陈实功曰∶喉痹咽喉肿痛，半塞半开，又宽又肿，此乃标病，虽重无妨。用金锁
匙吐出痰涎，利膈饮推荡积热。（《正宗》）
冯鲁瞻曰∶喉痹者，即缠喉风类是也。其候面赤气粗，咽喉肿闭，乃蓄热生风，积
聚毒痰而作。甚者内壅肉瘤一块，气闭不通。若至鼻而青黑，塞噎头低，痰胶声锯
者不治。更有脏寒，亦能令人咽闭而吞吐
不利者。盖诸证下寒过极，则上热反盛，不独此也。其候与蛾证相近，而治法不能无
异，大抵无形肿闭者为痹，有形肿痛者即是蛾耳。先吐风痰者，急则治其标也。后
解热毒者，缓则治其本也。至于上热下寒者，用热药食前冷服之，不可误服凉药也。
又曰∶经曰∶一阴一阳结谓之喉痹。一阴君火也，一阳少阳相火也，手少阴心脉
挟咽，足少阴肾脉循喉咙，其人膈间素有痰涎，或因饮酒过度，或因忿怒失常，或
因房室不节。盖饮酒过度，胃火动也，富贵人多犯之；忿怒失常，肝火动也，妇人
多犯之；房室不节，肾火动也，男子多犯之。火动痰上而痰热熏灼，壅塞咽嗌之间，
痰者火之本，火者痰之标，火性急速，所以内外肿痛，水浆不入，乃外证之最危者。
治疗之法，急则治标，缓则治本，治标用丸散以吐痰散热，治本用汤药以降火补虚。
奈何治者但云治脾肺火，而未云降肝肾火也，必须以《内经》从治之法，切不可骤
用寒凉，益促其危耳。故实火须用正治，虚火须用从治，须分明白不可少误。
又曰∶咽与喉，会厌与舌，四者同在一门，其用各异。喉以纳气，故喉气通于
天；咽以纳食，故咽气通于地，会厌管乎上，以主开阖，掩其气喉，令水谷能进食
喉而不错，四者交相为用，阙一则饮食废而死矣。云喉痹者，谓喉中呼吸不通，言
语不出，而天气闭塞也。云咽痛及嗌痛者，谓咽喉不能纳唾与食，而地气闭也。云喉
痹咽嗌痛者，谓咽喉诸病，天地之气，并闭塞也。（按咽之低处为嗌。）
又曰∶咽在后主食，喉在前主气，十二经中惟足太阳主表，别下项，余经皆内
循咽喉，尽得以病之。而统在君相二火，喉主天气，属肺金，变动为燥，燥则涩而闭。
咽生地气，属脾土，变动为湿，湿则肿而胀。皆火郁上焦，致痰涎气血结聚咽喉，肿
达于外，麻痒且痛为缠喉风，肿于两旁为喉痹，其单蛾、双蛾、木舌、舌胀、缠喉、
走马、喉风，病同于火故不分也。惟缠喉、走马，杀人最速。
又曰∶喉痹多属痰热，重者用桐油探吐。缠喉风亦属痰热，谓其咽喉里外皆肿
者是也。亦用桐油以鹅翎探吐。
又曰∶肺绝喉闭，其脉浮散而微细，其声如鼾，有如痰在喉中响者，此为肺绝之
候。宜速用人参汤调入竹沥、姜汁服之。若早治者十全七八，次则十全三四，迟则十不救一。
又曰∶喉痹用陈年霜梅，入蜒蚰令化，每患喉痹等证，用梅噙于口中，神效。（《锦囊》）
张子和曰∶治喉痹用针出血，最为上策。《内经》火郁发之。发谓发汗，出血者，
乃发汗之一端也。
《医论选要》曰∶脏腑停寒，寒则气缩，如物窒碍于其间，固有喉痹之证。
又曰∶阴证下虚，令人喉痹，又当治其下寒，则痹自通矣。
又曰∶走马喉痹者，谓喉痹急甚，其死又速，药缓不及救也。惟针出毒血，病实时愈。
窦汉卿曰∶或问风毒喉痹，内外俱肿，其故何也？风毒之气结于喉间，则壅塞喉
间，乃风毒与痰相搏故也。《素问》云∶无风则不动痰，无痰则不受风，风痰相搏，结
塞咽喉。其外证咽喉形如鸡子，其色微白，外面腮上有肿，其形似疮，身发寒热，牙
关紧强，语声不出者是也。先用 汁加元明粉，或蜜汤探取其痰，急服荆防消毒散，
牙间肿处紫黑，用小刀点破，即用冰片散吹之。无不效验。（《全书》）
又云∶风热喉闭，内外俱肿者，谓其人久积热毒，因而感风，风热相搏，发出
外来则壅喉间。其人面赤腮肿，身发寒热，喉中有块如拳，外血鲜红。先用玉字药蜜
调点之，次用荆防消毒加减治之。
又云∶如牙关紧强不得开者，此皆风痰相搏，壅塞咽喉。先用木针排开，或黄
菜汁，或温蜜汤，或醋水，俱入元明粉灌喉，再用鹅翎搅之，吐出痰涎几碗，外
用五倍子醋调敷之，急服荆防二陈汤，吹冰片散。
又云∶虚阳上攻，由于久病元气虚弱，邪火上行，咽喉肿痛，上下不升降，水火
不既济，心火冲喉故肿痛而闭塞，其形若何？曰语声不出，牙关紧急，痰涎满口，手
足厥冷，头目昏眩者是也。治法如前。
又云∶或厥重不省人事，目张直视，可用吴茱萸研烂，醋调涂两脚心，然后用降
气汤治之；气喘加前胡、乌药，气短加沉香、人参，待手足温，饮薄粥以敛元气。入
谷则昌，绝谷则亡，此之谓也。
又云∶如腮颔浮肿，外面赤者，此必感于风毒，急用紫苏、枫叶、柏枝煎汤洗
之，外用荆防羌活汤以祛其风。或十宣散。
又云∶酒毒喉痹，乃酒毒蒸于心脾二经，则壅咽喉，其人面赤而目睛上视者是
也。取痰法如前，再用冰片散吹之，清凉散饮之。
又云∶酒毒喉痹其形若鸡子，其肿鲜红，其光如镜。外证发热恶寒，头痛颈强。
此上焦积热，心脾受之，盖心脾二经主上焦。宜服粘子解毒汤。
又云∶风热喉痹由于忧思劳碌太过，或对风言语、风入肺经作痰，务多去痰为要。
其色鲜红，久而紫赤，急用小 刀点之，或用芦刀点之，血微出火已泻矣。再服煎剂，
并冰片散吹之甚效。凡紫赤色者变为淡红色，愈之渐也。
又云∶气痈喉痹，此证为因聚毒塞于喉间，痰涎稠实，发寒热者，仍分上中下
三关。毒在下关者难治，上中二关用吹药吹喉，茶汤送下雄黄化毒丸七粒。
窦梦麟曰∶喉闭，此证因外感寒邪，内伤热物，或大寒后便入热汤洗，故将寒气
逼入脾经，冷气阻于中脘，邪气热客于心经，故生此疾。急用三棱针刺手腕中紫筋
上，或少商穴出血，却将雄黄化毒丸冷茶
磨化灌之，仍将冰片散次入喉中，待漱出风涎稠痰为愈。
又云∶风毒喉痹，外赤肿，内肿微红带白色，其形似蒸饼，连腮肿痛。外证身
恶寒而无热，腮颔浮肿，牙关紧强，此乃风痰相搏，结寒喉间。治法必以去痰为主，
吹药吹之。若外面肿红，用围药敷之，中留一小孔，再润之，以助药力。
又云∶风热喉痹，其肿红而微紫，其形如拳，其人面青而目上视。外证壮热恶
寒，俨若伤寒，此病患久积热毒，因而感风所致。如病患声音不响，宜用润肺之药治之。
又云∶酒毒喉痹，其肿黄，其血黑，其形若臂，其肿若坎。外证面赤，目睛上视，
此乃热毒伤于心脾，气通于口，循环上下，故咽喉痛。治法先取其痰，再吹药，鼠粘
子汤多加干姜、花粉、生黄连、山栀、枳壳、连翘、桔梗、元参。
又云∶阴毒喉痹，肿如紫李，现黑色，其色光血红可治；阴毒血黑不治。外证恶
寒，其身 动振，腰痛脚冷，此乃冬月感阴湿火邪相干也。其血微红及肿处软，喉
中有痰可治；血红黑甚，肿硬喉干难治。先服五福化毒丹，次以苏子降气汤，再吹药，
一月之内戒酒。
又云∶伤寒喉痹，乃伤寒遗毒不散，致八九日后喉痹。皆因热毒入于心脾二经，吹冰片散。
钱青抡曰∶喉闭必先两日胸膈气紧，出气短促，蓦然喉痛，手足厥冷，气闭，命
悬顷刻。速用鸡翎或鹅毛蘸桐油，喉间搅探吐痰立开。切忌牛黄，入口不救。如无
药或有药不进者，急将两臂以手勒数十次，取油头绳扎大拇指，以针刺指甲边，（即少商
穴。）血滴下其喉即通。只刺男左女右，重者两手齐针。（《单方全集》）
丹溪曰∶喉痹属痰、属风、属热，皆因郁火而兼热毒，肿甚不红者，乃咽喉之虚证。
奎光曰∶伤寒后发喉痹乳蛾难治。为气闭不通，无形无势，其证喉项强硬，目
睛上视，故多不治。
Chen Shigong stated: Hou Bi (Sore Throat) presents with redness, swelling, and pain in the throat, half-blocked and half-open, appearing both wide and swollen. This is a *biao* syndrome (manifestation/symptom level); although severe, it is not fatal. Use Jin Suo Chi (Golden Lock Key) to induce vomiting and expel phlegm and saliva; use Li Ge Yin (Diaphragm-Opening Decoction) to purge accumulated heat. (From *Waike Zhengzong*)
Feng Luzhan stated: Hou Bi is similar to Chan Hou Feng (Throat-Wrapping Wind). Its symptoms include a red face and coarse breathing, with swelling and closure of the throat. It arises from accumulated heat generating wind and gathering toxic phlegm. In severe cases, a fleshy tumor forms internally, blocking Qi flow. If the nostrils turn cyan-black, swallowing is obstructed, the head hangs low, and the voice sounds like sawing wood due to thick phlegm, it is incurable. Furthermore, internal organ cold can also cause throat closure and difficulty in swallowing or speaking. Generally, when lower Jiao cold is extreme, upper heat becomes hyperactive, which applies not only to this disease. Its symptoms are similar to E Zheng (Millet Ear/Sore Throat), but the treatment methods differ. Broadly speaking, formless swelling and closure are called Bi (Obstruction), while有形 (form-based) swelling and pain are called E (Ear/Millet Ear). Expelling wind-phlegm first addresses the acute stage (*ji ze zhi qi biao* - treat the branch in emergencies); resolving heat toxicity later addresses the root (*huan ze zhi qi ben* - treat the root in chronic stages). For upper heat and lower cold, administer hot medicines cold before meals; do not mistakenly use cooling medicines.
He further stated: The Classics say: "The binding of one Yin and one Yang is called Hou Bi." One Yin refers to Ministerial Fire (Heart Fire), and one Yang refers to Shaoyang Xiang Huo (Ministerial Fire of Sanjiao/Gallbladder). The Hand-Shaoyin Heart meridian flanks the throat, and the Foot-Shaoyin Kidney meridian follows the throat. If a person has phlegm-saliva in the diaphragm from before, or due to excessive drinking, abnormal anger, or irregular sexual activity: Excessive drinking stirs Stomach Fire, common among the wealthy; abnormal anger stirs Liver Fire, common among women; irregular sexual activity stirs Kidney Fire, common among men. When fire moves, phlegm rises with it; phlegm-heat scorching and blocking the throat. Phlegm is the root of fire, and fire is the manifestation of phlegm. Since fire nature is rapid, there is internal and external swelling and pain, inability to swallow liquids, which is the most critical external syndrome. Treatment principle: treat the branch in emergencies, treat the root in chronic stages. Treating the branch uses pills/powders to induce vomiting and dissipate heat/phlegm; treating the root uses decoctions to descend fire and tonify deficiency. However, practitioners often only speak of treating Spleen-Lung fire, neglecting to descend Liver-Kidney fire. One must apply the *Cong Zhi* method (Reverse Treatment) from the *Nei Jing*. Do not abruptly use cold/cooling medicines, as this will hasten danger. Thus, Excess Fire requires *Zheng Zhi* (Direct/Opposite Treatment), while Deficiency Fire requires *Cong Zhi* (Indirect/Following Treatment). Distinction must be clear.
He further stated: The Yan (Pharynx) and Hou (Larynx), Huiyan (Epiglottis) and She (Tongue), these four share one gate but have different functions. The Hou receives Qi, so its Qi connects to Heaven; the Yan receives food, so its Qi connects to Earth. The Huiyan manages the upper aspect, controlling opening and closing, covering the airway, allowing food and drink to enter the esophagus without error. These four function mutually; if one is missing, diet ceases, leading to death. "Hou Bi" refers to blocked respiration in the Hou, inability to speak, and blockage of Heavenly Qi. "Yan Tong and Yi Tong" refer to the inability of the throat to swallow saliva and food, indicating blockage of Earthly Qi. "Hou Bi Yan Yi Tong" refers to diseases of the throat where both Heavenly and Earthly Qi are blocked. (Note: The lower part of the Yan is called Yi.)
He further stated: The Yan is posterior and governs eating; the Hou is anterior and governs breathing. Among the Twelve Meridians, only the Foot-Taiyang Bladder Meridian governs the exterior and descends separately to the nape; all other meridians circulate internally through the throat and can cause pathology there. However, they are unified under the Jun Huo (Monarch Fire) and Xiang Huo (Ministerial Fire). The Hou governs Heavenly Qi and belongs to Lung Metal; its change is Dryness, causing涩 (astringency/stagnation) and closure. The Yan generates Earthly Qi and belongs to Spleen Earth; its change is Dampness, causing swelling and distension. All result from Fire stagnating in the Upper Jiao, causing phlegm-saliva and Qi-Blood to knot in the throat, swelling outward. Numbness, itching, and pain constitute Chan Hou Feng; swelling on both sides constitutes Hou Bi. Single E, Double E, Mu She (Wooden Tongue), She Zhang (Swollen Tongue), Chan Hou, Zou Ma (Running Horse) Hou Feng—all share the same Fire etiology and are not distinguished. Only Chan Hou and Zou Ma kill fastest.
He further stated: Hou Bi mostly belongs to Phlegm-Heat. Severe cases use Tung Oil (Camellia oleifera oil) for probing to induce vomiting. Chan Hou Feng also belongs to Phlegm-Heat, characterized by swelling inside and outside the throat. It also uses Tung Oil with a goose feather probe to induce vomiting.
He further stated: Fei Jue (Lung Exhaustion) causing Hou Bi presents with a floating, scattered, minute pulse, a snoring sound, and rattling as if phlegm were in the throat. This is a sign of Lung Exhaustion. Immediately administer Renshen Tang (Ginseng Decoction) mixed with Zhuli (Bamboo Sap) and Jiang Zhi (Ginger Juice). Early treatment yields 70-80% recovery; secondary treatment 30-40%; delayed treatment saves less than 1 in 10.
He further stated: For Hou Bi, use aged Frost Plum (Shuang Mei) combined with Yan You (Snail) until dissolved. Patients holding the plum in their mouth during Hou Bi episodes experience miraculous effects. (From *Waike Jin Nang*)
Zhang Zihe stated: Treating Hou Bi by pricking to bleed is the supreme strategy. The *Nei Jing* states: "For Fire Stagnation, release it." Releasing means sweating; bleeding is a form of releasing sweat.
*Yi Lun Xuan Yao* stated: Cold stagnation in the Zang-Fu causes Qi contraction, creating an obstruction, naturally leading to Hou Bi.
It further stated: Yin Syndrome with Lower Deficiency causes Hou Bi; one must treat the Lower Cold, then the Obstruction will clear itself.
It further stated: Zou Ma Hou Bi (Running Horse Sore Throat) refers to extremely acute Hou Bi where death is rapid, and slow-acting drugs cannot save. Only pricking to release toxic blood cures the excess syndrome immediately.
Dou Hanqing stated: Someone asked about Feng Du Hou Bi (Wind-Toxin Sore Throat) with internal and external swelling. Why? Because Wind-Toxin Qi knots in the throat, blocking it, due to the struggle between Wind-Toxin and Phlegm. The *Su Wen* says: "Without Wind, Phlegm does not move; without Phlegm, Wind is not received." Wind and Phlegm struggle, knotting and blocking the throat. External signs: throat shape like an egg, slightly white color, swelling on the cheeks resembling sores, alternating chills and fever, locked jaw, inability to speak. First, use [missing text] juice plus Yuan Ming Fen (Mirabilite) or honey water to probe for phlegm. Immediately take Jing Fang Xiao Du San (Aristolochia and Saposhnikovia Detoxification Powder). If the gum swelling is purple-black, puncture with a small knife and apply Bing Pian San (Borneol Powder). No failure in efficacy. (From *Waike Quan Shu*)
It further stated: Feng Re Hou Bi (Wind-Heat Throat Closure) with internal and external swelling occurs when a person has long-standing accumulated heat-toxin, contracts wind, and Wind-Heat struggle, emerging externally to block the throat. Signs: red face, swollen cheeks, chills and fever, a lump in the throat like a fist, bright red external blood. First, apply Yu Zi Yao (Jade Character Medicine) mixed with honey locally. Next, treat with modified Jing Fang Xiao Du San.
It further stated: If the jaw is locked and cannot open, this is due to Wind-Phlegm struggling and blocking the throat. First, use a wooden needle to pry open, or pour Huang Cai Zhi (Yellow Vegetable Juice), warm honey water, or vinegar water mixed with Yuan Ming Fen into the throat. Stir with a goose feather to vomit out several bowls of phlegm-saliva. Externally, apply Wu Bei Zi (Galla Chinensis) mixed with vinegar. Internally, urgently take Jing Fang Er Chen Tang (Aristolochia, Saposhnikovia, and Two-Chen Decoction) and blow Bing Pian San.
It further stated: Xu Yang Shang Gong (Deficient Yang Attacking Upward) results from prolonged illness causing Yuan Qi weakness, allowing Evil Fire to ascend. Throat swells and hurts, Qi fails to ascend/descend, Water and Fire fail to interact, Heart Fire rushes to the throat causing swelling, pain, and closure. What does it look like? Answer: Inability to speak, locked jaw, mouth full of phlegm-saliva, cold extremities, dizziness. Treatment is as above.
It further stated: In cases of severe Jue (Cold Extremities) with loss of consciousness, eyes staring straight up, grind Wu Zhu Yu (Evodia Fruit), mix with vinegar, and apply to the soles of both feet. Then treat with Jiang Qi Tang (Qi-Descending Decoction). Add Qian Hu (Peucedani Radix) and Wu Yao (Lindera Root) for asthma; add Chen Xiang (Aquilaria Wood) and Renshen (Ginseng) for shortness of breath. Wait for extremities to warm, then drink thin porridge to gather Yuan Qi. Intake of grain leads to prosperity; cessation of grain leads to death. This is what is meant.
It further stated: If the cheeks and chin are swollen and red externally, this is definitely caused by Wind-Toxin. Urgently wash with decoction of Zi Su (Perilla Leaf), Feng Ye (Maple Leaf), and Bai Zhi (Cypress Branch). Externally use Jing Fang Qiang Huo Tang (Aristolochia, Saposhnikovia, and Notopterygium Decoction) to dispel wind. Or use Shi Xuan San (Ten-Acupoints Powder).
It further stated: Jiu Du Hou Bi (Alcohol-Toxin Sore Throat) occurs when alcohol toxin steams into the Heart and Spleen meridians, blocking the throat. Signs: red face, upward-gazing eyes. Extract phlegm as described above, then blow Bing Pian San and drink Qing Liang San (Cooling Powder).
It further stated: Jiu Du Hou Bi appears like an egg, swollen and bright red, shiny as a mirror. External signs: fever, aversion to wind, headache, stiff neck. This is Upper Jiao accumulated heat affecting Heart and Spleen, as these two meridians govern the Upper Jiao. Take Niu Bang Zi Jie Du Tang (Arctium Seed Detoxification Decoction).
It further stated: Feng Re Hou Bi (Wind-Heat Sore Throat) results from excessive worry, thought, and labor, or speaking into the wind, causing Wind to enter the Lung meridian and generate phlegm. Removing phlegm is essential. Color is bright red; if persistent, it turns purple-red. Urgently prick with a small knife or reed knife. Slight bleeding releases the fire. Then take decoction and blow Bing Pian San with great effect. Transition from purple-red to pale red indicates gradual healing.
It further stated: Qi Yong Hou Bi (Qi Abscess Sore Throat) occurs when toxic accumulation blocks the throat, with thick phlegm-saliva and chills/fever. Divide into Upper, Middle, and Lower Guan (Passes). Toxicity in the Lower Pass is difficult to treat. For Upper and Middle Passes, apply blowing medicine to the throat and swallow seven Xiong Huang Hua Du Wan (Realgar Detoxification Pills) with tea.
Dou Menglin stated: Hou Bi (Throat Closure) results from external cold pathogen and internal injury from hot foods, or bathing in hot water immediately after severe cold, forcing cold Qi into the Spleen meridian. Cold Qi blocks the Zhong Wan (Middle Jiao), and evil heat lodges in the Heart meridian, causing this disease. Urgently prick the purple vein in the wrist with a three-edged needle, or bleed Shao Shang (LU-11). Grind Xiong Huang Hua Du Wan in cold tea and灌 (administer). Then insert Bing Pian San into the throat. Recovery occurs when wind-phlegm and thick phlegm are spat out.
It further stated: Feng Du Hou Bi presents with external red swelling and internal slightly red-white swelling, shaped like a steamed bun, with cheek swelling and pain. External signs: aversion to cold without fever, swollen cheeks/chin, locked jaw. This is Wind-Phlegm struggling and knotting cold in the throat. Treatment must focus on removing phlegm using blowing medicine. If externally red and swollen, apply Wei Yao (Encircling Medicine) leaving a small hole in the center, keep moist to aid drug power.
It further stated: Feng Re Hou Bi presents with red-purple swelling, shaped like a fist, blue face, and upward-gazing eyes. External signs: high fever, aversion to cold, resembling Tai Yang Shang Han (Cold Damage). This is caused by long-standing heat-toxin contracted with wind. If the patient's voice is hoarse, treat with Lung-moistening herbs.
It further stated: Jiu Du Hou Bi presents with yellow swelling, black blood, arm-shaped swelling, and pit-like depressions. External signs: red face, upward-gazing eyes. This is heat-toxin injuring Heart and Spleen, Qi connecting to the mouth, circulating上下 (up and down), causing throat pain. Treatment: extract phlegm first, then apply blowing medicine. Use Shu Niu Zi Tang (Arctium Seed Decoction) adding Gan Jiang (Dried Ginger), Fen Hua (Trichosanthes Root), Sheng Huang Lian (Raw Coptis), Shan Zhi (Gardenia), Zhi Ke (Bitter Orange), Lian Qiao (Forsythia), Jie Geng (Platycodon), and Yuan Shen (Scrophularia).
It further stated: Yin Du Hou Bi (Yin-Toxin Sore Throat) swells like a purple plum, showing black color. If the color is bright red-blood, it is treatable; if Yin-Du blood is black, it is incurable. External signs: aversion to cold, body tremors, lower back pain, cold feet. This is contracting Yin-Damp-Huo (Fire) pathogens in winter. If blood is slightly red and swelling is soft with phlegm in the throat, it is treatable; if blood is dark red-black, swelling is hard, and throat is dry, it is difficult to treat. First take Wu Fu Hua Du Dan (Five-Fortune Detoxification Pill), then Su Zi Jiang Qi Tang (Perilla Seed Qi-Descending Decoction), then apply blowing medicine. Abstain from alcohol for one month.
It further stated: Shang Han Hou Bi (Cold Damage Sore Throat) occurs because residual toxins from Cold Damage do not disperse, leading to Hou Bi after 8-9 days. Heat-toxin enters the Heart and Spleen meridians. Apply Bing Pian San.
Qian Qinglun stated: Hou Bi must be preceded by chest tightness and shortness of breath for two days, sudden throat pain, cold extremities, Qi closure, and life hanging in the balance. Quickly use a chicken or goose feather dipped in Tung Oil to probe the throat and induce vomiting of phlegm for immediate relief. Strictly avoid Niu Huang (Calculus Bovis); if ingested, it is fatal. If no medicine is available or cannot be taken, tightly bind both arms dozens of times, tie the thumb with an oil-treated hair rope, and prick the side of the fingernail (Shao Shang LU-11). As blood drips, the throat opens. Prick left hand for men, right for women; for severe cases, prick both hands. (From *Dan Fang Quan Ji*)
Danxi stated: Hou Bi belongs to Phlegm, Wind, and Heat, all arising from Stagnant Fire combined with Heat-Toxin. Severe swelling without redness indicates a Deficiency Syndrome of the throat.
Kuiguang stated: Hou Bi and Ru E (Millet Ear) occurring after Shang Han are difficult to treat. Due to Qi closure and lack of form/momentum, with symptoms of stiff neck and upward-gazing eyes, most are incurable.