王氏 风热牙痛，用辛凉解散。荆芥、薄荷、桔梗、山栀、防风、赤芍、甘草，二服愈。
房兄 胃火牙痛。用石膏（ 研），开水冲服，随手而效。
堂妹 牙痈。由情志抑郁，致患左下牙龈肿痒，日久撑出多骨，外科用推车散不效，腐孔血水淋漓。近
又寒热，食减神疲，宜扶正为要。用潞参、茯苓、白术、当归、熟地、山栀、白芍（俱炒），六七服效。
刘 舌根肿。自用黄连泻心，两旬后寸脉犹浮大，舌边紫泡，咽肿妨食，耳痛，乃上焦火风阻络，宜辛凉
轻剂。薄荷、连翘、桔梗、山栀、钩藤、灯心、苦丁茶叶、菊叶、竹叶心，服愈。
（烂喉痧附）
喉以纳气而通于天，咽以纳食而通于地。会厌管乎其上以司开阖，惟其为心肺肝肾呼吸之门，饮食声音吐
纳之道，关系死生，为害速矣。经云∶一阴手少阴心一阳手少阳三焦结，谓之喉痹。以君相二火经脉并系咽喉。
热结则肿痹，痹者闭也，闭则痰塞以死，将发先三日，胸必不利，一二日肿痛，三四日势定有形，第三日必发
寒热，或头痛兼风寒者须疏散。察其二便秘结系实火者，以重剂润下，去其积热。壮实者用硝黄，弱者但滋燥
润肠，虚者宜蜜煎导法。大便行，乃可清利上焦痰热。清上丸。若虚火便涩，心脉数，肾脉微，宜滋阴降火。
养金汤。其症喉痹为总名，有缠喉风、乳蛾、喉癣、喉痈、喉菌、喉闭、HT 舌、喉杵等症。而缠喉风，及伤寒
喉闭，症为尤险。
〔喉痹〕肿痛闭塞，为风痰郁火热毒上攻之症。去风痰，解热毒，自愈。咽喉总络，系肺胃，急清此二经
之热。牛蒡汤，外用通隘散。如恶寒，寸脉小，一时患者皆同，为天行邪气，宜先表散。其病之由来有二，
一者少阳司天，三阳之气，民病喉痹。仲景用桔梗汤，根据阳毒施治。一者太阴湿胜，火气内郁，民病喉痹。
又太阴在泉，湿淫所胜，病喉肿喉痹。仲景用半夏甘桔汤。根据阴毒施治。若不恶寒，寸脉大滑实，为阳盛阴虚，
下之愈。酌用大小承气汤。其轻者可缓治，喉痹散。不可骤用寒凉，以痰实结胸，遇寒不运，渐至喘塞不治也。
其气急闭塞欲死者，缓则僵蚕炒末，姜汤下，立愈。或马蔺根苗捣汁，和醋含漱。急则用吹法，硼砂、胆矾末
吹患处，或皂角末吹鼻喷嚏，亦开。吐法，捣皂角水灌入，或新汲水磨雄黄，灌入即吐，或鸡鹅翎蘸桐油探吐。
针法，用砭针于肿处刺出血，若口噤针不能入，刺少商穴。左右皆刺二分出血，立愈。或 顶心头发一把，
力拔之，其喉自宽。又有阴虚阳浮痰结于上，脉浮大，重取或涩者，作实症治，必死。
加减八味丸。喉痹连项肿，芩连消毒饮。
〔缠喉风〕喉肿大，连项痛，喉有红丝缠紧，且麻且痒，指甲青，痰壅肢厥，由平时多怒，两日前胸不
利，痰塞气促，症最急。过一日夜，目直视，齿噤喉响，灯火近口即灭，此气已离根，不治。治法∶如喉痹，
用金碧二丹频吹，内加牛黄，效更速。针法，手足冷，以水温之，针照海、然谷四穴，使血出如珠。若刺少商
穴，出血散而不收者，不治。照海穴，在内踝下四分，软骨陷中。然谷穴，在内踝前大骨下陷中，皆肾经穴也。
〔乳蛾〕有单双，有连珠。单轻双重，连珠尤重。多因酒色郁热而生，单蛾生会厌一边，一日痛，二日
红肿，三日有形，如细白星，发寒热者凶。吹药先用碧丹五、金丹一，后用金丹二、碧丹三，内服喉症主方。
俟大便行，自痊。如至三日，喉中但红肿无细白星，即是喉痈，宜辨。双乳蛾生会厌，左右两边俱有细白星，
药照前用，左属心，右属肝。煎药于主方内，左加黄连、犀角。右加赤芍、柴胡。双蛾则兼用之。大便秘加枳
壳、元明粉。连珠蛾，一二白星上下相连，用药照前。或外用成吹药加冰片吹之，内服三黄桔梗汤。
〔喉癣〕为虚火上炎，肺受燥热，致咽喉生红丝如哥窑纹，如秋海棠背纹，干燥而痒，阻碍饮食，虽不
丧命，不能速愈。吹用碧丹、噙化青灵膏，内服喉症主方加土贝母。须戒忧怒、酒色，忌盐酱，及一切动风助
火之物，一月可愈。
〔喉痈〕红肿而痛，别无形状，因过食辛辣炙爆浓味而发。症属胃大肠二经，重则寒热头痛。犀角地黄
汤，吹用金丹一、碧丹十。四五日可愈。若鼻中出红涕，为毒攻脑，不治。
〔喉菌〕因忧郁气滞血热，妇人多患之，状如浮萍略高，面浓色紫，生喉旁。初起吹碧丹九、金丹一，
后用金丹二、碧丹三，内服喉症主方，勿间断。轻则半月，重或经月，亦须守戒忌口。
〔HT 舌喉痈〕肥人感热性燥者，多患此。犀角地黄汤加减，吹用金丹。但须吹至舌根下两旁，时刻勿间，
方能速愈。喉内吹用碧丹十、全丹一，亦须勤吹。凡舌下小舌，为HT 舌。连喉肿痛，即为喉痈，不痛者非痈。
大约HT 舌兼喉痈而发，十有六七其势凶。
煎药多加黄连、山栀、犀角。
〔喉闭〕伤寒后，发为气闭不通，无形无声，难治，喉项强硬。目睛上视，故多不治。
〔喉杵〕喉极痛肿。甘桔射干汤，外点烧盐散。
此外又有咽嗌痛。由阴虚火炎者，喉痹饮倍荆芥、元参。有喉中结块，饮食不通者，百灵丸，重者不过
二丸。有悬痈喉痛，生上 ，有紫泡如豆大，用簪脚挑破，血出愈，或口疳药吹，亦可。风热上搏者，启关散。
有悬痈垂长，咽中烦闷者，枯矾盐花研细，箸头点上去涎。有喉中生肉者，棉裹箸头，蘸盐揩之，日数次。有
梅核梗塞咽中、咯不出、咽不下，因为七情郁结者，四七汤、噙化丸。有喉痛因于相火，用凉药不愈者，六
味丸加桔梗、元参、知母、黄柏。有风火上郁，咽痛头胀项肿，当用辛凉者，滑石、连翘、杏仁、桑皮、西瓜
翠衣。近世烂喉痧最重，初起憎寒壮热，咽痛渴烦，先宜解表，务令透达，或兼清散。若骤服寒凉，外邪益闭，
内火益焰，咽痛愈剧，溃腐日甚矣。至丹痧透发，已无恶寒等症，则宜寒凉泄热，不宜杂进辛散煽动风火，
致增肿腐，必至滴水下咽，痛如刀割。盖此症由感风火湿热时邪而发。治法∶因风热者，主清透，普济消毒饮
去升麻、柴胡。因湿热者，主清渗，甘桔汤加栝蒌、通草、灯心。因痰火凝结者，主消降，消气化痰丸去半夏，
加贝母、淡竹茹。邪达则痧透，痧透则烂止，利膈汤、清咽太平丸选用。然症有可治不可治。其口气作臭，喉
色淡黄，或深黄者，系痰火所致，皆可治；若烂至小舌，及鼻塞目闭，元气日虚，毒瓦斯深伏，色白如粉皮者，
皆不可治。其愈后四肢酸痛，难于屈伸者，由火灼阴伤，络失所养，宜进滋阴，勿与痹症同治。
Wang suffered from wind-heat toothache, treated with acrid-cool dispersing and releasing. Used Jingjie (Schizonepetae Spica), Bohe (Menthae Haplocalycis Herba), Jiegeng (Platycodonis Radix), Shanzhi (Gardeniae Fructus), Fangfeng (Saposhnikoviae Radix), Chishao (Paeoniae Radix Rubra), Gancao (Glycyrrhizae Radix et Rhizoma), cured after two doses.
Brother Fang suffered from stomach-fire toothache. Used Shigao (Gypsum Fibrosum) (ground), taken with boiling water, effective immediately.
Cousin suffered from dental abscess (Ya Yong). Due to emotional depression, causing swelling and itching of the left lower gum, over time growing extra bone, surgical treatment with Tuiche San was ineffective, with blood and fluid dripping from the ulcerated hole. Recently suffering from alternating chills and fever, reduced appetite, and mental fatigue, it is essential to support the healthy qi. Used Lushen (Codonopsis Radix), Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui (Angelicae Sinensis Radix), Shudi (Rehmanniae Radix Preparata), Shanzhi (Gardeniae Fructus), Baishao (Paeoniae Radix Alba) (all stir-fried), effective after six or seven doses.
Liu suffered from swelling at the root of the tongue. Self-administered Huanglian (Coptidis Rhizoma) to drain heart fire; after twenty days, the cun pulse remained floating and large, purple blisters appeared on the sides of the tongue, throat swelling hindered eating, and ear pain occurred. This was due to upper jiao fire and wind obstructing the collaterals, suitable for a mild acrid-cool formula. Used Bohe (Menthae Haplocalycis Herba), Lianqiao (Forsythiae Fructus), Jiegeng (Platycodonis Radix), Shanzhi (Gardeniae Fructus), Gouteng (Uncariae Ramulus cum Uncis), Dengxincao (Junci Medullia), Kudingcha (Ilicis Kudingae Folium), Juye (Chrysanthemi Indici Folium), Zhuyexin (Bambusae Caulis in Taediae), cured after administration.
(Attached: Lanhou Sha / Malignant Sore Throat with Rash)
The Hou (throat) receives Qi and connects with Heaven; the Yan (pharynx) receives food and connects with Earth. The Epiglottis (Huiyan) governs opening and closing above; as the gateway for respiration of the Heart, Lung, Liver, and Kidney, and the pathway for diet, voice, and breathing, it relates to life and death, causing harm rapidly. The Classics state: The Hand-Shaoyin Heart Meridian (Yin One) and the Hand-Shaoyang Sanjiao Meridian (Yang One) converge, called Hou Bi (Sore Throat/Obstruction). Because the meridians of Ministerial Fire and Sovereign Fire both connect to the throat. Heat accumulation causes swelling and obstruction; Bi means closure. Closure leads to phlegm blocking and death. Three days before onset, the chest must feel uncomfortable. Within one to two days, swelling and pain occur; by three to four days, the condition stabilizes and becomes palpable. On the third day, chills and fever must appear. If accompanied by headache and wind-cold, dispersion is required. Observe if constipation indicates excess fire; use heavy moistening purgatives to remove accumulated heat. For robust individuals, use Xiaoshi (Natrii Sulfas) and Dahuang (Rhei Radix et Rhizoma); for weak individuals, only moisten dryness and lubricate the intestines; for deficient individuals, use Honey Suppository method. Once stool passes, clear and benefit the upper jiao phlegm-heat. Use Qing Shang Wan. If deficiency fire causes urinary difficulty, with rapid Heart pulse and faint Kidney pulse, nourish yin and descend fire. Use Yang Jin Tang. Hou Bi is the general term for symptoms including Chan Hou Feng (Coiling Wind around Throat), Ru E (Gooseberry Tonsils), Hou Xuan (Throat Lichen), Hou Yong (Throat Abscess), Hou Jun (Throat Fungus), Hou Bi (Throat Closure), Mu She (Wooden Tongue), and Hou Chu (Throat Pestle). Among these, Chan Hou Feng and Hou Bi caused by Cold Damage are particularly dangerous.
[Hou Bi] Manifests as swelling, pain, and obstruction, a symptom of wind-phlegm stagnation, fire-heat toxin attacking upward. Remove wind-phlegm, resolve heat-toxin, and it will heal naturally. The throat collaterals connect to the Lung and Stomach; urgently clear heat from these two meridians. Use Niubang Tang, externally apply Tong Ai San. If there is aversion to cold and small cun pulse, and patients present similarly at the same time, this is epidemic pathogenic qi; first apply exterior dispersion. The origin of this disease has two aspects: First, when Shaoyang governs the year, the Qi of the Three Yangs prevails, and people suffer from Hou Bi. Zhang Zhongjing used Jiegeng Tang, treating according to Yang Du (Yang Toxin). Second, when Taiyin dampness prevails, fire qi is internally depressed, and people suffer from Hou Bi. When Taiyin is in the source position, excessive dampness causes throat swelling and Hou Bi. Zhang Zhongjing used Banxia Ganjie Tang, treating according to Yin Du (Yin Toxin). If no aversion to cold, and the cun pulse is large, slippery, and solid, it is excess yang and deficient yin; purgation heals. Use Dachengqi Tang or Xiao Chengqi Tang酌情. Mild cases can be treated slowly with Hou Bi San. Do not abruptly use cold-cooling herbs, as phlegm-solidity may bind the chest, failing to move with cold, gradually leading to fatal wheezing and obstruction. For acute airway obstruction nearing death, slow treatment uses Jiangcan (Bombyx Batryticatus) powder fried, taken with ginger soup for immediate relief. Or mash Malin Genmiao (Iris lactea var. chinensis roots and shoots), mix with vinegar for gargling. Acute treatment uses blowing method: blow Pengsha (Borax) and Danfan (Alumen) powder into the lesion, or blow Zaofen (Gleditsiae Sinensis Fructus) powder into the nose to induce sneezing, which also opens the passage. Vomiting method: mash Zaofen, pour water infusion, or grind Xionghuang (Realgar) with fresh water and pour in to induce vomiting, or use chicken/goose feather dipped in tung oil to probe the throat for vomiting. Acupuncture method: use Bianzhen (stone needle) to prick bleeding at the swollen area. If trismus prevents needle insertion, prick Shaoshang (LU 11). Prick both sides two fen deep to bleed, immediate relief. Or pull out a handful of hair from the vertex forcefully, the throat will naturally relax. If yin deficiency with floating yang and phlegm binding above, with floating-large pulse, heavy pressure reveals choppy quality, treating as excess syndrome leads to death. Use Jiaban Bawei Wan. Hou Bi with neck swelling uses Qinlian Xiaodu Yin.
[Chan Hou Feng] Throat swells, pain radiates to the neck, red threads wrap tightly in the throat, with numbness and itching, cyanotic fingernails, phlegm congestion, and limb coldness. Caused by frequent anger, chest discomfort two days prior, phlegm blockage and shortness of breath, most urgent. After one night and day, eyes stare straight, teeth clenched, throat rattling, lamp extinguishes near mouth, indicating qi has separated from its root, untreatable. Treatment: Like Hou Bi, frequently blow Jinbi Er Dan, add Niuhuang (Calculus Bovis) internally for faster effect. Acupuncture: If hands and feet are cold, warm them with water, then needle Zhaohai (KI 6) and Ran Gu (KI 2) four points, letting blood bead out. If Shaoshang (LU 11) is pricked and blood scatters without stopping, it is untreatable. Zhaohai point is four fen below the medial malleolus, in the cartilage depression. Ran Gu point is in the depression anterior to the large bone below the medial malleolus; both are Kidney meridian points.
[Ru E] Can be single or double, or pearl-string type. Single is mild, double is severe, pearl-string is especially severe. Often arises from alcohol and sexual indulgence causing stagnant heat. Single Ru E forms on one side of the epiglottis; painful on day one, red and swollen on day two, distinct shape on day three like fine white stars. With chills and fever, prognosis is ominous. Blowing medicine: initially Bi Dan five parts, Jin Dan one part; later Jin Dan two parts, Bi Dan three parts. Internally take the main formula for throat diseases. Wait for bowel movement, then self-heal. If by day three, only redness and swelling without fine white stars, it is Hou Yong (Throat Abscess), distinguish carefully. Double Ru E forms on the epiglottis, with fine white stars on both left and right sides. Medication as before. Left belongs to Heart, Right belongs to Liver. In decoction of main formula, add Huanglian (Coptidis Rhizoma) and Xijiao (Rhinocerotis Cornu - note: substitute with Buffalo Horn/Shuiniujiao clinically) for left; add Chishao (Paeoniae Radix Rubra) and Chaihu (Bupleuri Radix) for right. For double, use both. Add Zhike (Aurantii Fructus) and Yuanmingfen (Natrii Sulfas Exsiccatus) for constipation. Pearl-string Ru E has one or two white stars connected vertically, medication as before. Externally, add Bingpian (Borneolum Syntheticum) to blowing powder; internally take Sanhuang Jiegeng Tang.
[Hou Xuan] Caused by deficiency fire flaming upward, Lung affected by dryness-heat, causing red threads in the throat like Ge ware cracks or Begonia leaf veins, dry and itchy, hindering diet. Though not fatal, does not heal quickly. Blowing: Bi Dan, Qinhua Qingling Gao. Internally: Main throat formula plus Tubei Mu (Fritillariae Thunbergii Bulbus). Must avoid worry, anger, alcohol, sex; avoid salt, soy sauce, and all wind-moving/fire-boosting foods. Heals in one month.
[Hou Yong] Red, swollen, painful, no other specific shape. Caused by excessive consumption of spicy, roasted, rich flavors. Syndrome belongs to Stomach and Large Intestine meridians; severe cases have chills, fever, headache. Use Xijiao Dihuang Tang. Blowing: Jin Dan one part, Bi Dan ten parts. Heals in four to five days. If red snot flows from nose, toxin attacks brain, untreatable.
[Hou Jun] Due to melancholy, qi stagnation, and blood heat, common in women. Shape like floating duckweed, slightly raised, thick purple surface, grows beside the throat. Initial blowing: Bi Dan nine parts, Jin Dan one part; later Jin Dan two parts, Bi Dan three parts. Internally take main throat formula without interruption. Mild cases half a month, severe cases a month; must observe dietary restrictions.
[Mu She Hou Yong] Fat people sensitive to heat-dryness often suffer this. Modify Xijiao Dihuang Tang. Blowing: Jin Dan. Must blow to both sides under the tongue root continuously for fast healing. Internal throat blowing: Bi Dan ten parts, Quan Dan one part; must blow diligently. The small fleshy appendage under the tongue is called Mu She. Swelling and pain connecting to throat is Hou Yong; no pain is not Yong. Approximately 60-70% of Mu She combined with Hou Yong are severe. Decoction adds more Huanglian, Shanzhi, Xijiao.
[Hou Bi] After Cold Damage, qi closes and does not flow, formless and soundless, difficult to treat, stiff throat and neck. Eyes look upward, so mostly untreatable.
[Hou Chu] Extreme throat pain and swelling. Use Ganjie Shegan Tang. External application: Shaoyan San.
Additionally, there is Yan Yi Tong (Pharyngeal Pain). Due to yin deficiency and fire flaming up, use Hou Bi Yin doubling Jingjie (Schizonepetae Spica) and Yuanshen (Scrophulariae Radix). If there is a mass in the throat blocking food, use Bailing Wan, max two doses for severe cases. If Xuan Yong (Hanging Abscess) causes throat pain, located above, with purple blister bean-sized, pierce with hairpin tip until blood comes out, heals; or blow Kougan medicine, also works. For wind-heat attacking upward, use Qiguan San. If Xuan Yong hangs long with throat stuffiness, grind Kufan (Alumen) and Yanhua (Halitum) finely, apply with chopstick tip to remove saliva. If flesh grows in throat, wrap cotton on chopstick, dip in salt, wipe several times daily. If Plum-pit Qi blocks throat, cannot spit out or swallow, due to seven emotions stagnation, use Siqi Tang or Qinhua Wan. If throat pain due to Ministerial Fire, unresponsive to cooling meds, use Liuwei Wan adding Jiegeng, Yuanshen, Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex). For wind-fire stagnating upward, throat pain, head distension, neck swelling, use acrid-cool: Shihuang (Talcum), Lianqiao, Xingren (Armeniacae Semen Amarum), Sangpi (Mori Cortex), Xiguacuiyi (Citrulli Citrulliformis Pericarpium). Recent malignant sore throat with rash (Lanhou Sha) is most severe. Initial aversion to cold, high fever, throat pain, thirst, irritability. First resolve exterior, ensure penetration, or combine clearing and dispersing. If abruptly using cold-cooling, external pathogens close further, internal fire flares, throat pain worsens, ulceration increases. Once Dan Sha (red rash) penetrates, and aversion to cold etc. cease, then use cold-cooling to drain heat. Do not mix acrid-dispersing herbs that stir wind-fire, causing increased swelling and ulceration, leading to inability to swallow even water, pain like knife cutting. This syndrome arises from contracting wind-fire-damp-heat seasonal pathogens. Treatment: For wind-heat, focus on clearing and penetrating, Puji Xiaodu Yin removing Shengma ( Cimicifugae Rhizoma) and Chaihu. For damp-heat, focus on clearing and leaching, Ganjie Tang adding Gualou (Trichosanthis Fructus), Tongcao (Akebiae Caulis), Dengxincao. For phlegm-fire condensation, focus on dissipating and descending, Xiaoqi Huatan Wan removing Banxia (Pinelliae Rhizoma), adding Beimu (Fritillariae Cirrhosae Bulbus), Danzhuru (Bambusae Caulis in Taediae). When pathogen reaches, rash penetrates; when rash penetrates, ulceration stops. Select Li Ge Tang or Qingyan Taiping Wan. However, some syndromes are treatable, others not. Bad breath, pale yellow or deep yellow throat color, caused by phlegm-fire, are all treatable. If ulceration reaches the uvula, nasal congestion, eye closure, daily decline of yuan qi, deep-seated toxin, color white like rice paper, are all untreatable. Post-recovery limb soreness and pain, difficult flexion/extension, caused by fire burning yin injury, collaterals losing nourishment, should advance yin-nourishing, do not treat same as Bi syndrome.