龙脑安神丸（见第十九）
河间犀角丸（见第二十五）
清心牛黄丸（见第四十二）
神应丹 治诸痫。
好辰砂（不拘多少）
上细研，猪心血和匀，以蒸饼裹剂蒸熟。就热取出，丸如桐子大。每服一丸，人参汤下。食后、临卧俱可。
三圣散
瓜蒂（拣净，炒微黄） 防风（去芦，各三两） 藜芦（《圣惠方》减用之，或一两，或半两，或三钱）
上为粗末。每服约半两，以齑汁三茶盏，先用二盏煎三五沸，去齑汁。次入水
一盏，煎至三沸。却将先二盏同一处熬二沸，去滓澄清放温。徐徐服之，以吐为度，不必尽剂。
大承气汤（见第十七）
喉痹之脉，数热迟寒。缠喉走马，微伏则难。
痹者，闭也，闭塞不通之谓。乃火盛气结，以致喉咙肿胀，呼吸难通，壅塞痰
涎，水浆不下。一二日，即能杀人。十二经脉与经别，多过于此。即不然，亦在其
前后左右也。有经脉过者，有经别过者，有经脉、经别俱过者。如肺手太阴经脉，
无过于此者。而经别篇则云∶手太阴之正，上出缺盆，循喉咙。大肠手阳明之脉，
循缺盆，上颈贯颊。经别篇又云∶上循喉咙。胃足阳明之脉，循喉咙，入缺盆。
经别篇又云∶上循咽，出于口。脾足太阴之脉，上膈夹咽，连舌本。经别篇又云∶
上结于咽，贯舌中。心手少阴之脉，上夹咽。经别篇又云∶上走喉咙，出于面。小
肠手太阳之脉，循咽下膈。其支者，循颈上颊。而经别则无。膀胱足太阳之脉，自
脑还出，别下项。经别篇又云∶直者从膂上出于项。肾足少阴之脉，循喉咙，夹舌
本。经别篇又云∶直者系舌本，复出于项。心包络手厥阴之脉，亦无过此者。而经
别则云∶手厥阴之正，别属三焦，出循喉咙。三焦手少阳之脉，上项系耳后。而经
别则无。经别虽无，其手厥阴之正，有别属三焦，出循喉咙者，以三焦与心包为配，
故曰属。属则经脉相属而合一也。胆足少阳之脉，下加颊车，下颈。经别篇又云∶
足少阳上夹咽，出颐颔中。肝足厥阴之脉，循喉咙之后，上入颃颡，而经别亦无。
故《灵枢》第十篇，诸经是动、所生之病，有云颈肿者，（手阳明是动。）有云鼽HT 喉痹者，
（手阳明所生。）有云颈肿喉痹者，（足阳明所生。）有云舌本强者，（足太阴是动。）有云舌本痛者，（足太
阴所生。）有云嗌干者，（手少阴、足厥阴二经是动。）有云嗌痛颔肿者，（手太阳是动。）有云颈颔
肿者，（手太阳所生。）有云项痛者，（足太阳所生。）有云咽肿者，（足少阴所生。）有云嗌干及痛者，（
足少阴所生。）有云嗌肿喉痹者，（手少阳是动。）有云颔痛者。（足少阳所生。）种种不同，总无外
气火二字。与本篇所云∶
气有余，则当脉所过者热肿，同一义也。（宜黄芩、枳壳、连翘、丹皮、薄荷、荆芥、山栀、防风、牛蒡、
玄参、黄柏、黄连、山豆根、射干、升麻、生地、甘草、桔梗、石膏等药。在临证定在何经，相宜者用。
又不可纯用寒凉，须配轻散者斯善矣。）然诸证之中，惟喉痹为急。而喉痹中，又惟以发于手少阴、少阳二经
者为最急。盖喉主天气，通呼吸，为生气之门。火热搏聚则肿胀，肿胀则窍闭，窍
闭则气塞，气塞则痰涎壅。愈壅愈塞，愈塞愈壅，呼吸亦将从此而断。况少阴君火，
少阳相火，火性速而炎上，较之他经，不更烈乎？故一二日即成不治。惟针刺出血，
以泻其实；探吐痰涎，以决其壅，皆仓卒治标之妙法也。（刺肿处出血，用鹅翎蘸酸涩之味以探吐。）
其脉多数，数则为热故也。间有脉迟者，乃是外寒袭经，经气不利，郁滞于所过之
处，故亦为痹。外则兼表证，内亦不如数热之肿痛，此不但忌用寒凉，而且当温散
也。更有一种缠喉风，或麻或痒，又肿又痛，缠绵于内，肿达于外。一种走马喉痹，
须臾之间，痛而肿，肿而闭，闭而气绝。暴发暴死，如走马然。二者俱火中挟风。
火性烈，风性疾。风火交煽，故发病凶暴如此。（此等证惟刺最妙。）其脉应浮大洪数，而
反见微伏，是正衰邪盛，补泻罔从。欲其生也，不亦难乎？
龙脑安神丸（参见第十九卷）
河间犀角丸（参见第二十五卷）
清心牛黄丸（参见第四十二卷）
神应丹：治疗各种痫病。
好辰砂（朱砂，用量不限）
将上述药材细细研磨，用猪心血调和均匀，用蒸饼包裹后蒸熟。趁热取出，制成梧桐子大小的药丸。每次服用一丸，用人参汤送服。饭后或临睡前服用均可。
三圣散
瓜蒂（挑选干净，炒至微黄）防风（去芦头，各三两）藜芦（《圣惠方》中建议减量使用，可用一两、半两或三钱）
将上述药材捣成粗末。每次服用约半两，用醋汁三茶盏，先用两盏醋汁煎煮三五沸，滤去醋汁。再加入水一盏，煎煮至三沸。然后将之前滤出的两盏醋汁倒回一起，再煮沸两次，滤去药渣，澄清后放温。慢慢服用，以引起呕吐为度，不必喝完所有药剂。
大承气汤（参见第十七卷）
喉痹的脉象表现为：脉搏数主热，脉搏迟主寒。缠喉风与走马喉痹，若脉象微伏则病情难治。
“痹”就是闭塞的意思，指气机闭塞不通。这是由于火邪旺盛、气机郁结，导致喉咙肿胀，呼吸难以通畅，痰涎壅塞，连水浆都无法咽下。发病一二日内，即可致人死亡。十二经脉及其经别，大多经过咽喉部位。即使不直接经过，也位于其前后左右。有的经脉经过，有的经别经过，有的经脉和经别都经过。例如手太阴肺经，没有直接经过此处。但《灵枢·经别》篇说：手太阴之正，上行出于缺盆，沿喉咙行走。手阳明大肠经，循行经过缺盆，上行颈部贯穿面颊。《经别》篇又说：上行沿喉咙。足阳明胃经，循行沿喉咙，进入缺盆。《经别》篇又说：上行沿咽部，出于口。足太阴脾经，上行穿过膈肌夹持咽部，连接舌根。《经别》篇又说：上行结于咽部，贯穿舌中。手少阴心经，上行夹持咽部。《经别》篇又说：上行走向喉咙，出于面部。手太阳小肠经，循行咽部下穿膈肌。其分支，循行颈部上达面颊。而《经别》篇中没有记载。足太阳膀胱经，从脑部出来，分支下行项部。《经别》篇又说：直行者从脊背向上出于项部。足少阴肾经，循行喉咙，夹持舌根。《经别》篇又说：直行者系连舌根，复出项部。手厥阴心包络经，也不经过此处。但《经别》篇说：手厥阴之正，别属三焦，外出沿喉咙行走。手少阳三焦经，上行项部系连耳后。而《经别》篇中没有记载。虽然《经别》篇未载，但手厥阴之正有别属三焦、外出沿喉咙的情况，因为三焦与心包相配，所以称为“属”。属意味着经脉相互联系而合一。足少阳胆经，下行加于颊车穴，下行颈部。《经别》篇又说：足少阳上行夹持咽部，出于颐颔中间。足厥阴肝经，循行喉咙后方，上行入颃颡，而《经别》篇也未记载。
因此，《灵枢》第十篇中，关于各经“是动”、“所生”的病证，有说颈肿的（手阳明经是动），有说鼻流清涕及喉痹的（手阳明经所生），有说颈肿喉痹的（足阳明经所生），有说舌根强硬的（足太阴经是动），有说舌根疼痛的（足太阴经所生），有说咽干的（手少阴、足厥阴二经是动），有说咽痛下颌肿的（手太阳经是动），有说颈下颌肿的（手太阳经所生），有说项痛的（足太阳经所生），有说咽肿的（足少阴经所生），有说咽干且痛的（足少阴经所生），有说咽肿喉痹的（手少阳经是动），有说下颌痛的（足少阳经所生）。种种症状不同，总离不开“气”和“火”两个字。这与本篇所说的：气有余，则在经脉所过之处出现热肿，意义相同。（适宜选用黄芩、枳壳、连翘、丹皮、薄荷、荆芥、山栀、防风、牛蒡、玄参、黄柏、黄连、山豆根、射干、升麻、生地、甘草、桔梗、石膏等药物。需根据临证时确定属于哪一经，选择适宜的药物使用。又不可单纯使用寒凉药，必须配合轻扬发散的药物才好。）然而在诸种病症中，只有喉痹最为急重。而在喉痹中，又以发于手少阴、手少阳二经者为最急。因为喉主管天气，通呼吸，是生气之门。火热搏结聚集则导致肿胀，肿胀则窍道闭塞，窍闭则气机阻塞，气塞则痰涎壅盛。越壅塞越阻滞，越阻滞越壅塞，呼吸也将因此中断。何况少阴君火、少阳相火，火性急速且炎上，比其他经脉的火更猛烈吗？所以一两天内就会变成不治之症。只有针刺出血，以泻其实邪；探吐痰涎，以决除其壅塞，都是仓促之间治标的妙法。（刺肿处出血，用鹅翎蘸酸涩之物以探吐。）其脉多数，因为数脉主热。间或有脉迟的，那是外寒侵袭经脉，经气不利，郁滞于经脉所过之处，所以也形成痹证。外部兼有表证，内部也不像数热那样肿痛，这不但忌用寒凉药，而且应当用温散法。还有一种缠喉风，或麻木或瘙痒，又肿又痛，缠绵于内，肿胀达于外。一种走马喉痹，须臾之间，先痛后肿，肿后闭塞，闭塞后气绝。暴发暴死，如走马般迅速。这两种情况都是火中挟风。火性猛烈，风性疾速。风火交煽，所以发病凶暴如此。（这类病症只有针刺最妙。）其脉象应见浮大洪数，反而出现微伏，这是正气衰败、邪气亢盛，补泻无从下手。想要使其生还，不也很难吗？
Longnao Anshen Wan (see Vol. 19)
Hejian Xijiao Wan (see Vol. 25)
Qingxin Niuhuang Wan (see Vol. 42)
Shenyang Dan: Treats various types of epilepsy (Xian Bing).
Hao Chensha (Cinnabar, quantity not restricted)
Grind the above herbs finely, mix evenly with pig heart blood, wrap in steamed dough, and steam until cooked. Take out while hot, pill to the size of paulownia seeds. Take one pill per dose, administered with Ginseng Decoction (Renshen Tang). Can be taken after meals or before bedtime.
Sansheng San
Gua Di (Segetum Melonis Pericarpium, selected clean, stir-fried until slightly yellow) Fang Feng (Saposhnikoviae Radix, remove rhizome, 3 liang each) Li Lu (Veratri Rhizoma, reduce dosage as per *Shenghui Fang*, use 1 liang, 0.5 liang, or 3 qian)
Pulverize the above into coarse powder. Take approximately 0.5 liang per dose. Use three tea cups of vinegar juice (Ji Zhi). First, boil two cups of vinegar juice for three to five boils, then strain off the vinegar juice. Next, add one cup of water, boil for three times. Then pour the previously strained two cups of vinegar juice back together, boil twice more, strain the dregs, clarify, and let cool to warm temperature. Administer slowly, stopping when vomiting occurs; it is not necessary to consume the entire dose.
Da Chengqi Tang (see Vol. 17)
The pulse of Hou Bi (Sore Throat/Throat Obstruction) indicates heat if rapid (Shu) and cold if slow (Chi). For Chan Hou Feng (Coiling Throat Wind) and Zou Ma Hou Bi (Running Horse Sore Throat), a faint and deep (Wei Fu) pulse indicates difficulty in treatment.
"Bi" means obstruction, referring to blockage and lack of free flow. It results from excessive fire and qi stagnation, leading to swelling of the throat, difficult breathing, accumulation of phlegm and saliva, and inability to swallow fluids. Within one or two days, it can be fatal. The Twelve Primary Meridians and their Extraordinary Branches (Jing Bie) mostly pass through this area. Even if they do not directly pass through, they are located anteriorly, posteriorly, laterally, or medially. Some meridians pass through, some Jing Bie pass through, and some both pass through. For example, the Hand-Taiyin Lung Meridian does not pass directly through here. However, the *Jing Bie* chapter states: The proper pathway of Hand-Taiyin emerges above the Clavicular Fossa (Quepen), follows the throat. The Hand-Yangming Large Intestine Meridian passes through the Clavicular Fossa, ascends the neck, and penetrates the cheek. The *Jing Bie* chapter also states: Ascends along the throat. The Foot-Yangming Stomach Meridian follows the throat and enters the Clavicular Fossa. The *Jing Bie* chapter states: Ascends along the pharynx, emerges at the mouth. The Foot-Taiyin Spleen Meridian ascends through the diaphragm, flanks the pharynx, and connects to the root of the tongue. The *Jing Bie* chapter states: Ascends to knot at the pharynx, penetrates the middle of the tongue. The Hand-Shaoyin Heart Meridian ascends flanking the pharynx. The *Jing Bie* chapter states: Ascends to walk along the throat, emerges on the face. The Hand-Taiyang Small Intestine Meridian follows the pharynx down through the diaphragm. Its branch follows the neck up to the cheek. The *Jing Bie* chapter has no record of this. The Foot-Taiyang Bladder Meridian returns from the brain, branches down to the nape. The *Jing Bie* chapter states: The straight branch rises from the spine and emerges at the nape. The Foot-Shaoyin Kidney Meridian follows the throat and flanks the root of the tongue. The *Jing Bie* chapter states: The straight branch ties to the root of the tongue, re-emerges at the nape. The Hand-Jueyin Pericardium Meridian also does not pass through here. But the *Jing Bie* chapter says: The proper pathway of Hand-Jueyin separately belongs to the Triple Burner (San Jiao), exits and follows the throat. The Hand-Shaoyang Triple Burner Meridian ascends the nape and ties behind the ear. The *Jing Bie* chapter has no record. Although the *Jing Bie* chapter lacks this record, the proper pathway of Hand-Jueyin has a branch belonging to the Triple Burner that exits and follows the throat. Because the Triple Burner and Pericardium are paired, it is called "belongs" (Shu). "Belongs" implies the meridians are connected and unified. The Foot-Shaoyang Gallbladder Meridian descends adding to the Jiache point, descends the neck. The *Jing Bie* chapter states: Foot-Shaoyang ascends flanking the pharynx, emerges in the center of the jaw and chin. The Foot-Jueyin Liver Meridian follows behind the throat, ascends into the Ying-Sang (upper nasal cavity/pharynx), and the *Jing Bie* also has no record.
Therefore, in Chapter 10 of *Ling Shu*, regarding diseases of "Is Moved" (Shi Dong) and "Is Generated" (Suo Sheng) by various meridians, it mentions swelling of the neck (Hand-Yangming Shi Dong), runny nose and Hou Bi (Hand-Yangming Suo Sheng), swelling of the neck and Hou Bi (Foot-Yangming Suo Sheng), stiffness of the tongue root (Foot-Taiyin Shi Dong), pain of the tongue root (Foot-Taiyin Suo Sheng), dryness of the throat (Hand-Shaoyin and Foot-Jueyin Shi Dong), pain of the throat and swelling of the mandible (Hand-Taiyang Shi Dong), swelling of the neck and mandible (Hand-Taiyang Suo Sheng), pain of the neck (Foot-Taiyang Suo Sheng), swelling of the pharynx (Foot-Shaoyin Suo Sheng), dryness and pain of the throat (Foot-Shaoyin Suo Sheng), swelling of the throat and Hou Bi (Hand-Shaoyang Shi Dong), pain of the mandible (Foot-Shaoyang Suo Sheng). These symptoms vary greatly but essentially revolve around the concepts of Qi and Fire. This aligns with the meaning stated in this chapter: Excess Qi causes heat and swelling in the areas traversed by the meridians. (Suitable herbs include Huang Qin, Zhi Ke, Lian Qiao, Dan Pi, Bo He, Jing Jie, Shan Zhi, Fang Feng, Niu Bang Zi, Xuan Shen, Huang Bai, Huang Lian, Shan Dou Gen, She Gan, Sheng Ma, Sheng Di, Gan Cao, Jie Geng, Shi Gao, etc. Determine which meridian is affected during clinical practice and use appropriate herbs. Do not use only cold-cooling herbs; they must be combined with light-dispersing herbs to be effective.) Among all these conditions, Hou Bi is the most urgent. Among Hou Bi cases, those originating from the Hand-Shaoyin and Hand-Shaoyang meridians are the most critical. The throat governs Heavenly Qi, facilitates respiration, and serves as the gate of vital energy. When fire and heat collide and accumulate, swelling occurs; swelling leads to orifice closure; closure leads to qi obstruction; obstruction leads to phlegm-saliva accumulation. The more accumulated, the more obstructed; the more obstructed, the more accumulated; respiration will eventually cease. Moreover, the Ministerial Fire of Shaoyin and the Ministerial Fire of Shaoyang have a nature that is rapid and ascending, fiercer than other meridians? Thus, within one or two days, it becomes incurable. Only pricking to bleed can drain excess pathogenic factors; inducing vomiting to expel phlegm-saliva can resolve obstruction. Both are excellent emergency methods for treating acute symptoms. (Prick swollen areas to bleed; use a goose feather dipped in astringent substances to induce vomiting.) The pulse is mostly rapid because rapid pulses indicate heat. Occasionally, a slow pulse appears, indicating external cold invading the meridian, causing meridian qi stagnation and blockage in the traversed area, thus forming Bi syndrome. Externally accompanied by exterior syndromes; internally, there is less swelling and pain compared to heat syndromes. In such cases, cold-cooling herbs are contraindicated, and warming-dispersing methods should be used. There is another type, Chan Hou Feng (Coiling Throat Wind), characterized by numbness or itching, swelling and pain, lingering internally, and swelling reaching externally. Another type is Zou Ma Hou Bi (Running Horse Sore Throat), where within moments, pain arises, followed by swelling, then closure, then cessation of breath. Sudden onset and sudden death, swift as a running horse. Both conditions involve wind夹杂 (mixed with) fire. Fire is fierce, wind is swift. Wind and fire fan each other, resulting in such violent onset. (For such conditions, acupuncture is best.) The pulse should be floating, large, surging, and rapid, but instead presents as faint and deep. This indicates deficiency of righteous qi and excess of pathogenic qi, making tonification and purgation indeterminate. To expect survival is indeed difficult.