治咽喉肿疼。
大生地黄（一两，切片） 蓬砂（钱半，研细）
将生地黄一片，裹蓬砂少许，徐徐嚼细咽之，半日许宜将药服完。
生地黄之性能滋阴清火，无论虚热实热服之皆宜。蓬砂能润肺，清热化痰，消肿止疼。二药并用，功力甚
大。而又必细细嚼服者，因其病在上，煎汤顿服，恐其力下趋，而病转不愈。且细细嚼咽，则药之津液常清润
患处也。此方愚用之屡矣，随手奏效
者不胜纪矣。
咽喉之证，有热有凉，有外感有内伤。《白喉忌表抉微》一书，此时盛行于世。其所载之方，与所载宜
用、宜忌之药，皆属稳善。惟其持论，与方中所用之药，有自相矛盾处。谆谆言忌表矣，而其养阴清肺汤，用
薄荷二钱半，岂非表药乎？至于他方中，所用之葛根、连翘亦发表之品也。盖白喉之证，原亦温病之类。人之
外肤肺主之，人之内肤三焦主之。盖此证心肺先有蕴热，外感之邪又袭三焦，而内逼心肺。则心肺之热，遂与
邪气上并，而现证于喉。既有外邪，原宜发表，因有内热，实大忌用辛热之药发表。惟薄荷、连翘诸药，辛凉
宣通，复与大队凉润之药并用，既能散邪，尤能清热，所以服之辄效也。若其内热炽盛，外感原甚轻者，其养
阴清肺汤亦可用，特其薄荷，宜斟酌少用，不必定用二钱半也。至谓其喉间肿甚者加 石膏四钱，微有可议。
夫石膏之性，生则散、 则敛。炽盛之火散之则消，敛之则实，此又不可不知也。况石膏生用，原不甚凉，
故《神农本草经》谓微寒，又何必如此之小心乎。今将其养阴清肺汤，详录于下，以备采用。
【附方】养阴清肺汤 大生地一两、寸麦冬六钱、生白芍四钱、薄荷二钱半、玄参八钱、丹皮四
钱、贝母四钱、生甘草二钱。喉间肿甚者，加生石膏（原用 石膏）四钱。大便燥结者，加清宁丸二钱、玄明
粉二钱。胸下胀闷，加神曲、焦山楂各二钱。小便短赤者，加木通、泽泻各一钱，知母二钱。燥渴者，加天冬、
马兜铃各三钱。面赤身热，或舌苔黄色者，加金银花四钱，连翘二钱。
白喉之证，间有服《白喉忌表抉微》诸方不效，而反加剧者。曾治一贵州人，孙××，年二十，得白喉
证。屡经医治，不外《白喉忌表抉微》诸方加减。病日增重，医者诿谓不治。后愚为诊视，其脉细弱而数，粘
涎甚多，须臾满口，即得吐出。知系脾
肾两虚，肾虚气化不摄，则阴火上逆，痰水上泛。而脾土虚损，又不能制之（若脾土不虚，不但能制痰水上泛，
并能制阴火上逆），故其咽喉肿疼，粘涎若是之多也。投以六味地黄汤，加于术，又少加苏子，连服十剂全愈。
咽喉之证，热者居多。然亦兼有寒者，不可不知。王洪绪曰∶“咽喉之间，素分毫无病，顷刻之间，或
疼或闷，此系虚寒阴火之证。用肉桂、炮姜、甘草各五分，置碗内浸以滚水，仍将碗置于滚水中，饮药一口，
徐徐咽下立愈。或用乌附之片，涂以鲜蜜，火炙透至黑，取一片口含咽津，至片不甜时，再换一片，亦立愈。”
按王氏之说，咽喉陡然疼闷者，皆系因寒。然亦有因热者，或其人素有蕴热，陡然为外感所束，或劳碌过度，
或暴怒过度，皆能使咽喉骤觉疼闷。斯在临证者，于其人之身体、性情、动作之际，细心考验，再参以脉象之
虚实凉热，自无差谬。若仍恐审证不确，察其病因似寒，而尤恐病因是热，可用蜜炙附子片试含一片，以细验
其病之进退亦可。
赵晴初曰∶鸡蛋能去喉中之风。余治一幼童喉风证，与清轻甘凉法，稍加辛药，时止时发。后有人教服
鸡蛋，顶上针一孔，每日生吞一枚，不及十枚，病愈不复发。
友人齐××曰∶平阳何××患喉疼，医者治以苦寒之药，愈治愈甚，渐至舌硬。后有人教用棉子油煎生鸡蛋，
煎至外熟，里仍微生，日服二枚，未十日遂大愈。
咽喉肿疼证，有外治异功散方甚效。其方用斑蝥一钱，真血竭、制乳香、制没药、上麝香、全蝎、大玄
参、上梅片各分半，将斑蝥去翅足，糯米拌炒，以米色微黄为度，去糯米。用诸药共研细，瓶收贮，勿令透气。
遇有咽喉肿疼证，将药捏作小块，如黄豆粒大，置在小膏药上，左肿贴右，右肿贴左，若左右俱肿，均贴在结
喉（项间高骨）旁边软处。阅五六时，即揭去膏药，有水泡，用银针挑破，拭净毒水，能消肿止疼，真救急之良方也。
Treatment for swelling and pain of the throat.
Sheng Di Huang (Rehmanniae Radix, 1 liang, sliced) Peng Sha (Borax, 1 qian 5 fen, finely ground).
Take one slice of Sheng Di Huang, wrap a small amount of Peng Sha in it, chew it slowly until fine, and swallow. The medicine should be taken within about half a day.
The nature and function of Sheng Di Huang is to nourish Yin and clear fire; it is suitable for both deficiency heat and excess heat. Peng Sha can moisten the lungs, clear heat, resolve phlegm, reduce swelling, and relieve pain. The combined use of these two herbs has great efficacy. Moreover, they must be chewed slowly because the disease is located in the upper part; if decocted and taken as a liquid, the medicinal force may tend downward, and the disease might not heal. Furthermore, chewing and swallowing slowly allows the fluid of the medicine to constantly moisten and clear the affected area. I have used this prescription many times, and cases where it took effect immediately are too numerous to record.
Throat disorders involve heat or cold, external contraction or internal injury. The book *Bai Hou Ji Biao Jue Wei* (Clarifying the Subtleties of Avoiding Exterior-Resolving Methods for White Diphtheria) was widely popular at that time. The prescriptions recorded in it, along with the indications and contraindications for herbs, were all considered stable and beneficial. However, its theoretical arguments contradicted the herbs used in the prescriptions. It earnestly warned against exterior-resolving methods, yet its Yang Yin Qing Fei Tang (Nourishing Yin and Clearing Lung Decoction) used 2 qian 5 fen of Bo He (Menthae Haplocalycis Herba), which is clearly an exterior-resolving herb? As for other prescriptions, Ge Gen (Puerariae Lobatae Radix) and Lian Qiao (Forsythiae Fructus) used therein are also exterior-resolving agents. Essentially, Bai Hou (White Diphtheria) belongs to the category of Warm Diseases. The human exterior skin is governed by the Lung, while the interior skin is governed by the San Jiao (Triple Burner). In this condition, there is initially accumulated heat in the Heart and Lung; external pathogenic factors attack the San Jiao and then press inward toward the Heart and Lung. Consequently, the heat in the Heart and Lung merges upward with the pathogenic factors, manifesting symptoms in the throat. Since there is an external pathogen, exterior resolution is originally indicated, but due to internal heat, it is strictly contraindicated to use acrid-warm herbs for exterior resolution. Only herbs like Bo He and Lian Qiao, which are acrid-cool and unblocking, when used in conjunction with a large group of cooling-moistening herbs, can both disperse pathogens and especially clear heat, thus yielding immediate effects. If internal heat is blazing and the external contraction is very mild, Yang Yin Qing Fei Tang can still be used, but the Bo He should be used sparingly after deliberation, not necessarily fixed at 2 qian 5 fen. Regarding the addition of Shi Gao (Gypsum Fibrosum) 4 qian for severe throat swelling, there is some room for discussion. The nature of Shi Gao: raw form disperses, calcined form astringes. Blazing fire is eliminated by dispersion but consolidated by astringency; this point must be understood. Moreover, raw Shi Gao is not inherently very cold; hence, *Shennong Bencao Jing* (Divine Farmer's Materia Medica) describes it as slightly cold. Why be so cautious? Below, I record Yang Yin Qing Fei Tang in detail for reference.
[Attached Prescription] Yang Yin Qing Fei Tang (Nourishing Yin and Clearing Lung Decoction): Da Sheng Di Huang (Rehmanniae Radix, 1 liang), Cun Mai Dong (Ophiopogonis Tuber, 6 qian), Sheng Bai Shao (Paeoniae Radix Alba, 4 qian), Bo He (Menthae Haplocalycis Herba, 2 qian 5 fen), Xuan Shen (Scrophulariae Radix, 8 qian), Dan Pi (Moutan Cortex, 4 qian), Bei Mu (Fritillariae Bulbus, 4 qian), Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 qian). For severe throat swelling, add Sheng Shi Gao (Raw Gypsum Fibrosum, 4 qian; original text used Calcined Gypsum). For dry stool constipation, add Qing Ning Wan (Qingning Pill, 2 qian) and Xuan Ming Fen (Mirabilite, 2 qian). For chest oppression and fullness, add Shen Qu (Medicated Leaven, 2 qian) and Jiao Shan Zha (Crataegi Fructus Preparata, 2 qian). For scanty dark urine, add Mu Tong (Akebiae Caulis, 1 qian), Ze Xie (Alismatis Rhizoma, 1 qian), and Zhi Mu (Anemarrhenae Rhizoma, 2 qian). For dry thirst, add Tian Dong (Asparagi Tuber, 3 qian) and Ma Dou Ling (Aristolochiae Fructus, 3 qian). For red face and body heat, or yellow tongue coating, add Jin Yin Hua (Lonicerae Japonicae Flos, 4 qian) and Lian Qiao (Forsythiae Fructus, 2 qian).
In cases of Bai Hou (White Diphtheria), occasionally prescriptions from *Bai Hou Ji Biao Jue Wei* fail and the condition worsens. I once treated a patient from Guizhou, Sun XX, aged twenty, who suffered from Bai Hou. After multiple treatments involving modifications of prescriptions from *Bai Hou Ji Biao Jue Wei*, his illness intensified daily, and physicians declared it incurable. Later, I examined him: his pulse was thin, weak, and rapid, with excessive sticky saliva filling his mouth instantly, requiring frequent spitting. This indicated deficiency of both Spleen and Kidney. Kidney deficiency led to failure of Qi transformation to control fluids, causing Yin Fire to rebel upward and Phlegm Fluids to flood. Spleen Earth deficiency failed to control this (if Spleen Earth were not deficient, it would control both flooding Phlegm and rebellious Yin Fire). Thus, his throat swelled and pained, accompanied by such abundant sticky saliva. I administered Liu Wei Di Huang Tang (Six-Ingredient Rehmannia Pill Decoction) added with Yu Zhu (Atractylodis Macrocephalae Rhizoma) and a small amount of Su Zi (Perillae Fructus). After ten doses, he recovered completely.
Most throat disorders are heat-related, but cold types exist and must be recognized. Wang Hongxu stated: "If the throat is healthy normally but suddenly becomes painful or stuffy within moments, this is a syndrome of Deficiency Cold and Yin Fire. Use Rou Gui (Cinnamomi Cortex), Pao Jiang (Zingiberis Rhizoma Preparatum), and Gan Cao (Glycyrrhizae Radix et Rhizoma), each 5 fen. Soak them in boiling water in a bowl, place the bowl in boiling water again, take one sip of the medicine, and swallow slowly for immediate relief. Alternatively, use slices of Wu Tou (Aconiti Lateralis Radix Preparata) or Fu Zi (Aconiti Lateralis Radix Preparata), coat with fresh honey, roast thoroughly until black. Take one slice, hold in the mouth to swallow saliva. When it loses sweetness, replace with another slice for immediate relief."
According to Mr. Wang, sudden throat pain and stuffiness are caused by cold. However, they can also be caused by heat, or by pre-existing accumulated heat suddenly constrained by external pathogens, overexertion, or extreme anger, all of which can cause sudden throat pain and stuffiness. Clinicians must carefully observe the patient's constitution, temperament, and actions, and correlate them with the pulse's deficiency/excess and cold/heat characteristics to avoid errors. If uncertainty remains regarding the differentiation, suspecting cold but fearing heat, one can try holding a piece of Honey-fried Fu Zi (Honey-processed Aconiti Lateralis Radix Preparata) to test the progression of the disease.
Zhao Qingchu said: Eggs can dispel wind from the throat. I treated a young child with Hou Feng (Throat Wind) using a light, sweet, and cool method with slight acrid herbs, resulting in intermittent remission and recurrence. Someone later advised eating eggs: pierce a hole in the top, swallow one raw egg daily. Within ten eggs, the disease cured without recurrence.
My friend Qi XX said: He XX from Pingyang suffered throat pain. Physicians treated him with bitter-cold herbs, worsening the condition until his tongue became stiff. Someone advised frying a raw egg in cottonseed oil until the outside was cooked but the inside slightly raw, taking two daily. Within ten days, he greatly improved.
For throat swelling and pain, an external treatment formula Yi Gong San (Extraordinary Efficacy Powder) is very effective. It uses Ban Mao (Mylabris, 1 qian), Zhen Xue Jie (Dragon's Blood, half fen), Zhi Ru Xiang (Processed Frankincense, half fen), Zhi Mo Yao (Processed Myrrh, half fen), Shang She Xiang (Premium Musk, half fen), Quan Xie (Scorpio, half fen), Da Xuan Shen (Large Scrophulariae Radix, half fen), and Shang Mei Pian (Premium borneolum, half fen). Remove wings and feet from Ban Mao, stir-fry with glutinous rice until the rice turns slightly yellow, then remove the rice. Grind all herbs into fine powder, store in a bottle, ensuring it is airtight. When encountering throat swelling and pain, shape the powder into small pieces the size of soybeans, place on small plasters. Apply left swelling to the right side, right swelling to the left side. If both sides swell, apply next to the Jie Hou (Adam's apple/high bone in the neck). After five to six hours, remove the plaster. If blisters form, puncture with a silver needle, wipe away toxic fluid. This reduces swelling and relieves pain, serving as an excellent emergency remedy.