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In the treatment of throat diseases, for excess syndromes such as wind pathogen, carbuncle, obstruction, and tonsillar swelling (Ru E), phlegm should be expelled first. For deficiency syndromes, although phlegm expulsion is indicated, it must not be done hastily to exhaust all phlegm at once. Powders for insufflation should utilize Jin Dan (Golden Pill) and Bi Dan (Green Pill), combined appropriately according to the severity of the condition. Decoctions should be modified from the principal formula based on the severity of symptoms. In cases of cold syndromes, cooling herbs should be removed; in deficiency syndromes, yin-nourishing methods should be employed. Clinical judgment must be meticulous and careful, never hasty.

Principal Formula (The sides of the throat belong to the Lung meridian, the neck belongs to the Liver meridian; select guiding herbs accordingly):
Zhen Chuan Lian (True Rhizoma Coptidis), Hei Shan Zhi (Black Fructus Gardeniae), Lian Qiao (Forsythia Fruit), Dan Qin (Light Scutellaria Root), Hai Fu Shi (Pumice), Niu Bang Zi (Arctii Fructus), Bo He (Menthae Haplocalycis Herba), Qian Hu (Peucedani Radix).

For treating Hou Xuan (throat ulceration) causing choking during eating and hoarseness, use Bi Jin Dan (Green Golden Pill) exclusively. Apply the paste medication intermittently by holding it in the mouth and swallowing, followed by decoction. The general principle is to nourish yin and descend fire, tonify qi and strengthen the spleen. The principal herbs should not be taken continuously. For treating dental disorders, Hou Feng (throat wind), Ya Yong (dental abscess), Jun Du (bacterial toxin), and Shang Yong (upper palate abscess), use Ba Wei Kou Gan Dan (Eight-Ingredient Mouth Ulcer Powder) for insufflation. For Ya Xuan (gum recession/bleeding), use Zhen Zhu San (Pearl Powder).

Hou Guan Qi Ci (Throat gate prickling): Often caused by chronic exhaustion leading to deficient fire flaming upward, with Ying Yin (nutritive yin) and Zong Yin (general yin) depleted and nearing exhaustion. Red spots in the throat, dense like mosquito bites, are difficult to treat.

Ya Zhang Feng (Mute Miasma Wind): Caused by contracting seasonal pathogens, resulting in stiffness of the jaw preventing opening and closing, with wind-phlegm obstructing upwards, rendering speech impossible. To urgently open the jaw, one must induce vomiting to expel wind-phlegm. Wait until the phlegm-saliva is nearly exhausted, then apply insufflation powder and administer decoction, ensuring safety. If the complexion and tongue appear cyanotic-purple, lips are black, fingernails are blue-green, and nasal discharge occurs, it is incurable.

Ru E (Tonsillar Swelling): Often arises from stagnation due to excessive alcohol and sexual indulgence. On the first day of onset, there is disease manifestation; on the second day, redness and swelling; on the third day, visible formation; on the fourth day, the condition stabilizes. Symptoms occur on both sides of the throat gate and around the uvula. Mild cases resolve in five to six days. If accompanied by alternating chills and fever, the condition is severe and dangerous, though distinctions exist in presentation.

Dan E (Unilateral Tonsillar Swelling): Occurs after Tai Yang Cold Damage (Shang Han), where dispersing measures were incomplete, leading to body heat, nausea, and suspicion of Sha illness (sand disease/toxic heat rash).

Shuang E (Bilateral Tonsillar Swelling): Triggered by seasonal pathogens, appearing cherry-sized, accompanied by chills and fever, with wiry and rapid pulses in all six positions. This is a syndrome of the Lung and Stomach.

When examining throat diseases, especially late at night, one must carefully scrutinize the condition, inspecting repeatedly and clearly before prescribing medication. Carelessness must be avoided to prevent harming patients and oneself. If the patient's tongue is curled up, obscuring the view, it must be depressed manually to reveal the throat pathology. Once the condition is clearly identified, the dosages for insufflation powders and decoctions must strictly follow the prescription without arbitrary modifications. Patients' families must not doubt the prescription due to strong-tasting herbs, which could lead to self-harm through non-compliance. Remember this, be cautious.