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The pharynx (Yan) and larynx (Hou), the epiglottis (Huiyan) and tongue (She), these four structures share a common gateway but have distinct functions. The larynx is for receiving qi, thus its qi connects with Heaven; the pharynx is for swallowing food, thus its qi connects with Earth. The epiglottis, situated above and below the larynx, governs opening and closing: when eating, it inhales and covers the pharynx; when breathing out, qi rises and exits. Therefore, when the tip of the tongue presses against the upper palate, the epiglottis can close the pharynx. These four structures interact to function; if one is missing, eating and drinking will cease, leading to death! These four are the most critical and urgent points in the gateway for the entry and exit of qi and food. Thus, *Nan Jing* states "Seven Chong Gates." Below the epiglottis is called the Xi Gate (Xi Men). When diseases occur in these areas, they can be summarized in one word. What is this word? Fire. *Nei Jing* says: "When one Yin and one Yang knot, it is called Hou Bi (Laryngeal Obstruction)." Wang Taipu's commentary states: One Yin refers to Shao Yin Jun Huo (Ministerial Fire of Hand Shaoyin), which is the meridian qi of the Heart Master (Pericardium); Shao Yang Xiang Huo (Ministerial Fire of Hand Shaoyang) is the meridian qi of the San Jiao (Triple Burner). Both fires primarily govern the vessels and connect to the larynx. If qi becomes hot, internal knotting occurs; severe knotting leads to swelling; severe swelling leads to obstruction (Bi); severe obstruction leads to death due to blockage!

The Foot Shaoyin Kidney Meridian runs along the throat and flanks the root of the tongue, ascending to flank the pharynx. This understanding is indeed correct. As for the Foot Yangming Stomach Meridian, it descends through the Renying point (ST9) and runs along the throat; the Foot Taiyin Spleen Meridian flanks the pharynx and connects to the root of the tongue; the Hand Taiyang Small Intestine Meridian runs along the pharynx descending through the diaphragm; the Foot Jueyin Liver Meridian runs behind the throat. These meridians all mention the throat and pharynx, except for the Foot Shaoyang Gallbladder Meridian. Why does *Nei Jing* say "One Yin and One Yang [knot], called Hou Bi"? It is likely because students of the Twelve Meridians often neglect Chapter 11 of *Ling Shu*, "Jing Bie" (Divergent Meridians), which details the Zheng (Regular) pathways of the Twelve Meridians. The text states: The Zheng pathway of the Foot Shaoyang Gallbladder Meridian winds around the spleen, enters the pubic region, combines with the Jueyin, and its branch enters the interval between the costal margin and the hypochondrium, running inside the chest, connecting to the Gallbladder, dispersing upward through the Liver, piercing the Heart, ascending to flank the pharynx, emerging at the jawline, dispersing on the face, connecting to the eye system, and combining with the Shaoyang externally. Additionally, the Zheng pathway of the Hand Jueyin Pericardium Meridian branches downward three cun below Yuanye, enters the chest, connects to the San Jiao, emerges running along the throat, emerges behind the ear, and combines with the Shaoyang below the Wangu bone. This indicates that the Qi of the Hand Shaoyang San Jiao combines with the Qi of the Hand Jueyin Pericardium (Shao Yin) and travels through the throat. Examining the Twelve Meridians, only the divergent pathway of the Foot Taiyang Bladder Meridian separates from the nape, while the others converge at the throat. So why does *Nei Jing* specifically attribute Hou Bi to the knotting of one Yin and one Yang? It is because the independent excess of Jun Huo (Ministerial Fire) and Xiang Huo (Ministerial Fire) causes heat to knot in the regular collaterals, resulting in pain and rapid onset.

I maintain that the single word summary is "Fire." Therefore, among the Twelve Meridians, symptoms such as dryness and pain in the yi (pharynx/larynx area), swelling of the pharynx and chin, and stiffness of the tongue root are caused by Jun Huo. Only the rapid onset of Hou Bi is caused by Xiang Huo. Jun Huo is like human fire; Xiang Huo is like dragon fire. Human fire burning wood has a slow momentum; dragon fire burning wood has a fast momentum. In *Nei Jing*'s discussion of Hou Bi, the pharynx and tongue are included within the scope. Because their pathology is both due to fire, they are not distinguished. Later physicians, detailing various manifestations, arbitrarily established eight names: Dan Ru E (Single Tonsillar Swelling), Shuang Ru E (Double Tonsillar Swelling), Dan Bi Hou (Single Closed Throat), Zi She Zhang (Child Tongue Swelling), Mu She Zhang (Wood Tongue Swelling), Chan Hou Feng (Entangling Throat Wind), and Zou Ma Hou Bi (Running Horse Laryngeal Obstruction). When hot qi ascends and knots thinly on both sides of the throat, causing external swelling resembling a shape, it is called Ru E (Tonsil). Single refers to unilateral, double to bilateral. Those slightly smaller than Ru E are named Bi Hou. Heat knotting under the tongue, generating a small additional tongue-like structure, is named Zi She Zhang. Heat knotting in the middle of the tongue, causing the tongue to swell, is named Mu She Zhang. "Mu" implies stiffness and lack of flexibility. Heat knotting in the pharynx, causing neck swelling surrounding the exterior, accompanied by numbness and itching, with significant swelling, is named Chan Hou Feng. Sudden onset and sudden death of Hou Bi is named Zou Ma Hou Bi. Although these eight names are detailed, without attributing them to Fire, the explanation would be far off.

Mild cases can be treated with salty substances to soften hardness, and severe cases with pungent substances to disperse. Current physicians possess medicines for this, such as Bohe (Menthae Haplocalycis Herba), Wutou (Aconiti Radix), Jiangcan (Bombyx Batryticatus), Baifan (Alumen), Puxiao (Natrii Sulfas), and Tonglv (Chalcanthi Crystallizatum). But what use are these for Zou Ma Hou Bi? It causes life or death in the blink of an eye! The method least likely to harm patients is no other than Bianzhen (Bian needle) bloodletting; once blood flows, the disease resolves. The *I Ching* states: "When blood leaves, fear departs," which is precisely the reason. Once, I treated a woman with Mu She Zhang; her tongue filled her mouth, and various medicines failed. I used a small, sharp needle to pierce it five or seven times; after the swelling subsided, it took three days to fully resolve. The amount of blood let was nearly a dou. I also treated a man with Chan Hou Feng swelling, affecting both interior and exterior, where oral medication could not be taken. I administered cooling medicine into his nose, inducing over ten bowel movements, and applied Badu San (Detoxification-Extracting Powder) externally. I heated Yangqishi (Stylobitidis Spinae) until red, mixed it with Fulonggan (Caulis Longii Cineres) in equal parts to make a fine powder, and swept the area with fresh water a hundred times daily. After three days, the heat subsided and the swelling decreased. I once treated a noblewoman with Hou Bi, which was Dragon Fire. Although cooling medicines were used, they must not be taken cold, as Dragon Fire should be driven away by fire. Human fire refers to cooking fire. I had her stand in the scorching sun and ascend a high hall, with attendants carrying a stove upon which the medicine pot was placed, keeping the medicine extremely hot but not boiling, allowing her to sip it frequently throughout the day. After more than a hundred sips, the Dragon Fire dispersed naturally. This method uses heat to administer cold properties, avoiding the rejection caused by heat pathogens. Generally, for treating Hou Bi, using needles to bleed is the supreme strategy. However, people fear needles and seek alternative methods, dying in an instant. For any wound caused by needling, crush a piece of ginger, mix with hot plain water, and sip frequently to promote healing. The *Tong Ren* texts also describe moxibustion, which can be used for mild pain, but for rapid diseases, delay may be fatal. Thus, treating the fire of Hou Bi is like fighting a fire; there is no room for delay. *Nei Jing* states: "For fire stagnation, vent it." Venting refers to sweating. However, how can one induce sweating in the throat and pharynx? Therefore, bleeding is a form of venting/sweating. Future scholars, do not cling to minor prescriptions claiming they do not affect the Zang-Fu organs and are superior to bleeding. If you are lucky with minor illnesses, you may succeed; if unfortunate with major illnesses, you will cause death. Do not leave regrets!