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Belongs to Heart Fire, internally there must be restlessness and mental disturbance.

It often arises from Qi stagnation, resembling fungi or wood ear mushrooms, with red-purple coloration, all belonging to Heart Fire. Treatment involves using Jindan (Golden Pill) and Bidan (Green Pill) mixed and insufflated into the throat, along with internal decoction, following the same method as treating Ling Yong (Tongue Abscess).

This refers to severe swelling of the "throat flowers" (pharyngeal tissues), leading to blistering that blocks the pharynx, causing difficulty in breathing. This belongs to Kidney Yin Deficiency with Hyperactive Fire, combined with contraction of Wind-Heat.

Redness and swelling on the chest, manifesting externally below, also threatening to attack inward; in severe cases, the throat swells shut and pus discharges.

Similar to the previous condition, occurring either on the cheeks, with itching and ulceration, or between the throat and under the tongue, with a yellow color like bees; this is a critical/fatal condition.

Similar to the previous condition, also known as Lan Jia Feng (Rotting Cheek Wind) or Sai Jia Feng (Cheek Wind). Toxicity accumulates at the gum line causing swelling, generally belonging to Stagnant Fire.

Occurring below the cheeks, caused by excessive consumption of rich flavors, mostly due to結聚 (accumulation) of heat toxicity from strong wine.

(1) Treating disease requires clear understanding of symptoms; medication should not "lock the door to catch the thief" (i.e., use astringents that trap pathogens inside), nor "invite the thief into the house" (i.e., use cold-natured herbs that damage healthy Qi and allow pathogens deeper entry), which would only increase other ailments. All throat conditions involve Ministerial Fire and Sovereign Fire; the method should be clearing and descending, treating both exterior and interior simultaneously, with expelling pathogenic factors as the priority. However, one must not indiscriminately use Shi Gao (Gypsum Fibrosum) to recklessly clear Lung and Stomach heat, as this traps the pathogen behind closed doors, damaging the pharynx and leading to death. If tongue conditions belong to Fire in the Heart and Spleen meridians, exterior and interior should be treated concurrently. One must not disorderly use Huang Qin (Scutellariae Radix) and Shi Gao to recklessly clear the Lung meridian, inviting pathogens inward and causing throat distension and phlegm obstruction. Similarly, if tooth conditions belong to Fire in the Spleen and Stomach meridians, one must not counterproductively use Huang Qin and Huang Lian (Coptidis Rhizoma), recklessly administering drugs that traverse inappropriate meridians, leading to throat and tongue swelling. In other cases, after warm-heat diseases, if Kidney fluids are dry and cannot moisten the Heart upward, causing Heart Fire to surge upward resulting in dry, painful throat, treatment should primarily focus on clearing the Heart and nourishing the Kidney; Zhi Mu (Anemarrhenae Rhizoma), Huang Bai (Phellodendri Cortex), Chuan Lian Zi (though text says Chuan Lian, likely referring to Huang Lian in context of clearing heart fire, but strictly translating text: Chuanlian/Coptis), Mai Dong (Ophiopogonis Radix), and Zhu Sha (Cinnabaris) can cure it. Do not mistakenly administer exterior-releasing agents. Using dispersants will inevitably lead to exhaustion of essence and spirit, resulting in death. Students must accurately diagnose the meridians before applying treatment; do not treat indiscriminately. [E's Note: This section discusses throat treatment methods with great precision, showing that reckless cooling is inadvisable, which is indeed sound reasoning. However, there are cases suitable for cooling, which must be judged by combining tongue coating and pulse; one must not be dogmatic.]

(2) For all throat conditions, first insufflate 1-2 tubes of Dan (pill/powder) to induce expectoration. Observe whether the phlegm is thick and tight. If the phlegm rises thick and yellow, tight, difficult to pull apart or manipulate, and sticks to the insufflation tube making it hard to wipe off, it is a critical condition. If upon initial insufflation, the phlegm is abundant and tight but does not come out, the situation is critical, and death may occur in an instant. Soak the insufflation powder in Bo He (Menthae Haplocalycis Herba) and Zhu Li (Bambusae Caulis in Taenia) decoction, cool thoroughly, administer mixed well, and there will naturally be no risk of phlegm obstruction; this is a core method. [E's Note: There are also cases suitable for needling Ya Men (GV15), Shao Shang (LU11), Qu Chi (LI11), and Lian Quan (CV23) acupoints, so that Lung Qi does not become obstructed and Nei Guan (PC6) can open and rotate. After needling, use Pili Zhen (Thunderbolt Needle) insufflation; phlegm will undoubtedly be expelled. When taking one liang of Zhu Li, it is essential to add 2-3 spoons of Sheng Jiang Zhi (Zingiberis Rhizoma Recens Juice) for safety.]

(3) For all throat conditions with redness and swelling of the neck, severely affected by seasonal toxins, if redness and swelling extend to the chest, death is inevitable; this is called "toxin returning to the Heart," and the person will necessarily laugh uncontrollably. Administer together with decoction to protect the Heart, and take more detoxifying substances to gradually calm the toxin; this is also a core method.

(4) For all throat, tooth, and tongue conditions, one must distinguish between internal and external causes, and deficiency and excess Fire. Deficiency patterns arise either post-illness or from alcohol and sexual excess, with deficient Fire flaming upward; treatment should nourish Yin and descend Fire, requiring abstinence and patience for gradual recovery. Excess patterns result from contracting seasonal pathogens, stirring up Sovereign and Ministerial Fire; in severe cases with chills, fever, and headache, initially clearing and draining, clearing and dispersing, opening knots, expelling toxins, and eliminating phlegm should be practiced concurrently. To clear the Heart, use Xi Jiao (Rhinocerotis Cornu); clearing with dispersion is preferred over the bitter-cold of Huang Lian and Huang Qin, [E's Note: If the tongue tip is deep crimson with prickles, they may also be used.] lest they suppress Fire-Toxicity, causing recurrence after recovery. For draining and dispersing, use Ge Gen (Puerariae Lobatae Radix), Bo He, Fang Feng (Saposhnikoviae Radix), and Qing Hao (Artemisiae Annuae Herba) (however, Ge Gen most exhausts Stomach fluids and should not be used lightly; replacing Qing Hao with Jing Jie (Schizonepetae Herba) is better). Avoid Sheng Ma (Cimicifugae Rhizoma), Chai Hu (Bupleuri Radix), and Jie Geng (Platycodonis Radix), [E's Note: Current Jie Geng is often Ji Jie Geng (Isodonis Radix), which has some utility, but should be used lightly.] raising Fire upwards. However, Huang Qin and Huang Lian are sometimes used; for tooth and tongue conditions, their use is acceptable. If Fire-Toxicity is stagnant in the middle, Da Huang (Rhei Radix et Rhizoma) and Mang Xiao (Natrii Sulfas) can be used to purge; when both patient and symptoms are excess, purging Fire leads to symptom resolution and recovery; this is a "hegemonic" (aggressive) method. One must be certain of the diagnosis before proceeding; any delay brings great harm. I believe that when symptoms recede, Fire dissipates naturally, and when fluids return, bowel movements resolve; this is also a secret method.

(5) For all Yin-Deficiency Hou Bi (Throat Bi/Sore Throat), with mouth and tongue ulcers/erosions, or hoarseness, these are signs of Water Deficiency and Hyperactive Fire. Initially, use Jia Wei She Gan Tang (Modified Belamcanda Decoction), followed by Zi Yin Xiao Bi Tang (Nourish Yin Eliminate Bi Decoction). Some cases develop sudden hoarseness without yet being consumptive (Lao Zhai), leading to incessant coughing and spitting. Occasional cold drinks or overuse of cold-natured medicines may stagnate Fire in the Lung. Initially, use Qing Fei San Huo Tang (Clear Lung Disperse Fire Decoction) to drive out cold air and drain Fire-Toxicity, followed by agents that nourish Yin, descend Fire, and clear the Lung. For severe throat Bi pain and swelling, use Jia Wei She Gan Tang, or insufflate Xiong Dan Bing Huang San (Bear Gallstone and Borneol Powder) into the throat. If throat Bi extends to mouth and tongue, causing ulcers and erosions, apply Liu Huang San (Willow Yellow Powder). For Yin-Fire flaming upward, without consumptive disease, sudden hoarseness with phlegm-cough, after 2-3 doses of Qing Fei San Huo Tang, use Zi Shui Kai Yin Tang (Nourish Water Open Yin Decoction).

(6) Throat conditions worsen on the fifth day. If within the first three days, although severe, suppuration has not formed, medicine can dissipate it. By days five or six, the affected area usually suppurates; even if it ruptures, a rotten cavity remains difficult to heal. The rotten area must use Kou Gan (Mouth Ulcer) medicine, adding Long Gu (Fossilia Ossis Mastodi) and Er Cha (Camelliae Semen), insufflated repeatedly until healed. For continuous pearl-like tonsils (Lian Zhu Ru E) and throat Bi occurring after Shang Han (Cold Damage), treatment is generally hopeless, except for treatments by Master Zhang. Nuchal rigidity, eyes rolling upward, and cessation of breath are untreatable. Throat pain appearing for 1-2 days may not present with chills/fever, indicating mild illness. By the third day, severe symptoms must appear, accompanied by chills and fever; one must ask about urination and defecation. If both are free, the condition is merely floating Fire attacking the throat, and clearing wind, clearing heat, and descending fire medications will cure it quickly. If urination and defecation are blocked, there is internal Excess Fire; unless using fire-descending and detoxifying agents combined with bowel-opening medicines, how can Fire be drained and the disease resolved? Thus, conditions vary in severity, and diseases in urgency. One must ask if there is headache; if yes, it is a difficult-to-treat Shang Han condition. [E's Note: Adding much Long Gu and Er Cha is not appropriate; if internal Heat-Toxicity is not cleared, rivers are prone to bursting.]

(7) Although throat conditions are fierce, if swelling manifests externally, even if critical signs are seen, treatment yields easy recovery.

(8) Swelling in the Emperor region (likely referring to specific anatomical area or typo for 'Di Zhong' - central throat), though a severe condition with difficulty inhaling, heals quickly with prompt treatment; delay makes it severe. Throat conditions can only hope for recovery after bowel movement; if stool is constipated, recovery cannot be lightly promised. [E's Note: This implies unblocking the lower pathway to allow Heaven Qi (upper Qi) to descend, akin to removing firewood from under the cauldron. There are also cases where bowels are open but Deficient Yang rebels upward, causing extreme swelling and pain; nourishing Yin and clearing transformation, the method for treating Bai Hou (White Throat/Diphtheria), applies here.]

(9) For early-stage throat conditions with constipation, use Da Huang and Yuan Ming Fen (Mirabilite), combined with exterior-interior releasing agents to purge, thereby descending Fire and facilitating recovery. If after five or six days of fasting, stool is blocked, this is due to prolonged illness depleting Stomach Qi and Yuan Qi; Xiao (Mirabilite) and Huang (Da Huang) are forbidden. Do not recklessly administer aggressive purgatives to avoid collapse and death. To relieve constipation, only nourish Yin, descend Fire, and use honey suppositories or similar lubricating laxatives; this is a secret method. If using Xiao and Huang, diagnose the pulse; if forceful, purge accordingly. [E's Note: If the Right Guan position is deep, solid, and forceful, or slippery and rapid beating against the finger, purging is applicable.] (Jinghua's Note: For Wind-Fire throat conditions, at the stage of throat closure, Qi and Blood must be stagnant, and the pulse must be deep and choppy; do not mistake this for weakness. At this time, rely on symptoms rather than pulse; assess the presence of Stomach Qi. If Stomach Qi remains, purging is indicated.)

(10) For throat condition insufflation, the powder must directly face the entire throat circumference. Insufflate heavily 4-5 tubes to reduce toxic phlegm; after 3-4 times, use decoction.

(11) For throat conditions that have already ulcerated, insufflate flesh-regenerating medicine to cover the broken area, then frequently insufflate various powders until swelling subsides.

(12) Throat conditions swell and hurt on days 1-2, stabilize with defined shape on days 3-4. If chills/fever or headache recur every third day, constant insufflation can alleviate it; knowing this indicates life/death hangs in the balance for a few days. (Jinghua's Note: For women with throat swelling/pain where menstruation has just stopped, and Fire cannot descend downward, regulating the menses allows the throat to heal spontaneously.) [E's Note: This is what is called "Heat entering the Blood Chamber"; it is not exclusive to throat conditions. Shang Han and Warm Diseases also present this syndrome; clearing the Ying (Nutrient) level cures it.]

(13) For fierce throat conditions, if head and face swell, appearing white and lustrous without radiance, and the pulse is deep, thin, and spiritless, this is Spirit Qi leaking outward, a condition devoid of Yang; it is absolutely untreatable. If the face shows redness and swelling, and the pulse is surging, large, and forceful, although the condition is extremely severe, Yuan Qi is still strong, and although Toxic Fire is flourishing, treatment yields easy recovery.

(14) Cheeks easily swell and rot; bind silk cotton to chopsticks, dip in water, and gently stir the affected area. If painful, medication will surely cure it. If there is no sensation of pain, it is dead flesh, difficult to heal.

(15) For tongue swelling filling the mouth, protruding outside, making it difficult to administer medicine, use Kai Guan San (Open Gate Powder) insufflated into the nose; the jaw will open naturally, and phlegm/saliva will discharge. Then, wrap cotton around chopsticks, dip in Gan Cao Tang (Licorice Decoction), moisten lips, then administer Dan/San (powders), insufflating frequently until healed.

(16) Insufflation is not only for swollen/ruptured areas but also for surrounding healthy flesh, to prevent spread and facilitate healing. For mouth/tongue conditions, if after insufflation the tongue has no saliva or resembles a dried orange peel, it is untreatable.

(17) Mouth/tongue erosion without bleeding is untreatable. Perforation through the cheek is untreatable. Rot extending to the nasal bridge with red spots is untreatable. Only Master Zhang treats these. For enlarged tongue, apply raw Huang Bai (Phellodendri Cortex) with Bing Pian (Borneolum Syntheticum). If bleeding occurs, use fried Huang Bai and Bing Pian; this is a wonderful method.

(18) For HT (likely typo for specific term, possibly 'Hou' Throat) Tongue-Throat Abscess, if constipated, add Yuan Ming Fen and Da Huang to decoction. If urination is blocked, mix Liu Yi San (Six-to-One Powder) and take orally; very effective, this is a core method.

(19) For Tooth-Biting Abscess, gum tissue swells and protrudes, jaw locks tightly, mouth cannot open. First, prepare Gan Suan San (Sweet Spiderwort Powder) mixed with a little Ba Dou (Crotonis Fructus), insufflate into gums. Use a tongue depressor to slowly pry open the jaw, frequently insufflating medication until healed.

(20) For Kou Gan (Mouth Ulcers), gently stir with silk cotton; never use blue cloth, lest it injure the affected area and hinder healing. Medications should be pungent and dispersing, finely ground. Storage must prevent gas escape; sealing the bottle mouth tightly with Wu Jin Zhi (Black Gold Paper) is best. Any medicinal ingredients not processed by fire should be sun-dried until crisp and powdered for use.