，则下体全无火症，而腹不喜冷，即是症也。盖此症必
因色欲伤精所致。或泄泻伤肾，或本无实火，而过服寒凉以伤阳气者，皆能患此症。速宜用
镇阴煎治之为上，八味地黄汤次之，或用蜜附子含咽亦可。若再用寒凉之剂，多致不救。
─阳虚喉痹。非喉痹因于阳虚也，乃阳虚因于喉痹也。盖有因喉痹过于用攻击之剂，致
伤胃
气者。有饮食难下，仓库空虚而伤胃气者。又有气体素弱，不耐劳倦，而伤胃气者。大凡中
气内虚，疼痛外逼，多致元阳飞越。脉浮而散，或弱而涩，以致声如鼾睡，痰如拽锯者，此
胃肺垂绝之候，速宜挽回元气，以人参一味浓煎，放心徐徐咽下。如痰多者，或加竹沥、姜
汁亦可。如迟多致不救，若作实火治之，则祸不旋踵矣。
─格阳喉痹。但见其头面浮火，喉头粗极，气急声哑，咽肿口疮，痛楚之甚。察其脉，
细甚
而数。问其言，则声微似不能振者。询其所服之药，无非黄连、栀、柏之属。此盖以伤阳而
起，复为寒凉所逼，以致寒盛于下，而格阳于上，即茶水之类，亦俱难入口，而尤畏烦热。
余曰∶危哉！再迟日子，必不能救矣。遂以镇阴煎泡好，以冷水座冷，徐徐使咽之，甫服一
剂，须早而头顶肿痛尽消，遂继用五福饮之类，数剂而愈。疑者始皆骇服矣。
─喉痹痛。大概痰火所致。急者宜吐痰后复下之，上下分消而愈。又甚者，以针刺去血
，然
后用药吐之，此为治之上策。若人畏惧，而委曲旁求，瞬息丧命。盖治喉痹之法与救火同，
不容少待。《内经》曰∶发之，发之者，发散也。吐中有发散之义。出血者，亦发散之端也
。治斯痰者，毋执缓方小方而治之。如曰吾药乃王道不动脏腑，若遇疾之轻者可获愈，疾之
重者，因循死矣。岂非误杀耶！
─喉癣症。凡阴虚劳损之人，多有此病。其症满喉生疮，红肿疼痛，久不能愈，此实水
亏虚
火症也，宜用前阴虚喉痹之法治之。若多咳嗽肺热，宜以四阴煎之类治之。若满喉生疮破烂
而痛者，宜用牛黄益金散吹敷之，仍内服滋补真阴之剂，自可痊愈。
─瘟毒喉痹。乃天行瘟疫之气。其症则咽喉项肿，甚有头面颈项俱肿者，北方尤多此病
，俗
呼为蟆瘟，又名鸬 瘟，亦名大头瘟。此湿热壅盛最凶之候，宜清诸经之火，或泻阳明之热
，当察缓急而治之。东垣有普济消毒饮，专治瘟毒喉痹，百发百中。
─伏气之症。古方谓之肾伤寒。谓非时有暴寒中人，毒瓦斯伏于少阴肾经，始初不病，旬
月乃
发，脉微弱，法当以伤寒治之。非喉痹之病也，次非下利不可，按此症亦所常有，是必以少
阴少阳之火，令太阳之寒，令太阴之湿，复兼令风寒之邪者，皆有此症。故治此者，不必治
喉痹，但治外邪，其喉自愈。即如新方之柴胡饮及散阵诸方，皆可随宜酌用。
─杨梅结毒。有喉间溃烂作痛久不愈者，此非喉痹之属，乃杨梅疮毒也。宜用仙遗粮汤
，甚者宜以土茯苓煎汤，吞五宝丹治之。
─虚损喉痹。未易辨也。若一人因患虚损，更兼喉癣肿痛，多医罔效。余诊其脉，则数
而无
力，察其症则大便溏泄，问其治则皆退热清火之剂，然愈清火而咽愈痛。余察之，既确知其
本非实火，而且日前多用寒凉，以致肚痛不实，总亦格阳之类也。遂专用理阴煎及大补元气
煎治之而愈。
─锁喉风症。时人以咽喉肿痛，饮食难入，或痰气壅塞不通，甚奇甚急者，皆称为锁喉
风。
而不知有真正锁喉风，其甚奇甚急之处，而实人所未知也。余在襄阳尝见一女子，年已及笄
，忽一日在于仲秋时，无病而喉窍涩愈甚。及延余诊视，按其脉，无火也。问其喉，无肿无
痛也。观其貌，则面青目瞠不能语也。听其声，则喉窍若细如针，抽息之窘如线，伸头挣命
求救之状，甚可怜也。予见而疑之，不得其解。然意谓风邪闭窒喉窍，非用辛温不能解散，
遂用二陈汤加生姜煎而与之服，毫忽无效。意复用独参汤以救其肺，然见势危若此。恐滋怨
谤，终亦未敢下手。他医见之，亦但束手而已。如此者一日夜而殁。后又一人，亦患此症而
殁。若此二人者，余及今莫识其所以病，此毕生之疑窦，殊自愧也。然意必肺气竭绝之故，
倘值此者，恐非独参汤决不能救。故特书此，以俟后之君子详酌焉。
─诸物鲠于喉中，或刺或骨，必有锋芒之逆，所以刺碍而不下。凡下而逆者，后而上之
则顺
矣。故治此者，当借饮食之势，涌而吐之，使之上出，则如拔刺之捷也。若芒刺既深，必难
推下，非惟理势不顺，必致迟延，或饮食既消，无可推还，以致渐肿，则为害非细矣。凡诸
骨鲠或以饴糖一大块，满口吞而咽之，或用韭菜炙熟，不可切断，作一小束吞之，芒刺即裹
而下，亦妙。
─小儿口中误吞铁钉痛甚，余以磁石（七钱）、朴硝（二钱）、熟猪油（二两），加蜜糖调
和药末与之食，次日其铁随粪出，是诚可谓良方矣。
凡是喉症没有痰的，无法治愈。痰声如雷响的，病情危重。声音像拖锯木头的，必死。声音嘶哑的，无法治愈。面色像煮熟的血肉颜色的，必死。面色发黑、神情凄惨的，必死。牙关紧闭的，病情危重。牙龈肿胀包过牙齿的，必死。怒目直视的，必死。肚子痛的，必死。鼻孔出血不止的，必死。大便排出黑色粪便的，必死。潮热不退的，病情危重。口动言语错乱的，必死。喉咙内生有肉笋（息肉），针刺不痛的，必死。脓血既不腥也不臭的，必死。气息呼出后不能收回的，必死。手不能抬举、脚不能行走的，必死。满喉咙都是薄膜的，无法治愈。口气恶臭的，必死。舌上白膜遮盖尽处的，必死。牙齿脱落的，无法治愈。舌头脱落的，必死。痰火上升导致咽喉痛的，无法治愈。瘰疬（颈部淋巴结结核）之火上升导致咽喉痛的，无法治愈。以上这些都是死症，一百个人中只能救活一两个罢了。
咽喉的疾病，都是由五脏六腑引发的。脏腑生病，其形色会反映在咽喉上，位于咽门以内的称为“咽”，位于咽门以外的称为“喉”。咽喉的形色各有阴阳、虚实之毒的区别，突然发作时，牙关紧急，痰涎壅盛，气息呼出不收，早晨发病晚上就会死亡，这是急症。医生如果不明白这一点，往往认为这是痰热，却不知道其中有阴阳虚实的区别。外症属于阳，内症属于阴，虚证用温法，实证用泻法，有热就清热，有风就祛风，有毒就解毒，有膜就去膜，有痰就化痰，有涎就去涎，闭塞就用开关药，到了里面红黄白烂点的情况，可以用药散吹入；外面红肿结核，就用药散敷贴；结核化脓用针刺破，审察病症用药不要慌张。这真是口诀啊。
─火症喉痹，都适宜以抽薪饮为主方治疗。
─火势猛烈难以控制的，适宜以徙薪饮为主方治疗。
─凡是胆肝之火旺盛的，适宜以芍药、栀子、草龙胆为主药。
─阳明胃火旺盛的，适宜以生石膏为主药。如果大便闭结不通，适宜加大黄、芒硝之类的药物来通便，火气自然下降。
─凡是火气浮越于上，而热结在头面咽喉的，最适宜清降，切不可误用升阳散风等药剂，因为这种火是从内部发出的，使用升提药会使火势更旺。经书说：“高者抑之”，正是这个意思，并不是火郁宜发及升阳散火的含义，学习的人在这里最需要体察，不要说误认了面目而致误事。
─凡是外治火症肿痛的方法，适宜用木鳖子磨醋，用鹅毛蘸取擦拭喉中，引出痰液。或者另外加少量清水调和，以免太酸，时时含漱喉中，不可咽下，引吐痰液更为理想。漱口后用代匙散吹入，仍然内服汤药，没有不好的。
─凡是火气壅塞于上，饮食调理方面，最适宜梨浆、绿豆汤之类的为妙。如果南方少梨的地方，可以用好萝卜捣汁，和泉水一起，加少量元明粉搅匀，慢慢饮用，既可以消痰，也可以清火。
─凡是单侧或双侧乳蛾（扁桃体炎），如果毒邪不严重，脓未形成的，治疗自然会消散。如果形势危急，必须砭刺放血，才可以迅速消退，这是因为情况紧急，也是不得已而用的方法。古代法治喉痹，用三针刺少商穴，血出即愈。
─阴虚喉痹。症状也是内热口渴、喉干，或者唇红颊赤，痰涎壅盛，但是六脉无神，或者六脉虽然数，但浮软无力，只要观察其过度饮酒色欲，或者素禀阴气不足，多疲倦少力气的，这都是肾阴亏损，水不制火造成的。火大的用滋阴八味煎、加减一阴煎之类主方治疗。火微而不喜欢冷物及大便不硬，小便不热的，适宜六味地黄汤、一阴煎之类主方治疗。如果是思虑焦劳兼动心火的，适宜用二阴煎主方治疗。
─格阳喉痹。由于火不归元，无根之火寄寓于咽喉所致，症状是上热下寒，完全不是火症。凡是辨别这个病的，只要诊察六脉微弱，完全没有滑大的意思，那么下体完全没有火症，而且腹部不喜欢冷，就是这个病。因为这个病必定是因为色欲伤精所致。或者泄泻伤肾，或者本来没有实火，而过服寒凉损伤阳气的人，都能患这个病。速宜用镇阴煎治疗为上策，八味地黄汤次之，或者用蜜附子含咽也可以。如果再使用寒凉药剂，大多导致无法救治。
─阳虚喉痹。不是说喉痹是因为阳虚引起的，而是阳虚是因为喉痹（治疗不当）导致的。大概有因为喉痹过于使用攻伐药剂，导致损伤胃气的。有饮食难下，仓库空虚而损伤胃气的。又有体质素弱，不耐劳累，而损伤胃气的。大凡中气内虚，疼痛外逼，多导致元阳飞越。脉浮而散，或弱而涩，以致声音像打鼾睡觉，痰声像拉锯子的，这是胃肺垂绝的征候，速宜挽回元气，用人参一味浓煎，放心慢慢咽下。如果痰多的，或者加竹沥、姜汁也可以。如果迟疑太久会导致无法救治，如果当作实火治疗，灾祸立刻就会降临。
─格阳喉痹。只见头面浮火，喉头粗极，气急声哑，咽肿口疮，痛苦非常。诊察其脉，细甚而数。询问其言语，则声音微弱似乎不能振作。询问所服的药，无非黄连、栀、柏之类的。这是因为损伤阳气而起，又被寒凉逼迫，导致寒盛于下，而格阳于上，即使是茶水之类，也难以下咽，尤其畏惧烦热。我说：危险啊！再迟些日子，一定不能救了。于是将镇阴煎泡好，用冷水坐冷，慢慢使其咽下，刚服一剂，第二天早晨头顶肿痛全部消除，接着用五福饮之类，几剂后痊愈。怀疑的人开始都惊骇佩服了。
─喉痹痛。大概是痰火所致。急症适宜先吐痰后再通下，上下分消而愈。更严重的，用针刺去血，然后用药催吐，这是治疗的最高策略。如果人害怕，而委曲求全寻找其他方法，瞬息之间丧命。因为治疗喉痹的方法与救火相同，不容稍待。《内经》说：“发之”，发之，就是发散的意思。吐中有发散的含义。出血，也是发散的开端。治疗这种痰，不要拘泥于缓方小方来治疗。如果说我的药是王道药不动脏腑，如果遇到轻的病可以痊愈，重的病，因循守旧就会死了。这难道不是误杀吗！
─喉癣症。凡是阴虚劳损的人，多有这个病。症状是满喉生疮，红肿疼痛，久不能愈，这实际上是水亏虚火症，适宜用前面阴虚喉痹的方法治疗。如果多咳嗽肺热，适宜以四阴煎之类治疗。如果满喉生疮破烂而痛的，适宜用牛黄益金散吹敷，仍然内服滋补真阴的药剂，自然可以痊愈。
─瘟毒喉痹。是天行瘟疫之气。症状是咽喉项肿，甚至有头面颈项俱肿的，北方尤其多这个病，俗称蟆瘟，又名鸬鹚瘟，也叫大头瘟。这是湿热壅盛最凶险的征候，适宜清诸经之火，或泻阳明之热，应当察缓急而治。东垣有普济消毒饮，专治瘟毒喉痹，百发百中。
─伏气之症。古方称之为肾伤寒。说是非时暴寒中人，毒瓦斯伏于少阴肾经，起初不病，旬月才发，脉微弱，法当以伤寒治之。这不是喉痹的病，其次非下利不可，按此症也常有，是必定由少阴少阳之火，令太阳之寒，令太阴之湿，复兼令风寒之邪者，都有这个症。所以治这个病的，不必治喉痹，只治外邪，喉自然自愈。就像新方的柴胡饮及散阵诸方，都可以随宜酌用。
─杨梅结毒。有喉间溃烂作痛久不愈的，这不是喉痹所属，是杨梅疮毒。适宜用仙遗粮汤，严重的适宜用土茯苓煎汤，吞五宝丹治疗。
─虚损喉痹。不容易辨别。如果一个人因为患虚损，更兼喉癣肿痛，多位医生无效。我诊察他的脉，则数而无力的，察其症则大便溏泄，问其治疗则都是退热清火的药剂，然而越清火咽越痛。我察之，既确知其本非实火，而且日前多用寒凉，导致肚痛不实，总也是格阳之类。于是专用理阴煎及大补元气煎治疗而愈。
─锁喉风症。时人以咽喉肿痛，饮食难入，或痰气壅塞不通，甚至很奇特很急的，都称为锁喉风。而不知道有真正的锁喉风，其很奇特很急之处，而实在人们所不知道的。我在襄阳曾见一女子，年已及笄，忽然一日在仲秋时，无病而喉窍涩越来越严重。等到延请我诊视，按其脉，无火。问其喉，无肿无痛。观其貌，则面青目瞠不能语。听其声，则喉窍若细如针，抽息之窘如线，伸头挣命求救之状，很可怜。我见而疑之，不得其解。然而心想风邪闭窒喉窍，不用辛温不能解散，于是用二陈汤加生姜煎而给她服用，毫无效果。心想再用独参汤以救其肺，然而见势危若此。恐怕招致怨恨诽谤，终究也不敢下手。其他医生见了，也只是束手而已。如此一天一夜而死。后又一人，也患此症而死。像这两个人，我至今不认识他们得什么病，这是我一生的疑惑，特别惭愧。然而心想必定是肺气竭绝的缘故，倘若遇到这种情况，恐怕非独参汤决不能救。所以特意写下这些，以等待后来的君子详细斟酌。
─各种异物卡在喉中，或者是刺或者是骨，必有锋芒逆反，所以刺碍而不下。凡是向下而逆的，向后而上推则顺了。所以治这个病的，应当借饮食之势，涌而吐之，使之上出，就像拔刺一样快捷。如果芒刺已经深，一定难以下推，不仅理势不顺，必然导致迟延，或者饮食既消，无可推还，导致逐渐肿胀，那么危害就不小了。凡各种骨鲠或者用饴糖一大块，满口吞而咽之，或者用韭菜炙熟，不可切断，作一小束吞之，芒刺即裹而下，也很奇妙。
─小儿口中误吞铁钉痛得很厉害，我用磁石（七钱）、朴硝（二钱）、熟猪油（二两），加蜜糖调和药末给他吃，第二天铁随着粪便排出，这诚可谓良方了。
Any throat disease without phlegm is incurable. Phlegm sounds like thunder indicate a critical condition. A voice resembling the sound of dragging a saw indicates death. Hoarseness is incurable. A complexion resembling cooked blood/flesh indicates death. A black face with a miserable spirit indicates death. Trismus (lockjaw) indicates a critical condition. Gums swollen over the teeth indicate death. Staring with angry eyes indicates death. Abdominal pain indicates death. Unstopping bleeding from the nose indicates death. Black stool indicates death. Persistent tidal fever indicates a critical condition. Mouth movements and confused speech indicate death. Meat buds (polyps) growing inside the throat that do not hurt when pricked indicate death. Pus and blood that are neither fishy nor foul-smelling indicate death. Breath that exits but cannot be retained indicates death. Inability to lift hands or walk indicates death. The entire throat covered by membranes is incurable. Foul breath indicates death. White membrane covering the tip of the tongue indicates death. Loose teeth are incurable. Loss of the tongue indicates death. Throat pain caused by rising phlegm-fire is incurable. Throat pain caused by rising fire from scrofula (tuberculous lymphadenitis) is incurable. All of the above are fatal conditions; only one or two out of a hundred can be saved.
Throat diseases all originate from the five zang and six fu organs. When these organs are diseased, their manifestations appear in the throat. That which is located inside the pharyngeal gate is called "Yan" (pharynx), and that which is outside is called "Hou" (larynx). The color and shape of the Yan and Hou have distinct yin-yang and deficiency-excess toxicities. When they arise suddenly, accompanied by tightness of the jaw, abundant saliva and phlegm, and uncontrolled exhalation, leading to death from morning to evening, this constitutes an acute syndrome. Physicians who do not understand this often attribute it to phlegm-heat, failing to recognize the distinction between yin-yang and deficiency-excess. External syndromes belong to Yang, internal syndromes to Yin. Deficiency requires warming, excess requires purging. Heat is cleared, wind is dispersed, toxicity is resolved, membranes are removed, phlegm is transformed, saliva is eliminated, obstruction is opened with opening agents. For red, yellow, white, and ulcerated spots internally, medicament powders should be blown into the throat. For external swelling, redness, and nodules, medicament powders should be applied topically. Nodules that suppurate should be punctured with needles. Examine the syndrome and administer medication without panic. This is truly a mantra.
─ For Fire Syndrome Obstruction of the Throat (Huo Zheng Hou Bi), Chou Xin Yin (Draw Out the Fire Decoction) is indicated as the principal formula.
─ If the fire is intense and uncontrollable, Xi Xin Yin (Remove the Firewood Decoction) is indicated.
─ For excessive fire in the Gallbladder and Liver, Peony Root (Radix Paeoniae Alba), Gardenia Fruit (Fructus Gardeniae), and Gentian Root (Radix Gentianae) are the main herbs.
─ For excessive fire in the Stomach (Yangming channel), Raw Gypsum (Gypsum Fibrosum) is the main herb. If constipation occurs, Rhubarb Root (Radix Rhei Palmati) and Mirabilite (Natrii Sulfas) should be added to unblock the bowels, causing the fire to subside naturally.
─ When fire floats upward and heat knots in the head, face, and throat, clearing and descending is most appropriate. One must absolutely avoid mistakenly using formulas that raise Yang and disperse wind, because this fire originates from the interior; raising it will intensify the fire. The Classics state: "For those high up, suppress them." This is precisely what is meant. It does not refer to the principle of venting trapped fire or raising Yang to scatter fire. Students must carefully contemplate this and not claim ignorance due to misidentification.
─ For external treatment of swelling and pain in Fire Syndromes, grind Chinese Manchineel Fruit (Fructus Hippomane Mancinellae) in vinegar, dip a goose feather in it, and wipe the throat to draw out phlegm. Alternatively, dilute with a little clear water to avoid excessive acidity. Swish frequently in the throat without swallowing; inducing vomiting of phlegm is preferable. After swishing, blow Dai Chi San (Spoon-Replacement Powder) into the throat, and continue internal decoction therapy. Recovery is assured.
─ For fire stagnating upward, dietary management should favor Pear Juice and Mung Bean Soup. In southern regions where pears are scarce, juice from good radishes can be used, mixed with spring water and a small amount of Mirabilite. Drink slowly; this eliminates phlegm and clears fire.
─ For unilateral or bilateral tonsillar hypertrophy (Ru E), if the toxin is not severe and pus has not formed, treatment will lead to resolution. If the condition is critical, bloodletting via scarification is necessary for rapid relief. This is a desperate measure for emergencies. Ancient methods for treating Obstruction of the Throat involved pricking the Shaoshang point (LU11) three times; healing occurs upon bleeding.
─ Yin Deficiency Obstruction of the Throat. Symptoms include internal heat, thirst, dry throat, red lips and cheeks, and abundant saliva/phlegm. However, the six pulses are spiritless, or although rapid, they are floating, soft, and weak. Observation reveals excessive sexual activity or innate yin deficiency, manifesting as fatigue and weakness. This results from Kidney Yin depletion, where water fails to control fire. For severe fire, Zi Yin Ba Wei Jian (Eight-Ingredient Decoction for Nourishing Yin) or Jia Jian Yi Yin Jian (Modified One-Yin Decoction) are indicated. For mild fire, where there is no preference for cold substances, hard stools, or hot urine, Liu Wei Di Huang Tang (Six-Ingredient Pill with Rehmannia) or Yi Yin Jian (One-Yin Decoction) are indicated. For mental anxiety and agitation stirring Heart Fire, Er Yin Jian (Two-Yin Decoction) is indicated.
─ Ge Yang Obstruction of the Throat (Floating Yang Obstruction). This arises because fire fails to return to its source, with rootless fire lodging in the throat. Symptoms present as upper heat and lower cold, distinctly different from typical Fire Syndromes. Differentiation relies on detecting weak, thready pulses without slippery or large qualities, indicating no fire in the lower body and abdominal aversion to cold. This condition is caused by seminal injury from sexual excess, diarrhea damaging the Kidneys, or excessive use of cold/cooling herbs damaging Yang Qi in the absence of excess fire. Zhen Yin Jian (Settling Yin Decoction) is the superior treatment, followed by Ba Wei Di Huang Tang (Eight-Ingredient Pill with Rehmannia), or holding Honeyed Prepared Aconite Root (Radix Aconiti Lateralis Preparata) in the mouth to swallow. Further use of cold/cooling agents will likely prove fatal.
─ Yang Deficiency Obstruction of the Throat. This does not mean the throat obstruction is caused by Yang deficiency, but rather that Yang deficiency is caused by the throat obstruction (mismanagement). Cases include excessive use of attacking/purging agents damaging Stomach Qi, difficulty eating leading to empty reserves and damaged Stomach Qi, or inherent physical weakness unable to withstand labor, damaging Stomach Qi. Generally, internal deficiency of Middle Qi combined with external pain forces Yuan Yang to flee. Pulses are floating and scattered, or weak and choppy, with snoring-like voices and sawing-like phlegm sounds. These are signs of impending failure of the Stomach and Lung. Rapidly restore Yuan Qi by decocting Ginseng Root (Radix Ginseng) alone strongly and swallowing slowly. If phlegm is abundant, add Bamboo Sap (Succus Bambusae) or Ginger Juice (Succus Zingiberis Recens). Delay leads to fatality; treating as excess fire brings immediate disaster.
─ Ge Yang Obstruction of the Throat. Manifests as floating fire on the head and face, extremely coarse larynx,急促 breathing, hoarseness, swollen throat, oral ulcers, and severe pain. Pulses are fine and rapid. Speech is faint and weak. History reveals consumption of Coptis Rhizome (Rhizoma Coptidis), Gardenia, and Phellodendron Bark (Cortex Phellodendri). This resulted from Yang damage compounded by cold/cooling agents, causing cold to dominate below and repel Yang to above. Even tea and water are difficult to swallow, with aversion to irritability and heat. I stated: "Critical! Delay further and rescue will be impossible." I prepared Zhen Yin Jian, cooled it with cold water, and administered it slowly. After one dose, headache and neck swelling subsided by morning. Subsequent treatment with Wu Fu Yin (Five-Fortune Infusion) cured the patient within several doses. Skeptics were amazed and convinced.
─ Throat Bi Pain. Generally caused by phlegm-fire. Acute cases require expectoration followed by purgation to resolve via upper and lower dispersion. Severe cases require bloodletting via needle puncture, followed by emetics. This is the supreme strategy. Fearfulness and seeking alternative remedies lead to sudden death. Treating Throat Bi is like fighting fire; delay is unacceptable. The *Neijing* states: "Vent it." Venting implies dispersal. Emesis contains the meaning of dispersal. Bleeding is also a form of dispersal. Do not adhere to slow or mild formulas for such phlegm. Claiming "King's Way" medicines do not disturb the viscera may cure mild cases but leads to death in severe ones through procrastination. Is this not mistaken killing?
─ Throat Xuan Syndrome. Common in individuals with Yin Deficiency and consumptive disease. Symptoms include ulcers throughout the throat, redness, swelling, pain, and chronic non-healing. This is essentially Water Deficiency with Empty Fire. Treat according to the Yin Deficiency Obstruction of the Throat protocol. If accompanied by cough and Lung Heat, Si Yin Jian (Four-Yin Decoction) is indicated. For painful, broken ulcers throughout the throat, blow Niu Huang Yi Jin San (Calculus Bovis Powder to Benefit Metal) locally, while internally administering tonics for True Yin. Recovery is expected.
─ Wen Du Obstruction of the Throat (Plague-Toxin Throat Disease). Caused by epidemic qi. Symptoms include swelling of the throat and neck, sometimes extending to the head and face. Prevalent in the North, commonly known as Toad Plague, Cormorant Plague, or Big Head Plague. This is a fierce manifestation of damp-heat stagnation. Clear fire from all meridians or purge Yangming heat, adjusting based on urgency. Dong Yuan's Pu Ji Xiao Du Yin (Universal Rescue Detoxification Decoction) specifically treats this and is highly effective.
─ Fu Qi Syndrome (Latent Qi Syndrome). Known in ancient texts as Kidney Cold Damage. It refers to atypical violent cold invading the body, with toxins lying latent in the Shaoyin Kidney Meridian. No initial illness occurs; symptoms emerge after ten days to a month. Pulses are weak. Treatment follows Cold Damage protocols. This is not Throat Bi. Secondary symptoms may include diarrhea. This syndrome often involves Shaoyin/Shaoyang fire interacting with Taiyang cold, Taiyin dampness, and wind-cold pathogens. Treatment should focus on external pathogens rather than the throat itself; the throat will heal spontaneously. New formulas like Chai Hu Yin (Bupleurum Infusion) and various powder prescriptions can be adapted as needed.
─ Yangmei Toxic Sores (Syphilitic Chancre). Chronic ulceration and pain in the throat not healing. This is not Throat Bi but Syphilitic toxin. Xian Yi Liang Tang (Immortal Grain Decoction) is indicated. For severe cases, decoct Smilax Glabra Rhizome (Rhizoma Smilacis Glabrae) and swallow Wu Bao Dan (Five-Treasure Pills).
─ Deficiency Consumptive Throat Bi. Difficult to differentiate. A patient with deficiency consumptive disease presents with Throat Xuan swelling and pain, unresponsive to multiple physicians. Pulse is rapid but weak. Symptoms include loose stools. Previous treatments were cooling/clearing agents, yet throat pain worsened with cooling. Confirmed as non-excess fire; prior excessive cold/cooling herbs caused abdominal discomfort. This resembles Ge Yang syndrome. Treated successfully with Li Yin Jian (Regulate Yin Decoction) and Da Bu Yuan Qi Jian (Great Tonify Yuan Qi Decoction).
─ Suo Hou Feng Syndrome (Lock-Throat Wind). Contemporary people label any severe throat swelling, dysphagia, or phlegm obstruction as Lock-Throat Wind, unaware of the true, rare, and acute form. In Xiangyang, I observed a girl of marriageable age in mid-autumn. Suddenly, her throat became increasingly obstructed without apparent cause. Pulse showed no fire. Throat was not swollen or painful. Face was blue, eyes staring, unable to speak. Sound was thin as a needle, breathing labored as a thread, stretching neck in desperation. I suspected wind-pathogen blocking the throat, requiring acrid-warm dispersants. Administered Er Chen Tang (Two-Cured Decoction) with Ginger, with no effect. Considered Du Shen Tang (Single-Ginseng Decoction) to save the Lung, but feared blame due to critical condition. Other physicians did nothing. She died within a day and night. Another case followed similarly. I remain puzzled by these deaths to this day, feeling ashamed. I suspect lung Qi exhaustion. If encountered, only Single-Ginseng Decoction might save. I record this for future scholars to consider.
─ Foreign bodies stuck in the throat, such as splinters or bones, have sharp edges preventing downward passage. Pushing down against resistance is counterproductive. Advancing upward with food momentum induces vomiting, extracting the object easily like pulling a splinter. Deep splinters are hard to push down; delay allows digestion of the food vehicle, leading to swelling and greater harm. For bone impaction, swallow a large piece of Malt Sugar (Saccharum Japonicum) whole, or swallow a bundle of roasted chives (not cut) to wrap the sharp object and guide it down. Both methods are effective.
─ A child accidentally swallowed an iron nail, causing severe pain. I used Magnetitum (Magnetic Ore, 7 qian), Mirabilite (2 qian), and cooked lard (2 liang), mixed with honey powder, and fed it to the child. The next day, the iron passed in the stool. This is indeed an excellent prescription.