白喉证古书未载。而时医专目为疫证。谬矣。凡治病必先寻经络。次察寒热。次审虚实。三者既明。虽杂证百
出。可一以贯之。如白喉证亦寒暑之不时。气血之不调所致。非六经之外别有一病也。焉有不审寒热虚
实。而概指为疫者乎。经云。赤属热。白属寒。如所言则白喉只有寒而无热。其曰热者。亦从证而别之耳。
若概指为疫。则只有热而无寒矣。于理安在。此其弊皆由不辨证不辨脉徒听时医之说。以人之性命。委诸无形之斧
斤。予甚惜之。诵读之暇。因将白喉证治法。条分缕晰。以寒热二字为纲领。而寒热之中又分轻重虚实。庶用药
无毫厘千里之谬。书既成。或有疑之者。曰既非疫。焉有传染。曰气之相感。理之常然。如伤风疮毒之类。防身者每
不与共寝食。若以传染为疫。则伤风疮毒。不亦可云疫乎。曰有传染不传染何也。曰物必先朽也。而后虫生。其传染
者。必其人内有寒热。始触而发也。故有同一室而传与不传各异。传者之寒与热亦各异。曰其色白。何也。曰白属肺。
凡风寒热之中人。未有不由肺入而伤气者。喉为气之门户故宜宣发。而时医忌表药。谬矣。曰寒热之为病甚
多。而独发于喉何也。
曰十二经惟足太阳主表。别下项。余皆内循于喉。尽得而病之也。盖阳明为水谷之海。而胃气直透咽喉。故喉
疾惟阳明之火最盛。少阳厥阴。为木火之藏。亦多热证。少阴之脉。络于舌本。凡阴火冲逆。多生喉疾。但
其中有虚有实。不得概从火断。而少阴尤不可概从火断。如酒色过度。真阴中之阴亏损。火无所养。非补水以
配火不可。易所谓水火既济者是也。真阴中之阳亏损。火无所归。非补火以引火不可。易所谓火就燥者是也。
此褚氏遗书所以有上病疗下之说也。曰何死之速也。白喉急证。非死证也。治之不善。则死矣。如热证投以
热药。寒证投以寒药。或表证而攻下。或虚证而表散。如人之无辜受戮。虽欲不死。焉得而不死。且每闻白喉之死。
死于热证者少。死于寒证者多。大抵人知有热证。而不知有寒证。即知有寒证。而不知有虚寒之证。皆误于
疫之一字也。然则予之辨之也。其容已乎。但见浅学寡。不无疏漏。尚冀高明之士。匡予不逮。则幸甚。
白喉这一病证，古代医书中没有记载。而当时的医生专门将其视为疫病。这是错误的。凡是治病，必须先探寻经络，其次观察寒热，再次审察虚实。这三者既然明确了，即使出现各种杂症，也可以用一个原则贯穿始终。比如白喉证，也是由于寒暑气候不时、气血不调所导致的，并不是在六经之外另外有一种病。哪里有不审察寒热虚实，就一概指认为疫病的道理呢？《内经》说：红色属于热，白色属于寒。如果按照这个说法，那么白喉只有寒而没有热。那些说是热的，也是根据具体症状来区分的罢了。如果一概指认为疫病，那就只有热而没有寒了。这在道理上怎么讲得通呢？这种弊病，都是因为不辨证候、不诊脉象，盲目听从当时医生的说法，把人的性命交给无形的斧斤（比喻错误的治疗手段）去宰割，我对此感到非常痛惜。
我在读书之余，于是将白喉证的治疗方法，条理分明地梳理出来，以“寒”和“热”两个字作为纲领，而在寒热之中又分为轻、重、虚、实，这样用药就不会有毫厘之差导致千里之谬的差错。书成之后，或许有人怀疑，问：“既然不是疫病，为什么会有传染性？”回答说：“这是气机相互感应的结果，是常理。比如伤风、疮毒之类的病，预防的人往往不与患者同寝共食。如果把有传染性的都称为疫病，那么伤风疮毒，不也可以称为疫病吗？”问：“有的传染，有的不传染，为什么呢？”回答说：“物体必须先腐朽，然后虫子才会生出来。那些被传染的，一定是因为人体内有寒热失调，接触后才发病的。所以同一间屋子里，有的传了有的没传，而且被传染者的寒热性质也各不相同。”问：“为什么颜色是白色的呢？”回答说：“白色属于肺。大凡风寒热邪侵袭人体，没有不从肺进入并损伤元气的。喉咙是气息的门户，所以应当宣发，而当时的医生忌讳使用解表药，这是错误的。”问：“寒热引起的疾病很多，为什么唯独发作在喉咙呢？”回答说：“十二经脉中，只有足太阳膀胱经主司体表，向下经过项部，其余经脉都在内部循行经过喉咙，所以都能导致喉咙生病。大概阳明胃经是水谷之海，胃气直通咽喉，所以喉部的疾病，只有阳明之火最盛；少阳胆经和厥阴肝经，是木火之脏，也多热证；少阴肾经的脉络联络舌根，凡是阴火冲逆，多产生喉部疾病。但是其中有虚有实，不能一概从火论断，尤其是少阴病更不可一概从火论断。比如酒色过度，导致真阴中的阴液亏损，火失去滋养，就必须补水以配合火，这就是《易经》所说的‘水火既济’。如果是真阴中的阳气亏损，火失去归宿，就必须补火以引火归元，这就是《易经》所说的‘火就燥’。这就是褚氏遗书中提到的‘上病疗下’的说法。”问：“为什么死得这么快呢？”回答说：“白喉急证，并不是必死的证候。如果治疗不当，就会死亡。比如热证投用热药，寒证投用寒药，或者表证却用攻下法，或者虚证却用解表发散法，这就好比无辜的人被处决，虽然想不死，怎么能不死呢？况且我常听说白喉的死亡，死于热证的少，死于寒证的多。大概人们只知道有热证，而不知道有寒证；即使知道有寒证，也不知道有虚寒证。这都是误信了‘疫’这一个字造成的。既然如此，我辨析它，难道能停止吗？只是见识浅薄，学识寡陋，不免有疏漏之处，还希望高明的人士，纠正我的不足，那就太幸运了。”
The condition of *Baihou* (White Throat) is not recorded in ancient medical texts. However, contemporary physicians exclusively categorize it as an epidemic disease (*Yi Zheng*). This is erroneous. In treating any disease, one must first identify the meridians, then observe cold and heat patterns, and subsequently assess deficiency and excess. Once these three aspects are clarified, even if a hundred miscellaneous symptoms arise, they can be understood through a single unifying principle. For instance, *Baihou* is caused by irregularities in cold and summer-heat climates and disharmony of Qi and Blood; it is not a distinct disease existing outside the Six Meridians (*Liu Jing*). How can one indiscriminately label it as an epidemic without assessing cold/heat and deficiency/excess? The Classics state: "Red indicates Heat, White indicates Cold." If we follow this, *Baihou* should only involve Cold and no Heat. Those who claim it involves Heat are distinguishing based on specific manifestations. If all cases were labeled as epidemics, there would be only Heat and no Cold, which defies logic. These errors stem from failing to differentiate syndromes and pulses, blindly following contemporary physicians, and entrusting human lives to invisible axes (metaphor for harmful treatments). I deeply lament this.
During my leisure time reading, I systematically outlined the treatment methods for *Baihou*, using "Cold" and "Heat" as the guiding principles. Within these categories, I further distinguished severity and deficiency/excess, ensuring that medication usage avoids minute errors leading to disastrous outcomes. Upon completion, some may doubt: "If it is not an epidemic, why is it contagious?" I reply: "Contagion arises from the mutual influence of Qi, which is a natural law. For example, with common colds or sores, those taking precautions often avoid sharing meals or beds with patients. If contagion defines an epidemic, then common colds and sores could also be called epidemics." Asked: "Why do some cases transmit while others do not?" I reply: "Objects must rot before worms emerge. Contagion occurs only when internal Cold/Heat imbalance exists, allowing external pathogens to trigger illness upon contact. Thus, within the same room, transmission varies, and the nature of Cold/Heat in transmitted cases differs." Asked: "Why is the color white?" I reply: "White corresponds to the Lung. When Wind-Cold or Heat pathogens invade, they invariably enter via the Lung and damage Qi. The throat is the gateway of Qi, so it requires dispersing and releasing. Contemporary physicians' taboo against using exterior-releasing herbs is erroneous." Asked: "Cold and Heat cause many diseases; why specifically manifest in the throat?" I reply: "Among the Twelve Meridians, only the Foot-Taiyang Bladder Meridian governs the exterior and descends through the nape; the others circulate internally through the throat, making them susceptible to throat pathology. The Yangming Stomach Meridian, being the sea of water and grain, has Stomach Qi penetrating directly to the throat; thus, Yangming Fire is most prevalent in throat disorders. Shaoyang Gallbladder and Jueyin Liver are stores of Wood and Fire, often presenting Heat syndromes. Shaoyin Kidney Meridian connects to the tongue base; rebellious Yin Fire frequently causes throat issues. However, these involve both deficiency and excess, and cannot be uniformly diagnosed as Fire, especially Shaoyin conditions. Excessive sexual activity or alcohol consumption depletes True Yin (Yin within Yin), leaving Fire without nourishment; this requires tonifying Water to harmonize with Fire, known as 'Water and Fire in Mutual Interaction' (*Shui Huo Ji Ji*). Depletion of True Yang (Yang within Yin) leaves Fire without residence; this requires tonifying Fire to guide Fire back, known as 'Fire follows Dryness' (*Huo Jiu Zao*). This explains the theory of 'treating lower body ailments for upper body symptoms' found in Chu Shi's遺書 (*Chu Shi Yi Shu*)." Asked: "Why is mortality so rapid?" I reply: "Acute *Baihou* is not inherently fatal; poor treatment leads to death. Applying Hot herbs to Heat syndromes, Cold herbs to Cold syndromes, purgatives to Exterior syndromes, or diaphoretics to Deficiency syndromes is akin to executing the innocent. Though survival is desired, it is impossible. Moreover, deaths from Heat syndromes are rare compared to Cold syndromes. People generally know of Heat but ignore Cold; even when aware of Cold, they overlook Deficient-Cold. All these mistakes stem from the misconception of 'epidemic.' Therefore, my differentiation is necessary. Due to my limited knowledge, omissions may exist. I hope learned scholars will correct my deficiencies, which would be greatly appreciated."