经曰∶咽喉者,水谷之道也。喉咙者,气之所以上下者也。又曰∶二阴一阳结,谓之喉痹。陈飞霞曰∶盖咽
者胃管,主纳水谷而居后。喉者肺管,主呼吸而居前,为人一身之总要。若胸中郁积热毒,至生风痰,壅滞不散,
发于咽喉。病名虽多,无非热毒,速宜清解,缓则有难救之患。轻则甘桔汤,重则化毒汤。如痘疮咽喉痛者,毒
气上攻也,加减甘桔汤。喉中生疮,不吮乳,化毒汤。小儿为诸骨所哽,骨大难咽者,以鹅毛扫咽吐之,骨小者,
用海上方治之。
甘桔汤 治小儿膈膜积热致生风痰,而患喉痹用。
粉甘草(二钱) 牙桔梗(一钱) 以净水煎,细细咽之。
化毒汤 治小儿咽喉证危迫者用。
牙桔梗(一钱) 薄荷(一钱) 荆芥穗(一钱) 炙甘草(一钱) 芒硝(一钱) 山豆根(一钱)
马牙硝(一钱) 硼砂(一钱) 明雄黄(一钱) 镜面砂(一钱)
共为细末,每服一钱,白汤调下,仍以此药吹喉中。
海上方 治小儿诸骨所哽用。
金凤花根捣碎,以米醋浓煎,用有嘴瓶盛之,口衔瓶嘴,仰面吸药吞之,其骨即下。吞药勿令沾牙。又或以
玉簪花根亦可,
如上法煎咽。
涂蔚生曰∶喉痛一症,虽多由于风火,然必阴虚之人,始易患此。小儿纵无伐伤肾阴情事,然食积等火烁
阴,亦与伐伤无异。故小儿素患久患喉症者,亦宜兼顾其阴。杨氏咽喉七十二症,无不以六味地黄汤为加减,盖
为此也。至阴虚至极,虚火上犯而作肿痛,有时必须加入桂附少许,以为反佐,立时引火归源,肿消痛止者,
此又不可不知。但桂附须用上等者,方不至误事,此亦不过百分中之一二耳。
《黄帝内经》说:咽喉,是饮食水谷通行的道路。喉咙,是气息上下出入的通道。又说:少阴肾经与少阳三焦经之气郁结,称为喉痹。陈飞霞说:咽部连接胃管,主要功能是容纳水谷,位置靠后;喉部连接肺管,主要功能是呼吸,位置靠前,是人体一身的关键要害。如果胸中郁积热毒,进而产生风痰,壅滞不散,发作于咽喉。病名虽然繁多,但无非都是热毒所致,应当迅速清热解毒,若拖延则会有难以救治的祸患。轻症用甘桔汤,重症用化毒汤。如果是痘疮引起的咽喉疼痛,这是毒气上攻所致,使用加减甘桔汤。喉中生疮,婴儿不愿吃奶,用化毒汤。小儿被各种骨头卡住,骨头大难以下咽的,用鹅毛刺激咽喉催吐,将骨头吐出;骨头小的,用海上方治疗。
甘桔汤:治疗小儿膈膜积热导致生风痰,从而患上喉痹。
粉甘草(二钱) 牙桔梗(一钱) 用清水煎煮,细细吞咽。
化毒汤:治疗小儿咽喉证候危急紧迫者。
牙桔梗(一钱) 薄荷(一钱) 荆芥穗(一钱) 炙甘草(一钱) 芒硝(一钱) 山豆根(一钱)
马牙硝(一钱) 硼砂(一钱) 明雄黄(一钱) 镜面砂(一钱)
共同研磨成细末,每次服用一钱,用白开水调服,并将此药吹入喉中。
海上方:治疗小儿被各种骨头卡住。
金凤花根捣碎,用米醋浓煎,用有嘴的瓶子盛装,口衔瓶嘴,仰面吸入药液吞下,骨头随即落下。服药时不要让药液沾到牙齿。也可以用玉簪花根,
按照上述方法煎煮吞咽。
涂蔚生说:喉痛这一病症,虽然多由风火引起,但必须是阴虚体质的人,才容易患此病。小儿即使没有耗伤肾阴的情况,但食积等产生的火热灼伤阴液,也与耗伤肾阴没有区别。所以小儿平时患有长期或反复喉症的,也应当兼顾滋养其阴液。杨氏《咽喉七十二症》中,无不以六味地黄汤为基础进行加减,大概就是这个原因。至于阴虚到了极点,虚火上炎导致肿痛,有时必须加入少许肉桂、附子,作为反佐之法,立即引导火气回归本源,使肿胀消退、疼痛停止,这一点又不可不知道。但肉桂、附子必须选用上等药材,才不会误事,这也不过是在百分之一二的情况下使用罢了。
The *Yellow Emperor's Inner Canon* states: The pharynx (throat) is the pathway for food and drink. The larynx (windpipe) is where qi ascends and descends. It also states: When the Shaoyin Kidney meridian and Shaoyang Sanjiao meridian qi become knotted, it is called Hou Bi (throat obstruction). Chen Feixia said: The pharynx connects to the esophagus, primarily responsible for receiving food and drink, located posteriorly; the larynx connects to the lungs, primarily responsible for respiration, located anteriorly. Together, they are the vital hub of the entire body. If heat toxins accumulate in the chest, generating wind-phlegm that stagnates and fails to disperse, it manifests in the throat. Although there are many disease names, they are all essentially due to heat toxins. One must clear and resolve them quickly; otherwise, delay may lead to incurable conditions. For mild cases, Gan Jie Tang (Licorice and Platycodon Decoction) is used; for severe cases, Hua Du Tang (Toxin-Resolving Decoction) is used. If throat pain occurs due to smallpox, it is caused by toxic qi attacking upward, and a modified Gan Jie Tang should be used. If ulcers form in the throat and the infant refuses to nurse, use Hua Du Tang. If a child is choked by various bones, and the bone is large and difficult to swallow, sweep the throat with a goose feather to induce vomiting and expel the bone; if the bone is small, treat it with Hai Shang Fang (Sea Superior Formula).
Gan Jie Tang: Used for children suffering from Hou Bi (throat obstruction) due to accumulated heat in the diaphragm generating wind-phlegm.
Fen Gan Cao (Powdered Licorice Root) (2 qian), Ya Jie Geng (Tooth-like Platycodon Root) (1 qian). Decoct in clean water and swallow slowly.
Hua Du Tang: Used for critical and urgent throat conditions in children.
Ya Jie Geng (Platycodon Root) (1 qian), Bo He (Mint) (1 qian), Jing Jie Sui (Schizonepeta Spike) (1 qian), Zhi Gan Cao (Honey-fried Licorice Root) (1 qian), Mang Xiao (Mirabilite) (1 qian), Shan Dou Gen (Sophora Tonkinensis Root) (1 qian), Ma Ya Xiao (Marine Mirabilite) (1 qian), Peng Sha (Borax) (1 qian), Ming Xiong Huang (Realgar) (1 qian), Jing Mian Sha (Mirror Sand/Arsenic Trioxide) (1 qian).
Grind all into fine powder. Take 1 qian per dose, mixed with warm water. Additionally, blow this medicine into the throat.
Hai Shang Fang: Used for children choked by various bones.
Crush the root of Jin Feng Hua (Golden Phoenix Flower, *Canna indica*), decoct strongly with rice vinegar. Hold the mouthpiece of a spouted bottle containing the liquid, tilt the head back, inhale the medicine, and swallow. The bone will then descend. Ensure the medicine does not touch the teeth. Alternatively, the root of Yu Zan Hua (Daylily, *Hemerocallis citrina*) can be used,
decocted and swallowed as described above.
Tu Weisheng said: Throat pain, although often caused by wind-fire, predisposes those with Yin deficiency. Even if children have not damaged their Kidney Yin through other means, heat generated from food stagnation can scorch Yin, which is no different from damaging Yin. Therefore, for children who suffer from chronic or recurrent throat diseases, one must also attend to nourishing their Yin. In Yang Shi’s *Seventy-Two Throat Syndromes*, modifications of Liu Wei Di Huang Tang (Six-Ingredient Rehmannia Pill) are universally employed, precisely for this reason. However, when Yin deficiency reaches an extreme, causing deficient fire to flare upward resulting in swelling and pain, it is sometimes necessary to add a small amount of Gui (Cinnamon Twig) and Fu Zi (Aconite Root) as a counter-agent (reverse adjuvant). This immediately guides the fire back to its source, resolving swelling and stopping pain. This point must not be overlooked. But Gui and Fu Zi must be of superior quality to avoid errors; such usage applies only to one or two percent of cases.