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The pharynx (Yan) is located behind the larynx (Hou), primarily responsible for receiving food, and is the connection of the Stomach; the larynx is located in front of the pharynx, primarily responsible for the entry and exit of Qi, and is the connection of the Lung. The meridians of the Stomach, Kidney, and Liver circulate through the throat. The Ren Mai (Conception Vessel) reaches the throat and pharynx. *Ling Shu* states: The regular pathways of the Hand-Yangming Large Intestine Meridian and the Hand-Taiyin Lung Meridian circulate along the throat. The regular pathway of the Foot-Shaoyang (Gallbladder) Meridian flanks the pharynx. the Spleen meridian flanks the pharynx. The branch of the Heart meridian flanks the pharynx. the Small Intestine meridian circulates through the epiglottis and pharynx. According to this, the throat and pharynx are passages for diet and respiration, situated above the Zang-Fu organs; pathogenic factors from any meridian can ascend to affect them. Observing that *Jing* (Nei Jing) states when pathogenic factors lodge in the collaterals of the Hand-Shaoyang (Sanjiao) Meridian, it causes people to suffer from Hou Bi (Sore Throat/Obstruction), one can understand this. It is not necessary for a meridian to directly circulate through the throat and pharynx to cause disease. Diseases of the throat and pharynx all belong to Fire patterns. Some are due to excessive Fire in the Upper Jiao, others to Fire rushing up from the Lower Jiao, leading to the accumulation of Phlegm-fluids, Qi, and Blood, resulting in swelling, pain, and obstruction.

Erythema Glandularium Oropharyngis (E-mou Hou), characterized by swelling and pain on both sides of the throat and pharynx, is called Double Erythema Glandularium Oropharyngis; (named so because its shape resembles a silkworm moth, though some resemble dates or chestnuts.) If on one side only, it is called Single Erythema Glandularium Oropharyngis; if resembling white stars connected vertically, it is called Pearl-like Erythema Glandularium Oropharyngis. Cases visible merely by opening the mouth allow easy application of medicated powder and acupuncture; those deep and invisible are difficult to treat. All are suitable for internal administration of Qingyan Lige Tang (Clear the Throat and Benefit the Diaphragm Decoction) and external insufflation of Bingpeng San (Ice and Borax Powder). (See Chapter on Mouth.) For easily visible cases, puncture with a needle when pus matures; for hard-to-see cases, use tung oil-wrapped probes to induce vomiting of pus and blood. If there is severe phlegm congestion, rapid breathing, and weak voice, and vomiting cannot be induced, the condition is critical. Urgently prick the Shaoshang acupoint (located on the medial border of the thumbnail, about the width of a leek leaf from the nail corner, insert depth 2 fen) with a three-edged needle to bleed, continue insufflating medication and taking the aforementioned decoctions, expecting gradual improvement. If the shape resembles a round eye, wrapped with red filaments, occurring singly or doubly beside the throat (some with large heads and small stalks), causing no pain unless touched, it is named Hou Liu (Throat Tumor), caused by stagnant Heat in the Lung Meridian and Qi damage from excessive talking. Acupuncture is contraindicated; internally administer Yiqi Qingjin Tang (Benefit Qi and Clear Metal Decoction), and externally apply Xiaoliu Biyu San (Eliminate Tumor Jasper Powder).

Hou Bi (Throat Obstruction), "Bi" meaning obstruction. Difficulty swallowing food, difficulty speaking, ulcers may or may not be present in the throat, or masses like pills or fists may form. If chills and fever appear immediately upon onset, with intense and rapid progression, accompanied by pain and itching, circumferential neck redness and swelling, severe phlegm congestion, and a voice like sawing wood, it is named Chan Hou Feng (Entangling Throat Wind). Without immediate rescue within moments, urgently instruct the patient to open their mouth, needle the swollen areas in the throat, and prick both Shaoshang acupoints to bleed, or use tung oil-wrapped probes to induce vomiting of phlegm, followed by rinsing the mouth with Licorice Decoction to neutralize the odor of tung oil—this is the best strategy. If the jaw is tightly closed, use Croton Oil, ignite a paper twist, extinguish it, and let the patient inhale the smoke; saliva will flow from the mouth and nose, and the jaw will naturally open. Alternatively, dissolve Jiedu Xionghuang Wan (Detoxify and Realgar Pill) in water, insufflate into the nasal cavity reaching the pharynx to induce vomiting, which also opens the jaw. Subsequently, use the above methods to clear the obstruction, frequently administer Hou Bi Yin (Throat Obstruction Drink) or Qingyan Lige Tang, insufflate Jin Bi Er Dan (Gold and Jasper Two Cinnabars) or Bingpeng San, and add Niuhuang (Calculus Bovis) to the medicine for faster efficacy. *Zhun Sheng* records that in acute Hou Bi, a snoring sound and loud phlegm indicate the exhaustion of Lung Qi; Ginseng Paste should be administered with Ginger Juice and Bamboo Sap, or first brew Dushen Tang (Single Ginseng Decoction) for rescue, as delay will be fatal. My commentary holds that this syndrome belongs to acute Wind-Fire and Phlegm congestion causing Qi obstruction and death, not Qi deficiency. Why prioritize tonifying Qi over removing Phlegm and inducing bleeding? Later, seeing *Yi Guan* cite this with a note stating: Similar to Stroke, many such cases occur. Also observing *Jingyue Quanshu* discussing Yang-deficiency Hou Bi stating: It is not that Hou Bi is caused by Yang deficiency, but rather Yang deficiency results from Hou Bi, because patients overused cold-natured medicines for Hou Bi or had difficulty eating, leading to sudden collapse of Middle Qi Cold Deficiency, with snoring sounds and sawing-like phlegm, requiring Ginseng Decoction for rescue, etc. Thus, I realize *Zhun Sheng* was not legislating for initial excess syndromes; do not misunderstand. If swelling occurs outside the neck with pus and pain, fear perforation into the throat; do not lightly needle. Urgently insufflate Sophora Flower Powder into the nose to induce sneezing, which breaks the swelling, or mix Sophora Flower Powder with vinegar and apply thickly to the neck swelling. All throat conditions arise from blazing internal Fire. If complicated by external Wind-Cold, the Fire is constrained by Cold, making its nature more fierce. Tongue swelling protruding from the mouth and moving is called Nong She Hou Feng (Playing Tongue Throat Wind); treatment is generally similar. For cases with external contraction, strictly avoid acid-astringent medicines like Alum for insufflation, which retains Heat; also avoid purgatives like Mirabilite and Rhubarb, which cause Yang to sink. (When multiple people suffer this simultaneously with aversion to cold, it belongs to epidemic Cold, i.e., external contraction.) One should use Ganjie Tang (Licorice and Platycodon Decoction) added with Coptis, Silkworm, Schizonepeta, Pinellia, Plantago Root, and Mint to disperse. For cases with deficiency, add Ginseng and Angelica. If fluids cannot enter, first administer 4-5 pills of Jiedu Xionghuang Wan ground in very sour vinegar to induce vomiting of phlegm. (Previously stated avoiding acid astringents; here vinegar is used for vomiting. Vomiting requires gathering phlegm in one place before expelling; once expelled, the vinegar exits too. Additionally, vinegar resolves blood stasis.) Then administer Ginger Juice to scatter Cold and remove the astringency of vinegar, then use the aforementioned medicines. (Throat conditions most forbid Pinellia and Ginger, as internal Fire intensifies with acrid dispersal; only usable with external contraction.) If Wind-Cold binds Heat, starting at Tinghui acupoint before the ear, resembling scrofula, gradually attacking throat swelling and pain, urgently use Niuhuang Qingxin Wan (Calculus Bovis Clear Heart Pill), concurrently take Qingyan Lige Tang, and insufflate Bingpeng San. If purely internal Fire without external Cold, then acid-astringent items and purgatives like Mirabilite and Rhubarb are appropriate. Generally, removing phlegm and inducing bleeding is the urgent priority for this condition. Determining whether external contraction exists is hardest; why? External contraction必然 presents with fever, aversion to cold, and floating pulse, while acute cases of this disease also present with chills and fever and floating pulse initially. (If chills and fever do not appear in the first 1-2 days but appear after 3 days, it is a slow case.) Thus, it is hard to distinguish. Must ask about exposure to Wind/Cold and concurrent epidemic symptoms, observing carefully. Generally, without external contraction, Chest/Stagnant Phlegm appears first, followed by sore throat, then body chills/fever; with external contraction, chills/fever appear first, followed by chest stagnation/phlegm and sore throat. The above discusses acute cases; slow cases should be treated slowly. Hou Bi Yin should be given frequently in small amounts; do not overuse cold-natured medicines, lest Phlegm congeals in the chest, becomes stagnant due to cold, and leads to untreatable wheezing and obstruction. For severe Qi urgency and closure, grind Silkworm into powder, mix with Ginger Juice, and ingest for immediate relief. Or crush Malan root and shoots, extract juice, dip goose feather to probe/vomit, or drink the juice; mixing juice with vinegar for gargling is also fine. Must ask about urination and defecation; if unobstructed, floating Fire attacks upward, suitable for dispelling Wind-Heat, descending Qi, and detoxifying.

Sore Throat extending to the chest with redness, swelling, and pain suggests Fei Yong (Lung Abscess); must use honey-modulated medicine, adding Bai Cao Shuang (Soot from Burning Grass) and Jie Geng (Platycodon) as essential. For women's throat conditions, first ask about menstruation; if obstructed, use Menstruation-Unblocking Medicine, cured in one dose. Although this condition arises from Fire, Fire has Excess and Deficiency types. Excess Fire stems from overeating fried foods, strong wine, and rich flavors, accumulating Heat-Toxins; symptoms include irritability, thirst, and constipation. Use heavy moistening purgatives to drain accumulated Heat. After bowel movement clears, use Phlegm-removing and Heat-clearing medicines to harmonize the Upper Jiao. If Yuan Qi is sufficient, Mirabilite and Rhubarb can be used; if weak, must moisten dryness and lubricate intestines, or use Honey Suppositories. Deficient Fire stems from mental overwork and sexual indulgence, emotional injury, leading to Kidney Water depletion and Fire flaming upward; severe pain in the afternoon requires nourishing Yin and descending Fire. Initially, the throat feels dry, like being pricked by grass or hard objects, with slight redness, swelling, and pain. Severe cases become dark purple over time, resembling frozen pomegranate seeds. Later, rotting tissue peels off like shrimp skins, voice becomes hoarse, foul decay spreads, hindering diet; Zhibai Dihuang Tang (Anemarrhena, Phellodendron, and Rehmannia Pill) is suitable. (See Deficiency Damage chapter.) If vomiting sweet-sour saliva, use Ganlu Yin (Sweet Dew Drink) added with Coptis. If stool is dry, take equal parts refined Lard and White Honey, two spoonfuls, 3-5 times daily. For swelling, insufflate Zixue San (Purple Snow Powder); for rot, insufflate Babao Zhenzhu San (Eight Treasures Pearl Powder); these treat Kidney Water deficiency with flaming Fire. If Kidney Yang is deficient, Yin-Cold from the Lower Jiao forces rootless Fire upward, also causing severe afternoon pain; use Bawei Wan (Eight Flavor Pill) material, brew heavily, drink cold to guide Fire back to its source; absolutely avoid cold-natured medicines. The human throat is like a crooked chimney. If fire blazes and water is poured from above, the chimney bursts. Only by placing a basin of water below the stove bed can upward flames be extinguished; this is treating upper disease via the lower. Sweating and acupuncture bleeding are also forbidden. There is also Middle Jiao Yang deficiency with floating Fire flaming upward causing sore throat, red face, dry throat, mouth/tongue ulcers, worsening with fatigue or in the morning; pulse is necessarily floating and large. Lizhong Tang (Regulate the Middle Decoction) added with Chinese Yam and Cornus officinalis, or Buzhong Yiqi Tang (Tonify the Middle and Benefit Qi Decoction) added with Ophiopogon, Platycodon, and Burdock Seed. If face and lips are pale, insomnia, and poor appetite, Guipi Tang (Restore the Spleen Decoction) added with Wine-fried Coptis. All should use Bingpeng San mixed with Charred Rush Pith for immediate effect. (For redness/swelling without distinct shape, Rush Pith is best.) All deficiency syndromes tend to be slow, color pale, and swelling mild.

Hou Xuan (Throat Lichen), red filaments grow in the throat, resembling kiln cracks or the back of Begonia leaves, dry and itchy, eventually ulcerating with small holes like ant bites, hence also named Tian Bai Yi (Heavenly White Ant). Caused by overeating pungent-hot foods leading to Stomach Fire flaming upward and burning the Lung. Tuberculosis often presents similarly, all belonging to Excess Fire and Deficient Water; dryness without swelling confirms this. Guangbi Shuniu Tang is suitable. Before ulceration, insufflate Fanjing San; after ulceration, insufflate Qingliang San. Must cultivate mind, reduce desires, avoid rich flavors and triggering foods to preserve health. If hoarseness occurs, or rotting tissue piles up like ant holes, prognosis is poor. Hou Jun (Throat Fungus), shaped like duckweed, purple color, caused by depression, Qi stagnation, and Blood Heat; common in women. Initially insufflate 5 parts Bijian Dan and 1 part Jindan, later 3 parts Bijian Dan and 2 parts Jindan. Hold Qingling Gao, take Hou Bi Yin. Hou Chuang (Throat Ulcer), layered like stacked plates, painless, emitting foul odor through pores over time; consume Goji Leaf with distilled liquor in one go. Chronic cough with sore throat: 5 fen Semen Pruni Mume, 2 qian each of Persimmon Frost, Asparagus Fern Tuber, Ophiopogon Tuber, and Borax, 1 qian Scrophularia Root, honey-pilled for sucking. Epiglottis pain: see An Gate. Swollen/painful throat pillars: grind roasted salt and calcined alum evenly, apply with chopstick tip for immediate resolution. Internally take Ganjie Shaye Tang. Contraindicate acupuncture, injurious to life.

For broken throat conditions, first insufflate flesh-generating medicine, then Bijian Dan. If phlegm does not expectorate, add processed Sophora to Jindan. If perforated/rotted, use Kougan medicines plus Dragon Bone and Pearl. Throat conditions without phlegm are untreatable; Water is exhausted, nothing to remove, how to open obstruction? Difficult. Tongue swelling filling the mouth, colored like walnut, eggplant, or cinnabar paper, is untreatable. Most feared are thirst, panting, phlegm like peach gum, entire neck swelling, red-purple or cyan-white face without spirit—all bad omens. If urgent medicine unavailable for throat conditions, use one piece of Tooth Soap, mix with honey and water, decoct and drink. If cold medicines fail for throat conditions, Ginger Juice is suitable. However, for already broken conditions, Ginger Juice causes spicy pain and disperses making healing difficult; thus forbidden.

Sore throat makes breathing and speech difficult; sore pharynx prevents swallowing saliva and food. Hou Bi always accompanies sore pharynx; sore pharynx does not always accompany Hou Bi.

Mass in pharynx blocking diet is critical; Belamcanda, Bull Tongue Leaf Juice, and Sargassum all treat this. Better yet, Bai Cao Shuang honey-pill size of Coix Seed, dissolve in fresh well water and swallow; severe cases need no more than two pills.

Sore pharynx must use Schizonepeta. Yin deficiency with Fire flaming upward must use Scrophularia. Qi deficiency adds Bamboo Sap to Ginseng. Blood deficiency adds Bamboo Sap to Siwu Tang. Excess Heat uses Sanhuang Wan. Or Coptis, Schizonepeta, Mint powder, mixed with Ginger Juice and Honey for sucking. Or suck Semen Daduae. Wind-Heat: disperse superficially, then resolve internally. Or use alone Borax, or mix with Alum, White Silkworm, White Frost Plum for sucking; avoid overusing cold medicines. One Trichosanthes Fruit, 5 qian lightly fried White Silkworm, 7 qian Platycodon, 2 qian fried Licorice, powdered; insufflate small amount. For redness/swelling, use 1 qian of this powder plus 1 qian Mirabilite, insufflate, swallow saliva. For small white-headed sores, add 5 fen White Alum to 1 qian of this powder. If sore pharynx responds to no medicine, it is not sore pharynx but a red filament in nose hanging a black blister like cherry to pharynx door, obstructing diet. Use straight single raw Achyranthes root, wash clean, add 3-5 drops good vinegar, grind fine, drip 2-3 drops into nostril; filament breaks, blister pops, immediate relief. If chronic ulceration from Syphilis, Primulae Radix and Smilax Glabra are primary.

Object in throat unable to swallow/spit, like hair thorn, cotton, membrane, plum pit, or meat lump, all named Mei He Qi (Plum Pit Qi). Caused by Qi knot generating Phlegm, fearing Yige (Dysphagia) over time. Muxiang Siqi Wan, Suzi Jiangqi Tang, Siqi Tang. Or Ginseng, Cassia Bark, Loquat Leaf 5 qian each, Almond 2.5 qian, honey-pilled large as bullet, suck until cured. Or Alum, Borax, Tooth Soap, Realgar, Jujube Meat, pill size Coix Seed, suck. Warm yellow wine cup passes mouth, add Qingyan Xie. For foreign bodies stuck in throat, *Sanyin Fang* boils Scallion Bulb half-cooked, tie with thread, hold thread end, chew little Scallion Bulb and swallow; when reaching blockage, pull thread, object comes out. Secret recipe: hang dust from silver furnace upside down, mix with sugar, pill, swallow falls down. Bone stuck: Hibiscus Leaf Oil, Polyporus, Sugar, boil paste, pill, suck. Ramie pounded rotten, pill size bullet, decoct stuck object in water and swallow. Animal bone stuck: hang dog by one leg, collect saliva, swallow slowly. Scissors Grass (like wild Arum), grows in hedges, white root, grinds like glue, swallow with water, spits out bone in 2-3 swallows. Veratrum root ground, swallowed with water, also good. Mirabilite ground, mixed with Elsholtzia, pill size bullet, suck, 3-4 pills. Southern Borax washed with well water, sucked, softens bones best. Cyathula decocted strongly 1.5 cups, divided 3 doses, spit out bone shortly. Fish bone stuck: small amount Tooth Soap in nose, sneeze brings it out. Fine Tea and Chinese Gall equal parts powder, insufflate throat, immediate cure. Eat olive to bring down, or grind pit, swallow with flowing water. Fish bone piercing stomach hurts: decoct Evodia Juice, drink, bone softens and exits. Chicken bone stuck: Water Curtain Grass juice drunk, bone dissolves. Wild Ramie washed, pounded mud, longan-sized. If injured by chicken bone, dissolve in chicken soup; fish bone, fish soup. Rice awn/husk stuck: hang goose by one leg, collect saliva, swallow slowly dissolves. Or chew Jian Tou Cao. Swallowing nails/iron/gold/silver/copper coins: eat much fatty meat, passes with stool. Coin/iron stuck in throat: burn Nan Zhu Gen, fine powder, mix with water, drink 1 qian. Swallow iron/needle: 8 oz Maltose, decoct Mugwort Juice strongly, mix and drink. Or magnet stone ground date-seed size, drilled, threaded, swallowed to draw out needle; magnet must be verified by Yin-Yang masters. Swallow coin: burn charcoal powder, mix with white water, drink several spoons, exits quickly. Or drink honey, eat water chestnut/arum, coin passes. Or mugwort bunch, 5 sheng water, decoct to 1 sheng, drink at once. Or Baibu root 4 liang, wine 1 sheng, soak overnight, warm drink 1 sheng, twice daily. Swallow hairpin: sun-dry Scallion Bulb till yellow, cook熟, do not cut, eat date-sized piece, exits. Swallow coin/hairpin: 1 jin Maltose, eat gradually. Swallow hair tangled throat: burn messy hair to ash, mix with white water, drink 1 qian.

Chen Wuyue said: All methods for stuck objects follow analogy; Cormorant treats fish stuck, Magnet treats needle stuck, Hair Ash treats hair stuck, Civet Cat treats bone stuck, each following its kind. *Jinjian* for fish bone: use duck raised in river, hang upside down, collect saliva, feed supine frequently.