喉痹谓喉中呼吸不通，语言不出，而天气闭塞也；咽痛嗌痛者，谓咽喉不能纳唾与食，
而地
乡村所患相同者，属天行运气之邪，治法当先表散。大忌酸药搽点寒药下之，恐郁其表于
内，而不得出也。其病有二∶
其一属火。经云∶少阳所到为喉痹。又云∶少阳同天之政，三之气，炎暑至民病喉痹，
用仲景桔梗汤。或面赤斑者属阳毒，用阳毒诸方汗之可也。
其二属阴湿。经云∶太阴之盛，火气内郁成喉痹。又云∶太阴在泉，湿淫所胜，病嗌肿
喉痹，用活人半夏桂枝甘草汤。或面青黑者，属阴毒，用阴毒法可汗之。
萧山先生云∶喉痹不恶寒，及寸脉大滑实于关尺者，皆属下症。宜硝石、青黛等寒药降
之，或胆矾等酸剂收之。韩 和先生云∶寸脉大于关尺者，宜消阳助阴。东垣先生云∶两寸脉实
，为阳盛阴虚，下之则愈。故予遵此法以治前症，如鼓应桴也。
陈无择治喉痹不语，用小续命加杏仁七个，煎服甚效。本草治中气急喉痹欲死，白僵蚕
为末，姜汁调下立愈。丹溪云∶僵蚕属火，而有土有水，得金气而成。治喉痹者，取其火中清化
之气，以从治相火，散浊逆结滞之痰。
陈藏器每治脏寒咽闭，吞吐不利，用附子去皮脐炮裂，以蜜涂炙，蜜入内，含之勿咽云
孙押班治都知潘元从喉闭，孙以药半钱，吹入喉中，少顷吐出脓血，立愈。潘诣孙谢曰∶大
急之患，非明公不能救，救人之急，非药不能疗，赠金百两，愿求方以济非常之急。孙曰∶
用猪牙皂角、白矾、黄连各等分，置新瓦上，焙干为末，既授为方，不受所赠。
谦甫云∶戊辰春乡村病喉痹者甚众，盖前年终之气，及当年初之气二火之邪也。用甘结
芩、连、半夏、僵蚕、鼠粘子、葛根等剂发之，虚加参、 、当归之类。水浆不入，先用解
毒雄黄丸，醋化灌之，痰出更灌姜汁，服前药无不神验。若用胆矾酸寒点过者皆不治，盖邪
郁不出故也。以上治法，《内经秘旨》救生之良法，故录之，见《医学纲目》。
治验
廷评张汝翰，患喉痛，日晡益甚，此气血虚而有热，用八珍汤而愈。后每入房，发热头
痛，用补中益气加麦门、五味及六味丸常服，后不复作。
秋官叶，素阴虚，因怒忽喉痛，寒热头痛，项强目直，小便自出，此皆肝火之症。肝主筋膜
，火主肿胀，火旺则血涸筋挛，自系紧急，颈项如拔，阴挺痿痹，则小便自遗。遂刺患处出
毒血，用四物、柴胡、山栀、玄参、甘草而苏。再用六味丸料，以生肝血滋肾水，诸症悉愈
太守叶，咽喉肿痛，痰涎不利，手足发热，喜冷冻饮料食，用清咽利膈汤二剂。不应，刺少
商穴，喉少宽，痰从鼻出如胶，患处出紫血稍宽，至七日咳出秽脓而愈。
一儒者三场毕，忽咽喉肿闭，不省人事，喘促痰涌，汗出如水，肢体痿软，脉浮大而
数。此饮食劳役，无根虚火上炎，用补中益气加肉桂，一剂顿苏。
义士顾克明，咽喉作痛，至夜发热，此肝肾阴虚之热。用四物，加酒炒黑黄柏、知母、
麦门
嘶，作渴发热，日晡足热，用滋肾丸、加减八味丸，间服三月余，喜其年富，谨疾得愈。
喉痹是指咽喉中呼吸不通畅，不能言语，这是天气闭塞所致；咽痛和嗌痛是指咽喉无法吞咽唾液和食物，这是地气闭塞所致。乡村地区所患症状相同的疾病，属于天行运气之邪，治疗方法应当先采用解表发散法。最忌讳使用酸味药物涂抹或寒凉药物攻下，恐怕会导致表邪郁结在体内而无法排出。这类病症主要有两种：
其一属于火证。医经说：“少阳经气到达人体则发为喉痹。”又说：“少阳同天之政，在三之气阶段，炎热暑气到来，民众易患喉痹”，此时应使用张仲景的桔梗汤。如果面部发红且有斑疹的，属于阳毒，可以使用治疗阳毒的各种方剂通过发汗法治愈。
其二属于阴湿证。医经说：“太阴经气旺盛时，火气在内郁结而发为喉痹。”又说：“太阴在泉之时，湿气淫盛，会导致咽喉肿胀、喉痹”，此时应使用《活人书》中的半夏桂枝甘草汤。如果面色青黑的，属于阴毒，可以采用治疗阴毒的方法进行发汗。
萧山先生说：“喉痹患者如果不恶寒，且寸脉比关尺脉大、滑、实，都属于下焦实证。适宜用硝石、青黛等寒凉药物降泄，或用胆矾等酸收药物收敛。”韩和先生说：“寸脉大于关尺脉的，适宜消减阳气、资助阴液。”东垣先生说：“两寸脉实，是阳气盛而阴气虚，采用攻下法即可痊愈。”所以我遵循这些方法来治疗上述病症，效果如击鼓应槌般迅速准确。
陈无择治疗喉痹导致不能言语，用小续命汤加七个杏仁，煎服后非常有效。本草记载治疗中气急迫、喉痹欲死的症状，将白僵蚕研成末，用姜汁调服，立即痊愈。丹溪说：“僵蚕属火，但兼具土和水性，得金气而成形。治疗喉痹，是取其火中清化之气，以从治相火，消散浊逆结滞之痰。”
陈藏器每次治疗脏寒导致的咽闭、吞吐不利，使用附子去皮脐炮裂，涂蜜炙烤，让患者含在口中不要咽下。
孙押班治疗都知潘元从的喉闭症，孙医生将半钱药粉吹入喉中，片刻后吐出脓血，立即痊愈。潘元从拜访孙医生致谢说：“如此紧急的病患，非明公不能救治；解救他人之急难，非药物不能疗治。赠送黄金百两，希望能求得药方以救济非常紧急的情况。”孙医生说：“使用猪牙皂角、白矾、黄连各等分，放在新瓦上焙干研成末，”随即授以此方，不接受所赠黄金。
谦甫说：“戊辰年春季，乡村患喉痹的人很多，这是因为前一年终之气以及当年年初之气，都是火邪所致。使用甘结芩、黄连、半夏、僵蚕、鼠粘子、葛根等药剂发散，体虚者加入人参、（此处原文缺字，推测为黄芪或类似补气药）、当归之类。如果水浆不能入口，先用解毒雄黄丸，用醋化开灌服，痰出后再灌姜汁，服用前述药物无不神效。如果使用胆矾酸寒药物点过喉部的，都无法治愈，因为邪气郁结无法排出的缘故。以上治疗方法，《内经秘旨》称之为救生的良法，所以记录下来，见于《医学纲目》。”
治验案例：
廷评张汝翰，患有喉痛，傍晚时分加重，这是气血虚弱而有热，使用八珍汤而痊愈。后来每次行房事，出现发热头痛，使用补中益气汤加麦门冬、五味子及六味丸常服，之后不再发作。
秋官叶某，素来阴虚，因愤怒突然喉痛，伴有寒热、头痛、项强、目直、小便自遗，这些都是肝火的症状。肝主筋膜，火主肿胀，火旺则血液枯竭、筋脉挛急，自然感觉颈部紧急，颈项像被拔起一样，阴部挺举痿痹，则小便自遗。于是针刺患处放出毒血，使用四物汤、柴胡、山栀、玄参、甘草，患者苏醒。再用六味丸的药料，以生肝血、滋肾水，各种症状全部痊愈。
太守叶某，咽喉肿痛，痰涎不利，手足发热，喜欢冷冻饮料和食物，使用清咽利膈汤两剂。未见效，针刺少商穴，喉咙稍感宽松，痰从鼻中流出如胶状，患处放出紫血后稍感宽松，到第七天咳出秽脓而痊愈。
一位儒生在三次考试结束后，突然咽喉肿闭，不省人事，喘促痰涌，出汗如水，肢体痿软，脉象浮大而数。这是饮食劳役过度，无根虚火上炎，使用补中益气汤加肉桂，一剂后顿时苏醒。
义士顾克明，咽喉作痛，到了夜间发热，这是肝肾阴虚产生的虚热。使用四物汤，加酒炒黑黄柏、知母、麦门冬，（后续文字缺失，推测为其他滋阴清热药），嘶哑，口渴发热，傍晚足部发热，使用滋肾丸、加减八味丸，交替服用三个多月，庆幸其年轻力壮，谨守医嘱得以痊愈。
Throat Bi (Obstruction of the Throat) refers to the condition where breathing through the throat is obstructed, speech is impossible, caused by the closure of Heaven's Qi; Yan Tong (Sore Throat) and Ai Tong (Pain in the Pharynx) refer to the inability to swallow saliva and food due to the closure of Earth's Qi. Diseases occurring in rural areas with identical symptoms belong to the pathogenic factors of Tian Xing Yun Qi (Heavenly Movement and Luck Qi), and the treatment method should first employ exterior-dispersing techniques. It is strictly forbidden to use sour medicines for application or cold medicines for purgation, as this may cause the exterior pathogens to become depressed inside and unable to exit. There are two types of this disease:
The first type belongs to Fire. The Classics state: "When Shaoyang (Lesser Yang) Qi arrives, it causes Throat Bi." It also states: "In the governance of Shaoyang with Heaven, during the third Qi phase, when hot summer heat arrives, the people suffer from Throat Bi," at which time Zhongjing's Jiegeng Tang (Platycodon Decoction) should be used. If the face is red with macules, it belongs to Yang Du (Yang Toxin), and various formulas for treating Yang Du can be used to induce sweating for cure.
The second type belongs to Yin-Dampness. The Classics state: "When Taiyin (Greater Yin) Qi is abundant, internal depression of Fire Qi causes Throat Bi." It also states: "When Taiyin governs the lower region, excessive Dampness causes swelling of the pharynx and Throat Bi," at which time Banxia Guizhi Gancao Tang (Pinellia, Cinnamon Twig, and Licorice Decoction) from *Huo Ren Shu* should be used. If the face is blue-black, it belongs to Yin Du (Yin Toxin), and methods for treating Yin Du involving sweating can be employed.
Mr. Xiaoshan stated: "For Throat Bi patients who do not fear cold, and whose Cun (Cun position pulse) pulse is larger, slippery, and solid compared to Guan (Guan position) and Chi (Chi position) pulses, all belong to Lower Jiao excess syndromes. It is suitable to use cold medicines like Shishi (Niter) and Qingdai (Indigo Naturalis) to descend, or astringent agents like Danfan (Chalcanthite) to consolidate." Mr. Han He stated: "When the Cun pulse is larger than the Guan and Chi pulses, it is suitable to reduce Yang and assist Yin." Mr. Dongyuan stated: "Solid pulses in both Cun positions indicate Excess Yang and Deficient Yin; purgation will lead to recovery." Therefore, I followed these methods to treat the aforementioned symptoms, achieving results as immediate and effective as striking a drum with a mallet.
Chen Wuyue treated Throat Bi causing aphonia using Xiao Xuming Tang (Minor Continuation of Life Decoction) plus seven Xingren (Apricot Seeds), which was very effective after decoction and ingestion. Materia Medica records that for sudden Qi urgency and fatal Throat Bi, Bai Jiangcan (Bombyx Batryticatus) powdered and taken with Ginger Juice leads to immediate recovery. Danxi said: "Jiangcan belongs to Fire but possesses Earth and Water natures, formed by obtaining Metal Qi. In treating Throat Bi, its clearing and transforming Qi within Fire is utilized to regulate Ministerial Fire and dissipate turbid, rebellious, stagnant phlegm."
Chen Cangqi treated each case of Zang Cold causing Yan Bi (Pharyngeal Closure) and difficulty in swallowing or spitting by using Fuzi (Aconite Lateral Root) peeled and processed, coated with honey and roasted, instructing the patient to hold it in the mouth without swallowing.
Sun Yaban treated Pan Yuancong, the Duke of Wei, for Hou Bi (Throat Closure). Sun blew half a qian of medicine into the throat; after a short while, pus and blood were expelled, leading to immediate recovery. Pan visited Sun to thank him, saying: "Such an urgent affliction could only be saved by you, my enlightened lord; relieving others' emergencies requires medicine. I present a hundred taels of gold and wish to obtain the prescription to aid in such critical emergencies." Sun replied: "Use Zhu Ya Zao Jiao (Gleditsia Sinensis Fruit), Bai Fan (Alumen), and Huanglian (Coptis Rhizome) in equal parts, dry-roast on a new tile, and powder them." He then gave the formula but did not accept the gift.
Qianfu said: "In the spring of the Wuchen year, many in the countryside suffered from Throat Bi, due to the Fire pathogenic factors of the final Qi of the previous year and the initial Qi of the current year. Formulas containing Ganjie Qin, Huanglian, Banxia, Jiangcan, Niubangzi, and Gegen were used to disperse; for deficiency, Renshen, [missing character], and Danggui were added. If water and fluids cannot enter, Jiedu Xionghuang Wan (Detoxifying Realgar Pill) dissolved in vinegar is administered first; after phlegm is expelled, Ginger Juice is given again. Taking the aforementioned medicines yields miraculous results. However, if treated with acid-cold agents like Danfan applied to the throat, they are incurable because the pathogens remain depressed and cannot exit. The above treatment methods are recorded in *Neijing Mizhi* as excellent life-saving methods, hence recorded here, as seen in *Yixue Gangmu*."
Clinical Cases:
Tingping Zhang Ruhhan suffered from sore throat, worsening in the late afternoon. This was Qi and Blood deficiency with Heat. He recovered after taking Bazhen Tang (Eight Treasures Decoction). Later, whenever he engaged in sexual intercourse, he experienced fever and headache. He took Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Maimendong and Wuweizi, along with Liuwei Wan (Six-Ingredient Pill with Rehmannia), regularly, and it never recurred.
Qiuguan Ye, constitutionally Yin-deficient, suddenly developed sore throat, aversion to cold and fever, headache, neck stiffness, staring eyes, and involuntary urination following anger. These are all symptoms of Liver Fire. The Liver governs sinews and fascia; Fire governs swelling. When Fire is vigorous, Blood dries up and sinews contract, causing tightness in the neck as if being pulled. Yin protrusion and flaccidity lead to urinary incontinence. Acupuncture was performed on the affected area to release toxic blood. Siwu Tang (Four Substances Decoction), Chaihu, Zhizi, Xuanshen, and Gancao were used, and the patient revived. Subsequently, ingredients of Liuwei Wan were used to generate Liver Blood and nourish Kidney Water, curing all symptoms.
Taishou Ye suffered from swollen and painful throat, difficult expectoration of phlegm-saliva, heat in hands and feet, and a preference for cold drinks and food. Two doses of Qingyan Lige Tang (Clear Throat and Benefit Diaphragm Decoction) were ineffective. Shaoshang acupoint was needled, providing slight relief to the throat. Phlegm was expelled from the nose like glue, and purple blood from the lesion provided slight relief. On the seventh day, foul pus was coughed up, and he recovered.
A scholar, after completing three rounds of examinations, suddenly developed swollen and closed throat, unconsciousness, panting with surging phlegm, profuse sweating like water, flaccid limbs, and a floating, large, and rapid pulse. This was rootless deficient Fire flaming upward due to dietary irregularities and overwork. Buzhong Yiqi Tang plus Rougui (Cinnamon Bark) was administered, resulting in immediate revival after one dose.
Yishi Gu Keming suffered from throat pain and night fever. This was Heat from Liver and Kidney Yin deficiency. Siwu Tang was used, plus Jiuchao Hei Huangbai (Wine-fried blackened Coptis Rhizome), Zhimu, and Maimendong... [text missing] hoarseness, thirst, fever, and foot heat in the late afternoon. Zishen Wan (Kidney-Nourishing Pill) and Jiajian Bawei Wan (Modified Eight-Flavor Pill) were taken alternately for over three months. Fortunately, being young and strong, and adhering strictly to health regimens, he recovered.