喉痹者，咽喉肿塞痹痛，水浆不得入是也。由脾肺不利，蕴积热毒，而复遇暴寒折之，
热为
寒闭，气不得通，结于喉间。其症发热恶寒，喘塞胀闷，不急治杀人，针刺出血，搐鼻吐痰
，皆急法也。
文潞公喉肿咽痛，喉科治之，三日愈甚。上召孙兆治之，孙曰∶疾得相公书判笔一管，
去笔
头，沾水点药入喉，便愈。孙随便刺，相公昏仆不省人事，左右皆惊愕流汗。孙乃笑曰∶非
我不能救相公。须臾呕出脓血升余，旬日乃平复如故。予尝治一男子喉痹，于太 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，取痰不愈，次取污血也。（娄全善《纲
目》。）火郁则发之，即发散之意也，血出多则愈。有针疮者，姜汁调熟水时时呷之。
治急喉痛，于大指外边指甲根齐针之，不问男左女右，只用人家常使针针之，令出血即
效。如大段危急，两手大指多针之甚妙。（《夷坚志》）
挑背法，于暗室中，用红纸条点火照背上，隐隐有红点，用针挑破，喉痹将死者，破尽
即苏。
元公章少卿，述闻德府士人，携仆入京。其一患喉闭胀满，气喘塞不通，命在须臾。询
诸郡
人云∶惟马行街山水李家可看治。即与之往。李骇曰∶此症甚危，犹幸来此，不然死耳。乃
于笥中取一纸捻，用火点着半，烟起吹灭之，令仆张口，刺于喉间，俄吐出紫血半合，实时
气宽能言，及啖粥，掺药敷之立愈。士人甚神其术。后还乡里，村落一医，偶传得此法，云
∶咽喉病发于六腑者，如引手可探及，刺破瘀血即已。若发于五脏，则受毒牢深，手法药力
难到，惟用纸捻为第一。然不言所以用之之意。后有人拾得其残者，盖预以巴豆油涂纸，故
施火即着，藉其毒瓦斯，径赴病处以破其毒也。牙关紧闭者，以烟熏入鼻中，实时口鼻涎流，
牙关自开。（《医说》）
周密《齐东野语》云∶密过南浦，有老医授治喉痹垂死方，用真鸭嘴胆矾为末，醋调灌
之，
大吐胶痰数升即瘥。临汀一老兵妻，苦此绝水粒三日矣，如法用之即瘥。屡用无不效验，神
方也。《济生方》用胆矾二钱半，白僵蚕炒，五钱，研，每以少许吹之吐涎，各二圣散。
孙兆治潘元从急喉痹，以药半钱，吹入喉中，少顷吐出脓血立愈。潘谢曰∶非明公不能
救，
赠金百两，愿求其方。孙曰∶猪牙皂、白矾、黄连等分，瓦上焙为末耳。既授方，不受所赠
。
解毒雄黄丸
雄黄 郁金（各一分） 巴豆（去皮油，十四粒）
细末，醋糊丸绿豆大，茶清下七丸，吐出顽痰立苏。水浆不得入口者，醋磨灌喉取吐，
未吐再服。丹溪云∶姜汁僵蚕末，治咽痛喉痹神效。
喉痹吹药
白矾末一钱，同巴豆一粒同炒，去巴豆，取矾研细末吹之，即吐浊痰，名碧云散。再入
轻粉、麝香少许，名粉香散。吹乳蛾即开。
玉锁匙
焰硝（七钱半） 硼砂（二钱半） 白僵蚕（一钱二分半） 龙脑（一字）
为末，以竹管吹五分，入喉中神效。（《直指》）
搐鼻透关散
雄黄（研） 猪牙皂荚（蜜炙，去皮） 藜芦（各一分）
上为末，每用一匙，分弹入两鼻中，关透即瘥。
凡人患喉闭及缠喉风，用药开得咽喉，可通汤水，急吸薄粥半碗或一碗，压下余热，不
尔即
病再来，不可不知也。咽喉既可，身热头痛不止，此感外邪，看脉气及大小便。有表症则发
散，有里症则微下之皆愈。愈后虚喘而身不热者，必是服凉药过多而下虚也。当服镇重温药
一服，如黑锡、正元之类，以粥压之。
冰梅丸 治喉风肿痛如神。
天南星（三十个） 大半夏 白矾 白盐 防风 朴硝（各四两） 桔梗（二两） 甘草（一
两） 大梅实（拣七分熟者一百个）
先将硝盐水浸一伏时，然后将各药研碎，入水拌匀，方将梅实置于水，淹过三指为度。
浸七
日，取出晒干，又入水中，浸透晒干，俟药水干为度。方将梅子入磁罐封密，如霜衣白，愈
佳。用时绵裹噙口中，徐徐咽汁下，痰出即愈。
时行喉痛，宜用普济消毒饮子。
神效散 治喉痹语声不出，猪牙皂角和霜梅为末噙之。急喉痹其声鼾者，有如痰
在喉
响，此为肺绝之候。宜用人参膏救之。用竹沥、姜汁放开，频频服之。如未得参膏，独参汤
亦得。早者十全七八，次则十全四，迟则十不全一也。
烂喉痧方（笔友张瑞符传）
西牛黄（五厘） 冰片（三厘） 真珠（三分） 人指甲（五厘，男病用女，女病用男） 象牙
屑（
三分，焙） 壁钱（二十个，焙，土壁砖上者可用，木板上者不可用） 青黛（六分，去灰脚净
）
共为极细末，吹患处效。
笔友张瑞符，湖州府人也，予往来二十年矣。其为人也，敦浓和平，年过五旬，并未生
育，
虽置外家亦终不得怀孕。忽一日遇李相士，即道喜云∶尔当生子矣。李乃张之同乡友也。张错
愕曰∶我半生已来，并未生育，尔何得相戏若此。李曰∶我昔年曾看尔相，许尔无子。今尔
阴骘纹已满面，岂无子之相。后果如其言。予因问张曰∶尔一生如何为善？张曰∶生平并未
有善，只有两事，亦人所当为者也。一舍弟早亡，所遗一子，我抚养长大。而舍弟所有主顾
，我已相与二十年矣。舍侄既长，我使之去，彼不愿。我曰∶尔在我处，我甚有益。但尔不
去，终身只作店伙，我所不忍，今于尔笔，同往各主顾家，相致曰∶此即我舍弟某之子也，
今已长，可仍用其笔。况此子自幼在我店习业，彼之笔即我之笔也。又此方甚效，我所不秘
，余亦无所为。予曰∶只此可称善矣。有侄少孤，抚之成立，并使其能继父业；有急救之方
而公之于世，善莫大焉。予得是方，并述其始末云尔。（鹤年。）
喉痹，是指咽喉肿胀堵塞、痹阻疼痛，导致饮食水浆无法咽下的病症。这是由于脾肺功能失调，热毒蕴积在内，又突然遭遇寒邪遏制，热气被寒气闭郁，气机不得通畅，结聚于咽喉之间。其症状表现为发热恶寒，气喘胸闷胀满，若不及时治疗会危及生命。针刺放血、搐鼻催吐痰涎，都是紧急的处理方法。
文潞公（文彦博）曾患喉肿咽痛，请喉科医生治疗，三天后病情反而加重。皇帝召孙兆来诊治。孙兆说：“只要得到宰相大人的一管书信判笔，去掉笔头，蘸水沾药点入喉中，病就会好。”孙兆随即进行针刺，相公昏倒不省人事，左右侍从都惊恐流汗。孙兆笑着说：“不是我不能救相公，只是需要一点时间。”片刻之后，相公呕出脓血一升多，十天便完全康复如初。我曾经治疗一名男子患喉痹，在少商穴针刺放出半盏黑血而痊愈。由此看来，喉痹是因为恶血不散造成的。
凡是治疗这种病，急暴发作的必须先发散表邪；发散后未愈，接着要祛除痰涎；祛痰后未愈，接着要清除污血。（娄全善《本草纲目》引语。）火郁结则用发散法，这就是发散的意思，出血多则病愈。如果有针孔疮口，用姜汁调熟水时时含漱。
治疗急性喉痛，在大拇指外侧指甲根部齐平处针刺，不论男女左侧还是右侧，只需用家常用的针针刺，令其出血即见效。如果情况非常危急，双手大拇指多刺几处效果更佳。（《夷坚志》）
挑背法：在暗室中，用红纸条点火照背部，隐约可见红点，用针挑破，喉痹濒临死亡者，挑破后即可苏醒。
元朝章少卿叙述，听说德府一位士人带着仆人进京。其中一人患喉闭胀满，气喘堵塞不通，命在旦夕。询问当地人说：“只有马行街山水李家可以诊治。”于是带他去见李医生。李医生惊骇地说：“这症候非常危险，幸好来了这里，否则必死无疑。”于是从箱中取出一纸捻，点燃一半，冒烟时吹灭，让仆人张口，刺入喉间，不久吐出紫血半合，顿时气息宽畅能说话，随后喝粥，敷上药物立即痊愈。士人觉得他的医术很神奇。后来回到家乡，村里一个医生偶然传得此法，说：“咽喉病发于六腑的，如伸手可探及之处，刺破瘀血即可治愈。若发于五脏，则受毒深重，手法和药力难到达，只有用纸捻作为第一选择。”然而没有说明使用它的原因。后来有人拾到残存的纸捻，发现预先用巴豆油涂抹过纸张，所以遇火即着，借助其毒气，直达病处以破除毒邪。牙关紧闭者，用烟熏入鼻中，立刻口鼻流涎，牙关自然张开。（《医说》）
周密《齐东野语》记载：我经过南浦，有一位老医生传授治疗濒死喉痹的方子，用真鸭嘴胆矾研为末，醋调灌服，大吐胶痰数升即痊愈。临汀一位老兵的妻子，苦于此病绝食三日，按此法使用即痊愈。屡用无不灵验，是神方。《济生方》用胆矾二钱半，白僵蚕炒制五钱，研细，每次取少许吹入喉中催吐涎液，名为各圣散。
孙兆治疗潘元从的急喉痹，用药半钱，吹入喉中，片刻后吐出脓血立即痊愈。潘元从感谢说：“不是明公不能救我，赠送黄金百两，希望能求得这个方子。”孙兆说：“不过是猪牙皂、白矾、黄连等分，在瓦上焙干研为末罢了。”既已授方，不接受所赠黄金。
解毒雄黄丸：雄黄、郁金（各一分），巴豆（去皮去油，十四粒）。研为极细末，醋糊丸如绿豆大，茶清送服七丸，吐出顽痰立即苏醒。水浆不能入口者，用醋磨药灌喉取吐，未吐再服。丹溪说：姜汁拌僵蚕末，治疗咽痛喉痹神效。
喉痹吹药：白矾末一钱，同巴豆一粒同炒，去巴豆，取矾研细末吹之，即吐浊痰，名碧云散。再加入轻粉、麝香少许，名粉香散。吹治乳蛾即开。
玉锁匙：焰硝（七钱半），硼砂（二钱半），白僵蚕（一钱二分半），龙脑（一字）。研为末，以竹管吹五分入喉中，神效。（《直指方》）
搐鼻透关散：雄黄（研），猪牙皂荚（蜜炙去皮），藜芦（各一分）。上为末，每用一匙，分弹入两鼻中，关窍通透即愈。
凡人患喉闭及缠喉风，用药开通咽喉，可通汤水，急吸薄粥半碗或一碗，压下余热，不然病会再来，不可不知。咽喉既通，身热头痛不止，这是感受外邪，看脉象及大小便。有表症则发散，有里症则微下之皆愈。愈后虚喘而身不热者，必然是服凉药过多导致下虚。当服镇重温药一服，如黑锡丹、正元散之类，以粥压之。
冰梅丸：治疗喉风肿痛如神。天南星（三十个），大半夏，白矾，白盐，防风，朴硝（各四两），桔梗（二两），甘草（一两），大梅实（拣七分熟者一百个）。先将硝盐水浸泡一昼夜，然后将各药研碎，入水拌匀，再将梅实置于水中，淹过三指为度。浸泡七日，取出晒干，又入水中浸透晒干，待药水干为止。然后将梅子入磁罐密封，如霜衣白色，更好。用时绵裹噙口中，徐徐咽汁下，痰出即愈。
时行喉痛，宜用普济消毒饮子。
神效散：治疗喉痹语声不出，猪牙皂角和霜梅为末噙之。急喉痹其声鼾者，有如痰在喉响，此为肺绝之候。宜用人参膏救之。用竹沥、姜汁放开，频频服之。如未得参膏，独参汤亦得。早者十全七八，次则十全四，迟则十不全一也。
烂喉痧方（笔友张瑞符传）：西牛黄（五厘），冰片（三厘），真珠（三分），人指甲（五厘，男病用女，女病用男），象牙屑（三分，焙），壁钱（二十个，焙，土壁砖上者可用，木板上者不可用），青黛（六分，去灰脚净）。共为极细末，吹患处效。
笔友张瑞符，湖州府人也，予往来二十年矣。其为人也，敦浓和平，年过五旬，并未生育，虽置外家亦终不得怀孕。忽一日遇李相士，即道喜云：“尔当生子矣。”李乃张之同乡友也。张错愕曰：“我半生已来，并未生育，尔何得相戏若此。”李曰：“我昔年曾看尔相，许尔无子。今尔阴骘纹已满面，岂无子之相。”后果如其言。予因问张曰：“尔一生如何为善？”张曰：“生平并未有善，只有两事，亦人所当为者也。一舍弟早亡，所遗一子，我抚养长大。而舍弟所有主顾，我已相与二十年矣。舍侄既长，我使之去，彼不愿。我曰：‘尔在我处，我甚有益。但尔不去，终身只作店伙，我所不忍，今于尔笔，同往各主顾家，相致曰：此即我舍弟某之子也，今已长，可仍用其笔。况此子自幼在我店习业，彼之笔即我之笔也。’又此方甚效，我所不秘，余亦无所为。”予曰：“只此可称善矣。有侄少孤，抚之成立，并使其能继父业；有急救之方而公之于世，善莫大焉。”予得是方，并述其始末云尔。（鹤年。）
Throat Bi (throat obstruction) refers to a condition characterized by swelling and blockage of the throat, bi-syndrome pain, and inability to swallow food or fluids. It arises from dysfunction of the Spleen and Lung, with accumulation of heat-toxin internally, compounded by sudden exposure to cold pathogen which constrains the heat. The heat is closed by the cold, Qi mechanism fails to circulate freely, and stagnates in the throat. Symptoms include fever and aversion to cold, wheezing, chest tightness, and distension. If not treated urgently, it can be fatal. Acupuncture bloodletting and nasal insufflation to induce vomiting of phlegm are emergency treatments.
Lord Wen (Wen Yanbo) once suffered from throat swelling and pain. Throat specialists treated him for three days, but the condition worsened. The Emperor summoned Sun Zhao for treatment. Sun Zhao said, "Obtain one of the Chancellor's letter-writing pens, remove the tip, dip it in water with medicine, and apply it into the throat; the disease will heal." Sun Zhao proceeded with acupuncture. The Chancellor fainted and lost consciousness, causing his attendants to panic and sweat. Sun Zhao smiled and said, "It is not that I cannot save the Chancellor, but time is needed." After a moment, the Chancellor vomited more than one sheng of pus and blood, and recovered completely after ten days. I once treated a man with throat Bi, pricking the Shaoshang point (LU-11) to release half a cup of dark blood, resulting in recovery. Thus, throat Bi is caused by the failure of evil blood to disperse.
In treating this disease, acute cases must first be addressed with dispersing methods. If dispersal fails, then resolve phlegm. If resolving phlegm fails, then remove stagnant blood. (Lou Quanshan, citing *Bencao Gangmu*.) Fire depression requires dispersal, which implies releasing the exterior; significant bleeding leads to cure. For needle wounds, rinse frequently with ginger juice mixed with warm water.
For acute sore throat, prick the outer corner of the thumbnail at the nail root level. Regardless of gender or side, use a common household needle to prick until blood flows for immediate effect. In critical cases, pricking both thumbs multiple times is excellent. (*Yijian Zhi*)
Back-picking method: In a dark room, light a red paper strip and shine it on the back. Faint red spots will appear. Pick these spots with a needle. Patients near death from throat Bi will revive once all spots are picked.
Vice Minister Yuan Zhang narrated that a scholar from De Prefecture brought his servant to the capital. The servant suffered from throat closure with distension, wheezing, and blockage, facing imminent death. Locals advised seeking treatment from Master Li at Shanshui Street. Master Li exclaimed, "This condition is critical; fortunately, you came here, otherwise he would have died." He took a paper twist from a box, lit half of it, blew out the flame when smoke rose, had the servant open his mouth, and pierced the throat. Soon, half a ge of purple blood was expelled. Breath immediately eased, speech returned, and after eating porridge and applying medication, he healed instantly. The scholar marveled at the skill. Later, a village doctor learned this method, stating: "Throat diseases originating in the Six Fu organs are accessible to hand manipulation; piercing stasis cures them. Those originating in the Five Zang organs involve deep toxin penetration where manual and medicinal force is insufficient; only paper twists are effective." However, the reason was not explained. Someone found a discarded twist and discovered it was pre-coated with croton oil, igniting easily to deliver toxic vapors directly to the lesion to break the toxicity. For trismus (lockjaw), smoke is insufflated into the nose, causing salivation and opening the jaw. (*Yi Shuo*)
Zhou Mi's *Qidong Yeyu* records: Passing Nanpu, an old physician taught me a formula for dying throat Bi. Use real duck-bill alum (Danfan) powdered, mixed with vinegar and灌ed. Profuse vomiting of gelatinous phlegm for several sheng results in cure. A veteran's wife in Linting suffered from this, abstaining from food and water for three days. Using this method cured her. It proved effective repeatedly, a divine prescription. *Jisheng Fang* uses 2.5 qian of Danfan and 5 qian of stir-fried White Silkworm (Bai Jiangcan), ground fine. Insufflate a small amount to induce salivary vomiting, named Ge Sheng San.
Sun Zhao treated Pan Yuancun's acute throat Bi by insufflating half a qian of medicine into the throat. Moments later, pus and blood were vomited, and he recovered instantly. Pan thanked him, offering 100 taels of gold for the formula. Sun Zhao replied, "It is merely equal parts of Pig Tooth Soapberry (Zhuya Zaorou), Alum (Baifan), and Coptis (Huanglian), roasted on tile and ground." He gave the formula but refused the gift.
Jiedu Xionghuang Wan (Detoxifying Realgar Pill): Realgar (Xionghuang) and Curcuma (Yujin) (1 fen each), Croton Seed (Badou) (peeled, oil removed, 14 seeds). Grind to fine powder, make pills with vinegar paste size of mung beans. Take 7 pills with clear tea broth to expel stubborn phlegm and restore consciousness. If unable to swallow liquids, grind medicine with vinegar and灌 into throat to induce vomiting; repeat if no vomiting occurs. Danxi stated: Ginger juice mixed with Silkworm powder is miraculous for sore throat and Bi.
Throat Bi Insufflation Powder: 1 qian Alum (Baifan) powder stir-fried with 1 Croton seed; discard Croton, grind Alum fine and insufflate to expel turbid phlegm, named Biyun San. Add a little Calomel (Qingfen) and Musk (Shexiang), named Fenxiang San. Effective for tonsillar abscess (Ru'e).
Yusuo Chi (Jade Lock Key): Saltpeter (Yanxiao) (7.5 qian), Borax (Pengsha) (2.5 qian), White Silkworm (Bai Jiangcan) (1.25 qian), Borneol (Longnao) (1 zi). Grind to powder. Insufflate 0.5 fen via bamboo tube into throat for miraculous effect. (*Zhizhi Fang*)
Chubi Touguan San (Nasal Insufflation to Open Orifices Powder): Realgar (Xionghuang) (ground), Honey-roasted Pig Tooth Soapberry (Zhuya Zaorou) (peeled), Veratrum (Lilu) (1 fen each). Grind to powder. Use one spoonful, flick into both nostrils. Once orifices open, cure follows.
When suffering from throat closure or winding throat wind, after medicine opens the throat allowing liquid intake, urgently drink half or one bowl of thin porridge to suppress residual heat; otherwise, the disease may return. This must be known. If throat opens but fever and headache persist, it indicates external pathogen invasion. Examine pulse and urination/defecation. If exterior syndrome exists, disperse; if interior syndrome exists, mildly purge. Both lead to cure. Post-recovery, if panting is empty and body is not hot, it is due to excessive cooling medicines causing deficiency below. Administer one dose of sedating and warming medicine, such as Heixi Dan or Zhengyuan San, suppressed with porridge.
Bingmei Wan (Ice Plum Pill): Treats throat wind swelling and pain miraculously. Arisaema (Tian Nanxing) (30 pieces), Pinellia (Ban Xia), Alum (Baifan), Salt (Bai Yan), Saposhnikovia (Fangfeng), Mirabilite (Puxiao) (4 liang each), Platycodon (Jiegeng) (2 liang), Licorice (Gancao) (1 liang), Large Plums (Meizi) (100 pieces, 70% ripe). Soak in nitrate-salt water for one day and night. Grind herbs, mix with water. Place plums in water, covering by three fingers' width. Soak for seven days, sun-dry, soak again, dry again until liquid evaporates. Seal plums in ceramic jar. Frost-like white coating is ideal. Wrap in silk, hold in mouth, slowly swallow juice. Phlegm expulsion brings cure.
For epidemic sore throat, use Puji Xiaodu Yinzi.
Shenxiao San: Treats throat Bi with loss of voice. Grind Soapberry (Zaorou) and frost-plum into powder, hold in mouth. For acute throat Bi with snoring sound, resembling phlegm rattling in throat, this indicates Lung exhaustion. Rescue with Ginseng Paste (Renshen Gao). Use Bamboo Juice (Zhuli) and Ginger Juice (Jiangzhi) to open orifices, administer frequently. If Ginseng Paste unavailable, Single Ginseng Decoction works. Early treatment yields 70-80% cure; moderate yields 40%; late yields less than 10%.
Lanhou Sha Formula (Transmitted by friend Zhang Ruifu): Buffalo Realgar (Xi Niu Huang) (5 li), Borneol (Bingpian) (3 li), Pearl (Zhenzhu) (3 fen), Human Nail (Ren Zhijia) (5 li, female nail for male patient, male for female), Ivory Dust (Xiangya Xie) (3 fen, roasted), Spider Web Sac (Bi Qian) (20 sacs, roasted, from earth walls/bricks, not wood), Indigo (Qingdai) (6 fen, purified). Grind to ultra-fine powder. Insufflate onto affected area for efficacy.
My pen friend Zhang Ruifu, from Huzhou Prefecture, I have known for twenty years. He was honest and peaceful, over fifty, childless despite having a concubine. One day, physiognomist Li congratulated him, saying, "You will have a son." Li was a fellow townsman. Zhang was bewildered, "I have never sired children, why joke?" Li said, "I read your face before, predicting no sons. Now your merit lines cover your face; how could you remain childless?" It came true. I asked Zhang how he did good deeds. Zhang said, "None, except two duties. My younger brother died early, leaving a son whom I raised. I managed his business clients for twenty years. When the nephew grew up, I urged him to leave, but he refused. I said, 'You benefit me greatly here. But staying makes you a mere clerk forever, which I cannot bear. Take my seal/stamp, visit all clients, say: This is my brother's son, now grown, continue using his credentials. He apprenticed here since childhood; his stamp is mine.' Also, this formula is effective; I do not hide it, nor seek profit." I said, "This is truly good. Raising an orphan nephew to succeed his father's trade; sharing a life-saving formula publicly—no greater good." I obtained this formula and recorded its origin. (He Nian.)