白喉病初起。头痛身寒热。右寸脉微数而涩。咽燥无痰。喉间发白。或咳或不咳。或
痛或不痛。但介介如梗状。饮食如常。此手太阴肺经燥气本病。加减喻氏清燥救肺汤
主之。右寸脉浮恶风寒甚者。挟有外感时邪也。前方略加辛凉药。如春则薄荷。夏则
荷叶扁豆花之类。或已误治。咽燥舌干。甚或绛者。郑氏养阴清肺汤亦可用。
素问刺热篇曰。肺热病者。先淅然厥起毫毛。恶风寒。舌上苔黄。身热。热争则
喘咳。痛走胸膺背。不得太息。头痛不堪。此症自始至终。与经旨一一吻合。故决
为肺经本病。主以加减喻氏清燥救肺汤。以此方实燥气化火之祖。方中西洋参色白
味苦性凉。有清无补。（他参如高丽东洋潞党及吉林参之类断不可用恐其太补肺气痰喘立至也）
石膏色白气辛味甘性寒。二味为
清手太阴经燥火专门之药。复以麦冬则清中有滋矣。臣以桑杏甘草。则辛寒而合苦
甘矣。与内经燥淫于内。治以辛寒。佐以苦甘语恰合。（此症往往遇外感时邪而发有桑杏便无引邪入
里之弊且性味清降较薄荷荷叶等味尤为易用）
至枇叶花露金汁不过佐使之药。借以清热解毒。且疏通经隧。不致留邪入
络。遗患将来也。平素痰多。或服药胃中觉寒。可加入蒌贝橘枳等味者。以药在对
病。既有是症。即可用是药。古人方中往往大开大阖。寒热温凉并用。如仲师之大
青龙麻杏甘石等汤是也。（曩谓仲师二汤恰是治燥气之祖方盖化气为湿麻桂可以散之复气为火甘石可
以清之极为合拍如白喉病发于秋冬之交重感外寒者似可先用麻杏甘石一二剂唯不可用青龙耳）
其仍用郑氏养阴清肺汤者。以既经误治。肺阴受伤。并及营血。非冬地丹芍
实难奏效。然鄙意须加入西洋参石膏本经药。方为至善。
此症轻者饮食如常。初无痛苦。稍延至旬日。而转为痰喘身热者。若初起时妄用张
氏方之粉葛马勃僵蚕等味。或以水麝等药吹喉。未有不转轻为重者。余大小女恰犯
此弊。本春三月余友蔡拔萃逸仲曾患此。以婚期在迩。（约三五日之内）颇着急。余曰无患也。
以此方略加减与之。日再服。二日内全痊。
白喉病初起时，出现头痛、身体寒热交替的症状。右手寸脉微数且涩，咽喉干燥无痰，喉间出现白色假膜，有时咳嗽有时不咳，有时疼痛有时不痛，但感觉喉咙像被异物梗塞一样，饮食如常。这是手太阴肺经燥气所致的本病，主方用加减喻氏清燥救肺汤。若右手寸脉浮，恶风寒症状严重，说明兼夹外感时邪，前方略加辛凉药物，如春季用薄荷，夏季用荷叶、扁豆花之类。如果已经误治，导致咽喉干燥、舌干，甚至舌色绛红，郑氏养阴清肺汤也可以使用。
《素问·刺热篇》说：肺热病患者，先感到寒冷战栗，毫毛竖起，恶风寒，舌上苔黄，身体发热。热邪与正气相争则气喘咳嗽，疼痛放射至胸膺背部，不能深吸气，头痛剧烈不堪忍受。此症自始至终，与经典旨意一一吻合，故断定是肺经本病，主方用加减喻氏清燥救肺汤。因为这个方子实际上是治疗燥气化火的祖方。方中西洋参色白、味苦、性凉，有清热而无补益作用。（其他人参如高丽参、东洋参、潞党参及吉林参之类绝对不可用，恐怕因其过于补益肺气而导致痰喘立即发作）石膏色白、气辛、味甘、性寒，这两味药是清泻手太阴经燥火的专门药物。再加上麦冬，则在清热之中兼具滋润作用。以桑叶、杏仁、甘草为臣药，则辛寒之性与苦甘之性相合。这与《内经》中“燥淫于内，治以辛寒，佐以苦甘”的论述完全契合。（此症往往因感受外感时邪而诱发，有桑叶、杏仁便没有引邪入里的弊端，且其性味清降，较薄荷、荷叶等更为易用）
至于枇杷叶、花露、金汁不过是佐使药，借以清热解毒，并且疏通经络隧道，不致使邪气留滞进入络脉，留下后患。平素痰多，或服药后胃中觉寒，可以加入瓜蒌、贝母、橘皮、枳实等药物，因为用药要对准病症，既然有此症状，即可用此药。古人方剂中往往大开大阖，寒热温凉并用，如张仲景的大青龙汤、麻杏甘石汤等即是如此。（过去认为仲景的二方恰是治疗燥气的祖方，盖因化气为湿，麻黄、桂枝可以发散；复气为火，石膏、杏仁可以清泄，极为合拍。如白喉病发于秋冬之交，重感外寒者，似乎可先用麻杏甘石汤一二剂，唯独不可用大青龙汤）
之所以仍用郑氏养阴清肺汤，是因为经过误治后，肺阴受伤，并波及营血，非用地黄、丹皮、芍药等药实在难以奏效。然而我的意见是必须加入西洋参、石膏这二味本经药物，方为完善。
此症轻者饮食如常，初时无痛苦，稍拖延至旬日，而转为痰喘、身热的，如果在初起时妄用张氏方中的粉葛、马勃、僵蚕等药，或以水麝等药吹喉，没有不转轻为重者的。我的大小女儿恰好犯了这种弊病。本是春三月，我的朋友蔡拔萃逸仲曾患此病，因为婚期在即（约三五日之内），颇为着急。我说不用担心。以此方略加减给予他服用，每日两次，两日内全愈。
At the onset of pseudodiphtheria (Baihou), symptoms include headache, and alternating sensations of cold and heat in the body. The pulse at the right Cun position is slightly rapid and choppy; the throat is dry without phlegm; white patches appear in the throat; coughing may or may not occur; pain may or may not be present, but there is a sensation of obstruction as if something were stuck in the throat; appetite remains normal. This is the primary disease of the Hand-Taiyin Lung Meridian caused by Dryness pathogen. The main formula is Modified Yu's Qingzao Jiufei Tang (Cleansing Dryness and Saving the Lung Decoction). If the pulse at the right Cun position is floating and aversion to wind and cold are severe, it indicates an accompanying external contraction of seasonal pathogens. Slightly add acrid-cool herbs to the aforementioned formula, such as Bohe (Menthae Haplocalycis Herba) in spring, or Heye (Nelumbinis Folium) and Biandouhua (Vigna radiata flos) in summer. If misdiagnosis and mistreatment have already occurred, resulting in a dry throat and dry tongue, or even a crimson tongue color, Zheng's Yangyin Qingfei Tang (Nourishing Yin and Clearing the Lung Decoction) can also be used.
The *Suwen* (Basic Questions), Chapter "Acupuncture for Heat Diseases" states: Patients with Lung Heat Disease first experience shivering with cold, erection of fine hair, aversion to wind and cold, yellow coating on the tongue, and fever. When heat struggles with healthy qi, wheezing and coughing occur; pain radiates to the chest, hypochondrium, and back; deep inhalation is difficult; headache is unbearable. This condition, from beginning to end, corresponds exactly with the classic teachings. Therefore, it is determined to be the primary disease of the Lung Meridian, and the main treatment is Modified Yu's Qingzao Jiufei Tang. This formula is actually the ancestral prescription for treating Dryness transforming into Fire. In this formula, Xiyangshen (American Ginseng Radix et Rhizoma), which is white in color, bitter in taste, and cool in nature, clears heat without tonifying. (Other ginsengs such as Gaolishen (Panax ginseng), Dongyangshen (Panax quinquefolius var. angustifolius), Ludangshen (Codonopsis pilosula), and Jilinishen (Panax ginseng) must absolutely not be used, as their excessive tonification of Lung Qi may immediately lead to phlegm and wheezing.) Shigao (Gypsum Fibrosum), which is white in color, acrid in aroma, sweet in taste, and cold in nature, along with these two herbs, serves as the specialized medicine for clearing Dryness-Fire of the Hand-Taiyin Meridian. With the addition of Maidong (Ophiopogonis Radix), nourishment is added to the clearing action. Sangye (Mori Folium), Xingren (Armeniacae Semen Amarum), and Gancao (Glycyrrhizae Radix et Rhizoma) serve as minister herbs, combining acrid-cold properties with bitter-sweet properties. This perfectly aligns with the *Neijing* statement: "For Dryness overflowing within, treat with acrid-cold, assist with bitter-sweet." (This condition often arises from contracting seasonal external pathogens; the presence of Sangye and Xingren avoids the drawback of drawing pathogens inward, and their clear-descending nature makes them easier to use than Bohe or Heye.)
Pipa ye (Loquat Leaf), Hualu (Flower Dew), and Jinzhi (Human Feces Decoction) serve only as assistant and guide herbs, borrowed to clear heat and detoxify, and to unblock the meridians and collaterals, preventing pathogens from lingering and entering the collaterals, thereby avoiding future complications. For those with abundant phlegm normally, or who feel cold in the stomach after taking medication, Loubei (Fructus Trichosanthis and Fritillariae Bulbus), Juqi (Citri Reticulatae Pericarpium and Aurantii Fructus Immaturus) etc. can be added. Medication must match the disease; since these symptoms exist, these herbs can be used. Ancient prescriptions often employ bold opening and closing strategies, using cold, hot, warm, and cool herbs together, such as Zhang Zhongjing's Daqinglong Tang (Major Green Dragon Decoction) and Maxing Gan Shi Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction). (Previously, I considered these two formulas by Zhang Zhongjing to be the ancestral prescriptions for treating Dryness, because when Qi transforms into Dampness, Mahuang and Guizhi can disperse it; when Re-qi transforms into Fire, Shigao and Xingren can clear it, which fits perfectly. For pseudodiphtheria occurring at the transition of autumn and winter, complicated by severe external cold, one might initially use Maxing Gan Shi Tang for one or two doses, but Daqinglong Tang should absolutely not be used.)
The reason for still using Zheng's Yangyin Qingfei Tang is that after mistreatment, Lung Yin is injured and extends to Ying and Blood levels. Without Dihuang (Rehmanniae Radix), Danpi (Moutan Cortex), and Shaoyao (Paeoniae Radix), efficacy is difficult to achieve. However, my opinion is that Xiyangshen and Shigao, the two herbs belonging to this meridian, must be added for the best result.
In mild cases of this condition, diet and digestion remain normal, and there is no initial pain. If delayed for ten days, it may transform into phlegm-wheezing and fever. If, at the onset, Zhang's formula containing Gefen (Puerariae Lobatae Radix), Mabo (Cacumen Bryoniae), and Jiangcan (Bombyx Batryticatus) is wrongly used, or if Shexiang (Moschus) mixed with water is blown into the throat, light conditions will invariably become heavy. My younger and elder daughters unfortunately committed this error. It was the third month of spring; my friend Cai Bahui Yizhong suffered from this illness. Since his wedding date was approaching (within three to five days), he was quite anxious. I said there was no cause for worry. I prescribed a modified version of this formula for him to take twice daily. He recovered completely within two days.