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At the initial stage of throat disorders, if the onset is accompanied by a chill, followed by a cooling of the body, no oral ulceration, no double tongue (a small extra tongue growing beneath the main tongue), or unobstructed urination and defecation, do not mistake it for a heat syndrome. These are all caused by Yang deficiency and cold invasion. The phlegm in this condition should not be completely expectorated, as this phlegm is transformed from the body's essence and spirit, differing from the phlegm associated with lockjaw, tonsillar hypertrophy (swollen tonsils), or tongue diseases, which are due to toxin accumulation. Recovery requires the expulsion of toxins; if this essence-transformed phlegm is forcibly cleared, the spirit will be exhausted, leading to death. Treatment should first involve insufflating medicine into the throat or using a water-rinsing method to facilitate bowel movement before administering herbal decoctions. The first dose should focus on dispersing and harmonizing, while the second dose should switch to warming, tonifying, and nourishing. If after three or four days chills recur, or symptoms such as heart pain, hypochondriac pain, or bone pain appear, it is a fatal condition that cannot be treated.

When the disease manifests with lockjaw, swelling of the throat and tongue, oral ulceration with foul breath, double tongue, or yellow flakes on the tongue, followed by mild chills and fever in the afternoon, and constipation of urine and stool, it should be diagnosed as a heat syndrome. Treat primarily with Shigao Baidu San (Gypsum Toxin-Resolving Powder); this condition is also relatively easy to cure. For gradually developing conditions where chills and fever appear after three or four days, although severe, they are not necessarily fatal. However, if symptoms persist without improvement, yet the jaw is not locked, lips are not swollen, and the patient appears normal, it is incurable. Tongue swelling filling the mouth is incurable. A tongue color resembling grapes or eggplant, or rough like sandpaper, is incurable. If accompanied by double tongue and chills/fever, it may still be treatable.

For double tongue, pressing reveals a snow-white color, which immediately turns purple or red upon release, indicating that the internal Qi and Blood have died. However, if there is foul breath, survival is still possible. The most ominous signs are thirst, rapid breathing, excessive thick phlegm resembling peach gum, indicating imminent death. Generalized neck redness and swelling are also extremely critical. A face red with purple tints, greenish-white, or lacking spiritual vitality is incurable. Inability to speak indicates death; slight ability to speak suggests a chance of survival. A dull complexion with a preference for sitting low is difficult to treat. The "throat flower" within the throat relates to the vital center and concerns life itself. The purple vein under the tongue, known as the lingual frenulum, connects to the Kidney; white swelling here is incurable, and injury leads to immediate death, also concerning life.

Lingual carbuncle (She Yong) presents with red, swollen, enlarged tongue, belonging to excess Fire in the Heart Meridian, often with swelling at the mandibular angle. Insufflate equal parts of blue and yellow powders to the tongue root; decoctions should heavily use Coptis Rhizome (Huanglian), Gardenia Fruit (Shanzhi), and Rhinoceros Horn (Xijiao).

Wooden tongue (Mu She) arises below the tongue root, resembling a white date. If accompanied by cyanotic veins, recovery takes half a month. If initial onset involves no pain or chills/fever but gradual swelling, delayed onset implies greater difficulty in recovery. This is caused by depression. Internal decoctions combined with external application of blue powder plus yellow powder are used; initially mixed, later yellow powder alone. Another variant involves a stiff, immobile swollen tongue, also called wooden tongue, treated similarly. An additional tongue growing under the tongue is named double tongue. Swelling of cheeks may appear externally first; any pus must be lanced with a sharp knife to drain blood, followed by pricking the cyanotic veins on both sides under the tongue. Early treatment is crucial; delay leads to rotting of the tongue root and death.

Tongue fungus (She Jun) belongs to the Heart Meridian, often arising from Qi stagnation. It grows on the tongue like a mushroom or wood ear fungus, appearing reddish-purple.

Purple tongue swelling (Zi She Zhang) belongs to Heart Fire, accompanied by internal irritability and restlessness. Use blue powder insufflation alone, combined internally with Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) for gradual recovery.

Suspension abscess (Xuan Yong) occurs on the hard palate, presenting as purple blisters bean-sized. Puncture with an silver needle to bleed, then apply cooling powder.

Alveolar periostitis (Yacao Feng) begins with persistent toothache, followed by gingival swelling, turning purplish-black or bleeding. Long-term results in rotting and foul odor, difficult to cure quickly.

Dental fistula (Yalou) is the chronic non-healing form of the above, with white pus exuding from gum margins. Extremely difficult to manage. If the upper left incisor falls out, it is incurable. This condition belongs to Stomach Fire and Kidney Deficiency.

Sweeping the gum bed (Sou Yachuang): Initial stage features painful, swollen gums. Prick to bleed, then rub with green salt. Repeated pricking leading to exposed bone is difficult to treat.

Dental carbuncle (Ya Yong), also known as Yaqi Feng, involves swollen, painful gums where toxicity forms sores. Small hard nodules appear on the gum tissue, anywhere up, down, inside, or outside. If blistered, puncture to drain pus and blood for cure. If hardened pus forms rash-like lesions, apply local anesthesia and Jingmo (Beijing Ink), cut according to protocol, and cauterize with a hot iron for self-healing.

Tooth-locking disorder (Ya Yao Zheng) occurs at the end of the teeth near the joint, preventing mouth opening. Severe heat, worse at night, but easily cured and non-fatal.

Dental kan (Ya HT/Zheng) belongs to Stomach Fire, bean-sized, location variable inside or outside.

Dental spouting (Ya Xuan Zheng) involves bleeding from gum margins, relating to Spleen (upper) and Stomach (lower), caused by excess Fire attacking upward from the Yangming Meridian, involving vacillating Stomach Fire. Rotting gums lead to constant leakage of pale blood.

Dental fungus (Ya Jun Zheng) grows on gums, purple-flowered, raised like a mushroom, caused by Blood Heat combined with Qi Stagnation.

Penetrating dental ding (Chuan Ya Ding Zheng): Two days of toothache and chills/fever precede unbearable pain, with a purple patch appearing on the gums.

Penetrating dental toxin (Chuan Ya Du): Same as above; unbroken initially is Ding, broken is Du. Red color is treatable; black is fatal.

Bengsha Gan Koufeng Zheng: Swelling and redness start from the lower gum under the tongue, causing discomfort and heat sensation in the mouth. Gums rot progressively, potentially causing tooth loss.

Lianzhu Gan Koufeng Zheng: Small blisters arise under the tongue, appearing sequentially. Severe cases may have five to nine blisters linked like beads.

Fish Wind (Yu Feng Zheng): A critical illness, named for its resemblance to a fish sucking water. Fatal and incurable.

Running Horse Dental Kan (Zouma Yagan Zheng): In adults, caused by Meichuang (syphilis) toxin attack; in children, due to fetal toxin or residual toxin after smallpox. Gingival rotting into kan kills rapidly. Red spots on the nose bridge like pearls indicate incurability. Color like dried sauce, rotting one fen per day and one cun per two days, hence "running horse" for speed. Teeth fall out until death. Insufflate yellow powder; administer Lushui Xiaogan Yin (Aloe Vera Toxin-Resolving Drink).

Five Incurable Conditions of Dental Kan: 1. Foul breath and turbid saliva; 2. Black rotting and shedding; 3. Tooth loss without bleeding; 4. Cheek penetration and lip rupture; 5. Ineffectiveness of medication.

Goat Mouth Kan (E Kou Gan Zheng), also known as Snow Mouth: Occurs in newborns, with white flakes covering the mouth and tongue, resembling a goat's mouth.

Horse Teeth (Ma Ya Zheng): Newborns, initially affected by fetal heat/toxins, then wind exposure post-birth. Wind-heat interaction causes it. Presence of brittle white bone on gums confirms diagnosis. Sneezing at birth indicates external wind invasion, rooting the horse teeth. If unnoticed during breastfeeding, the disease deepens and becomes critical; failure to treat urgently leads to death. Do not confuse with jaundice. Check immediately after birth; daily picking is required. By day 3-4, the disease solidifies; by day 5-6, it becomes hard and difficult to treat. Recurrences may happen; risk generally subsides after 100 days.

Any oral kan with black rot and foul odor is incurable. Infant fetal kan yellow like dried orange pulp is incurable.

For infant running horse dental kan and adult alveolar osteomyelitis, watch for tooth loss. The upper left incisor is the "King of Teeth"; if it falls, others follow, making it the heaviest and hardest to treat. If it remains, other teeth may be saved.

When treating oral kan, wrap cotton or silk around a chopstick, gently stir the lesion, then insufflate medicine. For canker sores on lips difficult to insufflate, mix with honey or moisten with warm water before applying.

Facial glow with white color is incurable; facial glow with red color is treatable. This has been repeatedly verified. "Glow" refers to tight, shiny skin on the face.

Tonsillar hypertrophy (Ru E) grows in the throat, shaped like a nipple.

When needling tonsils, prick the head and tail, not the middle. Fresh blood is easier to treat; dark blood is harder. When using knives/needles, avoid injuring the pedicle and the root under the tongue. Suspension abscess on the hard palate, like a purple plum, should be punctured. Parotid abscess below the cheek: induce vomiting first, then prick purple/black areas to remove stasis. Throat abscess: related to Mingmen and Ministerial Fire; if suppurating, puncture with silver needle. Dental carbuncle swelling/pain also suppurates; puncture accordingly.

Throat tumor (Hou Liu) grows beside the throat, round like a longan, wrapped in blood vessels. Do not use knives/needles. For mature ones, prick with a brush needle (see *Houke Zhenmi* for technique).

Eight Throat Syndromes Differentiated: The Hand Shaoyin and Shaoyang meridians connect to the throat. Heat Qi causes internal knotting and swelling; obstruction leads to death. Eight types of obstruction: Double Tonsils, Single Tonsil, Double Closed Throat, Single Closed Throat, Sublingual Swelling, Wooden Tongue Swelling, Entangling Throat Wind, Running Horse Throat Closure. Rising heat transmits to both sides of the throat, causing outward swelling resembling nipples, hence "Tonsils." Single vs. Double refers to unilateral vs. bilateral. Smaller than tonsils is "Closed Throat." Heat knotting under the tongue creates a small extra tongue, "Sublingual Swelling." Heat knotting in the tongue causes swelling, "Wooden Tongue Swelling" (wood implies stiffness and insensitivity). Heat knotting in the throat causes surrounding swelling, numbness, itching, and enlargement, "Entangling Throat Wind." Sudden onset and death is "Running Horse Throat Closure." All eight belong to Fire. Mild cases soften with salty substances; severe cases dissipate with purgatives. For Running Horse Throat Closure, life hangs in the balance; urgent scarification to bleed can cure the disease.

The throat belongs to the Lung, divided into Deficient Fire and Excess Fire, manifesting as Tight Throat or Slow Throat. Deficient Fire stems from excessive thinking and Middle Qi deficiency, feeling obstructed like shrimp shells, piercing like straw, with panting and phlegm; do not mistakenly use cooling agents. Excess Fire results from indulgence and accumulated heat; severe cases involve wind-phlegm blocking the pharynx, inability to swallow water, and loss of voice, constituting Emergency Throat Wind. If medication is too slow, only needling the throat to vent toxic blood works, followed by pulling hair, biting fingers, inducing vomiting, or nasal insufflation for effect. Carbuncles, obstruction, and tonsils are branch diseases; though severe, they are manageable. Failure to bleed for throat closure, induce vomiting for throat wind, drain pus for throat abscess, or needle/cauterize for throat obstruction and tonsils is illegal practice. For phlegm-fire consumption cough damaging the throat, when Kidney Water (Yin) is exhausted and Heart Fire (Yang) wreaks havoc, even with a benevolent heart, heaven-reversing power is lacking. Facing great calamity and devastation, my descendants who use my art to save the world must strictly adhere to these words.