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The throat (Hou) and the pharynx (Yan) are different. The throat is the gate of the Lung, the portal for respiration, primarily responsible for expelling air but not receiving it. The pharynx is the gate of the Stomach, the pathway for water and food, primarily responsible for receiving but not expelling. Thus, the throat and pharynx govern respiration and regulate the ascending and descending of Qi; they serve as the critical pivot of the body's Qi mechanism, akin to a bellows. The Classics state: Diseases generated by the Foot-Shaoyin Kidney Meridian include thirst, dry tongue, swelling and pain in the throat, upward rushing of Qi, dryness and pain in the throat. The *Suwen* states: When pathogenic factors invade the collaterals of the Foot-Shaoyin Kidney Meridian, it causes throat pain and inability to eat. It also states: The collateral of the Foot-Shaoyin Kidney Meridian runs along the throat and connects to the root of the tongue. Therefore, all cases of throat pain belong to Shaoyin disease, though they may be differentiated into Cold, Heat, Deficiency, or Excess patterns.

The Ministerial Fire of Shaoyin surges like a galloping horse, counterflowing upwards. Upon reaching the narrow and tight junction of the throat, Qi becomes stagnant and unable to disperse, resulting in swelling or pain. Symptoms must include internal heat, dry mouth, flushed face, and surging phlegm-saliva. The Chi pulse (Kidney pulse) will be rapid and forceless at the surface but weak upon pressure. This is due to the depletion of Kidney Water, allowing Ministerial Fire to become uncontrolled. One must administer Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) with added Maidong (Ophiopogon Tuber) and Wuweizi (Schisandra Fruit) in large doses as a decoction.

Furthermore, in cases of excessive sexual activity leading to the depletion of Primordial Yang, the Rootless Fire wanders uncontrollably and lodges in the throat. One must administer Bawei Shenqi Wan (Eight-Ingredient Kidney Qi Pill), prepared in large quantities, cooled before drinking, to guide the Fire back to its source. This may offer salvation. This discusses throat pain caused by Yin Deficiency; this treatment method aligns with Chu Shi’s principle of "treating upper diseases from the lower." The human throat and pharynx are like the curved flue of a chimney. If fire burns within the flue and water is poured from above, the flue will burst instantly. However, if water is heated from below at the stove base, the rising fire will extinguish. This is a verification of "treating upper diseases from the lower."

Among these, there are two distinct conditions named "Ruan E" (Goose-like swelling) and "Chan Hou" (Wrapping Throat). Swelling on both sides of the pharynx is called "Double Goose"; swelling on one side is called "Single Goose." The treatment involves dipping a goose feather in rice vinegar to stir the throat, removing all phlegm-saliva, then using the feather to induce vomiting, forcing a strong cough. Breaking the purple blood within the goose-like swelling leads to resolution. Alternatively, grinding Zijin Ding (Purple Gold Tablet) and taking it orally can cure it. For severe cases that do not dissipate, pricking the swelling to release purple blood cures it.

Ancient formulas recommend pricking the Shaoshang acupoint, which is excellent. Pricking with a needle or knife to bleed is used in emergencies. However, there are contraindications. Xue Ji’s medical case records: A fifty-year-old man suffered from swollen and painful throat. After someone pricked him to bleed, his mental clarity improved, but his Chi pulse was flooding and chaotic, yet faint and nearly imperceptible upon deep pressure. I said: This is a condition with physical signs but no pain, resembling Daiyang Syndrome (Floating Yang). It requires vigorous tonification of Yin. By injuring the Yin-Blood now, death is inevitable. He subsequently died. This case serves as a warning against crude practitioners rashly using needles and knives.

Chan Hou Feng (Wrapping Throat Wind) presents with swelling extending externally, accompanied by numbness, itching, and pain. Qianfu Jiedu Xionghuang Wan (Qianfu Antidote Realgar Pill) can be used.

**Jiedu Xionghuang Wan (Antidote Realgar Pill)**
Xionghuang (Realgar, 1 qian), Yujin (Curcuma Tuber, 1 fen), Badou (Croton Seed, 14 grains, oil and skin removed). Made into pills with vinegar paste, size of mung beans. Take with hot tea; stubborn phlegm will be vomited up, and consciousness restored immediately. If not vomited, take again.

Ancient formulas used Croton Oil spread on paper to make a burning roll. Ignite it, blow it out, and use the smoke to fumigate the nose. Saliva will flow from the mouth and nose, and the jaw will open naturally. This method can be used to insufflate the affected area for cure.

There is a type of throat pain caused by Yang Deficiency, characterized by sores in the mouth and tongue, worsening with fatigue. The pulse is necessarily floating and large. This indicates Spleen and Lung Qi Deficiency and Empty Heat in the Bladder. Lizhong Tang (Regulate the Middle Decoction) with added Shanyao (Chinese Yam) and Shanzhuyu (Cornus Fruit) should be taken to recover. For Upper Jiao Wind-Heat, Jingfang Baidu San (Atractylodes and Saposhnikovia Powder to Rescue from Misfortune) is effective. For throat swelling and pain, thirst for cold drinks, constipation, and solid pulses throughout, purgation is required for recovery. Fangfeng Tongsheng San (Saposhnikovia Powder to Unblock and Generate Health) can be used. Nowadays, most people have Empty Heat rather than Excess Heat. Such cases are rare; this method should not be used lightly.

In acute Hou Bi (Throat Obstruction), the voice sounds like snoring, and the phlegm sound resembles sawing wood. This is a sign of Lung Qi Exhaustion. Quickly prepare Renshen Gao (Ginseng Paste) and mix with Zhuli (Bamboo Sap) and Jiangzhi (Ginger Juice) for administration. If paste is unavailable, quickly decoct Dushen Tang (Single Ginseng Decoction) and take it. Early treatment saves seven or eight out of ten; later treatment saves four or five; delayed treatment is incurable.

Zhu Danxi stated: Throat swelling and pain caused by Yin Deficiency with Flying Away of Yang Qi and Phlegm knotting in the upper part present with a floating and large pulse, becoming choppy upon heavy pressure. Death is near. One should administer Nongjian Dushen Tang (Strongly Decocted Single Ginseng Decoction) and sip it slowly. Treating this as an Excess pattern brings disaster instantly.

Zhang Zhongjing stated: For Shaoyin External Heat causing throat pain, use Gancao Tang (Licorice Decoction). For Shaoyin Cold-Heat struggle, use Jiegeng Tang (Platycodon Decoction). For Shaoyin External Cold causing throat pain, use Banxia San Ji Tang (Pinellia Powder and Decoction). For Shaoyin disease where the throat is injured and sores form, preventing speech and voice production, use Kujiu Tang (Bitter Wine Decoction). For Shaoyin Yin Deficiency with External Heat causing obstruction, throat pain, chest fullness, and irritability, use Zhufu Tang (Pig Skin Decoction). People only know about Heat-type throat pain and ignore Cold-type throat pain. The Classics state: When Taiyang is in the Earthly Branch position, excess Cold causes the people to suffer from throat and chin swelling. Chen Cangqi recommended using Fuzi (Aconite Lateral Root) peeled and de-navelled, roasted until cracked and sliced, coated with honey, roasted again until honey penetrates, then held in the mouth to swallow the saliva. Replace slices as the sweet taste fades.

Zhang Zhongjing stated: For diarrhea with undigested food, Interior Cold with Exterior Heat, faint pulse nearing extinction, flushed face, and throat pain, use Tongmai Sini Tang (Pulse-Unblocking Four-Reverse Decoction). This is because latent Cold from winter resides in the Kidney Meridian; upon manifestation, it causes throat pain and diarrhea. Fuzi Tang warms the meridians to cure it.

Regarding Si Tian Yun Qi (Heavenly Stem and Earthly Branch Influence), if a village suffers epidemic infection in a certain year, and chills are present, it is often sudden Cold suppressing Heat. Cold closes the exterior, Heat stagnates inside. One must strictly avoid using Danshan (Chalcanthite) or other sour-cold agents to drop into the throat, as this further traps Yang Qi. Avoid purging with Xiaokui (Mirabilite) or Huanglian (Coptis Rhizome) etc., as this drives Yang downward into the interior, bringing immediate disaster. One must use dispersing agents, such as Zhang Zhongjing’s Ganjie Tang (Licorice and Platycodon Decoction). For Yang Du (Yang Toxin) throat pain, use Shengma Tang (Cimicifuga Decoction). For Yin Du (Yin Toxin) throat pain, use Gancao Tang. These formulas are found in *Jinkui Yaolue* and *Qianjin Fang*.

If throat pain does not respond to various medicines, it is not ordinary throat pain. It is a red thread like hair growing in the nose, suspending a black blister the size of a cherry, hanging down to the throat gate, preventing food and drink from entering the mouth. Use a straight, single-stemmed Niuxi (Achyranthes Root), wash it clean, add 4-5 drops of rice vinegar, grind finely, and drip 2-3 drops into the nostril. The red thread breaks and the blister bursts, and the illness resolves immediately.

For throat pain with ulceration persisting for a long time without healing, this is likely due to Syphilis toxin (Meiyang Chuang Du). The primary treatment must be Bibi Tang (Dioscorea Hypoglauca Decoction), specifically Tubervine Root (Tufuling).