治咽喉肿疼。
大生地黄（一两，切片） 蓬砂（钱半，研细）
将生地黄一片，裹蓬砂少许，徐徐嚼细咽之，半日许宜将药服完。
生地黄之性能滋阴清火，无论虚热实热服之皆宜。蓬砂能润肺，清热化痰，消肿止疼。二药并用，功力甚
大。而又必细细嚼服者，因其病在上，煎汤顿服，恐其力下趋，而病转不愈。且细细嚼咽，则药之津液常清润
患处也。此方愚用之屡矣，随手奏效
者不胜纪矣。
咽喉之证，有热有凉，有外感有内伤。《白喉忌表抉微》一书，此时盛行于世。其所载之方，与所载宜
用、宜忌之药，皆属稳善。惟其持论，与方中所用之药，有自相矛盾处。谆谆言忌表矣，而其养阴清肺汤，用
薄荷二钱半，岂非表药乎？至于他方中，所用之葛根、连翘亦发表之品也。盖白喉之证，原亦温病之类。人之
外肤肺主之，人之内肤三焦主之。盖此证心肺先有蕴热，外感之邪又袭三焦，而内逼心肺。则心肺之热，遂与
邪气上并，而现证于喉。既有外邪，原宜发表，因有内热，实大忌用辛热之药发表。惟薄荷、连翘诸药，辛凉
宣通，复与大队凉润之药并用，既能散邪，尤能清热，所以服之辄效也。若其内热炽盛，外感原甚轻者，其养
阴清肺汤亦可用，特其薄荷，宜斟酌少用，不必定用二钱半也。至谓其喉间肿甚者加 石膏四钱，微有可议。
夫石膏之性，生则散、 则敛。炽盛之火散之则消，敛之则实，此又不可不知也。况石膏生用，原不甚凉，
故《神农本草经》谓微寒，又何必如此之小心乎。今将其养阴清肺汤，详录于下，以备采用。
【附方】养阴清肺汤 大生地一两、寸麦冬六钱、生白芍四钱、薄荷二钱半、玄参八钱、丹皮四
钱、贝母四钱、生甘草二钱。喉间肿甚者，加生石膏（原用 石膏）四钱。大便燥结者，加清宁丸二钱、玄明
粉二钱。胸下胀闷，加神曲、焦山楂各二钱。小便短赤者，加木通、泽泻各一钱，知母二钱。燥渴者，加天冬、
马兜铃各三钱。面赤身热，或舌苔黄色者，加金银花四钱，连翘二钱。
白喉之证，间有服《白喉忌表抉微》诸方不效，而反加剧者。曾治一贵州人，孙××，年二十，得白喉
证。屡经医治，不外《白喉忌表抉微》诸方加减。病日增重，医者诿谓不治。后愚为诊视，其脉细弱而数，粘
涎甚多，须臾满口，即得吐出。知系脾
肾两虚，肾虚气化不摄，则阴火上逆，痰水上泛。而脾土虚损，又不能制之（若脾土不虚，不但能制痰水上泛，
并能制阴火上逆），故其咽喉肿疼，粘涎若是之多也。投以六味地黄汤，加于术，又少加苏子，连服十剂全愈。
咽喉之证，热者居多。然亦兼有寒者，不可不知。王洪绪曰∶“咽喉之间，素分毫无病，顷刻之间，或
疼或闷，此系虚寒阴火之证。用肉桂、炮姜、甘草各五分，置碗内浸以滚水，仍将碗置于滚水中，饮药一口，
徐徐咽下立愈。或用乌附之片，涂以鲜蜜，火炙透至黑，取一片口含咽津，至片不甜时，再换一片，亦立愈。”
按王氏之说，咽喉陡然疼闷者，皆系因寒。然亦有因热者，或其人素有蕴热，陡然为外感所束，或劳碌过度，
或暴怒过度，皆能使咽喉骤觉疼闷。斯在临证者，于其人之身体、性情、动作之际，细心考验，再参以脉象之
虚实凉热，自无差谬。若仍恐审证不确，察其病因似寒，而尤恐病因是热，可用蜜炙附子片试含一片，以细验
其病之进退亦可。
赵晴初曰∶鸡蛋能去喉中之风。余治一幼童喉风证，与清轻甘凉法，稍加辛药，时止时发。后有人教服
鸡蛋，顶上针一孔，每日生吞一枚，不及十枚，病愈不复发。
友人齐××曰∶平阳何××患喉疼，医者治以苦寒之药，愈治愈甚，渐至舌硬。后有人教用棉子油煎生鸡蛋，
煎至外熟，里仍微生，日服二枚，未十日遂大愈。
咽喉肿疼证，有外治异功散方甚效。其方用斑蝥一钱，真血竭、制乳香、制没药、上麝香、全蝎、大玄
参、上梅片各分半，将斑蝥去翅足，糯米拌炒，以米色微黄为度，去糯米。用诸药共研细，瓶收贮，勿令透气。
遇有咽喉肿疼证，将药捏作小块，如黄豆粒大，置在小膏药上，左肿贴右，右肿贴左，若左右俱肿，均贴在结
喉（项间高骨）旁边软处。阅五六时，即揭去膏药，有水泡，用银针挑破，拭净毒水，能消肿止疼，真救急之良方也。
治疗咽喉肿痛。
大生地黄（一两，切片） 硼砂（一钱半，研成细粉）
取一片生地黄，包裹少许硼砂，慢慢咀嚼细碎后咽下，大约半天时间内应将药物服完。
生地黄的性能是滋阴降火，无论是虚热还是实热，服用都适宜。硼砂能润肺，清热化痰，消肿止痛。两药合用，功效很大。而且必须细细咀嚼服用，是因为病位在上部，如果煎汤顿服，恐怕药力向下走，而病情反而不能痊愈。况且细细咀嚼吞咽，药物的津液就能经常清润患处。这个方子我使用过很多次了，随手见效的案例数不胜数。
咽喉的病症，有热证也有寒证，有外感也有内伤。《白喉忌表抉微》这本书，当时在世上广泛流行。书中记载的方剂，以及记载的宜用、宜忌的药物，都属于稳妥良善的。只是它的理论论述，与方中所用的药物，有自相矛盾的地方。它谆谆告诫忌讳发表（解表），可是它的养阴清肺汤中，却用了二钱半薄荷，这难道不是发表药吗？至于其他方剂中，所用的葛根、连翘也是发表的药物。大概白喉这种病症，原本也属于温病一类。人的体表皮肤由肺所主，人的体内肌肤由三焦所主。大概此证心肺先有蕴积的热邪，外感的邪气又侵袭三焦，进而向内逼迫心肺。那么心肺的热邪，便与邪气向上合并，从而表现在喉咙上。既然有外邪，原本应当发表，但因为内有热邪，实在非常忌讳使用辛热性质的药物来发表。只有薄荷、连翘等药物，性质辛凉宣通，再配合大队凉润的药物一起使用，既能疏散邪气，尤其能清除热邪，所以服用后往往见效。如果内热炽盛，外感原本很轻的情况，这个养阴清肺汤也可以使用，特别是其中的薄荷，应该斟酌少用，不必一定用二钱半。至于说咽喉肿胀严重的加石膏四钱，稍微有些可议论之处。夫石膏的性质，生用时具有发散作用，煅用时具有收敛作用。炽盛的火邪，用发散法可以消除，用收敛法则会使邪气固结，这一点是不可不知道的。况且石膏生用，原本不是很凉，所以《神农本草经》说它微寒，又何必如此小心谨慎呢。现在将它的养阴清肺汤详细记录在下面，以备采用。
【附方】养阴清肺汤：大生地一两、寸麦冬六钱、生白芍四钱、薄荷二钱半、玄参八钱、丹皮四钱、贝母四钱、生甘草二钱。咽喉间肿胀严重的，加生石膏（原书用煅石膏）四钱。大便干燥结滞的，加清宁丸二钱、玄明粉二钱。胸下胀闷的，加神曲、焦山楂各二钱。小便短赤的，加木通、泽泻各一钱，知母二钱。燥渴的，加天冬、马兜铃各三钱。面色红赤身体发热，或者舌苔黄色的，加金银花四钱，连翘二钱。
白喉这种病症，偶尔有用《白喉忌表抉微》诸方治疗无效，反而加重的情况。曾治疗一个贵州人，孙××，二十岁，得了白喉证。多次经过医治，不外乎对《白喉忌表抉微》中的方剂进行加减。病情日益加重，医生推脱说是无法治愈。后来我诊治，他的脉象细弱而快，粘痰非常多，一会儿就满口都是，立刻就要吐出来。知道这是脾肾两虚，肾虚气化功能不摄纳，导致阴火上逆，痰水上泛。而脾土虚损，又不能制约它（如果脾土不虚，不仅能制约痰水上泛，也能制约阴火上逆），所以他的咽喉肿痛，粘痰像这样多。投以六味地黄汤，加入于术，又少量加入苏子，连续服用十剂完全痊愈。
咽喉的病症，热证居多。然而也有兼有寒证的，不可不知道。王洪绪说：“咽喉之间，素来毫无疾病，顷刻之间，或者疼痛或者闷窒，这是虚寒阴火的病症。用肉桂、炮姜、甘草各五分，放在碗内用滚水浸泡，仍将碗置于滚水中，喝一口药，慢慢咽下立即痊愈。或者用乌头、附子的薄片，涂上鲜蜂蜜，用火烤透直到变黑，取一片含在口中咽津液，等到片不甜时，再换一片，也立即痊愈。”
按王氏的说法，咽喉突然疼痛闷窒的，都是因为寒邪。然而也有因为热邪的，或者其人素来有蕴积的热邪，突然被外感束缚，或者劳碌过度，或者暴怒过度，都能使咽喉骤然觉得疼痛闷窒。这在临证时，对于病人的身体、性情、动作之际，细心考验，再参考脉象的虚实凉热，自然没有差错。如果仍然担心辨证不确切，观察病因似乎属寒，而尤其担心病因是热，可以用蜜炙附子片尝试含一片，来仔细验证病情的进退也可以。
赵晴初说：鸡蛋能去除喉中的风邪。我治疗一个幼童的喉风证，给予清轻甘凉的方法，稍加辛散药物，症状时好时发。后来有人教他服用鸡蛋，在顶上扎一个孔，每天生吞一枚，不到十枚，病愈不再复发。
友人齐××说：平阳何××患喉痛，医生用苦寒药物治疗，越治越重，逐渐发展到舌头僵硬。后来有人教他用棉子油煎生鸡蛋，煎到外面熟了，里面仍然微生，每天服用两枚，不到十天就大大好转。
咽喉肿痛证，有一个外治异功散方非常有效。这个方子用斑蝥一钱，真血竭、制乳香、制没药、上麝香、全蝎、大玄参、上梅片（冰片）各半分，将斑蝥去掉翅膀和脚，用糯米拌炒，以米色微黄为度，去掉糯米。用所有药物共同研成细粉，装入瓶中储存，不要让透气。遇到有咽喉肿痛证，将药捏成小块，如黄豆粒大小，贴在小的膏药上，左边肿贴右边，右边肿贴左边，如果左右都肿，都贴在结喉（颈部高骨）旁边的软处。看五六个小时后，就揭去膏药，如果有水泡，用银针挑破，擦干净毒水，能消肿止痛，真是救急的好方子。
Treatment for swelling and pain of the throat.
Sheng Di Huang (Rehmanniae Radix, 1 liang, sliced) Peng Sha (Borax, 1 qian 5 fen, finely ground).
Take one slice of Sheng Di Huang, wrap a small amount of Peng Sha in it, chew it slowly until fine, and swallow. The medicine should be taken within about half a day.
The nature and function of Sheng Di Huang is to nourish Yin and clear fire; it is suitable for both deficiency heat and excess heat. Peng Sha can moisten the lungs, clear heat, resolve phlegm, reduce swelling, and relieve pain. The combined use of these two herbs has great efficacy. Moreover, they must be chewed slowly because the disease is located in the upper part; if decocted and taken as a liquid, the medicinal force may tend downward, and the disease might not heal. Furthermore, chewing and swallowing slowly allows the fluid of the medicine to constantly moisten and clear the affected area. I have used this prescription many times, and cases where it took effect immediately are too numerous to record.
Throat disorders involve heat or cold, external contraction or internal injury. The book *Bai Hou Ji Biao Jue Wei* (Clarifying the Subtleties of Avoiding Exterior-Resolving Methods for White Diphtheria) was widely popular at that time. The prescriptions recorded in it, along with the indications and contraindications for herbs, were all considered stable and beneficial. However, its theoretical arguments contradicted the herbs used in the prescriptions. It earnestly warned against exterior-resolving methods, yet its Yang Yin Qing Fei Tang (Nourishing Yin and Clearing Lung Decoction) used 2 qian 5 fen of Bo He (Menthae Haplocalycis Herba), which is clearly an exterior-resolving herb? As for other prescriptions, Ge Gen (Puerariae Lobatae Radix) and Lian Qiao (Forsythiae Fructus) used therein are also exterior-resolving agents. Essentially, Bai Hou (White Diphtheria) belongs to the category of Warm Diseases. The human exterior skin is governed by the Lung, while the interior skin is governed by the San Jiao (Triple Burner). In this condition, there is initially accumulated heat in the Heart and Lung; external pathogenic factors attack the San Jiao and then press inward toward the Heart and Lung. Consequently, the heat in the Heart and Lung merges upward with the pathogenic factors, manifesting symptoms in the throat. Since there is an external pathogen, exterior resolution is originally indicated, but due to internal heat, it is strictly contraindicated to use acrid-warm herbs for exterior resolution. Only herbs like Bo He and Lian Qiao, which are acrid-cool and unblocking, when used in conjunction with a large group of cooling-moistening herbs, can both disperse pathogens and especially clear heat, thus yielding immediate effects. If internal heat is blazing and the external contraction is very mild, Yang Yin Qing Fei Tang can still be used, but the Bo He should be used sparingly after deliberation, not necessarily fixed at 2 qian 5 fen. Regarding the addition of Shi Gao (Gypsum Fibrosum) 4 qian for severe throat swelling, there is some room for discussion. The nature of Shi Gao: raw form disperses, calcined form astringes. Blazing fire is eliminated by dispersion but consolidated by astringency; this point must be understood. Moreover, raw Shi Gao is not inherently very cold; hence, *Shennong Bencao Jing* (Divine Farmer's Materia Medica) describes it as slightly cold. Why be so cautious? Below, I record Yang Yin Qing Fei Tang in detail for reference.
[Attached Prescription] Yang Yin Qing Fei Tang (Nourishing Yin and Clearing Lung Decoction): Da Sheng Di Huang (Rehmanniae Radix, 1 liang), Cun Mai Dong (Ophiopogonis Tuber, 6 qian), Sheng Bai Shao (Paeoniae Radix Alba, 4 qian), Bo He (Menthae Haplocalycis Herba, 2 qian 5 fen), Xuan Shen (Scrophulariae Radix, 8 qian), Dan Pi (Moutan Cortex, 4 qian), Bei Mu (Fritillariae Bulbus, 4 qian), Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 qian). For severe throat swelling, add Sheng Shi Gao (Raw Gypsum Fibrosum, 4 qian; original text used Calcined Gypsum). For dry stool constipation, add Qing Ning Wan (Qingning Pill, 2 qian) and Xuan Ming Fen (Mirabilite, 2 qian). For chest oppression and fullness, add Shen Qu (Medicated Leaven, 2 qian) and Jiao Shan Zha (Crataegi Fructus Preparata, 2 qian). For scanty dark urine, add Mu Tong (Akebiae Caulis, 1 qian), Ze Xie (Alismatis Rhizoma, 1 qian), and Zhi Mu (Anemarrhenae Rhizoma, 2 qian). For dry thirst, add Tian Dong (Asparagi Tuber, 3 qian) and Ma Dou Ling (Aristolochiae Fructus, 3 qian). For red face and body heat, or yellow tongue coating, add Jin Yin Hua (Lonicerae Japonicae Flos, 4 qian) and Lian Qiao (Forsythiae Fructus, 2 qian).
In cases of Bai Hou (White Diphtheria), occasionally prescriptions from *Bai Hou Ji Biao Jue Wei* fail and the condition worsens. I once treated a patient from Guizhou, Sun XX, aged twenty, who suffered from Bai Hou. After multiple treatments involving modifications of prescriptions from *Bai Hou Ji Biao Jue Wei*, his illness intensified daily, and physicians declared it incurable. Later, I examined him: his pulse was thin, weak, and rapid, with excessive sticky saliva filling his mouth instantly, requiring frequent spitting. This indicated deficiency of both Spleen and Kidney. Kidney deficiency led to failure of Qi transformation to control fluids, causing Yin Fire to rebel upward and Phlegm Fluids to flood. Spleen Earth deficiency failed to control this (if Spleen Earth were not deficient, it would control both flooding Phlegm and rebellious Yin Fire). Thus, his throat swelled and pained, accompanied by such abundant sticky saliva. I administered Liu Wei Di Huang Tang (Six-Ingredient Rehmannia Pill Decoction) added with Yu Zhu (Atractylodis Macrocephalae Rhizoma) and a small amount of Su Zi (Perillae Fructus). After ten doses, he recovered completely.
Most throat disorders are heat-related, but cold types exist and must be recognized. Wang Hongxu stated: "If the throat is healthy normally but suddenly becomes painful or stuffy within moments, this is a syndrome of Deficiency Cold and Yin Fire. Use Rou Gui (Cinnamomi Cortex), Pao Jiang (Zingiberis Rhizoma Preparatum), and Gan Cao (Glycyrrhizae Radix et Rhizoma), each 5 fen. Soak them in boiling water in a bowl, place the bowl in boiling water again, take one sip of the medicine, and swallow slowly for immediate relief. Alternatively, use slices of Wu Tou (Aconiti Lateralis Radix Preparata) or Fu Zi (Aconiti Lateralis Radix Preparata), coat with fresh honey, roast thoroughly until black. Take one slice, hold in the mouth to swallow saliva. When it loses sweetness, replace with another slice for immediate relief."
According to Mr. Wang, sudden throat pain and stuffiness are caused by cold. However, they can also be caused by heat, or by pre-existing accumulated heat suddenly constrained by external pathogens, overexertion, or extreme anger, all of which can cause sudden throat pain and stuffiness. Clinicians must carefully observe the patient's constitution, temperament, and actions, and correlate them with the pulse's deficiency/excess and cold/heat characteristics to avoid errors. If uncertainty remains regarding the differentiation, suspecting cold but fearing heat, one can try holding a piece of Honey-fried Fu Zi (Honey-processed Aconiti Lateralis Radix Preparata) to test the progression of the disease.
Zhao Qingchu said: Eggs can dispel wind from the throat. I treated a young child with Hou Feng (Throat Wind) using a light, sweet, and cool method with slight acrid herbs, resulting in intermittent remission and recurrence. Someone later advised eating eggs: pierce a hole in the top, swallow one raw egg daily. Within ten eggs, the disease cured without recurrence.
My friend Qi XX said: He XX from Pingyang suffered throat pain. Physicians treated him with bitter-cold herbs, worsening the condition until his tongue became stiff. Someone advised frying a raw egg in cottonseed oil until the outside was cooked but the inside slightly raw, taking two daily. Within ten days, he greatly improved.
For throat swelling and pain, an external treatment formula Yi Gong San (Extraordinary Efficacy Powder) is very effective. It uses Ban Mao (Mylabris, 1 qian), Zhen Xue Jie (Dragon's Blood, half fen), Zhi Ru Xiang (Processed Frankincense, half fen), Zhi Mo Yao (Processed Myrrh, half fen), Shang She Xiang (Premium Musk, half fen), Quan Xie (Scorpio, half fen), Da Xuan Shen (Large Scrophulariae Radix, half fen), and Shang Mei Pian (Premium borneolum, half fen). Remove wings and feet from Ban Mao, stir-fry with glutinous rice until the rice turns slightly yellow, then remove the rice. Grind all herbs into fine powder, store in a bottle, ensuring it is airtight. When encountering throat swelling and pain, shape the powder into small pieces the size of soybeans, place on small plasters. Apply left swelling to the right side, right swelling to the left side. If both sides swell, apply next to the Jie Hou (Adam's apple/high bone in the neck). After five to six hours, remove the plaster. If blisters form, puncture with a silver needle, wipe away toxic fluid. This reduces swelling and relieves pain, serving as an excellent emergency remedy.