咽痛阴阳各异宜。要须脉证两参之。脉浮而数吐脓血。此是阳毒之所为。（伤寒。脉浮数而大。唾脓血。千金。外台
有乌扇膏治之。）脉沉兼细手足冷。或加吐利少阴兮。（仲景云。少阴法当咽痛。而复吐冷。）少阴阴阳脉俱紧。亡阳汗出
要医治。（仲景云。其脉。阴阳俱紧。而反汗出。必亡阳。病属少阴。）又有伏气之为病。非常寒冷着人肌。咽喉先痛次
下利。作肾伤寒方可医。（仲景云。伏气之病。以意候之。今月之内。欲有伏气。假令旧有伏气。当须脉之。若脉微弱者。
当喉中痛。似伤寒。非喉痹也。病患云。实喉中痛虽尔。今复欲下利。）
咳嗽三经要辨明。太阳阳明与少阴。太阳停水青龙候。（仲景小青龙二证。皆云心下有水气。干呕发热而咳者。小青
龙汤主之。又云。心下有水气。咳而微喘者。小青龙汤。）小柴治咳值千金。（仲景云。中风七八日。心下悸。小便不利。
身有微热。或咳者。小柴胡汤主之。）阳明能食咽必痛。咳时头痛定难禁。（仲景金匮云。冬阳明。但头眩不恶寒。故能
食而咳者。其人咽必痛。不咳者。咽不痛。又云。冬阳明。反无汗。小便利。二三日。呕而咳手足厥者。其人头必痛。
若不呕不咳。手足不厥者。头不痛。）少阴烦渴猪苓治。泄利须还四逆灵。（仲景云。少阴病。下利。六七日。咳而呕渴。
心烦不得眠者。猪苓汤主之。又云。少阴四逆。其人或咳。小便不利。腹中痛泄利者。四逆汤。）忽然水气因生咳。真武
汤功效最深。（仲景云。少阴病二三日不已。至四五日。腹痛。小便不利。四肢沉重。疼痛而利。此为有水气。其人或咳。
或小便自利。或下利。或呕。玄武汤主之。）
咽痛一证，需辨明阴阳属性，各有适宜的治疗原则。必须将脉象与症状相互参合来诊断。若脉象浮而数，且伴有吐脓血，这是阳毒所致。（《伤寒论》记载：脉浮数而大，唾出脓血；《千金方》和《外台秘要》中有乌扇膏治疗此症。）若脉象沉兼细，手足冰冷，或者加上呕吐、下利，则属于少阴病。（张仲景说：少阴病应当出现咽痛，却又伴随吐出冷物。）若少阴病的寸关尺三部脉象都紧，且出现亡阳汗出的情况，需要紧急医治。（张仲景说：其脉象阴阳俱紧，却反而出汗，必定是亡阳，病属少阴。）又有伏气致病的情况，并非因感受非常寒冷的邪气侵袭肌表所致。咽喉先疼痛，随后出现下利，诊断为肾伤寒方可医治。（张仲景说：伏气之病，需用心意去推测候察。在本月之内，可能有伏气潜伏。假如原本就有伏气，应当诊察脉象。如果脉象微弱，应当喉咙痛，看似伤寒，但不是喉痹。病人说确实喉咙痛，但现在又想下利。）
咳嗽一证，必须辨明太阳、阳明、少阴这三经的病变。太阳经停聚水饮，用小青龙汤证候来辨识。（张仲景《小青龙汤》两条条文都说：心下有痰饮水气，干呕发热而咳嗽的，主用的小青龙汤。又说：心下有痰饮水气，咳嗽且轻微喘息的，用小青龙汤。）小柴胡汤治疗咳嗽价值千金。（张仲景说：中风七八天，心下悸动，小便不利，身体有微热，或者咳嗽的，主用小柴胡汤。）阳明经病若能进食但咽喉必痛，咳嗽时头痛一定难以忍受。（张仲景《金匮要略》说：冬季患阳明病，只是头晕目眩而不恶寒，所以能进食且咳嗽的人，他的咽喉必定痛；不咳嗽的人，咽喉不痛。又说：冬季患阳明病，反而无汗，小便通利，两三天后，呕吐且咳嗽、手脚冰冷的，他的头必定痛；如果不呕吐不咳嗽，手脚不冰冷，头就不痛。）少阴病出现心烦口渴，用猪苓汤治疗；泄利不止须用四逆汤才灵验。（张仲景说：少阴病，下利，六七天，咳嗽且呕吐、口渴，心烦不得安眠的，主用猪苓汤。又说：少阴病四肢厥逆，其中人如果有咳嗽，小便不利，腹中痛泄利的，用四逆汤。）忽然因为水气内生而导致咳嗽，真武汤功效最为深厚。（张仲景说：少阴病两三天未愈，到了四五天，腹痛，小便不利，四肢沉重疼痛且下利，这是因为有水气。其中人如果有咳嗽，或者小便自利，或者下利，或者呕吐，用玄武汤即真武汤主治。）
Sore throat (yan tong) varies according to Yin and Yang patterns, each requiring appropriate treatment. It is essential to correlate pulse findings with symptoms. If the pulse is floating and rapid, accompanied by expectoration of pus and blood, this is caused by Yang toxicity (Yang du). (*Shanghan Lun* records: pulse floating, rapid, and large, spitting pus and blood; *Qianjin Fang* and *Waitai Mi Yao* mention Wushan Gao for treatment.) If the pulse is deep and fine, with cold hands and feet, or accompanied by vomiting and diarrhea, it belongs to Shaoyin disease. (Zhang Zhongjing stated: Shaoyin disease typically presents with sore throat, yet may also involve vomiting cold substances.) If the pulses at all three positions in Shaoyin are tight, and sweating indicating Yang collapse occurs, urgent treatment is required. (Zhang Zhongjing stated: When the pulse is tight at both Yin and Yang positions but sweating occurs contrary to expectation, it indicates Yang collapse, and the disease pertains to Shaoyin.) There is also the condition caused by latent pathogenic factors (Fu Qi), which does not arise from exposure to extreme cold invading the muscles. The throat hurts first, followed by diarrhea; it can be treated as Kidney Shanghan (Kidney Cold Damage). (Zhang Zhongjing stated: For diseases of latent pathogens, one must infer the condition mentally. Within the current month, latent pathogens may be present. If there was a pre-existing latent pathogen, the pulse should be examined. If the pulse is weak, there should be throat pain, resembling Shanghan but not Hou Bi [sore throat obstruction]. The patient states that although the throat indeed hurts, they now desire to have diarrhea.)
Cough (ke sou) must be differentiated among the Taiyang, Yangming, and Shaoyin meridians. Taiyang water retention is identified by the Xiao Qing Long Tang pattern. (Zhang Zhongjing's two clauses on Xiao Qing Long Tang both state: When there is fluid retention in the epigastrium, causing dry heaving, fever, and cough, Xiao Qing Long Tang is the primary formula. Also: When there is fluid retention in the epigastrium, causing cough with slight wheezing, Xiao Qing Long Tang is used.) Xiao Chai Hu Tang treats cough with great value. (Zhang Zhongjing stated: After seven or eight days of Wind Stroke, if there is palpitations in the epigastrium, difficulty urinating, slight fever, or cough, Xiao Chai Hu Tang is the primary formula.) Yangming disease where the patient can eat but has a sore throat, and coughing accompanied by severe headache, is difficult to bear. (Zhang Zhongjing's *Jin Gui Yao Lue* states: In winter, Yangming disease presenting only with dizziness and no aversion to cold allows the patient to eat; if such a patient coughs, their throat will surely hurt. If they do not cough, the throat does not hurt. Also: In winter, Yangming disease presenting without sweat, with free urination, and after two or three days, vomiting and coughing with cold extremities, the head will surely hurt. If there is no vomiting or coughing, and extremities are not cold, the head does not hurt.) Shaoyin disease with irritability and thirst is treated with Zhu Ling Tang; diarrhea requires the efficacy of Si Ni Tang. (Zhang Zhongjing stated: In Shaoyin disease, with diarrhea for six or seven days, accompanied by cough, vomiting, thirst, irritability, and insomnia, Zhu Ling Tang is the primary formula. Also: In Shaoyin disease with cold extremities, if the patient has cough, difficulty urinating, abdominal pain, and diarrhea, Si Ni Tang is used.) Sudden cough arising from internal fluid retention is deeply addressed by Zhen Wu Tang. (Zhang Zhongjing stated: If Shaoyin disease persists for two or three days and progresses to four or five days, with abdominal pain, difficulty urinating, heavy and painful limbs, and diarrhea, this indicates fluid retention. If the patient has cough, or spontaneous urination, or diarrhea, or vomiting, Xuan Wu Tang [i.e., Zhen Wu Tang] is the primary formula.)