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As stated in the *Huangdi Neijing* (Yellow Emperor's Inner Canon): The throat and pharynx are the pathways for food and drink. The larynx is the channel through which Qi ascends and descends. The epiglottis is the gate of voice production. The uvula is the hinge of voice production. The pharynx, larynx, epiglottis, and tongue are all located in the same region, yet their functions differ. The larynx receives air, thus its Qi connects with Heaven; the pharynx receives food, thus its Qi connects with Earth. The epiglottis is situated superiorly and governs opening and closing; when it covers the glottis, food descends; if it does not cover, dislocation occurs. By pressing the tongue against the hard palate, the epiglottis can close the larynx. These four structures function interdependently; the absence of any one leads to death due to inability to eat or drink.

When the classics mention "Laryngeal Bi" (throat obstruction), it refers to difficulty breathing through the throat and inability to speak, indicating the blockage of Heaven and Earth Qi. When mentioning "Pharyngeal Stagnation" or "Odynophagia," it refers to the inability to swallow saliva and food, indicating the blockage of Earth Qi. When mentioning both "Laryngeal Bi and Odynophagia," it indicates pathology of both the larynx and pharynx, with blockage of both Heaven and Earth Qi.

The two orifices of the throat and pharynx originate from the same upper digestive tract but follow different paths and transformations. The larynx is anterior and governs exhalation; the pharynx is posterior and governs swallowing. The larynx is firm and hollow, connecting to the root of the Lung, serving as the pathway for breath, governing exhalation without ingestion. The pharynx is soft and hollow, connecting to the root of the Stomach, serving as the pathway for food and drink, governing ingestion without exhalation. Speaking while eating causes food and liquid to enter the laryngeal passage along with the Qi, resulting in choking and coughing.

The classics state: Diseases generated by the Foot-Shaoyin Kidney Meridian include thirst, dry tongue, swollen and painful throat, upward rushing of Qi, dryness and pain in the throat. These syndromes present with internal heat, dry mouth, red face, surging phlegm-saliva, and a Chi pulse that is rapid and weak. This is likely due to the depletion of Kidney Water, allowing Ministerial Fire (Xiang Huo) to become uncontrolled. One must use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) added with Ophiopogonis Radix (Maidong) and Schisandrae Fructus (Wuweizi), prepared in large doses as a decoction. In cases of excessive sexual activity leading to the depletion of Primordial Yang, with rootless Fire roaming uncontrollably and lodging in the throat, Bawei Shenqi Wan (Eight-Ingredient Kidney Qi Pill) should be used. It should be decocted in large doses, cooled, and drunk to guide the Fire back to its source, which may save the patient.

Tonsillar hypertrophy (Ru E) and Coiling Throat Wind (Chan Hou Feng) are two different conditions. Swelling on both sides of the throat is called Double Goose (Shuang E); swelling on one side is called Single Goose (Dan E). Treatment involves dipping a goose feather in rice vinegar to stir the throat, removing all phlegm-saliva, then using the feather to induce vomiting, urging the patient to expectorate forcefully. If the purple blood in the throat ruptures, healing ensues. Alternatively, Yushu Dan (Jade Pivot Pill) can be ground and taken orally. For severe toxicity that does not dissipate, pricking with a small knife to release purple blood cures the condition. Ancient methods recommend pricking Shaoshang (LU11) acupoint, which is also effective; pricking with a needle or knife to bleed is used in emergencies. However, for swelling without pain, this method must not be used. Swelling without pain belongs to the Yang category; one should strongly tonify Yin. Pricking would damage Yin Blood, leading to death.

Coiling Throat Wind syndrome begins with dizziness and vertigo, tightness in the chest and diaphragm, and shortness of breath for two days, followed suddenly by sore throat, cold limbs, Qi blockage, inability to eat or drink, and abundant phlegm-toxin. This is the most urgent condition. If there are two masses forming beside the throat, potentially as large as a chicken egg, causing Qi blockage and incessant phlegm rattle, it is called Locked Throat Wind (Suo Hou Feng), which is even more severe. Do not scarify or break the skin. Immediately select fresh Achyranthes bidentata root (Tu Niuxi), choosing thick roots weighing approximately 60g, avoiding water washing and iron contact. Break and crush to extract juice, mix with half a cup of rice vinegar, and use a chicken wing feather dipped in the mixture to stir the throat. If the jaw is locked, stirring the cheeks will cause them to open; once open, frequently stir the throat to clear Qi. If masses exist on both sides of the throat, saliva will naturally subside. Subsequently, calcined Hydrargyri Oxydum Rubrum (Zhong Ren Bai) mixed with a small amount of Borneolum Syntheticum (Bingpian) should be blown into the throat once daily; recovery occurs within three to four days. Alternatively, Pengsha Dan (Borax Pill) can induce vomiting of stubborn phlegm, or Plantago asiatica seed (Zhuanshencao) juice mixed with vinegar can be gargled, or Glehnia littoralis (Tianmingjing) natural juice swept into the throat with a goose feather to remove phlegm, or Patrinia villosa (Mabiancao) juice used for gurgling. If swelling prevents swallowing, nasal irrigation to induce vomiting can reduce the pathogenic force, though Achyranthes bidentata juice is the fastest. If the two masses merge, phlegm rattles in the throat, the uvula retracts invisibly, and Qi is blocked, no divine medicine can save the patient. After stirring with Achyranthes bidentata and vinegar, press the thumb on both sides of the seventh thoracic vertebra; if painful, it is easy to cure. For severe cases, place a knee under the lower back, grasp both hypochondria, and pull upwards towards the clavicles to elevate the chest, extending the Qi for discharge. If profuse sticky sputum and tears appear after expectoration, it indicates Wind-Heat; absence indicates Wind-Cold. A mass in the chest indicates retained food. Treat according to the syndrome. Although this condition stems from epidemic toxic pathogens, it often arises from falls or dietary stagnation. Use Schizonepeta (Jingjie), Saposhnikovia (Fangfeng), Licorice (Gancao), Platycodon (Jiegeng), Forsythia (Lianqiao), Arctium (Niubang), Mint (Bohe), Scrophularia (Heishen), and Hawthorn (Shanzha) internally to resolve toxicity. Hawthorn resolves food stagnation, disperses blood, and breaks down masses, similar to the action of Magnolia bark (Houpo) in Xiaofeng San. If throat pain suddenly ceases but toxin attacks the chest and hypochondrium causing unbearable pain, shortness of breath, fever, and inability to lie down, use Arctium seed (Niubangzi), Fritillaria (Beimu), Vinegar-processed Cimicifuga (Shengma), Dioscorea bulbifera (Huangyaozi), Dry Lemna (Fupings), Scrophularia (Heishen), and Raw Licorice (Sheng Gancao) made into honey pills to hold in the mouth. After seven days, if toxicity is deep, panting is severe, and fingernails turn purple, the prognosis is poor. For throat powder, use seven Purple-mouth Clam shells (Zikou Heli) and seven Olive pits (Ganlanhe), calcined over mild fire, ground fine, mixed with one qian of Calcined Alum (Kufan), and dried Big Blue Fish gallbladder (Daqingyu Dan) placed in a bell until dry, adding bile until three gallbladders' worth is reached, then add Borneol (Bingpian) and blow into the throat. Tea must be avoided for one hundred days to prevent recurrence. For all throat Bi swelling and pain, including double tongue and wooden tongue, Wulong Gao (Black Dragon Paste) is used. For emergencies, pricking to bleed is the best strategy. For throat swelling and pain with thirst for cold drinks, constipation, and solid pulses in all six positions, Liangge San (Cool the Diaphragm Powder) is administered to purge. For throat Bi with floating pulse, aversion to cold, and fever, it is often sudden cold suppressing heat with strong exterior pathogens. Cold medicines and foods can condense and trap toxins; sour-astringent items like Borax, Alum, and White Plum, as well as Chalcanthite (Danchen) applied to the throat, must be avoided. One should use light, ascending herbs to release the exterior and vent Fire-Toxin, urgently scarify the affected area, and prick Shaoshang (LU11) to bleed, which is the crucial technique.

For Running Horse Throat Wind, if headache and fever are present, first decoct Fermented Soybean (Xiangchi) strongly, add green onion juice to induce vomiting, then use Schizonepeta, Saposhnikovia, Arctium, Licorice, Platycodon, Forsythia, Mint, and Rhinoceros Horn (Xijiao). If the mouth cannot open, blow Soap Fruit powder (Yazao) into the nose to induce sneezing before administering medicine. For Locked Throat Wind, some use Soap Fruit decoction to vomit stubborn phlegm, often causing hair loss, damaging Stomach Qi, and agitating phlegm so it locks and cannot be expelled, leading to instant death. For Running Horse Throat Bi, Croton seed (Badou) wrapped in cotton stuffed in the nose often exacerbates toxicity; caution is required. For tonsils, Borax and White Plum are effective but are pungent and hot; although they use sour astringency, they ultimately add fire to fire, causing frequent recurrences, a fact people often overlook. For epidemic throat swelling, Puji Xiaodu Yin (Universal Benefit Decoction to Eliminate Toxins) has Huangqin and Huanglian removed to avoid bitter-cold, taken hot to prioritize releasing the exterior. Infectious throat Bi is an epidemic pestilence; Jingfang Baidu San (Schizonepeta and Saposhnikovia Decoction to Overcome Toxicity) is used with modifications based on syndrome. Yin-deficiency cough with chronic throat pain indicates Lung Flower Ulcer (Feihua Chuang), which is difficult to treat. Jiegeng Tang (Platycodon Decoction) is used to send Duqi Wan (All-Surrounding Pill); do not use Borneol powder. For severe cases intolerant to decoctions, raw egg white mixed with rice water is taken daily to soothe pain, though death is inevitable. For Spleen-Lung heat with deficient Fire harassing upward causing throat ulcers, Ben Shi Li Ge Tang (Li Ge Decoction from Ben Cao) is used. For throat pain worsened by cold medicines, Ginger Juice is appropriate. A sensation of a roasted meat lump or foreign body in the throat indicates Phlegm-Fire lodging in the Upper Jiao; Banxia Houpo Tang (Pinellia and Magnolia Bark Decoction, i.e., Siqi Tang) is indicated. For uvular swelling and pain preventing eating, Scrophularia, Cimicifuga, Rhubarb, Belamcanda, and Licorice are decocted and taken. For throat pain unresponsive to other drugs, it is not true throat pain but rather red filaments like hair growing in the nose, hanging black blisters like goiter pearls, obstructing the throat entrance. Duzhugui (Achyranthes root) is washed, mixed with 3-5 drops of good vinegar, ground to juice, and dripped into the nostril; when the filament breaks and blister pops, relief follows. For uvular pain preventing eating due to elongated epiglottis blocking the uvula, apply salt heated on chopsticks. For persistent tonsillar redness and swelling, grind Duzhugui and apply with milk into the nose. For various foreign bodies stuck in the throat, identify the object and use the substance that controls it: Cormorant and Olive for fish bones, Dog saliva for bone fragments, Goose saliva for rice awns, Duck saliva for snail shells, Magnetite for iron, Mercury ash for gold/silver. Adaptability is key. For general impactions, crush Ramie root (Zhuma), form into pill size of a bullet, and swallow with decoction of the ingested object. For swallowed nails, coins, etc., use charcoal from melted silver pots, ground to powder, mixed with oil from silversmith's trough, taken orally, accompanied by high fat intake to lubricate. For copper coin impaction, chew raw Water Chestnut (Qibi) extensively, or add Cyrtosperma juice; if ineffective, use calcined Sheep Tibia Bone (Tinggu) mixed with Qibi juice. For various impactions, cook Scallion White (Xiebai) until half-cooked, bind with cotton, hold the thread end, chew and swallow the Xiebai slowly; when it reaches the impaction, pull the thread to extract it. Alternatively, use a small ball of silk floss similarly. For swallowed fish hooks, insert an iron wire to pull out; if a line remains, thread hundreds of layers of cotton paper onto the line, swallow slowly, and pull out later.

Luo Qianfu treated the Marshal of the Southern Expedition, aged seventy, who traveled to Chu. Due to excessive drinking, he suffered abdominal pain, borborygmus, and diarrhea, occurring about fifty times day and night. He had swollen and painful throat and pharynx, swelling around ears, stiff tongue base, thick sticky saliva unable to be expectorated unless pulled by hand, difficult speech, restlessness, and insomnia. His pulse was floating and rapid, but deep, thin, and wiry upon pressure. First, he was scarified at the swelling site, releasing purple-black blood, reducing swelling immediately. Then, Platycodon, Licorice, Forsythia, Arctium, Wine-processed Scutellaria, Cimicifuga, and Saposhnikovia were decocted hot for gargling; spit out when cool to avoid damaging Spleen and Stomach. After repeated gargling, saliva cleared, swelling subsided, and voice returned. Subsequently, pungent-hot pills were used to treat middle-Jiao cold, resolve retained food, and dry the Spleen. The pills were not taken immediately to avoid aggravating upper-heat, but allowed to reach the disease site before acting, employing a slow treatment approach. After a few doses, diarrhea stopped and pain resolved. Later, chest tightness and paroxysmal pain occurred; Yigong San (Yi Gong Powder) plus Cimicifuga was used to warm and nourish Spleen and Stomach, raising and smoothing Zheng Qi, leading to recovery.