(丹溪)
治缠喉急痹(咽在后主食,喉在前主气。十二经中,唯足太阳主表,别下项,余经皆内
循咽喉,尽得以病之,而统在君相二火。喉主天气,属肺金,变动为燥,燥则涩而闭;咽主
地气,属脾土,变动为湿,湿则肿而胀;皆火郁上焦,致痰涎气血结聚于咽喉。肿达于外,
麻痒且
雄黄(一两) 郁金(一钱) 巴豆(十四粒,去皮、油。)醋糊为丸。每服五分,津
咽下(或用巴豆油蘸纸捻上,燃火吹熄,带烟刺入喉中,出紫血恶涎,即宽;此以热攻热,
热则流通
此手足少阴、少阳药也。吴鹤皋曰∶缠喉急痹,缓治则死。雄黄能破结气,郁金能散恶
血,巴豆能下稠涎。丹溪生平不用厉剂,此盖不得已而用者乎(单蛾、双蛾、木舌、子舌胀、
缠喉
出血
(《金匮》)
治肺痈咳逆上气,时时唾浊,但坐不眠(肺者,五脏之华盖也,处于胸中,主气,候在
皮毛。劳伤血气,腠理虚而风邪乘之,内感于肺,汗出恶风,咳嗽短气,鼻塞项强,胸膈
胀满,久久不瘥,则成肺痿;风伤皮毛,热伤血脉,风热相搏,气血稽留,蕴结于肺,则成
肺痈。多唾涎沫而无脓者,肺痿也;口干喘满,咽燥而渴,甚则四肢微肿,咳吐脓血,胸中
隐痛者
皂角(刮去皮弦,酥炙)。为末,蜜丸。以枣膏和汤,服三丸。
此手太阴药也。喻嘉言曰∶火热之毒,结聚于肺,表之里之,温之清之,曾不少应,坚
而不可攻者,令服此丸,庶几无坚不入,聿成洗荡之功,不可以药之微贱而少之也。
《千金方》用桂枝汤去芍芍,加皂角,名桂枝去芍药加皂角汤∶治肺痿吐沫。本方加蛤
粉等分,为末,名皂蛤丸;治妇人风邪客于乳房,而成乳痈。每服二钱,酒下(此药能导其
汗,散
(朱丹溪)
治疗缠喉急痹。咽位于后方,主管饮食;喉位于前方,主管呼吸。在十二经脉中,只有足太阳膀胱经主表,向下经过项部,其余各经都向内循行经过咽喉,因此都能导致此处发病,且统属于君火和相火。喉主管天气,归属于肺金,其变动表现为燥,燥则导致涩滞而闭塞;咽主管地气,归属于脾土,其变动表现为湿,湿则导致肿胀而胀满;这都是因为火邪郁结于上焦,致使痰涎、气血凝结聚积于咽喉。肿胀延伸至外部,伴有麻木瘙痒感。
雄黄(一两)、郁金(一钱)、巴豆(十四粒,去皮、去油)。用醋调糊制成丸剂。每次服用五分,用唾液送服。(或者用巴豆油蘸纸捻点燃后吹灭,带着烟熏刺入喉中,排出紫黑色的血和恶臭的涎液,症状即刻缓解;这是以热攻热的方法,热气流通则病愈。)
此方是手足少阴经和手足少阳经的药物。吴鹤皋说:缠喉急痹,如果缓慢治疗就会死亡。雄黄能破除结聚之气,郁金能消散恶血,巴豆能泻下稠厚的涎液。朱丹溪生平不使用猛烈之药,这大概是不得已而使用的吧。(适用于单蛾、双蛾、木舌、子舌胀、缠喉等症引起的出血。)
(《金匮要略》)
治疗肺痈导致的咳嗽气逆,时常吐出浑浊之物,只能坐着不能平卧。(肺是五脏的华盖,位于胸中,主管呼吸,反映在皮毛。因劳损伤及血气,腠理空虚,风邪乘虚而入,内伤于肺,出现出汗、怕风、咳嗽、气短、鼻塞、项强、胸膈胀满等症状。若久治不愈,则形成肺痿;若风邪伤及皮毛,热邪伤及血脉,风热相互搏结,气血滞留,蕴结于肺,则形成肺痈。多唾涎沫而无脓的是肺痿;口干喘满,咽干口渴,甚至四肢轻微浮肿,咳吐脓血,胸部隐痛的是肺痈。)
皂角(刮去皮弦,用酥炙)。研为细末,蜂蜜制丸。用枣膏调和汤水,服用三丸。
此方是手太阴肺经的药物。喻嘉言说:火热毒邪结聚于肺,无论是解表还是攻里,无论是温法还是清法,都没有丝毫效果,病情坚硬不可攻伐时,让患者服用此丸,或许能达到无坚不摧,彻底涤荡的功效,不能因为药物微小低廉而轻视它。
《千金方》使用桂枝汤去掉芍药,加入皂角,名为桂枝去芍药加皂角汤:治疗肺痿吐沫。本方加上蛤粉等量,研为细末,名为皂蛤丸;治疗妇人风邪客居乳房,形成乳痈。每次服用二钱,酒送服(此药能引导发汗,散除……)
(Zhu Danxi)
Treats Chanhou Jibi (Acute Strangulating Throat Bi). The pharynx is located posteriorly and governs food intake; the larynx is located anteriorly and governs respiration. Among the twelve meridians, only the Foot-Taiyang Bladder Meridian governs the exterior and descends through the nape, while the remaining meridians all curve inward to pass through the throat; thus, pathology in any of these meridians can affect this area, collectively governed by Ministerial Fire and Sovereign Fire. The larynx governs Heavenly Qi and belongs to Lung Metal; its pathological change manifests as Dryness, leading to astringency and obstruction. The pharynx governs Earthly Qi and belongs to Spleen Earth; its pathological change manifests as Dampness, leading to swelling and distension. These conditions arise from Fire pathogen stagnation in the Upper Jiao, causing Phlegm-fluids, Qi, and Blood to knot and accumulate in the throat. Swelling extends externally, accompanied by numbness and itching.
Realgar (1 liang), Curcuma Aromatica Rhizome (1 qian), Croton Seed (14 grains, peeled and oil removed). Form pills using vinegar paste. Administer 5 fen per dose, swallowed with saliva. (Alternatively, dip a paper wick in Croton Seed oil, ignite it, blow out the flame, and insert the smoking wick into the throat to expel purple blood and foul phlegm, providing immediate relief; this employs Heat to attack Heat, where the flow of Heat resolves the condition.)
This formula acts on the Hand-Shaoyin and Foot-Shaoyin, and Hand-Yangming and Foot-Yangming meridians. Wu Hegao stated: Chanhou Jibi, if treated slowly, leads to death. Realgar can break up stagnant Qi, Curcuma Aromatica Rhizome can dissipate evil Blood, and Croton Seed can purge thick phlegm. Zhu Danxi generally did not use harsh agents in his lifetime; this was likely used out of necessity. (Applicable to single tonsillitis, double tonsillitis, wooden tongue, sublingual vein distension, strangulating throat, etc., associated with bleeding.)
(Jin Gui Yao Lue)
Treats Fei Yong (Lung Abscess) presenting with coughing and rebellious Qi, frequent expectoration of turbid matter, and orthopnea (ability to sit but not lie down). The Lung is the canopy of the five Zang organs, located in the chest, governing Qi, and reflecting on the skin and hair. Labor and injury damage Qi and Blood, leaving the Couli (pores) deficient, allowing Wind pathogen to invade. Internally affecting the Lung, symptoms include sweating, aversion to wind, cough, shortness of breath, nasal congestion, neck stiffness, and chest/diaphragmatic fullness. If prolonged and unhealed, it becomes Fei Wei (Lung Flaccidity); if Wind damages the skin/hair and Heat damages the vessels, Wind-Heat combats each other, causing Qi and Blood to stagnate and accumulate in the Lung, forming Fei Yong. Frequent expectoration of frothy sputum without pus indicates Fei Wei; dry mouth, panting and fullness, dry throat with thirst, slight edema of the four limbs, coughing up pus and blood, and dull pain in the chest indicate Fei Yong.
Gleditsia Sinensis Fruit (skin and strings scraped off, fried in butter). Grind into powder, form pills with honey. Take three pills mixed with jujube paste in decoction.
This formula acts on the Hand-Taiyin Lung Meridian. Yu Jiayan stated: When toxic Heat-Fire knots in the Lung, and neither releasing the exterior nor purging the interior, nor warming nor clearing, yields any effect, and the condition is hard and impervious to attack, administering this pill may achieve the result of penetrating all hardness and thoroughly cleansing. Do not despise it due to its humble nature or low cost.
Qian Jin Fang uses Guizhi Tang removing Shaoyao and adding Gleditsia Sinensis Fruit, named Guizhi Qu Shaoyao Jia Zaojiao Tang: treats Fei Wei with expectoration of foam. This formula added with equal parts of Concha Tridacnidae (Clam Powder), ground into powder, named Zao Ge Wan; treats women whose breasts are invaded by Wind pathogen, resulting in Ru Yong (Breast Abscess). Take 2 qian per dose, washed down with wine. (This drug can induce sweating and disperse...)