时疫喉病。喉间必红肿。甚则紫。而此症则独发白。或点或片或块。色如鸡脂。或发
热后数日始见。或顷刻满喉。病势虽有轻重之不同。其为手太阴燥火则一。服药后转
为微黄色者。病将已也。其间有红肿者。以挟少阳相火少阴君火也。紫则火势剧而成
毒矣。
张绍修曰。此症热症多。寒症少。（善按果系时疫白喉必无寒症）有以色白为寒者。不知此症初发于
肺。肺属金。其色白。为五脏六腑之华盖。处至高之位。毒瓦斯自下熏蒸而上。（二语未确）
肺病日深。故本色日着云云。恰与内经肺热病者。色白而毛败。又肺风之状。色
然白数语相发明。鄙意更有进者。肺色既白。而所伤之病又为燥。燥气属金。金为
西方白虎。其色亦白。故他经热喉病不发白。而此独发白也。其间有红紫者。则挟
君相二火矣。
白喉病初起。余脉如平。但右寸微数而涩或沉数者。手太阴伏邪本病也。其浮数或紧
者。挟有外感时邪也。左寸关动数者。少阳相火少阴君火并病也。洪滑者。火郁而成
痰也。延之日久。或经误治。两手脉滑数甚。按之搏指者。火势剧也。洪大无力。按
之芤或散大者。阴涸已极也。
张绍修曰。凡病此者两关及左尺脉多沉数而躁。其意专指足三阴受病而言。以余所
验。颇觉不然。唯不肿不红。咽干无痰。手太阴燥火自病者。右寸必微数而涩。红
肿且痛。初起即痰涎多。挟有少阳少阴风火者。左寸关必动数。其他病脉。皆误治
后始见。初起时未必尽具也。
凡治内伤病。必先脉而后症。至六淫必脉症参合。方有把握。甚有舍脉从症者。
（如伏脉与绝脉实难区别参之于症便易分晓）若专恃察脉。最易致误。此实阅历以来。屡试屡验。非欺人也。
时行疫病引起的喉病，咽喉部位必然出现红肿，严重时甚至呈现紫色。而白喉这一病症则唯独表现为发白，或呈点状、片状或块状，颜色如同鸡油。有的患者在发热数日后才显现症状，有的则在顷刻间布满整个咽喉。虽然病势有轻重之分，但其本质均为手太阴肺经的燥火为患。服药后若转为微黄色，说明病情即将痊愈。其中若有红肿现象，是因为兼夹了少阳相火和少阴君火；若呈现紫色，则是火势剧烈并化毒所致。
张绍修说：此症多为热证，寒证较少。（陈葆善按：如果是时行疫病的白喉，必定没有寒证。）有人因为患处色白而认为是寒证，却不知道此症初起于肺脏。肺属金，其色白，作为五脏六腑的华盖（覆盖诸脏的器官），处于人体最高位置，毒气自下熏蒸而上。（这两句话并不准确）随着肺病日益加深，所以本色日渐显露。这与《内经》中“肺热病患者，面色白且毫毛枯败”以及“肺风的症状，面色苍白”等论述相互印证。我认为还有更进一步的理解：肺的本色是白色，而所受的病邪又是燥邪。燥气属金，金对应西方的白虎，其色亦白。因此其他经络的热性喉病不发白，唯独此症发白。其中若有红紫之色，则是兼夹了君火和相火。
白喉病初起时，其余脉象如常人平和，只有右寸脉微数且涩，或者沉数，这是手太阴肺经伏邪本病的表现。如果脉象浮数或紧，则是兼夹了外感时邪。左寸、关脉动数，是少阳相火与少阴君火并病的表现。脉象洪滑，是火郁结而成痰的表现。病程迁延日久，或者经过误治，两手脉象滑数非常严重，按之搏指有力，说明火势剧烈。脉象洪大无力，按之空虚如葱管（芤脉）或散大无根，说明阴液枯竭到了极点。
张绍修说：凡是患此病的人，两关及左尺脉多沉数而躁动。他的意思专指足三阴经受病而言。根据我的验证，觉得并非如此。只有不肿不红、咽干无痰，属于手太阴燥火自病者，右寸脉必微数而涩；若红肿且痛，初起即痰涎多，兼夹少阳、少阴风火者，左寸、关脉必动数。其他的病脉，都是误治后才出现的，初起时未必全部具备。
凡是治疗内伤病，必须先诊脉而后察症；至于六淫外感病，必须脉症参合，才有把握。甚至有舍脉从症的情况。（例如伏脉与绝脉实在难以区别，参考症状就容易分辨清楚）。如果专门依赖诊脉，最容易导致误诊。这确实是阅历以来，屡试屡验的结果，并非欺骗人。
Throat diseases caused by epidemic pathogens must present with redness and swelling in the throat, which may become purple in severe cases. However, this specific disease (Baihou/White Diphtheria) uniquely presents with whiteness, appearing as spots, patches, or plaques, with a color resembling chicken fat. Symptoms may appear several days after fever onset, or the entire throat may be covered within moments. Although the severity of the illness varies, its nature is consistently identified as Dryness-Fire affecting the Hand-Taiyin Lung Meridian. If the color turns slightly yellow after medication, the disease is nearing resolution. Cases presenting with redness and swelling indicate an involvement of Shaoyang Ministerial Fire and Shaoyin Sovereign Fire. Purple discoloration signifies intense fire transforming into toxicity.
Zhang Xiuxiu stated: This condition involves mostly heat syndromes and few cold syndromes. (Chen Baoshan notes: If it is indeed epidemic Baihou, there must be no cold syndromes.) Some consider the white color as a sign of cold, not realizing that this disease originates in the Lungs. The Lung belongs to Metal, whose color is white. As the "Canopy" (Huagai) covering all viscera and bowels, it resides at the highest position, where toxic vapors steam upward from below. (These two statements are inaccurate.) As lung pathology deepens, the original color becomes more prominent. This elucidates the passages in the *Neijing* stating that patients with Lung Heat Disease have white complexions and brittle hair, and that symptoms of Lung Wind include a pale white complexion. I propose further insight: Since the Lung's color is white, and the pathogenic factor is Dryness, which also belongs to Metal and corresponds to the White Tiger of the West (whose color is white), other meridian-related heat throat diseases do not present with whiteness, whereas this one does. Redness and purple hues indicate the concurrent presence of Sovereign and Ministerial Fires.
In the early stage of Baihou, the remaining pulse qualities are like those of a healthy person, but the Right Cun pulse is slightly rapid and choppy, or deep and rapid, indicating the primary disease of latent pathogens in the Hand-Taiyin Lung Meridian. A floating, rapid, or tight pulse indicates concurrent exterior contraction of epidemic pathogens. A moving and rapid pulse at the Left Cun and Guan positions indicates concurrent disease of Shaoyang Ministerial Fire and Shaoyin Sovereign Fire. A surging and slippery pulse indicates fire stagnation transforming into phlegm. If the disease persists for a long time or has been treated incorrectly, a very rapid and slippery pulse at both hands that feels forceful upon pressure indicates intense fire. A surging and large pulse that is weak and feels hollow (Kou pulse) or scattered upon pressure indicates extreme depletion of Yin fluids.
Zhang Xiuxiu stated: In all cases of this disease, the pulses at both Guan positions and the Left Chi are often deep, rapid, and restless. His intent was specifically to refer to pathological changes in the Foot-Sanyin meridians. Based on my clinical experience, I find this not entirely accurate. Only in cases without swelling or redness, with dry throat and no phlegm, attributed to self-originating Dryness-Fire of the Hand-Taiyin, will the Right Cun pulse be slightly rapid and choppy. In cases with redness, swelling, pain, and abundant saliva/phlegm from the onset, due to concurrent Wind-Fire of Shaoyang and Shaoyin, the Left Cun and Guan pulses will be moving and rapid. Other pathological pulses typically appear only after incorrect treatment and are not necessarily present at the onset.
When treating internal injuries, one must examine the pulse before assessing symptoms. For diseases caused by the Six Exogenous Pathogens (Liu Yin), pulse and symptom assessment must be combined to ensure accuracy. There are even instances where symptoms take precedence over the pulse (e.g., distinguishing between a Hidden Pulse and an Absent Pulse is difficult; referencing symptoms clarifies the distinction). Relying solely on pulse diagnosis is most prone to error. This conclusion is based on extensive experience and repeated verification, not deception.