咽喉之地，尤为急证，（咽、喉、嗌、会厌，为饮食气息之道路，四者缺一，则食废息
闭而
，内系真寒，治当引火归元，如方中桂姜汤、归源丹是也。）婉转而痛方腾，乃为热病。（热
病者，风热也。风无热不熏，热无风不炽，治当疏风降火，如方中苏子利喉汤、黄连清喉饮
是也。）譬之龙雷之火，焰因阴生，（龙雷之火，虚火也。龙雷之性必阴云四合，然后遂其升
腾之势，得雨益炽。若天清日朗，则退藏不动矣。人身肾中之相火亦犹是，平素不能节欲，
致
炽，由渐着也。燎火之火，凡火也。积薪蔓草之中，初得一点凡火，星星然其势不觉，殊不
知由星星而至于焰焰，由焰焰至于炎炎，遂不可止遏，不可向迩。在人身或为外邪所伤，或
为内亏所致，津枯液竭，邪热灼炽，盖非一朝一夕之故，如喉痈、喉蛾之类是也。）经
骤起非火，缓起非寒，（此引《灵枢》、《内》、《难》之旨，以证辨虚实也。龙雷之火，
潜伏阴中，当其未动不知其为火也，及其一发，暴不可御，故病则骤起。若夫五行有形之阳
火，星星至于燎原，逐渐而甚，故病则缓起。火指阳火，寒指虚火，盖骤起缓起之间，正有
阳火
有天壤之殊，故治病非难，识病惟难耳。能于虚实寒热之间，辨得明，识得透，而投药未有
不获济于反掌者。）是在明睿之士。知所区别，乃随所投而无误耳。（阴寒之证，误投阳火之药，
则致顽痰塞满口鼻，声如曳锯，呼吸闭绝而死。阳火之证，误投阴寒之药，则致咽喉肿闭溃烂，
舌如紫茄，饮食废绝而死。噫！毫厘千里，性命系焉，岂可视医为小道哉。苟随证知所区别，投
药百无一误，非明睿之士不能。）
咽喉部位，尤其属于急症。（咽、喉、嗌、会厌，是饮食和气息通行的道路，这四个部分中缺少任何一个，就会导致饮食废绝、呼吸闭塞而死亡。若内部关联真寒证，治疗应当采用引火归元法，如方剂中的桂姜汤、归源丹等。）如果疼痛是逐渐加剧并伴有红肿热痛，这才是热病。（所谓热病，是指风热之邪。风邪没有热邪熏蒸则不烈，热邪没有风邪鼓动则不炽盛，治疗应当疏风降火，如方剂中的苏子利喉汤、黄连清喉饮等。）这好比龙雷之火，火焰因阴气而生发。（龙雷之火，即虚火。龙雷的习性一定是等到阴云四合时，才发挥其升腾之势，遇到雨水反而更加炽盛。如果天空晴朗、烈日当空，它就退藏不动了。人体肾中的相火也是如此，平时不能节制欲望，导致相火炽盛，是逐渐积累而成的。燎原之火，即凡火（实火）。堆积在柴草之中，起初只有一点凡火，星星点点其势头并不明显，殊不知从星星之火发展到烈焰熊熊，再到炎炎大火，最终就不可遏制、不可靠近了。在人体身上，或是被外邪所伤，或是因内里亏损所致，津液枯竭，邪热灼烧炽盛，这不是一朝一夕形成的缘故，如喉痈、喉蛾等疾病就是这类。）突然发作的不是火（实火），缓慢发作的不是寒（虚火）。（这是引用《灵枢》及《内经》、《难经》的宗旨，来证明辨别虚实的方法。龙雷之火（虚火），潜伏在阴分中，当它未发动时，不知道它是火；一旦发作，暴烈不可抵御，所以疾病突然发作。至于五行中具有形质的阳火（实火），从星星之火到燎原之势，逐渐加重，所以疾病缓慢发作。这里的“火”指阳火（实火），“寒”指虚火（龙雷之火），在突然发作与缓慢发作之间，有着天壤之别，所以治病不难，难的是识病。能够在虚实、寒热之间辨别清楚、认识透彻，那么用药没有不立刻见效的。）这需要明智睿智的人士去分辨。知道如何区别，才能根据病情投药而不犯错误。（如果是阴寒之证，误投阳火性质的药物，就会导致顽痰堵塞口鼻，声音像拉锯一样，呼吸闭塞断绝而死。如果是阳火之证，误投阴寒性质的药物，就会导致咽喉肿胀闭塞溃烂，舌头像紫茄子一样，饮食废绝而死。唉！毫厘之差，千里之谬，性命系于此，怎么能把医学看作是小道呢？如果能够随证候知道如何区别，投药百无一失，不是明智睿智的人是不能做到的。）
The throat region is particularly prone to acute conditions. (The pharynx, larynx, epipharynx, and epiglottis serve as the pathways for food and breath; if any one of these four is compromised, it leads to the cessation of eating and breathing, resulting in death. If the condition involves internal True Cold (Zhen Han), treatment should employ the method of guiding fire back to its source (Yin Huo Gui Yuan), such as using formulas like Guizhi Jiangtang Decoction or Guiyuan Dan.) Pain that escalates gradually with swelling and heat indicates a Heat Disease (Re Bing). (Heat diseases refer to Wind-Heat (Feng Re). Wind without Heat does not become intense, and Heat without Wind does not blaze; treatment should focus on dispersing Wind and descending Fire, such as using Su Zi Li Hou Tang or Huang Lian Qing Hou Yin.) Consider this akin to the "Dragon-Thunder Fire" (Long Lei Zhi Huo), whose flames arise from Yin. (Dragon-Thunder Fire refers to Deficient Fire (Xu Huo). The nature of Dragon-Thunder requires clouds to gather before it can rise; ironically, rain makes it more intense. If the sky is clear and the sun bright, it remains hidden. Similarly, the Ministerial Fire (Xiang Huo) in the Kidney (Shen) behaves thus: failure to regulate desires leads to a gradual accumulation of excessive Fire. In contrast, "Prairie Fire" (Liao Huo) refers to Ordinary Fire (Fan Huo), i.e., Excess Fire (Shi Huo). Accumulating among firewood and dry grass, it starts with a single spark, seemingly insignificant. However, from sparks to flames, and from flames to roaring fires, it becomes unstoppable and unapproachable. In the human body, this may result from external pathogens injuring the exterior or internal deficiency causing exhaustion of Jin-Ye (Body Fluids), leading to blazing pathogenic Heat. This is not a sudden occurrence but develops over time, as seen in conditions like Throat Abscess (Hou Yong) or Tonsillar Swelling (Hou E).) Sudden onset does not indicate Fire (Excess), while slow onset does not indicate Cold (Deficiency). (This cites the principles of *Ling Shu* and the *Nei Jing* and *Nan Jing* to demonstrate the differentiation of Deficiency and Excess. Dragon-Thunder Fire (Deficient Fire) lies latent within Yin; when inactive, it is unrecognized as Fire, but once activated, it is violent and uncontrollable, hence the sudden onset of disease. Conversely, the有形 (tangible) Yang Fire (Excess Fire) of the Five Elements grows gradually from sparks to a prairie fire, hence the slow progression of disease. Here, "Fire" refers to Yang Fire (Excess Fire), and "Cold" refers to Deficient Fire. There is a vast difference between sudden and slow onset. Treating disease is not difficult; recognizing it is. Only by clearly distinguishing between Deficiency/Excess and Cold/Heat can one ensure immediate efficacy in medication.) This requires discernment by wise individuals. Knowing how to differentiate ensures accurate prescription. (If a Yin-Cold syndrome is mistakenly treated with Yang-Fire warming drugs, it causes stubborn Phlegm to block the mouth and nose, producing a sawing sound during respiration, leading to death by respiratory arrest. If a Yang-Fire syndrome is mistakenly treated with Yin-Cold cooling drugs, it causes severe swelling, obstruction, and ulceration of the throat, with the tongue turning purple like an eggplant, leading to death by inability to eat or drink. Alas! A slight error leads to a thousand-mile deviation; life and death hang in the balance. How can medicine be regarded as a trivial pursuit? Only those who can differentiate according to symptoms and prescribe accurately—achieving near-perfect success—are truly wise.)