Library

The categories of medicine are the most numerous, and its principles are extremely difficult to grasp. Among them, the specialty of the throat is particularly difficult. The pharynx (throat for swallowing) receives food, and the larynx (throat for breathing) receives air. The pathway receiving food connects to the stomach cavity, extends downward to the spleen, and transforms according to the nature of Earth. The pathway receiving air connects to the lung cavity, extends downward to the heart, and transforms according to the nature of Metal. The nature of Metal is dry; its pathological change manifests as astringency (stagnation). Astringency leads to obstruction and insensibility; therefore, diseases of the larynx are termed Bi syndrome (obstruction and pain). The nature of Earth is damp; its pathological change manifests like mud. Mud leads to congestion, swelling, and blockage; therefore, diseases of the pharynx are termed Zhong syndrome (swelling). Those who treat throat diseases generally know this, but when it comes to distinguishing the deficiency or excess, cold or heat of the syndromes, and the application of attacking or tonifying, ascending or descending in treatment methods, to analyze with precision down to the finest detail and make correct judgments amidst ambiguity, one must listen to the voice, feel the pulse, distinguish the qi, and observe the form. Without these, even a tiny difference will lead to a vast divergence in outcome. Even if one proceeds cautiously, tentatively exploring and speculating, it is likely to be inappropriate. If urgent conditions are treated with slow remedies, or severe injuries are supported with mild interventions, the harm of procrastination and following routine differs little from error. Thus, it is said to be the most difficult of difficulties. Mr. Liuxian Zhang of our county has long been proficient in medical principles. His study of the throat specialty has become increasingly profound and enduring. He collected existing prescriptions, incorporated his own insights, detailed the regulations, and compiled them into a volume. From the spirit, qi, and pulse theory, to the colors of the complexion (blue, red, purple, white), and the pitch and depth of the voice, each item is annotated clearly and intuitively, more straightforward than listing eyebrows. Combined with the treated cases, it is as accurate as taking a shadow under a lamp, with hardly any failure. It is truly a boat of compassion saving people in distress, and a raft of treasures rescuing the critical. His successful clinical experiences are too numerous to record. Colleagues urged him to have it printed, so that practitioners near and far could circulate the teachings and unfold their depths. The merit to the world is immeasurable. This is the preface.

Written by Peng Qifeng, courtesy name Zhitting, from Changzhou, appointed Jinshi in the second year of Qianlong Dingchou, Spring, Second Month, Vice Minister of Works and Supervisor of Education in Zhejiang.

Regarding the throat region, the left side is the pharynx, and the right side is the larynx. The pharynx belongs to the Stomach, and the larynx belongs to the Lung. They are the vital hub of the body and the defensive pass of all joints, serving as the passage for respiration. The classics state: "When Yin and Yang bind together, it results in Hou Bi (sore throat/obstruction)." Bi means closure. Etiologies include Wind, Cold, Fire, Dampness, Toxin, and Deficiency. Wind and Fire may transmit to each other, or Cold and Dampness may gather together. Symptoms vary and are unpredictable. Therefore, diffuse swelling with much phlegm indicates Wind; pale color with tight jaw indicates Wind-Cold; purple color without swelling but with ulceration indicates latent Cold; red swelling with floating pulse indicates Wind-Fire; deep and solid pulse with ulceration but no swelling indicates Toxin; fine and rapid floating pulse indicates Deficient Fire; fine and slow pulse indicates Deficient Cold. Wind, Fire, Cold, Dampness, Toxin, and Deficiency can all be deduced by analogy. Generally, in early-stage symptoms, a flooding and tight pulse at the Right Cun position indicates Lung Wind; floating and rapid pulses at both Guan positions indicate Stomach Fire and Liver Wind; a floating and flooding pulse at the Left Cun position indicates Heart Fire; a deep and slow pulse at the Right Cun position indicates latent Cold; a deep and rapid pulse indicates latent Heat; a flooding and large pulse at the Right Chi position indicates flourishing Fire in the Sanjiao (Triple Burner); a flooding and forceful pulse at the Left Chi position indicates Kidney Deficiency Fire. These pulse patterns are general guidelines. One may generally use Liuwei Tang (Six-Ingredient Decoction) with modifications for treatment. For dangerous or critical conditions, one must examine the pulse, observe the form, investigate the source of the disease in detail, and carefully inquire about the onset. Then, prescribing medication against the specific condition will naturally lead to rapid recovery. Therefore, the key to treating throat diseases lies in the pulse and the naming of symptoms. The classics state: "Divine, Sacred, Work, and Skill" refer only to Observation, Auscultation/Olfaction, Inquiry, and Palpation. By deducing and investigating through these four methods, errors can be avoided. I have practiced medicine for decades and witnessed its efficacy. Now, I have carefully collected nine essential prescriptions, methods of preparing medicines, and clinical examination and treatment techniques, recording them here for the benefit of others.