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The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "When one Yin and one Yang become knotted, it is called Hou Bi (throat obstruction)." Wang Bing's commentary explains that "one Yin" refers to the Jueyin (Jueyin Meridian), corresponding to the Liver and Pericardium. "One Yang" refers to the Shaoyang (Shaoyang Meridian), corresponding to the Gallbladder and Sanjiao (Triple Burner). These four meridians all contain Xianghuo (Ministerial Fire). Zhang Zihe stated: "Treating fire in the Gallbladder and Sanjiao, as well as in the Liver and Pericardium, involves no difference." Li Dongyuan stated: "Fire and Yuanqi (Original Qi) cannot coexist; when one prevails, the other declines." Generally, when Yuanqi becomes deficient, Xianghuo (Ministerial Fire) rises accordingly, causing acute diseases such as Hou Bi (throat obstruction) to erupt. The epiglottis in the throat is referred to in the classics as Xi Men (Gate of Inhalation). Because it governs respiration and directs the ascending and descending of Qi, it serves as a critical gateway for human life.

If swelling and pain occur suddenly, preventing the intake of water or food, and speech is impaired, death may ensue within moments, which is indeed terrifying. If both sides of the epiglottis are swollen, commonly known as Shuang Ru E (Double Tonsillar Swelling), it is easy to treat; if only one side is swollen, commonly known as Dan Ru E (Single Tonsillar Swelling), it is difficult to treat. Ancient formulas generally refer to these conditions as Hou Bi (throat obstruction), caused by the counterflow of Xianghuo (Ministerial Fire). The classics state: "A single unit of Water cannot overcome two Fires." And again: "A single unit of Water cannot overcome five Fires." This emphasizes how easily Zhen Shui (True Kidney Water/Yin) can be depleted and how easily Xianghuo (Ministerial Fire) can become agitated. For instance, great anger causes fire to arise from the Liver; sexual exhaustion causes fire to arise from the Kidneys; irregular diet causes fire to arise from the Spleen and Stomach, etc. Therefore, it is understood that Fire is the root of Phlegm, and Phlegm is the branch manifestation of Fire. Since Fire nature is rapid and swift, the disease onset is violent and fierce. The treatment method must first induce copious expectoration of Phlegm, or use a Pi needle (a type of surgical knife/needle) to prick the swollen area. This is the method of treating the branch in emergencies. When using herbs, one must follow the principle of Congzhi (following/treating according to the nature, often implying paradoxical treatment or adding warming agents to cold herbs) from the *Neijing*, using herbs such as Jiegeng (Platycodon Root), Gancao (Licorice Root), Xuanshen (Scrophularia Root), Shengma (Cimicifuga Rhizome), Fangfeng (Saposhnikovia Root), Qianghuo (Notopterygium Rhizome), Jingjie (Schizonepeta Spike), Renshen (Ginseng Root), Baizhu (Atractylodes Rhizome), and Fuling (Poria), with small amounts of Ganjiang (Dried Ginger) and Fuzi (Prepared Aconite Root) added as guides. These should be administered slowly and frequently, not in a single large dose. This is the fundamental method of treatment. One must absolutely avoid suddenly administering cold-natured drugs, as this will not only be ineffective but also hasten death. Laypeople, unfamiliar with this principle, harshly employ drugs like Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), Zhizi (Gardenia Fruit), and Huangbai (Phellodendron Bark) for direct treatment (clearing heat). Worse still, they mix in strongly cold herbal medicines and administer them frequently and in large doses. They feel that although the swelling subsides slightly and speech improves somewhat, both doctor and patient rejoice at the apparent efficacy. Little do they know that the heat above remains unremoved, while cold arises in the middle jiao. The pathogenic toxin enters the abdomen through the deficiency, gradually leading to incessant asthma, which becomes incurable. This is truly lamentable! Additionally, there is a type of epidemic disease called Datou Bing (Big Head Disease), commonly called Niejing Wen (Neck-Pinch Plague). Its symptoms are extremely malignant; eight or nine out of ten who contract it die. It should be treated by analyzing the Six Qi movements (Yunqi theory). The treatment methods are not very different from those described above. Li Dongyuan's Puji Xiaodu Yinzi (Universal Benefit Decoction to Eliminate Toxins) is excellent and truly a formula that never misses. Students should study it in detail and expand upon it, striving to save lives in this world, which would be a great fortune.

Pulse Diagnosis

If the pulses at both Cun (Inch) positions are floating, surging, and overflowing, it indicates Hou Bi (throat obstruction). If the pulse is minute and hidden/deep, it indicates death.

Methods

Zhu Danxi stated: "Hou Bi (throat obstruction) mostly belongs to Phlegm. In severe cases, emesis (vomiting) therapy is appropriate. Alternatively, one can use the oil residue from a tung oil lamp wick, inserting it into the throat with a goose feather to induce vomiting. For mild cases, freshly gathered roots of garden plum trees can be held in the mouth, and the juice ground and applied to the neck."

Mr. Lu stated: "According to the Materia Medica, Lishi Gen (root of *Iris lactea*) is the same as Malin Gen (root of *Iris lactea*), which can treat Hou Bi (throat obstruction) and is common in the north. Here it mentions garden plum roots; it is unknown which is correct."

Chan Feng (Coiling Throat Wind) belongs to Phlegm-Heat and is also suitable for emesis therapy.

Another prescription: Use Yuanzhi (Polygala Root), remove the heart, grind into powder, mix with water, and apply to the neck.

Another prescription: Burn Dengxincao (Juncus Effusus Stem) to ash, and blow it into the throat.

One prescription for treating sore throat and swelling:
Jingjie Sui (Schizonepeta Spike), Danggui Shen (Angelica Sinensis Root Base), Jiegeng (Platycodon Root), Gancao (Licorice Root) (equal parts).
Finely cut, decoct in water, let cool to warm, gargle and swallow. Add Huangqin (Scutellaria Root) and Zhike (Bitter Orange) if there is heat. Pricking Shaoshang (LU11) to bleed brings immediate cure.

Another prescription for treating dry and painful throat: Use Siwu Tang (Four Substances Decoction) plus Jiegeng (Platycodon Root), Jingjie (Schizonepeta Spike), Huangbai (Phellodendron Bark), and Zhimu (Anemarrhena Rhizome). Immediate relief occurs.

Another prescription for treating throat ulcers with pain: Mostly due to Deficient Fire wandering without restraint. Use Renshen (Ginseng Root), Huangbai (Phellodendron Bark) (honey-fried), and Jingjie (Schizonepeta Spike). For Deficient Fire, use Renshen (Ginseng Root) and Zhuli (Bamboo Sap). For Blood Deficiency, use Siwu Tang (Four Substances Decoction) plus Zhuli (Bamboo Sap).

Another prescription: Use Huang Liaolang Gen (root of *Rubus parvifolius*, commonly called Dao Zhai Ci) with a little good wine, grind to extract juice, and drip into the throat for cure.

Another prescription: Stir-fry Denglong Cao (Lantern Grass) until charred, grind into powder, mix with wine, and apply to the throat.

To drain Excess Heat and Fire: Use Huanglian (Coptis Rhizome), Jingjie (Schizonepeta Spike), Bohe (Mint), and Xiaoshi (Saltpeter) ground into powder. Mix with ginger juice and honey, hold in mouth to dissolve.

Diseases of the throat and tongue all belong to Heat and Fire. Although there are several names and differences in severity, this is merely due to the slightness or intensity of the Fire. Slight and mild cases can be treated slowly; intense and urgent cases require only bloodletting with Bian needles (stone/surgical knives), which is the supreme strategy.

(Above are eleven methods from Danxi.)

Tongguan Yin (Li Dongyuan): Treats Hou Bi (throat obstruction) with swelling, pain, and inability to speak. As long as medication can be taken, cure is certain. This is the method of Congzhi (following treatment). Another version contains Niubangzi (Arctii Fructus) but lacks Baizhu (Atractylodes Rhizome), Fuling (Poria), Ganjiang (Dried Ginger), and Fuzi (Prepared Aconite Root). It is named Lige Tang (Diaphragm-Opening Decoction) and treats all sores and swelling/pain in the throat.
Renshen (Ginseng Root), Baizhu (Atractylodes Rhizome), Fuling (Poria) (each 1 qian), Zhi Gancao (Honey-fried Licorice Root) (1.5 qian), Jiegeng (Platycodon Root, remove radicle) (2 qian), Fangfeng (Saposhnikovia Root, remove radicle) (0.7 qian), Jingjie (Schizonepeta Spike) (0.5 qian), Bohe (Mint) (0.5 qian), Ganjiang (Dried Ginger, processed) (0.5 qian), or add Fuzi (Prepared Aconite Root, processed) (0.5 qian).
Finely cut, prepare as one dose. With two cups of water, decoct to 0.7 cup, administer slowly.

Another prescription (Li Dongyuan): Treats Hou Bi (throat obstruction).
Use Yazui Danfan (Duck-bill Alum) 3 or 5 fen, blow into the throat. Vomiting phlegm leads to cure.

Puji Xiaodu Yinzi (Li Dongyuan): Treats epidemic sore throat and other symptoms. (Formula see Plague Section.)

Jiegeng Tang (Li Dongyuan): Treats slight swelling and pain in the throat, hoarseness, and difficulty speaking.
Danggui Shen (Angelica Sinensis Root Base), Mabo (Polyporus Umbellatus) (each 1 qian), Bai Jiangcan (Silkworm, stir-fried), Huangqin (Scutellaria Root) (each 0.3 qian), Mahuang (Ephedra Stem, remove joints) (0.5 qian), Jiegeng (Platycodon Root, remove radicle), Gancao (Licorice Root, honey-fried) (each 1 qian), Guizhi (Cinnamon Twig) (a little).
Finely cut, prepare as one dose. With two cups of water, decoct to one cup, remove dregs, and take warm.

Another prescription for treating Hou Bi (throat obstruction): Freshly gather Qing Ai Ye (Green Mugwort Leaf), pound to extract juice, and pour into the throat for immediate cure.

Another prescription: Place Shechuangzi (Cnidium Fruit) in a bottle with a spout, burn it, and have the patient hold the spout in their mouth to inhale the smoke into the throat for immediate cure.

Chui Hou San (Throat-Blowing Powder): Treats all swelling and pain in the throat.
Danfan (Alum) (5 qian, separately take one Green Fish Gallbladder, grind alum finely into the gallbladder, dry in shade), Badou (Croton Seed) (7 grains, remove shell), Puxiao (Mirabilite) (2.5 qian, grind separately), Tongqing (Verdigris) (1 qian), Qingfen (Calomel) (0.5 qian), Qingdai (Indigo Naturalis) (a little, grind separately).
First, fly Danfan (Alum) together with Badou (Croton Seed) meat in a copper pot, remove Badou (Croton Seed). Combine with Puxiao (Mirabilite) and the following four ingredients. Add a little Shexiang (Musk) and grind uniformly. Use one zi amount each time, blow into the throat. Vomiting phlegm and blood brings immediate cure.

Sheng Yan Tong (Holy Smoke Tube): Treats Hou Bi (throat obstruction).
Take Bimazi (Castor Bean) meat, crush it, roll in paper to make a tube, burn, and inhale the smoke.

(Ancestral Prescription)
Godly efficacy for treating Hou Bi (throat obstruction).
Malanju (Kalimeris Indica), Wuzhao Long Cao (Polygonum Multiflorum Vine?), Cheqian Cao (Plantago Seed Herb) (each one handful, commonly called Hamayi).
Pound the three substances to extract juice, drink slowly.

Another prescription for treating Hou Bi (throat obstruction) and heat-pain in the throat:
Use high-quality Xiao Li (Pear), pound to extract juice, drink frequently. If the patient can chew and swallow it themselves, that is also fine. Eating more is beneficial, greatly resolving heat toxins. However, those with metal wounds, postpartum women, and various hemorrhagic syndromes must not eat it, because it breaks blood. For other carbuncles, sores, and back infections, eating more is extremely good.