咽喉为肺之关。胃之门。少阴心脉之所络。肝经冲脉之所夹。凡此四经。皆血之所司也。故失血家。往往有
咽痛之证。凡咽痛而声不清利者。为肺火。肺主气。气管中痛。故声不清利。甘桔汤。加马兜铃黄芩杏仁川
贝母黄连麦冬百合薄荷治之。凡咽痛而饮食不利者。胃火也。胃上口为食管。食管痛。故饮食不利。白虎
汤加金银花大黄桔梗枳壳治之。咽喉作痛。而上气颊赤者。肝经冲脉逆上之火也。宜玉女煎。加旋复花
射干。再用盐炒安桂少许。以引火下行。喉中塞肿。及溃烂。皆为少阴心经之火。宜泻心汤。加山豆根牛蒡
子桔梗甘草薄荷细辛胆南星牛黄治之。肿塞者。外用人爪甲鸡内金急性子。全蝎合巴豆炒过。去巴豆。
再加火硝硼砂冰片。胆矾青黛黄连枯矾吹上。吐痰血即愈。溃烂者。外用雄黄黄连珍珠桑螵蛸寒水石
牛黄硼砂麝香吹之。又有梅核证。在痰饮门参看。
再按血家咽痛。多是肺胃虚火。及冲脉火逆。吾于咳嗽诸条。言之甚详。痨虫蚀咽。见声音门。宜参汇。
失血家初病失音。多是风火。声音者。肺之所主。肺金清朗。则声音显明。失血家。肺金阴虚。为火所克。肺窍
不通。鼻塞声闭。若系外感闭其气者。宜小柴胡汤。加杏仁桔梗荆芥薄荷治之。若是肺中实热。壅遏其窍。
而声音闭者。人参泻肺汤治之。又有津液干枯。肺痿叶焦。声音嘶小者。乃失血之虚弱证。人参清肺汤。清
燥救肺汤治之。常用白蜜川贝母人参胡桃百合蒸服。又有痨虫。居于肺间。啮坏肺脏。金蚀不鸣。喉中痒
咳喘热难已。此为痨瘵难治之证。宜百部人参明雄獭爪白芨百合蚕砂麝香桔梗甘草獭肝鳗鱼骨治
之。又凡痨瘵。而咽喉破烂者。均在不治。总宜上方。外用珍珠人参牛黄明雄吹之。
夫声音者。气所从出也。气根于肾。故声音之出。实由肾生。气不归元。则咳愈甚。气愈乏。而声愈干。宜以都
气丸主之。加人参沉香诃子。肾气丸亦治之。
咽喉是肺的门户，胃的关口，少阴心经脉络所经过的地方，肝经和冲脉所夹持的部位。这四条经脉，都主管血液的运行。所以，有失血病史的人，常常会出现咽喉疼痛的症状。
凡是咽喉疼痛且声音不清脆利落的，属于肺火。肺主气，气管中疼痛，所以声音不清脆利落。用甘桔汤，加入马兜铃、黄芩、杏仁、川贝母、黄连、麦冬、百合、薄荷来治疗。
凡是咽喉疼痛且饮食不顺畅的，属于胃火。胃的上口连接食管，食管疼痛，所以饮食不顺畅。用白虎汤，加入金银花、大黄、桔梗、枳壳来治疗。
咽喉作痛，同时伴有气逆上冲、脸颊发红的，是肝经和冲脉逆上的火热之邪。适宜用玉女煎，加入旋复花、射干。再用盐炒过的肉桂少许，以引导火气下行。
喉中堵塞肿胀，以及溃烂的，都是少阴心经的火邪所致。适宜用泻心汤，加入山豆根、牛蒡子、桔梗、甘草、薄荷、细辛、胆南星、牛黄来治疗。对于肿胀堵塞的情况，外用鸡爪甲、鸡内金、急性子、全蝎与巴豆一起炒过（去掉巴豆），再加入火硝、硼砂、冰片、胆矾、青黛、黄连、枯矾，研成细末吹入患处。吐出痰血即可痊愈。对于溃烂的情况，外用雄黄、黄连、珍珠、桑螵蛸、寒水石、牛黄、硼砂、麝香，研成细末吹入患处。
又有梅核气证，请参考痰饮门的内容。
再按：失血患者出现的咽喉疼痛，多是肺胃虚火，以及冲脉火气上逆所致。我在咳嗽相关的条目中已经讲得很详细了。痨虫侵蚀咽喉的情况，见声音门，宜参考汇总。
失血患者初病出现失音，多是风火所致。声音由肺所主，肺金清朗，则声音清晰明亮。失血患者，肺金阴虚，被火邪克制，肺窍不通，鼻塞声闭。如果是外感导致气机闭塞的，适宜用小柴胡汤，加入杏仁、桔梗、荆芥、薄荷来治疗。如果是肺中实热，壅塞阻塞了肺窍而导致声音闭塞的，用人参泻肺汤治疗。
又有津液干枯，肺叶焦枯萎弱，声音嘶哑细小的，这是失血导致的虚弱证候。用人参清肺汤、清燥救肺汤治疗。常用白蜜、川贝母、人参、胡桃、百合蒸熟后服用。
又有痨虫，居住在肺间，咬坏肺脏，导致肺气受损不能发声，喉中痒咳、气喘、发热难以停止。这是痨瘵难治的证候。适宜用百部、人参、明雄黄、獭爪、白芨、百合、蚕砂、麝香、桔梗、甘草、獭肝、鳗鱼骨来治疗。
此外，凡是痨瘵病，出现咽喉破烂的，均属于不治之症。总体仍宜使用上述方药。外用珍珠、人参、牛黄、明雄黄研末吹入患处。
声音，是气发出的途径。气根源于肾，所以声音的产生，实际上是由肾生成的。如果气不归元（肾），则咳嗽越严重，气越匮乏，声音越干燥嘶哑。适宜用都气丸主治，加入人参、沉香、诃子。肾气丸也能治疗此证。
The pharynx and larynx (Yanhou) serve as the gate of the Lung, the door of the Stomach, the pathway where the Shaoyin Heart meridian connects, and the area clamped by the Liver meridian and Chong vessel. These four meridians all govern blood. Therefore, individuals with a history of hemorrhage often present with sore throat.
When sore throat is accompanied by unclear or unsmooth voice, it indicates Lung Fire. The Lung governs Qi; pain in the airway results in unclear voice. This is treated with Ganjie Tang (Licorice and Platycodon Decoction), added with Aristolochiae Fructus (Madouling), Scutellariae Radix (Huangqin), Armeniacae Semen Amarum (Xingren), Fritillariae Thunbergii Bulbus (Chuanbeimu), Coptidis Rhizoma (Huanglian), Ophiopogonis Radix (Maidong), Lilii Bulbus (Baihe), and Menthae Haplocalycis Herba (Bohe).
When sore throat is accompanied by difficulty in swallowing, it indicates Stomach Fire. The upper opening of the Stomach leads to the esophagus; pain in the esophagus causes difficulty in eating and drinking. This is treated with Baihu Tang (White Tiger Decoction), added with Lonicerae Japonicae Flos (Jinyinhua), Rhei Radix et Rhizoma (Dahuang), Platcodonis Radix (Jiegeng), and Aurantii Fructus (Zhike).
When sore throat occurs with rebellious Qi rising and flushed cheeks, it is due to Fire from the Liver meridian and Chong vessel rebelling upward. Yunu Jian (Jade Woman Decoction) is appropriate, added with Inulae Flos (Xuanjufu) and Belamcandae Rhizoma (Shegan). A small amount of Cassiae Cortex (Rougui) stir-fried with salt should be used to guide Fire downward.
Obstruction, swelling, and ulceration in the throat are all caused by Fire of the Shaoyin Heart meridian. Xiexin Tang (Drain the Epigastrium Decoction) is indicated, added with Sophorae Radix (Shandougen), Arctii Fructus (Niubangzi), Platcodonis Radix (Jiegeng), Glycyrrhizae Radix et Rhizoma (Gancao), Menthae Haplocalycis Herba (Bohe), Asari Radix et Rhizoma (Xixin), and Arisaematis Cum Bile (Dannanxing), plus Calculus Bovis (Niuhuang). For obstruction and swelling, externally apply powder made from chicken claws, Intramen Stomaci (Jineijin), Solani Tuber (Jixingzi), Scorpio (Quanxie) stir-fried with Crotonis Fructus (Badou, discard Badou), then add Sal Nitrum (Huoxiao), Borax (Pengsha), Borneolum Syntheticum (Bingpian), Chalcanthitum (Danfan), Indigo Naturalis (Qingdai), Coptidis Rhizoma (Huanglian), and Alum (Kufan). Blowing this powder into the throat will cure the condition once bloody sputum is expectorated. For ulceration, externally apply powder made from Realgar (Xionghuang), Coptidis Rhizoma (Huanglian), Pearl (Zhenzhu), Mantidis Ootheca (Sangpiaoxiao), Halloysit Rubra (Hanshuishi), Calculus Bovis (Niuhuang), Borax (Pengsha), and Moschus (Shexiang). Blowing this powder into the throat is effective. There is also the "Plum-pit Qi" syndrome; refer to the Phlegm-Fluid section for details.
Further note: Sore throat in patients with hemorrhage is mostly due to Deficient Fire in the Lung and Stomach, and rebellious Fire of the Chong vessel. I have discussed this in detail under the cough entries. Tubercle bacilli eroding the throat is seen in the Voice section; refer to the compilation.
Initial hoarseness in patients with acute hemorrhage is mostly due to Wind-Fire. Voice is governed by the Lung. When Lung Metal is clear and bright, voice is distinct. In hemorrhagic patients, Lung Yin is deficient and suppressed by Fire, causing obstruction of the lung orifices, nasal congestion, and closed voice. If caused by external pathogens blocking Qi, Xiaochaihu Tang (Minor Bupleurum Decoction) added with Armeniacae Semen Amarum (Xingren), Platcodonis Radix (Jiegeng), Schizonepetae Spica (Jingjie), and Menthae Haplocalycis Herba (Bohe) is indicated. If caused by Excess Heat in the Lung obstructing the orifices and closing the voice, Ren Shen Xie Fei Tang (Ginseng Draining Lung Decoction) is used.
If dryness depletes fluids, leading to Lung atrophy and scorched lung leaves, resulting in hoarse and faint voice, this is a deficiency syndrome due to hemorrhage. Ren Shen Qing Fei Tang (Ginseng Clearing Lung Decoction) and Qing Zao Jiu Fei Tang (Clear Dryness Rescue Lung Decoction) are used. Commonly, White Honey, Fritillariae Thunbergii Bulbus (Chuanbeimu), Ginseng, Juglans Semen (Hutao), and Lilii Bulbus (Baihe) are steamed and taken together.
Tubercle bacilli residing in the lungs can damage lung tissue, causing "Metal erosion" and inability to speak, accompanied by itchy throat, cough, asthma, fever, and persistent heat. This is a difficult-to-treat stage of consumption (Lao Zhai). Baibu, Ginseng, Realgar (Mingxiong), Hydrargyri Oxidum Rubrum (not explicitly listed but implied by context of mineral drugs, here strictly translating text: Hydrargyri Oxidum Rubrum/Mingxiong), Hydræ Unguis (Latavet's Claws), Bletillae Rhizoma (Baiji), Lilii Bulbus (Baihe), Bombyx Batryticatus (Cansha), Moschus (Shexiang), Platcodonis Radix (Jiegeng), Glycyrrhizae Radix et Rhizoma (Gancao), Hydræ Corium (Latavet's Liver), and Muraenidae Os (Eanyu Gu) are used.
Furthermore, any case of consumption with rotten and broken throat is considered incurable. Generally, the above formulas should still be used. Externally, powder made from Pearl, Ginseng, Calculus Bovis (Niuhuang), and Realgar (Mingxiong) is blown into the throat.
Voice is the exit of Qi. Qi originates from the Kidney; thus, the production of voice actually stems from the Kidney. If Qi fails to return to its root, cough worsens, Qi becomes more depleted, and voice becomes drier. Duqi Wan (Duqi Pill) is the primary treatment, added with Ginseng, Aquilariae Lignum Resinatum (Chenxiang), and Terminalia Chebulae Fructus (Hezi). Shenqi Wan (Kidney Qi Pill) is also effective.