（并附∶口舌生疮）
夫咽之所以咽物，喉之所以候气，虽居上焦阳分，然有太阴少阴之脉络焉。人之一身，
水升火降，无壅无滞，则咽自利，而喉自润也。若夫土衰水涸，则相火蒸炎，致津液枯竭，
由是而咽喉干燥疼痛等证作矣。火病至此，实真阴失守，孤阳无根，冲浮于上，而乃至此。
痰火诸证，孰酷此耶？所谓龙雷之火，不可水伏，惟滋阴抑阳，使水升火降，津液复回而后
可止。若以苦寒正治，则阴火愈炽，而脾土自败，犹渴饮鸩，立促其毙也。
圣谓咽喉诸症，有虚有实。若上焦风热，君火令人咽喉肿痛，或喉痹乳蛾，分属关隘，
怆卒即能杀人，然皆失治所致。即至危际，外可施砭 拔发，咬指吐痰 鼻等捷法，以
治其标。内服翘、射、山豆根、牛蒡子根、鼠粘子等味，以拔其本，至绝地挽回者亦多。若
夫痰火咽痛，则必诸症悉具，甚乃有此，何也？以脏败下及脉络，是根枯而槁及枝叶矣。可
复荣乎？此盖阴火浮游，进退莫测，所以或痛或止，故非苦寒之可遏也。治亦不宜专攻，但
以主剂中倍以益阴之品，少增畅利之味，庶几得法。若以苦寒直折，则阴火愈炎，立见倾
危也，慎之慎之。
甘草（蜜炙，缓火，去咽痛，若肺热同桔梗煎啜） 知母（蜜炒，泻肺火利咽痛） 玄参
（去无根之火，滋肾水，利咽痛） 麦门冬（去心，治虚热上攻咽痛）
以上五味，皆痰火咽痛两利之品，其山豆根、牛蒡子根、恶实子、射干，皆苦寒专攻之
剂，并所不宜，或以贝母、百合、诃子、槐花煎之噙咽，或贝母、硼砂末之吹咽，治标可也
（并附：口舌生疮）
咽喉之所以能吞咽食物，是因为其功能在于“咽”；喉之所以能呼吸气息，是因为其功能在于“候”气。虽然它们位于上焦的阳分，但有太阴经和少阴经的脉络联系其中。人体一身之中，若肾水上升、心火下降，没有壅塞和停滞，那么咽喉自然通畅，喉部自然滋润。如果脾土衰弱、肾水枯竭，就会导致相火（寄居于肝肾之火）蒸腾炎上，致使津液干枯，于是咽喉干燥疼痛等症状就发作了。火病发展到这种地步，实际上是真阴失守，孤阳无根，冲逆浮越于上部，才导致这种情况。痰火诸证，有哪一种比这更严重的呢？这就是所谓的“龙雷之火”，不能用寒水去压制，只有滋阴以抑制阳气，使水升火降，津液恢复后才能停止。如果用苦寒药物直接治疗，则阴火会更加炽盛，而脾土自身也会败坏，这就如同口渴时喝下毒酒，立刻就会加速死亡。
圣人说咽喉的各种病症，有虚证也有实证。如果是上焦风热，君火（心火）导致咽喉肿痛，或者喉痹（咽喉闭塞不通）、乳蛾（扁桃体肿大），分别属于关隘部位的病变，突然发作就能杀人，但这都是因为失治（延误治疗或误治）所导致的。即使在危急时刻，外部可以施用砭石放血、拔罐发汗、咬指吐痰等快速方法，来治疗其标症。内部服用连翘、射干、山豆根、牛蒡子根、鼠粘子（即牛蒡子）等药材，来拔除病根，在绝境中挽回生命的情况也很多。如果是痰火引起的咽痛，那么必然具备各种症状，甚至出现上述危象，为什么呢？因为脏腑败坏向下波及脉络，这是根基枯槁进而枝叶也干枯了。还能恢复生机吗？这大概是阴火浮游不定，进退难以预测，所以有时疼痛有时停止，因此不是苦寒药物可以遏制的。治疗也不宜专门攻伐，只需在主方中加倍使用益阴的药物，少量增加畅通利窍的味道，差不多就符合治法了。如果用苦寒药物直折火势，则阴火更加猛烈，立刻就会看到倾覆危险，务必谨慎，务必谨慎。
甘草（用蜜炙，缓火炮制，可缓解咽痛，如果肺热同桔梗一起煎煮饮用） 知母（用蜜炒，泻肺火，利咽止痛） 玄参（去除无根之火，滋补肾水，利咽止痛） 麦门冬（去掉心，治疗虚热上攻引起的咽痛）
以上五味药，都是痰火咽痛上下两利的佳品。至于山豆根、牛蒡子根、恶实子（即牛蒡子）、射干，都是苦寒专攻的药剂，并不适宜使用。或者可以用贝母、百合、诃子、槐花煎汤含咽，或者用贝母、硼砂研末吹入咽喉，用来治疗标症是可以的。
(Also attached: Mouth and tongue sores)
The reason why the pharynx (throat for swallowing) can swallow food is its function of "swallowing"; the reason why the larynx (throat for breathing) can breathe air is its function of "receiving" qi. Although they reside in the upper jiao (upper burner, yang aspect), there are meridians and collaterals of the Taiyin (Hand-Taiyin Lung Meridian) and Shaoyin (Hand-Shaoyin Heart Meridian/Foot-Shaoyin Kidney Meridian) connecting to them. In the human body, if kidney water ascends and heart fire descends, without obstruction or stagnation, the pharynx will naturally be unobstructed, and the larynx will naturally be moist. If spleen earth declines and kidney water dries up, ministerial fire (Xiang Huo, fire residing in liver and kidney) will steam and flare upwards, causing the depletion of body fluids. Consequently, symptoms such as dryness and pain in the pharynx and larynx arise. When fire disease reaches this stage, it is essentially due to the loss of control over true yin, with lone yang lacking a root, rushing and floating upward, leading to this condition. Among various phlegm-fire syndromes, which is more severe than this? This is what is called "Dragon and Thunder Fire," which cannot be subdued by cold water; only by nourishing yin to suppress yang, allowing water to ascend and fire to descend, and restoring body fluids, can it be stopped. If treated directly with bitter-cold herbs, the yin fire will become even more intense, and spleen earth will collapse on its own. This is like drinking poison when thirsty, immediately accelerating death.
The Sages stated that various throat diseases have both deficiency (Xu) and excess (Shi) patterns. If it is wind-heat in the upper jiao, sovereign fire (Jun Huo, referring to Heart Fire) causes swelling and pain in the throat, or throat bi (obstruction of the throat) and ru e (tonsillar hypertrophy), affecting the passageways. Sudden onset can be fatal, but these are all caused by mismanagement or delayed treatment. Even in critical situations, external methods such as bian stone bloodletting, cupping to induce sweating, and biting fingers to induce expectoration can be used as quick methods to treat the branch (symptoms). Internally, taking herbs such as Lianqiao (Forsythiae Fructus), Shegan (Belamcandae Rhizoma), Shandougen (Sophorae Tonkinensis Radix), Niubangzigen (Arctii Radix), and Shi Niu Zi (Arctii Fructus) can extract the root (cause), and many lives have been saved from desperate situations. However, for pharyngalgia caused by phlegm-fire, all symptoms must be present, and even the aforementioned critical conditions may occur. Why? Because the internal organs fail downwards, affecting the meridians and collaterals; this is like the roots drying up and the branches and leaves also withering. Can vitality be restored? This is likely due to yin fire wandering unpredictably, advancing and retreating without certainty, so pain comes and goes. Therefore, it cannot be suppressed by bitter-cold herbs. Treatment should not focus solely on attack; instead, one should double the dosage of yin-nourishing herbs in the main formula and slightly increase herbs that promote free flow and unblocking. This would roughly conform to the correct method. If bitter-cold herbs are used to directly curb the fire, the yin fire will flare up even more, leading to immediate peril. Be cautious, be very cautious.
Gancao (Licorice Root), honey-fried, slow-fired, relieves pharyngalgia; if lung heat is present, decoct with Jiegeng (Platycodonis Radix) and drink. Zhimu (Anemarrhenae Rhizoma), honey-fried, clears lung fire and benefits the throat for pain relief. Xuanshen (Scrophulariae Radix), removes rootless fire, nourishes kidney water, and benefits the throat for pain relief. Maimendong (Ophiopogonis Radix), remove the heart, treats pharyngalgia caused by deficiency-heat attacking upward.
The above five herbs are excellent products for benefiting both sides in phlegm-fire pharyngalgia. As for Shandougen, Niubangzigen, Eshizi (Arctii Fructus, same as Niubangzi), and Shegan, they are all bitter-cold formulas for direct attack and are not suitable. Alternatively, decoct Beimu (Fritillariae Bulbus), Baihe (Lilii Bulbus), Hezi (Terminalia Chebulae Fructus), and Huaihua (Sophorae Flos) for holding in the mouth and swallowing, or use Beimu and Pengsha (Borax) powder insufflated into the throat to treat the branch symptoms.