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Transparent Realgar (ground finely and purified by water flotation) Curcumae Longae Rhizoma (Yujin, 郁金) Semen Crotonis Tiglii Frost (Badou Shuang, 巴豆霜)

The above herbs are ground into fine powder. Rice vinegar is boiled to make a concentrated decoction. The powder is mixed with the vinegar juice to form pills the size of mung beans. Each dose is four fen (approx. 1.2g). Soak in tea soup until soft, then mash and swallow. Children's dosage is halved.

(From *Baihou Jibiao Juwei*)

Contraindications for Baihou (Diphtheria-like throat disease) have been discussed in detail by various authors. They are listed item by item below. For those points requiring particular elucidation and deliberation, brief comments are added as follows:

Baihou arises from the transformation of dryness-heat fire in the Hand-Taiyin Lung Meridian. Treatment should focus on nourishing yin and clearing heat. Even if accompanied by superficial symptoms of wood-fire from the Shaoyang and Shaoyin meridians, one should follow Wu Juzhong’s method in Warm Disease theory: clearing heat while simultaneously dispersing. One must strictly avoid using warming and ascending herbs such as Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), or Fenge (Puerariae Radix), as these would assist the flame. This principle was analyzed in great detail by Wu Juzhong; it can be studied carefully. Zhang Shanwu’s formulas, such as Chuwen Huadu Shengong Pixie San, all prioritize the use of Gegen (Puerariae Radix), which precisely violates this contraindication. Vomiting therapy is a key technique for treating the Six Exogenous Pathogens, but it is strictly contraindicated in this condition. There is a fear that inducing vomiting will cause the pathogenic qi to surge upward.

Mahuang (Ephedrae Herba), Guizhi (Cinnamomi Ramulus), Qianghuo (Notopterygii Rhizoma et Radix), and Fangfeng (Saposhnikoviae Radix) are ancestral herbs for inducing sweating in cold-damp conditions. Their use is strictly prohibited in warm diseases; how much more so in Baihou, which is purely dryness-fire? Administering diaphoretic agents would damage body fluids.

In throat disorders, if fire-toxin accumulates between the intestines and stomach, causing abdominal pain and constipation, purgative methods may be used. However, in Baihou, purgatives must be used with extreme caution. Dryness-fire scorches metal (Lung), leading to the internal depletion of Lung fluids. Treatment must primarily focus on nourishing yin and clearing dryness; it cannot be resolved in just one or two doses. After severe purgation, Stomach qi becomes exhausted, making it impossible for yin-nourishing medicines to be tolerated. This not only severely damages body fluids. If absolutely necessary, one may imitate Wu Juzhong’s Xuanbai Chengqi Tang method, rather than directly applying Zhang Zhongjing’s three Chengqi Decoctions.

The use of knives and needles in throat surgery is usually due to wind-fire stagnating in the blood level, causing redness, swelling, pain, and obstruction, with danger imminent. It is necessary to puncture and release evil blood to vent the qi, allowing the fire to subside naturally. Since Baihou has a slower onset, it can be treated according to standard methods. Why resort to indiscriminate use of knives and needles, thereby injuring yin blood? Only when the Taiyin primary syndrome is mild, but the Shaoyang and Shaoyin wind-fire secondary syndromes are severe, with abnormal redness and swelling, turning purple, and swelling extending to the neck and back, may puncturing be used intermittently. Areas showing white patches must still not be touched. This principle is elaborated slightly in the section on simultaneous involvement of these three meridians; please refer to it.