白喉病或已误或未误。以法治之。当无不愈。愈后饮食起居如常者。不必服补养药。
如肺阴未复。可用补土生金法。张氏养正汤去花粉加制甘草沙参主之。数月后喉间仍
介介如梗者。前方加归身黄 。甚则用东垣甘温法。
白喉为燥火烁金。善后自宜清润甘淡。以补土生金。张氏养正汤最为合度。去花粉
不可令复凉也。或过服寒凉以后。营血往往受伤。每有终年累月。喉间仍介介不
已。此必重用归 。藉甘温以和调营血。盖当时一味寒凉。必有余热。滞入营卫
隧道。郁久不达。势必复蒸。先贤陆九芝所谓过服冬地。易发骨蒸劳热。真有得之
言也。
善患白喉。愈后数月喉间常觉介介。后因中寒。服大甘温药始痊。主讲自京都
归。言北方此病甚多。愈后服温养。始能撤消。些言适符合。长女同时患此。于初
起医治不得法。未能疏通经隧。致余毒流入骨髓。次年仍发青腿牙疳颇重。医治月
余始痊。
生玉竹 淮山药 白茯苓 熟地黄 生地黄 生白芍 制首乌 女贞子 北沙参 制甘草 麦门冬（去心）
上药十一味。水五杯。煎取三杯。分二次温服。
白喉病手太阴本症未罢。始终不得用吹喉法。初起即红肿痰涎。挟有风火标症者。间
用吹喉。盖风火来势自急。且易为痰。不参外治。恐难速效。
大凡时疫喉症。多因风火挟痰。冲激于喉咙一线之地。猝不得出。遂致顷刻肿闭。
其五内腑初无大病。此时服药不及。唯有用辛散药吹喉。以吐痰涎。故外治之法。
为喉科要诀。独此症咽干无痰。不痛不肿。纯系太阴燥火烁金。肺汁内涸。滋之不
暇。岂可复用辛散以吹喉。善见有起初无痰。用吹喉药后。反觉痰声漉漉。实因燥
火重。得辛香以张其焰也。若挟少阳少阴风火标症。红肿异常。痰涎壅盛。则吹喉
之法。亦可间用。轻者以青黄散。重者以张氏雄黄解毒丸。或白填鸭散。其用雄黄
解毒丸者。实以万分危急之际。不得已权宜而用。非常法也。然其间实有至理。巴
豆大辛大热。虽为白喉所最忌。而斩关夺隘。峻利无比。下咽后未有不直达肛门。
与寻常辛烈之品。不能驱痰下坠。反足助火上焰者。迥乎不同。此症若至痰气壅
闭。药不得入。多因误治后。火势燎原所致。此时若仅用张氏之瓜霜散。耐修子之凤
衣散。与外治之异功散。非但无益。恐适以增病。唯暂借此药开通径路。随以大清
凉或甘咸寒大剂。频频灌服。即可救效。断不至停留上焦。以助火势也。此所谓出
奇制胜。非胸有成竹者不能用。亦且不敢用也。白填鸭散未曾试验。大概非手太阴
本症所宜。痰涎壅盛者。亦可备用。较锡类散尚优。余长女曾以锡类散吹喉。实时
音哑。盖珠黄人指甲壁钱冰片象牙等味。既燥而又涩。皆在大忌。
白喉病无论之前是否误治，只要采用正确的治疗方法，应当没有不痊愈的。痊愈后如果饮食起居恢复正常，就不必服用补养药物。
如果肺阴尚未恢复，可以使用“补土生金”法（通过健脾来滋养肺脏）。以张氏养正汤为基础，去掉天花粉，加入制甘草和沙参作为主方。数月后如果喉咙间仍有异物感（介介如梗），在前方的基础上加入当归身和黄耆。严重时则使用李东垣的甘温疗法。
白喉是由于燥火灼伤肺金所致，善后调理自然适宜采用清润、甘淡的方法，通过补益脾胃（土）来滋养肺脏（金）。张氏养正汤最为恰当。去掉天花粉，是为了避免药性再次变得寒凉。或者因为过度服用寒凉药物后，营血往往受到损伤，常常出现整年累月喉咙间仍有异物感的情况。这必定需要重用当归和黄耆，借助甘温的药性来调和营血。因为当时一味地服用寒凉药，必然会有余热滞留，陷入营卫运行的通道中，郁结日久无法发散，势必会重新蒸腾发热。先贤陆九芝所说的“过度服用地黄类药物，容易引发骨蒸劳热”，确实是经验之谈。
曾经有患白喉的人，痊愈数月后喉咙间常觉有异物感，后来因为感受寒邪，服用大剂量的甘温药物后才痊愈。主讲人从京都归来，说北方这种病很多，痊愈后服用温养药物，才能彻底消除症状。这些言论恰好符合实际情况。我的长女同时患有此病，在初起时医治不得法，未能疏通经络通道，导致余毒流入骨髓。次年仍然发作青腿牙疳，病情颇重，经过一个多月的医治才痊愈。
药材组成：玉竹、淮山药、白茯苓、熟地黄、生地黄、生白芍、制首乌、女贞子、北沙参、制甘草、麦门冬（去心）。
以上十一味药，用水五杯，煎取三杯药液，分两次温服。
白喉病的手太阴肺经本症未解除时，始终不能使用吹喉法。如果在初起阶段就出现红肿、痰涎，并夹杂有风火的标症，可以偶尔使用吹喉法。因为风火发病急骤，且容易形成痰浊，如果不配合外治法，恐怕难以迅速见效。
大凡时疫引起的喉症，多因风火挟带痰浊，冲激于喉咙这一狭窄部位，突然无法排出，于是导致顷刻间肿胀闭塞。此时五脏六腑起初并没有大病，口服药物来不及发挥作用，唯有使用辛散的药物吹入喉中，以吐出痰涎。因此，外治法是喉科的关键秘诀。唯独白喉症咽干无痰，不痛不肿，纯粹是太阴燥火灼伤肺金，肺津内耗枯竭，滋润都来不及，怎么可以再复用辛散药物吹喉呢？我常见到起初没有痰，用了吹喉药后，反而觉得痰声漉漉作响，实在是因为燥火严重，遇到辛香药物反而助长了火势。如果夹杂少阳、少阴的风火标症，出现异常红肿，痰涎壅盛，那么吹喉法也可以偶尔使用。轻症用青黄散，重症用张氏雄黄解毒丸，或者白填鸭散。使用雄黄解毒丸的情况，实在是在万分危急之际，不得已而采取的权宜之计，并非常规方法。但这其中确实有至理。巴豆大辛大热，虽然是白喉最忌讳的，但它斩关夺隘，峻利无比，吞服后没有不直达肛门的，这与寻常辛烈之品不能驱痰下坠，反而足以助火上炎截然不同。此症如果发展到痰气壅闭，药物无法进入，多是因为误治后火势燎原所致。此时如果仅使用张氏的瓜霜散、耐修子的凤衣散以及外治用的异功散，不仅无益，恐怕反而会加重病情。唯有暂时借这些药物开通径路，随后以大剂量的大清凉或甘咸寒药物频频灌服，即可收到救治效果。绝不会让药物停留在上焦从而助长火势。这就是所谓的出奇制胜，不是胸有成竹的人不能用，也不敢用。白填鸭散未曾试验过，大概不适合手太阴肺经的本症，但对于痰涎壅盛者，也可以备用，比锡类散还要优越。我的长女曾用锡类散吹喉，随即声音嘶哑。这是因为其中的珍珠、牛黄、人指甲、壁钱、冰片、象牙等药味，既干燥又涩滞，都是白喉的大忌。
Baihou disease (White Diphtheria), whether previously misdiagnosed or not, if treated with the correct method, should invariably recover. If diet and daily life return to normal after recovery, there is no need to take tonic medicines.
If Lung Yin has not yet recovered, the method of "Supplementing Earth to Generate Metal" (nourishing the Lungs by strengthening the Spleen) can be used. Zhang's Yangzheng Decoction (Zhang Shi Yangzheng Tang), with Tianhuafen removed and processed Gancao (Licorice Root) and Shashen added, should be administered as the primary formula. If a sensation of obstruction in the throat persists for months, Danggui Shen (Radix Angelicae Sinensis) and Huangqi (Astragalus Root) should be added to the previous prescription. In severe cases, Li Dongyuan's Sweet-Warm Method should be employed.
Baihou is caused by Dry-Fire scorching Metal (Lung). Therefore, post-illness care should naturally suit clear-moistening and sweet-bland methods, supplementing Earth to generate Metal. Zhang's Yangzheng Decoction is most appropriate. Removing Tianhuafen prevents the medicine from becoming too cold again. Alternatively, after excessive consumption of cold-natured medicines, Ying Blood often suffers injury, resulting in a persistent sensation of obstruction in the throat throughout the year. This definitely requires heavy use of Danggui and Huangqi, relying on sweet-warm properties to harmonize Ying Blood. Because the initial treatment relied solely on cold medicines, residual heat must have remained, stagnating in the channels of Ying and Wei. After long-term stagnation, it inevitably steams upward. As the ancient expert Lu Jiuzhi stated, "Excessive consumption of Dihuang (Rehmannia) easily triggers bone-steaming consumptive fever," which is truly insightful advice.
There was a case of a patient who, months after recovering from Baihou, constantly felt an obstruction in the throat. Later, due to contracting Cold, they were cured only after taking large doses of sweet-warm medicines. The lecturer returned from Beijing, stating that this disease is very common in the North, and only by taking warm-tonifying medicines after recovery can symptoms be completely eliminated. These words coincidentally matched reality. My eldest daughter suffered from this simultaneously; because the initial treatment was improper and failed to unblock the meridians, residual toxins flowed into the bone marrow. The following year, she still developed severe Qingtui Yagan (Green Leg and Tooth Gangrene), requiring over a month of treatment to recover.
Ingredients: Yuzhu (Polygonati Rhizoma), Huai Shanyao (Dioscoreae Rhizoma), Bai Fuling (Poria), Shu Dihuang (Prepared Rehmanniae Radix), Sheng Dihuang (Raw Rehmanniae Radix), Sheng Baishao (Raw Paeoniae Radix Alba), Zhi Shouwu (Prepared Polygoni Multiflori Radix), Nvzhenzi (Ligustri Lucidi Fructus), Beishashen (Glehniae Radix), Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma), Maimendong (Ophiopogonis Radix, heart removed).
The above eleven herbs are decocted in five cups of water until three cups remain. Take half at a time, warm.
When the primary syndrome of the Hand-Taiyin Lung channel in Baihou has not resolved, the blowing-the-throat method should never be used. If redness, swelling, and phlegm-saliva appear at the onset, accompanied by superficial syndromes of Wind-Fire, the blowing method may be used occasionally. Since Wind-Fire arises urgently and easily generates phlegm, without external treatment, rapid effect is unlikely.
Generally, epidemic throat syndromes are often caused by Wind-Fire carrying phlegm, rushing against the narrow passage of the throat, suddenly unable to exit, leading to instantaneous swelling and closure. At this moment, the internal organs initially have no major disease. Oral medication is too slow; only by using acrid-dispersing medicines blown into the throat to expel phlegm-saliva can one succeed. Thus, external treatment is the key secret of throat specialties. However, Baihou is characterized by dry throat, no phlegm, no pain, and no swelling. It is purely Taiyin Dry-Fire scorching Metal, with Lung fluids internally dried up. There is no time even to moisten them, let alone reuse acrid-dispersing medicines for blowing. I have seen cases where there was initially no phlegm, but after using blowing medicines, gurgling phlegm sounds increased. This is actually because the Dry-Fire was severe, and the acrid-aromatic nature of the medicine fanned the flames. If accompanied by Shaoyang and Shaoyin Wind-Fire superficial syndromes, with abnormal redness and swelling and abundant phlegm-saliva, the blowing method can also be used occasionally. For mild cases, Qinghuang San (Blue-Yellow Powder) is used; for severe cases, Zhang's Xionghuang Jiedu Wan (Realgar Antidote Pill) or Bai Tianya San (White Fill-Duck Powder) is used. Using Xionghuang Jiedu Wan is truly a temporary expedient in desperate, critical situations, not a standard method. Yet, there is profound logic here. Badou (Croton Seed) is extremely acrid and hot. Although it is the greatest taboo for Baihou, it cuts through barriers with unparalleled potency. After swallowing, it inevitably reaches the anus directly, which is vastly different from ordinary acrid-hot substances that cannot drive phlegm downward but instead help fire flare up. If this condition progresses to phlegm-Qi congestion and closure, preventing medication intake, it is mostly due to fire spreading like a prairie fire after misdiagnosis. At this time, using only Zhang's Guashuang San (Melon Frost Powder), Naixiu Zi's Fengyi San (Phoenix Feather Powder), or the external Yigong San (Extraordinary Efficacy Powder) is not only useless but may worsen the disease. One must temporarily borrow these medicines to open the pathway, then frequently administer large doses of Great-Cooling or Sweet-Salty-Cold medicines orally to achieve rescue effects. The medicine will not stay in the Upper Jiao to assist the fire. This is what is called winning by surprise tactics; only those with a clear strategy can use it, and dare not use it lightly. Bai Tianya San has not been tested, but generally, it is not suitable for the primary Hand-Taiyin syndrome. However, for those with abundant phlegm-saliva, it can be kept as a backup option and is superior to Xilei San. My eldest daughter once used Xilei San for blowing the throat and immediately lost her voice. This is because ingredients such as Pearl, Calculus Bovis, Human Nail, Wall Spider Web, Borneolum Syntheticum, and Ivory are both drying and astringent, all of which are strictly contraindicated in Baihou.