典藏书目

When treating, physicians must examine the etiology of the disease and consider the seasonal climate. It is essential to induce profuse expectoration of phlegm. The method for removing phlegm involves first preparing warm water for the patient to rinse their mouth. If using acupuncture pricking or insufflation of powder, the patient should bow their head to allow saliva and phlegm to flow out. Once the discharge subsides, frequent rinsing with warm water should continue.

For patients who are physically weak or have severe conditions, assistants must support them properly, or silver needles may be used to prick the affected area. For Wind-Heat patterns, dispersing methods are used; for Fire patterns, clearing methods are used; for severe cases, purgative methods are applied; for Yin-Cold patterns, warming methods are employed. If cold-natured medicines are abruptly used at the onset, upper Heat will not be resolved, while Middle Jiao Cold will arise. Pathogenic toxins will then enter through the deficiency, causing unceasing panting and death that cannot be saved. Generally, seven-tenths of cases are Wind-Heat, three-tenths are Fire, and only one or two-tenths are Cold.

If a patient presents with coma, excessive phlegm, rapid breathing, inability to eat, persistent fever, locked jaw, and a faint pulse, the condition is definitely severe.

If the patient is unconscious, with phlegm-Qi attacking upward, loud roaring sounds, choking on food, open eyes, collapse of the Tianzhu (neck muscles), blackened scorched complexion, nostrils resembling soot, irregular flaring of alae nasi, protruding eyeballs, sweating like rain, dry and painful throat, hoarseness without phlegm, numbness of limbs extending to the knees, panting, hiccups, and a thread-like pulse, these are signs of impending death.

In clinical practice, life and death can change in an instant. Physicians must not harbor hopes of miracle cures or intentionally delay treatment. Patients must not become negligent, leading to irreversible deterioration. As the ancients said: "Examining the throat requires speed like a galloping horse, waiting not a moment," which refers to this urgency.

After medication, if phlegm decreases and swelling recedes, recovery occurs. If ulceration has already occurred and the patient can eat after two days of treatment, success is assured within three days.

For Pharyngeal Herpes (Hou Xuan), after medication, the affected area should turn red, indicating sensation of pain and itching, and presence of moist fluids signifies treatability. When using knives or needles, one must pull towards oneself, never pushing into the patient's mouth.

There are four locations in the throat where incision with a knife is contraindicated: Longhua (throat transformation point), Yamen (GV6), the depressions on both sides of the Houguan (throat gate), and the tendons under the tongue. If a knife must be used, the blade tip should be dipped in Si Medicine, Shen Medicine, or Hai Medicine to prevent pain.

Clinically, first diagnose the pulse depth and strength, then assess the depth of the lesion. If the pulse is absent, abnormal, or dead, medication is unnecessary because the toxin has entered the abdomen and cannot be reversed by medicinal force.

Throat-Winding Wind (Chan Hou Feng) and Yin-Deficiency Pharyngeal Herpes (Yin Xu Hou Xuan) are the most dangerous and difficult to treat, critically severe and hard to recognize. Throat-Winding Wind is formless internally and externally, with lesions inside the gate, showing red filaments above. If it has not reached the Heart, medication can work; once it reaches the Heart, it is incurable. Early treatment within one to half a day ensures safety. Yin-Deficiency Pharyngeal Herpes resembles dried shrimp skin with blue-white spots of varying sizes, like summer melon seeds. Although critical, it progresses slowly, potentially killing the patient in six months to a year, or even half a month. If treated within a few days of onset, nine out of ten cases can be cured. Reddening of the swollen throat indicates pus formation, which may rupture spontaneously without need for puncture.

For throat conditions, Rice Water (Nuomi Gan Shui), Ganjie Decoction (Licorice and Platycodon Decoction), or Mint Decoction should all be administered in a mild temperature. Roasted Hawthorn Fruit (Shanzha) ground into fine powder, added to decoctions, is a key herb for reducing swelling and detoxifying the throat (The above fourteen points are from Mr. Wu).

Medication can be strong for robust patients but should be gentle for the weak. Acupuncture must avoid injuring the uvula, which is crucial.

Nighttime examinations require extra care; use Liuwei Decoction (Six-Ingredient Decoction), and re-evaluate at dawn for adjustments.

Regarding acupuncture of the blue veins on both sides under the tongue: bright red blood indicates vitality, dark blood indicates death. Medication should consist of agents that clear the Diaphragm, resolve phlegm, and detoxify (The above four points are from Mr. Zhang).