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*Yuan Bing Shi* states: "Hou Bi" (throat obstruction) refers to numbness and insensitivity; it is commonly written as "Bi" (closure), retaining the meaning of blockage. Fire governs swelling, so when heat lodges in the Upper Jiao (Triple Burner), it causes swelling of the pharynx and larynx.

Zhang Hezi says: *Nei Jing* (The Inner Canon) states: "When one Yin and one Yang knot, it is called Hou Bi." Wang Taipu explains: One Yin refers to the meridian qi of the Hand Shaoyin Ju Huo (Ministerial Fire/Heart Pericardium); One Yang refers to the meridian qi of the Hand Shaoyang Xiang Huo (Ministerial Fire/Triple Burner). These two meridians both connect to the throat. When qi becomes hot, internal knotting occurs; severe knotting leads to swelling; severe swelling leads to obstruction; severe obstruction leads to blockage, and blockage results in death. Investigating the twelve meridians, only the Foot Taiyang Bladder Meridian has a branch descending to the nape, while all others converge at the throat. Why does *Nei Jing* specifically state that the knotting of one Yin and one Yang causes Hou Bi? It is likely because the independent excess of Ju Huo and Xiang Huo causes heat to knot in the regular collaterals, resulting in rapid pain. I believe this can be summarized in one word: Fire. Therefore, in the twelve meridians, symptoms such as dry throat, sore throat, swollen throat, swollen mandible, and stiff tongue base are all caused by Ju Huo. Only Hou Bi, which develops rapidly, is caused by Xiang Huo. Ju Huo is like human fire, while Xiang Huo is like dragon fire. Human fire burning wood proceeds slowly; dragon fire burning wood proceeds rapidly. The Hou Bi mentioned in *Nei Jing* involves the area between the pharynx and the tongue, but since the pathology is identical regarding fire, no distinction is made. Later physicians described various conditions in detail and arbitrarily established eight names: Dan Ru E (Unilateral Tonsillar Abscess), Shuang Ru E (Bilateral Tonsillar Abscess), Dan Bi Hou (Unilateral Throat Closure), Shuang Bi Hou (Bilateral Throat Closure), Zi She Zhang (Sublingual Swelling), Mu She Zhang (Wooden Tongue Swelling), Chan Hou Feng (Throat-Encircling Wind), and Zou Ma Hou Bi (Galloping Horse Throat Obstruction). Heat rises and transmits to both sides of the throat near the exterior, causing swelling. Due to its shape resembling a moth's breast, it is called Ru E, occurring singly or doubly. Those slightly smaller than Ru E are called Bi Hou. Heat knotting under the tongue generates a small secondary tongue, called Zi She Zhang. Heat knotting in the middle of the tongue causes it to swell, called Mu She Zhang ("Mu" means stiff and unyielding). Heat knotting in the throat causes swelling surrounding the exterior, accompanied by numbness and itching; if large, it is called Chan Hou Feng. Sudden onset and sudden death in Hou Bi is called Zou Ma Hou Bi. Although these eight names are detailed, if they are not attributed to fire, they deviate significantly from the root cause. Mild cases can be treated with salty substances to soften hardness, and severe cases with pungent substances to disperse. Current physicians possess such herbs as Bohe (Mint), Wutou (Aconite Root), Jiangcan (Bombyx Batryticatus), Baifan (Alumen), Puxiao (Natrii Sulfas), and Tonglv (Chalcanthum). As for Zou Ma Hou Bi, why rely on these? Life and death hang in the balance. The method least likely to harm patients is bloodletting with Bian needles (stone needles); once blood flows, the disease resolves. The *I Ching* states "when blood leaves, fear departs," which is precisely this principle. Formerly, I treated a woman with Mu She Zhang whose tongue filled her mouth; other physicians failed to cure her. I ordered the use of small, sharp Bian needles to puncture the area five to seven times. After the swelling subsided, it took three days to fully resolve, and the estimated blood loss was nearly a dou (a unit of volume). I also treated a man with Chan Hou Feng, where swelling affected both interior and exterior, preventing oral medication. I administered cooling decoctions nasally, inducing more than ten bowel movements, and applied Baidu San (Detoxification Powder) externally. I roasted Yangqishi (Crocoitum) until red, mixed it with an equal amount of Fulonggan (Uterus of Hearth Earth), ground them into fine powder, and applied the mixture with fresh water one hundred times daily. After three days, the heat receded and swelling subsided. I once treated a noblewoman with Hou Bi, which was Dragon Fire. Although cooling formulas were used, they must not be taken cold; instead, the Dragon Fire should be driven out by fire. This "fire" refers to cooking fire. Thus, I had the patient ascend to a high hall under the scorching sun, with attendants carrying a stove and placing the medicine pot upon it, keeping the decoction extremely hot without boiling vigorously. The patient sipped the hot medicine continuously over one hundred times, causing the Dragon Fire to dissipate naturally. This method uses heat to administer cold properties, avoiding conflict with heat pathologies. Generally, bloodletting with needles is the supreme strategy for treating Hou Bi, yet people fear needles and seek alternative methods, leading to death in moments. For any needle-induced wounds, crushed ginger mixed with hot water should be sipped frequently to promote healing. Acupuncture charts also mention moxibustion, but it is suitable only for mild pain; for acute conditions, delay may be fatal. Treating the fire in Hou Bi is akin to fighting a fire; there is no room for delay. *Nei Jing* states "disperse fire stagnation," where "disperse" implies sweating. However, how can one induce sweating through the throat? Thus, bloodletting is essentially a form of dispersing sweat. Gentlemen of later generations should not cling to minor prescriptions claiming they do not affect the zang-fu organs and excel in bloodletting. If fortunate enough to succeed in minor illnesses but unfortunate to die from major ones, do not leave regrets.