此症轻者。须日服二剂。重者三四剂不等。慎不可一二剂后。见病不退。漫施杂
药。癸巳春善及二女一子于数日间次第传染。每人服药三四剂。家庭遍列药碗。司
煎者日以二人替换。二旬后始获痊可。唯夭一小子。及今思之。亦由初起医治不
得法。然是时非得同院诸友反复调护。恐更不可问矣。
白喉病手太阴本症未罢。始终不得用苦燥药。若挟风火标病。必须参用苦泄。此理
上论辨之颇详。兹不复赘。耐修子谓黄芩一味凉入细窍。此谬论也。黄芩若此。则
连柏胆草犀角石膏等味。更何如耶。不知芩连胆柏性寒而味苦。苦禀火化。适足以
助燥。湿热症用之者。以苦能燥湿。寒能清热也。若白喉燥火本病。应以柔润滋养
之药为主。佐以泄火清热。苦味中除黄柏外。（黄柏虽苦却有津液试嚼之滋粘满口）均在禁忌。唯标症实火
太盛。苦泄法自亦不禁。识者察之。
白喉本无坏病。不识本源。适足碍事。若经误治者。症必危险。亦当悉心讲求。设法
救补。慎不可泥张氏之言。委诸无治。所列之症十一条。详辨于下。
此候极多。最不足怪。尝见有悬丁之旁。虚悬白片。色若鸡脂。遇大咳辄自落。其
症后亦无恙。余二小女亦然。
此候亦属寻常。余喉间白点数处。自正月初旬至月杪始退。
此真手太阴燥火本病。宜重用西洋参石膏冬地。甚则用官燕阿胶真珠母牡蛎。切不
可用水麝吹喉药。断无不效。
这种病症，轻的每天需服用两剂药，重的则三到四剂不等。千万不可在服用了一两剂药后，见病情没有退去，就随意施用各种杂药。癸巳年春天，我和两个女儿、一个儿子在几天内相继被传染。每人服药三到四剂，家里到处摆满了药碗，负责煎药的人每天两人轮换。二十天后才痊愈。唯独那个夭折的小儿子，现在回想起来，也是由于起初治疗不得法所致。然而当时如果不是同院的各位朋友反复照料护理，恐怕后果更不堪设想。
白喉病的手太阴肺经本证未解时，始终不能使用苦燥的药物。如果兼挟风火等标证，必须参用苦泄之法。这个道理在上篇论述中已经讲得很详细，这里不再赘述。耐修子说黄芩一味药凉性能深入细微窍道，这是错误的言论。如果黄芩是这样，那么黄连、黄柏、龙胆草、犀角、石膏等药物又该怎样呢？不知道黄芩、黄连、龙胆、黄柏性质寒凉而味道苦涩，苦味禀受火的化气，恰恰足以助长燥邪。湿热证使用这些药，是因为苦能燥湿，寒能清热。如果是白喉燥火的本证，应以柔润滋养的药物为主，佐以泻火清热的药物。除了黄柏以外，苦味的药物都在禁忌之列。（黄柏虽然味苦，但咀嚼时有津液，滋腻粘满口腔）只有当标证实火太盛时，苦泄法自然也不在禁忌之中。有见识的人请仔细考察。
白喉本身并没有所谓的“坏病”（指病情恶化转为危重复杂的病证），如果不认识本源，反而足以妨碍治疗。如果经过误治，症状必然危险，也应当悉心探究，设法补救。千万不要拘泥于张氏（张锡纯或指代前代医家张景岳等，此处泛指持特定观点者）的说法，认为无药可治。下面详细辨析所列的十一条症状。
这种候象非常多，最不值得奇怪。曾见过有人悬雍垂旁边，虚悬着白色的片状物，颜色像鸡油一样，遇到剧烈咳嗽时就会自行脱落。其后的症状也没有异常。我的两个小女儿也是这样。
这种候象也属于寻常情况。我喉咙间有几处白点，从正月初旬一直到月底才消退。
这真是手太阴肺经燥火的本证，宜重用西洋参、石膏、冬地（麦冬）。严重的甚至要用官燕（上等燕窝）、阿胶、真珠母、牡蛎。千万不可用水麝吹喉药（一种外用吹喉散剂）。断然没有不有效的。
For this condition, mild cases require taking two doses per day, while severe cases may require three to four doses. One must be extremely cautious not to indiscriminately administer miscellaneous medicines after just one or two doses if the disease does not recede. In the spring of the Gui Si year, I and my two daughters and one son were successively infected within a few days. Each person took three to four doses of medicine; medicine bowls were placed all over the house, and those responsible for decocting the herbs rotated in pairs daily. It took twenty days before recovery was achieved. The only child who died prematurely—thinking of him now—it seems it was due to improper treatment at the onset. However, at that time, without the repeated care and nursing by friends in the same courtyard, the outcome might have been even more dire.
When the primary syndrome of the Hand-Taiyin Lung meridian in Diphtheria (Baihou) has not resolved, bitter-drying medicines should never be used throughout the course. If there are concurrent branch syndromes involving Wind-Fire, bitter-draining methods must be employed alongside. This principle has been discussed in detail in the previous section, so no further elaboration is needed here. Naixiu Zi claimed that Scutellariae Radix (Huangqin, 黄芩) alone has a cooling nature that penetrates fine orifices; this is a fallacy. If Scutellariae Radix were like that, then what about Coptidis Rhizoma (Huanglian, 黄连), Phellodendri Cortex (Huangbai, 黄柏), Gentianae Radix (Longdancao, 龙胆草), Rhinocerotis Cornu (Xijiao, 犀角), and Gypsum Fibrosum (Shigao, 石膏)? They do not know that Scutellariae Radix, Coptidis Rhizoma, Gentianae Radix, and Phellodendri Cortex are cold in nature and bitter in taste. Bitterness inherits the transformation of Fire, which is precisely sufficient to assist dryness. When used in damp-heat syndromes, it is because bitterness can dry dampness and coldness can clear heat. However, for the primary syndrome of Diphtheria characterized by dryness-fire, the main treatment should rely on softening, moistening, and nourishing medicines, assisted by fire-draining and heat-clearing agents. Among bitter-tasting substances, except for Phellodendri Cortex (which, although bitter, contains fluid when chewed, feeling moist and sticky in the mouth), all others are contraindicated. Only when the branch syndrome involves excessive solid fire is the bitter-draining method not prohibited. Those with insight should observe this carefully.
Diphtheria itself does not inherently involve "ruined diseases" (complex, critical conditions resulting from mismanagement). Ignorance of the root cause only hinders treatment. If mismanaged, symptoms will inevitably become dangerous, requiring careful study and remedial measures. One must not rigidly adhere to Zhang's assertions that the condition is incurable. The following details the analysis of eleven listed symptom patterns.
This presentation is very common and nothing surprising. I have seen white patches hanging loosely beside the uvula, resembling chicken fat in color, which would fall off spontaneously upon severe coughing. The subsequent condition remained uneventful. My two young daughters exhibited the same phenomenon.
This presentation is also ordinary. I had several white spots in my throat that persisted from early January until the end of the month before they subsided.
This is truly the primary syndrome of dryness-fire in the Hand-Taiyin Lung meridian. It is appropriate to heavily use American Ginseng (Yangshen), Gypsum Fibrosum (Shigao), and Ophiopogonis Tuber (Dongdi, i.e., Maidong). In severe cases, official-grade Swallow's Nest (Guanyan), Donkey-hide Gelatin (Ejiao), Mother-of-Pearl (Zhenzhumu), and Ostrea Shell (Muli) may be used. Water musk throat powder (a topical insufflation preparation containing Civet Musk) must absolutely not be used. There is no doubt that this approach will be effective.