脉
两寸脉浮洪而溢者，喉痹也。脉微而伏者，死。
病
夫喉以候气，咽以咽物。咽则通水谷，接三脘以通胃。喉有九节，通五脏以系肺，并行两异，气谷攸分，
诸脏热则肿塞不通，腑寒则缩而硬，硬如有物，常欲痒痛多涎唾，皆使喉闭，风燥亦然。若夫卒然肿痛，水浆
不入，语言不通，死在须臾，诚可惊骇。其会厌两旁肿者，俗谓之双乳蛾，易治；会厌一边肿者，谓之单
乳蛾，难治。古方通谓之喉痹，皆相火之所冲逆耳。
治
治宜先大涌其痰，或以铍针刺其肿处，此急则治其标之法也，内当从治，而以桔梗、甘草、玄参、
升麻、防风、羌活、荆芥、人参、白术，茯苓之类，少加干姜、附子等药为向导，徐徐频服，
不可顿服。切不可骤用寒凉之药而正治之，非徒无益，而且促其死矣。
单乳蛾 双乳蛾 喉闭 双喉闭 子舌胀 木舌胀 缠喉风 走马喉
盖因湿气上行，转于喉之两旁，近外肿作，以其形似乳蛾，一为单，二为双。其乳蛾差小者，名喉闭，
热结于舌下，复生一小舌子，名子舌胀。热结于舌中，舌为之肿，名木舌胀，木者，强而不柔和也。热结
于咽喉，肿绕于外，且麻且痒，肿而大者，名缠喉风。喉闭暴发暴死者，名走马喉风。
喉闭之症，其人胸膈素有痰涎，或因饮酒过度，或因忿怒失常，或因房事不节而发作也，何则？饮酒
过度，是胃火动也；忿怒失常，是肝火动也；房事不节，是肾火动也。火动痰上而为痰热，燔
灼壅塞于喉嗌之间，所以内外肿痛，而水浆不入也。治疗之法，急
则治其标，缓则治其本。标则用丸散以吐痰散热，治本用汤药以降火补虚。
方
甘桔汤
甘草 防风 荆芥 薄荷 黄芩（各一钱） 桔梗（三钱） 加玄参（一钱）
上锉一剂，水煎，食后频频噙咽。
咳逆，加陈皮。咳嗽，加知母、贝母。咳发渴，加五味子。唾脓血，加紫菀。肺痿，加阿胶。面目肿，
加茯苓。呕，加半夏、生姜。少气，加人参、麦门冬。肤痛，加黄 。目赤，加栀子、黄连，咽痛，加
鼠粘子、竹茹。声哑，加半夏、桂枝 疫毒头痛肿，加鼠粘子、大黄、芒硝。胸膈不利，加枳壳。
心胸痞，加枳实。不得卧，加栀子。发斑，加防风、荆芥 酒毒，加干姜、陈皮之类。
清咽利膈散〔批〕（按此方治咽痛清火之剂）
连翘 黄芩 栀子 薄荷 防风 荆芥 桔梗 玄参 黄连 大黄 金银花 牛蒡子 朴硝 甘草
上锉一剂，水煎服。
绵球散（王伯泉传）
草乌（一个，重一钱，余药各一钱，生） 胡椒 荜茇 红豆 细辛 牙皂
上为末，用乌梅去核，拈作饼，包药末在内，仍以药末掺之，以绵裹缚筋头上，先用鹅翎管，削针
刺破，将绵球蘸淡醋缴喉中患处，去痰为度。如牙关不开，先用开关散搐鼻，嗅涕即开。
开关散
用杨梅树皮，向东者晒干，去粗皮为末，吹鼻中，喷嚏为验。
金锁匙（秘方）
朱砂（三分三厘） 硼砂（一分二厘） 枯矾（一分六厘） 雄胆（一分） 焰硝（一分）
片脑（一分） 麝香（少许）
上为细末，竹筒吹入喉中。
春风散 治咽喉肿痛，缠喉风闭塞。
腊月初一日，取猪胆五、六个，用僵蚕、黄连俱锉，朴硝、白矾、青黛俱各五钱，装入胆内，缚定，用
青纸裹了，将地掘一方坑，长、阔一尺，上用竹竿横吊，以胆悬定于内，候至立春日取出，置当风处吹干，
去皮以药研末，密收吹喉。
吹喉散（宋举人传）〔批〕（按此方止痛外治之剂）
壁钱（烧存性） 枯白矾 发灰
上各等分，研末吹喉。
清火补阴汤 治虚火上升，喉痛，并喉生疮，喉闭热毒，最能降火补虚。
当归（一钱） 川芎（一钱） 白芍（一钱二分） 熟地黄（一钱二分） 黄柏（一钱，童
便炒） 知母（一钱，生用） 天花粉（一钱） 甘草（一钱） 加玄参（三钱）
上锉一剂，水煎，入竹沥，温服。
通隘散（方外人传） 喉痛生疮声哑。
白硼砂（二钱） 孩儿茶（一钱） 蒲黄（六分） 青黛（一钱） 牙硝（六分） 枯矾
（六分） 片脑（二分） 黄连（五分，末） 滑石（一钱） 寒水石（一钱） 黄柏（五分，末）
上共为末，以苇筒，药少许，吹入喉中，即效。
清上丸（太医院传）〔批〕（按此方治阴虚咽痛之剂） 治喉中热毒肿痛，喉闭，乳蛾等证。
雄胆（一钱） 雄黄（五分） 硼砂（一钱） 薄荷叶（五钱） 青盐（五分） 胆矾（少许）
上为细末，炼化白砂糖为丸，如鸡头子大，卧时舌压一丸，自化入喉，神效。
清音散 治声音不清。
诃子（三钱，半生半泡熟） 木通（二钱，半生半泡熟） 桔梗（生用） 甘草（三钱，
半生半炙）
上锉，水煎，用生地黄捣烂，入药贴。
钱笛丸〔批〕（按此方治失声之剂） 治声失音，或不清。
当归（一两） 生地黄（一两） 熟地黄（一两） 天门冬（盐炒，五钱） 黄柏（一
两，蜜炙） 麦门冬（五钱，盐炒） 知母（五钱） 人参（三钱） 白茯苓（一两，去皮）
诃子（五钱） 阿胶（五钱） 乌梅（十五个） 人乳（一碗） 牛乳（一碗） 梨汁（一碗）
上为末，炼蜜为丸，如黄豆大。每服八十丸，诃子汤下，或萝卜汤下亦可。
驱风解毒散 治 腮肿痛。
防风 荆芥 羌活 连翘 牛蒡子 甘草（各等分）
上锉一剂，水煎，食后频服，外用后方敷药。
赤豆散
赤小豆为细末，醋调敷肿处，恐毒瓦斯入喉难治。
白灰散〔批〕（按此方治 腮之剂）
锻石不拘多少，炒七次，地下窨七次，醋调敷肿处，立消。
Pulse Diagnosis
When the pulses at both Cun (inch) positions are floating, large, surging, and overflowing, it indicates Throat Bi Syndrome (Throat Obstruction). When the pulse is faint and deep-hidden, it signifies a fatal prognosis.
Pathology
The throat is used to observe Qi (vital energy), and the pharynx is used to swallow food. The pharynx connects water and grain, linking the three Jiao (San Jiao, Triple Burner) to communicate with the Stomach. The throat has nine segments, connecting the Five Zang Organs to bind with the Lungs. Qi and Grain proceed along different paths and are separated therein.
Heat in any of the Zang Organs causes swelling and blockage; Cold in the Fu Organs causes contraction and hardness. A sensation of a foreign body, frequent itching, pain, and excessive saliva all lead to Throat Closure (Hou Bi). Wind-Dryness also causes similar conditions. If sudden swelling and pain occur, preventing the intake of water or gruel, and causing inability to speak, death may ensue in an instant, which is indeed terrifying. Swelling on both sides of the epiglottis is commonly known as Double Tonsillar Abscess (Shuang Ru E) and is easy to treat; swelling on one side is called Single Tonsillar Abscess (Dan Ru E) and is difficult to treat. Ancient formulas generally refer to this as Throat Bi Syndrome, caused by the counterflow of Ministerial Fire (Xiang Huo, fire associated with the Liver and Kidney that drives physiological activities).
Treatment Principles
Treatment should first focus on inducing copious vomiting to expel phlegm, or using a Pi needle (a type of ancient surgical needle) to puncture the swollen area. This is the method of treating the branch (symptoms) in acute cases. Internally, treatment should follow the disease's trend for guidance, using herbs such as Jiegeng (Platycodon Root), Gancao (Licorice Root), Xuanshen (Scrophularia Root), Shengma (Cimicifuga Rhizome), Fangfeng (Saposhnikovia Root), Qianghuo (Notopterygium Rhizome), Jingjie (Schizonepeta Spike), Renshen (Ginseng Root), Baizhu (Atractylodes Rhizome), and Fuling (Poria), with small amounts of Ganjiang (Dried Ginger) and Fuzi (Prepared Aconite Root) added as guides. These should be taken slowly and frequently, not in a single large dose. One must absolutely avoid suddenly using cold-natured herbs for direct treatment, as this will be not only ineffective but also hasten death.
Single Tonsillar Abscess, Double Tonsillar Abscess, Throat Closure, Double Throat Closure, Sublingual Tongue Swelling, Wooden Tongue Swelling, Winding Throat Wind, Running-Horse Throat Wind
These conditions are often caused by Dampness ascending and turning towards both sides of the throat, causing external swelling. Because their shape resembles tonsils, they are classified as single or double. Those with smaller tonsil-like swellings are named Throat Closure. Heat binding under the tongue generates a small additional tongue, named Sublingual Tongue Swelling. Heat binding in the middle of the tongue causes the tongue to swell, named Wooden Tongue Swelling ("Wood" implies stiffness and lack of flexibility). Heat binding in the throat causes swelling surrounding the exterior, accompanied by numbness and itching, with significant swelling, named Winding Throat Wind. Throat Closure that occurs suddenly and leads to rapid death is named Running-Horse Throat Wind.
Symptoms of Throat Closure: The patient typically has phlegm-fluids in the chest and diaphragm beforehand. It may be triggered by excessive drinking, abnormal anger, or immoderate sexual activity. Why? Excessive drinking stirs Stomach Fire; abnormal anger stirs Liver Fire; immoderate sexual activity stirs Kidney Fire. When Fire moves, Phlegm rises to form Phlegm-Heat, burning and blocking the throat and pharynx. Thus, internal and external swelling and pain occur, preventing the intake of fluids. The treatment principle is: treat the branch in acute cases, and the root in chronic cases. To treat the branch, use pills and powders to induce vomiting of phlegm and dissipate heat. To treat the root, use decoctions to descend Fire and tonify Deficiency.
Formulas
Gan-Jie Decoction
Ingredients: Gancao (Licorice Root), Fangfeng (Saposhnikovia Root), Jingjie (Schizonepeta Spike), Bohe (Mint Leaf) (each 1 qian); Jiegeng (Platycodon Root) (3 qian); add Xuanshen (Scrophularia Root) (1 qian).
Preparation and Administration: Coarsely crush the above ingredients for one dose, decoct in water, and frequently hold in the mouth and swallow after meals.
Modifications: For coughing and rebellious Qi, add Chenpi (Tangerine Peel). For cough, add Zhimu (Anemarrhena Rhizome) and Beimu (Fritillaria Bulb). For cough with thirst, add Wuweizi (Schisandra Berry). For expectoration of pus and blood, add Ziwan (Aster Root). for Lung萎 (Lung Atrophy/Withering), add Ejiao (Donkey-hide Gelatin). For swelling of face and eyes, add Fuling (Poria). For vomiting, add Banxia (Pinellia Tuber) and Shengjiang (Fresh Ginger). For shortness of breath, add Renshen (Ginseng Root) and Maimendong (Ophiopogon Tuber). For skin pain, add Huangqin (Scutellaria Root). For red eyes, add Zhizi (Gardenia Fruit) and Huanglian (Coptis Rhizome). For sore throat, add Niubangzi (Arctium Seed) and Zhuru (Bamboo Sap). For hoarseness, add Banxia (Pinellia Tuber) and Guizhi (Cinnamon Twig). For epidemic toxin headache and swelling, add Niubangzi (Arctium Seed), Dahuang (Rhubarb Root), and Mangxiao (Mirabilite). For chest and diaphragm discomfort, add Zhike (Aurantium Fruit). For fullness in heart and chest, add Zhishi (Immature Aurantium Fruit). For inability to lie down, add Zhizi (Gardenia Fruit). For macules/rash, add Fangfeng (Saposhnikovia Root) and Jingjie (Schizonepeta Spike). For alcohol toxin, add Ganjiang (Dried Ginger) and Chenpi (Tangerine Peel).
Qing-Yan Li-Ge Powder [Commentary] (Note: This formula clears heat and treats sore throat.)
Ingredients: Lianqiao (Forsythia Fruit), Huangqin (Scutellaria Root), Zhizi (Gardenia Fruit), Bohe (Mint Leaf), Fangfeng (Saposhnikovia Root), Jingjie (Schizonepeta Spike), Jiegeng (Platycodon Root), Xuanshen (Scrophularia Root), Huanglian (Coptis Rhizome), Dahuang (Rhubarb Root), Yinhua (Honeysuckle Flower), Niubangzi (Arctium Seed), Puxiao (Mirabilite), Gancao (Licorice Root).
Preparation and Administration: Coarsely crush the above ingredients for one dose, decoct in water, and take orally.
Mian-Qiu San (Transmitted by Wang Boquan)
Ingredients: Caowu (Aconitum Carmandii Root) (one piece, weighing 1 qian; other herbs each 1 qian, raw); Hujiao (Black Pepper); Bibo (Long Pepper Fruit); Hongdou (Adzuki Bean); Xixin (Asarum Root); Yazao (Gleditsia Sinensis Fruit).
Preparation and Administration: Grind all into fine powder. Remove the pit from a Chinese Plum (Wumei), knead into a cake, wrap the powder inside, and sprinkle more powder on the outside. Wrap in cotton and tie to the affected area (tendon head/swollen site). First, use a goose feather tube with a sharpened needle to prick the area. Dip the cotton ball in light vinegar and insert it into the throat lesion until phlegm is removed. If the jaw is locked, first use Kai-Guan San (Open the Gate Powder) insufflated into the nose; sneezing and nasal discharge indicate the jaw will open.
Kai-Guan San (Open the Gate Powder)
Ingredients: Bark of Yangmei Tree (Chinese Bayberry), preferably from trees facing east, dried, coarse bark removed, ground into powder.
Preparation and Administration: Insufflate into the nose. Sneezing indicates efficacy.
Jin-Suo Chi (Golden Lock Key) (Secret Formula)
Ingredients: Zhusha (Cinnabar) (3 fen 3 li); Pengsha (Borax) (1 fen 2 li); Kufan (Alum); Xiongdan (Bear Gallbladder) (1 fen); Yanxiao (Saltpeter/Niter) (1 fen); Pian Nao (Borneol) (1 fen); Shexiang (Musk) (a little).
Preparation and Administration: Grind into fine powder. Use a bamboo tube to insufflate into the throat.
Chun-Feng San (Spring Breeze Powder) Treats sore throat and swelling, and Winding Throat Wind obstruction.
Preparation: On the first day of the twelfth lunar month, take five or six pig gallbladders. Coarsely crush Jiangcan (Bombyx Batryticatus) and Huanglian (Coptis Rhizome). Measure 5 qian each of Puxiao (Mirabilite), Baifan (White Alum), and Qingdai (Indigo Naturalis). Place these into the gallbladders, tie securely, wrap in green paper, dig a square pit one chi long and wide, hang a bamboo pole across the top, suspend the gallbladder inside, and wait until the Start of Spring (Lichun) to retrieve it. Dry it in the wind, remove the skin, grind the contents into powder, store tightly, and insufflate into the throat when needed.
Chui-Hou San (Insufflate Throat Powder) (Transmitted by Scholar Song Ju Ren) [Commentary] (Note: This is an external analgesic formula.)
Ingredients: Biqian (Spider Web/Cocoon) (burned to retain its nature); Kufan (Alum); Fa Hui (Ash of Human Hair).
Preparation and Administration: Mix equal parts, grind into powder, and insufflate into the throat.
Qing-Huo Bu-Yin Tang (Clear Fire and Tonify Yin Decoction) Treats rising deficiency Fire, sore throat, sores in the throat, and toxic heat in Throat Closure. It is most effective in descending Fire and tonifying Deficiency.
Ingredients: Danggui (Angelica Sinensis Root) (1 qian); Chuanxiong (Ligusticum Rhizome) (1 qian); Baishao (White Peony Root) (1.2 qian); Shudihuang (Prepared Rehmannia Root) (1.2 qian); Huangbai (Phellodendron Bark) (1 qian, stir-fried with child's urine); Zhimu (Anemarrhena Rhizome) (1 qian, raw); Tianhuafen (Trichosanthes Root) (1 qian); Gancao (Licorice Root) (1 qian); add Xuanshen (Scrophularia Root) (3 qian).
Preparation and Administration: Coarsely crush for one dose, decoct in water, add Zhuli (Bamboo Sap), and take warm.
Tong-Ai San (Unblock Narrow Passage Powder) (Transmitted by Fang Wai Ren) Treats sore throat with sores and hoarseness.
Ingredients: Bai Pengsha (White Borax) (2 qian); Hai'er Cha (Child's Tea/Catechu) (1 qian); Puhuang (Lygodium Spore) (6 fen); Qingdai (Indigo Naturalis) (1 qian); Yaxiao (Saltpeter) (6 fen); Kufan (Alum) (6 fen); Pian Nao (Borneol) (2 fen); Huanglian (Coptis Rhizome) (5 fen, powder); Huashi (Talcum) (1 qian); Hanshui Shi (Calcite/Halloysite) (1 qian); Huangbai (Phellodendron Bark) (5 fen, powder).
Preparation and Administration: Grind all into powder. Use a reed tube to insufflate a small amount into the throat. Immediate effect.
Qing-Shang Wan (Clear Upper Pill) (Transmitted by Imperial Hospital) [Commentary] (Note: This formula treats yin-deficiency sore throat.) Treats toxic heat swelling and pain in the throat, Throat Closure, and Tonsillar Abscess.
Ingredients: Xiongdan (Bear Gallbladder) (1 qian); Xionghuang (Realgar) (5 fen); Pengsha (Borax) (1 qian); Bohe Ye (Mint Leaf) (5 qian); Qingyan (Green Salt) (5 fen); Danfan (Chalcanthite) (a little).
Preparation and Administration: Grind into fine powder. Refine white rock sugar to make pills, size of a chicken egg. Place one pill under the tongue before sleep to melt and enter the throat. Divine efficacy.
Qing-Yin San (Clear Voice Powder) Treats unclear voice.
Ingredients: Hezi (Chebulic Myrobalan) (3 qian, half raw, half soaked/cooked); Mutong (Akebia Stem) (2 qian, half raw, half soaked/cooked); Jiegeng (Platycodon Root) (raw); Gancao (Licorice Root) (3 qian, half raw, half honey-roasted).
Preparation and Administration: Coarsely crush, decoct in water. Mash fresh Dihuang (Rehmannia Root) and apply externally mixed with the medicine.
Qian-Di Wan [Commentary] (Note: This formula treats loss of voice.) Treats aphonia or unclear voice.
Ingredients: Danggui (Angelica Sinensis Root) (1 liang); Sheng Dihuang (Fresh Rehmannia Root) (1 liang); Shu Dihuang (Prepared Rehmannia Root) (1 liang); Tianmendong (Asparagus Tuber) (salt-fried, 5 qian); Huangbai (Phellodendron Bark) (1 liang, honey-roasted); Maimendong (Ophiopogon Tuber) (salt-fried, 5 qian); Zhimu (Anemarrhena Rhizome) (5 qian); Renshen (Ginseng Root) (3 qian); Baifuling (Poria) (peeled, 1 liang); Hezi (Chebulic Myrobalan) (5 qian); Ejiao (Donkey-hide Gelatin) (5 qian); Wumei (Chinese Plum) (15 pieces); Renru (Human Milk) (1 bowl); Niuru (Cow's Milk) (1 bowl); Lizhi (Pear Juice) (1 bowl).
Preparation and Administration: Grind into powder, refine honey to make pills, size of soybeans. Take 80 pills per dose, washed down with Hezi Decoction or Radish Decoction.
Qu-Feng Jie-Du San (Expel Wind and Resolve Toxicity Powder) Treats cheek swelling and pain.
Ingredients: Fangfeng (Saposhnikovia Root), Jingjie (Schizonepeta Spike), Qianghuo (Notopterygium Rhizome), Lianqiao (Forsythia Fruit), Niubangzi (Arctium Seed), Gancao (Licorice Root) (equal parts).
Preparation and Administration: Coarsely crush for one dose, decoct in water, take frequently after meals. Apply the following external paste.
Chi-Dou San (Red Bean Powder)
Ingredients: Chixiaodou (Adzuki Bean) ground into fine powder.
Preparation and Administration: Mix with vinegar and apply to the swollen area to prevent toxin from entering the throat, which would be difficult to treat.
Bai-Hui San [Commentary] (Note: This formula treats cheek swelling.)
Ingredients: Duanshi (Burnt Lime/Dolomite) (any amount).
Preparation and Administration: Stir-fry seven times, bury underground for seven cycles, mix with vinegar, and apply to the swollen area. It subsides immediately.