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
属体虚病实。其发缓,其色淡,其肿微,其咽干,舌见滑白苔,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 灰存性
三分,吹之立验。
甘露饮
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) 茵陈蒿
甘草(各等分)
水二盅,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。
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)
(附∶酒毒喉闭)
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,汤水难咽,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。痰雍塞者,桐油饯探吐痰涎。若肿发于项外,脓
胀痛者,防透咽喉不可轻针,急用皂角未吹鼻取嚏,其肿即破;或兼用皂角未醋调,浓
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,以桐油饯导吐痰涎,宜服鼠粘子解毒汤,亦用紫雪散吹之。
鼠粘子解毒汤
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。
荆防败毒散(见项部脑疽)
清咽利膈汤 桐油饯(俱见紧喉风)
紫雪散(见舌部重舌)
独参汤(见溃疡门)
Slow throat wind (Man Hou Feng) arises from constitutional deficiency, presenting with slight swelling of the pharynx, dryness, and a pale red color. Its etiology may stem from sudden anger or excessive consumption of pungent spices (Wu Xin), leading to fire flaring upward, or it may result from excessive worry and overthinking.
[Annotation] This syndrome occurs either in individuals with pre-existing constitutional weakness who are subjected to sudden anger or excessive intake of pungent spices, or those formed by excessive worry. All such cases belong to "root deficiency and branch excess" (Ben Xu Biao Shi). The onset is slow, the color is pale, the swelling is slight, the pharynx is dry, the tongue shows a slippery white coating, bowel movements are normal, the six pulses are faint and fine, and the lips resemble the color of alum. If pain occurs before noon, administer Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), adding cooling herbs such as Tian Dong (Asparagus Root), Xuan Shen (Scrophularia Root), Jie Geng (Platycodon Root), and Niu Bang Zi (Arctium Fruit). 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 are contraindicated. Instead, use Shao Yin Gan Jie Tang (Minor Yin Ganjie Decoction) to diffuse and reach the pathogen. If the face is red and the pharynx dry without thirst, the pulse will necessarily be large and empty; administering Gan Lu Yin (Sweet Dew Decoction) will be effective. In all these cases, Bing Peng San (Ice and Borax Powder) one qian, mixed with three fen of preserved ash of Deng Cao (Juncus Effusus Stem), should be blown into the throat for immediate effect.
Gan Lu Yin (Sweet Dew Decoction)
Tian Dong (Asparagus Root, heart removed), Mai Dong (Ophiopogon Root, heart removed), Huang Qin (Scutellaria Root), Sheng Di Huang (Rehmannia Root, fresh), Shu Di Huang (Rehmannia Root, prepared), Pi Pa Ye (Loquat Leaf, honey-fried), Shi Hu (Dendrobium Stem), Zhi Qiao (Bitter Orange Peel, bran-fried), Yin Chen Hao (Artemisia Capillaris Herb), Gan Cao (Licorice Root) (all in equal parts).
Boil two bowls of water until reduced to eight-tenths, take after meals.
[Formula Song] Gan Lu Yin clears internal heat invasion, red face and dry throat generate fluids and saliva; Tian Dong, Mai Dong, Huang Qin, Sheng Di, Shu Di, Pi Pa Ye, Shi Hu, Gan Cao, Zhi Qiao, Yin Chen Hao.
Bu Zhong Yi Qi Tang (See Ulcer Section)
Shao Yin Gan Jie Tang (See Mouth Aphthous Ulcer Section)
Bing Peng San (See Mouth Thrush Section)
(Attachment: Alcohol-Toxicity Throat Closure)
Throat closure (Hou Bi) is caused by excessive fire in the Liver and Lungs, where wind-cold combats with fire, causing swelling of the throat and pharynx. Severe cases involve swelling and pain extending to the outer neck. There are also cases due to alcohol toxicity that require careful differentiation.
[Annotation] This syndrome results from excessive fire in the Liver and Lungs combined with contraction of wind-cold, leading to combat between the two. Symptoms include swelling and pain of the throat and pharynx, red face, swollen cheeks, and in severe cases, diffuse swelling on the outer neck. A mass like a fist may form in the throat, making swallowing difficult and speech impossible, with sudden onset of chills and fever. Urgently prick the Shaoshang (LU-11) acupoint or needle the Hegu (LI-4) acupoint to open the throat. Initially, disperse the pathogen using Jing Fang Bai Du San (Schizonepeta and Saposhnikovia Decoction to Overcome Toxicity). Once chills and fever subside, use Qing Yan Li Ge Tang (Clear the Pharynx and Purge the Diaphragm Decoction), simultaneously blowing Zi Xue San (Purple Snow Powder) into the throat, followed by rinsing the mouth with ginger juice to diffuse heat; or rinse with vinegar to resolve blood stasis. For phlegm obstruction, use Tong You Jian (Camellia Oil Lozenge) to induce vomiting of phlegm and saliva. If swelling occurs on the outer neck with purulent distension and pain, avoid puncturing through the throat; do not lightly needle. Urgently blow Sao Jiao Mo (Gleditsia Sinensis Spine Powder) into the nose to induce sneezing, which will rupture the swelling; or mix Sao Jiao 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, Lung Qi is about to exhaust; urgently rescue with Du Shen Tang (Single Ginseng Decoction). If sudden aphonia and difficulty in swallowing occur, this is due to cold qi lodging in the epiglottis; hold a slice of honey-fried Fu Zi (Aconite Root) in the mouth, do not swallow. Bitter-cold herbs are contraindicated at both the beginning and end stages, fearing they will hinder resolution and suppuration. Another type is alcohol-toxicity throat closure, caused by alcohol toxicity steaming the Heart and Spleen meridians, with heat obstructing the throat, causing yellowish throat swelling, red face, and upward gaze of the eyes. Use Tong You Jian to guide the expulsion of phlegm and saliva via vomiting, administer Shu Niu Zi Jie Du Tang (Arctium Root Detoxification Decoction), and also use Zi Xue San blown into the throat.
Shu Niu Zi Jie Du Tang (Arctium Root Detoxification Decoction)
Shu Niu Zi (Arctium Fruit, fried, ground), Jie Geng (Platycodon Root), Qing Pi (Bitter Orange Peel), Sheng Ma (Cimicifuga Rhizome), Huang Qin (Scutellaria Root), Hua Fen (Trichosanthes Root), Gan Cao (Licorice Root, raw), Yuan Shen (Scrophularia Root), Zhi Zi (Gardenia Fruit, raw, ground), Huang Lian (Coptis Rhizome), Lian Qiao (Forsythia Fruit, heart removed), Ge Gen (Pueraria Root), Bai Zhu (Atractylodes Macrocephala Rhizome, earth-fried), Fang Feng (Saposhnikovia Root), Sheng Di Huang (Rehmannia Root, fresh) (all in equal parts).
Decoct in water, take after meals.
[Formula Song] Shu Niu Zi detoxifies alcohol-toxicity closure, Jie Geng and Qing Pi descend Qi; Sheng Ma, Huang Qin, Hua Fen, Gan Cao, Yuan Shen, Zhi Zi, Huang Lian, Lian Qiao, Ge Gen, Bai Zhu, Fang Feng, Sheng Di.
Jing Fang Bai Du San (See Occipital Carbuncle Section)
Qing Yan Li Ge Tang, Tong You Jian (Both see Tight Throat Wind Section)
Zi Xue San (See Tongue Double Tongue Section)
Du Shen Tang (See Ulcer Section)