《心鉴》咽喉为一身之总要，与胃气相接，呼吸之所从出，若胸膈之间蕴积热
毒，致生风痰，壅滞不散，发而为咽喉之病。喉内生疮，或状如肉腐，为HT 为痛，
窒塞不通，吐咽不下，甚则生出重舌，治之尤宜先去风痰，以通咽膈，然后解其热
毒，迟则有不救之患。又有热毒冲于上 而生疮，谓之悬痈。及腑寒亦能令人咽闭，
吞吐不利。临病详审治之。咽喉之疾，本伤热毒上攻也，四时受热，藏心腑之间，
一旦所触，上攻咽喉，所谓肾伤寒也，然其证有单肉蛾、双肉蛾，有重舌、木舌、
腮，有悬痈肿胀，有里外皆肿，甚者上攻头面皆肿。大法，先洗去口中舌上白胎，
其次扫去风涎，如是单、双肉蛾，可针则针，有不可针者，则用熏掺药，退后，方
根据次用服药。如是木舌，服药之外，仍用掺药。 腮则用涂药，轻者但服药而自
退，不须用针及药，点其疮而自消也。〔薛〕小儿喉痹，因膏粱积热，或禀赋有
热，或乳母七情之火、饮食之毒，当分其邪蓄表里，与证之轻重，经之所主而治之。
若左腮色青赤者，肝胆经风热也，用柴胡栀子散。右腮色赤者，肺经有热也，用泻
白散。额间色赤者，心与小肠经热也，用导赤散。若兼青色，风热相搏也，用加味
逍遥散。鼻间色黄，脾胃经有热也，用泻黄散。若兼青色，木乘土位也，用加味逍
遥散。兼赤色，心传土位也，用柴胡栀子散。颏间色赤，肾经有热也，用地黄丸。
凡此积热内蕴，二便不通者，当疏利之。风邪外客而发寒热者，当发散之。外感风
邪，大便闭结、烦渴痰盛者，当内疏外解。若因乳母膏粱积热者，母服东垣清胃散。
若因乳母恚怒肝火者，母服加味逍遥散。禀赋阴虐者，儿服地黄丸。大概当用轻和
之剂，以治其本，切不可用峻利之药以伤真气也。一小儿喉间肿痛，惊悸饮水，
服惊风降火之药益甚，仍欲攻风痰。余曰惊悸饮水，心经虚证，盖胃为五脏之本，
先用五味异功散以补胃，加桔梗甘草以消毒，诸证顿退，后用牛蒡子汤加柴胡而愈。
一小儿发热引冷，大便黄色，手足并热，不能吮乳。视口内无患，扪其喉间则哭，
此喉内作痛，乃脾胃实热也。用泻黄、清胃二散，各一剂，母子并服而愈。后因
乳母饮酒，儿躁不安，口内流涎，仍用前二散而愈。一小儿喉间肿痛，发热咳嗽，
大便秘结。此肝与大肠有热也。先用牛蒡子汤加硝。黄一服，大便随通，乃去硝
黄，再剂顿愈。审其母有肝火发热，用柴胡清肝散，母子并服而痊。
甘桔汤 治婴孩感冒风热，火气熏逼痘疮，蕴毒上攻，咽喉肿痛，痰气不顺，咳嗽
失音。
人参（去芦，半两） 桔梗（蜜浸，炒，一两） 甘草（半生半炙，三钱）
上锉散。用水煎，不拘时候服。
立效散 治婴孩小儿，咽喉痹痛，不能吞咽。
硼砂 龙脑 雄黄 朴硝（各半钱）
上为极细末，干掺。
吹喉散 治婴孩咽喉肿痛，气塞不通。
甘草（生，二钱半） 朴硝（一两）
上为极细末。干掺喉中，如肿甚者，用小竹管吹入喉内。
牛蒡汤 主伤风发热烦躁，鼻塞气喘，痰嗽惊啼，及诸疮赤紫丹毒，咽喉肿痛。
牛蒡子（三两，略炒，细研） 大黄（一两半） 防风（去芦） 薄荷（去老梗。各一两）
荆芥（去根梗，四两） 甘草（一两一钱半）
上 咀。每服二钱，水一盏，煎七分，无时，温服。
化毒汤 解风热上攻，咽喉肿痛，饮食不便。
桔梗（锉、炒，半两） 薄荷叶 荆芥穗 甘草（各二钱半） 山豆根（取净皮一钱半。以上
五味俱焙为末） 牙硝 硼砂 朴硝 雄黄 朱砂（各二钱。以上五味，乳钵细研）
上，五味焙为末，五味研为末，同一处，再研匀。每用一字至半钱，干点舌上
化下，或以温汤浓调，少与含咽，亦可。
备急散 治小儿诸般骨哽，咽喉肿痛。
五倍子（一两，研） 先春茶末（半两）
上二味，和匀。抄一钱，温汤半盏调化，无时，少与咽下。根据法服饵，不过三
五次即效。如骨出或刺破处血来多者，硼砂末六钱，水煎消毒散饮调服，血止痛住，
肿消食进。
牛蒡子汤
牛蒡子（炒，杵） 玄参 升麻 桔梗（炒） 犀角（镑） 黄芩 木通 甘草（各等分）
上，每服一二钱，水煎。
《拔萃》桔梗汤 治热肿喉痹。
桔梗（炒） 甘草（炒） 连翘 栀子（炒） 薄荷 黄芩（各等分）
上为末。每服一二钱，水煎服。
消毒饮 解急惊风毒，赤紫丹瘤，壮热狂躁，睡卧不安，胸膈满闷，咽喉肿痛，九
道有血妄行，及遍身疮疥。
牛蒡子（六两） 荆芥穗（二两） 甘草（一两）
上锉。每服二钱，水一盏，煎七分，无时，温服。
柴胡饮（见积热） 东垣人参安胃散（见吐利） 《三因》玉钥匙 九味芦荟丸（见疳）
《济生》犀角 地黄汤（见吐血） 五味异功散（见吐利） 柴胡清肝散（见发热）
《心鉴》指出，咽喉是全身的关键部位，与胃气相连，是呼吸之气出入的通道。如果胸膈之间蕴积热毒，导致风痰生成，壅滞不散，就会引发咽喉疾病。喉内生疮，有的形状像腐烂的肉，造成吞咽困难、疼痛，堵塞不通，呕吐和吞咽都无法进行，严重时甚至长出重舌（舌下肿胀如双舌），治疗时尤其应该先祛除风痰，以疏通咽膈，然后才能解除热毒，如果延误时机，就会有无法挽救的危险。又有热毒冲向上方而生疮的，称为悬痈。此外，腑脏寒冷也能使人咽喉闭塞，吞吐不利。临证时要详细审察并治疗。咽喉的疾病，根本原因是热毒上攻。四季感受热邪，藏于心腑之间，一旦受到触动，便上攻咽喉，这被称为“肾伤寒”。然而其症状有单侧肉蛾、双侧肉蛾，有重舌、木舌（舌体僵硬肿大）、腮部肿胀，有悬痈肿胀，有里外皆肿，严重的甚至上攻头面全部肿胀。一般的治疗大法，先洗去口中舌上的白苔，其次扫去风涎，如果是单侧或双侧肉蛾，可以针刺的就针刺，有不适合针刺的，就用熏药和掺药，待肿痛消退后，再依次服用汤药。如果是木舌，除了服药之外，仍要用掺药。腮部肿胀则用涂药，轻者只需服药就能自行消退，不需要用针及药物，点治其疮口就能自行消散。〔薛己〕小儿喉痹，是因为膏粱厚味积热，或者禀赋有热，或者乳母七情之火、饮食之毒所致，应当分辨邪气蓄积在表还是里，以及证候的轻重，根据经络的主病来治疗。如果左腮颜色青赤，是肝胆经风热，用柴胡栀子散。右腮颜色赤红，是肺经有热，用泻白散。额头间颜色赤红，是心与小肠经有热，用导赤散。如果兼见青色，是风热相搏，用加味逍遥散。鼻间颜色黄，是脾胃经有热，用泻黄散。如果兼见青色，是肝木乘脾土，用加味逍遥散。如果兼见赤色，是心火传于脾土，用柴胡栀子散。下巴间颜色赤红，是肾经有热，用地黄丸。凡是这种积热内蕴，大小便不通的，应当疏利通便。风邪外袭而发寒热的，应当发散解表。外感风邪，大便闭结、烦渴痰多的，应当内疏外解。如果是因为乳母膏粱积热引起的，母亲服用东垣清胃散。如果是因为乳母恚怒导致肝火旺盛的，母亲服用加味逍遥散。禀赋阴亏的，孩子服用地黄丸。大概应当使用轻平和的药剂来治本，切不可使用峻烈通利的药物来损伤真气。有一个小儿喉间肿痛，惊悸想喝水，服用惊风降火的药物后病情加重，仍然想要攻逐风痰。我说惊悸想喝水，是心经虚证，因为胃是五脏的根本，先用五味异功散来补胃，加桔梗甘草来解毒，各种症状顿时减退，后用牛蒡子汤加柴胡而痊愈。有一个小儿发热引饮冷水，大便黄色，手足都热，不能吮吸乳汁。查看口腔内部没有病变，触摸其喉间他就哭，这是喉内作痛，属于脾胃实热。用泻黄散、清胃散各一剂，母子同时服用而痊愈。后来因为乳母饮酒，孩子躁动不安，口内流涎，仍然用前两种散剂而痊愈。有一个小儿喉间肿痛，发热咳嗽，大便秘结。这是肝与大肠有热。先用牛蒡子汤加硝黄（芒硝、大黄）一服，大便随即通畅，于是去掉硝黄，再服两剂顿时痊愈。审察其母亲有肝火发热，用柴胡清肝散，母子同时服用而康复。
甘桔汤 治疗婴儿感冒风热，火气熏逼痘疮，蕴毒上攻，咽喉肿痛，痰气不顺，咳嗽失音。
人参（去芦头，半两） 桔梗（蜜浸，炒，一两） 甘草（半生半炙，三钱）
以上锉成散剂。用水煎煮，不拘时候服用。
立效散 治疗婴幼儿咽喉痹痛，不能吞咽。
硼砂 龙脑 雄黄 朴硝（各半钱）
以上研成极细末，干掺患处。
吹喉散 治疗婴幼儿咽喉肿痛，气塞不通。
甘草（生，二钱半） 朴硝（一两）
以上研成极细末。干掺喉中，如果肿胀严重，用小竹管吹入喉内。
牛蒡汤 主治伤风发热烦躁，鼻塞气喘，痰嗽惊啼，以及诸疮赤紫丹毒，咽喉肿痛。
牛蒡子（三两，略炒，细研） 大黄（一两半） 防风（去芦头） 薄荷（去老梗，各一两） 荆芥（去根梗，四两） 甘草（一两一钱半）
以上切碎。每服二钱，水一盏，煎至七分，随时温服。
化毒汤 解除风热上攻，咽喉肿痛，饮食不便。
桔梗（锉、炒，半两） 薄荷叶 荆芥穗 甘草（各二钱半） 山豆根（取净皮一钱半。以上五味均焙干为末） 牙硝 硼砂 朴硝 雄黄 朱砂（各二钱。以上五味，乳钵细研）
以上，五味焙干为末，五味研为末，混合在一起，再次研匀。每次用一字至半钱，干点舌上使其融化，或者用温水调浓，少量含咽，也可以。
备急散 治疗小儿各种骨哽，咽喉肿痛。
五倍子（一两，研） 先春茶末（半两）
以上两味，和匀。取一钱，用半盏温水调化，随时少量咽下。按照此法服用，不过三四五次即见效。如果骨头取出或刺破处出血多者，用硼砂末六钱，水煎消毒散饮调服，血止疼痛停，肿消食进。
牛蒡子汤
牛蒡子（炒，杵） 玄参 升麻 桔梗（炒） 犀角（镑） 黄芩 木通 甘草（各等分）
以上，每服一二钱，水煎。
《拔萃》桔梗汤 治疗热肿喉痹。
桔梗（炒） 甘草（炒） 连翘 栀子（炒） 薄荷 黄芩（各等分）
以上为末。每服一二钱，水煎服。
消毒饮 解除急惊风毒，赤紫丹瘤，壮热狂躁，睡卧不安，胸膈满闷，咽喉肿痛，九窍有血妄行，以及遍身疮疥。
牛蒡子（六两） 荆芥穗（二两） 甘草（一两）
以上锉碎。每服二钱，水一盏，煎至七分，随时温服。
柴胡饮（见积热） 东垣人参安胃散（见吐利） 《三因》玉钥匙 九味芦荟丸（见疳） 《济生》犀角地黄汤（见吐血） 五味异功散（见吐利） 柴胡清肝散（见发热）
Xin Jian (Mirror of the Heart) states that the throat and pharynx are the vital hub of the body, connecting with the Stomach Qi, and serving as the passage for respiration. If heat-toxin accumulates in the chest and diaphragm, generating wind-phlegm that obstructs and fails to disperse, it will manifest as diseases of the throat and pharynx. Sores may form inside the throat; some resemble rotting flesh, causing difficulty in swallowing and pain, obstruction without passage, and inability to vomit or swallow. In severe cases, a double tongue (Zhong She, swelling of the tongue resembling a second tongue) may develop. Treatment should primarily focus on dispelling wind-phlegm to unblock the pharynx and diaphragm, followed by resolving the heat-toxin; delay may lead to incurable conditions. Another type is the hanging abscess (Xuan Yong), caused by heat-toxin rushing upward and forming sores. Additionally, coldness in the fu organs can cause throat closure and difficulty in swallowing. Clinical examination must be thorough. Diseases of the throat and pharynx fundamentally stem from heat-toxin attacking upward. Heat pathogens acquired throughout the four seasons hide within the heart and fu organs; once triggered, they attack the throat, a condition referred to as "Kidney Cold Damage" (Shen Shang Han). However, symptoms vary: there are single or double fleshy moths (Rou E, tonsillar hypertrophy); double tongue, wooden tongue (Mu She, stiff and swollen tongue), and malar swelling; hanging abscess swelling; internal and external swelling; and in severe cases, swelling extending to the head and face. The general treatment principle is first to wash away white coating on the mouth and tongue, then sweep away wind-saliva. For single or double fleshy moths, acupuncture may be used if applicable; otherwise, fumigation and insufflation medicines are applied. After reduction, oral decoctions are administered sequentially. For wooden tongue, besides oral medication, insufflation is still required. For malar swelling, topical application is used; mild cases resolve spontaneously with oral medication alone, without need for needles or drugs, as point-treatment of sores leads to spontaneous resolution. [Xue Ji] Pediatric throat bi (Hou Bi, sore throat with obstruction) arises from accumulation of heat due to rich diet, innate constitution prone to heat, or fire from the wet nurse's emotional disturbances and toxins from her diet. One must differentiate whether the pathogen is stored in the exterior or interior, assess the severity of the syndrome, and treat according to the governing meridians. If the left cheek is cyan-red, it indicates wind-heat in the Liver and Gallbladder meridians; use Chaihu Zhizi San (Bupleurum and Gardenia Powder). If the right cheek is red, it indicates heat in the Lung meridian; use Xie Bai San (Drain White Powder). If the forehead is red, it indicates heat in the Heart and Small Intestine meridians; use Dao Chi San (Direct Red Powder). If accompanied by cyan color, it indicates wind-heat struggling together; use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder). If the nose area is yellow, it indicates heat in the Spleen and Stomach meridians; use Xie Huang San (Drain Yellow Powder). If accompanied by cyan color, it indicates Wood overacting on Earth; use Jia Wei Xiao Yao San. If accompanied by red color, it indicates Heart fire transmitting to Earth; use Chaihu Zhizi San. If the chin is red, it indicates heat in the Kidney meridian; use Di Huang Wan (Rehmannia Pill). For all such cases of internal heat accumulation with constipation of both bowels and urine, purgation and drainage are indicated. For exterior wind-pathogen causing chills and fever, dispersing and releasing the exterior is indicated. For exterior wind-pathogen with constipation, irritability, thirst, and profuse phlegm, internal purgation and exterior release are indicated. If caused by the wet nurse's rich diet accumulation, the mother takes Dongyuan Qingwei San (Stomach-Clearing Powder). If caused by the wet nurse's anger leading to Liver fire, the mother takes Jia Wei Xiao Yao San. For infants with yin deficiency constitution, the child takes Di Huang Wan. Generally, mild and harmonizing formulas should be used to treat the root; harsh purgatives must never be used to damage true Qi.
One infant had throat swelling and pain, palpitations, and desire to drink water. After taking herbs for convulsions and fire-draining, the condition worsened, and there was still a desire to attack wind-phlegm. I said that palpitations and desire to drink indicate Heart Qi deficiency, as the Stomach is the foundation of the five zang organs. First, use Wu Wei Yi Gong San (Five-Ingredient Powder for Benefiting the Work) to tonify the Stomach, adding Jie Geng (Platycodon) and Gan Cao (Licorice) to detoxify. All symptoms subsided suddenly. Later, Niu Bang Zi Tang (Arctium Decoction) with added Chai Hu (Bupleurum) cured him.
Another infant had fever, craving cold drinks, yellow stool, hot hands and feet, and inability to suckle milk. Inspection of the oral cavity showed no lesions, but palpation of the throat elicited crying, indicating throat pain due to excess heat in the Spleen and Stomach. Xie Huang San and Qingwei San were prescribed, one dose each, taken by both mother and child, resulting in recovery. Later, after the wet nurse drank alcohol, the infant became restless with drooling; the same two powders were used again, leading to recovery.
Another infant had throat swelling and pain, fever, cough, and constipation. This indicated heat in the Liver and Large Intestine. Niu Bang Zi Tang with Xiao Huang (Mang Xiao/Rhubarb) was given for one dose; stool passed immediately. Xiao Huang was then removed, and two more doses led to complete recovery. Examination revealed the mother had Liver fire with fever; Chaihu Qinggan San (Bupleurum Liver-Clearing Powder) was prescribed for both mother and child, resulting in cure.
Gan Jie Tang (Licorice and Platycodon Decoction) treats infants with wind-heat common cold, where fire qi harasses smallpox sores, accumulating toxin attacking upward, causing throat swelling and pain, adverse phlegm-qi, cough, and loss of voice.
Ren Shen (Ginseng Root, radix removed, 0.5 liang) Jie Geng (Platycodon Root, honey-steeped, stir-fried, 1 liang) Gan Cao (Licoriza Root, half raw half roasted, 3 qian)
Crush into powder. Decoct in water, take at any time.
Li Xiao San (Instant Effect Powder) treats pediatric throat bi pain, inability to swallow.
Peng Sha (Borax) Long Nao (Borneol) Xiong Huang (Realgar) Pu Xiao (Mirabilite) (each 0.5 qian)
Grind into extremely fine powder, apply dry insufflation.
Chui Hou San (Blow Throat Powder) treats pediatric throat swelling and pain, qi obstruction.
Gan Cao (Licoriza Root, raw, 2.5 qian) Pu Xiao (Mirabilite, 1 liang)
Grind into extremely fine powder. Apply dry insufflation into the throat; if swelling is severe, blow into the throat using a small bamboo tube.
Niu Bang Tang (Arctius Decoction) governs wind-cold with fever and irritability, nasal congestion, asthma, phlegm-cough, convulsive crying, as well as various sores with red-purple carbuncles, throat swelling and pain.
Niu Bang Zi (Arctii Fructus, lightly stir-fried, finely ground, 3 liang) Da Huang (Rhei Radix et Rhizoma, 1.5 liang) Fang Feng (Saposhnikoviae Radix, radix removed) Bo He (Menthae Haplocalycis Herba, old stems removed, each 1 liang) Jing Jie (Schizonepetae Spica, roots and stems removed, 4 liang) Gan Cao (Licoriza Root, 1 liang 1 qian 5 fen)
Cut into pieces. Take 2 qian per dose, decoct in 1 cup of water until 0.7 cup remains, warm and take at any time.
Hua Du Tang (Detoxifying Decoction) resolves wind-heat attacking upward, throat swelling and pain, difficulty in eating and drinking.
Jie Geng (Platycodon Root, cut, stir-fried, 0.5 liang) Bo He Ye (Menthae Haplocalycis Folium) Jing Jie Sui (Schizonepetae Spica) Gan Cao (Licoriza Root, each 2.5 qian) Shan Dou Gen (Sophorae Tonkinensis Radix et Rhizoma, cleaned bark, 1.5 qian. The above five herbs are roasted and ground into powder) Ya Xiao (Natrii Sulfas) Peng Sha (Borax) Pu Xiao (Mirabilite) Xiong Huang (Realgar) Zhu Sha (Cinnabar, each 2 qian. The above five herbs are finely ground in a mortar)
Roast the first five herbs into powder, grind the latter five into powder, mix them together, and grind uniformly. Use 1 zi to 0.5 qian per dose, sprinkle dry on the tongue to dissolve, or mix thickly with warm water and hold/swallow slightly.
Bei Ji San (Emergency Preparation Powder) treats various bone obstructions in children, throat swelling and pain.
Wu Bei Zi (Galla Chinensis, 1 liang, ground) Xian Chun Cha Mo (Early Spring Tea Powder, 0.5 liang)
Mix the two ingredients evenly. Take 1 qian, dissolve in half a cup of warm water, swallow slightly at any time. Following this method, effectiveness is seen within three to five doses. If bleeding occurs from bone extraction or puncture wounds, take 6 qian of Peng Sha powder, decoct in water, mix with Xiaodu San (Detoxification Powder) drink, to stop bleeding and pain, reduce swelling, and restore appetite.
Niu Bang Zi Tang (Arctium Seed Decoction)
Niu Bang Zi (Arctii Fructus, stir-fried, pounded) Xuan Shen (Scrophulariae Radix) Sheng Ma (Cimicifugae Rhizoma) Jie Geng (Platycodon Root, stir-fried) Xi Jiao (Rhino Horn, shaved) Huang Qin (Scutellariae Radix) Mu Tong (Akebiae Caulis) Gan Cao (Licoriza Root, equal parts)
Take 1-2 qian per dose, decoct in water.
Ba Cui Jie Geng Tang (Extracts of Extraction Platycodon Decoction) treats heat-swelling throat bi.
Jie Geng (Platycodon Root, stir-fried) Gan Cao (Licoriza Root, stir-fried) Lian Qiao (Forsythiae Fructus) Zhi Zi (Gardeniae Fructus, stir-fried) Bo He (Menthae Haplocalycis Herba) Huang Qin (Scutellariae Radix, equal parts)
Grind into powder. Take 1-2 qian per dose, decoct in water and take.
Xiao Du Yin (Detoxifying Drink) resolves acute convulsion wind-toxin, red-purple carbuncles, high fever and mania, restlessness in sleep, chest and diaphragm fullness, throat swelling and pain, hemorrhage from the nine orifices, and widespread skin sores and scabies.
Niu Bang Zi (Arctii Fructus, 6 liang) Jing Jie Sui (Schizonepetae Spica, 2 liang) Gan Cao (Licoriza Root, 1 liang)
Cut into pieces. Take 2 qian per dose, decoct in 1 cup of water until 0.7 cup remains, warm and take at any time.
Chai Hu Yin (Bupleurum Drink) (see Accumulated Heat)
Dongyuan Ren Shen An Wei San (Dongyuan Ginseng Stomach-Calming Powder) (see Vomiting and Diarrhea)
San Yin Yu Yao Chi (Three Causes Jade Key)
Jiu Wei Lu Hui Wan (Nine-Ingredient Aloe Pill) (see Infantile Malnutrition)
Jisheng Xi Jiao Di Huang Tang (Jisheng Rhino Horn and Rehmannia Decoction) (see Hematemesis)
Wu Wei Yi Gong San (Five-Ingredient Powder for Benefiting the Work) (see Vomiting and Diarrhea)
Chai Hu Qing Gan San (Bupleurum Liver-Clearing Powder) (see Fever)