盛锡朋曰∶咽喉内生疮,鼻孔俱烂,此名天白蚁疮。此证方书不载,多有不识,常
作喉风医,最为误事。此乃肺脾蕴毒而成,宜用穿山甲散治之。
穿山甲散
白霜梅(烧存性,一个) 枯矾(一钱) 穿山甲(炒) 雄黄(各五分)
共研细末。吹喉中,立效。
窦汉卿曰∶锁喉疮者,乃心经毒瓦斯,小肠邪风发于听会之端,注于悬膺之侧。初
生如 瘰,不能饮食,闭塞难通,渐次肿破化脓。早治得生,宜服当归、连翘之类,
用冰片散,蜒蜉不拘多少,加冰麝捣搽。(《全书》)
陈实功曰∶梅核气,乃痰气结于喉中,咽之不下,吐之不出,如茅草常刺作痒。初
则吐酸,妨碍久则闭塞不通,即此候也。(《正宗》)
冯鲁瞻曰∶痰结块在喉中如梗状者,梅核气也。宜噙化丸。(《锦囊》)
《金匮》曰∶妇人咽中有如炙脔,半夏浓朴汤主之。炙脔,干肉也,咽中贴贴,如
有炙肉,吐之不出,吞之不下。此病不因肠胃,故不碍饮食二便,不因表邪,故无
骨痛寒热。乃为积寒所伤,不与血和,血中之气溢而浮于咽中,得水湿之气凝结难
移,男子亦间有之。药用半夏浓朴汤,乃
二陈汤去陈皮、甘草,加浓朴、紫苏、生姜也。专治妇人七情之气郁滞不散,结成
痰涎,或如梅核在咽,咯咽不下,或中脘痞满,气不舒畅,或痰饮中滞,呕逆恶心,
并可取效。盖半夏降逆,浓朴散结,生姜、茯苓宣至高之滞而下其湿,苏叶味辛气香,
色紫性温,能入阴和血,则气与血和,不复上浮也。
盛锡朋说:咽喉内部生疮,鼻孔也溃烂,这种病名叫天白蚁疮。这个证候在医书中没有记载,很多人不认识,常常把它当作喉风(以咽喉红肿疼痛、吞咽困难为主要表现的疾病)来治疗,这是最大的失误。这是因为肺脾蕴积毒气而形成的,适宜用穿山甲散来治疗。
穿山甲散
白霜梅(烧至保留药性,一个) 枯矾(一钱) 穿山甲(炒制) 雄黄(各五分)
共同研成细末。吹入咽喉中,立刻见效。
窦汉卿说:锁喉疮,是心经的毒瓦斯,小肠的邪风发作于听会穴之端,流注到悬膺穴的一侧。刚开始生长时像瘰疬(颈部淋巴结结核),不能饮食,闭塞不通,逐渐肿胀破溃化脓。早期治疗可以存活,适宜服用当归、连翘之类的药物,使用冰片散,蜒蜉(一种昆虫,此处指代某种药材或虫类药)不拘多少,加入冰片、麝香捣碎后搽涂。(《全书》)
陈实功说:梅核气,是痰气结聚在喉咙中,咽不下去,吐不出来,像茅草刺一样经常感到发痒。起初则泛吐酸水,妨碍进食,时间久了则闭塞不通,就是这个证候。(《正宗》)
冯鲁瞻说:痰结成的块状物在喉咙中像梗塞一样的,就是梅核气。适宜含服噙化丸。(《锦囊》)
《金匮要略》说:妇女咽喉中有像烤肉块一样的异物感,用半夏厚朴汤主治。炙脔,就是干肉,咽喉中贴滞不适,好像有烤肉块卡在那里,吐不出来,吞不下去。这个病不源于肠胃,所以不影响饮食和二便;不源于表邪,所以没有骨节疼痛、恶寒发热等症状。这是由于积寒所伤,不与血液调和,血中的气溢出并浮越于咽喉中,遇到水湿之气凝结难以移动,男子也有偶尔患此病的。药用半夏厚朴汤,也就是二陈汤去掉陈皮、甘草,加上厚朴、紫苏、生姜。专门治疗妇女七情之气郁滞不散,结成痰涎,或者感觉像梅核卡在咽喉,咯吐不出,吞咽不下,或者中脘部痞满,气机不舒畅,或者痰饮停滞在中焦,呕吐逆气恶心,都可以取得疗效。因为半夏能降逆气,厚朴能散结气,生姜、茯苓宣通至高部位的滞气并下行湿气,紫苏叶味辛气香,色紫性温,能入阴分和血,那么气与血调和,不再上浮了。
Sheng Xipeng stated: Sores arising within the throat, accompanied by ulceration of both nostrils, is named Tianbaiyi Chuang (Heavenly White Ant Sore). This syndrome is not recorded in medical texts, and many are unfamiliar with it, often treating it as Houfeng (Throat Wind), which is a major error. This condition results from toxic heat accumulating in the Lung and Spleen, and should be treated with Chanshanjia San (Pangolin Scale Powder).
Chanshanjia San (Pangolin Scale Powder)
Bai Shuang Mei (White Frost Plum, burned to retain its properties, one piece)
Ku Fan (Alum, one qian)
Chanshanjia (Pangolin Scale, stir-fried)
Xionghuang (Realgar, each five fen)
Grind all into a fine powder. Blow into the throat for immediate effect.
Dou Hanqing stated: Suohou Chuang (Lock-Throat Sore) is caused by toxic vapors of the Heart Meridian and pathogenic wind from the Small Intestine manifesting at the end of Tinghui (GB2), flowing to the side of Xuanying. Initially, it resembles Luoli (Scrofula/neck lymph node tuberculosis), preventing eating and causing blockage and difficulty in passage. It gradually swells, breaks open, and suppurates. Early treatment leads to survival; it is suitable to take herbs such as Danggui (Angelica Sinensis Root) and Lianqiao (Forsythia Fruit), and apply Bingpian San (Borneol Powder) mixed with Yanfu (a type of insect medicine) in any amount, along with Borneolum Syntheticum (Bingpian) and Moschus (Shexiang), ground and applied externally. (From *Quan Shu*)
Chen Shigong stated: Meihé Qi (Plum-Pit Qi) is phlegm-qi knotting in the throat, impossible to swallow down or spit out, feeling like frequent itching from thatch grass刺. Initially, there is acid regurgitation hindering food intake; over time, it becomes blocked and impassable, which is this syndrome. (From *Zheng Zong*)
Feng Luzhan stated: When phlegm knots into a mass in the throat resembling a foreign body obstruction, it is Meihé Qi (Plum-Pit Qi). It is suitable to use Qin Hua Wan (Qin-Hua Pill) held in the mouth to dissolve. (From *Jin Nang*)
*Jin Gui Yao Lue* states: In women, there is a sensation in the throat as if there were a roasted meat lump; Banxia Houpo Tang (Pinellia and Magnolia Bark Decoction) is indicated. "Zhi luan" refers to dried meat. The throat feels stuck and uncomfortable, as if a piece of roasted meat is lodged there, impossible to spit out or swallow down. This disease does not originate from the Stomach and Intestines, so it does not hinder diet or urination/defecation; it does not stem from exterior pathogens, so there are no bone pain, aversion to cold, or fever. It is injured by accumulated cold, which fails to harmonize with blood. The qi within the blood overflows and floats upward into the throat, condensing with dampness and water qi, making it difficult to move. Men also occasionally suffer from this. The medicinal prescription is Banxia Houpo Tang (Pinellia and Magnolia Bark Decoction), which is Erchen Tang (Two-Aged Phlegm Resolving Decoction) minus Chenpi (Aged Tangerine Peel) and Gancao (Licorice Root), plus Houpo (Magnolia Bark), Zisu (Perilla Leaf), and Shengjiang (Fresh Ginger). It specifically treats qi stagnation due to the seven emotions in women, failing to disperse, forming phlegm-saliva, or causing a sensation like a plum pit stuck in the throat, impossible to cough up or swallow; or epigastric fullness and stuffiness with unsmooth qi mechanism; or phlegm-fluid retention in the middle jiao with vomiting, counterflow, nausea, and disgust. All can be effectively treated. This is because Banxia (Pinellia Rhizome) descends rebellious qi, Houpo (Magnolia Bark) dissipates knots, Shengjiang (Fresh Ginger) and Fuling (Poria) ventilate stagnation in the high region and drain downward dampness, while Zisu Ye (Perilla Leaf), being pungent in flavor, fragrant in qi, purple in color, and warm in nature, enters the Yin to harmonize blood. Thus, qi and blood harmonize and no longer float upward.