治心经蕴热,舌上血出,及诸失血。
熟艾(以糯米半协议炒) 松黄 柏叶(炙,各半两)
上 咀,每服三钱匕,水一盏,煎七分,去滓,不拘时温服。
治舌上出血,窍如针孔。
紫金沙(即露蜂房顶上实处是,研,一两) 芦荟(研,三钱) 贝母(去心,四钱)
上为细末,炼蜜和丸,如樱桃大,每服一丸,水一小盏化开,煎至五分,温服,吐血衄
血,用温酒化开服。
黄连(半两) 黄柏(三两) 栀子(二十枚)
上锉碎,以酒二升渍一宿,煮三沸,去滓顿服。
治舌上出血不止。
黄药子(一两) 青黛(一分)
上为细末,每服一钱匕,食后新汲水调下,日二服。
治心经热极,舌上血出。
黄柏(二两,涂蜜,以慢火炙焦,研为末)
上每服二钱匕,温米饮调下。
治舌出血不止,名曰舌衄。
槐花(不以多少)
上晒干研末,傅舌上,或火炒,出火毒为末傅。如舌肿,以真蒲黄末干掺之。
戴人云∶咽与喉,会厌与舌,此四者同在一门,而其因各异。咽以纳气,故咽气通于天
∶喉以纳食,故喉气通于地;会厌管乎其上,以司开阖,掩其食下,不掩之,其喉错,必舌
抵上 ,则会厌能闭其咽矣。四者相交为用,缺一则饮食废而死矣。此四者,乃气与食出入
之门户,最急之处,故为病也,为咽痛喉痹之证,是以难治。轻者或治而愈,甚者虽治必殆
矣。《内经》曰∶一阴一阳结为之喉痹。王注曰∶一阴者手少阴,君火心主之脉也。一阳者
手少阳,相火三焦之脉也。二火皆主脉,并络于喉,气热则内结,甚则肿胀,肿胀则甚,甚
则痹,痹甚而不通则死矣。非惟二脉系此为病,以十二经推之,惟足太阳 别下项,其余皆
腠于喉咙。惟君相二火独胜,则热结正络,故痛且速也。故十二经中,言嗌痛咽肿,颔肿舌
本强,皆君火为之也。惟喉闭急速,相火之所为也。夫君火者,犹人火也;相火者,犹龙火
也。人火焚木,其势缓;龙火焚木,其势速。经言喉痹,则咽与舌在其中矣,以其病同是火
,故不分也。后之学人,各详其状,今略咽喉一十八证∶一曰单蛾风,其形圆如小箸头,生
于咽喉关上,或左或右,可治,生于关下者难治;二曰双蛾风,生两个在喉关两边,亦圆如
小箸头大,或生关下者难治;三曰蝉舌风,又名子舌,自舌下再生重舌者是也;四曰牙蜞风
,牙龈上肿盛聚毒成疮者是;五曰木舌风,其舌渐渐长大,相似煮熟猪舌,不能转动;六曰
舌黄风,自舌上肿痛黄色;七曰切牙噤风,牙尽头作 ,口噤不开;八曰鱼口风,如鱼吸水
者不治;九曰聚毒塞喉风,喉关聚毒,涎唾稠实,发寒热,仍分上下,关上者根据法治疗,关
下者难治,十曰悬蜞虫毒风,上眶肿,食而不能掩水,外形肿如鸡卵;十一曰抢食风,又名
飞丝毒,口中或食腥 之恶物发泡者;十二曰猎颊风,腮颊结肿者是,牙尽处肿破;十三曰
缠喉风,风自颐边过,颐下赤色者是,亦有寒热甚者,危殆;十四曰松子风,口内满喉,赤
如猪肝,张口吞物,则气逆关闭,饮食不能者,用吹喉药或绛雪点肿处,轻者退,甚者喉关
响急不治;十五曰崩砂甘口风,自舌下牙龈上下肿赤,口内作 如汤热,牙龈渐甚烂者,亦
能脱齿;十六曰连珠风,自舌下起,初起一个,又起一个,甚者三五七九个,连珠者是也;
十七曰蜂子毒,或在肋腮脸痒烂,或在喉关舌下作 ,其色黄如蜂者是;十八曰走疰瘰 风
,颈项结核五七个,皮肤赤肿作寒热者。惟木舌者,木者强而不柔和也,热结于喉头,肿绕
于外,且麻且痒,肿而大者名曰缠喉风。喉痹暴发暴死者,名走马喉痹,于十八证外之别名
,虽为治,若不归之于火,则相去远矣。其微者可以酸软之,其大者可以辛散之。治此疾者
,世之有方,如薄荷乌头僵蚕白矾朴硝铜绿之类。至如走马喉痹,何待此乎?其死生如人之
反掌之间耳。其最不误人者,无如砭针出血,血出则病已。但人畏针,委曲傍求,若执不从
,瞬息丧命。凡用针时喉中抢者,宜捣生姜一块入热白汤,时时呷之,则抢而止。治喉痹之
疾,如救火之法同,岂可容易哉?诸书治验,木舌胀者,急以绯针小而锐者砭之,五七度肿
减,出血而安。缠喉风肿药不能下者,以凉药灌鼻中吐之,外以拔毒散之剂敷之,热退肿消
而已。喉痹者,龙火也,虽用凉剂,常令煎极热,时时呷之。此药热行寒,不为热病扦格故
也。又常以 针刺少商穴出血而愈。后之业医者,须分人火龙火之病,用药无不取效矣。
To treat heat accumulation in the Heart channel (Heart channel, meridian of the Heart), resulting in bleeding from the tongue and various types of hemorrhage.
Artemisia argyi (Shu Ai, prepared by stir-frying with half a yi of glutinous rice) Pines pollen Songhuang Polygonum aviculare leaves (Boye, roasted, each half liang)
The above herbs are chopped. Each dose is three qian bi (a small measuring spoon), added with one zhan of water, decocted until seven-tenths remain, strained, and taken warm at any time.
To treat bleeding from the tongue where the orifices resemble needle holes.
Zijinsha (the solid part on top of the honeycomb, ground, one liang) Aloe vera (Luhui, ground, three qian) Fritillaria thunbergii bulb (Beimu, heart removed, four qian)
The above herbs are made into fine powder, mixed with refined honey to form pills the size of a cherry. Each dose is one pill, dissolved in a small zhan of water, decocted until five-tenths remain, and taken warm. For hematemesis (vomiting blood) or epistaxis (nosebleed), dissolve and take with warm wine.
Coptis chinensis rhizome (Huanglian, half liang) Phellodendron amurense bark (Huangbai, three liang) Gardenia jasminoides fruit (Zhizi, twenty pieces)
The above herbs are crushed, soaked in two sheng of wine overnight, boiled for three boils, strained, and taken in one dose.
To treat continuous bleeding from the tongue.
Dioscorea bulbifera (Huangyaozi, one liang) Indigo naturalis (Qingdai, one fen)
The above herbs are made into fine powder. Each dose is one qian bi, taken after meals with fresh cool water, twice daily.
To treat extreme heat in the Heart channel, resulting in bleeding from the tongue.
Phellodendron amurense bark (Huangbai, two liang, coated with honey, roasted slowly until scorched, ground into powder)
Each dose is two qian bi, taken with warm rice drink.
To treat continuous bleeding from the tongue, known as "She Nu" (Tongue Hemorrhage).
Sophora japonica flower bud (Huaihua, as needed)
The above is dried, ground into powder, and applied to the tongue. Alternatively, it can be fire-roasted to remove fire toxicity before grinding and applying. If the tongue is swollen, apply pure Puerariae Lobatae Radix powder (Puhuang) dry to the affected area.
Dai Yuanli said: The pharynx (Yan) and larynx (Hou), the epiglottis (Huiyan) and the tongue (She), these four share the same gate but have different etiologies. The pharynx receives qi, thus its qi connects to Heaven; the larynx receives food, thus its qi connects to Earth; the epiglottis controls the upper opening and closing, covering food downward. If not covered, the larynx will dislocate, requiring the tongue to press against the palate so that the epiglottis can close the pharynx. These four interact and function together; lacking one leads to cessation of diet and death. These four are the portals for the entry and exit of qi and food, the most critical areas. Therefore, when diseased, they present as sore throat and throat obstruction (Hou Bi), making them difficult to treat. Mild cases may heal with treatment; severe cases are dangerous even with treatment. The *Neijing* states: "When one Yin and one Yang knot, it becomes Hou Bi." Wang Bing's commentary notes: One Yin refers to the Hand-Shaoyin Heart channel, governed by Ministerial Fire (Jun Huo). One Yang refers to the Hand-Shaoyang Sanjiao channel, governed by Assistant Fire (Xiang Huo). Both fires govern the vessels and connect to the throat. Heat causes internal knotting, leading to swelling; severe swelling leads to obstruction; severe obstruction without unblocking leads to death. Not only these two channels cause this disease; deducing from the twelve meridians, only the branch of Foot-Taiyang descends to the neck, while the rest gather at the throat. Only when Jun Huo and Xiang Huo prevail does heat knot the main collaterals, causing rapid pain. Thus, among the twelve meridians, symptoms like sore throat, swollen pharynx, swollen jaw, and stiff tongue base are all caused by Jun Huo. Only urgent throat closure is caused by Xiang Huo. Jun Huo is like human fire; Xiang Huo is like dragon fire. Human fire burning wood has a slow momentum; dragon fire burning wood has a fast momentum. The scripture mentions Hou Bi, which includes the pharynx and tongue, because the pathology is both fire-related, hence not distinguished. Later scholars detailed their appearances. Here briefly listed are eighteen throat syndromes: 1. Dan E Feng (Single Tonsil Abscess): Round like a small chopstick head, located at the upper gate of the throat, left or right; treatable if upper, difficult if lower. 2. Shuang E Feng (Double Tonsil Abscess): Two lesions on both sides of the throat gate, round like small chopstick heads; difficult if lower. 3. Chan She Feng (Cicada Tongue Wind): Also called Zi She, double tongue growing from under the tongue. 4. Ya Qi Feng (Tooth Beetle Wind): Gum swelling gathering toxin into sores. 5. Mu She Feng (Wooden Tongue Wind): Tongue gradually enlarges, resembling cooked pig tongue, immobile. 6. She Huang Feng (Yellow Tongue Wind): Swelling and pain on the tongue turning yellow. 7. Qie Ya Jin Feng (Teeth-Gnashing Lockjaw Wind): Pain at the end of teeth, mouth locked open/closed. 8. Yu Kou Feng (Fish Mouth Wind): Like fish sucking water; untreatable. 9. Ju Du Sai Hou Feng (Gathering Toxin Blocking Throat Wind): Toxin gathers at throat gate, thick saliva, chills and fever; upper gate treatable, lower gate difficult. 10. Xuan Qi Chong Du Feng (Suspended Beetle Toxin Wind): Upper eyelid swelling, eating but unable to swallow water, external swelling like chicken egg. 11. Qiang Shi Feng (Snatching Food Wind): Also Fei Si Du, blisters from eating foul-smelling things. 12. Lie Jia Feng (Cheek Hunting Wind): Cheek swelling, breaking at tooth ends. 13. Chan Hou Feng (Entangling Throat Wind): Wind passes cheekbone, redness below cheekbone; severe chills/fever, critical. 14. Song Zi Feng (Pine Seed Wind): Mouth/throat full, red like pig liver, gas reverses when swallowing, unable to eat/drink; use throat powder or Jiangxue on swelling; mild improves, severe throat noise untreatable. 15. Beng Sha Gan Kou Feng (Sand-Collapsing Sweet Mouth Wind): Gums/swelling red below tongue, mouth feels hot like boiling water, gums rot, teeth fall out. 16. Lian Zhu Feng (String of Pearls Wind): Starts under tongue, one then another, severe cases have 3-5-7 pearls in a row. 17. Feng Zi Du (Bee Larva Toxin): Itchy/rotting cheeks/jaw or throat/tongue, yellow like bees. 18. Zou Zhu Luo Li Feng (Wandering Tuberculosis Scrofula Wind): 5-7 neck nodes, red swollen skin with chills/fever. Wooden tongue implies stiffness/rigidity; heat knots throat head, swelling surrounds outside, numb/itchy, large swelling named Chan Hou Feng. Sudden onset/death of Hou Bi is named Zou Ma Hou Bi (Running Horse Throat Obstruction), an alias outside the 18 syndromes. Treatment must attribute to fire. Mild cases softened by sour taste; severe cases dispersed by pungent taste. Worldly formulas include Bohe, Wutou, Jiangcan, Baifan, Xiaoyan, Tonglv. For Zou Ma Hou Bi, what need for these? Life and death turn in an instant. Most effective method is Bianzhen (stone needle) bleeding; blood release cures. People fear needles, seek alternatives; refusal leads to sudden death. If throat spasms during needling, crush ginger in hot water, sip slowly to stop spasms. Treating Hou Bi is like fighting fire; cannot be casual. Books verify: For wooden tongue swelling, urgently use small sharp red needle to pierce 5-7 times, swelling reduces, bleeding brings safety. For Chan Hou Feng where medicine cannot go down, pour cold medicine into nose to induce vomiting, apply external detoxification powder externally, heat retreats, swelling subsides. Hou Bi is Dragon Fire; even with cold medicines, boil extremely hot, sip slowly. This uses heat to move cold, avoiding rejection by heat pathology. Also commonly pierce Shaoshang acupoint to bleed for cure. Future physicians must distinguish Human Fire vs. Dragon Fire diseases; medication will be effective.