《心鉴》咽喉为一身之总要，与胃气相接，呼吸之所从出，若胸膈之间蕴积热
毒，致生风痰，壅滞不散，发而为咽喉之病。喉内生疮，或状如肉腐，为HT 为痛，
窒塞不通，吐咽不下，甚则生出重舌，治之尤宜先去风痰，以通咽膈，然后解其热
毒，迟则有不救之患。又有热毒冲于上 而生疮，谓之悬痈。及腑寒亦能令人咽闭，
吞吐不利。临病详审治之。咽喉之疾，本伤热毒上攻也，四时受热，藏心腑之间，
一旦所触，上攻咽喉，所谓肾伤寒也，然其证有单肉蛾、双肉蛾，有重舌、木舌、
腮，有悬痈肿胀，有里外皆肿，甚者上攻头面皆肿。大法，先洗去口中舌上白胎，
其次扫去风涎，如是单、双肉蛾，可针则针，有不可针者，则用熏掺药，退后，方
根据次用服药。如是木舌，服药之外，仍用掺药。 腮则用涂药，轻者但服药而自
退，不须用针及药，点其疮而自消也。〔薛〕小儿喉痹，因膏粱积热，或禀赋有
热，或乳母七情之火、饮食之毒，当分其邪蓄表里，与证之轻重，经之所主而治之。
若左腮色青赤者，肝胆经风热也，用柴胡栀子散。右腮色赤者，肺经有热也，用泻
白散。额间色赤者，心与小肠经热也，用导赤散。若兼青色，风热相搏也，用加味
逍遥散。鼻间色黄，脾胃经有热也，用泻黄散。若兼青色，木乘土位也，用加味逍
遥散。兼赤色，心传土位也，用柴胡栀子散。颏间色赤，肾经有热也，用地黄丸。
凡此积热内蕴，二便不通者，当疏利之。风邪外客而发寒热者，当发散之。外感风
邪，大便闭结、烦渴痰盛者，当内疏外解。若因乳母膏粱积热者，母服东垣清胃散。
若因乳母恚怒肝火者，母服加味逍遥散。禀赋阴虐者，儿服地黄丸。大概当用轻和
之剂，以治其本，切不可用峻利之药以伤真气也。一小儿喉间肿痛，惊悸饮水，
服惊风降火之药益甚，仍欲攻风痰。余曰惊悸饮水，心经虚证，盖胃为五脏之本，
先用五味异功散以补胃，加桔梗甘草以消毒，诸证顿退，后用牛蒡子汤加柴胡而愈。
一小儿发热引冷，大便黄色，手足并热，不能吮乳。视口内无患，扪其喉间则哭，
此喉内作痛，乃脾胃实热也。用泻黄、清胃二散，各一剂，母子并服而愈。后因
乳母饮酒，儿躁不安，口内流涎，仍用前二散而愈。一小儿喉间肿痛，发热咳嗽，
大便秘结。此肝与大肠有热也。先用牛蒡子汤加硝。黄一服，大便随通，乃去硝
黄，再剂顿愈。审其母有肝火发热，用柴胡清肝散，母子并服而痊。
甘桔汤 治婴孩感冒风热，火气熏逼痘疮，蕴毒上攻，咽喉肿痛，痰气不顺，咳嗽
失音。
人参（去芦，半两） 桔梗（蜜浸，炒，一两） 甘草（半生半炙，三钱）
上锉散。用水煎，不拘时候服。
立效散 治婴孩小儿，咽喉痹痛，不能吞咽。
硼砂 龙脑 雄黄 朴硝（各半钱）
上为极细末，干掺。
吹喉散 治婴孩咽喉肿痛，气塞不通。
甘草（生，二钱半） 朴硝（一两）
上为极细末。干掺喉中，如肿甚者，用小竹管吹入喉内。
牛蒡汤 主伤风发热烦躁，鼻塞气喘，痰嗽惊啼，及诸疮赤紫丹毒，咽喉肿痛。
牛蒡子（三两，略炒，细研） 大黄（一两半） 防风（去芦） 薄荷（去老梗。各一两）
荆芥（去根梗，四两） 甘草（一两一钱半）
上 咀。每服二钱，水一盏，煎七分，无时，温服。
化毒汤 解风热上攻，咽喉肿痛，饮食不便。
桔梗（锉、炒，半两） 薄荷叶 荆芥穗 甘草（各二钱半） 山豆根（取净皮一钱半。以上
五味俱焙为末） 牙硝 硼砂 朴硝 雄黄 朱砂（各二钱。以上五味，乳钵细研）
上，五味焙为末，五味研为末，同一处，再研匀。每用一字至半钱，干点舌上
化下，或以温汤浓调，少与含咽，亦可。
备急散 治小儿诸般骨哽，咽喉肿痛。
五倍子（一两，研） 先春茶末（半两）
上二味，和匀。抄一钱，温汤半盏调化，无时，少与咽下。根据法服饵，不过三
五次即效。如骨出或刺破处血来多者，硼砂末六钱，水煎消毒散饮调服，血止痛住，
肿消食进。
牛蒡子汤
牛蒡子（炒，杵） 玄参 升麻 桔梗（炒） 犀角（镑） 黄芩 木通 甘草（各等分）
上，每服一二钱，水煎。
《拔萃》桔梗汤 治热肿喉痹。
桔梗（炒） 甘草（炒） 连翘 栀子（炒） 薄荷 黄芩（各等分）
上为末。每服一二钱，水煎服。
消毒饮 解急惊风毒，赤紫丹瘤，壮热狂躁，睡卧不安，胸膈满闷，咽喉肿痛，九
道有血妄行，及遍身疮疥。
牛蒡子（六两） 荆芥穗（二两） 甘草（一两）
上锉。每服二钱，水一盏，煎七分，无时，温服。
柴胡饮（见积热） 东垣人参安胃散（见吐利） 《三因》玉钥匙 九味芦荟丸（见疳）
《济生》犀角 地黄汤（见吐血） 五味异功散（见吐利） 柴胡清肝散（见发热）
Xin Jian (Mirror of the Heart) states that the throat and pharynx are the vital hub of the entire body, connecting with Stomach Qi (Stomach energy), and serving as the passage for respiration. If heat toxins accumulate in the chest and diaphragm, generating wind-phlegm that becomes congested and fails to disperse, it will manifest as diseases of the throat and pharynx. Sores may form inside the larynx, sometimes resembling rotting flesh, causing difficulty in swallowing and pain, obstruction without passage, and inability to vomit or swallow. In severe cases, a double tongue (swelling on the underside of the tongue resembling a second tongue) may develop. Treatment should primarily focus on expelling wind-phlegm to unblock the pharynx and diaphragm before resolving the heat toxin; delay may lead to incurable conditions. Additionally, heat toxins rushing upward can cause sores known as Xuan Yong (Hanging Abscess). Conversely, cold pathogens in the fu organs can also cause throat closure and difficulty in swallowing. One must carefully examine and treat each case. Diseases of the throat and pharynx originate from heat toxins attacking upwards. Heat acquired through the four seasons hides between the Heart and fu organs; once triggered, it attacks the throat, a condition referred to as "Kidney Cold Injury" (a term here denoting severe throat pathology potentially involving reverse transmission). However, symptoms vary: there are single or bilateral Rou E (fleshy growths resembling tonsils), double tongue, Mu She (wooden tongue/stiff swollen tongue), mumps-like swelling of the cheeks, swelling of the Xuan Yong, generalized internal and external swelling, and in severe cases, swelling extending to the head and face. The general treatment principle is first to wash away white coating on the mouth and tongue, then sweep away wind-phlegm saliva. For single or bilateral Rou E, acupuncture may be used if appropriate; otherwise, fumigation and powder application should be employed. After the swelling subsides, oral medication is administered sequentially. For Mu She, in addition to oral medication, powder application is still required. For cheek swelling, topical ointments are used; mild cases resolve spontaneously with oral medication alone, without need for needles or direct application, as applying medicine to the sores leads to spontaneous resolution. [Xue Ji] Pediatric throat bi (obstruction) arises from accumulation of heat due to rich diet, congenital heat predisposition, or fire from the wet nurse's emotions and toxins from her diet. One must differentiate whether the pathogen is stored in the exterior or interior and assess the severity of the syndrome, treating according to the governing meridians. If the left cheek is blue-red, it indicates Wind-Heat in the Liver and Gallbladder meridians; use Chai Hu Zhi Zi San (Bupleurum and Gardenia Powder). If the right cheek is red, it indicates Heat in the Lung meridian; use Xie Bai San (Drain White Powder). If the forehead is red, it indicates Heat in the Heart and Small Intestine meridians; use Dao Chi San (Direct to Red Powder). If accompanied by blueness, it signifies Wind-Heat clashing; use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder). If the nose area is yellow, it indicates Heat in the Spleen and Stomach meridians; use Xie Huang San (Drain Yellow Powder). If accompanied by blueness, it signifies Wood overacting on Earth (Liver invading Spleen); use Jia Wei Xiao Yao San. If accompanied by redness, it signifies Heart Fire transmitting to Earth; use Chai Hu Zhi Zi San. If the chin is red, it indicates Heat in the Kidney meridian; use Di Huang Wan (Rehmannia Pill). For all such cases of internal accumulated heat with constipation and urinary retention, one should promote drainage and purgation. For exterior Wind invasion causing chills and fever, one should induce sweating to release the exterior. For exterior Wind invasion with constipation, irritability, thirst, and profuse phlegm, one should internally purge and externally release. If caused by the wet nurse's rich diet accumulation, the mother should take Dong Yuan Qing Wei San (Dongyuan's Stomach-Clearing Powder). If caused by the wet nurse's anger leading to Liver Fire, the mother should take Jia Wei Xiao Yao San. For infants with congenital Yin deficiency, they should take Di Huang Wan. Generally, mild and harmonizing formulas should be used to treat the root; harsh purgatives must never be used to damage True Qi.
One infant presented with throat swelling and pain, palpitations, and desire to drink water. Administration of anticonvulsant and fire-draining medicines worsened the condition, and there was an intention to attack wind-phlegm. I stated that palpitations and desire to drink indicate a Deficiency pattern of the Heart meridian, as the Stomach is the foundation of the five zang organs. First, use Wu Wei Yi Gong San (Five-Ingredient Powder for Restoring Meritorious Function) to tonify the Stomach, adding Jie Geng (Platycodon) and Gan Cao (Licorice) to detoxify. All symptoms receded abruptly. Later, Niu Bang Zi Tang (Arctium Decoction) with added Chai Hu (Bupleurum) cured the patient.
Another infant had fever, craved cold drinks, passed yellow stool, had hot hands and feet, and could not suckle milk. Examination showed no lesions in the oral cavity, but crying upon palpation of the throat indicated internal throat pain, belonging to Excess Heat of the Spleen and Stomach. Xie Huang San and Qing Wei San were prescribed, one dose each, taken by both mother and child, resulting in recovery. Later, after the wet nurse consumed alcohol, the infant became restless with drooling; the same two powders were used again to effect a cure.
A third infant presented with throat swelling and pain, fever, cough, and constipation. This indicated Heat in the Liver and Large Intestine. Niu Bang Zi Tang with Xiao Shi (Niter) and Da Huang (Rhubarb) was administered initially. Upon bowel movement, Xiao Shi and Da Huang were removed, and two more doses resulted in complete recovery. Examination revealed the mother had Liver Fire fever; Chai Hu Qing Gan San (Bupleurum Liver-Clearing Powder) was prescribed for both mother and child, leading to recovery.
Gan Jie Tang (Licorice and Platycodon Decoction) treats infants with Wind-Heat common cold, where fire qi harasses acne/pox, accumulating toxins attacking upwards, causing throat swelling and pain, obstructed phlegm-qi, cough, and loss of voice.
Ren Shen (Ginseng Root, radix removed, 0.5 liang) Jie Geng (Platycodon Root, honey-steeped, stir-fried, 1 liang) Gan Cao (Licorice Root, half raw half roasted, 3 qian)
Crush into coarse powder. Decoct in water and take at any time.
Li Xiao San (Instant Effect Powder) treats infant throat bi pain and inability to swallow.
Peng Sha (Borax) Long Nao (Borneol) Xiong Huang (Realgar) Pu Xiao (Mirabilite) (each 0.5 qian)
Grind into extremely fine powder and apply dryly to the affected area.
Chui Hou San (Blow-Throat Powder) treats infant throat swelling and pain with obstructed qi flow.
Gan Cao (Raw Licorice Root, 2.5 qian) Pu Xiao (Mirabilite, 1 liang)
Grind into extremely fine powder. Apply dryly into the throat; if swelling is severe, blow into the throat using a small bamboo tube.
Niu Bang Tang (Arctius Decoction) governs Wind-Strike with fever and irritability, nasal congestion, asthma, phlegmatic cough, startle crying, as well as various sores, erysipelas, and throat swelling and pain.
Niu Bang Zi (Arctii Fructus, lightly stir-fried, finely ground, 3 liang) Da Huang (Rhei Radix et Rhizoma, 1.5 liang) Fang Feng (Saposhnikoviae Radix, radix removed) Bo He (Menthae Haplocalycis Herba, old stems removed, each 1 liang) Jing Jie (Schizonepetae Spica, roots and old stems removed, 4 liang) Gan Cao (Licorice Root, 1 liang 1 qian 5 fen)
Crush into pieces. Take 2 qian per dose, decoct in one cup of water until reduced to 0.7 cup, warm and take at any time.
Hua Du Tang (Detoxifying Decoction) resolves Wind-Heat attacking upwards, causing throat swelling and pain and difficulty eating/drinking.
Jie Geng (Platycodon Root, crushed, stir-fried, 0.5 liang) Bo He Ye (Menthae Haplocalycis Folium) Jing Jie Sui (Schizonepetae Spica) Gan Cao (Licorice Root, each 2.5 qian) Shan Dou Gen (Sophorae Tonkinensis Radix et Rhizoma, clean skin removed, 1.5 qian. The above five herbs are roasted and ground into powder) Ya Xiao (Saltpeter) Peng Sha (Borax) Pu Xiao (Mirabilite) Xiong Huang (Realgar) Zhu Sha (Cinnabar) (each 2 qian. The above five minerals are finely ground in a mortar)
Roast the first five herbs into powder, grind the latter five minerals into powder, mix them together, and grind uniformly. Use 1 zi to 0.5 qian per dose, sprinkle dryly on the tongue to dissolve and swallow, or mix thickly with warm water and hold/swallow in small amounts.
Bei Ji San (Emergency Preparation Powder) treats various bone obstructions in children and throat swelling and pain.
Wu Bei Zi (Galla Chinensis, 1 liang, ground) Xian Chun Cha Mo (Early Spring Tea Powder, 0.5 liang)
Mix the two ingredients evenly. Take 1 qian, dissolve in half a cup of warm water, and swallow in small amounts at any time. Following this method, efficacy is seen within three to five doses. If bleeding occurs after bone removal or puncture, take 6 qian of Peng Sha powder, decoct in water, mix with Xiao Du San Yin (Detoxification Drink), and administer to stop bleeding and pain, reduce swelling, and restore appetite.
Niu Bang Zi Tang (Arctium Seed Decoction)
Niu Bang Zi (Arctii Fructus, stir-fried, pounded) Xuan Shen (Scrophulariae Radix) Sheng Ma (Cimicifugae Rhizoma) Jie Geng (Platycodon Root, stir-fried) Xi Jiao (Rhinocerotis Cornu, sliced) Huang Qin (Scutellariae Radix) Mu Tong (Akebiae Caulis) Gan Cao (Licorice Root) (equal parts)
Take 1-2 qian per dose, decoct in water.
Ba Cui Jie Geng Tang (Extracts of Excellence Platycodon Decoction) treats Heat-Swelling Throat Bi.
Jie Geng (Platycodon Root, stir-fried) Gan Cao (Licorice Root, stir-fried) Lian Qiao (Forsythiae Fructus) Zhi Zi (Gardeniae Fructus, stir-fried) Bo He (Menthae Haplocalycis Herba) Huang Qin (Scutellariae Radix) (equal parts)
Grind into powder. Take 1-2 qian per dose, decoct in water and take.
Xiao Du Yin (Detoxification Drink) resolves acute convulsion toxicity, erysipelas, high fever with mania and restlessness, sleep disturbance, chest and diaphragm fullness, throat swelling and pain, hemorrhage from the nine orifices, and generalized skin sores and scabies.
Niu Bang Zi (Arctii Fructus, 6 liang) Jing Jie Sui (Schizonepetae Spica, 2 liang) Gan Cao (Licorice Root, 1 liang)
Crush into pieces. Take 2 qian per dose, decoct in one cup of water until reduced to 0.7 cup, warm and take at any time.
Chai Hu Yin (Bupleurum Drink) (see Accumulated Heat section)
Dong Yuan Ren Shen An Wei San (Dongyuan's Ginseng Stomach-Anchoring Powder) (see Vomiting and Diarrhea section)
San Yin Yu Yao Chi (Three Causes' Jade Key)
Jiu Wei Lu Hui Wan (Nine-Ingredient Aloe Pill) (see Infantile Malnutrition section)
Ji Sheng Xi Jiao Di Huang Tang (Jisheng's Rhinoceros Horn and Rehmannia Decoction) (see Hematemesis section)
Wu Wei Yi Gong San (Five-Ingredient Powder for Restoring Meritorious Function) (see Vomiting and Diarrhea section)
Chai Hu Qing Gan San (Bupleurum Liver-Clearing Powder) (see Fever section)