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The pharynx (located anterior to the larynx, thus used for swallowing food. Yang Shangshan stated that the area posterior to the glottis belongs to the pharynx is incorrect). It is the convergence point of the Hand-Taiyang Small Intestine Meridian, Foot-Shaoyin Heart Meridian, Foot-Taiyin Spleen Meridian, and Foot-Jueyin Liver Meridian. (*Suwen* states: The pharynx governs Earth Qi; Earth Qi connects through the orifice. The Foot-Taiyin Meridian spreads in the stomach and connects with the epiglottis/pharynx, so disease manifests as abdominal fullness and dry throat. *Ling Shu* states: The regular branch of the Foot-Taiyin ascends and knots at the pharynx). It also belongs to the Foot-Shaoyin Kidney Meridian. (*Ling Shu* states: Diseases generated by the Foot-Shaoyin include heat in the mouth and tongue, dry tongue, swelling of the throat, ascending Qi, dry and painful throat. *Suwen* states: When pathogenic factors invade the collateral of the Foot-Shaoyin, it causes throat pain, inability to ingest food, spontaneous anger, and Qi moving upward to the cardia. Note: "Ben" refers to the diaphragm. "Ben shang" refers to the cardia. *Nanjing* calls the upper opening of the stomach the cardia. Old annotations claiming "Qi rushing upward" is incorrect. Zhu Danxi stated: Manifestations from the combination of Hand and Foot Yin-Yang meridians include throat swelling, involving the Foot-Shaoyin and Foot-Jueyin meridians). It also belongs to the Foot-Yangming Stomach Meridian. (*Ling Shu* states: The Yangming Meridian ascends to connect with the heart, follows the pharynx, and emerges from the mouth). It also belongs to the Foot-Jueyin Liver Meridian and Foot-Shaoyang Gallbladder Meridian. (*Suwen* states: The Liver is the general, decisions are made by the Gallbladder, and the throat serves as its envoy. *Ling Shu* states: The regular branch of the Foot-Shaoyang ascends flanking the pharynx and emerges from the jaw. *Suwen* further states: When one Yin (Jueyin) and one Yang (Shaoyang) alternate and cease, this Yin Qi reaches the heart, moving up and down without constancy, entering and exiting unknowingly, causing dry throat and pharynx, with the pathology in Spleen-Earth. Note: One Yin refers to the Jueyin meridian, One Yang refers to the Shaoyang meridian, both possessing Wood Qi. Wood overcomes Earth, therefore although throat diseases manifest on the Spleen, they are actually caused by the Liver and Gallbladder). The area flanking the pharynx is the convergence of the Hand-Shaoyin Heart Meridian and Foot-Taiyin Spleen Meridian.

The larynx (located posterior to the pharynx, thus used for monitoring Qi). It is the convergence point of the Hand-Taiyin Lung Meridian, Foot-Yangming Stomach Meridian, Foot-Shaoyin Kidney Meridian, Foot-Jueyin Liver Meridian, and Ren Mai (Conception Vessel). (*Ling Shu* states: The regular branch of the Hand-Taiyin emerges from the supraclavicular fossa and follows the larynx. *Suwen* states: The larynx governs Heaven Qi; Heaven Qi connects through the Lung, termed the Lung System). It also belongs to the Hand-Shaoyin Heart Meridian and Hand-Shaoyang Sanjiao Meridian. (*Ling Shu* states: The regular branch of the Hand-Shaoyin ascends to the larynx and emerges on the face. *Suwen* states: In Heart Cough, coughing causes heart pain, a sensation of something stuck in the throat like a fishbone, and severely, throat swelling and Bi syndrome. Zhang Jiegu stated: The Sanjiao connects to the larynx; when Laryngeal Qi is harmonious, voice is clear and smooth; when disharmonious, sudden aphonia and heat obstruction occur. *Suwen* further states: Pathogenic factors invading the collateral of the Hand-Shaoyang cause throat Bi, curled tongue, dry mouth, and vexation. It also states: In Six Qi transformations, the arrival of Shaoyang results in throat Bi, tinnitus, and vomiting/urge. It also states: When one Yin and one Yang knot together, it is called throat Bi. Note: One Yin refers to the Hand-Shaoyin Heart Meridian, One Yang refers to the Hand-Shaoyang Sanjiao Meridian; these two meridians both network the larynx, and internal knotting of Qi-Heat causes throat Bi). It also converges with the Hand-Yangming Large Intestine Meridian, Foot-Yangming Stomach Meridian, and Hand-Shaoyang Sanjiao Meridian. (*Ling Shu* states: The regular branch of the Hand-Yangming ascends along the larynx and emerges from the supraclavicular fossa. It also states: For throat Bi with inability to speak, select Foot-Yangming points; if able to speak, select Hand-Yangming points. *Suwen* states: Reversal of Qi in the Hand-Yangming and Shaoyang meridians triggers throat Bi and pharyngeal swelling. Note: This refers to rigidity of bones and lack of mobility. Zhu Danxi stated: Manifestations from the combination of Hand and Foot Yin-Yang meridians include throat Bi, involving the Hand and Foot Yangming meridians and Hand-Shaoyang meridian). It also belongs to the Foot-Taiyin Spleen Meridian. (*Qianjin Fang* states: The larynx is the indicator of Spleen and Stomach function). The posterior aspect of the larynx belongs to the Hand-Jueyin Pericardium Meridian. The large artery palpable on both sides of the thyroid cartilage (known as the Renying pulse, or Wuhui) belongs to the Foot-Yangming Stomach Meridian. (*Neijing* states: The artery on the side of the neck flanking the larynx is Renying, which belongs to the Foot-Yangming Stomach Meridian. The Yangming Meridian constantly moves. Note: "Move" refers to pulsation beside the thyroid cartilage. *Suwen* states: Its pulse movement is usually smaller on the left and larger on the right; the smaller left pulse often diagnoses Zang diseases, and the larger right pulse often diagnoses Fu diseases. Commentary: This "movement" differs from the previous text, referring to the pulsation of the arteries in both left and right wrists). Posterior to Renying belongs the Hand-Yangming Large Intestine Meridian. Medical classics state: The throat and pharynx are the pathways for water and grain. The larynx is where Qi ascends and descends. The epiglottis is the gate of sound. The uvula is the hinge of sound. The pharynx and larynx, epiglottis and tongue, these four exist in the same chamber but have different functions. The larynx accepts Qi, thus Laryngeal Qi connects to Heaven. The pharynx accepts food, thus Pharyngeal Qi connects to Earth. The epiglottis manages the upper part, controlling opening and closing; covering the epiglottis allows food to descend, while failing to cover it leads to aspiration. If the tongue presses against the hard palate, the epiglottis can close the larynx. These four interact mutually; lacking any one leads to the cessation of diet and death.

A question was posed: Besides Bi syndrome and swelling in the throat and pharynx, there are other diseases such as Chan Hou Feng (Throat-Wrapping Wind) and Ru E (Mamillary Pappus/Tonsillitis) with ulcers. What pathogenic factors cause them? Which meridians are involved? What are the general treatment methods? Please explain. The answer is: All twelve meridians ascend along the throat and pharynx and can cause disease, but generally, they are governed by Ministerial Fire and Sovereign Fire. Why? Classics state: The larynx governs Heaven Qi, the pharynx governs Earth Qi. It also states: All rebellious Qi rushing upward belongs to Fire. The Lung governs Qi (Heaven), the Spleen governs Food (Earth). Thus, the larynx accepts Qi, and the pharynx accepts food. Accepting Qi transforms via Metal; accepting food transforms via Earth. Metal's nature is Dryness; Earth's nature is Dampness. Upon disease, Metal transformation changes to Dryness; Dryness causes astringency, astringency causes blockage and numbness, hence in the larynx it is called Bi. Earth transformation changes to Dampness; Dampness causes stickiness, stickiness causes congestion and distension without unblocking, hence in the pharynx it is called swelling. Although Bi and swelling differ slightly, they are both caused by temporary Fire stagnation in the Upper Jiao, leading to the accumulation of Phlegm-Saliva, Qi, and Blood in the throat and pharynx. Differentiating by the shape of pharyngeal swelling yields the names Chan Hou Feng and Ru E. Chan Hou Feng involves swelling penetrating outward, accompanied by numbness, itching, and pain. Ru E involves swelling on both sides of the pharynx, named Double Ru E; swelling on one side is Single Ru E. Throat Bi that strikes suddenly and causes rapid death is called Zou Ma Hou Bi (Running-Horse Throat Bi). *Neijing* also mentions obstruction in the epiglottis and dry throat/pharynx, all caused by various meridians; although there may be differences in Cold or Heat of Meridian Qi, they are essentially Fire syndromes.

Generally, treatment depends on the severity of Fire: mild cases use direct treatment, severe cases use reverse treatment. Methods include removing phlegm, bleeding, and others applied as appropriate, or bleeding the Shaoshang point on the thumb to move Qi. If swelling penetrates outward, external application of medicine is necessary. I have treated this condition using a goose feather dipped in rice vinegar to swab the throat and remove phlegm. Vinegar is sour and astringent; phlegm exits with the feather, and it also resolves blood stasis. If Ru E is severe and does not resolve, prick the tonsil with a small knife to bleed, apply Natrii Sulfas (Maxiya Xiao) to the throat to reduce Fire. Decoctions containing Belamcandae Rhizoma (Shegan), Indigo Naturalis (Qingdai), Glycyrrhizae Radix et Rhizoma (Gancao), Platycodonis Radix (Jiegeng), Gardeniae Fructus (Zhizi), Scutellariae Radix (Huangqin), Alumen (Fanshi), Arctii Fructus (Efang), and Rhei Radix et Rhizoma (Dahuang) are prescribed according to suitability to disperse Upper Jiao Heat. External applications include Lumbricus (Sheng Dilong), Allii Tuberosi Bulbus (Jiu Gen), and Longan Earth (Fulong Gan). If ulcers form, appearing white or red, white ones often involve excess saliva, red ones excess blood; generally similar to oral ulcers. Decocting Rosae Rugosae Cortex (Qiangweigenpi), Phellodendri Cortex (Huangbai), and Indigo Naturalis (Qingdai) for holding in the mouth and swallowing slowly is also effective. Whenever classics mention "Hou Bi," they refer to blocked breathing in the larynx, inability to speak, and closure of Heaven Qi. "Yan Tong" or "Ai Tong" refers to the inability to swallow saliva and food due to closure of Earth Qi. "Hou Bi Yan Ai Tong" refers to disease in both larynx and pharynx, with closure of both Heaven and Earth Qi. Those with Hou Bi must have Yan Ai Tong, but those with Yan Ai Tong do not necessarily have Hou Bi.