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Zi Hezi stated: The pharynx (Yan) and larynx (Hou), the epiglottis (Huiyan) and tongue (She), these four structures share the same gate but have distinct functions. The larynx is for monitoring qi, while the pharynx is for swallowing food. The epiglottis is located above and below the larynx, controlling opening and closing; when eating, it inhales and covers the pharynx, and when exhaling, it opens to let air out. Therefore, when the tongue touches the upper palate, the epiglottis can cover the pharynx. These four interact with each other, serving as the gateway for qi and food entry and exit, which is the most critical area. Thus, the *Nan Jing* mentions the "Seven Rushing Gates," and the area below the epiglottis is called the Gate of Inhalation (Ximen). When disease occurs in these areas, it can be summarized in one word: Fire (Huo). The *Nei Jing* states: "When one Yin and one Yang knot together, it is called throat obstruction (Houbi)." One Yin refers to the meridian qi of the Hand Shaoyin Jueyin Heart Pericardium (Shou Shao Yin Jun Huo Xin Zhu); One Yang refers to the meridian qi of the Hand Shaoyang Sanjiao (Shou Shao Yang Xiang Huo). Both fires primarily govern the vessels and connect to the throat. Excess qi leads to internal knotting; severe knotting causes swelling; severe swelling causes obstruction; severe obstruction leads to death. Investigating the twelve meridians, only the Foot Taiyang Bladder Meridian branches down the neck, while all others converge at the throat. Why does the *Nei Jing* specifically state that the knotting of one Yin and one Yang causes Houbi? It is likely because the Jueyin and Shaoyang fires prevail exclusively, causing heat to knot in the main collaterals, resulting in rapid pain. All mentions in the twelve meridians regarding dryness of the pharynx (Yigan), pain in the pharynx (Yatong), swelling of the pharynx (Yanzhong), swelling of the jaw (Hanzhong), and stiffness of the tongue root (Sheben) are caused by Jueyin Fire. Only Houbi occurs most rapidly, which is the action of Shaoyang Fire. Jueyin Fire is like human fire, while Shaoyang Fire is like dragon fire. Human fire burning wood has a slow momentum; dragon fire burning wood has a fast momentum. In the *Nei Jing*'s discussion of Houbi, the pharynx and tongue are included. Because their pathology is both Fire, they are not distinguished. Later generations established eight names: Dan'e (Single Tonsil), Shuang'e (Double Tonsils), Danbi (Single Closure), Zishe Zhang (Child Tongue Swelling), Musheshe Zhang (Wooden Tongue Swelling), Chanhou Feng (Entangling Throat Wind), and Zouma Houbi (Running Horse Throat Obstruction). Life and death can turn in an instant. Treatment is best achieved by bloodletting with a bi needle; once blood flows, the disease resolves. However, Houbi belongs to Dragon Fire. Although cooling agents are used, patients should not be commanded to ingest them. It is appropriate to use fire methods to drive it out, using heat to move cold, avoiding rejection by the heat pathogen, thereby dispersing the Dragon Fire. For any wound created by needling, crush a piece of ginger, mix with hot water, and sip occasionally to facilitate healing. The *Nei Jing* says "disperse fire stagnation"; bloodletting is one aspect of dispersion. For mild cases, salty substances can soften hardness. For severe cases, pungent substances can disperse, such as Bohe (Menthae Haplocalycis Herba), Wutou (Aconiti Radix), Jiangcan (Bombyx Batryticatus), Baifan (Alumen), Puxiao (Natrii Sulfas), and Tonglv (Chalcanthitum).

Fang Yuezhi stated: The symptoms of Chanhou Feng and Houbi involve patients who have phlegm-fluids (Tanyan) in the diaphragm region. These may arise from overeating, emotional anger, or sexual indiscretion. Why? Excessive drinking moves Stomach Fire; emotional anger moves Liver Fire; sexual indiscretion moves Kidney Fire. Fire movement carries phlegm upward, forming Phlegm-Heat, which burns and obstructs the throat, causing internal and external swelling and pain, preventing the intake of fluids. Treatment principle: Treat the branch in acute stages, treat the root in chronic stages. To treat the branch, use pills and powders to induce vomiting and dissipate heat-phlegm; to treat the root, use decoctions to descend fire and tonify deficiency. Previous formulas mention wind-heat without addressing phlegm; they mention treating Spleen and Liver fire but do not mention descending Kidney and Liver fire. I add my humble opinion: If accompanied by phlegm, add Gualou (Trichosanthis Fructus), Banxia (Pinelliae Rhizoma), or Qianmin Tang; if accompanied by Liver fire, add Chaihu (Bupleuri Radix), Huanglian (Coptidis Rhizoma), or Xiaochaihu Tang, Zuojin Wan; if accompanied by Kidney fire, add Shengdi (Rehmanniae Radix), Huangbai (Phellodendri Cortex), or Siwu Tang plus Zhimu (Anemarrhenae Rhizoma) and Huangbai. The five zang and six fu organs all contain fire, but the fire of these three meridians often alternates to cause the most diseases.

Zhao Yangkui stated: Throat and pharynx pain differ. The larynx is the portal for lung respiration, governing exhalation but not ingestion; the pharynx is the pathway for stomach digestion, governing ingestion but not exhalation. The classics state: Diseases of the Foot Shaoyin Kidney Meridian include thirst, dry tongue, swollen pharynx, rising qi, dysphagia, and pain. The *Su Wen* says: Pathogens invading the Foot Shaoyin collateral cause throat pain and inability to eat. It also states: The Foot Shaoyin collateral runs along the throat and connects to the tongue root. All throat pains are diseases of Shaoyin, differing in cold, heat, excess, and deficiency. Shaoyin Fire rushes like a galloping horse, counterflowing upward. Reaching the tight lock of the throat, it knots and cannot relax, causing swelling or pain. Symptoms must include internal heat, dry mouth, red face, surging phlegm-fluids, and a chi pulse that is rapid yet forceless. This is due to dried-up Kidney Water failing to control Shaoyang Fire. One must use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus) in large doses as a decoction. For those with excessive sexual activity leading to Yuan Yang deficiency and uncontrolled rootless fire lodging in the throat, use Bawei Shenqi Wan (Eight-Ingredient Kidney Qi Pill) in large doses, cooled before drinking, to guide fire back to its source. This treatment aligns with Chu Shi's principle of "treating lower body disorders for upper body symptoms." The above discusses Yin-deficiency throat pain.

Zhang Jingyue stated: Houbi differs between Excess Fire and Deficiency Fire. Excess Fire can be cleared; Deficiency Fire indicates Water Deficiency. There is also True Cold due to Yin Excess repelling Yang, which should not be cleared. The classics say: When Taiyang is in the interior, excessive cold causes people to suffer from throat pain and jaw swelling. This explains the meaning. Regarding meridians involved in Houbi—Shaoyang, Yangming, Jueyin, Shaoyin—these are Wood-Fire organs and thus prone to heat syndromes. Yangming is the sea of water and grain, with Stomach Qi penetrating directly to the throat, making Fire particularly severe. Cases arising from emotional depression and anger mostly belong to Shaoyang and Jueyin; those caused by rich, sweet, pungent, and hot foods mostly belong to Yangming; this is Excess Fire. If the Shaoyin collateral from Henggu ends at the epiglottis and ties to the tongue root, with Yin Fire counterflowing upward, it often causes Houbi. Excess Fire presents with typical Fire symptoms and pulses. If caused by excessive wine and sex leading to True Yin deficiency, it is Kidney Deficiency Fire, requiring nourishment of Water. If Fire is deficient below and repels Yang above, it is rootless Fire, requiring warming and tonification of the Mingmen (Gate of Life).
Fire floating upward and knotting in the head, face, and throat requires clearing and descending; ascending and dispersing must be avoided. Ascending makes Fire more intense, contradicting the principle of dispersing Fire stagnation. The classics say "suppress what is high," which applies here.
Yin-deficiency Houbi often involves internal heat, thirst, dry throat, red lips and cheeks, and abundant phlegm, but the chi pulse lacks spirit, being rapid yet floating, soft, and forceless. If caused by excessive wine/sex or innate Yin deficiency with fatigue, it is Water failing to control Fire. For severe Fire, use nourishing Yin methods, Bawei Jian. For mild Fire with hard stools and hot urine, use Liuwei Dihuang Tang.
Ge-Yang Houbi results from Fire not returning to its source, presenting with upper heat and lower cold. The six pulses are weak and faint, lacking slippery or large qualities, with no heat signs in the lower body and abdominal preference for warmth. This is caused by sexual injury to essence and diarrhea injuring the Kidney; use Bawei Dihuang Tang.
Yang-deficiency Houbi: It is not that Houbi causes Yang deficiency, but that Yang deficiency results from Houbi treatment. Over-aggressive treatment of Houbi damages Stomach Qi. Internal Middle Qi deficiency with external pressing pain often leads to flying away of Yuan Yang, presenting with floating-rapid or weak-choppy pulses and a voice like sawing wood. This is a sign of impending Lung and Stomach collapse; urgently restore Yuan Qi with Dushen Tang. Add Zhuli (Bambusa Textilis Caulis Juice) and Jiangzhi (Zingiberis Recens Juice) for profuse phlegm. Using cold-cooling agents again will lead to untreatable conditions.