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The throat (hou) accepts air and connects with Heaven; the pharynx (yan) accepts food and connects with Earth. The epiglottis (huiyan) is located superiorly and governs opening and closing. Precisely because it serves as the gateway for respiration of the Heart, Lung, Liver, and Kidney, and as the pathway for diet, voice, and qi transformation, its condition relates to life and death, and harm can occur rapidly. The Classics state: "When one Yin and one Yang knot together, it is called Hou Bi (throat obstruction)." Hou Bi is the general term for such conditions, among which wind-warmth sore throat (feng wen hou tong) is most common, and internal and external treatments should be combined.

Specific manipulations include: Fen Yin Yang (divide yin and yang) (200 times), Tui San Guan (push Three Gates) (100 times), Tui Liu Fu (push Six Bowels) (100 times), Qia Xin Jing (pinch Heart Meridian) (50 times), Qia Zong Jing (pinch General Meridian) (50 times), Qing Tian He Shui (clear River Water) (50 times), Shui Di Lao Ming Yue (fish bright moon from the bottom of the water) (50 times), Xie Shen Shui (drain Kidney Water) (50 times), Er Long Xi Zhu (two dragons playing with a pearl) (36 times), Yun Dou Zhou (rotate elbow dipper) (50 times). All pushing techniques should use ginger and scallion water as a medium.

Note: Cheng Zhongling, in his *Ten Methods of Surgery*, stated that not bleeding swollen throats, not inducing expectoration for throat wind, not draining pus for throat abscesses, and not puncturing tonsils are all incorrect methods. When using knives or needles, one must never injure the Diding (uvula/pillar area) or the root of the tongue. You Shi considered Hou Bi to be related to phlegm, and Hou Feng (throat wind) to be related to fire, generally caused by constrained fire and heat toxins leading to symptoms such as Ru E (tonsillar swelling). Treatment should involve dispelling wind and resolving phlegm, clearing heat and relieving constraint, after which the condition will naturally heal. In the early stage with chills and fever, dispersing methods are required. Once constipation of both bowels occurs, indicating excess fire, purgative methods should be used. Cold-natured drugs should not be used abruptly, as this may cause phlegm and excess to knot in the chest, stagnate due to cold, and gradually progress to fatal asthma and obstruction. For cases of urgent breathing difficulty and obstruction approaching death, blowing, vomiting-inducing, and needle methods must be employed urgently. The blowing method involves insufflating powder of Borax (Peng Sha) and Alum (Dan Fan), or a small amount of Sophora Flower (Zao Jiao) powder into the nose; sneezing will open the airway. The vomiting method involves crushing Sophora Flower, soaking it in water, and pouring the water into the mouth to induce vomiting, or grinding Realgar (Xiong Huang) in fresh well water and pouring it in to induce vomiting, or dipping a chicken or goose feather in 1-2 drops of tung oil, placing it in boiling water, tapping the water with chopsticks, and then inserting the feather into the throat to provoke vomiting. The needle method involves using a three-edged needle to prick the swollen area of the throat to release blood. If the jaw is locked and the needle cannot enter, warm the limbs with warm water if they are cold. Prick the Shaoshang (LU11) acupoint on both sides to a depth of two fen, releasing blood; the mouth will open, and the throat will feel relieved. Alternatively, prick the Zhaohai (KI6) and Ran Gu (KI2) acupoints until blood beads form; recovery can be sought through these methods. If blood from the Shaoshang point flows out diffusely and does not coagulate, the case is incurable. Recently, there has been a disease called Lan Hou Sha (rotten throat sand/scarlet fever-like illness), which is extremely dangerous. In the initial stage, there is aversion to cold, high fever, sore throat, thirst, and irritability;辛凉清散 (acrid-cool clearing and dispersing) is appropriate. If cold-natured drugs are taken abruptly, external pathogens become more closed, internal fire flares up, sore throat worsens, and ulceration increases daily. Once the scarlet rash (Dan Sha) erupts and symptoms like aversion to cold disappear, cold-natured drugs should be used to drain heat, and acrid-dispersing drugs should not be mixed in, lest they stir up wind-fire, increasing swelling and corruption, leading to an inability to swallow even a drop of water and pain like knife-cutting. This disease arises from contracting wind-fire damp-heat. For cases due to wind-heat, the treatment principle is clearing and penetrating. Pu Ji Xiao Du Yin (Universal Relief Decoction to Eliminate Toxins), without Sheng Ma (Cimicifugae Rhizoma) and Chai Hu (Bupleuri Radix), is the main formula. For cases due to damp-heat, the principle is clearing and leaching; for cases where phlegm-fire aggregates, the principle is dissipating and descending. When pathogens reach the exterior, the rash emerges; when the rash emerges, rotting stops. The concern is that toxic vapors lie deep within, constrained and unable to erupt, forming the condition of Men Sha (stifled sand). Many people in Hangzhou suffer from this. It is caused either by epidemic toxins sinking inward or by quacks treating incorrectly. Using acrid-wind-drying herbs like Chai Hu, Ge Gen, and Sheng Ma lifts heat toxins into the throat. City physicians often fall into this trap, causing patients to die immediately. Alas, this is mis-treatment. Physicians do not realize it, nor do families, though those who die might know, but can the dead be content? I have written *Sha Hou Zheng Yi* (Correct Principles for Sore Throat and Sand Disease), which will soon be published. I hope scholars throughout the land will correct any errors, which would be greatly appreciated. (Tili Zi)