（麻证，俗名痧子，必兼喉痛。医家恫喝人曰∶烂喉痧者，此也。）
治麻证之喉痛，与治郁火之喉痛大异。盖麻证风热，其邪袭肺，故必鼻塞涕清，咳嗽眼
红，
声哑喉痛，面红花杂，身或作痒。一见此症，须用升、柴、前、葛、羌、独等品，提毒祛风
透发之，一剂喉痛止，二剂余邪尽矣。若早用寒凉之品，以彻去其皮毛之热，使麻不能乘汗
外达，遂至温邪内踞，欲出不出，毒火上炎，喉咙腐烂。医者不知其为麻也，外吹珠黄以遏
之，内服犀、羚、芩、连以制之，使邪无一毫之出路。始若稍安，终必不治，群相诧曰以喉
证死。（有谓，近今喉证以古方治之不效，不如以热药从治者，杀人愈速，不可不知。）而不
知麻证不早透发，以致毒邪攻喉而死。其实非喉证也，而以喉证之药治之，岂能有效乎？是
以治喉痛者，必先辨其是否麻证；如果麻也，用夏禹铸天保采薇汤方加减治之，无不透发而
愈者。即喉痛目赤，亦放胆投之，不庸疑虑，屡试屡验。《铁镜》所谓圣莫圣于天保采薇汤
，神莫神于天保采薇汤也。大忌寒凉，如犀、羚、芩、连、柏、石、珠、黄之类。倘系喉证
由于郁火，则升、柴、羌、独等升提温燥之品，均属切忌。轻者清肺养阴，一剂即痊；重则
犀、羚、珠、黄，皆为要品。盖治病贵先辨证，犹之作文，贵先识题。不识何题而便作文，
文
必不取，所失者仅一己之名。不辨何证而便治病，病必不治，所误者乃众人之命。呜呼!医
者奈何以人 之命，试我之药，屡误而终不悟也!
炳按∶论痧痘（前辈陈飞霞有《痧痘金针篇》），论喉痧者，有（叶天士、李纯修、高锦
庭、
计寿乔、祖鸿范、王步山、屠尊彝。）陈耕道着有《烂喉疫痧草》，皆可为痧痘喉痧金针。
执一夏禹铸天保采薇，以为手到病治，他书皆可不读，我恐误人也不浅。此病之门径未窥，
难与之辨，不议。
原注云∶光绪二十八年春夏间，以喉证死者，比户皆然，几成大疫。其实真喉证十不得
一二，大半皆麻证也。余所见者，麻证为多用天保采薇汤加减治之，无不转危为安。然以此方告
人，人反不敢用。有某医者，余尝举以语之。彼笑曰∶不必用此，以生军磨汁饮之，可内消
耳。余知其不可与语也，遂置之不辨。既而，其家连死数人，皆以此症。问所用药，则惟珠
、
黄、犀、羚、芩、连、大青等味耳。想必生军汁亦用过不验矣。噫!师心自用，善言不入
，
为人犹不宜若是，而况行医。吾愿世之讲究卫生者，慎毋一觉喉痛，便延医治，而奉珠、黄
、犀、羚贵重之乐，为无上之妙品，以自戕其性命也。（王鞠坪识。）
（麻疹，俗称痧子，必定伴有咽喉疼痛。医生们恐吓人说：这就是烂喉痧。）
治疗麻疹引起的咽喉痛，与治疗郁火引起的咽喉痛大不相同。因为麻疹是风热之邪，病邪侵袭肺脏，所以必然出现鼻塞、流清涕、咳嗽、眼睛发红、声音嘶哑、咽喉疼痛、面部红疹夹杂、身体有时发痒等症状。一旦见到这些症状，必须使用升麻、柴胡、前胡、葛根、羌活、独活等药物，以提毒祛风、透疹外出。服用一剂后咽喉痛停止，两剂后其余邪气尽除。如果过早使用寒凉药物，来清除皮毛表面的热邪，使得麻疹不能随着汗液向外透发，从而导致温邪内伏，想出而不能出，毒火上炎，导致喉咙腐烂。医生不知道这是麻疹，反而在外部吹敷珠黄粉以遏制它，内部服用犀角、羚羊角、黄芩、黄连以压制它，使得邪气没有任何出路。开始似乎稍微安宁，最终必然不治，众人惊讶地说：“这是因为患喉证而死。”（有人说，近来的喉证用古方治疗无效，不如用热药从治，这样杀人更快，不可不知道。）却不知道麻疹如果不早点透发，导致毒邪攻喉而死。这其实不是喉证，而是用治疗喉证的药物治疗它，怎么会有效果呢？因此治疗咽喉痛的人，必须先辨别是否属于麻疹；如果是麻疹，使用夏禹铸的天保采薇汤加减治疗，没有不透发而痊愈的。即使有咽喉痛、眼睛发红，也放心大胆地投用此方，不必疑虑，屡试屡验。《铁镜》所谓最圣明的莫过于天保采薇汤，最神奇的莫过于天保采薇汤。特别禁忌寒凉药物，如犀角、羚羊角、黄芩、黄连、黄柏、石膏、珍珠、牛黄之类。如果确实是因郁火导致的喉证，那么升麻、柴胡、羌活、独活等升提温燥的药物，都属于绝对禁忌。轻症者清肺养阴，一剂即可痊愈；重症者犀角、羚羊角、珍珠、牛黄，都是重要药物。大概治病贵在先辨证，就像写文章贵在先识别题目。不认识是什么题目就写文章，文章一定不被采纳，损失的只是个人的名声。不辨别是什么证候就治病，病一定治不好，耽误的是众人的性命。唉！医生怎么能拿别人的性命来试验自己的药物，屡次出错却始终不觉悟呢！
炳按：论述痧痘（前辈陈飞霞著有《痧痘金针篇》），论述喉痧的，有（叶天士、李纯修、高锦庭、计寿乔、祖鸿范、王步山、屠尊彝）。陈耕道著有《烂喉疫痧草》，都可以作为痧痘喉痧的金针指南。如果只执着于夏禹铸的天保采薇汤，认为手到病除，其他书都可以不读，我恐怕这会误人不浅。这种病的门径尚未窥探，难以与他辩论，不予议论。
原注说：光绪二十八年春夏之间，因喉证死亡的，家家户户都是如此，几乎成了大瘟疫。其实真正的喉证十不到一二，大半都是麻疹。我所见到的病例，用天保采薇汤加减治疗，没有不转危为安的。然而把这个方子告诉别人，别人反而不敢用。有位医生，我曾经把这事告诉他。他笑着说：不必用这个，用生大黄磨汁饮用，可以内消罢了。我知道无法和他交谈，于是搁置不再辩论。不久，他的家人接连死了数人，都是因为这种病症。询问所用的药物，则是只有珍珠、牛黄、犀角、羚羊角、黄芩、黄连、大青叶等味道。想必生大黄汁也用过了但没有见效。唉！自以为是，听不进善言，做人尚且不应该像这样，何况行医。我希望世上讲究卫生的人，千万不要一觉得咽喉痛，就延请医生医治，而供奉珍珠、牛黄、犀角、羚羊角这些贵重的乐品，当作无上的妙品，从而残害自己的生命。（王鞠坪识。）
(Ma Zheng, commonly known as Sha Zi [measles], must be accompanied by throat pain. Physicians intimidate people by saying: This is Lan Hou Sha [rotten throat scarlet fever].)
Treating throat pain caused by Ma Zheng differs significantly from treating throat pain caused by Yu Huo (Depressed Fire). Since Ma Zheng involves Wind-Heat pathogenic factors, the evil Qi invades the Lung, thus inevitably presenting with nasal congestion, clear rhinorrhea, cough, red eyes, hoarseness, throat pain, facial rash with mixed colors, and occasional body itching. Upon observing these symptoms, one must use herbs such as Sheng Ma (Cimicifugae Rhizoma), Chai Hu (Bupleuri Radix), Qian Hu (Peucedani Radix), Ge Gen (Puerariae Lobatae Radix), Qiang Huo (Notopterygii Rhizoma et Radix), and Du Huo (Angelicae Pubescentis Radix) to lift toxins, dispel wind, and promote eruption. After one dose, throat pain ceases; after two doses, residual pathogens are eliminated. If cold-natured medicines are used too early to clear heat from the skin and hair follicles, preventing the measles from emerging via sweat, the Warm Evil will become entrenched internally. The pathogens desire to emerge but cannot, causing Toxic Fire to flare upward and rot the throat. Physicians, unaware that this is Ma Zheng, apply Zhu Huang (Pearl and Realgar powder) externally to suppress it, and administer Xi Jiao (Rhinocerotis Cornu), Ling Yang Jiao (Capra Hircus Cornu), Huang Qin (Scutellariae Radix), and Lian Qiao (Forsythiae Fructus) internally to restrain it, leaving the pathogens with no exit. Initially, there may be slight relief, but ultimately it is incurable. People marvel and say, "He died of a throat condition." (Some argue that recent throat conditions do not respond to ancient prescriptions, and using hot medicines for treatment is faster in killing, which must be known.) Yet they fail to realize that death results from failing to promote the eruption of Ma Zheng early, allowing toxic pathogens to attack the throat. In reality, this is not a throat condition; therefore, using medicines for throat conditions on it cannot be effective. Thus, those treating throat pain must first distinguish whether it is Ma Zheng. If it is indeed Ma Zheng, using Xia Yu Zhu's Tian Bao Cai Wei Tang (Heavenly Preservation Nourishing Veins Decoction) with modifications ensures eruption and recovery without exception. Even if accompanied by throat pain and red eyes, one should boldly administer it without doubt; it has been tested repeatedly with success. As stated in *Tie Jing* (Iron Mirror): "Nothing is more sagacious than Tian Bao Cai Wei Tang; nothing is more miraculous than Tian Bao Cai Wei Tang." Cold-natured medicines are strictly contraindicated, such as Xi Jiao (Rhinocerotis Cornu), Ling Yang Jiao (Capra Hircus Cornu), Huang Qin (Scutellariae Radix), Lian Qiao (Forsythiae Fructus), Huang Bo (Phellodendri Cortex), Shi Gao (Gypsum Fibrosum), Zhen Zhu (Margarita), and Zhu Huang (Realgar and Pearl powder). If the throat condition is indeed due to Yu Huo (Depressed Fire), then ascending and lifting warm-dry agents like Sheng Ma (Cimicifugae Rhizoma), Chai Hu (Bupleuri Radix), Qiang Huo (Notopterygii Rhizoma et Radix), and Du Huo (Angelicae Pubescentis Radix) are absolutely contraindicated. For mild cases, clearing the Lung and nourishing Yin cures the disease in one dose; for severe cases, Xi Jiao (Rhinocerotis Cornu), Ling Yang Jiao (Capra Hircus Cornu), Zhen Zhu (Margarita), and Zhu Huang (Realgar and Pearl powder) are essential. Treating disease prioritizes syndrome differentiation, just as writing an essay prioritizes understanding the topic. Writing without knowing the topic leads to rejection, costing only personal reputation. Treating without differentiating the syndrome leads to failure, costing lives. Alas! How can physicians risk others' lives to test their own medicines, making repeated errors without awakening?
Bing notes: Discussions on Sha Dou (Measles and Smallpox) include Chen Fei Xia's *Sha Dou Jin Zhen Pian* (Golden Needle Chapter on Measles and Smallpox). Those discussing Hou Sha (Throat Scarlets) include Ye Tian Shi (Ye Tianshi), Li Chun Xiu, Gao Jin Ting, Ji Shou Qiao, Zu Hong Fan, Wang Bu Shan, and Tu Zun Yi. Chen Geng Dao authored *Lan Hou Yi Sha Cao*, all serving as golden needles for Sha Dou and Hou Sha. Clinging solely to Xia Yu Zhu's Tian Bao Cai Wei Tang, believing it cures instantly so that other books need not be read, I fear this causes significant harm. Without grasping the fundamentals of this disease, it is difficult to debate; thus, I do not discuss it.
The original note states: Between spring and summer of the 28th year of Guangxu, deaths attributed to throat conditions were ubiquitous, nearly becoming a great epidemic. In truth, genuine throat conditions accounted for less than one or two out of ten; the majority were Ma Zheng. Cases I observed were treated with modified Tian Bao Cai Wei Tang, resulting in turning danger into safety without exception. However, when I shared this formula, people dared not use it. I once mentioned this to a certain physician. He laughed and said, "No need for this; grinding raw Jun (Radix et Rhizoma Rhei) into juice and drinking it allows internal resolution." Knowing he was unteachable, I ceased debating. Subsequently, several members of his family died consecutively from this same condition. Inquiry revealed they had only used Zhen Zhu (Margarita), Zhu Huang (Realgar and Pearl powder), Xi Jiao (Rhinocerotis Cornu), Ling Yang Jiao (Capra Hircus Cornu), Huang Qin (Scutellariae Radix), Lian Qiao (Forsythiae Fructus), and Da Qing Ye (Isatidis Folium). Presumably, the raw Jun juice was also tried without effect. Alas! Being self-opinionated and rejecting good advice is inadvisable even in general conduct, let alone in medicine. I hope those concerned with hygiene in the world do not, upon feeling throat pain, immediately seek medical treatment and offer precious items like Zhen Zhu (Margarita), Zhu Huang (Realgar and Pearl powder), Xi Jiao (Rhinocerotis Cornu), and Ling Yang Jiao (Capra Hircus Cornu) as supreme remedies, thereby destroying their own lives. (Recorded by Wang Ju Ping.)