窦汉卿曰∶喉瘤生于喉间两旁，或单或双，形如圆眼大，血丝相裹如瘤，故名
之。此乃肺经受热，多语损气，或怒中高喊，或诵读太急，或多饮烧酒，或多啖炙
。须要敛神晏息，以药攻之，则此证脱落矣。不可用刀点破。（《全书》）
《心法》曰∶喉瘤生于喉旁，或单或双，亦有顶大蒂小者。凡怒气喊叫，犯之则痛，不犯不痛。
清瘤碧玉散
硼砂（三钱） 胆矾 冰片（各三分）
研细，以箸蘸点。
窦汉卿曰∶喉节，此候生于鸠尾之中，初起如梅核，在喉膈之间，吐不出咽不下，
至三日渐上喉节之间，名曰喉节。其疾须用刺破后，用胆硝丹吹入喉中，再用雄黄
化毒丸吞下七粒。（《全书》）
陈实功曰∶单双蛾皆标病也。其患生于咽旁，或单或双，其咽门虽肿，半塞半
开，其病虽凶，而喉道又宽又肿，虽重无妨，宜金锁匙吐出痰涎，推荡积热。（《正宗》）
经曰∶宜针烙。
冯鲁瞻曰∶单双肉蛾可针即针，有不可针者，亦用吹药劫药吐去风痰，以图捷
效，次服煎剂。盖急证难于久待也。（《锦囊》）
又曰∶肿于咽两旁者为双蛾，易治，肿于一边者为单蛾，难治。如有恶寒表证，用
荆防败毒散散之；不恶寒而无表证者，惟有辛凉清利，外用鹅翎蘸米醋搅喉中，去
尽痰涎，复以鹅翎探吐之，令着实一咯，咯破蛾中紫血即溃。或紫金锭磨下即安，慎
勿轻用刀针。古方有用巴豆油染纸作捻子，点火吹灭，以烟熏鼻中，实时口鼻流涎，牙
关自开，再用此搐患处，即愈。
岐天师曰∶有病双蛾者，人以为热也。喉门肿痛，痰如锯拽不绝，茶水一滴不能
下咽，岂非热证！然而痛虽甚，至早少轻，喉虽肿，舌必不燥，痰虽多，必不黄而成
块，此乃假热之证也。若以寒凉之药急救之，下喉非不暂快，少顷而热转甚，人以
为凉药之少也，再加寒凉之品服之，更甚。急须刺其少商穴出血少许，喉门必有一线
之路开矣。急以附子一钱，熟地一两，山萸肉四钱，白茯苓五钱，麦冬、牛膝、北五
味各三钱煎服，下喉一声响亮，其火势热证立时消散。盖少阴之火直如奔马，凡人
肾水大耗者，肾中元阳不能下藏，盖无水以养火，而火必上越也。日日冲上而咽喉
口小，不能任其出入，乃结成肿痛。状似双蛾，实非双蛾也。方中妙在附子辛热之
药，引龙雷之火下藏于窟宅。夫龙雷之火，乃相火也，喜水而不喜火，故药中熟地、山
茱萸之类，纯是补阴之味，使火有所归，而不再沸，此因其逆势而引道之也。（喜水而不喜
火，喜水者，喜其真阴之水也，而非寒凉之水；不喜火者，不喜邪热之火也，而非辛热之火。）
又曰∶日重夜轻，治之犹易，用山豆根、桔梗各三钱，甘草、半夏各一钱治之，一剂立愈。
张仲景曰∶阴虚双蛾之证，用附子一钱，盐水炒成片，用一片含在口中，立时
有路可以用汤药矣。后以八味地黄丸一两，白汤送下，立时而愈。
雷真君曰∶凡人有咽喉忽肿作痛，生双蛾者，饮食不能下，五日不食即死矣。但
此证实火易治，而虚火难医，实火世人已有妙方，芩连之类治之立消；惟虚火乃肾
火不藏于命门，浮游于咽喉之间，其证亦如实火，惟夜重于日，清晨反觉少轻，若
实火清晨反重，夜间反轻，实火口燥舌干而开裂，虚火口不甚渴，舌滑而不裂也。以
此断之，决不差错。此种虚痛，若亦以治实火之法治之，是人已下井而又益之石也，
故不特不可用寒凉，并不可用发散，盖虚火必须补也。然徒补肾水，虽水能制火可
以少差，而火势太盛未易制伏，又宜于水中补火，则引火归原而火势顿除，有消亡
于顷刻矣。方用引火汤主之，一剂而痰声静，痛顿除，肿亦尽消，二剂全愈。盖熟
地、山萸、五味之类，纯是补肾水圣药，茯苓、山药又益精而利水，助肉桂之下行，元
参以消在上之浮火，白芥子以消壅塞之痰，上焦既宽而下焦又得肉桂之热，则龙雷之
火有不归根于命门者乎？一剂便生，真有鬼神莫测之机，又胜于八味地黄汤也。倘
喉肿闭塞，勺水不能下咽，虽有此神方，将安施乎！我更有法∶用附子一个，破故纸
五钱，各研末调如糊，作膏布摊如膏药，大如茶盅，贴脚心中央，以火烘之，一时辰
喉即宽而开一线路，可以服药矣，又不可不知。此妙法也。
又曰∶阴蛾之证，乃肾水亏乏，火不能藏于下，乃飞越于上，而喉中关狭，火不
得直泄，乃结成蛾，以蛾而非蛾也。早晨痛轻，下午痛重，至黄昏而痛更甚，得热则
快，得凉则加，其证之重者，滴水不能下喉。若作外感阳证治，误用山豆根、芩、连、
栀子之类，则痛益甚，而关不开，有不尽命而死者也。惟单补阴虚，用引火归源之
法而痛顿失也。治以化蛾汤主之。此方大补肾之水，不治蛾之痛，壮水则火息，引
火则痛消，可收全功，诚奇绝之法也。（《活人录。》）
华真君曰∶双蛾阴证，最难治而最易治也。不知其窍，则最难，知其法则最易。
余常为人治此证。用附子一枚，盐一合，水煮透，令其口含一片，而火势立止，然后
以六味地黄汤大剂饮之，不再发。神方也。
陈远公曰∶人有感冒风寒，咽喉肿痛，其势甚急，变成双蛾者。其证痰涎稠浊，不
时口渴索饮，疼痛水不能入喉，此阳火壅阻咽喉，势若重而病实轻也。夫阳火，太
阳之火也，膀胱之火也，膀胱之火与肾火为表里，膀胱火动，肾火即来相助，故直
冲咽喉，而肺脾胃之火亦复相从上升，于是借三经之痰涎，尽阻塞于咽喉，结成火
毒而不可解。治法似宜统治数经矣。然其本实始于太阳，泄膀胱之火，则诸经之火
自安。但咽喉地近于肺，太阳既假道于肺，肺经险要之地，即狭路之战场也，安有舍
战场要地不解其围，而先捣其本国乎？贵有兼治之法也。清燥汤∶桔梗、元参、花
粉各二钱，甘草二钱，白芍五钱，山豆根、柴胡、麻黄各一钱，水煎服。一剂喉宽，二
剂蛾尽消矣。（《冰鉴》。此方散太阳之邪者居四，散各经之邪者居六，尤加意于散肺邪者，由近以及远也。）
又曰∶人一时咽喉肿大作痛，吐痰如涌，口渴求水，下喉少快，已而又热索水，
喉成双蛾，既大且赤，其形宛如鸡冠，此喉痹证，即俗称缠喉风也。乃阴阳二火兼
炽也。一为少阳相火，一为少阴君火，今二火齐发，其势更暴，喉管细小，大难遽
泄，遂遏抑其间，初作肿而后成蛾也。蛾有二∶双蛾、单蛾也。双蛾生两枚，两相
壅挤，中间反留一线之隙可通，茶水药食尚可下咽；若单蛾则独形反塞住水谷之路，
往往有勺水不能入者，药物既不可咽，又从何路以进药哉！法先用刺法，一则刺少
商等穴，尚非快捷方式，惟用刀直刺喉之处一分，则喉肿必少消，可用吹药开之，吹药
方∶皂角烧灰，胆矾、牛黄、冰片各一分，麝香三厘，为细末。吹喉中，必大吐痰而
愈。后用煎剂名救喉汤∶元参一两，麦冬五钱，花粉三钱，甘草、山豆根、射干各
一钱，水煎一服全愈。若双蛾不必用刺法，
用此方自效。（元参为君，足以泻心肾君相火，佐以豆根、射干、花粉，祛邪消痰，则火自归经，
咽喉之关隘整肃矣。）
又曰∶咽喉肿痛，日轻夜重，长成喉蛾，宛如阳证，但不甚疼，咽喉自觉有一
线干燥之至，饮水咽入稍快，至水入腹而又不安，吐痰如水甚多，将涎投入水中，即
化为水，人以为喉痛生蛾，投泻火之方，不特不验，反增其重，亦有勺水不能入者，何
也？盖属阴蛾也。阴蛾则日轻夜重，阳蛾则日重夜轻，此乃少阴肾火下无可藏之地，
直上炎于喉也。治法宜大补肾水，加入补火之味，引火归源，下热则上自寒矣。引火
汤∶熟地三两，巴戟、天冬、麦冬各一两，茯苓五钱，北五味二钱，水煎服。一剂火
下喉肿全消，二剂全愈。（此方以熟地为君，大补肾水，麦冬、五味重滋肺金，金水相资，子母有滂沱之
沛，水旺足以制火矣。加入巴戟天之温，又是补水之药，则水火既济，水趋下而火不得不随之，又加茯苓前导，则
水火同趋，共安肾宫，如琴瑟之和矣。何必用桂附大热，引火归源乎！然桂附为引火归源之圣药，胡弃而不用，不
知此证因水之不足而火沸腾，今用大热虽引火于一时，必耗水于日后，所以只用巴戟天引火而又补水，则肾无
干燥之虞，喉有清肃之益也。）
《医论选要》曰∶单蛾者，其形圆小如箸头，生于咽喉关上，或左或右，双蛾则
两边俱生也。若生于关下为难治。
窦汉卿曰∶左咽软主吞咽，右喉主出声，咽门分两路，其受病不同。（《全书》）
又曰∶咽喉左畔虚阳上攻，其肿微红者，名单乳蛾。若肺气外证手足厥冷，痰
涎自出，头重目昏，急用 菜酸汁加玄明粉灌之，旋去痰涎，吹药，如厥重不省人
事，气欲绝者，急以吴茱萸研烂，醋调涂脚心。右畔虚阳上攻，其色微黄，其形若
蚕茧，故谓之乳蛾，其证亦手足厥冷。
又曰∶双蛾风，此证有两枚，在喉间两边如豆大，急将黄 汁蜜少许，加玄明
粉，漱出风痰，吹冰片散。
奎光曰∶乳蛾有单有双，有连珠，多因酒色郁结而发，单轻双重。初起一日痛，
二日红肿，三日有形如细白星，发寒热者凶，四日势定，治之四五日可愈。其证生
于喉傍，一边生者单蛾，左右生者双蛾，二白星上下相连如缠袋者，连珠也。
又曰∶治乳蛾先用碧丹（五），金丹一吹，次用金丹（二），碧丹（三）同吹出痰，兼用煎剂，左
加犀角、黄连，右加赤芍、柴胡，连珠兼用之。大便秘加玄明粉、大黄。（吹药丹方详载咽喉门。）
《心法》曰∶乳蛾由肺经积热，受风凝结而成。生咽喉旁，状如蚕蛾，有单有双，
双者轻，单者重。生于关前者，形多易见，吹药易到，手法易施，故易治；生于关后
者，难见形色，吹药不到，手法难施，故难治。
又曰∶双单蛾汤水不下，看头顶发内有细窠，挑破即刻开关。
窦汉卿说：喉瘤生长在咽喉两侧，或单侧或双侧，形状像圆眼那么大，血丝包裹其中如同肿瘤，因此得名。这是由于肺经受热，多说话损伤元气，或者愤怒时高声喊叫，或者诵读过于急促，或者大量饮用烧酒，或者多吃烧烤炙烤的食物所致。必须收敛心神、安静休息，并用药物攻治，此证即可脱落痊愈。不可用刀刺破。（《疡医大全》）
《医宗心法》说：喉瘤生长在咽喉旁边，或单侧或双侧，也有顶部大、蒂部小的情况。凡是因怒气喊叫引发的，触碰就会疼痛，不触碰则不痛。
清瘤碧玉散
硼砂（三钱） 胆矾 冰片（各三分）
研成细末，用筷子蘸取后点涂患处。
窦汉卿说：喉节，这种病症生长在鸠尾穴部位，初起时像梅核一样，位于咽喉膈膜之间，吐不出来也咽不下去，到了第三天向上发展到喉结部位，名叫喉节。此病需要用针刺破后，将胆硝丹吹入喉中，再吞服雄黄化毒丸七粒。（《疡医大全》）
陈实功说：单蛾和双蛾都属于标病。病变发生在咽喉旁边，或单侧或双侧，虽然咽门肿胀，但半开半闭；病情虽然凶险，但喉道宽阔且肿胀，即使严重也无妨，宜用金锁匙吐出痰涎，推荡积热。（《外科正宗》）
经典记载说：适宜使用针烙法。
冯鲁瞻说：单肉蛾和双肉蛾如果可以针刺就立即针刺；有不能针刺的情况，也使用吹药和劫药催吐风痰，以图快速见效，随后服用煎剂。因为急症难以长久等待。（《外科锦囊》）
又说：咽喉两旁肿胀的叫双蛾，容易治疗；只有一边肿胀的叫单蛾，难治。如果有恶寒等表证，用荆防败毒散发散解表；没有恶寒且无表证的，只有采用辛凉清利的方法，外用鹅毛蘸米醋搅动咽喉，去除所有痰涎，再用鹅毛探喉催吐，令患者用力咯出，一旦咯破蛾体中的紫血即溃烂愈合。或者磨紫金锭服用即可安定，千万不要轻易使用刀针。古方有用巴豆油浸染纸做成捻子，点火吹灭，用烟熏鼻子，立刻口鼻流涎，牙关自然张开，再用此药搐鼻患处，即可痊愈。
岐天师说：有患双蛾的人，人们认为是热证。喉门肿痛，痰液如锯拽般不断，茶水一滴都不能下咽，难道不是热证吗！然而疼痛虽然剧烈，到早晨稍轻；喉咙虽然肿胀，舌头必定不干燥；痰虽然多，必定不黄且不结成块，这是假热证。如果用寒凉药物急救，喝下去暂时舒服，一会儿后热势反而更重，人们以为是凉药剂量不够，再加寒凉药物服用，病情更重。急需针刺少商穴放出少许血液，喉门必然会出现一线通路。急忙用附子一钱，熟地黄一两，山茱萸四钱，白茯苓五钱，麦冬、牛膝、北五味子各三钱煎服，喝下去一声响亮，火势热证立刻消散。这是因为少阴之火直如奔马，凡人肾水大耗者，肾中元阳不能下行潜藏，因为没有水来涵养火，火必然上越。日日冲上而咽喉口小，承受不了其出入，于是结成肿痛。形状似双蛾，实际上并非双蛾。方中妙在附子这味辛热的药，引导龙雷之火下行潜藏于窟宅。所谓龙雷之火，就是相火，喜欢水而不喜欢火，所以药中熟地、山茱萸之类，全是补阴的味道，使火有所归宿，而不再沸腾，这是顺应其逆势而引导它。（喜欢水而不喜欢火，喜欢水是指喜欢真阴之水，而非寒凉之水；不喜欢火是指不喜欢邪热之火，而非辛热之火。）
又说：症状白天加重晚上减轻的，治疗还容易，用山豆根、桔梗各三钱，甘草、半夏各一钱治疗，一剂立愈。
张仲景说：阴虚双蛾之证，用附子一钱，用盐水炒成片状，含一片在口中，立刻就有通路可以用汤药了。随后用八味地黄丸一两，白开水送下，立刻痊愈。
雷真君说：凡人有咽喉突然肿胀作痛，生双蛾的，饮食不能下咽，五天不进食就会死亡。但这种病证实火容易治疗，而虚火难医，实火世人已有妙方，用黄芩、黄连之类治疗立刻消除；只有虚火是肾火不藏在命门，浮游在咽喉之间，其症状也像实火，只是夜间重于白天，清晨反而觉得稍轻，若实火则是清晨重、夜间轻；实火口燥舌干而开裂，虚火口不甚渴，舌滑而不裂。以此判断，决不会出错。这种虚痛，如果也用治实火的方法治疗，就是人已经掉进井里又往里面加石头，所以不仅不可用寒凉，也不可用发散，因为虚火必须补益。然而单纯补肾水，虽然水能制火可以稍微缓解，但火势太盛不易制服，又宜于水中补火，则引火归原而火势顿除，顷刻间消亡。方用引火汤为主，一剂后痰声静，痛顿除，肿亦尽消，二剂全愈。因为熟地、山茱萸、五味子之类，全是补肾水的圣药，茯苓、山药又益精而利水，助肉桂下行，玄参以消除在上之浮火，白芥子以消除壅塞之痰，上焦既宽而下焦又得肉桂之热，那么龙雷之火有不归根于命门的吗？一剂便生，真有鬼神莫测之机，又胜于八味地黄汤。倘若喉肿闭塞，勺水不能下咽，虽然有此神方，将如何施用呢！我还有办法：用一个附子，破故纸五钱，各研末调成糊状，做成膏药布摊开如膏药，大如茶盅，贴于脚心中央，用火烘烤，一个时辰后喉即宽而开一线路，可以服药了，这也不可不知。这是妙法。
又说：阴蛾之证，是肾水亏乏，火不能藏于下部，乃飞越于上部，而喉中关隘狭窄，火不得直接宣泄，于是结成蛾，名为蛾而非蛾。早晨痛轻，下午痛重，至黄昏而痛更甚，得热则快，得凉则加重，重症者滴水不能下喉。若作为外感阳证治疗，误用山豆根、黄芩、黄连、栀子之类，则痛更甚，而关隘不开，有不尽性命而死的可能。只有单纯补阴虚，用引火归源之法而痛顿失。治疗以化蛾汤为主。此方大补肾之水，不治蛾之痛，壮水则火息，引火则痛消，可收全功，真是奇绝之法。（《活人录》）
华真君说：双蛾阴证，最难治而又最容易治。不知道窍门，则最难；知道法则，则最容易。我常常为人治疗此证。用附子一枚，盐一合，水煮透，令其含一片在口中，而火势立刻停止，然后以大剂六味地黄汤饮用，不再复发。这是神方。
陈远公说：有人感冒风寒，咽喉肿痛，其势很急，变成双蛾的。其症状痰涎稠浊，不时口渴索饮，疼痛水不能入喉，这是阳火壅阻咽喉，形势看似重而病其实轻。所谓阳火，是太阳之火，也是膀胱之火，膀胱之火与肾火为表里关系，膀胱火动，肾火即来相助，所以直冲咽喉，而肺脾胃之火也随从上升，于是借这三经的痰涎，全部阻塞于咽喉，结成火毒而不可解。治法似乎应该统管这几经。然而其根本实在始于太阳，泄膀胱之火，则诸经之火自安。但咽喉地近于肺，太阳既假道于肺，肺经是险要之地，即是狭路之战场，哪有舍弃战场要地不解其围，而先去攻打其本国（肾脏）的道理？贵在兼治之法。清燥汤：桔梗、玄参、天花粉各二钱，甘草二钱，白芍五钱，山豆根、柴胡、麻黄各一钱，水煎服。一剂喉宽，二剂蛾尽消矣。（《冰鉴》。此方散太阳之邪者占四分，散各经之邪者占六分，尤其注重散肺邪，由近及远。）
又说：人一时咽喉肿大作痛，吐痰如涌，口渴求水，喝下去稍快，不久又热索水，喉成双蛾，既大且赤，形状宛如鸡冠，这是喉痹证，即俗称缠喉风。这是阴阳二火兼炽。一是少阳相火，一是少阴君火，如今二火齐发，其势更暴，喉管细小，大难遽泄，遂遏抑其间，初作肿而后成蛾。蛾有两种：双蛾、单蛾。双蛾生两枚，两相壅挤，中间反留一线之隙可通，茶水药食尚可下咽；若单蛾则独形反塞住水谷之路，往往有勺水不能入者，药物既不可咽，又从何路以进药哉！法先用刺法，一则刺少商等穴，尚非快捷方式，惟用刀直刺喉之处一分，则喉肿必少消，可用吹药开之，吹药方：皂角烧灰，胆矾、牛黄、冰片各一分，麝香三厘，为细末。吹喉中，必大吐痰而愈。后用煎剂名救喉汤：玄参一两，麦冬五钱，花粉三钱，甘草、山豆根、射干各一钱，水煎一服全愈。若双蛾不必用刺法，用此方自效。（玄参为君药，足以泻心肾君相火，佐以豆根、射干、花粉，祛邪消痰，则火自归经，咽喉之关隘整肃矣。）
又说：咽喉肿痛，日轻夜重，长成喉蛾，宛如阳证，但不甚疼，咽喉自觉有一线干燥之至，饮水咽入稍快，至水入腹而又不安，吐痰如水甚多，将涎投入水中，即化为水，人以为喉痛生蛾，投泻火之方，不特不验，反增其重，亦有勺水不能入者，为什么呢？盖属阴蛾。阴蛾则日轻夜重，阳蛾则日重夜轻，这是少阴肾火下无可藏之地，直上炎于喉也。治法宜大补肾水，加入补火之味，引火归源，下热则上自寒矣。引火汤：熟地三两，巴戟天、天冬、麦冬各一两，茯苓五钱，北五味二钱，水煎服。一剂火下喉肿全消，二剂全愈。（此方以熟地为君药，大补肾水，麦冬、五味重滋肺金，金水相资，子母有滂沱之沛，水旺足以制火矣。加入巴戟天之温，又是补水之药，则水火既济，水趋下而火不得不随之，又加茯苓前导，则水火同趋，共安肾宫，如琴瑟之和矣。何必用桂附大热，引火归源乎！然桂附为引火归源之圣药，胡弃而不用，不知此证因水之不足而火沸腾，今用大热虽引火于一时，必耗水于日后，所以只用巴戟天引火而又补水，则肾无干燥之虞，喉有清肃之益也。）
《医论选要》说：单蛾，其形圆小如筷子头，生于咽喉关上，或左或右，双蛾则两边俱生也。若生于关下为难治。
窦汉卿说：左咽软主吞咽，右喉主出声，咽门分两路，其受病不同。（《疡医大全》）
又说：咽喉左畔虚阳上攻，其肿微红者，名单乳蛾。若肺气外证手足厥冷，痰涎自出，头重目昏，急用菖蒲菜酸汁加玄明粉灌之，旋去痰涎，吹药，如厥重不省人事，气欲绝者，急以吴茱萸研烂，醋调涂脚心。右畔虚阳上攻，其色微黄，其形若蚕茧，故谓之乳蛾，其证亦手足厥冷。
又说：双蛾风，此证有两枚，在喉间两边如豆大，急将黄柏汁蜜少许，加玄明粉，漱出风痰，吹冰片散。
奎光说：乳蛾有单有双，有连珠，多因酒色郁结而发，单轻双重。初起一日痛，二日红肿，三日有形如细白星，发寒热者凶，四日势定，治之四五日可愈。其证生于喉傍，一边生者单蛾，左右生者双蛾，二白星上下相连如缠袋者，连珠也。
又说：治乳蛾先用碧丹（五），金丹一吹，次用金丹（二），碧丹（三）同吹出痰，兼用煎剂，左加犀角、黄连，右加赤芍、柴胡，连珠兼用之。大便秘加玄明粉、大黄。（吹药丹方详载咽喉门。）
《医宗心法》说：乳蛾由肺经积热，受风凝结而成。生咽喉旁，状如蚕蛾，有单有双，双者轻，单者重。生于关前者，形多易见，吹药易到，手法易施，故易治；生于关后者，难见形色，吹药不到，手法难施，故难治。
又说：双单蛾汤水不下，看头顶发内有细窠，挑破即刻开关。
Dou Hanqing said: Throat tumor (Houliu) grows on both sides of the throat, either unilateral or bilateral, shaped like a round eye, wrapped in blood vessels resembling a tumor, hence the name. This is caused by heat in the Lung Meridian (Fei Jing), damage to Qi from excessive talking, shouting in anger, reading too hastily, drinking excessive distilled spirits, or eating too much roasted and grilled food. One must gather the spirit and rest quietly, and attack the condition with medicine, then this syndrome will fall off and heal. It must not be pierced with a knife. (Quan Shu)
Xin Fa says: Throat tumor grows beside the throat, either unilateral or bilateral, some having a large head and small pedicle. Whenever anger and shouting trigger it, touching causes pain; without touching, there is no pain.
Qing Liu Bi Yu San (Clear Tumor Jade Powder)
Borax (San Qian / 3 qian) Dan Fan (Alum) Bing Pian (Borneol) (each San Fen / 3 fen)
Grind into fine powder, dip a chopstick into it, and apply locally.
Dou Hanqing said: Throat joint (Houjie), this condition arises in the area of Jiutui (CV15). Initially, it resembles a plum pit located between the throat and diaphragm, unable to be spat out or swallowed. By the third day, it moves up to the thyroid cartilage area, named Houjie. This disease requires piercing with a needle, followed by blowing Dan Xiao Dan (Gall Nitrate Pill) into the throat, and then swallowing seven pills of Xiong Huang Hua Du Wan (Realgar Detoxification Pill). (Quan Shu)
Chen Shigong said: Single and double Eme (tonsils) are all exterior syndromes (Biao Bing). The affliction occurs beside the pharynx, unilateral or bilateral. Although the throat gate is swollen, it is half-open and half-closed. Although the disease appears fierce, the airway is wide and swollen; even if severe, it is not obstructive. One should use Jin Suo Chi (Golden Lock Key) to induce vomiting of phlegm and saliva, pushing away accumulated heat. (Zheng Zong)
The Classics state: Acupuncture and cauterization are suitable.
Feng Luzhan said: For single and double fleshy Eme, if acupuncture is possible, do it immediately. If not, use blowing medicines and coercive medicines to expel wind-phlegm via vomiting for rapid effect, followed by decoction. Urgent conditions cannot wait long. (Jin Nang)
He also said: Swelling on both sides of the pharynx is Double Eme, which is easy to treat; swelling on one side is Single Eme, which is difficult to treat. If there are exterior symptoms such as aversion to cold, use Jing Fang Bai Du San (Atractylodes and Saposhnikovia Decoction to Overcome Toxicity) to disperse the exterior. If there is no aversion to cold and no exterior syndrome, only acrid-cool clearing and draining methods should be used. Externally, dip a goose feather in rice vinegar and stir the throat to remove all phlegm and saliva, then use the feather to induce gagging, causing a forceful cough. Once the purple blood in the tonsil is broken, it will ulcerate and heal. Alternatively, grinding Zijin Ding (Purple Gold Tablet) orally brings relief. Do not lightly use knives or needles. Ancient formulas used paper soaked in croton oil rolled into a taper, lit, blown out, and the smoke inhaled into the nose, causing immediate salivation from mouth and nose, and natural opening of the jaw. Then using this medicine insufflated into the nose cures the condition.
Master Qi said: Patients with Double Eme are considered to have Heat Syndrome. The throat gate is swollen and painful, phlegm is continuous like sawing, and not a drop of tea or water can be swallowed; is this not Heat? However, although pain is severe, it lightens slightly in the early morning; although the throat is swollen, the tongue is definitely not dry; although there is much phlegm, it is not yellow nor clumped. This is False Heat Syndrome. If cold-cooling medicines are used for emergency treatment, there is temporary relief upon swallowing, but shortly after, the heat becomes worse. People think the cooling dose was insufficient and add more cold medicines, making it worse. Immediately prick Shaoshang (LU11) acupoint to bleed slightly; a channel will open in the throat gate. Immediately decoct Fuzi (Prepared Aconite Root) 1 qian, Shudi (Prepared Rehmannia Root) 1 liang, Shanzhuyu (Cornus Fruit) 4 qian, Baifuling (Poria with Hostwood) 5 qian, Maidong (Ophiopogon Tuber), Niuxi (Achyranthes Root), Bei Wuwei Zi (Schisandra Berry) each 3 qian, and administer. Upon swallowing, a loud sound is heard, and the fire-heat syndrome dissipates instantly. This is because Fire of Shaoyin (Lesser Yin) runs like a galloping horse. When Kidney Water is greatly depleted, the Original Yang of the Kidney cannot descend and hide. Without water to nourish Fire, Fire must ascend. Daily rising against the narrow throat cannot pass through, forming swelling and pain. It looks like Double Eme but is not truly Double Eme. The brilliance of the formula lies in Fuzi, an acrid-hot medicine, guiding Dragon-Lei Fire (Ministerial Fire) down to its dwelling. Dragon-Lei Fire is Ministerial Fire; it likes Water but dislikes Fire. Therefore, medicines like Shudi and Shanzhuyu in the formula are purely Yin-nourishing, giving Fire a place to return so it does not boil again. This guides it along its counter-flow. (Likes Water means liking True Yin Water, not cold-water; dislikes Fire means disliking Evil Heat Fire, not acrid-hot Fire.)
He also said: If symptoms worsen during the day and lighten at night, treatment is relatively easy. Use Shandougen (Sophora Tonkinensis Root) and Jiegeng (Platycodon Root) each 3 qian, Gancao (Licorice Root) and Banxia (Pinellia Tuber) each 1 qian. One dose cures immediately.
Zhang Zhongjing said: For Yin Deficiency Double Eme, use Fuzi 1 qian, fried in salt water until it forms slices. Hold one slice in the mouth; a passage opens immediately for taking decoctions. Afterwards, take Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) 1 liang with warm water, curing immediately.
Lei Zhenjun said: When people suddenly have swollen and painful throats with Double Eme, unable to swallow food or drink, death ensues if fasting for five days. This condition shows that Excess Fire is easy to treat, while Deficient Fire is hard to cure. The world has good prescriptions for Excess Fire, treating it with Huangqin (Scutellaria Root) and Lianzi (Lotus Plumule) eliminates it quickly. Only Deficient Fire is Kidney Fire not hiding in Mingmen (Gate of Life), floating in the throat. Its symptoms resemble Excess Fire, but nighttime is heavier than daytime, and early morning feels lighter. Excess Fire is heavier in the morning and lighter at night; Excess Fire has dry mouth and cracked tongue; Deficient Fire has little thirst, smooth tongue without cracks. Judging by this, there will be no error. If this Deficient Pain is treated like Excess Fire, it is like throwing someone into a well and adding stones. Thus, not only should cold medicines be avoided, but also dispersing medicines, because Deficient Fire must be tonified. Merely tonifying Kidney Water can control Fire slightly, but if Fire is too strong, it is hard to subdue. It is better to tonify Fire within Water, guiding Fire back to its origin, removing Fire power instantly. The main formula is Yin Huo Tang (Guiding Fire Decoction). After one dose, phlegm sounds cease, pain vanishes, and swelling disappears; two doses bring full recovery. Shudi, Shanzhuyu, Wuweizi are holy medicines for tonifying Kidney Water. Fuling (Poria) and Shanyao (Dioscorea Tuber) benefit Essence and promote urination, assisting Rougui (Cinnamon Bark) in descending. Xuanshen (Scrophularia Root) clears floating Fire above; Baijiezhi (White Mustard Seed) clears obstructive Phlegm. With the Upper Jiao widened and Lower Jiao warmed by Rougui, how can Dragon-Lei Fire fail to return to Mingmen? One dose produces miraculous results, surpassing Bawei Dihuang Tang. If throat swelling blocks everything, preventing even a spoonful of water from entering, how can this divine prescription be applied? I have another method: Take one Fuzi and Pogu Zhi (Cibotium Rhizome) 5 qian, grind into powder, mix into paste, make into a plaster the size of a teacup, apply to the center of the sole (Yongquan KI1), and warm with fire. In one shichen (2 hours), the throat widens and a path opens for medication. This is a wonderful method.
He also said: Yin Eme syndrome is due to Kidney Water deficiency, Fire cannot hide below, flies upward, and the throat gate is narrow, preventing direct discharge of Fire, thus forming Eme. It is called Eme but is not true Eme. Pain is light in the morning, heavy in the afternoon, worst at dusk. Relief comes with heat; worsening with cold. Severe cases cannot swallow a drop of water. If treated as Exterior Yang Syndrome, mistakenly using Shandougen, Huangqin, Lianzi, Zhizi, etc., pain increases, the gate remains closed, leading to death. Only tonifying Yin Deficiency using the method of Guiding Fire back to its Origin stops pain immediately. Treat with Hua E Tang (Transform Eme Decoction). This formula greatly tonifies Kidney Water. It does not directly treat Eme pain; strengthening Water extinguishes Fire, guiding Fire eliminates pain, achieving complete success. Truly a miraculous method. (Huoren Lu)
Hua Zhenjun said: Yin Syndrome of Double Eme is hardest to treat yet easiest to treat. Not knowing the trick makes it hardest; knowing the method makes it easiest. I often treat this. Use one Fuzi and one he of salt, boiled thoroughly. Let the patient hold a slice in the mouth; Fire stops immediately. Then drink a large dose of Liujun Dihuang Tang (Six-Ingredient Rehmannia Decoction); it will not recur. Divine prescription.
Chen Yuan Gong said: Someone contracts Wind-Cold, throat swells and hurts urgently, turning into Double Eme. Symptoms include thick turbid phlegm, frequent thirst for drinks, pain preventing water entry. This is Yang Fire blocking the throat. The situation seems severe but the disease is actually mild. Yang Fire refers to Taiyang Fire and Bladder Fire. Bladder Fire and Kidney Fire are interior-exterior related. When Bladder Fire moves, Kidney Fire assists, rushing straight to the throat. Fire of Lung, Spleen, and Stomach follows upward. Borrowing phlegm-saliva from these three meridians, they block the throat, forming indissoluble Fire-Toxin. Treatment seems to require managing multiple meridians. However, the root begins in Taiyang. Draining Bladder Fire calms Fire in other meridians. But the throat is close to the Lung. Taiyang passes through the Lung. The Lung meridian is dangerous terrain, a battlefield in a narrow path. Why abandon the battlefield to relieve the siege and attack the homeland (Kidney) first? The value lies in combined treatment. Qing Zao Tang: Jiegeng, Xuanshen, Huafen (Trichosanthes Root) each 2 qian, Gancao 2 qian, Baishao (White Peony Root) 5 qian, Shandougen, Chaihu (Bupleurum Root), Mahuang (Ephedra Stem) each 1 qian. Decoct in water and take. One dose widens the throat; two doses eliminate Eme completely. (Bing Jian. This formula disperses Taiyang pathogen in four parts, other meridians in six parts, paying special attention to dispersing Lung pathogen, from near to far.)
He also said: Suddenly, throat swells and hurts, vomiting phlegm like a surge, thirsty for water. Swallowing brings slight relief, but soon heat returns demanding water. Throat forms Double Eme, large and red, shape like a rooster comb. This is Hou Bi (Throat Bi) syndrome, commonly known as Chan Feng (Coiling Wind). It is simultaneous blazing of Yin and Yang Fire. One is Shaoyang Ministerial Fire, the other is Shaoyin Sovereign Fire. Now both fires erupt together, their momentum violent. The throat tube is small, difficult to drain quickly, so it is suppressed, initially swelling then forming Eme. There are two types of Eme: Double Eme and Single Eme. Double Eme has two masses, pressing against each other, leaving a slit in the middle for tea, water, and medicine. Single Eme blocks the food and water path entirely; often, not even a spoonful of water can enter. If medicine cannot be swallowed, how to administer it? First, use needling. Pricking Shaoshang (LU11) etc. is not the fastest way. Only piercing the throat directly with a knife by one fen reduces swelling slightly, allowing insufflation. Insufflation Formula: Burn Zaojiao (Gleditsia Sinensis Fruit) to ash, Dan Fan, Niuhuang (Calculus Bovis), Bing Pian each one fen, Shexiang (Musk) 3 li. Grind to fine powder. Insufflate into throat; massive vomiting of phlegm leads to cure. Follow with decoction named Jiu Hou Tang (Save Throat Decoction): Xuanshen 1 liang, Maidong 5 qian, Huafen 3 qian, Gancao, Shandougen, Shaye (Belamcanda Rhizome) each 1 qian. Decoct in water; one dose cures completely. For Double Eme, needling is unnecessary; this formula works effectively. (Xuanshen is the sovereign herb, sufficient to drain Sovereign and Ministerial Fire of Heart and Kidney. Assisted by Dougen, Shaye, Huafen to dispel evil and eliminate phlegm, Fire returns to its meridian, and the throat gate is restored.)
He also said: Throat swelling and pain, light in day and heavy at night, growing into Throat Eme, resembling Yang Syndrome, but not very painful. The throat feels extremely dry in a line. Drinking water enters quickly, but discomfort arises after swallowing into the abdomen. Vomiting copious watery phlegm; spitting saliva into water dissolves it. People think it is Throat Pain with Eme and prescribe Fire-draining formulas, which not only fail but worsen the condition. Some cannot even swallow a spoonful of water. Why? It belongs to Yin Eme. Yin Eme is light in day and heavy at night; Yang Eme is heavy in day and light at night. This is Shaoyin Kidney Fire having nowhere to hide below, flaring straight up to the throat. Treatment should greatly tonify Kidney Water, add Fire-tonifying flavors, guide Fire back to origin. Cooling below naturally cools above. Yin Huo Tang: Shudi 3 liang, Bajitian (Morinda Root), Tiandong (Asparagus Tuber), Maidong each 1 liang, Fuling 5 qian, Bei Wuwei Zi 2 qian. Decoct in water and take. One dose lowers Fire, swelling and throat resolve; two doses cure completely. (This formula uses Shudi as sovereign, greatly tonifying Kidney Water. Maidong and Wuweizi heavily nourish Lung Metal. Metal and Water support each other; mother and son have abundant nourishment. Abundant Water controls Fire. Adding the warmth of Bajitian, which is also a Water-tonifying medicine, achieves balance of Water and Fire. Water flows down, forcing Fire to follow. Fuling guides them forward, so Water and Fire move together, resting peacefully in the Kidney Palace, like harmony of zither and lute. Why use Gui (Cinnamon Twig) and Fu (Aconite) great heat to guide Fire back? Gui and Fu are holy medicines for guiding Fire back, why discard them? Unknown is that this syndrome is Fire boiling due to Water insufficiency. Using great heat guides Fire temporarily but consumes Water later. So using only Bajitian guides Fire while tonifying Water, avoiding Kidney dryness and benefiting throat clarity.)
Yi Lun Xuan Yao says: Single Eme is round and small like a chopstick head, growing at the upper gate of the throat, left or right. Double Eme grows on both sides. If growing below the lower gate, it is difficult to treat.
Dou Hanqing said: The soft part of the left pharynx governs swallowing; the right throat governs voice production. The throat gate divides into two paths, suffering different diseases. (Quan Shu)
He also said: On the left side of the throat, Deficient Yang attacks upward, swelling is slightly red, named Ru E (Breast Eme). If accompanied by exterior Lung symptoms like cold limbs, spontaneous phlegm-saliva, heavy head, and dizziness, urgently pour Changpu (Acorus Rhizome) sour juice mixed with Xuanming Fen (Mirabilite) into the mouth, remove phlegm-saliva, and insufflate medicine. If coma is severe and breath is failing, urgently grind Wuzhuyu (Evodia Fruit), mix with vinegar, and apply to the soles. On the right side, Deficient Yang attacks upward, color is slightly yellow, shape resembles silkworm cocoon, hence called Ru E. Symptoms also include cold limbs.
He also said: Double Eme Wind, this condition has two masses, bean-sized on both sides of the throat. Quickly use Huangbo (Phellodendron Bark) juice with a little honey, add Xuanming Fen, gargle to expel wind-phlegm, and insufflate Bing Pian San (Borneol Powder).
Kui Guang said: Ru E can be single or double, or linked pearls (Lianzhu). Often caused by stagnation from alcohol and sexual excess. Single is mild, double is severe. Day 1: pain. Day 2: redness and swelling. Day 3: appearance of fine white spots. Fever and chills indicate ominous prognosis. Day 4: condition stabilizes; treatment over 4-5 days leads to cure. The condition grows beside the throat. Growing on one side is Single Eme; growing on both sides is Double Eme. Two white spots connected vertically like a bag are Lianzhu.
He also said: To treat Ru E, first blow Bidan (5 parts) and Jindan (1 part). Next, blow Jindan (2 parts) and Bidan (3 parts) together to expel phlegm. Combine with decoction. Add Xijiao (Rhinoceros Horn - substitute with Buffalo Horn) and Huanglian (Coptis Rhizome) for left side; add Chishao (Red Peony Root) and Chaihu for right side. Use both for Lianzhu. If constipated, add Xuanming Fen and Dahuang (Rhubarb Root). (Insufflation formulas detailed in Throat Section.)
Xin Fa says: Ru E is formed by accumulated heat in the Lung Meridian condensing with Wind. Grows beside the throat, shape like silkworm moth, single or double. Double is mild, single is severe. Growing before the gate, shape is easily seen, insufflation reaches easily, manipulation is easy, thus easy to treat. Growing behind the gate, shape and form are hard to see, insufflation does not reach, manipulation is difficult, thus hard to treat.
He also said: If Double or Single Eme prevents swallowing water, look for fine pits inside the hair on the top of the head. Pierce them to immediately open the passage.