【方歌】喉疳初觉阴虚成,嗌干刺痛色淡红,肾火炎上金受克,
破烂失音臭腐疼。
【注】此证一名阴虚喉疳。初觉咽嗌干燥,如毛草常刺喉中,
又如硬物隘于咽下,呕吐酸水,哕出甜涎,淡红,微肿
微痛,日久其色紫暗不鲜,颇似冻榴子色。由肾液久亏
,相火炎上,消烁肺金,薰燎咽喉,肿痛日增,破烂腐
衣,叠若虾皮,声音雌哑,喘急多痰,臭腐蚀延,其疼
倍增,妨碍饮食,胃气由此渐衰。而虚火益盛,烦躁者
宜服知柏地黄汤;若吐酸哕涎者,宜服甘露饮加川黄连
;便燥者,兼服万氏润燥膏;面唇俱白,不寐懒食者,
宜归脾汤加酒炒川黄连;肿吹紫雪散,腐吹八宝珍珠散
。其证投方应病,或者十全一、二,否则难救。
方剂:万氏润燥膏
组成:猪脂一斤,切碎炼油去滓,加炼过白蜂蜜一斤,搅匀候
凝,挑服二匙,日用三、五次。
【方歌】万氏润燥膏神验,降火清金滋便干,猪脂炼油加白蜜,
挑服失音也能痊。
又方:八宝珍珠散
组成:儿茶 川连末
川贝母(去心,研) 青黛(各一钱五分)
红褐(烧灰存性) 官粉
黄柏末 鱼脑石(微〔火段〕)
琥珀末(各一钱) 人中白(〔火段〕,二钱)
硼砂(八分) 冰片(六分)
京牛黄
珍珠(豆腐内煮半柱香时取出,研末,各五分)
麝香(三分)
各研极细末,共兑一处,再研匀,以细笔管吹入喉
内烂肉处。
【方歌】八宝珍珠喉疳属,冰麝儿茶连贝母,红褐官粉黛牛黄,
脑石中白柏硼琥。
又方:知柏地黄汤(六味地黄丸加知母、黄柏,见面部雀斑)
甘露饮(见慢喉风)
归脾汤(见乳部乳中结核)
【方歌】喉疳(一种以咽喉部溃烂、腐烂为主要特征的疾病)初期多因阴虚所致,表现为咽喉干燥、刺痛且颜色淡红。这是肾中虚火上炎克制肺金,导致咽喉破烂、失音、恶臭及疼痛。
【注】此证又名阴虚喉疳。初起时感觉咽喉干燥,如同有草刺常扎喉咙,又像是有硬物阻塞在咽下,呕吐酸水,呃逆并吐出甜涎,咽喉色淡红,微肿微痛。日久之后,颜色变为紫暗而不鲜亮,颇似冻石榴子的颜色。这是由于肾液长期亏损,相火(寄居于肝肾的命门之火)上炎,消烁肺金,熏燎咽喉,导致肿痛日益加重,咽喉破烂腐衣层层叠叠如虾皮状,声音变得嘶哑,气喘急促且多痰,恶臭腐蚀蔓延,疼痛倍增,妨碍饮食,胃气由此逐渐衰弱。而虚火更加旺盛。烦躁者适宜服用知柏地黄汤;若吐酸水、呃逆吐涎者,适宜服用甘露饮加川黄连;大便燥结者,兼服万氏润燥膏;面色和嘴唇都苍白,失眠且食欲不振者,适宜服用归脾汤加酒炒川黄连;肿胀者吹入紫雪散,腐烂者吹入八宝珍珠散。其证候与投药方剂相应,或许能治愈一、二成,否则难以救治。
方剂:万氏润燥膏
组成:猪脂一斤,切碎炼油去渣,加入炼过的白蜂蜜一斤,搅匀待凝固,每次挑服两匙,每日使用三至五次。
【方歌】万氏润燥膏神效验,降火清肺滋润大便干,猪脂炼油加白蜜,挑服后失音也能痊愈。
又方:八宝珍珠散
组成:儿茶、川黄连末、川贝母(去心,研粉)、青黛(各一钱五分)、红褐(烧灰存性)、官粉、黄柏末、鱼脑石(微煅)、琥珀末(各一钱)、人中白(煅,二钱)、硼砂(八分)、冰片(六分)、京牛黄、珍珠(在豆腐内煮半柱香时间取出,研粉,各五分)、麝香(三分)。
将各药研成极细粉末,混合一处,再研均匀,用细笔管吹入咽喉内的腐烂肉处。
[Formula Song] Throat Gan (a disease characterized by ulceration and putrefaction of the throat) initially arises from Yin deficiency, presenting with dryness and stabbing pain in the pharynx, with a pale red color. This is due to Kidney fire flaming upward and overcoming Lung Metal, leading to ulceration, loss of voice, foul odor, and pain in the throat.
[Note] This syndrome is also known as Yin Deficiency Throat Gan. Initially, there is a sensation of dryness in the pharynx, as if grass thorns are constantly pricking the throat, or as if a hard object is obstructing the swallowing passage. There is vomiting of sour water, hiccups accompanied by the expulsion of sweet saliva, pale red discoloration of the throat, slight swelling, and mild pain. After a long time, the color becomes dark purple and dull, resembling the color of a frozen pomegranate seed. This is caused by the long-term depletion of Kidney fluids, allowing Ministerial Fire (Ministerial Fire, referring to the vital fire residing in the Liver and Kidneys) to flare upward, consuming Lung Metal, and scorching the pharynx. Consequently, swelling and pain increase daily, the throat becomes ulcerated with layers of rotting tissue resembling shrimp skins, the voice becomes hoarse, breathing is rapid and labored with excessive phlegm, foul odor spreads, pain intensifies significantly, eating is hindered, and Stomach Qi gradually declines. Meanwhile, deficient fire becomes more vigorous. For those with irritability, Zhi Bai Di Huang Tang (Anemarrhena, Phellodendron, and Rehmannia Pill) is suitable; for those vomiting sour fluid and hiccuping saliva, Gan Lu Yin (Sweet Dew Decoction) added with Chuan Huang Lian (Coptidis Rhizoma) is suitable; for those with dry stools, Wan Shi Run Zao Gao (Wan's Moistening Dryness Ointment) should be taken concurrently; for those with pale complexion and lips, insomnia, and poor appetite, Gui Pi Tang (Restore the Spleen Decoction) added with wine-fried Chuan Huang Lian is suitable; for swelling, Zi Xue San (Purple Snow Powder) should be insufflated into the throat; for ulceration, Ba Bao Zhen Zhu San (Eight-Treasure Pearl Powder) should be insufflated. If the syndrome matches the formula, perhaps one or two cases may be cured; otherwise, it is difficult to save the patient.
Formula: Wan Shi Run Zao Gao (Wan's Moistening Dryness Ointment)
Composition: Pig fat (Suis Adeps) 1 jin, chopped, refined, and filtered; add refined white honey (Mel Album) 1 jin, stir evenly until solidified. Take 2 teaspoons each time, 3 to 5 times daily.
[Formula Song] Wan Shi Run Zao Gao is miraculous and effective, lowering fire, clearing the Lungs, and moistening dry bowels; pig fat refined with white honey, when taken, can also cure loss of voice.
Another Formula: Ba Bao Zhen Zhu San (Eight-Treasure Pearl Powder)
Composition: Er Cha (Catechu), Chuan Lian Mo (Coptidis Rhizoma Powder), Chuan Bei Mu (Fritillariae Bulbus, heart removed and powdered), Qing Dai (Indigo Naturalis) (each 1.5 qian); Hong He (burned to ash but retaining nature), Guan Fen (Lead Carbonate), Huang Bo Mo (Phellodendri Cortex Powder), Yu Nao Shi (Otolithus) (lightly calcined); Hu Po Mo (Amber Powder) (each 1 qian), Ren Zhong Bai (Calcinata Urinae Coagulum) (calcined, 2 qian), Peng Sha (Borax) (0.8 qian), Bing Pian (Borneolum Syntheticum) (0.6 qian), Jing Niu Huang (Bovis Calculus), Zhen Zhu (Margarita) (boiled in tofu for half an incense stick's time, then powdered, each 0.5 qian), She Xiang (Moschus) (0.3 qian).
Grind all ingredients into extremely fine powder, mix them together, grind uniformly again, and insufflate into the ulcerated areas of the throat using a fine brush tube.
[Formula Song] Ba Bao Zhen Zhu San treats Throat Gan, containing Borneol, Moschus, Catechu, Coptis, Fritillaria; Hong He, Lead Carbonate, Indigo Naturalis, Bovis Calculus, Otolithus, Calcinata Urinae Coagulum, Phellodendrum, Borax, Amber.
Another Formula: Zhi Bai Di Huang Tang (Liu Wei Di Huang Wan [Six-Ingredient Pill with Rehmannia] added with Zhi Mu [Anemarrhenae Rhizoma] and Huang Bo [Phellodendri Cortex], used for facial freckles)
Gan Lu Yin (See section on Man Hou Feng [Slow Throat Wind])
Gui Pi Tang (See section on Ru Bu Ru Zhong He Jie [Lump in the Breast])