（麻证，俗名痧子，必兼喉痛。医家恫喝人曰∶烂喉痧者，此也。）
治麻证之喉痛，与治郁火之喉痛大异。盖麻证风热，其邪袭肺，故必鼻塞涕清，咳嗽眼
红，
声哑喉痛，面红花杂，身或作痒。一见此症，须用升、柴、前、葛、羌、独等品，提毒祛风
透发之，一剂喉痛止，二剂余邪尽矣。若早用寒凉之品，以彻去其皮毛之热，使麻不能乘汗
外达，遂至温邪内踞，欲出不出，毒火上炎，喉咙腐烂。医者不知其为麻也，外吹珠黄以遏
之，内服犀、羚、芩、连以制之，使邪无一毫之出路。始若稍安，终必不治，群相诧曰以喉
证死。（有谓，近今喉证以古方治之不效，不如以热药从治者，杀人愈速，不可不知。）而不
知麻证不早透发，以致毒邪攻喉而死。其实非喉证也，而以喉证之药治之，岂能有效乎？是
以治喉痛者，必先辨其是否麻证；如果麻也，用夏禹铸天保采薇汤方加减治之，无不透发而
愈者。即喉痛目赤，亦放胆投之，不庸疑虑，屡试屡验。《铁镜》所谓圣莫圣于天保采薇汤
，神莫神于天保采薇汤也。大忌寒凉，如犀、羚、芩、连、柏、石、珠、黄之类。倘系喉证
由于郁火，则升、柴、羌、独等升提温燥之品，均属切忌。轻者清肺养阴，一剂即痊；重则
犀、羚、珠、黄，皆为要品。盖治病贵先辨证，犹之作文，贵先识题。不识何题而便作文，
文
必不取，所失者仅一己之名。不辨何证而便治病，病必不治，所误者乃众人之命。呜呼!医
者奈何以人 之命，试我之药，屡误而终不悟也!
炳按∶论痧痘（前辈陈飞霞有《痧痘金针篇》），论喉痧者，有（叶天士、李纯修、高锦
庭、
计寿乔、祖鸿范、王步山、屠尊彝。）陈耕道着有《烂喉疫痧草》，皆可为痧痘喉痧金针。
执一夏禹铸天保采薇，以为手到病治，他书皆可不读，我恐误人也不浅。此病之门径未窥，
难与之辨，不议。
原注云∶光绪二十八年春夏间，以喉证死者，比户皆然，几成大疫。其实真喉证十不得
一二，大半皆麻证也。余所见者，麻证为多用天保采薇汤加减治之，无不转危为安。然以此方告
人，人反不敢用。有某医者，余尝举以语之。彼笑曰∶不必用此，以生军磨汁饮之，可内消
耳。余知其不可与语也，遂置之不辨。既而，其家连死数人，皆以此症。问所用药，则惟珠
、
黄、犀、羚、芩、连、大青等味耳。想必生军汁亦用过不验矣。噫!师心自用，善言不入
，
为人犹不宜若是，而况行医。吾愿世之讲究卫生者，慎毋一觉喉痛，便延医治，而奉珠、黄
、犀、羚贵重之乐，为无上之妙品，以自戕其性命也。（王鞠坪识。）
(Ma Zheng, commonly known as Sha Zi [measles], must be accompanied by throat pain. Physicians intimidate people by saying: This is Lan Hou Sha [rotten throat scarlet fever].)
Treating throat pain caused by Ma Zheng differs significantly from treating throat pain caused by Yu Huo (Depressed Fire). Since Ma Zheng involves Wind-Heat pathogenic factors, the evil Qi invades the Lung, thus inevitably presenting with nasal congestion, clear rhinorrhea, cough, red eyes, hoarseness, throat pain, facial rash with mixed colors, and occasional body itching. Upon observing these symptoms, one must use herbs such as Sheng Ma (Cimicifugae Rhizoma), Chai Hu (Bupleuri Radix), Qian Hu (Peucedani Radix), Ge Gen (Puerariae Lobatae Radix), Qiang Huo (Notopterygii Rhizoma et Radix), and Du Huo (Angelicae Pubescentis Radix) to lift toxins, dispel wind, and promote eruption. After one dose, throat pain ceases; after two doses, residual pathogens are eliminated. If cold-natured medicines are used too early to clear heat from the skin and hair follicles, preventing the measles from emerging via sweat, the Warm Evil will become entrenched internally. The pathogens desire to emerge but cannot, causing Toxic Fire to flare upward and rot the throat. Physicians, unaware that this is Ma Zheng, apply Zhu Huang (Pearl and Realgar powder) externally to suppress it, and administer Xi Jiao (Rhinocerotis Cornu), Ling Yang Jiao (Capra Hircus Cornu), Huang Qin (Scutellariae Radix), and Lian Qiao (Forsythiae Fructus) internally to restrain it, leaving the pathogens with no exit. Initially, there may be slight relief, but ultimately it is incurable. People marvel and say, "He died of a throat condition." (Some argue that recent throat conditions do not respond to ancient prescriptions, and using hot medicines for treatment is faster in killing, which must be known.) Yet they fail to realize that death results from failing to promote the eruption of Ma Zheng early, allowing toxic pathogens to attack the throat. In reality, this is not a throat condition; therefore, using medicines for throat conditions on it cannot be effective. Thus, those treating throat pain must first distinguish whether it is Ma Zheng. If it is indeed Ma Zheng, using Xia Yu Zhu's Tian Bao Cai Wei Tang (Heavenly Preservation Nourishing Veins Decoction) with modifications ensures eruption and recovery without exception. Even if accompanied by throat pain and red eyes, one should boldly administer it without doubt; it has been tested repeatedly with success. As stated in *Tie Jing* (Iron Mirror): "Nothing is more sagacious than Tian Bao Cai Wei Tang; nothing is more miraculous than Tian Bao Cai Wei Tang." Cold-natured medicines are strictly contraindicated, such as Xi Jiao (Rhinocerotis Cornu), Ling Yang Jiao (Capra Hircus Cornu), Huang Qin (Scutellariae Radix), Lian Qiao (Forsythiae Fructus), Huang Bo (Phellodendri Cortex), Shi Gao (Gypsum Fibrosum), Zhen Zhu (Margarita), and Zhu Huang (Realgar and Pearl powder). If the throat condition is indeed due to Yu Huo (Depressed Fire), then ascending and lifting warm-dry agents like Sheng Ma (Cimicifugae Rhizoma), Chai Hu (Bupleuri Radix), Qiang Huo (Notopterygii Rhizoma et Radix), and Du Huo (Angelicae Pubescentis Radix) are absolutely contraindicated. For mild cases, clearing the Lung and nourishing Yin cures the disease in one dose; for severe cases, Xi Jiao (Rhinocerotis Cornu), Ling Yang Jiao (Capra Hircus Cornu), Zhen Zhu (Margarita), and Zhu Huang (Realgar and Pearl powder) are essential. Treating disease prioritizes syndrome differentiation, just as writing an essay prioritizes understanding the topic. Writing without knowing the topic leads to rejection, costing only personal reputation. Treating without differentiating the syndrome leads to failure, costing lives. Alas! How can physicians risk others' lives to test their own medicines, making repeated errors without awakening?
Bing notes: Discussions on Sha Dou (Measles and Smallpox) include Chen Fei Xia's *Sha Dou Jin Zhen Pian* (Golden Needle Chapter on Measles and Smallpox). Those discussing Hou Sha (Throat Scarlets) include Ye Tian Shi (Ye Tianshi), Li Chun Xiu, Gao Jin Ting, Ji Shou Qiao, Zu Hong Fan, Wang Bu Shan, and Tu Zun Yi. Chen Geng Dao authored *Lan Hou Yi Sha Cao*, all serving as golden needles for Sha Dou and Hou Sha. Clinging solely to Xia Yu Zhu's Tian Bao Cai Wei Tang, believing it cures instantly so that other books need not be read, I fear this causes significant harm. Without grasping the fundamentals of this disease, it is difficult to debate; thus, I do not discuss it.
The original note states: Between spring and summer of the 28th year of Guangxu, deaths attributed to throat conditions were ubiquitous, nearly becoming a great epidemic. In truth, genuine throat conditions accounted for less than one or two out of ten; the majority were Ma Zheng. Cases I observed were treated with modified Tian Bao Cai Wei Tang, resulting in turning danger into safety without exception. However, when I shared this formula, people dared not use it. I once mentioned this to a certain physician. He laughed and said, "No need for this; grinding raw Jun (Radix et Rhizoma Rhei) into juice and drinking it allows internal resolution." Knowing he was unteachable, I ceased debating. Subsequently, several members of his family died consecutively from this same condition. Inquiry revealed they had only used Zhen Zhu (Margarita), Zhu Huang (Realgar and Pearl powder), Xi Jiao (Rhinocerotis Cornu), Ling Yang Jiao (Capra Hircus Cornu), Huang Qin (Scutellariae Radix), Lian Qiao (Forsythiae Fructus), and Da Qing Ye (Isatidis Folium). Presumably, the raw Jun juice was also tried without effect. Alas! Being self-opinionated and rejecting good advice is inadvisable even in general conduct, let alone in medicine. I hope those concerned with hygiene in the world do not, upon feeling throat pain, immediately seek medical treatment and offer precious items like Zhen Zhu (Margarita), Zhu Huang (Realgar and Pearl powder), Xi Jiao (Rhinocerotis Cornu), and Ling Yang Jiao (Capra Hircus Cornu) as supreme remedies, thereby destroying their own lives. (Recorded by Wang Ju Ping.)