Library

In the treatment of throat diseases, if the symptoms are severe within the first three days but pus has not yet formed, medication can resolve them. However, if it reaches the fifth or sixth day and pus forms and ruptures, necrosis will inevitably occur, making healing difficult. For necrotic areas, Bawei Kougan Dan (Eight-Ingredient Mouth Ulcer Powder) is commonly used, combined with Longgu Zhenzhu San (Dragon Bone and Pearl Powder). Patients who develop Lianzhu E (Pearl-shaped Tonsillar Hypertrophy) and Hou Bi (Throat Closure) after contracting Shanghan (Cold Damage Disease) are considered incurable. This is because their necks become stiff and rigid, and their eyes roll upward.

For throat diseases, if chills and fever appear on the first or second day, the condition is mild; if chills and fever do not appear initially but emerge on the third day, the condition is severe. If urination and defecation are smooth, recovery is easy, as this indicates merely floating fire attacking upwards, suitable for treatment with formulas that dispel wind, clear heat, and detoxify. Smooth bowel movements allow heat to dissipate easily, facilitating recovery. Conversely, if urination and defecation are obstructed, the condition must be severe. If there is internal cold with external heat, heavy doses of fire-descending and detoxifying agents should be used. If headache occurs, one must fear transmission into Shanghan, making it difficult to treat.

Generally, even if the disease course is fierce, conditions manifesting externally are easier to treat. If constipation occurs at the onset, Dahuang (Rhubarb Root) and Yuanming Fen (Mirabilite) should be used to purge, allowing the pathogen to descend and the illness to resolve. However, if the condition persists for six or seven days without improvement and constipation remains, using purgatives will cause immediate death. This is because prolonged illness depletes stomach qi and severely damages primal qi; thus, Xiaoshi (Mirabilite) and Dahuang (Rhubarb Root) are strictly contraindicated. Even in cases of severe constipation, only honey suppositories (Mi Jian Dao Fa) should be used, such as those containing Yazao (Gleditsia Sinensis Fruit) or Xixin (Asarum Root).

For throat diseases presenting with redness and swelling without distinct form, Yuandan (Cinnabar Pill) is appropriate.

Women suffering from throat swelling and pain may have it due to amenorrhea causing deficient fire to ascend. In cases of pain, blood-invigorating and menstruation-promoting medicines are suitable.

For severe throat diseases, a pale, bright, lusterless complexion and a deep, faint, and weak pulse indicate the leakage of spirit and collapse of yang, which are signs of incurability. If the face is red and swollen, and the pulse is surging and forceful, although the condition appears fierce, the primal qi remains intact, and treatment can be effective. Swelling without pain indicates dead flesh, which is difficult to treat.

If the tongue swells and fills the mouth, preventing medication intake, Jiangcan (Bombyx Batryticatus) and Yazao (Gleditsia Sinensis Fruit) can be stir-fried, ground into fine powder, and insufflated into the nose. Once the jaw opens and phlegm saliva exits, silk cotton wrapped around a chopstick dipped in Gancao Tang (Licorice Decoction) can be used to moisten the throat and tongue. When insufflating medicine onto broken or swollen areas, care must be taken to ensure thorough coverage everywhere; neglecting any area prevents the medicinal power from taking effect and reducing the disease severity.

The most crucial aspect of treating throat diseases is meticulousness. For example, "Houhua" (Throat Flower), also known as "Diding" (Uvula), requires extreme caution if punctured with a knife; injury to surrounding tissues could be fatal. Other conditions such as Zouma Gan (Running Horse Gangrene) and Xu Lao Hou Xuan (Deficiency Consumption Throat Lichen) vary and are discussed subsequently.

Hou Bi (Throat Obstruction): Caused by accumulated heat in the Liver, Stomach, and Lung meridians, compounded by seasonal pathogens. It resembles the purple veins on the back of a crabapple leaf, appearing fragmented and ulcerated, with small blisters forming beside the veins. Diet remains normal. Treatment requires decoctions that nourish yin, descend fire, and tonify the lungs, prioritizing heat-clearing agents. The exception is Zouma Hou Bi (Running Horse Throat Obstruction), which is extremely dangerous and requires early treatment with lozenge-like pastes held in the mouth and swallowed intermittently. Insufflation uses Zhenjin San (True Restriction Powder) and Zhuhuang San (Pearl and Gold Powder) mixed with Shenye Mo (Ginseng Leaf Powder).

Qiangshi Ya Hou (Choking Food and Hoarse Throat): This condition presents with no redness or swelling. Due to latent pathogens in the lungs, the voice is hoarse, and eating causes choking. The six pulses are slow and thin, indicating a very dangerous condition where death ensues if food intake ceases. If the pulse has a root, treatment may be possible. Initially, release the latent pathogens via sweating; subsequently, use strong tonification to strengthen the Spleen.

Nei Wai Hou Yong (Internal and External Throat Abscess): Caused by excessive consumption of rich flavors and heat invasion. It arises at the throat gate (isthmus of fauces), causing internal and external swelling, fever, and headache. It typically resolves in four to five days. Insufflate Zhenjin Zhuhuang San; take cooling decoctions.

HT She Hou Yong (HT Tongue and Throat Abscess): This results from excessive fire in the Heart meridian, often affecting obese individuals with irritable temperaments who contract heat. A small tongue forms under the main tongue, called HT She; if it extends to the throat causing pain, it is called Hou Yong. If painless, it is not an abscess. The combination of HT She and Hou Yong is ominous. Insufflate Zhenjin Yao; take Dihuang Tang (Rehmannia Decoction).

She Jun (Tongue Fungus): Belongs to the Heart meridian, caused by alcoholism, sexual excess, depression, and qi stagnation. It resembles fungi or wood ear mushrooms, colored red-purple, varying in size. Insufflate Zhenjin Yao primarily, adding Zhuhuang San is better.

Seven Attached Conditions Belonging to the Heart Meridian: These include She Gen Yong (Root of Tongue Abscess), She Xin Yong (Center of Tongue Abscess), Ce She Yong (Side of Tongue Abscess), Sanjian HT She (Three-Pointed HT Tongue), Zi Zhang Tun (Purple Swallowing Distension), Mu She (Wood Tongue), and Chong She (Double Tongue). Insufflate Zhenjin Yao and Zhuhuang San; decoct Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction), which serves as a general formula for tongue conditions.

Heishanzhi (Black Gardenia), Fen Danpi (Moutan Cortex), Chishaoyao (Red Peony Root), Sheng Gancao (Raw Licorice Root), Xian Shengdi (Fresh Rehmannia Root), Xijiao Jian (Rhinoceros Horn Tip), Xiao Mutong (Akebia Stem), Jing Yin Hua (Honeysuckle Flower), Jingjie Sui (Schizonepeta Spike), Lianqiao (Forsythia Fruit).

She Shang Yong (Abscess on Tongue Surface): Also known as She Xin Yong. Located at the center of the tongue, sized like a plum, causing inability to speak. It arises from heat entering the Pericardium. Red and swollen cases are treatable; black ones are not. Yellow coating on the tongue with swelling and pain also indicates Heart fire.

She Xia Yong (Abscess Under Tongue): Also known as She Gen Yong. Caused by accumulated heat in the Spleen and Kidney meridians, manifesting at Jinjin (Metal Fluid) and Yuye (Jade Fluid) acupoints under the tongue, connecting to the Kidney meridian. It arises when Kidney water is exhausted. Treatment should strengthen water and support the Spleen.

Zi She (Purple Tongue): Caused by heat invading the Heart and Spleen meridians. It features red spots turning purple, with ulceration and pain, or nausea/vomiting. Watch out for eruption syndromes.

Mu She (Wood Tongue): Caused by excessive consumption of roasted/fried foods or food stagnation in the Middle Jiao, leading to accumulated heat in the Heart, Spleen, and Lung meridians. The tongue becomes coarse, purple, and swollen, preventing speech. If the Cun and Guan pulses on both wrists are surging, the condition is excess and easy to treat; if all six pulses are thin, the condition is deficiency and difficult to treat.

Chong She (Double Tongue): Caused by heat in the Heart and Spleen. A small tongue forms under the main tongue. If untreated early, the large tongue becomes thick and short, while the small tongue grows long and painful. Prolonged cases will ulcerate, becoming difficult to treat.

Ya Ding (Tooth Carbuncle): Fever for two days, followed by unbearable toothache, with a purple blister appearing on the gum root. Those arising on the upper central incisors are ominous; those on other teeth are easier to treat. Loss of the upper left central incisor is incurable due to Kidney deficiency combined with Heart and Stomach fire attacking upwards. Unruptured lesions are Ding (Carbuncles); ruptured ones are Du (Poison). Red color is treatable; green/black is not. Insufflate Zhenjin Zhuhuang San.

Ya Xuan (Tooth Lichen): Caused by excess fire in the Yangming meridians attacking upwards, bleeding from gum margins, associated with the Spleen above and Stomach below, leading to gum root necrosis. Use Zhenzhu San, Shengji San, Zhuhuang San, and Zhenjin Yao.

Ma Ya (Horse Teeth): Occurs in newborns due to fetal toxicity manifesting upon exposure to wind. They suck, swallow, or spit milk. Treat with Zhenjin insufflation and cooling medicines. Dental issues belong to the Yangming Stomach meridian. Lesions on the gums relate to the Yangming Large Intestine; lesions below the gums stem from Kidney deficiency heat. Teeth are the essence of bones and the exterior marker of the Kidneys. However, they are not solely caused by the Kidneys; wind pathogens also play a role. Medication must be carefully selected based on syndrome differentiation.

Xuan Shen (Scrophularia Root), Sheng Di (Rehmannia Root), Dan Pi (Moutan Cortex), Zhi Mu (Anemarrhena Rhizome), Bai Shao (White Peony Root), Di Gu Pi (Lycium Bark), Che Qian Zi (Plantago Seed), Sheng Gancao (Raw Licorice Root), Huang Bo (Phellodendron Bark).

Lianzhu E (Pearl-shaped Tonsils): The mouth resembles white net fat, with slight swelling near the navel area, white spots at the roots tinged with red, and red/swollen uvula. Drinking soup causes severe pain. The disease stems from depression and heat-toxin. The pulses at both Cun and Chi positions are floating, surging, and large, indicating an upper-excess and lower-deficiency condition of extreme severity.

Shi E (Stone Tonsil): Due to constitutional deficiency, sometimes congenital, located slightly higher than regular Ru E (Milky Tonsils). Cold-natured drugs are initially contraindicated. It is caused by Liver fire and depression. Old phlegm and evil blood obstruction are common in women.

Suo Hou Feng (Lock-Throat Wind): Caused by heat-toxin accumulation and viscid phlegm saliva blocking the epiglottis, leading to wheezing and upward rushing of qi, with external neck swelling. Opening the orifices and resolving phlegm can cure it. If there is no external swelling and no internal phlegm, it is called "Internal Lock-Throat," which is incurable.

Bai Chan Hou Feng (White-Wrapping Throat Wind): Caused by Kidney deficiency and cold invasion, fatigue, and thirst. Cold generates heat, heat generates wind; wind-cold struggle, causing phlegm-qi to rise, obstructing and condensing. Symptoms include white sclerae, red/purple ears, inability to speak, internal swelling, white upper/red lower appearance. It is a critical emergency. White gum roots are incurable.

Qian Si Chan Hou Feng (Thread-Pulling Wrapping Throat Wind): Features purple-red blood threads inside the throat. This condition requires prevention of contagion.

Hou Jun (Throat Fungus): Excessive depression allows evil fire from the Heart and Stomach meridians to enter collaterals, causing qi and blood stagnation. Most common in women. Resembles a fungus, purple in color, growing on both sides. Use Huanglian Jiedu Tang (Coptis Detoxification Decoction).

Hou Liu (Throat Tumor): Constitutional deficiency, anger injuring the Liver, or straining the voice (shouting high or reading too fast) causes qi and blood coagulation. Small purple nodules appear inside the throat gate, recurring intermittently. Treatment should nourish the constitution.

Hou Xuan (Throat Lichen): Caused by Kidney deficiency fire flaring and Lung meridian fire hyperactivity. There is no swelling, only slight redness, resembling red veins on a crabapple leaf back, with blue-white spots. Some resemble mustard seeds or mung beans, each with thorn-like projections. Diet is obstructed; the throat is dry, voice hoarse, cough without phlegm. Spots within tendons are Xuan (Lichen); spots beside tendons are Bi (Obstruction). Use pastes held in the mouth, insufflate Zhenjin Zhuhuang San added with Rushi (Oyster Shell), Zhongbai (Magnolia Bark), and Shenye Mo (Ginseng Leaf Powder); decoct Lung-clearing and Yin-nourishing herbs.

Hou Yong (Throat Abscess): Caused by excessive rich food heating the Spleen and Stomach, compounded by cold invasion. Color is pale red, swollen and very painful. Fever and headache may occur. Once pus forms, it is easier to treat. Insufflate Zhenjin Zhuhuang San.

Shang Yong (Upper Abscess): Arises in the hard palate, sized like a plum pit, obstructing diet. Caused by Stomach heat transforming into toxin. Use detoxifying and cooling methods; insufflation same as before. This condition arises from accumulated heat and toxin, or Yin deficiency triggering ministerial fire, or wine toxin attacking upwards, internal heat with external cold, fire invading the Lungs causing throat swelling. Shape is broad-based and narrow-tipped, red and painful, hanging down from the upper part of the throat gate.

Chui Kou Hou Feng (Blowing-Mouth Throat Wind): Belongs to the Taiyin. Taiyin swelling and pain, tongue pointing upward, indicate insufficient Heart blood allowing fire to move easily, and deficient Lung qi failing to generate fluids. Speech is governed by the throat and tongue. Heart heat manifests externally, worsening Yin deficiency and fire, leading to a stiff tongue and difficulty speaking.

Hou Ding (Throat Carbuncle): An insensible condition. Initially shaped like a goji berry, appearing near the tongue at both sides of the throat gate, caused by accumulated heat in the five zang organs. Pale red and hard, causing severe pain and difficulty eating, with chills on the back and fever on the body, resembling blooming flowers. Black color is incurable. Caused by anger and excessive thinking, leading to premature exhaustion of Heart blood; death occurs soon. Women die immediately upon contracting this. Upper palate pain belongs to the Spleen meridian; sores on the upper palate resembling yellow millet grains with foul breath and cold extremities are caused by Spleen meridian heat.

Zuo You Que She (Left and Right Sparrow Tongues): Caused by excessive fried/cooked foods accumulating heat in the Stomach, manifesting on either side of the tongue near the gum roots as a small tongue. Prolonged cases will ulcerate and heal slowly.

Hou Gan (Throat Ulcer): Caused by Kidney deficiency and hyperactive fire ascending. Blue-white flat spots without thorns appear on the upper palate, hence the name. Voice is not hoarse, no cough, Chi pulses are deficient.

Various Gan (Ulcers): Suo Kou (Outer Lips), Suo Hou (Throat), Diao Gen (Below Center of Tongue), Dou Ban (Full Mouth), Dui Sha (Center of Tongue), Mei Hua (Fragmented Full Mouth), Mi Kou (Erosive Mouth), Xue Kou (White-Coated Full Mouth), Zhuo She (Pecked Tongue). All treated with Zhuhuang Yudan insufflated with Zhenjin. Above ulcers result from prolonged deficiency due to convulsions, dysentery, malnutrition, or chronic adult illness. Post-smallpox residual toxins contraindicate Longgu (Dragon Bone) insufflation; post-measles contraindicates cutting teeth to prevent tooth loss. All various ulcers and oral erosions are treated with Bawei Kougan Dan insufflation.

Xiao'er Zouma Ya Gan (Pediatric Running Horse Tooth Gangrene): Due to fetal toxin or unresolved post-smallpox toxin. Manifests in mouth/teeth or gum roots post-measles, causing rapid necrosis and death. Color like dried sauce, rotting one point per day; untreatable after ten days. Red dots on the nasal bridge are incurable. The upper left central incisor is the master tooth; its loss causes all others to fall, which is incurable. If this tooth does not fall, others are unlikely to fall, allowing desperate treatment, though survival is only 2-3 in 10 cases. Treatment must include Zhuhuang (Pearl and Gold).

Jian Chun (Silkworm Lip): Belongs to the Foot-Yangming Stomach meridian. Caused by long-term rich diet or sudden anxiety/anger, causing phlegm-fire to pour into the lips. Initially bean-sized, resembling a silkworm cocoon swelling, protruding, hard, painful, obstructing diet. May bleed serum; long-term transformation into Xiao Ke (Wasting-Thirst) or Xiao Zhong (Wasting-Fatigue). Emaciation, deficient heat-phlegm, dark complexion, severe dry mouth/thirst indicate difficult prognosis. Early treatment leads to cure. Treat with moxibustion 3-4 times, apply Chansu Bing (Toad Venom Cake), internally take Bawei Wan (Eight-Ingredient Pill), formula listed below.

Da Shudi (Prepared Rehmannia Root, 4 liang), Fuling (Poria, 2 liang), Shanyao (Chinese Yam, 2 liang), Zexie (Alisma Rhizome, 2 liang), Rourou (Cornus Fruit, 1 liang), Huangbo (Phellodendron Bark, 2 liang), Zhimu (Anemarrhena Rhizome, 5 qian), Danpi (Moutan Cortex, 2 liang).

Pill made with honey water, taken with clear soup in the morning. In the afternoon, take Qingliang Ganlu Yin (Cooling Sweet Dew Drink).

Heixuan Shen (Black Scrophularia Root, 1.5 qian), Danpi (Moutan Cortex, 2 qian), Maidong (Ophiopogon Tuber, 2 qian), Chuanbei (Fritillaria Bulb, 2 qian), Ku Jiegeng (Bitter Platycodon Root, 1 qian), Xingren (Apricot Seed, 3 qian), Gancao (Licorice Root, 1 shallow measure), Huafen (Trichosanthes Root, 2 qian).