白见于关内外。色稍不润。喉内红肿。下午痛甚口干不渴。舌苔虽黄而滑。小
便略赤而长。饮食稍碍。心烦不眠。此虚阳上浮。不可认作实热攻下。治宜甘桔汤。四物汤。甘露饮。加减主之。
甘桔汤
甘草(三钱) 桔梗(四钱) 银花(一钱五分) 麦冬(二钱,去心)
僵虫(二钱,姜汁炒) 鼠粘(二钱) 冬桑叶(三皮) 水煎服。
四物汤
生地黄(三钱) 僵虫(二钱,姜汁炒) 川芎(二钱) 白芍(一钱五分)
银花(一钱五分) 当归(一钱) 粉草(一钱) 青果(一粒) 水煎服。
甘露饮
生地黄(四钱) 熟地(三钱) 麦冬(三钱,去心) 僵虫(二钱,姜汁炒)
银花(一钱五分) 天冬(一钱五分) 石斛(一钱) 枳壳(一钱) 粉草(一钱) 水煎服。
白见于关内。色明润成块。甚或凹下。不红不肿。不甚疼痛。饮食稍碍。舌苔
滑白。二便如常。或自溏泻。间或寒热往来。两颧作红。嘴唇燥裂。此上假热下真寒证也。宜治理中汤。
镇阴煎。附桂理阴煎。加减主之。
理中汤
党参(五钱) 淮药(四钱,炒) 僵虫(二钱,姜汁炒) 炮姜(二钱) 银花(二钱) 炙草(一钱) 水
煎服
镇阴煎
熟地黄(四钱) 泽泄(五钱) 淮牛膝(五分,盐水炒) 本制附片(三钱)
僵虫(二钱) 银花(一钱五分) 肉桂(四分,去粗皮蒸兑) 炙草(一钱) 煨姜(一片) 水煎服。
附桂理阴煎
熟地(四钱) 僵虫(二钱) 本制附片(三钱) 炮姜(一钱五分,炒)
银花(一钱五分) 当归(一钱) 炙草(一钱) 肉桂(八分,去粗皮蒸兑) 水煎服。
白喉的病变部位可见于关脉的内侧和外侧。如果色泽稍显干燥不润泽,喉部内部红肿,下午疼痛加剧,口干但不想喝水,舌苔虽然发黄但表面滑润,小便颜色略红且尿量较长,饮食稍有阻碍,心烦意乱无法入睡,这是虚阳上浮的表现,不可误认为是实热证而使用攻下法治疗。治疗适宜使用甘桔汤、四物汤、甘露饮进行加减化裁来主治。
甘桔汤
甘草(三钱) 桔梗(四钱) 金银花(一钱五分) 麦冬(二钱,去除心)
僵蚕(二钱,用姜汁炒制) 牛蒡子(二钱) 冬桑叶(三皮) 用水煎煮后服用。
四物汤
生地黄(三钱) 僵蚕(二钱,用姜汁炒制) 川芎(二钱) 白芍(一钱五分)
金银花(一钱五分) 当归(一钱) 粉草(一钱) 青果(一粒) 用水煎煮后服用。
甘露饮
生地黄(四钱) 熟地黄(三钱) 麦冬(三钱,去除心) 僵蚕(二钱,用姜汁炒制)
金银花(一钱五分) 天冬(一钱五分) 石斛(一钱) 枳壳(一钱) 粉草(一钱) 用水煎煮后服用。
白喉的病变部位仅见于关脉内侧。色泽明亮润泽甚至成块状,或者凹陷下去,不红不肿,疼痛不明显,饮食稍有阻碍,舌苔滑白,大小便正常,或者出现自发性腹泻,偶尔有寒热往来的症状,两颧发红,嘴唇干燥开裂,这是上假热下真寒的证候。适宜使用理中汤、镇阴煎、附桂理阴煎进行加减化裁来主治。
理中汤
党参(五钱) 淮山药(四钱,炒制) 僵蚕(二钱,用姜汁炒制) 炮姜(二钱) 金银花(二钱) 炙甘草(一钱) 用水煎煮后服用。
镇阴煎
熟地黄(四钱) 泽泻(五钱) 怀牛膝(五分,用盐水炒制) 本制附片(三钱)
僵蚕(二钱) 金银花(一钱五分) 肉桂(四分,去除粗皮蒸制后兑入) 炙甘草(一钱) 煨姜(一片) 用水煎煮后服用。
附桂理阴煎
熟地黄(四钱) 僵蚕(二钱) 本制附片(三钱) 炮姜(一钱五分,炒制)
金银花(一钱五分) 当归(一钱) 炙甘草(一钱) 肉桂(八分,去除粗皮蒸制后兑入) 用水煎煮后服用。
The lesion of diphtheria (Baihou) can be observed on both the interior and exterior aspects of the Guan pulse position. If the color is slightly dry and lacks luster, with redness and swelling inside the throat, severe pain in the afternoon, dry mouth without desire to drink, yellow but slippery tongue coating, slightly reddish and long urine stream, slight difficulty in eating, restlessness, and insomnia, this indicates floating deficient Yang. It must not be mistaken for excess heat treated with purgation. The treatment should employ Ganjie Tang (Licorice and Platycodon Decoction), Siwu Tang (Four Substance Decoction), and Ganlu Yin (Sweet Dew Drink) with modifications as the main regimen.
Ganjie Tang (Licorice and Platycodon Decoction)
Gancao (Glycyrrhizae Radix et Rhizoma, 3 qian) Jiegeng (Platycodonis Radix, 4 qian) Yinhua (Lonicerae Japonicae Flos, 1.5 qian) Maidong (Ophiopogonis Radix, 2 qian, heart removed)
Jiangcan (Bombyx Batryticatus, 2 qian, stir-fried with ginger juice) Niuniu (Araliae Chinensis Fructus/Arctii Fructus, 2 qian) Dong Sangye (Mori Folium, 3 pi) Decoct in water and take orally.
Siwu Tang (Four Substance Decoction)
Sheng Dihuang (Rehmanniae Radix Recens, 3 qian) Jiangcan (Bombyx Batryticatus, 2 qian, stir-fried with ginger juice) Chuanxiong (Ligustici Chuanxiong Rhizoma, 2 qian) Baishao (Paeoniae Radix Alba, 1.5 qian)
Yinhua (Lonicerae Japonicae Flos, 1.5 qian) Danggui (Angelicae Sinensis Radix, 1 qian) Fencao (Glycyrrhizae Radix et Rhizoma Preparata, 1 qian) Qingguo (Canarii Fructus, 1 piece) Decoct in water and take orally.
Ganlu Yin (Sweet Dew Drink)
Sheng Dihuang (Rehmanniae Radix Recens, 4 qian) Shudi (Rehmanniae Radix Preparata, 3 qian) Maidong (Ophiopogonis Radix, 3 qian, heart removed) Jiangcan (Bombyx Batryticatus, 2 qian, stir-fried with ginger juice)
Yinhua (Lonicerae Japonicae Flos, 1.5 qian) Tiandong (Asparagi Radix, 1.5 qian) Shihu (Dendrobii Caulis, 1 qian) Zhiqiao (Aurantii Fructus, 1 qian) Fencao (Glycyrrhizae Radix et Rhizoma Preparata, 1 qian) Decoct in water and take orally.
When the lesion is seen only on the interior aspect of the Guan pulse position, with bright, lustrous, or even clumped/appearance, or sunken, without redness or swelling, and mild pain, slight difficulty in eating, slippery white tongue coating, normal urination and defecation, or spontaneous diarrhea, occasional alternating chills and fever, red malar flush, and dry, cracked lips, this is a syndrome of false heat above and true cold below. The treatment should employ Lizhong Tang (Regulate the Middle Decoction), Zhenyin Jian (Settle Yin Decoction), and Fugui Liyin Jian (Aconite and Cinnamon Regulate Yin Decoction) with modifications as the main regimen.
Lizhong Tang (Regulate the Middle Decoction)
Dangshen (Codonopsis Radix, 5 qian) Huaiyao (Dioscoreae Hypoglaucae Rhizoma, 4 qian, stir-fried) Jiangcan (Bombyx Batryticatus, 2 qian, stir-fried with ginger juice) Paojiang (Zingiberis Rhizoma Preparatum, 2 qian) Yinhua (Lonicerae Japonicae Flos, 2 qian) Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata, 1 qian) Decoct in water and take orally.
Zhenyin Jian (Settle Yin Decoction)
Shudi (Rehmanniae Radix Preparata, 4 qian) Zexie (Alismatis Rhizoma, 5 qian) Huainiuxi (Cyathulae Radix/Achyranthis Bidentatae Radix, 0.5 qian, stir-fried with salt water) Benzhi Fupian (Aconiti Lateralis Radix Preparata, 3 qian)
Jiangcan (Bombyx Batryticatus, 2 qian) Yinhua (Lonicerae Japonicae Flos, 1.5 qian) Rougui (Cinnamomi Cortex, 0.4 qian, coarse bark removed, steamed and added later) Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata, 1 qian) Weijiang (Zingiberis Rhizoma Praeparatum, 1 slice) Decoct in water and take orally.
Fugui Liyin Jian (Aconite and Cinnamon Regulate Yin Decoction)
Shudi (Rehmanniae Radix Preparata, 4 qian) Jiangcan (Bombyx Batryticatus, 2 qian) Benzhi Fupian (Aconiti Lateralis Radix Preparata, 3 qian) Paojiang (Zingiberis Rhizoma Preparatum, 1.5 qian, stir-fried)
Yinhua (Lonicerae Japonicae Flos, 1.5 qian) Danggui (Angelicae Sinensis Radix, 1 qian) Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata, 1 qian) Rougui (Cinnamomi Cortex, 0.8 qian, coarse bark removed, steamed and added later) Decoct in water and take orally.