夫缠喉风者,热结于喉,肿绕于外(喉之外面亦肿),且麻且痒,风痰壅甚,声如曳锯,
是其候也。其证有虚有实。虚证初起前二日,必胸膈气逆,出气短促,忽然咽喉肿痛,痰涎
上涌,甚则颈如蛇掣,水浆不入,手足厥冷,手指甲白,手心壮热,最为危险,此由阴亏火
亢而发。其人素有痰热,或因饮酒过度而胃火动,或因忿怒失常而肝火动,或因房劳不节而
肾火动,火动痰生,而痰热燔灼,壅塞于咽嗌之间;火性最速,所以内外肿痛而水浆难下也
。治疗之法,急则治标(标者痰也),缓则治本(本者火也)。或用丸散以吐痰散热,或用鹅翎
醮桐油探吐,或以银针刺肿处出恶血,吹以冰硼散,或刺大指少商穴出血,后用汤药以降火
补虚。但治法虽多,愈者不过十之一二,医遇此证,亦惟尽人事以待天而已。其证之实者,
则由风温袭犯肺胃,风火相煽,上逆于喉,痰涎随而涌上。亦宜先去其痰,后服麻杏甘膏汤
。若待三日后,病势不退,或更加咽喉掣紧,面赤气粗,即为不治之证矣。
小儿患马脾风,是风温袭于肺窍,或胸膈积热,心火凌肺,热痰壅盛,肺胀喘满,胸高
气急,胁缩鼻张,闷乱咳嗽,烦渴痰潮声嗄,喉间气喘如曳锯者是也;若不急治,死在旦夕
。陈飞霞道人曰∶盖心为午火,属马,言心脾有风热也,急用牛黄夺命散下之效;用黑牵牛
(半生半炒)、白牵牛(半生半炒)、锦纹大黄(晒)、槟榔(切,晒)各取末一钱,和匀,每用五
分,蜜汤调下,量儿大小加减。痰盛,加轻粉一字,以大便泄、痰气平为度。
缠喉风这一病症,是热邪结聚于咽喉,肿胀蔓延至外部(咽喉的外侧也出现肿胀),并且伴有麻木和瘙痒感,风痰壅盛严重,声音像拉锯一样嘶哑,这是它的症状表现。这种病证有虚证和实证之分。
虚证在初起的头两天,必然出现胸膈部位气机逆乱,呼气短促,突然发生咽喉肿痛,痰涎向上涌出,甚至颈部僵硬如同被蛇牵引抽搐,饮食难进,手足冰冷,手指指甲发白,手心灼热,这种情况最为危险,这是由阴液亏损、虚火亢盛所引发的。患者平素就有痰热内蕴,或者因为饮酒过度导致胃火妄动,或者因为愤怒失常导致肝火妄动,或者因为房事不节导致肾火妄动,火热内生则生痰,痰热炽盛燔灼,壅塞在咽喉之间;火性急速,所以内外迅速肿痛且饮食难以咽下。治疗原则,急则治其标(标指痰浊),缓则治其本(本指火热)。或者使用丸剂散剂来催吐以排出痰浊并散热,或者用鹅毛管蘸桐油探喉催吐,或者用银针刺破肿胀处放出恶血,吹入冰硼散,或者刺破大拇指上的少商穴出血,之后再用汤药来降火补虚。但是治疗方法虽然多,治愈的不过十分之一二,医生遇到这种病证,也只能尽力救治而听天由命了。
其实证,则是由于风温之邪侵袭肺胃,风火相互煽动,向上逆行于咽喉,痰涎随之涌上。也应当先去除痰浊,然后服用麻杏甘膏汤。如果等待三天后,病情没有减退,或者更加出现咽喉拘紧牵拉感,面色红赤呼吸粗重,这就属于无法医治的证候了。
小儿患马脾风,是风温之邪侵袭肺窍,或者是胸膈积热,心火克制肺金,热痰壅盛,导致肺部胀满喘急,胸部高耸气息急促,两胁收缩鼻翼扇动,烦闷混乱咳嗽,烦躁口渴痰声如潮声音嘶哑,喉间气喘声如拉锯,就是这种病;如果不紧急治疗,死亡就在早晚之间。陈飞霞道人说道:心对应午火,属马,这里是指心脾有风热,必须紧急使用牛黄夺命散攻下,效果显著;配方是用黑牵牛(半生半炒)、白牵牛(半生半炒)、锦纹大黄(晒干)、槟榔(切片,晒干)各取粉末一钱,混合均匀,每次服用五分,用蜂蜜水调服,根据患儿年龄大小增减剂量。如果痰盛,加轻粉一字,以大便通畅、痰气平息为限度。
Chanting Throat Wind (Chan Hou Feng) refers to a condition where heat pathogens accumulate in the throat, causing swelling that extends to the exterior (the outer surface of the throat also swells), accompanied by numbness and itching. With severe obstruction of wind-phlegm, the voice becomes hoarse like a sawing sound; this constitutes its clinical presentation. This syndrome has both deficiency (Xu) and excess (Shi) types.
In the deficiency type, during the first two days of onset, there must be rebellious Qi in the chest and diaphragm, shortness of exhalation, sudden swelling and pain of the throat, surging of saliva and phlegm upwards, and even neck stiffness resembling convulsions pulled by a snake. Inability to take food or water, cold extremities, white fingernails, and intense heat in the palms are present, making it extremely dangerous. This is caused by Yin deficiency with hyperactive fire. The patient typically has latent phlegm-heat internally. It may arise from excessive alcohol consumption stirring up Stomach Fire, from uncontrolled anger stirring up Liver Fire, or from sexual indiscretion stirring up Kidney Fire. When fire stirs, phlegm is generated; phlegm-heat blazes fiercely, obstructing the throat. Since fire moves rapidly, external and internal swelling and pain occur quickly, making swallowing difficult. The treatment principle is: in acute cases, treat the branch (Biao, referring to phlegm); in chronic cases, treat the root (Ben, referring to fire). One may use pills or powders to induce vomiting to expel phlegm and dissipate heat, or use a goose feather dipped in tung oil to stimulate the gag reflex for vomiting, or puncture the swollen area with a silver needle to release bad blood, apply Bingpeng San (Ice and Borax Powder), or prick the Shaoshang (LU-11) acupoint on the thumb to bleed. Subsequently, decoctions should be used to descend fire and tonify deficiency. Although many treatments exist, only one or two out of ten recover. Physicians encountering this syndrome can only do their utmost and leave the outcome to Heaven.
The excess type arises when Wind-Warmth pathogens invade the Lung and Stomach. Wind and fire fan each other, rebelling upwards into the throat, causing saliva and phlegm to surge. One should first eliminate the phlegm, then administer Maxing Gan Shi Tang (Ephedra, Apricot Seed, Licorice, and Gypsum Decoction). If after three days the disease persists or worsens with tightening of the throat, red face, and coarse breathing, it becomes an untreatable condition.
Infants suffering from Horse Spleen Wind (Ma Pi Feng) have Wind-Warmth invading the lung orifices, or accumulated heat in the chest and diaphragm, with Heart Fire suppressing the Lung. Severe phlegm-heat causes lung distension, wheezing, and fullness, high chest, rapid breathing, retracted intercostal spaces, flaring nostrils, chaotic coughing, irritability, thirst, tidal phlegm, hoarseness, and saw-like wheezing in the throat. Without urgent treatment, death occurs within a day or night. Chen Feixia stated: "Heart corresponds to Wu Fire and is associated with the Horse, indicating Wind-Heat in the Heart and Spleen." Urgently use Niuhuang Jueming San (Calculus Bovis Life-Taking Powder) to purge. The formula consists of Heiqian Niu (Semen Sterculiae Lychnophorae, half raw, half stir-fried), Baiqian Niu (Semen Phytolaccae Acinosa, half raw, half stir-fried), Jinwen Dahuang (Radix et Rhizoma Rhei, sun-dried), and Binglang (Areca Seed, sliced and sun-dried), each ground into powder, mixed evenly. Take 0.5 qian per dose, mixed with honey water, adjusting according to the child's age. If phlegm is abundant, add Qingfen (Calomel) in the amount of "one character," stopping when bowel movements become loose and phlegm-qi subsides.