哑瘴喉风肿痛咽,牙关紧急不能言,风痰涌塞咽膈上,火盛生痰风搏源。
【注】此证颇类紧喉,由肺胃蕴热,积久生痰,外复受风邪,与痰热相搏,涌塞咽膈
之上,而成斯疾。初起咽喉肿塞疼痛,汤水难咽,语言不出,牙关紧急,此属险候。急
用雄黄解毒丸,水化,用细竹管将药水吹入鼻孔,直达咽喉,药入作呕,即令患者吐之,
其牙关顿松,咽喉即稍开通。先与米饮饮之,次服清咽利膈汤,兼吹冰硼散。用药不应者
险,若唇黑、鼻流冷涕者逆。
雄黄解毒丸 清咽利膈汤(俱见紧喉风)
冰硼散(见口部鹅口疮)
弄舌喉风心脾经,实火外寒凝滞成,舌出搅动因胀闷,咽喉作肿更兼疼。
【注】此证由心、脾实火,与外寒郁遏凝滞而成。咽喉肿痛,痰涎堵塞,音哑言涩,舌
出不缩,时时搅动,觉舌胀闷,常欲以手扪之,故名弄舌。急刺少商穴,穴在两手大指
里侧,去指甲角旁韭叶宽即是,用三棱针刺之,有血者生,无血者死。噙蟾酥丸,徐咽
药汁。若痰涎上涌,不能咽药者,急用桐油饯探吐痰涎,随服清咽利膈汤,吹金锁匙;若
喉内如松子及鱼鳞状,不堵塞者,此属虚阳上浮,急用蜜炙附子片噙、咽其汁即效。
金锁匙
冰片(二分五厘) 白僵蚕(一钱) 雄黄(二钱) 焰硝(一两五钱) 硼砂(五钱)
各研末,共和匀,以细笔管吹入喉内肿痛处。
【方歌】金锁匙吹弄舌风,心脾火郁外寒乘,消痰逐热除疼痛,冰片僵蚕雄焰硼。
蟾酥丸(见疔疮门)
桐油饯 清咽利膈汤(俱见紧喉风)
哑瘴喉风的症状表现为咽喉肿痛、牙关紧闭导致无法言语。这是由于风痰涌塞于咽膈之上,火热炽盛生痰,风邪搏结为病源。
【注】此证颇似紧喉风,由肺胃蕴积热邪,日久生痰,外感风邪,与痰热相互搏结,涌塞于咽膈之上,从而形成此疾。初起时咽喉肿塞疼痛,汤水难以吞咽,不能说话,牙关紧急,这属于险恶的证候。急需使用雄黄解毒丸,用水化开,用细竹管将药液吹入鼻孔,直达咽喉。药物进入后引发呕吐,随即让患者吐出,这样牙关顿时松弛,咽喉稍通。先喂米汤饮用,随后服用清咽利膈汤,并配合吹撒冰硼散。用药后无效者病情危险,若出现嘴唇发黑、鼻流冷涕者则为逆证(预后不良)。
雄黄解毒丸 清咽利膈汤(均见“紧喉风”条下)
冰硼散(见“口部鹅口疮”条下)
弄舌喉风涉及心经和脾经,由实火与外寒凝滞而成。舌头伸出并搅动是因为胀闷感,咽喉肿胀且伴有疼痛。
【注】此证由心、脾二经实火,与外寒郁遏凝滞而形成。症状包括咽喉肿痛,痰涎堵塞,声音嘶哑言语涩滞,舌头伸出不能回缩,时时搅动,感觉舌体胀闷,常想用手触摸,因此名为弄舌。急需针刺少商穴,该穴位于两手大拇指内侧,距离指甲角旁约韭叶宽处,用三棱针点刺,有血出者预后良好,无血出者预后凶险。含服蟾酥丸,慢慢咽下药汁。若痰涎上涌,无法吞咽药物者,急需用桐油饯探吐以排出痰涎,随后服用清咽利膈汤,并吹撒金锁匙。若喉内呈现如松子或鱼鳞状物,但不堵塞气道者,此属虚阳上浮,急需含服蜜炙附子片,咽下其汁液即见效。
金锁匙
冰片(二分五厘) 白僵蚕(一钱) 雄黄(二钱) 焰硝(一两五钱) 硼砂(五钱)
各研成粉末,混合均匀,用细笔管吹入喉内肿痛部位。
【方歌】金锁匙吹治弄舌风,心脾火郁外寒乘,消痰逐热除疼痛,冰片僵蚕雄焰硼。
蟾酥丸(见“疔疮门”)
桐油饯 清咽利膈汤(均见“紧喉风”条下)
The symptoms of Ya Zhang Hou Feng (Mute Miasma Throat Wind) manifest as swelling and pain in the throat, stiffness of the jaw preventing speech. This is caused by wind-phlegm surging and obstructing above the pharynx and diaphragm, where excessive fire generates phlegm, and wind pathogens collide to form the source of the disease.
[Note] This condition closely resembles Jin Hou (Tight Throat). It arises from heat accumulating in the Lung and Stomach, generating phlegm over time, compounded by external wind pathogens colliding with phlegm-heat, surging and obstructing above the pharynx and diaphragm, resulting in this illness. Initially, there is swelling and obstruction of the throat with pain, difficulty swallowing liquids or solids, inability to speak, and stiffness of the jaw; this belongs to a critical prognosis. Urgently use Xionghuang Jiedu Wan (Realgar Detoxifying Pill), dissolve it in water, and blow the medicinal liquid into the nostrils using a fine bamboo tube, reaching directly to the throat. Once the medicine enters and induces vomiting, instruct the patient to vomit. The jaw will immediately relax, and the throat will slightly open. First, give rice water to drink, then administer Qingyan Lige Tang (Throat-Clearing and Diaphragm-Purifying Decoction), and simultaneously apply Bingpeng San (Borneol and Borax Powder). If the medication fails to produce an effect, the condition is dangerous; if the lips turn black and cold runny nose discharge occurs, it indicates a adverse prognosis (Ni syndrome).
Xionghuang Jiedu Wan and Qingyan Lige Tang are both described under the section "Jin Hou Feng" (Tight Throat Wind).
Bingpeng San is described under the section "Kou Bu E Kou Chuang" (Oral Cavity Thrush).
Nong She Hou Feng (Tongue-Manipulating Throat Wind) involves the Heart and Spleen meridians, formed by the stagnation of excess fire and external cold. The tongue protrudes and moves because of distension and stuffiness; the throat swells and is accompanied by pain.
[Note] This condition is caused by excess fire in the Heart and Spleen meridians, constrained and stagnated by external cold. Symptoms include swelling and pain in the throat, blockage by saliva and phlegm, hoarseness and slurred speech, the tongue protruding without retracting, constantly moving, feeling distended and stuffy in the tongue, often desiring to touch it with the hand, hence named Nong She (Manipulating Tongue). Urgently prick the Shaoshang acupoint (LU11), located on the medial side of the thumb of both hands, about the width of a leek leaf from the corner of the nail. Use a three-edged needle to puncture; if blood appears, survival is likely; if no blood appears, death is likely. Hold Chan Su Wan (Toad Venom Pill) in the mouth and slowly swallow the medicinal juice. If saliva and phlegm surge upward, making swallowing impossible, urgently use Tong You Qian (Camellia Oil Paste) to induce vomiting to expel phlegm, then follow with Qingyan Lige Tang, and apply Jin Suo Chi (Golden Lock Key). If the interior of the throat presents structures resembling pine nuts or fish scales but does not obstruct the airway, this belongs to floating deficient Yang. Urgently hold Mi Zhi Fu Zi Pian (Honey-Fried Aconite Slice) in the mouth and swallow its juice for immediate efficacy.
Jin Suo Chi:
Bingpian (Borneol, 2.5 fen), Bai Jiangcan (White Silkworm, 1 qian), Xionghuang (Realgar, 2 qian), Yanxiao (Saltpeter/Niter, 1.5 liang), Pengsha (Borax, 5 qian).
Grind each into powder, mix uniformly, and blow into the swollen and painful areas inside the throat using a fine brush-like tube.
[Prescription Verse] Jin Suo Chi blown treats Nong She Wind, Heart-Spleen fire depression and external cold attack, Eliminate phlegm, purge heat, relieve pain, Borneol, Silkworm, Realgar, Niter, Borax.
Chan Su Wan is described under the section "Ding Chuang Men" (Carbuncle and Boil Section).
Tong You Qian and Qingyan Lige Tang are both described under the section "Jin Hou Feng" (Tight Throat Wind).