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Bombyx Batryticatus (Erjiang) and Sophora Flavescens Root (Sushen, 苦参) are ground into fine powder and insufflated into the throat three or four times to reduce swelling and stop pain.

Huisheng Jiuku Shangqing Dan: Treats eighteen types of acute throat emergencies.
Formula: Bombyx Batryticatus (Yijian, 僵蚕), Natrii Sulfas Crystallisatum (Xiaojing, 硝尖), Borax (Pingsha, 硼砂) (each five fen), Alum (Mingfan, 明矾), Calcined Alum (Kufan, 枯矾) (each one fen), Borneolum Syntheticum (Bingpian, 冰片) (one fen), Sepiae Endoconcha (Haipiao Xiao, 海螵蛸) (three fen). Grind all into an extremely fine powder. Use a small amount to insufflate into the affected area; expel phlegm and saliva for recovery.

Chilin Dan: Effectively treats seventy-two conditions including Pharyngitis (Houbi, 喉痹), Throat Wind (Houfeng, 喉风), Throat Moth (Hou'e, 喉蛾), and Throat Abscess (Houyong, 喉痈).
Formula: Alum (Mingfan, 明矾) (two liang), Sanguis Draconis (Xuejie, 血竭) (two qian), Semen Crotonis Tiglii (Badou Ren, 巴豆仁) (twenty-one grains), Borax (Pingsha, 硼砂) (two qian), Borneolum Syntheticum (Bingpian, 冰片) (one qian). Prepare a gold ingot-shaped jar. Place Alum and Sanguis Draconis in the jar. Place Semen Crotonis Tiglii on charcoal fire until smoke ceases. After cooling, add Borax and Borneolum Syntheticum, grind into fine powder, and store. Insufflate a small amount into the affected area as needed.

Critical Throat Conditions:
Fagopyrum Dibotrys Herb (Ye Qiaomai, 野荞麦): In early spring, it bears red flowers resembling Crabapple; by June-July, it grows four to five chi tall. Leaves and stems resemble Crabapple, with red nodes and palm-sized leaves. Fresh leaves are collected, crushed for juice, mixed with one spoonful of vinegar, and applied with cotton or chicken feathers to wipe out phlegm and saliva, saving the patient.

Unilateral and Bilateral Throat Moths are both exterior syndromes. Lesions occur beside the pharynx, either unilateral or bilateral. Although the glottis is swollen, it remains partially open. Though the condition appears severe, the airway is relatively wide, so even significant swelling is not fatal. It is appropriate to use Jin Suo Chi (Golden Lock Key) powder to expel phlegm and clear accumulated heat. As stated in the classics: "Acupuncture and cauterization are suitable."
For Unilateral and Bilateral Fleshy Moths, acupuncture should be used if possible. If not, insufflation medicines or drastic purgatives should be used to expel wind-phlegm for rapid effect, followed by decoctions, as acute conditions cannot wait.

Swelling on both sides of the throat is Bilateral Throat Moth (Shuang'e, 双蛾), which is easy to treat. Swelling on one side is Unilateral Throat Moth (Dan'e, 单蛾), which is difficult to treat. If accompanied by aversion to cold and exterior symptoms, use Jingfang Baidu San (Atractylodes and Saposhnikovia Decoction to Overcome Toxicity) to dissipate the exterior. If there is no aversion to cold or exterior symptoms, use acrid-cool methods to clear and benefit the throat. Externally, use chicken feathers dipped in rice vinegar to probe the throat, remove all phlegm, and induce vomiting. Force the patient to cough hard to rupture the purple blood within the moth, causing it to ulcerate. Alternatively, grind Zijin Ding (Purple Gold Pill) with water and swallow; peace will ensue. Do not lightly use knives or needles. Ancient formulas suggest using paper twisted with Croton oil, lighting it, blowing it out, and smoking the nose to induce salivation and relax the jaw. Then insufflate the medicine into the lesion for cure.

Conditions vary in severity; some are worse during the day and lighter at night, making them easier to treat. Use Radix Sophorae Tonkinensis (Shandougen, 山豆根) and Platycodonis Radix (Jiegeng, 桔梗) each three qian, Licorice Root (Gancao, 甘草) and Pinelliae Rhizoma Preparatum (Banxia, 半夏) each one qian. One dose brings immediate relief. Accurate diagnosis and targeted medication ensure efficacy.

Unilateral Moth: Small shape like a tendon head, located above the isthmus of the palate, left or right. Bilateral Moth occurs on both sides. If located below the isthmus, it is difficult to treat.
The left pharynx governs swallowing; the right larynx governs voice. The glottis has two pathways, and diseases differ by location.
Bilateral Moth with Wind: Two bean-sized masses appear on both sides of the throat. Immediately use Scutellariae Radix (Huangqin, 黄芩) juice with a little honey and Natrii Sulfas (Yuanmingfen, 元明粉) to gargle, expelling wind-phlegm, then insufflate Borneolum Syntheticum Powder (Bingpian San, 冰片散).

Tonsillar Moth (Rumei, 乳蛾): Can be unilateral or bilateral, sometimes connected like beads. Often caused by stagnation from alcohol and sexual excess. Unilateral is mild; bilateral is severe. Day 1: pain; Day 2: redness and swelling; Day 3: formation of white spots like fine stars; chills and fever indicate a critical prognosis. By Day 4, the condition stabilizes; treatment leads to recovery in 4-5 days. Lesions are beside the throat. Unilateral is Dan'e; bilateral is Shuang'e. Connected white spots are called Lianzhu (Connected Beads).

When Bilateral/Unilateral Moths prevent swallowing liquids, check the scalp hair for small pits. Break them to bleed, immediately opening the passage. Decoct Polygonum aviculare root juice (Tuniuxi Gen Zhi, 土牛膝根汁) and swallow frequently. Insufflate Jin Suo Chi San (Golden Lock Key Powder) and Bingpeng San (Borneol and Borax Powder).

To treat Tonsillar Moth: First insufflate Bidan (Green Pill) and Wujin Dan (Five Metals Pill). Then insufflate Jindan (Gold Pill) and Bidan in a 2:3 ratio. Expel phlegm and use decoctions. Add Rhinoceros Horn (Xijiao, 犀角) and Coptidis Rhizoma (Huanglian, 黄连) for the left side; add Red Peony Root (Chishaoyao, 赤芍药) and Bupleuri Radix (Chaihu, 柴胡) for the right side. For Connected Beads type, combine treatments. If constipated, add Natrii Sulfas (Yuanmingfen, 元明粉) and Rheum Palmatum (Dahuang, 大黄) along with insufflation.

Tonsillar Moth results from accumulated heat in the Lung Meridian combined with wind condensation. It appears beside the throat, resembling silkworm moths. Bilateral is milder; unilateral is heavier. Those anterior to the isthmus are visible, accessible to medicine, and easy to treat. Those posterior are hidden, inaccessible, and difficult to treat.
Left-side deficiency fire attacking upward causes slight redness, named Single Tonsillar Moth. If Lung Qi is constrained, presenting with cold limbs, spontaneous phlegm, heavy head, and dizziness, urgently administer Rapeseed Vinegar Juice (Youcai Cu Zhi, 油菜醋汁) with Natrii Sulfas (Yuanmingfen, 元明粉) to induce vomiting of phlegm. If severe collapse with loss of consciousness occurs, apply Fuzi (Prepared Aconite Root, 附子) paste mixed with vinegar to the sole of the foot. Right-side deficiency fire attack presents with yellowish color and cold limbs, resembling a silkworm, hence called Tonsillar Moth.

For Yin-deficiency Bilateral Moth: Use one qian of Fuzi (Prepared Aconite Root, 附子) stir-fried in salt water. Hold one piece in the mouth to create a pathway for decoctions. Then take eight liang of Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) with plain water for immediate recovery.

Yin-type Bilateral Moth is hardest to treat yet easiest once understood. I often treat this using one piece of Fuzi (Prepared Aconite Root, 附子) boiled in salt water, held in the mouth to stop the fire immediately, followed by large doses of Liuyun Dihuang Wan (Six-Ingredient Pill with Rehmannia) to prevent recurrence. This is a divine prescription. Honey-roasted Fuzi can also be held in the mouth. Both salty and sweet tastes are effective.

Patients with Bilateral Moth are often mistaken for having Heat Syndrome due to swelling, pain, profuse frothy sputum, and inability to swallow fluids. However, pain is lighter in the morning, tongue is not dry despite swelling, and sputum is not yellow or clotted. This is False Heat. Using cold herbs provides temporary relief but worsens heat later. Urgently prick Shaoshang (LU11, 少商) acupoint to bleed slightly to open a passage. Then decoct Fuzi (Prepared Aconite Root, 附子) one qian, Shudi (Prepared Rehmannia Root, 熟地) one liang, Cornus Officinalis Fruit (Shanzhuyu, 山茱萸) four qian, Poria (Fuling, 茯苓) five qian, Ophiopogon Tuber (Maidong, 麦冬), Achyranthes Root (Niuxi, 牛膝), and Schisandra Berry (Wuweizi, 五味) each three qian. Swallowing produces a loud sound, and the fire/heat dissipates instantly. This is because Shaoyin Fire rushes like a horse; when Kidney Fire is depleted, Yuan Yang cannot descend, leading to floating fire. The throat is too narrow to accommodate this rising fire, causing swelling resembling Bilateral Moth. The formula's brilliance lies in using acrid-hot Fuzi to guide Dragon-Lei Fire (Ministerial Fire, 相火) back to its residence. Ministerial Fire prefers Water (Yin) over Fire (Yang). Ingredients like Shudi and Shanzhuyu nourish Yin, giving the fire a home. This guides the counter-flowing fire. Note: "Prefers Water" means True Yin Water, not cold herbs; "Dislikes Fire" means Evil Heat Fire, not acrid-hot herbs.

Throat swelling with Bilateral Moth preventing eating for five days is fatal. Excess Fire is easy to treat with Huangqin (Scutellaria Root, 黄芩) and Huanglian (Coptis Rhizome, 黄连). Deficient Fire is harder; it is Kidney Fire floating between Mingmen and the throat. Symptoms mimic Excess Fire but are worse at night and lighter in the morning. Excess Fire is worse in the morning; Deficient Fire is not thirsty with a slippery, non-cracked tongue. Differentiate carefully. Treating Deficient Pain with Excess Fire methods is like adding stones to a well. Cold and dispersing herbs are contraindicated; tonification is required. Simply tonifying Kidney Water may not control strong fire. It is better to tonify Fire within Water to guide Fire back to its origin. Use Yinhuo Tang (Guide Fire Back to Source Decoction): One dose calms phlegm, stops pain, and reduces swelling; two doses cure. Shudi, Shanzhuyu, and Wuweizi tonify Kidney Water. Fuling and Shanyao benefit essence and drain dampness, assisting Rougui (Cinnamon Bark, 肉桂) to descend. Xuanshen (Scrophulariae Radix, 玄参) clears floating fire; Baijiez (White Mustard Seed, 白芥子) resolves obstructive phlegm. With the upper jiao cleared and lower jiao warmed by Rougui, Ministerial Fire returns to Mingmen. This is more effective than Liuwei Dihuang Wan. If the throat is completely blocked, this decoction cannot be swallowed. Alternative method: Grind Fuzi (Prepared Aconite Root, 附子) and Psoralea Fructus (Puguzhi, 破故纸) into paste, apply as a plaster to the center of the sole for one hour to open a passage for medication.

Yin Moth: Kidney Water deficiency allows Fire to fly upward. The throat isthmus is narrow, trapping Fire, forming a moth-like appearance. Pain is light in the morning, heavy in the afternoon/evening, relieved by heat, aggravated by cold. Severe cases cannot swallow water. Treating as Exterior Yang Syndrome with Shandougen (Sophora Root, 山豆根), Huanglian (Coptis, 黄连), or Zhizi (Gardenia Fruit, 栀子) worsens pain and obstruction, potentially causing death. Tonify Yin deficiency and guide Fire back to source using Huamei Tang (Transform Moth Decoction). This formula greatly tonifies Kidney Water. Strengthening Water extinguishes Fire; guiding Fire eliminates pain.

Throat swelling/pain lighter in day, heavier at night, resembling Yang Syndrome but less painful, with dryness and excessive watery phlegm that dissolves in water. This is Yin Moth. Yin Moth is lighter in day/heavier at night; Yang Moth is heavier in day/lighter at night. This is Shaoyin Kidney Water failing to hide, flaming upward. Treat by tonifying Kidney Water and adding Fire-tonifying herbs to guide Fire back to source. Use Yinhuo Tang (Guide Fire Back to Source Decoction): Shudi (Prepared Rehmannia Root, 熟地) three liang, Ejing Tian (Morinda Officinalis Root, 巴戟天) and Maidong (Ophiopogon Tuber, 麦冬) each one liang, Fuling (Poria, 茯苓) five qian, Wuweizi (Schisandra Berry, 五味) two qian. Decoct and drink. One dose lowers fire and reduces swelling; two doses cure. Shudi tonifies Kidney Water; Maidong and Wuweizi nourish Lung Metal. Metal and Water support each other. Ejing Tian warms and tonifies Water. Fuling guides Water downward. This harmonizes Water and Fire without needing Gui (Cinnamon Twig, 桂枝) or Fu (Aconite, 附子), which consume Water long-term. Ejing Tian guides Fire while tonifying Water, keeping the throat clear.

Wind-Cold invasion causing acute throat swelling and Bilateral Moth with thick phlegm, thirst, and inability to swallow indicates Yang Fire blocking the throat. This is superficially severe but actually mild. Taiyang Fire (Bladder Fire) and Kidney Fire are exterior-interior pairs. Bladder Fire agitation aids Kidney Fire, rushing to the throat, joined by Spleen/Lung/Stomach Fire and phlegm. Although treating multiple meridians seems necessary, the root is Taiyang. Draining Bladder Fire calms other meridians. However, the throat is near the Lung, a strategic battlefield. Simultaneous treatment is best. Qingzao Tang (Clear Dryness Decoction): Jiegeng (Platycodon Root, 桔梗), Xuanshen (Scrophularia Root, 玄参), and Fengmi (Trichosanthes Root, 花粉) each three qian, Gancao (Licorice, 甘草) two qian, Baishao (White Peony Root, 白芍) five qian, Shandougen (Sophora Root, 山豆根), Chaihu (Bupleurum Root, 柴胡), and Mahuang (Ephedra Stem, 麻黄) each one qian. Decoct. One dose widens the throat; two doses eliminate moths. This formula disperses Taiyang pathogenic factors (4 parts) and other meridians (6 parts), focusing on the Lung.

Sudden throat swelling/pain, surging phlegm, thirst, and Bilateral Moth resembling a rooster comb is Hou Bi (Pharyngitis), commonly known as Chanhou Feng (Wrapping Throat Wind). It involves simultaneous blazing of Shaoyang Ministerial Fire and Shaoyin Sovereign Fire. The narrow airway traps fire, causing initial swelling then moth formation. Bilateral Moths leave a gap allowing liquid intake. Unilateral Moths block the airway completely. Acupuncture alone is slow. Directly incise the swelling slightly to allow insufflation.

Insufflation Formula: Ya Zhao (Burned Toothpod Fruit, 牙皂), Dan Fan (Calculated Alum, 胆矾), Niuhuang (Calculus Bovis, 牛黄), Bingpian (Borneol, 冰片) each one fen, Shexiang (Musk, 麝香) three li. Grind fine, insufflate to expel phlegm. Follow with Jiuhou Tang (Save Throat Decoction): Xuanshen (Scrophularia Root, 玄参) one liang, Maidong (Ophiopogon Tuber, 麦冬) five qian, Fengmi (Trichosanthes Root, 花粉) three qian, Shandougen (Sophora Root, 山豆根), Gancao (Licorice, 甘草), and Yeganye (Belamcanda Rhizome, 射干) each one qian. Decoct for immediate effect.
For Bilateral Moth, prick Shaoshang (LU11, 少商) only, then use these formulas. Xuanshen clears Heart/Kidney Fire; Shandougen, Yeganye, and Fengmi dispel pathogens and resolve phlegm.

Bilateral/Unilateral Moth Insufflation: Huoxiao (Saltpeter, 火硝) one qian five fen, Pingsha (Borax, 硼砂) five fen, Xionghuang (Realgar, 雄黄) one fen, Bingpian (Borneol, 冰片) three li. Grind fine, insufflate into throat or nostrils.

Throat Insufflation: Human Nail (any amount), Mingfan (Alum, 明矾) three qian, Large Spider (one). Grind in silver jar with Bingpian (Borneol, 冰片) one fen.

Nasal Obstruction Formula: Badou Rou (Croton Flesh, 巴豆肉) and Xixin (Asarum Root, 细辛) equal parts. Grind, wrap in cotton. Left Moth: stuff right nostril. Right Moth: stuff left nostril.

Treats Throat Moth, Pharyngitis, Throat Wind, Carbuncles, and Boils: Wulongzhao (White Flower Vegetable, 乌龙爪) dried and ground one qian with Bingpian (Borneol, 冰片) three-five li. Insufflate. For carbuncles/boils, apply crushed leaves topically.

Treats Throat Moth and Mouth Ulcers: Shanmu Pi (Fir Bark, 杉木皮) calcined, Renzhongbai (Human Bone Ash, 人中白), Ercha (Terminalia Chebula Resin, 儿茶) each three qian, Zhenzhu (Pearl, 珍珠), Hupo (Amber, 琥珀), Ganshi (Calamine, 甘石), Qingdai (Indigo Naturalis, 青黛) each one qian, Bingpian (Borneol, 冰片) six fen. Grind fine, insufflate. Rinse mouth first with Huanglian (Coptis, 黄连), Gancao (Licorice, 甘草), Bohe (Mint, 薄荷), and Songluocha (Old Man's Beard Moss, 松萝茶). Prick red veins behind ears to bleed for cure.

Critical Throat Moth, Lichen Planus, Abscess with inability to swallow: Fenghuangyi (Silkworm Cocoon Membrane, 凤凰衣), Ganlan He (Olive Pit, 橄榄核) calcined, Ercha (Terminalia Chebula Resin, 儿茶) equal parts. Grind fine. For each qian, add Bingpian (Borneol, 冰片) five li. Insufflate for immense effect.

Urgent Tonsillar Moth Formula: Pig Gallbladder from Laba Festival, filled with Baijian (Alum, 白矾) powder, dried, ground, refilled, repeated 3-4 times. Insufflate one-two fen for divine effect.

Miracle Formula: Grass Carp Gallbladder (one) with seven glutinous rice grains, hung in shade for 49 days. Unilateral: one grain under tongue. Bilateral: two grains. Swallow saliva.

Polygonum aviculare (Tuniuxi, 土牛膝) juice swallowed frequently or brewed as tea is excellent.