多因气郁而生,如菌状,或如木耳样,色红色紫,皆属心火。治用金丹、碧丹和吹,内
服煎剂,同舌痈法。
即喉咙花肿胀重者,至于发泡,盖塞咽喉,气难呼吸。此属肾虚火旺,并感风热而生。
胸前红肿,形现下外,亦欲内攻,甚则喉肿闭而出脓。
与前症相似,或在脸腮,痒烂,或在喉间舌下,色黄如蜂者,凶症也。
与前症相仿,又名烂颊风、腮颊风。毒结尽牙处肿,大抵皆属郁火也。
生于腮下,因过食浓味,多因醇酒热毒所结而生也。
(一)治病必须明症,用药不可闭门捉贼,又不可引贼入门,反增他疾。凡治喉症,皆君
相二火,法当清降,表里同治,驱放贼邪为要。然不可混用石膏妄清肺胃,关门留贼,伤咽而毙
。如舌症属心脾二经之火,又宜表里兼治。亦不可乱用芩、膏,妄清肺经,引贼入门,致生
喉胀痰塞之患。又如牙症属脾胃二经之火,不可反用芩、连,妄投过经药味,致有喉舌肿胀
之患。他若温热病后,肾液干枯,不能上润于心,心火发动上冲,咽喉干痛,宜用清心滋肾
为主,知柏、川连、麦冬、朱砂等味可愈。不可误投表味。若用发散,必致精竭神枯而死。
学人须审准经络,方可下手,不得混行施治。【谔按∶此段论喉症治法极精,示人以不可妄
凉,确有至理,然亦有宜凉者,须合苔脉方可,不得胶柱豉瑟也。】
(二)凡喉症先用吹丹一二管,使其痰出,视其痰浓否紧否,如痰起浓黄紧,扯捺不开,
痰粘药管,难拭去者,危症也。如吹初管药,其痰多紧而不出,其势危急,死在须臾。将吹丹用
薄荷、竹沥泡汤,冷透,投入,调匀灌之,自无痰塞之患,此心法也。【谔按∶亦有宜针哑
门、少商、曲池、廉泉等穴,而后肺气不致蔽塞,内关得以开转者,针后,再用霹雳针吹之
,痰无有不吐之理。惟服竹沥一两者,必滴入生姜汁二三匙,方妥。】
(三)凡喉症颈项赤肿,深受时毒,赤肿不可至胸,至胸必死,谓之毒归于心,其人必欢
笑。与煎剂同服,护住其心,多服解毒之品,使毒渐平为妥,亦心法也。
(四)凡咽喉齿舌症,须辨内外二因,虚实二火。虚者或病后,或酒色,虚火上炎,宜养
阴降火,又须守戒耐心,自能渐愈;实者因感时邪,触动君相二火,重者寒热头疼,先宜清泄清
散,开结逐毒涤痰之法,并行为妙。清心用犀角,清中有散,不宜黄连、黄芩苦寒,【谔按
∶如舌尖深绛有刺,亦有可用之处。】恐扼火毒,使痊后复发。泄散宜用葛根、薄荷、防风
、青蒿(然葛根最竭胃汁,不宜轻用,青蒿易荆芥为妙),不可用升麻、柴胡、桔梗,【谔按
∶今之桔梗,率是荠 ,亦有可用处,惟宜轻。】升提其火,然芩、连亦有用之者,齿舌之
症,用亦无妨。火邪郁结于中,而用大黄、芒硝下之,人症俱实,泻火后,症消而愈,是霸
术也。务期认症的确,方可行之,若稍差迟,为祸非浅,愚谓症退而火自泄,津液回而大便
解,亦秘法也。
(五)凡阴虚喉痹,口舌生疮破烂,或声哑者,皆水亏火旺之症。初起宜加味射干汤
,次用滋阴消痹汤。亦有未成劳瘵,遽然音哑,以致嗽唾无休。偶或饮寒,或过用凉剂,郁其火
于肺。初宜清肺散火汤,驱寒气以泄火邪,次用滋阴降火清肺之剂。如喉痹肿痛,甚者加味
射干汤,或用熊胆冰黄散吹喉中。如喉痹延及口舌,生疮破烂者,柳黄散搽之。阴火上炎,
未成劳瘵,遽然声哑,有痰嗽者,清肺散火二三剂后,用滋水开阴汤。
(六)喉症至五日则重,如三日前,症虽重,尚未成脓,药能消散。若至五六日,患处多
成脓矣,纵使穿破,必有烂窠难愈。烂处必用口疳药,多加龙骨、儿茶,叠吹而愈。凡伤寒后患
连珠乳蛾,及喉痹者,不治,惟张氏有治其喉症。颈项强硬,目睛上视,气绝者不治。喉痛
起至一二日,未必发寒热,病尚轻缓。若至第三日,必发重症,必加寒热,须问大小便通利
否,如二便俱利,其症不过浮游之火,攻于咽喉,宜服清风清热降火之药,即愈。若大小便
不通,内有实火,若非用降火解毒之剂,兼通二便之药,火从何而泄,病如何而解乎?故症
有轻重,病有缓急,要问其头痛不痛,如痛,则是伤寒难治之症也。【谔按∶多加龙骨、儿
茶,亦非所宜,若内蕴之热毒未清,则江河易于溃决也。】
(七)喉症虽凶,若肿发于外,危症虽见者,治之易愈。
(八)帝中肿胀,虽难吸气之重症,速治即愈,迟则亦重矣。喉症必大便去后,方可望痊
,如大便闭结,不可轻许其愈。【谔按∶此即地道通而天气降,釜底抽薪之意,亦有大便虽通,
而虚阳上逆,肿痛极甚者,宜用养阴清化,治白喉法是也。】
(九)喉症初起,大便闭结,宜大黄、元明粉,兼用表里之品下之,则降火而易痊。若五
六日久不食,大便闭塞,此由病久,胃气已虚,元气已弱,禁用硝黄,不可妄投霸剂,以致虚脱
而死,欲通其便,只宜养阴降火,兼蜜导等润药下之,此秘法也。若用硝黄,须诊其脉,来
有无力,可下则下之。【谔按∶右关沉实有力,或滑数鼓指者,均可下。】(景华按∶风火
喉症,至喉闭时,气血必滞,脉必沉涩,不可误认无力,斯时凭症不凭脉,须审其胃气之有
无,如胃气尚存,宜下之)。
(十)喉症吹药,必要直对喉中周遍,重吹四五管,方可消降毒痰,三四次后,用煎药,
(十一)喉症先碎,须长肉药吹盖破处,后用诸吹药频吹,肿消为妙。
(十二)喉症一二日肿痛,三四日势定有形,每至三日犹发寒热,或头疼,须刻刻吹药,
可缓,即知生死在几日间矣。(景华按∶妇人喉症肿痛,经水适止,火不下达者,宜通其经
而喉自愈。)【谔按∶此即所谓热入血室也,不独喉症为然,伤寒温病,均有此症,宜清营分而愈。】
(十三)凶喉之症,头面发肿,白亮无光彩,脉来沉细无神,是神气外泄,无阳之症也,
断不可治。若面发红肿,脉洪大有力,症虽极重,元气尚强,毒火虽盛,治之易痊。
(十四)腮易肿烂,用筷缚丝绵,蘸水轻搅患处。痛者,用药必愈。若不知痛者,是死肉,难愈。
(十五)舌肿胀满口,吐舌在外,难以纳药者,用开关散吹入鼻中,牙关自开,痰涎自出
。然后用筷卷绵,蘸甘草汤,润其口唇,后送丹散,频吹而愈。
(十六)吹药非惟肿破患处要吹,并周遭好肉上,亦须吹之,方免延开,且易于愈也。口
舌等症,吹药后,如舌上无涎,或如干橘囊者,不治。
(十七)口舌腐烂,无血出者,不治。穿腮者,不治。烂至鼻梁,发红点者,不治。惟张
氏有治。如舌肿大,用生黄柏,加冰片敷之。若出血,用炒黄柏、冰片,此妙法也。
(十八)如患HT 舌喉痈,若大便闭结,煎剂内加元明粉、大黄。小便不通,加六一散调服
,服之甚效,此心法也。
(十九)如患牙咬痈,则牙龈肉胀突出,牙关紧闭,口不能开。先用甘遂散配制巴豆少许
,吹入牙龈内,用押舌器,渐渐擦开牙关,用药频吹而愈。
(二十)口疳用丝绵轻搅,切不可用青布,恐患处受伤,难愈。合药取于辛散,以细为主
,收储不可出气,须用乌金纸塞紧瓶口为妙。凡不经火之药味,宜晒脆为末用之。
多因气机郁结而生,形状像菌类,或者像木耳一样,颜色红紫,都属于心火。治疗用金丹、碧丹调和吹入咽喉,内服煎剂,方法与治疗舌痈相同。
即喉咙花朵肿胀严重的情况,以至于起泡,堵塞咽喉,导致呼吸困难。这属于肾虚火旺,并感受风热而生成。
胸前红肿,形态显现于下外部,也有向内攻伐的趋势,严重时喉部肿胀闭塞并流出脓液。
与前一种症状相似,或者出现在脸颊腮部,瘙痒溃烂,或者在喉间舌下,颜色黄如蜂状,这是凶险的病症。
与前一种症状相仿,又叫做烂颊风、腮颊风。毒邪结聚在牙齿尽头处肿胀,大抵都属于郁火所致。
生长在腮下,因为过食浓味食物,多因醇酒热毒结聚而生。
(一)治病必须明确证候,用药不可“闭门捉贼”(指误用收敛药使邪气内闭),也不可“引贼入门”(指误用寒凉药损伤正气使邪气深入),反而增加其他疾病。凡是治疗喉症,都涉及君火和相火,治法应当清降,表里同治,驱除邪气是关键。然而不可混用石膏妄图清泻肺胃,那样会关门留寇,损伤咽喉致死。如果舌症属于心脾二经之火,又宜表里兼治。也不可以乱用黄芩、石膏,妄图清泻肺经,引邪深入,导致喉胀痰塞的祸患。又如牙症属于脾胃二经之火,不可反而使用黄芩、黄连,妄投过经的药味,导致喉舌肿胀的祸患。其他如温热病后,肾液干枯,不能上润于心,心火发动上冲,咽喉干痛,宜用清心滋肾为主,知母、黄柏、川黄连、麦冬、朱砂等药味可以治愈。不可误投解表发散的药物。如果使用发散药,必定导致精气枯竭、神气衰败而死。学习者必须审准经络,方可下手,不得混淆施治。【谔按:这段论述喉症治法极其精妙,告诫人们不可妄用凉药,确有至理,但亦有适宜用凉药的情况,必须结合舌苔脉象判断,不可拘泥固执。】
(二)凡是喉症先用吹丹一二管,使其痰液排出,观察痰液是否浓稠紧束,如果痰起呈浓黄色且紧束,拉扯捻弄不开,痰粘附药管,难以拭去的,是危重病症。如果吹初管药时,痰多紧束而不出,病情危急,死在顷刻之间。将吹丹用薄荷、竹沥泡汤,冷却透彻,投入调匀灌服,自然没有痰塞的祸患,这是心法。【谔按:也有适宜针刺哑门、少商、曲池、廉泉等穴位,从而使肺气不致蔽塞,内关得以开转的,针刺后,再用霹雳针吹药,痰没有不吐出的道理。只是服用一两竹沥时,必须滴入生姜汁二三匙,才稳妥。】
(三)凡是喉症颈项赤肿,深受时行毒邪侵袭,赤肿不可蔓延至胸部,蔓延至胸部必死,这叫毒归于心,其人必定欢笑。与煎剂同服,护住其心,多服解毒之品,使毒邪逐渐平复为妥,也是心法。
(四)凡是咽喉齿舌症,须辨别内外二因,虚实二火。虚证或者是病后,或者是酒色过度,虚火上炎,宜养阴降火,又须守戒耐心,自然能渐渐痊愈;实证是因为感受时邪,触动君相二火,重症者寒热头疼,先宜清泄清散,开结逐毒涤痰之法,并行治疗为妙。清心用犀角,清中有散,不宜用黄连、黄芩苦寒,【谔按:如果舌尖深绛且有刺,也有可用的地方。】恐怕扼制火毒,使痊愈后复发。泄散宜用葛根、薄荷、防风、青蒿(然而葛根最耗竭胃汁,不宜轻用,青蒿改用荆芥为妙),不可用升麻、柴胡、桔梗,【谔按:现在的桔梗,大多是荠桔梗,也有可用的地方,只宜轻用。】升提其火,然而芩、连也有使用的,齿舌之症,使用也无妨。火邪郁结于中,而用大黄、芒硝下之,人症俱实,泻火后,症消而愈,这是霸道之术。务必确认证候确切,方可施行,若稍有差迟,祸患非浅,我认为症退而火自泄,津液回而大便解,也是秘法。
(五)凡是阴虚喉痹,口舌生疮破烂,或者声音嘶哑的,都是水亏火旺的症候。初起宜加味射干汤,次用滋阴消痹汤。也有未成劳瘵,突然音哑,以致咳嗽唾痰不止。偶然饮冷,或过用凉剂,郁其火于肺。初宜清肺散火汤,驱寒气以泄火邪,次用滋阴降火清肺之剂。如喉痹肿痛,甚者加味射干汤,或用熊胆冰黄散吹喉中。如喉痹延及口舌,生疮破烂的,柳黄散搽之。阴火上炎,未成劳瘵,突然声哑,有痰嗽的,清肺散火二三剂后,用滋水开阴汤。
(六)喉症到了第五日则加重,如前三天,症虽重,尚未成脓,药能消散。若到五六日,患处多已成脓了,纵使穿破,必有烂窠难愈。烂处必用口疳药,多加龙骨、儿茶,叠吹而愈。凡是伤寒后患连珠乳蛾,及喉痹的,不治,只有张氏有治其喉症。颈项强硬,目睛上视,气绝的不治。喉痛起至一二日,未必发寒热,病尚轻缓。若到第三日,必发重症,必加寒热,须问大小便通利否,如二便俱利,其症不过浮游之火,攻于咽喉,宜服清风清热降火之药,即愈。若大小便不通,内有实火,若非用降火解毒之剂,兼通二便之药,火从何而泄,病如何而解呢?故症有轻重,病有缓急,要问其头痛不痛,如痛,则是伤寒难治之症也。【谔按:多加龙骨、儿茶,也不是适宜的,如果内蕴的热毒未清,则江河易于溃决啊。】
(七)喉症虽然凶险,若肿发于外,危症虽见者,治之易愈。
(八)帝中肿胀,虽是难吸气之重症,速治即愈,迟则亦重矣。喉症必大便去后,方可望痊愈,如大便闭结,不可轻许其愈。【谔按:这就是地道通而天气降,釜底抽薪的意思,也有大便虽通,而虚阳上逆,肿痛极甚的,宜用养阴清化,治白喉法是也。】
(九)喉症初起,大便闭结,宜大黄、元明粉,兼用表里之品下之,则降火而易痊。若五六日久不食,大便闭塞,此由病久,胃气已虚,元气已弱,禁用硝黄,不可妄投霸剂,以致虚脱而死,欲通其便,只宜养阴降火,兼蜜导等润药下之,此秘法也。若用硝黄,须诊其脉,来有无力,可下则下之。【谔按:右关沉实有力,或滑数鼓指者,均可下。】(景华按:风火喉症,至喉闭时,气血必滞,脉必沉涩,不可误认无力,斯时凭症不凭脉,须审其胃气之有无,如胃气尚存,宜下之)。
(十)喉症吹药,必要直对喉中周遍,重吹四五管,方可消降毒痰,三四次后,用煎药,
(十一)喉症先碎,须长肉药吹盖破处,后用诸吹药频吹,肿消为妙。
(十二)喉症一二日肿痛,三四日势定有形,每至三日犹发寒热,或头疼,须刻刻吹药,可缓,即知生死在几日间矣。(景华按:妇人喉症肿痛,经水适止,火不下达者,宜通其经而喉自愈。)【谔按:此即所谓热入血室也,不独喉症为然,伤寒温病,均有此症,宜清营分而愈。】
(十三)凶喉之症,头面发肿,白亮无光彩,脉来沉细无神,是神气外泄,无阳之症也,断不可治。若面发红肿,脉洪大有力,症虽极重,元气尚强,毒火虽盛,治之易痊。
(十四)腮易肿烂,用筷缚丝绵,蘸水轻搅患处。痛者,用药必愈。若不知痛者,是死肉,难愈。
(十五)舌肿胀满口,吐舌在外,难以纳药者,用开关散吹入鼻中,牙关自开,痰涎自出。然后用筷卷绵,蘸甘草汤,润其口唇,后送丹散,频吹而愈。
(十六)吹药非惟肿破患处要吹,并周遭好肉上,亦须吹之,方免延开,且易于愈也。口舌等症,吹药后,如舌上无涎,或如干橘囊者,不治。
(十七)口舌腐烂,无血出者,不治。穿腮者,不治。烂至鼻梁,发红点者,不治。惟张氏有治。如舌肿大,用生黄柏,加冰片敷之。若出血,用炒黄柏、冰片,此妙法也。
(十八)如患HT 舌喉痈,若大便闭结,煎剂内加元明粉、大黄。小便不通,加六一散调服,服之甚效,此心法也。
(十九)如患牙咬痈,则牙龈肉胀突出,牙关紧闭,口不能开。先用甘遂散配制巴豆少许,吹入牙龈内,用押舌器,渐渐擦开牙关,用药频吹而愈。
(二十)口疳用丝绵轻搅,切不可用青布,恐患处受伤,难愈。合药取于辛散,以细为主,收储不可出气,须用乌金纸塞紧瓶口为妙。凡不经火之药味,宜晒脆为末用之。
Belongs to Heart Fire, internally there must be restlessness and mental disturbance.
It often arises from Qi stagnation, resembling fungi or wood ear mushrooms, with red-purple coloration, all belonging to Heart Fire. Treatment involves using Jindan (Golden Pill) and Bidan (Green Pill) mixed and insufflated into the throat, along with internal decoction, following the same method as treating Ling Yong (Tongue Abscess).
This refers to severe swelling of the "throat flowers" (pharyngeal tissues), leading to blistering that blocks the pharynx, causing difficulty in breathing. This belongs to Kidney Yin Deficiency with Hyperactive Fire, combined with contraction of Wind-Heat.
Redness and swelling on the chest, manifesting externally below, also threatening to attack inward; in severe cases, the throat swells shut and pus discharges.
Similar to the previous condition, occurring either on the cheeks, with itching and ulceration, or between the throat and under the tongue, with a yellow color like bees; this is a critical/fatal condition.
Similar to the previous condition, also known as Lan Jia Feng (Rotting Cheek Wind) or Sai Jia Feng (Cheek Wind). Toxicity accumulates at the gum line causing swelling, generally belonging to Stagnant Fire.
Occurring below the cheeks, caused by excessive consumption of rich flavors, mostly due to結聚 (accumulation) of heat toxicity from strong wine.
(1) Treating disease requires clear understanding of symptoms; medication should not "lock the door to catch the thief" (i.e., use astringents that trap pathogens inside), nor "invite the thief into the house" (i.e., use cold-natured herbs that damage healthy Qi and allow pathogens deeper entry), which would only increase other ailments. All throat conditions involve Ministerial Fire and Sovereign Fire; the method should be clearing and descending, treating both exterior and interior simultaneously, with expelling pathogenic factors as the priority. However, one must not indiscriminately use Shi Gao (Gypsum Fibrosum) to recklessly clear Lung and Stomach heat, as this traps the pathogen behind closed doors, damaging the pharynx and leading to death. If tongue conditions belong to Fire in the Heart and Spleen meridians, exterior and interior should be treated concurrently. One must not disorderly use Huang Qin (Scutellariae Radix) and Shi Gao to recklessly clear the Lung meridian, inviting pathogens inward and causing throat distension and phlegm obstruction. Similarly, if tooth conditions belong to Fire in the Spleen and Stomach meridians, one must not counterproductively use Huang Qin and Huang Lian (Coptidis Rhizoma), recklessly administering drugs that traverse inappropriate meridians, leading to throat and tongue swelling. In other cases, after warm-heat diseases, if Kidney fluids are dry and cannot moisten the Heart upward, causing Heart Fire to surge upward resulting in dry, painful throat, treatment should primarily focus on clearing the Heart and nourishing the Kidney; Zhi Mu (Anemarrhenae Rhizoma), Huang Bai (Phellodendri Cortex), Chuan Lian Zi (though text says Chuan Lian, likely referring to Huang Lian in context of clearing heart fire, but strictly translating text: Chuanlian/Coptis), Mai Dong (Ophiopogonis Radix), and Zhu Sha (Cinnabaris) can cure it. Do not mistakenly administer exterior-releasing agents. Using dispersants will inevitably lead to exhaustion of essence and spirit, resulting in death. Students must accurately diagnose the meridians before applying treatment; do not treat indiscriminately. [E's Note: This section discusses throat treatment methods with great precision, showing that reckless cooling is inadvisable, which is indeed sound reasoning. However, there are cases suitable for cooling, which must be judged by combining tongue coating and pulse; one must not be dogmatic.]
(2) For all throat conditions, first insufflate 1-2 tubes of Dan (pill/powder) to induce expectoration. Observe whether the phlegm is thick and tight. If the phlegm rises thick and yellow, tight, difficult to pull apart or manipulate, and sticks to the insufflation tube making it hard to wipe off, it is a critical condition. If upon initial insufflation, the phlegm is abundant and tight but does not come out, the situation is critical, and death may occur in an instant. Soak the insufflation powder in Bo He (Menthae Haplocalycis Herba) and Zhu Li (Bambusae Caulis in Taenia) decoction, cool thoroughly, administer mixed well, and there will naturally be no risk of phlegm obstruction; this is a core method. [E's Note: There are also cases suitable for needling Ya Men (GV15), Shao Shang (LU11), Qu Chi (LI11), and Lian Quan (CV23) acupoints, so that Lung Qi does not become obstructed and Nei Guan (PC6) can open and rotate. After needling, use Pili Zhen (Thunderbolt Needle) insufflation; phlegm will undoubtedly be expelled. When taking one liang of Zhu Li, it is essential to add 2-3 spoons of Sheng Jiang Zhi (Zingiberis Rhizoma Recens Juice) for safety.]
(3) For all throat conditions with redness and swelling of the neck, severely affected by seasonal toxins, if redness and swelling extend to the chest, death is inevitable; this is called "toxin returning to the Heart," and the person will necessarily laugh uncontrollably. Administer together with decoction to protect the Heart, and take more detoxifying substances to gradually calm the toxin; this is also a core method.
(4) For all throat, tooth, and tongue conditions, one must distinguish between internal and external causes, and deficiency and excess Fire. Deficiency patterns arise either post-illness or from alcohol and sexual excess, with deficient Fire flaming upward; treatment should nourish Yin and descend Fire, requiring abstinence and patience for gradual recovery. Excess patterns result from contracting seasonal pathogens, stirring up Sovereign and Ministerial Fire; in severe cases with chills, fever, and headache, initially clearing and draining, clearing and dispersing, opening knots, expelling toxins, and eliminating phlegm should be practiced concurrently. To clear the Heart, use Xi Jiao (Rhinocerotis Cornu); clearing with dispersion is preferred over the bitter-cold of Huang Lian and Huang Qin, [E's Note: If the tongue tip is deep crimson with prickles, they may also be used.] lest they suppress Fire-Toxicity, causing recurrence after recovery. For draining and dispersing, use Ge Gen (Puerariae Lobatae Radix), Bo He, Fang Feng (Saposhnikoviae Radix), and Qing Hao (Artemisiae Annuae Herba) (however, Ge Gen most exhausts Stomach fluids and should not be used lightly; replacing Qing Hao with Jing Jie (Schizonepetae Herba) is better). Avoid Sheng Ma (Cimicifugae Rhizoma), Chai Hu (Bupleuri Radix), and Jie Geng (Platycodonis Radix), [E's Note: Current Jie Geng is often Ji Jie Geng (Isodonis Radix), which has some utility, but should be used lightly.] raising Fire upwards. However, Huang Qin and Huang Lian are sometimes used; for tooth and tongue conditions, their use is acceptable. If Fire-Toxicity is stagnant in the middle, Da Huang (Rhei Radix et Rhizoma) and Mang Xiao (Natrii Sulfas) can be used to purge; when both patient and symptoms are excess, purging Fire leads to symptom resolution and recovery; this is a "hegemonic" (aggressive) method. One must be certain of the diagnosis before proceeding; any delay brings great harm. I believe that when symptoms recede, Fire dissipates naturally, and when fluids return, bowel movements resolve; this is also a secret method.
(5) For all Yin-Deficiency Hou Bi (Throat Bi/Sore Throat), with mouth and tongue ulcers/erosions, or hoarseness, these are signs of Water Deficiency and Hyperactive Fire. Initially, use Jia Wei She Gan Tang (Modified Belamcanda Decoction), followed by Zi Yin Xiao Bi Tang (Nourish Yin Eliminate Bi Decoction). Some cases develop sudden hoarseness without yet being consumptive (Lao Zhai), leading to incessant coughing and spitting. Occasional cold drinks or overuse of cold-natured medicines may stagnate Fire in the Lung. Initially, use Qing Fei San Huo Tang (Clear Lung Disperse Fire Decoction) to drive out cold air and drain Fire-Toxicity, followed by agents that nourish Yin, descend Fire, and clear the Lung. For severe throat Bi pain and swelling, use Jia Wei She Gan Tang, or insufflate Xiong Dan Bing Huang San (Bear Gallstone and Borneol Powder) into the throat. If throat Bi extends to mouth and tongue, causing ulcers and erosions, apply Liu Huang San (Willow Yellow Powder). For Yin-Fire flaming upward, without consumptive disease, sudden hoarseness with phlegm-cough, after 2-3 doses of Qing Fei San Huo Tang, use Zi Shui Kai Yin Tang (Nourish Water Open Yin Decoction).
(6) Throat conditions worsen on the fifth day. If within the first three days, although severe, suppuration has not formed, medicine can dissipate it. By days five or six, the affected area usually suppurates; even if it ruptures, a rotten cavity remains difficult to heal. The rotten area must use Kou Gan (Mouth Ulcer) medicine, adding Long Gu (Fossilia Ossis Mastodi) and Er Cha (Camelliae Semen), insufflated repeatedly until healed. For continuous pearl-like tonsils (Lian Zhu Ru E) and throat Bi occurring after Shang Han (Cold Damage), treatment is generally hopeless, except for treatments by Master Zhang. Nuchal rigidity, eyes rolling upward, and cessation of breath are untreatable. Throat pain appearing for 1-2 days may not present with chills/fever, indicating mild illness. By the third day, severe symptoms must appear, accompanied by chills and fever; one must ask about urination and defecation. If both are free, the condition is merely floating Fire attacking the throat, and clearing wind, clearing heat, and descending fire medications will cure it quickly. If urination and defecation are blocked, there is internal Excess Fire; unless using fire-descending and detoxifying agents combined with bowel-opening medicines, how can Fire be drained and the disease resolved? Thus, conditions vary in severity, and diseases in urgency. One must ask if there is headache; if yes, it is a difficult-to-treat Shang Han condition. [E's Note: Adding much Long Gu and Er Cha is not appropriate; if internal Heat-Toxicity is not cleared, rivers are prone to bursting.]
(7) Although throat conditions are fierce, if swelling manifests externally, even if critical signs are seen, treatment yields easy recovery.
(8) Swelling in the Emperor region (likely referring to specific anatomical area or typo for 'Di Zhong' - central throat), though a severe condition with difficulty inhaling, heals quickly with prompt treatment; delay makes it severe. Throat conditions can only hope for recovery after bowel movement; if stool is constipated, recovery cannot be lightly promised. [E's Note: This implies unblocking the lower pathway to allow Heaven Qi (upper Qi) to descend, akin to removing firewood from under the cauldron. There are also cases where bowels are open but Deficient Yang rebels upward, causing extreme swelling and pain; nourishing Yin and clearing transformation, the method for treating Bai Hou (White Throat/Diphtheria), applies here.]
(9) For early-stage throat conditions with constipation, use Da Huang and Yuan Ming Fen (Mirabilite), combined with exterior-interior releasing agents to purge, thereby descending Fire and facilitating recovery. If after five or six days of fasting, stool is blocked, this is due to prolonged illness depleting Stomach Qi and Yuan Qi; Xiao (Mirabilite) and Huang (Da Huang) are forbidden. Do not recklessly administer aggressive purgatives to avoid collapse and death. To relieve constipation, only nourish Yin, descend Fire, and use honey suppositories or similar lubricating laxatives; this is a secret method. If using Xiao and Huang, diagnose the pulse; if forceful, purge accordingly. [E's Note: If the Right Guan position is deep, solid, and forceful, or slippery and rapid beating against the finger, purging is applicable.] (Jinghua's Note: For Wind-Fire throat conditions, at the stage of throat closure, Qi and Blood must be stagnant, and the pulse must be deep and choppy; do not mistake this for weakness. At this time, rely on symptoms rather than pulse; assess the presence of Stomach Qi. If Stomach Qi remains, purging is indicated.)
(10) For throat condition insufflation, the powder must directly face the entire throat circumference. Insufflate heavily 4-5 tubes to reduce toxic phlegm; after 3-4 times, use decoction.
(11) For throat conditions that have already ulcerated, insufflate flesh-regenerating medicine to cover the broken area, then frequently insufflate various powders until swelling subsides.
(12) Throat conditions swell and hurt on days 1-2, stabilize with defined shape on days 3-4. If chills/fever or headache recur every third day, constant insufflation can alleviate it; knowing this indicates life/death hangs in the balance for a few days. (Jinghua's Note: For women with throat swelling/pain where menstruation has just stopped, and Fire cannot descend downward, regulating the menses allows the throat to heal spontaneously.) [E's Note: This is what is called "Heat entering the Blood Chamber"; it is not exclusive to throat conditions. Shang Han and Warm Diseases also present this syndrome; clearing the Ying (Nutrient) level cures it.]
(13) For fierce throat conditions, if head and face swell, appearing white and lustrous without radiance, and the pulse is deep, thin, and spiritless, this is Spirit Qi leaking outward, a condition devoid of Yang; it is absolutely untreatable. If the face shows redness and swelling, and the pulse is surging, large, and forceful, although the condition is extremely severe, Yuan Qi is still strong, and although Toxic Fire is flourishing, treatment yields easy recovery.
(14) Cheeks easily swell and rot; bind silk cotton to chopsticks, dip in water, and gently stir the affected area. If painful, medication will surely cure it. If there is no sensation of pain, it is dead flesh, difficult to heal.
(15) For tongue swelling filling the mouth, protruding outside, making it difficult to administer medicine, use Kai Guan San (Open Gate Powder) insufflated into the nose; the jaw will open naturally, and phlegm/saliva will discharge. Then, wrap cotton around chopsticks, dip in Gan Cao Tang (Licorice Decoction), moisten lips, then administer Dan/San (powders), insufflating frequently until healed.
(16) Insufflation is not only for swollen/ruptured areas but also for surrounding healthy flesh, to prevent spread and facilitate healing. For mouth/tongue conditions, if after insufflation the tongue has no saliva or resembles a dried orange peel, it is untreatable.
(17) Mouth/tongue erosion without bleeding is untreatable. Perforation through the cheek is untreatable. Rot extending to the nasal bridge with red spots is untreatable. Only Master Zhang treats these. For enlarged tongue, apply raw Huang Bai (Phellodendri Cortex) with Bing Pian (Borneolum Syntheticum). If bleeding occurs, use fried Huang Bai and Bing Pian; this is a wonderful method.
(18) For HT (likely typo for specific term, possibly 'Hou' Throat) Tongue-Throat Abscess, if constipated, add Yuan Ming Fen and Da Huang to decoction. If urination is blocked, mix Liu Yi San (Six-to-One Powder) and take orally; very effective, this is a core method.
(19) For Tooth-Biting Abscess, gum tissue swells and protrudes, jaw locks tightly, mouth cannot open. First, prepare Gan Suan San (Sweet Spiderwort Powder) mixed with a little Ba Dou (Crotonis Fructus), insufflate into gums. Use a tongue depressor to slowly pry open the jaw, frequently insufflating medication until healed.
(20) For Kou Gan (Mouth Ulcers), gently stir with silk cotton; never use blue cloth, lest it injure the affected area and hinder healing. Medications should be pungent and dispersing, finely ground. Storage must prevent gas escape; sealing the bottle mouth tightly with Wu Jin Zhi (Black Gold Paper) is best. Any medicinal ingredients not processed by fire should be sun-dried until crisp and powdered for use.