Library

The throat area: the left side, the pharynx (Yan), belongs to the Stomach; the right side, the larynx (Hou), belongs to the Lung. This is the vital hub of the entire body. It serves as the passageway connecting all joints and is the route through which breath enters and exits. The Classics state: "When one Yin and one Yang knot together, it is called Hou Bi (Laryngeal Obstruction)." Bi means obstruction. There are syndromes caused by Wind, Cold, Summerheat, Dampness, Dryness, Fire, Yin Deficiency, and Excess Heat. All these conditions involve toxicity. When pathogens contend or accumulate with each other, the symptoms vary and are unpredictable. The Classics also say: "The skill of the sage lies in Observation, Inquiry, Auscultation/Olfaction, and Palpation." By applying these four diagnostic methods, treatment of throat diseases will likely be error-free. The larynx is the passageway for Qi; when open, it flows smoothly; when blocked, it obstructs. Regardless of whether the pathology is exterior or interior, urgent treatment is required. If toxic Wind-Qi lodges in the throat and contends with Blood and Qi, causing swelling and toxin formation, if Heat enters the Pericardium (Xin Bao), leading to restlessness and inability to eat, death will ensue.

The pharynx has two openings: the left pharynx belongs to the Stomach and is the gateway for food intake; the right larynx belongs to the Lung and is the gateway for air intake. The upper part of the mouth belongs to the Stomach, and the lower part belongs to the Spleen; the Stomach is associated with Yang, and the Spleen with Yin. From the center of the tongue to the tip belongs to the Heart Meridian; the four sides of the tongue belong to the Spleen Meridian; the root of the tongue also belongs to the Heart Meridian. The uvula is named Di Ding and belongs to the Stomach; the left and right sides of the larynx belong to the Liver Meridian, and the area below the earlobes also belongs to the Liver. A white tongue coating indicates Cold; pale white with purple hues indicates Wind-Cold; a yellow coating indicates Heat; scorched yellow indicates severe Heat; and a black coating indicates extreme Heat. For any tongue coating color—scorched yellow, red, white, or black—it is appropriate to wipe it for observation. If it is slippery and moist with fluids, it indicates True Heat. Generally, when treating throat diseases, one must not rely solely on cold-natured herbs. Although immediate relief may be achieved, there is a risk that upper Heat remains while Middle Jiao Cold arises, allowing toxins to enter the abdomen due to deficiency. This leads to severe swelling in the chest and above, upper asthma, and lower diarrhea, which is incurable.

The two apertures under the tongue require utmost attention: the left is called Huachi Jinjin (Golden Spring at the Flower Pool), and the right is called Shenshui Yuye (Divine Water and Jade Fluid). The purple veins under the tongue are called the lingual frenulum (She Xi) and connect to the Kidney. If these two apertures are injured by needles or knives, fluids will dissipate, connections will sever, and the tongue will become like a dried orange pulp, rendering it incurable. Furthermore, injury to the uvula (Di Ding) concerns life itself; physicians must be aware of this.

In general, when examining symptoms, press the tongue with chopsticks. If the color is peach-red, and upon lifting the chopsticks it appears purplish-red, this is the true color, and the case is treatable. If the color appears cloud-white upon pressing, but turns purplish-red upon lifting, the blood has died, and the case is untreatable. If the tongue color fades gradually upon pressing, and purplish-black slowly appears upon lifting, death is imminent, and the case is untreatable.

When treating cases, first assess whether Qi and Blood are robust. Those with robust Qi and Blood can take cooling medicines. Those with deficient Qi and Blood must avoid cold-natured medicines; using them will further deplete Qi, making treatment difficult.

At the onset of throat diseases, if chills occur followed immediately by pain, and after the attack the body feels cold, the oral cavity shows no ulceration, there are no other systemic symptoms, and urination and defecation are normal, do not diagnose it as a Fire-Toxin Heat syndrome. These are caused by deficiency-cold of Yin-Qi. Initially, use herbal powder insufflation or water-induction irrigation into the throat. Then administer oral medicine, starting with dispersing and harmonizing methods, followed by warming, tonifying, and yin-nourishing agents. If after two or three days chills and fever recur, or if heart pain, bone/joint, waist, or rib pain are added, the case becomes difficult to treat.

If, during the onset of throat diseases, the jaw is tightly closed, the throat and tongue are swollen, the mouth is ulcerated and foul-smelling; or if there is tongue swelling, tonsillar hypertrophy (Ru E), or wind-stroke of the throat (Hou Feng), accompanied by recurrent chills and fever in the afternoon, and constipation/urinary retention, diagnose it as a Fire-Toxin Heat syndrome. Treat with Shigao Baidu Tang (Gypsum Toxin-Resolving Decoction).

During the onset of throat diseases, if there is chest and diaphragm discomfort in the first three days, and the pulse is wiry and rapid, treatment should first dispel Wind-Phlegm, then resolve Heat-Toxin. Drinking alcohol damages the Spleen; anger damages the Liver; sexual excess damages the Kidney. In individuals with dampness stagnation, Phlegm-Fire attacks upward, causing dry throat, with normal urination and defecation. Treatment should tonify deficiency and descend fire. If throat disease begins with bad breath, indicating Phlegm, and head/face swelling/redness, although critically dangerous, it is uniquely curable.

However, if early-stage fire-toxin danger presents without swelling, with a complexion like a healthy person, and the jaw is not tightly closed, it is untreatable. If, during onset, the face is cyan with white tints, spirit is depleted, the patient prefers sitting in low places, and disregards the Five Elements principles, it is untreatable. Tongue swelling filling the mouth is untreatable. A tongue color resembling walnut skin is untreatable. A color resembling lychee flesh is untreatable. Inability to speak at the onset is untreatable.