夏子益《奇疾方》云∶有人患咽喉生肉一块，层层叠叠，渐渐肿起不痛，日久有窍出臭气，废饮食。用臭橘叶煎
汤，连服而愈。
〔源按〕病患肿而不痛，或痛而不溃者，皆痰也。此症生肉喉间，层层相叠，渐肿不痛，亦痰之所为。久则但有窍
出臭气，乃痰之毒，泄于外也。若非痰则必痛而溃矣。臭橘叶散气消痰，气散则痰化，故服之得愈。
华佗云∶有人喉中似有物，行动吐痰则痛难忍。身上皮肤开裂，有水流出，目红肿而又不痛，足如斗肿而又可行，
真绝世不见之症。此乃人食生菜，有蜈蚣子在叶，不知而食之，乃生蜈蚣于胃口之上。入胃则胃痛，上喉则喉痛，饥则
痛更甚也。方用鸡一只，煮熟，五香调治，芬馥之气逼人，乘人睡熟，将鸡列在病患口边，则蜈蚣自然外走。若蜈蚣走
出之时，当即拿住，或一条，或数条，候出尽自愈。大约喉中无物走动，则无蜈蚣矣。当即服全肤汤十剂，则皮肤之裂
自愈，而双足如斗亦消矣。盖蜈蚣在上焦，非药入能救，因药下后即至胃中而蜈蚣却在胃口之上，故不能杀之也。所以
引其外出，然后以药调治，其气血自愈。皮肤开裂者，乃蜈蚣毒瓦斯盘居肺边，肺生毛皮，故皮肤开裂。两足如斗，足乃
肾之部位，肺居上为肾之母，母病则子亦病，然肾水不乏而毒留于肾部，故足之皮，大而浮，非骨之病也。所以能走
耳，眼属肝，肝受肺气之毒熏蒸，故红肿耳。
丹溪云∶有咽痛诸药不效者，此非咽痛，乃鼻中生一条红线如发，悬一黑泡，大如樱珠，垂挂到咽门而止。口中饮
食不入，惟用深取土牛膝根，独条肥大者，捣碎入好醋三五滴，同研细，滴入鼻中二三点，即系断珠破，吐出瘀血立安。
《纲目》云∶有人患饮食食下，若别有咽喉，斜过膈下，经达在胁，而作痞闷。以手按之，则沥沥有声。以控涎
丹十粒服之，少时闷处热作，一声转泻，下痰饮数升。垂饮食正下，而达胃矣。
窦氏云∶有一妇年二十三岁，怀妊九月矣。一日鱼骨梗喉间，至半日呕吐，继至以血碗许，鱼骨尚在喉中。忽吐一
条约三尺余，形如小肠润五分。内有所食鱼菜、粉皮，饭未化，家人为推入口中，尚余五寸，其夫复纳之。遂昏倦，自
此呕吐不止，汤亦不能进，延余治之，遂将生炭火一盆，放病榻前，以好醋一碗沃之，使醋气盈满其室，清其神也。进
以牛黄清心丸，腹觉有微痛，再用人参一分，红花、丹皮、当归、川芎、生地、阿胶煎服，五六帖病愈。
孙东宿治臧少庚，年五十。每饮食胸膈不顺利，觉喉管中梗梗，宛转难下，大便燥结，内热，肌肉渐瘦。医与五香
连翘汤、五膈丁香散，诸治膈之剂，尝试不效。孙至，观其色苍黑，目中炯炯不耗，惟气促骨立。孙知其有机心人也。
其脉左弦大，右滑大。孙谓之曰∶据脉乃谋而不决，气郁成火，脾志不舒，致成痰涎。因而血少便燥，内热肌消。张鸡
峰有言，膈乃神思间病，即是推之，子当减思虑，断色欲，薄滋味，绝妄想，俾神思清净，然后服药有效。不然，世无
大丹，而草木石何足恃哉？子既远来，予敢不以肝膈相照！兹酌一方颇妥，归即制服，其方用桂府滑石六两，炙甘草、
白芥子各一两，萝卜子、射干、连翘各一两半，辰砂五钱，以竹茹四两煎汤，打馒头为丸，绿豆大。每食后及夜用灯心
汤送下一钱五分，一日三服，终剂而病如失。
全肤汤
甘草 苡仁 当归（各一两） 白芍（五钱） 黄 防风（各五分） 荆芥 陈皮（各一钱）
水煎服。
控涎丹
甘遂（去心） 大戟（去皮） 白芥子
等分为末，糊丸，临卧姜汤送下。
牛黄清心丸（见目门）
夏子益在《奇疾方》中记载：有人咽喉处长出一块肉，层层叠叠，逐渐肿胀但不疼痛，时间久了有孔窍排出臭气，导致无法进食饮水。使用臭橘叶煎汤，连续服用后痊愈。
〔沈源按语〕病人身体肿胀却不疼痛，或者疼痛却未溃烂的，都是痰湿所致。此症在喉间生肉，层层相叠，逐渐肿胀且不痛，也是痰湿造成的。时间久了只有孔窍排出臭气，这是痰毒向外排泄的表现。如果不是痰湿，必然会疼痛且溃烂。臭橘叶能行气消痰，气机疏散则痰湿化解，所以服用后得以痊愈。
华佗说：有人感觉喉中似有异物，行动时吐痰则疼痛难忍。身上皮肤开裂，有水流出，眼睛红肿却不痛，双脚像斗一样肿胀却能行走，真是世间罕见之症。这是因为人吃了生菜，菜叶中有蜈蚣卵，不知情而吃下，于是在胃口上方生出蜈蚣。蜈蚣进入胃中则胃痛，上行至喉则喉痛，饥饿时疼痛更剧烈。方剂用一只鸡，煮熟后用五种香料调味，香气逼人，趁病人睡熟时，将鸡放在病人嘴边，蜈蚣自然会向外爬走。如果蜈蚣爬出来时，立即抓住，可能是一条也可能是多条，等全部出来后自然痊愈。大约喉中没有东西走动，就没有蜈蚣了。此时应立即服用全肤汤十剂，皮肤的裂口自然愈合，双脚像斗一样的肿胀也会消退。因为蜈蚣在上焦，不是药物进入就能救急，因为药液下去后即到达胃中，而蜈蚣却在胃口之上，所以不能杀死它。因此引导其外出，然后用药物调理，气血自然恢复。皮肤开裂，是因为蜈蚣的毒气盘踞在肺边，肺主皮毛，所以皮肤开裂。两脚像斗一样肿，足部是肾所主的部位，肺居上为肾之母，母病则子亦病，然而肾水并不缺乏而是毒邪留在肾部，所以足的皮肤大而浮肿，并非骨骼的疾病。所以还能行走。眼睛属于肝，肝受肺气中毒邪熏蒸，所以红肿。
朱丹溪说：有咽痛各种药物无效的，这不是咽痛，而是鼻中生出一条红线如头发般，悬挂一个黑泡，大如樱桃珠，垂挂到咽门为止。口中饮食无法进入，只用深挖土牛膝根，选择单条肥大者，捣碎加入好醋三五滴，一同研细，滴入鼻中二三点，即见断珠破裂，吐出瘀血立刻安宁。
《本草纲目》记载：有人患饮食咽下后，好像另有咽喉，斜过膈下，经过胁肋，而产生痞闷感。用手按压，则有沥沥的水声。服用控涎丹十粒，过了一会儿闷处发热，一声响后泻下痰饮数升。饮食正下方达胃中。
窦氏说：有一位二十三岁的妇女，怀孕九个月了。一天鱼骨卡在喉间，半天后呕吐，接着吐了一碗血，鱼骨仍在喉中。忽然吐出一条长约三尺余，形状像小肠，湿润五分厚。里面有吃过的鱼菜、粉皮、饭还未消化，家人将其推入口中，还剩下五寸，她的丈夫又将其纳入。随后昏倦，从此呕吐不止，连汤水也不能进，请我治疗，于是放一盆烧红的炭火在病榻前，用一碗好醋浇在上面，使醋气充满房间，以清神醒脑。给予牛黄清心丸，腹部觉得微痛，再用一分人参，红花、丹皮、当归、川芎、生地、阿胶煎服，五六帖病愈。
孙东宿治疗臧少庚，五十岁。每次饮食胸膈不顺畅，感觉喉管中梗塞，辗转难下，大便燥结，内热，肌肉逐渐消瘦。医生给予五香连翘汤、五膈丁香散，各种治疗噎膈的药剂，尝试均无效。孙东宿到来，观察其面色苍黑，目光炯炯有神不耗散，只是气促骨立。孙东宿知道他是多谋略而不决断的人。其脉左弦大，右滑大。孙东宿对他说：“根据脉象是谋略多而犹豫不决，气郁化火，脾志不舒，导致形成痰涎。因而血少便燥，内热肌消。张鸡峰曾说，噎膈是神思间的疾病，由此推断，你应当减少思虑，节制色欲，清淡饮食，断绝妄想，使神思清净，然后服药才有效。否则，世上没有大丹，草木金石又怎能依赖呢？你既然远道而来，我岂敢不以肝胆相照！现在斟酌一方颇为妥当，回去立即服用，方子用桂府滑石六两，炙甘草、白芥子各一两，萝卜子、射干、连翘各一两半，辰砂五钱，用竹茹四两煎汤，打馒头面为丸，绿豆大小。每食后及夜间用灯心草汤送下一钱五分，一日三服，服完一疗程病如失。”
全肤汤
甘草 苡仁 当归（各一两） 白芍（五钱） 黄芪 防风（各五分） 荆芥 陈皮（各一钱）
水煎服。
控涎丹
甘遂（去心） 大戟（去皮） 白芥子
等分为末，糊丸，临睡前姜汤送下。
牛黄清心丸（见目门）
Xia Ziyi recorded in *Qiji Fang* (Strange Disease Prescriptions): A person had a piece of flesh growing in the throat, layered and stacked, gradually swelling without pain. After a long time, orifices appeared emitting foul odor, rendering them unable to eat or drink. Using leaves of *Citrus aurantium* L. (Chouju Ye) decocted in water, taken continuously, resulted in recovery.
[Commentary by Shen Yuan] Patients with swelling but no pain, or pain without ulceration, are all caused by Phlegm-Dampness (Tan Shi). This condition involves flesh growing in the throat, layered and stacked, gradually swelling without pain, which is also caused by Phlegm-Dampness. Over time, only orifices emit foul odor, which is the excretion of Phlegm-Toxin outward. If it were not Phlegm-Dampness, there would inevitably be pain and ulceration. Leaves of *Citrus aurantium* L. disperse Qi and resolve Phlegm; when Qi disperses, Phlegm transforms, hence recovery upon ingestion.
Hua Tuo said: A person felt as if there were an object in the throat; moving while expectorating sputum caused unbearable pain. The skin on the body cracked with fluid oozing out; eyes were red and swollen but painless; feet swelled like a measuring cup yet could walk. This is truly a rare and unseen disease. It arises from eating raw vegetables containing centipede eggs unknowingly, leading to the growth of centipedes above the stomach entrance. Entering the stomach causes stomach pain; ascending to the throat causes throat pain; hunger exacerbates the pain. The prescription uses one chicken, boiled and seasoned with five spices, emitting a strong fragrance. While the patient sleeps soundly, place the chicken near their mouth; the centipedes will naturally crawl out. When they emerge, capture them immediately—there may be one or several. Once all have exited, the patient will recover spontaneously. Generally, if nothing moves in the throat, there are no centipedes. At this point, administer Quanfu Tang (Whole Skin Decoction) for ten doses; skin cracks will heal naturally, and foot swelling resembling a cup will subside. Since the centipedes are in the Upper Jiao (Upper Burner), mere drug ingestion cannot save them, as the medicine descends to the stomach while the centipedes remain above the stomach entrance, thus unable to kill them. Therefore, guide them out first, then treat with herbs to restore Qi and Blood. Skin cracking occurs because centipede toxic fumes reside beside the Lung, which governs skin and hair, hence skin cracking. Feet swelling like cups relates to the Kidney, as the foot is the domain of the Kidney. The Lung resides above and is the Mother of the Kidney; when the Mother is ill, the Child suffers. However, Kidney Water is not deficient, but toxin remains in the Kidney region, causing large, floating edema of the foot skin, not a bone disease. Hence, walking is still possible. Eyes belong to the Liver; the Liver is steamed by toxic Qi from the Lung, causing redness and swelling.
Zhu Danxi said: For cases of sore throat unresponsive to various medicines, this is not merely a sore throat. Instead, a red line like a hair grows in the nose, suspending a black blister the size of a cherry pit, hanging down to the pharyngeal gate. Food and drink cannot enter the mouth. Use deep-dug roots of *Achyranthes bidentata* (Tuniuxi), selecting single, thick ones, crush them, add three to five drops of good vinegar, grind finely, and drip two or three drops into the nose. The blister breaks, blood stasis is vomited out, and relief follows immediately.
*Bencao Gangmu* records: A person suffered such that after swallowing food, it seemed to go down a separate throat, slanting under the diaphragm, passing through the hypochondrium, causing distension and stuffiness. Pressing with hand produced gurgling sounds. Administering Kongyan Dan (Controlling Phlegm-Fluid Pill) ten pills; after a short while, heat arose in the stifled area, followed by a loud sound and evacuation of several sheng of phlegm-fluid. The food then reached the stomach normally.
The Dou family case: A twenty-three-year-old woman, nine months pregnant. One day, a fishbone lodged in the throat. Half a day later, she vomited, followed by vomiting about a bowl of blood, yet the fishbone remained in the throat. Suddenly, she vomited a tube-like object over three chi long, shaped like small intestine, moist and half a cun thick. Inside were undigested fish, vegetables, vermicelli, and rice. Family members pushed it back into her mouth, leaving five cun remaining, which her husband re-inserted. She became comatose and weak, vomiting incessantly, unable to even take liquids. I was called to treat her. I placed a basin of burning charcoal before the bed and poured a bowl of good vinegar onto it, filling the room with vinegar vapor to clear the spirit. Administered Niuhuang Qingxin Wan (Calculus Bovis Clear Heart Pill); abdomen felt slight pain. Then administered Ren Shen (Ginseng Root) one fen, Hong Hua (Safflower), Mu Dan Pi (Moutan Cortex), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligusticum Chuanxiong Rhizome), Sheng Di Huang (Rehmanniae Radix), and E Jiao (Colla Corii Asini) decocted together. After five or six doses, the illness resolved.
Sun Dongsu treated Zang Shaogeng, aged fifty. Every time he ate or drank, his chest and diaphragm felt unsmooth, sensing obstruction in the throat tube, difficult to swallow. Stool was dry and constipated, internal heat present, muscles gradually wasting away. Physicians prescribed Wuxiang Lianqiao Tang (Five-Spice Forsythia Decoction) and Wuge Dingxiang San (Five-Fold Cardamom Powder), various formulas for dysphagia/obstruction, but none were effective. Sun arrived, observed his dark complexion, bright eyes without depletion, but rapid breathing and emaciation. Sun knew he was a man of complex schemes and indecision. His pulse was wiry and large on the left, slippery and large on the right. Sun said to him: "Based on the pulse, you are overly scheming yet indecisive, Qi stagnation transforms into Fire, Spleen emotion is not smooth, leading to formation of Phlegm-Saliva. Consequently, Blood deficiency, dry stool, internal heat, and muscle wasting. Zhang Jifeng stated that dysphagia is a disorder of the Spirit/Mind. Inferring from this, you must reduce thinking, restrain sexual desires, eat bland food, and abandon delusions, keeping the Spirit pure. Only then will medication be effective. Otherwise, even if great elixirs existed, how could herbs and minerals suffice? Since you traveled far, how dare I not speak my mind frankly! I have devised a suitable formula; take it immediately. The formula uses Liushi (Calcitrum) six liang, Zhi Gancao (Honey-fried Licorice Root) and Baijiezi (White Mustard Seed) one liang each, Luobozi (Radish Seed), Yexia (Belamcanda Rhizome), and Lianqiao (Forsythia Fruit) one and a half liang each, Zhensha (Cinnabar) five qian. Decoct Zhuru (Bamboo Shavings) four liang in water, make dough with mantou flour, form pills the size of mung beans. Take one qian five fen with Dengxin Cao Tang (Juncus Effusus Decoction) after meals and at night, three times daily. Upon completing the course, the illness vanished."
Quanfu Tang (Whole Skin Decoction)
Gancao (Licorice Root), Yiren (Coix Seed), Danggui (Angelicae Sinensis Radix) (each one liang); Baishao (White Peony Root) (five qian); Huangqi (Astragali Radix), Fangfeng (Saposhnikoviae Radix) (each five fen); Jingjie (Schizonepetae Spica), Chenpi (Citri Reticulatae Pericarpium) (each one qian).
Decoct in water and take orally.
Kongyan Dan (Controlling Phlegm-Fluid Pill)
Gansui (Kansui Radix) (remove heart), Daji (Euphorbiae Pekinensis Radix) (remove skin), Baijiezi (White Mustard Seed).
Grind into powder in equal parts, make pills with paste, take with Ginger Decoction before sleep.
Niuhuang Qingxin Wan (Calculus Bovis Clear Heart Pill) (See Eye Section)