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When I was in my early twenties, I had already been prescribing formulas to treat diseases for others. However, due to my young age, people generally did not trust me. At that time, there was a case of throat disease in my village. A doctor was invited for treatment, and I was asked to accompany him. The patient's throat was severely swollen, making breathing quite difficult. Yet, the physician still heavily prescribed diaphoretic agents (formulas to induce sweating), and the specific herbs used were not acrid-cool muscle-relaxing agents. I strongly disagreed with this approach and voiced my objections. The doctor claimed it was *Chan Hou Feng* (Coiling Throat Wind, a severe throat condition) and insisted that sweating must be induced thoroughly to reduce the swelling. The family believed his assertion, administered the medication erroneously, and the patient ultimately died from the mismanagement.

Later, when I went to Tianjin for the imperial examinations, the book *Bai Hou Ji Biao Jue Wei* (Clarifying the Subtleties of Avoiding Diaphoresis in White Throat) had just been published. I read it and found its theoretical basis centered on moistening dryness, nourishing yin, and clearing heat, with only small amounts of Bohe (Menthae Haplocalycis Herba, 薄荷) and Lianqiao (Forsythiae Fructus, 连翘) added to dissipate constrained heat. This was exactly opposite to the medications used by the previous doctor. Delighted, I tried using its formulas and achieved frequent success.

Subsequently, many people in my county suffered from throat disorders. Using the methods from *Bai Hou Ji Biao Jue Wei*, some cases responded well while others did not. Observing the throats, they did not necessarily appear white but were often abnormally red and swollen. Some said this was *Lan Hou Sha* (Rotting Throat Rash), while others called it *Jie Hou Yong* (Throat-Blocking Carbuncle). Generally, these were caused by the spread of pestilential qi (pathogenic factors causing epidemics) through mutual infection. In the initial stage of the disease, the pulse was mostly floating and slightly rapid, or floating and forceful; after a long duration, it would acquire a surging quality. This indicates that the throat disorder is accompanied by a pestilential disease.

At this time, I was nearing thirty years old and often had my own insights during clinical practice. When encountering a pulse that was initially floating, rapid, and forceful, I would heavily use Xuanshen (Scrophulariae Radix, 玄参) and Huafen (Trichosanthis Radix, 天花粉) to clear heat, Niubangzi (Arctii Fructus, 牛蒡子) and Lianqiao (Forsythiae Fructus, 连翘) to benefit the throat, and add two qian of Bohe Ye (Menthae Haplocalycis Folium, 薄荷叶) to vent the exterior. These measures usually proved effective. If the illness had persisted for a long time and the pulse became surging and forceful, I would frequently use Baihu Tang (White Tiger Decoction) supplemented with Yinhua (Lonicerae Japonicae Flos, 金银花), Lianqiao (Forsythiae Fructus, 连翘), Ruxiang (Boswelliae Resina, 乳香), and Moyao (Commiphorae Myrrha, 没药) to achieve cures. Given the name "Jie Hou Yong," I occasionally added Zhi Shan Jia (Pangolin Scale, processed) to dissipate the carbuncle swelling. If the swelling was extremely severe and breathing was obstructed, I would first use a Pi Zhen (a flat needle for draining pus) to puncture and release evil blood, allowing the swelling to subside before administering herbal medicine. The combination of acupuncture and herbal therapy yielded faster results.

Although I cured many people at that time, the terms "Lan Hou Sha" and "Jie Hou Yong" had not yet appeared in medical texts. Later, reading the *Yong Ju Pian* (Chapter on Carbuncles and Ulcers) in the *Ling Shu* (Spiritual Pivot), I encountered the statement: "A carbuncle arising in the pharynx is called Meng Ju (Fierce Carbuncle). If Meng Ju is not treated, it turns into pus. If the pus is not drained, it blocks the throat, leading to death within half a day." Since the classic explicitly states that carbuncles arise in the pharynx, this explains the origin of the later term "Jie Hou Yong." Furthermore, since failing to drain the pus leads to imminent danger, needle drainage of pus is originally a correct therapeutic method. Even without waiting for suppuration, using needles to release evil blood can also serve as a correct treatment.

I also consulted the *Shang Han Lun* (Treatise on Cold Damage Disorders): "The disease of Yang Du (Yang Toxin) presents with a red face and mottled rash like brocade patterns, sore throat, and expectoration of pus and blood. It is treatable within five days but untreatable after seven days." Wang Mengying explained: "Yang Du is what later generations call Lan Hou Sha." This shows that Lan Hou Sha derives from Yang Du in the *Shang Han Lun* and has been transmitted for a long time; Jie Hou Yong is simply the severe form of Lan Hou Sha.

Generally speaking, both Bai Hou (White Throat) and Lan Hou Sha involve external contraction. However, in Bai Hou, internal injury is heavy while external contraction is light; the exogenous pathogen only invades the San Jiao (Triple Burner). Since the color associated with the San Jiao is white, the throat appears white. Therefore, in the formula, dispersing agents are used sparingly; even small amounts of Bohe (Menthae Haplocalycis Herba, 薄荷) and Lianqiao (Forsythiae Fructus, 连翘) are sufficient to expel the pathogen. In contrast, Lan Hou Sha is originally Yang Du from the *Shang Han Lun*, containing pestilential toxic qi. In the initial stage, heavy use of dispersing agents is appropriate, but they must be acrid-cool dispersants, never acrid-warm ones. Moreover, heavy use of cooling medicines should be employed as adjuvants. This summarizes the general principles for treating throat disorders.

Having practiced clinically for decades, I know that throat disorders often present with many variations. Here, I record two cases in detail for reference.

While residing in my hometown, a boy surnamed Liu, over ten years old, suffered from swollen and painful throat, chest fullness and obstruction. During severe episodes, breathing would suddenly cease, eyes would roll upward, and the body would arch backward. However, the reason for the sudden cessation of breathing was not blockage of the throat itself, but rather a sensation of blockage in the chest and diaphragm. His pulse was fine, thin, and slow. He often felt coldness in his chest and diaphragm; sometimes this coldness would rush upward, causing inability to breathe and manifesting as eye-rolling and body-arching. Based on the pulse and symptoms, I determined this was undoubtedly Cold Phlegm Binding in the Chest (Han Tan Jie Xiong). The swelling and pain in his throat were caused by cold phlegm overflowing in the Upper Jiao, forcing the Yang Qi of the Heart and Lungs to float upward. I prescribed a formula consisting of 1 liang of finely powdered Sheng Zhe Shi (Hematitum, 生赭石), 3 qian each of Gan Jiang (Zingiberis Rhizoma, 干姜) and Wu Fu Zi (Aconiti Lateralis Radix Praeparata, 乌附子), and 1.5 qian each of Hou Po (Magnoliae Officinalis Cortex, 厚朴) and Chen Pi (Citri Reticulatae Pericarpium, 陈皮).

After one dose decocted and taken, the chest felt immediately open, and the throat swelling and pain decreased significantly. After two more doses, he was completely cured.

Sun XX from Fengtian, aged twenty, contracted a throat disorder. Multiple treatments involved modifications of formulas from *Bai Hou Ji Biao Jue Wei*, yet the condition worsened daily. Physicians declared it incurable. Upon my examination, his pulse was fine, weak, and rapid, with excessive sticky saliva filling his mouth within moments, which he then spat out. I diagnosed this as deficiency of both Spleen and Kidney. Kidney deficiency leads to failure of Qi transformation to control fluids, causing Yin Fire to rebel and Phlegm-Fluids to flood upward. Meanwhile, Spleen Earth deficiency fails to control these fluids (if Spleen Earth were not deficient, it would not only control the flooding of Phlegm-Fluids but also restrain the rebellion of Yin Fire). Consequently, his throat swelled and pained, accompanied by such excessive sticky saliva. I administered Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill) modified with Yu Zhu (Atractylodis Macrocephalae Rhizoma, 于术) and a small amount of Su Zi (Perillae Fructus, 苏子). After ten consecutive doses, he was fully recovered.