甘胆丸 治食醋呛喉哮嗽不止,诸药不效。
甘草(去皮,二两作二段,用猪胆五个浸三日取出,火上炙干)
为末蜜丸,每服四五十丸,临卧茶清送下。
自颈项至结喉止,凡一切痈疽、瘿瘤、瘰 、马刀,皆汇于此部中,以便检阅参治。
邪客三阳则痛,寒搏则筋急,风搏则筋弛。左多属血,右多属痰。丹溪治一人,
项强痛甚,不可以回顾,作痰客太阳经治之,用二陈汤加酒芩、羌活、红花,服二
剂而愈。有挫闪及失枕而项强痛者,皆由肾虚不能荣筋也,六味地黄汤加秦艽。
王肯堂曰∶夹疽生喉之两旁,属手少阴心经、足太阴脾经,足厥阴肝火热毒上
攻而成。内溃者难治;虚火上升痰壅,饮食不进者死。(《准绳》)
汪省之曰∶气颈乃七情抑郁不伸,肝脾气郁不舒,结喉之间气结如胞,随喜怒
消长,甚则饮食嗌碍,治以四海舒郁丸主之。(《理例》)
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四海舒郁丸
青木香(五钱) 陈皮 海蛤粉(各三钱) 海带 海藻 昆布 海螵蛸(各二两。俱用滚水泡去盐。)
共研细,每服三钱,不拘酒水,日服三次;渣沉在碗底内者,敷气颈上。愈后
用黄药子四两,生酒三大壶,煮三炷香,窨
一七去火毒,早晚任饮数杯,酒完永除根。
王肯堂曰∶颈痈属手少阳三焦经郁火,积愤惊惶所致。初觉即隔蒜灸;若溃后不
敛,烦躁胀满,小便如淋,呕吐者死。(《准绳》)
《灵枢》云∶发于颈者,名曰夭疽。其痈大而赤黑,不急治,则热气下入渊腋,前
伤任脉,内熏肝肺;熏肝肺,十余日而死矣。
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申斗垣曰∶颈左发为痈,右发为疽,皆由脏腑热毒,风气伏结风府之间,故毒发
于颈之上下,但内近咽喉,饮食气道呼吸所关。其见证也,寒热往来,喉咙疼痛,饮
食妨碍,亦恶候也。(《启玄》)
奎光曰∶颈痈,胸前红肿,情势在外,防其内攻,甚则红肿出脓。
Guizhi Wan (Cinnamon Twig Pill): Treats persistent severe coughing caused by vinegar aspiration into the throat, when other medications have failed.
Gancao (Licorice Root, *Glycyrrhizae Radix et Rhizoma*) (peeled, two liang, cut into two sections, soaked in five pig gallbladders for three days, then removed and dried over fire)
Grind into powder, form pills with honey. Take forty to fifty pills per dose, swallowed with clear tea before bedtime.
From the neck to the laryngeal prominence, all types of carbuncles, ulcers, goiters, scrofula, and "horse knives" are compiled in this section for easy reference and treatment consultation.
When pathogenic factors invade the Three Yang meridians, pain occurs; when cold binds, tendons become stiff; when wind binds, tendons become flaccid. Left-sided manifestations mostly belong to blood disorders, while right-sided ones mostly belong to phlegm disorders. Zhu Danxi treated a patient with severe neck stiffness and pain, unable to turn the head back. He diagnosed it as phlegm lodging in the Taiyang Meridian and prescribed Erchen Tang (Two-Aged Powder) modified with wine-fried Huangqin (Scutellaria Root), Qianghuo (Notopterygium Rhizome), and Honghua (Safflower). After two doses, the patient recovered. Cases of neck stiffness and pain due to sprains or sleeping awkwardly are caused by Kidney Deficiency failing to nourish the tendons; Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) modified with Qinjiao (Gentiana Macrophylla Root) should be used.
Wang Kentang stated: Jiaju (Clamp Carbuncle) arises on both sides of the throat, resulting from Fire-Toxin attacking upward from the Hand-Shaoyin Heart Meridian, Foot-Taiyin Spleen Meridian, and Foot-Jueyin Liver Meridian. Internal ulceration is difficult to treat; if Deficient-Fire rises with Phlegm obstruction and inability to eat, death ensues. (*Yixue Zhunsheng*)
Wang Shengzhi stated: Qi Jing (Qi Neck) results from the depression of the Seven Emotions, causing stagnation of Liver and Spleen Qi. Qi knots in the region of the laryngeal prominence like a sac, expanding and contracting with emotions such as anger and joy. In severe cases, it obstructs swallowing. The primary treatment is Sihai Shuyu Wan (Four Seas Soothing Stagnation Pill). (*Lili*)
Sihai Shuyu Wan (Four Seas Soothing Stagnation Pill):
Qingmuxiang (Aucklandiae Radix) (five qian) Chenpi (Tangerine Peel) Haigefen (Concha Arcae) (each three qian) Haidai (Laminariae Thallus) Haizao (Sargassum Thallus) Kunbu (Eckloniae Thallus) Haipiaoxiao (Sepiae Endoconcha) (each two liang. All soaked in boiling water to remove salt.)
Grind together into fine powder. Take three qian per dose, taken with either water or alcohol, three times daily. Apply the dregs settled at the bottom of the bowl to the affected area of Qi Neck. After recovery, use Huangyaozi (Dioscorea bulbifera Tuber) four liang, boiled in three large pots of raw liquor for the time it takes to burn three incense sticks. Seal and store for seven days to eliminate fire toxicity. Drink several cups morning and evening until the liquor is finished, which will permanently eradicate the root cause.
Wang Kentang stated: Jing Yong (Neck Carbuncle) belongs to the stagnation-fire of the Hand-Shaoyang Sanjiao Meridian, caused by accumulated resentment and fright. At the initial stage, moxibustion through garlic should be applied immediately; if after ulceration the wound fails to heal, accompanied by irritability, distension, fullness, urination resembling strangury, and vomiting, death ensues. (*Yixue Zhunsheng*)
The *Ling Shu* states: Those that erupt on the neck are called Tian Ju (Early Death Carbuncle). The abscess is large, red, and black. If not treated urgently, heat qi descends into Yuanye, damaging the Ren Mai anteriorly and steaming the Liver and Lungs internally. Steaming the Liver and Lungs leads to death within ten-plus days.
Shen Douyuan stated: Eruption on the left side of the neck is a Yong (Carbuncle), while eruption on the right is a Ju (Ulcer). Both are caused by Heat-Toxin of the Zang-Fu organs and Wind-Qi knotting between the Fengfu points. Thus, the toxin erupts above and below the neck. However, being close to the throat internally, it affects the pathways of food, air, and respiration. Its manifestations include alternating chills and fever, sore throat, and difficulty swallowing, which are also ominous signs. (*Waike Qixuan*)
Kui Guang stated: Jing Yong (Neck Carbuncle) presents with redness and swelling on the chest. The condition is external, but one must guard against internal attack. In severe cases, redness and swelling lead to suppuration.