咽喉诸症。古人分七十二名目。其实三大纲统之矣。三大纲者何。一曰喉蛾。二曰喉痹。三曰喉风。喉蛾者。初起
恶寒发热。形圆高肿。色赤脉数或紧。四五日即脓成，治法于未溃时。宜刺少。商、少冲、中冲、出血。药宜解毒消肿。
方剂如银花、赤芍、丹皮、黄连、黄芩、皂角、生甘草、贝母、枳壳之类。吹药如稀涎散。开关散之类。或用桐油探吐
其痰。关窍一通。即能消肿进食。如四五日后。脓已成。其色或赤或紫。脉洪大而数。须刺破患处。泄其脓毒恶血。内
服解毒清火。如银花、连翘、丹皮、山栀、黄连、黄芩、生甘草、贝母、归地之类。外吹排脓化毒之药。如黄连、黄
芩、朴硝、冰片、硼砂。少
加轻粉、牛黄。即冰硼散随症加味可也。如溃久不愈。则名烂喉蛾。有虚实二种。虚者色白腐。脉虚数。实者色紫而
脉沉紧。虚者宜人参养荣汤、生脉散之类。实者宜鲜菊叶、紫花地丁草之类。火毒盛者。仍用芩、黄、丹皮等清之。甚
者加犀角、大黄。喉痹乃君相二火相并所发。形如小棋。初起无发热恶寒之表症。十余日方成脓。内经云。一阴一阳
结而为喉痹。一阴者。手少阴君火之脉气也。一阳者。手少阳三焦之脉气也。二脉共络于喉。气盛则内结而肿
胀。胀甚则气痹痹者闭也。故治喉痹。当以散结泻火为主。初起亦宜刺少商等穴出血。治与喉蛾大同小异。方中
宜加桔梗、僵蚕、玉枢丹等散结之品。吹药如吕雪、品雪、锡类散等类。惟喉风形症。与前不同。治亦迥异。其症初起
漫肿不高。或外连颈肿。必发热恶寒。而脉浮数。痰涎壅塞。初起宜普济消毒饮、张氏六味汤、随症加减。吹药宜疏
凡化痰顺气。如皂角、薄荷、僵蚕、人中白、黄芩、黄连、硼砂、冰片之类。溃烂色紫。必加珍珠、西牛黄、琥珀之类。
以生肌败毒。如虚烂日久。色白脉虚。方药宜用温补。吹药亦勿过寒。如芩、连、西牛黄、冰片之类。咸在所忌。宜用
琥珀、珍珠、
滴乳石、人中白、朱砂之类。生肌和血。又有弄舌喉风。哑喉风。乃毒盛于内。必重用解毒。缠喉风乃风毒上盛。主以
辛凉轻散。锁喉风真者。乃绝症不治。面青瞠目。轻者以桂附八味加玉枢丹一锭。磨冲。此须开其上而温其下也。
喉症之书甚多。大略不越于此。更能深思类推。则游刃有余矣。近有时疫白喉一书。论症以足三阴为主。盖喉症
皆在手经。不关足经。古书具在。何得经脉倒置。真是无知妄作。明者自知。姑勿深辨耳。
咽喉的各种病症，古人分为七十二种名目。其实可以用三个大纲来统摄。这三个大纲是什么？一是喉蛾，二是喉痹，三是喉风。
喉蛾（扁桃体炎）初起时，出现恶寒发热，形状圆而高耸肿胀，颜色红赤，脉象数或紧。四五天后就会化脓。治疗在未溃破时，适宜针刺少商、少冲、中冲穴出血。药物宜用解毒消肿的方剂，如金银花、赤芍、丹皮、黄连、黄芩、皂角、生甘草、贝母、枳壳之类。吹药（局部用药）可用稀涎散、开关散之类。或者用桐油探吐其痰，关窍一通，就能消肿进食。如果四五日后，脓已形成，颜色或红或紫，脉象洪大而数，必须刺破患处，泄出脓毒恶血。内服解毒清火的药物，如金银花、连翘、丹皮、山栀、黄连、黄芩、生甘草、贝母、当归、地黄之类。外用吹排脓化毒的药物，如黄连、黄芩、朴硝、冰片、硼砂，少量加入轻粉、牛黄，即冰硼散随症加味即可。如果溃烂日久不愈，则称为烂喉蛾。有虚实两种类型。虚证颜色白且腐，脉象虚数；实证颜色紫且脉象沉紧。虚证宜用人参养荣汤、生脉散之类。实证宜用鲜菊叶、紫花地丁草之类。火毒盛者，仍用黄芩、黄连、丹皮等清热。严重者加入犀角、大黄。
喉痹（咽喉闭塞不通）是君火和相火相互搏结所发。形态像小棋子。初起没有发热恶寒的表证。十多天才化脓。《内经》说：“一阴一阳结而为喉痹。”一阴，是指手少阴心经君火的脉气。一阳，是指手少阳三焦经的脉气。这两条经脉共同络属于咽喉。气盛则内部结聚而肿胀。胀甚则气机闭塞。“痹”就是闭的意思。所以治疗喉痹，应当以散结泻火为主。初起也适宜针刺少商等穴出血。治疗方法与喉蛾大同小异。方剂中宜加桔梗、僵蚕、玉枢丹等散结的药物。吹药如吕雪、品雪、锡类散之类。
只有喉风的形态症状，与前两者不同，治疗方法也截然不同。其症状初起漫肿不高，或者向外连及颈部肿胀，必定发热恶寒，脉象浮数。痰涎壅塞。初起宜用普济消毒饮、张氏六味汤，随症加减。吹药宜疏风化痰顺气，如皂角、薄荷、僵蚕、人中白、黄芩、黄连、硼砂、冰片之类。溃烂颜色紫，必须加入珍珠、西牛黄、琥珀之类，以生肌败毒。如果是虚证烂久，颜色白脉虚，方药宜用温补。吹药也不要过于寒凉，如黄芩、黄连、西牛黄、冰片之类，都在禁忌之列。宜用琥珀、珍珠、滴乳石、人中白、朱砂之类，生肌和血。
又有弄舌喉风、哑喉风，这是毒邪盛于内部，必须重用解毒。缠喉风是风毒上盛，主治以辛凉轻散。锁喉风真正的情况，是绝症不治，面色青黑，瞪眼直视。轻者用桂附八味丸加上一锭玉枢丹，磨水冲服。这需要开通上部并温煦下部。
关于喉症的书籍很多，大略都不超出这个范围。如果能深思类推，就能游刃有余了。近来有关于时疫白喉的书，论述病症以足三阴经为主。大概喉症都在手经，不关乎足经。古书俱在，怎么能颠倒经脉？真是无知妄作。明白的人自然知道，姑且不深入辩驳罢了。
Various diseases of the throat and pharynx were divided into seventy-two categories by ancient physicians. In reality, they can be governed by three main principles. What are these three principles? First is Hou'e (Tonsillitis), second is Houbi (Pharyngeal Obstruction), and third is Housheng (Wind-Throat).
Hou'e (Tonsillitis): At the onset, there is aversion to cold and fever. The swelling is round, high, and elevated, with red coloration; the pulse is rapid or tight. After four to five days, pus forms. During the pre-ulcerative stage, it is appropriate to prick Shaoshang (LU-11), Shaochong (HT-9), and Zhongchong (PC-9) acupoints to bleed. Medications should focus on resolving toxicity and reducing swelling, such as Flos Lonicerae (Jinyinhua), Radix Paeoniae Rubra (Chishao), Cortex Moutan (Danpi), Rhizoma Coptidis (Huanglian), Cortex Phellodendri (Huangqin), Fructus Gleditsiae Sinensis (Zaocys/Shaojiao), Raw Radix Glycyrrhizae (Sheng Gancao), Bulbus Fritillariae (Beimu), and Fructus Aurantii (Zhike). Topical powders for insufflation include Xixian San and Kaiguan San. Alternatively, using tung oil to induce vomiting can expel phlegm; once the orifice is cleared, swelling subsides and eating resumes. If after four to five days pus has formed, appearing red or purple, with a surging and rapid pulse, the affected area must be lanced to drain pus, toxins, and foul blood. Internal medications should resolve toxicity and clear fire, such as Flos Lonicerae, Fructus Forsythiae (Lianqiao), Cortex Moutan, Fructus Gardeniae (Shanzhi), Rhizoma Coptidis, Cortex Phellodendri, Raw Radix Glycyrrhizae, Bulbus Fritillariae, Radix Angelicae Sinensis (Danggui), and Radix Rehmanniae Preparata (Dihuang). External insufflations for draining pus and resolving toxins include Rhizoma Coptidis, Cortex Phellodendri, Natrii Sulfas (Puxiao), Borax (Pengsha), and Borneolum Syntheticum (Bingpian), with small amounts of Minium (Qingfen) and Calculus Bovis (Niuhuang); this resembles Bingpeng San modified according to symptoms. If ulceration persists without healing, it is called Lanhou'e (Rotting Tonsillitis). There are deficiency and excess patterns. Deficiency presents with white, necrotic tissue and a deficient-rapid pulse; excess presents with purple coloration and a deep-tight pulse. Deficiency is treated with Renshen Yangrong Tang and Shengmai San. Excess is treated with fresh Chrysanthemi Folium (Xian Juye) and Radix et Rhizoma Violae (Zihuadiding). For severe fire-toxicity, Huangqin, Huanglian, and Danpi are used to clear heat; in severe cases, Cornu Rhinocerotis (Xijiao) and Radix et Rhizoma Rhei (Dahuang) are added.
Houbi (Pharyngeal Obstruction) arises from the conjunction of Ministerial Fire and Sovereign Fire. It resembles a small chess piece. Initially, there are no exterior symptoms of fever or aversion to cold. Pus forms after more than ten days. The *Neijing* states: "When one Yin and one Yang knot together, it becomes Houbi." One Yin refers to the meridian qi of the Hand-Shaoyin Heart channel (Sovereign Fire). One Yang refers to the meridian qi of the Hand-Shaoyang Sanjiao channel. These two meridians interconnect at the throat. Excessive Qi leads to internal knotting and swelling. Severe swelling causes Qi obstruction ("Bi" means closure). Therefore, treating Houbi focuses primarily on dissipating knots and purging fire. Initially, pricking Shaoshang and other acupoints to bleed is also appropriate. Treatment is largely similar to that of Hou'e but with minor differences. Formulas should include Platycodonis Radix (Jiegeng), Bombyx Batryticatus (Jiangcan), and Yushu Dan for dissipating knots. Insufflations include Lv Xue, Pin Xue, and Xi Lei San.
Housheng (Wind-Throat) differs significantly in morphology and treatment. Symptoms begin with diffuse, non-elevated swelling, potentially extending to the neck, accompanied by fever, aversion to cold, and a floating-rapid pulse. Phlegm-saliva obstructs the airway. Initial treatment uses Puji Xiaodu Yin or Zhang's Liuwei Tang, modified per symptoms. Insufflations should disperse wind, transform phlegm, and regulate Qi, using Fructus Gleditsiae Sinensis, Menthae Haplocalycis Herba (Bohe), Bombyx Batryticatus, Natrii Uridas Carbonisat (Renzhongbai), Cortex Phellodendri, Rhizoma Coptidis, Borax, and Borneolum Syntheticum. If ulceration is purple, Pearl (Zhenzhu), Indian Calculus Bovis (Xi Niuhuang), and Succinum (Hupo) are added to generate flesh and defeat toxins. If chronic ulceration is due to deficiency, presenting with white color and deficient pulse, warming and tonifying formulas are used. Insufflations should not be overly cold; Huangqin, Huanglian, Xi Niuhuang, and Bingpian are contraindicated. Instead, Hupo, Zhenzhu, Petra Cum Drosta (Dilushi), Renzhongbai, and Cinnabaris (Zhusha) are used to generate flesh and harmonize blood.
Other types include Lengshe Housheng (Tongue-Winding Wind-Throat) and Ya Housheng (Mute Wind-Throat), caused by severe internal toxicity requiring heavy detoxification. Chan Housheng (Coiling Wind-Throat) is caused by ascending wind-toxicity, treated with pungent-cool light dispersants. Suo Housheng (Lock-Throat) in its true form is a terminal, incurable condition characterized by cyanotic face and staring eyes. Mild cases are treated with Guifu Bawei Wan plus one tablet of Yushu Dan ground and mixed with water. This approach opens the upper orifices while warming the lower body.
There are many books on throat diseases, generally covering these points. Deep reflection and analogical reasoning allow for flexible application. Recently, a book on epidemic White Throat (Baihou) claims that throat diseases are primarily related to the Three Foot-Yin meridians. However, throat diseases involve the Hand meridians, not the Foot meridians. Ancient texts are available; how can meridians be reversed? This is ignorant fabrication. Those who understand will know; I shall not debate it further.