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"One Yin and One Yang knotting is called Hou Bi (throat obstruction)", Wang Bing annotated: The so-called One Yin refers to the Liver and Pericardium meridians; the so-called One Yang refers to the Gallbladder and Sanjiao (Triple Burner) meridians. These four meridians have Ministerial Fire (Xiang Huo, fire associated with metabolic activity) running and connecting to the throat. If Qi-heat knots internally, severe knotting leads to swelling; severe swelling leads to obstruction (Bi); severe obstruction leads to blockage where phlegm blocks the airway, resulting in death.

The manifestation of Heart Cough includes coughing accompanied by heart pain, a sensation of something stuck in the throat as if obstructed, and in severe cases, swelling of the pharynx and Hou Bi (throat obstruction).

When pathogenic factors lodge in the collaterals of the Shaoyin (Lesser Yin) meridian, it causes people to suffer from Hou Bi (throat obstruction), presenting with tongue retraction, dry mouth, and vexation.

Reversal of Qi in the Hand-Yangming and Hand-Shaoyang meridians triggers Hou Bi (throat obstruction) and swelling of the throat and neck. (From *Nei Jing*)

For Hou Bi (throat obstruction) causing inability to speak, select points from the Foot-Yangming meridian; for those who can speak, select points from the Hand-Yangming meridian. (From *Ling Shu*)

All twelve regular meridians ascend along the throat, thus all are susceptible to disease therein. However, the pathology is fundamentally governed by the Sovereign Fire (Jun Huo, physiological fire regulating organ function) and Ministerial Fire (Xiang Huo). The Lung governs Qi, corresponding to Heaven; the Spleen governs food intake, corresponding to Earth. The assimilation of Qi transforms according to Metal properties; the assimilation of food transforms according to Earth properties. Metal is dry; Earth is damp. When disease occurs, the transformation of Metal manifests as dryness, leading to astringency, blockage, and insensibility; the transformation of Earth manifests as dampness, leading to stickiness, stagnation, swelling, and obstruction. Therefore, in the larynx it is termed Bi (obstruction), and in the pharynx it is termed swelling. Although there are various differences such as Chan Hou Feng (strangling wind), Ru E (tonsillar hypertrophy), Ai Sai (pharyngeal blockage), and Hou Gan (dry throat), they all share the same etiology: Fire郁 (stagnation) in the Upper Jiao (Upper Burner), causing phlegm, saliva, Qi, and Blood to accumulate in the throat. Treatment methods should be determined by the severity of the Fire: mild cases require direct treatment (Zheng Zhi), while severe cases require contrary treatment (Fan Zhi). Methods such as scraping phlegm or inducing bleeding should be applied as appropriate. (From *Zhun Sheng*)

The Twelve Meridians texts mention dryness and pain in the Yi (pharynx/throat), swelling of the throat, swelling of the mandible, and stiffness of the tongue base, all caused by Sovereign Fire (Jun Huo). Only Hou Bi (throat obstruction) is rapid in onset, caused by Ministerial Fire (Xiang Huo). Sovereign Fire is like human fire; Ministerial Fire is like Dragon Fire. Human fire burning wood has a slow intensity; Dragon Fire burning wood has a rapid intensity. In the *Nei Jing*, Hou Bi (throat obstruction) includes conditions of the pharynx and tongue because their pathology is identical—both are due to Fire—hence no distinction is made. Treating Fire in Hou Bi (throat obstruction) is akin to extinguishing a fire, allowing no delay. The *Nei Jing* states "Fire stagnation should be dispersed" (Huo Yu Fa Zhi). Here, "Fa" (disperse) refers to sweating. However, how can one induce sweating through the throat? Therefore, bloodletting is considered one form of dispersing (Fa Han). (From Yu Shi)