客热咽痛者,凡风邪客喉间,气郁成热,故为痛也。《统旨》云∶有初得病发热而咽喉
自痛
者,此得之感冒后,顿浓衣被,或用辛热即卧,遂成上壅,或有壅热而欲取寒凉,为外邪所
袭者,俱宜甘桔汤,甘以除热,辛以散结也。
喉痹咽痛,一乡皆相似者,属于天行运气之邪,勿用酸寒之药,点之下之,郁其邪于内
,不得出也。
清咽利膈散
薄荷 防风 元参 甘草(各五分) 桔梗 连翘(各一钱) 大黄(酒炒) 芒硝 牛蒡
荆芥(各七分) 片芩(酒炒) 栀子(各五分)
上作一帖,水煎,温服食后。(《医鉴》)
甘桔汤
甘草(二两,炒) 桔梗(一两,米泔浸)
每服五钱,水一盅半,煎服。 钱氏加阿胶;海藏加牛蒡子、竹茹;太无加荆芥、生姜
。
丹溪云∶咽痛必用荆芥,阴虚火炎,必用元参。
《必用方》加荆芥、薄荷、元参、防风、黄芩各一两。
《圣济总录》云∶一切咽喉痛,紫雪为要药。
绛雪散 治咽喉热痛肿塞。
寒水石(半两, 红) 硼砂 牙硝 朱砂(各研一钱) 龙脑(半钱)
上为细末,每一字,掺入口咽津。
《千金》乌扇散
生乌扇(十两) 升麻(三两) 羚羊角 通草 芍药(各二两) 蔷薇根(切,一升) 生地
(切,五升) 猪脂(二斤) 生艾叶(六铢)
上 咀,绵裹,苦酒一升,淹浸一宿,内猪脂中,微火煎取苦酒尽,膏不鸣为度。去滓
,薄绵裹膏,似大杏仁大,内喉中,细细吞之。
碧雪 治积热,口舌生疮,心烦喉闭。
芒硝 青黛 寒水石 石膏( ,各飞研) 朴硝 硝石 马牙硝(各等分)
甘草煎汤二升,入诸药再煎,用柳枝不住搅令溶,方入青黛和匀,倾入砂盆内,冷即成
霜,研末,每用少许,以津含化,如喉闭,以竹管吹入喉中。
牛蒡子汤
牛蒡子(二钱) 元参 犀角 升麻 黄芩 木通 桔梗 甘草(各一钱)
水煎食后服,此辛凉解散之剂。
《圣济》射干丸方
射干(一两) 香豉(一合) 杏仁(去皮尖,炒) 芍药 犀角(各二两) 升麻(一两) 炙
草(半两)
蜜丸小弹子大,每一丸含化咽津,日三五服。
元参散
元参(一两) 升麻 射干 大黄(各五钱,酒浸) 甘草(二钱半,炙)
每服五钱,水煎,时时含咽。
客热咽痛,是指风邪侵袭喉间,导致气机郁滞而化热,从而引起疼痛。《统旨》记载:有的患者在初患病时发热且咽喉自然疼痛,这是因感冒后突然穿着过厚、盖被过多,或服用辛热药物后立即躺卧,致使热气上壅;也有因体内有壅热想要用寒凉药缓解,却反被外邪侵袭的情况。这些情况都适宜使用甘桔汤,利用甘草的甘味来清除热邪,桔梗的辛味来散结消肿。
如果喉痹咽痛在一个地区内普遍相似发作,这属于时行运气之邪(传染性疫病之气)所致,不可使用酸寒性质的药物,以免收敛闭塞,将邪气郁闭在体内,使其无法排出。
清咽利膈散
配方:薄荷、防风、元参、甘草(各五分),桔梗、连翘(各一钱),大黄(酒炒)、芒硝、牛蒡子、荆芥(各七分),黄芩(酒炒)、栀子(各五分)。
制法与用法:以上药材为一帖的量,加水煎煮,饭后温服。(出自《医鉴》)
甘桔汤
配方:甘草(二两,炒制),桔梗(一两,用米泔水浸泡)。
用法:每次服用五钱,加水一盅半,煎煮后服用。钱乙在此方基础上加阿胶;张元素(海藏)加牛蒡子、竹茹;太无先生加荆芥、生姜。
朱丹溪说:治疗咽痛必须用荆芥;若是阴虚火炎引起的,必须用元参。
《必用方》中的甘桔汤加荆芥、薄荷、元参、防风、黄芩各一两。
《圣济总录》记载:所有咽喉疼痛,紫雪是重要的药物。
绛雪散 治疗咽喉热痛肿胀堵塞。
配方:寒水石(半两,煅红),硼砂、牙硝、朱砂(各研细一钱),龙脑(半钱)。
制法与用法:以上药材研成细末,每次取“一字”量(约0.5-1克),掺入口中,随唾液吞咽。
《千金方》乌扇散
配方:生乌扇(十两),升麻(三两),羚羊角、通草、芍药(各二两),蔷薇根(切碎,一升),生地(切碎,五升),猪脂(二斤),生艾叶(六铢)。
制法与用法:将药材切碎,用绵布包裹,放入苦酒(醋)一升中浸泡一夜,然后加入猪脂中,用微火煎煮,直到苦酒完全蒸发,膏体不再发出声响为止。滤去药渣,将膏体裹在薄绵布中,做成如大杏仁大小的丸剂,放入喉中,细细吞咽。
碧雪 治疗积热,口舌生疮,心烦喉闭。
配方:芒硝、青黛、寒水石、石膏(煅制,各飞研极细),朴硝、硝石、马牙硝(各等分)。
制法与用法:用甘草煎汤二升,加入上述药物再煎,用柳枝不断搅拌直至溶解,然后加入青黛混合均匀,倒入砂盆中,冷却后结成霜状,研成粉末。每次取少许,含于口中用唾液化开;如果是喉闭症,可用竹管吹入喉中。
牛蒡子汤
配方:牛蒡子(二钱),元参、犀角、升麻、黄芩、木通、桔梗、甘草(各一钱)。
用法:加水煎煮,饭后服用,此方为辛凉解散之剂。
《圣济总录》射干丸方
配方:射干(一两),香豉(一合),杏仁(去皮尖,炒制),芍药、犀角(各二两),升麻(一两),炙甘草(半两)。
制法与用法:炼蜜为丸,大小如小弹珠。每次含化一丸,随唾液吞咽,每日三至五次。
元参散
配方:元参(一两),升麻、射干、大黄(各五钱,酒浸),甘草(二钱半,炙制)。
用法:每次服用五钱,加水煎煮,时时含咽。
Patient heat causing throat pain refers to wind pathogenic factors invading the throat, leading to qi stagnation transforming into heat, thereby causing pain. *Tongzhi* states: In some cases, patients experience fever and spontaneous throat pain upon initial onset of illness. This results from wearing thick clothing or heavy quilts immediately after a cold, or taking acrid-warm medicines and then lying down, causing heat to congest upwards. Alternatively, it may occur when internal heat congestion prompts the desire for cold-cooling remedies, but external pathogenic factors invade in response. All such conditions are suitable for Ganjie Tang (Licorice and Platycodon Decoction), utilizing the sweet nature of Licorice to clear heat and the acrid nature of Platycodon to dissipate nodules.
If pharyngeal obstruction and throat pain manifest similarly across a region, this belongs to epidemic qi pathogens (contagious disease qi). Acid-cold medicines should not be used, as they would astringe and close, trapping the pathogen internally and preventing its expulsion.
Qingyan Lige San (Clear Throat and Benefit Diaphragm Powder)
Ingredients: Bohe (Menthae Haplocalycis Herba), Fangfeng (Saposhnikoviae Radix), Xuanshen (Scrophulariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (each 5 fen); Jiegeng (Platycodi Radix), Lianqiao (Forsythiae Fructus) (each 1 qian); Dahuang (Rhei Radix et Rhizoma, stir-fried with wine), Mangxiao (Natrii Sulfas), Niubangzi (Arctii Fructus), Jingjie (Schizonepetae Herba) (each 7 fen); Huangqin (Scutellariae Radix, stir-fried with wine), Zhizi (Gardeniae Fructus) (each 5 fen).
Preparation and Administration: These ingredients constitute one dose. Decoct in water and take warm after meals. (From *Yijian*)
Ganjie Tang (Licorice and Platycodon Decoction)
Ingredients: Gancao (Glycyrrhizae Radix et Rhizoma) (2 liang, stir-fried); Jiegeng (Platycodi Radix) (1 liang, soaked in rice washing water).
Administration: Take 5 qian per dose, decoct in 1.5 zhong of water. Qian Yi added Ejiao (Colla Corii Asini); Zhang Yuansu (Haicang) added Niubangzi (Arctii Fructus) and Zhuru (Bambusae Caulis in Taeniam); Taiwu added Jingjie (Schizonepetae Herba) and Shengjiang (Zingiberis Rhizoma Recens).
Zhu Danxi stated: Jingjie (Schizonepetae Herba) must be used for throat pain; if caused by yin deficiency with flaming fire, Xuanshen (Scrophulariae Radix) must be used.
*Biyong Fang* adds Jingjie (Schizonepetae Herba), Bohe (Menthae Haplocalycis Herba), Xuanshen (Scrophulariae Radix), Fangfeng (Saposhnikoviae Radix), and Huangqin (Scutellariae Radix), each 1 liang.
*Shengji Zonglu* states: For all throat pains, Zi Xue (Purple Snow) is an essential medicine.
Jiangxue San (Crimson Snow Powder) treats hot pain and swelling obstruction of the throat.
Ingredients: Hanshuishi (Aegiri Lithospermum, calcined until red); Pengsha (Borax), Yaxiao (Natrii Sulfas), Zhusha (Cinnabaris) (each finely ground to 1 qian); Longnao (Borneolum Syntheticum) (0.5 qian).
Preparation and Administration: Grind all ingredients into fine powder. Apply "yi zi" (approx. 0.5-1 g) into the mouth and swallow with saliva.
*Qianjin* Wushan San (Blackberry Leaf Powder)
Ingredients: Sheng Wushan (Pruni Mume Folium, fresh) (10 liang); Shengma ( Cimicifugae Rhizoma) (3 liang); Lingyangjiao (Saigae Tataricae Cornu), Tongcao (Tetrapanacis Medulla), Shaoyao (Paeoniae Radix Alba) (each 2 liang); Qiangweigen (Rosae Rugosae Radix) (cut, 1 sheng); Shengdi (Rehmanniae Radix) (cut, 5 sheng); Zhuzhi (Suis Adeps) (2 jin); Sheng Aiye (Artemisiae Argyi Folium, fresh) (6 zhu).
Preparation and Administration: Cut the herbs, wrap in silk, soak in 1 sheng of Ku Jiu (vinegar) overnight. Add to Zhuzhi (Suis Adeps) and simmer over low heat until the vinegar is fully evaporated and the ointment no longer bubbles. Strain the dregs, wrap the ointment in thin silk, form into pills the size of large apricot kernels, place in the throat, and swallow slowly.
Bixue (Green Snow) treats accumulated heat, sores on the mouth and tongue, restlessness, and throat closure.
Ingredients: Mangxiao (Natrii Sulfas), Qingdai (Indigo Naturalis), Hanshuishi (Aegiri Lithospermum), Shigao (Gypsum Fibrosum, calcined and levigated); Puxiao (Natrii Sulfas), Xiaoshi (Natrii Nitratis Crystalloides), Mayaxiao (Natrii Sulfatis Crystallizatus) (each equal parts).
Preparation and Administration: Decoct Gancao (Glycyrrhizae Radix et Rhizoma) in 2 sheng of water, add the other medicines and decoct again. Stir constantly with willow branches until dissolved. Add Qingdai (Indigo Naturalis) and mix evenly. Pour into a clay basin; upon cooling, it forms frost-like crystals. Grind into powder. Take a small amount, hold in the mouth, and dissolve with saliva. If throat closure occurs, blow into the throat using a bamboo tube.
Niubangzi Tang (Arctii Fructus Decoction)
Ingredients: Niubangzi (Arctii Fructus) (2 qian); Xuanshen (Scrophulariae Radix), Xijiao (Rhinocerotis Cornu), Shengma (Cimicifugae Rhizoma), Huangqin (Scutellariae Radix), Mutong (Akebiae Caulis), Jiegeng (Platycodi Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (each 1 qian).
Administration: Decoct in water and take after meals. This is a formula for acrid-cool dispersal and resolution.
*Shengji* Shegan Wan (Belamcanda Pill Formula)
Ingredients: Shegan (Belamcandae Rhizoma) (1 liang); Xiangchi (Sojae Semen Preparatum) (1 he); Xingren (Prunus Armeniacae Semen, skin and tip removed, stir-fried); Shaoyao (Paeoniae Radix Alba), Xijiao (Rhinocerotis Cornu) (each 2 liang); Shengma (Cimicifugae Rhizoma) (1 liang); Zhi Cao (Glycyrrhizae Radix et Rhizoma, honey-fried) (0.5 liang).
Preparation and Administration: Make pills with honey, size of small marbles. Hold one pill in the mouth, dissolve, and swallow with saliva. Take 3-5 times daily.
Xuanshen San (Scrophularia Powder)
Ingredients: Xuanshen (Scrophulariae Radix) (1 liang); Shengma (Cimicifugae Rhizoma), Shegan (Belamcandae Rhizoma), Dahuang (Rhei Radix et Rhizoma) (each 5 qian, soaked in wine); Gancao (Glycyrrhizae Radix et Rhizoma) (2.5 qian, honey-fried).
Administration: Take 5 qian per dose, decoct in water, hold in the mouth and swallow frequently.