积热喉初起，多有夜半睡觉，咽津碍气，牙关强而不开，鼻气觉有些烧，痰涎壅粘，壮
热多，憎寒少。此症属心经三焦之火，生发顶，双单鹅亦宜。每日吹真喉末二三次，每次三
匙，出痰多效。内用泻心通圣散一剂，次用清膈凉血汤数剂。若泻心通圣散服后大泻，不用
多服。若无多泻，再进本药一剂，方可吹药。一日不宽，急用三棱针刺去鹅顶毒血，三五针。
吹喉药，点之毋得迟延。日久自溃烂变成牙疳，虽不至死，臭恶半年不愈。故当速治。又
恐延迟日久，兼胃虚之人，毒攻心胃，可谓快杀。此宜深察趋行，勿怠也。
泻心通圣散
黄连（一钱） 犀角（五分） 栀子（五分） 桔梗（八分） 甘草（三分） 枳壳（五分） 黄芩
（一钱） 升麻（四分） 葛根（五分） 生地（五分） 白芍（五分） 石膏（一钱五分） 大黄（生一
钱，熟二钱） 芒硝（一钱五分） 归尾（五分） 麻黄（五分） 生姜（一片）
水二碗，煎八分，空心服。令泻为度。若无泻，再进一服，后服清膈活血汤。（炳章按∶
此证多得心经实热与时气风火为症，升、葛、麻、姜、梗等温升，皆忌，宜加辛凉散风药为要。）
清膈活血汤
黄连（一钱） 麦冬（二钱） 连翘（一钱） 栀子（五分） 石膏（一钱） 桔梗（八分） 黄芩
（一钱） 甘草（三分） 归尾（五分） 升麻（三分）
水二碗，煎七分，温服。（炳章按∶升、桔宜换为桑叶、丹皮、紫花地丁草、鲜大青等更佳。）
Jire Hou (Throat disease caused by accumulated heat) in its initial stage often presents with waking up at midnight, experiencing difficulty in swallowing saliva and obstructed qi, stiffness of the jaw making it difficult to open, a sensation of heat in the nasal breath, copious and sticky phlegm and saliva, prominent high fever with slight aversion to cold. This syndrome belongs to the fire of the Heart Meridian and Sanjiao (Triple Burner), rising to the top of the head; it is also suitable for unilateral or bilateral E Kou (Goose mouth/tonsillar abscess). Blow Zhen Hou Mo (True Throat Powder) into the throat two to three times daily, three spoons each time; expelling much phlegm yields good efficacy. Internally, administer one dose of Xiexin Tongsheng San, followed by several doses of Qingge Liangxue Tang. If severe diarrhea occurs after taking Xiexin Tongsheng San, do not take more. If no severe diarrhea occurs, take another dose of this medicine before applying throat powder. If symptoms do not relieve within one day, urgently use a Three-edged Needle to puncture the top of the Goose Mouth to drain toxic blood, five to three punctures. Do not delay the application of throat powder or drops. If delayed for a long time, it will naturally ulcerate and transform into Ya Gan (Gangrene of the gums); although not fatal, it causes foul odor and may persist for half a year without healing. Therefore, prompt treatment is essential. Furthermore, if delayed for a long time, especially in individuals with Spleen-Stomach deficiency, the toxin may attack the Heart and Stomach, leading to rapid death. One must deeply observe and act swiftly, without negligence.
Xiexin Tongsheng San
Coptidis Rhizoma (Huanglian, 黄连) (1 qian)
Rhinocerotis Cornu (Xijiao, 犀角) (0.5 qian)
Gardeniae Fructus (Zhizi, 栀子) (0.5 qian)
Platycodonis Radix (Jiegeng, 桔梗) (0.8 qian)
Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) (0.3 qian)
Aurantii Fructus Immaturus (Zhiqiao, 枳壳) (0.5 qian)
Scutellariae Radix (Huangqin, 黄芩) (1 qian)
Bupleuri Radix (Shengma, 升麻) (0.4 qian)
Puerariae Radix (Gegen, 葛根) (0.5 qian)
Rehmanniae Radix (Shengdi, 生地) (0.5 qian)
Paeoniae Radix Alba (Baishao, 白芍) (0.5 qian)
Gypsum Fibrosum (Shigao, 石膏) (1.5 qian)
Rhei Radix et Rhizoma (Dahuang, 大黄) (Raw: 1 qian, Cooked: 2 qian)
Natrii Sulfas (Mangxiao, 芒硝) (1.5 qian)
Angelicae Sinensis Radix (Guiwei, 归尾) (0.5 qian)
Ephedrae Herba (Mahuang, 麻黄) (0.5 qian)
Zingiberis Rhizoma Recens (Shengjiang, 生姜) (1 slice)
Decoct with two bowls of water until reduced to 0.8 bowl; take on an empty stomach. The goal is to induce diarrhea. If no diarrhea occurs, take another dose, then follow with Qingge Huoxue Tang. (Note by Bingzhang: This syndrome is mostly due to excess heat in the Heart and seasonal wind-fire. Warming and ascending herbs like Shengma, Gegen, Mahuang, Shengjiang, and Jiegeng are contraindicated; it is essential to add acrid-cool wind-dispersing herbs.)
Qingge Huoxue Tang
Coptidis Rhizoma (Huanglian, 黄连) (1 qian)
Ophiopogonis Tuber (Maidong, 麦冬) (2 qian)
Forsythiae Fructus (Lianqiao, 连翘) (1 qian)
Gardeniae Fructus (Zhizi, 栀子) (0.5 qian)
Gypsum Fibrosum (Shigao, 石膏) (1 qian)
Platycodonis Radix (Jiegeng, 桔梗) (0.8 qian)
Scutellariae Radix (Huangqin, 黄芩) (1 qian)
Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) (0.3 qian)
Angelicae Sinensis Radix (Guiwei, 归尾) (0.5 qian)
Bupleuri Radix (Shengma, 升麻) (0.3 qian)
Decoct with two bowls of water until reduced to 0.7 bowl; take warm. (Note by Bingzhang: Shengma and Jiegeng should be replaced with Folium Mori (Sangye), Moutan Cortex (Danpi), Violae Herba (Zihua Diding Cao), and Isatidis Radix (Daqingye) fresh, which is better.)