凡治症，三日前症虽重，尚未成脓，药能消散。若至五六日，成脓穿破后，必腐烂难愈。烂处多用八味口疳丹，加
龙骨珍珠散。凡伤寒之后，患连珠蛾及喉闭者，不治。盖其颈顶硬强，目睛上视，故不治也。
凡喉症，一二日即发寒热者轻；若初起不发寒热者，至第三日发寒热者重。大小便通利则易愈，不过浮游火上攻，宜
服消风清火解毒之剂。若通二便，则火易泄，病易愈。若大小便不通，其症必重。若内有寒而外有火，用降火解毒重剂。
若头痛，恐传变伤寒，则难治矣。
凡症势虽凶，发于外者易治。若初起大便闭结，宜用大黄元明粉下之，则自下降而愈。若至六七日不愈，仍闭结者，
用之立死。盖病久胃虚，元气大亏，宜禁用硝黄等味矣。虽大便闭甚，只宜用蜜煎导法，如牙皂、细辛。
凡喉症无形便红肿者，宜用元丹。
凡妇人喉肿痛者，有因经闭虚火上升而作。痛者，宜服通经药。
凡喉症凶者，面色白亮无光，脉息沉微无力，此系神气外泄亡阳之征，不治。若面色红肿，脉来洪大有力，其势虽
凶，而元气尚存者，治之可效。若肿而不痛，即系死肉，症难治矣。
凡舌肿胀，满口塞住，不能入药，用姜蚕、牙皂二味，炒研细末，吹鼻中。牙关开而痰涎出，然后用箸卷丝棉蘸甘
草汤，润其喉舌。凡碎处、肿处，吹药要细，须要各处吹到，不可忽略，因能得药力，其势即减矣。
凡治喉症最要细心，即如喉花，名曰蒂丁。若用刀刺，必须谨慎，切勿可碍，倘或伤之，即有性命之忧。至于走马
疳、虚劳喉癣等症不一，论附于后。
喉痹 肝胃肺三经积热所致，复感时邪而骤发。其形如海棠叶背紫纹，其纹样碎烂，有小泡生于纹旁，饮食如
常，治此症，煎剂须用滋阴降火养肺之药，最利乎清火之品，惟走马喉痹之症，其症至险，尤宜早治，用膏子药不时含
咽；吹用真禁散、珠黄散，加参叶末吹。
呛食哑喉 此症不红不肿，因伏邪在肺，声哑呛食，六脉迟细，甚属险症，饮食不进而死。其脉若有根，或可
调治。宜先表伏邪，后用健脾峻补。
内外喉痈 喉痈，因过食浓味感热而发，生于喉关，内外皆肿，发热头痛，四五日可愈。吹用真禁珠黄散，煎
用清凉之品。
HT 舌喉痈 此乃心经火甚，肥人性躁急者，每患此症，感热而发，舌之下生小舌，为HT 舌；如连喉痛
者，为喉痈，不痛者，非痈也。如HT 舌并喉痈者，凶。吹用真禁药，煎用地黄汤。
舌菌 属心经，因酒色忧郁气滞而生，其状如菌，或木耳形，其色红紫，时大时小，吹真禁药为主，加珠黄散
更妙。
附症七种属心经。舌根痈、舌心痈、侧舌痈、三尖HT 舌、紫胀吞、木舌、重舌。吹用真禁药、珠黄散；煎用犀角
地黄汤，舌症通治。
黑山栀 粉丹皮 赤芍药 生甘草 鲜生地 犀角尖 小木通 净银花 荆芥穗 连翘
舌上痈 即舌心痈。生于舌之中心，如梅子大，不能言语，此因热入心包而发。红肿者可治，色黑者不治。又
有舌黄，舌上肿痛，黄色亦属心火。
舌下痈 即舌根痈。此乃脾肾两经积热，发于舌下金津、玉液二穴，通于肾经，肾水枯竭，方生此穴。治宜壮
水扶脾。
紫舌 此因心脾两经热乘所致，有红点紫色而烂痛，或恶心欲呕，防发斑等症。
木舌 因多食炙爆，或由食滞中宫，心脾肺三经积热所致。舌粗紫胀，不能言语。如两寸关脉洪大，症实，易
治；六脉细者，症虚，难治。
重舌 此乃心脾之热所致。舌下生小舌，早不治，大舌粗短，小舌长而痛，久必烂，烂则难治。
牙疔 先二日发热，后则牙痛不可忍，牙根上发一紫泡是也。生于上牙门者凶，生于别牙旁者易治，上左边门
牙脱落者不治，因肾脏虚损，挟心胃二火上攻。初起未破为疔，已破者为毒。色红者可治，青色者不治。吹真禁珠黄散。
牙癣 由阳阴经实火上攻而发，齿缝中出血，上属脾，下属胃；牙根腐烂。珍珠散、生肌散、珠黄散、真禁药。
马牙 初生小儿，因胎中受毒，见风而发。含乳或吞或吐，吹真禁，服凉药。牙症乃是阳明胃经之症。病生牙
上，阳明大肠之症；病生牙下，要知皆从肾家虚热而生。盖齿乃骨之精，肾之标也。然不独因肾而发，亦有风邪所致。
用药审症，煎方宜酌。
玄参 生地 丹皮 知母 白芍 地骨皮 车前子 生甘草 黄柏
连珠蛾 满口如白网油，象肚两边微肿，根有白点，带红色，小舌红肿，进汤大痛，病由忧郁热毒而发。其脉
两寸、尺浮洪而大，上盛下虚之症，势极重者也。
石蛾 此因本源不足，亦有胎生，在乳蛾地位稍进半寸。初忌寒凉。盖肝火、忧郁所致。老痰恶血阻遏，妇人
最多。
锁喉风 因热毒积聚，痰涎粘稠，阻塞会厌，喘急上气，外颈肿胀，用开关豁痰可治。外不肿，内无痰者，名
曰∶内锁喉，不治。
白缠喉风 此乃肾虚受寒，劳碌而渴，寒则生热，热则生风，风寒相搏，痰气上跻，壅滞凝结，故患此症。必
眼白耳赤而紫，口不能言，关内肿，上白下红，最为急症。牙根白者不治。
牵丝缠喉风 此症喉内有紫红色血丝，其症须防传染。
喉菌 忧郁过度，心胃两经邪火入络，气血滞而不散，妇人患者最多。状如菌，色紫，生于两旁，用黄连解毒
汤。
喉瘤 本源不足，怒气伤肝，或仰高叫、或诵读太急，所以气血相凝，生于关内，两旁有小紫块，不时而发，
治宜培养本源。
喉癣 因肾虚火炎，肺经火旺，不肿而微红，如海棠叶背红筋状，有斑点青白。又一或如芥菜子大，或如绿豆
大，每点生芒刺，饮食阻碍，喉干音哑，咳嗽无痰。其斑点生于筋中者癣，生于筋旁者痹，用膏子药，不时含咽，吹真
禁珠黄散，内加乳石，中白、参叶末；煎用清肺养阴。
喉痈 因过食浓味，脾胃受热，感寒而发，其色淡红，肿而痛甚者是也，如李大，亦发热头痛，成脓易治，吹
真禁珠黄散。
上 痈 生于上 ，如梅核大，饮食妨碍；又因胃家积热，化毒而发。用解毒清凉，吹同前。此症由蕴热积毒
而生，或因水亏，致动相火∶或酒毒上攻，内热外寒，火乘于肺，致咽喉肿胀，其形根大头小，红色大痛，下垂于关口
上部。
吹口喉风 此属太阴。病太阴肿胀疼痛，舌向上，是心血少而火易动，肺气虚而水不生。盖言语乃喉舌所司，
心有热，则现象于外，是以水愈亏而火愈甚，舌将强而难言也。
喉疔 此不仁之症也。初起形如杞子，生于喉关口两旁近舌处，五脏积热所致。色淡红而硬，大痛难食，背寒
身热，如开花；黑色者不治。盖因愤怒积思所致，心血先绝，死在旦夕，女人得此立死。上 痛属脾经，上 生疮，形
如黄粟，口中腥臭，手足怕冷。此由脾经积热而生。
左右雀舌 此因多食煎熬之物，积热于胃，故发于舌旁，或左或右，近牙根，生一小舌，延久必烂，烂则不能
速愈。
喉疳 此因肾虚火旺，升腾而发，喉间上 有青白水点，平塌无刺，故名。喉声不哑不咳嗽，两尺脉虚者是也。
诸疳 锁口（外嘴唇）、锁喉（咽喉）、吊根（生舌中心下）、豆瓣（生满口）、堆沙（舌心中）、梅花（满口碎）、
糜口、雪口（白布满口）、啄舌（舌上），皆用珠黄玉丹，加真禁吹之。以上疳症，因惊风久虚、痢疾久虚、疳积久虚、
间有大人久病，亦要发疳。痘后有余毒，忌吹龙骨∶痧后忌切牙，恐其牙落也。凡诸疳及口碎者，俱用八味口疳丹吹之。
小儿走马牙疳 或因胎毒，或因痘后毒未尽。发于口齿，或痧后发于牙根，以致腐烂，杀人最速。色
如干酱，一日烂一分，十日不治。鼻梁上有红点者，不治。上左边门牙，为牙中之主，此牙一落，余牙尽
落，不治。若此牙不落，别牙难落，犹可强治，然亦不过十中救二三也。治此口疳，药内必用珠黄。
茧唇 症属足阳明胃经。因久食浓味，或思虑暴怒，痰火上注于唇。起初如黄豆大，形如茧肿，突
起，硬而坚甚，作痛，饮食妨碍。或流血水，久则变为消渴、消中之症。形体瘦弱，虚热痰生，面色黧
黑，口干渴甚者，难治。初起即治，可愈。治用艾灸三四次，后用蟾酥饼贴，内服八味丸，方列于下。
大熟地（四两） 茯苓（二两） 山药（二两） 泽泻（二两） 萸肉（一两） 黄柏（二两） 知母（五钱） 丹
皮（二两）
蜜水为丸，早晨清汤送下。下午后，服清凉甘露饮。
黑玄参（一钱五分） 丹皮（二钱） 麦冬（二钱） 川贝（二钱） 苦桔梗（一钱） 杏仁（三钱） 甘草（一
浅） 花粉（二钱）
凡是治疗喉症，发病前三天虽然症状严重，但尚未化脓，药物能够使其消散。如果到了第五六天，脓液形成并破溃后，必然会出现腐烂且难以愈合的情况。对于腐烂的部位，多使用八味口疳丹，配合龙骨珍珠散。凡是伤寒病之后，出现连珠蛾（一种咽喉重症）及喉闭（咽喉闭塞不通）的患者，属于不治之症。这是因为患者颈部僵硬强直，眼球上翻，所以无法治愈。
凡是喉症，如果在第一二天就出现恶寒发热的，病情较轻；如果初起时不出现恶寒发热，而到第三天才出现的，病情较重。大小便通畅则容易痊愈，这不过是浮游之火上攻所致，适宜服用具有疏风、清火、解毒功效的药剂。如果大小便通畅，火热之邪就容易排出，疾病容易痊愈。如果大小便不通畅，病情必然严重。如果体内有寒而体表有火，应使用重剂量的降火解毒药。如果出现头痛，恐怕会传变为伤寒，那就难以治疗了。
凡是病症势头虽然凶险，但病变表现于外部的，容易治疗。如果初起时大便闭结，适宜用大黄和元明粉泻下，使邪气自下降而痊愈。如果到了第六七天仍然没有痊愈，且依然大便闭结的，再用泻下药会导致立即死亡。因为病程久了胃气虚弱，元气大亏，应当禁用芒硝、大黄等峻下之品。即使大便闭结非常严重，只适宜采用蜜煎导法（外用通便法），如使用牙皂、细辛等。
凡是喉症中无形体红肿的，适宜使用元丹。
凡是妇女咽喉肿痛，有的是因为月经闭止、虚火上炎而引起的。疼痛者，适宜服用通经的药物。
凡是喉症凶险的，如果面色白亮无光泽，脉象沉微无力，这是神气外泄、亡阳的征兆，属于不治之症。如果面色红肿，脉象洪大有力，虽然病势凶险，但元气尚存，治疗可以见效。如果肿胀但不疼痛，那就是死肉，病情难以治疗。
凡是舌头肿胀，充满口腔，导致药物无法进入，可用姜蚕、牙皂两味药，炒制后研成细末，吹入鼻中。牙关打开且痰涎流出后，然后用筷子卷起丝棉蘸取甘草汤，润湿其喉舌。凡是破碎处、肿胀处，吹药要细致，必须照顾到各个部位，不可疏忽，因为只要药力到达，病势就会减轻。
凡是治疗喉症最要紧的是细心，就像喉花，名叫蒂丁（悬雍垂）。如果用刀刺破，必须谨慎，切勿损伤周围组织，倘若伤及它，就有性命之忧。至于走马疳、虚劳喉癣等病症不一而足，论述附在后面。
喉痹：由肝、胃、肺三经积热所致，又感受时令邪气而突然发作。其形态像海棠叶背面的紫纹，纹路破碎糜烂，小泡生于纹路旁边，饮食正常。治疗此症，煎剂必须使用滋阴降火、养肺的药物，最利于清火之品。只有走马喉痹这一症候，极其危险，尤其应当早治，使用膏子药不时含咽；吹药使用真禁散、珠黄散，加入参叶末吹入。
呛食哑喉：此症不红不肿，因伏邪在肺，声音嘶哑且进食呛咳，六脉迟细，属于很危险的症候，若饮食不进则会死亡。如果脉象有根，或许可以调治。适宜先解表透发伏邪，后用健脾峻补之法。
内外喉痈：喉痈，因过食浓味感受热邪而发，生于喉关，内外皆肿，伴有发热头痛，四五日可愈。吹药使用真禁珠黄散，煎服清凉之品。
HT 舌喉痈：这是心经火气极盛，体型肥胖且性情急躁的人，常患此症，感受热邪而发，舌下生出小舌，称为 HT 舌；如果连及喉咙疼痛，称为喉痈，不痛的则不是痈。如果 HT 舌并见喉痈，则凶险。吹药使用真禁药，煎服地黄汤。
舌菌：属心经，因酒色过度、忧郁气滞而生，形状像菌类，或像木耳，颜色红紫，有时大有时小，吹药以真禁药为主，加入珠黄散更好。
附症七种属心经。包括舌根痈、舌心痈、侧舌痈、三尖 HT 舌、紫胀吞、木舌、重舌。吹药使用真禁药、珠黄散；煎服犀角地黄汤，此为舌症通用方。
黑山栀 粉丹皮 赤芍药 生甘草 鲜生地 犀角尖 小木通 净银花 荆芥穗 连翘
舌上痈：即舌心痈。生于舌之中心，如梅子大小，不能言语，这是由于热入心包而发。红肿者可治，色黑者不治。又有舌苔发黄，舌上肿痛，黄色也属心火。
舌下痈：即舌根痈。这是脾肾两经积热，发于舌下的金津、玉液二穴，通于肾经，肾水枯竭，方才生出此症。治疗宜壮水扶脾。
紫舌：这是由于心脾两经热邪乘袭所致，有红点紫色而腐烂疼痛，或恶心欲呕，需防发斑等症。
木舌：因多食炙烤爆炒之物，或由食滞中焦，心脾肺三经积热所致。舌体粗紫肿胀，不能言语。如果两手寸关脉洪大，症属实证，易治；六脉细弱者，症属虚证，难治。
重舌：这是心脾之热所致。舌下生出小舌，早期不治疗，大舌粗短，小舌长而疼痛，时间久了必然腐烂，腐烂则难治。
牙疔：前两日发热，随后牙痛不可忍受，牙根上发出一个紫泡即是。生于上牙门齿者凶险，生于其他牙齿旁者易治，上左边门牙脱落者不治，这是因为肾脏虚损，挟带心胃二火上攻。初起未破溃为疔，已破溃者为毒。色红者可治，青色者不治。吹药使用真禁珠黄散。
牙癣：由阳明经实火上攻而发，齿缝中出血，上属脾，下属胃；牙根腐烂。使用珍珠散、生肌散、珠黄散、真禁药。
马牙：初生婴儿，因胎中受毒，见风而发。含乳或吞或吐，吹真禁药，服用凉药。牙症乃是阳明胃经的病症。病生在牙龈上，是阳明大肠的病症；病生在牙龈下，要知道皆从肾家虚热而生。因为牙齿是骨之精华，肾之外标。然而不仅因肾而发，也有风邪所致。用药审察病症，煎方宜斟酌。
连珠蛾：满口如白网油状，像肚脐两边微肿，根部有白点，带红色，小舌红肿，喝汤时剧痛，病由忧郁热毒而发。其脉两寸、尺部浮洪而大，属于上盛下虚的症候，病势极重。
石蛾：这是因为本源不足，也有胎生的，在乳蛾位置稍进半寸。初起忌用寒凉。盖因肝火、忧郁所致。老痰恶血阻遏，妇人最多见。
锁喉风：因热毒积聚，痰涎粘稠，阻塞会厌，喘急上气，外部颈部肿胀，用开关豁痰法可治。外部不肿，内部无痰的，名叫“内锁喉”，不治。
白缠喉风：这是肾虚受寒，劳累而渴，寒则生热，热则生风，风寒相搏，痰气上逆，壅滞凝结，故患此症。必定眼白耳赤而紫，口不能言，关内肿，上白下红，最为急症。牙根白者不治。
牵丝缠喉风：此症喉内有紫红色血丝，此症须防传染。
喉菌：忧郁过度，心胃两经邪火入络，气血滞而不散，妇人患者最多。形状像菌，色紫，生于两旁，用黄连解毒汤。
喉瘤：本源不足，怒气伤肝，或仰头高叫、或诵读太急，所以气血相凝，生于关内，两旁有小紫块，不时发作，治疗宜培养本源。
喉癣：因肾虚火炎，肺经火旺，不肿而微红，像海棠叶背面红筋状，有斑点青白。有的像芥菜子大，或像绿豆大，每点生芒刺，饮食阻碍，喉干音哑，咳嗽无痰。其斑点生于筋中的为癣，生于筋旁的为痹，使用膏子药，不时含咽，吹真禁珠黄散，内加乳石、中白、参叶末；煎服清肺养阴之剂。
喉痈：因过食浓味，脾胃受热，感寒而发，其色淡红，肿而痛甚者是也，如李大（注：原文疑为衍文或特定指代，此处保留原意描述症状），也发热头痛，成脓易治，吹真禁珠黄散。
上痈：生于上颚，如梅核大小，妨碍饮食；又因胃家积热，化毒而发。用解毒清凉，吹药同前。此症由蕴热积毒而生，或因水亏，致动相火；或酒毒上攻，内热外寒，火乘于肺，致咽喉肿胀，其形根大头小，红色大痛，下垂于关口上部。
吹口喉风：此属太阴。病太阴肿胀疼痛，舌向上翘，是心血少而火易动，肺气虚而水不生。盖言语乃喉舌所司，心有热，则现象于外，是以水愈亏而火愈甚，舌将强而难言也。
喉疔：这是不仁之症。初起形如枸杞子，生于喉关口两旁近舌处，五脏积热所致。色淡红而硬，大痛难食，背寒身热，如开花；黑色者不治。盖因愤怒积思所致，心血先绝，死在旦夕，女人得此立死。上颚痛属脾经，上颚生疮，形如黄粟，口中腥臭，手足怕冷。此由脾经积热而生。
左右雀舌：这是因为多食煎熬之物，积热于胃，故发于舌旁，或左或右，近牙根，生一小舌，延久必烂，烂则不能速愈。
喉疳：这是因为肾虚火旺，升腾而发，喉间上颚有青白水点，平塌无刺，故名。喉声不哑不咳嗽，两尺脉虚者是也。
诸疳：锁口（外嘴唇）、锁喉（咽喉）、吊根（生舌中心下）、豆瓣（生满口）、堆沙（舌心中）、梅花（满口碎）、糜口、雪口（白布满口）、啄舌（舌上），皆用珠黄玉丹，加真禁药吹之。以上疳症，因惊风久虚、痢疾久虚、疳积久虚、间有大人久病，也要发疳。痘后有余毒，忌吹龙骨；痧后忌切牙，恐其牙落也。凡诸疳及口碎者，俱用八味口疳丹吹之。
小儿走马牙疳：或因胎毒，或因痘后毒未尽。发于口齿，或痧后发于牙根，以致腐烂，杀人最速。色如干酱，一日烂一分，十日不治。鼻梁上有红点者，不治。上左边门牙，为牙中之主，此牙一落，余牙尽落，不治。若此牙不落，别牙难落，犹可强治，然亦不过十中救二三也。治此口疳，药内必用珠黄。
茧唇：症属足阳明胃经。因久食浓味，或思虑暴怒，痰火上注于唇。起初如黄豆大，形如茧肿，突起，硬而坚甚，作痛，饮食妨碍。或流血水，久则变为消渴、消中之症。形体瘦弱，虚热痰生，面色黧黑，口干渴甚者，难治。初起即治，可愈。治用艾灸三四次，后用蟾酥饼贴，内服八味丸，方列于下。
大熟地（四两） 茯苓（二两） 山药（二两） 泽泻（二两） 萸肉（一两） 黄柏（二两） 知母（五钱） 丹皮（二两）
蜜水为丸，早晨清汤送下。下午后，服清凉甘露饮。
In the treatment of throat diseases, if the symptoms are severe within the first three days but pus has not yet formed, medication can resolve them. However, if it reaches the fifth or sixth day and pus forms and ruptures, necrosis will inevitably occur, making healing difficult. For necrotic areas, Bawei Kougan Dan (Eight-Ingredient Mouth Ulcer Powder) is commonly used, combined with Longgu Zhenzhu San (Dragon Bone and Pearl Powder). Patients who develop Lianzhu E (Pearl-shaped Tonsillar Hypertrophy) and Hou Bi (Throat Closure) after contracting Shanghan (Cold Damage Disease) are considered incurable. This is because their necks become stiff and rigid, and their eyes roll upward.
For throat diseases, if chills and fever appear on the first or second day, the condition is mild; if chills and fever do not appear initially but emerge on the third day, the condition is severe. If urination and defecation are smooth, recovery is easy, as this indicates merely floating fire attacking upwards, suitable for treatment with formulas that dispel wind, clear heat, and detoxify. Smooth bowel movements allow heat to dissipate easily, facilitating recovery. Conversely, if urination and defecation are obstructed, the condition must be severe. If there is internal cold with external heat, heavy doses of fire-descending and detoxifying agents should be used. If headache occurs, one must fear transmission into Shanghan, making it difficult to treat.
Generally, even if the disease course is fierce, conditions manifesting externally are easier to treat. If constipation occurs at the onset, Dahuang (Rhubarb Root) and Yuanming Fen (Mirabilite) should be used to purge, allowing the pathogen to descend and the illness to resolve. However, if the condition persists for six or seven days without improvement and constipation remains, using purgatives will cause immediate death. This is because prolonged illness depletes stomach qi and severely damages primal qi; thus, Xiaoshi (Mirabilite) and Dahuang (Rhubarb Root) are strictly contraindicated. Even in cases of severe constipation, only honey suppositories (Mi Jian Dao Fa) should be used, such as those containing Yazao (Gleditsia Sinensis Fruit) or Xixin (Asarum Root).
For throat diseases presenting with redness and swelling without distinct form, Yuandan (Cinnabar Pill) is appropriate.
Women suffering from throat swelling and pain may have it due to amenorrhea causing deficient fire to ascend. In cases of pain, blood-invigorating and menstruation-promoting medicines are suitable.
For severe throat diseases, a pale, bright, lusterless complexion and a deep, faint, and weak pulse indicate the leakage of spirit and collapse of yang, which are signs of incurability. If the face is red and swollen, and the pulse is surging and forceful, although the condition appears fierce, the primal qi remains intact, and treatment can be effective. Swelling without pain indicates dead flesh, which is difficult to treat.
If the tongue swells and fills the mouth, preventing medication intake, Jiangcan (Bombyx Batryticatus) and Yazao (Gleditsia Sinensis Fruit) can be stir-fried, ground into fine powder, and insufflated into the nose. Once the jaw opens and phlegm saliva exits, silk cotton wrapped around a chopstick dipped in Gancao Tang (Licorice Decoction) can be used to moisten the throat and tongue. When insufflating medicine onto broken or swollen areas, care must be taken to ensure thorough coverage everywhere; neglecting any area prevents the medicinal power from taking effect and reducing the disease severity.
The most crucial aspect of treating throat diseases is meticulousness. For example, "Houhua" (Throat Flower), also known as "Diding" (Uvula), requires extreme caution if punctured with a knife; injury to surrounding tissues could be fatal. Other conditions such as Zouma Gan (Running Horse Gangrene) and Xu Lao Hou Xuan (Deficiency Consumption Throat Lichen) vary and are discussed subsequently.
Hou Bi (Throat Obstruction): Caused by accumulated heat in the Liver, Stomach, and Lung meridians, compounded by seasonal pathogens. It resembles the purple veins on the back of a crabapple leaf, appearing fragmented and ulcerated, with small blisters forming beside the veins. Diet remains normal. Treatment requires decoctions that nourish yin, descend fire, and tonify the lungs, prioritizing heat-clearing agents. The exception is Zouma Hou Bi (Running Horse Throat Obstruction), which is extremely dangerous and requires early treatment with lozenge-like pastes held in the mouth and swallowed intermittently. Insufflation uses Zhenjin San (True Restriction Powder) and Zhuhuang San (Pearl and Gold Powder) mixed with Shenye Mo (Ginseng Leaf Powder).
Qiangshi Ya Hou (Choking Food and Hoarse Throat): This condition presents with no redness or swelling. Due to latent pathogens in the lungs, the voice is hoarse, and eating causes choking. The six pulses are slow and thin, indicating a very dangerous condition where death ensues if food intake ceases. If the pulse has a root, treatment may be possible. Initially, release the latent pathogens via sweating; subsequently, use strong tonification to strengthen the Spleen.
Nei Wai Hou Yong (Internal and External Throat Abscess): Caused by excessive consumption of rich flavors and heat invasion. It arises at the throat gate (isthmus of fauces), causing internal and external swelling, fever, and headache. It typically resolves in four to five days. Insufflate Zhenjin Zhuhuang San; take cooling decoctions.
HT She Hou Yong (HT Tongue and Throat Abscess): This results from excessive fire in the Heart meridian, often affecting obese individuals with irritable temperaments who contract heat. A small tongue forms under the main tongue, called HT She; if it extends to the throat causing pain, it is called Hou Yong. If painless, it is not an abscess. The combination of HT She and Hou Yong is ominous. Insufflate Zhenjin Yao; take Dihuang Tang (Rehmannia Decoction).
She Jun (Tongue Fungus): Belongs to the Heart meridian, caused by alcoholism, sexual excess, depression, and qi stagnation. It resembles fungi or wood ear mushrooms, colored red-purple, varying in size. Insufflate Zhenjin Yao primarily, adding Zhuhuang San is better.
Seven Attached Conditions Belonging to the Heart Meridian: These include She Gen Yong (Root of Tongue Abscess), She Xin Yong (Center of Tongue Abscess), Ce She Yong (Side of Tongue Abscess), Sanjian HT She (Three-Pointed HT Tongue), Zi Zhang Tun (Purple Swallowing Distension), Mu She (Wood Tongue), and Chong She (Double Tongue). Insufflate Zhenjin Yao and Zhuhuang San; decoct Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction), which serves as a general formula for tongue conditions.
Heishanzhi (Black Gardenia), Fen Danpi (Moutan Cortex), Chishaoyao (Red Peony Root), Sheng Gancao (Raw Licorice Root), Xian Shengdi (Fresh Rehmannia Root), Xijiao Jian (Rhinoceros Horn Tip), Xiao Mutong (Akebia Stem), Jing Yin Hua (Honeysuckle Flower), Jingjie Sui (Schizonepeta Spike), Lianqiao (Forsythia Fruit).
She Shang Yong (Abscess on Tongue Surface): Also known as She Xin Yong. Located at the center of the tongue, sized like a plum, causing inability to speak. It arises from heat entering the Pericardium. Red and swollen cases are treatable; black ones are not. Yellow coating on the tongue with swelling and pain also indicates Heart fire.
She Xia Yong (Abscess Under Tongue): Also known as She Gen Yong. Caused by accumulated heat in the Spleen and Kidney meridians, manifesting at Jinjin (Metal Fluid) and Yuye (Jade Fluid) acupoints under the tongue, connecting to the Kidney meridian. It arises when Kidney water is exhausted. Treatment should strengthen water and support the Spleen.
Zi She (Purple Tongue): Caused by heat invading the Heart and Spleen meridians. It features red spots turning purple, with ulceration and pain, or nausea/vomiting. Watch out for eruption syndromes.
Mu She (Wood Tongue): Caused by excessive consumption of roasted/fried foods or food stagnation in the Middle Jiao, leading to accumulated heat in the Heart, Spleen, and Lung meridians. The tongue becomes coarse, purple, and swollen, preventing speech. If the Cun and Guan pulses on both wrists are surging, the condition is excess and easy to treat; if all six pulses are thin, the condition is deficiency and difficult to treat.
Chong She (Double Tongue): Caused by heat in the Heart and Spleen. A small tongue forms under the main tongue. If untreated early, the large tongue becomes thick and short, while the small tongue grows long and painful. Prolonged cases will ulcerate, becoming difficult to treat.
Ya Ding (Tooth Carbuncle): Fever for two days, followed by unbearable toothache, with a purple blister appearing on the gum root. Those arising on the upper central incisors are ominous; those on other teeth are easier to treat. Loss of the upper left central incisor is incurable due to Kidney deficiency combined with Heart and Stomach fire attacking upwards. Unruptured lesions are Ding (Carbuncles); ruptured ones are Du (Poison). Red color is treatable; green/black is not. Insufflate Zhenjin Zhuhuang San.
Ya Xuan (Tooth Lichen): Caused by excess fire in the Yangming meridians attacking upwards, bleeding from gum margins, associated with the Spleen above and Stomach below, leading to gum root necrosis. Use Zhenzhu San, Shengji San, Zhuhuang San, and Zhenjin Yao.
Ma Ya (Horse Teeth): Occurs in newborns due to fetal toxicity manifesting upon exposure to wind. They suck, swallow, or spit milk. Treat with Zhenjin insufflation and cooling medicines. Dental issues belong to the Yangming Stomach meridian. Lesions on the gums relate to the Yangming Large Intestine; lesions below the gums stem from Kidney deficiency heat. Teeth are the essence of bones and the exterior marker of the Kidneys. However, they are not solely caused by the Kidneys; wind pathogens also play a role. Medication must be carefully selected based on syndrome differentiation.
Xuan Shen (Scrophularia Root), Sheng Di (Rehmannia Root), Dan Pi (Moutan Cortex), Zhi Mu (Anemarrhena Rhizome), Bai Shao (White Peony Root), Di Gu Pi (Lycium Bark), Che Qian Zi (Plantago Seed), Sheng Gancao (Raw Licorice Root), Huang Bo (Phellodendron Bark).
Lianzhu E (Pearl-shaped Tonsils): The mouth resembles white net fat, with slight swelling near the navel area, white spots at the roots tinged with red, and red/swollen uvula. Drinking soup causes severe pain. The disease stems from depression and heat-toxin. The pulses at both Cun and Chi positions are floating, surging, and large, indicating an upper-excess and lower-deficiency condition of extreme severity.
Shi E (Stone Tonsil): Due to constitutional deficiency, sometimes congenital, located slightly higher than regular Ru E (Milky Tonsils). Cold-natured drugs are initially contraindicated. It is caused by Liver fire and depression. Old phlegm and evil blood obstruction are common in women.
Suo Hou Feng (Lock-Throat Wind): Caused by heat-toxin accumulation and viscid phlegm saliva blocking the epiglottis, leading to wheezing and upward rushing of qi, with external neck swelling. Opening the orifices and resolving phlegm can cure it. If there is no external swelling and no internal phlegm, it is called "Internal Lock-Throat," which is incurable.
Bai Chan Hou Feng (White-Wrapping Throat Wind): Caused by Kidney deficiency and cold invasion, fatigue, and thirst. Cold generates heat, heat generates wind; wind-cold struggle, causing phlegm-qi to rise, obstructing and condensing. Symptoms include white sclerae, red/purple ears, inability to speak, internal swelling, white upper/red lower appearance. It is a critical emergency. White gum roots are incurable.
Qian Si Chan Hou Feng (Thread-Pulling Wrapping Throat Wind): Features purple-red blood threads inside the throat. This condition requires prevention of contagion.
Hou Jun (Throat Fungus): Excessive depression allows evil fire from the Heart and Stomach meridians to enter collaterals, causing qi and blood stagnation. Most common in women. Resembles a fungus, purple in color, growing on both sides. Use Huanglian Jiedu Tang (Coptis Detoxification Decoction).
Hou Liu (Throat Tumor): Constitutional deficiency, anger injuring the Liver, or straining the voice (shouting high or reading too fast) causes qi and blood coagulation. Small purple nodules appear inside the throat gate, recurring intermittently. Treatment should nourish the constitution.
Hou Xuan (Throat Lichen): Caused by Kidney deficiency fire flaring and Lung meridian fire hyperactivity. There is no swelling, only slight redness, resembling red veins on a crabapple leaf back, with blue-white spots. Some resemble mustard seeds or mung beans, each with thorn-like projections. Diet is obstructed; the throat is dry, voice hoarse, cough without phlegm. Spots within tendons are Xuan (Lichen); spots beside tendons are Bi (Obstruction). Use pastes held in the mouth, insufflate Zhenjin Zhuhuang San added with Rushi (Oyster Shell), Zhongbai (Magnolia Bark), and Shenye Mo (Ginseng Leaf Powder); decoct Lung-clearing and Yin-nourishing herbs.
Hou Yong (Throat Abscess): Caused by excessive rich food heating the Spleen and Stomach, compounded by cold invasion. Color is pale red, swollen and very painful. Fever and headache may occur. Once pus forms, it is easier to treat. Insufflate Zhenjin Zhuhuang San.
Shang Yong (Upper Abscess): Arises in the hard palate, sized like a plum pit, obstructing diet. Caused by Stomach heat transforming into toxin. Use detoxifying and cooling methods; insufflation same as before. This condition arises from accumulated heat and toxin, or Yin deficiency triggering ministerial fire, or wine toxin attacking upwards, internal heat with external cold, fire invading the Lungs causing throat swelling. Shape is broad-based and narrow-tipped, red and painful, hanging down from the upper part of the throat gate.
Chui Kou Hou Feng (Blowing-Mouth Throat Wind): Belongs to the Taiyin. Taiyin swelling and pain, tongue pointing upward, indicate insufficient Heart blood allowing fire to move easily, and deficient Lung qi failing to generate fluids. Speech is governed by the throat and tongue. Heart heat manifests externally, worsening Yin deficiency and fire, leading to a stiff tongue and difficulty speaking.
Hou Ding (Throat Carbuncle): An insensible condition. Initially shaped like a goji berry, appearing near the tongue at both sides of the throat gate, caused by accumulated heat in the five zang organs. Pale red and hard, causing severe pain and difficulty eating, with chills on the back and fever on the body, resembling blooming flowers. Black color is incurable. Caused by anger and excessive thinking, leading to premature exhaustion of Heart blood; death occurs soon. Women die immediately upon contracting this. Upper palate pain belongs to the Spleen meridian; sores on the upper palate resembling yellow millet grains with foul breath and cold extremities are caused by Spleen meridian heat.
Zuo You Que She (Left and Right Sparrow Tongues): Caused by excessive fried/cooked foods accumulating heat in the Stomach, manifesting on either side of the tongue near the gum roots as a small tongue. Prolonged cases will ulcerate and heal slowly.
Hou Gan (Throat Ulcer): Caused by Kidney deficiency and hyperactive fire ascending. Blue-white flat spots without thorns appear on the upper palate, hence the name. Voice is not hoarse, no cough, Chi pulses are deficient.
Various Gan (Ulcers): Suo Kou (Outer Lips), Suo Hou (Throat), Diao Gen (Below Center of Tongue), Dou Ban (Full Mouth), Dui Sha (Center of Tongue), Mei Hua (Fragmented Full Mouth), Mi Kou (Erosive Mouth), Xue Kou (White-Coated Full Mouth), Zhuo She (Pecked Tongue). All treated with Zhuhuang Yudan insufflated with Zhenjin. Above ulcers result from prolonged deficiency due to convulsions, dysentery, malnutrition, or chronic adult illness. Post-smallpox residual toxins contraindicate Longgu (Dragon Bone) insufflation; post-measles contraindicates cutting teeth to prevent tooth loss. All various ulcers and oral erosions are treated with Bawei Kougan Dan insufflation.
Xiao'er Zouma Ya Gan (Pediatric Running Horse Tooth Gangrene): Due to fetal toxin or unresolved post-smallpox toxin. Manifests in mouth/teeth or gum roots post-measles, causing rapid necrosis and death. Color like dried sauce, rotting one point per day; untreatable after ten days. Red dots on the nasal bridge are incurable. The upper left central incisor is the master tooth; its loss causes all others to fall, which is incurable. If this tooth does not fall, others are unlikely to fall, allowing desperate treatment, though survival is only 2-3 in 10 cases. Treatment must include Zhuhuang (Pearl and Gold).
Jian Chun (Silkworm Lip): Belongs to the Foot-Yangming Stomach meridian. Caused by long-term rich diet or sudden anxiety/anger, causing phlegm-fire to pour into the lips. Initially bean-sized, resembling a silkworm cocoon swelling, protruding, hard, painful, obstructing diet. May bleed serum; long-term transformation into Xiao Ke (Wasting-Thirst) or Xiao Zhong (Wasting-Fatigue). Emaciation, deficient heat-phlegm, dark complexion, severe dry mouth/thirst indicate difficult prognosis. Early treatment leads to cure. Treat with moxibustion 3-4 times, apply Chansu Bing (Toad Venom Cake), internally take Bawei Wan (Eight-Ingredient Pill), formula listed below.
Da Shudi (Prepared Rehmannia Root, 4 liang), Fuling (Poria, 2 liang), Shanyao (Chinese Yam, 2 liang), Zexie (Alisma Rhizome, 2 liang), Rourou (Cornus Fruit, 1 liang), Huangbo (Phellodendron Bark, 2 liang), Zhimu (Anemarrhena Rhizome, 5 qian), Danpi (Moutan Cortex, 2 liang).
Pill made with honey water, taken with clear soup in the morning. In the afternoon, take Qingliang Ganlu Yin (Cooling Sweet Dew Drink).
Heixuan Shen (Black Scrophularia Root, 1.5 qian), Danpi (Moutan Cortex, 2 qian), Maidong (Ophiopogon Tuber, 2 qian), Chuanbei (Fritillaria Bulb, 2 qian), Ku Jiegeng (Bitter Platycodon Root, 1 qian), Xingren (Apricot Seed, 3 qian), Gancao (Licorice Root, 1 shallow measure), Huafen (Trichosanthes Root, 2 qian).