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Raw Gypsum Fibrosum (Shigao), Phellodendri Cortex (Huangbai), Ophiopogonis Radix (Maidong, 麦冬) [use after removing the heart], Raw Gardeniae Fructus (Zhizi), Rehmanniae Radix (Shengdi), Violae Herba (Zihuadiding), Forsythiae Fructum cum Calyce (Lianqiao Jia), Akebiae Caulis (Mutong), Armeniacae Semen Amarum (Xingren, 杏仁) [remove skin and tips, pound], Scrophulariae Radix (Yuanyuan Shen), Mori Folium (Sangye).

The above eleven herbs. Add five cups of water. Decoct to obtain three cups. Take warm in two doses. Administer two or three times daily. If dryness is severe and Yin fluids are depleted, urgently preserve fluids by adding Panax Quinquefolii Radix (Xi Yangshen) and Rhinocerotis Cornu (Xijiao), doubling the dosage of Ophiopogonis Radix (Maidong), Rehmanniae Radix (Dìhuáng), and Scrophulariae Radix (Yuán Shēn). If fire pathogen is intense with throat swelling turning purple, urgently add blood-cooling and fire-toxin-resolving herbs such as Lithospermi Radix (Zicao), Moutan Cortex (Danpi), and Jinzhi (Gold Juice). If phlegm-saliva is abundant and obstructing, add Calculus Bovis (Niuhuang). Alternatively, use Qinghuang San intermittently.

Rehmanniae Radix (Shengdi), Forsythiae Fructum cum Calyce (Lianqiao Jia), Arctii Fructus (Niubangzi, 牛蒡子) [use raw and pound], Ophiopogonis Radix (Maidong, 麦冬) [use after removing the heart], Lophatheri Herba (Danzhuye), Akebiae Caulis (Mutong), Fritillariae Bulbus (Beimu), Raw Gardeniae Fructus (Sheng Zhiren), Violae Herba (Zihuadiding), Lonicerae Japonicae Flos (Jinyinhua), Junci Medulla (Dengxincao).

The above ten herbs. Add five cups of water. Decoct to obtain three cups. Filter out dregs. Take warm in two doses. Administer twice daily.

When Diphtheria (Baihou) presents symptoms involving all three meridians (Taiyin, Shaoyang, Shaoyin), treat according to the severity of the syndrome, referencing medications for these three meridians. If fire-toxin is extremely abundant, causing purple swelling in the throat, even extending to the neck and back, with danger imminent, urgently puncture the red and swollen areas with a knife and needle to release evil blood and curb the momentum. Or use the method of blowing powder into the throat.

"Three meridians" refers to Taiyin, Shaoyang, and Shaoyin. Manifestations of root and branch have varying degrees of severity; treating according to the syndrome ensures recovery. However, there are cases of concurrent disease of the three meridians, where signs of Taiyin, Shaoyang, and Shaoyin appear together. Treat each according to the severity of its condition. If Shaoyang branch symptoms are predominant, heavily utilize Shaoyang medications; if Shaoyin branch symptoms are predominant, heavily utilize Shaoyin medications. By observing previous and subsequent discussions, the essential principles become clear. If fire pathogen is excessively strong, beyond the reach of herbal medicine, urgently use knife and needle. Diphtheria (Baihou) is generally contraindicated for knife and needle therapy, and predecessors often emphasized this warning. The current assertion that it can be punctured likely has profound rationale. If there is no redness, swelling, or pain, only dry throat without phlegm, indicating purely Taiyin dry-fire, Lung Yin must already be injured. At this point, relying on a trace of Yin blood for self-preservation is crucial. Puncturing now would inevitably lead to collapse. However, if accompanied by Shaoyang and Shaoyin branch symptoms with excessive solid fire stagnating in the throat causing red-purple discoloration, even swelling to the neck and back, with rapid onset potentially fatal within moments, one cannot fail to urgently puncture to release evil blood and vent Qi. This applies only to abnormal severe cases, used as a last resort, not as standard practice. Areas with white pseudomembranes must still not be violated; physicians must exercise caution. I once heard Mr. Naixiu recount how his relative's daughter and maid suffered from this disease sequentially. Learning from Dr. Jia's error, they refused medication and had an old woman scrape off the white membranes, expelling several dou of saliva and blood, resulting in recovery. One month later, Mr. Wang himself contracted the disease and used the same method, but the illness did not subside. He claimed he could not understand why, attributing it to differences in constitution strength and fate. I privately doubted this statement. Later, my medical friend Xue Yunru told me his wife contracted this disease in autumn of the Bing-Shen year and recovered shortly after the red and swollen areas were punctured with a knife and needle. This year, Friend Lin's daughter also contracted this disease with extreme throat redness and swelling, extending to shoulders, back, chest, and neck, accompanied by epistaxis. I stated this condition requires knife and needle therapy, as medication alone was ineffective. The family followed the local doctor's advice and dared not puncture. Days later, she vomited several bowls of evil blood and died. Only then did I realize that the cases of Wang's daughter/maid and Friend Xue's wife were both Shaoyang-Shaoyin branch diseases with urgent wind-fire patterns, hence recovery after puncture. Mr. Wang's case was purely Taiyin dry-fire root disease; puncturing was not only useless but accelerated disaster. The nuances here are subtle. How can one fail to investigate carefully and exhaustively, instead using vague notions of fate to shirk responsibility? This fails to achieve the full potential of investigating things to acquire knowledge.