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Zihe said: Pharyngitis (Hou Bi, throat obstruction) is generally caused by phlegm-fire. In acute cases, it is appropriate to induce vomiting to expel phlegm, followed by purgation. The disease can be cured by dispersing pathogens from both the upper and lower aspects. For more severe cases, acupuncture bloodletting should be performed first, followed by medication for vomiting and purgation; this is the superior treatment strategy. If patients fear these methods and seek circuitous alternatives, they may lose their lives in an instant. Treating the fire of pharyngitis is like fighting a fire; there is no room for delay. The *Neijing* states: "For fire constrained, disperse it." "Disperse" means to scatter; vomiting contains the meaning of dispersion, and bloodletting is also a form of dispersion. Physicians treating this disease must not adhere strictly to mild or small-dose formulas, claiming, "My medicine follows the Kingly Way and does not disturb the Zang-Fu organs." If by chance a mild case is cured, but a severe case dies due to this approach, is this not mistaken killing?

Pang stated: The disease of latent qi was called "Kidney Cold Damage" (Shen Shanghan) in ancient prescriptions. It refers to sudden cold invading the body out of season, where toxic qi lies latent in the Shaoyin Meridian. Initially, there are no symptoms, but after ten days or a month, it manifests with a faint pulse. According to the method, it should be treated as Cold Damage. This is not pharyngitis. Subsequently, dysentery will inevitably occur. I observe: I have encountered this syndrome before. It occurs when the Fire Command of Shaoyin and Shaoyang, the Cold Command of Taiyang, and the Dampness Command of Taiyin coincide, compounded by Wind-Cold pathogens. Therefore, treating this condition does not require targeting the pharyngitis specifically; one only needs to treat the external pathogens, and the throat will heal itself. For example, various Chaihu Yin formulas and other dispersive prescriptions can be used as appropriate.

My friend Wang Pengque, aged just over thirty, whom I had never met before, suffered from pharyngitis for more than ten days and invited me to examine him. His head and face were swollen and enlarged, his throat and neck extremely thick, he had rapid breathing and hoarseness, swollen throat and mouth ulcers, and experienced severe pain. A maid supported his back; he sat upright without lying down for several days. Upon examining his pulse, it was extremely fine, rapid, and weak. Listening to his speech, his voice was so faint it seemed unable to project. Asking about the medicines he had taken, they were all herbs such as Huangqin (Scutellariae Radix), Lianzi (Coptidis Rhizoma), Zhizi (Gardeniae Fructus), and Huangbai (Phellodendri Cortex). This illness likely originated from Yin injury, further aggravated by cold-cooling medicines, leading to excessive cold in the lower part and floating Yang in the upper part (Ge Yang, rejecting Yang). At this stage, even water and drinks were difficult to swallow, and he particularly feared heat and irritability. I said, "Dangerous! If we delay another half day, he certainly cannot be saved." I then prescribed Zhenyin Decoction (Zhenyin Jian), cooled thoroughly with cold water, and instructed him to swallow it slowly. After finishing one decoction, by overnight, the swelling and pain in his head and neck disappeared completely as if they had never existed. When I saw him the next morning, he appeared merely as a thin, frail person; how could he have been so imposing yesterday? I then continued using Wufu Decoction (Wufu Yin) and similar formulas. After a few doses, he recovered. Those who doubted were initially shocked and convinced. From then on, grateful for my giving him a second life, we became bosom friends.