刘 三十二岁 脉弦而长,木气太旺,与君火结而成喉痹。
荆芥穗(二钱) 薄荷(二钱) 元参(八钱) 银花(六钱) 牛蒡子(五钱) 连翘(五钱)
马勃(二钱) 人中黄(二钱)
共为粗末,分八包,每一包芦根汤煎,一时一服。
酒客脉弦数,与苦药清酒中之湿,即于前方内加∶
桔梗(四钱) 射干(四钱) 黄芩(四钱) 儿茶(三钱)
煎法如前。
灵 乙丑六月二十六日 舌苔边白中浊,喉肿而痛,头晕,身热,脉数,疠气所干。
切戒谷食,急开关窍,用时时轻扬法。
桔梗(八钱) 人中黄(三钱) 薄荷(三钱) 荆芥穗(三钱) 元参(一两) 牛蒡子(八钱)
黄
芩(三钱) 黄连(三钱) 马勃(二钱) 板蓝根(三钱) 僵蚕(三钱) 连翘(八钱) 银花(八
钱) 鲜荷叶(半张去蒂)
共为粗末,分八包,一时许服一包,芦根汤煎。
二十七日 舌浊甚,邪之传化甚缓,于前方内,加∶
黄芩(二钱成五钱) 黄连(二钱成五钱)
二十八日 湿热厉气,相搏以成喉痹,舌苔重浊色暗,必得湿气宣化,而后热可以解。
盖无形之邪热,每借有形之秽浊以为根据附故也,因前法而小变之。
桔梗(八钱) 人中黄(二钱) 黄芩(五钱) 黄连(五钱) 马勃(五钱) 牛蒡子(五钱)
僵蚕
(三钱) 连翘(八钱) 银花(八钱) 通草(三钱) 荆芥(二钱) 杏仁(五钱) 薄荷(三钱)
滑石(一两) 犀角(三钱)
共为粗末,分十包,一时许服一包。每服鲜荷叶边二钱,芦根三钱,同煎,去渣服。
二十九日 喉痛虽止,舌浊未除,脉仍微数,则其中之湿可知。按∶《灵枢经》五脏温
病,以舌苔专属之肺,故药方一以宣通肺气为主,盖气化则湿化,而火亦无根据矣。
桔梗(三钱) 人中黄(八分) 连翘(二钱) 银花(二钱) 黄连(钱半) 黄芩(二钱) 马
勃(八分) 通草(一钱) 杏仁泥(一钱) 滑石(三钱) 芦根(一枝) 荷叶(半张)
今晚一帖,明早一帖。
王 二十岁 壬午四月十一日 湿毒身热喉痹,滴水不能下咽,已二日矣。与代赈普济
散二
十包,先煎一包,衔入口内,仰面浸渍喉疮,一刻许有稀涎满口,即控出吐之。再噙再浸如
上法,噙至半日,喉即开,得下咽。于是每一包药,煎一碗,咽一半,浸吐一半,三日得快
便,喉痹全消,身热亦退,育阴而愈。
王氏 三十八岁 乙酉五月初二日 六脉沉弦而细,纯阴之象,喉痛足痹宜温。
川椒炭(三钱) 防己(三钱) 桂枝(三钱) 肉桂(二钱) 茯苓皮(五钱) 姜黄(二钱)
萆(五钱) 苡仁(五钱)
四帖。
初八日 喉痛止去肉桂,痰不活加半夏(五钱)。
满氏 三十五岁 面色青黄,呼吸定息,脉再至而弦紧,食减,经不行,腹中有块二三
枚,
长三四寸,肝厥无五日不发,喉痛十数年不休。向来所服之方,非寒凉,即妇科地芍药等,
以致历年沉困不休,病势日重,十二年不孕矣。与苦辛热法,急回真阳,或者可救。
肉桂(钱半) 良姜(二钱) 川椒(二钱) 广皮(二钱) 吴萸(钱半) 半夏(三钱)
前方服二帖,喉痛减其大半,厥未发,食少进,腹痛减,与前方加∶
人参(钱半) 茯苓(三钱)
前方服四帖,服三至,喉痛止,食大进,腹痛亦减,仍服前方,去良姜,并减刚药分量
。
前方服七帖,六脉将进至四至,服通补奇经丸一料,半年后受孕。
刘姓患者,三十二岁。脉象弦而长,这是肝木之气过旺,与心君之火相结,从而形成喉痹(咽喉肿痛闭塞之病)。
荆芥穗(二钱) 薄荷(二钱) 玄参(八钱) 金银花(六钱) 牛蒡子(五钱) 连翘(五钱)
马勃(二钱) 人中黄(二钱)
以上药物共研为粗末,分成八包,每包用芦根汤煎煮,每隔一个时辰服用一包。
嗜酒之人脉象弦数,需用苦寒药清解酒湿,即在前方基础上加入:
桔梗(四钱) 射干(四钱) 黄芩(四钱) 儿茶(三钱)
煎服方法同前。
灵姓患者,乙丑年六月二十六日就诊。舌苔边缘白、中部浊腻,喉咙肿胀疼痛,头晕,身体发热,脉数,这是被疠气(疫毒之气)所侵犯。
切戒吃谷物食物,急需开通窍道,采用“时时轻扬法”(频繁使用轻清宣透的药物)。
桔梗(八钱) 人中黄(三钱) 薄荷(三钱) 荆芥穗(三钱) 玄参(一两) 牛蒡子(八钱)
黄芩(三钱) 黄连(三钱) 马勃(二钱) 板蓝根(三钱) 僵蚕(三钱) 连翘(八钱) 金银花(八钱) 鲜荷叶(半张,去蒂)
以上药物共研为粗末,分成八包,约一个时辰服用一包,用芦根汤煎煮。
二十七日。舌苔更加浊腻,邪气传变化热较慢,在前方基础上加入:
黄芩(由二钱增至五钱) 黄连(由二钱增至五钱)
二十八日。湿热厉气相互搏结形成喉痹,舌苔厚重浊腻且颜色暗滞,必须使湿气宣散化解,然后热邪才能解除。因为无形的邪热,往往借助有形的秽浊之物作为依附的基础,所以在前法基础上稍作变化。
桔梗(八钱) 人中黄(二钱) 黄芩(五钱) 黄连(五钱) 马勃(五钱) 牛蒡子(五钱)
僵蚕(三钱) 连翘(八钱) 金银花(八钱) 通草(三钱) 荆芥(二钱) 杏仁(五钱) 薄荷(三钱)
滑石(一两) 犀角(三钱)
以上药物共研为粗末,分成十包,约一个时辰服用一包。每次服药时加鲜荷叶边二钱、芦根三钱,一同煎煮,去渣后服用。
二十九日。喉咙痛虽然停止,但舌苔浊腻未除,脉仍微数,说明体内仍有湿气。按:《灵枢经》认为五脏温病,舌苔的变化专门归属于肺,所以药方以宣通肺气为主,因为气化则湿气自化,火邪也就失去了依附的基础。
桔梗(三钱) 人中黄(八分) 连翘(二钱) 金银花(二钱) 黄连(一钱五分) 黄芩(二钱) 马勃(八分) 通草(一钱) 杏仁泥(一钱) 滑石(三钱) 芦根(一枝) 荷叶(半张)
今晚服一帖,明早服一帖。
王姓患者,二十岁,壬午年四月十一日就诊。湿毒导致身体发热、喉痹,滴水不能下咽,已经两天了。给予代赈普济散二十包,先煎一包,含在口中,仰面让药液浸渍喉部疮口,约一刻钟后口中会有稀涎流出,随即吐出。再次含漱再次浸渍,照此法进行,含漱半天后,喉咙即开通,能够吞咽。于是每一包药煎成一碗,喝一半,另一半用来含漱吐掉,三天后大便通畅,喉痹完全消除,身体发热也退了,通过滋养阴液而痊愈。
王氏,三十八岁,乙酉年五月初二日就诊。六脉沉弦而细,呈现纯阴的征象,喉咙痛和足部麻木应当用温法治疗。
川椒炭(三钱) 防己(三钱) 桂枝(三钱) 肉桂(二钱) 茯苓皮(五钱) 姜黄(二钱)
萆薢(五钱) 薏苡仁(五钱)
共四帖。
满氏,三十五岁。面色青黄,呼吸平稳,脉搏跳动两次且弦紧,食欲减退,月经不行,腹中有二三枚肿块,长三四寸,肝厥证没有五天不发作的,喉咙痛十数年不愈。向来所服的方剂,不是寒凉药,就是妇科用的地黄、芍药等,导致多年来病情沉重困顿不休,病势日益加重,十二年未能受孕。给予苦辛热法,急回真阳,或许可以救治。
肉桂(一钱五分) 高良姜(二钱) 川椒(二钱) 陈皮(二钱) 吴茱萸(一钱五分) 半夏(三钱)
前方服用两帖后,喉咙痛减轻大半,肝厥未发作,食欲稍增,腹痛减轻,在前方基础上加入:
人参(一钱五分) 茯苓(三钱)
前方服用四帖后,脉象恢复至三次跳动,喉咙痛停止,食欲大增,腹痛也减轻,继续服用前方,去掉高良姜,并减少刚燥药物的分量。
前方服用七帖后,六脉即将恢复到四次跳动,服用通补奇经丸一料,半年后受孕。
Patient Liu, aged thirty-two. The pulse is wiry and long, indicating excessive Wood Qi (Liver Qi). This combines with the Ministerial Fire of the Heart to form Hou Bi (Sore Throat/Throat Obstruction).
Schizonepeta Spike (2 qian), Mint (2 qian), Scrophularia Root (8 qian), Honeysuckle Flower (6 qian), Burdock Fruit (5 qian), Forsythia Fruit (5 qian)
Toad Venom (2 qian), Human Waste Yellow (2 qian)
Grind all into coarse powder, divide into eight packets. Decoct each packet in Reed Rhizome Decoction. Take one packet every two hours (one shichen).
For wine drinkers, the pulse is wiry and rapid. Bitter medicines are used to clear dampness from alcohol. Add to the previous formula:
Platycodon Root (4 qian), Belamcanda Rhizome (4 qian), Scutellaria Root (4 qian), Catechu (3 qian)
Decoct and take as before.
Patient Ling, June 26th, Yichou year. Tongue coating is white at the edges and turbid in the center. Throat is swollen and painful, accompanied by dizziness, fever, and a rapid pulse. This is caused by invasion of Li Qi (Epidemic Toxins).
Strictly avoid grain food. Urgently open orifices using the "Frequent Light-Yang Method" (frequent administration of light, clearing, and dispersing herbs).
Platycodon Root (8 qian), Human Waste Yellow (3 qian), Mint (3 qian), Schizonepeta Spike (3 qian), Scrophularia Root (1 liang), Burdock Fruit (8 qian)
Scutellaria Root (3 qian), Coptis Rhizome (3 qian), Toad Venom (2 qian), Isatis Root (3 qian), Silkworm (3 qian), Forsythia Fruit (8 qian), Honeysuckle Flower (8 qian), Fresh Lotus Leaf (half a leaf, stem removed)
Grind all into coarse powder, divide into eight packets. Take one packet approximately every two hours, decocted in Reed Rhizome Decoction.
27th Day. Tongue coating is even more turbid; the transformation of pathogens is slow. Add to the previous formula:
Scutellaria Root (increase from 2 qian to 5 qian), Coptis Rhizome (increase from 2 qian to 5 qian)
28th Day. Damp-heat epidemic qi struggles together to form Hou Bi. Tongue coating is heavy, turbid, and dark. Moisture must be dispersed and transformed before heat can be resolved. This is because formless pathogenic heat often relies on有形 (form/material) filth as its foundation. Therefore, slightly modify the previous method.
Platycodon Root (8 qian), Human Waste Yellow (2 qian), Scutellaria Root (5 qian), Coptis Rhizome (5 qian), Toad Venom (5 qian), Burdock Fruit (5 qian)
Silkworm (3 qian), Forsythia Fruit (8 qian), Honeysuckle Flower (8 qian), Akebia Stem (3 qian), Schizonepeta Herb (2 qian), Apricot Seed (5 qian), Mint (3 qian)
Talcum (1 liang), Rhinoceros Horn (3 qian)
Grind all into coarse powder, divide into ten packets. Take one packet approximately every two hours. For each dose, add 2 qian of fresh lotus leaf edge and 3 qian of Reed Rhizome, decoct together, strain, and take.
29th Day. Throat pain has stopped, but tongue turbidity remains, and the pulse is still slightly rapid, indicating internal dampness. Note: According to *Ling Shu* (Spiritual Pivot), for warm diseases of the five zang organs, tongue coating is exclusively attributed to the Lung. Thus, the prescription focuses primarily on diffusing Lung Qi. When Qi transforms, dampness transforms, and Fire loses its foundation.
Platycodon Root (3 qian), Human Waste Yellow (8 fen), Forsythia Fruit (2 qian), Honeysuckle Flower (2 qian), Coptis Rhizome (1.5 qian), Scutellaria Root (2 qian), Toad Venom (8 fen), Akebia Stem (1 qian), Apricot Seed Paste (1 qian), Talcum (3 qian), Reed Rhizome (one branch), Lotus Leaf (half a leaf)
Take one decoction tonight, one tomorrow morning.
Patient Wang, aged twenty, April 11th, Renwu year. Damp-toxin causes fever and Hou Bi. Cannot swallow even a drop of water for two days. Administer Dai Zhen Pu Ji San (General Relief Powder for Famine Relief) in twenty packets. First, decoct one packet, hold it in the mouth, tilt head back to soak the throat sores. After about fifteen minutes, thin saliva will fill the mouth; spit it out. Repeat soaking and spitting as above. After holding for half a day, the throat opens, allowing swallowing. Then, decoct each packet into one bowl. Drink half, use the other half for soaking and spitting. After three days, smooth bowel movement occurs, Hou Bi completely resolves, and fever subsides. Recover through nourishing Yin.
Ms. Wang, aged thirty-eight, May 2nd, Yiyi year. Six pulses are deep, wiry, and fine, presenting a pure Yin image. Throat pain and foot numbness require warming treatment.
Zanthoxylum Carbonized (3 qian), Stephania Root (3 qian), Cinnamon Twig (3 qian), Cinnamon Bark (2 qian), Poria Peel (5 qian), Turmeric Rhizome (2 qian)
Dioscorea Hypoglauca Rhizome (5 qian), Coix Seed (5 qian)
Four doses.
8th Day. Throat pain stops; remove Cinnamon Bark. Phlegm is not active; add Pinellia Tuber (5 qian).
Ms. Man, aged thirty-five. Complexion is greenish-yellow. Respiration is steady; pulse beats twice per breath and is wiry-tight. Appetite is reduced, menstruation has ceased. There are two or three masses in the abdomen, three to four cun long. Liver Jue (Liver Cold Reversal) attacks without fail every five days. Throat pain has persisted for over ten years. Past prescriptions were either cold-cooling herbs or gynecological herbs like Rehmannia Root and Peony Root. This has led to chronic debility year after year, worsening condition, and infertility for twelve years. Prescribe Bitter-Acrid-Hot method to urgently restore True Yang; perhaps this can save her.
Cinnamon Bark (1.5 qian), Galangal Rhizome (2 qian), Zanthoxylum (2 qian), Tangerine Peel (2 qian), Evodia Fruit (1.5 qian), Pinellia Tuber (3 qian)
After taking two doses of the previous formula, throat pain reduced by more than half, Liver Jue did not attack, appetite slightly improved, abdominal pain decreased. Add to the previous formula:
Ginseng Root (1.5 qian), Poria (3 qian)
After taking four doses of the previous formula, pulse returned to three beats per breath, throat pain stopped, appetite greatly improved, abdominal pain also decreased. Continue taking the previous formula, remove Galangal Rhizome, and reduce the dosage of acrid-hot drugs.
After taking seven doses of the previous formula, six pulses are approaching four beats per breath. Take one course of Tong Bu Qi Jing Wan (Pill to Unblock and Tonify the Extraordinary Vessels). Conceived pregnancy six months later.