疼痛或寒热者，邪在表也，宜发散。肿痛痰涎壅盛者，邪在上也，宜降之。痛而脉数无
力者，属阴虚，宜滋阴降火。肿痛发热便闭者，表里俱实病也，宜解表攻里。如证紧急，更刺患
处，或刺少商穴。
一男子咽痛而脉数，以荆防败毒散加芩、连二剂稍愈，乃去芩、连，又二剂而愈。
一男子咽喉肿闭，牙关紧急，针不能入，先刺少商二穴，出黑血，口即开；更针患处，
饮清
救。
一妇人咽喉肿痛，大小便秘，以防风通圣散一剂，诸证悉退；又荆防败毒散，三剂而安
。常治此证，轻则荆防败毒散、吹喉散，重则用密钥匙，及刺患处，出血最效，否则不救。针少
商二穴，亦可，不若刺患处之为神速耳。
一男子咽喉肿痛，脉数而实，以凉膈散，一剂而痛止；以荆防败毒散加牛蒡子，二剂而
肿退；以荆防败毒散二剂，又以甘、桔、荆、防、玄参、牛蒡子，四剂而平。
一男子咽喉肿闭，痰涎壅甚，以胆矾吹咽中，吐痰碗许；更以清咽利膈汤，四剂而安。
一男子咽喉肿痛，药不能下，针患处，出紫血稍愈，以破棺丹噙之；更以清咽消毒散，
服之而愈。
一男子咽喉干燥而痛，以四物汤加黄柏、知母、玄参、四剂稍愈，更以人参固本丸，一
剂不再发。
一男子口舌生疮，服凉药愈甚，治以理中汤而愈。
一男子咽痛，午后益甚，脉数无力，以四物汤，加黄柏、知母、荆、防，四剂而愈；仍
以前药，去荆、防加玄参、甘桔数剂，后不再发。
一弱人咽痛，服凉药，或遇劳愈甚，以补中益气汤加芩、连，四剂而愈；乃去芩、连，
又数剂，不再发。常治午后痛，去芩连加知母、黄柏、玄参，亦效。
一老人咽痛，日晡尤甚，以补中益气汤加酒炒黄柏、知母，数剂而愈。
一男子乳蛾肿痛，脉浮数，尚未成脓，针去恶血，饮荆防败毒散，二剂而消。
一男子乳蛾肿痛，饮食不入，疮色白，其脓已成，针之，脓出即安。
一男嗌痈肿痛，脉浮数，更沉实，饮防风通圣散一剂，泻一次，势顿退；又荆防败毒散
，二剂而消。
一男子咽喉肿痛，余欲针之，以泄其毒，彼畏针止，服药，然药既熟，已不能下矣；始
急针患处，出毒血，更饮清咽消毒药而愈。
一患者，其色已绝，心头尚温，急针患处，出黑血即苏，如鲍符卿、乔侍御素有此证，
每患皆以针去血即愈。
大抵咽喉之症，皆因火为患，其害甚速，须分缓急，及脓成否。若肿闭及壅塞者，死在
反掌
须急针患处，否则不治。前人云∶治喉闭之火，与救火同，不容少待。又云∶走马看喉闭，
信夫！治喉之方固多，惟用针有回生之功。
一男子口舌生疮，饮食不甘，劳而愈甚，以理中汤，治之顿愈。
一男子口舌糜烂，服凉药愈甚，脉数而无力，以四物加酒炒黄柏、知母、玄参，一剂顿
退，四剂而痊。
一男子口舌生疮，脉浮而缓，饮补中益气汤加炮姜，更以桂末，含之即愈。
一男子患之，劳而愈甚，以前药加附子三片，二剂即愈。丹溪云∶口疮服凉药不愈者，
此中焦气不足，虚火泛上，无制，用理中汤，甚则加附子。
一男子咽喉作痛，痰涎上壅，余欲治以荆防败毒散，加连翘、山栀、牛蒡子，彼自服甘
寒降
紫
荆防败毒散以散之；治之迟，或势重者，须刺少商穴。瘀血已结，必刺患处，亦有刺少商。
咽虽利而未全消者，必成脓也，然脓去即安。若有大便秘结者，虽经针刺去血，必欲以防风
通圣散攻之，甘寒之剂，非虚火不宜用。
一妇人咽间作痛，两月后始溃，突而不敛，遍身筋骨亦痛，诸药不应，先以萆 汤，数
剂而
身上，年余不愈，以萆 为末，乳汁调服，母以白汤调服，月余而愈。 一男子咽间先患，
及于身，服轻粉之剂，稍愈；已而复发，仍服之，亦稍愈；后大发，上 溃蚀，与鼻相通，
臂腿数枚，其状如桃，大溃，年余不敛；神思倦怠，饮食少思，虚证悉具，投以萆 汤为主
，以健脾胃之剂，兼服之，月余而安。
一妇人患之，脸鼻俱蚀，筋骨作痛，脚面与跟各肿一块，三月而溃，脓水淋漓，半载不敛，治以前药亦愈。（萆 汤
方见杨梅疮门）
一男子齿痛，脉数实便秘，用防风通圣散即愈。
一男子齿痛，而胃脉数而有力，以清胃散加石膏、荆防风，二剂而痊。
一男子齿痛甚，胃脉数实，以承气汤一剂即止。
一男子齿痛，脉浮无力，以补中益气汤，加黄连、生地黄、石膏治之，不复作。
一老人齿痛，午后即发，至晚尤甚，胃脉数而实，以凉膈散加荆芥、防风、石膏，一剂
而瘳。
一妇人常口舌糜烂，颊赤唇干，眼涩作渴，脉数，按之则涩，此心肺壅热，伤于气血为
患，
云∶妇人热劳者，由心肺壅热，伤于气血。气血不调，脏腑壅滞，热毒内积，不得宣通之所
致也。其候心神烦躁，颊赤头痛，眼涩唇干，四肢壮热，烦渴不止，口舌生疮，神思沉昏，
嗜卧少寐，饮食无味，举体酸疼，或时心怔，或时盗汗，肌肤日渐消瘦，故名热劳也。
附方
荆防败毒散（方见溃疡发热门）
清咽利膈汤 治积热咽喉肿痛，痰涎壅盛，或胸膈不利，烦躁饮冷，大便秘结。
金银花 防风 荆芥 薄荷 桔梗（炒） 黄芩（炒） 黄连（炒，各钱半） 山栀（炒、研）
翘（各二钱） 玄参 大黄（煨） 朴硝 牛蒡子（研） 甘草（各七分） 作一剂，水二钟煎一
钟，食后服。
密钥匙 治喉闭缠喉风痰涎壅塞盛者，水浆难下。
焰硝（一两五钱） 鹏砂（五钱） 脑子（一字） 白僵蚕（一钱） 雄黄（二钱） 各另为细末
，和匀，以竹管吹患处，痰涎即出。如痰虽出，咽喉仍不消，急针患处，去恶血。
凉膈散（方见作渴门）
防风通圣散（方见天泡疮门）
补中益气汤（方见溃疡发热门）
刺少商穴法 穴在手大指内侧，去爪甲如韭叶。刺入二分许，以手自臂勒至刺处
出血，即消。若重者，及脓成者，必须针患处，否则不治（复绘图于卷末。）
四物汤（方见瘰 门）
破棺丹（方见发背门）
理中汤 治脾胃不健，饮食少思，或作呕，或服寒药，致饮食少思，或肚腹作痛
人参 干姜（炮） 甘草（炙） 白术（炒，各一钱半） 作一剂，水一钟，煎五分，食远服
清胃散 治胃经湿热，牙齿或牙龈肿痛，或牵引头脑，或面发热，并治之。
当归身（酒拌，一钱） 黄连 生地黄（酒拌，各二钱） 牡丹皮（一钱五分） 升麻（二钱）
作一剂，水二钟，煎七分，食远服。
承气汤 治肠胃积热，口舌生疮，或牙齿龈作痛。
大黄（煨） 甘草 朴硝（各二钱） 作一剂，水一钟半，煎八分，食前服。
清咽消毒散 治咽喉生疮肿痛，痰涎壅盛，或口舌生疮，大便秘结，即荆防败毒
散加芩、连、硝黄（方见溃疡发热门。）
人参固本丸 治肺气燥热作渴，或小便短少赤色，及肺气虚热，小便涩滞如淋，
此虚而有火之圣药也。
生地黄（酒拌） 熟地黄（用生者酒拌，铜器蒸半日） 天门冬（去心） 麦门冬（去心，各
一两）
温酒下，中寒人不可服。
Pain accompanied by aversion to cold and fever indicates pathogenic factors in the exterior; dispersing methods should be used. Swelling, pain, and profuse phlegm-saliva indicate pathogenic factors in the upper jiao; descending methods should be used. Pain with a rapid but weak pulse indicates Yin deficiency; nourishing Yin and descending fire should be used. Swelling, pain, fever, and constipation indicate excess conditions in both the interior and exterior; releasing the exterior and purging the interior should be used. If the condition is urgent, acupuncture at the affected area or at Shaoshang (LU-11) acupoint may be applied.
A male patient suffered from sore throat with a rapid pulse. After two doses of Jingfang Baidu San (Jing-Jie and Fang-Feng Decoction for Overcoming Toxins) added with Huangqin (Scutellariae Radix) and Lianhua (Coptidis Rhizoma), he improved slightly. The Huangqin and Lianhua were then removed, and after another two doses, he recovered.
A male patient presented with swollen and obstructed throat, trismus (lockjaw), and inability to swallow medicine or insert needles. First, Shaoshang (LU-11) bilaterally was pricked to release dark blood, which immediately opened his mouth. Then, the affected area was needled, and he drank a clearing and rescuing decoction.
A female patient had sore throat and swelling, with difficulty in urination and defecation. One dose of Fangfeng Tongsheng San (Saposhnikovia Decoction for Unblocking the Intestines and Releasing the Exterior) resolved all symptoms. Subsequently, three doses of Jingfang Baidu San brought stability. Generally, for mild cases, Jingfang Baidu San and Chuihou San (Throat Blowing Powder) are used; for severe cases, Miyaoshi (Secret Key) and acupuncture at the affected area to bleed are most effective; otherwise, rescue is impossible. Pricking Shaoshang (LU-11) is also an option, but not as rapid as needling the affected area.
A male patient had sore throat and swelling with a rapid and solid pulse. One dose of Liangge San (Cooling the Epigastrium Decoction) stopped the pain. Two doses of Jingfang Baidu San added with Niubangzi (Arctii Fructus) reduced the swelling. Another two doses of Jingfang Baidu San, followed by four doses of a formula containing Gancao (Licorice Root), Jiegeng (Platycodon Root), Jingjie (Schizonepeta Spike), Fangfeng (Saposhnikovia Root), Xuanshen (Scrophulariae Radix), and Niubangzi, brought resolution.
A male patient had swollen and obstructed throat with severe phlegm-saliva accumulation. Dianfan (Alum) was blown into the throat, causing him to expectorate about one bowl of phlegm. Then, Qingyan Lige Tang (Clear Throat and Descend Diaphragm Decoction) was administered for four doses, resulting in stability.
A male patient had sore throat and swelling, unable to swallow medicine. Acupuncture at the affected area released purple blood, leading to slight improvement. He then held Po Guan Dan (Corpse-Breaking Pill) in his mouth. Finally, Qingyan Xiaodu San (Clear Throat and Eliminate Toxin Powder) cured him.
A male patient had dry and painful throat. Four doses of Siwu Tang (Four Substances Decoction) added with Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), and Xuanshen provided slight relief. One dose of Renshen Guben Wan (Ginseng Root-Nourishing Pill) prevented recurrence.
A male patient had sores on the mouth and tongue. His condition worsened with cooling medicines. Lizhong Tang (Regulate the Middle Decoction) cured him.
A male patient had sore throat worsening in the afternoon with a rapid, weak pulse. Four doses of Siwu Tang added with Huangbai, Zhimu, Jingjie, and Fangfeng cured him. Subsequently, removing Jingjie and Fangfeng from the previous formula and adding Xuanshen, Gancao, and Jiegeng for several doses prevented recurrence.
A frail patient had sore throat worsening with cooling medicines or exertion. Four doses of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Huangqin and Lianhua cured him. Removing Huangqin and Lianhua and continuing for several doses prevented recurrence. For afternoon pain, removing Huangqin and Lianhua and adding Zhimu, Huangbai, and Xuanshen is also effective.
An elderly patient had sore throat worsening in the late afternoon. Several doses of Buzhong Yiqi Tang added with wine-fried Huangbai and Zhimu cured him.
A male patient had swollen and painful tonsils (Ru'e) with a floating, rapid pulse, before suppuration. Needling to remove bad blood and drinking Jingfang Baidu San for two doses resolved it.
A male patient had swollen and painful tonsils, unable to eat, with white lesions indicating suppuration. Needling released pus, bringing immediate relief.
A male patient had neck abscess with swelling and pain. The pulse was initially floating and rapid, then became deep and solid. One dose of Fangfeng Tongsheng San caused one bowel movement, significantly reducing the severity. Two doses of Jingfang Baidu San resolved it.
A male patient had sore throat and swelling. I intended to needle to drain toxicity, but he feared needles and chose medicine. However, by the time the medicine was ready, he could no longer swallow. Urgent needling of the affected area released toxic blood, and drinking Qingyan Xiaodu San cured him.
A patient appeared clinically dead with only warmth remaining in the heart region. Urgent needling of the affected area released black blood, and he revived instantly. Patients like Bao Fuqing and Qiao Shiyu, who frequently suffered this condition, always recovered after bloodletting via needling.
Generally, throat diseases are caused by Fire, acting rapidly. One must distinguish urgency and whether suppuration has formed. In cases of severe swelling, obstruction, and congestion, death can occur instantly; urgent needling of the affected area is required, otherwise it is untreatable. Ancients said: Treating throat closure due to Fire is like fighting a fire; there is no time to lose. They also said: "Watch throat closure as if riding a swift horse," which is true! Although many formulas exist for treating the throat, only needling has the power to revive the dying.
A male patient had sores on the mouth and tongue, poor appetite, worsening with fatigue. Lizhong Tang cured him immediately.
A male patient had eroded mouth and tongue, worsening with cooling medicines. Pulse was rapid and weak. One dose of Siwu Tang added with wine-fried Huangbai, Zhimu, and Xuanshen rapidly reduced symptoms; four doses led to recovery.
A male patient had sores on the mouth and tongue with a floating, slow pulse. Drinking Buzhong Yiqi Tang added with Paojiang (Prepared Ginger) and holding Cinnamon powder in the mouth cured him.
A male patient suffered from this condition, worsening with fatigue. Adding three slices of Fuzi (Aconiti Lateralis Radix Praeparata) to the previous formula for two doses cured him. Danxi stated: For mouth sores unresponsive to cooling medicines, this is due to insufficient Qi in the Middle Jiao, allowing deficient Fire to float upward without restraint. Use Lizhong Tang; in severe cases, add Fuzi.
A male patient had sore throat with phlegm-saliva congestion. I intended to treat with Jingfang Baidu San added with Lianqiao (Forsythiae Fructus), Zhizi (Gardeniae Fructus), and Niubangzi. He self-medicated with sweet-cold descending herbs. Jingfang Baidu San was used to disperse. If treatment is delayed or severe, Shaoshang (LU-11) must be pricked. If blood stasis has formed, the affected area must be needled; sometimes Shaoshang is also used.
If the throat feels clear but swelling does not fully resolve, suppuration will likely form; however, once pus drains, relief follows. If constipation exists, even after bloodletting, Fangfeng Tongsheng San should be used to purge. Sweet-cold agents are not suitable for deficient Fire.
A female patient had throat pain. After two months, it ulcerated, protruded, and did not heal. Whole-body bone and joint pain occurred, unresponsive to various medicines. First, Bixie Tang (Dioscorea Hypoglauca Decoction) for several doses improved her body. She had not healed for over a year. Taking Bixie as powder mixed with milk, and her mother taking it with plain water, cured her within a month. A male patient first suffered throat issues spreading to the body. Taking Calomel (Qingfen) provided slight relief; upon recurrence, taking it again provided slight relief. Later, a severe outbreak occurred with upper erosion connecting to the nose, and several large, peach-like ulcers on arms and legs, not healing for over a year. Mental fatigue, poor appetite, and full deficiency signs appeared. Mainly using Bixie Tang combined with spleen-strengthening agents brought stability within a month.
A female patient suffered from this disease, with facial and nasal erosion, bone/joint pain, and swelling on the instep and heel. Ulceration occurred after three months with dripping pus, not healing for half a year. Treatment with the previous formula also cured her. (Bixie Tang formula is seen in the Chancre section).
A male patient had toothache with a rapid, solid pulse and constipation. Fangfeng Tongsheng San cured him.
A male patient had toothache with a rapid, forceful stomach pulse. Qingwei San (Clear Stomach Powder) added with Shigao (Gypsum Fibrosum), Jingjie, and Fangfeng cured him in two doses.
A male patient had severe toothache with a rapid, solid stomach pulse. Chengqi Tang (Chengqi Decoction) stopped it in one dose.
A male patient had toothache with a floating, weak pulse. Buzhong Yiqi Tang added with Huanglian (Coptidis Rhizoma), Shengdihuang (Rehmanniae Radix), and Shigao treated it without recurrence.
An elderly patient had toothache starting in the afternoon, worsening at night. Stomach pulse was rapid and solid. Liangge San added with Jingjie, Fangfeng, and Shigao cured him in one dose.
A female patient frequently had eroded mouth and tongue, red cheeks, dry lips, dry eyes, thirst, rapid pulse that becomes choppy upon pressure. This is caused by Heat congestion in Heart and Lung damaging Qi and Blood. [Missing Name] stated: Female Heat Exhaustion (Re Lao) is caused by Heat congestion in Heart and Lung damaging Qi and Blood. Disharmony of Qi and Blood, stagnation of Zang-Fu, internal accumulation of Heat-Toxin, and failure to vent cause this. Symptoms include mental restlessness, red cheeks, headache, dry eyes/lips, strong heat in limbs, incessant thirst, mouth/tongue sores, lethargy, insomnia, loss of taste, whole-body ache, palpitations, night sweats, and gradual emaciation. Hence named Heat Exhaustion.
Attached Formulas
Jingfang Baidu San (See Ulcer Fever Section)
Qingyan Lige Tang Treats accumulated Heat causing sore throat/swelling, profuse phlegm-saliva, chest/diaphragm discomfort, irritability, craving cold drinks, and constipation.
Jinyinhua (Lonicerae Japonicae Flos), Fangfeng (Saposhnikovia Radix), Jingjie (Schizonepetae Spica), Bohe (Menthae Haplocalycis Herba), Jiegeng (Platycodonis Radix, stir-fried), Huangqin (Scutellariae Radix, stir-fried), Huanglian (Coptidis Rhizoma, stir-fried, each 1.5 qian), Shanzhi (Gardeniae Fructus, stir-fried and crushed), Lianqiao (Forsythiae Fructus, each 2 qian), Xuanshen (Scrophulariae Radix), Dahuang (Rhei Radix et Rhizoma, baked), Pomiao (Natrii Sulfas), Niubangzi (Arctii Fructus, crushed), Gancao (Glycyrrhizae Radix et Rhizoma, each 0.7 qian). Make one dose, boil in two zhong of water to one zhong, take after meals.
Miyaoshi Treats throat closure and strangling wind with severe phlegm-saliva congestion, making swallowing difficult.
Yanxiao (Natrii Nitras, 1.5 liang), Pengsha (Borisovi Borax, 5 qian), Naozhi (Camphora, one zi), Baijiangcan (Bombyx Batryticatus, 1 qian), Xionghuang (Realgar, 2 qian). Grind each separately into fine powder, mix evenly. Blow into affected area with bamboo tube; phlegm-saliva will discharge. If phlegm clears but throat remains swollen, urgently needle the affected area to remove bad blood.
Liangge San (See Thirst Section)
Fangfeng Tongsheng San (See Vesicle Disease Section)
Buzhong Yiqi Tang (See Ulcer Fever Section)
Needling Shaoshang Acupoint Method The acupoint is on the medial side of the thumb, distance from nail edge like a leek leaf. Insert approximately 2 fen. Press from arm towards the puncture site to induce bleeding; swelling will subside. For severe cases or when suppuration forms, needling the affected area is mandatory; otherwise, it is untreatable. (Diagram repeated at end of volume.)
Siwu Tang (See Scrofula Section)
Po Guan Dan (See Carbuncle Section)
Lizhong Tang Treats Spleen-Stomach weakness, poor appetite, vomiting, or poor appetite induced by cold medicines, or abdominal pain.
Renshen (Ginseng Radix), Ganjiang (Zingiberis Rhizoma, processed), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried, each 1.5 qian). Make one dose, boil in one zhong of water to five fen, take far from meals.
Qingwei San Treats Damp-Heat in Stomach Meridian causing tooth/gum swelling/pain, radiating to head, or facial heat.
Danggui Shen (Angelicae Sinensis Radix, wine-soaked, 1 qian), Huanglian (Coptidis Rhizoma), Shengdihuang (Rehmanniae Radix, wine-soaked, each 2 qian), Mudanpi (Moutan Cortex, 1.5 qian), Shengma (Cimicifugae Rhizoma, 2 qian). Make one dose, boil in two zhong of water to seven fen, take far from meals.
Chengqi Tang Treats Intestinal-Stomach accumulated Heat causing mouth/tongue sores or gum/tooth pain.
Dahuang (Rhei Radix et Rhizoma, baked), Gancao (Glycyrrhizae Radix et Rhizoma), Pomiao (Natrii Sulfas, each 2 qian). Make one dose, boil in one and a half zhong of water to eight fen, take before meals.
Qingyan Xiaodu San Treats throat sores/swelling, profuse phlegm-saliva, mouth/tongue sores, and constipation. It is Jingfang Baidu San added with Huangqin, Huanglian, Pomiao, and Dahuang (See Ulcer Fever Section).
Renshen Guben Wan Treats Lung-Qi dry-heat causing thirst, or short/scanty red urine, and Lung-Qi deficient heat causing dysuria resembling strangury. It is a sacred medicine for deficiency with Fire.
Shengdihuang (Rehmanniae Radix, wine-soaked), Shudihuang (Rehmanniae Radix Praeparata, made from raw root wine-soaked and steamed in copper vessel for half day), Tianmendong (Asparagi Radix, heart removed), Maimendong (Ophiopogonis Radix, heart removed, each 1 liang). Take with warm wine. Not for those with Middle Cold.