某 阴亏体质。温气上蒸。齿痛连及头巅。（温邪） 用玉女煎。
某 火郁。巅顶属厥阴。上结核。龈肿。（火）
犀角 羚羊角 元参 知母 生甘草 连翘 黑山栀 银花 夏枯草
王（四一） 酒客牙宣。衄血痰血。形寒内热。食少。阴药浊味姑缓。（阴虚火炎）
小黑豆皮 人中白 旱莲草 川斛 左牡蛎 泽泻
徐（二二） 脉细数上出。体属阴虚。内热。牙痈后。颊车穴闭。口不能张。其病在络。药饵难效。拟进宣
通络痹方后（牙痈后络痹）
羚羊角 僵蚕 川桂枝尖 煨明天麻 炒丹皮 黑山栀 钩藤
汪 风热上蒸。龈胀头痛。当用轻清上焦。（风热）
活水芦根 囫囵滑石 西瓜翠衣 生绿豆皮 连翘 银花
牙症不外乎风火虫虚。此但言其痛也。其他如牙宣牙HT 。牙菌牙疳。牙痈穿牙毒。骨槽风
走马牙疳之类。皆由于湿火热毒。蕴结牙床。须分上下二齿。辨明手足阳明。及少阴之异。
又当察其专科而任之。（华玉堂）
陆 风火上郁。项肿咽痛。（风火）
薄荷 连翘 射干 牛蒡子 马勃 绿豆皮
邵 风火上郁。咽痛头胀。宜用辛凉。
西瓜翠衣 滑石 连翘 桑皮 射干 杏仁
汪（二三） 左脉弦数。咽痛脘闷。阴亏体质。不耐辛温。当以轻药。暂清上焦。（肺燥热）
桑叶 生绿豆皮 白沙参 川贝 元参 川斛
王（二七） 劳伤恐有瘀腐。进辛润宣血。初服身痛。继渐平复。但喉间紧痹。而呼吸饮食仍不觉其苦。
眼白仍带黄。议清肺中气热治。
百部 大沙参 鲜枇杷叶 活水芦根 川贝 地骨皮 南花粉 苡仁
徐（五六） 老劳咽疼。
生鸡子白（一枚） 糯稻根须（水洗五钱） 甜北沙参（一钱半） 炒麦冬（三钱） 川石斛（一钱半）
生甘草（三分）
杨 未病阴气走泄为虚。秽浊上受则实。咽喉肿痹。上窍邪蒙。日暮昏烦。阴伤日炽。肌肤柔白。
气分不足。此医药虽宜凉解清上。但不可犯及中下。（秽浊上受喉肿痹）
连翘 郁金 马勃 牛蒡子 竹叶心 黑山栀 杏仁 橘红
艾 上焦之病。都是气分。气窒则上下不通。而中宫遂胀。热气蒸灼。喉舌疳蚀。清气之中。必佐
解毒。皆受重药之累瘁。（气分热毒）
银花（二钱） 川贝（三钱） 马兜铃（五分） 连翘心（一钱半） 川通草（一钱） 白金汁（一杯）
活水芦根汁（半杯）
又 余热蒸痰壅气。当脘膈因咳而痛。议以润降清肃。
甜杏仁 花粉 川贝 甘草 桔梗
孙（四九） 肾液不收。肝阳上越。巅胀流涕。咽喉微痛。（阴虚火炎）六味加牛膝车前五味
伍（四六） 咽喉痛痹。发时如有物阻膈。甚至痛连心下。每晚加剧。是阴液日枯。肝脏厥阳化火风上
灼。法以柔剂。仿甘以缓其急耳。
细生地 天冬 阿胶 生鸡子黄 元参心 糯稻根须
陈（三七） 阴阳交虚营卫欹斜。为忽冷忽热。周身骸骨皆痛。百脉皆损。秋半天气已降。身中气反泄
越。汗出喉痹。阳不入于阴。致自为动搏耳。夫咽喉之患。久则喉痹喉宣。妨阻受纳。最不易治。
从少阴咽痛例。用猪肤汤旬日。喉痛得缓。对症转方。
张（二三） 阴损三年不复。入夏咽痛拒纳。寒凉清咽。反加泄泻。则知龙相上腾。若电光火灼。虽倾
盆豪雨。不能扑灭。必身中阴阳协和方息。此草木无情难效耳。从仲景少阴咽痛用猪肤汤主之。
又 阴涸于下。阳炽于上。为少阴喉痛。乃损怯之末传矣。用猪肤甘凉益坎。有情之属而效。今
肉腠消烁殆尽。下焦易冷。髓空极矣。何暇以痰嗽为理。议滑涩之补味咸入肾可也。
牛骨髓（四两） 羊骨髓（四两） 猪骨髓（四两） 麋角胶（四两）
用建莲肉五两。山药五两。芡实二两。同捣丸。
金（四二） 脏液不充。阳气虚风鼓动。病起喉辣心震。频频举发。多因劳怒。用内经甘缓一法。
人参 萸肉炭 白芍 炙甘草 茯神 小麦
又 复脉汤去桂。
内经云。一阴一阳结。谓之喉痹。一阴者手少阴君火。心之脉气也。一阳者。手少阳相火。
三焦之脉气也。夫二经之脉。并络于喉。故气热则内结。结甚则肿胀。胀甚则痹。痹甚则不
通而死矣。即今之所谓喉癣喉风喉蛾等类是也。夫推原十二经。惟足太阳别下项。其余
皆凑咽喉。然内经独言一阴一阳结。为喉痹者。何也。盖以君相二火独胜。则热且痛也。愚
历考咽喉汤方。皆用辛散咸软。去风痰。解热毒为主。如元参升麻汤。圣济透关散。及玉钥
匙。如圣散。普济消毒饮子。皆急于治标。而缓于治本。恐缓则伤人。故以治标为急耳。又尝
考仲景伤寒论。咽喉生疮等症。每用甘草桔梗半夏散及汤为主。一为少阴水亏。不能上
济君火。以致咽喉生疮。不能出声。故以半夏之辛滑。佐鸡子清利窍通声。使以苦酒入阴。
劫涎敛疮。桂枝解肌由经脉而出肌表。悉从太阳开发。而半夏治咽痛。可无燥津涸液之
患。一为阴火上结而为咽痛。故用生甘草甘凉泄热。功在缓肾急而救阴液。佐以桔梗开
提足少阴之热邪。如肾液下泄。不能上蒸于肺。致络燥而为咽痛者。仲景又有猪肤一法。
润燥解热缓中。使其阴阳协和而后愈。是固本而兼治标者也。如风火上郁。阴亏脉数而
为咽痛者。先生又有辛凉清上诸法。如咽喉紧痹。气热而为咽痛者。又有清肺中气热一
法。如情志郁勃。相火上炎。而为咽痛者。则又有降气开浊一法。如肾液不收。肝阳上越而
为咽痛者。宗钱氏六味汤。如阴阳交虚。龙相上灼而为咽痛者。宗仲景猪肤汤法。（邹滋九）
徐评 凡病属于经络脏腑者。皆煎丸之所能治。一属形体及九窍。则属有形之病。实有邪气
凝结之处。药入胃中。不过气到耳。安能去凝结之邪。故煎丸之功。不过居其半耳。若欲速效。必
用外治之法。可以应手而愈。博考方书。广求秘法。自能得之。此老尚未知之也。故其治有形诸
病。皆非所长。又外治之法。上古所鲜闻。因其用针灸之术。通神入妙。何必外治。此则外治之最
者也。后世针法不传。于是乎以药代针。而多外治之法。若针灸既废。而外治之法亦不讲。则天
下之病。即使用药的当。只能愈其半耳。其外症之必需外治者。竟无愈理。此亦医道之一大关
也。后之学人须知之。
某患者，体质阴液亏虚。温热邪气向上蒸腾。牙齿疼痛牵连至头顶。（此为温邪所致） 使用玉女煎治疗。
某患者，火邪郁结。头顶部位归属于厥阴经。上部出现结节肿块，牙龈肿胀。（此为火邪所致）
处方：犀角、羚羊角、玄参、知母、生甘草、连翘、黑山栀、金银花、夏枯草。
王某（四十一岁），长期饮酒者患牙宣（牙龈萎缩出血）。伴有鼻衄（鼻出血）、痰中带血。身体怕冷但体内发热，食欲减退。因阴虚火炎，暂且避免使用气味浑浊滋腻的滋阴药物。（病机为阴虚火炎）
处方：小黑豆皮、人中白、旱莲草、川石斛、左牡蛎、泽泻。
徐某（二十二岁），脉象细数且浮越于上。体质属于阴虚。内有热邪。在牙痈（牙龈脓肿）之后，颊车穴处经络闭塞，嘴巴无法张开。病变在于络脉，药物治疗难以见效。拟采用宣通络痹方后法治疗。（病因为牙痈后导致的络脉痹阻）
处方：羚羊角、僵蚕、川桂枝尖、煨明天麻、炒丹皮、黑山栀、钩藤。
汪某，风热邪气向上蒸腾。牙龈肿胀头痛。应当使用轻清之品清解上焦。（病因为风热）
处方：活水芦根、囫囵滑石、西瓜翠衣、生绿豆皮、连翘、金银花。
牙齿病症不外乎风、火、虫、虚四种原因。此处仅论述了疼痛的情况。其他的如牙宣、牙疳、牙菌、牙痈、穿牙毒、骨槽风、走马牙疳等，都是由于湿火热毒蕴结在牙床所致。必须区分上齿和下齿，辨明手阳明、足阳明以及足少阴经的差异。又应当考察专科医生来负责治疗。（华玉堂按语）
陆某，风火邪气郁结于上。颈部肿胀，咽喉疼痛。（病因为风火）
处方：薄荷、连翘、射干、牛蒡子、马勃、绿豆皮。
邵某，风火邪气郁结于上。咽喉疼痛，头部胀闷。适宜使用辛凉之法。
处方：西瓜翠衣、滑石、连翘、桑白皮、射干、杏仁。
汪某（二十三岁），左侧脉象弦数。咽喉疼痛，胃脘部闷塞。体质阴亏，不耐受辛温药物。应当使用轻清之药，暂时清解上焦。（病因为肺燥热）
处方：桑叶、生绿豆皮、南沙参、川贝母、玄参、川石斛。
王某（二十七岁），劳损可能导致瘀血腐浊。进用辛润活血之法。初服时身体疼痛，随后逐渐平复。但喉间感觉紧束痹阻，然而呼吸和饮食仍不觉得痛苦。眼白仍然带黄。议定清泄肺中气热的方法治疗。
处方：百部、大沙参、鲜枇杷叶、活水芦根、川贝母、地骨皮、南花粉、薏苡仁。
徐某（五十六岁），年老体劳导致咽痛。
处方：生鸡蛋清（一枚）、糯稻根须（水洗五钱）、甜北沙参（一钱半）、炒麦冬（三钱）、川石斛（一钱半）、生甘草（三分）。
杨某，未患病时阴气耗散则为虚证；感受秽浊邪气则为实证。咽喉肿胀痹阻，上窍被邪气蒙蔽。傍晚时分昏沉烦乱。阴伤日益严重，肌肤柔白。气分不足。虽然医药适宜凉解清上，但不可触犯中下二焦。（病因为秽浊上受导致喉肿痹）
处方：连翘、郁金、马勃、牛蒡子、竹叶心、黑山栀、杏仁、橘红。
艾某，上焦的疾病，多关乎气分。气机窒塞则上下不通，从而导致中焦胀满。热气蒸灼，导致喉舌生疮蚀烂。在清气之中，必须佐以解毒之品。这都是受到重药伤害的结果。（病因为气分热毒）
处方：金银花（二钱）、川贝母（三钱）、马兜铃（五分）、连翘心（一钱半）、川通草（一钱）、白金汁（一杯）、活水芦根汁（半杯）。
复诊：余热蒸腾导致痰壅气逆。胃脘膈部因咳嗽而疼痛。议定以润降清肃之法治疗。
处方：甜杏仁、花粉、川贝母、甘草、桔梗。
孙某（四十九岁），肾液不收摄，肝阳上越。头顶胀闷流涕，咽喉微痛。（病因为阴虚火炎）六味地黄丸加牛膝、车前子、五味子。
伍某（四十六岁），咽喉痛痹。发作时感觉如有物体阻塞胸膈，甚至疼痛牵连心下。每晚加剧。这是阴液日渐枯竭，肝脏厥阳化火生风上灼所致。治法宜用柔剂，仿效“甘以缓急”的方法。
处方：细生地、天冬、阿胶、生鸡蛋黄、玄参心、糯稻根须。
陈某（三十七岁），阴阳两虚，营卫失调。表现为忽冷忽热，周身骨骼皆痛，百脉受损。秋半时节天气已降，体内气机反而泄越，汗出导致喉痹。阳气不能入于阴，导致自身搏动不安。夫咽喉的病患，日久则成喉痹或喉宣，妨碍吞咽，最不易治疗。参照少阴咽痛的先例，服用猪肤汤旬日，喉痛得以缓解。对症转换方药。
张某（二十三岁），阴精亏损三年未恢复。入夏后咽痛拒食。使用寒凉清咽药物，反而加重腹泻。由此可知是龙雷之火（相火）上腾，如同电光火灼，即使倾盆大雨也不能扑灭。必须体内阴阳协和才能平息。此乃草木无情之药难以为效。参照张仲景《伤寒论》少阴咽痛例，使用猪肤汤主治。
复诊：阴液枯竭于下，阳气炽盛于上，导致少阴喉痛，这是虚损劳怯病的末期传变。使用猪肤汤甘凉益肾（坎水），利用有情之品而见效。如今肌肉腠理消烁殆尽，下焦容易寒冷，骨髓空虚至极。哪里还有闲暇去调理痰嗽？议定使用滑涩兼备、味咸入肾的补益方法。
处方：牛骨髓（四两）、羊骨髓（四两）、猪骨髓（四两）、鹿角胶（四两）。
用法：用建莲肉五两、山药五两、芡实二两，一同捣碎制成丸药。
金某（四十二岁），脏腑津液不充盈，阳气虚弱，虚风鼓动。病起于喉咙辣痛、心脏震动，频频发作。多因劳累和愤怒引起。采用《内经》中“甘以缓急”的方法。
处方：人参、山萸肉炭、白芍、炙甘草、茯神、小麦。
复诊：复脉汤去掉桂枝。
《内经》说：“一阴一阳结，谓之喉痹。”一阴指的是手少阴君火，即心的脉气。一阳指的是手少阳相火，即三焦的脉气。这两条经脉的脉气，都联络于咽喉。所以气热则内部结聚，结聚严重则肿胀，肿胀严重则痹阻，痹阻严重则不通而死。这就是现在所说的喉癣、喉风、喉蛾等类疾病。推究十二经脉，只有足太阳膀胱经别行向下项部，其余经脉都凑集于咽喉。然而《内经》唯独说一阴一阳结导致喉痹，为什么呢？大概是因为君火和相火独胜，所以既热且痛。我历次考证治疗咽喉的汤方，大多使用辛散咸软的药物，以祛风痰、解热毒为主。如元参升麻汤、圣济透关散、玉钥匙、如圣散、普济消毒饮子等，都急于治标而迟缓治本，恐怕迟缓则会伤人，所以以治标为急务。我又曾考证张仲景《伤寒论》，对于咽喉生疮等症状，每用甘草桔梗半夏散及汤为主。一是针对少阴水亏，不能上济君火，以致咽喉生疮，不能出声。故用半夏的辛滑，佐以鸡蛋清利窍通声，使以苦酒入阴，劫取涎沫收敛疮口，桂枝解肌通过经脉出于肌表，全部从太阳经开发。这样半夏治疗咽痛，就没有燥伤津液的危害。二是针对阴火上结导致的咽痛，故用生甘草甘凉泄热，功效在于缓和肾急而救阴液，佐以桔梗开提足少阴的热邪。如果肾液下泄，不能上蒸于肺，导致络脉干燥而咽痛，张仲景又有猪肤汤一法，润燥解热缓中，使其阴阳协和而后痊愈。这是固本兼治标的方法。如风火上郁，阴亏脉数而导致咽痛者，先生又有辛凉清上的各种方法。如咽喉紧痹，气热而导致咽痛者，又有清肺中气热一法。如情志郁勃，相火上炎而导致咽痛者，则有降气开浊一法。如肾液不收，肝阳上越而导致咽痛者，宗法钱乙的六味地黄汤。如阴阳交虚，龙雷之火上灼而导致咽痛者，宗法张仲景的猪肤汤法。（邹滋九按语）
徐某评注：凡是疾病属于经络脏腑的，都可以用煎剂和丸剂治疗。一旦属于形体及九窍，就属于有形的疾病，是有邪气凝结的地方。药物进入胃中，不过气机到达而已，怎么能去除凝结的邪气？所以煎丸的功效，只占一半。如果想要速效，必须使用外治法，可以应手而愈。广泛考证方书，广求秘法，自然能得到。这位老先生还不知道这一点。所以他治疗有形的诸病，都不是他的专长。另外，外治法在上古时期很少听闻，因为其运用针灸之术，通神入妙，何必需要外治？这才是外治的最高境界。后世针法失传，于是用药物代替针刺，从而有了多种外治法。如果针灸废弃，而外治法也不讲究，那么天下的疾病，即使用药得当，也只能治愈一半。那些外症必需外治的，竟然没有痊愈的道理。这也是医道的一大关键。后来学习医学的人必须知晓。
A certain patient has a constitution of Yin deficiency. Warm pathogenic qi steams upward. Toothache radiates to the vertex of the head. (Caused by warm pathogen) Use Yü Nü Jian (Jade Woman Decoction).
A certain patient suffers from Fire stagnation. The vertex belongs to the Jueyin channel. There are nodules and swelling in the upper part, and swollen gums. (Caused by Fire)
Prescription: Rhinoceros Horn (Xijiao), Antelope Horn (Lingyangjiao), Scrophulariae Radix (Yuánshēn), Anemarrhenae Rhizoma (Zhīmǔ), Raw Licorice Root (Shēng Gāncǎo), Forsythiae Fructus (Liánqiào), Gardenia Fruit (Hēi Shānzhī), Lonicerae Japonicae Flos (Yínghuā), Prunellae Spica (Xiàkūcǎo).
Mr. Wang (41 years old), a chronic drinker suffers from Gingival Atrophy (Yá Xuān). Accompanied by epistaxis (Níxuè) and blood in sputum. Chills with internal heat, poor appetite. Due to Yin deficiency with flaming fire, turbid-flavored Yin-nourishing medicines are temporarily avoided. (Pathogenesis: Yin deficiency with flaming fire)
Prescription: Black Soybean Skin (Xiǎo Hēidòupí), Human Calcined Bone (Rénzhōngbái), Ecliptae Herba (Hàoliáncǎo), Dendrobii Caulis (Chuān Shíhú), Left-side Oyster Shell (Zuǒ Mǔlì), Alisma Rhizoma (Zéxiè).
Mr. Xu (22 years old), pulse is fine, rapid, and floating upwards. Constitution is Yin deficiency. Internal heat. After a dental abscess (Yá Yōng), the Jiache acupoint area is blocked, mouth cannot open. The disease lies in the collaterals, medicinal administration is difficult to be effective. Propose to advance the method after Xuantong Luobi Formula. (Etiology: Collateral obstruction after dental abscess)
Prescription: Antelope Horn (Língyángjiǎo), Silkworm (Jiāngcán), Cinnamon Twig Tip (Chuān Guìzhījiān), Gingered Gastrodia Rhizome (Wēi Tiānmá), Fried Moutan Cortex (Chǎo Dānpí), Gardenia Fruit (Hēi Shānzhī), Uncaria Ramulus cum Uncis (Gōuténg).
Mr. Wang, Wind-Heat steams upward. Swollen gums and headache. Should use light and clear agents to clear the Upper Jiao. (Etiology: Wind-Heat)
Prescription: Fresh Reed Rhizome (Huóshuǐ Lúgēn), Whole Talcum (Húlún Huáshí), Watermelon Rind (Xīguā Cuìyī), Raw Mung Bean Skin (Shēng Lǜdòupí), Forsythiae Fructus (Liánqiào), Lonicerae Japonicae Flos (Yínghuā).
Dental diseases are not outside of Wind, Fire, Worms, and Deficiency. This text only discusses pain. Others such as gingival atrophy, cancrorum oris, gum polyps, dental abscess, penetrating tooth poison, alveolar osteitis, and gangrenous stomatitis are all due to dampness, fire, and toxic heat accumulating in the gum bed. One must distinguish between upper and lower teeth, differentiate the Hand Yangming, Foot Yangming, and Foot Shaoyin channels. Furthermore, one should consult specialists for treatment. (Commentary by Hua Yutang)
Mr. Lu, Wind-Fire stagnates upward. Neck swelling and sore throat. (Etiology: Wind-Fire)
Prescription: Mint (Bòhe), Forsythiae Fructus (Liánqiào), Belamcanda Rhizome (Shègān), Arctii Fructus (Niúfùzǐ), Pseudobulbus Pleiones (Mǎbó), Mung Bean Skin (Lǜdòupí).
Mr. Shao, Wind-Fire stagnates upward. Sore throat and head distension. Suitable to use Acrid-Cool methods.
Prescription: Watermelon Rind (Xīguā Cuìyī), Talcum (Huáshí), Forsythiae Fructus (Liánqiào), Mulberry Bark (Sāngpí), Belamcanda Rhizome (Shègān), Apricot Seed (Xìngrén).
Mr. Wang (23 years old), left pulse is wiry and rapid. Sore throat and epigastric stuffiness. Yin deficient constitution, intolerant to Acrid-Warm drugs. Should use light medicines to temporarily clear the Upper Jiao. (Etiology: Lung dryness-heat)
Prescription: Mulberry Leaf (Sāngyè), Raw Mung Bean Skin (Shēng Lǜdòupí), Nan Sha Shen (Báishāshēn), Fritillaria Bulb (Chuān Bèi), Scrophulariae Radix (Yuánshēn), Dendrobii Caulis (Chuān Shíhú).
Mr. Wang (27 years old), labor injury may cause blood stasis and putrefaction. Advance Acrid-Moistening blood-invigorating method. Initially body pain, then gradually subsides. But throat feels tight and obstructed, yet breathing and eating are still not bothersome. Whites of eyes still yellow. Propose to clear Qi-heat in the Lung.
Prescription: Stemona Root (Bǎibù), Large Glehnia Root (Dà Shāshēn), Fresh Loquat Leaf (Xiān Pípányè), Fresh Reed Rhizome (Huóshuǐ Lúgēn), Fritillaria Bulb (Chuān Bèi), Phellodendri Cortex (Dìgǔpí), Trichosanthes Root (Nán Huāfěn), Coix Seed (Yǐrén).
Mr. Xu (56 years old), elderly and overworked causing sore throat.
Prescription: Raw Egg White (One egg), Glutinous Rice Rootlets (Ruóxídàogēnxū - washed, 5 qian), Sweet Northern Glehnia Root (Tiān Běi Shāshēn - 1.5 qian), Fried Ophiopogon Tuber (Chǎo Màidōng - 3 qian), Dendrobii Caulis (Chuān Shíhú - 1.5 qian), Raw Licorice Root (Shēng Gāncǎo - 0.3 fen).
Mr. Yang, before illness, leakage of Yin Qi leads to deficiency; receiving turbid pathogens leads to excess. Swelling and obstruction of throat and pharynx, upper orifices obscured by pathogens. Dusk brings drowsiness and irritability. Yin injury intensifies daily, skin is soft and white. Qi deficiency. Although medicine should cool and clear the upper, it must not offend the Middle and Lower Jiao. (Etiology: Turbid pathogen affecting throat swelling/obstruction)
Prescription: Forsythiae Fructus (Liánqiào), Curcuma Aromatica Rhizome (Yùjīn), Pseudobulbus Pleiones (Mǎbó), Arctii Fructus (Niúfùzǐ), Bamboo Leaf Heart (Zhúyèxīn), Gardenia Fruit (Hēi Shānzhī), Apricot Seed (Xìngrén), Tangerine Peel (Júhóng).
Mr. Ai, diseases of the Upper Jiao relate to Qi. Qi stagnation causes blockage above and below, leading to middle jiao distension. Heat steams and burns, causing sores and erosion of throat and tongue. In clearing Qi, detoxifying agents must be assisted. All have suffered from heavy medicines. (Etiology: Qi-level heat-toxin)
Prescription: Lonicerae Japonicae Flos (Yínhuā - 2 qian), Fritillaria Bulb (Chuān Bèi - 3 qian), Aristolochiae Fructus (Mǎdōulíng - 0.5 fen), Forsythia Calyx (Liánqiào xīn - 1.5 qian), Taro Stem (Chuān Tōngcǎo - 1 qian), Platinum Juice (Báijīnzhī - 1 cup), Fresh Reed Rhizome Juice (Huóshuǐ Lúgēnzhī - half cup).
Follow-up: Residual heat steams phlegm obstructing Qi. Epigastric and diaphragmatic pain due to cough. Propose moistening, descending, clearing, and purifying method.
Prescription: Sweet Apricot Seed (Tián Xìngrén), Trichosanthes Root (Huāfěn), Fritillaria Bulb (Chuān Bèi), Licorice Root (Gāncǎo), Platycodon Root (Jié gěng).
Mr. Sun (49 years old), Kidney fluid fails to consolidate, Liver Yang floats upward. Vertex distension and runny nose, slight sore throat. (Etiology: Yin deficiency with flaming fire) Liu Wei Di Huang Wan plus Achyranthes Root (Niúxī), Alisma Rhizoma (Chēqiánzǐ), Schisandra Berry (Wǔwèizi).
Mr. Wu (46 years old), sore throat obstruction. Onset feels like an object blocking the chest/diaphragm, even pain radiating to the heart region. Worsens every night. This is daily depletion of Yin fluids, Liver Jue-Yang transforming into Fire and Wind burning upward. Method uses soft agents, imitating "Sweet to relieve urgency."
Prescription: Fine Rehmannia Root (Xì Shēngdì), Asparagus Tuber (Tiāndōng), Donkey-hide Gelatin (Ējiāo), Raw Egg Yolk (Shēng Jīzihuáng), Scrophulariae Radix Heart (Yuánshēn xīn), Glutinous Rice Rootlets (Ruóxídàogēnxū).
Mr. Chen (37 years old), Yin and Yang both deficient, Ying and Wei disharmonious. Presents with alternating chills and fever, pain in all bones, damage to all vessels. Mid-autumn weather descends, but body Qi leaks outward. Sweating causes throat obstruction. Yang fails to enter Yin, causing self-pulsation. Throat ailments, if prolonged, become throat obstruction or dilation, hindering swallowing, most difficult to treat. Following the example of Shaoyin sore throat, used Zhufu Tang for ten days, throat pain eased. Adjust formula based on symptoms.
Mr. Zhang (23 years old), Yin damage for three years without recovery. Summer onset of sore throat refusing food. Cold-cooling throat-clearing medicines caused diarrhea. Thus, Dragon Fire (Ministerial Fire) surges upward, like lightning and fire, which cannot be extinguished by heavy rain. Only when internal Yin and Yang harmonize will it cease. Herbaceous medicines are ineffective. Follow Zhang Zhongjing's Shaoyin sore throat example, use Zhufu Tang as main treatment.
Follow-up: Yin dried up below, Yang blazing above, causing Shaoyin throat pain. This is the terminal transmission of consumptive weakness. Use Zhufu Tang, sweet and cool to benefit Kan (Kidney/Water), using sentient substances for effect. Now flesh and pores are consumed, lower jiao easily cold, marrow extremely empty. No time to manage phlegm-cough. Propose slippery/astringent tonics, salty entering Kidney.
Prescription: Beef Marrow (4 liang), Mutton Marrow (4 liang), Pork Marrow (4 liang), Deer Antler Glue (Líjiǎojiāo - 4 liang).
Usage: Use Jian Lotus Seeds (5 liang), Chinese Yam (5 liang), Euryale Seed (2 liang), pound together into pills.
Mr. Jin (42 years old), organ fluids insufficient, Yang Qi deficient, virtual wind stirring. Disease starts with spicy throat and heart palpitations, frequent recurrence. Often due to labor and anger. Use the "Sweet to relieve urgency" method from Neijing.
Prescription: Ginseng Root (Rénshēn), Charred Cornus Fruit (Yúròutàn), White Peony Root (Báisháo), Roasted Licorice Root (Zhì Gāncǎo), Poria (Fúshén), Wheat (Xiǎomài).
Follow-up: Fu Mai Tang minus Cinnamon Twig.
Neijing states: "One Yin and One Yang knotting is called Hou Bi (Throat Obstruction)." One Yin refers to Hand Shaoyin Sovereign Fire, the pulse qi of the Heart. One Yang refers to Hand Shaoyang Ministerial Fire, the pulse qi of the Sanjiao. The pulses of these two meridians connect to the throat. Thus, Qi heat causes internal knotting; severe knotting causes swelling; severe swelling causes obstruction; severe obstruction leads to death. These are what we now call Hou Xuan (Throat Ulcer), Hou Feng (Throat Wind), Hou E (Tonsillar Abscess), etc. Investigating the twelve meridians, only Foot Taiyang branches down the neck; others converge at the throat. Why does Neijing specifically say One Yin and One Yang knotting causes Hou Bi? Because Sovereign and Ministerial Fires alone prevail, causing heat and pain. I have historically examined throat decoctions, mostly using Acrid-dispersing and Saline-softening drugs to remove wind-phlegm and resolve heat-toxin. Such as Yuan Shen Sheng Ma Tang, Sheng Ji Tou Guan San, Yu Yao Chi, Ru Sheng San, Pu Ji Xiao Du Yin Zi, all prioritize treating symptoms over root, fearing delay harms the patient, hence treating symptoms is urgent. I also examined Zhang Zhongjing's Shanghan Lun, where throat sores often use Gan Cao Jie Geng Ban Xia San & Tang as main. One case: Shaoyin water deficiency fails to nourish Sovereign Fire, causing throat sores and inability to speak. Uses Banxia's acrid-slippery, aided by egg white to open orifices and restore voice, with vinegar entering Yin to seize saliva and contract sores, Guizhi releasing muscle layer via meridians to surface, all opening from Taiyang. Thus Banxia treats sore throat without drying fluids. Another case: Yin-fire knotting causing sore throat, uses raw Gancao sweet-cool to drain heat, easing Kidney urgency and saving Yin, aided by Jiegeng lifting Foot Shaoyin heat. If Kidney fluid leaks down, failing to steam Lung, causing dry collaterals and sore throat, Zhongjing has Zhufu Tang method, moistening dryness, resolving heat, easing middle, harmonizing Yin-Yang for cure. This consolidates root while treating symptoms. For Wind-Fire stagnation, Yin deficiency, rapid pulse causing sore throat, Mr. Ye uses Acrid-Cool clearing upper methods. For tight throat obstruction, Qi heat causing sore throat, there is clearing Lung Qi-heat method. For emotional depression, Ministerial Fire flaring causing sore throat, there is descending Qi and opening turbidity method. For Kidney fluid not gathering, Liver Yang floating causing sore throat, follow Qian Yi's Liu Wei Tang. For Yin-Yang mutual deficiency, Dragon/Ministerial fire burning causing sore throat, follow Zhongjing's Zhufu Tang method. (Commentary by Zou Zijiu)
Mr. Xu's Commentary: Diseases belonging to meridians and organs can be treated with decoctions and pills. Once belonging to form and nine orifices, they are tangible diseases with pathogenic condensation. Medicine enters stomach, only Qi reaches, how can it remove condensed pathogens? Thus decoctions/pills achieve only half the effect. For speed, external therapy is necessary, yielding immediate results. Extensively study formularies, seek secret methods, one will find them. This old man did not know this. Hence his treatment of tangible diseases was not his strength. Also, external therapy was rarely heard of in ancient times because acupuncture/moxibustion were divine and subtle, why need external therapy? This is the highest form of external therapy. Later generations lost acupuncture methods, substituting herbs for needles, creating many external methods. If acupuncture is abandoned and external methods neglected, even accurate herbal prescriptions only cure half. External symptoms requiring external therapy will never heal. This is a major key in medical Dao. Future students must know this.