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This condition arises from the Yangming Stomach Meridian, caused by roasting (or consumption of spicy, roasted foods), or accompanied by excessive thinking and sudden anger. Phlegm follows the fire qi, flows to the lips, and knots like a bean. If it protrudes and swells like a silkworm cocoon, becoming hard and painful, hindering eating and drinking, or breaking and bleeding, it becomes difficult to treat if left for a long time. If there are no internal symptoms at the onset, moxibustion with three cones of mugwort the size of a hemp seed should be applied, followed by covering with Chan Su Paste (Toad Venom Plaster). It will gradually heal over time. If there are internal symptoms such as thirst, take Bawei Wan (Eight-Ingredient Pill) in the morning and Ganlu Yin (Sweet Dew Decoction) at noon. If bleeding persists for a long time, with emaciation, dark complexion, deficiency heat generating phlegm, redness of the cheeks and zygomatic bones, and severe thirst, it is difficult to treat.

Qingliang Ganlu Yin (Cooling Sweet Dew Decoction)
Xijiao (Rhinoceros Horn - *Note: Substitute with Water Buffalo Horn in modern practice*), Yinchenteng (Artemisiae Scopariae Herba), Shihu (Dendrobii Caulis), Zhike (Aurantii Fructus), Maidong (Ophiopogonis Radix), Shengdihuang (Rehmanniae Radix Recens), Huangqin (Scutellariae Radix), Chaihu (Bupleuri Radix), Zhimu (Anemarrhenae Rhizoma), Shenggancao (Glycyrrhizae Radix et Rhizoma Preparata), Pipaye (Loquat Leaf) (each 1 qian); Dengcao (Junci Medulla), Danzhuyeye (Bambusae Folium).

Generally, throat diseases become severe on the fifth day. If treated within the first three days, although the symptoms may be severe, suppuration has not yet formed, and medication can dissipate them. However, by the fifth or sixth day, the affected area often suppurates; once ruptured, it tends to ulcerate into a cavity that is difficult to heal. The ulcerated area requires Kougan Yao (Mouth Ulcer Medicine), using large amounts of Longgu (Fossilized Bones) and Zhenzhu (Pearl). Throat closure (Houbi) and Lianzhu E (String-of-Pearls Tonsillitis) occurring after Shanghan (Cold Damage) are incurable. The symptoms include stiffness of the throat and neck, upward deviation of the eyes, making prognosis poor.

Throat diseases are not always emergencies; chills and fever may not appear in the first one or two days, indicating a mild condition. If chills and fever appear on the third day, the condition must worsen. One must ask whether urination and defecation are unobstructed. If both are free, even if symptoms worsen, it is merely floating fire attacking upwards; taking detoxifying, wind-dispersing, and fire-clearing agents will lead to recovery. If urination and defecation are obstructed, this indicates excess fire internally. Heavy doses of fire-reducing and detoxifying agents, along with medicines to promote bowel and bladder movement, are required. How else can the fire be expelled? How else can the disease resolve? Also inquire about headache; if present, it suggests concurrent Shanghan, which is difficult to treat.

For throat diseases, recovery cannot be expected until stool is passed freely. If constipation exists, one cannot lightly assume safety.

At the onset of throat disease with constipation, Dahuang (Rhei Radix et Rhizoma) and Xuanmingfen (Mirabilite) should be used to purge, allowing fire to descend naturally and facilitating recovery. In fire-reducing and detoxifying formulas, remove Qianhu (Peucedani Radix) and add Dahuang and Xuanmingfen. However, if five or six days have passed without food intake and constipation persists, using these purgatives will cause immediate death. After prolonged illness, stomach qi is deficient; how can Nuxiao (Niter) and Huanglian/Dahuang be used again? Only Mi Dao Fa (Honey Suppository Method) is appropriate; this is a secret technique. Throat diseases accompanied by absence of phlegm are incurable.

Treatment requires blowing medicine four or five times through the tube to expectorate phlegm; three treatments can achieve full recovery. For initial expectoration, using more Jindan (Golden Pellet) is essential. Blow heavily directly into the throat, then immediately withdraw the tube to prevent vomiting.

In the first one or two days of throat disease, use Bidan (Green Pellet) gradually increasing Jindan. In severe cases, Jindan serves as the sovereign drug, or is used alone, to extract stubborn phlegm; expectoration requires Jindan.

If redness and swelling appear on the chest during throat disease, this indicates Feiyong (Lung Abscess). Take mixed with honey, adding Baiyaojian (Myrobalan Extract). For redness and pain in the throat without visible structural changes, blow Dengcao Hui (Ash of Junci Medulla).

For women suffering from throat swelling and pain due to amenorrhea causing fire to attack upwards, internal administration of menstruation-promoting drugs is indicated; once menstruation flows, the throat heals spontaneously.

In critical throat cases, facial swelling with a bright white luster lacking radiance, and a deep, faint, and weak pulse, indicate leakage of spirit and absence of Yang; this is absolutely incurable. Conversely, if the face is red and swollen with a surging, forceful pulse, despite severe symptoms, it indicates robust Yuanqi (Original Qi) and excess fire, which is easy to treat.

Swelling and ulceration inside the cheeks and mouth should be gently stirred with silk-wrapped chopsticks dipped in water. If painful, medication will cure it; if painless, it is necrotic tissue and difficult to treat.

For tongue swelling filling the mouth with the tongue protruding, making oral medication difficult, grind Jiangcan (Bombyx Batryticatus) and Zaojiao (Gleditsiae Sinensis Fructus) into fine powder. Mix equal parts, take a small amount, and blow into the nose. The jaw will open naturally, and saliva/phlegm will flow out. Then, use cotton-wrapped bamboo chopsticks dipped in Gancao Tang (Licorice Decoction) to moisten the lips and mouth. Add Siwei Kougan Yao (Four-Ingredient Mouth Ulcer Medicine) with extra Bingpian (Borneolum Syntheticum), blowing frequently until healing occurs.

When blowing medicine, apply not only to the swollen/ulcerated area but also to the surrounding healthy tissue to prevent spread and facilitate healing. If the tongue is extremely dry, making blowing difficult, moisten with honey or decoction before application. For intra-throat blowing, maintain calm breathing and ensure the tube reaches all areas evenly.

For tongue enlargement, apply Shenghuangbai Mo (Raw Phellodendri Cortex Powder) mixed with Bingpian. If bleeding occurs, use Chao Huangbai (Stir-fried Phellodendri Cortex) with Bingpian.

For Sheyong (Tongue Abscess) and Houyong (Throat Abscess), if stool is blocked, add Xuanmingfen and Dahuang to the formula. If urination is difficult, add Liuyisan (Six-to-One Powder); this method is very effective.

When using Bidan, if symptoms are critical, use more Bingpian than Gancao; as recovery approaches, use more Gancao than Bingpian.

For Yayong (Gum Abscess), the gum root is red and swollen, but the jaw is not locked, allowing mouth opening/closing. If Yaoyao (Lockjaw/Tetanus-like symptom) occurs, the gum root is red/swollen with protruding flesh.

For lockjaw where the mouth cannot open, first blow Jin dan and Bi dan into the gum roots. Externally, carve Huangshu Xiang (Yellow Resin) into a chisel shape and gently insert it into the tooth gap to gradually open the jaw, then blow Jindan into the affected area.

When blowing the throat or inducing expectoration, add a small amount of Zaojiao.

During initial treatment, instruct the patient to lower their head to allow saliva and phlegm to drain out.

For Houyong (Throat Abscess) and Dan/Shuang E (Single/Double Tonsillitis), generally use Bidan. For other severe conditions, combine Jindan and Bidan, noting the sequence and ratio: initially 9 parts Bidan to 1 part Jindan; after five applications, change to 8 parts Bidan to 2 parts Jindan; next, 7 parts Bidan to 3 parts Jindan. If severe, use equal parts. After 3-5 applications, if phlegm accumulates upwards, switch to 6 parts Jindan to 4 parts Bidan. Blow heavily directly into the throat and withdraw immediately to extract phlegm; this is a key technique. For extremely severe cases, using 8 parts Jindan to 2 parts Bidan is superior.

If the throat lesion has already ulcerated, first blow flesh-regenerating medicine, then treat with Bidan.

Tongjing Fang (Menstruation-Promoting Formula) (Contraindicated for pregnant women)
Danggui (Angelicae Sinensis Radix), Chishao (Paeoniae Radix Rubra), Guangpi (Citri Reticulatae Pericarpium), Chuanduan (Dioscoreae Nipponicae Rhizoma) (each 1 qian); Niuxi (Achyranthis Bidentatae Radix) (1.5 qian); Chuanxiong (Ligustici Chuanxiong Rhizoma) (0.6 qian); Honghua (Carthami Flos) (0.7 qian); Gancao (Glycyrrhizae Radix et Rhizoma) (0.5 qian); Jiegeng (Platycodonis Radix) (1 qian).
Add Shengdihuang and Danpi for blood heat; add Xijiao for extreme heat. Add Sumu (Sappan Lignum), Wulingzi (Trogopteri Dung), and Zelan Ye (Lycopus Herb) for chronic obstruction. Add Yuansuoxo (Corydalis Rhizoma) and Taoren (Persicae Semen) for abdominal pain. Add Duzhong (Eucommiae Cortex) and doubled Niuxi for thigh pain.
Gao Zi Yao (Paste Medicines): Mix honey to a green-black color. Use Longnao (Camphora) and Bohe (Menthae Haplocalycis Herba) as sovereign, Yudang (Jade Pellet) as minister, Chuanbei (Fritillariae Cirrhosae Bulbus, de-hearted) as assistant, and Dengcao Hui, Baicaoshuang (Soot from Kitchen Chimney), Gancao, and Bingpian as guides. First grind Yudang and Baicaoshuang together, add Dengcao Hui and grind again, then add Bohe, Gancao, and Chuanbei, grinding to extreme fineness. Finally add Bingpian and mix uniformly. Take mixed with honey. For Houyong and Houjun (Throat Polyp/Fungus), keep in mouth and swallow frequently. If severe, take three doses internally and use blowing therapy.