喉症用药,必须认症的确,按脉之虚实,火之盛衰,须要活泼,不可按图索骥,又不可
胶柱豉瑟,乃为善治。若症有寒热头疼,六脉弦紧,始发必须表散,须兼清火、开结、涤痰、解
毒
山豆根,此清心胃肾之火;芦根亦清胃火三焦火;黑山栀,肝郁火;青黛,开郁结∶射干、
川贝,涤痰;淡竹油、前胡、杏仁、橘红、大力子、解毒。大贝母、甘草、金银花,宽痈,
天花粉、赤芍。小便赤涩,木通、通草、车前子、鲜荷梗;胸膈饱闷,枳壳;大便闭结,六
脉有力,舌苔黄,壮火,大黄、鲜生地、元明粉;肾经虚火,可用知母、黄柏,投之无不验也
。如舌症,舌乃心之苗,宜用清心解毒,前法可用,舌症之毒,可用伏龙肝、灯心为引。牙
症,乃脾胃之部,清用石膏、生地、知母、黄柏、黄芩、黄连,或炒黑升麻为佐,解毒用人
中黄、人中白、金汁,若穿牙疔与牙咬痈,用紫花地丁草,如素虚与病后,虚火上炎,可用
滋阴降火,佐之以补,宜大生地、大熟地、枸杞、玉竹,洋参、人参、西党参、北沙参、天
麦冬、女贞子、黄香梨、甘蔗、首乌,虚热,地骨皮、丹皮、丹参、鲜沙参、鲜首乌、鲜石
斛、川石斛之类是也。略具大纲,以备选用。【谔按∶此例可遵用者固多,不适用者亦有,
在学人临证时权衡,不可刻板方以治活病,斯得余重编之心矣。】
治疗喉部疾病用药,必须准确辨识病症,根据脉象的虚实、火邪的盛衰来灵活施治,不可机械地按图索骥,也不可拘泥成法不知变通,这才是善于治疗。如果症状表现为寒热交替、头痛,六脉弦紧,初起时必须采用解表发散的方法,并兼用清火、开郁结、涤除痰浊、解毒的药物。
山豆根,用于清除心、胃、肾之火;芦根也能清胃火和三焦之火;黑山栀(栀子),用于清肝郁之火;青黛,用于开郁结;射干、川贝母,用于涤痰;淡竹油、前胡、杏仁、橘红、牛蒡子,用于解毒。大贝母、甘草、金银花,用于宽胸散痈;天花粉、赤芍。若小便赤涩,可用木通、通草、车前子、鲜荷梗;若胸膈饱闷,可用枳壳;若大便闭结,六脉有力,舌苔黄,属壮火(实火),可用大黄、鲜生地、元明粉;若是肾经虚火,可用知母、黄柏,投药无不应验。
如果是舌症,舌为心之苗窍,宜用清心解毒之法,前述方法可用,治疗舌症之毒,可用伏龙肝、灯心草作为引经药。牙症,属于脾胃的部位,清热可用石膏、生地、知母、黄柏、黄芩、黄连,或炒黑的升麻作为佐使药,解毒可用人中黄、人中白、金汁。如果是穿牙疔与牙咬痈,可用紫花地丁草。如果是素体虚弱或病后,虚火上炎,可用滋阴降火法,佐以补益,宜用大生地、大熟地、枸杞、玉竹、西洋参、人参、西党参、北沙参、天冬、麦冬、女贞子、黄香梨、甘蔗、首乌。对于虚热,可用地骨皮、丹皮、丹参、鲜沙参、鲜首乌、鲜石斛、川石斛之类。以上略具大纲,以备选用。【谔按:此例可供遵循使用的固然很多,不适用的也有,在于学习的人在临证时权衡利弊,不可刻板地用方去治疗活生生的病人,这才符合我重新编纂此书的心意。】
In the treatment of throat disorders, medication must be prescribed after accurately identifying the syndrome. One must assess the deficiency or excess in the pulse and the severity of fire pathogenic factors, applying flexibility in treatment. One should not mechanically follow a fixed pattern (like following a map to find horses), nor should one be rigidly bound by conventions without adaptation; this constitutes skillful treatment. If symptoms manifest as alternating chills and fever, headache, with wiry and tight pulses in all six positions, initial treatment must employ exterior-releasing methods, combined with clearing fire, resolving stagnation, eliminating phlegm, and detoxifying.
Shandougen (Sophorae Tonkinensis Radix) clears fire from the Heart, Stomach, and Kidney; Lugen (Phragmitis Rhizoma) also clears Stomach and Sanjiao fire; Heishanzhi (Gardeniae Fructus carbonized) clears Liver depression-fire; Qingdai (Indigo Naturalis) resolves stagnation; Shegan (Belamcandae Rhizoma) and Chuanbeimu (Fritillariae Cirrhosae Bulbus) eliminate phlegm; Danzhuyou (Bambusa Textilis Pith juice), Qianhu (Peucedani Radix), Xingren (Armeniacae Semen Amarum), Juhong (Citri Reticulatae Pericarpium Rubrum), and Niu Bang Zi (Arctii Fructus) detoxify. Dabeimu (Fritillariae Thunbergii Bulbus), Gancao (Glycyrrhizae Radix et Rhizoma), and Yinhua (Lonicerae Japonicae Flos) broaden the chest and dissipate abscesses; Tianhuafen (Trichosanthis Radix) and Chishao (Paeoniae Radix Rubra). For red and scanty urination, Mutong (Akebiae Caulis), Tongcao (Tetrapanacis Medulla), Cheqianzi (Plantaginis Semen), and Xian Hegeng (Nelumbinis Petiolus fresh) are used; for fullness and oppression in the chest and diaphragm, Zhike (Aurantii Fructus Immaturus) is used; for constipation with strong pulses in all six positions, yellow tongue coating, and vigorous fire (excess heat), Dahuang (Rhei Radix et Rhizoma), Xian Shengdi (Rehmanniae Radix Preparata fresh), and Yuanmingfen (Natrii Sulfas) are used; for deficient fire of the Kidney meridian, Zhimu (Anemarrhenae Rhizoma) and Huangbai (Phellodendri Cortex) may be employed, with no failure in efficacy.
Regarding tongue disorders, since the tongue is the sprout of the Heart, clearing Heart fire and detoxification are appropriate, utilizing the aforementioned methods. For toxicity in tongue disorders, Fulonggan (Dolomiatis ustus) and Dengxincao (Junci Medulla) can serve as guiding herbs. Regarding dental disorders, which belong to the Spleen and Stomach regions, for clearing heat, Shigao (Gypsum Fibrosum), Shengdi (Rehmanniae Radix Preparata), Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex), Huangqin (Scutellariae Radix), and Huanglian (Coptidis Rhizoma) are used, or Chao Heishengma (Bupleuri Radix carbonized black) as an assistant herb; for detoxification, Renzhonghuang (Calcinatus Hominis Excrementum), Renzhongbai (Calcinatus Hominis Urinae Sedimentum), and Jinzhi (Hominis Stomachus purgatum) are used. For penetrating gum carbuncles and molar biting abscesses, Zihua Didingcao (Violae Herba) is used. For those with constitutive deficiency or post-illness states where deficient fire flares upward, nourishing Yin and descending fire methods should be employed, assisted by tonification. Suitable herbs include Dashengdi (Rehmanniae Radix Preparata), Dashudi (Rehmanniae Radix Preparata), Gouqi (Lycii Fructus), Yuzhu (Polygonati Odorati Rhizoma), Yangshen (Panacis Quinquefolii Radix), Renshen (Ginseng Radix et Rhizoma), Xi Dangshen (Codonopsis Radix western variety), Bei Shashen (Adenophorae Radix), Taidong (Asparagi Radix), Maidong (Ophiopogonis Radix), Nvzhenzi (Ligustri Lucidi Fructus), Huangxiangli (Pyrus bretschneideri fruit), Zhugan (Sacchari Sinarum), and Shouwu (Polygoni Multiflori Radix). For deficient heat, Digupi (Lycii Cortex), Danpi (Moutan Cortex), Danshen (Salviae Miltiorrhizae Radix et Rhizoma), Xian Shashen (Adenophorae Radix fresh), Xian Shouwu (Polygoni Multiflori Radix fresh), Xian Shihu (Dendrobii Caulis fresh), and Chuan Shihu (Dendrobii Caulis) are examples. This outlines the general principles for selection. [Editor's Note: While many of these examples are applicable, others are not. It is up to the practitioner to weigh them during clinical practice. One must not rigidly apply formulas to treat dynamic diseases; this aligns with my intention in re-compiling this book.]