【方歌】慢喉发缓体虚生，微肿咽干色淡红，或由暴怒五辛火，
或因忧思过度成。
【注】此证有因平素体虚，更兼暴怒，或过食五辛而生者；亦
有忧思太过而成者，俱属体虚者实。其发缓，其色淡，
其肿微，其咽干，舌见滑白胎，大便自利，六脉微细，
唇如矾色。若午前痛者，服补中益气汤，加以清凉，如
麦冬、黑参、桔梗、牛蒡子服之；若午后作痛、作渴，
身热足冷者，阴阳两虚也，忌用苦寒，宜少阴甘桔汤，
以宣达之；若面赤咽干不渴者，其脉必虚大，以甘露饮
服之必效。俱兼用冰硼散一钱，加灯草〔火段〕灰存性
三分，吹之立验。
方剂：甘露饮
组成：天冬（去心） 麦冬（去心）
黄芩 生地
熟地 枇杷叶（蜜炙）
石斛 枳壳（麸炒）
茵蔯蒿 甘草（各等分）
水二钟，煎八分，食后服。
【方歌】甘露饮清内热侵，面赤咽干生液津，天麦冬芩生熟地，
枇杷斛草枳茵陈。
又方：补中益气汤（见溃疡门）
少阴甘桔汤（见口部口糜）
冰硼散（见口部鹅口疮）
【方歌】喉闭肝肺火盛由，风寒相搏肿咽喉，甚则肿痛连项外，
又有酒毒当细求。
【注】此证由肝、肺火盛，复受风寒，相搏而成，咽喉肿痛，
面赤腮肿，甚则项外漫肿，喉中有块如拳，汤火难咽，
语言不出，暴起身发寒热。急刺少商穴或针合谷穴，以
开咽喉。初宜疏散，服荆防败毒散，寒热已退，即用清
咽利膈汤，兼吹紫雪散，随以姜汁漱口，以宣其热；或
用醋漱，以消积血。痰壅塞者，桐油钱探吐痰涎。若肿
发于项外，脓胀痛者，防透咽喉不可轻针，急用皂角末
吹鼻取嚏，其肿即破；或兼用皂角末醋调，厚敷项肿，
须臾即破。初肿时用生羊肉片贴之。喉闭声鼾者，肺气
将绝，急宜独参汤救之。若卒然如哑，吞吐不利，系寒
气客于会厌也，宜蜜炙附子片含之，勿咽。初、终忌用
苦寒之药，恐难消难溃。又有酒毒喉闭，由酒毒蒸于心
、脾二经，热壅咽喉，喉肿色黄，其人面赤，目睛上视
以桐油钱导吐痰涎，宜服鼠粘子解毒汤，亦用紫雪散吹
之。
方剂：鼠粘子解毒汤
组成：鼠粘子（炒，研） 桔梗
青皮 升麻
黄芩 花粉
甘草（生） 元参
栀子（生，研） 黄连
连翘（去心） 葛根
白术（土炒） 防风
生地（各等分）
水煎，食后服。
【方歌】鼠粘解毒酒毒闭，桔梗青皮能降气，升芩花粉草元参，
栀连翘葛术防地。
又方：荆防败毒散（见项部脑疽）
清咽利膈汤、桐油钱（俱见紧喉风）
紫雪散（见舌部重舌）
独参汤（见溃疡门）
[Prescription Verse] Slow throat wind (Man Hou Feng) develops slowly, arising from constitutional deficiency; there is slight swelling and dryness of the pharynx with a pale red color. It may be caused by sudden anger or the fire generated by consuming five pungent spices (Wu Xin), or it may result from excessive worry and overthinking.
[Annotation] This condition arises in individuals with pre-existing constitutional deficiency who are additionally subjected to sudden anger or excessive consumption of five pungent spices; it can also be formed by excessive worry and overthinking. All these cases belong to "deficiency with excess manifestations" (Ben Xu Biao Shi). The onset is slow, the color is pale, the swelling is slight, the pharynx is dry, the tongue coating is slippery and white, bowel movements are normal (or loose), the six pulses are faint and fine, and the lips have the color of alum. If pain occurs before noon, administer Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), adding cooling herbs such as Maidong (Ophiopogonis Radix), Heishen (Scrophulariae Radix), Jiegeng (Platycodonis Radix), and Niubangzi (Arctii Fructus). If pain and thirst occur after noon, accompanied by body heat but cold feet, this indicates deficiency of both Yin and Yang; bitter-cold herbs should be avoided. Instead, Shaoyin Ganjie Tang (Gancao and Jiegeng Decoction for Shaoyin) should be used to promote dissemination and unblocking. If there is facial redness and pharyngeal dryness without thirst, the pulse will necessarily be large and empty; administering Ganlu Yin (Sweet Dew Drink) will be effective. In all these cases, Bingpeng San (Ice and Borax Powder) one qian, mixed with three fen of preserved ash of Dengcao (Junci Medulla), should be insufflated into the throat for immediate effect.
Formula: Ganlu Yin (Sweet Dew Drink)
Composition: Tiandong (Asparagi Radix, heart removed), Maidong (Ophiopogonis Radix, heart removed), Huangqin (Scutellariae Radix), Shengdi (Rehmanniae Radix), Shudi (Rehmanniae Radix Preparata), Pipaye (Eriobotryae Folium, honey-fried), Shihu (Dendrobii Caulis), Zhiqiao (Aurantii Fructus, bran-fried), Yichen (Artemisiae Scopariae Herba), Gancao (Licorice Root, equal parts of each).
Usage: Decoct two zhong of water until reduced to eight fen, take after meals.
[Prescription Verse] Ganlu Yin clears internal heat invasion, treating facial redness and pharyngeal dryness while generating fluids; it contains Tiandong, Maidong, Huangqin, Shengdi, Shudi, Pipaye, Shihu, Gancao, Zhiqiao, and Yichen.
Alternative Formulas:
Buzhong Yiqi Tang (See Chapter on Ulcers)
Shaoyin Ganjie Tang (See Chapter on Mouth Aphthous Ulcers)
Bingpeng San (See Chapter on Oral Thrush)
[Prescription Verse] Throat closure (Hou Bi) is caused by excessive fire in the Liver and Lungs, where wind and cold contend causing swelling of the throat and pharynx; severe cases involve swelling and pain extending to the neck exterior. There is also throat closure due to alcohol toxicity that requires careful investigation.
[Annotation] This condition results from excessive fire in the Liver and Lungs combined with an invasion of wind and cold, leading to contention. Symptoms include swelling and pain of the throat and pharynx, facial redness, swollen cheeks, and in severe cases, diffuse swelling of the neck exterior. A mass like a fist may form in the throat, making swallowing difficult, speech impossible, and sudden onset of chills and fever. Urgently prick the Shaoshang point or needle the Hegu point to open the throat. Initially, use dispersing methods and administer Jingfang Baidu San (Schizonepeta and Saposhnikovia Decoction to Overcome Toxins). Once chills and fever subside, immediately use Qingyan Lige Tang (Clear the Pharynx and Purge the Diaphragm Decoction), and concurrently insufflate Zixue San (Purple Snow Powder). Subsequently, rinse the mouth with ginger juice to disperse heat; or rinse with vinegar to resolve accumulated blood. If phlegm obstructs severely, use a copper coin dipped in tung oil to induce vomiting of phlegm and saliva. If swelling occurs on the exterior of the neck with pus formation and distending pain, care must be taken not to penetrate the throat; do not lightly needle. Urgently insufflate Sophora flavescens root powder (Zaojiao Mo) into the nose to induce sneezing, which will rupture the swelling; or mix Zaojiao Mo with vinegar and apply thickly to the neck swelling, which will rupture shortly. For initial swelling, apply slices of raw mutton. If throat closure presents with snoring sounds, it indicates the Lung Qi is about to perish; urgently administer Dushen Tang (Single Ginseng Decoction) to rescue. If sudden muteness occurs with difficulty in swallowing and spitting, it is due to cold qi lodging in the epiglottis; hold a slice of honey-fried Fuzi (Aconiti Lateralis Radix Preparata) in the mouth without swallowing. Bitter-cold medicines are contraindicated at both the beginning and end stages, as they may hinder resolution and suppuration. Additionally, there is alcohol-toxicity throat closure, caused by alcohol toxicity steaming the Heart and Spleen meridians, with heat obstructing the throat. Symptoms include yellow-swollen throat, facial redness, and upward gaze of the eyes. Use a copper coin dipped in tung oil to guide the vomiting of phlegm and saliva. Administer Niuzai Zi Jiedu Tang (Arctii Fructus Antidote Decoction) and also insufflate Zixue San.
Formula: Niuzai Zi Jiedu Tang (Arctii Fructus Antidote Decoction)
Composition: Niuzai Zi (Arctii Fructus, fried and ground), Jiegeng (Platycodonis Radix), Qingpi (Citri Reticulatae Pericarpium Viride), Shengma (Cimicifugae Rhizoma), Huangqin (Scutellariae Radix), Huafen (Puerariae Radix), Gancao (Licorice Root, raw), Yuan Shen (Scrophulariae Radix), Zhizi (Gardeniae Fructus, raw and ground), Huanglian (Coptidis Rhizoma), Lianqiao (Forsythiae Fructus, heart removed), Gegen (Puerariae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma, earth-fried), Fangfeng (Saposhnikoviae Radix), Shengdi (Rehmanniae Radix, equal parts of each).
Usage: Decoct in water, take after meals.
[Prescription Verse] Niuzai Zi Jiedu Tang treats alcohol-toxicity throat closure; Jiegeng and Qingpi can descend Qi. It contains Shengma, Huangqin, Huafen, Gancao, Yuan Shen, Zhizi, Huanglian, Lianqiao, Gegen, Baizhu, Fangfeng, and Shengdi.
Alternative Formulas:
Jingfang Baidu San (See Chapter on Neck Carbuncle)
Qingyan Lige Tang, Tongyou Qian (Tung Oil Coin) (Both See Chapter on Tight Throat Wind)
Zixue San (See Chapter on Double Tongue)
Dushen Tang (See Chapter on Ulcers)