Library

Throat Bi (Obstruction of the Throat) refers to the condition where breathing through the throat is obstructed, speech is impossible, caused by the closure of Heaven's Qi; Yan Tong (Sore Throat) and Ai Tong (Pain in the Pharynx) refer to the inability to swallow saliva and food due to the closure of Earth's Qi. Diseases occurring in rural areas with identical symptoms belong to the pathogenic factors of Tian Xing Yun Qi (Heavenly Movement and Luck Qi), and the treatment method should first employ exterior-dispersing techniques. It is strictly forbidden to use sour medicines for application or cold medicines for purgation, as this may cause the exterior pathogens to become depressed inside and unable to exit. There are two types of this disease:

The first type belongs to Fire. The Classics state: "When Shaoyang (Lesser Yang) Qi arrives, it causes Throat Bi." It also states: "In the governance of Shaoyang with Heaven, during the third Qi phase, when hot summer heat arrives, the people suffer from Throat Bi," at which time Zhongjing's Jiegeng Tang (Platycodon Decoction) should be used. If the face is red with macules, it belongs to Yang Du (Yang Toxin), and various formulas for treating Yang Du can be used to induce sweating for cure.

The second type belongs to Yin-Dampness. The Classics state: "When Taiyin (Greater Yin) Qi is abundant, internal depression of Fire Qi causes Throat Bi." It also states: "When Taiyin governs the lower region, excessive Dampness causes swelling of the pharynx and Throat Bi," at which time Banxia Guizhi Gancao Tang (Pinellia, Cinnamon Twig, and Licorice Decoction) from *Huo Ren Shu* should be used. If the face is blue-black, it belongs to Yin Du (Yin Toxin), and methods for treating Yin Du involving sweating can be employed.

Mr. Xiaoshan stated: "For Throat Bi patients who do not fear cold, and whose Cun (Cun position pulse) pulse is larger, slippery, and solid compared to Guan (Guan position) and Chi (Chi position) pulses, all belong to Lower Jiao excess syndromes. It is suitable to use cold medicines like Shishi (Niter) and Qingdai (Indigo Naturalis) to descend, or astringent agents like Danfan (Chalcanthite) to consolidate." Mr. Han He stated: "When the Cun pulse is larger than the Guan and Chi pulses, it is suitable to reduce Yang and assist Yin." Mr. Dongyuan stated: "Solid pulses in both Cun positions indicate Excess Yang and Deficient Yin; purgation will lead to recovery." Therefore, I followed these methods to treat the aforementioned symptoms, achieving results as immediate and effective as striking a drum with a mallet.

Chen Wuyue treated Throat Bi causing aphonia using Xiao Xuming Tang (Minor Continuation of Life Decoction) plus seven Xingren (Apricot Seeds), which was very effective after decoction and ingestion. Materia Medica records that for sudden Qi urgency and fatal Throat Bi, Bai Jiangcan (Bombyx Batryticatus) powdered and taken with Ginger Juice leads to immediate recovery. Danxi said: "Jiangcan belongs to Fire but possesses Earth and Water natures, formed by obtaining Metal Qi. In treating Throat Bi, its clearing and transforming Qi within Fire is utilized to regulate Ministerial Fire and dissipate turbid, rebellious, stagnant phlegm."

Chen Cangqi treated each case of Zang Cold causing Yan Bi (Pharyngeal Closure) and difficulty in swallowing or spitting by using Fuzi (Aconite Lateral Root) peeled and processed, coated with honey and roasted, instructing the patient to hold it in the mouth without swallowing.

Sun Yaban treated Pan Yuancong, the Duke of Wei, for Hou Bi (Throat Closure). Sun blew half a qian of medicine into the throat; after a short while, pus and blood were expelled, leading to immediate recovery. Pan visited Sun to thank him, saying: "Such an urgent affliction could only be saved by you, my enlightened lord; relieving others' emergencies requires medicine. I present a hundred taels of gold and wish to obtain the prescription to aid in such critical emergencies." Sun replied: "Use Zhu Ya Zao Jiao (Gleditsia Sinensis Fruit), Bai Fan (Alumen), and Huanglian (Coptis Rhizome) in equal parts, dry-roast on a new tile, and powder them." He then gave the formula but did not accept the gift.

Qianfu said: "In the spring of the Wuchen year, many in the countryside suffered from Throat Bi, due to the Fire pathogenic factors of the final Qi of the previous year and the initial Qi of the current year. Formulas containing Ganjie Qin, Huanglian, Banxia, Jiangcan, Niubangzi, and Gegen were used to disperse; for deficiency, Renshen, [missing character], and Danggui were added. If water and fluids cannot enter, Jiedu Xionghuang Wan (Detoxifying Realgar Pill) dissolved in vinegar is administered first; after phlegm is expelled, Ginger Juice is given again. Taking the aforementioned medicines yields miraculous results. However, if treated with acid-cold agents like Danfan applied to the throat, they are incurable because the pathogens remain depressed and cannot exit. The above treatment methods are recorded in *Neijing Mizhi* as excellent life-saving methods, hence recorded here, as seen in *Yixue Gangmu*."

Clinical Cases:

Tingping Zhang Ruhhan suffered from sore throat, worsening in the late afternoon. This was Qi and Blood deficiency with Heat. He recovered after taking Bazhen Tang (Eight Treasures Decoction). Later, whenever he engaged in sexual intercourse, he experienced fever and headache. He took Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Maimendong and Wuweizi, along with Liuwei Wan (Six-Ingredient Pill with Rehmannia), regularly, and it never recurred.

Qiuguan Ye, constitutionally Yin-deficient, suddenly developed sore throat, aversion to cold and fever, headache, neck stiffness, staring eyes, and involuntary urination following anger. These are all symptoms of Liver Fire. The Liver governs sinews and fascia; Fire governs swelling. When Fire is vigorous, Blood dries up and sinews contract, causing tightness in the neck as if being pulled. Yin protrusion and flaccidity lead to urinary incontinence. Acupuncture was performed on the affected area to release toxic blood. Siwu Tang (Four Substances Decoction), Chaihu, Zhizi, Xuanshen, and Gancao were used, and the patient revived. Subsequently, ingredients of Liuwei Wan were used to generate Liver Blood and nourish Kidney Water, curing all symptoms.

Taishou Ye suffered from swollen and painful throat, difficult expectoration of phlegm-saliva, heat in hands and feet, and a preference for cold drinks and food. Two doses of Qingyan Lige Tang (Clear Throat and Benefit Diaphragm Decoction) were ineffective. Shaoshang acupoint was needled, providing slight relief to the throat. Phlegm was expelled from the nose like glue, and purple blood from the lesion provided slight relief. On the seventh day, foul pus was coughed up, and he recovered.

A scholar, after completing three rounds of examinations, suddenly developed swollen and closed throat, unconsciousness, panting with surging phlegm, profuse sweating like water, flaccid limbs, and a floating, large, and rapid pulse. This was rootless deficient Fire flaming upward due to dietary irregularities and overwork. Buzhong Yiqi Tang plus Rougui (Cinnamon Bark) was administered, resulting in immediate revival after one dose.

Yishi Gu Keming suffered from throat pain and night fever. This was Heat from Liver and Kidney Yin deficiency. Siwu Tang was used, plus Jiuchao Hei Huangbai (Wine-fried blackened Coptis Rhizome), Zhimu, and Maimendong... [text missing] hoarseness, thirst, fever, and foot heat in the late afternoon. Zishen Wan (Kidney-Nourishing Pill) and Jiajian Bawei Wan (Modified Eight-Flavor Pill) were taken alternately for over three months. Fortunately, being young and strong, and adhering strictly to health regimens, he recovered.