咽喉不利,或痛或痒,不可纳食,皆毒瓦斯上冲所致。经曰∶太阳病,下之,脉
紧者,必咽痛,以太阳之邪搏于少阴也。少阴之脉循喉咙,夹舌本。
少阴咽痛,脉浮迟,厥冷,或吐利,亦属少阴,并不可汗下,用桔梗汤、猪肤汤;甚者,半夏
散、通脉四逆汤去芍药,加桔梗;汗不止, 本、温粉扑之;咽中生疮,不能言语,声不出者,苦
酒汤。
若伤寒六七日,大下后寸脉沉迟,尺脉不至,咽喉不利,唾血脓,手足厥,利不止者,难治,
宜麻黄升麻汤。
肾伤寒一证,乃非时暴寒伏于少阳之经,头痛腰痛,脉微弱,初咽痛以伤寒,后必下利。咽痛,
半夏桂枝汤;(即半夏散。)利,四逆汤。
阳毒咽痛,见发斑条。咽中闭塞,乌扇汤。口疮赤烂,蜜浸黄柏噙。咽痛甚者,升麻六物汤。
少阳居表里之间,表邪传里,表中阳虚,故头眩也。又有发汗、吐、下后而眩者,亦阳虚所致
也。若少阴病,下利止而头眩,时自冒者,此虚极而脱。而风家亦
有眩者,风主运动故也。其或诸逆,发汗剧者,言乱目眩而死也。
太阳病,若下之,因复发汗,以此表里俱虚,其人必眩冒,冒家汗自出而愈。
阳明病,但头眩,不恶寒,故能食而咳,茯苓白术甘草桂枝汤。
少阳之为病,口苦咽干,目眩,小柴胡汤。
太阳病,发汗,汗出不解,其人仍发热,心下悸,头眩,身 动,振振欲擗地,真武汤。
吐、汗、下后虚烦,脉微沉紧,心下癖,胁下痛,气上冲咽喉,眩冒身摇,筋脉动惕,久而成
痿,茯苓桂枝白术甘草汤;痿,用栝蒌汤。
咽喉部感觉不畅利,或者疼痛、或者瘙痒,无法进食,这都是毒邪之气上冲所致。医经中说:太阳病,误用攻下法,如果脉象紧的,必定出现咽痛,这是因为太阳表的邪气搏结于少阴经的缘故。足少阴肾经的经脉循行经过喉咙,夹持舌根。属于少阴病的咽痛,脉象浮而迟缓,伴有四肢厥冷,或者呕吐腹泻,也归属于少阴病,此时既不可发汗,也不可攻下,应使用桔梗汤、猪肤汤;病情严重的,使用半夏散、通脉四逆汤去掉芍药,加入桔梗;如果汗出不止,用附子(本)和温粉扑敷;咽喉中生出疮疡,不能说话,声音发不出来的,使用苦酒汤。
如果是伤寒六七天,经过猛烈攻下后,寸口脉沉迟,尺部脉搏摸不到,咽喉不畅利,咳唾带血或脓液,手足厥冷,腹泻不止的,属于难治之证,适宜使用麻黄升麻汤。
肾伤寒这一证候,是由于非时节的暴寒潜伏在少阳经所致,表现为头痛腰痛,脉象微弱,起初像伤寒一样咽痛,后来必然出现腹泻。对于咽痛,使用半夏桂枝汤(即半夏散);对于腹泻,使用四逆汤。
阳毒引起的咽痛,参见发斑的条文。咽喉部闭塞不通,使用乌扇汤。口腔生疮且红肿溃烂,用蜂蜜浸泡的黄柏含漱。咽痛剧烈的,使用升麻六物汤。
少阳经位于表里之间,表邪传入体内,由于体表阳气虚弱,所以出现头晕目眩。又有经过发汗、催吐、攻下之后出现眩晕的,也是由阳气虚弱所导致。如果是少阴病,腹泻停止但出现头晕,时常感到头昏蒙如被物覆盖,这是虚损到了极点而即将脱失的表现。此外,患风病的人也有眩晕的,因为风性主动的缘故。那些各种逆乱病症,如果发汗过于猛烈的,会导致神志言语错乱、目眩而死。
太阳病,如果先攻下,接着又发汗,因此导致表里俱虚,病人必定会出现头晕目眩,这种头晕目眩的病人,通过自然出汗即可痊愈。
阳明病,仅仅出现头晕目眩,不恶寒,能够进食并且咳嗽,使用茯苓白术甘草桂枝汤。
太阳病,发汗后,汗出而病不解,病人仍然发热,心下悸动,头晕目眩,身体肌肉跳动,震颤欲倒在地上,使用真武汤。
经过催吐、发汗、攻下之后,出现虚烦,脉象微细沉紧,心下有癖块,胁下疼痛,气向上冲至咽喉,头晕目眩身体摇晃,筋脉跳动惕惧,时间久了会形成痿证,使用茯苓桂枝白术甘草汤;对于痿证,使用栝蒌汤。
Throat discomfort, or pain, or itching, making it impossible to swallow food, are all caused by the upward rush of toxic qi. The Classics state: In Taiyang disease, if purgation is mistakenly applied and the pulse is tight, throat pain will inevitably occur, because the pathogenic factor of Taiyang combats with Shaoyin. The meridian of Shaoyin runs along the throat and flanks the root of the tongue. Throat pain belonging to Shaoyin, characterized by a floating and slow pulse, cold extremities, or vomiting and diarrhea, also falls under Shaoyin; neither sweating nor purging should be used. Instead, Jiegeng Tang (Platycodon Decoction) or Zhufu Tang (Pig Skin Decoction) should be administered. For severe cases, Banxia San (Pinellia Powder) or Tongmai Sini Tang (Decoction to Revive the Pulse and Restore Yang) with Shao Yao removed and Jie Geng added should be used. If sweating does not stop, Fuzi (Aconite Root) and warm powder should be dusted on the body. If sores form in the throat, preventing speech and voice production, Kujiu Tang (Bitter Wine Decoction) is indicated.
If, after six or seven days of Shanghan (Cold Damage), severe purgation has been performed, resulting in a deep and slow cun pulse and an inaccessible chi pulse, accompanied by throat discomfort, expectoration of blood or pus, cold extremities, and unceasing diarrhea, the condition is difficult to treat. Mahuang Shengma Tang (Ephedra and Ligusticum Decoction) is appropriate.
Shen Shanghan (Kidney Cold Damage) is a syndrome where sudden cold from an improper season lies latent in the Shaoyang meridian, causing headache and lower back pain with a weak and minute pulse. Initially presenting as throat pain similar to Shanghan, it will subsequently lead to diarrhea. For throat pain, Banxia Guizhi Tang (Pinellia and Cinnamon Twig Decoction, i.e., Banxia San) is used; for diarrhea, Sini Tang (Frigid Extremities Decoction) is indicated.
Yangdu (Yang Toxin) causing throat pain is described in the section on macules. For throat obstruction, Wushan Tang (Iris Decoction) is used. For oral ulcers with redness and erosion, Huangbai (Phellodendron Bark) soaked in honey should be held in the mouth. For severe throat pain, Shengma Liuwu Tang (Ligusticum Six-Ingredient Decoction) is prescribed.
Shaoyang resides between the exterior and interior. When exterior pathogens transmit inward, combined with deficiency of yang in the exterior, dizziness occurs. Dizziness following sweating, emesis, or purgation is also caused by yang deficiency. In Shaoyin disease, if diarrhea stops but dizziness persists, accompanied by occasional feeling of being covered or obscured, this indicates extreme deficiency and impending collapse. Additionally, patients suffering from wind disorders may experience dizziness because wind is characterized by movement. In cases of various rebellious conditions, if sweating is induced too violently, it can lead to disordered speech, dizziness, and death.
In Taiyang disease, if purgation is followed by sweating, leading to deficiency in both exterior and interior, the patient will inevitably suffer from dizziness and vertigo. Such patients will recover through spontaneous sweating.
In Yangming disease, if there is only dizziness without aversion to cold, and the patient can eat while coughing, Fuling Baizhu Gancao Guizhi Tang (Poria, Atractylodes, Licorice, and Cinnamon Twig Decoction) is indicated.
The hallmark of Shaoyang disease includes bitter taste in the mouth, dry throat, and dizziness; Xiaochaihu Tang (Minor Bupleurum Decoction) is used.
In Taiyang disease, if sweating fails to resolve the condition, and the patient still has fever, palpitations in the heart region, dizziness, muscle twitching, and trembling as if about to fall to the ground, Zhenwu Tang (True Warrior Decoction) is indicated.
After emesis, sweating, or purgation, if restlessness due to deficiency occurs with a faint, deep, and tight pulse, epigastric masses, hypochondriac pain, qi rushing up to the throat, dizziness, body tremors, and tendon twitching, which may eventually lead to flaccidity syndrome, Fuling Guizhi Baizhu Gancao Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction) is used. For flaccidity syndrome, Gualou Tang (Trichosanthes Decoction) is indicated.