总括 喉中肿痛称喉痹，实因相火冲逆至；急须刺破涌其痰，并敷立效散而愈。
脉法 两寸脉浮而溢者，喉痹也，脉微而伏者死。
《内经》曰∶一阴一阳结谓之喉痹。王注谓一阴即厥阴，肝与胞络是也。一阳即少阳，胆与三焦是也，四经皆有相
火存焉。子和曰∶胆与三焦寻火治，肝与胞络都无异。东垣曰∶火与元气不两立，一胜则一负。盖元气一虚，则相火随
起而喉痹等暴病作矣。夫喉之为会厌者，经谓之吸门是也，以其司呼吸，主升降，为人身紧关之橐龠门户也。若夫卒然
肿痛，水浆不入，言语不通，死在须臾，诚可惊骇。其会厌之两旁肿者，俗谓之双乳蛾，易治；会厌之一边肿，俗谓之
单乳蛾，难治，古方通谓之喉痹，皆相火之所冲逆耳。治之先必大涌其痰，或以针刺其患处，此急则治标之法也。用药
者必须以桔梗、甘草、玄参、升麻、防风、羌活、荆芥、薄荷、山豆根之类服之，以立效散敷之可也。
〔附方〕
立效散 硼砂 龙脑 雄黄 朴硝 俱为末，干掺。
一方 治喉痹，用韭菜地上蚯蚓数条，活入蜂蜜内，没半日，去蚓实时服蜜并泥，效。
一急救散 用木鳖一个，以新汲水磨滴入喉中便退，后用汤药调治之。
总括 孩儿胎受诸般热，热壅三焦病在舌；或成鹅口症堪忧，用药更虽针刺裂。
脉法 右关脉洪数者口疮，或为重舌、木舌。
《内经》曰∶中央黄色，入通于脾，开窍于口，藏精于脾，故病在舌。夫口之为病，重舌者，心脾俱有热也。心候
于舌而主血，脾之脉络出于舌下。（批∶脾之脉络系舌旁，肝之脉络系舌本，心之脉络系舌根。）若心热则血气俱盛，附
于舌根，重生壅出如舌而短小是也。有生颊里及上 者，名曰重 ；生齿根者，名曰重龈，皆当刺去其血，而用真蒲黄
敷之，或发灰或马牙硝或硼砂敷之，或竹沥浸黄柏点之。
木舌者，脏腑壅滞，心脾积热，热气上冲，故令舌肿，渐渐胀大塞满口中，是为木舌，若不急疗必致害人。用朴硝
二分，霜紫一分、白盐半分同研，用竹沥水调敷，单用脑子亦效。
弄舌者，脾脏微热，令弄络微紧，时时舒舌。治之，勿用冷药下之，当少与泻黄散服，亦或饮水。医疑为热，以冷
药下之，非也。饮水者脾胃虚，津液少也，又加肌瘦面黄，五心烦热，即为瘦疳，宜胡黄连丸。如大病未愈，用药后弄
舌者凶。又有舌上白苔并黑色者，用硼砂末掺之，热甚者加脑子。
口糜者，乃膀胱移热于小肠，故不小便，上为口糜。心胃壅热，水谷不转，下传小肠，以导赤散去小肠热，五苓散
泻膀胱热，二剂合用可也。
鹅口者，初生小儿，口内白屑，舌上如鹅之口，此乃胎热，而心脾最盛，熏发于口也，葛氏以发缠指头，蘸井华水
揩拭之，以黄丹 过，出火毒，掺患处。
口疮者，乃小儿将养过温，心脏积热，熏蒸于上，故成口疮也。宜南星末醋调，涂两足心，乳母宜服洗心散、泻心
汤。
丹溪曰∶小儿口疮不下食，众以狐惑治之，必死。（批∶上唇有疮，曰惑虫食其脏；下唇有疮，曰狐虫食其肛。）须
以矾汤于脚上浸半日，顿宽。以黄柏蜜炙、姜蚕炒为末，敷之立下乳而安。
舌者心之官，心热则生疮破裂，肝壅则血出如壅，脾闭则白苔如雪，热则肿满，风则强木，口合不开，四肢壮热，
气喘语涩，皆其候也。
舌忽肿退场门外，俗名蜈蚣毒，用雄鸡血一小盏，抹之即缩入，舌长过寸，研冰片敷之即收。
口疮以桑树汁涂之得愈，吞咽亦无妨也，大人小儿俱效。
〔附方〕
泻黄散 见热症内。
胡连丸 胡黄连 宣黄连（各五钱） 麝香（一匙） 芦荟（一钱） 朱砂（二钱半）
导赤散 见五淋症内。
五苓散 见惊风症内。
洗心散 见伤寒症内。
泻心汤 见诸热症内。
总括：咽喉部位出现肿痛称为喉痹，其根本原因在于相火（寄居于肝肾胆三焦的虚火）冲逆向上；治疗时必须迅速刺破患处以排出痰涎，并外敷立效散即可痊愈。
脉法：两手寸口脉象浮大且溢出的，是喉痹病；若脉象微细且沉伏不起的，预后不良，主死。
《黄帝内经》说：“一阴与一阳之气结滞不通，就称为喉痹。”王冰注解说，“一阴”指的是厥阴经，包括肝和心包络；“一阳”指的是少阳经，包括胆和三焦。这四条经脉中都有相火存在。张子和说：“治疗胆和三焦的病要寻找火邪来治，治疗肝和心包络的病也没有两样。”李东垣说：“火邪与元气不能并存，一方强盛则另一方衰弱。”大概是因为元气一旦虚弱，相火就会随之而起，导致喉痹等突发疾病发作。所谓喉部的会厌，经络上称为“吸门”，因为它主管呼吸，主持气机升降，是人体气息出入的关键门户。如果突然发生肿痛，连水浆都无法咽下，言语不能通畅，很快就会死亡，确实令人惊恐害怕。如果会厌两侧肿胀，俗称“双乳蛾”，容易治疗；如果只有一侧肿胀，俗称“单乳蛾”，难以治疗，古方通称为喉痹，这都是因为相火冲逆所致。治疗时首先必须大量涌吐痰涎，或者用针刺患处，这是急则治其标的方法。使用内服药物的，必须以桔梗、甘草、玄参、升麻、防风、羌活、荆芥、薄荷、山豆根等药物服用，并配合外敷立效散，就可以了。
〔附方〕
立效散：将硼砂、龙脑（冰片）、雄黄、朴硝（芒硝）全部研成粉末，直接干撒于患处。
另一方法：治疗喉痹，取几条在土地上的韭菜蚯蚓，放入蜂蜜中浸泡半天，取出蚯蚓后，立即服用蜂蜜及混有蚯蚓泥的药液，效果显著。
一急救散：用一个木鳖子，用新汲取的冷水磨汁滴入喉中，症状随即消退，之后再用汤药调理。
总括：婴儿在母胎中受到各种热邪的影响，热邪壅滞在三焦，病变表现在舌头上；有的形成鹅口疮令人担忧，用药治疗的同时还可以进行针刺放血。
《黄帝内经》说：“中央对应黄色，内通于脾，开窍于口，精气藏于脾，所以病表现在舌头。”口部的疾病中，重舌是由于心和脾都有热邪。心对应舌头并主宰血液，脾的脉络出于舌下。（批注：脾的脉络系于舌旁，肝的脉络系于舌根底部，心的脉络系于舌根。）如果心热，则气血都旺盛，附着在舌根，重新生长出像舌头一样但短小的肉赘，这就是重舌。有的在脸颊内部及上颚生长的，名叫重腭；生在齿龈根的，名叫重龈，这些都应当刺破放出瘀血，然后敷上真蒲黄，或者使用发灰、马牙硝或硼砂敷贴，或者用竹沥浸渍的黄柏点涂。
木舌，是由于脏腑气机壅滞，心脾积热，热气上冲，导致舌头肿胀，逐渐胀大塞满口中，这就叫木舌，如果不紧急治疗必定致人死命。用朴硝二分、霜紫（可能指紫草或特定炮制品，此处依原文保留）一分、白盐半分共同研磨，用竹沥水调匀后敷贴，单用冰片也有效。
弄舌，是由于脾脏轻微发热，导致舌络微微紧绷，不时伸出舌头。治疗时，不要用寒凉药攻下，应当少量给予泻黄散服用，或者喂水。医生误以为是实热，用寒凉药攻下，这是错误的。喂水是因为脾胃虚弱，津液不足，再加上肌肉消瘦面色发黄，五心烦热，这就变成了瘦疳，适宜用胡黄连丸。如果大病未愈，用药后出现弄舌现象的，预后凶险。又有舌上出现白色苔垢并伴有黑色的，用硼砂末掺撒，热势严重的加用冰片。
口糜，是由于膀胱的热邪移传于小肠，导致小便不利，热气上行导致口腔糜烂。心胃壅滞热邪，水谷运化停滞，下传至小肠，可以用导赤散清除小肠热邪，五苓散清除膀胱热邪，两方合用即可。
鹅口，初生婴儿，口腔内有白色屑状物，舌上如同鹅的口，这是由于胎热，且心脾热邪最盛，熏蒸于口所致。葛氏建议用头发缠在手指头上，蘸井华水（清晨第一次打的井水）擦拭患处，然后用经过煅制的黄丹（去除火毒后），掺撒在患处。
口疮，是由于小儿养育过暖，心脏积热，熏蒸于上部，从而形成口疮。适宜用南星末醋调，涂抹在两足心，乳母适宜服用洗心散、泻心汤。
朱丹溪说：“小儿口疮不下奶进食，众人用狐惑病来治疗，必死无疑。（批注：上唇有疮，叫做惑虫吃内脏；下唇有疮，叫做狐虫吃肛门。）必须用矾汤浸泡双脚半天，症状顿时缓解。用黄柏蜜炙、姜蚕炒后研成粉末，敷贴患处，立刻就能哺乳并安宁。
舌头是心的官窍，心热则生疮破裂，肝气壅滞则出血如涌，脾气闭塞则舌苔白如雪，热则肿胀满闷，风则僵硬如木，嘴巴闭合不开，四肢壮热，气喘语涩，都是这些征候。
舌头突然肿得像蜈蚣一样伸出嘴门外，俗名蜈蚣毒，用雄鸡血一小盏，涂抹其上即缩回；舌头伸长超过一寸，研碎冰片敷贴即可收回。
〔附方〕
泻黄散：见热症章节内。
胡连丸：胡黄连、宣黄连（各五钱）、麝香（一匙）、芦荟（一钱）、朱砂（二钱半）。
导赤散：见五淋症章节内。
五苓散：见惊风症章节内。
洗心散：见伤寒症章节内。
泻心汤：见诸热症章节内。
General Overview: Swelling and pain in the throat are called Hou Bi (Throat Bi / Sore Throat). The root cause is the counter-flow of Xiang Huo (Ministerial Fire). It is urgent to pierce the area to drain phlegm and apply Li Xiao San (Miraculous Efficacy Powder) externally for recovery.
Pulse Diagnosis: If the Cun (inch) pulses on both hands are floating and overflowing, it indicates Hou Bi. If the pulse is minute and hidden/deep, the prognosis is fatal.
The *Nei Jing* (Inner Canon) states: "When one Yin and one Yang bind together, it is called Hou Bi." Wang Bing's commentary explains that "one Yin" refers to the Jue Yin (Liver and Pericardium), and "one Yang" refers to the Shao Yang (Gallbladder and San Jiao). Ministerial Fire exists in these four meridians. Zhang Zihe said: "Treat Gallbladder and San Jiao by addressing fire; treat Liver and Pericardium similarly." Li Dongyuan said: "Fire and Yuan Qi (Original Qi) cannot coexist; when one prevails, the other declines." Generally, when Yuan Qi is deficient, Ministerial Fire rises, causing sudden diseases like Hou Bi. The epiglottis in the throat is referred to in the meridians as Xi Men (Gate of Inhalation), as it governs respiration and the ascending/descending of Qi, serving as a critical portal for the body's breath. If swelling and pain occur suddenly, preventing the intake of water or food and speech, death may follow shortly, which is indeed alarming. Swelling on both sides of the epiglottis is commonly known as Shuang Ru E (Double Tonsillar Hypertrophy) and is easy to treat; swelling on only one side is known as Dan Ru E (Single Tonsillar Hypertrophy) and is difficult to treat. Ancient formulas generally refer to this as Hou Bi, all caused by the counter-flow of Ministerial Fire. Treatment must first involve inducing copious expectoration of phlegm or needling the affected area; this is the method of treating the branch (symptoms) in acute cases. For internal medication, use herbs such as Jie Geng (Platycodon Root), Gan Cao (Licorice Root), Xuan Shen (Scrophularia Root), Sheng Ma (Cimicifuga Rhizome), Fang Feng (Saposhnikovia Root), Qiang Huo (Notopterygium Rhizome), Jing Jie (Schizonepeta Spike), Bo He (Mint), and Shan Dou Gen (Sophora Tonkinensis Root), combined with external application of Li Xiao San.
[Attached Formulas]
Li Xiao San (Miraculous Efficacy Powder): Borax, Borneol, Realgar, and Mirabilite, all ground into powder, applied dry to the lesion.
Another Method: For Hou Bi, take several earthworms from leek fields, place them alive in honey, leave for half a day, remove the worms, and immediately consume the honey mixed with the worm residue. Effective.
Yi Ji Jiu San (One-Emergency Rescue Powder): Use one Momordica charantia seed (Mu Bie Zi), grind it with fresh cold water, and drip the juice into the throat to reduce symptoms immediately, followed by decoction treatment.
General Overview: Infants receive various heat pathogens in utero; heat stagnates in the San Jiao, manifesting in the tongue. This may develop into E Kou (Goose Mouth / Thrush), causing worry; treatment involves medication and needle pricking to release blood.
Pulse Diagnosis: A surging and rapid pulse at the Right Guan (bar) position indicates Kou Chuang (Mouth Ulcers), or Chong She (Double Tongue), or Mu She (Wooden Tongue).
The *Nei Jing* states: "The center corresponds to yellow, connects internally to the Spleen, opens into the mouth, stores essence in the Spleen, so disease manifests in the tongue." Among oral diseases, Chong She (Double Tongue) results from heat in both the Heart and Spleen. The Heart corresponds to the tongue and governs blood; the Spleen's collaterals emerge under the tongue. (Commentary: Spleen collaterals attach to the sides of the tongue, Liver collaterals attach to the root of the tongue, Heart collaterals attach to the base.) If the Heart is hot, Qi and Blood become excessive, attaching to the tongue root, growing anew like a small tongue. Growth inside the cheeks or on the palate is named Chong E (Double Palate); growth at the gum line is named Chong Yin (Double Gum). These should be pricked to release blood, then applied with Zhen Pu Huang (True Cinnamon Flower/Corydalis Rhizome ash?), Fa Hui (Hair Ash), Ma Ya Xiao (Saltpeter), or Borax, or pointed with Huang Bai (Phellodendron Bark) soaked in Bamboo Sap.
Mu She (Wooden Tongue) results from organ stagnation and accumulated heat in the Heart and Spleen, with hot Qi rushing upward, causing tongue swelling that gradually fills the mouth. If not treated urgently, it can be fatal. Mix 2 parts Mirabilite, 1 part Frost Purple (likely a specific preparation), and 0.5 part White Salt, grind together, and apply with Bamboo Sap. Using only Borneol is also effective.
Nong She (Playing Tongue) results from slight heat in the Spleen, causing slight tension in the tongue collaterals and frequent protrusion of the tongue. Treatment: Do not use cold purgatives. Instead, administer small amounts of Xie Huang San (Drain Yellow Powder) or give water. Physicians mistakenly suspect excess heat and use cold purgatives, which is incorrect. Giving water addresses Spleen/Stomach deficiency and scant fluids. Combined with emaciation, yellow complexion, and five-palm heat, this becomes Shou Gan (Emaciation Syndrome), suitable for Hu Huang Lian Wan (Coptis Pill). If playing tongue occurs after medication during a severe illness, the prognosis is ominous. White coating with black patches on the tongue should be treated with Borax powder; add Borneol if heat is severe.
Kou Mi (Oral Miasma/Sloughing) occurs when Bladder heat transfers to the Small Intestine, causing dysuria, with heat rising to cause oral sloughing. Heart/Stomach heat stagnation leads to poor digestion of water and grain, transmitting downward to the Small Intestine. Use Dao Chi San (Guide Out Red Powder) to clear Small Intestine heat and Wu Ling San (Five-Ingredient Powder with Poria) to clear Bladder heat; using both together for two doses is appropriate.
E Kou (Goose Mouth) appears in newborns as white flakes in the mouth and on the tongue, resembling a goose's mouth. This is due to fetal heat, most intense in the Heart and Spleen, steaming upwards to the mouth. Ge Shi suggests wrapping hair around a finger, dipping it in Jing Hua Shui (First-drawn well water), wiping the lesion, then applying Huang Dan (Lead Monoxide) calcined to remove fire toxicity, sprinkled on the site.
Kou Chuang (Mouth Ulcers) result from infants being kept too warm, leading to accumulated heat in the Heart steaming upwards. Treat with Nan Xing (Arisaema Rhizome) powder mixed with vinegar, applied to the soles of the feet. The nursing mother should take Xi Xin San (Wash Heart Powder) and Xie Xin Tang (Drain Heart Decoction).
Zhu Danxi said: "If an infant with mouth ulcers refuses milk/food, treating it as Hu Huo Disease (Beriberi-like/Fox Infection) will lead to death. (Commentary: Sores on the upper lip indicate 'Huo' worms eating the viscera; sores on the lower lip indicate 'Hu' worms eating the anus.) One must soak the feet in Fan Tang (Alum Water) for half a day for immediate relief. Apply powdered Huang Bai (Phellodendron Bark) honey-fried and Jiang Can (Silkworm) stir-fried to the lesion to restore nursing and peace."
The tongue is the organ of the Heart. Heart heat causes sores and rupture; Liver stagnation causes bleeding like a surge; Spleen closure causes white coating like snow; Heat causes swelling; Wind causes stiffness like wood, locking the mouth shut. Robust limb heat, asthma, and slurred speech are all signs.
If the tongue suddenly swells and extends outside the mouth like a centipede, commonly called Centipede Poison, smear with one cup of Rooster Blood to retract it. If the tongue extends over one inch, apply crushed Borneol to retract it.
Applying Mulberry Tree Juice to mouth ulcers leads to recovery; swallowing it is harmless and effective for adults and children alike.
[Attached Formulas]
Xie Huang San (Drain Yellow Powder): See in Heat Syndromes section.
Hu Lian Wan (Coptis Pill): Hu Huang Lian (Coptis Chinensis), Xuan Huang Lian (Coptis Teeta), Moschus (1 spoon), Aloe (1 qian), Cinnabar (2.5 qian).
Dao Chi San (Guide Out Red Powder): See in Five Strangury Syndromes section.
Wu Ling San (Five-Ingredient Powder with Poria): See in Convulsion Syndromes section.
Xi Xin San (Wash Heart Powder): See in Cold Damage Syndromes section.
Xie Xin Tang (Drain Heart Decoction): See in Various Heat Syndromes section.