李王公主患喉痈数日，肿痛，饮食不下。才召到医官，言须针刀开口，方得溃破。公主闻用针刀，哭不肯
治，痛逼水谷不入。忽有一草泽医曰∶某不使刀针，只用笔头蘸药痈上，霎时便溃。公主喜，遂令召之。方两
次上药，遂溃出脓血一盏余，便觉痛减，两日疮无事。今传其方∶医云乃以针系笔心中，轻轻画破肿处，乃溃
散耳。（《名医录》。此与旧案苑九思法同。凡喉病当用针者，此法甚妙，故首录之。）
元 五年，自春至秋，祁黄二郡人患急喉痹，十死八九，速者半日、一日而死。黄州推官潘昌言，得黑龙
膏方，救活数千人。其方治九种喉痹，用大皂角四十梃，切，水三斗，浸一夜，煎至一斗半，入人参末半两，
甘草末一两，煎至五升去渣，入无灰酒一升，釜煤二匙，煎如饧，入瓶封埋地中一夜。每用温酒化下一匙，或
扫入喉内。取恶涎尽为度，后噙甘草数片。（《本草纲目》。）
孙兆治文潞公，一日喉肿，翰林咽喉科治之，经三日愈甚。上召孙治之，孙曰∶须得相公判笔一管，去笔
头，水沾笔点入喉便愈。孙随手便刺，相公昏仆，不省人事，左右皆惊愕流汗。孙曰∶非我不救相公。须臾更
呕出脓升余，旬余乃平复如故。见上，上喜曰∶孙兆良医，甚有手段。（即前草泽医针法。）
孙押班治都知潘元从喉闭，孙以药半钱吹入喉中，少顷吐出脓血立愈。潘诣孙谢曰∶大急之患，非公不能
救，救人之急，非药不能疗。赠金百两，愿求方，以济非常之急。孙曰∶用猪牙皂角、白矾、黄连各等分，置
新瓦上焙干为末。即授以方，不受所赠。（《万病回春》。其方已见旧案。）
窦材治一人患喉痹，痰气上攻，咽喉肿塞，灸天突五十壮，即可进粥，服姜附汤一剂即愈。此治肺也。
一人患喉痹，颐颔粗肿，粥药不下，四肢逆冷，六脉沉细，急灸关元穴二百壮，四肢方暖，六脉渐生。但
咽喉尚肿，仍令服黄药子散，吐出稠痰一合乃愈。此治肾也。
一人患喉痹，六脉细，为灸关元二百壮，六脉渐生。一医曰∶此乃热症，复以火攻，是抱薪救火也。遂进
凉药一剂，六脉复沉，咽中更肿。医计穷，用尖刀于肿处刺之，出血一杯而愈。盖此症忌用凉药，痰见寒则凝，
故用刀出其肺血，而肿亦随消也。
张子和治一妇人，病咽喉肿塞，浆粥不下，数日肿不退。药既难下，针亦无效。以当归、荆芥、甘草，煎
使热漱之，以冷水拔其两手。不及五六日，痛减肿消，饮食如故。咽喉之病甚急，不可妄下针药。
楼全善治一男子喉痹，于大溪（疑即太溪。）穴，刺出黑血半盏而愈。由是言之，喉痹以恶血不散故也。凡治此
疾，暴者必先发散。发散不愈，次取痰。不愈，又次取污血也。
薛立斋治一妇人，咽间作痛，旬余突肿如赤杨梅状，两月后始溃而不敛，遍身筋骨亦痛，诸药不应。（此时行
杨梅疮也。）先以土萆 汤，数剂而敛。更以四物汤，倍加土茯苓、黄 ，二十余剂，诸症悉愈。
薛立斋治甫田史侍卫，患喉痹，以防风通圣投之，肿不能咽。此症须针乃可，奈牙关已闭，遂刺少商穴出
血，口即开。更以胆矾吹患处，吐痰一二碗许，仍投前药而愈。常见患此病者，畏针不刺多毙。（此笔头藏针之法，
为至妙也。）少商穴在手大指内侧，去爪甲角韭叶许。
薛立斋治于县尹喉痹，肿痛寒热。此手少阴心火，足少阴相火，二经为病，其症最恶，惟刺患处，出血为
上。因彼畏针，先以凉膈散服之，药从鼻出，急乃愿刺，则牙关已紧，不可刺，遂刺少商二穴，以手勒去黑血，
口即开。乃刺喉间，治以前药，及金锁匙吹之，顿退。又以人参败毒散加芩、连、元参、牛蒡，四剂而平。经
曰∶火郁发之。发谓发汗，出血乃发汗之一端也。凉膈散∶连翘 大黄 芒硝 甘草 黄芩 薄荷 栀子
廷评张汝翰患喉痛，日晡益甚。此气血虚而有热，用八珍汤而愈。后每入房，发热头痛，用补中益气汤加
麦冬、五味，及六味丸常服，后不复作。
一儒者，三场毕，忽咽喉肿闭，不省人事，喘促痰涌，汗出如水，肢体痿软，脉浮大而数，此饮食劳役无
度，虚火上炎。用补中益气加肉桂，一剂顿苏。（上盛下虚者，此方未可轻用。）
李通判咽喉肿痛，口舌生疮，此上焦风热。先用荆防败毒散二剂，喉痰渐愈。又以元参升麻汤，口舌遂愈。
孙文垣治侄妇，下午喉肿，近来痰多晕厥，一日二三发，头痛面赤。素未生育，左脉弦大，右寸关滑大有
力。以荆芥、薄荷、甘草、桔梗、元参、僵蚕、柴胡、枳壳、竹茹、贝母水煎，连进二剂，其夜得睡。惟背胀
怔忡，痰犹不清，面多热，用黄芩、枳壳、甘草、桑白皮、地骨皮、天花粉、元参、前胡、半夏曲、橘红、山
栀，调养而安。
张景岳治王蓬雀，年出三旬，患喉痹十余日，头面浮大，喉头粗极，气急声哑，咽肿口疮，痛楚之甚。一
婢倚背，坐而不卧者累日矣。察其脉，则细数弱微之甚。问其言，则声微似不能振者。所服皆芩、连、栀、柏
之类。此盖伤阴而起，复为寒凉所逼，致寒甚于下，格阳于上，水饮难入，而尤畏烦热。张曰∶危哉，少迟半
日，必不救矣。遂与镇阴煎，以凉水顿冷，徐徐使咽之，一服头颈肿痛尽消。继用五福饮之类，数剂而起。
来宅妇年近三旬，因患虚损，更兼喉癣疼痛，多医罔效，脉数而无力，大便溏泻。所服皆清火退热之剂，
而喉愈痛。知其本非实火，多用寒凉，肚腹复不实，亦格阳之类也。以理阴煎及大补元煎之类，出入间用，不
半月而喉痛减，不半年而疾全愈。
景岳在燕都，尝见一女子，年及笄，于仲秋时，无病而喉窍紧涩，息难出入，不半日紧涩愈甚。诊其脉，
无火也。问其喉，无肿无痛也。面清目瞪，不能语，其声之细如针，息之窘如线，伸颈挣命，不堪之状，甚可
怜也。（据证候绝非外症，能以左归合生脉投之，尚可生。）心疑之，不得其解。意谓风邪闭塞喉窍，非辛温
不解散，遂以二陈汤加生姜，（噫！下愚之俗工也。）毫忽无效。意欲用独参汤，以救其肺。（叶天士曰∶
若肺气竭绝，必自汗气喘。此是闭塞关窍不通而死，用人参则愈闭其气，焉得不死？景岳立言，害人不浅。）
然见其势危若此，恐滋谤怨，终亦未敢下手。他医见之，亦束手而己，（此辈宁可效耶？）竟一日夜而殁。
后又一人亦如此而殁。若此二人者，至今莫识其所以病此，终身之疑窦，殊自愧也。
然意其必肺气竭绝而然，倘再值此，恐非独参汤决不能救。笔之以俟后之君子。
按∶丹溪云，咽喉肿痛，有阴虚阳气飞越，痰结在上，脉必浮大，重取必涩，去死为近，宜人参一味浓
煎，细细饮之。如作实症治之，祸如反掌。观此，丹溪之学，何可薄哉？传忠录之言，九原有知，宜滋愧矣。
叶天士曰∶锁喉风，杜撰立名也。病有闭症、脱症。闭症者，气道闭塞，关窍不通而死；脱症者，大汗大
吐大泻，虚脱而死。闭症当以开通关窍为急，脱症当以补虚收敛为要。即如此女之病，乃闭症也。夫女子善怀，
性执抑郁者多。年已及笄，未免有难出诸口者。愤闷抑郁，肝气不得疏泄，决非一日。交秋令则肝气愈敛，或
食生冷，或受寒凉，郁遏肝气。肝性促急，触而暴发，上干心肺之窍，口不能言，无肿无痛，见面色之青者，
知其为肝病也。经云∶暴病暴死，皆属于火。火郁于内，不能外达，故似寒症。关窍闭塞，经络不通，脉道不
行，多见沉滞无火之脉。此时治法，惟用紫金丹，以淡姜汤磨灌，则关隘必开，因内有麝香通窍也，开口之后，
然后用二陈加石菖蒲、郁金、枳壳、香附之类降之。视为脱症用参，此雪上加霜耳。凡治难明之症，必有至理
焉，故不得不为之细辨。景岳白恃绝世聪明，毁谤前贤，今遇此等症，束手无策，毫无见识，而竟以独参汤议
补，何得谓之明理乎？余在新场镇闵介申家，彼一仆妇，在闵若舟家为乳母，年满归家，适届中秋往彼候安，
因食梨藕生冷，一时喉间锁定，不能出声，不知痛痒，手足冰冷，面色白而青，脉息沉伏，药不能进，余以
前法治之而安。盖因郁怒，又食生冷而起也。又裁衣费姓之女，年已二十外未嫁，忽然仆倒，手足冰，面色青，
无痰声，不开口，脉息伏，亦用紫金丹，开口进药而愈。如此症者甚多，凡遇不开口，无痛楚，忽然而起者，
先以开导关隘为第一着。语言得出，可以得生。若认为虚，妄用人参，无有不死者。附太乙紫金丹方∶山慈菇、
川文蛤各二两，红芽大戟、白檀香、苏合油各一两五钱，千金紫霜一两，飞净明雄黄、琥珀各五钱，冰片、麝
香各三钱。上十一味，各研极细末，再合研匀，浓糯米饮杵丸如绿豆大，外以飞净辰砂为衣。此方治湿瘟疫疠
之邪，弥漫熏蒸，神明昏乱，及霍乱吐泻，痧胀腹痛，水土不服，岚瘴中恶等症，兼解诸毒。薛一瓢云∶比
苏合丸而无热，较至宝丹而不凉，兼太乙丹之解毒，备二方之开闭，洵仙品也。（雄按∶今世上所行太乙丹，
药品庞杂燥热，惟风餐露宿，藜藿寒湿为病者，服之颇宜。若一概施之，误人匪浅。）
杨乘六治房氏子，年近三十，病咳嗽，午后稍安。医作伤风，连进芎、苏、十神等剂，咽喉肿，痰涎上涌。
更医则以为喉痹也，猛用芩、连苦寒之剂，热益甚，喉益闭，气喘如锯，不寐不食，危症悉具。脉之，轻按满
指，两尺更觉有力，面油红，甚舌枯黑，其唇焦燥生皮，其气自脐下冲上。此肾水不足，六味症也，乃不壮水
之主，以制阳光，反用风燥以劫其阴，煽其火，致痰涌咽闭，复用苦寒以伤之，病剧而危，又何怪乎？遂与都
气饮，一剂喘息定而熟睡，醒则肿痛，痰涎已减，饮食渐加。继用六味合生脉，归脾加白芍间服，月余咳嗽亦愈。
吴氏妇两目赤肿，上连太阳，下及肩胛，杂用荆、防、辛、芷之属，赤障如膜，目痛转盛，口燥唇干，喉
中如烟火上冲，窒塞不通利。重以苦寒之剂，生冷之物，遂至咽喉肿闭，点水难吞，势甚急。脉之，两尺浮而
软，两寸洪而旺，两关紧而细，舌见紫色，上加微黄而胖。诊间闻一妪云∶昨日尚吃大柿数枚，今水不能下咽，
纵有仙丹，奈喉咙作坝何？得此数语，益悉肿闭之故。为想一进药之法，即令老妪取砖一块，投火 热，夹布
数层熨于气海，（妙法可师。）顷之觉满腹温和，试以米汤，可咽矣。遂与附子养荣汤，服后即睡至晚，肿闭如失。
盖此本由肝脾虚火上冲，妄用发散，火得风而愈炽，重以苦寒生冷，致下焦益寒，火不能下归，壅逼于上而为
肿闭，故温补一剂而愈。
冯楚瞻治何太学，咽喉口舌腐烂而不疼，胸膈胀闭，不寐不食。脉之，左寸关弦洪搏指，右寸关沉微欲脱。
乃平时劳心恼怒，以致内伤身热。医误发散，乃见红点，认为麻疹，更用疏解清托，遂困倦益甚。颊内肿硬，
疑为疹毒，更用清凉解毒，于是胀闷不堪，疼痛欲绝。盖劳伤发热，原系中气不足，误发散而荣气逆行，乃为
斑点，复误清解，致阴火上浮，齿颊为肿。又谓疹毒，益进寒凉清解，脾胃愈虚，元气愈损，于是咽嗌腐溃成
穴而不疼，如物失天日照临，易为腐坏，名为阴烂。非若阳火冲击，为肿为痛也。以熟地一两二钱，炒白术、
麦冬二钱，五味八分，制附子一钱五分，二剂胀减睡安。改用人参三钱，枣仁二钱，熟地四钱，当归一钱五
分，牛膝、麦冬各二钱，五味六分，肉桂八分，姜、枣煎，二剂神爽思食，咽喉始痛。此阳和已转，如冻
解而水活，故知疼也。外用铜青三钱 ，人中白二钱，牛黄一分，冰片二分，麝香一分，研极细，少许吹之，涎
痰涌出。再吹再流，不日而愈。
吴孚先治柯子宁，患咽喉齿痛，脉沉细，足冷，大便泄泻。此肾虚，龙火飞腾，欲用《金匮》肾气，彼疑
火症，恐桂、附不合。或以石膏、连翘苦寒进之，其病尤甚。复求治，用前方一剂减，二剂痊。
凡咽喉初觉壅塞，一时无药，以纸绞探鼻中，或嗅皂角末，喷嚏数次，可散热毒。仍以李树近根，磨水涂
喉外良愈。（《菽园杂记》。）
金陵黄泥巷杨马军治咽喉拿法，以中指蘸药少许，于喉中用力一捻肿处，出血并痰涎，随即能下汤水，绝
妙。即前用针刺之意，药恐伪也。（《治法汇》。）
陆养愚曰∶郁仲开室人，壬子年忽患咽喉阻塞，汤水不入，六脉平和，身无寒热，但气逆喘满，昼夜不眠。
（雄按∶此瘀血阻隔之证，其人必多郁怒。脉反平和者，气机窒滞，而流行自缓也。苟不吐出，即为关格。亦有
阻于咽而饮水即呛者。）予与诸君俱作痰治，药到即吐，强咽一口，面色紫胀，气窒睛突，躁乱靡宁，状如发狂，
呕尽药汁则略可，投牛黄亦不纳。疑受暑，与新汲水亦如之，又与淡姜汤苏合丸，重捺内关，俱无一效。经七八
日，或云脉不病而症如是，乃关格也。今药不下咽，虽灵丹亦无如之何矣。两日后，蓦然鼻闻 香，遂作汤与
李王公主患喉痈数日，肿痛，饮食不下。才召到医官，言须针刀开口，方得溃破。公主闻用针刀，哭不肯治，痛逼水谷不入。忽有一草泽医曰∶某不使刀针，只用笔头蘸药痈上，霎时便溃。公主喜，遂令召之。方两次上药，遂溃出脓血一盏余，便觉痛减，两日疮无事。今传其方∶医云乃以针系笔心中，轻轻画破肿处，乃溃散耳。（《名医录》。此与旧案苑九思法同。凡喉病当用针者，此法甚妙，故首录之。）
元五年，自春至秋，祁黄二郡人患急喉痹，十死八九，速者半日、一日而死。黄州推官潘昌言，得黑龙膏方，救活数千人。其方治九种喉痹，用大皂角四十梃，切，水三斗，浸一夜，煎至一斗半，入人参末半两，甘草末一两，煎至五升去渣，入无灰酒一升，釜煤二匙，煎如饧，入瓶封埋地中一夜。每用温酒化下一匙，或扫入喉内。取恶涎尽为度，后噙甘草数片。（《本草纲目》。）
孙兆治文潞公，一日喉肿，翰林咽喉科治之，经三日愈甚。上召孙治之，孙曰∶须得相公判笔一管，去笔头，水沾笔点入喉便愈。孙随手便刺，相公昏仆，不省人事，左右皆惊愕流汗。孙曰∶非我不救相公。须臾更呕出脓升余，旬余乃平复如故。见上，上喜曰∶孙兆良医，甚有手段。（即前草泽医针法。）
孙押班治都知潘元从喉闭，孙以药半钱吹入喉中，少顷吐出脓血立愈。潘诣孙谢曰∶大急之患，非公不能救，救人之急，非药不能疗。赠金百两，愿求方，以济非常之急。孙曰∶用猪牙皂角、白矾、黄连各等分，置新瓦上焙干为末。即授以方，不受所赠。（《万病回春》。其方已见旧案。）
窦材治一人患喉痹，痰气上攻，咽喉肿塞，灸天突五十壮，即可进粥，服姜附汤一剂即愈。此治肺也。一人患喉痹，颐颔粗肿，粥药不下，四肢逆冷，六脉沉细，急灸关元穴二百壮，四肢方暖，六脉渐生。但咽喉尚肿，仍令服黄药子散，吐出稠痰一合乃愈。此治肾也。
一人患喉痹，六脉细，为灸关元二百壮，六脉渐生。一医曰∶此乃热症，复以火攻，是抱薪救火也。遂进凉药一剂，六脉复沉，咽中更肿。医计穷，用尖刀于肿处刺之，出血一杯而愈。盖此症忌用凉药，痰见寒则凝，故用刀出其肺血，而肿亦随消也。
张子和治一妇人，病咽喉肿塞，浆粥不下，数日肿不退。药既难下，针亦无效。以当归、荆芥、甘草，煎使热漱之，以冷水拔其两手。不及五六日，痛减肿消，饮食如故。咽喉之病甚急，不可妄下针药。
楼全善治一男子喉痹，于大溪（疑即太溪。）穴，刺出黑血半盏而愈。由是言之，喉痹以恶血不散故也。凡治此疾，暴者必先发散。发散不愈，次取痰。不愈，又次取污血也。
薛立斋治一妇人，咽间作痛，旬余突肿如赤杨梅状，两月后始溃而不敛，遍身筋骨亦痛，诸药不应。（此时行杨梅疮也。）先以土萆薢汤，数剂而敛。更以四物汤，倍加土茯苓、黄柏，二十余剂，诸症悉愈。
薛立斋治甫田史侍卫，患喉痹，以防风通圣投之，肿不能咽。此症须针乃可，奈牙关已闭，遂刺少商穴出血，口即开。更以胆矾吹患处，吐痰一二碗许，仍投前药而愈。常见患此病者，畏针不刺多毙。（此笔头藏针之法，为至妙也。）少商穴在手大指内侧，去爪甲角韭叶许。
薛立斋治于县尹喉痹，肿痛寒热。此手少阴心火，足少阴相火，二经为病，其症最恶，惟刺患处，出血为上。因彼畏针，先以凉膈散服之，药从鼻出，急乃愿刺，则牙关已紧，不可刺，遂刺少商二穴，以手勒去黑血，口即开。乃刺喉间，治以前药，及金锁匙吹之，顿退。又以人参败毒散加芩、连、元参、牛蒡，四剂而平。经曰∶火郁发之。发谓发汗，出血乃发汗之一端也。凉膈散∶连翘 大黄 芒硝 甘草 黄芩 薄荷 栀子
廷评张汝翰患喉痛，日晡益甚。此气血虚而有热，用八珍汤而愈。后每入房，发热头痛，用补中益气汤加麦冬、五味，及六味丸常服，后不复作。
一儒者，三场毕，忽咽喉肿闭，不省人事，喘促痰涌，汗出如水，肢体痿软，脉浮大而数，此饮食劳役无度，虚火上炎。用补中益气加肉桂，一剂顿苏。（上盛下虚者，此方未可轻用。）
李通判咽喉肿痛，口舌生疮，此上焦风热。先用荆防败毒散二剂，喉痰渐愈。又以元参升麻汤，口舌遂愈。
孙文垣治侄妇，下午喉肿，近来痰多晕厥，一日二三发，头痛面赤。素未生育，左脉弦大，右寸关滑大有力。以荆芥、薄荷、甘草、桔梗、元参、僵蚕、柴胡、枳壳、竹茹、贝母水煎，连进二剂，其夜得睡。惟背胀怔忡，痰犹不清，面多热，用黄芩、枳壳、甘草、桑白皮、地骨皮、天花粉、元参、前胡、半夏曲、橘红、山栀，调养而安。
张景岳治王蓬雀，年出三旬，患喉痹十余日，头面浮大，喉头粗极，气急声哑，咽肿口疮，痛楚之甚。一婢倚背，坐而不卧者累日矣。察其脉，则细数弱微之甚。问其言，则声微似不能振者。所服皆芩、连、栀、柏之类。此盖伤阴而起，复为寒凉所逼，致寒甚于下，格阳于上，水饮难入，而尤畏烦热。张曰∶危哉，少迟半日，必不救矣。遂与镇阴煎，以凉水顿冷，徐徐使咽之，一服头颈肿痛尽消。继用五福饮之类，数剂而起。
来宅妇年近三旬，因患虚损，更兼喉癣疼痛，多医罔效，脉数而无力，大便溏泻。所服皆清火退热之剂，而喉愈痛。知其本非实火，多用寒凉，肚腹复不实，亦格阳之类也。以理阴煎及大补元煎之类，出入间用，不半月而喉痛减，不半年而疾全愈。
景岳在燕都，尝见一女子，年及笄，于仲秋时，无病而喉窍紧涩，息难出入，不半日紧涩愈甚。诊其脉，无火也。问其喉，无肿无痛也。面清目瞪，不能语，其声之细如针，息之窘如线，伸颈挣命，不堪之状，甚可怜也。（据证候绝非外症，能以左归合生脉投之，尚可生。）心疑之，不得其解。意谓风邪闭塞喉窍，非辛温不解散，遂以二陈汤加生姜，（噫！下愚之俗工也。）毫忽无效。意欲用独参汤，以救其肺。（叶天士曰∶若肺气竭绝，必自汗气喘。此是闭塞关窍不通而死，用人参则愈闭其气，焉得不死？景岳立言，害人不浅。）然见其势危若此，恐滋谤怨，终亦未敢下手。他医见之，亦束手而己，（此辈宁可效耶？）竟一日夜而殁。后又一人亦如此而殁。若此二人者，至今莫识其所以病此，终身之疑窦，殊自愧也。然意其必肺气竭绝而然，倘再值此，恐非独参汤决不能救。笔之以俟后之君子。
按∶丹溪云，咽喉肿痛，有阴虚阳气飞越，痰结在上，脉必浮大，重取必涩，去死为近，宜人参一味浓煎，细细饮之。如作实症治之，祸如反掌。观此，丹溪之学，何可薄哉？传忠录之言，九原有知，宜滋愧矣。
叶天士曰∶锁喉风，杜撰立名也。病有闭症、脱症。闭症者，气道闭塞，关窍不通而死；脱症者，大汗大吐大泻，虚脱而死。闭症当以开通关窍为急，脱症当以补虚收敛为要。即如此女之病，乃闭症也。夫女子善怀，性执抑郁者多。年已及笄，未免有难出诸口者。愤闷抑郁，肝气不得疏泄，决非一日。交秋令则肝气愈敛，或食生冷，或受寒凉，郁遏肝气。肝性促急，触而暴发，上干心肺之窍，口不能言，无肿无痛，见面色之青者，知其为肝病也。经云∶暴病暴死，皆属于火。火郁于内，不能外达，故似寒症。关窍闭塞，经络不通，脉道不行，多见沉滞无火之脉。此时治法，惟用紫金丹，以淡姜汤磨灌，则关隘必开，因内有麝香通窍也，开口之后，然后用二陈加石菖蒲、郁金、枳壳、香附之类降之。视为脱症用参，此雪上加霜耳。凡治难明之症，必有至理焉，故不得不为之细辨。景岳白恃绝世聪明，毁谤前贤，今遇此等症，束手无策，毫无见识，而竟以独参汤议补，何得谓之明理乎？余在新场镇闵介申家，彼一仆妇，在闵若舟家为乳母，年满归家，适届中秋往彼候安，因食梨藕生冷，一时喉间锁定，不能出声，不知痛痒，手足冰冷，面色白而青，脉息沉伏，药不能进，余以前法治之而安。盖因郁怒，又食生冷而起也。又裁衣费姓之女，年已二十外未嫁，忽然仆倒，手足冰，面色青，无痰声，不开口，脉息伏，亦用紫金丹，开口进药而愈。如此症者甚多，凡遇不开口，无痛楚，忽然而起者，先以开导关隘为第一着。语言得出，可以得生。若认为虚，妄用人参，无有不死者。附太乙紫金丹方∶山慈菇、川文蛤各二两，红芽大戟、白檀香、苏合油各一两五钱，千金紫霜一两，飞净明雄黄、琥珀各五钱，冰片、麝香各三钱。上十一味，各研极细末，再合研匀，浓糯米饮杵丸如绿豆大，外以飞净辰砂为衣。此方治湿瘟疫疠之邪，弥漫熏蒸，神明昏乱，及霍乱吐泻，痧胀腹痛，水土不服，岚瘴中恶等症，兼解诸毒。薛一瓢云∶比苏合丸而无热，较至宝丹而不凉，兼太乙丹之解毒，备二方之开闭，洵仙品也。（雄按∶今世上所行太乙丹，药品庞杂燥热，惟风餐露宿，藜藿寒湿为病者，服之颇宜。若一概施之，误人匪浅。）
杨乘六治房氏子，年近三十，病咳嗽，午后稍安。医作伤风，连进芎、苏、十神等剂，咽喉肿，痰涎上涌。更医则以为喉痹也，猛用芩、连苦寒之剂，热益甚，喉益闭，气喘如锯，不寐不食，危症悉具。脉之，轻按满指，两尺更觉有力，面油红，甚舌枯黑，其唇焦燥生皮，其气自脐下冲上。此肾水不足，六味症也，乃不壮水之主，以制阳光，反用风燥以劫其阴，煽其火，致痰涌咽闭，复用苦寒以伤之，病剧而危，又何怪乎？遂与都气饮，一剂喘息定而熟睡，醒则肿痛，痰涎已减，饮食渐加。继用六味合生脉，归脾加白芍间服，月余咳嗽亦愈。
吴氏妇两目赤肿，上连太阳，下及肩胛，杂用荆、防、辛、芷之属，赤障如膜，目痛转盛，口燥唇干，喉中如烟火上冲，窒塞不通利。重以苦寒之剂，生冷之物，遂至咽喉肿闭，点水难吞，势甚急。脉之，两尺浮而软，两寸洪而旺，两关紧而细，舌见紫色，上加微黄而胖。诊间闻一妪云∶昨日尚吃大柿数枚，今水不能下咽，纵有仙丹，奈喉咙作坝何？得此数语，益悉肿闭之故。为想一进药之法，即令老妪取砖一块，投火热，夹布数层熨于气海，（妙法可师。）顷之觉满腹温和，试以米汤，可咽矣。遂与附子养荣汤，服后即睡至晚，肿闭如失。盖此本由肝脾虚火上冲，妄用发散，火得风而愈炽，重以苦寒生冷，致下焦益寒，火不能下归，壅逼于上而为肿闭，故温补一剂而愈。
冯楚瞻治何太学，咽喉口舌腐烂而不疼，胸膈胀闭，不寐不食。脉之，左寸关弦洪搏指，右寸关沉微欲脱。乃平时劳心恼怒，以致内伤身热。医误发散，乃见红点，认为麻疹，更用疏解清托，遂困倦益甚。颊内肿硬，疑为疹毒，更用清凉解毒，于是胀闷不堪，疼痛欲绝。盖劳伤发热，原系中气不足，误发散而荣气逆行，乃为斑点，复误清解，致阴火上浮，齿颊为肿。又谓疹毒，益进寒凉清解，脾胃愈虚，元气愈损，于是咽嗌腐溃成穴而不疼，如物失天日照临，易为腐坏，名为阴烂。非若阳火冲击，为肿为痛也。以熟地一两二钱，炒白术、麦冬二钱，五味八分，制附子一钱五分，二剂胀减睡安。改用人参三钱，枣仁二钱，熟地四钱，当归一钱五分，牛膝、麦冬各二钱，五味六分，肉桂八分，姜、枣煎，二剂神爽思食，咽喉始痛。此阳和已转，如冻解而水活，故知疼也。外用铜青三钱，人中白二钱，牛黄一分，冰片二分，麝香一分，研极细，少许吹之，涎痰涌出。再吹再流，不日而愈。
吴孚先治柯子宁，患咽喉齿痛，脉沉细，足冷，大便泄泻。此肾虚，龙火飞腾，欲用《金匮》肾气，彼疑火症，恐桂、附不合。或以石膏、连翘苦寒进之，其病尤甚。复求治，用前方一剂减，二剂痊。
凡咽喉初觉壅塞，一时无药，以纸绞探鼻中，或嗅皂角末，喷嚏数次，可散热毒。仍以李树近根，磨水涂喉外良愈。（《菽园杂记》。）
金陵黄泥巷杨马军治咽喉拿法，以中指蘸药少许，于喉中用力一捻肿处，出血并痰涎，随即能下汤水，绝妙。即前用针刺之意，药恐伪也。（《治法汇》。）
陆养愚曰∶郁仲开室人，壬子年忽患咽喉阻塞，汤水不入，六脉平和，身无寒热，但气逆喘满，昼夜不眠。（雄按∶此瘀血阻隔之证，其人必多郁怒。脉反平和者，气机窒滞，而流行自缓也。苟不吐出，即为关格。亦有阻于咽而饮水即呛者。）予与诸君俱作痰治，药到即吐，强咽一口，面色紫胀，气窒睛突，躁乱靡宁，状如发狂，呕尽药汁则略可，投牛黄亦不纳。疑受暑，与新汲水亦如之，又与淡姜汤苏合丸，重捺内关，俱无一效。经七八日，或云脉不病而症如是，乃关格也。今药不下咽，虽灵丹亦无如之何矣。两日后，蓦然鼻闻 香，遂作汤与
Princess Li Wang suffered from a throat abscess for several days, experiencing swelling and pain, unable to eat or drink. When the imperial physicians were summoned, they stated that incision with needles and knives was necessary to drain the pus. Upon hearing this, the princess cried and refused treatment; the pain forced her to abstain from food and water. Suddenly, a folk physician appeared, saying, "I do not use blades or needles; I will merely dip the tip of a brush in medicine and apply it to the abscess, which will rupture instantly." The princess was delighted and ordered him to be called. After only two applications of the medicine, the abscess ruptured, discharging over a cup of pus and blood. She immediately felt relief from pain, and within two days, the wound healed. The method is now transmitted: the physician explained that a needle is tied inside the center of the brush, and by gently drawing it across the swollen area, the abscess ruptures and disperses. (*Records of Famous Physicians*. This is identical to the method of Yuan Jiusi in previous cases. For throat diseases requiring needling, this method is excellent, hence recorded first.)
In the fifth year of the Yuan dynasty, from spring to autumn, people in Qi and Huang prefectures suffered from acute throat bi (sudden sore throat with difficulty swallowing), with eight or nine out of ten dying; some died within half a day or one day. Pan Changyan, the Vice Prefect of Huangzhou, obtained the Black Dragon Ointment formula and saved thousands. This formula treats nine types of throat bi: using forty large pods of *Gleditsia sinensis* (Tang Shen), sliced, soaked in three dou of water overnight, decocted until reduced to one and a half dou; add half liang of powdered *Panax ginseng* (Ren Shen) and one liang of powdered *Glycyrrhiza uralensis* (Gan Cao); decoct until reduced to five sheng, strain, add one sheng of unadulterated wine and two spoonfuls of soot from the pot bottom; decoct until thick like syrup, bottle and seal, bury in the ground overnight. Each time, dissolve one spoonful in warm wine and swallow, or sweep into the throat. Continue until all foul phlegm is expelled, then hold several slices of *Glycyrrhiza uralensis* (Gan Cao) in the mouth. (*Compendium of Materia Medica*.)
Sun Zhao treated Duke Wen Lu, who developed a swollen throat one day. The Imperial Academy's Throat Department treated him, but after three days, the condition worsened. The Emperor summoned Sun to treat him. Sun said, "You must obtain one of the Chancellor's judgment brushes, remove the brush head, moisten it with water, and dab it into the throat to cure him." Sun immediately stabbed with the handle; the Duke fainted and lost consciousness, causing his attendants to be startled and sweat profusely. Sun said, "It is not that I cannot save the Chancellor." Shortly after, the Duke vomited over a sheng of pus, and after more than ten days, he recovered as before. Meeting the Emperor, the Emperor rejoiced, saying, "Sun Zhao is an excellent physician, truly skilled." (This is the same needle method as the folk physician mentioned above.)
Sun Yaban treated Du Zhi Pan Yuancong, who suffered from throat obstruction (throat bi). Sun blew half a qian of medicine into the throat; shortly after, the patient vomited pus and blood and was instantly cured. Pan visited Sun to thank him, saying, "For such an urgent affliction, only you could save me. To relieve others' urgency, only medicine can heal." He offered one hundred taels of gold and wished to obtain the formula to aid in emergencies. Sun said, "Use equal parts of pig-tooth *Gleditsia sinensis* (Zao Jiao), alum (Bai Fan), and *Coptis chinensis* (Huang Lian); dry them on new tiles and grind into powder." He gave the formula immediately but did not accept the gift. (*Ten Thousand Diseases Returned to Spring*. The formula has been seen in previous cases.)
Dou Cai treated a man suffering from throat bi, with phlegm and qi attacking upward, causing throat swelling and blockage. He moxa Tian Tu (CV-22) fifty moxibustion cones; the patient could then consume porridge. One dose of Ginger and Aconite Decoction (Jiang Fu Tang) cured him. This treats the Lung. Another man suffered from throat bi, with coarse swelling of the jaw and chin, unable to take porridge or medicine, cold limbs, and deep, fine pulses throughout. He urgently received two hundred moxibustion cones at Guan Yuan (CV-4); only then did his limbs warm up, and the pulses gradually reappear. However, the throat remained swollen, so he was still instructed to take Yellow Drug Powder (Huang Yao Zi San); after vomiting one he of thick phlegm, he was cured. This treats the Kidney.
Another man suffered from throat bi, with fine pulses throughout. Dou Cai moxa Guan Yuan (CV-4) two hundred cones, and the pulses gradually reappeared. One physician said, "This is a heat syndrome; attacking it with fire is like carrying firewood to put out a fire." He administered a dose of cooling medicine; the pulses became deep again, and the throat swelled further. With no other options, the physician used a sharp knife to stab the swollen area, releasing a cup of blood, and the patient was cured. This syndrome contraindicates cooling medicines; phlegm congeals when exposed to cold. Thus, using a knife to release lung blood caused the swelling to subside.
Zhang Zihe treated a woman suffering from throat swelling and blockage, unable to take broth or porridge; the swelling persisted for several days. Since medicine was difficult to administer and needling was ineffective, he decocted *Angelica sinensis* (Dang Gui), *Schizonepeta tenuifolia* (Jing Jie), and *Glycyrrhiza uralensis* (Gan Cao), had the patient gargle while hot, and immersed her hands in cold water. Within five or six days, the pain decreased, swelling subsided, and diet returned to normal. Throat diseases are very urgent; one must not recklessly administer needles or medicines.
Lou Quanshan treated a man with throat bi, needling the Da Xi point (likely Tai Xi, KI-3) to release half a cup of dark blood, curing him. From this, we see that throat bi is caused by the failure of foul blood to disperse. In treating this disease, acute cases must first be dispersed. If dispersion fails, next address phlegm. If that fails, next remove dirty blood.
Xue Lizhai treated a woman with throat pain; after more than ten days, sudden swelling resembling red mulberry berries occurred. Two months later, it ulcerated but did not heal, accompanied by body-wide bone and tendon pain, unresponsive to various medicines. (This was likely epidemic syphilis.) First, she took Earth Ban Xia Decoction (Tu Bi Xie Tang) for several doses until it healed. Then, Four Substances Decoction (Si Wu Tang) was used, doubling the dosage of *Smilax glabra* (Tu Fu Ling) and *Phellodendron amurense* (Huang Bai); after more than twenty doses, all symptoms resolved.
Xue Lizhai treated Shi Shewei from Futian, who suffered from throat bi. He prescribed Wind Protection and Unblocking Great Powder (Fang Feng Tong Sheng San), but the swelling prevented swallowing. This case required needling, but the jaw was locked. He therefore needled Shao Shang (LU-11) to release blood, immediately opening the mouth. He then blew Alum (Dan Fan) onto the affected area; after vomiting one or two bowls of phlegm, he administered the previous medicine again, and the patient recovered. It is common for patients fearing needling to die if not treated. (The method of hiding a needle in a brush tip is extremely ingenious.) Shao Shang is located on the medial side of the thumb, about the width of a leek leaf from the corner of the nail.
Xue Lizhai treated County Magistrate Yu, who suffered from throat bi with swelling, pain, chills, and fever. This involved the Hand Shaoyin Heart Fire and Foot Shaoyin Ministerial Fire; the condition was severe. Only needling the affected area to release blood was superior. Because he feared needling, Xue first administered Cooling Diaphragm Powder (Liang Ge San), but the medicine came out through the nose. Urgently, he agreed to needling, but the jaw was tight. He then needled both Shao Shang (LU-11) points, squeezing out dark blood by hand, which opened the mouth. He then needled the throat, treated with the previous medicine, and blew Golden Lock Key (Jin Suo Chi) powder, resulting in immediate improvement. He then administered Ginseng and Detoxifying Powder (Ren Shen Bai Du San) added with *Scutellaria baicalensis* (Huang Qin), *Coptis chinensis* (Huang Lian), *Scrophularia ningpoensis* (Yuan Shen), and *Aucklandia lappa* (Niu Bang Zi) for four doses, resolving the condition. The Classic states: "For constrained fire, vent it." Venting refers to sweating; releasing blood is one aspect of sweating. Cooling Diaphragm Powder consists of *Forsythia suspensa* (Lian Qiao), *Rheum palmatum* (Da Huang), *Mirabilite* (Mang Xiao), *Glycyrrhiza uralensis* (Gan Cao), *Scutellaria baicalensis* (Huang Qin), *Mentha haplocalyx* (Bo He), and *Gardenia jasminoides* (Zhi Zi).
Vice Director Zhang Ruhán suffered from throat pain, worsening in the late afternoon. This was deficiency of qi and blood with internal heat; Eight Treasures Decoction (Ba Zhen Tang) cured him. Later, after intercourse, he experienced fever and headache; he regularly took Tonify the Middle and Augment Qi Decoction (Bu Zhong Yi Qi Tang) added with *Ophiopogon japonicus* (Mai Dong) and *Schisandra chinensis* (Wu Wei Zi), along with Six Ingredients Pill (Liu Wei Wan), preventing recurrence.
A scholar, after completing the three examination sessions, suddenly suffered from throat swelling and closure, loss of consciousness, panting with surging phlegm, sweating like water, flaccid limbs, and floating, large, rapid pulses. This was due to excessive diet and labor, causing deficient fire to flare upward. Tonify the Middle and Augment Qi Decoction (Bu Zhong Yi Qi Tang) added with *Cinnamomum cassia* (Rou Gui) cured him in one dose. (For patterns of upper excess and lower deficiency, this formula should not be used lightly.)
Assistant Li suffered from throat swelling and pain, with sores on the mouth and tongue. This was wind-heat in the Upper Jiao. First, Jing Fang Detoxifying Powder (Jing Fang Bai Du San) for two doses gradually improved the throat phlegm. Then, Scrophularia and Cimicifuga Decoction (Yuan Shen Sheng Ma Tang) cured the mouth and tongue sores.
Sun Wenyuan treated his niece-in-law, who had afternoon throat swelling, frequent dizziness and fainting due to phlegm (two to three times daily), headache, and flushed face. She had never given birth; the left pulse was wiry and large, the right cun and guan pulses slippery, large, and forceful. He decocted *Schizonepeta tenuifolia* (Jing Jie), *Mentha haplocalyx* (Bo He), *Glycyrrhiza uralensis* (Gan Cao), *Platycodon grandiflorus* (Jie Geng), *Scrophularia ningpoensis* (Yuan Shen), *Bombyx batryticatus* (Jiang Can), *Bupleurum chinense* (Chai Hu), *Citrus aurantium* (Zhi Ke), *Bambusa vulgaris* juice (Zhu Ru), and *Fritillaria cirrhosa* (Bei Mu) in water. After two doses, she slept that night. However, she still had back distension, palpitations, unclear phlegm, and facial heat. He used *Scutellaria baicalensis* (Huang Qin), *Citrus aurantium* (Zhi Ke), *Glycyrrhiza uralensis* (Gan Cao), *Morus alba* root bark (Sang Bai Pi), *Lycium barbarum* root bark (Di Gu Pi), *Trichosanthes kirilowii* root (Tian Hua Fen), *Scrophularia ningpoensis* (Yuan Shen), *Peucedanum praeruptorum* (Qian Hu), *Pinellia ternata* fermented (Ban Xia Qu), *Citrus reticulata* peel (Ju Hong), and *Gardenia jasminoides* (Zhi Zi) to regulate and stabilize her.
Zhang Jingyue treated Wang Pengque, aged thirty, who suffered from throat bi for over ten days. His head and face were swollen and large, the throat extremely coarse, with shortness of breath, hoarseness, throat swelling, and mouth sores, causing severe pain. A maid supported his back; he sat but could not lie down for days. His pulse was extremely fine, rapid, weak, and minute. His voice was faint, as if unable to resonate. All medicines taken were *Scutellaria baicalensis* (Huang Qin), *Coptis chinensis* (Huang Lian), *Gardenia jasminoides* (Zhi Zi), and *Phellodendron amurense* (Huang Bai). This injury originated from yin damage, exacerbated by cold-cooling medicines, causing extreme cold below and blocking yang above. Water and drinks were difficult to enter, and he feared irritability and heat. Zhang said, "Dangerous! Delay by half a day, and he will certainly not be saved." He prescribed Calming Yin Decoction (Zhen Yin Jian), cooled with cold water, and slowly let him swallow it. One dose eliminated head and neck swelling and pain. Subsequently, Five Blessings Decoction (Wu Fu Yin) was used for several doses, and he recovered.
The wife of the Lai family, nearing thirty, suffered from deficiency consumption and throat herpes pain. Many physicians failed; her pulse was rapid but powerless, with loose stools. All medicines taken were fire-clearing and heat-reducing agents, yet the throat pain worsened. Knowing this was not excess fire, and that excessive cold-cooling had weakened the abdomen, it was also a type of false heat (ge yang). He alternately used Reconciling Yin Decoction (Li Yin Jian) and Great Supplement to Origin Decoction (Da Bu Yuan Jian). Within half a month, throat pain decreased; within half a year, the disease completely resolved.
Jingyue, in Yanjing, once saw a girl of marriageable age in mid-autumn. Without prior illness, her throat orifice became tight and dry, breathing difficult. Within half a day, the tightness worsened. Her pulse showed no heat. Her throat had no swelling or pain. Her face was clear, eyes staring, unable to speak; her voice was thin as a needle, breathing strained as a thread, stretching her neck to survive, a pitiful sight. (According to symptoms, this is definitely not an external pathogen; if Zuogui Wan combined with Sheng Mai San were administered, she might have survived.) Jingyue suspected it but could not understand. He thought wind-pathogen blocked the throat orifice, requiring acrid-warm dispersal. He thus used Er Chen Tang added with fresh ginger. (Alas! Ignorant quacks!) It had no effect. He intended to use Single Ginseng Decoction (Du Shen Tang) to save the lungs. (Ye Tianshi said: "If lung qi is exhausted, there must be spontaneous sweating and panting. This is death by blocked orifices; using ginseng would further close the qi, how could she not die? Jingyue's statement harms people deeply.") Seeing the critical situation, fearing slander, he ultimately dared not act. Other physicians also stood helpless. She died after one day and night. Another person died similarly later. For these two, Jingyue never understood the cause of their illness, a lifelong doubt, causing him great shame. He believed it must be lung qi exhaustion. If he encountered this again, he feared only Single Ginseng Decoction could save her. He wrote this to await future scholars.
Commentary: Danxi said, for throat swelling and pain, if yin deficiency causes yang qi to fly away, with phlegm knotting above, the pulse must be floating and large, and deep pressing reveals choppy quality; this is near death. It is appropriate to decoct a single ingredient of *Panax ginseng* (Ren Shen) strongly and sip it slowly. If treated as an excess syndrome, disaster follows instantly. Observing this, how can Danxi's learning be despised? The words in *Zhuan Zhong Lu*, if Danxi knew, would surely cause shame.
Ye Tianshi said: "Locking Throat Wind" is a fabricated name. Diseases include closed syndrome and collapsed syndrome. Closed syndrome: airway blockage, orifices不通, leading to death. Collapsed syndrome: massive sweating, vomiting, diarrhea, leading to collapse and death. Closed syndrome requires urgent opening of orifices; collapsed syndrome requires tonifying deficiency and consolidating. This girl's disease is a closed syndrome. Women are prone to emotional attachment; those with stubborn, depressed natures are many. Of marriageable age, there are matters difficult to speak of. Anger and depression prevent liver qi from coursing freely, certainly not for just one day. Entering autumn, liver qi becomes more constrained. Or eating raw/cold foods, or catching cold, depresses liver qi. Liver nature is urgent; upon stimulation, it erupts, affecting the orifices of heart and lung above. Unable to speak, without swelling or pain, seeing blue complexion indicates liver disease. The Classic says: "Acute diseases and sudden deaths all belong to fire." Fire constrained internally cannot reach exterior, thus resembling cold syndrome. Orifices blocked, meridians不通, pulse channels not flowing, often showing deep, stagnant, non-fire pulses. At this time, the treatment is solely Zijin Dan, ground in light ginger soup and灌ed; the orifices will open because it contains *Moschus* (She Xiang) to open orifices. After opening, use Er Chen Tang added with *Acorus tatarinowii* (Shi Chang Pu), *Curcuma wenyujin* (Yu Jin), *Citrus aurantium* (Zhi Ke), *Cyperus rotundus* (Xiang Fu) etc. to descend. If treated as collapsed syndrome using ginseng, this is adding frost to snow. For difficult-to-understand syndromes, there must be profound principles, hence detailed differentiation is necessary. Jingyue arrogantly relied on his peerless intelligence, slandering former sages. Encountering such syndromes, he was helpless, lacking insight, yet proposed tonifying with Single Ginseng Decoction. How can this be called understanding principles? I was at Min Jieshen's house in Xinchang Town. A servant woman, working as a wet nurse for Min Ruozhou, returned home upon contract completion. Mid-Autumn Festival, she went to visit, ate pear and lotus root (raw/cold), and suddenly her throat locked, unable to make sound, unaware of pain or itch, cold hands and feet, white-blue complexion, deep-hidden pulse, medicine could not enter. I treated her with the aforementioned method, and she stabilized. This arose from depression/anger and eating raw/cold foods. Also, a tailor's daughter, over twenty, unmarried, suddenly collapsed, cold hands and feet, blue complexion, no phlegm sound, closed mouth, hidden pulse. I also used Zijin Dan, opened the mouth, administered medicine, and she recovered. There are many such cases. Whenever encountering closed mouth, no pain, sudden onset, first priority is to open the orifices. If speech returns, life can be saved. If mistaken for deficiency and recklessly using ginseng, none will survive. Attached is Ta Yi Zijin Dan Formula: *Fritillaria thunbergii* bulb (Shan Ci Gu) and *Meretrix meretrix* shell (Chuan Wen Ge) each two liang; *Euphorbia erythrorhiza* (Hong Ya Da Ji), *Santalum album* (Bai Tan Xiang), *Styrax* resin oil (Su He You) each one and a half liang; *Qianjin Zi Shuang* one liang; purified realgar (Fei Jing Ming Xiong Huang) and amber (Hu Po) each five qian; borneol (Bing Pian) and *Moschus* (She Xiang) each three qian. These eleven ingredients, each ground to fine powder, mixed evenly, pounded with thick glutinous rice water into pills the size of mung beans, coated with purified cinnabar (Chen Sha). This formula treats damp-pestilence pathogens, pervasive steaming, confusion of spirit, cholera with vomiting/diarrhea, sha distension and abdominal pain,水土不服, mountain miasma and evil qi, etc., and resolves various toxins. Xue Yupiao said: "Warmer than Suhexiang Wan, cooler than Zhibao Dan, combines detoxification of Taiyi Dan, prepares for opening/closing of both formulas, truly a celestial product." (Xiong notes: The Taiyi Dan currently circulated is complex and drying/hot; suitable only for those suffering from wind, meals, dew, exposure, and cold-damp from poor diet. Applied indiscriminately, it harms people significantly.)
Yang Chengliu treated Fang's son, nearing thirty, suffering from cough, slightly better in the afternoon. Physicians treated it as wind-cold, continuously administering *Ligusticum chuanxiong* (Xiong), *Perilla frutescens* (Su), and Ten Spirits formulas. Throat swelled, phlegm surged upward. Another physician diagnosed throat bi, fiercely using bitter-cold *Scutellaria baicalensis* (Huang Qin) and *Coptis chinensis* (Huang Lian). Heat increased, throat closed further, panting like a saw, insomnia, anorexia, critical symptoms all present. Pulse: superficial full fingers, two chi pulses even more forceful, oily-red face, black withered tongue, dry cracked lips, qi rushing up from below the navel. This is kidney water insufficiency, a Liuwei syndrome. Instead of strengthening the master of water to control sunlight, they used wind-drying to rob yin and fan fire, causing phlegm surge and throat closure. Using bitter-cold again injured further. Disease progressed critically; why be surprised? He prescribed Douchi Yin (Du Qi Yin). One dose settled panting and induced deep sleep. Upon waking, swelling/pain remained, but phlegm decreased, diet increased. Subsequently, Liuwei Wan combined with Sheng Mai San, and Guipi Tang added with *Paeonia lactiflora* (Bai Shao) were alternated. After a month, cough also resolved.
Mrs. Wu had red-swollen eyes, extending to temples and shoulder blades. Mixed use of *Schizonepeta* (Jing Jie), *Saussurea* (Fang Feng), *Ligusticum* (Xiong), *Angelica dahurica* (Zhi) resulted in red membranes like films, worsening eye pain, dry mouth/lips, sensation of fire/smoke rising in throat, blockage. Heavy use of bitter-cold medicines and raw/cold foods led to throat swelling/closure, unable to swallow even a drop of water, critical situation. Pulse: two chi floating and soft, two cun flooding and vigorous, two guan tight and fine, purple tongue with slight yellow coating and puffy. During consultation, an old woman said, "Yesterday she ate several large persimmons; today water cannot go down. Even with immortal pills, what can be done against the dam in the throat?" These words clarified the cause of swelling/closure. Thinking of a method to administer medicine, he ordered the old woman to take a brick, heat it in fire, wrap in several layers of cloth, and apply to Qi Hai (CV-6). (Excellent method worthy of emulation.) Soon, the abdomen felt warm. Testing with rice soup, she could swallow. He then prescribed Aconite Nourishing Harmony Decoction (Fu Zi Yang Rong Tang). After taking it, she slept until evening, swelling/closure disappeared. This originally stemmed from liver/spleen deficient fire rushing up; reckless dispersion made fire blaze with wind; heavy bitter-cold/raw-cold caused lower jiao to become colder, fire unable to descend, congesting above causing swelling/closure. Thus, one dose of warming/tonifying cured it.
Feng Chuzhan treated He Tai Xue, with rotting/throat and tongue ulcers without pain, chest/diaphragm distension/closure, insomnia/anorexia. Pulse: left cun/guan wiry, flooding, beating fingers; right cun/guan deep, minute, nearly vanished. Normally, mental labor and anger caused internal injury and fever. Physicians mistakenly dispersed, causing red spots, mistaking for measles, using dispersing/clearing/supporting methods, increasing fatigue. Inner cheek swollen/hard, suspected rash toxin, used cooling/detoxifying methods, causing unbearable distension/pain. Labor-induced fever originally stems from middle qi deficiency. Mistaken dispersion caused nutritive qi to reverse, forming spots. Mistaken clearing/collapsing caused yin fire to float up, swelling teeth/cheeks. Suspecting rash toxin, advancing cold-cooling/clearing further depleted spleen/stomach and yuan qi. Thus, throat/esophagus rotted into holes without pain, like objects losing sun exposure, easily decaying, named "yin rot." Unlike yang fire impact causing swelling/pain. He used prepared *Rehmannia glutinosa* (Shu Di) one liang two qian, stir-fried *Atractylodes macrocephala* (Bai Zhu) two qian, *Ophiopogon japonicus* (Mai Dong) two qian, *Schisandra chinensis* (Wu Wei Zi) eight fen, processed *Aconitum carmichaelii* (Zhi Fu Zi) one qian five fen. Two doses reduced distension, ensured sleep. Changed to *Panax ginseng* (Ren Shen) three qian, *Ziziphus jujuba* seed (Zao Ren) two qian, *Rehmannia glutinosa* (Shu Di) four qian, *Angelica sinensis* (Dang Gui) one qian five fen, *Achyrantes bidentata* (Niu Xi), *Ophiopogon japonicus* (Mai Dong) each two qian, *Schisandra chinensis* (Wu Wei Zi) six fen, *Cinnamomum cassia* (Rou Gui) eight fen, decocted with ginger/jujube. Two doses restored spirit, appetite, throat began to hurt. This indicates yang harmony has turned, like ice melting and water flowing, hence pain is perceived. Externally, copper green (Tong Qing) three qian, human bone ash (Ren Zhong Bai) two qian, bovine calculus (Niu Huang) one fen, borneol (Bing Pian) two fen, *Moschus* (She Xiang) one fen, ground extremely fine, blown sparingly into throat. Saliva/phlegm surged. Blowing repeatedly flowed it out; healed in days.
Wu Fuxian treated Ke Zining, suffering from throat/tooth pain, deep/fine pulse, cold feet, loose stools. This is kidney deficiency, dragon fire flying. Intended to use *Jin Gui* Kidney Qi Pill, but he suspected fire syndrome, fearing *Cinnamomum cassia* (Gui) and *Aconitum carmichaelii* (Fu) were inappropriate. Others used *Gypsum fibrosum* (Shi Gao) and *Forsythia suspensa* (Lian Qiao) bitter-cold, worsening the disease. Seeking treatment again, he used the previous formula; one dose reduced symptoms, two doses cured.
Whenever throat initially feels obstructed, with no medicine available, twist paper to probe the nose, or sniff *Gleditsia sinensis* (Zao Jiao) powder; several sneezes can dissipate heat/toxin. Still, grind water from near the root of a plum tree and apply externally to the throat for good healing. (*Shuyuan Miscellaneous Records*.)
Yang Majun from Huangni Alley, Jinling, treated throat grasping method: dip middle finger in small amount of medicine, forcefully twist the swollen area in the throat, releasing blood and phlegm/saliva; immediately able to swallow liquids. Excellent. This implies the previous needle method; the medicine may be fake. (*Methods of Treatment Compilation*.)
Lu Yangyu said: Yu Zhongkai's wife, in Renzi year, suddenly suffered throat blockage, unable to take soup/water, six pulses peaceful, no chills/fever, only rebellious qi, panting/fullness, insomnia day and night. (Xiong notes: This is blood stasis obstruction; the person likely has much depression/anger. Pulse appearing peaceful indicates qi mechanism stagnation, flow naturally slow. If not vomited, it becomes guan ge. Some have obstruction at throat causing choking on drinking water.) I and others all treated as phlegm; medicine arrived, immediately vomited. Forced one swallow, face purple/swollen, qi blocked, eyes protruding, restless, mad-like. Vomiting all medicine juice allowed slight relief; even Niuhuang was rejected. Suspected summerheat, gave newly drawn water, same result. Also gave light ginger soup and Suhexiang Wan, heavily pressing Neiguan (PC-6), all ineffective. After seven/eight days, some said pulse not diseased but symptoms like this, it is guan ge. Now medicine cannot go down; even spiritual pills are useless. Two days later, suddenly smelled fragrance from nose, then made soup and...